This study examines rates of reporting of new or worse post-traumatic symptoms for patients with a broad range of injury severity at 1 month and 1 year after traumatic brain injury (TBI), as compared with those whose injury spared the head, and assesses variables related to symptom reporting at 1 year post-injury. Seven hundred thirty two TBI subjects and 120 general trauma comparison (TC) subjects provided new or worse symptom information at 1 month and/or 1 year post-injury. Symptom reporting at 1 year post-injury was compared in subgroups based on basic demographics, preexisting conditions, and severity of brain injury. The TBI group reported significantly more symptoms at 1 month and 1 year after injury than TCs (each p < .001). Although symptom endorsement declined from 1 month to 1 year, 53% of people with TBI and 24% of TC continued to report 3 or more symptoms at 1 year post-injury. Symptom reporting in the TBI group was significantly related to age, gender, preinjury alcohol abuse, pre-injury psychiatric history, and severity of TBI. Symptom reporting is common following a traumatic injury and continues to be experienced by a substantial number of TBI subjects of all severity levels at 1 year post-injury. (JINS, 2010, 16, 401–411.)

Previous studies have consistently reported age-related changes in cognitive abilities and brain structure. Previous studies also suggest compensatory roles for specialized training, skill, and years of education in the age-related decline of cognitive function. The Stanford/VA Aviation Study examines the influence of specialized training and skill level (expertise) on age-related changes in cognition and brain structure. This preliminary report examines the effect of aviation expertise, years of education, age, and brain size on flight simulator performance in pilots aged 45–68 years. Fifty-one pilots were studied with structural magnetic resonance imaging, flight simulator, and processing speed tasks. There were significant main effects of age (p < .01) and expertise (p < .01), but not of whole brain size (p > .1) or education (p > .1), on flight simulator performance. However, even though age and brain size were correlated (r = −0.41), age differences in flight simulator performance were not explained by brain size. Both aviation expertise and education were involved in an interaction with brain size in predicting flight simulator performance (p < .05). These results point to the importance of examining measures of expertise and their interactions to assess age-related cognitive changes. (JINS, 2010, 16, 412–423.)

Healthy participants (n = 237) aged 45–79 were tested neuropsychologically with tests of memory, speed, and cognitive control and followed up for 3–5 years (mean, 3.4 years). The sample was genotyped for apolipoprotein E (APOE) and CHolinergic Receptor for Nicotine Alpha 4 (CHRNA4), and genetic effects on cognitive function at initial testing and on cognitive decline was studied. We predicted relatively stronger effects of APOE on memory, and of CHRNA4 on speeded tasks. The predictions were partially confirmed, but we found interactive effects of APOE and CHRNA4 in several cognitive domains. Being an APOE ε4/CHRNA4 TT carrier was associated with slower and less efficient performance, and with steeper decline in speed tasks and in delayed recall. Age dependent genetic effects were found for both APOE and CHRNA4, where old participants (60–79 years) showed a negative influence of TT carrier status on initial memory performance, but a tendency for steeper memory decline in ε4 carriers. Inconsistent and small effects of APOE reported in previous studies of healthy groups may be caused by failure to consider epistasis of APOE with nicotinic receptor and other genes. (JINS, 2010, 16, 424–432.)

Theories of lexical processing differ as to how multimorphemic words, such as compounds, are mentally processed. The most recent findings seem to support the dual route hypothesis, which assumes that complex words can be stored and retrieved either whole or by decomposition into their constituents. Despite great efforts to investigate the cognitive mechanisms involved in processing complex words, very little is known about how compounds are represented in the brain. The present study was designed to address this issue in a group of 20 left-hemispheric stroke patients who were submitted to four picture-naming tasks involving nouns, verbs, noun-noun (NN) and verb-noun (VN) compounds. To determine the brain lesions implicated in these tasks, we analyzed patients’ performances together with their lesions using Voxel-based Lesion Symptom Mapping (VLSM). Results showed that while NN involved the same temporal areas as nouns, VN (although they belong to the noun category) involved different fronto-temporal regions. This latter finding is discussed within the view that distinct mechanisms process the different constituents of complex words. (JINS, 2010, 16, 433–442.)

Very few attempts have been made to apply a mathematical model to the learning curve in the California Verbal Learning Test list A immediate recall. Our rationale was to find out whether modeling of the learning curve can add additional information to the standard CVLT-II measures. We applied a standard transfer function in the form Y = B3*exp(-B2*(X-1))+B4*(1-exp(-B2*(X-1))), where X is the trial number; Y is the number of recalled correct words, B2 is the learning rate, B3 is readiness to learn and B4 is ability to learn. The coefficients of the model were found to be independent measures not duplicating standard CVLT-II measures. Regression analysis revealed that readiness to learn (B3) and ability to learn (B4) were significantly (p < .05) higher in a group of healthy participants than in a group of participants with type 2 diabetes mellitus (T2DM), but the learning rate (B2) did not differ (p > .2). The proposed model is appropriate for clinical application and as a guide for research and may be used as a good supplemental tool for the CVLT-II and similar memory tests. (JINS, 2010, 16, 443–452.)

