Output order and variability in free recall are linked to cognitive ability and hippocampal volume in elderly individuals.

Adapted from the work of Kahana and colleagues (e.g., Kahana, 1996), we present two measures of order of recall in neuropsychological free recall tests. These are the position on the study list of the first recalled item, and the degree of variability in the order in which items are reported at test (i.e., the temporal distance across the first four recalled items). We tested two hypotheses in separate experiments: (1) whether these measures predicted generalized cognitive ability, and (2) whether they predicted gray matter hippocampal volume. To test hypothesis 1, we conducted ordinal regression analyses on data from a group of 452 participants, aged 60 or above. Memory performance was measured with Rey's AVLT and generalized cognitive ability was measured with the MMSE test. To test hypothesis 2, we conducted a linear regression analysis on data from a sample of 79 cognitively intact individuals aged 60 or over. Memory was measured with the BSRT and hippocampal volume was extracted from MRI images. Results of Experiment 1 showed that the position of the first item recalled and the degree of output order variability correlated with MMSE scores only in the delayed test, but not in the immediate test. In Experiment 2, the degree of variability in the recall sequence of the delayed trial correlated (negatively) with hippocampal size. These findings confirm the importance of delayed primacy as a marker of cognitive ability, and are consistent with the idea that the hippocampus is involved in coding the temporal context of learned episodes

Adverse performance effects of acute lorazepam administration in elderly long-term users: pharmacokinetic and clinical predictors.

BACKGROUND: The benzodiazepine lorazepam is widely utilized in the treatment of elderly individuals with anxiety disorders and related conditions. Negative effects of acute lorazepam administration on cognitive performance, especially memory, have been reported in both previously untreated elderly and in individuals who have received short term (up to three weeks) treatment with therapeutic doses. However, it remains unclear if these adverse cognitive effects also persist after long-term use, which is frequently found in clinical practice. METHODS: Cognitively intact elderly individuals (n=37) on long-term (at least three months) daily treatment with lorazepam were studied using a double-blind placebo-controlled cross-over study design. Subjects were administered their highest daily unit dose of lorazepam (0.25-3.00 mg) or placebo on different days, approximately 1 week apart in a random order, and were assessed on memory, psychomotor speed, and subjective mood states. RESULTS: Subjects had significantly poorer recall and slowed psychomotor performance following acute lorazepam administration. There were no significant effects on self-ratings of mood, sedation, or anxiety in the whole group, but secondary analyses suggested a differential response in subjects with Generalized Anxiety Disorder. CONCLUSIONS: The reduced recall and psychomotor slowing that we observed, along with an absence of significant therapeutic benefits, following acute lorazepam administration in elderly long-term users reinforces the importance of cognitive toxicity as a clinical factor in benzodiazepine use, especially in this population

The Affective Nature of Formulaic Language: A Right-Hemisphere Subcortical Process

Formulaic expressions naturally convey affective content. The unique formal and functional characteristics of idioms, slang, expletives, proverbs, conversational speech formulas, and the many other conventional expressions in this repertory have been well-described: these include unitary form, conventionalized and non-literal meanings, and reliance on social context. Less highlighted, but potent, is the intrinsic presence of affective meaning. Expletives, for example, signal strong emotion. Idioms, too, inherently communicate emotional connotations, and conversational speech formulas allow for empathetic bonding and humor. The built-in affective content of formulaic expressions, in combination with their other unique characteristics, is compatible with the proposal that brain structures other than those representing grammatical language are in play in producing formulaic expressions. Evidence is presented for a dual process model of language, whereby a right hemisphere-subcortical system modulates formulaic language

Evaluation, treatment, and analysis of a rare case of motor speech systems dyscoordination syndrome

This report describes an unusual presentation of a voice disorder arising from inability to coordinate the three components of motor speech: respiration, phonation, and articulation. These systems were individually intact, as demonstrated by laryngoscopy, motor speech examination, and treatment methods achieving success under controlled conditions. Following initial programming of his deep brain stimulation device, a 62-year-old male, diagnosed with Parkinson’s disease 14 years previously, abruptly experienced a vocal disorder characterized by pressed, very low frequency creaky voice produced on held breath. Evaluation and therapy sessions revealed intact respiration, phonation, and articulation as component systems of motor speech, while indicating a severe deficit in coordinating these systems for articulated speech. Performance varied with mode of vocal production. Vowel prolongation and singing were normal in contrast to severe impairment when respiration and phonation were integrated with articulated speech. A listening study utilizing speech samples from five spoken modes—conversation, repetition, formulaic expressions, continuously phonated material and singing, yielded higher intelligibility on sung and continuously phonated phrases, confirming clinical impressions. Acoustic measures of fundamental frequency, vowel quality (harmonic-to-noise ratios) and duration supported the intelligibility results. Repetition and conversation were similarly impaired, suggesting that the disability was not attributable to the basal ganglia. This case reveals the role of higher order management of respiration, articulation, and voice for speech and describes a successful treatment utilizing breath control

Emotionally expressed voices are retained in memory following a single exposure.

