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Background: Although considerable research has been conducted on post‐COVID‐19 syndrome (PCS), cognitive symptoms, particularly those related to language, are still not well understood. Aims: To provide a detailed quantitative and qualitative analysis of language performance in PCS patients using a comprehensive set of semantic and verbal production tasks. Methods & Procedures: The study involved 195 PCS patients aged 26–64 years and 50 healthy controls aged 25–61 years. Participants were assessed using two semantic tasks, three naming tasks and four types of verbal fluency tasks, designed to evaluate different aspects of language processing. Outcomes & Results: PCS patients demonstrated significantly poorer performance compared with controls across all verbal fluency tasks. This was evident in both the total number of words generated and their types, with patients tending to choose more easily accessible words. In naming tasks, the pattern of errors was similar in both groups, although patients showed a higher number of non‐responses and made more errors, reflecting difficulties in word retrieval. The analysis highlighted the impact of factors such as stimulus availability, educational level and cognitive reserve on performance. Notably, younger patients performed worse than older, a paradoxical trend also observed in previous research. Conclusions & Implications: These findings reveal significant word retrieval difficulties in PCS patients, suggesting that cognitive impairment related to language may be more pronounced than previously understood. The results underscore the need for a thorough evaluation of language functions in PCS patients and the development of more targeted and individualized language rehabilitation strategies to address these specific challenges. WHAT THIS PAPER ADDS: What is already known on the subject: Studies on the cognitive characteristics of CPS have focused mainly on broad‐spectrum neuropsychological assessments covering all cognitive functions. However, there are very few studies analysing oral production with specific lexical and semantic system tasks. Furthermore, no work has specifically included tasks assessing semantic processing or conducted qualitative analyses of the psycholinguistic variables affecting performance. Such analyses could undoubtedly help clarify the nature of the language impairments in patients with PCS. What this paper adds to the existing knowledge: This study explores in depth the evaluation and analysis of the oral production of patients with PCS using several lexical and semantic tasks. In addition, psycholinguistic variables are analysed that could undoubtedly help clarify the nature of the language impairments in patients with PCS. What are the potential or actual clinical implications of this work?: The study allows the identification of specific lexical–semantic deficits in the spoken language in patients with this PCS. A more detailed assessment of the oral language of these patients, keeping in mind the psycholinguistic variables that may affect the performance, will facilitate the design of more efficient and individualized rehabilitation programmes. [ABSTRACT FROM AUTHOR]

Semantic verbal fluency (SVF) impairment is present in several neurological disorders. Although activation in SVF-related areas has been reported, how these regions are connected and their functional roles in the network remain divergent. We assessed SVF static and dynamic functional connectivity (FC) and effective connectivity in healthy participants using functional magnetic resonance imaging. We observed activation in the inferior frontal (IFG), middle temporal (pMTG) and angular gyri (AG), anterior cingulate (AC), insular cortex, and regions of the superior, middle, and medial frontal gyri (SFG, MFG, MidFG). Our static FC analysis showed a highly interconnected task and resting state network. Increased connectivity of AC with the pMTG and AG was observed for the task. The dynamic FC analysis provided circuits with connections similarly modulated across time and regions related to category identification, language comprehension, word selection and recovery, word generation, inhibition of speaking, speech planning, and articulatory planning of orofacial movements. Finally, the effective connectivity analysis provided a network that best explained our data, starting at the AG and going to the pMTG, from which there was a division between the ventral and dorsal streams. The SFG and MFG regions were connected and modulated by the MidFG, while the inferior regions formed the ventral stream. Therefore, we successfully assessed the SVF network, exploring regions associated with the entire processing, from category identification to word generation. The methodological approach can be helpful for further investigation of the SVF network in neurological disorders. [ABSTRACT FROM AUTHOR]

Between 2.5% and 28% of people infected with SARS-CoV-2 suffer long COVID or persistence of symptoms for months after acute illness. Many symptoms are neurological, but the brain changes underlying the neuropsychological impairments remain unclear. This study aimed to provide a detailed description of the cognitive profile, the pattern of brain alterations in long COVID and the potential association between them. To address these objectives, 83 patients with persistent neurological symptoms after COVID-19 were recruited, and 22 now healthy control subjects chosen because they had suffered COVID-19 but did not experience persistent neurological symptoms. Patients and controls were matched for age, sex and educational level. All participants were assessed by clinical interview, comprehensive standardized neuropsychological tests and structural MRI. The mean global cognitive function of patients with long COVID assessed by Addenbrooke's Cognitive Examination-III screening test [overall cognitive level (OCLz) = −0.39 ± 0.12] was significantly below the infection recovered-controls (OCLz = +0.32 ± 0.16, P < 0.01). We observed that 48% of patients with long COVID had episodic memory deficit, with 27% also with impaired overall cognitive function, especially attention, working memory, processing speed and verbal fluency. The MRI examination included grey matter morphometry and whole brain structural connectivity analysis. Compared to infection recovered controls, patients had thinner cortex in a specific cluster centred on the left posterior superior temporal gyrus. In addition, lower fractional anisotropy and higher radial diffusivity were observed in widespread areas of the patients' cerebral white matter relative to these controls. Correlations between cognitive status and brain abnormalities revealed a relationship between altered connectivity of white matter regions and impairments of episodic memory, overall cognitive function, attention and verbal fluency. This study shows that patients with neurological long COVID suffer brain changes, especially in several white matter areas, and these are associated with impairments of specific cognitive functions. [ABSTRACT FROM AUTHOR]

Aim: This observational longitudinal study aimed to explore the risk factors for disabilities in older Japanese individuals with diabetes at a frailty clinic, an outpatient clinic specializing in comprehensive geriatric assessments for older patients. Methods: The outcome was the onset of disability as a new certification of long‐term care needs in outpatients aged ≥65 years. Multivariable Cox regression analyses examined the independent associations between the onset of disability and the variables that reached significance in the bivariate analysis, after adjusting for age and sex, years of education, and certification of need for support. Results: A total of 182 participants (mean age 77.8 years, 59.9% female) were included in the study. During a mean follow‐up period of 1070 days, 28 patients (15.4%) developed disabilities. Multivariable analysis showed that poor glycemic control (higher levels of glycosylated albumin and HbA1c), frailty as measured by the Clinical Frailty Scale (CFS), cognitive decline as assessed by the revised Hasegawa Dementia Scale (especially "5 object recall" and verbal fluency as assessed by the number of "vegetable names"), poor adherence to medications, and reduced muscle mass were significantly associated with the development of disability. Multivariable Cox regression analyses revealed independent and significant associations between the development of disability and HbA1c ≥7.5%, CFS ≥4, and generating vegetable names≤9. Conclusion: In identifying older patients with diabetes who are at risk of developing disabilities, it may be useful to evaluate glycemic control, CFS, cognition, and medication adherence. Verbal fluency tests using vegetable names may serve as simple tools for assessing the risk of disability. Geriatr Gerontol Int 2024; 24: 1030–1038. [ABSTRACT FROM AUTHOR]

Objective: We conducted two empirical studies (in a cross-sectional and a longitudinal design) with the aim at establishing normative data (including norms for strategy use [i.e., clustering and switching strategies] and performance over time), and examining the convergent validity, the test–retest reliability (3–4 wks interval) and the changes in performance with practice (1 year interval) of the different verbal fluency (VF) quantitative and qualitative scores in Spanish-speaking children and adolescents. Method: In S1 (n = 620 6- to 15-year-old Spanish-speaking children and adolescents), MANCOVA and Pearson's correlations were employed. In S2 (n = 148 6- to 12-year-old Spanish-speaking children), intraclass correlation coefficient (ICC), paired t-tests, and Confirmatory Factor Analysis (CFA) were used. Results: S1 results showed an age effect on all VF measures (quantitative and qualitative). The number of switches/clusters was more related to total word productivity and to executive functions (EF) than the mean cluster size. In S2, a significant increase in phonological VF performance was observed on number of switches and word productivity scores from baseline (Time 1) to repeat testing at Time 2. Practice effects were observed at Time 3 on all measures except for semantic and phonological mean cluster size. Test–retest reliability coefficients at Time 2 for number of clusters and switches, but not for mean cluster size, fell in the moderate range, ranging from ICCs.61 to ICCs.81. Test–retest reliability coefficients for total word productivity were higher (ICCs above.80) and stronger when testing as a unity with CFA methods (ϕ=.94, p <.001). Conclusions: These data may be relevant for informing the neuropsychological assessment of spontaneous cognitive flexibility in children with typical development (TD) and those with developmental or acquired disorders. [ABSTRACT FROM AUTHOR]

