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The development of treatments for attention impairments is hampered by limited knowledge about the malleability of underlying neural functions. We conducted the first randomized controlled trial to determine the modulations of brain activity associated with working memory (WM) training in adults with attention-deficit hyperactivity disorder (ADHD). At baseline, we assessed the aberrant functional brain activity in the n-back WM task by comparing 44 adults with ADHD with 18 healthy controls using fMRI. Participants with ADHD were then randomized to train on an adaptive dual n-back task or an active control task. We tested whether WM training elicits redistribution of brain activity as observed in healthy controls, and whether it might further restore aberrant activity related to ADHD. As expected, activity in areas of the default-mode (DMN), salience (SN), sensory-motor (SMN), frontoparietal (FPN), and subcortical (SCN) networks was decreased in participants with ADHD at pretest as compared with healthy controls, especially when the cognitive load was high. WM training modulated widespread FPN and SN areas, restoring some of the aberrant activity. Training effects were mainly observed as decreased brain activity during the trained task and increased activity during the untrained task, suggesting different neural mechanisms for trained and transfer tasks.

Studies have indicated that video gaming is positively associated with cognitive performance in select cognitive domains, but the magnitudes of these associations have been called into question, as they have frequently been based on extreme groups analyses that have compared video gamers with non-gamers. When including the whole range of participants, and not just extreme cases, these effects were observed to reduce markedly (Unsworth et al., 2015). To further study this issue, we compared the associations between video gaming and aspects of working memory (WM) performance in an extreme groups design to those of a design that includes the full range of participants in a large adult sample (n = 503). WM was measured with three composite scores (verbal WM, visuospatial WM, n-back). The extreme groups analyses showed that video gamers performed better than non-gamers on all three WM measures, while the whole sample analyses indicated weak positive associations between the time spent playing video games and visuospatial WM and n-back performance. Thus, study design modulated the effects, but two of the three associations between WM and video gaming were consistent across both analysis techniques. A separate study confirmed that our questionnaire-based estimate of gaming hours was reliable when compared with one-week diaries of videogame playing. While the present cross-sectional results preclude causal inferences, possible mechanisms of WM - videogame playing associations and future research directions are discussed. Overall, our results indicate that cognition - videogame playing relationships, albeit weak, are not solely due to recently discussed methodological artefacts concerning the particular analytical approach and survey reliability.

Objective: We aimed to analyse patient outcomes following open (OAR) or endovascular repair (EVAR) of an abdominal aortic aneurysm (AAA) in Finland and Sweden from 1998 to 2017. Both intact and ruptured AAAs (rAAAs) were included in the analysis. Methods: Patient-level data from national registries in Finland and Sweden were analysed, pairing operations for intact and ruptured AAA repair with mortality data (date of death). All-cause mortality was the primary endpoint. Anonymized patient data from both countries were pooled, comprising a total of 32,324 operations. Ruptured and intact AAAs were considered separately. In total, EVAR was performed on 9619 intact AAAs and 1470 rAAAs, while OAR was performed on 13,241 intact AAAs and 7994 rAAAs. The patient's age, sex and the date of operation were obtained as demographic information. Cox regression and Kaplan–Meier analyses were used to evaluate long-term (10-year) survival after the treatment of AAA or rAAA with either modality. Kaplan–Meier analysis was performed in three different age groups (<65 years, 65–79 years and ≥80 years). Results: Considering all age groups together, the 1-, 3- and 10-year Kaplan–Meier survival rates after EVAR were 93.4%, 80.5% and 35.3%, respectively, for intact AAA repair and 67.2%, 55.9% and 22.2%, respectively, for rAAA repair. For OAR of intact AAAs, the 1-, 3- and 10-year Kaplan–Meier survival rates were 92.1%, 84.8% and 48.7%, respectively. The respective rates for OAR of rAAAs were 55.4%, 49.3% and 24.6%. In a Cox regression analysis, a more recent year of operation was associated with improved survival, and older age affected survival negatively for both intact and ruptured AAA repair. If patients survived the first 90 days after the operation, the survival after intact AAA repair was 13.5 years for those <65 years (general population: 18.0 years), and 7.3 years for those ≥80 years (general population: 7.9 years). After rAAA repair, the mean survival was 13.1 years for patients <65 years and 5.5 years for patients ≥80 years, respectively. Conclusions: The long-term survival of patients undergoing intact AAA treatment at the age of 80 or older is close to that of the general population, provided they survive the operation. Conversely, for patients younger than 65, the long-term survival is markedly worse. The long-term survival of AAA patients has improved over time. Open surgery is still a safe and effective option for young patients undergoing intact AAA repair. Our results support the ESVS guidelines recommendation of EVAR being the first-line treatment for patients with rAAA. [ABSTRACT FROM AUTHOR]

