Relationship between cognitive function and prevalence of decrease in intrinsic academic motivation in adolescents

<p>Abstract</p> <p>Background</p> <p>Decrease in intrinsic motivation is a common complaint among elementary and junior high school students, and is related to poor academic performance. Since grade-dependent development of cognitive functions also influences academic performance by these students, we examined whether cognitive functions are related to the prevalence of decrease in intrinsic academic motivation.</p> <p>Methods</p> <p>The study group consisted of 134 elementary school students from 4th to 6th grades and 133 junior high school students from 7th to 9th grades. Participants completed a questionnaire on intrinsic academic motivation. They also performed paper-and-pencil and computerized cognitive tests to measure abilities in motor processing, spatial construction, semantic fluency, immediate memory, short-term memory, delayed memory, spatial working memory, and selective, alternative, and divided attention.</p> <p>Results</p> <p>In multivariate logistic regression analyses adjusted for grade and gender, scores of none of the cognitive tests were correlated with the prevalence of decrease in intrinsic academic motivation in elementary school students. However, low digit span forward test score and score for comprehension of the story in the <it>kana </it>pick-out test were positively correlated with the prevalence of decrease in intrinsic academic motivation in junior high school students.</p> <p>Conclusions</p> <p>The present findings suggest that decrease in capacity for verbal memory is associated with the prevalence of decrease in intrinsic academic motivation among junior high school students.</p

Estudio preliminar del cogval-senior, una nueva prueba informatizada para la detección de la demencia Alzheimer en personas mayores

[ES] La enfermedad de Alzheimer (EA) es una de las patologías más prevalentes y suponen una verdadera epidemia entre la población mayor de 65 años en el mundo pudiendo afectar a más de 27 millones de personas en todo el mundo. Por ello el diagnóstico precoz se convierte imprescindible y actualmente se acepta como beneficioso tanto para los pacientes, los familiares y la sociedad, además de ser un factor determinante en la eficacia terapéutica y el pronóstico de la enfermedad. Las nuevas tecnologías ofrecen grandes aportaciones en la evaluación y la atención especializada a las personas mayores, permitiendo aumentar la sensibilidad de las medidas, permitiría hacer un cribado cognitivo a gran escala y hacer seguimientos con costes relativamente más accesibles y económico. Pero la utilidad real dependerá de la validez de los instrumentos aplicados: tienen que ser sensibles y específicos para el campo de aplicación. Además es necesario que estos instrumentos sean fáciles de usar y comprensibles por las personas mayores, para integrarlos a la práctica clínica habitual. Es por ello que esta investigación tenía como objetivo principal valorar la utilidad diagnóstica y usabilidad del CogVal-Senior como una prueba informatizadas para detección para la demencia en una población mayor. Paralelamente se valoraron las posibles influencias asociadas a los resultados y la usabilidad de la prueba A todos los sujetos se les administró el protocolo de evaluación del estudio que incluía el CogVal-Senior, cuestionario de usabilidad, el MEC y el Test del Reloj. La muestra fue de 220 sujetos, normal (N=110) y DTA (N=110) con una media de edad de 79,74±8,723 años y en su mayoría con escolaridad primaria. Los resultados encontrados en el estudio, indican que el CogVal-Senior, posee una alta exactitud diagnóstica para discriminar entre sujetos con y sin demencia, y en comparación con las otras pruebas aplicadas, es la que posee una mejor exactitud global. Además posee buenos índices de fiabilidad y validez. Es una prueba que no parece estar influenciada por el nivel de escolaridad de los participantes, pero sí por el grado de deterioro y por la edad de éstos. En general, los participantes consideraron a la prueba muy fácil de usar y entender, lo que indicaría que es una prueba usable por las personas mayores. Estos resultados indicarían que el CogVal-Senior es una prueba con correlaciones significativas con pruebas de screening de reconocida utilidad clínica, como también una alta exactitud para detectar la demencia, además de ser muy fácil de usar y entender. Estas buenas características psicométricas obtenidas por el CogVal-Senior, unidas a las ventajas que ofrece una evaluación automatizada refuerzan la idea de los beneficios de las nuevas tecnologías en la detección temprana de la demencia

Neurocognitive screening following acquired brain injury: an adaptation of the Birmingham Cognitive Screen for Zimbabwe (Zim-BCoS)

