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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.

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]