Search results for: verbal cognition

Authors: Tuyuan Cheng

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As we age, many things become more difficult. Among the abilities are the linguistic and cognitive ones. Competing theories have shown that these two functions could diminish together or that one is selectively affected by the other. In other words, some proposes aging affects sentence production in the same way it affects sentence comprehension and other cognitive functions, while some argues it does not.To address this question, the current investigation is conducted into the critical aspect of sentences as well as cognitive abilities – the syntactic complexity and the number of perspective shifts being contained in the elicited production. Healthy non-pathological aging is often characterized by a cognitive and neural decline in a number of cognitive abilities. Although the language is assumed to be of the more stable domain, a variety of findings in the cognitive aging literature would suggest otherwise. Older adults often show deficits in language production and multiple aspects of comprehension. Nevertheless, while some age differences likely reflect cognitive decline, others might reflect changes in communicative goals, and some even display cognitive advantages. In the domain of language processing, research efforts have been made in tests that probed a variety of communicative abilities. In general, there exists a distinction: Comprehension seems to be selectively unaffected, while production does not. The current study raises a novel question and investigates whether aging affects the production of relative clauses (RCs) under the cognitive factor of perspective shifts. Based on Perspective Hypothesis (MacWhinney, 2000, 2005), our cognitive processes build upon a fundamental system of perspective-taking, and language provides a series of cues to facilitate the construction and shifting of perspectives. These cues include a wide variety of constructions, including RCs structures. In this regard, linguistic complexity can be determined by the number of perspective shifts, and the processing difficulties of RCs can be interpreted within the theory of perspective shifting. Two experiments were conducted to study language production under controlled conditions. In Experiment 1, older healthy participants were tested on standard measures of cognitive aging, including MMSE (Mini-Mental State Examination), ToMI-2 (a simplified Theory of Mind Inventory-2), and a perspective-shifting comprehension task programmed with E-Prime. The results were analyzed to examine if/how they are correlated with aging people’s subsequent production data. In Experiment 2, the production profile of differing RCs, SRC vs. ORC, were collected with healthy aging participants who perform a picture elicitation task. Variable containing 0, 1, or 2 perspective shifts were juxtaposed respectively to the pictures and counterbalanced presented for elicitation. In parallel, a controlled group of young adults were recruited to examine the linguistic and cognitive abilities in question. The results lead us to the discussion whetheraging affects RCs production in a manner determined by its semantic structure or the number of perspective shifts it contains or the status of participants’ mental understanding. The major findingsare: (1) Elders’ production on Chinese RCtypes did not display intrinsic difficulty asymmetry. (2) RC types (the linguistic structural features) and the cognitiveperspective shifts jointly play important roles in the elders’ RCproduction. (3) The production of RC may defy the aging in the case offlexibly preserved cognitive ability.

Keywords: cognition aging, perspective hypothesis, perspective shift, relative clauses, sentence complexity

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Authors: Sara Mosteller, Larissa K. Samuelson, Sobanawartiny Wijeakumar, John P. Spencer

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This study was designed to examine how humans are able to teach and learn semantic information as well as cooperate in order to jointly achieve sophisticated goals. Specifically, we are measuring individual differences in how these abilities develop from foundational building blocks in early childhood. The current study adopts a paradigm for novel noun learning developed by Samuelson, Smith, Perry, and Spencer (2011) to a hyperscanning paradigm [Cui, Bryant and Reiss, 2012]. This project measures coordinated brain activity between a parent and child using simultaneous functional near infrared spectroscopy (fNIRS) in pairs of 2.5, 3.5 and 4.5-year-old children and their parents. We are also separately testing pairs of adult friends. Children and parents, or adult friends, are seated across from one another at a table. The parent (in the developmental study) then teaches their child the names of novel toys. An experimenter then tests the child by presenting the objects in pairs and asking the child to retrieve one object by name. Children are asked to choose from both pairs of familiar objects and pairs of novel objects. In order to explore individual differences in cooperation with the same participants, each dyad plays a cooperative game of Jenga, in which their joint score is based on how many blocks they can remove from the tower as a team. A preliminary analysis of the noun-learning task showed that, when presented with 6 word-object mappings, children learned an average of 3 new words (50%) and that the number of objects learned by each child ranged from 2-4. Adults initially learned all of the new words but were variable in their later retention of the mappings, which ranged from 50-100%. We are currently examining differences in cooperative behavior during the Jenga playing game, including time spent discussing each move before it is made. Ongoing analyses are examining the social dynamics that might underlie the differences between words that were successfully learned and unlearned words for each dyad, as well as the developmental differences observed in the study. Additionally, the Jenga game is being used to better understand individual and developmental differences in social coordination during a cooperative task. At a behavioral level, the analysis maps periods of joint visual attention between participants during the word learning and the Jenga game, using head-mounted eye trackers to assess each participant’s first-person viewpoint during the session. We are also analyzing the coherence in brain activity between participants during novel word-learning and Jenga playing. The first hypothesis is that visual joint attention during the session will be positively correlated with both the number of words learned and with the number of blocks moved during Jenga before the tower falls. The next hypothesis is that successful communication of new words and success in the game will each be positively correlated with synchronized brain activity between the parent and child/the adult friends in cortical regions underlying social cognition, semantic processing, and visual processing. This study probes both the neural and behavioral mechanisms of learning and cooperation in a naturalistic, interactive and developmental context.

