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Verbal fluency data for semantic (animals, fruit and vegetables and objects) and formal fluency (X [Chi], Σ [Sigma] Α [Alpha]) were collected from 32 L1Greek-L2English late bilingual speakers and 32 Greek monolinguals. The verbal fluency task has been used in both language attrition and bilingualism studies. Language attrition studies, which mostly employ only the semantic task, show that bilinguals perform worse than monolinguals. In bilingualism studies, which employ both the semantic and formal tasks, we find greater variance and the results are mixed (bilinguals perform similarly, better or poorly compared to monolinguals). In our study, we investigated quantitative measures (number of correct responses) and strategic processes (clustering, switching). In the quantitative measures, monolinguals outperformed bilinguals in both tasks with the difference being more pronounced in the semantic task. In clustering, both groups behaved similarly, while in switching monolinguals performed better than bilinguals. The implications of these results are discussed.
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves motor outcomes in Parkinson’s disease (PD) but may have adverse long-term effects on specific cognitive domains. The aim of this study was to investigate the association between total electrical energy (TEED) delivered by DBS and postoperative changes in verbal fluency.
Methods
Seventeen PD patients undergoing bilateral STN-DBS were assessed with the Alternate Verbal Fluency Battery (AVFB), which includes phonemic (PVF), semantic (SVF), and alternate verbal fluency (AVF) tests, before surgery (T0) and after 6 (T1) and 12 months (T2). Bilateral TEED and average TEEDM were recorded at T1 and T2. For each AVFB measurement, changes from T0 to T1 (Δ-01) and from T0 to T2 (Δ-02) were calculated.
Results
At T1, PVF (p = 0.007) and SVF scores (p = 0.003) decreased significantly. TEED measures at T1 and T2 were unrelated to Δ-01 and Δ-02 scores, respectively. However, an inverse, marginally significant association was detected between the TEEDM and Δ-01 scores for the AVF (p = 0.041, against an αadjusted = 0.025).
Conclusions
In conclusion, the present reports provide preliminary evidence that TEED may not be responsible or only slightly responsible for the decline in VF performance after STN-DBS in PD.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, in which cognitive dysfunction is common, but poorly understood. This study aims to characterize the prevalence and patterns of cognitive dysfunction in SLE.
Method:
SLE patients (n = 95) and demographically matched healthy controls (n = 48) underwent cross-sectional cognitive testing using the 1-hr conventional neuropsychological test battery recommended by the American College of Rheumatology for use in SLE. We used standard deviations (SD) from the healthy control group to define impairment. For each cognitive test we compared SLE and control groups using independent samples t-tests (or alternatives when needed). We performed cluster analysis using a machine learning algorithm to look for patterns of cognitive dysfunction.
Results:
The SLE group performed significantly worse than healthy controls on every cognitive test. The largest differences were in the domains of verbal fluency, working memory and attention, while fine motor and psychomotor speed were the least affected domains. As expected, the prevalence of cognitive dysfunction varied depending on the SD cut-off used, with 49% of participants being >1.5 SD below the healthy control mean in at least two cognitive domains. Heat mapping showed variability in the pattern of dysfunction between individual patients and cluster analysis confirmed the presence of two clusters of patients, which were those significantly impaired versus those having preserved cognition.
Conclusions:
Cognitive dysfunction is common in SLE but markedly heterogeneous across both cognitive domains and across the SLE group. Cluster analysis supports the use of a binary definition of cognitive dysfunction in SLE.
The performance of cognitive tests is highly dependent on the proficiency of the language in which the tests are administered. Not all Indonesians speak Indonesian daily and many are bilingual. We investigate whether language(s) spoken affects the performance on three language tests in 840 participants ranging in age (16–80) and education (6–22 years). Analysis of covariance followed by Helmert contrasts showed a disadvantage on the Boston Naming Test (BNT) and on the most difficult items of the Token Test for those who do not speak Bahasa daily. Bilinguals did worse on the BNT. Education had a large positive effect on the language tests, age a smaller negative effect. This suggests that besides age and education, the factor of language spoken, either in public or at home, needs to be taken into account when a participant's test scores on the BNT and TT are interpreted and compared with normative data.
