Complaints of neuropsychological dysfunction have emerged among subsets of military personnel after almost every major deployment involving western nations in recent history. Although deployments have been characterized by a range of neural risk factors, psychological stress is common to most prolonged deployments. This review uses a public health framework to address associations between deployment-related stress and neuropsychological performance. Specifically, the review covers mechanisms by which deployment-related psychological stress may affect neuropsychological functioning, considers the advantages and disadvantages of approaching the question from a public health perspective, and discusses how epidemiological research may sort out questions regarding course, cause, and effect. (JINS, 2011, 17, 000–000)

There is rapidly accumulating evidence of a close relationship between sleep loss and cognition. Neuropsychologists need to become aware of this body of knowledge as the effects of sleep loss on brain functions are significant. The current study (a) outlines the extent to which insufficient sleep affects performance on cognitive tasks in otherwise healthy people, (b) discusses the relationship between sleep and neurocognitive disorders, and (c) highlights key issues that merit consideration for neuropsychologists. This review shows that sleep loss has a measurable impact on performance through decreases in cognitive functions and effects on biological pathways that support cognitive performance. Sleep loss reliably produces reductions in speed of processing and attention. Higher order cognitive functions are affected to a lesser extent, and there is sparing on tasks of crystallized abilities. Deficits worsen with increasing time awake, but may be overturned after normal sleep is resumed. The review also shows that sleep disorders are a major feature of neuropsychological conditions contributing to the pattern of cognitive impairment. Overall, neuropsychologists must be alert to sleep problems in their clients, so that sleep interventions, or referrals, are put in place in the rehabilitation plan of individuals with cognitive dysfunctions. Recommendations also include routine screening of sleep as part of cognitive assessment. (JINS, 2011, 17, 571–586)

Brain abnormalities have been documented by neuropsychological assessment as well as a variety of neuroimaging techniques in patients with systemic lupus erythematosus (SLE). Conventional neuroimaging in patients with neuropsychiatric disease (NPSLE) typically discloses periventricular white matter (WM) hyperintensities, infarcts, hemorrhages, and cerebral atrophy. In SLE patients with none of these findings, sophisticated neuroimaging techniques have recently supported associations between microstructural WM abnormalities and abnormal attention, executive function, and processing speed. This mild cognitive dysfunction in SLE (MCD-SLE), which may result from early myelinopathy, precedes the more severe cognitive dysfunction of NPSLE, related to more obvious WM and neuronal damage. (JINS, 2011, 17, 385–392)

The use of nonliteral language in clinical assessment, especially testing the patients’ ability to interpret proverbs, has a long tradition in psychiatry. However, its diagnostic sensitivity and specificity in dementias is not yet clear. The aim of this review article is to examine the current evidence on nonliteral/figurative language (proverb, metaphor, metonymy, idiom, irony, sarcasm) comprehension in Alzheimer's disease and related disorders. A comprehensive literature search identified 25 studies (16 proverb, 3 metaphor, 0 metonymy, 5 idiom, 3 sarcasm) on nonliteral language comprehension in dementia. Studies predominantly indicate a deficit. Most studies investigated Alzheimer's dementia. Applied correctly, nonliteral language is a worthwhile diagnostic tool to evaluate language and abstract thinking in dementias. During assessment, familiarity testing (e.g., by asking “are you familiar with the proverb XY”) is obligatory. Still, future research is needed in several areas: evidence on decline of nonliteral language over the course of the illness is limited. So far, almost no studies delineated proverb comprehension in high risk populations such as patients with mild cognitive impairment. Currently, there is a lack of studies addressing performance in direct comparison to relevant differential diagnosis like older-age depression, delirium, brain lesion, or other psychiatric conditions. (JINS, 2011, 17, 207–218)

Proceeding from the assumptions that specific frontal regions control discrete functions and that very basic cognitive processes can be systematically manipulated to reveal those functions, recent reports have demonstrated consistent anatomical/functional relationships: dorsomedial for energization, left dorsolateral for task setting, and right dorsolateral for monitoring. There is no central executive. There are, instead, numerous domain general processes discretely distributed across several frontal regions that act in concert to accomplish control. Beyond these functions, there are two additional “frontal” anatomical/functional relationships: ventral–medial/orbital for emotional and behavioral regulation, and frontopolar for integrative—even meta-cognitive—functions. (JINS, 2011, 17, 759–765)

With time and experience, memories undergo a process of reorganization that involves different neuronal networks, known as systems consolidation. The traditional view, as articulated in standard consolidation theory (SCT), is that (episodic and semantic) memories initially depend on the hippocampus, but eventually become consolidated in their original forms in other brain regions. In this study, we review the main principles of SCT and report evidence from the neuropsychological literature that would not be predicted by this theory. By comparison, the evidence supports an alternative account, the transformation hypothesis, whose central premise is that changes in neural representation in systems consolidation are accompanied by corresponding changes in the nature of the memory. According to this view, hippocampally dependent, episodic, or context-specific memories transform into semantic or gist-like versions that are represented in extra-hippocampal structures. To the extent that episodic memories are retained, they will continue to require the hippocampus, but the hippocampus is not needed for the retrieval of semantic memories. The transformation hypothesis emphasizes the dynamic nature of memory, as well as the underlying functional and neural interactions that must be taken into account in a comprehensive theory of memory. (JINS, 2011, 17, 766–780)