Objective: Of current interest in aphasia research is the relevance of what we can learn from studying word learning ability in aphasia. In a preliminary study, we addressed 2 issues related to the novel word learning ability of individuals with aphasia. First, as word learning engages large-scale cognitive-linguistic systems (language skills, verbal short-term memory [STM], other memory and executive functions), we probed whether novel word learning practice in 3 people with aphasia could stimulate these language-related systems. Second, as lesion correlates affecting word learning in aphasia remain unclear, we examined whether the structural integrity of the left arcuate fasciculus (AF) in the same 3 individuals is related to outcomes of novel word learning practice. Method: To stimulate word learning systems, our 3 participants practiced for 4 weeks with an explicit novel word-novel referent word learning task, adopted from the Ancient Farming Equipment learning paradigm (Laine & Salmelin, 2010). The participants' progress on receptive and expressive novel word learning was followed up, and their language and verbal STM abilities as well as single-session novel word learning (Learning to Name Aliens by Gupta, Martin, Abbs, Schwartz, & Lipinski, 2006) were tested before and after the practice period. To address the second question, we analyzed the participants' structural magnetic resonance images with respect to the integrity of the left AF and its overlap with the lesion areas. Results: All participants showed some receptive word learning in the trained task, as well as improvements in verbal STM span at posttesting. Two of the 3 participants also showed improved performance on some of the language outcome measures. One participant with a partially spared left AF, especially temporoparietal connections, exhibited better word learning performance than the other 2 who had larger damage and disconnection of the AF. Conclusions: Although the present results are preliminary, they open the possibility that novel word learning practice in aphasia may stimulate remaining word learning mechanisms in aphasia and thereby influence language and verbal STM abilities. These results also suggest that preservation of novel word learning ability in aphasia in part depends on the integrity of the left arcuate track.

This study tested whether executive functioning (EF)/learning tasks from the CogState computerized test battery show a unitary latent structure. This information is important for the construction of composite measures on these tasks for applied research purposes. Based on earlier factor analytic research, we identified five CogState tasks that have been labeled as EF/learning tasks and examined their intercorrelations in a new sample of Finnish birth cohort mothers (N = 233). Using confirmatory factor analyses, we compared two single-factor EF/learning models. The first model included the recommended summative scores for each task. The second model exchanged summative scores for first test round results for the three tasks providing these data, as initial task performance is expected to load more heavily on EF. A single-factor solution provided a good fit for the present five EF/learning tasks. The second model, which was hypothesized to tap more onto EF, had slightly better fit indices, X[superscript 2](5) = 1.37, p = 0.93, standardized root mean square residual (SRMR) = 0.02, root mean square error of approximation (RMSEA) = 0.00, 90% CI = [0.00-0.03], comparative fit index (CFI) = 1.00, and more even factor loadings (0.30-0.56) than the first model, X[superscript 2](5) = 4.56, p = 0.47, SRMR = 0.03, RMSEA = 0.00, 90% CI = [0.00-0.09], CFI = 1.00, factor loadings (0.20-0.74), which was hypothesized to tap more onto learning. We conclude that the present CogState sum scores can be used for studying EF/learning in healthy adult samples, but call for further research to validate these sum scores against other EF tests.

