This meta-analysis summarizes the broad spectrum of neuropsychological research on HIV disease across a sample of 41 primary studies and an aggregate of 8,616 participants for 10 major neuropsychological ability areas. Analyses of the course of cognitive decline within and across Centers for Disease Control classifications reveals statistically significant cognitive deficits from asymptomatic HIV to AIDS. Effect sizes (Cohen, 1988) were calculated to reflect between-group (asymptomatic, symptomatic, AIDS) differences in each neuropsychological domain. Relatively small effect sizes were obtained for the asymptomatic (0.05–0.21) patients, and generally small to moderate effect sizes were obtained for symptomatic (0.18–0.65) HIV+ patients, with motor functioning exhibiting the greatest effects in this later disease stage. The most notable deficits in cognitive functioning were found in the AIDS group with moderate (attention and concentration) to large (motor functioning) effect sizes with values ranging from 0.42–0.82. Comparison of cognitive functioning as a function of disease progression revealed that motor functioning, executive skills, and information processing speed were among the cognitive domains showing the greatest decline from early to later stages of HIV. These findings indicate that cognitive deficits in the early stages of HIV are small and increase in the later phases of the illness, and that specific patterns of cognitive deficits can be detected with disease progression. These results and their clinical utility are further discussed. (JINS, 2002, 8, 410–424.)

We examined asymmetry of hippocampal volume as well as other temporal lobe structures (temporal lobe, temporal horn of the lateral ventricular system, parahippocampal and fusiform gyri) in 194 subjects from the Cache County, Utah study, with varying disorders [85 with Alzheimer's disease (AD), 59 with some cognitive or neuropsychiatric disorder—referenced as a Mixed Neuropsychiatric group, 30 with mild ambiguous/mild cognitive impairment (MA/MCI) and 20 controls] and APOE genotypes. Asymmetry was determined by subtracting left-side volume from the right corrected by total intracranial volume. No significant asymmetry was observed to be associated with presence of the ε4 allele. Since the AD-ε4 allele risk effect may be expressed early in the course of the disorder, we also examined asymmetry indices in AD, MA/MCI and Mixed Neuropsychiatric subjects early in the course of their disorder (2 years or less) to those with longer duration illness (greater than 2 years). We observed a leftward asymmetry (i.e., left side larger) regardless of APOE genotype in hippocampal volume where both AD and MCI subjects demonstrated a leftward shift in hippocampal size when length of disease (LOD) was less but not more than 2 years. Leftward asymmetry was not associated with LOD in the Mixed Neuropsychiatric group. These findings do not support an association between ε4 and hippocampal asymmetry in dementia. We also examined whether asymmetry influenced neuropsychological performance, but minimal effects were observed. Where significance or strong trends were observed, better neuropsychological performance was associated with larger parenchymal volume of temporal lobe structures. These findings were interpreted as representing cognitive reserve effects where larger volume was protective against impairment. The role of asymmetry research in understanding neuropsychological performance in dementia is discussed. (JINS, 2002, 8, 925–933.)

Children with hydrocephalus have poor math skills. We investigated the nature of their arithmetic computation errors by comparing written subtraction errors in good readers with hydrocephalus, typically developing good readers of the same age, and younger children matched for math level to the children with hydrocephalus. Children with hydrocephalus made more procedural errors (although not more fact retrieval or visual–spatial errors) than age-matched controls; they made the same number of procedural errors as younger, math-level matched children. We also investigated a broad range of math abilities, and found that children with hydrocephalus performed more poorly than age-matched controls on tests of geometry and applied math skills such as estimation and problem solving. Computation deficits in children with hydrocephalus reflect delayed development of procedural knowledge. Problems in specific math domains such as geometry and applied math, were associated with deficits in constituent cognitive skills such as visual spatial competence, memory, and general knowledge. (JINS, 2002, 8, 72–82.)

