Corina Satler

Emotional Working Memory in Alzheimer's Disease Patients

Background: Few studies have assessed whether emotional content affects processes supporting working memory in Alzheimer disease (AD) patients. Methods: We assessed 22 AD patients and 40 elderly controls (EC) with a delayed matching and non-matching to sample task (DMST/DNMST), and a spatial-delayed recognition span task (SRST; unique/varied) using emotional stimuli. Results: AD patients showed decreased performance on both tasks compared with EC. With regard to the valence of the stimuli, we did not observe significant performance differences between groups in the DMST/DNMST. However, both groups remembered a larger number of negative than positive or neutral pictures on unique SRST. Conclusion: The results suggest that AD patients show a relative preservation of working memory for emotional information, particularly for negative stimuli.

Emotion Processing for Arousal and Neutral Content in Alzheimer's Disease

Objective. To assess the ability of Alzheimers disease (AD) patients to perceive emotional information and to assign subjective emotional rating scores to audiovisual presentations. Materials and Methods. 24 subjects (14 with AD, matched to controls for age and educational levels) were studied. After neuropsychological assessment, they watched a Neutral story and then a story with Emotional content. Results. Recall scores for both stories were significantly lower in AD (Neutral and Emotional: P = .001). CG assigned different emotional scores for each version of the test, P = .001, while ratings of AD did not differ, P = .32. Linear regression analyses determined the best predictors of emotional rating and recognition memory for each group among neuropsychological tests battery. Conclusions. AD patients show changes in emotional processing on declarative memory and a preserved ability to express emotions in face of arousal content. The present findings suggest that these impairments are due to general cognitive decline.

Executive Dysfunctions: The Role in Attention Deficit Hyperactivity and Post-traumatic Stress Neuropsychiatric Disorders

Executive functions (EFs) is an umbrella term for various cognitive processes controlled by a complex neural activity, which allow the production of different types of behaviors seeking to achieve specific objectives, one of them being inhibitory control. There is a wide consensus that clinical and behavioral alterations associated with EF, such as inhibitory control, are present in various neuropsychiatric disorders. This paper reviews the research literature on the relationship between executive dysfunction, frontal-subcortical neural circuit changes, and the psychopathological processes associated with attention deficit hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD). A revision on the role of frontal-subcortical neural circuits and their presumable abnormal functioning and the high frequency of neuropsychiatric symptoms could explain the difficulties with putting effector mechanisms into action, giving individuals the necessary tools to act efficiently in their environment. Although, neuronal substrate data about ADHD and PTSD has been reported in the literature, it is isolated. Therefore, this review highlights the overlapping of neural substrates in the symptomatology of ADHD and PTSD disorders concerning EFs, especially in the inhibitory component. Thus, the changes related to impaired EF that accompany disorders like ADHD and PTSD could be explained by disturbances that have a direct or indirect impact on the functioning of these loops. Initially, the theoretical model of EF according to current neuropsychology will be presented, focusing on the inhibitory component. In a second stage, this component will be analyzed for each of the disorders of interest, considering the clinical aspects, the etiology and the neurobiological basis. Additionally, commonalities between the two neuropsychiatric conditions will be taken into consideration from the perspectives of cognitive and emotional inhibition. Finally, the implications and future prospects for research and interventions in the area will be outlined, with the intention of contributing scientific reference information that encompasses the knowledge and understanding of executive dysfunction and its relationship with these treated disorders.

Programa de reabilitação neuropsicológica da memória aplicada à demência: um estudo não controlado intrasujeitos

In this intra-subject non-controlled study, twenty-one elderly patients with Alzheimer Disease or other forms of dementia participated in a neuropsychological rehabilitation program involving gardening and colored cues. At the end of the neuropsychological rehabilitation program, improved scores were noted in the following tests: Mini-Mental State Examination (Z=-1.98, p<0.05); Wechsler Verbal Performance Scale subtest [(Z=-2.09) p<0.05]; Wechsler Memory Scale (Associated Pairs with Delayed Recall) [(Z=-2.07) p<0.05] and in the Yesavage Geriatric Depression Scale [(Z=-3.02) p<0.00]. It was also demonstrated that patients who learnt the contextual cues (reminiscences and flags) saw a significant reduction in the Geriatric Depression Scale. Depression Scale scores were lower in those who correctly free-recalled this association (F=2.12, p=0.14). Use of anticholinesterase drugs in the 4th and 12th weeks was associated with a reduction in the Geriatric Depression Scale, but not for those in the 30th week following the neuropsychological rehabilitation program.

Computerized spatial delayed recognition span task: a specific tool to assess visuospatial working memory.