A more in-depth understanding of the relationship between depressive symptoms, neurocognition and suicidal behavior could provide insights into the prognosis and treatment of major depressive disorder (MDD) and suicide. We conducted a network analysis among depressed patients examining associations between history of suicide attempt (HSA), core emotional major depression disorder, and key neurocognitive domains. Depressed patients (n = 120) aged 18–65 years were recruited from a larger randomized clinical trial conducted at the Douglas Institute in Montreal, Canada. They were randomly assigned to receive one of two antidepressant treatments (i.e., escitalopram or desvenlafaxine) for 8 weeks. Core emotional MDD and key neurocognitive domains were assessed pre-post treatment. At baseline, an association between history of suicide attempt (HSA) and phonemic verbal fluency (PVF) suggested that HSA patients reported lower levels of the latter. After 8 weeks of antidepressant treatment, HSA became conditionally independent from PVF. Similar results were found for both the HAM-D and the QIDS-SR core emotional MDD/neurocognitive networks. Network analysis revealed a pre-treatment relationship between a HSA and decreased phonemic VF among depressed patients, which was no longer present after 8 weeks of antidepressant treatment. • Core emotional MDD and key neurocognitive domains pre-post treatment associated with a history of suicide attempt. • Similar results for both the HAM-D and the QIDS-SR core emotional MDD/neurocognitive networks. • Network analysis revealed a pre-treatment relationship between a HSA and decreased phonemic VF among depressed patients. • Relationship between a HSA and decreased phonemic VF disappeared after 8 weeks of antidepressant treatment. [ABSTRACT FROM AUTHOR]

To test a Chinese character version of the phonemic verbal fluency task in patients with temporal lobe epilepsy (TLE) and assess the verbal fluency deficiency pattern in TLE with and without hippocampal sclerosis, a cross-sectional study was conducted including 30 patients with TLE and hippocampal sclerosis (TLE-HS), 28 patients with TLE and without hippocampal sclerosis (TLE-NHS), and 29 demographically matched healthy controls (HC). Both sexes were enrolled. Participants finished a Chinese character verbal fluency (VFC) task during functional MRI. The activation/deactivation maps, functional connectivity, degree centrality, and community features of the left frontal and temporal regions were compared. A neural network classification model was applied to differentiate TLE-HS and TLE-NHS using functional statistics. The VFC scores were correlated with semantic fluency in HC while correlated with phonemic fluency in TLE-NHS. Activation and deactivation deficiency was observed in TLE-HS and TLE-NHS (p < 0.001, k≥10). Functional connectivity, degree centrality, and community features of anterior inferior temporal gyri were impaired in TLE-HS and retained or even enhanced in TLE-NHS (p < 0.05, FDR-corrected). The functional connectivity was correlated with phonemic fluency (p < 0.05, FDR-corrected). The neural network classification reached an area under the curve of 0.90 in diagnosing hippocampal sclerosis. The VFC task is a Chinese phonemic verbal fluency task suitable for clinical application in TLE. During the VFC task, functional connectivity of phonemic circuits was impaired in TLE-HS and was enhanced in TLE-NHS, representing a compensative phonemic searching strategy applied by patients with TLE-NHS. [ABSTRACT FROM AUTHOR]

BACKGROUND: Linguistic deficits are common across neurological and neurodegenerative disorders. Currently there are limited neuropsychological norms available for Spanish-speaking adults residing in the U.S. OBJECTIVE: To generate norms for two verbal fluency tests and the Boston Naming Test (BNT) in a Spanish-speaking population in the U.S., with adjustments for demographic and cultural variables. METHODS: The sample consisted of 245 adults from the U.S. Participants completed phonological and semantic verbal fluency tests and the BNT. A standardized four-step statistical procedure was used. RESULTS: For the phoneme F, interactions between Spanish proficiency, age, and education arose. Better performance on phonemes A, S, and M was related to education. Spanish proficiency, acculturation, and time in the U.S. were associated with the phonemes S, A, P, M, and R. An age by education interaction was found for phonemes M and R. The FAS and PMR triads were related to age, sex, time in U.S., and Spanish proficiency. For the semantic verbal fluency tests, an interaction between education and Spanish proficiency arose. For the BNT, test scores were related to education, and significant interactions were also found based on education's interaction with Spanish proficiency and acculturation. CONCLUSION: This study highlights the importance of accounting for sociodemographic and acculturative factors when developing normative data for verbal fluency tests and the BNT for dominant Spanish-speaking adults in the U.S. These sociodemographically-adjusted norms will help improve accuracy of diagnosis and interpretation of linguistic test performance in Spanish speakers living in the U.S. [ABSTRACT FROM AUTHOR]

Analyzing data from the verbal fluency task (e.g., "name all the animals you can in a minute") is of interest to both memory researchers and clinicians due to its broader implications for memory search and retrieval. Recent work has proposed several computational models to examine nuanced differences in search behavior, which can provide insights into the mechanisms underlying memory search. A prominent account of memory search within the fluency task was proposed by Hills et al. (2012), where mental search is modeled after how animals forage for food in physical space. Despite the broad potential utility of these models to scientists and clinicians, there is currently no open-source program to apply and compare existing foraging models or clustering algorithms without extensive, often redundant programming. To remove this barrier to studying search patterns in the fluency task, we created forager, a Python package (https://github.com/thelexiconlab/forager) and web interface (https://forager.research.bowdoin.edu/). forager provides multiple automated methods to designate clusters and switches within a fluency list, implements a novel set of computational models that can examine the influence of multiple lexical sources (semantic, phonological, and frequency) on memory search using semantic embeddings, and also enables researchers to evaluate relative model performance at the individual and group level. The package and web interface cater to users with various levels of programming experience. In this work, we introduce forager's basic functionality and use cases that demonstrate its utility with pre-existing behavioral and clinical data sets of the semantic fluency task. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have yielded conflicting results concerning the disparities in verbal (semantic and letter) fluency between monolingual and bilingual individuals. Given the linguistic variations among bilinguals and the influence of cultural differences on language, this study examined verbal fluency in Kurdish and Azari bilinguals and compared it with that of Farsi monolinguals.Methods: This cross-sectional study involved 30 Farsi monolingual students, 28 Kurdish-Farsi bilinguals, and 29 Azari-Farsi bilinguals. The study utilized semantic (fruits and animals) and letter fluency tasks (/f/, /a/, and /s/). Each bilingual participant was instructed to perform the verbal fluency tasks twice: once in their native language and once in Farsi.Results: In both fluency tasks, bilinguals demonstrated superior performance in Farsi compared to their mother languages (Azari and Kurdish) (P

This study investigates verbal fluency as an indicator of executive function in middle-aged adults with mild sensorineural hearing loss, comparing them to age-matched controls with normal hearing. In this study, 50 middle-aged participants were recruited, comprising 25 with bilateral unaided mild hearing loss and 25 age-matched controls with normal hearing. Demographic information, including age, gender, and health-related factors, was collected. Audiological evaluations confirmed the participants' hearing status, and verbal fluency tests were conducted, encompassing semantic, phonemic, and alternate fluency tasks. Significant differences in audiological measures were observed between both groups. Verbal fluency tests revealed lower mean ranks between the groups on almost all tasks suggesting distinct accuracy and error patterns. This study establishes a link between mild sensorineural hearing loss and executive function in middle-aged adults, evidenced by deficits in verbal fluency tasks. The findings underscore the need for targeted interventions to address cognitive impairments, emphasizing the importance of comprehensive care strategies for individuals in this population. [ABSTRACT FROM AUTHOR]