The present study examined the serial position effect in 2 subgroups of individuals with vascular dementia (VaD). Nineteen individuals with mild VaD and 17 individuals with moderate VaD were administered the California Verbal Learning Test. Both groups were impaired on a general memory measure, and the moderately impaired group demonstrated significantly poorer recall than the mildly impaired group on the first learning trial and on total learning across trials. In addition, individuals with mild dementia demonstrated an intact primacy and recency effect, whereas individuals with moderate dementia demonstrated neither primacy nor recency effects. The latter findings are consistent with studies examining the serial position effect in other dementia populations, and suggests that the absence of primacy and recency effects in more advanced dementia may occur regardless of dementia type. (JINS, 2002, 8, 584–587.)

A Stroop negative priming (NP) task was used to assess immediate selective attention and priming in schizophrenia and schizoaffective disorder. Subject groups were comprised of 12 state hospital inpatients (41.8 ± 7.5 years of age), 11 outpatients (39.8 ± 7.5 years of age), and 16 controls (36.4 ± 11.7 years of age). Compared with the control group and the outpatients, inpatients failed to exhibit NP [F(2,36) = 6.09, p < .01], despite exhibiting equivalent Stroop RT interference (p > .05). Error rates did not differ significantly between the 3 groups. Although medication types and dosages were similar between the 2 patient groups, length of illness was significantly longer in the inpatients (19.8 years) than in the outpatients (12.4 years; p < .05). Positive symptom ratings were also significantly higher in the inpatients. The finding of reduced NP in the state hospital patients appears to be related to severity of symptomatology and chronicity of illness. (JINS, 2002, 8, 794–803.)

In this retrospective cohort study we examined the independent and interactive effects of drinking and smoking on cognition in a sample of 3361 males, ages 31 to 49, with varying lifetime histories of alcohol and cigarette use. Dependent variables were neuropsychological measures of global and specific cognitive abilities. Comparison of the ability scores of seven groups, defined by their drinking and smoking histories, explained only 5.4% of the multivariate variance in cognitive ability and less than 2% in any individual cognitive measure. Regression analyses for current drinkers and smokers showed only a single significant, but negligible, effect of pack-years of smoking on a measure of global cognitive ability. Differences in cognitive function in groups defined by intensity of alcohol and cigarette use revealed no significant effect for drinking and a significant, but very small, effect for smoking.

The aim of this study was to examine the associations of apolipoprotein E (APOE) genotype, metabolic changes in the posterior cingulate detected by 1H magnetic resonance spectroscopy (MRS), and neuropsychologic measures of memory and cognition both in normally aging elderly, and in patients with mild cognitive impairment (MCI) and AD. We studied 67 controls, 18 MCI and 33 AD patients. We used the Dementia Rating Scale total score (DRSTOT) as a measure of general cognitive function and the total learning from the Auditory Verbal Learning Test (AVTOT) as a measure of memory performance. No differences were noted on 1H-MRS metabolite ratios or cognitive measures across APOE genotype within control and patient groups. In controls, age was a significant predictor of both cognitive test scores, and NAA/Cr was a univariate associate of DRSTOT. All 3 1H-MRS metabolite ratios, N-acetylaspartate (NAA)/creatine (Cr), myoinositol (MI)/Cr, and NAA/MI, were univariate associates of AVTOT and DRSTOT scores in the combined MCI and AD group. In stepwise regression analyses in the combined patient group only NAA/MI entered the models. These data suggest NAA/Cr could be a modest predictor of general cognitive function in both healthy elderly and impaired patients, while MI/Cr is a more specific marker for neuropsychologic dysfunction associated with neurodegenerative disease. Among 1H-MRS measurements, the NAA/MI ratio maybe the most efficient predictor of memory and cognitive function in patients with MCI and AD. (JINS, 2002, 8, 934–942.)