Neuropsychology as a discipline has not taken root in low- and middle-income countries. Most neurocognitive tests used in these countries were developed and normed in high-income, mostly western countries. The psychometric robustness of these tests is often weak when they are used on low to middle-income clinical populations. The objectives of this study were to select, adapt and generate normative data for a suitable neurocognitive screen for use in Zimbabwe. To achieve these objectives, we divided the study into 4 phases. In Phase 1 of the study, we did a systematic review that identified 83 neurocognitive assessment instruments commonly used in low- and middle-income countries on patients who have suffered a stroke. From these instruments, we selected, adapted and normed the Birmingham Cognitive Screen (BCoS; Humphreys al., 2012) through phases 2 to 4 of this study. The screen offers a robust and sufficiently broad but shallow assessment tool for cognitive deficits across key cognitive domains commonly impaired following a stroke. In particular, in Phase 2 of the study, we evaluated the cross-cultural sensitivity of BCoS on healthy participants (N=105). We then performed surveys using the Delphi method on a panel of experts to culturally adapt BCoS for use in Zimbabwe (Zim-BCoS). We evaluated the inter-rater and test-retest reliability of the translated and validated Zim-BCoS and also compared its agreement with the original BCoS version to determine its robustness. In Phase 3, we evaluated the effects of demographic variables on performance on the cognitive domains assessed by Zim-BCoS. To do this, we performed multiple linear regression analyses to calculate regression-based norms using scores from a sample of healthy participants (N=412). From these analyses, participants' age, level of education and sex had significant effects, mainly on subtests in the language cognitive domain (Picture Naming, Sentence/Word Reading/Writing and Instruction Comprehension). In Phase 4 of the study, we performed neurocognitive assessments using Zim-BCoS (and other tests) to assess and determine the frequency of specific neurocognitive deficits in patients who had suffered a stroke and were attending two major hospitals in Harare, Zimbabwe's capital city (N=103). We also compared the performance of these patients to a matched control sample (N=103). To determine the psychometric stability of Zim-BCoS we determined its validity and reliability by comparing scores on its subtests to parallel neurocognitive tests that assess similar cognitive domains. We also assessed the predictive value of Zim-BCoS on patients' neuropsychiatric and functional outcomes. We evaluated the convergence and predictive validity as well as the inclusivity of Zim-BCoS to assess patients with aphasia. We used the Zim-BCoS test scores to establish prevalence rates of cognitive deficits and other post-stroke sequelae in the sample of patients with stroke. We also assessed the predictive value of ZimBCoS subtests on patients' neuropsychiatric and functional outcomes. All comparisons of ZimBCoS against standard cognitive tests and post-stroke sequelae measures had statistically significant convergence, predictive validity and inclusivity. In this study, we demonstrated the utility of Zim-BCoS for assessing cognitive impairment in patients who have suffered a stroke, particularly in resource poor contexts typical of low-income countries. We concluded that ZimBCoS is a robust neuropsychological screen suitable for research and clinical use in Zimbabwe. The screen has the potential to offer a cost effective and easy to use neurocognitive screen for patients with acquired neurological changes in low-income countries in Southern Africa

The construct validity of a brief neurocognitive screening battery in a paediatric oncology population

Introduction: Central nervous system (CNS) tumours and leukaemia in children are associated with detrimental neurocognitive outcomes across a wide range of cognitive domains. It is recommended these children receive regular neuropsychological assessment to screen for deficits that may affect their long term outcomes. Barriers to this include time constraints and practice effects associated with traditional neuropsychological assessment. CogState is a brief computerised neuropsychological battery which assesses the neurocognitive domains at risk in this population. This study aimed to evaluate the construct validity of the battery in this population through convergent validity with standardised neuropsychological measures. A secondary aim was to investigate the relationship between time since diagnosis and performance on the CogState battery. Method: A cross-sectional within subject correlation design was used to assess the construct validity in a sample of 37 children aged 8-16 years treated for leukaemia or CNS tumours. Partial correlation was used to assess the relationship between overall performance on the battery and time since diagnosis controlling for IQ and emotional distress. Results: One subtest of the CogState battery correlated significantly with the standard measure assessing the same cognitive domain, showing a large effect size. Four further subtests showed small to medium correlations, however these were not significant and confidence intervals were large. One subtest showed no clear correlation. No significant correlation was found between overall performance on the battery and time since diagnosis, however there was also no relationship between time since diagnosis and IQ in this sample. Conclusion: This study provides some evidence for the construct validity of sections of the CogState battery in a paediatric oncology population. Sample characteristics and methodological limitations which may have affected the scope and reliability of results are discussed. Further research in larger samples is needed before it can be recommended as a standard follow up assessment

