From a public health standpoint, identifying factors that contribute to risky sexual practices among substance-dependent individuals is critical, particularly in the context of HIV infection. This study examines the respective contributions of executive neurocognitive functions, sensation seeking, and HIV serostatus in predicting risky sexual practices among poly-substance users (with a history of dependence primarily for cocaine or cocaine/heroin). HIV+ (n = 109) and HIV− (n = 154) substance-dependent individuals were assessed using three neurocognitive tasks of executive functions: Stroop reaction time, delayed non-matching to sample, and the Iowa Gambling Task. Sensation seeking was assessed using the Sensation Seeking Scale–V. Greater sensation seeking was associated with more risky sexual practices among HIV+ participants, particularly among those who performed best on the Iowa Gambling Task. Our findings indicate that continued risk behavior among HIV+ drug users may be driven by sensation seeking (a personality trait common among drug users); however, the impact of executive functions is less clear. (JINS, 2005, 11, 121–131.)

Patients with unilateral, right frontal lobe damage (N = 13) and matched controls (N = 20) performed a task of lexical ambiguity resolution in order to explore the contribution of right frontal regions to lexical-semantic priming. Word triplets consisting of balanced homographs were presented to participants in four conditions: concordant, discordant, neutral, and unrelated. Controls demonstrated facilitation for concordant meanings of homographs, as evidenced by their faster reaction times in the concordant relative to the unrelated (baseline) condition, as well as a lack of facilitation for the discordant meaning relative to the neutral and concordant conditions. Results in patients with right frontal lobe damage differed depending on the site of the lesion. Patients with lesions restricted to the right medial frontal lobe only showed facilitation in the neutral condition, while those with lesions encroaching upon the right dorsolateral region demonstrated facilitation of both discordant and concordant meanings relative to the baseline condition. These results support a role for the right frontal lobe in semantic priming and suggest possible specialization within the right prefrontal cortex for the processing of lexical-semantic information. (JINS, 2005, 11, 132–143.)

There is evidence that the prevention of errors during learning might be helpful in improving an impaired memory performance, both in amnesia as well as in normal age-related memory decline. Although errorless learning is a promising technique for use in rehabilitation practice, the underlying mechanisms are unclear. That is, it has been suggested that the beneficial effects of errorless learning operate through implicit memory, whereas others implicate that it is explicit memory that is responsible for the enhanced memory performance after errorless learning. The current study examined the contribution of implicit and explicit memory function to the memory performance after errorless and errorful learning using the process-dissociation procedure. A group of young adults (N = 40) was compared to a matched group of older individuals (N = 40) on a spatial memory task (i.e., learning the locations of everyday objects in a room). The results clearly show age-related decline in explicit spatial memory, while implicit spatial memory was unaffected. Furthermore, the young group benefited from errorless learning compared to errorful learning, while the older group did not show a difference between the two learning conditions. Also, it was found that the effects of errorful learning were related to explicit memory function, and not implicit processing, corroborating and extending recent findings. (JINS, 2005, 11, 144–151.)

It is unclear if the commonly observed “subcortical” verbal memory profile in schizophrenic patients is present at the onset of the disease. Therefore, the performance of 43 first-episode patients with schizophrenia or schizophreniform disorder on the Dutch version of the California Verbal Learning Test (VLGT) was compared to that of 43 normal comparison participants. We hypothesized that the first-episode patients would exhibit a “subcortical” memory profile, that is, they would show a primary retrieval deficit. This hypothesis was not confirmed: the patients displayed a profile suggestive of a prominent storage deficit, that is, a “cortical” memory profile. Subsequently, patients' VLGT performance was cluster analyzed to determine whether subgroups could be identified exhibiting a cortical, subcortical, and normal profile, respectively. Two subgroups (N = 22; N = 13) exhibited memory impairments, while one subgroup (N = 8) was unimpaired. The memory profiles of the two impaired subgroups differed both qualitatively and quantitatively, but did not conform neatly to a cortical and a subcortical profile. Demographic and verbal fluency data provided limited validation of the subgroup classification. Our results may suggest that combining the verbal memory performance of first-episode patients obscures meaningful heterogeneity. Alternatively, the cluster solution could merely reflect a continuum of severity. (JINS, 2005, 11, 152–162.)

