Cognitive impairment can begin in the early stages of multiple sclerosis (MS). No medicine has been approved for treating cognitive impairment in MS patients. There is a lack of data on the role of ...rituximab in managing cognitive impairment in MS patients. Using minimal assessment of cognitive function in MS (MACFIMS), this study aims to investigate the effect of rituximab on the cognitive status of relapsing-remitting MS (RRMS) patients.
In this pre-post interventional trial, 28 eligible RRMS patients participated. They were administered rituximab for a year. Cognitive tests (MACFIMS), MS neuropsychological questionnaire (MSNQ), and Beck depression inventory-fast screen (BDI-FS) scores were evaluated at baseline, six, and 12 months following rituximab administration.
Eighteen participants with a mean age of 40.5 ± 12.91, 7 men, completed all three follow-ups. There was no statistically significant change in BDI-FS, MSNQ, Paced Auditory Serial Addition Test (P: 0.743), Symbol Digit Modalities Test (P: 0.711), Brief Visual Memory Test (BVMT) (P: 0.426), learning BVMT (P: 0.268), and delayed recall BVMT (P: 0.394) scores. However, the California Verbal Learning Test (CVLT), CVLT learning, and Controlled Oral Word Association Test scores significantly improved by 45.2% (P < 0.001), 12.3% (P: 0.013), and 26.7% (P: 0.011), respectively, 6-month follow-up rituximab treatment. There was a significant improvement in CVLT (+55.7%, P < 0.001), CVLT learning (+15.9%, P: 0.011), and delayed recall CVLT (+28%, P: 0.022) scores 12-month follow-up rituximab treatment.
Rituximab prevents cognitive deterioration and improves some cognitive functions. Further investigations with a larger sample size, longer follow-ups, and inclusion of a placebo or another treatment arm are recommended.
Display omitted
Objective: Much of our knowledge concerning the neural basis of human memory derives from lab-based verbal recall tasks. Outside of the lab, clinicians use validated and normed neuropsychological ...tests to assess patients' memory function and to evaluate clinical interventions. Here we sought to establish the clinical validity of examining memory through multitrial free recall of semantically organized and unrelated word lists. Method: We compare memory performance in multitrial free recall tasks with the Rey Auditory Verbal Learning Test and the California Verbal Learning Test, two common neuropsychological tests aimed at evaluating memory function in clinical settings. We compare predictive validity between the tasks by evaluating deficits in a patient sample and examining age-related declines in memory. We additionally compare test-retest reliability, establish convergent validity, and show the emergence of common recall dynamics between the tasks. Results: We demonstrate that both laboratory free recall tasks have better predictive validity and test-retest reliability than the established neuropsychological tests. We further show that all tasks have good convergent validity and reveal core memory processes, including temporal and semantic organization. However, we also demonstrate the benefits of repeated trials for evaluating the dynamics of memory search and their neuropsychological sequelae. Conclusions: These results provide evidence for the clinical validity of lab-based multitrial free recall tasks and highlight their psychometric benefits over neuropsychological measures. Based on these results, we discuss the need to bridge the gap between clinical understanding of putative mechanisms underlying memory disorders and neuroscientific findings obtained using lab-based free recall tasks.
Key Points
Question: How do the reliability and validity of laboratory-based recall paradigms compare with traditional neuropsychological recall measures? Findings: Laboratory-based recall paradigms have strong internal validity, test-retest reliability, and convergent validity with established neuropsychological tests. Importance: These data support the clinical validity of multitrial free recall tests with unique word lists. Next Steps: Identifying the neural correlates of behavioral deficits in recall tasks can offer novel insights into clinical disorders resulting in impaired memory performance.
Despite an increasing need for new Rey Auditory Verbal Learning Test (RAVLT)-based word lists in computerized testing, no criteria or standardized procedures exist for its development. To lay a ...foundation for future development of new and alternate computerized RAVLT(-based) word lists, we present cross-lingual word criteria, developed new lists using the criteria and evaluated performance on the lists using online assessment.
