The present study investigated the rate and pattern of neuropsychological recovery in heavy episodic drinking teens during the initial days to weeks of abstinence from alcohol. Adolescents (ages, 16–18 years) with histories of heavy episodic drinking (HED; N = 39) and socio-demographically similar control teens (CON; N = 26) were recruited from San Diego area schools. HED and CON were comparable on 5th grade standardized math and language arts test performance to ensure similar functioning before onset of substance use. Participants were administered three neuropsychological test batteries with 2-week intervals during a 4-week monitored abstinence period. HED teens performed worse overall than CON on tests of prospective memory (p = .005), cognitive switching (p = .039), inhibition task accuracy (p = .001), verbal memory (p's < .045), visuospatial construction (p's < .043), and language and achievement (p's < .008). The statistically significant group × time interaction for block design demonstrated normalization within the 4 weeks of abstinence for the HED (p = .009). This study identified cognitive performance deficits associated with heavy episodic drinking in adolescence during early abstinence and with sustained 4-week abstention. These findings suggest alcohol-related influences on several underlying brain systems that may predate the onset of alcohol abuse or dependence or take longer than 4 weeks to recover. (JINS, 2014, 20, 218–229)

Previous studies of depression after stroke have reported widely variable findings, possibly due to differences between studies in patient characteristics and methods for the assessment of depression, small sample sizes, and the failure to examine stroke-free reference groups to determine the base rate of depression in the general population. In an effort to address certain of those methodologic issues and further investigate the frequency and clinical determinants of depression after stroke, we administered the Structured Interview Guide for the Hamilton Depression Rating Scale (SIGH–D) and neurological, neuropsychological, and functional assessments to 421 patients (age = 71.5 ± 8.0 years) 3 months after ischemic stroke and 249 stroke-free control subjects (age = 70.8 ± 6.7 years). We required a SIGH–D total score > 11 for the identification of depression. We found that depression was less frequent (47/421 patients, or 11.2%, and 13/249 control subjects, or 5.2%), less severe, and less persistent in our stroke cohort than previously reported, possibly due to the underrepresentation of patients with a premorbid history of affective illness. Depression was associated with more severe stroke, particularly in vascular territories that supply limbic structures; dementia; and female sex. SIGH–D item analyses suggested that a reliance on nonsomatic rather than somatic symptoms would result in the most accurate diagnoses of depression after ischemic stroke. (JINS, 2003, 9, 429–439.)

Previous studies showed that cortex in the anterior portions of the left frontal and temporal lobes participates in generating words with emotional connotations and processing pictures with emotional content. If these cortices process the semantic attribute of emotional connotation, they should be active whenever processing emotional connotation, without respect to modality of input or mode of output. Thus, we hypothesized that they would activate during monitoring of words with emotional connotations. Sixteen normal subjects performed semantic monitoring of words with emotional connotations, animal names, and implement names during fMRI. Cortex in the anterior left frontal lobe demonstrated significant activity for monitoring words with emotional connotations compared to monitoring tone sequences, animal names, or implement names. Together, the current and previous results implicate cortex in the anterior left frontal lobe in semantic processing of emotional connotation, consistent with connections of this cortex to paralimbic association areas. Current findings also indicate that neural substrates for processing emotional connotation are independent of substrates for processing the categories of living and nonliving things.

Evidence for abnormal brain function as measured with diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI) and cognitive dysfunction have been observed in inter-episode bipolar disorder (BD) patients. We aimed to create a joint statistical model of white matter integrity and functional response measures in explaining differences in working memory and processing speed among BD patients. Medicated inter-episode BD (n=26; age=45.2±10.1 years) and healthy comparison (HC; n=36; age=46.3±11.5 years) participants completed 51-direction DTI and fMRI while performing a working memory task. Participants also completed a processing speed test. Tract-based spatial statistics identified common white matter tracts where fractional anisotropy was calculated from atlas-defined regions of interest. Brain responses within regions of interest activation clusters were also calculated. Least angle regression was used to fuse fMRI and DTI data to select the best joint neuroimaging predictors of cognitive performance for each group. While there was overlap between groups in which regions were most related to cognitive performance, some relationships differed between groups. For working memory accuracy, BD-specific predictors included bilateral dorsolateral prefrontal cortex from fMRI, splenium of the corpus callosum, left uncinate fasciculus, and bilateral superior longitudinal fasciculi from DTI. For processing speed, the genu and splenium of the corpus callosum and right superior longitudinal fasciculus from DTI were significant predictors of cognitive performance selectively for BD patients. BD patients demonstrated unique brain-cognition relationships compared to HC. These findings are a first step in discovering how interactions of structural and functional brain abnormalities contribute to cognitive impairments in BD. (JINS, 2015, 21, 330–341)

