Prediction of declarative memory profile in panic disorder patients: a machine learning-based approach

Objective: To develop a classification framework based on random forest (RF) modeling to outline the declarative memory profile of patients with panic disorder (PD) compared to a healthy control sample. Methods: We developed RF models to classify the declarative memory profile of PD patients in comparison to a healthy control sample using the Rey Auditory Verbal Learning Test (RAVLT). For this study, a total of 299 patients with PD living in the city of Rio de Janeiro (70.9% females, age 39.9 ± 7.3 years old) were recruited through clinician referrals or self/family referrals. Results: Our RF models successfully predicted declarative memory profiles in patients with PD based on RAVLT scores (lowest area under the curve [AUC] of 0.979, for classification; highest root mean squared percentage [RMSPE] of 17.2%, for regression) using relatively bias-free clinical data, such as sex, age, and body mass index (BMI). Conclusions: Our findings also suggested that BMI, used as a proxy for diet and exercises habits, plays an important role in declarative memory. Our framework can be extended and used as a prospective tool to classify and examine associations between clinical features and declarative memory in PD patients.

The Von Restorff effect in the Brazilian version of the Rey Auditory Verbal Learning Test in an elderly population / Efeito de Von Restorff na versão brasileira do Teste de Aprendizagem Auditivo-Verbal de Rey em idosos

ABSTRACT. The Von Restorff (isolation) effect refers to a stimulus that is more likely to be remembered amongst other stimuli in memory tasks. It has been demonstrated with different age ranges and methodologies. Objective: To investigate: a) the presence of the isolation effect in elders tested with the new Brazilian Portuguese version of the Rey Auditory Verbal Learning Task (RAVLT) in which a word with potential emotional weight (mother) was introduced; b) whether isolation effects persist in memory disorders of different degrees of severity (Mild Cognitive Impairment [MCI]; Alzheimer's Dementia [AD]). Methods: The RAVLT was administered to 287 consecutive volunteers. Individuals underwent medical and neuropsychological evaluation and were further sub-grouped into normal controls (n=114), MCI (n=87) and AD (n=86) patients. One-way analysis of variance (ANOVA) and Chi-squared tests were performed. Post-hoc Tukey analysis was conducted to assess significance of group differences. Results: There were significant group effects on the learning curve. A W-shape - instead of the classical U-shape - was found for the serial position curve in all groups. Conclusion: The new Brazilian version of the RAVLT exhibited the Von Restorff effect, where this phenomenon was evident not only in older adults but also patients with MCI and AD, providing further psychometric measures for inter-group analyses.

RESUMO. Efeito de von Restorff (efeito de isolamento) refere-se ao estímulo que é mais facilmente lembrado em relação a outros em tarefas de memória. Tal efeito foi demonstrado em diferentes faixas etárias com diferentes metodologias. Objetivo: Investigar: a) presença do efeito de isolamento numa população idosa avaliada com a nova versão brasileira do Teste de Aprendizagem Auditivo-Verbal de Rey (RAVLT), em que uma palavra com potencial carga emocional ('mãe') foi introduzida; b) se o efeito de isolamento persiste em distúrbios de memória de diferentes gravidades (Comprometimento Cognitivo Leve [MCI]; Demência de Alzheimer [AD]). Métodos: RAVLT foi aplicado em 287 voluntários. Indivíduos participaram de avaliações médica e neuropsicológica e foram posteriormente agrupados em controles normais (n=114), MCI (n=87) e DA (n=86). Análises de variância e testes de Chi-quadrado foram realizados. Análises post-hoc foram conduzidas para avaliar diferenças de características entre os grupos. Resultados: Observaram-se efeitos significativos de grupo na curva de aprendizagem. Todos os grupos apresentaram curva de posição serial em formato W - invés do clássico formato em U. Conclusão: A nova versão brasileira do RAVLT evidenciou um efeito de von Restorff. Tal fenômeno foi visto não apenas em idosos, mas também em pacientes com MCI e AD, fornecendo medidas psicométricas adicionais para análises de diferenças intergrupais.