Lhermitte (1983) coined the term “utilization behavior” (UB) to define a neurobehavioral syndrome in which the visuo-tactile presentation of objects compels patients to grasp and use them, despite the fact that they have not been instructed to do so. The author suggested that UB was the consequence of frontal lobe damage. Thereafter, Shallice, Burgess, Schon, and Baxter (1989) questioned Lhermitte’s (1983) procedure for eliciting UB, putting forward an alternative research methodology that led to differentiate two forms of UB: “induced” and “incidental.” To date, there has been no direct comparison between these two procedures, nor have any other methodologies been used to explore this clinical sign, which is related to fundamental concepts such as free will and human autonomy. We investigated UB in 70 subjects (25 patients with frontal lobe lesions, 10 patients with posterior brain damage and 35 control subjects) using the methodologies of Lhermitte (1983) and Shallice et al. (1989), as well as an original “verbal generation” procedure. Our results show that the verbal generation procedure reveals UB efficiently and that elicitation of this sign appears to be directly linked to the content of the task. We discuss the interpretation of UB in terms of an executive control deficit. (JINS, 2010, 16, 453–462.)

Impaired insight for deficits (anosognosia) is common in Alzheimer’s disease (AD). However, it has not yet been determined clearly (a) whether different methods for assessing insight are comparable, and (b) whether anosognosia affects different domains to different degrees (domain-specificity). Impaired insight was investigated in 32 patients with AD, who were each accompanied by a caregiver. Anosognosia was assessed by a global clinical rating, questionnaire discrepancies (patient vs. caregiver) covering different domains, and performance discrepancies (self-assessment vs. performance) based on four neuropsychological tests which were compared with those of a healthy control sample. The results of clinical rating and questionnaire discrepancies were closely correlated, but performance discrepancies showed no association with the other methods. Anosognosia was present in the majority of the sample, and occurred across domains. The domains corresponding to core deficits in AD (recent memory, activities of daily living) appeared especially prone to anosognosia. However, results do not suggest that anosognosia itself is domain-specific. Rather, it appears that insight may be invariant, while differences in patient-caregiver discrepancies arise largely from different degrees of deficit across domains. (JINS, 2010, 16, 463–473.)

Facial emotion recognition deficits have been widely investigated in individuals with schizophrenia; however, it remains unclear whether these deficits reflect a trait-like vulnerability to schizophrenia pathology present in individuals at risk for the disorder. Although some studies have investigated emotion recognition in this population, findings have been mixed. The current study uses a well-validated emotion recognition task, a relatively large sample, and examines the relationship between emotion recognition, symptoms, and overall life quality. Eighty-nine individuals with psychometrically defined schizotypy and 27 controls completed the Schizotypal Personality Questionnaire, Penn Emotion Recognition Test, and a brief version of Lehman’s Quality of Life Interview. In addition to labeling facial emotions, participants rated the valence of faces using a Likert rating scale. Individuals with schizotypy were significantly less accurate than controls when labeling emotional faces, particularly neutral faces. Within the schizotypy sample, both disorganization symptoms and lower quality of life were associated with a bias toward perceiving facial expressions as more negative. Our results support previous research suggesting that poor emotion recognition is associated with vulnerability to psychosis. Although emotion recognition appears unrelated to symptoms, it probably operates by means of different processes in those with particular types of symptoms. (JINS, 2010, 16, 474–483.)

This study evaluated the impact of distractor objects and their similarity to target objects on everyday task performance in dementia. Twenty participants with dementia due to Alzheimer’s disease (n = 12) or subcortical vascular disease (n = 8) were videotaped while they performed 3 discrete tasks: (1) make a cup of coffee, (2) wrap a gift, and (3) pack a lunch under two conditions that were counterbalanced across participants. The conditions differed in terms of the type of distractor objects included in the workspace: (1) Target-Related Distractor Condition - distractor objects were functionally and visually similar to target objects (e.g., salt for sugar) (2) Unrelated Distractor Condition - distractors were neither visually nor functionally similar to targets (e.g., glue for sugar). Participants touched (t = 4.19; p < .01) and used (z = 3.00; p < .01) significantly more distractors, made more distractor errors (i.e., substitutions; t = 2.93; p < .01), and took longer to complete tasks (t = 2.27; p < .05) in the Target-Related Distractor condition. The percent of steps accomplished and non-distractor errors did not differ across conditions (t < 1.26; p > .05 for both). In summary, distractors that were similar to targets elicited significant interference effects circumscribed to object selection. (JINS, 2010, 16, 484–494.)

