The spatial allocation of attention influences estimates of stimulus magnitude, including line length and the line bisection task has been used to assess the asymmetrical allocation of spatial attention. The purpose of this study is to learn if normal subjects' allocation of attention changes as a function of the trunk–head centered spatial position of the line stimuli. Normal subjects were asked to bisect lines placed in five different head–trunk centered special positions (central, right up–distal, left up–distal, right down–proximal, left down–proximal). When compared with the central condition, deviations in the right or left lateral conditions were only significant in the down–proximal conditions, such that the bisection bias significantly shifted direction to the left of the objective midline in left hemispace and to the right of the objective midline in right hemispace, suggesting that stimuli presented in lateral hemispace primarily activate the contralateral hemisphere's attentional systems. The finding that the lines presented in down–proximal lateral hemispace induce a greater spatial bias than lines in up–distal lateral space suggests that the portion of the brain's dorsal visual system, which processes stimuli in down–proximal space, influences the horizontal (right–left) spatial allocation of attention more than does the brain's ventral visual system. (JINS, 2006, 12, 532–537.)

Patients with Alzheimer's disease (AD) exhibit a deficit in episodic recognition memory for odors. It is hypothesized that the higher rate of AD in women may be due to estrogen-deprivation in postmenopausal women. Research suggests that estrogen may help to minimize cognitive decline in AD as well as postmenopausal olfactory loss. The current study examined the effects of estrogen replacement therapy (ERT) on performance of a recognition memory task for olfactory and visual stimuli in women AD patients. Participants included 24 women AD patients who were ERT users and 77 women AD patients who never used ERT. Compared with the ERT non-users, the ERT users committed significantly less false-positive memory errors for olfactory stimuli, whereas performance for visual stimuli did not differentiate between ERT users and non-users. The results suggest benefits of ERT could help ameliorate the earliest symptoms of AD, olfactory dysfunction, and memory impairment. (JINS, 2006, 12, 400–404.)

Naming of two semantically impaired aphasic patients was treated with the contextual repetition priming technique, which involves repeated repetition of names of pictures that are related semantically, phonologically, or are unrelated. Our previous studies using this technique have suggested that patients with impaired access to lexical-semantic representations benefit in the short-term from this treatment technique, but show no long-term improvement in naming. In contrast, patients with good access to semantics show short- and long-term benefits from this treatment. Here we report two studies of treatment for two individuals with aphasia affecting access to lexical semantics and anomia but spared access to input and output phonology and spared conceptual semantics. We predicted that they would show short-term facilitation from the contextual priming, but no long-term improvements in naming. The results confirmed the prediction. An account of this pattern is offered within the framework of an interactive activation model of word retrieval. Additionally, we discuss alternative techniques for addressing naming deficits when access to semantics is impaired. (JINS, 2006, 12, 853–866.)

Although the prefrontal cortex (PFC) is consistently found to be associated with various working memory processes, the necessity of the PFC for such processes remains unclear. To elucidate PFC contributions to storage and rehearsal/maintenance processes engaged during verbal working memory function, we assessed behavior of patients with lesions to the left or right lateral PFC, and neural activity of healthy young subjects during fMRI scanning, during performance of working memory tasks. We found that PFC lesions did not affect storage processes—which is consistent with the notion that posterior cortical networks can support simple retention of information. We also found that PFC lesions did not affect rehearsal/maintenance processes, which was in contrast to our finding that healthy subjects performing a verbal delayed recognition task showed bilateral PFC activation. These combined imaging and behavioral data suggest that working memory rehearsal/maintenance processes may depend on both hemispheres, which may have implications for recovery of function and development of rehabilitation therapies after frontal injury. (JINS, 2006, 12, 248–260.)

Previous research has indicated that performance on verbal fluency tests (VFTs) is influenced by language and/or culture. Consequently, normative VFT data for English-speaking people cannot be used for people for whom English is not their first language. The aim of the present study was to provide normative data for the Animal Naming, Profession Naming, and Letter M Naming (four-letter words beginning with the letter M) VFTs for Dutch-speaking populations, based on a large sample (N = 1856) of healthy men and women aged 24–81 years of different educational levels. The results showed that age affected the performance of all VFTs profoundly, but the age effect was not uniform: in the Profession and Letter M Naming VFTs, performance was stable in young adulthood but declined strongly after age 50. In contrast, in the Animal Naming VFT, performance appeared to decline linearly, starting early in life. Furthermore, males had higher scores than females on the Profession Naming VFT, and higher educated participants outperformed their lower educated counterparts on all three VFTs. Regression-based normative data were prepared for the 3 VFTs, and the advantages of using a regression-based normative approach instead of a traditional normative approach are discussed. (JINS, 2006, 12, 80–89.)