Primary progressive aphasia : neuropsychological analysis and evolution

Tese de doutoramento, Ciências Biomédicas (Neurociências), Universidade de Lisboa, Faculdade de Medicina, 2015Frontotemporal lobar degeneration (FTLD) is the second leading cause of early-onset ( 2) revealed some clusters composed mostly by nonfluent or by semantic PPA cases. However, we could not evidence any group chiefly composed of logopenic PPA cases. Hence, findings obtained with the application of unsupervised data mining approaches do not clearly support a logopenic PPA. However further, supervised learning studies may indicate distinct results. Behaviour changes may occur early in PPA but the frequency of these symptoms across the three variants is still controversial. In the third study, 94 consecutive PPA patients (26 nonfluent, 36 semantic, 32 logopenic) underwent language and neuropsychological assessments. The presence of behavioural changes was ascertained by semi-structured informant-based interviews using the Blessed Dementia Rating Scale. Eighty-two percent of the cases endorsed at least one behaviour change. Nonfluent patients presented significantly more behaviour changes and scored more often (46.2%) the item “hobbies relinquished” when compared to logopenic patients. These differences in behaviour symptoms probably reflect distinct underlying neurodegenerative diseases. PPA is a neurodegenerative disorder with no effective pharmacological treatment. Cognition-based interventions are adequate alternatives, but their benefit has not been thoroughly explored. The aim of this last investigation was to study the effect of speech and language therapy (SLT) on naming ability in PPA. An open parallel prospective longitudinal study involving two centers was designed to compare patients with PPA submitted to SLT (1 h/week for 11 months, on average) with patients receiving no therapy. Twenty patients were enrolled and undertook baseline language and neuropsychological assessments; among them, 10 received SLT and 10 constituted an age- and education-matched historical control group. The primary outcome measure was the change in group mean performance on the Snodgrass and Vanderwart Naming Test between baseline and follow-up assessments. Intervention and control groups did not significantly differ on demographic and clinical variables at baseline. A mixed repeated measures ANOVA revealed a significant main effect of therapy (F(1,18) = 10.763; p = 0.005) on the performance on the Snodgrass and Vanderwart Naming Test. Although limited by a non-randomized open study design with a historical control group, the present study suggests that SLT may have a benefit in PPA, and it should prompt a randomized, controlled, rater-blind clinical trial. Conclusion: Despite the recent harmonization efforts, the delineation of certain PPA variants is still controversial. The present results show that neuropsychology is a key instrument not only for the clear definition of PPA subtypes but also for the study of the abnormal mechanisms and features underlying the main forms of PPA. Moreover, a neuropsychological approach to disease management seems to be feasible. Specifically, SLT emerges as an alternative and adequate approach to tackle the increasing language deficits experienced in all PPA phenotypes for some time. The emergence of promising disease-modifying therapies in the context of FTLD, in association with these cognitive-based interventions, will certainly be the future of PPA disease management

Effortful Control, Attention and Executive Functioning in the Context of Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) involves a broad presentation of symptoms classified along continuum of severity, with core deficits in Social Affect and Restricted, Repetitive Behaviours required for formal diagnosis (American Psychiatric Association, 2013; Lauritsen, 2013). The development of particular cognitive, behavioural and interpersonal difficulties seen in ASD is of great interest. Temperament offers particular value given that it influences the development of social behaviours, emotionality and self-regulation (Shiner et al., 2012). The self-regulatory temperament factor, effortful control, is known to be diminished in ASD (Garon et al., 2009, 2016) and is theorised to be related to attention and executive functioning (Rothbart &amp; Rueda, 2005). This link is of particular interest, given that attention and executive function deficits are prominent in ASD (Craig et al., 2016; Lai et al., 2017; Sanders, Johnson, Garavan, Gill, &amp; Gallagher, 2008). To date, however, a thorough literature search failed to yield a study which has investigated whether effortful control,attention and executive functioning are concurrently associated with ASD symptomatology.Moreover, the relationship between effortful control, attention and executive functioning is not as unambiguous as previously theorised in typical development, with little investigation into these relationships in ASD. To elucidate the association effortful control, attention and executive functioning have with ASD symptomatology, the relationship between effortful control and these cognitive variable needs to be better established empirically. Therefore the current investigation’s aims were twofold. Study One investigated the relationship of effortful control with attention and executive functions in neurotypical and ASD samples. Study Two explored the association between effortful control, attention, executive functions and core ASD deficits (i.e. Social Affect and Restricted, Repetitive Behaviours). A sample of 38 ASD and 38 neurotypical boys (aggregate-matched on key demographic factors), aged 6 - 15, and their primary caregivers were recruited. Study One considered both groups (n=76) and featured both quasi-experimental and relational investigations. Study Two focused only on the ASD sample (n=38) and used a purely relational design. Neurocognitive measures were used to assess two attention domains (i.e. attention span and sustained attention), and three executive functions (i.e. working memory, inhibition and switching). Effortful control was measured using a parent-report questionnaire and ASD core deficits were examined using the Autism Diagnostic Observation Schedule, Second edition (ADOS-2; Lord, Luyster, Gotham, &amp; Guthrie, 2012). Results of Study One revealed effortful control was a significant predictor of attention span, working memory and inhibition, with ASD participants performing significantly more poorly on these cognitive domains and rated significantly more poorly on effortful control. Study Two’s results indicated that Social Affect was significantly correlated with inhibition and the interaction effect between effortful control and working memory. Furthermore, only effortful control, attention span and their interaction effect were significantly associated with Restricted Repetitive Behaviours. Specifically, effortful control was found to moderate this relationship. At high levels of effortful control, increased attention span was associated with less Restricted, Repetitive Behaviours. These findings may aid efforts to establish a predictive model for ASD core deficits on the basis of temperament and cognitive difficulties. Keywords: Autism Spectrum Disorder (ASD), Effortful Control, Attention, Executive Functions, Social Affect, Restricted Repetitive Behaviour