Neuropsychology is poised for transformations of its concepts and methods, leveraging advances in neuroimaging, the human genome project, psychometric theory, and information technologies. It is argued that a paradigm shift toward evidence-based science and practice can be enabled by innovations, including (1) formal definition of neuropsychological concepts and tasks in cognitive ontologies; (2) creation of collaborative neuropsychological knowledgebases; and (3) design of Web-based assessment methods that permit free development, large-sample implementation, and dynamic refinement of neuropsychological tests and the constructs these aim to assess. This article considers these opportunities, highlights selected obstacles, and offers suggestions for stepwise progress toward these goals. (JINS, 2011, 17, 000–000)

The development of antiretroviral therapy (ART) has dramatically improved survival for those living with human immunodeficiency virus (HIV), but whether ART improves cognitive functioning remains unclear. The aim of the present review was to examine systematically the extent to which ART improves cognition among individuals with HIV using meta-analytic methods. Twenty-three studies were included in the quantitative review. ART was associated with modest improvements in attention (mean d = .17; p < .001; 95% confidence interval [CI], .09/.25), executive function (mean d = .18; p < .001; 95% CI, .10/.26), and motor function (mean d = .24; p < .001; 95% CI, .16/.32). ART did not improve language, verbal memory, visual memory or visuospatial function. The extent to which cognition improved was correlated with the change in CD4 cell count following ART, suggesting a link between cognitive outcome and immune system integrity. Together, the present findings indicate that the neuropsychological test performance of most HIV patients taking ART is comparable to those not taking ART. Development of pharmaceutical treatments and rehabilitation strategies that target the cognitive effects of HIV infection is needed. (JINS, 2011, 17, 956–969)

Cognitive changes of Parkinson's disease (PD) manifest earlier and are more heterogeneous than previously appreciated. Approximately one-third of patients have at least mild cognitive changes at PD diagnosis, and subtle changes might be appreciable among those at risk for PD. Executive dysfunction is the most common cognitive change, but other phenotypes exist. Pathobiologic and potential prognostic differences among cognitive phenotypes remain poorly understood. Progress in the neuropsychology, epidemiology and pathobiology of mild cognitive impairment (MCI) in PD is hampered by lack of diagnostic criteria. This study proposes preliminary research criteria for two categories of PD non-dementia cognitive impairment. (JINS, 2011, 17, 393–406)

Persistent cognitive complaints are common following a mild head injury (MHI), but deficits are rarely detected on neuropsychological tests. Our objective was to examine the effect of symptom expectation on self-report and cognitive performance measures in MHI individuals. Prior research suggests that when MHI participants are informed they may experience cognitive difficulties, they perform worse on neuropsychological tests compared to MHI participants who are uninformed. In this study, undergraduate students with and without a prior MHI were either informed that the study's purpose was to investigate the effects of MHI on cognitive functioning (“diagnosis threat” condition) or merely informed that their cognitive functioning was being examined, with no mention of status (“neutral” condition). “Diagnosis threat” MHIs self-reported more attention failures compared to “diagnosis threat” controls and “neutral” MHIs, and more memory failures compared to “diagnosis threat” controls. In the “neutral” condition, MHIs reported higher anxiety levels compared to controls and compared to “diagnosis threat” MHIs. Regardless of condition, MHIs performed worse on only one neuropsychological test of attention span. “Diagnosis threat” may contribute to the prevalence and persistence of cognitive complaints made by MHI individuals found in the literature, but may not have as strong of an effect on neuropsychological measures. (JINS, 2011, 17, 219–229)

Although blind people heavily depend on working memory to manage daily life without visual information, it is not clear yet whether their working memory processing involves functional reorganization of the memory-related cortical network. To explore functional reorganization of the cortical network that supports various types of working memory processes in the early blind, we investigated activation differences between 2-back tasks and 0-back tasks using fMRI in 10 congenitally blind subjects and 10 sighted subjects. We used three types of stimulus sequences: words for a verbal task, pitches for a non-verbal task, and sound locations for a spatial task. When compared to the sighted, the blind showed additional activations in the occipital lobe for all types of stimulus sequences for working memory and more significant deactivation in the posterior cingulate cortex of the default mode network. The blind had increased effective connectivity from the default mode network to the left parieto-frontal network and from the occipital cortex to the right parieto-frontal network during the 2-back tasks than the 0-back tasks. These findings suggest not only cortical plasticity of the occipital cortex but also reorganization of the cortical network for the executive control of working memory. (JINS, 2011, 17, 407–422)