Based on psycholinguistic literature, we identified relevant word selection criteria. To validate the criteria, we developed two new American-English word lists and one new Dutch list, and administered the RAVLT using visual presentation of the new or original list in an online American (n = 248) and Dutch sample (n = 246) of healthy people. We compared performance of the new and original word lists on trial scores and serial position effects using Bayesian correlations and analyses of variance. Additionally, we compared proportions of correct responses per item, corrected for serial position.
We identified 13 relevant word selection criteria. The criteria led to two new highly comparable American-English word lists with lower trial scores compared to the original American-English list, indicating that the criteria helped to develop parallel lists with fewer associations between items. The new Dutch word list showed similar trial scores, serial position effects, and proportions of correct responses per item corrected for serial position compared to the original Dutch version.
The systematic use of word selection criteria can facilitate development of new parallel word lists, including in new language areas. Future studies should evaluate the use of the word criteria for the other sections of the RAVLT (such as delayed recall and recognition), performance using original test modalities (auditory presentation and recall of words) as well as performance in clinical samples.
Background
Previous studies using the California Verbal Learning Test‐Children's Version (CVLT‐C) to examine effects of heavy prenatal alcohol exposure on verbal learning and memory have reported ...impaired information acquisition (i.e., encoding), rather than retrieval, as the primary mechanism underlying learning and memory impairment. We administered the CVLT‐C to 2 independent cohorts to determine whether (i) effects on encoding are also seen at moderate exposure levels, using both categorical (diagnostic/exposure group) and continuous exposure measures; (ii) these deficits are specific or secondary to alcohol‐related impairment in IQ; (iii) effects on retrieval can be detected over and above effects on initial encoding; and (iv) effects on learning are attributable to less efficient learning strategy use.
Methods
We administered the CVLT‐C and Wechsler Intelligence Scale for Children to 151 Cape Town heavy and nonexposed children (M = 10.3 years), and 291 Detroit adolescents recruited to over‐represent moderate‐to‐heavy prenatal alcohol exposure (M = 14.4 years).
Results
Effects on encoding in the heavily exposed Cape Town cohort and on retrieval in both cohorts were significant after adjustment for IQ. Although effects on retrieval were no longer significant in Cape Town after control for initial encoding, effects on recognition memory continued to be evident in Detroit. Children with full or partial fetal alcohol syndrome were less able to use the semantic cluster encoding strategy implicit in the CVLT‐C.
Conclusions
Effects on verbal learning were seen primarily in the more heavily exposed Cape Town cohort; effects on recall and recognition memory were also seen at moderate exposure levels in Detroit. These effects were not attributable to alcohol‐related impairment in overall intellectual competence. The finding that effects on retention continued to be evident after statistical adjustment for initial encoding in Detroit suggests that a fetal alcohol‐related deficit in retrieval is not secondary to a failure to encode the initial information. These data confirm that this impairment in initial learning is mediated, in part, by failure to use the semantic cluster learning strategy.
Both the original and second editions of the California Verbal Learning Test (CVLT) provide an index of total recognition discriminability (TRD) but respectively utilize nonparametric and parametric ...formulas to compute the index. However, the degree to which population differences in TRD may vary across applications of these nonparametric and parametric formulas has not been explored. We evaluated individuals with Huntington's disease (HD), individuals with Alzheimer's disease (AD), healthy middle-aged adults, and healthy older adults who were administered the CVLT-II. Yes/no recognition memory indices were generated, including raw nonparametric TRD scores (as used in CVLT-I) and raw and standardized parametric TRD scores (as used in CVLT-II), as well as false positive (FP) rates. Overall, the patient groups had significantly lower TRD scores than their comparison groups. The application of nonparametric and parametric formulas resulted in comparable effect sizes for all group comparisons on raw TRD scores. Relative to the HD group, the AD group showed comparable standardized parametric TRD scores (despite lower raw nonparametric and parametric TRD scores), whereas the previous CVLT literature has shown that standardized TRD scores are lower in AD than in HD. Possible explanations for the similarity in standardized parametric TRD scores in the HD and AD groups in the present study are discussed, with an emphasis on the importance of evaluating TRD scores in the context of other indices such as FP rates in an effort to fully capture recognition memory function using the CVLT-II.
