Neuropsychology

Engineering love

by Brian Earp

Savulescu, J. and Sandberg, A. (2012). Love machine: Engineering lifelong romance. New Scientist, 2864, 28-29.

Essay partially adapted from Earp, B. D., Sandberg, A., and Savulescu, J. (2012). Natural selection, childrearing, and the ethics of marriage (and divorce): Building a case for the neuroenhancement of human relationships. Philosophy & Technology, forthcoming [see "profile" box in article].

Available at the New Scientist website: http://www.newscientist.com/article/mg21428646.200-love-machine-engineering-lifelong-romance.html

New Scientist BIG IDEA section, May 2012.

With break-up and divorce a major part of modern life, it looks... more New Scientist BIG IDEA section, May 2012.

With break-up and divorce a major part of modern life, it looks like we may be outliving our inborn capacity to love. But there could be a way to outwit evolution and make love last.

Also available at New Scientist: http://www.newscientist.com/article/mg21428646.200-love-machine-engineering-lifelong-romance.html.

The effects of mindfulness on executive processes and autobiographical memory specificity

by Alexandre Heeren

Heeren, A., Van Broeck, N., & Philippot, P. (2009). The effects of mindfulness training on executive processes and autobiographical memory specificity. Behaviour Research and Therapy, 47, 403-409.

[Review of the book Traite de psychopathologie cognitive: Tome I. Bases theoriques, by M. Van der Linden & G. Ceschi (Eds.)]

by Alexandre Heeren

Heeren, A. (2008). [Review of the book Traite de psychopathologie cognitive: Tome I. Bases theoriques, by M. Van der Linden & G. Ceschi (Eds.)]. Psychologos, 23, 3, pp. 16.

Evaluation et traitement du Syndrome de Gilles de la Tourette: Une revue empirique [Assessment and treatment of Tourette Syndrome: An evidence-based review].

by Alexandre Heeren

Heeren, A., Brevers, D., Eeckhout, C., & Philippot, P. (in press). Evaluation et traitement du Syndrome de Gilles de la Tourette: Une revue empirique [Assessment and treatment of Tourette Syndrome: An evidence-based review]. Revue Francophone de Clinique Comportementale et Cognitive

A Bayesian case-controls exploration of the malleability of attentional bias for threat in social phobia

by Alexandre Heeren

Heeren, A., Maurage, P., & Philippot, P. (in press). A Bayesian case-controls exploration of the malleability of attentional bias for threat in social phobia. International Journal of Cognitive Therapy.

Neurobehavioural and cognitive function is linked to childhood trauma in homeless adults

by Graham Pluck

Cerebral microbleeds and long-term cognitive outcome: longitudinal cohort study of stroke clinic patients.

by Maxwell Benjamin

Gregoire, S. M., Smith, K., Jager, H. R., Benjamin, M., Kallis, C., Brown, M. M., Cipolotti, L., & Werring, D. J. Cerebrovascular Diseases (2012).