Working memory (WM) is a key cognitive system that is strongly related to other cognitive domains and relevant for everyday life. However, the structure of WM is yet to be determined. A number of WM models have been put forth especially by factor analytical studies. In broad terms, these models vary by their emphasis on WM contents (e.g., visuospatial, verbal) vs. WM processes (e.g., maintenance, updating) as critical, dissociable elements. Here we conducted confirmatory and exploratory factor analyses on a broad set of WM tasks, half of them numerical-verbal and half of them visuospatial, representing four commonly used task paradigms: simple span, complex span, running memory, and n-back. The tasks were selected to allow the detection of both content-based (visuospatial, numerical-verbal) and process-based (maintenance, updating) divisions. The data were collected online which allowed the recruitment of a large and demographically diverse sample of adults (n = 711). Both factor analytical methods pointed to a clear division according to task content for all paradigms except n-back, while there was no indication for a process-based division. Besides the content-based division, confirmatory factor analyses supported a model that also included a general WM factor. The n-back tasks had the highest loadings on the general factor, suggesting that this factor reflected high-level cognitive resources such as executive functioning and fluid intelligence that are engaged with all WM tasks, and possibly even more so with the n-back. Together with earlier findings that indicate high variability of process-based WM divisions, we conclude that the most robust division of WM is along its contents (visuospatial vs. numerical-verbal), rather than along its hypothetical subprocesses.

Background: We sought to investigate the differential impact of EVAR (endovascular aneurysm repair) vis-à-vis OSR (open surgical repair) on ruptured AAA (abdominal aortic aneurysm) mortality by sex and geographically. Methods: We performed a retrospective study of administrative data on EVAR from state statistical agencies, vascular registries, and academic publications, as well as ruptured AAA mortality rates from the World Health Organization for 14 14 states across Australasia, East Asia, Europe, and North America. Results: Between 2011–2016, the proportion of treatment of ruptured AAAs by EVAR increased from 26.1 to 43.8 percent among females, and from 25.7 to 41.2 percent among males, and age-adjusted ruptured AAA mortality rates fell from 12.62 to 9.50 per million among females, and from 34.14 to 26.54 per million among males. The association of EVAR with reduced mortality was more than three times larger (2.2 vis-à-vis 0.6 percent of prevalence per 10 percentage point increase in EVAR) among females than males. The association of EVAR with reduced mortality was substantially larger (1.7 vis-à-vis 1.1 percent of prevalence per 10 percentage point increase in EVAR) among East Asian states than European+ states. Conclusions: The increasing adoption of EVAR coincided with a decrease in ruptured AAA mortality. The relationship between EVAR and mortality was more pronounced among females than males, and in East Asian than European+ states. Sex and ethnic heterogeneity should be further investigated. [ABSTRACT FROM AUTHOR]

Selective attention-related top-down modulation plays a significant role in separating relevant speech from irrelevant background speech when vocal attributes separating concurrent speakers are small and continuously evolving. Electrophysiological studies have shown that such top-down modulation enhances neural tracking of attended speech. Yet, the specific cortical regions involved remain unclear due to the limited spatial resolution of most electrophysiological techniques. To overcome such limitations, we collected both electroencephalography (EEG) (high temporal resolution) and functional magnetic resonance imaging (fMRI) (high spatial resolution), while human participants selectively attended to speakers in audiovisual scenes containing overlapping cocktail party speech. To utilise the advantages of the respective techniques, we analysed neural tracking of speech using the EEG data and performed representational dissimilarity-based EEG-fMRI fusion. We observed that attention enhanced neural tracking and modulated EEG correlates throughout the latencies studied. Further, attention-related enhancement of neural tracking fluctuated in predictable temporal profiles. We discuss how such temporal dynamics could arise from a combination of interactions between attention and prediction as well as plastic properties of the auditory cortex. EEG-fMRI fusion revealed attention-related iterative feedforward-feedback loops between hierarchically organised nodes of the ventral auditory object related processing stream. Our findings support models where attention facilitates dynamic neural changes in the auditory cortex, ultimately aiding discrimination of relevant sounds from irrelevant ones while conserving neural resources. Selective attention enables separation of overlapping speech in noisy environments. This study shows that attention triggers bidirectional informational flow from sensory regions to regions associated with semantic, syntactic and executive functions during active processing of cocktail-party speech. [ABSTRACT FROM AUTHOR]