BackgroundSchizophrenic patients have metabolic disorders， impaired language and information processing function. Inflammatory factors may play an important role in the occurrence and development of schizophrenia.ObjectiveTo explore the relationship of the inflammatory factor levels with metabolic levels， language fluency and information processing function in patients with schizophrenia， so as to provide references for clinical understanding of the neuropathological mechanisms of schizophrenia.MethodsA total of 96 patients with schizophrenia were included in the study group， who were hospitalized in the Fourth People's Hospital of Hefei from January 2021 to December 2022 as well as met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and Mini-International Neuropsychiatric Interview （MINI） 6.0 .Meanwhile， population who underwent physical examination at the same hospital were included in the control group （n=42）. A high-sensitivity multi factor electrochemiluminescence analyzer was used to detect the levels of inflammatory factors IL-4， IL-5， IL-7， IL-8， IL-10 and IL-13. A fully automated biochemical analyzer was used to detect the levels of metabolic indicators such as fasting blood glucose， triglycerides， high-density lipoprotein， apolipoprotein A， creatinine and urea nitrogen. Verbal fluency and information processing function of all participants were assessed by using Verbal Fluency Test （VFT） and Stroop Color Word Test （SCWT）.ResultsThere were statistically significant differences in the levels of IL-4， IL-5， IL-7， IL-8， IL-10， IL-13 and IL-15 between the study group and the control group （P

Background: Changes in cognitive functioning with the progression of age have been suggested as indicator of potential degenerative disorders in older adults. With growing age, deterioration in executive functions happens and is noticeable from the difficulties in day-to-day planning, problem-solving, decision-making, and inhibition or fluency in the elderly. However, in the early stages, it might be tricky to clinically identify if the decline in the cognitive functions is clinically significant or not. Verbal fluency is a valuable executive function and posited as one of the indicators of cognitive impairment. Within this construct, categorical and semantic fluency are inclined to indicate the verbal stimulus recognition and association. It is suggested that the capability to distinguish and associate verbal stimulus could be at different levels of decline with aging with a possible pattern of decline from the early stage of old age and later and distinct among males and females. This progressive decline and changes in verbal fluency could indicate the probable occurrence of cognitive impairment in the aging population. The study aimed to explore the verbal and semantic fluency as an indicator of the progression of cognitive decline with aging and to explore the sex differences in verbal fluency of the studied sample if any. Methodology: Hundred individuals of both sexes in the age range of 50–70 years were selected for the study. The Controlled Oral Word Association Test (COWA) and animal naming test were administered to measure the semantic and categorical verbal fluency of the participants. Results: Results suggest significant changes in verbal fluency with aging in the participants. However, the sex difference in verbal fluency was marginal, as males performed slightly better on the naming task but not in the word association task. Conclusions: Changes in verbal fluency are evident and prominent among the aging population and could be a valuable tool for early identification and intervention, decreasing the risks of degeneration and improving the quality of life of the elderly.

Abstract Background This study explores recent cohort trends in cognitive performance among older Europeans from 2007 to 2017, addressing three key questions: (1) Did cognitive performance improve universally and across the performance distribution during this period? (2) Did these improvements occur across educational levels and for both men and women? (3) Can established risk factors explain these performance gains? Methods Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) across 12 European countries, we assessed immediate recall, delayed recall, and verbal fluency in individuals aged 60 to 94 in both 2007 and 2017 (n = 32 773). Differences between the two time points were estimated with linear mixed effects regression models and quantile regression. Results Cognitive performance improved in all age groups, across educational levels, and for both men and women between 2007 and 2017. Notably, improvements were more pronounced at the upper end of the performance distribution for delayed recall and verbal fluency. Education explained approximately 20% of the observed improvements. Risk factors did not explain the observed improvements. Conclusions European cohorts of both younger-old and older adults continue to exhibit improvements in cognitive performance. Variation in the size of the cohort improvements across the performance distributions in delayed recall and in verbal fluency may contribute to growing inequalities in cognitive outcomes. Future research should further investigate the potential heterogeneity in cognitive performance gains. Trial registration Not applicable.

AbstractSemantic and phonemic verbal fluency tests are widely used neuropsychological assessments of executive functions and language skills and are easy to administer. The aim of this study was to determine the impact of age, education, and gender on semantic and phonemic verbal fluency tests and to establish normative data for Turkish adults aged between 18 and 86 years. The results revealed significant main effects of age and education on all subscores of verbal fluency tests. Furthermore, an interaction effect between age and education was observed on semantic fluency and letter K fluency scores. While no significant differences were found among the 18–29, 30–39, and 40–49 age groups in any of the subscores, performance on the tests decreased with increasing age. Significant differences were observed among all education groups in all subscores. No main or interaction effects of gender were found on any subscore. These normative data could prove useful in clinical and research settings for the assessment of cognitive impairment. [ABSTRACT FROM AUTHOR]

Background: Verbal fluency (VF) tasks are known as suitable for detecting cognitive impairment (CI) in Parkinson's disease (PD). This study thus aimed to evaluate the psychometrics and diagnostics of the Alternate Verbal Fluency Battery (AVFB) by Costa et al. (2014) in an Italian cohort of non-demented PD patients, as well as to derive disease-specific cut-offs for it. Methods: N = 192 non-demented PD patients were screened with the Montreal Cognitive Assessment (MoCA) and underwent the AVFB—which includes phonemic, semantic and alternate VF tests (PVF; SVF; AVF), as well as a Composite Shifting Index (CSI) reflecting the "cost" of shifting from a single- to a double-cued VF task. Construct validity and diagnostics were assessed for each AVFB measure against the MoCA. Internal reliability and factorial validity were also tested. Results: The MoCA proved to be strongly associated with PVF, SVF and AVF scores, whilst moderately with the CSI. The AVFB was internally consistent and underpinned by a single component; however, an improvement in both internal reliability and fit to its factorial structure was observed when dropping the CSI. Demographically adjusted scores on PVF, SVF and AVF tests were diagnostically sound in detecting MoCA-defined cognitive impairment, whilst this was not true for the CSI. Disease-specific cut-offs for PVF, SVF and AVF tests were derived. Discussion: In conclusion, PVF, SVF and AVF tests are reliable, valid and diagnostically sound instruments to detect cognitive impairment in non-demented PD patients and are therefore recommended for use in clinical practice and research. [ABSTRACT FROM AUTHOR]

Background Schizophrenic patients have metabolic disorders, impaired language and information processing function. Inflammatory factors may play an important role in the occurrence and development of schizophrenia. Objective To explore the relationship of the inflammatory factor levels with metabolic levels, language fluency and information processing function in patients with schizophrenia, so as to provide references for clinical understanding of the neuropathological mechanisms of schizophrenia. Methods A total of 96 patients with schizophrenia were included in the study group, who were hospitalized in the Fourth People's Hospital of Hefei from January 2021 to December 2022 as well as met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and Mini-International Neuropsychiatric Interview (MINI) 6. 0 . Meanwhile, population who underwent physical examination at the same hospital were included in the control group (n=42). A high-sensitivity multi factor electrochemiluminescence analyzer was used to detect the levels of inflammatory factors IL-4, IL-5, IL-7, IL-8, IL-10 and IL-13. A fully automated biochemical analyzer was used to detect the levels of metabolic indicators such as fasting blood glucose, triglycerides, high-density lipoprotein, apolipoprotein A, creatinine and urea nitrogen. Verbal fluency and information processing function of all participants were assessed by using Verbal Fluency Test (VFT) and Stroop Color Word Test (SCWT). Results There were statistically significant differences in the levels of IL-4, IL-5, IL-7, IL-8, IL-10, IL-13 and IL-15 between the study group and the control group (P<0. 05). There were statistically significant differences in BMI, waist circumference, fasting blood glucose, triglycerides, high-density lipoprotein, urea nitrogen, apolipoprotein A and creatinine levels between the two groups (P<0. 05). The differences in the correct number of household appliances, animals, fruits, vegetables, names starting with "water" and "self" in VFT between the two groups were statistically significant (P<0. 05). The differences in point reaction time, character reaction time and character color reaction time in SCWT between the two groups were statistically significant (P<0. 05). Correlation analysis showed that except for creatinine levels, the levels of IL-4 and IL-5 in patients with schizophrenia were correlated with other indicators (P<0. 05). IL-7 levels were correlated with creatinine levels, household appliances, animals, fruits, correct number of names starting with "water" in VFT, point reaction time and word reaction time in SCWT (P<0. 05). IL-8 levels were correlated with triglyceride levels, household appliances, animals, fruits, vegetables, correct number of names starting with "water" and "self" in VFT and word reaction time in SCWT (P<0. 05). Except for creatinine levels and the correct number of names starting with "self", IL-10 levels were correlated with all other indicators (P<0. 05). Except for creatinine and urea nitrogen levels, IL-13 levels were correlated with other indicators (P<0. 05). Conclusion The levels of inflammatory factors in patients with schizophrenia may be related to their metabolic levels, language fluency and information processing function. [ABSTRACT FROM AUTHOR]