There is limited research on the prognostic value of language tasks regarding mild cognitive impairment (MCI) and Alzheimer’s clinical syndrome (ACS) development in the cognitively normal (CN) elderly, as well as MCI to ACS conversion.
Methods:
Participants were drawn from the population-based Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) cohort. Language performance was evaluated via verbal fluency [semantic (SVF) and phonemic (PVF)], confrontation naming [Boston Naming Test short form (BNTsf)], verbal comprehension, and repetition tasks. An additional language index was estimated using both verbal fluency tasks: SVF-PVF discrepancy. Cox proportional hazards analyses adjusted for important sociodemographic parameters (age, sex, education, main occupation, and socioeconomic status) and global cognitive status [Mini Mental State Examination score (MMSE)] were performed.
Results:
A total of 959 CN and 118 MCI older (>64 years) individuals had follow-up investigations after a mean of ∼3 years. Regarding the CN group, each standard deviation increase in the composite language score reduced the risk of ACS and MCI by 49% (8–72%) and 32% (8–50%), respectively; better SVF and BNTsf performance were also independently associated with reduced risk of ACS and MCI. On the other hand, using the smaller MCI participant set, no language measurement was related to the risk of MCI to ACS conversion.
Conclusions:
Impaired language performance is associated with elevated risk of ACS and MCI development. Better SVF and BNTsf performance are associated with reduced risk of ACS and MCI in CN individuals, independent of age, sex, education, main occupation, socioeconomic status, and MMSE scores at baseline.
Identifying more homogenous subtypes of patients with obsessive–compulsive disorder (OCD) using biological evidence is critical for understanding complexities of the disorder in this heterogeneous population. Age of onset serves as a useful subtyping scheme for distinguishing OCD into two subgroups that aligns with neurodevelopmental perspectives. The underlying neurobiological markers for these distinct neurodevelopmental differences can be identified by investigating gyrification changes to establish biological evidence-based homogeneous subtypes.
Methods
We compared whole-brain cortical gyrification in 84 patients with early-onset OCD, 84 patients with late-onset OCD, and 152 healthy controls (HCs) to identify potential markers for early neurodevelopmental deficits using the local gyrification index (lGI). Then, the relationships between lGI in clusters showing significant differences and performance in visuospatial memory and verbal fluency, which are considered trait-related neurocognitive impairments in OCD, were further examined in early-onset OCD patients.
Results
The early-onset OCD patients exhibited significantly greater gyrification than those with late-onset OCD patients and HCs in frontoparietal and cingulate regions, including the bilateral precentral, postcentral, precuneus, paracentral, posterior cingulate, superior frontal, and caudal anterior cingulate gyri. Moreover, impaired neurocognitive functions in early-onset OCD patients were correlated with increased gyrification.
Conclusions
Our findings provide a neurobiological marker to distinguish the OCD population into more neurodevelopmentally homogeneous subtypes, which may contribute to the understanding of the neurodevelopmental underpinnings of an etiology in early-onset OCD consistent with the accumulated phenotypic evidence of greater neurodevelopmental deficits in early-onset OCD than in late-onset OCD.
The study followed 6-year-old children in Canadian French Immersion for three years to investigate the effect of home language background on acquisition of French, the language of schooling. None of the children knew French before beginning the program. French proficiency was indicated by French vocabulary and verbal fluency tasks. A language background questionnaire was used to (a) assign children to monolingual or bilingual groups and (b) provide a continuous score for degree of bilingual experience. Categorical analyses showed bilingual children had smaller English vocabulary than monolingual children when they entered the program. For French vocabulary, categorical comparisons revealed no language group differences in the first two years but higher French scores for bilingual children in the third year. In contrast, analyses of the continuous scores revealed a relation between more bilingual experience and higher French vocabulary throughout. Similarly, categorical analyses of verbal fluency results indicated no significant language group differences for either semantic or phonological fluency, but continuous analyses of semantic fluency showed an association between more bilingual experience and better outcomes in each year. These results suggest that language experience impacts progress in learning the language of schooling and that different analytic approaches reveal different aspects of the pattern.
