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Understanding facial emotions is fundamental to interact in social environments and modify behavior accordingly. Neurodegenerative processes can progressively transform affective responses and affect social competence. This exploratory study examined the neurocognitive correlates of face recognition, in individuals with two mild cognitive impairment (MCI) etiologies (prodromal to dementia - MCI, or consequent to Parkinson's disease - PD-MCI). Performance on the identification and memorization of neutral and emotional facial expressions was assessed in 31 individuals with MCI, 26 with PD-MCI, and 30 healthy controls (HC). Individuals with MCI exhibited selective impairment in recognizing faces expressing fear, along with difficulties in remembering both neutral and emotional faces. Conversely, individuals with PD-MCI showed no differences compared with the HC in either emotion recognition or memory. In MCI, no significant association emerged between the memory for facial expressions and cognitive difficulties. In PD-MCI, regression analyses showed significant associations with higher-level cognitive functions in the emotional memory task, suggesting the presence of compensatory mechanisms. In a subset of participants, voxel-based morphometry revealed that the performance on emotional tasks correlated with regional changes in gray matter volume. The performance in the matching of negative expressions was predicted by volumetric changes in brain areas engaged in face and emotional processing, in particular increased volume in thalamic nuclei and atrophy in the right parietal cortex. Future studies should leverage on neuroimaging data to determine whether differences in emotional recognition are mediated by pathology-specific atrophic patterns., (© 2024. The Psychonomic Society, Inc.)

Introduction: Neuropsychological studies infer brain-behavior relationships from focal lesions like stroke and tumors. However, these pathologies impair brain function through different mechanisms even when they occur at the same brain's location. The aim of this study was to compare the profile of cognitive impairment in patients with brain tumors vs. stroke and examine the correlation with lesion location in each pathology., Methods: Patients with first time stroke (n = 77) or newly diagnosed brain tumors (n = 76) were assessed with a neuropsychological battery. Their lesions were mapped with MRI scans. Test scores were analyzed using principal component analysis (PCA) to measure their correlation, and logistic regression to examine differences between pathologies. Next, with ridge regression we examined whether lesion features (location, volume) were associated with behavioral performance., Results: The PCA showed a similar cognitive impairment profile in tumors and strokes with three principal components (PCs) accounting for about half of the individual variance. PC1 loaded on language, verbal memory, and executive/working memory; PC2 loaded on general performance, visuo-spatial attention and memory, and executive functions; and, PC3 loaded on calculation, reading and visuo-spatial attention. The average lesion distribution was different, and lesion location was correlated with cognitive deficits only in stroke. Logistic regression found language and calculation more affected in stroke, and verbal memory and verbal fluency more affected in tumors., Conclusions: A similar low dimensional set of behavioral impairments was found both in stroke and brain tumors, even though each pathology caused some specific deficits in different domains. The lesion distribution was different for stroke and tumors and correlated with behavioral impairment only in stroke., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

People with Parkinson's disease (PD) experience functional limitations early in the progression of the disease, showing, among other cognitive deficits, difficulties in mathematical abilities. The neural correlates of such abilities have been scarcely investigated in PD, and it is not known whether patients may exhibit difficulties only in formal numerical tasks (e.g., mental multiplications), or also in everyday activities involving numbers (i.e., informal numerical abilities such as time estimates). The present study investigated formal and informal numerical abilities in PD patients and explored their relationship with cortical and subcortical brain volume. We examined patients with PD and mild cognitive impairment (PD-MCI) and age-matched healthy controls (HCs) using the numerical activities of daily living (NADL) battery, assessing both scholastic numerical abilities (formal test), and the ability to use numbers in everyday life (informal test). We compared NADL performances in both groups. Within the PD group, we investigated the association between NADL and cortical and subcortical volumes using multiple linear regressions. The correlation with other cognitive tests was also explored. PD-MCI performed worse than HC in the formal NADL test. In PD-MCI patients, brain-behavior correlations showed two distinct patterns: cortical volumes correlated positively, while striatal volumes correlated negatively with NADL formal tasks. Both formal and informal tests correlated with measures of cognitive functioning. Our results suggest specific impairments in formal numerical abilities in PD-MCI, but not in everyday activities. While cortical atrophy is associated with worse performance, the negative correlations with subcortical regions suggest that their activation may reflect potential compensatory mechanisms., (© 2022. Fondazione Società Italiana di Neurologia.)