Bipolar disorder (BPD) is a severe psychiatric illness that is characterized by episodes of extreme mood states. The affective components of bipolar disorder have been studied extensively, but only recently have investigators begun to systematically examine its cognitive concomitants. Although executive dysfunction has been reported in this population, especially while patients are manic, the tasks administered in many previous studies have made it difficult to determine the specific executive abilities that were compromised. The present study examined 15 patients with bipolar disorder who were manic, 18 who were euthymic, and 18 healthy participants. Tests were selected to evaluate two specific aspects of executive functioning in these participants. The Object Alternation Task was given as a measure of inhibitory control, and the Delayed Response Task was included as a measure of spatial delayed working memory. All groups performed similarly on the Delayed Response Task. On the Object Alternation Task, however, the manic and euthymic patients committed significantly more perseverative errors than healthy participants. These results indicated that patients in the present sample had relatively normal working memory abilities, but had a deficit in behavioral self-regulation, which was evident across mood states. (JINS, 2005, 11, 163–172.)Location of work: Center for Bipolar Disorders Research, Department of Psychiatry, University of Cincinnati School of Medicine, Cincinnati, Ohio.

The early assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) children has mainly focused on the behavioral, social, and pre-academic impairments. This study examined whether 5 to 6-year-old children at risk of ADHD are characterized by information-processing deficits. By screening 1,317 children in Southern Limburg (the Netherlands) with the Child Behavior Checklist, 363 were selected and underwent a computerized examination. Eighteen months later, standardized psychiatric information was obtained. Thirty-three ADHD children were compared with 75 borderline ADHD children, 122 pathological controls, and 133 healthy controls. ADHD and borderline ADHD children were slower and more variable in their processing speed on all tasks than children with no or other pathology. These differences were most pronounced for the divided and focused attention tasks. Furthermore, one measure of a state regulation deficit discriminated between groups. With regard to accuracy, only the proportion of misses on a go–no-go task was higher in the ADHD group than in the other groups. Evidence was found that ADHD is better seen as a continuum rather than a discrete category. Already at a young age, children at risk of ADHD show specific information-processing deficits. Deficits in time perception and/or energetic state control in children with ADHD may possibly account for subnormal task performance. (JINS, 2005, 11, 173–183.)

Covariance structure analyses of a core neuropsychological test battery consisting of the Wechsler Adult Intelligence Scale–Revised, Wechsler Memory Scale–Revised, and Auditory Verbal Learning Test have previously identified a 5-factor model in a sample of cognitively normal White volunteers from Mayo's Older Americans Normative Studies (MOANS). The present study sought to replicate this factor structure in a sample of 289 cognitively normal, community-dwelling African American elders from Mayo's Older African Americans Normative Studies (MOAANS). The original 5-factor model was tested against 2 alternative 4-factor models and a 6-factor model generated on a substantive basis. Confirmatory factor analysis supported the construct validity of this core battery in older African Americans by replicating the original 5-factor model of Verbal Comprehension, Perceptual Organization, Attention/Concentration, Learning, and Retention as viable in the present sample. (JINS, 2005, 11, 184–191.)

Norms for cognitive measures used to assess dementia are scant for minority groups, in particular for older Japanese Americans. Using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Neuropsychology Battery, we compared the baseline performance of demented and nondemented Japanese Americans. Participants came from two harmonized epidemiological studies of dementia which were examined separately: the Kame Project, Seattle (350 men and women; 201 nondemented), age 65 and older; Honolulu-Asia Aging Study (HAAS), Hawaii (418 men; 120 nondemented), age 71 and older. The measures examined were Verbal Fluency; abbreviated Boston Naming; constructional praxis; and Word List Learning, Recall, and Recognition. Within each study, the CERAD measures distinguished between nondemented participants and those with mild cognitive impairment. Among persons with dementia, average level of performance decreased as severity of dementia increased. Determinants of score (age, education, language of administration, stage of dementia) varied between the two studies. Among Japanese Americans, the CERAD Neuropsychology Battery distinguished nondemented persons from those with dementia, but was less consistent in distinguishing levels of severity of dementia. This battery is useful for comparative epidemiological studies of dementia in minority populations. (JINS, 2005, 11, 192–201.)

Schizophrenia is characterized by profound disturbances in cognition, emotion, and social functioning. Catechol-O-methyl transferase (COMT) is the important enzyme for the metabolism of monoamines, which play important part in the pathogenesis of schizophrenia. COMT exists in high and low activity forms. The low activity form was found to be an amino acid substitution (Val-108-Met), which reduces the thermostability of the enzyme. This genetic polymorphism has been reported to be associated with schizophrenia and its associated clinical features (Li et al., 1996).

