Andrea Zangrossi

Cognitive Reserve in Dementia: Implications for Cognitive Training.

Cognitive reserve (CR) is a potential mechanism to cope with brain damage. The aim of this study was to evaluate the effect of CR on a cognitive training (CT) in a group of patients with dementia. Eighty six participants with mild to moderate dementia were identified by their level of CR quantified by the CR Index questionnaire (CRIq) and underwent a cycle of CT. A global measure of cognition mini mental state examination (MMSE) was obtained before (T0) and after (T1) the training. Multiple linear regression analyses highlighted CR as a significant factor able to predict changes in cognitive performance after the CT. In particular, patients with lower CR benefited from a CT program more than those with high CR. These data show that CR can modulate the outcome of a CT program and that it should be considered as a predictive factor of neuropsychological rehabilitation training efficacy in people with dementia.

I didn't want to do it! The detection of past intentions.

In daily life and in courtrooms, people regularly analyze the minds of others to understand intentions. Specifically, the detection of intentions behind prior events is one of the main issues dealt with in courtrooms. To our knowledge, there are no experimental works focused on the use of memory detection techniques to detect past intentions. This study aims at investigating whether reaction times (RTs) could be used for this purpose, by evaluating the accuracy of the autobiographical Implicit Association Test (aIAT) in the detection of past intentions. Sixty healthy volunteers took part in the experiment (mean age: 36.5 y; range: 18–55; 30 males). Participants were asked to recall and report information about a meeting with a person that had occurred at least 1 month before. Half of the participants were required to report about an intentional meeting, whereas the other half reported on a chance meeting. Based on the conveyed information, participants performed a tailored aIAT in which they had to categorize real reported information contrasted with counterfeit information. Results demonstrated that RTs can be a useful measure for the detection of past intentions and that aIAT can detect real past intentions with an accuracy of 95%.

Chapter 16 – Honesty

The cognitive perspective on honesty holds that deception is cognitively more demanding than truth telling. Attempted deception is associated with the activation of executive brain regions (particularly the prefrontal and anterior cingulate cortices), while truthful responding has not been shown to be associated with any areas of increased activation (relative to deception). This chapter discusses the recent findings regarding the cognitive correlates of deception and proposes a framework for understanding the neural mechanisms that allow people to tell lies. We explore lying from a developmental perspective and describe the findings obtained from cognitive and neuroimaging studies. Finally, in the last sections, we discusses the findings on pathological lying, on the moral brain, and on future research directions in the cognitive neuroscience of honesty.

Cognitive and motor reaction times in obstructive sleep apnea syndrome: A study based on computerized measures

HighlightsObstructive sleep apnea syndrome (OSAS) globally impairs cognitive functioning.Patients with OSAS show slowness in the “motor” component of reaction times, not in “cognitive” reaction times.Hypoxia might accelerate the normal aging processes by compromising the motor component of reaction times. Abstract Obstructive Sleep Apnea Syndrome (OSAS) is mainly associated with executive dysfunction. Although delayed reaction times (RTs) in patients with OSAS have been reported, sensitivity of processing speed has not been adequately assessed. This study suggests sensitive and reliable measures to clarify whether different components of information processing speed, i.e. cognitive and motor responses, are equally impaired in OSAS. Thirty‐three patients with OSAS were compared with thirty healthy controls. The MoCA test was administered to assess participants’ global neuropsychological profile. Cognitive and motor reaction times were measured using a detector panel which allows to distinguish between stimulus encoding, decision processing, and selection of the appropriate motor response. Logistic regression models highlighted both MoCA test and motor RTs as the best predictors differentiating patients from healthy participants. Results support the hypothesis of a slight decline in the cognitive profile of patients with OSAS and identify significant slowing down in the motor component of responses. It could be hypothesized that slower motor responsiveness is the cause of the global cognitive profile of these patients. With aging, motor movements and RTs usually become impaired and hypoxia might accelerate the aging process by compromising first of all the motor component of RTs.