Patients with mild cognitive impairment (MCI) might experience difficulties in numerical and financial abilities of daily living that compromise their autonomy. The aim of the present work was to examine whether specific tests of the standard neuropsychological assessment could be used to predict these deficits in the clinical practice. Thirty-four MCI patients underwent a comprehensive clinical and neuropsychological examination including (1) a complete assessment of financial abilities and (2) a traditional neuropsychological assessment including measures of language, memory, executive functioning, reasoning, attention, and visuospatial abilities. The neuropsychological tests were used as predictors of the performance in everyday financial tasks using logistic regression analysis. Deficits in financial tasks including calculating percentages, using financial concepts and applying financial judgments were significantly predicted by tests of executive functions, language and short-term memory, while deficits in frequently encountered financial tasks activities such as item purchase and reading numbers could not be predicted by standard neuropsychological evaluations. Contingency tables on performance above/below clinical cut-offs evidenced some cases of financial deficits in the absence of cognitive deficits and, vice versa, some patients with cognitive decline did not show financial impairments. These results suggest that while some cognitive functions might be crucial for taking financial decisions, an ad hoc test of financial capacity is essential to make overall inferences about the everyday financial autonomy of MCI patients. This has potential implications for clinical and legal decisions that directly impact the individuals and their families., (© 2021. Fondazione Società Italiana di Neurologia.)

High quality of sleep may mitigate the impact of pathophysiological mechanisms in mild cognitive impairment (MCI) through functional connectivity reorganization of neural networks underlying higher cognitive functions. Thirty-eight patients with MCI stratified into high and low quality of sleep in accordance with a self-reported questionnaire for sleep habits, and 38 controls underwent resting-state functional magnetic resonance imaging. Independent component analysis was used to reconstruct the default mode network and frontoparietal network (FPN). High quality of sleep was associated with increased FPN connectivity among patients with MCI. Moreover, a positive coupling of connectivity between networks was found in MCI reporting high quality of sleep, congruently with the pattern observed in controls, whereas this coupling was disrupted in MCI with low quality of sleep. An association between FPN connectivity and language scores was observed in MCI. These findings suggest a relationship between sleep quality and FPN connectivity in MCI that may underlie compensatory mechanisms to overcome advancing neurodegeneration., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Mild Cognitive Impairment (MCI) patients experience problems in financial abilities that affect everyday functioning. To date, the neural correlates of decline in this domain are unclear. This study aims at examining the correlation between the pattern of brain atrophy of MCI patients and performance on financial abilities. Forty-four MCI patients and thirty-seven healthy controls underwent structural magnetic resonance imaging, and assessment of financial abilitiesby means of the Numerical Activities of Daily Living Financial battery (NADL-F). As compared to healthy controls, MCI patients showed impaired performance in three out of the seven domains assessed by NADL-F: Item purchase, percentage, and financial concepts. The patients' performance in the NADL-F correlated with memory, language, visuo-spatial, and abstract reasoning composite scores. The analysis also revealed that volumetric differences in the limbic structures significantly correlated with financial abilities in MCI. Specifically, the patients' performance in the NADL-F was correlated with atrophy in the left medial and lateral amygdala and the right anterior thalamic radiation. These findings suggest that completing daily financial tasks involves sub-cortical regions in MCI and presumably also the motivational and emotional processes associated to them. Involvement of altered limbic structures in MCI patients suggests that impairment in financial abilities may be related to emotional and reflexive processing deficits., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Despite network studies of the human brain have brought consistent evidence of brain regions with diverse functional roles, the neuropsychological approach has mainly focused on the functional specialization of individual brain regions. Relatively few neuropsychological studies try to understand whether the severity of cognitive impairment across multiple cognitive abilities can be related to focal brain injuries. Here we approached this issue by applying a latent variable modeling of the severity of cognitive impairment in brain tumor patients, followed by multivariate lesion-symptom methods identifying brain regions critically involved in multiple cognitive abilities. We observed that lesions in confined left lateral prefrontal areas including the inferior frontal junction produced the most severe cognitive deficits, above and beyond tumor histology. Our findings support the recently suggested integrated albeit modular view of brain functional organization, according to which specific brain regions are highly involved across different sub-networks and subserve a vast range of cognitive abilities. Defining such brain regions is relevant not only theoretically but also clinically, since it may facilitate tailored tumor resections and improve cognitive surgical outcomes., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Purpose: In the general population, sleep disorders are associated with an increased risk of cognitive impairment. The prevalence of sleep disorders, such as sleep apnea, in acromegalic patients is higher than in the general population, and they may have additional risk of cognitive impairment due to acromegaly treatment and comorbidities. We aim to study the relationship between sleep disturbances and cognitive dysfunction in a group of acromegalic patients., Methods: We studied 67 consecutive acromegalic patients. We performed a neurocognitive assessment and patients completed the Acromegaly Quality of Life Questionnaire (AcroQoL), Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index., Results: Of the 67 acromegaly patients in the study, 38.8% were male and median age at the neurological examination was 56 (IQR 48, 65). Approximately 6-10% of patients had impaired cognitive assessment, depending on the test. In linear regression models adjusted for age, sex, BMI, disease duration, and disease activity, poorer sleep quality was associated with lower global cognitive z-score (B = -0.03, 95% CI -0.06, -0.002). Daytime somnolence was associated with poorer physical AcroQoL sub-score (B = -0.04, 95% CI -0.08, -0.002). Sleep quality was associated with poorer overall AcroQoL (B = -0.03, 95% CI -0.05, -0.006), physical AcroQoL (B = -0.04, 95% CI -0.07, -0.005), psychological AcroQoL (B = -0.02, 95% CI -0.04, -0.001), and social AcroQoL (B = -0.02, 95% CI -0.04, -0.0009)., Conclusions: In acromegaly patients, we found robust evidence that poor sleep quality is associated with poorer quality of life, and some evidence that it is associated with poorer cognitive function.