Rationale:
Regular cannabis users have been shown to differ from non-using controls in learning performance. It is unclear if these differences are specific to distinct domains of learning (verbal, ...visuospatial), exacerbate with extent of cannabis exposure and dissipate with sustained abstinence.
Objective:
This study examines different domains of learning (verbal, visuospatial) in current and abstaining cannabis users, and the role of chronicity of use.
Methods:
In a cross-sectional design, we examined 127 psychiatrically healthy participants (65 female) with mean aged of 34 years. Of these, 69 individuals were current regular cannabis users (mean 15 years use), 12 were former cannabis users abstinent for ~2.5 yrs (after a mean of 16 years use), and 46 were non-cannabis using controls. Groups were compared on verbal learning performance assessed via the California Verbal Learning Test (CVLT-II) and for visuospatial learning measured with the Brown Location Test (BLT). We explored the association between CVLT/BLT performance and cannabis use levels in current and former users.
Results:
Current cannabis use compared to non-use was associated with worse performance on select aspects of verbal learning (
Long Delay Cued Recall
) and of visuospatial learning (
Retroactive Interference
and
LD Rotated Recall
). Prolonged abstinence was associated with altered verbal learning but intact visuospatial learning. There were non-significant correlations between distinct cannabis use measures, age and learning in both current and former users.
Conclusions:
Our findings suggest cannabis use status (current use, former use) affects different domains of learning (verbal and visuospatial) in a distinct fashion. These findings might be accounted for in the design of cognitive interventions aimed to support abstinence in cannabis users.
The California Verbal Learning Test-Second Edition (CVLT-II), is a commonly used tool to assess episodic memory. This study analyzed learning and memory characteristics in a cognitively healthy ...Chinese population, as well as the effects of age, sex and education on CVLT-II factors. In total, 246 healthy people aged 20–80 years and 29 persons with multiple sclerosis (MS) were included in this study and completed the CVLT-II. Factors including total learning, learning strategy, serial position effects, short-delay free and cued recall, long-delay free and cued recall, repetitions and intrusions during recall, hits and false positives of recognition, and total recognition discriminability were calculated. The effects of age, sex and education on these factors were analyzed using ANCOVA or independent two-sample
t
-tests and further confirmed by multiple regression analysis. The regression-based normative data were then computed by the equivalent scores method. Moreover, differences in learning and memory were compared between persons with MS and age-, sex- and education-matched healthy individuals. Most CVLT-II factors significantly differed between different age and education groups; in particular, better performance in total learning, recall, semantic clustering and recognition was observed in the younger and more educated groups than in the older and less educated groups. Male participants showed higher recency effect scores, more repetitions and fewer hits than female participants. Compared with healthy individuals, persons with MS showed extensive impairments in memory processes, such as learning, recall, learning strategy and recognition (
p
< 0.05). These findings indicated that verbal learning and memory were highly dependent on age and educational level but not strongly affected by sex. The CVLT-II effectively assesses episodic memory impairment in the Chinese-speaking population.
Objective
Translations and adaptations of traditional neuropsychological tests to virtual reality (VR) technology bear the potential to increase their ecological validity since the technology enables ...simulating everyday life conditions in a controlled manner. The current paper describes our translation of a commonly used neuropsychological test to VR, the Rey Auditory Verbal Learning Test (RAVLT). For this aim, we developed a VR adaptation of the RAVLT (VR-RAVLT) Which is based on a conversation with a secretary in a virtual office using a fully immersive VR system. To validate the VR-RAVLT, we tested its construct validity, its age-related discriminant validity and its test-retest validity in reference to the original gold standard RAVLT (GS-RAVLT).