Detection of Malingering in Personal Injury and Damage Ascertainment

One of the most important challenges encountered by forensic and medicolegal professionals is the evaluation of simulating and dissimulating behaviors exhibited by litigants. The main feature of malingering is represented by the intentional production of false or exaggerated symptoms, motivated by external incentives. Assessment of malingering is often inadequate when exclusively based on the clinical interview, sometimes also grounded solely on the clinician’s negative opinion. For this reason, the misclassification rate in the detection of malingerers can be considered alarmingly high (over 80 %). Malingering is not an all-or-nothing phenomenon, but it can be realized on several levels. Moreover, an examinee may attempt to malinger in a number of different ways, including fabricating or exaggerating psychiatric symptoms or presenting various types of cognitive deficits. Thus, several strategies have been identified for malingering detection (e.g., discrepancy method, symptoms analysis, and symptom validity testing).

Normative data for the Italian version of the Montreal Cognitive Assessment (MoCA): the impact of sociocultural variables on cut-offs

Objective: Cognitive dysfunction is common in patients with primary brain tumors and it is now recognized as an independent prognostic factor in survival. In addition, cognitive functioning has a major impact on quality of life and the ability to perform activities of daily living. Previous studies have mainly focused on glioma patients. This prospective follow-up study focuses on cognitive functioning in meningioma patients before and after surgery. Participants and Methods: Sixty-one meningioma patients, who underwent an intracranial neurosurgical procedure in the St. Elisabeth Hospital, were assessed one day before surgery and 3 months after surgery. To identify the impaired domains of cognitive function, all patients were assessed with a computerized neuropsychological test, CNS Vital Signs. The standard scores of the patients on seven cognitive domains were compared with the normative healthy American control group from CNS VS by means of one-tailed one-sample t-tests. Results: Meningioma patients showed significantly lower scores on all cognitive domains preoperatively, in comparison with healthy controls (p < 0.05). After surgery, the performance of the patients was significantly lower on the domains of memory, psychomotor speed, reaction time and complex attention. Their scores on the three other domains (cognitive flexibility, processing speed and executive functioning) did not deviate from the controls. Conclusions: Based on these results, we can conclude that meningioma patients are faced with substantial cognitive dysfunction in several cognitive domains both pre- and postoperatively. This study emphasizes the importance of the use of neuropsychological tests to identify cognitive deficits in meningioma patients, so that appropriate treatment can be provided.

Global cognitive profile and different components of reaction times in obstructive sleep apnea syndrome: effects of continuous positive airway pressure over time

Obstructive sleep apnea syndrome (OSAS) has been recurrently associated with cognitive and psychomotor impairments. However, the occurrence and possible reversibility of these deficits are still extremely controversial, also as a result of different methodologies adopted used by scholars. The aim of the present study was to compare over time the global cognitive profile of patients with OSAS undergoing the continuous positive airway pressure treatment (CPAP; N=23) with that of patients with OSAS who were not (N=10). A group of healthy participants (N=30) was also included. This study adopted a specific methodological approach allowing the researchers to distinguish between the cognitive and the motor component of reaction times (RTs). After baseline assessment, the same tests were administered after three and six months. No significant differences emerged between groups at each time point. On the other hand, the analysis of cognitive score trajectory over time revealed differences between groups. While healthy controls and OSAS patients undergoing CPAP showed increased MoCA test scores after three months, patients not undergoing CPAP improved their scores only after six months. In addition, patients treated with CPAP also showed significantly faster psychomotor response in motor RTs over time. Results seem to conceivably support a global cognitive vulnerability of non-treated OSAS patients. Conversely, the RT response of treated patients can be increased over time by CPAP, at least in the motor component of RTs. Therefore, our study suggests that CPAP may play an important role by slowing down the negative effects of OSAS, and by fostering sufficient cognitive functioning and adequate psychomotor speed.

Detection of Malingering in Psychic Damage Ascertainment

Malingering is the intentional feigning or exaggeration of physical or psychological symptoms. Since the beginning of 1900 malingering detection has been one of the main challenges in medico-legal practice and in particular in psychiatric and cognitive assessment, as behavioral symptoms are very easy to produce, so that the need for specific tools and strategies for malingering detection is crucial. Although several tools and strategies are available, conclusions are often derived from mere subjective impressions and in many cases they lead to misclassifications. Here we present a non-exhaustive review of strategies for the detection of malingering, starting from the logic underlying a qualitative analysis of symptoms, to validated tools specifically designed to detect attempts at simulating or exaggerating psychopathological, psychiatric or cognitive diseases. Finally, we describe two recent approaches to the malingering detection problem. These approaches are grounded on the analysis of the reaction-times and on the dynamic analysis of kinematic features of mouse trajectories while an examinee is answering to double-choice questions.