Drug addiction is associated with impaired judgment in unstructured situations in which success depends on self-regulation of behavior according to internal goals (adaptive decision-making). However most executive measures are aimed at assessing decision-making in structured scenarios, in which success is determined by external criteria inherent to the situation (veridical decision-making). The aim of this study was to examine the performance of Substance Abusers (SA, n = 97) and Healthy Comparison participants (HC, n = 81) in two behavioral tasks that mimic the uncertainty inherent in real-life decision-making: the Cognitive Bias Task (CB) and the Iowa Gambling Task (IGT) (administered only to SA). A related goal was to study the interdependence between performances on both tasks. We conducted univariate analyses of variance (ANOVAs) to contrast the decision-making performance of both groups; and used correlation analyses to study the relationship between both tasks. SA showed a marked context-independent decision-making strategy on the CB's adaptive condition, but no differences were found on the veridical conditions in a subsample of SA (n = 34) and HC (n = 22). A high percentage of SA (75%) also showed impaired performance on the IGT. Both tasks were only correlated when no impaired participants were selected. Results indicate that SA show abnormal decision-making performance in unstructured situations, but not in veridical situations. (JINS, 2006, 12, 90–99.)

Links between verbs and gesture knowledge suggest that verb retrieval may be particularly amenable to gesture+verbal training (GVT) in aphasia compared to noun retrieval. This study examines effects of GVT for noun and verb retrieval in nine individuals with aphasia subsequent to left hemisphere stroke. Participants presented an array of noun and verb retrieval deficits, including impairments of semantic and/or phonologic processing. In a single-participant experimental design, we investigated effects of GVT for noun and verb retrieval in two counterbalanced treatment phases. Effects were evaluated in spoken naming and gesture production to pictured objects and actions. Spoken naming improvements associated with large effect sizes were noted for trained nouns (5/9) and verbs (5/9); no improvements were evident for untrained words. Gesture production improved for trained nouns (8/9) and verbs (6/9), and for untrained nouns (2/9) and verbs (2/9). No significant differences were evident between nouns and verbs in spoken naming or gesture production. Improvements were evident across individuals with varied sources of word retrieval impairments. GVT has the potential to improve communication by increasing spoken word retrieval of trained nouns and verbs and by promoting use of gesture as a means to communicate when word retrieval fails. (JINS, 2006, 12, 867–882.)

Increasing evidence indicates that substance-dependent individuals (SDI) are impaired in executive control tasks relying on different systems within the prefrontal cortex (PFC). Three different functional systems have been described: the dorsolateral prefrontal cortex (DLPC), orbitofrontal cortex (OFC), and anterior cingulate cortex (ACC) circuits. Dysfunction within each PFC system is associated with different behavioral, cognitive, and emotional abnormalities. Few studies have conducted an exhaustive examination of all these different factors in SDI. In this study, SDI (including alcohol, cocaine, and methamphetamine polysubstance users, n = 35) were compared with healthy controls (n = 36) on a series of behavioral (Frontal Systems Behaviour Scale, FrSBe), cognitive (N-back, Go-No Go, and Wisconsin Card Sorting Tasks), and emotional (International Affective Picture System, IAPS) tasks, each of which was thought to tax a different component of these PFC functional systems. SDI showed greater behavioral problems in the apathy, disinhibition, and executive dysfunction subscales of the FrSBe. Behavioral deficits were significantly associated with several real-life domains in which SDI typically have problems. SDI also showed poorer performance on cognitive tests of working memory, response inhibition and mental flexibility, and abnormal processing of affective images from the IAPS. Cognitive, behavioral, and emotional measures were moderately correlated.This study was conducted in the Department of Neurology, University of Iowa, Iowa City, USA (JINS, 2006, 12, 405–415.)

Three hypotheses for cognitive deficits among psychopaths were tested: executive dysfunction, left hemisphere activation, and an interaction between the two. Twenty-one psychopathic and 23 nonpsychopathic criminal offenders identified with the Hare Psychopathy Checklist-Revised participated in verbal and visual-spatial tasks during which the level of executive processing demands was manipulated. Consistent with prior research, psychopathic offenders made more errors than controls, but only during the verbal task and only on trials with high executive demand. Within those trials, most errors occurred when set-maintenance demands were the highest. No response latency differences between groups were found. (JINS, 2006, 12, 538–548.)This article is a replication and extension of our previous study that was published in the JINS, volume 11, 2005. The article appeared as “State-dependent Executive Deficits Among Psychopathic Offenders,” by Suchy & Kosson, 2005, JINS, 11:3, pp. 311–321. There was no overlap in participants between the two studies.

