Emilia Łojek

Cognitive patterns of normal elderly subjects are consistent with frontal cortico-subcortical and fronto-parietal neuropsychological models of brain aging.

Three neuropsychological theories have been developed according to a possible existence of a similar pattern of cognitive decline in elderly individuals and patients with brain damage. The respective neuropsychological theories attribute age-related deficits to: (a) dysfunction of the frontal lobes, (b) temporo-parietal dysfunction, or (c) decline of right-hemisphere functions. In the present study, we examined which of these theories best explains the cognitive patterns of normal elderly subjects older than 80 years of age (old elderly). Thirty normal old elderly subjects, 14 patients with subcortical vascular dementia, 14 with mild Alzheimers disease, 15 with damage of the right hemisphere of the brain, and 20 young elderly controls participated. A test battery covering the main cognitive domains was administered to all participants. A hierarchical cluster analysis revealed five groups of individuals with different cognitive patterns across the whole sample. Old elderly subjects were assigned to four groups according to: (a) preserved overall cognitive performance, (b) processing speed decline, (c) attention decline, or (d) executive impairment. The results of the study are most congruent with models emphasizing frontal-lobe cortical–subcortical and fronto-parietal changes in old age. The results also indicate considerable heterogeneity in the cognitive patterns of normal old elderly adults.

The nature of the relationship between neurocognition and theory of mind impairments in stroke patients.

Objective: Theory of mind (ToM) is a complex, high-level cognitive function that allows people to infer the cognitive and affective mental states of others. Previous studies have produced limited and frequently contradictory findings on the neuropsychological underpinnings of ToM performance in patients with stroke. The aim of the present study is to investigate neuropsychological mechanisms of cognitive and affective theory of mind dysfunctions in patients with stroke. Method: Fifty-eight patients with stroke and 22 healthy controls matched in age, gender, and education level underwent robust neuropsychological examination of their pragmatic abilities, executive functions, attention, memory, psychomotor speed, and visuospatial abilities as well as a cognitive and affective ToM assessment. Results: Patients with stroke demonstrated impaired performance in all ToM tasks. While pragmatic competence and, to a lesser degree, executive functions had the strongest contribution to ToM impairments, attention and general cognitive functioning did not directly affect mentalizing abilities, as demonstrated by a path analysis. Our study reveals the different roles of cognitive functions in cognitive and affective components of ToM. Executive functions contributed only to the cognitive components of ToM. Conclusion: Deficits in cognitive aspects of ToM are best explained by impairment of pragmatic competence and executive functions. In contrast, executive dysfunction does not affect the ability to understand the affective mental states of others.

Age and HIV effects on resting state of the brain in relationship to neurocognitive functioning

HighlightsHIV reduces resting state functional connectivity (FC) within Occipital Network.Age‐HIV interaction affects FC within Motor Network (MN).HIV strengthens relationship between FC within‐MN values and cognitive performance.In healthy aging, FC values have decreasing power in explaining cognitive functions.In HIV, age does not moderate relationships between RS‐FC and cognitive functions. ABSTRACT This study examined the effects of age and HIV infection on the resting state (RS) functional connectivity (FC) of the brain and cognitive functioning. The objective was to evaluate the moderating role of age and HIV on the relationship between RS‐FC and cognition. To examine RS‐FC we implemented the Independent Component Analysis (ICA) and Regional Homogeneity (ReHo). Neurocognition was evaluated with comprehensive battery of standardized neuropsychological tests. Age and HIV were entered as the independent variables. The independent effects of age, HIV, and interaction effects of age‐HIV on RS‐fMRI measures (ICA, ReHo) were tested in 108 participants (age M = 42). RS‐FC indices that exhibited age‐HIV interactions were entered into further analysis. Bivariate correlation analysis was performed between the retained RS‐FC indices and T‐scores of neurocognitive domains (Attention, Executive, Memory, Psychomotor, Semantic Skills). Multivariate regression modeling determined the impact of age and HIV on these relationships. We found that in the ICA measures, HIV‐seropositivity was decreasing RS‐FC in the left middle occipital gyrus (p < .001). Age‐HIV interaction was observed in the left superior frontal gyrus (LSupFrontG), where FC was decreasing with age in HIV+ (p < .001) and increasing in HIV− (p = .031). ReHo indices did not reveal significant effects. HIV strengthened the relationship between RS‐FC in LSupFrontG, Memory and Psychomotor Factor scores. Aging weakened those relationships only in control group. In sum, age‐HIV interaction effects are prominent rather in remote than local RS‐FC. Seroconversion strengthens relationships between intrinsic brain activity and neurocognition, but no acceleration with years of age was noted in HIV+ individuals.

HIV infection across aging: Synergistic effects on intrinsic functional connectivity of the brain.

