Perception of emotion in voice is impaired following traumatic brain injury (TBI). This study examined whether an inability to concurrently process semantic information (the “what”) and emotional prosody (the “how”) of spoken speech contributes to impaired recognition of emotional prosody and whether impairment is ameliorated when little or no semantic information is provided. Eighteen individuals with moderate-to-severe TBI showing social skills deficits during inpatient rehabilitation were compared with 18 demographically matched controls. Participants completed two discrimination tasks using spoken sentences that varied in the amount of semantic information: that is, (1) well-formed English, (2) a nonsense language, and (3) low-pass filtered speech producing “muffled” voices. Reducing semantic processing demands did not improve perception of emotional prosody. The TBI group were significantly less accurate than controls. Impairment was greater within the TBI group when accessing semantic memory to label the emotion of sentences, compared with simply making “same/different” judgments. Findings suggest an impairment of processing emotional prosody itself rather than semantic processing demands which leads to an over-reliance on the “what” rather than the “how” in conversational remarks. Emotional recognition accuracy was significantly related to the ability to inhibit prepotent responses, consistent with neuroanatomical research suggesting similar ventrofrontal systems subserve both functions. (JINS, 2010, 16, 369–382.)

This study compared the ability of clinical and ecologic simulation measures to predict performance on environment-specific criterion measures of wayfinding. Thirty-one unilateral stroke participants comprised the right and left hemisphere groups (16 patients with left sided and 15 patients with right sided strokes). Participants completed a battery of clinical tasks (e.g., traditional paper-and-pencil measures of visualization, mental rotation, visual memory and spatial orientation), ecologic simulations (e.g., slide route recall and visualization of a model town from differing perspectives) and environment specific criterion tasks (e.g., route recall and directional orientation). The groups were equivalent in age, sex, education, handedness, and weeks since stroke. Both ecologic simulation tasks were found to have fairly good internal consistency and 1 simulation task was significantly related to real world wayfinding. Of the clinical tasks, 1 visual memory test was correlated with a directional orientation criterion task, but none correlated with route navigation ability. Results are consistent with literature purporting the benefits of ecologic simulation tasks as predictors of real world functioning. (JINS, 2001, 7, 675–682.)

Wide-ranging conceptual and diagnostic approaches to defining mild cognitive impairment (MCI) have led to highly variable prevalence and progression rates. We sought to examine whether bilateral hippocampal volumes and cerebrovascular risk factors in individuals characterized by two different neuropsychological definitions of MCI subtypes would also differ. Participants were 65 nondemented, community-dwelling, older adults, ages 62–91 years, drawn from a larger group of individuals enrolled in a longitudinal study of normal aging. A comprehensive neuropsychological definition of MCI that required the presence of more than one impaired score in a cognitive domain resulted in expected anatomical results; hippocampal volumes were significantly smaller in the aMCI group as compared to cognitively normal or nonamnestic MCI participants. However, a typical definitional scheme for classifying MCI based only on the presence of one impaired score within a cognitive domain did not result in hippocampal differences between groups. Global stroke risk factors did not differ between the two definitional schemes, although the relationship between stroke risk variables and neuropsychological performance did vary by diagnostic approach. The comprehensive approach demonstrated associations between stroke risk and cognition, whereas the typical approach did not. Use of more sophisticated clinical decision-making and diagnostic approaches that incorporate comprehensive neuropsychological assessment techniques is supported by this convergence of neuropsychological, neuropathological, and stroke risk findings. (JINS, 2009, 15, 890–897.)

Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) can produce a higher incidence of neuropsychological complications than other types of highly invasive noncardiac vascular surgery. Cognitive complications most likely arise from either embolization or hypoxia. An alternative surgical procedure has been developed that allows CABG to be performed without stopping the heart (“off-pump” CABG, or OPCABG). This study examined the neuropsychological performance of patients undergoing OPCABG, hypothesizing that patients undergoing OPCABG would show fewer cognitive deficits than patients whose hearts were stopped. A 1-hr neuropsychological battery was administered preoperatively to 43 patients before prospective randomization to either CPB CABG or OPCABG, and again to 34 of those patients 2 to 3 months postoperatively by an examiner blind to surgical condition. Neuropsychological status did not change 2.5 months postsurgically in either OPCABG or CABG groups. However, both groups showed dramatic presurgical cognitive deficits in multiple domains, particularly verbal memory and psychomotor speed. This corroborates previous research suggesting that patients requiring CABG surgery may evidence significant presurgical cognitive deficits as a result of existing vascular disease. (JINS, 2003, 9, 913–924.)