The Forced Choice Recognition (FCR) and the Critical Item Analysis (CIA) indices of the California Verbal Learning Test-II (CVLT-II) have been identified by the CVLT-II test developers as potentially useful, brief screening indicators of effort in neuropsychological assessment. This retrospective study analyzes performance on these measures in three groups: (1) clinically referred individuals; (2) forensically referred individuals not suspected of inadequate effort; and (3) forensically referred individuals whose performance on freestanding tests of effort suggested inadequate effort. Performances on FCR were analyzed for their relation to actual memory impairment and with regard to concrete and abstract distractor endorsement. FCR and CIA performances were analyzed for agreement with formal tests of inadequate effort and their test characteristics. Incremental validity was assessed by hierarchical logistic regression with previously identified indices for detection of inadequate effort on the CVLT. Results indicate that (1) FCR and CIA performances are not related to decreased memory performance; (2) FCR and CIA indices exhibit higher specificity and lower sensitivity, with higher positive predictive value than negative predictive value; and (3) FCR and CIA indices exhibit modest incremental validity with previously identified indices. Implications for use of FCR and CIA indices in inadequate effort detection are discussed (JINS, 2006, 12, 688–696.)

The frontal lobes (FL), are they a general adaptive global capacity processor, or a series of fractionated processes? Our lesion studies focusing on attention have demonstrated impairments in distinct processes due to pathology in different frontal regions, implying fractionation of the “supervisory system.” However, when task demands are manipulated, it becomes evident that the frontal lobes are not just a series of independent processes. Increased complexity of task demands elicits greater involvement of frontal regions along a fixed network related to a general activation process. For some task demands, one or more anatomically distinct frontal processes may be recruited. In other conditions, there is a bottom-up nonfrontal/frontal network, with impairment noted maximally for the lesser task demands in the nonfrontal automatic processing regions, and then as task demands change, increased involvement of different frontal (more “strategic”) regions, until it appears all frontal regions are involved. With other measures, the network is top-down, with impairment in the measure first noted in the frontal region and then, with changing task demands, involving a posterior region. Adaptability is not just a property of FL, it is the fluid recruitment of different processes anywhere in the brain as required by the current task. (JINS, 2006, 12, 261–271.)

Acquired disorders of face processing have long played an important role in our theorizing about how the brain encodes and matches faces to memory, because functional deficits in some, but not other aspects of face processing, reveal whether different processes operate independently. One striking dissociation is between the processing of face identity and facial emotion, which suggests that these two forms of information are, to some extent, processed independently. However, such dissociations can be over-interpreted; though identity and emotion processing can dissociate, the two processes could also rely on many common operations. To understand how facial identity and emotion are computed, we need to assess in more detail the nature of their breakdown in patients.

Research findings have suggested that individuals with traumatic brain injury (TBI) show greater psychophysiological and subjective costs associated with performing vigilance tasks, but have not examined relationships with fatigue. The present study aimed to investigate vigilance and its relationship with subjective and objective fatigue measures. Forty-six TBI participants and 46 controls completed a 45-minute vigilance task. They also completed a subjective fatigue scale (the VAS-F) and a selective attention task before and after the vigilance task, and had their blood pressure (BP) monitored. TBI participants performed at a lower level on the vigilance task, but performed at a similar level across the duration of the task. Higher subjective fatigue ratings on the VAS-F were associated with more misses on the vigilance task for TBI participants. TBI participants showed greater increases in diastolic BP, and these were associated with greater increases in subjective fatigue ratings on the VAS-F. A subgroup of TBI participants showed a decline in performance on the vigilance task and also showed disproportionate increases in subjective fatigue. Findings provide support for the coping hypothesis, suggesting that TBI individuals expend greater psychophysiological costs in order to maintain stable performance over time, and that these costs are also associated with subjective increases in fatigue. (JINS, 2006, 12, 100–110.)

Some studies of negative priming and other tasks assumed to reflect inhibitory functions suggest a decline in inhibitory processes in Alzheimer's disease. However, none of the measures used in previous studies can be interpreted as an unambiguous reflection of distractor inhibition. The present study investigates whether reductions in negative priming associated with Alzheimer's disease reflect reduced distractor inhibition, rather than perceptual review processes. Individuals with early Alzheimer's disease were predicted to show reduced negative priming on a spatial localization task designed to provide an unambiguous measure of distractor inhibition. Sixteen clinical participants showed significantly less negative priming than old and young healthy control groups, which is interpreted as evidence for reduced distractor inhibition in early dementia. A second analysis indicated that, within the clinical sample only, negative priming effect size was significantly correlated with prime trial response speed. Clinical participants showing the least negative priming were slower to respond to an initial stimulus. The results may mean that people with early Alzheimer's disease have a reduced capacity to use excitatory as well as inhibitory processes in selection. (JINS, 2006, 12, 416–423.)

Warrington and Shallice's (1984) report on patient J.B.R. [4] was the first and most influential study about the living/nonliving semantic dissociation.