Most recordings of verbal fluency tasks include substantial amounts of task-irrelevant content that could provide clinically valuable information for the detection of mild cognitive impairment (MCI). We developed a method for the analysis of verbal fluency, focusing not on the task-relevant words but on the silent segments, the hesitations, and the irrelevant utterances found in the voice recordings.
Methods:
Phonemic (‘k’, ‘t’, ‘a’) and semantic (animals, food items, actions) verbal fluency data were collected from healthy control (HC; n = 25; Mage = 67.32) and MCI (n = 25; Mage = 71.72) participants. After manual annotation of the voice samples, 10 temporal parameters were computed based on the silent and the task-irrelevant segments. Traditional fluency measures, based on word count (correct words, errors, repetitions) were also employed in order to compare the outcome of the two methods.
Results:
Two silence-based parameters (the number of silent pauses and the average length of silent pauses) and the average word transition time differed significantly between the two groups in the case of all three semantic fluency tasks. Subsequent receiver operating characteristic (ROC) analysis showed that these three temporal parameters had classification abilities similar to the traditional measure of counting correct words.
Conclusion:
In our approach for verbal fluency analysis, silence-related parameters displayed classification ability similar to the most widely used traditional fluency measure. Based on these results, an automated tool using voiced-unvoiced segmentation may be developed enabling swift and cost-effective verbal fluency-based MCI screening.
According to the literature, cognition may be more preserved in late-onset schizophrenia (LOS) compared to early-onset schizophrenia (EOS), but data are limited.
Objectives
To compare performance on cognitive tests in LOS and EOS.
Methods
LOS patients (n=14, mean age 58.1±8.2, 13 females, illness duration 1.07±1.5 years) and age-comparable controls (n=17, mean age 55.3±7.8, 12 females), EOS patients (n=25, mean age 20.7±3.9, 25 males, illness duration 0.75±0.62 years) and age-comparable controls (n=15, mean age 22.9±2.3, 15 males) underwent the Brief Assessment of Cognition in Schizophrenia (BACS) comprised of six subtests: Verbal Memory, Digit Sequencing, Verbal Fluency, Token Motor Task, Symbol Coding, and Tower of London. The Mann-Whitney U test with Bonferroni correction for multiple comparisons was applied (p <.05/8, i.e. p <.006).
Results
Compared to LOS, EOS patients had lower score on Verbal Fluency (VF): U=78, p=.004; mean T-scores are 43.5±9.5 and 33.6±12.6 for LOS and EOS, respectively. Additionally, we compared VF performance in each clinical group with age-comparable controls and revealed significantly lower performance in both LOS (U=37.5, p=.001) and EOS (U=56.5, p=.000).
Conclusions
Performance on VF is deteriorated in clinical groups, but may be more intact in LOS compared to EOS. This result is of particular interest because low performance on VF is considered as a cognitive endophenotype of schizophrenia. Performance on VF requires preserved executive functions, language, and processing speed. Our results are in line with the idea that LOS and EOS may be different subtypes of schizophrenia. Limitation of this study is that the clinical groups are not sex-matched.
Cognitive reserve, or the extent to which brain can cope with damage, is associated with extended healthy aging and with slow age-related cognitive decline, as well as a lower number of dementia-associated clinical cognitive signs. Thus, understanding how cognitive reserve might affect different cognitive abilities is important. This study aims at investigating the associations between cognitive reserve and linguistic abilities in a group of Spanish older adults with Alzheimer’s disease.
Method:
The sample comprised 25 older adults with a clinical diagnostic of AD with mild to moderate dementia, and 25 controls who were residing in care homes from the province of Granada and with ages between 52 and 92 years old (M= 83.40, SD= 7.18). The Mini Mental State Examination (MMSE), the Global Deterioration Scale, the Cognitive Reserve Questionnaire, and the Short Form of the Boston Naming Test for Individuals with Aphasia were used to collect data. Correlations and regression analysis were performed.