The Behavior Rating Inventory of Executive Function (BRIEF) is commonly used in the assessment of children and adolescents presenting with a wide range of concerns. It is unclear, however, whether the questionnaire is more closely related to general measures of behavioral disruption and impairment or to specific measures of executive function. In the present study, associations between the Behavioral Regulation Index and Metacognition Index of the BRIEF and cognitive, behavioral, and academic measures were examined in a sample of clinic-referred youth (n = 60) and healthy youth (n = 37) 6–15 years of age. Measures included ratings of inattentive and hyperactive-impulsive symptoms in youth, ratings of how well youth functioned in their everyday environments, youth’s scores on measures of reading and math, and youth’s scores on measures of inhibition, performance monitoring, and working memory. Although both BRIEF indices were strongly related to parent and teacher ratings of behavioral disruption and impairment, neither was associated with youth’s scores on the performance-based tasks of executive function. These findings support the use of the BRIEF as a clinical tool for assessing a broad range of concerns, but raise questions about the relation of the BRIEF to performance-based tasks that are commonly used to assess executive function. (JINS, 2010, 16, 495–505.)

Following mild traumatic brain injury (TBI), a percentage of individuals report chronic memory and attention difficulties. Traditional neuropsychological assessments often fail to find evidence for such complaints. We hypothesized that mild TBI patients may, in fact, experience subtle cognitive deficits that reflect diminished initial acquisition that can be explained by changes in cerebral white matter microstructure. In the data presented here, a sample of nonlitigating and gainfully employed mild TBI patients demonstrated statistically significant differences from age and education matched control participants in performance on the first trial of a verbal learning task. Performance on this trial was associated with reduced fractional anisotropy in the uncinate fasciculus and the superior longitudinal fasciculus providing an anatomical correlate for the cognitive findings. Mild TBI patients were not impaired relative to control participants on total learning or memory composite variables. Performance on the first learning trial was not related to any psychological variables including mood. We concluded that patients with mild TBI demonstrate diminished verbal learning that is not often interpreted in standard neuropsychological assessment. (JINS, 2010, 16, 506–516.)

Spina bifida meningomyelocele (SBM) is a neurodevelopmental disorder associated with intact word decoding and deficient text and discourse comprehension. This study investigated the ability to adjust reading in accordance with specified reading goals in 79 children and adolescents with SBM (9–19 years of age) and 39 controls (8–17 years of age). Both groups demonstrated slower reading times and enhanced comprehension when reading to study or to come up with a title than when reading for specific information or for entertainment. For both groups, verbal working memory contributed to comprehension performance in those reading conditions hypothesized to require more cognitive effort. Despite their sensitivity to the goals of reading, the group with SBM answered fewer comprehension questions correctly across all reading goal conditions. The results are discussed in relation to the hypothesized cognitive underpinnings of comprehension deficits in SBM and to current models of text comprehension. (JINS, 2010, 16, 517–525.)

The cerebellar hypothesis of dyslexia posits that cerebellar deficits are associated with reading disabilities and may explain why some individuals with reading disabilities fail to respond to reading interventions. We tested these hypotheses in a sample of children who participated in a grade 1 reading intervention study (n = 174) and a group of typically achieving children (n = 62). At posttest, children were classified as adequately responding to the intervention (n = 82), inadequately responding with decoding and fluency deficits (n = 36), or inadequately responding with only fluency deficits (n = 56). Based on the Bead Threading and Postural Stability subtests from the Dyslexia Screening Test-Junior, we found little evidence that assessments of cerebellar functions were associated with academic performance or responder status. In addition, we did not find evidence supporting the hypothesis that cerebellar deficits are more prominent for poor readers with “specific” reading disabilities (i.e., with discrepancies relative to IQ) than for poor readers with reading scores consistent with IQ. In contrast, measures of phonological awareness, rapid naming, and vocabulary were strongly associated with responder status and academic outcomes. These results add to accumulating evidence that fails to associate cerebellar functions with reading difficulties. (JINS, 2010, 16, 526–536.)