Abstract The objective of the study was to examine additive and synergistic effects of age and HIV infection on resting state (RS) intra‐ and inter‐network functional connectivity (FC) of the brain. We also aimed to assess relationships with neurocognition and determine clinical‐, treatment‐, and health‐related factors moderating intrinsic brain activity in aging HIV‐positive (HIV+) individuals. The current report presents data on 54 HIV+ individuals (age M = 41, SD = 12 years) stabilized on cART and 54 socio‐demographically matched healthy (HIV−) comparators (age M = 43, SD = 12 years), with cohort education mean of 16 years (SD = 12). Age at seroconversion ranged 20–55 years old. ANOVA assessed additive and synergistic effects of age and HIV in 133 ROIs. Bivariate statistics examined relationships of FC indices vulnerable to age‐HIV interactions and neurocognitive domains T‐scores (attention, executive, memory, psychomotor, semantic skills). Multivariate logistic models determined covariates of FC. This study found no statistically significant age‐HIV effects on RS‐FC after correcting for multiple comparisons except for synergistic effects on connectivity within cingulo‐opercular network (CON) at the trending level. However, for uncorrected RS connectivity analyses, we observed HIV‐related strengthening between regions of fronto‐parietal network (FPN) and default mode network (DMN), and particular DMN regions and sensorimotor network (SMN). Simultaneously, FC weakening was observed within FPN and between other regions of DMN‐SMN, in HIV+ vs. HIV‐ individuals. Ten ROI pairs revealed age‐HIV interactions, with FC decreasing with age in HIV+, while increasing in controls. FC correlated with particular cognitive domains positively in HIV+ vs. negatively in HIV‐ group. Proportion of life prior‐to‐after HIV‐seroconversion, post‐infection years, and treatment determined within‐FPN and SMN‐DMN FC. In sum, highly functioning HIV+/cART+ patients do not reveal significantly altered RS‐FC from healthy comparators. Nonetheless, the current findings uncorrected for multiple comparisons suggest that HIV infection may lead to simultaneous increases and decreases in FC in distinct brain regions even in patients successfully stabilized on cART. Moreover, RS‐fMRI ROI‐based analysis can be sensitive to age‐HIV interactions, which are especially pronounced for inter‐network FC in relation to neurocognition. Aging and treatment‐related factors partially explain RS‐FC in aging HIV+ patients. HighlightsHIV infection may lead not only to weakened but also strengthened RS connectivity.RS‐fMRI FC is sensitive to age‐HIV synergistic effects in patients stable on cART.Age‐HIV interactions change directionality rather than exacerbate HIV effects on FC.Negative relations between FC and cognitive domains in health are positive in HIV.Infection duration, proportion of life prior‐to‐after conversion, cART determine FC.

Effects of age, HIV, and HIV-associated clinical factors on neuropsychological functioning and brain regional volume in HIV+ patients on effective treatment

It is yet unclear if people infected with human immunodeficiency virus (HIV+) on stable, combined antiretroviral therapies (cARTs) decline with age at the same or greater rate than healthy people. In this study, we examined independent and interactive effects of HIV, age, and HIV-related clinical parameters on neuropsychological functioning and brain regional volume in a sizable group of Polish HIV+ men receiving cART. We also estimated the impact of nadir CD4 cell count, CD4 cell count during participation in the study, duration of HIV infection, or duration of cART along with age. Ninety-one HIV+ and 95 control (HIV−) volunteers ages 23–75 completed a battery of neuropsychological tests, and 54 HIV+ and 62 HIV− of these volunteers participated in a brain imaging assessment. Regional brain volume in the cortical and subcortical regions was measured using voxel-based morphometry. We have found that HIV and older age were independently related to lower attention, working memory, nonverbal fluency, and visuomotor dexterity. Older age but not HIV was associated with less volume in several cortical and subcortical brain regions. In the oldest HIV+ participants, age had a moderating effect on the relationship between the duration of cART and visuomotor performance, such as that older age decreased speed of visuomotor performance along with every year on cART. Such results may reflect the efficacy of cART in preventing HIV-associated brain damage. They also highlight the importance of monitoring neuropsychological functioning and brain structure in HIV+ patients. This is particularly important in older patients with long adherence to cART.

Metaphor Processing in Schizophrenia Patients: A Study of Comprehension and Explanation of Metaphors

Abstract The study assessed the quantity and quality of errors made by schizophrenia patients in understanding and interpretation of the same metaphors, to evaluate metaphor understanding and explanation depending on the type of presentation material, and to analyze the correlation of illness symptoms with metaphor comprehension and explanation. Two groups of participants were examined: a schizophrenia sample (40 participants) and a control group (39 participants). Metaphor processing was assessed by the subtests of the Polish version of the Right Hemisphere Language Battery (RHLB-PL). The patients were also evaluated with the Positive and Negative Syndrome Scale (PANSS). Schizophrenia patients scored significantly lower in explanation of metaphors, making more incorrect literal and abstract mistakes or providing no answer more frequently. No differences were observed in understanding metaphors; no correlation between symptoms and metaphor processing was obtained. In both groups, picture metaphors were easier to comprehend and written metaphors were easier to comprehend than to explain.

Metaphor Comprehension and Interpretation in Cleft Palate Children Aged 6–9

Abstract The level of metaphor comprehension and interpretation was investigated in a sample of children with cleft palate (CP), aged 6;0-8;11, and healthy controls matched with age, sex, socioeconomic status, and IQ level. The Wechsler Intelligence Scale for Children - Revised (WISC-R) was used to evaluate the children’s cognitive functioning, and the metaphor tests from a modified version of the Right Hemisphere Language Battery - Polish version (RHLB-PL) were used to assess comprehension of figurative language. The CP and control groups differed significantly in Verbal IQ values and in performance in the Vocabulary test, Comprehension test, Picture Metaphor Explanation test, and Written Metaphor Explanation test. In both metaphor explanation tests, children with CP gave fewer responses than controls. The results suggest no differences between children with CP and controls in understanding figurative language, although they point to weaker performance in communicating responses and producing statements in the CP children group.

Validity and Reliability of the Polish Adaptation of the Ruff Figural Fluency Test

Abstract Normative studies of the Polish adaptation of Th e Ruff Figural Fluency Test (RFFT) were conducted on 475 men and women aged 16-79, taking into consideration such factors as gender, education, and place of residence. Clinical studies were also performed on a group of patients with left -, right-, or bilateral hemispheric brain lesions, Parkinson’s disease, Huntingon’s disease, progressive obturational lung disease, dementia and depression. Th e results support the utility of the RFFT as a measure of executive functions. Th e validity and reliability indices of the Polish version of the test are similar to those reported by Ruff (1996). However, the sample Polish test performance differs notably from American samples performance and this difference is discussed.