Cognitive impairment is frequent in progressive supranuclear palsy (PSP) and less common in multiple system atrophy (MSA), but characteristics and progression compared with Parkinson's disease (PD) need to be properly defined. We evaluated 35 PSP with Richardson's syndrome (PSP-RS), 30 MSA as well as 65 age-, sex-, and education-matched PD with an extensive clinical and neuropsychological assessment, allowing Level II cognitive diagnosis. Eighteen PSP, 12 MSA and 30 PD had a second evaluation between 12 and 18 months (mean 15 months) after the first assessment. PSP performance at Montreal Cognitive Assessment (MoCA), verbal fluencies (phonemic and semantic tasks), Stroop test (Error and Time), Digit Span Sequencing (DSS), incomplete letters of Visual Object and Space Perception (VOSP) and Benton's Judgment of Line Orientation (JLO) performance were significantly poorer at baseline compared to PD and MSA. Executive, language and visuospatial abilities declined longitudinally in PSP, but not in PD and MSA. After 1.5 year, 16% of PSP converted to dementia. Our study provides evidence that cognitive progression is more severe and rapid in PSP-RS than PD and MSA. Further, we observed that MoCA, verbal fluency (particularly semantic), DSS and Benton's JLO are valuable tests to detect cognitive progression in PSP-RS and may be proposed as possible biomarker to assess efficacy of disease modification strategies.

Financial capacity is the ability to manage one's own finances according to self-interests. Failure in financial decisions and lack of independence when dealing with money can affect people's quality of life and are associated with neuropsychological deficits or clinical conditions such as mild cognitive impairment or Alzheimer's disease. Despite the importance of evaluating financial capacity in the assessment of patients with neuropsychological and psychiatric disorders, only a few tools have been developed. In the present article, the authors introduce the Numerical Activities of Daily Living - Financial (NADL-F) test, a new test to assess financial capacity in clinical populations. The NADL-F is relatively short, yet it encompasses the most common activities involving financial capacities. The NADL-F proved to have satisfactory psychometric properties and overall good validity for measuring financial abilities. Associations with performance on basic neuropsychological tests were investigated, in particular focusing on mathematical abilities as cognitive correlates of financial capacity. Results indicate that the NADL-F could be a useful tool to guide treatments for the enhancement of financial capacities. By sharing all materials and procedures, the authors hope to promote the development of further versions of the NADL-F in different languages, taking into account the necessary adjustments related to different socio-cultural contexts.