Background: Vascular cognitive impairment causes significant disability in the elderly and is common following... more Background: Vascular cognitive impairment causes significant disability in the elderly and is common following ischaemic stroke. Although the underlying mechanisms and prognostic factors remain unclear, small vessel diseases are known to contribute. Cerebral microbleeds (CMBs) are a magnetic resonance imaging (MRI) manifestation of small vessel diseases and may contribute to vascular cognitive impairment, particularly frontal-executive functions. We hypothesized that baseline CMBs would predict long-term cognitive outcome, specifically frontal-executive function. Methods: A cohort of consecutive patients found to have CMBs when first referred to a stroke clinic, together with a CMB-free control group matched for age, gender and clinicoradiological characteristics, were invited for follow-up cognitive assessment a median of 5.7 years later. MRI and detailed cognitive assessment (including current intellectual function, verbal memory, visual memory, naming skills, perceptual functions, frontal-executive functions; and speed and attention) were performed at baseline and follow-up. Patients were classified (blinded to MRI and clinical data) as impaired or unimpaired in each domain using predefined criteria. We compared the prevalence of cognitive impairments in each domain at baseline and follow-up and investigated clinical and radiological predictors [including baseline CMBs and white matter changes (WMCs)] of frontal-executive cognitive impairment. Results: Of the original cohort of 55 patients, 13 died without follow-up. Twenty-six of the surviving patients (9 with, 17 without baseline CMBs) agreed to follow-up neuropsychological assessment; 21 of these patients had a repeat MRI scan. The median number of cognitive domains impaired increased, regardless of the presence of baseline CMBs (with baseline CMBs: median 3, range 0-5 at follow-up vs. median 2, range 0-2 at baseline, p = 0.016; without CMBs: median 1.0, range 0-5 at follow-up vs. median 0, range 0-5 at baseline, p = 0.035). Frontal-executive impairment at follow-up was more prevalent in patients with baseline CMBs than in those without (78 vs. 29%, p = 0.038). The presence of baseline CMBs predicted frontal-executive impairment at follow-up (OR 8.40, 95% CI 1.27-55.39, p = 0.027). Fifty percent of patients with CMBs versus 8% of patients without baseline CMBs developed new CMBs (p = 0.047). The severity of WMCs increased; the difference was statistically significant only in patients without baseline CMBs (p = 0.027). There were no new cortical infarcts. Conclusion: In stroke clinic patients, CMBs are consistently associated with frontal-executive impairment; baseline CMBs are associated with frontal-executive impairment at follow-up after 5.7 years. The presence of CMBs has prognostic relevance for long-term cognitive outcome in stroke clinic patients, and may help to optimally target preventive strategies in individuals at highest risk of cognitive decline.

Neuropsychological and cognitive performance of homeless adults

by Graham Pluck

Speech arrest after sleeping on the left body side

by Lars Wojtecki

Premorbid and current neuropsychological function in opiate abusers receiving treatment

by Graham Pluck

L’uomo di superficie di Vittorino Andreoli. Un passo avanti nell'aggravarsi della condizione dell’uomo-massa.

by Pietro Piro

Recensione critica a V. Andreoli, L’uomo di superficie, Rizzoli, Milano 2012.

L'uomo di superficie descritto dallo psichiatra italiano Vittorino Andreoli, rappresenta il punto di approdo di un... more L'uomo di superficie descritto dallo psichiatra italiano Vittorino Andreoli, rappresenta il punto di approdo di un lungo processo degenerativo. Questo tipo d'uomo: "ha abolito, con l'aiuto di strumenti tecnologico sostitutivi, il cervello superiore, e ora è in balia delle pulsioni, delle emozioni, delle frustrazioni. E così la violenza istintiva può tracciare il campo del proprio dominio che si fonda sul potere". Tuttavia, la crisi del capitalismo, proprio perché mette tutto in discussione, permette d'ipotizzare strategie di evasione e nuovi e imprevedibili risvolti.

Attention Deficit Hyperactivity Disorder: Applying Neuropsychological Assessment to Inform ADHD Diagnosis and Treatment. The Case of Richie.

by Ilona Tsvetkov Kristen

"Behavioural manifestations of third ventricular colloid cysts"

by Robert Winer

Journal of Neurology, Neurosurgery, and Psychiatry 1985;48:847

This case calls to attention behavioral manifestations associated with colloid cyst of the third ventricle without... more This case calls to attention behavioral manifestations associated with colloid cyst of the third ventricle without hydrocephalus.
In general, it is the impression of my neurosurgical colleagues in the United States that in the absence of hydrocephalus, removal of a colloid cyst is not mandatory.

It is my hope that reports of cases such as this will raise the awareness of behavioral manifestations in colloid cysts of third ventricle without hydrocephalus.