Subarachnoid hemorrhage (SAH) survivors often report psychosocial and emotional changes, including a diminished capacity for decision making. However, systematic investigations into the nature of the changes have been limited to those patients surviving SAH secondary to aneurysms of the anterior communicating artery. This study aimed to explore the nature of decision making in survivors of SAH secondary to aneurysms of the middle cerebral or posterior communicating artery using a series of computerized tasks. Twenty SAH survivors and 20 matched controls completed a battery of computerized decision-making tasks. These included tasks examining an individual's ability to make probabilistic choices and risk-taking behavior, as well as tasks examining aspects of impulsivity. The results revealed two key patterns of abnormal decision-making behavior in the SAH survivors: altered sensitivity to both reward and punishment, and impulsive responding. These complex deficits may contribute to difficulties in daily living resulting from apathy, poor judgment, or inhibition in SAH survivors. (JINS, 2006, 12, 697–706.)

Cognitive impairment occurs in roughly 50% of patients with multiple sclerosis (MS). It is well known that processing speed and episodic memory deficits are the most common neuropsychological (NP) sequelae in this illness. Consensus has emerged about the specific tests that prove most helpful for routine monitoring of MS associated cognitive impairment. The purpose of this study was to examine the validity of the Minimal Assessment of Cognitive Function in MS (MACFIMS), a recommended battery based on the findings of an international conference held in 2001. We tested 291 MS patients and 56 healthy controls. Frequencies of impairment paralleled those reported in previous work for both individual cognitive domains and general impairment. All tests were impaired in the MS group, and distinguished relapsing-remitting (RR) from secondary progressive (SP) course. Principle components analysis showed a distinct episodic memory component. Most of the MACFIMS tests discriminated disabled from employed patients. However, in regression models accounting for all NP tests, those emphasizing verbal memory and executive function were most predictive of vocational status. We conclude that the MACFIMS is a valid approach to routine NP assessment of MS patients. Future work is planned to determine its psychometric properties in a longitudinal study. (JINS, 2006, 12, 549–558.)

The evolution of the progressive loss of semantic knowledge of a patient, VZ, with lesions mainly affecting the infero-medial temporal lobes, was followed for two years. At the beginning of the study VZ's performance was mainly characterized by a category-specific deficit for living things and a modality-specific deficit for perceptual attribute knowledge. As time went on, VZ's disorder affected all categories by changing the relationship between category and attribute knowledge. Data show that dissociations may change in the course of progressive cognitive breakdown, depending on both degeneration stage and task demands. VZ's performance is discussed in the light of the most influential theoretical accounts. Methodological suggestions regarding longitudinal studies of degenerative patients are also put forward. (JINS, 2006, 12, 275–284.)

The present study investigated the utility of the International Classification of Diseases and Related Health Problems, 10th edition (ICD-10) diagnostic criteria for postconcussion syndrome (PCS) symptoms by comparing symptom endorsement rates in a group of patients with mild traumatic brain injury (MTBI) to those of a noninjured control group at one month and three months post-injury. The 110 MTBI patients and 118 control participants were group-matched on age, gender, and education level. Seven of the nine self-reported ICD-10 PCS symptoms differentiated the groups at one month post-injury and two symptoms differentiated the groups at three months post-injury: symptom endorsement rates were higher in the MTBI group at both time periods. Fatiguing quickly and dizziness/vertigo best differentiated the groups at both time periods, while depression and anxiety/tension failed to differentiate the groups at either time period. Collectively, the ICD-10 PCS symptoms accurately classified the MTBI patients at one month post-injury, with the optimal positive test threshold of endorsement of five symptoms coinciding with a sensitivity and specificity of 73% and 61%, respectively. The ICD-10 PCS symptoms were unable to accurately classify the MTBI patients at three months post-injury. (JINS, 2006, 12, 111–118.)

Alzheimer's disease (AD) is a common, devastating form of dementia. With the advent of promising symptomatic treatment, the importance of recognizing AD at its very earliest stages has increased. We review the extant neuropsychological and neuroimaging literature on preclinical AD, focusing on longitudinal studies of initially nondemented individuals and cross-sectional investigations comparing at-risk with normal individuals. We systematically reviewed 91 studies of neuropsychological functioning, structural neuroimaging, or functional neuroimaging in preclinical AD. The neuropsychological studies indicated that preclinical AD might be characterized by subtle deficits in a broad range of neuropsychological domains, particularly in attention, learning and memory, executive functioning, processing speed, and language. Recent findings from neuroimaging research suggest that volume loss and cerebral blood flow or metabolic changes, particularly in the temporal lobe, may be detected before the onset of dementia. There exist several markers of a preclinical period of AD, in which specific cognitive and biochemical changes precede the clinical manifestations. The preclinical indicators of AD reflect early compromise of generalized brain integrity and temporal lobe functioning in particular. (JINS, 2006, 12, 707–735.)