Background: Changes in cognitive functioning with the progression of age have been suggested as indicator of potential degenerative disorders in older adults. With growing age, deterioration in executive functions happens and is noticeable from the difficulties in day-to-day planning, problem-solving, decision-making, and inhibition or fluency in the elderly. However, in the early stages, it might be tricky to clinically identify if the decline in the cognitive functions is clinically significant or not. Verbal fluency is a valuable executive function and posited as one of the indicators of cognitive impairment. Within this construct, categorical and semantic fluency are inclined to indicate the verbal stimulus recognition and association. It is suggested that the capability to distinguish and associate verbal stimulus could be at different levels of decline with aging with a possible pattern of decline from the early stage of old age and later and distinct among males and females. This progressive decline and changes in verbal fluency could indicate the probable occurrence of cognitive impairment in the aging population. The study aimed to explore the verbal and semantic fluency as an indicator of the progression of cognitive decline with aging and to explore the sex differences in verbal fluency of the studied sample if any. Methodology: Hundred individuals of both sexes in the age range of 50-70 years were selected for the study. The Controlled Oral Word Association Test (COWA) and animal naming test were administered to measure the semantic and categorical verbal fluency of the participants. Results: Results suggest significant changes in verbal fluency with aging in the participants. However, the sex difference in verbal fluency was marginal, as males performed slightly better on the naming task but not in the word association task. Conclusions: Changes in verbal fluency are evident and prominent among the aging population and could be a valuable tool for early identification and intervention, decreasing the risks of degeneration and improving the quality of life of the elderly. [ABSTRACT FROM AUTHOR]

The present study investigated the relation between continuous measures of two qualitatively different types of bilingual experience and outcome measures that varied in domain (verbal or nonverbal) and processing demands (degree of conflict). Participants were 195 English-speaking children, 7 years old, who were enrolled in French immersion programs. Children were assessed for their degree of "home bilingualism," reflecting language use patterns at home, and "school bilingualism," reflecting progress in learning French. None of the children spoke French at home. Participants completed verbal fluency, n-back, and global–local tasks, with conditions within tasks varying in degree of attentional processing required. Type of bilingual experience affected verbal and nonverbal tasks differently. Home bilingualism was positively associated with performance on attentionally demanding conditions of the n-back and global–local tasks, the two nonverbal tasks, whereas school bilingualism was positively associated with performance on English verbal fluency, the linguistic task. In both cases, results were modulated by the degree of bilingual experience. These results underline the importance of specifying the type and degree of bilingual experience and the details of the outcome tasks to understand the impact of bilingualism on children's development. Public Significance Statement: The possibility that bilingualism impacts children's cognitive development is controversial, but parents must make crucial decisions about their children's linguistic environments despite the absence of clear evidence. However, bilingualism can be achieved in different ways and the outcomes can be measured in different domains. The present study compares the effect of bilingualism achieved through heritage language use at home and language education in school on verbal and nonverbal task performance. The results show specific effects of each form of bilingualism on each type of outcome, underlining the complexity of these relations. [ABSTRACT FROM AUTHOR]

Introduction: Formal educational attainment, or years of schooling, has a well-established positive effect on cognitive health across the life course. We hypothesized that the content and difficulty of the curriculum influence this relationship, such that more challenging curricula in high school lead to higher levels of socioeconomic attainment in adulthood and, in turn, to better cognitive outcomes in older adulthood. Methods: We estimated multilevel structural equation models (MSEMs) in data from 2,405 individuals who attended one of 1,312 US high schools in 1960 and participated in the Project Talent Aging Study in 2018. Results: A college preparatory curriculum and a greater number of semesters of math and science in high school were positively related to word recall and verbal fluency at an average age of 75. Effects were robust to controlling for adolescent cognitive ability, academic performance, socioeconomic background, and school characteristics. Discussion: We discuss the implications of these findings for educational policy. [ABSTRACT FROM AUTHOR]

The relationship between psychological distress and verbal fluency remains underexplored and it remains unclear regarding how age may play a role in this association given that both verbal fluency and psychological distress change with age. The aim of the current brief report is to look at how age may moderate the association between psychological distress and verbal fluency. By analyzing data from 3,3080 participants with an age range from 15 to 101 using a hierarchical regression and three simple slope regressions from the United Kingdom, this brief report found age significantly moderates the association between psychological distress and verbal fluency performance with this association insignificant in young people, negative (b=-0.053, p < 0.001, 95% C.I. [-0.070, -0.037]) in middle-aged people, and strongly negative (b=-0.136, p < 0.001, 95% C.I. [-0.169, -0.103]) in older adults. These results provided novel findings regarding the role of age in the associations between psychological distress and verbal fluency. [ABSTRACT FROM AUTHOR]

Background: This study explores recent cohort trends in cognitive performance among older Europeans from 2007 to 2017, addressing three key questions: (1) Did cognitive performance improve universally and across the performance distribution during this period? (2) Did these improvements occur across educational levels and for both men and women? (3) Can established risk factors explain these performance gains? Methods: Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) across 12 European countries, we assessed immediate recall, delayed recall, and verbal fluency in individuals aged 60 to 94 in both 2007 and 2017 (n = 32 773). Differences between the two time points were estimated with linear mixed effects regression models and quantile regression. Results: Cognitive performance improved in all age groups, across educational levels, and for both men and women between 2007 and 2017. Notably, improvements were more pronounced at the upper end of the performance distribution for delayed recall and verbal fluency. Education explained approximately 20% of the observed improvements. Risk factors did not explain the observed improvements. Conclusions: European cohorts of both younger-old and older adults continue to exhibit improvements in cognitive performance. Variation in the size of the cohort improvements across the performance distributions in delayed recall and in verbal fluency may contribute to growing inequalities in cognitive outcomes. Future research should further investigate the potential heterogeneity in cognitive performance gains. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Amyotrophic lateral sclerosis (ALS) is a multi‐system disorder that commonly affects cognition and behaviour. Verbal fluency impairments are consistently reported in ALS patients, and we aimed to investigate whether this deficit extends beyond the verbal domain. We further aimed to determine whether deficits are underpinned by a primary intrinsic response generation impairment (i.e., a global reduction across tasks), potentially related to apathy, or an inability to maintain responding over time (i.e., a 'drop off' pattern). Twenty‐two ALS patients and 21 demographically‐matched controls completed verbal and nonverbal fluency tasks (phonemic/semantic word fluency, design fluency, gesture fluency and ideational fluency), requiring the generation of responses over a specified time period. Fluency performance was analysed in terms of the overall number of novel items produced, as well as the number of items produced in the first 'initiation' and the remaining 'maintenance' time periods. ALS patients' overall performance was not globally reduced across tasks. Patients were impaired only on meaningful gesture fluency, which requires the generation of gestures that communicate meaning (e.g., waving). On phonemic fluency, ALS patients showed a 'drop off' pattern of performance, where they had difficulty maintaining responding over time, but this pattern was not evident on the other fluency tasks. Apathy did not appear to be related to fluency performance. The selective meaningful gesture fluency deficit, in the context of preserved meaningless gesture fluency, highlights that the retrieval of action knowledge may be weakened in early ALS. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Generalization (or near-transfer) effects of an intervention to tasks not explicitly trained are the most desirable intervention outcomes. However, they are rarely reported and even more rarely explained. One hypothesis for generalization effects is that the tasks improved share the same brain function/computation with the intervention task. We tested this hypothesis in this study of transcranial direct current stimulation (tDCS) over the left inferior frontal gyrus (IFG) that is claimed to be involved in selective semantic retrieval of information from the temporal lobes. MATERIALS AND METHODS: In this study, we examined whether tDCS over the left IFG in a group of patients with primary progressive aphasia (PPA), paired with a lexical/semantic retrieval intervention (oral and written naming), may specifically improve semantic fluency, a nontrained near-transfer task that relies on selective semantic retrieval, in patients with PPA. RESULTS: Semantic fluency improved significantly more in the active tDCS than in the sham tDCS condition immediately after and two weeks after treatment. This improvement was marginally significant two months after treatment. We also found that the active tDCS effect was specific to tasks that require this IFG computation (selective semantic retrieval) but not to other tasks that may require different computations of the frontal lobes. CONCLUSIONS: We provided interventional evidence that the left IFG is critical for selective semantic retrieval, and tDCS over the left IFG may have a near-transfer effect on tasks that depend on the same computation, even if they are not specifically trained. CLINICAL TRIAL REGISTRATION: The Clinicaltrials.gov registration number for the study is NCT02606422.