We investigated sex difference across a number of olfactory tasks. Thirty-six men and 35 women ranging in age from 19 to 36 years were assessed in 6 different tasks: absolute sensitivity for n-butanol, intensity discrimination, quality discrimination, episodic recognition memory for familiar and unfamiliar odors, and odor identification. No sex differences were observed in the tasks tapping primarily sensory acuity (i.e., odor sensitivity, intensity discrimination, and quality discrimination) or in episodic memory for unfamiliar odors. By contrast, women outperformed men in the tasks involving verbal processing (i.e., memory for familiar odors and odor identification). Interestingly, controlling for odor naming ability resulted in that the observed sex difference in episodic odor memory for familiar odors disappeared. This outcome suggests that women's superiority in episodic odor memory is largely mediated by their higher proficiency in odor identification.

Deficits on tasks requiring semantic memory in Alzheimer's disease (AD) may be due to storage loss, a retrieval deficit, or both. To address this question, we administered multiple tasks involving 9 exemplars of the category “animals,” presented as both words and pictures, to 12 AD patients and 12 nondemented individuals. Participants made semantic judgments by class (sorting task), similarity (triadic comparison task), and dimensional attributes (ordering task). Relative to control participants, AD patients were impaired on an unstructured sorting task, but did not differ on a constrained sorting task. On the triadic comparison task, the patients were as likely to make judgments based on size as domesticity attributes, whereas control participants made judgments based primarily on domesticity. The patients' judgments were also less consistent across tasks than those of control participants. On the ordering tasks, performance was generally comparable between groups with pictures but not words, suggesting that pictures enable AD patients to access information from semantic memory that is less accessible with lexical stimuli. These results suggest that AD patients' semantic judgments are impaired when the retrieval context is unstructured, but perform normally under supportive retrieval conditions. (JINS, 2002, 8, 83–94.)

There is little longitudinal data examining outcome of pediatric near-drowning. Most literature tracks status 5 years or less post insult, focusing primarily on gross neurologic status as opposed to more subtle neurocognitive deficits. The present case tracks the neuropsychological profile of a child who was submerged for 66 min, the longest time documented. Acute medical support was aggressive, and recovery was dramatic, being featured in multiple media reports. Although an article published 6 years after the near-drowning described the child as “recovering completely,” the longitudinal profile indicates a pronounced pattern of broad cognitive difficulties, particularly notable for global memory impairment. Neuropsychological test results were significant despite the fact that the patient's recent MRI and MEG were within normal limits. This case demonstrates the need for long-term neuropsychological follow-up of pediatric patients with histories of neurologic injury, as gross neurological examination and MRI and MEG scans may not reveal underlying brain dysfunction. (JINS, 2002, 8, 588–595.)

When required to locate places on outline maps, males consistently perform more accurately than females. This sex difference in geographical knowledge has been observed in samples throughout the United States, in all age ranges examined from the second to the 9th decade of life and in samples differing in average education level from high school to postgraduate degrees. Both males and females appear to acquire geographical knowledge during surface travel through the environment. The information acquired during everyday travel is apparently integrated into topographic representations that comprise a cognitive map. This process is less efficient in females probably because they attend to and remember more about landmarks and less about distance and directional cues than do males. To examine the importance of driving experience on the ability to locate places on an outline map of the Oklahoma City metropolitan area, adolescents who were too young to drive and older persons with varying amounts of experience traveling in the metropolitan area were studied. In the present study the magnitude of the sex difference in accuracy, though not the absolute level of performance, was similar in groups of people too young to drive and in younger and older drivers. Hence, the sex difference in geographical knowledge cannot be the product of differences in driving that may exist between males and females. (JINS, 2002, 8, 804–810.)

The original California Verbal Learning Test (CVLT) employed a semantic clustering index that used the words recalled during a given trial as the baseline for calculating expected values of chance clustering (recall-based expectancy). Although commonly used in cognitive psychology, clustering indices that use recall-based calculations of expectancy are implied by the assumption that organizational processes do not occur until after words are retrieved from memory. This assumption contradicts the generally held assumptions among neuropsychologists that (1) organization is an antecedent to recall, and (2) increases in the use of organizational strategies will result in better recall performance. After reviewing a brief history of clustering metrics, we used Monte Carlo simulations, informative examples, and patient data to examine clustering indices that use the word list as a baseline for calculating expectancy and propose these list-based expectancy measures as a refinement of the clustering indices used on the original CVLT. These indices are used on the recently published CVLT–II. (JINS, 2002, 8, 425–435.)