Two individuals with anomic aphasia and acquired alexia were each provided treatment for their reading impairment. Although reading of single words in isolation was fairly accurate, their text reading was slow and effortful, including functor substitutions and semantic errors. Prior to treatment, reading reaction times for single words showed grammatical class and word-length effects. Both patients responded positively to a treatment protocol that included two phases: (1) multiple oral rereading of text, and (2) reading phrase-formatted text that had increased spacing between phrasal clauses. Their reading rates for text improved while maintaining good comprehension. Following treatment, reading reaction times for single words showed the elimination of grammatical class and word-length effects, suggesting improved access to word forms, particularly functors. (JINS, 1998, 4, 621–635.)

This study explored the nature of the relationship between attention available at learning and subsequent implicit and explicit memory performance. One hundred neurologically normal subjects rated their liking of target words on a five-point scale. Half of the subjects completed the word-rating task in a full attention condition and the other half performed the task in a divided attention condition. Following administration of the word-rating task, all subjects completed five memory tests, three implicit (category association, tachistoscopic identification, and perceptual clarification) and two explicit (semantic-cued recall and graphemic-cucd recall), each bearing on a different subset of the list of previously presented target words. The results revealed that subjects in the divided attention condition performed significantly more poorly than subjects in the full attention condition on the explicit memory measures. In contrast, there were no significant group differences in performance on the implicit memory measures. These findings suggest that the attention to an episode that is necessary to produce later explicit memory may differ from that necessary to produce unconscious influences. The relationship between implicit memory, neurologic injury, and automatic processes is discussed. (JINS, 1996, 2, 111–125.)

Clinical and experimental observation have shown that patients who confabulate, especially but not exclusively when provoked by specific questions, retrieve personal habits, repeated events or over-learned information and mistake them for actually experienced, specific, unique events. Accordingly, the aim of this study is to characterize and quantify the relative contribution of this type of confabulation, which we refer to as Habits Confabulation (HC), to confabulations produced by 10 mild Alzheimer’s disease (AD) patients and 8 confabulating amnesics (CA) of various etiologies. On the Confabulation Battery (Dalla Barba, 1993a, Dalla Barba & Decaix, 2009), a set of questions involving the retrieval of various kinds of semantic and episodic information, patients produced a total of 424 confabulation. HC accounted for 42% and 62% of confabulations in AD patients and CA, respectively. This result indicates that, regardless the clinical diagnosis, the brain pathology or their lesion’s site, confabulation largely reflects the individuals’ tendency to consider habits, routines, and over-learned information as unique episodes. These results are discussed in the framework of the Memory Consciousness and Temporality Theory (Dalla Barba, 2002). (JINS, 2010, 16, 967–974.)