Marijuana use associated with worse verbal learning and delayed recall in a sample of young adults / El consumo de marihuana se asocia a una menor capacidad de aprendizaje verbal y memoria tardía en adultos jóvenes

ABSTRACT Background: There is concern about the cognitive consequences of marijuana consumption. Aim: To assess the influence of current and past marijuana use and frequency on verbal learning and memory in a sample of adults aged 21 years old. Material and Methods: Marijuana use was assessed using a clinician administered interview in 654 participants (56% females), who reported frequency of use, age of first use and whether its use led to problems in their lives. The CogState International Shopping List was administered to assess learning and memory. Results: Seventy percent reported ever using marijuana, 46% consuming during the past year and 27% during the past 30 days. The latter scored significantly lower on delayed recall. Current and frequent use were significantly associated with lower accuracy in verbal learning and memory. Conclusions: In this cohort of adults aged 21 years old, marijuana use was prevalent and related to worse verbal memory.

Antecedentes: Existe preocupación acerca de los efectos cognitivos del consumo de marihuana. Objetivo: Estudiar el efecto de consumo de marihuana presente o pasado en la capacidad de aprendizaje verbal y memoria en una muestra de adultos de 21 años. Material y Métodos: El consumo de marihuana fue evaluado mediante una entrevista médica en 654 adultos de 21 años (56% mujeres), quienes informaron acerca de la frecuencia de consumo, edad de comienzo y si el consumo les ha causado problemas en sus vidas. Se les administró el Cogstate International Shopping List para evaluar aprendizaje y memoria. Resultados: El 70% informó haber consumido marihuana alguna vez, 46% la usó durante el último año y el 27% en los últimos 30 días. Estos últimos tuvieron un menor puntaje en memoria tardía. El consumo actual y frecuente se asoció a una menor precisión en la capacidad de aprendizaje verbal y memoria. Conclusiones: En esta cohorte de adultos de 21 años, el consumo de marihuana fue prevalente y relacionado a una menor memoria verbal.

Ensino por múltiplos exemplares e integração de comportamentos de ouvinte e falante com unidades sintáticas substantivo-adjetivo em crianças com DENA e IC / Multiple exemplar instruction and integration of listening and speaking behaviors with substantive-adjective syntactic units in children with ANSD and CI

RESUMO Objetivo Verificar o efeito do ensino por múltiplos exemplares na aquisição e integração dos comportamentos de ouvinte e falante, com substantivos e combinações substantivo-adjetivo, em crianças com Desordem do Espectro da Neuropatia Auditiva (DENA) e implante coclear (IC). Método Participaram duas crianças com DENA que usavam IC. Foram adotados estímulos ditados e figuras que correspondiam a palavras (substantivo) e unidades sintáticas substantivo+adjetivo. O estudo foi organizado em passos de ensino que foram intercalados por avaliações dos comportamentos de ouvinte e falante, com todos os estímulos. O ensino por múltiplos exemplares apresentou tarefas de imitação oral (ecoico), reconhecimento auditivo (ouvinte) e nomeação de figuras (tato) de maneira rotativa; os substantivos foram ensinados primeiro e, em seguida, as combinações substantivo-adjetivo. Resultados No pré-teste, os participantes mostraram variabilidade e discrepância nas porcentagens de acertos de ouvinte e de falante. Todos alcançaram primeiro 100% de acertos nas tarefas de ouvinte e os desempenhos de falante ficaram próximos aos de ouvinte após o ensino. Todos estenderam a aprendizagem dos substantivos para as unidades sintáticas substantivo-adjetivo. Conclusão Crianças com DENA e IC podem aprender e integrar comportamentos de ouvinte e de falante por meio do ensino por múltiplos exemplares, de palavras a unidades sintáticas.

ABSTRACT Purpose To verify the effect of the multiple exemplar instruction at the acquisition and integration of listening and speaking behaviors, with substantives and substantive-adjective combinations, in children with Auditory Neuropathy Spectrum Disorder (ANSD) and cochlear implant (CI). Methods Participants were two children with ANSD that were users of CI. We adopted dictated stimulus and pictures that corresponded to words (substantive) and substantive-adjective syntactic units. The study was arranged in teaching steps that were intercalated with listening and speaking behaviors probes, with all stimuli. The multiple exemplar instruction presented oral imitation (echoic), auditory recognition (listening) and pictures naming (touch) tasks, on a rotating way; the substantives were taught first and, after that, the substantive-adjective combinations. Results In the pre-test, the participants showed variability and discrepancy in the correct responses percentages of listening and speaking. All achieved firstly 100% correct responses in the listening task and the speaking performances were close to listening after the teaching. All extended substantive learning to substantive-adjective syntactic units. Conclusion Children with ANSD and CI can learn and integrate listening and speaking behaviors by multiple exemplar instruction, from words to syntactic units.