Keywords: communication, cooperation, development, interaction, neuroscience

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Authors: Alexandria Carey, Angela Starkweather, Ann Horgas, Hwayoung Cho, Jason Beneciuk

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Background/Significance: Over 3.4 million acute axial low back pain (aLBP) cases are treated annually in the United States (US) emergency departments (ED). ED patients with aLBP receive varying verbal and written discharge routine care (RC), leading to ineffective patient self-management. Ineffective self-management increase chronic low back pain (cLPB) transition risks, a chief cause of worldwide disability, with associated costs >$60 million annually. This research addresses this significant problem by evaluating an ED digital pain self-management intervention (EDPSI) focused on improving self-management through improved knowledge retainment, skills, and self-efficacy (confidence) (KSC) thus reducing aLBP to cLBP transition in ED patients discharged with aLBP. The research has significant potential to increase self-efficacy, one of the most potent mechanisms of behavior change and improve health outcomes. Focusing on accessibility and usability, the intervention may reduce discharge disparities in aLBP self-management, especially with low health literacy. Study Questions: This research will answer the following questions: 1) Will an EDPSI focused on improving KSC progress patient self-management behaviors and health status?; 2) Is the EDPSI sustainable to improve pain severity, interference, and pain recurrence?; 3) Will an EDPSI reduce aLBP to cLBP transition in patients discharged with aLBP? Aims: The pilot randomized-controlled trial (RCT) study’s objectives assess the effects of a 12-week digital self-management discharge tool in patients with aLBP. We aim to 1) Primarily assess the feasibility [recruitment, enrollment, and retention], and [intervention] acceptability, and sustainability of EDPSI on participant’s pain self-management; 2) Determine the effectiveness and sustainability of EDPSI on pain severity/interference among participants. 3) Explore patient preferences, health literacy, and changes among participants experiencing the transition to cLBP. We anticipate that EDPSI intervention will increase likelihood of achieving self-management milestones and significantly improve pain-related symptoms in aLBP. Methods: The study uses a two-group pilot RCT to enroll 30 individuals who have been seen in the ED with aLBP. Participants are randomized into RC (n=15) or RC + EDPSI (n=15) and receive follow-up surveys for 12-weeks post-intervention. EDPSI innovative content focuses on 1) highlighting discharge education; 2) provides self-management treatment options; 3) actor demonstration of ergonomics, range of motion movements, safety, and sleep; 4) complementary alternative medicine (CAM) options including acupuncture, yoga, and Pilates; 5) combination therapies including thermal application, spinal manipulation, and PT treatments. The intervention group receives Booster sessions via Zoom to assess and reinforce their knowledge retention of techniques and provide return demonstration reinforcing ergonomics, in weeks two and eight. Outcome Measures: All participants are followed for 12-weeks, assessing pain severity/ interference using the Brief Pain Inventory short-form (BPI-sf) survey, self-management (measuring KSC) using the short 13-item Patient Activation Measure (PAM), and self-efficacy using the Pain Self-Efficacy Questionnaire (PSEQ) weeks 1, 6, and 12. Feasibility is measured by recruitment, enrollment, and retention percentages. Acceptability and education satisfaction are measured using the Education-Preference and Satisfaction Questionnaire (EPSQ) post-intervention. Self-management sustainment is measured including PSEQ, PAM, and patient satisfaction and healthcare utilization (PSHU) requesting patient overall satisfaction, additional healthcare utilization, and pain management related to continued back pain or complications post-injury.