OBJECTIVE: To investigate the relationship between of distinct domains of childhood disadvantage and cognitive performance among older adults within the context of a middle-income country. METHODS: This study used baseline data (2015/2016) from the Brazilian Longitudinal Study of Aging (ELSI), a nationally representative cohort of 9412 adults aged 50 and over. Nine childhood exposure variables were grouped into three domains (family SES, childhood health, and cultural capital), for which scores were created. Survey-weighted Ordinary Least Squares (OLS) regressions estimated the association childhood disadvantage with cognitive performance as measured by immediate memory, late memory and semantic verbal fluency. Mediation analysis assessed whether adulthood socioeconomic status (SES) mediated this relationship of interest. RESULTS: Important disparities in cognitive performance were observed, particularly in terms of age, education, income, occupational status. Before controlling for adulthood SES in the multivariable analysis, all domains of childhood disadvantage were found to be associated with lower cognitive performance across all three measures. After inclusion of adulthood SES variables, the observed associations only remained for semantic verbal fluency. Formal mediation analysis indicated that adulthood SES mediates 47.9% (95% CI: 34.3%-78.6%) of the association between later-life verbal fluency and poor childhood health, and 49.9% (95% CI: 43.6%-57.8%) of the association between later-life verbal fluency and low childhood cultural capital. CONCLUSIONS: We found that childhood disadvantage is associated with low performance in memory tests and semantic verbal fluency tests among older Brazilians. Adulthood SES fully mediated the association between all domains of childhood disadvantage and memory performance and only partially mediated its association with verbal fluency. Our findings support policy efforts to enhance early childhood development and improve adulthood SES, and guide additional research to better the mechanisms driving these relationships.

Abstract Vitamin D (VitD) is a naturally occurring, fat-soluble vitamin which regulates calcium and phosphate homeostasis in the human body and is also known to have a neuroprotective role. VitD deficiency has often been associated with impaired cognition and a higher risk of dementia. In this study, we aimed to explore the relationship between levels of VitD and cognitive functioning in adult individuals. 982 cognitively healthy adults (≥ 45 years) were recruited as part of the CBR-Tata Longitudinal Study for Aging (TLSA). Addenbrooke’s cognitive examination-III (ACE-III) and Hindi mental status examination (HMSE) were used to measure cognitive functioning. 25-hydroxyvitamin D [25(OH)D] levels were measured from the collected serum sample and classified into three groups— deficient (

Vitamin D (VitD) is a naturally occurring, fat-soluble vitamin which regulates calcium and phosphate homeostasis in the human body and is also known to have a neuroprotective role. VitD deficiency has often been associated with impaired cognition and a higher risk of dementia. In this study, we aimed to explore the relationship between levels of VitD and cognitive functioning in adult individuals. 982 cognitively healthy adults (≥ 45 years) were recruited as part of the CBR-Tata Longitudinal Study for Aging (TLSA). Addenbrooke's cognitive examination-III (ACE-III) and Hindi mental status examination (HMSE) were used to measure cognitive functioning. 25-hydroxyvitamin D [25(OH)D] levels were measured from the collected serum sample and classified into three groups— deficient (< 20 ng/ml), insufficient (20–29 ng/ml) and normal (≥ 30 ng/ml). Statistical analysis was done using IBM SPSS software, version 28.0.1.1(15). The mean age of the participants was 61.24 ± 9 years. Among 982 participants, 572 (58%) were deficient, 224 (23%) insufficient and only 186 (19%) had normal levels of VitD. Kruskal–Wallis H test revealed a significant difference in age (p = 0.015) and education (p = 0.021) across VitD levels and the Chi-square test revealed a significant association between gender (p = 0.001) and dyslipidemia status (p = 0.045) with VitD levels. After adjusting for age, education, gender and dyslipidemia status, GLM revealed that individuals with deficient (p = 0.038) levels of VitD had lower scores in ACE-III verbal fluency as compared to normal. Additionally, we also found that 91.2% individuals who had VitD deficiency were also having dyslipidemia. It is concerning that VitD deficiency impacts lipid metabolism. Lower levels of VitD also negatively impacts verbal fluency in adult individuals. Verbal fluency involves higher order cognitive functions and this result provides us with a scope to further investigate the different domains of cognition in relation to VitD deficiency and other associated disorders. [ABSTRACT FROM AUTHOR]

Psychological constructs related to health outcomes and well-being, such as metacognitive beliefs, have been linked to executive functions in general, and cognitive flexibility more specifically. However, such effects have previously only been discussed on a theoretical level and behavioral flexibility has most often been measured through self-report, only approximating information processing capacities. Objectively measured executive functions may be a more potent predictor of health outcomes. We set out to test whether cognitive flexibility capacity was associated with sick leave in a medium sized company. We included 111 subjects of widely different occupations and assessed their executive functions using Delis-Kaplan Executive Function System test battery (D-KEFS). To assess cognitive flexibility capacity, we included Design Fluency (DF) and Verbal Fluency (VF) and computed these into an index of cognitive flexibility (DFVF). Detailed information on sick leave for the last 5 years was gathered from the company. Our results showed that there was a significant negative correlation between DFVF and sick leave [rs(109) = -0.23, p = 0.015] in the full group as well as in the group that had at least 1 day of sick leave [rs(72) = -0.25, p = 0.03]. The results withstood adjustment for sex, age, occupation, and several core executive functions as well as autistic and ADHD-traits. The results remained for separate analyses using DF or VF. Our main findings were conceptually replicated in a group of bipolar disorder patients. This study shows that objectively measured capacity of cognitive flexibility is associated with key health outcomes such as sick leave. [ABSTRACT FROM AUTHOR]

The capacity to quickly verbalize words beginning with a specific letter is integral in assessing language skills as well as an essential part of a comprehensive neuropsychological assessment. Using the letters F, A, S as a word fluency measure is limited by having no direct parallel alternative that can use the same F, A, S norms. This observational and cross-sectional study examined the correlation between the Word Fluency Test (WFT), utilizing letters M, D, H, as a parallel alternative to the clinical standard F, A, S to determine if the two are equivalent. This would allow for the use of existing F, A, S norms. Study participants (N = 356) were comprised of both adult control participants and out-patients with normal neuropsychological test results. Between-group differences for both task performances were not statistically significant indicating that patients and controls performed similarly on each of the six letters. Between-letter correlations were moderate in strength indicating an acceptable level of agreement between all of the letters. The results confirm equivalency and support administering the WFT and employing F, A, S norms offering a corresponding parallel alternative measure with strong correlation indicating high level of agreement. [ABSTRACT FROM AUTHOR]

