Repetitive transcranial magnetic stimulation in the treatment of mild cognitive impairment due to cerebral small vessel disease

Introduction. Mild cognitive impairment (MCI) negatively affects patients quality of life and is a risk factor for dementia. One of the main causes of MCI is cerebral small vessel disease (CSVD). The previously established link between decreased activity in the supplementary motor area (SMA) and cognitive impairment in patients with CSVD makes it possible to consider repetitive transcranial magnetic stimulation (rTMS) of the SMA with functional magnetic resonance imaging (fMRI)-assisted positioning as a promising method for treating MCI caused by CSVD. The aim of the study was to evaluate the efficacy and tolerability of fMRI-guided rTMS of the SMA in patients with MCI caused by CSVD. Materials and methods. Twenty patients were randomly assigned to the intervention (SMA stimulation; n = 10) and the control (vertex stimulation; n = 10) groups. All patients underwent 10 sessions of high-frequency rTMS. The MoCA scale, trail making test, Tower of London test, and copying and delayed recall in the ReyOsterrieth complex figure test were used to assess treatment effect. Testing was conducted before, immediately after and 3 months post rTMS. Results. The intervention group demonstrated a significant improvement in the MoCA, the Tower of London test and delayed recall in the ReyOsterrieth complex figure test immediately after rTMS. Statistically significant improvement in the MoCA and the Tower of London test results was maintained after 3 months. No statistically significant improvements were found in the control group. Groups were comparable in the incidence of headache during and in the 24-hour period after the stimulation session, and in unpleasant sensations during the session. Conclusion. fMRI-guided rTMS of the SMA is an effective and promising treatment method for MCI caused by CSVD, with effects lasting three or more months, and good tolerability.

Impact of post-stroke cognitive dysfunction on driving ability

The paper aims to present the current views on the impact of post-stroke cognitive deficits on driving ability, and diagnostic assessment practices in this area. Firstly, the neuropsychological consequences of stroke are briefly presented. This part focuses specifically on visuospatial and executive dysfunctions. Among those dysfunctions, unilateral neglect, especially as it is frequently associated with anosognosia, may have the greatest impact on driving ability, leading to an increased accident risk. Then, different approaches to assessing fitness to drive after stroke are presented, including on-road testing, testing with the use of simulator, and clinical assessment focusing on cognition. The role of cognitive assessment in predicting fitness to drive is described in more detail. The Clock Drawing Test is the most appropriate screening measure in this context, as it engages both visuospatial and executive functions. The Trail Making Test is the most popular working memory test in the context of drivers’ assessment, as it requires visual search and psychomotor speed. The Rey Complex Figure Test is another commonly used test. It requires visuospatial and executive functions, and may also serve as a measure of visuospatial memory. Finally, the legal aspects of the assessments are discussed with reference to the practices used in Great Britain, Belgium, Sweden, and Germany. In Poland, there are no detailed standards for post-stroke fitness-to-drive assessment.

Regression-Based Normative Data for Independent and Cognitively Active Spanish Older Adults: Free and Cued Selective Reminding Test, Rey–Osterrieth Complex Figure Test and Judgement of Line Orientation

The aim of this work was to develop normative data for neuropsychological tests for the assessment of independent and cognitively active Spanish older adults over 55 years of age. Methods: regression-based normative data were calculated from a sample of 103 nondepressed independent community-dwelling adults aged 55 or older (66% women). The raw data for the Free and Cued Selective Reminding Test (FCSRT), the Rey–Osterrieth Complex Figure Test (ROCF) and the Judgement of Line Orientation Test (JLO) were regressed on age, sex and education. The model predicting the FCSRT delayed-recall (FCSRT-Del) scores also included the FCSRT immediate-recall (FCSRT-Imm) scores. The model predicting the ROCF immediate-recall (ROCF-Imm) scores included the ROCF copy-trial (ROCF-C) scores, and the model predicting the ROCF delayed-recall (ROCF-Del) scores included both the ROCF-C and the ROCF-Imm scores. In order to identify low scores, z-scores were used to determine the discrepancy between the observed and the predicted scores. The base rates of the low scores for both the SABIEX normative data and the published normative data obtained from the general population were compared. Results: the effects of the different sociodemographic variables (age, sex and education) varied throughout the neuropsychological measures. Despite finding similar proportions of low scores between the normative data sets, the agreement was irrelevant or only fair-to-good. Conclusions: the normative data obtained from the general population might not be sensitive enough to identify low scores in cognitively active older adults, incorrectly classifying them as cognitively normal compared to the less active population.