Information processing speed and episodic memory are two commonly affected cognitive abilities in MS. Insights into the mechanisms of and relationships between these abilities have recently come from structural neuroimaging techniques, but few studies have used fluid-attenuated inversion recovery (FLAIR), a neuroimaging sequence known to be sensitive to cortical and juxtacortical lesions in MS. We hypothesized that a volumetric index of FLAIR total lesion volume (TLV) would be associated with slowed processing speed and verbal memory dysfunction in MS. Twenty MS patients underwent FLAIR imaging and were administered measures of verbal memory and processing speed. Correlational and regression analyses indicated that TLV was directly and independently related to measures of processing speed and verbal memory, and TLV accounted for 56% of the variance in cognitive performance. These findings, considered in the context of prior work, suggest that FLAIR TLV is a useful predictor of commonly impaired cognitive functions in MS, and shows promise as a functionally relevant biomarker for disease status. (JINS, 2005, 11, 205–209.)

Neuropsychological Assessment, Fourth Edition. Muriel D. Lezak, Diane B. Howieson, and David W. Loring, with H. Julia Hannay and Jill S. Fischer. 2004, New York: Oxford University Press. 1016 pp., $89.50 (HB).

When I was in my 3rd year of graduate school, I became interested in neuropsychology and purchased the first (1976) edition of Muriel Lezak's Neuropsychological Assessment to help prepare for my qualifying examination. It was the first neuropsychology book I ever owned and it was one of the few textbooks I have ever read from cover to cover. Neuropsychological Assessment is one of the classics in the field of clinical neuropsychology. It and the subsequent three editions of this classic have both reflected and shaped the field it represents. The book, often referred to as “Lezak,” is without question the most widely-consulted source on neuropsychological assessment as a clinical enterprise. The fourth edition continues in the great tradition of its predecessors, except that the sheer scope and magnitude of current work in neuropsychological assessment has now made an exhaustive and inclusive review of available tests impossible. As indicated in the preface, the revised goal of “Lezak IV” is to provide a “broad but necessarily and selectively restricted range of the information that is currently relevant and necessary for understanding and undertaking neuropsychological assessment.”

The Asymmetrical Brain. Kenneth Hugdahl and Richard J. Davidson (Eds.). 2003. Cambridge, MA: The MIT Press. 796 pp., $90.00.

One of the most fundamental questions in cognitive neuroscience relates to the biological basis of functional hemispheric specialization and the relationship of structure to function. These important and controversial concepts are reviewed in The Asymmetrical Brain. Drs. Hugdahl and Davidson have selected core topics discussed by an impressive group of internationally recognized experts. This text was originally conceived as an update to the 1995 book Brain Asymmetry edited by Hugdahl and Davidson, but this text offers a completely reorganized approach to the topic that is both timely and comprehensive within a narrow focus on specific neural systems and neural syndromes. This book will appeal to students and experts in the broader field of human cognitive neuroscience and should be required reading to anyone with an academic interest in cerebral laterality and human cognition. Indeed, the field has advanced since 1995, and this book will surely become a major impetus to future research advancement in brain laterality.

Mental and Behavioral Dysfunction in Movement Disorders. Marc-André Bédard, Yves Agid, Sylvain Chouinard, Stanley Fahn, Amos D. Korczyn, and Paul Lespérance (Eds.). 2003. Totowa, NH: Humana Press, Inc. 561 pp., $185.00 (HB).

Disorders having an impact on subcortical brain structures, such as Parkinson's disease, Huntington's disease, and progressive supranuclear palsy (to name a few), have long been known to disrupt basic motor functions. We have also come to understand, however, that these diseases result in cognitive and psychiatric alterations. Many of these cognitive and psychiatric changes are often unrelated to the motor abnormalities seen in these diseases, highlighting the multi-faceted processes mediated by different subcortical structures. In addition, these cognitive and behavioral changes can be more debilitating than the movement deficits experienced by these patients. Thus, it is imperative that clinicians further understand the characteristics of, and treatment options for, these types of symptoms. Further, our understanding of the mental and behavioral changes in these diseases has also informed us about the role of the subcortical brain structures (and their connections) in cognition and psychiatric functioning. From this work, it has become increasingly clear that frontal-subcortical pathways play an important (if not central) role in directing human activity.