Moral judgment involves considering not only the outcome of an action but also the intention with which it was pursued. Previous functional magnetic resonance imaging (fMRI) research has shown that integrating outcome and belief information for moral judgment relies on a brain network including temporo-parietal, precuneus, and medial prefrontal regions. Here, we investigated whether the ventromedial prefrontal cortex (vmPFC) plays a crucial role in this process. Patients with lesions in vmPFC (vmPFC patients), and brain-damaged and healthy controls considered scenarios in which the protagonist caused intentional harm (negative-outcome, negative-belief), accidental harm (negative-outcome, neutral-belief), attempted harm (neutral-outcome, negative-belief), or no harm (neutral-outcome, neutral-belief), and rated the moral permissibility of the protagonists’ behavior. All groups responded similarly to scenarios involving intentional harm and no harm. vmPFC patients, however, judged attempted harm as more permissible, and accidental harm as less permissible, than the control groups. For vmPFC patients, outcome information, rather than belief information, shaped moral judgment. The results indicate that vmPFC is necessary for integrating outcome and belief information during moral reasoning. During moral judgment vmPFC may mediate intentions’ understanding, and overriding of prepotent responses to salient outcomes. (JINS, 2012, 18, 1–10)

Two new tasks designed to individualize and assess aspects of cognitive flexibility and complex integration were administered to patients with schizophrenia (n = 16), Parkinson's disease (PD; n = 25) and Huntington's disease (HD; n = 12). Findings indicated impaired performance in the schizophrenic and HD groups on components of solution fluency, reactive flexibility and integration. The PD group demonstrated normal performance on all but the solution fluency and reaction time measures. These findings corroborate previous studies suggesting that executive and problem solving disturbances feature in schizophrenia and HD and that these functions may not be as severely affected in medicated PD. Slowed reaction time by both dementia groups is explained with reference to the concept of bradyphrenia. (JINS, 1995, 1, 545–553.)

The preoperative delayed memory performance on the Rey-Osterrieth Complex Figure (Lezak, 1983) of 54 patients with complex partial seizures of temporal lobe origin was analyzed using 3 different indices. One index (composite) was derived using a common scoring method that included both spatial and figural aspects of memory in its score. The other two indices were derived emphasizing either spatial or figural aspects of memory for the elements of the figure separately. All 3 indices distinguished between individuals with right-sided (RTLE) and left-sided (LTLE) seizure onset. However, spatial memory was significantly lower than figural memory in individuals with RTLE as compared to those with LTLE. Both the spatial and figural memory indices were significantly lower in the presence of magnetic resonance imaging (MRI) evidence for hippocampal selerosis in individuals with RTLE. Results suggest that while both the spatial and figural aspects of nonverbal memory are sensitive to right hippocampal dysfunction, figural memory may be less vulnerable to the effects of RTLE. (JINS, 1996, 2, 535–540.)

Sensitive measures of neuropsychological function were adapted to a telephone administration format for use in a large survey of quality of life in breast cancer survivors (BCS). Healthy controls (HC) and BCS were recruited from the community and administered the same neuropsychological test battery on two occasions separated by 1 week. Subjects were randomly assigned to conditions, stratified by diagnosis: In-person at Time-1 and In-person at Time-2 (P-P); Telephone at Time-1 and Telephone at Time-2 (T-T); T-P; and P-T. Four cognitive (Rey Auditory Verbal Learning Test, Controlled Oral Word Association, Digit Span, Symbol Digit) and two self-report measures (Squire Memory Self-Report Scale, Center for Epidemiological Studies Depression Scale) were used. The 106 subjects were randomized (54 HC and 52 BCS). Test–retest reliabilities (intraclass correlations) did not differ significantly by condition across the cognitive or self-report measures and ranged from moderate to near perfect (r's .43–.93; p's < .05). Mean scores at Time-1, practice effects (Time-1 to Time-2), and standard errors of measurement were comparable between In-person and Telephone administration formats. Results suggest that memory, attention, information processing speed, verbal fluency, and self-report of mood and memory can be measured reliably and precisely over the telephone. (JINS, 2007, 13, 799–806.)