People can use different internal strategies to manage their daily tasks, but systematic research on these strategies and their significance for actual performance is still quite sparse. Here we examined self-reported internal strategy use with a 10-block version of the videogame EPELI (Executive Performance in Everyday LIving) in a group of 202 neurotypical adults of 18–50 years of age. In the game, participants perform lists of everyday tasks from memory while navigating in a virtual apartment. Open-ended strategy reports were collected after each EPELI task block, and for comparison also after an EPELI Instruction Recall task and a Word List Learning task assessing episodic memory. On average, 45% of the participants reported using some strategy in EPELI, the most common types being grouping (e.g., performing the tasks room by room), utilising a familiar action schema, and condensing information (e.g., memorising only keywords). Our pre-registered hypothesis on the beneficial effect of self-initiated strategy use gained support, as strategy users showed better performance on EPELI as compared with no strategy users. One of the strategies, grouping, was identified as a clearly effective strategy type. Block-by-block transitions suggested gradual stabilisation of strategy use over the 10 EPELI blocks. The proneness to use strategies showed a weak but reliable association between EPELI and Word List Learning. Overall, the present results highlight the importance of internal strategy use for understanding individual differences in memory performance, as well as the potential benefit for internal strategy employment when faced with everyday memory tasks. [ABSTRACT FROM AUTHOR]

In literates, reading is a fundamental channel for acquiring new vocabulary both in the mother tongue and in foreign languages. By using an artificial language learning task, we examined the acquisition of novel written words and their embedded regularities (an orthographic surface feature and a syllabic feature) in three groups of university students with different exposures (Group 1 saw 2 words once, Group 2 saw 20 words once, Group 3 saw 20 words three times). Recognition memory results for Groups 2 and 3 indicated that adults can learn novel written words even with just a single exposure, albeit repeated exposure improved target detection. A generalization task revealed that even the minimal exposure in Group 1 was enough for acquisition of the two embedded regularities. More exemplars and repeated exposure provided more robust effects for the syllable regularity. Finally, post-test interview showed that repeated exposure was needed to become aware of the regularities. The present results show that adults learn novel written words and their inherent regularities in a fast and effective fashion.

The diagnosis of ADHD is based on real-life attentional-executive deficits, but they are harder to detect in adults than in children and objective quantitative measures reflecting these everyday problems are lacking. We developed an online version of EPELI 3D videogame for naturalistic and scalable assessment of goal-directed action and prospective memory in adult ADHD. In EPELI, participants perform instructed everyday chores in a virtual apartment from memory. Our pre-registered hypothesis predicted weaker EPELI performances in adult ADHD compared to controls. The sample comprised 112 adults with ADHD and 255 neurotypical controls comparable in age (mean 31, SD = 8 years), gender distribution (71% females) and educational level. Using web-browser, the participants performed EPELI and other cognitive tasks, including Conner's Continuous Performance Test (CPT). They also filled out questionnaires probing everyday executive performance and kept a 5-day diary of everyday prospective memory errors. Self-reported strategy use in the EPELI game was also examined. The ADHD participants' self-ratings indicated clearly more everyday executive problems than in the controls. Differences in the EPELI game were mostly seen in the ADHD participants' higher rates of task-irrelevant actions. Gender differences and a group × gender interaction was found in the number of correctly performed tasks, indicating poorer performance particularly in ADHD males. Discriminant validity of EPELI was similar to CPT. Strategy use strongly predicted EPELI performance in both groups. The results demonstrate the feasibility of EPELI for online assessment and highlight the role of impulsivity as a distinctive everyday life problem in adult ADHD. [ABSTRACT FROM AUTHOR]

We investigated reading and writing in two domestic languages (Swedish and Finnish) and one foreign language (English) among multilingual university students with (n = 20) versus without dyslexia (n = 20). Our analyses encompassed overall speed and accuracy measures and an in-depth analysis of grapheme-phoneme-grapheme errors and inflectional errors. Dyslexic impairments were most conspicuous in word and sentence segmentation, accuracy in oral text reading, single word writing to dictation and free writing across the three languages, most prominently in English. The writing tasks exhibited significantly higher proportions of phoneme-to-grapheme errors in the dyslexia group, especially in English, and marginal differences in inflectional errors, again discernible in English. The results indicate that language proficiency and orthographic depth modulate the appearance of high-performing multilinguals' dyslexic problems in reading and writing. These problems surfaced most clearly in a less proficient foreign, orthographically opaque language. (Contains 5 notes and 4 tables.)