Naming and verbal learning in adults with Alzheimer's disease, mild cognitive impairment and in healthy aging, with low educational levels / Nomeação e aprendizagem verbal na doença de Alzheimer, no comprometimento cognitivo leve e no envelhecimento sadio com baixa escolaridade

ABSTRACT Language assessment seems to be an effective tool to differentiate healthy and cognitively impaired aging groups. This article discusses the impact of educational level on a naming task, on a verbal learning with semantic cues task and on the MMSE in healthy aging adults at three educational levels (very low, low and high) as well as comparing two clinical groups of very low (0-3 years) and low education (4-7 years) patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) with healthy controls. The participants comprised 101 healthy controls, 17 patients with MCI and 19 with AD. Comparisons between the healthy groups showed an education effect on the MMSE, but not on naming and verbal learning. However, the clinical groups were differentiated in both the naming and verbal learning assessment. The results support the assumption that the verbal learning with semantic cues task is a valid tool to diagnose MCI and AD patients, with no influence from education.

RESUMO A linguagem tem se mostrado uma ferramenta eficiente para diferenciar grupos de idosos saudáveis dos com deficiências cognitivas. O artigo objetiva discutir o impacto do nível educacional na nomeação, na aprendizagem verbal (AV) com pistas semânticas e no MEEM no envelhecimento saudável em três níveis de escolaridade (muito baixa: 0-3 anos, baixa: 4-7 anos e alta: >8 anos) e em dois grupos clínicos de escolaridade muito baixa e baixa (Doença de Alzheimer - DA - e Comprometimento Cognitivo Leve - CCL), comparados a controles saudáveis. Participaram 101 controles, 17 CCL e 19 DA. Comparações entre grupos saudáveis demonstraram um efeito da escolaridade no MEEM, mas não nas tarefas de nomeação e de AV. Considerando as comparações entre os grupos clínicos, tanto a nomeação quanto a AV os diferenciaram. Os resultados corroboram a pressuposição de que a tarefa de AV com pistas semânticas é válida para diagnosticar CCL e DA, não sendo influenciada pela escolaridade.

Effects of Add-on Ramelteon on Cognitive Impairment in Patients with Schizophrenia: An Open-label Pilot Trial

OBJECTIVE: This open-label study examined the effects of ramelteon on cognitive functions in 10 outpatients with schizophrenia. METHODS: Ramelteon (8 mg/day) was administered to 10 patients with schizophrenia for six months. The verbal fluency test, Trail-Making Test, the Wisconsin Card Sorting Test, the Stroop Test, the Digit Span Distraction Test, Iowa Gambling Task, the Rey Auditory Verbal Learning Test were evaluated at baseline and 6 months after treatment with ramelteon. RESULTS: Ramelteon improved significantly the scores of Rey Auditory Verbal Learning Test. Additionally, ramelteon exerted improvements in the verbal fluency and Iowa Gambling Task in 4 patients. CONCLUSION: Ramelteon could be a potential therapeutic drug, in adjunctive treatment of learning and memory deficits seen in patients with schizophrenia.

A Telephone Method for Helping Lay Rescuers Perform High Quality Cardiopulmonary Resuscitation

PURPOSE: Dispatcher-assisted telephone instruction during cardiopulmonary resuscitation (CPR) improves the quality of CPR performed by laypersons. However, in Korea, CPR instruction guidelines for bystanders have not made. We therefore studied the effects of verbal instruction on the quality of chest compression. METHODS: Data from two randomized, double-blinded, controlled trials using identical methodology were combined to obtain 175 records for analysis. Subjects were randomized into either a "push as hard as you can and fast" (n=87) or "push down 5~6 cm, 100~120 rate/min" (n=88), verbal instructions in the 2011 Korea Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC). Data were recorded via a Resusci(R) Anne SkillReporter(TM), Laerdal Medical mannequin. Primary outcome measures included chest compression depth and chest compression rate per minute. RESULTS: The average compression depth and speed of chest compressions did not significantly differ between the two verbal instructions. CONCLUSION: The verbal istructions provided by telephone based on the 2011 Korean Guidelines for CPR and ECC are not effective. The instructions for high quality CPR of layperson should therefore be studied.

