Maurits van den Noort

Foreign language proficiency and working memory capacity

In this study, the hypothesis that working memory capacity interacts with (foreign) language proficiency was tested on multilinguals, who were native (L1) Dutch speakers, were fluent in their second (L2) language, German, and had recently started the acquisition of their third (L3) language, Norwegian. So far, the results of second-language studies on simple and complex working-memory tasks are mixed. In previous second-language studies, however, languages that belong to different linguistic groups were used. The question arises whether the interaction between working memory capacity and language proficiency is language-specific. In our multilingualism study we, therefore, controlled for this. Both simple (digit-span) and complex working-memory tasks (reading-span task and letter-number ordering) were used. The general results show that differences in performance between L1, L2, and L3 can be found on both simple and complex working-memory tasks, supporting the working memory capacity interaction hypothesis.

A Standard Computerized Version of the Reading Span Test in Different Languages

The Reading Span Test (RST) is a verbal working-memory test. The original RST (Daneman & Carpenter, 1980), and derivatives of it, are being used increasingly as assessments of central executive functioning and for research on aging-associated cognitive decline (Whitney, Arnett, Driver, & Budd, 2001). Several versions have been made in order to further improve the test or to develop a version in a different language. However, all versions changed different things, making direct comparisons of the results with the RST between different research groups and across different languages impossible. This paper presents the results of testing a new standard computerized version of the RST in four languages (Dutch, English, German, and Norwegian). The new RST meets strict methodological criteria that are the same for all four language versions. A plausibility test, an abstract-concrete rating scale, and a pilot-study were conducted on native speakers to test the new RST. In addition, the internal and external relia...

Cross-linguistic neuroimaging and dyslexia: A critical view

Recent neuro-cognitive theories of dyslexia presume that all dyslexics have the same type of brain abnormality irrespective of the particular writing system their language uses. In this article, we indicate how this presumption is inconsistent with cross-linguistic investigations of reading and dyslexia. There are two main issues. First, the information-processing requirements of reading vary greatly across different orthographies. Second, it is known that even within a single orthography there are different subtypes of dyslexia. Consequentially, it cannot be the case, not even within a single orthography let alone across orthographies, that all dyslexics have the same type of brain abnormality. Neuro-cognitive theorizing about dyslexia cannot afford to ignore these issues.

Acupuncture on GB34 activates the precentral gyrus and prefrontal cortex in Parkinson’s disease

BackgroundAcupuncture is increasingly used as an additional treatment for patients with Parkinson’s disease (PD).MethodsIn this functional magnetic resonance imaging study, brain activation in response to acupuncture in a group of 12 patients with PD was compared with a group of 12 healthy participants. Acupuncture was conducted on a specific acupoint, the right GB 34 (Yanglingquan), which is a frequently used acupoint for motor function treatment in the oriental medical field.ResultsAcupuncture stimulation on this acupoint activates the prefrontal cortex, precentral gyrus, and putamen in patients with PD; areas that are known to be impaired in patients with PD. Compared with healthy participants, patients with PD showed significantly higher brain activity in the prefrontal cortex and precentral gyrus, especially visible in the left hemisphere.ConclusionsThe neuroimaging results of our study suggest that in future acupuncture research; the prefrontal cortex as well as the precentral gyrus should be treated for symptoms of Parkinson’s disease and that GB 34 seems to be a suitable acupoint. Moreover, acupuncture evoked different brain activations in patients with Parkinson’s disease than in healthy participants in our study, stressing the importance of conducting acupuncture studies on both healthy participants as well as patients within the same study, in order to detect acupuncture efficacy.Trial registrationKCT0001122 at cris.nih.go.kr (registration date: 20140530)

Consecutive Acupuncture Stimulations Lead to Significantly Decreased Neural Responses