Studies of voice recognition in biology suggest that long exposure may not satisfactorily represent the voice acquisition process. The current study proposes that humans can acquire a newly familiar voice from brief exposure to spontaneous speech, given a personally engaging context. Studies have shown that arousing and emotionally engaging experiences are more likely to be recorded and consolidated in memory. Yet it remains undemonstrated whether this advantage holds for voices. The present study examined the role of emotionally expressive context in the acquisition of voices following a single, 1-minute exposure by comparing recognition of voices experienced in engaging and neutral contexts at two retention intervals. Listeners were exposed to a series of emotionally nuanced and neutral videotaped narratives produced by performers, and tested on the recognition of excerpted voice samples, by indicating whether they had heard the voice before, immediately and after a one-week delay. Excerpts were voices from exposed videotaped narratives, but utilized verbal material taken from a second (nonexposed) narrative provided by the same performer. Overall, participants were consistently able to distinguish between voices that were exposed during the video session and voices that were not exposed. Voices experienced in emotional, engaging contexts were significantly better recognized than those in neutral ones both immediately and after a one-week delay. Our findings provide the first evidence that new voices can be acquired rapidly from one-time exposure and that nuanced context facilitates initially inducting new voices into a repertory of personally familiar voices in long-term memory. The results converge with neurological evidence to suggest that cerebral processes differ for familiar and unfamiliar voices

Speech Intelligibility During Clinical and Low Frequency

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has become an effective and widely used tool in the treatment of Parkinson’s disease (PD). STN-DBS has varied effects on speech. Clinical speech ratings suggest worsening following STN-DBS, but quantitative intelligibility, perceptual, and acoustic studies have produced mixed and inconsistent results. Improvements in phonation and declines in articulation have frequently been reported during different speech tasks under different stimulation conditions. Questions remain about preferred STN-DBS stimulation settings. Seven right-handed, native speakers of English with PD treated with bilateral STN-DBS were studied off medication at three stimulation conditions: stimulators off, 60 Hz (low frequency stimulation—LFS), and the typical clinical setting of 185 Hz (High frequency—HFS). Spontaneous speech was recorded in each condition and excerpts were prepared for transcription (intelligibility) and difficulty judgements. Separate excerpts were prepared for listeners to rate abnormalities in voice, articulation, fluency, and rate. Intelligibility for spontaneous speech was reduced at both HFS and LFS when compared to STN-DBS off. On the average, speech produced at HFS was more intelligible than that produced at LFS, but HFS made the intelligibility task (transcription) subjectively more difficult. Both voice quality and articulation were judged to be more abnormal with DBS on. STN-DBS reduced the intelligibility of spontaneous speech at both LFS and HFS but lowering the frequency did not improve intelligibility. Voice quality ratings with STN-DBS were correlated with the ratings made without stimulation. This was not true for articulation ratings. STN-DBS exacerbated existing voice problems and may have introduced new articulatory abnormalities. The results from individual DBS subjects showed both improved and reduced intelligibility varied as a function of DBS, with perceived changes in voice appearing to be more reflective of intelligibility than perceived changes in articulation

The formulaic schema in the minds of two generations of native speakers

Schemata are expressions that are fixed except for slots available for novel words (I’m not a ____ person). Our goals were to quantify speakers’ knowledge, examine semantic flexibility in open slots, and compare performance data in two generations of speakers using cloze procedures in formulaic expressions, schemata open slots, fixed portions of schemata, and novel sentences. Fewer unique words appeared for the schemata-fixed and formulaic exemplars, reflecting speakers’ knowledge of these utterances; the most semantic categories appeared for schemata-open responses. Age groups did not differ. Schemata exemplify creative interplay between novel lexical retrieval and fixed formulaic expression

Dysprosodic speech following basal ganglia insult: Toward a conceptual framework for the study of cerebral representation of prosody

Progress in understanding brain/behavior relationships in adult-acquired dysprosody has led to models of cortical hemispheric representation of prosodic processing based on functional (linguistic vs affective) or physical (timing vs pitch) parameters. These explanatory perspectives have not been reconciled, and also a number of neurobehavior syndromes that include dysprosody among their neurological signs have not yet been integrated. In addition to expanding the functional perspective on prosody, some of these syndromes have implicated a significant role of subcortical nuclei in prosodic competence. In this article, two patients with acquired dysprosodic speech following damage to basal ganglia nuclei were evaluated using behavioral, acoustic, cognitive, and radiographic approaches. Selective quantitative measures were performed on each individual’s performance to provide detailed verification and clarification of clinical observations, and to test hypotheses regarding prosodic function. These studies, combined with a review of related clinical research findings, exemplify the value of a broader perspective on the neurobehavioral dysfunction underlying acquired adult dysprosodic speech, and lead to a new, proposed conceptual framework for the cerebral representation of prosody