Neurocognitive sequelae of cerebral malaria in adults：A pilot study in Benguela Central Hospital, Angola

Objective: To characterize the neurocognitive sequelae of cerebral malaria (CM) in an adult sample of the city of Benguela, Angola. Methods:A neuropsychological assessment was carried out in 22 subjects with prior history of CM ranging from 6 to 12 months after the infection. The obtained results were compared to a control group with no previous history of cerebral malaria. The study was conducted in Benguela Central Hospital, Angola in 2011. Results: CM group obtained lower results on the two last trials of a verbal learning task and on an abstract reasoning test. Conclusions: CM is associated to a slower verbal learning rate and to difficulties in the ability to discriminate and perceive relations between new elements.

Characteristics of Verbal Memory after Subarachnoid Hemorrhage caused by Ruptured Aneurysm / The Japanese Journal of Rehabilitation Medicine

Objective : To clarify the characteristics of memory impairment caused by ruptured aneurysm induced subarachnoid hemorrhage, we examined memory function using the auditory verbal learning test (AVLT). Methods : Subjects were 45 patients with subarachnoid hemorrhage caused by ruptured aneurysm in 14 anterior cerebral arteries (ACA), 12 middle cerebral arteries, 7 vertebrobasilar arteries (VA), and 12 internal cerebral arteries. We discussed the scores of short-term memory (STM), total immediate memory (TIM), verbal learning ability (VLA), retroactive interference effect (RI), recognition and learning curve in different portions of ruptured aneurysm. Additionally, we compared them with healthy subjects (HS). Results : The scores of VLA in ACA were lower than that in HS, and the scores of RI in VA were higher than that in HS. There were no difference in STM, TIM and recognition among groups. The learning curve in ACA and VA were flattening in later trials. Conclusion : Because patients after ruptured subarachnoid hemorrhage in ACA and VA have higher rate of memory impairment, we supposed detailed assessment for memory is important.

Verbal Learning & Memory Function among Children with ADHD and Emotional Disorders.

Memory function and learning process are commonly observed impaired among children with Attention Deficit Hyperactive Disorder (ADHD). However, children with Emotional Disorders (ED) too report inability to attend, register and recall the stimuli that eventually result in poor academic performance. The present study aimed to study the nature of impairment in verbal learning and memory function among children with ADHD and ED. The study further aimed to explore the effect of severity of illnesses over the degree of impairment in verbal learning and memory function in both the groups. Twenty children meeting the ICD-10 criteria for ADHD and twenty children meeting the ICD-10 criteria under F-93 for Emotional Disorders (ED) were assessed on the measure of verbal learning & memory and compared with twenty age and education matched normal control group. Children with ADHD and ED performed poorly on the measure of verbal learning and memory in comparison of normal control, but the degree of impairment was observed relatively higher among ADHD children than children with ED. However, severity of illness was not observed a contributory factor for the impairment in verbal learning and memory function in both the groups. Impairment in verbal learning and memory function is not confined only to the children with ADHD but these are now recognizable among children with Emotional Disorders too. Both the groups (Children with ADHD and ED) reflected impaired memory and learning function but in terms of degree of impairment the children with ADHD were always found standing towards higher side than children with emotional disorder.

Demographic and Clinical Factors Associated With Verbal memory Performance In Patients With Schizophrenia In Hospital Universiti Sains Malaysia (HUSM), Malaysia

Objective: The present study aims to assess verbal memory performance in patients with schizophrenia attending HUSM and determine the relationship between the patients’ verbal memory performance and their demographic/clinical factors. Methods: A cross sectional study of 114 patients with schizophrenia attending HUSM psychiatric services from December 2007 to May 2008 was conducted. The schizophrenia symptoms as well as verbal memory performance were assessed using the Brief Psychiatric Rating Scale, the Malay version of the Calgary Depression Scale (MVCDS), and the Malay version of the Auditory Verbal Learning Test (MVAVLT). The relationship between verbal memory performance and demographic/clinical symptoms was evaluated using Pearson Correlation. Results: Overall MVAVLT scores in all the trials were lowered in patients with schizophrenia compared to average healthy controls. There were significant relationships between occupational status and MVAVLT performance in Trial A1-A5 Total; between educational level and MVAVLT performance in Trial A1 and Trial A1-A5 Total and between severities of illness and MVAVLT performance in all indexes except Trial A1 after controlled for occupation and educational level. Conclusions: Patient with schizophrenia in HUSM performed significantly worse than healthy controls in verbal memory with or without interference. There were significant relationships between MVAVLT performance and patient’s occupational status, educational level and severity of the illness but not depressive symptoms.