Keywords: digital, pain self-management, education, tool

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Authors: Valerie Porr, Sydney A. DeCaro

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TARA for borderline personality disorder (BPD), an education and advocacy organization, helps families to compassionately and effectively deal with troubling BPD behaviors. Our psychoeducational programs focus on understanding underlying neurobiological features of BPD and evidence-based methodology integrating dialectical behavior therapy (DBT) and mentalization based therapy (MBT,) clarifying the inherent misunderstanding of BPD behaviors and improving family communication. TARA4BPD conducts online surveys, workshops, and topical webinars. For over 25 years, we have collected data from BPD helpline callers. This data drew our attention to particular childhood idiosyncrasies that seem to characterize many of the children who later met the criteria for BPD. The idiosyncrasies we observed, heightened sensory sensitivity and hypervigilance, were included in Adolf Stern’s 1938 definition of “Borderline.” This aspect of BPD has not been prioritized by personality disorder researchers, presently focused on emotion processing and social cognition in BPD. Parents described sleep reversal problems in infants who, early on, seem to exhibit dysregulation in circadian rhythm. Families describe children as supersensitive to sensory sensations, such as specific sounds, heightened sense of smell, taste, textures of foods, and an inability to tolerate various fabrics textures (i.e., seams in socks). They also exhibit high sensitivity to particular words and voice tones. Many have alexithymia and dyslexia. These children are either hypo- or hypersensitive to sensory sensations, including pain. Many suffer from fibromyalgia. BPD reactions to pain have been studied (C. Schmahl) and confirm the existence of hyper and hypo-reactions to pain stimuli in people with BPD. To date, there is little or no data regarding what comprises a normative range of sensitivity in infants and children. Many parents reported that their children were tested or treated for sensory processing disorder (SPD), learning disorders, and ADHD. SPD is not included in the DSM and is treated by occupational therapists. The overwhelming anecdotal data from thousands of parents of children who later met criteria for BPD led TARA4BPD to develop a sensitivity survey to develop evidence of the possible role of early sensory perception problems as a pre-cursor to BPD, hopefully initiating new directions in BPD research. At present, the research community seems unaware of the role supersensory sensitivity might play as an early indicator of BPD. Parents' observations of childhood sensitivity obtained through family interviews and results of an extensive online survey on sensory responses across various ages of development will be presented. People with BPD suffer from a sense of isolation and otherness that often results in later interpersonal difficulties. Early identification of supersensitive children while brain circuits are developing might decrease the development of social interaction deficits such as rejection sensitivity, self-referential processes, and negative bias, hallmarks of BPD, ultimately minimizing the maladaptive methods of coping with distress that characterizes BPD. Family experiences are an untapped resource for BPD research. It is hoped that this data will give family observations the critical credibility to inform future treatment and research directions.

Keywords: alexithymia, dyslexia, hypersensitivity, sensory processing disorder

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Authors: Kartik Gupta, Virendra Kumar, Sanjeev Sinha, N. Jagannathan

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Introduction: A significant number of patients having human immunodeficiency virus (HIV) infection show a neurocognitive decline (NCD) ranging from minor cognitive impairment to severe dementia. The possible causes of NCD in HIV-infected patients include brain injury by HIV before cART, neurotoxic viral proteins and metabolic abnormalities. In the present study, we compared the level of NCD in asymptomatic HIV-infected patients with changes in brain metabolites measured by using magnetic resonance spectroscopy (MRS). Methods: 43 HIV-positive patients (30 males and 13 females) coming to ART center of the hospital and HIV-seronegative healthy subjects were recruited for the study. All the participants completed MRI and MRS examination, detailed clinical assessments and a battery of neuropsychological tests. All the MR investigations were carried out at 3.0T MRI scanner (Ingenia/Achieva, Philips, Netherlands). MRI examination protocol included the acquisition of T2-weighted imaging in axial, coronal and sagittal planes, T1-weighted, FLAIR, and DWI images in the axial plane. Patients who showed any apparent lesion on MRI were excluded from the study. T2-weighted images in three orthogonal planes were used to localize the voxel in left frontal lobe white matter (FWM) and left basal ganglia (BG) for single voxel MRS. Single voxel MRS spectra were acquired with a point resolved spectroscopy (PRESS) localization pulse sequence at an echo time (TE) of 35 ms and a repetition time (TR) of 2000 ms with 64 or 128 scans. Automated preprocessing and determination of absolute concentrations of metabolites were estimated using LCModel by water scaling method and the Cramer-Rao lower bounds for all metabolites analyzed in the study were below 15\%. Levels of total N-acetyl aspartate (tNAA), total choline (tCho), glutamate + glutamine (Glx), total creatine (tCr), were measured. Cognition was tested using a battery of tests validated for Indian population. The cognitive domains tested were the memory, attention-information processing, abstraction-executive, simple and complex perceptual motor skills. Z-scores normalized according to age, sex and education standard were used to calculate dysfunction in these individual domains. The NCD was defined as dysfunction with Z-score ≤ 2 in at least two domains. One-way ANOVA was used to compare the difference in brain metabolites between the patients and healthy subjects. Results: NCD was found in 23 (53%) patients. There was no significant difference in age, CD4 count and viral load between the two groups. Maximum impairment was found in the domains of memory and simple motor skills i.e., 19/43 (44%). The prevalence of deficit in attention-information processing, complex perceptual motor skills and abstraction-executive function was 37%, 35%, 33% respectively. Subjects with NCD had a higher level of Glutamate in the Frontal region (8.03 ± 2.30 v/s. 10.26 ± 5.24, p-value 0.001). Conclusion: Among newly diagnosed, ART-naïve retroviral disease patients from India, cognitive decline was found in 53\% patients using tests validated for this population. Those with neurocognitive decline had a significantly higher level of Glutamate in the left frontal region. There was no significant difference in age, CD4 count and viral load at initiation of ART between the two groups.