Risk-taking behavior and impulsivity are core features of bipolar disorder. Whether they are part of the inherited aspect of the illness is not clear. We aimed to evaluate risk-taking behavior as a potential endophenotype for bipolar disorders, and its relationship with impulsivity and illness features. The Balloon Analogue Risk Task (BART) and Barratt Impulsiveness Scale-11 (BIS-11) were used to assess risk-taking behavior and impulsivity respectively in 30 euthymic bipolar I patients (BD), their 25 asymptomatic first-degree relatives (BD-R), and 30 healthy controls (HC). The primary BART outcome measure was the behavioral adjustment score (number of pumps after trials where the balloon did not pop minus the number of pumps after trials where the balloon popped). BD (p < .001) and BD-R (p = .001) had similar and significantly lower adjustment scores than HC. Only BD scored significantly higher on BIS-11 total (p = .01) and motor (p = .04) subscales than HC. Neither the BART, nor impulsivity scores associated with illness features. A limitation of this study is medicated patients and a heterogeneous BD-R were included. Riskiness may be a candidate endophenotype for bipolar disorder as it appears independently from illness features, presents similarly in BD and BD-R groups and differs from impulsivity. (JINS, 2013, 19, 1–9)

Although it is widely known that high intra-individual variability (IIV) is a key characteristic of attention deficit/hyperactivity disorder (ADHD), a detailed exploration of the IIV pattern during the time course of a cognitive task has never been carried out. In this study, 30 children with ADHD and 30 controls, were administered the Conners’ Continuous Performance Task (CPT-II). The across-block individual performance of the groups was analyzed using an ex-Gaussian approach, which enabled a clearer understanding of how individual response times (RTs) fluctuate during a task in comparison with conventional measures of central tendency. While the conventional measures showed a significant group effect on mean RTs but similar RT trends across blocks between the two groups, the ex-Gaussian results revealed no actual differences between the two groups in the normally distributed component of mean RTs (mu). In contrast to the control group, the children with ADHD showed a steep increase in the exponentially distributed component of RTs (tau) across blocks, thereby indicating that extremely long RTs progressively increased soon after the beginning of the task. Taken together, the results demonstrated that sustained attention deficit in ADHD can be detected by analyzing the IIV in the first few task blocks. (JINS, 2013, 19, 1–9)

Several investigations have reported high frequencies of reading and writing disabilities in criminal populations. The aims of the present study were to assess the frequency of dyslexia among Swedish prison inmates and to relate dyslexia to other indices of neuropsychological functions. Sixty-three prison inmates with Swedish as their native language, age 19 to 57 years, were examined by interviews, tests of academic achievement, and neuropsychological assessment. Twenty-six (41%) were diagnosed as dyslexic. As expected, the dyslexic group performed more poorly on verbal tests as compared to the normal readers among the prison inmates, but they also performed more poorly on tests measuring nonverbal abilities. The dyslexic group had higher frequencies of paranoid and avoidant personality disorders compared to the nondyslexics. They also reported higher levels of anxiety and suspicion and a lower degree of socialization. Previous studies report low IQ to be associated with criminal propensity, supporting the interpretation that a double handicap (dyslexia and low IQ) increases the risk of entering a criminal career and remaining in it. (JINS, 1999, 5, 452–461.)

Objectives: As surprisingly little is known about the developing brain studied in vivo in youth with Down syndrome (DS), the current review summarizes the small DS pediatric structural neuroimaging literature and begins to contextualize existing research within a developmental framework. Methods: A systematic review of the literature was completed, effect sizes from published studies were reviewed, and results are presented with respect to the DS cognitive behavioral phenotype and typical brain development. Results: The majority of DS structural neuroimaging studies describe gross differences in brain morphometry and do not use advanced neuroimaging methods to provide nuanced descriptions of the brain. There is evidence for smaller total brain volume (TBV), total gray matter (GM) and white matter, cortical lobar, hippocampal, and cerebellar volumes. When reductions in TBV are accounted for, specific reductions are noted in subregions of the frontal lobe, temporal lobe, cerebellum, and hippocampus. A review of cortical lobar effect sizes reveals mostly large effect sizes from early childhood through adolescence. However, deviance is smaller in adolescence. Despite these smaller effects, frontal GM continues to be largely deviant in adolescence. An examination of age-frontal GM relations using effect sizes from published studies and data from Lee et al. (2016) reveals that while there is a strong inverse relationship between age and frontal GM volume in controls across childhood and adolescence, this is not observed in DS. Conclusions: Further developmentally focused research, ideally using longitudinal neuroimaging, is needed to elucidate the nature of the DS neuroanatomic phenotype during childhood and adolescence. (JINS, 2018, 24, 966–976)