Results:
Results showed that cognitive reserve positively and significantly correlated with naming and with phonological fluency but not with semantic fluency word or sentence repetitions or with the global cognitive functioning and the severity of cognitive impairment. The regression analysis showed that cognitive reserve explained 24.7% of the variance in spontaneous naming (F=3.764, p=.039). On the contrary cognitive reserve did not predict verbal fluency.
Conclusions:
People with higher cognitive reserve score obtained higher scores in phonological fluency and in spontaneous naming and in naming after a semantic clue. Thus, cognitive reserve is linked with better linguistic abilities in AD patients and therefore it should be considered when designing speech therapy interventions for these patients.
Several neurodegenerative conditions negatively impact linguistics skills. Despite this, many studies carried out with these kinds of patients either only include participants with initial stages of cognitive impairment either do not contemplate linguistic skills, or they do assess language in clinical or experimental settings. Due to it this study aims at investigating verbal fluency and spontaneous conversation abilities in a group of institutionalized Spanish older adults with and without cognitive impairment.
Method:
The sample comprised 50 older adults who were residing in care homes from the province of Granada and with ages between 52 and 92 years old (M= 83.40, SD= 7.18). The Mini Mental State Examination (MMSE), the Global Deterioration Scale, and the Short Form of the Boston Naming Test for Individuals with Aphasia were used to collect data. In order to analyze the differences in verbal fluency and in spontaneous conversation between participants ANOVA analysis were performed.
Results:
Results showed that people without cognitive impairment or with initial stages of Parkinson’s’ disease showed a higher complexity in their spontaneous conversation and obtained higher scores in verbal fluency when compared with patients with Alzheimer’s disease, and with people with cognitive impairment but without a clinical diagnose. No significant differences were found between participants in word or sentence repetitions tasks.
Conclusions:
Language impairment in people with cognitive impairment has dramatic consequences, affecting people’s communication and social interaction, their identity and autonomy thus language skills should be assessed in institutionalized older adults with cognitive impairment and interventions should be designed to maintain their linguistic abilities.
Sex difference in the brain is of great interest, because it is believed to reveal the “real” or biologically predetermined basis for differences between men's and women’s behavior. However, current neuroscience research does not support this conception. First, most male/female brain differences are attributable to body size; thus, all brain structures are 10% larger in males, but after accounting for individuals’ total brain volume, sex/gender explains only ~1% of the variance in structural volumes at both the cortical and subcortical level. Other differences, such as higher ratio of gray:white matter and density of interhemispheric connections in women, are also found to be due to brain size rather than sex per se.Second, functional measures of brain activity (fMRI) have not revealed reliable differences in the neural circuits that process verbal, spatial, and emotional information, even though men and women as groups perform differently on such tasks. Finally, it is important to appreciate that brain structure and function are both influenced by experience, or neuroplasticity, so even when small differences are identified, it is not possible to determine whether they were induced by “Nature” (sexually differentiated genes and hormone levels) or “Nurture” (gender enculturation). Overall, measures of brain structure and function exhibit far more overlap than difference between males and females. In spite of much hype, current brain findings do not explain any of the well-described male/female differences in behavior, interests, or mental health.
To identify which improvements in cognitive function are associated with symptom resolution in schizophrenic patients treated with atypical antipsychotics. Design: a prospective open trial with atypical neuroleptics (risperidone, clozapine, quetiapine). Setting: Inpatient and outpatient units, Institute of Psychiatry. Patients: Thirty-nine patients with schizophrenia according to DSM-IV criteria were included. Clinical and cognitive assessment were done at baseline (T0) and again after six months of treatment (T2). Twenty-five patients completed the trial. Interventions: New-generation antipsychotics during six months. Patients were considered as responders if their PANSS score decreased at least 20% (n = 15) and non-responders if it did not (n = 10). Outcome measures: a computerized cognitive assessment comprised tests of short-term-memory (digit span), explicit long-term memory (word pair learning), divided attention, selective attention and verbal fluency (orthographic and semantic). Clinical assessment included PANSS and ESRS. Results: A discriminant function analysis was performed to determine which changes in cognitive performance predicted symptomatic response status. Semantic fluency and orthographic fluency were significant predictors. Together they correctly predicted responder status in 88% of cases. Memory was not a significant predictor of symptomatic response. Conclusion: Verbal fluency discriminated the responder from the non-responder group during a pharmacological treatment.