Use of the Rorschach test in neuropsychology

by Ana Ozura

Co-authored with Vita Štukovnik, published in Horizons of Psychology, 20, 4, 117–130 (2011)

The Rorschach test is widely used as a part of the assessment in clinical psychology in the world. It is also often... more The Rorschach test is widely used as a part of the assessment in clinical psychology in the world. It is also often used as a part of neuropsychological assessment in our unit at Division of Neurology in Ljubljana. We are presenting a review of clinically relevant information for the use of the Rorschach test in clinical practice with an emphasis on neuropsychology. The Rorschach test was considered a controversial instrument in the past. We are presenting a summary of research on its utility and psychometric characteristics. The number of studies in the field of neuropsychological application of the Rorschach test is limited. We describe theoretical models of cognitive processes involved in the process of solving the Rorschach test as a problem solving test apart from projection processes. The
test however still lacks a theoretical basis formed on the brain behavior relations that is needed for every neuropsychological test. Nevertheless we noticed a recent growing interest in the published literature for finding neurological correlates of the response process in this test. Our research with patients with multiple sclerosis performed is described. We state implications for further research.

Arquitecturas cognitivas y cerebro: hacia una teoría unificada de la cognición

by José María Ruiz Sánchez de León

Ruiz-Sánchez de León, J.M. y Fernández Blázquez, M.A. (2011). Cognitive architectures and brain: towards an unified theory of cognition [In Spanish]. International Journal of Psychological Research, 4(2), 38-47

Las arquitecturas cognitivas se definen como el conjunto de componentes esenciales de un sistema que permite el... more Las arquitecturas cognitivas se definen como el conjunto de componentes esenciales de un sistema que permite el análisis de sus cogniciones y sus conductas. El objetivo de este trabajo es revisar una de las arquitecturas cognitivas que resulta más plausible desde el punto de vista neuroanatómico: ACT-R es una teoría sobre el funcionamiento de la mente humana. Tras un acercamiento inicial a sus conceptos básicos, se describen sus dos niveles de computación: un nivel simbólico que contiene toda la información declarativa del sistema, y un nivel subsimbólico que está representado como un juego de procesos en paralelo. A su vez, se relacionan los módulos que componen la arquitectura con la neuroanatomía funcional del cerebro, describiendo el funcionamiento del circuito córtico-estriado-talámico.

Palabras clave: Modelos computacionales; arquitecturas cognitivas; simulación; psicología cognitiva; neuropsicología cognitiva.

Cognitive architectures are defined as the group of essential components belonging to a system which allows the analysis of its cognitions and behaviors. The aim of this study is to review one of the most plausible cognitive architectures from the neuroanatomic perspective: The Adaptive Control of Thought-Rational (ACT-R) is a theory about how human mind works. Following an initial approach to its basic concepts its two computational levels are described, these are: a symbolic level, which includes declarative information; and a sub-symbolic level which is represented as a parallel set of processes. At the same time, architecture’s modules are related to brain’s functional neuroanatomy describing how cortico-striatal-thalamic circuit works.

Key words: Computational models; cognitive architectures; simulation; cognitive psychology; cognitive neuropsychology.

Caracterización neuropsicológica de la impulsividad funcional y disfuncional en adictos a sustancias: implicaciones clínicas

by José María Ruiz Sánchez de León

Pedrero-Pérez, E.J., Ruiz-Sánchez de León, J.M., Rojo Mota, G., Llanero Luque, M. y Puerta-García, C. (2012). Neuropsychological characterization of functional and dysfunctional impulsivity in drug addicts: clinical implications [In Spanish]. Adicciones, 24(1), 51-58.

La impulsividad es una de las variables más consistentemente vinculadas a las distintas fases del proceso adictivo.... more La impulsividad es una de las variables más consistentemente vinculadas a las distintas fases del proceso adictivo. Sin embargo, casi siempre se ha estudiado como una condición negativa, vinculada a psicopatología. Dickman (1990) propuso dos tipos de impulsividad, una disfuncional (ID) y otra funcional (IF). A ésta última la definió como la tendencia a tomar decisiones rápidas, orientadas a metas, mediante un proceso de toma de decisiones con riesgo calculado. Pocos estudios han abordado la caracterización neuropsicológica de ambas variantes, relacionándolas con el rendimiento en pruebas clásicas. Una muestra de 52 sujetos adictos en tratamiento cumplimentó el Dickman Impulsivity Inventory y una batería de pruebas neuropsicológicas clásicas. Se observaron correlaciones de débiles a moderadas entre la IF e indicadores de éxito en las tareas neuropsicológicas, mientras que la ID mostró una relación difusa y débiles correlaciones con indicadores de mal rendimiento en todas las tareas. La ID se mostró como una disposición que dificulta la realización de las tareas de forma global, sin interferencia específica, en tanto que la IF se relacionó consistentemente con mayor precisión, menor número de errores y mejor mantenimiento de los planes, y ello a partir de una mejor gestión atencional y una mayor resistencia al ruido. Se sugieren las implicaciones de cara a los tratamientos de las adicciones.