This study explored whether remote blast-related MTBI and/or current Axis I psychopathology contribute to neuropsychological outcomes among OEF/OIF veterans with varied combat histories. OEF/OIF veterans underwent structured interviews to evaluate history of blast-related MTBI and psychopathology and were assigned to MTBI (n = 18), Axis I (n = 24), Co-morbid MTBI/Axis I (n = 34), or post-deployment control (n = 28) groups. A main effect for Axis I diagnosis on overall neuropsychological performance was identified (F(3,100) = 4.81; p = .004), with large effect sizes noted for the Axis I only (d = .98) and Co-morbid MTBI/Axis I (d = .95) groups relative to the control group. The latter groups demonstrated primary limitations on measures of learning/memory and processing speed. The MTBI only group demonstrated performances that were not significantly different from the remaining three groups. These findings suggest that a remote history of blast-related MTBI does not contribute to objective cognitive impairment in the late stage of injury. Impairments, when present, are subtle and most likely attributable to PTSD and other psychological conditions. Implications for clinical neuropsychologists and future research are discussed. (JINS, 2012, 18, 1–11)

While neuropsychological deficits are evident among methamphetamine (meth) addicts, they are often unrelated to meth exposure parameters such as lifetime consumption and length of abstinence. The notion that some meth users develop neuropsychological impairments while others with similar drug exposure do not, suggests that there may be individual differences in vulnerability to the neurotoxic effects of meth. One source of differential vulnerability could come from genotypic variability in metabolic clearance of meth, dependent on the activity of cytochrome P450-2D6 (CYP2D6). We compared neuropsychological performance in 52 individuals with a history of meth dependence according with their CYP2D6 phenotype. All were free of HIV or hepatitis C infection and did not meet dependence criteria for other substances. Extensive metabolizers showed worse overall neuropsychological performance and were three times as likely to be cognitively impaired as intermediate/poor metabolizers. Groups did not differ in their demographic or meth use characteristics, nor did they evidence differences in mood disorder or other substance use. This preliminary study is the first to suggest that efficient meth metabolism is associated with worse neurocognitive outcomes in humans, and implicates the products of oxidative metabolism of meth as a possible source of brain injury. (JINS, 2010, 16, 890–901.)

This study investigated the relationship between bilingualism and task switching ability using a standardized measure of switching and an objective measure of bilingual language proficiency. Heritage Language (HL) speaking Spanish-English and Mandarin-English bilinguals and English speaking monolinguals completed all four subtests of the Color-Word Interference Test (CWIT), an English verbal fluency task, and a picture naming test (the Multilingual Naming Test) in English. Bilinguals also named pictures in their HL to assess HL proficiency. Spanish-English bilinguals were advantaged in task switching, exhibiting significantly smaller switching cost than monolinguals, but were disadvantaged in verbal fluency and picture naming. Additionally, performance on these cognitive and linguistic tasks was related to degree of HL proficiency, so that increased ability to name pictures in Spanish was associated with greater switching advantage, and greater disadvantage in both verbal fluency and picture naming. Mandarin-English bilinguals, who differed from the Spanish-English bilinguals on several demographic and language-use characteristics, exhibited a smaller but statistically significant switching advantage, but no linguistic disadvantage, and no clear relationship between HL proficiency and the switching advantage. Together these findings demonstrate an explicit link between objectively measured bilingual language proficiency and both bilingual advantages and disadvantages, while also showing that consequences of bilingualism for cognitive and linguistic task performance can vary across different language combinations. (JINS, 2015, 21, 531–544)

Impairments in executive cognition (EC) may be predictive of incident dementia in patients with mild cognitive impairment (MCI). The present study examined whether specific EC tests could predict which MCI individuals progress from a Clinical Dementia Rating (CDR) score of 0.5 to a score ≥1 over a 2-year period. Eighteen clinical and experimental EC measures were administered at baseline to 104 MCI patients (amnestic and non-amnestic, single- and multiple-domain) recruited from clinical and research settings. Demographic characteristics, screening cognitive measures and measures of everyday functioning at baseline were also considered as potential predictors. Over the 2-year period, 18% of the MCI individuals progressed to CDR ≥ 1, 73.1% remained stable (CDR = 0.5), and 4.5% reverted to normal (CDR = 0). Multiple-domain MCI participants had higher rates of progression to dementia than single-domain, but amnestic and non-amnestic MCIs had similar rates of conversion. Only three EC measures were predictive of subsequent cognitive and functional decline at the univariate level, but they failed to independently predict progression to dementia after adjusting for demographic, other cognitive characteristics, and measures of everyday functioning. Decline over 2 years was best predicted by informant ratings of subtle functional impairments and lower baseline scores on memory, category fluency, and constructional praxis. (JINS, 2011, 17, 277–288)