Validation of The Malay Version of Auditory Verbal Learning Test (MVAVLT) Among Schizophrenia Patients In Hospital Universiti Sains Malaysia (HUSM), Malaysia

Objective: Many studies have emphasized the significance of verbal memory for the functional outcome in schizophrenia. A preserved capability to encode and recall verbal information is essential for the long-term efficacy of psychoeducational programs and other psychological intervention to ensure the successful transfer of newly acquired skills or knowledge into everyday life. Aims of this study aimed to validate the MVALT among schizophrenia patients in HUSM. Methods: The subjects were 15 schizophrenia patients conveniently selected from the patients that attended follow up at the psychiatry clinic in HUSM or inpatients who have been admitted during the study period and 15 healthy control subjects as a comparison. Reliability and validity of the MVAVLT were analyzed. Results: The validation study showed that the Malay version Auditory Verbal Learning Test (MVAVLT) had a good validity (factor analysis 0.66 to 0.98) and test-retest reliability (pearson correlation ranged from 0.24 to 0.84) and has been shown to be sensitive in discriminating between normal and schizophrenia patients. In line with the previous research, the schizophrenia patients performed significantly worse than healthy control in all indexes measured in MVAVLT. Conclusion: The screening of deficits in verbal learning and memory among the schizophrenia patients is important, for early detection and treatment since it can be helpful for clinicians and psychologists in their counseling sessions. Subsequently, it helps patients to reduce such cognitive difficulties and their impact by using specific rehabilitation with the usage of newer antipsychotic agents.

Avaliação da fluência verbal em crianças com transtorno da falta de atenção com hiperatividade: um estudo comparativo / Verbal fluency evaluation in attention deficit disorder with hyperactivity children: a comparative study

OBJETIVO: comparar o desempenho de indivíduos com TDAH e grupo controle, em provas de fluência verbal, na faixa etária de 7 aos 12 anos, sem déficit cognitivo. MÉTODOS: foram avaliadas 22 crianças com TDAH e 34 do grupo controle, estudantes de escolas públicas no Estado do Rio de Janeiro. Aplicou-se uma prova de fluência verbal, subdividida em avaliação da fluência fonológica e semântica, sendo utilizada a letra F na prova fonológica e a categoria Animais na prova semântica. Os testes de fluência verbal avaliam o número de palavras produzidas espontaneamente, de forma oral, no período de um minuto. Foram criados quatro intervalos de tempo de 15 segundos procurando estabelecer relação de palavras ditas em cada intervalo por cada grupo. Os participantes foram divididos por idade para facilitar a análise dos resultados. RESULTADOS: não houve diferença relevante entre os sexos. As médias de palavras nas provas fonológica e semântica foram comparadas. Os resultados da prova fonológica foram inferiores aos da semântica, tanto no grupo com TDAH, quanto no grupo controle. Verificou-se, entretanto que os grupos com TDAH e controle apresentaram valores similares nas provas semântica e fonológica, porém com períodos de latência diferentes. CONCLUSÃO: os desempenhos de indivíduos com TDAH em provas de fluência verbal fonológica e semântica foram similares aos do grupo controle, e os resultados superiores ocorreram na prova semântica quando comparados com a prova fonológica em ambos os grupos.

PURPOSE: to compare the performances of individuals with ADHD and control group, in verbal fluency tests, from 7 to 12 years, without cognitive deficit. METHODS: 22 children with ADHD and 34 control group had been evaluated, students of a public school in the State of Rio de Janeiro. A verbal fluency test was applied, subdivided in evaluation of the phonological fluency, using the letter F and semantics, using Animal category in the semantic test. The verbal fluency tests evaluate the number of verballyproduced words, in just one minute period. Four intervals of 15 seconds had been created looking for setting up the relation of words said in each interval for each group. The participants had been divided by age to make easier the analysis of the results. RESULTS: no difference between genders was found. The average number of words in phonological and semantics tests had been compared. The performance of the phonological test had been lower than semantics in both groups. The ADHD group presented similar results to the control group in both tests, but with different latency periods. CONCLUSION: the performances of ADHD in phonological verbal fluency and semantics had been similar to the control group, and the higher results had occurred in the semantics tests in both groups.