Palabras clave: Impulsividad funcional, impulsividad disfuncional, evaluación neuropsicológica, adicción, tratamiento, atención, funciones ejecutivas.

Impulsivity is a stable correlate throughout the course of drug addiction. However, it has always been studied as a negative condition, linked to psychopathology. Dickman (1990) proposed two subdimensions of impulsivity, dysfunctional (DI) and functional (FI). He defines the latter as the tendency for rapid, goal-oriented decision-making characterized by well calculated risks. Only a few studies have attempted to differentiate between these two subdimensions using classical neuropsychological tests. Fifty two drug addicts in treatment were tested using Dickman’s Impulsivity Inventory and a battery of classical neuropsychological tests. FI shows moderate to high correlations with many classical neuropsychological test scores in relation to enhanced executive functioning, whereas DI reveals surprisingly weak and scarce correlations with indicators of impaired executive functioning. DI appears to be a trait related to some difficulties in classical neuropsychological tests, while FI emerges as a consistent and much stronger predictor of higher attention capacity, lower distractibility, better precision, fewer errors, and better maintenance of goal-oriented strategies. Thus, functional impulsivity is related to positive conditions and more efficient cognitive functioning. Implications for the treatment of drug addictions are suggested.

Key words: Functional impulsivity, dysfunctional impulsivity, neuropsychological assessment, drug addiction, treatment, attention, executive functions.

Validación de un cuestionario de quejas cognitivas para adultos jóvenes: relación entre las quejas subjetivas de memoria, la sintomatología prefrontal y el estrés percibido

by José María Ruiz Sánchez de León

Lozoya-Delgado P, Ruiz-Sánchez de León JM, Pedrero-Pérez EJ. Validation of a cognitive complaints questionnaire for young adults: the relation between subjective memory complaints, prefrontal symptoms and perceived stress [In Spanish] Rev Neurol 2012; 54: 137-50.

Introducción. Las quejas subjetivas de memoria constituyen uno de los motivos de consulta más frecuentes a los... more Introducción. Las quejas subjetivas de memoria constituyen uno de los motivos de consulta más frecuentes a los servicios sanitarios, aunque apenas existen instrumentos validados en castellano para valorar su magnitud. Así como los cuestionarios de quejas de memoria habitualmente incluyen ítems referentes a aspectos atencionales y ejecutivos, se formulan hipótesis acerca de su relación con otros procesos dependientes de la integridad de la corteza prefrontal. Objetivo. Se trata de estudiar las propiedades psicométricas de un instrumento basado en el cuestionario de fallos de memoria de la vida cotidiana –Memory Failures Everyday (MFE)–, proporcionando una baremación sobre una amplia muestra de población española. Como objetivo secundario, se pretenden analizar las relaciones existentes entre la aparición de las quejas, la sintomatología de origen prefrontal y el estrés percibido. Sujetos y métodos. Se administran el MFE-30 (una modificación del MFE), el cuestionario disejecutivo y la escala de estrés percibido a una muestra de adultos jóvenes de población general no clínica (n = 900). Resultados. Los análisis muestran que el MFE-30 es un cuestionario unifactorial que valora un único constructo llamado ‘quejas cognitivas’. Además, se observa un intenso patrón de correlaciones entre dichas quejas, la sintomatología de origen prefrontal y el estrés percibido. Conclusiones. Los baremos aportados muestran que el MFE-30 es un instrumento útil en la práctica clínica. Los resultados encontrados están en consonancia con estudios anteriores, sugiriendo que existe una estrecha relación entre la aparición de quejas cognitivas, la presencia de sintomatología prefrontal y el estrés percibido.