OBJECTIVE Functional magnetic resonance imaging (fMRI), in combination with block design paradigms with consecutive acupuncture stimulations, has often been used to investigate the neural responses to acupuncture. In this study, we investigated whether previous acupuncture stimulations can affect brain activations of later acupuncture stimulations. DESIGN All subjects were measured twice in the same scanning session and a block design was used. SETTING The study was conducted at Kyung Hee University, Seoul, Republic of Korea. SUBJECTS Fifteen (15) healthy right-handed male volunteers participated in the study. INTERVENTION The subjects received two acupuncture stimulations on BL62 (Shenmai) on the right foot with a time interval of 5 minutes. In addition, sham stimulations were tested with the same paradigm. OUTCOME MEASURES One-sample t tests were conducted in order to map the brain activations induced by the acupuncture and sham stimulations. Moreover, paired-sample t tests were conducted to investigate the signal changes between the first and second acupuncture stimulation. RESULTS During the first acupuncture stimulation, in the left hemisphere, significant foci of activation were found in the hypothalamus, thalamus, claustrum, cerebellum, inferior frontal gyrus, and the superior temporal gyrus. In the right hemisphere, a significant focus of activation was found in the middle frontal gyrus. In addition, in both hemispheres, a significant focus of activation was found in the inferior parietal lobule. Interestingly, however, during the second acupuncture stimulation, the only areas that were also significantly activated were the cerebellum in the left hemisphere and the inferior parietal lobule in the right hemisphere. CONCLUSIONS We found that consecutive acupuncture stimulations on BL62 affected the neural responses in a significant way, resulting in decreased activations during the second acupuncture stimulation. This is an important finding, suggesting that in future fMRI studies on acupuncture, researchers should take this methodological issue more seriously.

Sleep Ameliorating Effects of Acupuncture in a Psychiatric Population

The interest of psychiatric patients for complementary medicine, such as acupuncture, is stable, but effect studies in psychiatry remain scarce. In this pilot study, the effects of 3 months of acupuncture treatment on sleep were evaluated and compared between a group of patients with schizophrenia (n = 16) and a group with depression (n = 16). Healthy controls were included in order to establish reference values (n = 8). Patients with schizophrenia and depression were randomly assigned to either a waiting list or a treatment condition. The Pittsburgh Sleep Quality Inventory was completed before and after the acupuncture treatment (individualized and according to traditional Chinese medicine principles) or the waiting list condition. Both acupuncture groups showed significant lower scores on the sleep inventory, which was not the case for the waiting list condition. Moreover, it was found that the effectiveness of the acupuncture treatment was higher in the patients with schizophrenia than in the patients with depression. Acupuncture seems able to improve sleep in this convenient sample of patients with long-lasting psychiatric problems and may be a suitable and cost-effective add-on treatment for this group, particularly if conducted group-wise.

The effect of acupuncture on mood and working memory in patients with depression and schizophrenia.

BACKGROUND In patients with depression, as well as in patients with schizophrenia, both mood and working memory performance are often impaired. Both issues can only be addressed and improved with medication to some extent. OBJECTIVE This study investigates the mood and the working memory performance in patients with depression or schizophrenia and whether acupuncture can improve these. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS A pragmatic clinical trial design was used. The study was conducted in a psychiatric clinic. Fifty patients with depression and 50 with schizophrenia were randomly divided into an experimental and a waiting-list group. Additionally, 25 healthy control participants were included. Twelve weeks of individualized acupuncture treatment was used as the clinical intervention. MAIN OUTCOME MEASURES All patients were tested before (T1) and after (T2) acupuncture treatment on a mood scale (Beck Depression Inventory-II, BDI-II), a simple working memory task (digit span), and a complex working memory task (letter-number sequencing); the healthy controls were tested at T1 only. RESULTS Patients with depression scored worse than the others on the BDI-II, and patients with schizophrenia scored worse than the healthy controls. On the digit span, patients with schizophrenia did not differ from healthy controls whereas they scored worse of all on the letter-number sequencing. With respect to the acupuncture findings, first, the present study showed that the use of acupuncture to treat patients with schizophrenia was both practical and safe. Moreover, acupuncture had a positive effect on the BDI-II for the depression group, but acupuncture had no effect on the digit span and on the letter-number sequencing performance for the two clinical groups. CONCLUSION The clinical improvement in patients with depression after acupuncture treatment was not accompanied by any significant change in a simple working memory task or in a more complex working memory task; the same was true for the patients with schizophrenia. TRIAL REGISTRATION Dutch Trial Register NTR3132.