Teste de fluência verbal no adulto e no idoso: verificação da aprendizagem verbal / Verbal fluency test in adult and elderly: verification of verbal learning

Objetivo: verificar a aprendizagem verbal em indivíduos normais submetidos ao teste de fluência verbal, considerando idade, nível de escolaridade e sexo. Métodos: indivíduos de 40 a 80 anos de idade, submetidos aos testes de fluência verbal semântica e fonológica, geradas em 1 minuto, realizado em dois momentos em 24 horas. Resultados: na análise longitudinal dos dados obtidos naprova semântica (1º dia versus 2º dia) o G1 apresentou aprendizagem verbal em todos os níveis de escolaridade, com exceção de 9 a 12 anos. No G2 observou-se significância no nível de 0 a 4 anos de escolaridade. Na prova fonológica observou-se aprendizagem verbal no G1 para todos os níveis deescolaridade, exceto de 9 a 12 anos. E no G2 foi significante no nível de 5 a 8 anos de escolaridade. Na análise transversal dos dados (G1 versus G2) não foram encontrados resultados significantes na prova semântica e na fonológica observou-se significância apenas no 2º dia nos sujeitos de 0 a4 anos de escolaridade. Na comparação entre os sexos para todas as combinações de grupo e dia na prova semântica o G1 apresentou dados significantes tanto no 1º quanto no 2º dia. Conclusão: verificou-se a ocorrência da aprendizagem verbal mais nos adultos que nos idosos em ambas asprovas. Porém na comparação entre os grupos não foram encontradas diferenças estatisticamente significantes, mas observou-se decréscimo na produção de palavras com o aumento da idade e diminuiçãodo nível de escolaridade. Na comparação entre os sexos verificou-se melhor desempenho dos homens na prova semântica.

PURPOSE: to check verbal learning in normal subjects submitted to a verbal fluency test, considering age, schooling and sex. METHODS: 200 subjects, from 40 to 80-year old, submitted to a semantic and phonologic verbal fluency test, 1 minute long, taking place twice in a 24 hours period. RESULTS: after longitudinal analysis of the data obtained from the semantic test (1st day versus 2nd day) G1 indicated verbal learning in all schooling levels, except from 9 to 12 years of schooling. For G2 the level from 0 to 4 years of schooling was significant. In phonologic test G1 indicated verbal learning in all schooling levels, except from 9 to 12 years of schooling. And for G2, the level from 5 to 8 years of schooling was significant. Transversal analysis of the data (G1 versus G2) indicated no significant semantic test results and considering the phonologic test, just the second day was significant, observing the subjects from 0 to 4 years of schooling. Comparing both genders, among all groups and combinations of days, considering the semantic test, G1 gave evidence of significant data during the first and the second day. CONCLUSION: both tests attest that verbal learning was more effective for adults than for elderly people. However, there were no significant statistical differences among all groups, except from a decrease in words creation as long as age increased and schooling decreased. By comparing both genders, men performance improved in the semantic test.

Brazilian children performance on Rey’s auditory verbal learning paradigm

The Rey Auditory Verbal Learning paradigm is worldwide used in clinical and research settings. There is consensus about its psychometric robustessness and that its various scores provide relevant information about different aspects of memory and learning. However, there are only a few studies in Brazil employing this paradigm and none of them with children. This paper describes the performance of 119 Brazilian children in a version of Rey´s paradigm. The correlations between scores showed the internal consistency of this version. Also, the pattern of results observed was very similar to that observed in foreign studies with adults and children. There was correlation between age in months and recall scores, showing that age affects the rhythm of learning. These results were discussed based on the information processing theory.

O paradigma de aprendizagem auditivo-verbal de Rey é utilizado em todo o mundo, tanto em pesquisa quanto na clínica. Há consenso sobre sua robustez psicométrica e de que seus vários escores fornecem informações relevantes sobre diferentes aspectos da memória e da aprendizagem. No entanto, existem apenas alguns poucos estudos no Brasil envolvendo este paradigma e nenhum deles com crianças. Este artigo descreve o desempenho de 119 crianças brasileiras em uma versão do paradigma de Rey. As correlações entre escores mostraram a consistência interna desta versão. Além disso, o padrão de resultados encontrado foi muito similar àquele observado em estudos estrangeiros com adultos e crianças. Verificou-se correlação entre idade em meses e os escores de evocação, mostrando que a idade afeta o ritmo de aprendizagem. Estes resultados foram discutidos a partir da teoria do processamento da informação.