Palabras clave. Atención. Corteza prefrontal. Cribado. DEX. Funciones ejecutivas. Lóbulos frontales. Memoria. Metamemoria. MFE. Neuropsicología. Quejas de memoria. Síndrome disejecutivo.

Introduction. Although subjective memory complaints are one of the most common causes behind visits to health services, there are hardly any validated instruments in Spanish for evaluating their magnitude. Since memory complaint questionnaires usually include items referring to attentional and executive aspects, it has been hypothesised that they may well be related with other processes that depend on the integrity of the prefrontal cortex. Aim. The purpose of this study was to examine the psychometric properties of an instrument based on the Memory Failures in Everyday (MFE) questionnaire, thus providing a valuation over a broad sample of the Spanish population. A second aim of the study was to analyse the relations that exist between the appearance of the complaints, the symptoms of a prefrontal origin and perceived stress. Subjects and methods. The MFE-30 (a modified version of the MFE), the dysexecutive questionnaire and the perceived stress scale were administered to a sample of young adults from a non-clinical general population (n = 900). Results. The analyses show that the MFE-30 is a single-factor questionnaire that evaluates a single construct called ‘cognitive complaints’. Moreover, an intense pattern of correlations among these complaints, the symptoms of a prefrontal origin and perceived stress is observed. Conclusions. The resulting scores show that the MFE-30 is a useful instrument in clinical practice. Findings are in line with those from previous studies, thus suggesting that there is a close relation among the appearance of cognitive complaints, the presence of prefrontal symptoms and perceived stress.

Key words. Attention. DEX. Dysexecutive syndrome. Executive functions. Frontal cortex. Frontal lobes. Memory complaints. Memory. Metamemory. MFE. Neuropsychology. Screening.

Propuesta de un protocolo para la evaluación neuropsicológica de las adicciones

by José María Ruiz Sánchez de León

A proposal for a protocol of neuropsychological assessment for use in addictions [In Spanish]. Revista de Neurología 2011; 53(8): 483-493.

Introducción. El interés por los procesos cerebrales implicados en la instauración, el mantenimiento y el abandono de... more Introducción. El interés por los procesos cerebrales implicados en la instauración, el mantenimiento y el abandono de las adicciones ha desencadenado que, en los últimos años, se hayan planteado algunos modelos neurocognitivos con un sustancial apoyo empírico. Sin embargo, existe la necesidad de un consenso en cuanto a las pruebas de valoración clínica que se pueden administrar y por qué hacerlo. El presente trabajo pretende recoger algunos de los tests neuropsicológicos más útiles para valorar a individuos adictos, así como las escalas de sintomatología cotidiana y pruebas de desempeño ocupacional que se han validado en castellano para esta población. Desarrollo. Los subprocesos cognitivos abordados en este trabajo, que han demostrado ser útiles en el diagnóstico sindrómico de las adicciones, son la velocidad de procesamiento, la atención selectiva y sostenida, la atención alternante y dividida, la amplitud atencional y el ejecutivo central, la memoria, la flexibilidad cognitiva y la fluidez, la inhibición de respuestas, la planificación, la abstracción, la toma de decisiones y, por último, la teoría de la mente. Se propone un protocolo en dos sesiones de 50 minutos, en el que la segunda sesión es opcional en función de la necesidad y la oportunidad en cada caso. Conclusión. El presente protocolo proporciona algunas ventajas importantes para los clínicos, como la sistematización, la posibilidad de replicación y convergencia entre evaluadores o la delimitación de los subprocesos susceptibles de evaluación compartiendo un mismo esquema, y, todo ello, en sesiones asequibles en cuanto a duración para casi todos los servicios que se dedican a atender a adictos que solicitan tratamiento.