The Common Objects Memory Test (COMT) was developed to assess age-related memory impairments in individuals with a range of educational, language and cultural backgrounds. The COMT is a list-learning protocol that uses photographs of common objects to bypass difficulties posed by written words for individuals who are illiterate or have limited education. Preliminary data are presented for 336 healthy adults and 90 patients with dementia. Their age ranged from 54 to 99 years, education ranged from 0 to 22 years, and they were from five culturally and linguistically distinct populations: Caucasian and African-American English speakers, and native Chinese, Spanish, and Vietnamese speakers. Performance on the COMT was influenced by age, but little influenced by education, and un-influenced by gender or ethnic background. Among 11 neuropsychological tests, the recall scores from the COMT best distinguished healthy individuals from patients with dementia, underscoring its clinical utility for ethnically diverse populations. (JINS, 2010, 16, 537–545.)

Autonoetic consciousness refers to the ability to mentally transport oneself back in subjective time to relive elements of, or all, of a past event, and is compromised in the early stages of Alzheimer’s disease (AD). Here, we investigate autobiographical memory (ABM) and the recollective experience in amnestic mild cognitive impairment (aMCI). aMCI participants exhibited significant deficits compared with healthy elderly controls for both personal semantic and event detail components of ABM. These decrements were evident across all life epochs for episodic recall. Recall of an event that occurred 1 week previously, was tested in the same spatiotemporal context, and provided the greatest group dissociation, with elderly controls benefitting from a context-dependent memory effect. This reinstantiation of context did not ameliorate the anterograde deficits in the aMCI cohort, nor did it facilitate the mental reliving of these memories for either participant group. Whereas reliving judgments were comparable in both groups, aMCI participants exhibited a compromised capacity to generate vivid, self-referential visual imagery and to re-experience the original emotion of events. These contextual and experiential deficits extended beyond recently encountered events into remote epochs, and suggest a greater level of ABM impairment in aMCI than previously assumed. (JINS, 2010, 16, 546–555.)

The most common cognitive complaint reported by healthy older adults and young adults with traumatic brain injury (TBI) is memory difficulties. We investigated the effects of normal aging and the long-term effects of TBI in young adults on the susceptibility to incorrectly endorse distracter information on a memory test. Prior to a study phase, participants viewed a “pre-exposure” list containing distracter words, presented once or three times, and half of the target study words. Subsequently, during the study phase, all target words were presented such that, across lists, study words were viewed either once or three times. On the recognition test, TBI and older adult participants were more likely to falsely endorse “pre-exposed” distracter words viewed three times as being from the target study list, compared to non-head-injured young controls. Normal aging and head injury in young may similarly compromise one’s ability to reject highly familiar, but distracting, information during recognition. Older adult and TBI participants were also slower to complete the Trail Making task and had poorer output on a Digit Span task, suggesting these two populations share a deficit in executive function and working memory. Similar changes in frontal lobe function may underlie these shared cognitive deficits. (JINS, 2010, 16, 556–565.)

We sought to elucidate the existence of neuropsychological subtypes in Complex Regional Pain Syndrome (CRPS). One hundred thirty seven patients with CRPS were administered tests that assess executive control, naming/lexical retrieval, and declarative memory. A 2-step cluster analysis that does not require any a priori specification regarding the number of clusters, classified patients into three groups. Group 1 obtained scores that were in the average range on all tests (n = 48; normal CRSP group). Group 2 (n = 58; dysexecutive CRSP group) presented with mild impairment or statistically low average test performance on working memory/verbal fluency tests. Group 3 (n = 31; global CRSP group) produced scores in the statistically low average/borderline range on all tests with particularly reduced scores on naming/declarative memory tests. Between-group analyses found that the CRPS group 1 obtained higher scores than CRPS groups 2 and 3 on all tests. However, groups 2 and 3 were equally impaired on executive tests. CRPS group 3 was impaired on tests of naming/memory tests compared to the other groups. Significant neuropsychological deficits are present in 65% of patients, with many patients presenting with elements of a dysexecutive syndrome and some patients presenting with global cognitive impairment. (JINS, 2010, 16, 566–573.)

It is still an open question whether short-term and long-term memory are two anatomically dissociable memory systems working in parallel or whether they are represented by neural circuits within similar cortical areas. Epilepsy may be used as a model to study these memory processes. We hypothesized that a double dissociation of short-term and long-term memory exists in temporal lobe epilepsy (TLE) and idiopathic generalized epilepsy (IGE). Immediate and 24-hour face recognition was tested in 10 TLE patients, 9 IGE patients, and 10 healthy controls. TLE patients’ immediate recognition was unimpaired, but their memory scores were reduced as compared to healthy controls after 24 hours. In IGE patients, memory was already reduced during immediate recognition. These results are in line with the idea that short-term memory is a transient trace that requires consolidation supported by the medial temporal lobe to change into a more stable status of long-term memory. (JINS, 2010, 16, 574–578.)