Schizophrenia and Depression: A systematic Review of the Effectiveness and the Working Mechanisms Behind Acupuncture

OBJECTIVE This systematic review assessed clinical evidence for the use of acupuncture as an add-on treatment in patients with depression and schizophrenia and for its underlying working mechanisms. DATA SOURCES Four databases (Medline, Scopus, ERIC, and the Cochrane Library) were searched with a cutoff date of March 31, 2014. STUDY SELECTION Systematic reviews and meta-analyses of acupuncture treatment for depression and schizophrenia were considered for inclusion. The scarcity of acupuncture research involving schizophrenia led to the inclusion of randomized controlled trials and case studies. DATA EXTRACTION The primary and secondary aims of this study were to evaluate the effects of acupuncture in treating patients with depression or schizophrenia and the possible working mechanisms underlying acupuncture through a systematic literature review. DATA SYNTHESIS The overall clinical results on using acupuncture to treat depression are promising, but only limited evidence for its effectiveness in treating schizophrenia was found. Acupuncture improves the quality of life, particularly that of sleep, in psychiatric patients. Brain research has revealed that acupuncture has a modulating and normalizing effect on the limbic-paralimbic-neocortical network (LPNN), including the default mode network. Because the LPNN is related to sleep and emotions, this might explain the improved qualities of life and sleep after acupuncture. CONCLUSIONS From the evidence found in this study, acupuncture seems to be an effective add-on treatment in patients with depression and, to a lesser degree, in patients with schizophrenia, but large well-designed studies are needed to confirm that evidence.

Gender differences in the neural response to acupuncture: Clinical implications

Objective To examine gender differences and similarities in the psychophysical and brain responses to acupuncture at GB34, a point that is frequently used to treat motor function issues in Traditional Chinese Medicine. Methods Functional MRI (fMRI) was used to measure brain activation in response to acupuncture at GB34 (on the right) in 19 healthy participants (9 male, 10 female). De qi sensations were rated to measure their psychophysical responses. Results Overall de qi scores did not differ by gender, although females reported greater intensity of aching (p=0.04). Acupuncture activated the hippocampus, thalamus, globus pallidus, caudate body, claustrum, cingulate gyrus, and culmen in males, and the middle and inferior frontal gyrus, precuneus, postcentral gyrus, inferior parietal lobule, superior temporal gyrus, caudate body, insula, fusiform gyrus, cingulate gyrus, amygdala, and parahippocampal gyrus in females. The middle/medial frontal gyrus, middle temporal gyrus, thalamus, globus pallidus, caudate body, uvula, and cerebellar tonsil were activated when data from all subjects were combined. Relative to males, females exhibited greater brain activation in the right-sided postcentral gyrus, precentral gyrus, precuneus, postcentral gyrus, inferior parietal lobule, declive, middle occipital gyrus and parahippocampal gyrus. Conclusions The neural effects of GB34 acupuncture might differ between males and females because different brain structures were modulated in response to acupuncture. This potential gender effect should be taken into account in future clinical research. We also revealed that the caudate body was activated by GB34 acupuncture in both males and females and may represent a major target of GB34 acupuncture. Trial Registration Number KMC IRB 0861-06.

Schizophrenia, Depression, and Sleep Disorders: Their Traditional Oriental Medicine Equivalents

Psychiatric disorders can be described and treated from both a Western (allopathic) and an Eastern perspective, which should be taken into account when conducting research. Patients with schizophrenia or depression are likely to be undergoing Western treatment when they are referred to an acupuncturist for (add-on) treatment, and knowledge of both types of treatments is necessary to integrate them successfully. In this study, the different Traditional Oriental Medicine (TOM) diagnostic patterns in patients with a Western diagnosis of schizophrenia, depression, or sleep disorders are described from a literature and a clinical perspective. The data on 30 depression and 30 schizophrenia patients from a German study are presented. Our results show that if a psychiatric group, sorted in accordance to Western diagnostic principles, is diagnosed on the basis of TOM diagnostic patterns, it can be categorized into different groups of patients with psychiatric disorders; this finding has far-reaching consequences in scientific research on acupuncture. Moreover, we found a high prevalence of sleep disorders in patients with both schizophrenia and depression, which could be explained from the perspective of a TOM diagnostic pattern. Finally, we discuss sleep quality as a treatment objective that may play a crucial role in mediating acupuncture-induced treatment effects in patients with schizophrenia and depression.