Alzheimer's disease—occurring upward of 15% of individuals age 65 and older—is the most prevalent age-related dementia. Since the late 1970s, neuropsychologists have been instrumental in identifying patterns of sparing and impairment of cognitive, sensory, and motor functions and rates of declines in selective functions. Anyone who has engaged in longitudinal study of AD and anyone of that large segment of the population with relatives suffering with AD has witnessed first-hand the relentless, irreversible demise of function and ultimate loss of dignity characteristic of AD's course. The approach of Scinto and Daffner's edited book, Early Diagnosis of Alzheimer's Disease, avoids rehashing the already established descriptions of AD and provides firm, scientific rationale for the meaningfulness of early and accurate diagnosis of AD despite its current dire prognosis and lack of effective medical treatment.

The objective of this study was to examine the independent and interactive effects of lifetime patterns of drinking and smoking on cognitive performance in the elderly. A sample of 395 individuals with varying histories of alcohol and cigarette use was drawn from the Charlotte County Healthy Aging Study, a community-based, cross-sectional study of randomly selected older adults of age 60 to 84. Dependent variables were the results of a neuropsychological battery that provided measures of general cognitive ability, executive function, and memory. Specifically, we examined (1) differences in performance among groups of abstainers, drinkers, and smokers, (2) the effects of lifetime drinking and smoking dose on cognition within the group of users, and (3) the effects of intensity of drinking and smoking on cognition. Potential methodological confounds, such as age, education, and medical history, were controlled by means of sampling and covariance procedures. Analyses failed to provide evidence for a beneficial J-curve or threshold effect for drinking, but did not reveal any detrimental effect. No detrimental effect of smoking was found in any analysis; nor was there any evidence of an interaction between alcohol and cigarette use on any cognitive measure. (JINS, 2002, 8, 811–818.)

The present study was designed to examine the impact of neuropsychological performance on the relationships between stress, social support, and depression in 217 HIV-infected men. Using path analysis, the contributions of four domains of cognitive functioning (memory, attention, executive function, and psychomotor speed), IQ, and relevant psychosocial variables to depression were evaluated. In the model which best fit the data, cognitive domains did not contribute directly to depression, but contributed significantly to psychosocial variables which affected levels of depression. Attention and executive function contributed to reduced illness-related disability; while higher IQ was associated with fewer stressful life events. Number of stressful life events and level of illness-related disability were associated with depressive symptoms. Higher IQ led to greater numbers of social contacts, which was associated with fewer reported symptoms of depression. These findings suggest that better neuropsychological performance may lead to reduced stress and perceived disability, and more available social contacts. By these multiple paths, different domains of cognitive ability contribute indirectly to ameliorating depression in HIV-infected men. (JINS, 2002, 8, 436–447.)

In this paper, we present a review of semantic priming experiments in schizophrenia. Semantic priming paradigms show utility in assessing the role of deficits in semantic memory network access in the pathology of schizophrenia. The studies are placed in the context of current models of information processing. In this review we include all English-language reports (from peer-reviewed journals) of single-word semantic priming studies involving participants with schizophrenia. The studies to date show schizophrenic patients to exhibit variable semantic priming effects under automatic processing conditions, and consistent impairments under controlled0attentional conditions. We also describe associations with other neurocognitive dysfunction, neurochemical and electrophysiological disturbances, and clinical manifestations (such as thought disorder).