Background: Patients with mild cognitive impairment (MCI) show lower decision making and ratio processing abilities as compared to healthy peers., Objective: To evaluate whether cognitive training on number processing and/or executive functions improves performance on ratio processing and decision making under risk., Methods: In a controlled cross-over study, patients with MCI (n = 23; mean MMSE 26.48, SD 2.43) underwent a week of numerical training followed by a week of executive-functions training (subgroup A), or vice versa (subgroup B). Before training (T1), patients performed experimental tasks of decision making (Game of Dice Task, GDT; Probability-Associated Gambling task, PAG-60 task) and of ratio processing as well as a neuropsychological background assessment. Experimental tasks were also administered after the first (T2) and the second (T3) training week., Results: The numerical training and the training of executive functions had a differential effect on experimental tasks of ratio processing. Only the numerical training proved to be effective. The effects of the two training types on decision making under risk were less clear-cut. While no changes over time were observed in the GDT, performance on the PAG-60 task improved in both training subgroups. These improvements were apparent in one subgroup after a period of executive-functions training, in the other subgroup after both training weeks. That means, improvements are not attributable to one specific training type., Conclusion: Patients with MCI can profit from a cognitive training on number processing and executive functions. Improvements are reflected in higher ratio processing abilities and more advantageous decisions after training. These results are consistent with assumptions of current cognitive models.

Background: This study aimed to identify the mathematical domains affected in adults with neurofibromatosis 1 (NF1) and the impact of the numerical difficulties on the patients' activities of daily living., Methods: We assessed 28 adult patients with NF1 and 28 healthy control participants. All participants completed the standardised battery of numerical activities of daily living along with clinical batteries of cognitive (Mini-Mental State Examination) and daily functioning (instrumental activities of daily living). The group comparisons of the performance on numerical activities of daily living were carried out using t-test correcting for multiple comparisons., Results: The results showed that the NF1 group performed worse than controls in written subtractions, written multiplication, multiplication principles and digit comprehension (dot counting) tasks. Importantly, no significant differences in numerical ecological tasks were found between patients and controls, suggesting a possible use of compensatory strategies in daily living abilities in spite of calculation deficits., Conclusion: The findings indicate that NF1 affects calculation but not the basic comprehension or representation of numbers in adult patients. These data have important implications for designing cognitive interventions tailored to the cognitive profile of individuals with NF1., (© 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

Patients with mild cognitive impairment experience difficulties in mathematics that affect their functioning in the activities of everyday life. What are the associated anatomical brain changes and the cognitive correlates underlying such deficits? In the present study, 33 patients with Mild Cognitive Impairments (MCI) and 29 cognitively normal controls underwent volumetric MRI, and completed the standardized battery of Numerical Activities of Daily Living (NADL) along with a comprehensive clinical neuropsychological assessment. Group differences were examined on the numerical tasks and volumetric brain measures. The gray (GM) and white matter (WM) volume correlates were also evaluated. The results showed that relative to controls, the MCI group had impairments in number comprehension, transcoding, written operations, and in daily activities involving time estimation and money usage. In the volumetric measures, group differences emerged for the transcoding subtask in the left insula and left superior temporal gyrus. Among MCI patients, number comprehension and formal numerical performance were correlated with volumetric variability in the right middle occipital areas and right frontal gyrus. Money-usage scores showed significant correlations with left mesial frontal cortex, right superior frontal and right superior temporal cortex. Regression models revealed that neuropsychological measures of long-term memory, language, visuo-spatial abilities, and abstract reasoning were predictive of the patients' decline in daily activities. The present findings suggest that early neuropathology in distributed cortical regions of the brain including frontal, temporal and occipital areas leads to a breakdown of cognitive abilities in MCI that impacts on numerical daily functioning. The findings have implications for diagnosis, clinical and domestic care of patients with MCI., (Copyright © 2015 Elsevier Ltd. All rights reserved.)