Metacognitive Awareness of Reading Strategy Use between Field-Dependent and Field-Independent EFL Learners

This paper aimed to study the metacognitive awareness of reading strategies between field-dependent (FD)and field-independent (FI) Turkish EFL university students who are learning English as a foreign language. To this end, 270 students from Istanbul (Cerrahpasa) University were chosen.First, Group Embedded Figure Test was used to appoint the participants into either FD or FI groups.After this, participants’ metacognitive awareness of reading strategy was assessed by using MARSI-R (Metacognitive Awareness of reading Strategies Inventory-Revised). Recently revised by Mokhtari et al., the MARSI-R instrument contains 15 items and measures three large sets of strategies including: Global Reading Strategies (GRS), Problem-Solving Strategies (PSS) and Support Reading Strategies (SRS).The results showed that the students reported using the 3 categories of strategies almost at a high-frequency level and they were aware of their metacognitive strategies. And statistically significant difference was found between FI and FD students regarding their use of GRS and SRS, hence, the use of students’ metacognitive reading strategies was affected by their different FI/FD cognitive styles.

EFFECT OF SCHOOL LOCATION ON THE ADOPTED COGNITIVE STYLE OF PRIMARY SCHOOL STUDENTS IN KOGI STATE

Primary education is globally recognized as the foundation laying stage of education.Over the past few decades, researchers have devoted interest to the differences in reasoning, problem-solving, and perception that underlie cognitive style. Numerous researchers have also attributed the differences in cognitive style to various social, cultural, psychological, and demographic factors. However, the purpose of the present study is to examine school location as an environmental factor that could predict childrens cognitive styles. Sixty-four primary school students drawn from primary schools in rural and urban communities in the Kogi state participated in the study. The Group Embedded Figure Test (GEFT) was used for data collection. The result of the study revealed that the school location significantly predicted field independent/dependent cognitive style. Thus, the study concluded that the school environment is a positive determinant of adopted cognitive style.

White Matter Correlates of Hostility and Aggression in the Visuospatial Function Network in Patients With Schizophrenia

Background: Violent acts in patients with schizophrenia are often associated with their hostility and aggression levels. Poor visuospatial processing has been suggested as a possible risk factor of violence in schizophrenia. However, studies investigating the relationship between hostility, aggression, and the visuospatial function have been lacking. Here, we aimed to investigate brain dysconnectivity associated with hostility and aggression in schizophrenia, particularly focusing on the visuospatial function network.Methods: Eighty-eight participants with schizophrenia and 42 healthy controls were enrolled. The visuospatial function network regions of interest were analyzed using Tract-Based Spatial Statistics. The hostility item from the Positive and Negative Syndrome Scale (PANSS), aggressive, and agitated behavior item from the Scale for the Assessment of Positive Symptoms (SAPS), and the Rey Complex Figure Test (R-CFT) were measured.Results: Among the participants with schizophrenia, the SAPS aggressive and agitated behavior scores were significantly correlated with fractional anisotropies (FAs) of the white matter regions in the splenium of the corpus callosum (CC), left posterior thalamic radiations (PTR), and left posterior corona radiata (PCR). Exploratory correlational analysis revealed significant negative correlations between FAs of the splenium of the CC and R-CFT copy and immediate recall scores. In addition, three regions including CC, PTR, and PCR that significantly correlated with the aggression scores showed significant correlations with the total PANSS scores.Conclusion: Our main finding suggests that aggression of patients with schizophrenia may be associated with poor visuospatial ability and underlying white matter dysconnectivity. These may help enhance understanding aggression in patients with schizophrenia.

