A psychological investigation into the relationship between hemispheric functioning and specific written language difficulties (dyslexia), using pharmaceutical intervention techniques

This thesis attempts a psychological investigation of hemispheric functioning in developmental dyslexia. Previous work using neuropsychological methods with developmental dyslexics is reviewed ,and original work is presented both of a conventional psychometric nature and also utilising a new means of intervention. At the inception of inquiry into dyslexia, comparisons were drawn between developmental dyslexia and acquired alexia, promoting a model of brain damage as the common cause. Subsequent investigators found developmental dyslexics to be neurologically intact, and so an alternative hypothesis was offered, namely that language is abnormally localized (not in the left hemisphere). Research in the last decade, using the advanced techniques of modern neuropsychology, has indicated that developmental dyslexics are probably left hemisphere dominant for language. The development of a new type of pharmaceutical prep~ration (that appears to have a left hemisphere effect) offers an oppertunity to test the experimental hypothesis. This hypothesis propounds that most dyslexics are left hemisphere language dominant, but some of these language related operations are dysfunctioning. The methods utilised are those of psychological assessment of cognitive function, both in a traditional psychometric situation, and with a new form of intervention (Piracetam). The information resulting from intervention will be judged on its therapeutic validity and contribution to the understanding of hemispheric functioning in dyslexics. The experimental studies using conventional psychometric evaluation revealed a dyslexic profile of poor sequencing and name coding ability, with adequate spatial and verbal reasoning skills. Neuropsychological information would tend to suggest that this profile was indicative of adequate right hemsiphere abilities and deficits in some left hemsiphere abilities. When an intervention agent (Piracetam) was used with young adult dyslexics there were improvements in both the rate of acquisition and conservation of verbal learning. An experimental study with dyslexic children revealed that Piracetam appeared to improve reading, writing and sequencing, but did not influence spatial abilities. This would seem to concord with other recent findings, that deve~mental dyslexics may have left hemisphere language localisation, although some of these language related abilities are dysfunctioning.

Migraine, A study of environmental and intrapersonal factors

A study was carried out of 45 migrainous patients with visually induced migraine (VIM), and 25 migrainous students, each having an age and sex matched control. The study utilised questionnaires, interviews, electroencephalography (EEG) and visual evoked potentials (VEP). The experimental work and analysis was carried out in the Neuropsychology Unit in collaboration with the Birmingham Migraine Clinic, over a period of five years. The study suggests: 1. The literature on a possible relationship between migraine and epilepsy hitherto published is unreliable (supporting evidence is given). 2. That a much greater precision is needed in defining migraine for research purposes. 3. A revised methodology for the selection of controls is needed and this is proposed. 4. That despite what are now seen to be superficial similarities, there are clear distinctions of a fundamental nature between photo-sensitive epilepsy (PSE) and VIM. 5. Caution be used when taking headache as a symptom, since many of the precipitants of migrainous headache can also precipitate non-migrainous headache (NMH). 6. The list of visual precipitants of migraine is expanded (particularly flicker and pattern). 7. That colour (principally red) is a previously unreported precipitant of migraine. 8. The extended range of responses to flicker (the 'H' response) has no significant difference in its frequency of occurrence in patients and normal controls, which contradicts previous literature. 9. The mechanisms thought to underlie migraine serve to explain previously unexplained EEG findings. 10. Further research is needed and proposed.

Model evaluation and case series data

We discuss aggregation of data from neuropsychological patients and the process of evaluating models using data from a series of patients. We argue that aggregation can be misleading but not aggregating can also result in information loss. The basis for combining data needs to be theoretically defined, and the particular method of aggregation depends on the theoretical question and characteristics of the data. We present examples, often drawn from our own research, to illustrate these points. We also argue that statistical models and formal methods of model selection are a useful way to test theoretical accounts using data from several patients in multiple-case studies or case series. Statistical models can often measure fit in a way that explicitly captures what a theory allows; the parameter values that result from model fitting often measure theoretically important dimensions and can lead to more constrained theories or new predictions; and model selection allows the strength of evidence for models to be quantified without forcing this into the artificial binary choice that characterizes hypothesis testing methods. Methods that aggregate and then formally model patient data, however, are not automatically preferred to other methods. Which method is preferred depends on the question to be addressed, characteristics of the data, and practical issues like availability of suitable patients, but case series, multiple-case studies, single-case studies, statistical models, and process models should be complementary methods when guided by theory development.