Method
Seventy-eight participants from different age groups performed the GS-RAVLT and the VR-RAVLT tests in a counterbalanced order in addition to other neuropsychological tests. Construct validity was validated using Pearson’s correlations coefficients and serial position effects; discriminant validity was validated using receiver operating characteristic area under the curve values and test-retest reliability was validated using intraclass correlation coefficients.
Results
Comparing both RAVLTs’ format results indicates that the VR-RAVLT has comparable construct, discriminant and test–retest validities.
Conclusion
the novel VR-RAVLT and the GS-RAVLT share similar psychometric properties suggesting that the two tests measure the same cognitive construct. This is an indication of the feasibility of adapting the RAVLT to the VR environment. Future developments will employ this approach for clinical diagnosis and treatment.
Display omitted
•Stressors during the reconsolidation have dissimilar long-term outcomes.•A stressor during reconsolidation impaired a neutral verbal declarative memory.•A mismatch-reminder structure ...was necessary for the memory impairment.•An increased arousal at testing accompanied the memory impairment.•During reconsolidation, memory might incorporate the stressor’s emotion.
Stress alters memory. Understanding how and when acute stress improves or impairs memory is a challenge. Stressors can affect memory depending on a combination of factors. Typically, mild stressors and stress hormones might promote consolidation of memory processing and impair memory retrieval. However, studies have shown that during reconsolidation, stressors may either enhance or impair recalled memory. We propose that a function of reconsolidation is to induce changes in the behavioral expression of memory. Here, we adapted the Rey Auditory Verbal Learning Test (RAVLT) to evaluate the effect of cold pressor stress (CPS) during the reconsolidation of this declarative memory. A decay in memory performance attributable to forgetting was found at the time of memory reactivation 5 d after training (day 6). Contrary to our initial predictions, the administration of CPS after memory reactivation impaired long-term memory expression (day 7), an effect dependent on the presence of a mismatch during Reactivation Session. No differences in recognition tests were found. To assess putative sources of the negative memory modulation effects induced during reconsolidation, current emotional state was evaluated immediately after Testing Session (day 7). An increase in arousal was revealed only when CPS was administered concurrently with memory reactivation–labilization. The possibility of integration during reconsolidation of independent associations of these emotive components in the trace is a critical factor in modulating neutral memories during reconsolidation by stressors.
This study was designed to evaluate the classification accuracy of the recently introduced forced-choice recognition trial to the Hopkins Verbal Learning Test - Revised (FCR
HVLT-R
) as a performance ...validity test (PVT) in a clinical sample. Time-to-completion (T2C) for FCR
HVLT-R
was also examined.
Forty-three students were assigned to either the control or the experimental malingering (expMAL) condition. Archival data were collected from 52 adults clinically referred for neuropsychological assessment. Invalid performance was defined using expMAL status, two free-standing PVTs and two validity composites.
Among students, FCR
HVLT-R
≤11 or T2C ≥45 seconds was specific (0.86-0.93) to invalid performance. Among patients, an FCR
HVLT-R
≤11 was specific (0.94-1.00), but relatively insensitive (0.38-0.60) to non-credible responding0. T2C ≥35 s produced notably higher sensitivity (0.71-0.89), but variable specificity (0.83-0.96). The T2C achieved superior overall correct classification (81-86%) compared to the accuracy score (68-77%). The FCR
HVLT-R
provided incremental utility in performance validity assessment compared to previously introduced validity cutoffs on Recognition Discrimination.
Combined with T2C, the FCR
HVLT-R
has the potential to function as a quick, inexpensive and effective embedded PVT. The time-cutoff effectively attenuated the low ceiling of the accuracy scores, increasing sensitivity by 19%. Replication in larger and more geographically and demographically diverse samples is needed before the FCR
HVLT-R
can be endorsed for routine clinical application.
PDF