Palabras clave. Abuso de drogas. Adicción. Amnesia. Atención. Corteza frontal. Déficit cognitivo. Deterioro cognitivo. Diagnóstico. Drogodependencias. Evaluación neuropsicológica. Funciones ejecutivas. Lóbulos frontales. Memoria. Neuropsicología. Síndrome disejecutivo. Trastorno cognitivo.


Introduction. Interest in the brain processes involved in establishing, maintaining and overcoming addictions has led to the development, in recent years, of a number of neurocognitive models with a substantial amount of empirical support. However, agreement still needs to be reached regarding the clinical evaluation tests that can be administered and the reason for doing so. The aim of this work is to outline some of the most useful neuropsychological tests for evaluating addicts, as well as the scales of day-to-day symptoms and occupational performance tests that have been validated in Spanish for this population. Development. The cognitive sub-processes addressed in this work, which have proved to be useful in the syndromic diagnosis of addictions, are processing speed, selective and sustained attention, alternating and divided attention, attentional amplitude and central executive, memory, cognitive flexibility and fluency, response inhibition, planning, abstraction, decision-making and, lastly, theory of mind. A protocol involving two 50-minute sessions is proposed, where the second session is optional depending on the needs and suitability in each case. Conclusions. This protocol offers several important advantages for physicians, including systemisation, the possibility of replication and convergence among evaluators or delimitation of the sub-processes that can be evaluated by sharing the same scheme. Moreover, it can all be carried out in sessions that are short enough to allow them to be offered by nearly all services that attend to addicts who request treatment.

Key words. Addiction. Amnesia. Attention. Cognitive deficit. Cognitive disorder. Cognitive impairment. Diagnosis. Drug abuse. Drug addiction. Dysexecutive syndrome. Executive functions. Frontal cortex. Frontal lobes. Memory. Neuropsychological evaluation. Neuropsychology.

Error analysis at the level of single moves in block design

by Alessio Toraldo

Toraldo A., Shallice T. (2004). Cognitive Neuropsychology 21(6), 645-659.

The method of error analysis has been fruitfully applied to the performance of brain-damaged patients in a number of... more The method of error analysis has been fruitfully applied to the performance of brain-damaged patients in a number of different domains. This approach has also been used for investigating the visuo-constructional abilities of neurological patients, but only in a limited fashion. In the present work we applied error analysis to the performance of three patients, each showing a different pattern of errors, and 12 controls on a modified version of the WAIS Block Design task. Data were collected about the single moves made by the subjects to arrive at a copy of the model, and errors were classified using 14 categories. The error patterns of the three patients were found to be reliably different and so putatively suggest different processing impairments. Patient BV showed errors possibly reflecting the lack, or absence, of a plan during the reproduction attempt. Patient GP mainly showed errors reflecting impairment in the processing of metric spatial relations, while patient VQ's errors were those predicted by impaired mental rotation ability. Overall, we showed that Block Design performance can be used productively in the investigation of spatial processing by means of the single-case approach.

Do You Know What I Mean? Laypeople and Experts' Concepts of Cognition

by Linda Schoo

Patients' cognitive complaints and subsequent performance on neuropsychological tests often fail to relate. This... more Patients' cognitive complaints and subsequent performance on neuropsychological tests often fail to relate. This could, in part, be caused by a Babylonic incongruence between laypeople's and experts' use of cognition words or “jargon.” The present study examined the concurrency of experts and laypeople for 18 neuropsychological tests in the cognitive domains “language,” “memory,” “attention/concentration,” “perception,” and “thinking” (executive functioning). This was done by correlating the classifications of the laypeople and experts for individual tests and within each domain. A high domain concurrency was found, indicated by domain correlations of the classifications between laypeople and experts ranging from rs=.79 to .92, with exception of the domain “attention” (rs=.32). Importantly, with respect to the classification of each individual test in a cognitive domain, large variations in correlations were found, ranging from rs=.30 up to rs=1.0. These results indicate that there is agreement between the concepts laypeople use and the theory-based concepts of the experts. Our study also offers valuable insight for the clinical practice: tests with a high correlation should be used to aid the clarity of communication in the clinical practice, for instance when giving feedback on performance.