Desarrollo de la habilidad oral de inglés para estudiantes de enfermería y medicina / Development of Oral Skill in English for Medical and Nursing Students

El desarrollo de las habilidades comunicativas orales es uno de los objetivos fundamentales en la enseñanza de idiomas. Esta es de vital importancia para la inserción interactiva del hombre en el mundo de hoy. Por ello hemos valorado en el mismo elementos teóricos sobre el desarrollo de la habilidad oral en la enseñanza de dicha lengua extranjera, e hicimos énfasis en la necesidad de que los profesores interioricen la importancia de planificar como parte de nuestras actividades, tareas que estimulen el desarrollo de la misma mediante la participación de los alumnos en las clases, que se conviertan en verdaderos entes activos de ella y hacedores de su propio conocimiento. Utilizamos como variables técnicas tales como: Tormenta de ideas, narración, predicción y otras vías, para un mayor uso del idioma; y fueron utilizadas en el 100% de los grupos de enfermería y medicina de ambas carreras, explorando dichos resultados a través de encuestas elaboradas con ese fin. Se concluyó que estas actividades interactivas posibilitan que el 100% de los alumnos desarrollen la habilidad oral. Por ello se analizaron una serie de posibilidades en cuanto a este tipo de actividades que se puedan desarrollar en el aula y que requieran de la activa participación de los estudiantes.

The development of oral communicative skills is one of the main objectives in teaching foreign languages. It plays a significant role for the interactive insertion of man in today's world, thus some theoretical aspects have been assessed, taking into account the development of oral skills in the teaching of the English language. Teachers need to be informed, putting emphasis on planning tasks which encourage the development of this skill through the participation of students in English classrooms, and to make them actively involved individuals and doers of their own knowledge. Technical strategies used were: brain storming ideas, narrations, predictions and others, to enhance the use of the foreign language. These strategies were used in 100% of both medical and nursery groups, exploring results obtained through surveys for this purpose. Concluding that these interactive activities make possible the development of oral skill in 100% of the students. For this, a series of possibilities to perform these kind of tasks in English clasrooms were analyzed to elicit students' talk.

Usefulness of Seoul Verbal Learning Test in Differential Diagnosis of Alzheimer's Disease and Subcortical Vascular Dementia

BACKGROUND: The Seoul Verbal Learning Test (SVLT) is a relatively brief test of verbal learning and memory, which is used to examine dementia patients when a more comprehensive memory assessment is not feasible or when serial testing is desired. The aim of this study was to investigate the pattern of the SVLT performance and its usefulness in making a differential diagnosis between Alzheimer's disease (AD) and subcortical vascular dementia (SVD). METHODS: The SVLT was administered to 15 younger controls, 12 elderly controls, 84 probable AD and 53 SVD patients who met the DSM-IV criteria for dementia. In order to determine the difference of the SVLT parameters between AD and SVD according to the disease severity, the subjects were first grouped into mild dementia (CDR 1 or less) and advanced dementia (CDR2), then the parameters were compared. RESULTS: Pattern analysis of the SVLT performance in subjects with AD and SVD revealed that the mild AD subjects recalled fewer words in trial 2, had a lower discrimination index, a lower combination memory score and more recognition of semantically-unrelated distracter items. In advanced cases, with the exception of combination memory score, there were no differences between the groups in terms of the overall learning or the discrimination index. CONCLUSIONS: Although SVLT has limited differential diagnostic value in advanced cases, in mild cases, pattern analysis of the SVLT performance is a useful tool for discriminating mild AD from SVD. Therefore, a further clinical study should be promising.

Neurocognitive Deficits during the Acute and Remitted Stages of Schizophrenia / 신경정신의학