Figure Disembedding: The Gottschaldt’s Hidden Figure Test in Children with Typical Development and Autism

In two studies, we used the Gottschaldt’s Hidden Figure Test (GHFT) for assessing figure disembedding ability in children aged 7–11. Study 1 demonstrated in a large sample of typically developing children that GHFT accuracy and time scores differed across age groups, without sex and socioeconomic differences. Thus, we provided normative data only taking into account children’s age. In Study 2, GHFT normative values were used to assess children with autism, who were also compared with a closely age-matched group of typical controls. Children with autism achieved time scores at or above the 50th centile and significantly differed from the controls for time score. The GHFT seems a valuable tool for defining the cognitive profile of children with autism.

A-21 Neuropsychological Differentiation of Dementia with Lewy Bodies and Parkinson’s Disease Dementia

Objective To determine whether or not distinct neuropsychological profiles could be created to aid in earlier detection in Dementia with Lewy Bodies (DLB) and Parkinson’s Disease Dementia (PDD). Data Selection A literature review was conducted informally to search for articles pertaining to neuropsychological testing with individuals with DLB or PDD that were dated within the past fifteen years. Data Synthesis Results indicated DLB typically has greater impairment in executive functioning, visuospatial, and attention in comparison to PDD. More specifically, individuals with DLB had significantly worse results on the Rey Complex Figure Test Copy Trial and Digit Span Forward than individuals with PDD. PDD was shown to typically have greater impairment in motor symptoms in comparison to DLB. These impairments, however, depend on the severity of disease progression. Conclusions In conclusion, DLB and PDD have very similar neuropsychological deficits, with greater deficits observed in executive functioning, visuospatial, and attention for individuals with DLB. Overall, majority of the literature is unsure of concrete diagnostic criteria for both individuals with DLB and PDD. This inconsistency has led the comparison of overall research to also been quite difficult as well. Future studies should try to control for medication and comorbidities, as well as include larger and more diverse samples with a full neuropsychological battery to include all domains of functioning. By doing this, the focus will shift more to on early detection and prevention of DLB and PDD and therefore reduce the financial burden of a neurocognitive disorder and the strain of caregiving that is usually placed within on the family.

A-29 Lack of Performance Differences on the RCFT between Administration Methods in Adults with ADHD

Objective The Rey Complex Figure Test (RCFT) has the potential to assess executive function deficits commonly associated with ADHD. While commonly scored using the visuospatial criterion established in the Qualitative Scoring System (QSS), alternative methods have incorporated administration using colored pencils to evaluate planning and organization. Existing literature has discouraged administration using the colored pencil approach given suggestion that distractibility will impair performance. The current study challenged the assumption that individuals with distractibility should not be exposed to color administration. Methods Data was extracted from files of ADHD individuals previously assessed at a southern Florida hospital. A total of 25 participants (11 females and 14 males) were included in the analysis. Methods of analysis included independent t-tests and ANOVA to explore moderating factors of age, sex, race and diagnostic presentation. Results This study found that performance across the various parts of the test were not significantly different based on administration method (t = −1.021, p = 0.318, 95% CI: −4.3755, 1.4845). Interestingly, an ANOVA revealed no significant differences between the broad demographic groups in their performance. Independent t-test did not indicate that the RCFT performance could differentiate between types of ADHD (t = 0.118, p = 0.907, 95% CI: −2.8420, 3.1862). Conclusion In contrast to the RCFT manual, the results of the data analysis revealed no significant differences between administration methods in a highly inattentive population group. This study provides the basis for the introduction of studying the RCFT as a diagnostic tool for re-assessing ADHD throughout adulthood.