Objective: Verbal fluency, the capacity to generate words from a designated category, predicts myriad cognitive and life outcomes. The study investigated verbal fluency in children with ADHD, autism spectrum disorder (ASD), and comorbid ADHD and ASD, to understand how ADHD- and ASD-related symptoms individually and jointly predict verbal fluency, and the underlying linguistic and cognitive substrates. Method: Thirty-three school-aged children with ADHD, 27 with ASD, 25 with comorbid ADHD and ASD, and 39 with typical development, were assessed for ADHD and ASD symptoms and completed a semantic verbal fluency task. Results: Findings indicated that ADHD and ASD symptoms, especially ADHD hyperactivity-impulsivity symptoms and language-related ASD symptoms, interactively predicted verbal fluency across diagnostic groups. Conclusion: The study implicated the potential cognitive and linguistic mechanisms underlying verbal fluency differences in ADHD and/or ASD, and clinical practices on enhancing verbal fluency in these clinical groups. [ABSTRACT FROM AUTHOR]

AbstractSubjective cognitive decline (SCD) may serve as an early indicator of Alzheimer’s disease (AD). However, accurately quantifying cognitive impairment in SCD is challenging, mainly because existing assessment tools lack sensitivity. This study examined how tasks specifically designed to assess knowledge of famous people, could potentially aid in identifying cognitive impairment in SCD. A total of 60 adults with SCD and 60 healthy controls (HCs) aged 50 to 82 years performed a famous people verbal fluency task and a famous people naming task. In the famous people fluency task, the results showed that the individuals with SCD produced significantly fewer famous names in the total time allowed than the HCs, and this difference was also found in the first and the second time interval. In the famous people naming task, the performance of the SCD group was significantly lower than that of the HC group only in the more recent period of fame. Overall, these results suggest that retrieving the names of famous people was more difficult for people with SCD than for people without cognitive complaints. They also suggest that famous people verbal fluency and naming tasks could be useful in detecting cognitive decline at the preclinical stage of AD. [ABSTRACT FROM AUTHOR]

AbstractVerbal fluency (VF) evaluates language and cognitive abilities. This study compared VF in Relapsing-Remitting Multiple Sclerosis (RRMS) and healthy controls (HC), examining variables including correct responses (CR), mean cluster size (MCS), switches (S), and fluency difference score (FDS). RRMS participants were subgrouped by Expanded Disability Status Scale (EDSS), to explore the relationship between MS severity and VF. Twenty-four RRMS participants and matched HCs underwent Mini-Mental State Exam and VF Test. Statistical analysis compared VF between RRMS subgroups based on severity levels, and in HC. RRMS significantly impacted the CR, and S (CRSF p = 0.01, SSF p = 0.002; CRPF=0.002, SPF p = 0.002), while there was no significant difference in FDS between RRMS groups (p = 0.9). No significant relationship was found between EDSS scores, and VF subtests (CRSF p = 0.061, MCSSF p = 0.46, SSF p = 0.051, CRPF p = 0.521, MCSPF p = 0.966, SPF p = 0.599). In RRMS, our results demonstrate impairments in all VF parameters except the MCSSF+PF, and FDS. This study suggests that intact MCSSF+PF may reflect preserved verbal memory and word recall, while significant switching differences may indicate impaired cognitive flexibility. Similar FDS to those of HC suggest that no performance discrepancy in subtests in RRMS. Intact MCS might be a distinctive pattern in the early clinical stage of MS. [ABSTRACT FROM AUTHOR]

The Controlled Oral Word Association (COWA) test is used to assess phonemic fluency and executive function. Formal validation of test scores is important for accurate cognitive evaluation. However, there is a dearth of psychometric validation among American Indian adults. Given high burden of dementia risk and key contextual factors associated with cognitive assessments, this represents a critical oversight. In a large, longitudinal population-based cohort study of adult American Indians, we examined several validity inferences for COWA, including scoring, generalization, and extrapolation inferences, by investigation of factor structure, internal consistency, test–retest reliability, and differential test functioning. We found adequate unidimensional model fit, with high factor loadings. Internal consistency reliability and test–retest reliability were 0.88 and 0.77, respectively, for the full group. COWA scores were lowest among the oldest, lowest education, bilingual speakers; group effects for sex and bilingual status were small; age effect was medium; and education effect was largest. However, Wide Range Achievement Test (WRAT) score effect was stronger than education effect, suggesting better contextualization may be needed. These results support interpretation of total COWA score, including across sex, age, or language use strata. [ABSTRACT FROM AUTHOR]

Increased schizotypal traits have previously been associated with atypical semantic cognition in community samples. However, no study has yet examined whether adults diagnosed with schizotypal personality disorder (SPD) display atypical semantic fluency and memory. We hypothesized that 24 adults diagnosed with SPD would name more idiosyncratic words on the semantic fluency task and show decreased semantic recall for animal and fruit category words compared with 29 participants with borderline personality disorder (BPD) and a community sample of 96 age-matched controls. We examined whether atypical semantic cognition was specifically associated with disorganized and eccentric speech and thinking, or more broadly with pathological personality traits and personality functioning. Our main hypothesis was confirmed, as the SPD participants named more idiosyncratic words and recalled fewer semantically related words compared with controls. Surprisingly, participants with BPD likewise named more atypical words compared with controls. More idiosyncratic semantic fluency was associated with more eccentric speech and thinking. Increased idiosyncratic semantic fluency and reduced semantic recall were both coupled to increased detachment and lowered personality functioning, while reduced semantic recall further was related to increased interpersonal problems. Our findings suggest that persons with SPD, and to a lesser degree BPD, show atypical semantic cognition, which is associated with eccentric speech and thinking, and more broadly with impaired personality function, social withdrawal, and emotional flatness. The idiosyncratic semantic cognition may worsen difficulties with social reciprocity seen in SPD and BPD. [ABSTRACT FROM AUTHOR]

Background: Functional abnormalities of the habenula in patients with depression have been demonstrated in an increasing number of studies, and the habenula is involved in cognitive processing. However, whether patients with late‐life depression (LLD) exhibit disrupted habenular functional connectivity (FC) and whether habenular FC mediates the relationship between depressive symptoms and cognitive impairment remain unclear. Methods: Overall, 127 patients with LLD and 75 healthy controls were recruited. The static and dynamic FC between the habenula and the whole brain was compared between LLD patients and healthy controls, and the relationships of habenular FC with depressive symptoms and cognitive impairment were explored by correlation and mediation analyses. Results: Compared with the controls, patients with LLD exhibited decreased static FC between the right habenula and bilateral inferior frontal gyrus (IFG); there was no significant difference in dynamic FC of the habenula between the two groups. Additionally, the decreased static FC between the right habenula and IFG was associated with more severe depressive symptoms (especially psychomotor retardation) and cognitive impairment (language, memory, and visuospatial skills). Last, static FC between the right habenula and left IFG partially mediated the relationship between depressive symptoms (especially psychomotor retardation) and cognitive impairment (verbal fluency and working memory). Conclusions: Patients with LLD exhibited decreased static FC between the habenula and IFG but intact dynamic FC of the habenula. This decreased static FC mediated the relationship between depressive symptoms and cognitive impairment. [ABSTRACT FROM AUTHOR]

Glioma patients often suffer from deficits in language and executive functioning. Performance in verbal fluency (generating words within one minute according to a semantic category–category fluency, or given letter–letter fluency) is typically impaired in this patient group. While both language and executive functioning play a role in verbal fluency, the relative contribution of both domains remains unclear. We aim to retrospectively investigate glioma patients' performance on verbal and nonverbal fluency and to explore the influence of language and executive functioning on verbal fluency. Sixty‐nine adults with gliomas in eloquent areas underwent a neuropsychological test battery (verbal fluency, nonverbal fluency, language, and executive functioning tests) before surgery (T1) and a subgroup of 31 patients also at three (T2) and twelve months (T3) after surgery. Preoperatively, patients were impaired in all verbal fluency tasks and dissociations were found based on tumour location. In contrast, nonverbal fluency was intact. Different language and executive functioning tests predicted performance on category fluency animals and letter fluency, while no significant predictors for category fluency professions were found. The longitudinal results indicated that category fluency professions deteriorated after surgery (T1–T2, T1–T3) and that nonverbal fluency improved after surgery (T1–T3, T2–T3). Verbal fluency performance can provide information on different possible underlying deficits in language and executive functioning in glioma patients, depending on verbal fluency task selection. Efficient task (order) selection can be based on complexity. Category fluency professions can be selected to detect more permanent long‐term deficits. [ABSTRACT FROM AUTHOR]