We present a case study of a 43-year-old woman with chronic and stable pure alexia. Using a multiple baseline design we report the results of two different interventions to improve reading. First, a restitutive treatment approach using an implicit semantic access strategy was attempted. This approach was designed to exploit privileged access to lexical–semantic representations and met with little success. Treatment was then switched to a substitutive treatment strategy, which involved using the patient's finger to pretend to copy the letters in words and sentences. Reading using this motor cross-cuing strategy was 100% accurate and doubled in speed after 4 weeks of intervention. We propose that this patient's inability to benefit from the implicit semantic access treatment approach may be in part related to her inability to suppress the segmental letter identification process of word recognition. (JINS, 1998, 4, 636–647.)

The relation of body side of motor symptom onset in Parkinson's disease (PD) to memory measures associated with hemispheric dominance was examined. Fourteen patients with right body side motor symptom onset (RPD, inferred left hemisphere dysfunction) and 16 patients with left side onset (LPD, right hemisphere dysfunction) were administered measures of verbal (Hopkins Verbal Learning Test-Revised) and visual memory (Brief Visual Memory Test-Revised), that require similar task demands and are associated with left or right hemisphere dominance, respectively. The LPD group demonstrated poorer visual than verbal memory, both within group and in comparison to the RPD group. By contrast, the RPD group showed poorer verbal than visual memory within group. These findings suggest that side of motor symptom onset is associated with asymmetrical memory dysfunction (JINS, 2006, 12, 736–740.)

Twenty participants with self-reported long-term benzodiazepine use (mean 108 months) who had previously withdrawn from medication (mean 42 months) were administered a battery of neuropsychological tests. Each long-term user was case matched for age, sex, and education to two control participants who reported never taking benzodiazepines (those with and those without anxiety). The results indicated that long-term benzodiazepine use may lead to impairments in the areas of verbal memory, motor control/performance, and nonverbal memory but not visuospatial skills and attention/concentration. The length of abstinence (> 6 months) indicates that these impairments persist well beyond cessation of benzodiazepine use. However, observed impairments in the area of nonverbal memory were not solely attributable to benzodiazepine use and may be influenced by the elevated anxiety levels present in both the case and the anxious control group. (JINS, 2005, 11, 281–289.)

Objectives: The aim of this study was to investigate the effects of infant and toddler head growth on intelligence scores from early childhood to adulthood in very preterm (<32 weeks gestational age; VP) and/or very low birth weight (<1500 g; VLBW) and term born individuals. Methods: 203 VP/VLBW and 198 term comparisons were studied from birth to adulthood as part of the prospective geographically defined Bavarian Longitudinal Study (BLS). Head circumference was assessed at birth; 5, 20 months; and 4 years of age. Intelligence was assessed with standardized tests in childhood (6 and 8 years: K-ABC) and at 26 years (Wechsler Adult Intelligence Scale, WAIS). Structural equation modeling (SEM) was used to model the effect of head growth on IQ. Results: On average, VP/VLBW had lower head circumference at birth (27.61 cm vs. 35.11 cm, mean difference 7.49, 95% confidence interval [7.09–7.90]) and lower adult intelligence scores (88.98 vs. 102.54, mean difference 13.56 [10.59–16.53]) than term born comparison individuals. Head circumference at birth (e.g., total effect β=.48; p<.001 for adult IQ) and head growth in childhood predicted intelligence development from age 6 to 26 years in both VP/VLBW and term born individuals (70% of variance in adult IQ explained by full model). Effects of gestation and birth weight on intelligence were fully mediated by head circumference and growth. Conclusions: This longitudinal investigation from birth to adulthood indicates head growth as a proxy of brain development and intelligence. Repeated early head circumference assessment adds valuable information when screening for long-term neurocognitive risk. (JINS, 2019, 25, 48#x2013;56)