A new tablet device version (IOS platform) of the Spatial Delayed Recognition Span Task (SDRST) was developed with the aim of investigating visuospatial Working Memory (WM) abilities based on touchscreen technology. This new WM testing application will be available to download for free in Apple Store app (“SDRST app”). In order to verify the feasibility of this computer-based task, we conducted three experiments with different manipulations and groups of participants. We were interested in investigating if (1) the SDRST is sensitive enough to tap into cognitive differences brought by aging and dementia; (2) different experimental manipulations work successfully; (3) cortical brain activations seen in other WM tasks are also demonstrated here; and (4) non-human primates are able to answer the task. Performance (scores and response time) was better for young than older adults and higher for the latter when compared to Alzheimer’s disease (AD) patients. All groups performed better with facial stimuli than with images of scenes and with emotional than with neutral stimuli. Electrophysiology data showed activation on prefrontal and frontal areas of scalp, theta band activity on the midline area, and gamma activity in left temporal area. There are all scalp regions known to be related to attention and WM. Besides those data, our sample of adult captive capuchin monkeys (Sapajus libidinosus) answered the task above chance level. Taken together, these results corroborate the reliability of this new computer-based SDRST as a measure of visuospatial WM in clinical and non-clinical populations as well as in non-human primates. Its tablet app allows the task to be administered in a wide range of settings, including hospitals, homes, schools, laboratories, universities, and research institutions.

Age-Related Differences in Cortical Activity during a Visuo-Spatial Working Memory Task with Facial Stimuli

Emotion, importantly displayed by facial expressions, is one of the most significant memory modulators. The interaction between memory and the different emotional valences change across lifespan, while young adults (YA) are expected to better recall negative events (Negativity Bias Hypothesis), older adults (OA) tend to focus on positive stimuli (Positivity Effect Hypothesis). This research work aims at verifying whether cortical electrical activity of these two age groups would also be differently influenced by emotional valences in a visuo-spatial working memory task. 27 YA (13 males) and 25 OA (14 males), all healthy volunteers, underwent electroencephalographic recordings (21 scalp electrodes montage), while performing the Spatial Delayed Recognition Span Task using a touch screen with different stimuli categories: neutral, positive and negative faces and geometric pictures. YA obtained higher scores than OA, and showed higher activation of theta and alpha bands in the frontal and midline regions, besides a more evident right-hemispheric asymmetry on alpha band when compared to OA. For both age groups, performance in the task was worse for positive faces than to negative and to neutral faces. Facial stimuli induced a better performance and higher alpha activation on the pre-frontal region for YA, and on the midline, occipital and left temporal regions for OA when compared to geometric figures. The superior performance of YA was expected due to the natural cognitive deficits connected to ageing, as was a better performance with facial stimuli due to the evolutionary importance of faces. These results were related to cortical activity on areas of importance for action-planning, decision making and sustained attention. Taken together, they are in accordance with the Negativity Bias but do not support the Positivity Effect. The methodology used was able to identify age-related differences in cortical activity during emotional mnemonic processing and may be interesting to future investigations.

Philadelphia Brief Assessment of Cognition in healthy and clinical Brazilian sample