Studies of patients with brain damage, as well as studies with normal subjects have revealed that the right hemisphere is important for recognizing emotions expressed by faces and prosody. It is unclear, however, if the knowledge needed to perform recognition of emotional stimuli is organized by modality or by the type of emotion. Thus, the purpose of this study is to assess these alternative a priori hypotheses. The participants of this study were 30 stroke patients with right hemisphere damage (RHD) and 31 normal controls (NC). Subjects were assessed with the Polish adaptation of the Right Hemisphere Language Battery of Bryan and the Facial Affect Recognition Test based on work of Ekman and Friesen. RHD participants were significantly impaired on both emotional tasks. Whereas on the visual-faces task the RHD subjects recognized happiness better than anger or sadness, the reverse dissociation was found in the auditory-prosody test. These results confirm prior studies demonstrating the role of the right hemisphere in understanding facial and prosodic emotional expressions. These results also suggest that the representations needed to recognize these emotional stimuli are organized by modality (prosodic-echoic and facial-eidetic) and that some modality specific features are more impaired than others. (JINS, 2006, 12, 774–781.)

Objectives: Subjective memory complaints (SMC) in older adults are associated with a decline in everyday functioning and an increased risk for future cognitive decline. This study examines the effect of a memory strategy training compared to a control memory training on memory functioning in daily life. Methods: This was a randomized controlled trial with baseline, post-treatment, and 6-month follow-up assessments conducted in 60 older adults (50–87 years) with SMC. Participants were randomly assigned to either seven sessions of memory strategy training or seven sessions of control memory training. Both interventions were given in small groups and included psycho-education. Primary outcome measure was memory functioning in daily life. Objective measures of memory performance and self-reported measures of strategy use were included as secondary outcome measures. Results: Participants in each intervention group reported an improvement in personal memory goals (p<.0005), up to 6 months after training. An interaction effect showed that participants following memory strategy training reported a larger improvement in personal memory goals (p=.002). Both intervention groups improved on two memory tests (p<.001 and p<.01). In the memory strategy training group, an increase in strategy use in daily life was the strongest predictor (p<.05) of improvement in subjective memory functioning. Conclusions: Older adults with subjective memory complaints benefit from memory strategy training, especially in their memory functioning in daily life. (JINS, 2018, 24, 1110–1120)

Good cognitive performance requires adherence to rules specific to the task at hand. Patients with neurological disease often make rule violation (RV) errors, but the anatomical basis for RV during cognitive testing remains debated. The present study examined the neuroanatomical correlates of RV errors made on tests of executive functioning in 166 subjects diagnosed with neurodegenerative disease or as neurologically healthy. Specifically, RV errors were voxel-wisely correlated with gray matter volume derived from high-definition magnetic resonance images using voxel-based morphometry implemented in SPM2. Latent variable analysis showed that RV errors tapped a unitary construct separate from repetition errors. This analysis was used to generate factor scores to represent what is common among RV errors across tests. The extracted RV factor scores correlated with tissue loss in the lateral middle and inferior frontal gyri and the caudate nucleus bilaterally. When a more stringent control for global cognitive functioning was applied using Mini Mental State Exam scores, only the correlations with the right lateral prefrontal cortex (PFC) remained significant. These data underscore the importance of right lateral PFC in behavioral monitoring and highlight the potential of RV error assessment for identifying patients with damage to this region. (JINS, 2009, 15, 354–364.)

A microanalysis of task events in a common go/no-go task was completed to examine how task events impact individual reaction times. Predictors of long reaction times were analyzed to better understand increased intra-individual variability (IIV) among children with ADHD compared with normal controls. Sixty-five children with ADHD and 65 normal controls matched on gender, ethnicity, and age completed a go/no-go task. Children across both groups were slower before and after omission errors than all other trials. They were also slower on the trial before successfully inhibiting their response to no-go trials. Children with ADHD exhibited a pronounced slowing on trials prior to omission errors and trials prior to successful inhibitions compared with the normal control group. Pre-error slowing in children with ADHD may represent the beginning stages of attentional disengagement that subsequently results in the absence of responding (i.e., errors of omission or successful inhibition). While these event-related increases in reaction time explain some of the increased IIV observed in children with ADHD, the removal of these trials did not remove the pronounced between-group differences in IIV, suggesting that additional unmeasured processes are contributing to IIV in children with ADHD. (JINS, 2010, 16, 138–147.)