OBJECTIVES: The purpose of this study is to examine whether the neurocognitive deficits of schizophrenia may be associated with certain features of symptomatology or a stable vulnerability of disease itself. METHOD: The 42 schizophrenic patients and 35 matched normal controls with sex, age, and education level were examined for their sustained attention, sensory register, executive function, concentration and attention, and verbal memory and learning in the acute and remitted stages of schizophrenia using Degraded Stimulus Continuous Performance Test, Span Apprehension Task, Wisconsin Card Sorting Test, Digit Span, and Rey Auditory Verbal Learning Test, respectively. RESULTS: The schizophrenic patients showed significant deficits in the sustained attention, sensory register, executive function, and verbal memory and learning compared with the normal controls in both acute and remitted stages of schizophrenia. Regarding the concentration and attention, the schizophrenic patients showed significant deficits in the backward digit span compared with the normal controls during acute stages, but there was no difference between two groups in the forward and backward digit span during remitted stages. No difference was evident in the sustained attention, sensory register, executive function, and verbal memory and learning between acute and remitted stages of schizophrenia. But the forward and backward digit span of schizophrenic patients showed significant improvement in the remitted stages compared with acute stages. CONCLUSIONS: The sustained attention and sensory register deficits in the visual information processing associated with schizophrenia, detected by high-processing-load version of the Degraded Stimulus Continuous Performance Test and Span Apprehension Task, are highly possible to be stable vulnerability indicators. Executive functioning deficit in the schizophrenic patients detected by Wisconsin Card Sorting Test is not likely to be dependent on symptoms, so it is difficult to conclude that it is a stable vulnerability indicators of schizophrenia. In the digit span task, the forward digit span is more likely to be a episodic indicator but the backward digit span is likely to be a mediating vulnerability indicator. And the forward and backward digit span tasks seem to be tap different cognitive abilities that are differentially associated with the diathesis for schizophrenia. Some forms of the verbal memory and learning deficits associated with schizophrenia appear to be a stable vulnerability indicators.

Contrasts between Remitted Schizophrenic Patients and Euthymic Bipolar Patients on Verbal Memory and Learning / 신경정신의학

OBJECTIVES: This study was to investigate the verbal memory and learning ability in remitted schizophrenic patients and euthymic bipolar patients in order to explore trait-dependent cognitive deficits of each disorder. METHODS: Verbal memory was assessed with KAVLT(the Korean version of Rey Auditory Verbal Learning Test) in outpatients with remitted schizophrenia(N=30), euthymic bipolar disorder(N=28), and normal control(N=72). KAVLT is made for assessment of immediate supraspan memory, registration, retention, retrieval, recognition, learning strategy, and interference effect. Several confounding factors including age, sex, educational level, attention span, residual psychopathology, and extrapyramidal symptoms were controlled among 3 groups. Patient groups were matched according to the age of onset, duration of illness, and frequency of hospitalization. RESULTS: 1) The performance of bipolar group generally fall between the performance of schizophrenia and normal controls, while being most impaired in retroactive interference. Schizophrenic group showed significant impairment on most variables of KAVLT in comparison with the groups of bipolar disorder and normal control. 2) Within group analysis revealed that residual negative symptoms, duration of illness, and number of admission were highly correlated with the impairment of verbal memory and learning in schizophrenics. Number of depressive episodes and age were negatively correlated with verbal memory and learning among bipolar disorder patients. CONCLUSIONS: Both remitted schizophrenia and euthymic bipolar patients showed distinctive impairment in verbal memory and learning compared with controls. These results suggest that specific impairment of verbal memory and learning in remitted state can be a trait-dependent marker in both diseases. These deficits can give clues to the understanding of the pathophysiology and searching for more appropriate therapeutic interventions of mental disorders to improve cognitive deficits in remitted patients.

Development of Korean Auditory Verbal Learning Test / 신경정신의학

OBJECTIVES: The present study was designed to develop KAVLT (Korean Auditory Verbal Learning Test)and to examine its reliability and validity. The KAVLT is a modified Korean version of RAVLT (Rey Auditory Verbal Learning Test) The KAVLT assesses immediate supraspan memory, registration, retention, retrieval, recognition, learning strategy, and interference effect. METHODS: Final version of KAVLT was developed through preliminary trials. The KAVLT was administered to 75 normal healthy adults and 30 organic brain syndrome patients. Twenty-five normal controls were retested 3 weeks after the first trial to examine the test-retest reliability. The scores of basic and combined indices of KAVLT were compared between normal controls and patients. Factor analysis was done to investigate the construct validity. RESULTS: Significant correlations were found between the test-retest scores of most of the basic indices. Discriminant validity which differentiates organic brain syndrome patients from normal controls was excellent. In order to accomplish the structure analysis of the KAVLT, different sets of scores were submitted to factor analysis procedure. Factor analysis of KAVLT basic indices revealed 2 factors, 'aquisition' and 'retention'. In the factor analysis of KAVLT's basic and combined indices, 4 factors emerged: 'general learning', 'retroactive interference', 'proactive interference', and 'primacy/recency effect'. CONCLUSION: The newly developed KAVLT was found to be a reliable and valid tool for evaluating multifactorial assesment of verbal memory and learning in Korean subjects.