Tuesday, December 27, 2011

Neuropsychology Abstract of the Day: Aging and Cognition

Subjective Cognitive Complaints of Older Adults at the Population Level: An Item Response Theory Analysis
Alzheimers Disease and Associated Disorders. 2011 Dec 20;
Snitz BE, Yu L, Crane PK, Chang CC, Hughes TF, Ganguli M


Subjective cognitive complaints (SCCs) are increasingly a focus in studies on prodromal Alzheimer disease (AD) and risk for dementia. Little is known about the optimal approach to measure SCCs. We used item response theory (IRT) to examine the characteristics of 24 SCC items in a sample of 3495 older adults pooled from 4 community-based studies. We investigated the potential advantages of IRT scoring over conventional scoring on the basis of participants' item response patterns. Items most likely endorsed by individuals low in SCC severity relate to word retrieval and general subjective memory decline. Items likely endorsed only by individuals high in SCC severity relate to nonepisodic memory changes, such as decline in comprehension, judgment and executive functions, praxis and procedural memory, and social behavior changes. Above and beyond conventional total score, IRT scoring of SCCs was associated with performance on objective cognitive tests, and was associated with cognitive test performance among participants endorsing only 1 SCC item. Thus, IRT scoring captures additional information beyond a simple sum of SCC symptoms. Modern psychometric approaches including IRT may be useful in developing: (1) brief community screening questionnaires; and (2) more sensitive measures of very subtle subjective decline for use in prodromal Alzheimer disease research.

PMID: 22193355 [PubMed - as supplied by publisher]

Friday, December 23, 2011

Clinical Trials in England

The BBC's "Newspod" podcast from the 22nd of December includes an item looking at contemporary issues in performing pharma clinical trials in England. Comparison is made to what is considered to be the more-successful Scotland model.

Approx 7 minutes into the podcast; lasting several minutes.

University of Iowa College of Law to Hold Colloquium on Aging Population

UI College of Law to hold colloquium on aging population
5:23 PM, Dec. 21, 2011


"The 13 weekly sessions start Jan. 12 and will be available online to the public through live-streaming and podcasts, law professor and organizer Josephine Gittler said. Nationally-recognized experts in the field of public policy and aging, including Charles Sabatino, director of the American Bar Association’s Commission on Law and Aging; Robert Egge, vice president of public policy and advocacy for the Alzheimer’s Association, and Daniel Marson, director of the Alzheimer’s Disease Center at the University of Alabama at Birmingham, will attend some of the sessions."


Read the full article

Thursday, December 22, 2011

It's a Free Download!

Executive deficits are related to the inferior frontal junction in early dementia
Brain. 2011 Dec 19;
Schroeter ML, Vogt B, Frisch S, Becker G, Barthel H, Mueller K, Villringer A, Sabri O

Access article here

Tuesday, December 20, 2011

Neuropsychology Abstract of the Day: Alzheimer's Disease Progression

Measuring Alzheimer disease progression with transition probabilities: Estimates from NACC-UDS
Curr Alzheimer Res. 2011 Nov 28;
Spackman DE, Kadiyala S, Neumann PJ, Veenstra DL, Sullivan SD


Objectives: Estimate the probabilities, for Alzheimer's disease (AD) patients, of transitioning between stages of disease severity (mild, moderate, severe, dead) and care settings (community, institutional). Methods: Data were compiled by the National Alzheimer Coordinating Center. The main analyses were limited to 3,852 patients who were >50 years old, diagnosed with possible/probable AD and had at least two center visits. A multinomial logistic model accounting for patient and center level correlation was used to calculate transition probabilities between stages of the Clinical Dementia Rating (CDR). Separately we calculated the probabilities of being institutionalized based on CDR stage. Both analyses controlled for baseline age, time between visits, sex, marital status, whether white, whether Hispanic and number of years of education. Results: The annual probabilities of dying for patients in mild, moderate and severe health states were 5.5%, 21.5% and 48.0%, respectively, while the annual probabilities for institutionalization were 1.2%, 3.4% and 6.6%, respectively. The majority of mild and moderate patients remain in the same health state after one year, 77.4% and 50.1% respectively. Progressing patients are most likely to transition one stage, but 1.3% of mild patients become severe in one year. Some patients revert to lower severity stages, 7% from moderate to mild. Conclusions: Transition probabilities to higher CDR stages and to institutionalization are lower than those published previously, but the probability of death is higher. These results are useful for understanding AD progression and can be used in simulation models to evaluate costs and compare new treatments or policies.