Given the widespread popularity of videogames, research attempted to assess their effects on cognitive and affective abilities, especially in children and adolescents. Despite numerous correlational studies, robust evidence on the causal relationship between videogames and cognition remains scarce, hindered by the absence of a comprehensive assessment tool for gaming skills across various genres. In a sample of 347 adolescents, this study aimed to develop and validate the Gaming Skill Questionnaire (GSQ) and assess the impact of gaming skills in six different genres (sport, first-person shooters, role-playing games, action-adventure, strategy, and puzzle games) on cognitive and affective abilities of adolescents. The GSQ exhibited strong reliability and validity, highlighting its potential as a valuable tool. Gaming skills positively affected executive function, memory, overall cognition, cognitive flexibility, and emotion recognition, except for empathy. Various game genres had different effects on cognitive and affective abilities, with verbal fluency influenced mainly by sports, executive functions by action, strategy, and puzzle, and emotion recognition positively impacted by action and puzzle but negatively by sports and strategy games. Both age and gaming skills influenced cognitive flexibility, with gaming having a greater effect. These intriguing genre-specific effects on cognitive and affective functioning postulate further research with GSQ's contribution. [ABSTRACT FROM AUTHOR]

Verbal fluency is one of the most severely impaired components of cognitive function in schizophrenia and is also impaired in at-risk mental states (ARMSs) for psychosis. The aim of this study was to explore the markers of disease progression in subjects with ARMSs by comparing the association between the white matter integrity of the superior longitudinal fasciculus (SLF) and verbal fluency in subjects with ARMSs and healthy control (HC) subjects. The correlations of the fractional anisotropy (FA) values on diffusion tensor imaging (DTI) and the laterality index (LI) values of SLF branches I, II, and III with the verbal fluency performance were analyzed in right-handed subjects with ARMSs (ARMS group; n = 18) and HC subjects (HC group; n = 34) aged 18 to 40 years old. In the HC group compared with the ARMS group, the LI values suggested right lateralization of the SLF II and III. Letter fluency was significantly correlated with the LI of the SLF III in both the ARMS and HC groups. The regression coefficient (β) of this correlation was calculated using the least squares method and yielded a positive number (73.857) in the ARMS group and a negative number (−125.304) in the HC group. The association of the rightward asymmetry of the SLF III with the verbal fluency performance observed in the HC group appeared to be lost in the ARMS group, and this could serve as one of the markers of the pathological progression to psychosis in patients with schizophrenia. [ABSTRACT FROM AUTHOR]

Vulnerable persons living with HIV (PLWH) are at high risk of cognitive impairment and challenges accessing quality social support in later life. Impaired verbal fluency (VF), a cognitive domain linked to HIV, could impede social support associated with health and well-being for already vulnerable PLWH. We examined the structure of social support, using latent class analysis, and the associations among quantity, specific forms and quality of social support and VF among PLWH. Participants enrolled in the BEACON study (n = 383) completed the Controlled Oral Word Association test (COWAT) and a social support network inventory. Latent class analysis with count variables was used to determine the number of classes of PLWH based on their social network characteristics. The majority of PLWH were male (61.4%) and African American (85.9%). Two distinct latent classes, with a major distinction in the number of network members who were female, knew participants' HIV status and HIV medication usage. Fewer support network members (β = -.13, p < 0.01), greater negative interactions (β = -.16, p < 0.01), and less positive interactions with network members (β =.15, p < 0.05) were significantly associated with lower COWAT scores. Comprehensive screening of high-risk PLWH and early intervention with those with cognitive impairment are important for addressing social support needs. [ABSTRACT FROM AUTHOR]

Clinical populations with basal ganglia pathologies may present with language production impairments, which are often described in combination with comprehension measures or attributed to motor, memory, or processing-speed problems. In this systematic review and meta-analysis, we studied word production in four (vascular and non-vascular) pathologies of the basal ganglia: stroke affecting the basal ganglia, small vessel disease, Parkinson's disease, and Huntington's disease. We compared scores of these clinical populations with those of matched cognitively unimpaired adults on four well-established production tasks, namely picture naming, category fluency, letter fluency, and past-tense verb inflection. We conducted a systematic search in PubMed and PsycINFO with terms for basal ganglia structures, basal ganglia disorders and language production tasks. A total of 114 studies were included, containing results for one or more of the tasks of interest. For each pathology and task combination, effect sizes (Hedges' g) were extracted comparing patient versus control groups. For all four populations, performance was consistently worse than that of cognitively unimpaired adults across the four language production tasks (p-values < 0.010). Given that performance in picture naming and verb inflection across all pathologies was quantified in terms of accuracy, our results suggest that production impairments cannot be fully explained by motor or processing-speed deficits. Our review shows that while language production difficulties in these clinical populations are not negligible, more evidence is necessary to determine the exact mechanism that leads to these deficits and whether this mechanism is the same across different pathologies. [ABSTRACT FROM AUTHOR]

Aim: This study investigates the effects of degree of multilingualism on cognitive functions in adulthood, with focus on episodic memory recall and including measures of verbal fluency as well as global cognition. Design: We studied a large population-based cohort cross-sectionally, and we also assessed changes over time through longitudinal measurements on four time-points over a 15 year period. Participants were drawn from the Betula prospective cohort study in Umeå, Sweden. The participants included in this study at baseline (n = 894, mean age = 51.44, 59.4% females) were divided according to number of languages into bilinguals (n = 395), trilinguals (n = 284), quadrilinguals (n = 169), and pentalinguals (n = 46). Data and analysis: We analysed performance on tasks of episodic memory recall, verbal fluency (letter and category) and global cognition (Minimental State Examination, MMSE) both cross-sectionally and longitudinally. The control background variables were baseline age, gender, years of education, general fluid ability Gf (Wechsler Block Design Test), and socioeconomic status. We employed a linear mixed modelling approach with entropy balancing weights to assess effects of degree of multilingualism on cognitive functions. Findings and conclusions: Using bilinguals as the reference group, our results indicated that all the other multilingual groups exhibited superior performance on episodic memory recall than bilinguals at baseline. The rate of change over time did not differ for trilinguals and pentalinguals compared to bilinguals. While quadrilinguals declined more over time than bilinguals, they still scored significantly higher than bilinguals at the last test wave. For letter fluency, similarly, all language groups scored higher than bilinguals at baseline, and none of the groups differed from bilinguals in rate of change over time. With regard to category fluency, quadrilinguals scored higher than bilinguals at baseline, but trilinguals and pentalinguals did not differ from bilinguals and none of the groups differed in change over time compared to bilinguals. Finally, for global cognition (MMSE), trilinguals and quadrilinguals scored significantly higher than bilinguals at baseline with no differences in change over time for any of the groups relative to bilinguals. Our study contributes to the understanding of multilingual cognition and sheds light into an under-researched cognitive domain known to decline in normal ageing, namely episodic memory recall. Significance: Our study emphasizes the importance of researching less explored aspects of multilingualism on cognition, in particular on episodic memory recall, to aid our understanding of factors that could potentially aid cognitive decline in later adulthood. [ABSTRACT FROM AUTHOR]