It has been claimed that due to their experience in controlling two languages, bilinguals exceed monolinguals in certain executive functions, especially inhibition of task-irrelevant stimuli. Here we investigated the effects of bilingualism on an executive phonological task, namely the forced-attention dichotic listening task with syllabic stimuli. In the standard non-forced (NF) condition, the participants reported all syllables they heard, be it from the right or the left ear. In the forced-right (FR) and forced-left (FL) attention conditions, they had to direct their attention to either the right- or the left-ear stimulus and inhibit information coming to the other ear. We tested Finnish monolinguals and early simultaneous Finnish-Swedish bilinguals from two age groups: (30-50-year-olds and 60-74-year-olds). The results showed that the bilinguals performed better than the monolinguals in the FR and FL conditions. This supports the idea of a bilingual advantage in directing attention and inhibiting task-irrelevant stimuli.

High-performing adults with compensated dyslexia pose particular challenges to dyslexia diagnostics. We compared the performance of 20 multilingual Finnish university students with suspected dyslexia with 20 age-matched and education-matched controls on an extensive test battery. The battery tapped various aspects of reading, writing, word retrieval, phonological processing and other cognitive functions relevant for dyslexia. Reading and writing were examined in the two domestic languages, Swedish and Finnish. The most prominent group differences in reading and writing emerged on accuracy measures in both languages (reading text aloud, proofreading, writing to dictation, free writing). The dyslexia group also performed less well on speeded segmentation of written input, complex speeded naming and complex phoneme manipulation. The pattern of results fits the phonological deficit hypothesis of dyslexia and indicates the presence of pervasive underlying defects in compensated dyslexia. (Contains 2 notes and 5 tables.)

This Special Issue on Morphological Processing is based on the sixth MOrphological PROcessing Conference (MOPROC), which was kept in June 2009 in Turku, Finland. The issue contains 13 articles by leading scholars in the field of morphological processing. These articles investigate the role morphemes play in language comprehension, production and acquisition. Specific questions relate to the time course with which morphemes come available, what factors facilitate their use, the role of orthographic and semantic transparency in complex word processing and how morphology should be incorporated in models of word processing. The papers in this issue provide a wealth of empirical results in several languages obtained with state-of-the-art experimental paradigms and will be an inspiration for further studies in morphological processing. (Contains 1 table.)

We studied how subjects with mild cognitive impairment (MCI), early Alzheimer's disease (AD) and age-matched controls learned and maintained the names of unfamiliar objects that were trained with or without semantic support (object definitions). Naming performance, phonological cueing, incidental learning of the definitions and recognition of the objects were tested during follow-up. We found that word learning was significantly impaired in MCI and AD patients, whereas forgetting patterns were similar across groups. Semantic support showed a beneficial effect on object name retrieval in the MCI group 8 weeks after training, suggesting that the MCI patients' preserved semantic memory can compensate for impaired episodic memory. The MCI group performed equally well as the controls in the tasks measuring incidental learning and recognition memory, whereas the AD group showed impairment in this respect. Both the MCI and the AD group benefited less from phonological cueing than the controls. Our findings indicate that word learning is compromised in both MCI and AD, whereas long-term retention of newly learned words is not affected to the same extent. Incidental learning and recognition memory seem to be well preserved in MCI. (Contains 4 tables and 3 figures.)

This study investigated the recognition of Swedish inflected nouns in two participant groups. Both groups were Finnish-speaking late learners of Swedish, but the groups differed in regard to their Swedish language proficiency. In a visual lexical decision task, inflected Swedish nouns from three frequency ranges were contrasted with corresponding monomorphemic nouns. The reaction times and error rates suggested morphological decomposition for low-frequency inflected words. Yet, both medium- and high-frequency inflected words appeared to possess full-form representations. Despite an overall advantage for the more proficient participants, this pattern was present in both groups. The results indicate that even late exposure to a language can yield such input representations for morphologically complex words that are typical of native speakers.