PMID: 22175655 [PubMed - as supplied by publisher]

Monday, December 19, 2011

Neuropsychology Abstract of the Day: Epilepsy

The cognitive impact of antiepileptic drugs
Ther Adv Neurol Disord. 2011 Nov; 4(6): 385-407
Eddy CM, Rickards HE, Cavanna AE


Effective treatment of epilepsy depends on medication compliance across a lifetime, and studies indicate that drug tolerability is a significant limiting factor in medication maintenance. Available antiepileptic drugs (AEDs) have the potential to exert detrimental effects on cognitive function and therefore compromise patient wellbeing. On the other hand, some agents may serve to enhance cognitive function. In this review paper, we highlight the range of effects on cognition linked to a variety of newer and older AEDs, encompassing key alterations in both specific executive abilities and broader neuropsychological functions. Importantly, the data reviewed suggest that the effects exerted by an AED could vary depending on both patient characteristics and drug-related variables. However, there are considerable difficulties in evaluating the available evidence. Many studies have failed to investigate the influence of patient and treatment variables on cognitive functioning. Other difficulties include variation across studies in relation to design, treatment group and assessment tools, poor reporting of methodology and poor specification of the cognitive abilities assessed. Focused and rigorous experimental designs including a range of cognitive measures assessing more precisely defined abilities are needed to fill the gaps in our knowledge and follow up reported patterns in the literature. Longitudinal studies are needed to improve our understanding of the influence of factors such as age, tolerance and the stability of cognitive effects. Future trials comparing the effects of commonly prescribed agents across patient subgroups will offer critical insight into the role of patient characteristics in determining the cognitive impact of particular AEDs.

PMID: 22164192 [PubMed - in process]

Sunday, December 18, 2011

Neuropsychology Abstract of the Day: Sports-Related Concussion

Role of Neuropsychologists in the Evaluation and Management of Sport-related Concussion: An Inter-Organization Position Statement
Clin Neuropsychol. 2011 Nov; 25(8): 1289-1294
Echemendia RJ, Iverson GL, McCrea M, Broshek DK, Gioia GA, Sautter SW, Macciocchi SN, Barr WB


Over the past 20 years, clinical neuropsychologists have been at the forefront of both scientific and clinical initiatives aimed at developing evidence-based approaches to the evaluation and management of sport-related concussion. These efforts have directly impacted current policy on strategies for injury assessment and return-to-play by athletes after concussion. Many states are considering legislation requiring (a) education of athletes, parents, coaches, and school/organization officials on the recognition, evaluation, and management of sport-related concussions; (b) removal from play of any youth athlete that is suspected of having sustained a concussion; and (c) not allowing the student to return to participation until the student is evaluated and cleared for return to participation in writing by an appropriate healthcare professional. It is the official position of the American Academy of Clinical Neuropsychology (AACN), American Board of Neuropsychology (ABN), Division 40 (Neuropsychology) of the American Psychological Association (APA), and the National Academy of Neuropsychology (NAN) that neuropsychologists should be included among the licensed health care professionals authorized to evaluate, clinically manage, and provide return to play clearance for athletes who sustain a sport-related concussion.

PMID: 22171535 [PubMed - in process]

From MindHacks: The Pavement Dance!

From the MindHacks blog, with a link to the piece in The Economist:

The crowd dynamics of the city safari
18 December 2011
Read the blog post

Tuesday, December 13, 2011

From Pharmalot: Informed Consent Form Readibility

An interesting read. I always aimed for 6th-grade reading level myself, so it surprised me to read of this finding:

Informed Consent Forms Target 11th Grade Readers
By Ed Silverman
December 12th, 2011 // 9:29 am
Read the full blog post

Friday, December 09, 2011

Vegetative States

From last Sunday's New York Times Sunday Magazine:

A Drug That Wakes the Near Dead
04 December 2011

"A surprising drug has brought a kind of consciousness to patients once considered vegetative — and changed the debate over pulling the plug."

Read the article

Thursday, December 08, 2011

Neuropsychology Abstract of the Day: Orbitofrontal Cortex

Balkanizing the primate orbitofrontal cortex: distinct subregions for comparing and contrasting values
Annals of the New York Academy of Science. 2011 Dec; 1239(1): 1-13
Rudebeck PH, Murray EA


The primate orbitofrontal cortex (OFC) is often treated as a single entity, but architectonic and connectional neuroanatomy indicate that it has distinguishable parts. Nevertheless, few studies have attempted to dissociate the functions of its subregions. Here we review findings from recent neuropsychological and neurophysiological studies that do so. The lateral OFC seems to be important for learning, representing, and updating specific object-reward associations. The medial OFC seems to be important for value comparisons and choosing among objects on that basis. Rather than viewing this dissociation of function in terms of learning versus choosing, however, we suggest that it reflects the distinction between contrasts and comparisons: differences versus similarities. Making use of high-dimensional representations that arise from the convergence of several sensory modalities, the lateral OFC encodes contrasts among outcomes. The medial OFC reduces these contrasting representations of value to a single dimension, a common currency, in order to compare alternative choices.