Recognition accuracy and response bias to happy and sad facial expressions in patients with major depression

Impaired facial expression recognition has been associated with features of major depression, which could underlie some of the difficulties in social interactions in these patients. Patients with major depressive disorder and age- and gender-matched healthy volunteers judged the emotion of 100 facial stimuli displaying different intensities of sadness and happiness and neutral expressions presented for short (100 ms) and long (2,000 ms) durations. Compared with healthy volunteers, depressed patients demonstrated subtle impairments in discrimination accuracy and a predominant bias away from the identification as happy of mildly happy expressions. The authors suggest that, in depressed patients, the inability to accurately identify subtle changes in facial expression displayed by others in social situations may underlie the impaired interpersonal functioning.

Morphological-compound dysgraphia in an aphasic patient:"A wild write through the lexicon"

We describe the case of a dysgraphic aphasic individual-S.G.W.-who, in writing to dictation, produced high rates of formally related errors consisting of both lexical substitutions and what we call morphological-compound errors involving legal or illegal combinations of morphemes. These errors were produced in the context of a minimal number of semantic errors. We could exclude problems with phonological discrimination and phonological short-term memory. We also excluded rapid decay of lexical information and/or weak activation of word forms and letter representations since S.G.W.'s spelling showed no effect of delay and no consistent length effects, but, instead, paradoxical complexity effects with segmental, lexical, and morphological errors that were more complex than the target. The case of S.G.W. strongly resembles that of another dysgraphic individual reported in the literature-D.W.-suggesting that this pattern of errors can be replicated across patients. In particular, both patients show unusual errors resulting in the production of neologistic compounds (e.g., "bed button" in response to "bed"). These patterns can be explained if we accept two claims: (a) Brain damage can produce both a reduction and an increase in lexical activation; and (b) there are direct connections between phonological and orthographic lexical representations (a third spelling route). We suggest that both patients are suffering from a difficulty of lexical selection resulting from excessive activation of formally related lexical representations. This hypothesis is strongly supported by S.G.W.'s worse performance in spelling to dictation than in written naming, which shows that a phonological input, activating a cohort of formally related lexical representations, increases selection difficulties. © 2014 Taylor & Francis.

Basic Principles of Organization of the Medium and Thinking Process of the Human in its Conceptual Presentation

Given in the report conceptual presentation of the main principles of fractal-complexity Ration of the media and thinking processes of the human was formulated on the bases of the cybernetic interpretation of scientific information (basically from neurophysiology and neuropsychology, containing the interpretation giving the best fit to the authors point of view) and plausible hypothesis's, filling the lack of knowledge.

The impact of ageing and gender on visual mental imagery processes:a study of performance on tasks from the Complete Visual Mental Imagery Battery (CVMIB)

In this study we aim to evaluate the impact of ageing and gender on different visual mental imagery processes. Two hundred and fifty-one participants (130 women and 121 men; age range = 18–77 years) were given an extensive neuropsychological battery including tasks probing the generation, maintenance, inspection, and transformation of visual mental images (Complete Visual Mental Imagery Battery, CVMIB). Our results show that all mental imagery processes with the exception of the maintenance are affected by ageing, suggesting that other deficits, such as working memory deficits, could account for this effect. However, the analysis of the transformation process, investigated in terms of mental rotation and mental folding skills, shows a steeper decline in mental rotation, suggesting that age could affect rigid transformations of objects and spare non-rigid transformations. Our study also adds to previous ones in showing gender differences favoring men across the lifespan in the transformation process, and, interestingly, it shows a steeper decline in men than in women in inspecting mental images, which could partially account for the mixed results about the effect of ageing on this specific process. We also discuss the possibility to introduce the CVMIB in clinical assessment in the context of theoretical models of mental imagery.