Keywords: HIV, neurocognitive decline, neurometabolites, magnetic resonance spectroscopy

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Authors: C. Bel, J. Nevado, F. Ciceri, M. Ropacki, T. Hoffmann, P. Lapunzina, C. Buesa

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Background: The Phelan-McDermid syndrome (PMS) is a genetic disorder caused by the deletion of the terminal region of chromosome 22 or mutation of the SHANK3 gene. Shank3 disruption in mice leads to dysfunction of synaptic transmission, which can be restored by epigenetic regulation with both Lysine Specific Demethylase 1 (LSD1) inhibitors. PMS subjects result in a variable degree of intellectual disability, delay or absence of speech, autistic spectrum disorders symptoms, low muscle tone, motor delays and epilepsy. Vafidemstat is an LSD1 inhibitor in Phase II clinical development with a well-established and favorable safety profile, and data supporting the restoration of memory and cognition defects as well as reduction of agitation and aggression in several animal models and clinical studies. Therefore, vafidemstat has the potential to become a first-in-class precision medicine approach to treat PMS patients. Aims: The goal of this research is to perform an observational trial to psychometrically characterize individuals carrying deletions in SHANK3 and build a foundation for subsequent precision psychiatry clinical trials with vafidemstat. Methodology: This study is characterizing the clinical profile of 20 to 40 subjects, > 16-year-old, with genotypically confirmed PMS diagnosis. Subjects will complete a battery of neuropsychological scales, including the Repetitive Behavior Questionnaire (RBQ), Vineland Adaptive Behavior Scales, Escala de Observación para el Diagnostico del Autismo (Autism Diagnostic Observational Scale) (ADOS)-2, the Battelle Developmental Inventory and the Behavior Problems Inventory (BPI). Results: By March 2021, 19 patients have been enrolled. Unsupervised hierarchical clustering of the results obtained so far identifies 3 groups of patients, characterized by different profiles of cognitive and behavioral scores. The first cluster is characterized by low Battelle age, high ADOS and low Vineland, RBQ and BPI scores. Low Vineland, RBQ and BPI scores are also detected in the second cluster, which in contrast has high Battelle age and low ADOS scores. The third cluster is somewhat in the middle for the Battelle, Vineland and ADOS scores while displaying the highest levels of aggression (high BPI) and repeated behaviors (high RBQ). In line with the observation that female patients are generally affected by milder forms of autistic symptoms, no male patients are present in the second cluster. Dividing the results by gender highlights that male patients in the third cluster are characterized by a higher frequency of aggression, whereas female patients from the same cluster display a tendency toward higher repetitive behavior. Finally, statistically significant differences in deletion sizes are detected comparing the three clusters (also after correcting for gender), and deletion size appears to be positively correlated with ADOS and negatively correlated with Vineland A and C scores. No correlation is detected between deletion size and the BPI and RBQ scores. Conclusions: Precision medicine may open a new way to understand and treat Central Nervous System disorders. Epigenetic dysregulation has been proposed to be an important mechanism in the pathogenesis of schizophrenia and autism. Vafidemstat holds exciting therapeutic potential in PMS, and this study will provide data regarding the optimal endpoints for a future clinical study to explore vafidemstat ability to treat shank3-associated psychiatric disorders.

Keywords: autism, epigenetics, LSD1, personalized medicine

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