PMID: 22145870 [PubMed - in process]

Wednesday, December 07, 2011

From the In The Pipeline Blog: Novartis and Neuroscience

Read the In The Pipeline blog entry (06 December 2011).

Clinical Trials: Solanezumab in Alzheimer's Disease

From Bloomberg:

Eli Lilly Shares Rise on Alzheimer’s Drug Hopes
By Drew Armstrong and Robert Langreth
Dec 6, 2011


"Solanezumab is an antibody designed to clear protein fragments called beta amyloid that clutter the brains of patients with Alzheimer’s disease. Pfizer Inc. (PFE), Johnson & Johnson and Elan are testing bapineuzumab, a similar drug."


Read the article

Tuesday, December 06, 2011

Clinical Trials: EVP-6124 Phase 2b Clinical Trial in Schizophrenia

From Drug Discovery & Development:

Positive Study Results for Schizophrenia Drug
Drug Discovery & Development
December 05, 2011

"EnVivo Pharmaceuticals announced the analysis of a completed Phase 2b clinical trial of EVP-6124, a novel, orally bioavailable nicotinic alpha-7 agonist, in schizophrenia."

Read the full report

Neuropsychology Abstract of the Week: First-Person Narrative

Narrative accounts like this are not common, but still excellent reading for students of neuropsychology:

A Mind "Surrounded by a Moat": A First-person Account of Cognitive Impairment in Multiple Sclerosis
Cogn Behav Neurol. 2011 Nov 29;
Anonymous , Stern EB


This is a first-person account of the cognitive impairments-in speaking, writing, and thinking-caused by multiple sclerosis in a professional writer. The patient explains how she has worked around her deficits in rebuilding her life over the 18 years since her diagnosis. Her personal account is woven together with her clinical history, including her neuropsychological testing and magnetic resonance imaging results. A companion article giving perspectives on the case was written by a cognitive neuroscientist who has been studying some of the types of deficits reported by the patient.

PMID: 22134193 [PubMed - as supplied by publisher]

Friday, December 02, 2011

Congratulations Dr. Patricia Kuhl!

The 20th Jean-Louis Signoret Neuropsychology Prize of the Fondation Ipsen is Awarded to Prof. Patricia K. Kuhl (University of Washington, Seattle, USA)

PARIS--(BUSINESS WIRE)--Dec 2, 2011 - The international jury under the presidency of Prof. Albert Galaburda (Harvard Medical School, Boston, USA) awarded on November 29th, 2011 the 20th Jean-Louis Signoret Neuropsychology Prize of the Fondation Ipsen (Paris:IPN) (20.000€) to Prof. Prof. Patricia K. Kuhl (University of Washington, Seattle, USA) for her work that played a major role in the understanding of language acquisition and the neural bases of language.

Infants are born with innate abilities to easily identify every sound of every language, however, by the end of the first year of life, infants show a perceptual narrowing of their language skills. Their ability to discern differences in the sounds that make up words in the world’s languages shrinks. Nonnative sounds are no longer differentiated. This developmental transition is caused by two interacting factors: the child’s computational skills and their social brains. Computational skills allow rapid statistical learning and social interaction is necessary for this computational learning process to occur. Neuroimaging using Magnetoencephalography (MEG) may help explain the neuroplasticity of the child’s mind versus the more expert (but less open) mind of the adult, and account for the “critical period” for language. She also studied the early development of the brain of bilingual children. By 10 to 12 months bilingual infants do not show the perceptual narrowing of the monolingual children. This is another piece of evidence that experiences shape the brain.

Patricia Kuhl is a Professor of Speech and Hearing Sciences at the Institute for Brain and Learning Sciences at the University of Washington since 1977 and co-director of the Institute. Prof. Kuhl is a member of the National Academy of Science USA, the American Academy of Arts and Sciences and has been elected a fellow in the American Association for the Advancement of Science, the American Psychological Association, and the Association for Psychological Science. Prof. Kuhl was awarded the Silver Medal of the Acoustical Society of America in 1997, the Kenneth Craik Research Award from Cambridge University in 2005, and the Gold Medal from the acoustics branch of the American Institute of Physics in 2008.