Although supportive parenting has been shown to have positive effects on development, the neurobiological basis of supportive parenting has not been investigated. Thirty-three adolescents were systemically selected from a longitudinal study on child development based on maternal responsiveness during childhood, a measure of supportive parenting, and whether they were born term or preterm. We analyzed the effect of preterm birth on hemispheric and regional (frontal, temporal, parietal) cortical thickness and surface area using mixed-model analysis while also considering the effect of brain hemisphere (left vs. right). We then determined whether these factors were moderated by maternal responsiveness during childhood. Preterm birth was associated with regional and hemispheric differences in cortical thickness and surface area. Maternal responsiveness during childhood moderated hemispheric cortical thickness. Adolescence with mothers that were inconsistently responsive during childhood demonstrated greater overall cortical thickness and greater asymmetry in cortical thickness during adolescence as compared to adolescence with mothers who were consistently responsive or unresponsive during childhood. Maternal responsiveness and preterm birth did not interact. These data suggest that changes in brain morphology associated with preterm birth continue into adolescence and support the notion that the style of maternal-child interactions during childhood influence brain development into adolescence. (JINS, 2010, 16, 784–794.)

Healthy subjects demonstrate leftward bias on visual–spatial tasks. However, young controls may also be left-biased when drawing communicatively, depicting the subject of a sentence leftward on a page relative to the sentence object, that is, a spatial–syntactic, implicit task. A leftward visual–spatial bias may decrease with aging, as right-hemisphere, dorsal, visual–spatial activation may be reduced in elderly subjects performing these tasks. We compared horizontal and radial (near–far) visual spatial bias, and spatial–syntactic bias, in healthy young and aged participants. Both horizontal and radial visual–spatial bias were smaller in aged participants when explicitly, but not implicitly assessed. Mean implicit far bias was greater in aged subjects, although this varied by task. We observed less implicit, spatial–syntactic left bias in aged than young participants. These results may be consistent with relatively less dominance of right hemisphere, dorsal spatial systems with aging. (JINS, 2008, 14, 562–570.)

Using magnetic resonance imaging, this study compared hippocampal volume between 145 very preterm children and 34 children born full-term at 7 years of age. The relationship between hippocampal volume and memory and learning impairments at 7 years was also investigated. Manual hippocampal segmentation and subsequent three-dimensional volumetric analysis revealed reduced hippocampal volumes in very preterm children compared with term peers. However, this relationship did not remain after correcting for whole brain volume and neonatal brain abnormality. Contrary to expectations, hippocampal volume in the very preterm cohort was not related to memory and learning outcomes. Further research investigating the effects of very preterm birth on more extensive networks in the brain that support memory and learning in middle childhood is needed. (JINS, 2013, 19, 1–11)

Objectives: Chemotherapy has adverse effects on cognitive performance in women treated for breast cancer, but less is known about the period before chemotherapy. Studies have focused on mean level of performance, yet there is increasing recognition that variability in performance within an individual is also an important behavioral indicator of cognitive functioning and underlying neural integrity. Methods: We examined intraindividual variability (IIV) before chemotherapy and surgery in women diagnosed with breast cancer (n=31), and a healthy control group matched on age and education (n=25). IIV was calculated across trials of a computerized Stroop task, including an examination of the slowest and fastest trials of reaction time (RT) responses. Results: The groups were equivalent on overall accuracy and speed, and participants in both groups were less accurate and slower on incongruent trials compared with congruent trials. However, women with breast cancer became more variable with increased task difficulty relative to healthy controls. Among the slowest RT responses, women with breast cancer were significantly more variable than healthy controls on incongruent trials. This suggests that a specific variability-producing process (e.g., attentional lapses) occurs in task conditions that require executive control (e.g., incongruent trials). Conclusions: Results are consistent with other evidence of executive dysfunction among women treated for breast cancer. These findings highlight the importance of pretreatment assessment and show that variability in performance provides information about cognition that measures of central tendency do not. (JINS, 2016, 23, 1–10)