Risk factors for delirium and cognitive decline following coronary artery bypass grafting surgery: a systematic review and meta-analysis

Background: Coronary artery bypass grafting (CABG) is known to improve heart function and quality of life, while rates of surgery-related mortality are low. However, delirium and cognitive decline are common complications. We sought to identify preoperative, intraoperative, and postoperative risk or protective factors associated with delirium and cognitive decline (across time) in patients undergoing CABG. Methods and Results: We conducted a systematic search of Medline, PsycINFO, EMBASE, and Cochrane (March 26, 2019) for peer-reviewed, English publications reporting post-CABG delirium or cognitive decline data, for at least one risk factor. Random-effects meta-analyses estimated pooled odds ratio for categorical data and mean difference or standardized mean difference for continuous data. Ninety-seven studies, comprising data from 60 479 patients who underwent CABG, were included. Moderate to large and statistically significant risk factors for delirium were as follows: (1) preoperative cognitive impairment, depression, stroke history, and higher European System for Cardiac Operative Risk Evaluation (EuroSCORE) score, (2) intraoperative increase in intubation time, and (3) postoperative presence of arrythmia and increased days in the intensive care unit; higher preoperative cognitive performance was protective for delirium. Moderate to large and statistically significant risk factors for acute cognitive decline were as follows: (1) preoperative depression and older age, (2) intraoperative increase in intubation time, and (3) postoperative presence of delirium and increased days in the intensive care unit. Presence of depression preoperatively was a moderate risk factor for midterm (1–6 months) post-CABG cognitive decline. Conclusions: This meta-analysis identified several key risk factors for delirium and cognitive decline following CABG, most of which are nonmodifiable. Future research should target preoperative risk factors, such as depression or cognitive impairment, which are potentially modifiable.Danielle Greaves, Peter J. Psaltis, Daniel H.J. Davis, Tyler J. Ross, Erica S. Ghezzi, Amit Lampit, Ashleigh E. Smith, Hannah A.D. Keag

Implicit social cognition in autism spectrum disorder

Implicit learning about people’s states of mind relies inherently on associated emotions and affective valences, with abstract concepts such as disposition, attitude and intention being an intrinsic part of what is learned. Yet, similarly to studies aiming at the typically developed population, nearly all implicit learning studies on individuals with Autism Spectrum Disorder (ASD), are limited to the non-social domain, neglecting the possibility of domain-specific implicit learning impairments. Human behaviour is variable and complex and therefore detecting regularities in social interactions may be more challenging than in the physical world, which is largely governed by predictable laws.This project employed a novel implicit learning paradigm to evaluate implicit learning abilities in the social and non-social domains in typically-developed individuals with varying levels of ASD traits and individuals with a clinical diagnosis of ASD.The results revealed that impairments in implicit learning in ASD individuals emerge with respect to implicit social learning, with intact implicit learning abilities in the non-social domain. Deficits in implicit social learning were observed despite the participants’ ability to correctly identify facial expressions, gaze direction and identities of the characters used in the studies. These findings extrapolated to typically-developed individuals high in ASD traits, suggesting a gradient of social implicit learning ability that runs throughout the population.The relative contributions of three potential mechanisms underpinning implicit social learning were examined: (i) contingency learning per se, (ii) contribution of other cognitive processes such as memory for facial expressions and social attention, (iii) implicit affective tagging. The evidence suggests that individuals with ASD may be impaired in their ability to implicitly incorporate affective values into cognitive processing, supporting the implicit affective tagging hypothesis. I argue that ASD individuals use alternative strategies to comprehend others’ minds, relying more on physical characteristics, rather than socio-emotional meaning