About the Jean-Louis Signoret Neuropsychology Prize

Launched in 1992, this prize has been awarded by the Fondation Ipsen to many renowned specialists: Eric Kandel (1992), Jacques Paillard (1993), Rodolfo Llinas (1994), Stephen Kosslyn (1995), Alfonso Caramazza (1996), Jean-Pierre Changeux (1997), Edoardo Bisiach (1998), Joseph LeDoux (1999), Joaquin Fuster (2000), Stanislas Dehaene (2001), Deepak Pandya (2002), Uta Frith (2003), Hanna and Antonio Damasio (2004), Marc Jeannerod (2005), Faraneh Vargha-Khadem (2006), Alvaro Pascual Leone (2007), Elizabeth Warrington (2008), Pierre Maquet (2009) and Giacomo Rizzolati (2010).

The jury members are: Albert Galaburda (Harvard Medical School, Boston, USA), President, Jocelyne Bachevalier (Emory University, Atlanta, USA), Laurent Cohen (Hôpital de la Salpétrière, Paris, France), Branch Coslett (University of Pennsylvania, Philadelphia, USA), Richard Frackowiak (CHUV, Lausanne, Switzerland), Didier Hannequin (Hôpital Charles Nicolle, Rouen, France), Kenneth Heilman (University of Florida, Gainesville, USA), Bernard Laurent (Hôpital Bellevue, Saint-Etienne, France), Kimford Meador (Emory University, Atlanta, USA), Michel Poncet (C.H.U. Hôpital Timone, Marseille, France), Donald Stuss (The Rotman Research Institute, Toronto, Canada).

La Fondation Ipsen

Established in 1983 under the aegis of the Fondation de France, the mission of the Fondation Ipsen is to contribute to the development and dissemination of scientific knowledge. The long-standing action of the Fondation Ipsen aims at fostering the interaction between researchers and clinical practitioners, which is indispensable due to the extreme specialisation of these professions. The ambition of the Fondation Ipsen is to initiate a reflection about the major scientific issues of the forthcoming years. It has developed an important international network of scientific experts who meet regularly at meetings known as Colloques Médecine et Recherche, dedicated to six main themes: Alzheimer's disease, neurosciences, longevity, endocrinology, the vascular system and cancer science. Moreover, in 2007, the Fondation Ipsen started three new series of meetings. The first series is an annual meeting organized in partnership with the Salk Institute and Nature and focuses on Biological Complexity; the second series is the “Emergence and Convergence” series with Nature, and the third with Cell and the Massachusetts General Hospital entitled “Exciting Biologies”. Since its beginning, the Fondation Ipsen as organised more than 100 international conferences, published 72 volumes with renowned publishers and 219 issues of a widely distributed bimonthly newsletter Alzheimer Actualités. It has also awarded more than 100 prizes and grants.

Neuropsychology Abstract of the Day: Hippocampal Function and Alzheimer's Disease

Hippocampal hyperactivation associated with cortical thinning in Alzheimer's disease signature regions in non-demented elderly adults
Journal of Neuroscience. 2011 Nov 30; 31(48): 17680-17688
Putcha D, Brickhouse M, O'Keefe K, Sullivan C, Rentz D, Marshall G, Dickerson B, Sperling R


Alzheimer's disease (AD) is associated with functional and structural alterations in a distributed network of brain regions supporting memory and other cognitive domains. Functional abnormalities are present in mild cognitive impairment (MCI) with evidence of early hyperactivity in medial temporal lobe regions, followed by failure of hippocampal activation as dementia develops. Atrophy in a consistent set of cortical regions, the "cortical signature of AD," has been reported at the stage of dementia, MCI, and even in clinically normal (CN) older individuals predicted to develop AD. Despite multiple lines of evidence for each of these findings, the relationship between this structural marker of AD-related neurodegeneration and this functional marker of the integrity of the episodic memory system has not yet been elucidated. We investigated this relationship in 34 nondemented older humans (CN, N = 18; MCI, N = 16). Consistent with previous studies, we found evidence of hippocampal hyperactivation in MCI compared with CN. Additionally, within this MCI group, increased hippocampal activation correlated with cortical thinning in AD-signature regions. Even within the CN group, increased hippocampal activity was negatively correlated with cortical thinning in a subset of regions, including the superior parietal lobule (r = -0.66; p < 0.01). These findings, across a continuum of nondemented and mildly impaired older adults, support the hypothesis that paradoxically increased hippocampal activity may be an early indicator of AD-related neurodegeneration in a distributed network.

PMID: 22131428 [PubMed - in process]