The patient was a 19-year-old woman with chronic head-ache, hand tremor, and school difficulties. The examination revealed large subcutaneous nodules, epidermal nevus, gi-gantism of the feet, hypertrophy of the hemibody, and mild postural hand tremor. The magnetic resonance imaging (MRI) showed distortion in the morphology of cerebellar fo-lia, increased size of the cerebellum, and foci hypersignal on T2 (Figure). Based on diagnostic criteria published, this per-son has Proteus syndromeThe Philadelphia Brief Assessment of Cognition (PBAC) is a neuropsychological screening instrument that assesses five cognitive domains: working memory, visuospatial functioning, language, episodic memory and comportment. The aim is to verify if PBAC can properly be used in the Brazilian sample. Participated in this study: (a) 200 healthy volunteers - 100 young [21.6(2.5) years old] and 100 older adults [70.1(7.3) years old]; >12 years of education; (b) 30 Alzheimers patients (AD) [73.7(5.7) years old], 4-11 years in education. The PBAC scores: (a) 95.8(2.6), 90.0(4.4) and (b) 65.0(10.8) were correlated with the Mini-Mental State Examination (MMSE) for young 29.1(0.9), older adults 28.3(1.4) and AD 18.4(3.0) groups. A positive correlation between MMSE and PBAC (r=0.9, p<0.001) was found. Negative correlations were observed between PBAC domains [memory (-0.63), visuospatial abilities (-0.44) and working memory (-0.3) tasks]. MANOVA showed a better male performance in visuospatial functioning (F=8.5, p=0.004). The Brazilian version of PBAC proved to be a promising screening instrument for clinical purposes.O instrumento de rastreio neuropsicologico Philadelphia Brief Assessment of Cognition (PBAC) avalia cinco dominios cognitivos: memoria de trabalho, habilidade visuoespacial, linguagem, memoria episodica e comportamento. O objetivo e verificar a viabilidade do PBAC em amostra brasileira. Participaram: (a) 200 voluntarios - 100 jovens com 21,6(2,5) anos e 100 idosos com 70,1(7,3) anos, ambos com media de escolaridade maior que 12 anos; (b) 30 pacientes com Alzheimer, com 73,7(5,7) anos e escolaridade entre 4 e 11 anos. Os escores do PBAC para os respectivos grupos (a) 95,8(2,6), 90(4,4) e (b) 65(10,8) foram correlacionados com o Mini Exame do Estado Mental (MEEM). Houve correlacao positiva (r=0,9; p<0,001) entre MEEM e PBAC, e negativas entre os dominios do PBAC [memoria (-0,63), habilidades visuoespaciais (-0,44) e memoria de trabalho (-0,3)]. Foi demonstrado pela MANOVA melhor desempenho no funcionamento visuoespacial em homens (F=8,5, p=0,004). A versao brasileira do PBAC provou ser promissora como um instrumento de rastreio para propositos clinicos.

Cognitive anosognosia and behavioral changes in probable Alzheimer’s disease patients

Anosognosia, impairment insight and unawareness of deficits are used as equivalent terms in this study. OBJECTIVE To investigate the relationship between the presence of anosognosia symptoms and cognitive domains, functional abilities, and neuropsychiatric symptoms in patients with probable Alzheimers disease (pAD) and elderly controls (EC). METHODS Twenty-one pAD (14 women) and twenty-two EC (16 women) were submitted to a neuropsychological battery of tests assessing global cognitive status, and specific cognitive functions: memory, executive and attention functions, verbal fluency and visuoconstructive abilities. Additionally, functional abilities (FAQ) and neuropsychiatric symptoms (NPI) were measured. RESULTS The linear regression statistical test found general anosognosia to be associated with subjective memory complaints, age and Arithmetic-DRS in the EC group. On the other hand, cognitive and functional abilities scores (Arithmetic-DRS, IQCODE and FAQ) were the best predictors in pAD patients, particularly for behavioral awareness. CONCLUSION These results indicated that different variables are associated with self-awareness for pAD patients and EC, but for both groups executive functions appear to play an important role, contributing particularly to awareness of behavioral changes.

Frontotemporal dementia and neurocysticercosis. A case report

We report a case of a 67-year-old woman with frontotemporal dementia (FTD) and a history of neurocysticercosis. After her retirement she showed progressive behavioral changes and neuropsychiatric symptoms with relative preservation of cognitive functioning. During the next three years, the patient manifested progressive deterioration of verbal communication gradually evolving to mutism, a hallmark of cases of progressive nonfluent aphasia.

Negative Facial Expressions – But Not Visual Scenes – Enhance Human Working Memory in Younger and Older Participants

Many studies have investigated the influence of emotion on memory processes across the human lifespan. Some results have shown older adults (OA) performing better with positive stimuli, some with negative items, whereas some found no impact of emotional valence. Here we tested, in two independent studies, how younger adults (YA) and OA would perform in a visuospatial working memory (VSWM) task with positive, negative, and neutral images. The task consisted of identifying the new location of a stimulus in a crescent set of identical stimuli presented in different locations in a touch-screen monitor. In other words, participants should memorize the locations previously occupied to identify the new location. For each trial, the number of occupied locations increased until 8 or until a mistake was made. In study 1, 56 YA and 38 OA completed the task using images from the International Affective Picture System (IAPS). Results showed that, although YA outperformed OA, no effects of emotion were found. In study 2, 26 YA and 25 OA were tested using facial expressions as stimuli. Data from this study showed that negative faces facilitated performance and this effect did not differ between age groups. No differences were found between men and women. Taken together, our findings suggest that YA and OA’s VSWM can be influenced by the emotional valence of the information, though this effect was present only for facial stimuli. Presumably, this may have happened due to the social and biological importance of such stimuli, which are more effective in transmitting emotions than IAPS images. Critically, our results also indicate that the mixed findings in the literature about the influence of aging on the interactions between memory and emotion may be caused by the use of different stimuli and methods. This possibility should be kept in mind in future studies about memory and emotion across the lifespan.