Body representation alterations in personal but not in extrapersonal neglect patients

There is still a matter of debate around the nature of personal neglect. Is it an attention disorder or a body representation disorder? Here we investigate the presence of body representation deficits (i.e., the visuo-spatial body map) in right and left brain-damaged patients and in particular in those affected by personal neglect. 23 unilateral brain-damaged patients (5 left-brain-damaged and 18 right-brain-damaged patients) and 15 healthy controls took part in the study. The visuo-spatial body map was assessed by means of the “Frontal body-evocation subtest (FBE),” in which participants have to put tiles representing body parts on a small wooden board where only the head is depicted as a reference point. In order to compare performance on the FBE with performance on an inanimate object that had well-defined right and left sides, participants also performed the “Car test.” Group statistical analysis shows that the performance of patients with personal neglect is significantly worse than that of the controls and patients without personal neglect in the FBE but not in the Car test. Single case analyses of the five patients with pure personal neglect confirm the results of group analysis. Our data supports the hypothesis that personal neglect is a pervasive body representation disorder.

Cognitive-behavioural phenotype in a group of girls from 1.2 to 12 years old with the Incontinentia Pigmenti syndrome:recommendations for clinical management

Incontinentia Pigmenti (IP, OMIM#308300) is a rare X-linked genomic disorder (about 1,400 cases) that affects the neuroectodermal tissue and Central Nervous System (CNS). The objective of this study was to describe the cognitive-behavioural profile in children in order to plan a clinical intervention to improve their quality of life. A total of 14 girls (age range: from 1 year and 2 months to 12 years and 10 months) with IP and the IKBKG/NEMO gene deletion were submitted to a cognitive assessment including intelligence scales, language and visuo-spatial competence tests, learning ability tests, and a behavioural assessment. Five girls had severe to mild intellectual deficiencies and the remaining nine had a normal neurodevelopment. Four girls were of school age and two of these showed no intellectual disability, but had specific disabilities in calculation and arithmetic reasoning. This is the first description of the cognitive-behavioural profile in relation to developmental age. We stress the importance of an early assessment of learning abilities in individuals with IP without intellectual deficiencies to prevent the onset of any such deficit.

Analysis and interpretation of serial position data

The representation of serial position in sequences is an important topic in a variety of cognitive areas including the domains of language, memory, and motor control. In the neuropsychological literature, serial position data have often been normalized across different lengths, and an improved procedure for this has recently been reported by Machtynger and Shallice (2009). Effects of length and a U-shaped normalized serial position curve have been criteria for identifying working memory deficits. We present simulations and analyses to illustrate some of the issues that arise when relating serial position data to specific theories. We show that critical distinctions are often difficult to make based on normalized data. We suggest that curves for different lengths are best presented in their raw form and that binomial regression can be used to answer specific questions about the effects of length, position, and linear or nonlinear shape that are critical to making theoretical distinctions. © 2010 Psychology Press.

Future thinking instructions improve prospective memory performance in adolescents

Funding This work was supported by the German Research Foundation [DFG grants SFB 940/1]. Acknowledgements We would like to thank Lia Kvavilashvili for her helpful comments on this study during the International Conference on Prospective Memory (ICPM4) in Naples, Italy, 2014. We thank Daniel P. Sheppard for proofreading the manuscript.

Children's Planning Performance in the Zoo Map Task (BADS-C) : Is It Driven by General Cognitive Ability, Executive Functioning, or Prospection?

Peer reviewed

Are stress and mixed urinary incontinence associated with impaired executive control in community-dwelling older women?

Objectives: To assess whether stress or mixed urinary incontinence (UI) is associated with deficits in executive functioning among community-dwelling women. Design: An observational study comparing the performance, using multivariate analyses of variance (MANOVAs) and Bonferroni post hoc test, of continent women and women with stress or mixed UI during executive control tasks. Setting: The research center of the Institut universitaire de gériatrie de Montréal. Participants: One hundred and fifty-five community-dwelling women aged 60 and older participated in the study. Measurements: Based on the Urogenital Distress Inventory (UDI), participants were split into three groups: 35 continent women, 43 women with stress UI, and 78 women with mixed UI. Participants completed a battery of neuropsychological tests and a computerized dual-task test. Results: Women with mixed UI showed poorer performances than continent and stress UI women in executive control functions. Deficits were specific to tests involving switching and sharing/dividing attention between two tasks. Conclusion: Results of this study suggest that mixed UI can be associated with executive control deficits in community-dwelling older women. Future intervention studies in the treatment of UI should take the higher risk of an executive control deficit in women with UI under consideration.

Are stress and mixed urinary incontinence associated with impaired executive control in community-dwelling older women?