Children with spina bifida and hydrocephalus (SBH) have long been known to have difficulties with visual perception. We studied how children with SBH perform 12 visual perception tasks requiring object identification, multistable representations of visual space, or visually guided overt actions. Four tasks required object-based processing (visual constancy illusions, face recognition, recognition of fragmented objects, line orientation). Four tasks required the representation of visual space in egocentric coordinates (stereopsis, visual figure-ground identification, perception of multistable figures, egocentric mental rotation). Four tasks required the coupling of visual space to overt movement (visual pursuit, figure drawing, visually guided route finding, visually guided route planning). Effect sizes, measuring the magnitude of the difference between SBH children and controls, were consistently larger for action-based than object-based visual perception tasks. Within action-based tasks, effect sizes were large and roughly comparable for tasks requiring the representation of visual space and for tasks requiring visually guided action. The results are discussed in terms of the physical and brain problems of children with SBH that limit their ability to build effective situation models of space. (JINS, 2002, 8, 95–106.)

A subtle decline in episodic memory often occurs prior to the emergence of the full dementia syndrome in nondemented older adults who develop Alzheimer's disease (AD). The APOE-ε4 genotype may engender a more virulent form of AD that hastens this decline. To examine this possibility, we compared the rate of decline in episodic memory during the preclinical phase of AD in individuals with or without at least one APOE ε4 allele. Nondemented normal control (NC; n = 84) participants, nondemented older adults who subsequently developed dementia within 1 or 2 years (i.e., preclinical AD; n = 20), and patients with mild AD (n = 53) were examined with 2 commonly employed tests of episodic memory, the Logical Memory subtest of the Wechsler Memory Scale–Revised and the California Verbal Learning Test. Results revealed a precipitous decline in verbal memory abilities 1 to 2 years prior to the onset of the dementia syndrome, but there was little effect of APOE genotype on the rate of this memory decline. The presence of an APOE-ε4 allele, however, did have a differential effect on the sensitivity of the 2 types of memory tests for tracking progression and made an independent contribution to the prediction of conversion to AD. (JINS, 2002, 8, 943–955.)

The idea of reserve against brain damage stems from the repeated observation that there does not appear to be a direct relationship between the degree of brain pathology or brain damage and the clinical manifestation of that damage. This paper attempts to develop a coherent theoretical account of reserve. One convenient subdivision of reserve models revolves around whether they envision reserve as a passive process, such as in brain reserve or threshold, or see the brain as actively attempting to cope with or compensate for pathology, as in cognitive reserve. Cognitive reserve may be based on more efficient utilization of brain networks or of enhanced ability to recruit alternate brain networks as needed. A distinction is suggested between reserve, the ability to optimize or maximize normal performance, and compensation, an attempt to maximize performance in the face of brain damage by using brain structures or networks not engaged when the brain is not damaged. Epidemiologic and imaging data that help to develop and support the concept of reserve are presented. (JINS, 2002, 8, 448–460.)

The aim of this study was to analyze the performance of Spanish–English bilinguals on the Golden Stroop Test. The effects of bilingualism, participants' age, age of acquisition of the second language, and proficiency in each language were analyzed. Participants consisted of 71 Spanish–English bilinguals, 40 English monolinguals, and 11 Spanish monolinguals from South Florida. Proficiency in Spanish and English was established using a self-report questionnaire and the English and Spanish versions of the Boston Naming Test. In bilinguals, the Golden Stroop Test was administered in English and in Spanish. Overall, performance was slower in bilinguals than in monolinguals. No significant differences were observed in color reading but bilinguals performed worse in the naming color condition. Even though bilinguals were 5% to 10% slower in the color–word condition, one-way ANOVAs revealed no statistically significant differences between groups. Within the bilingual group, the Stroop Test scores were similar in both English and Spanish. Age of acquisition of the second language did not predict the Stroop Test performance. Repeated measures ANOVA demonstrated a significant interaction between Language Proficiency × Language (in which the test was administered) in some of the ST conditions. In balanced bilinguals, the language used in the ST did not matter, but in unbalanced subjects, the best-spoken language showed better results. In addition, our results support the presence of both between- and within-language interference in Spanish–English bilinguals. Different conceptualization models of the structure of bilingual memory are disclosed. (JINS, 2002, 8, 819–827.)