The purpose of this study was to reexamine research that used verbal fluency tasks to reinforce assumed deficits in word knowledge and retrieval in the autistic population. We identified seventeen articles that compared the performance of autistic and non‐autistic people on verbal fluency measures and provided an interpretation of the observed performance. In this narrative review, we summarize many components of these studies, including a comprehensive account of how authors framed their research findings. Overall, results of the studies showed variation both between and within groups in terms of total number of correct words, how many subsequent words fell into subcategories, and how frequently participants switched between subcategories. Despite wide variation in findings across studies, authors consistently interpreted results as revealing or reinforcing autistic deficits. To contrast the deficit narrative, we offer an alternative interpretation of findings by considering how they could provide support for the autistic‐led theory of monotropism. This alternative interpretation accounts for the inconsistencies in findings between studies, since wide individual variation in performance is an expected feature of the monotropic theory. We use our review as an exercise in reframing a body of literature from a neurodiversity‐affirming perspective. We propose this as a case example and model for how autism research and clinical practice can move away from the consistent narrative of autism deficits that has pervaded our field for decades. Accordingly, we offer suggestions for future research and clinical practice. Lay Summary: Lots of resources – time, money, energy – have been spent comparing the number of words autistic and non‐autistic individuals can list from a given category (e.g., animals) in a short amount of time (e.g., 60 s). This task is argued to provide a measure of verbal fluency, the ability to recall language on a given topic quickly and effortlessly. Across research, there is wide variation in how autistic people perform this task, including some research showing that autistic people perform similarly to non‐autistic people. However, despite inconsistencies in findings, the authors of this research universally conclude that autistic individuals are impaired in verbal fluency. This review offers an example of an alternative, neurodiversity‐affirming interpretation of these findings using a theory of attention, called monotropism, originally proposed by an autistic theorist. The authors use this model to advocate for changes in data interpretation by scholars. [ABSTRACT FROM AUTHOR]

Background: The effects of subthalamic nucleus deep brain stimulation (STNDBS) on the cognition and mood of patients with PD are still not uniformly concluded, and young-onset Parkinson's disease (YOPD) is even less explored. Objective: To observe the effectiveness of STN-DBS on the cognition and mood of YOPD patients. Methods: A total of 27 subjects, with a mean age at onset of 39.48 ± 6.24 and age at surgery for STN-DBS of 48.44 ± 4.85, were followed up preoperatively and for 2 years postoperatively. Using the Unified Parkinson disease rating scale (UPDRS), H&Y(Hoehn and Yahr stage), 39-Item Parkinson's Disease Questionnaire (PDQ-39), Mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) to assess motor, cognition, and mood. Results: At the 2-year follow-up after STN-DBS, YOPD patients showed significant improvements in motor and quality of life (UPDRS III: p < 0.001, PDQ-39: p < 0.001); overall cognition was not significantly different from preoperative (MMSE: p = 0.275, MoCA: p = 0.913), although language function was significantly impaired compared to preoperative (MMSE: p = 0.004, MoCA: p = 0.009); depression and anxiety symptoms also improved significantly (HAMD: p < 0.001, HAMA: p < 0.001) and the depression score correlated significantly with motor (preoperative: r = 0.493, p = 0.009), disease duration (preoperative: r = 0.519, p = 0.006; postoperative: r = 0.406, p = 0.036) and H&Y (preoperative: r = 0.430, p = 0.025; postoperative: r = 0.387, p = 0.046); total anxiety scores were also significantly correlated with motor (preoperative: r = 0.553, p = 0.003; postoperative: r = 0.444, p = 0.020), disease duration (preoperative: r = 0.417, p = 0.031), PDQ-39 (preoperative: r = 0.464, p = 0.015) and H&Y (preoperative: r = 0.440, p = 0.022; postoperative: r = 0.526, p = 0.005). Conclusion: STN-DBS is a safe and effective treatment for YOPD. The mood improved significantly, and overall cognition was not impaired, were only verbal fluency decreased but did not affect the improvement in quality of life. [ABSTRACT FROM AUTHOR]

Throughout adulthood, the brain undergoes an array of structural and functional changes during the typical aging process. These changes involve decreased brain volume, reduced synaptic density, and alterations in white matter (WM). Although there have been some previous neuroimaging studies that have measured the ability of adult language production and its correlations to brain function, structural gray matter volume, and functional differences between young and old adults, the structural role of WM in adult language production in individuals across the life span remains to be thoroughly elucidated. This study selected 38 young adults and 35 old adults for diffusion tensor imaging (DTI) and performed the Controlled Oral Word Association Test to assess verbal fluency (VF). Tract-Based Spatial Statistics were employed to evaluate the voxel-based group differences of diffusion metrics for the values of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and local diffusion homogeneity (LDH) in 12 WM regions of interest associated with language production. To investigate group differences on each DTI metric, an analysis of covariance (ANCOVA) controlling for sex and education level was performed, and the statistical threshold was considered at p < 0.00083 (0.05/60 labels) after Bonferroni correction for multiple comparisons. Significant differences in DTI metrics identified in the ANCOVA were used to perform correlation analyses with VF scores. Compared to the old adults, the young adults had significantly (1) increased FA values on the bilateral anterior corona radiata (ACR); (2) decreased MD values on the right ACR, but increased MD on the left uncinate fasciculus (UF); and (3) decreased RD on the bilateral ACR. There were no significant differences between the groups for AD or LDH. Moreover, the old adults had only a significant correlation between the VF score and the MD on the left UF. There were no significant correlations between VF score and DTI metrics in the young adults. This study adds to the growing body of research that WM areas involved in language production are sensitive to aging. [ABSTRACT FROM AUTHOR]

AbstractIndividuals with euthymic bipolar disorder (BD) type I exhibit deficits in executive functions. Although less explored in the BD population, the tasks of verbal fluency (VF) have shown great potential in understanding semantic organization. This study provides an extensive exploration across the letter and semantic VF tasks in 27 demographically matched euthymic BD-I and healthy controls (HC). The groups were compared on measures of the total number of correct words (TNCW), temporal pattern analysis, number of clusters (NC), mean cluster size (MCS), number of switches (NS), and error pattern. An overall reduction in letter fluency scores (the TNCW, number of switches, and NC) as compared to semantic fluency scores was noted for both groups, with a significantly greater decrease in the BD-1 group. The MCS and temporal pattern were relatively similar across the two groups. The influence of education with no gender difference was observed between groups with error types prevalent in both groups. The study findings call attention toward assessing the VF performance in persons with BD in terms of error production and the strategies employed (clustering–switching). [ABSTRACT FROM AUTHOR]

Verbal fluency tests are easy and quick to use in neuropsychological assessments, so they have been counted among the most classical tools in this context. To date, several normative data for verbal fluency tests have been provided in different languages and countries. A systematic review was carried out with studies that provide normative data for verbal fluency tests. Studies were collected from Scopus, PubMed and Web of Science. 183 studies were retrieved from the database search, of which 73 finally met the inclusion criteria. An analysis of the risk of bias regarding samples selection/characterization and procedure/results reports is conducted for each article. Finally, a full description of the normative data characteristics, considering country and language, verbal fluency task characteristics (type of task) and sample characteristics (number of subjects, gender, age, education) is included. The current systematic review provides an overview and analysis of internationally published normative data that might help clinicians in their search for valid and useful norms on verbal fluency tasks, as well as updated information about qualitative aspects of the different options currently available. [ABSTRACT FROM AUTHOR]

Background: Decrements in verbal fluency following deep brain stimulation (DBS) in people with Parkinson's disease (PwP) are common. As such, verbal fluency tasks are used in assessing DBS candidacy and target selection. However, the correspondence between testing performance and the patient's perception of communication abilities is not well‐established. Methods: The Communication Participation Item Bank (CPIB) was administered to 85 PwP during pre‐DBS neuropsychological evaluations. Central tendencies for CPIB responses and correlations between CPIB total scores, clinical and demographic factors, and language‐based tasks were examined. Results: Most PwP indicated some degree of communication interference on the CPIB. Worse scores on semantic fluency and greater motor impairment were associated with more communication interference. Conclusions: Our findings suggest an incomplete correspondence between commonly used language‐based tests and patient‐reported outcomes of communication abilities. The need for a functional communication instrument that reflects the different aspects of communication abilities in functional contexts is emphasized. [ABSTRACT FROM AUTHOR]