Objectives: To assess whether stress or mixed urinary incontinence (UI) is associated with deficits in executive functioning among community-dwelling women. Design: An observational study comparing the performance, using multivariate analyses of variance (MANOVAs) and Bonferroni post hoc test, of continent women and women with stress or mixed UI during executive control tasks. Setting: The research center of the Institut universitaire de gériatrie de Montréal. Participants: One hundred and fifty-five community-dwelling women aged 60 and older participated in the study. Measurements: Based on the Urogenital Distress Inventory (UDI), participants were split into three groups: 35 continent women, 43 women with stress UI, and 78 women with mixed UI. Participants completed a battery of neuropsychological tests and a computerized dual-task test. Results: Women with mixed UI showed poorer performances than continent and stress UI women in executive control functions. Deficits were specific to tests involving switching and sharing/dividing attention between two tasks. Conclusion: Results of this study suggest that mixed UI can be associated with executive control deficits in community-dwelling older women. Future intervention studies in the treatment of UI should take the higher risk of an executive control deficit in women with UI under consideration.

Marqueurs électrophysiologiques des dysfonctions attentionnelles et de leur récupération suite à un traumatisme craniocérébral léger

L’objectif principal de cette thèse était d’obtenir, via l’électrophysiologie cognitive, des indices de fonctionnement post-traumatisme craniocérébral léger (TCCL) pour différents niveaux de traitement de l’information, soit l’attention sélective, les processus décisionnels visuoattentionnels et les processus associés à l’exécution d’une réponse volontaire. L’hypothèse centrale était que les mécanismes de production des lésions de même que la pathophysiologie caractérisant le TCCL engendrent des dysfonctions visuoattentionnelles, du moins pendant la période aiguë suivant le TCCL (i.e. entre 1 et 3 mois post-accident), telles que mesurées à l’aide d’un nouveau paradigme électrophysiologique conçu à cet effet. Cette thèse présente deux articles qui décrivent le travail effectué afin de rencontrer ces objectifs et ainsi vérifier les hypothèses émises. Le premier article présente la démarche réalisée afin de créer une nouvelle tâche d’attention visuospatiale permettant d’obtenir les indices électrophysiologiques (amplitude, latence) et comportementaux (temps de réaction) liés aux processus de traitement visuel et attentionnel précoce (P1, N1, N2-nogo, P2, Ptc) à l’attention visuelle sélective (N2pc, SPCN) et aux processus décisionnels (P3b, P3a) chez un groupe de participants sains (i.e. sans atteinte neurologique). Le deuxième article présente l’étude des effets persistants d’un TCCL sur les fonctions visuoattentionelles via l’obtention des indices électrophysiologiques ciblés (amplitude, latence) et de données comportementales (temps de réaction à la tâche et résultats aux tests neuropsychologiques) chez deux cohortes d’individus TCCL symptomatiques, l’une en phase subaigüe (3 premiers mois post-accident), l’autre en phase chronique (6 mois à 1 an post-accident), en comparaison à un groupe de participants témoins sains. Les résultats des articles présentés dans cette thèse montrent qu’il a été possible de créer une tâche simple qui permet d’étudier de façon rapide et peu coûteuse les différents niveaux de traitement de l’information impliqués dans le déploiement de l’attention visuospatiale. Par la suite, l’utilisation de cette tâche auprès d’individus atteints d’un TCCL testés en phase sub-aiguë ou en phase chronique a permis d’objectiver des profils d’atteintes et de récupération différentiels pour chacune des composantes étudiées. En effet, alors que les composantes associées au traitement précoce de l’information visuelle (P1, N1, N2) étaient intactes, certaines composantes attentionnelles (P2) et cognitivo-attentionnelles (P3a, P3b) étaient altérées, suggérant une dysfonction au niveau des dynamiques spatio-temporelles de l’attention, de l’orientation de l’attention et de la mémoire de travail, à court et/ou à long terme après le TCCL, ceci en présence de déficits neuropsychologiques en phase subaiguë surtout et d’une symptomatologie post-TCCL persistante. Cette thèse souligne l’importance de développer des outils diagnostics sensibles et exhaustifs permettant d’objectiver les divers processus et sous-processus cognitifs susceptible d’être atteints après un TCCL.