To test if specific correlations exist between cognitive measures and psychotic dimensions in schizophrenic subjects and if similar correlations, between cognition and schizotypal dimensions, are present in non-psychotic subjects.
Methods
We administered the same battery of cognitive tests (Source Monitoring, Verbal Fluency [VF] and Stroop tests) to schizophrenic subjects (N = 54), their first-degree relatives (N = 37) and controls (N = 41). Scores of negative, positive and disorganisation dimensions were derived from the Signs and Symptoms of Psychotic Illness scale in schizophrenic subjects, and from the Schizotypal Personality Questionnaire in relatives and controls.
Results
In schizophrenic subjects, as hypothesised, the negative dimension correlated with performance on VF and disorganisation with performance in the Stroop test. The positive dimension did not correlate with any cognitive measure.
With only one exception, the significant correlations observed in non-psychotic subjects did not match correlations seen in schizophrenic subjects. In non-psychotic subjects greater disorganisation was associated with more clustered words in VF suggesting that excessive automatic spreading of activation in semantic networks could underlie this dimension.
Conclusion
As a whole, data lent partial support to our hypothesis of specific cognitive–clinical correlations in schizophrenic subjects but did not support the existence of similar correlations in non-psychotic subjects.
The aim of this study was to determine whether schizophrenic patients' impairment in semantic verbal fluency tasks is due to difficulties in organizing their search or, in other words, in organizing output in terms of clusters of meaningfully related words. Consecutive association of words belonging to subcategories of the semantic task was defined as semantic clustering. A categorical verbal fluency task was first administered to 100 healthy subjects and then to 22 schizophrenic patients and 22 healthy subjects matched for sex, age and education. In the normal population, semantic clustering was found to be involved in word generation. A large number of semantic clusters indicated efficient organization of semantic knowledge and led to better word production. Schizophrenic patients showed impaired verbal fluency and generated a smaller number of semantic clusters than the control subjects. These findings point to a defect in self-initiation of semantic categorization in schizophrenia.
The personality traits of neuroticism, openness, and conscientiousness are relevant factors for cognitive aging outcomes. The present study examined how these traits were associated with cognitive abilities and corresponding resting-state functional connectivity (RSFC) of the default mode network (DMN) in an older and predominantly minority sample. A sample of 58 cognitively unimpaired, largely African-American, older adults (M age = 68.28 ± 8.33) completed a standard RSFC magnetic resonance imaging sequence, a Big Five measure of personality, and delayed memory, Stroop, and verbal fluency tasks. Personality trait associations of within-network connectivity of the posterior cingulate cortex (PCC), a hub of the DMN, were examined using a seed-based approach. Trait scores were regressed on cognitive performance (delayed memory for neuroticism, Stroop for conscientiousness, and verbal fluency for openness). Greater openness predicted greater verbal fluency and greater RSFC between the PCC and eight clusters, including the medial prefrontal cortex, left middle frontal gyrus, and precuneus. Greater PCC–precuneus connectivity predicted greater verbal fluency. Neuroticism and conscientiousness did not significantly predict either cognitive performance or RSFC. Although requiring replication and elaboration, the results implicate openness as a contributing factor to cognitive aging via concomitant cognitive performance and connectivity within cortical hubs of the DMN and add to the sparse literature on these variables in a diverse group of older adults.
In the same spirit as the previous chapter, the present one endeavors to further contextualize the larger puzzle in which L3 morphosyntactic studies are located. In fact, it is important to understand the historical provenance of the theories and related empirical work within L3/Ln morphosyntax on which the remainder of the book will focus. In equal measure, it is important to keep abreast of the trends in the related fields of multilingual acquisition and processing, not only to be a well-rounded L3/Ln scholar but also to understand one’s own subarea better and to ensure the continuity of ideas via potential, when appropriate, cross-fertilization. Thus, before traveling down the road of L3/Ln morphosyntax and transfer studies from a formal linguistic perspective, it makes sense to recap what has been or is being done in the related fields of multilingual lexical processing and acquisition, as well as in phonology.