Objectives: Neurofibromatosis type 1 (NF1) is a genetic disorder in which the most frequent complication in children is learning disabilities. Over the past decade, growing arguments support the idea that executive dysfunction is a core deficit in children with NF1. However, some data remain inconsistent. The aim of this study was to determine the magnitude of impairment for each executive function (EF) and clarify the impact of methodological choices and participant’s characteristics on EFs. Methods: In this meta-analysis, 19 studies met the selection criteria and were included with data from a total of 805 children with NF1 and 667 controls. Based on the Diamond’s model (2013), EF measures were coded separately according to the following EF components: working memory, inhibitory control, cognitive flexibility, planning/problem solving. The review protocol was registered with PROSPERO (International prospective register of systematic reviews; CRD42017068808). Results: A significant executive dysfunction in children with NF1 is demonstrated. Subgroup analysis showed that the impairment varied as a function of the specific component of executive functioning. The effect size for working memory and planning/problem solving was moderate whereas it was small for inhibitory control and cognitive flexibility. Executive dysfunction seems to be greater with increasing age whereas assessment tool type, intellectual performance, attention deficit hyperactivity disorder and control group composition did not seem to affect EF results. Conclusions: EF deficits are a core feature in children with NF1 and an early identification of executive dysfunctions is essential to limit their impact on the quality of life. (JINS, 2018, 24, 977–994)

Performance on some neuropsychological tests is best expressed as an intra-individual measure of association (such as a parametric or non-parametric correlation coefficient or the slope of a regression line). Examples of the use of intra-individual measures of association (IIMAs) include the quantification of performance on tests designed to assess temporal order memory or the accuracy of time estimation. The present paper presents methods for comparing a patient's performance with a control or normative sample when performance is expressed as an IIMA. The methods test if there is a significant difference between a patient's IIMA and those obtained from controls, yield an estimate of the abnormality of the patient's IIMA, and provide confidence limits on the level of abnormality. The methods can be used with normative or control samples of any size and will therefore be of particular relevance to single-case researchers. A method for comparing the difference between a patient's scores on two measures with the differences observed in controls is also described (one or both measures can be IIMAs). All the methods require only summary statistics (rather than the raw data from the normative or control sample); it is hoped that this feature will encourage the development of norms for tasks that use IIMAs to quantify performance. Worked examples of the statistical methods are provided using data from a clinical case and controls. A computer program (for PCs) that implements the methods is described and made available. (JINS, 2003, 9, 989–1000.)

The influence of action knowledge associated with novel objects was investigated using functional magnetic resonance imaging. Participants were trained on complex actions associated with novel objects (“tools”) and had experience manipulating other visually similar novel objects (“shapes”). During scanning, participants viewed, imagined grasping, and imagined using the objects. Based on previous neuroimaging and neuropsychological findings, our primary goal was to examine frontal and parietal regions subserving action representations associated with visual objects, namely the left inferior parietal lobule (IPL), the left ventral premotor cortex (VPM) and the presupplementary motor cortex (pre-SMA). We predicted differences between the tool and shape stimuli, modulated also by task demands. In viewing, we found greater effect sizes in the left VPM and IPL for tools versus shapes. In grasping, there was similar activation with both object types. The largest differences existed in using, in which greater effect sizes were found for tools versus shapes in left IPL and pre-SMA, and marginally in the left VPM. We suggest that representations of tools extend beyond classically defined affordances and recruit processing about both graspability and known action plans in tasks involving visual memory, motor imagery, and motor execution. (JINS, 2007, 13, 1009–1020.)

Despite the potential impact on development, few studies have examined the influence of prefrontal lesions occurring prior to maturation of the central nervous system. This study investigates the effect of prefrontal lesions in general, as well as the impact of lesion laterality, with respect to attentional abilities. The sample comprised 36 children with prefrontal lesions and 40 healthy controls. Attentional function was assessed across four domains: selective, shifting and divided attention, and processing speed. Group mean performances for children with prefrontal lesions indicated global attentional deficits, with greatest difficulties for “higher-order” skills including shifting and divided attention. Children with left prefrontal lesions performed similarly to controls, with a specific deficit characterized by difficulties with on-line processing of auditory-verbal information. Right prefrontal lesions were primarily associated with impairments in day-to-day executive functions, including reduced monitoring, poor shifting attention and disinhibition. Children with bilateral prefrontal lesions performed worse than controls on tasks requiring greater cognitive resources. These results provide evidence of the important role played by prefrontal cortex in the development of attentional skills, and the particular role of the right prefrontal cortex. The pattern of attention deficits observed following early prefrontal lesions suggests some lateralization of function within the frontal lobes, even during childhood. (JINS, 2005, 11, 817–831.)Source of funding: Australian National Health and Medical Research Council, Australian Research Council, Murdoch Children's Research Institute.