Verbal fluency tasks, in which participants generate words during a set time, have been used in research and assessments of neurobiological disorders and impairments. Research on verbal fluency in dyslexia has shown impaired performance in semantic and letter fluency. However, studies report inconsistent results, and action fluency has not been examined in dyslexia. Current research has mainly examined verbal fluency in relation to executive functions, vocabulary, and phonological processing. The present study examined performance on letter, semantic, and action fluency in relation to reading ability in 42 students in higher education, of which 16 had developmental dyslexia and 26 had typical reading development. It was examined if verbal fluency can predict variance in reading ability when group, phonological awareness, and rapid automatized naming are controlled for. Results showed impaired verbal fluency in the developmental dyslexia group. Action fluency and group were significant predictors of reading ability, together explaining 73% of the variance, in a backward elimination regression analysis. The results point to a possible, unique connection between action fluency and reading ability; this connection is discussed based on their neurocognitive underpinnings.
Objectives: Past research suggests that youth with sex chromosome aneuploidies (SCAs) present with verbal fluency deficits. However, most studies have focused on sex chromosome trisomies. Far less is known about sex chromosome tetrasomies and pentasomies. Thus, the current research sought to characterize verbal fluency performance among youth with sex chromosome trisomies, tetrasomies, and pentasomies by contrasting how performance varies as a function of extra X number and X versus Y status. Methods: Participants included 79 youth with SCAs and 42 typically developing controls matched on age, maternal education, and racial/ethnic background. Participants completed the phonemic and semantic conditions of a verbal fluency task and an abbreviated intelligence test. Results: Both supernumerary X and Y chromosomes were associated with verbal fluency deficits relative to controls. These impairments increased as a function of the number of extra X chromosomes, and the pattern of impairments on phonemic and semantic fluency differed for those with a supernumerary X versus Y chromosome. Whereas one supernumerary Y chromosome was associated with similar performance across fluency conditions, one supernumerary X chromosome was associated with relatively stronger semantic than phonemic fluency skills. Conclusions: Verbal fluency skills in youth with supernumerary X and Y chromosomes are impaired relative to controls. However, the degree of impairment varies across groups and task condition. Further research into the cognitive underpinnings of verbal fluency in youth with SCAs may provide insights into their verbal fluency deficits and help guide future treatments. (JINS, 2018, 24, 917–927)
Objectives: Deficits in semantic verbal fluency (SVF) can stem from dysfunction of an executive control system and/or of semantic knowledge. Previous analyses of SVF responses were devised to characterize these two components including switching and mean cluster size (MCS) indices, but these rely on subjective experimenter-based assessment of the words’ relatedness. To address this limitation, computational data-driven SVF indices have been developed. Our aim is to assess the validity and usefulness of these automated indices in the context of cognitive decline in Parkinson’s disease (PD). Methods: This is a retrospective study including 50 advanced PD patients with (n=28) or without (n=22) mild cognitive impairment (PD-MCI). We analyzed animal SVF outputs using an automated computational approach yielding switching, MCS, and cumulative relatedness (CuRel) indices. We compared these indices to the classic experimenter-based switching and MCS indices to assess concurrent validity, and against neuropsychological measures of executive functioning and semantic knowledge to assess construct validity. We also examined whether these indices were impaired and predicted PD-MCI. Results: Automated switching indices, but not MCS or CuRel, showed evidence of concurrent and construct validity, and characterized individual difference in advanced PD. Automated switching indices also outperformed the experimenter-dependent index in predicting the presence of PD-MCI. Conclusion: Computational methods hold promise as fine-grained, unbiased indices reflecting the executive component of SVF, but none of the methods provided valid measures of semantic knowledge in PD. Our data also confirm that SVF are not adequate tests of semantic memory in patients with executive dysfunction such as PD. (JINS, 2018, 24, 1047–1056)