Neuropsychology

Potential cognitive risks of generative transformer-based AI chatbots on higher order executive functions.
Background: Chat generative retrained transformer (ChatGPT) represents a groundbreaking advancement in Artificial Intelligence (AI-chatbot) technology, utilizing transformer algorithms to enhance natural language processing and facilitating their use for addressing specific tasks. These AI chatbots can respond to questions by generating verbal instructions similar to those a person would provide during the problem-solving process. Aim: ChatGPT has become the fastest growing software in terms of user adoption in history, leading to an anticipated widespread use of this technology in the general population. Current literature is predominantly focused on the functional aspects of these technologies, but the field has not yet explored hypotheses on how these AI chatbots could impact the evolutionary aspects of human cognitive development. Thesis: The “neuronal recycling hypothesis” posits that the brain undergoes structural transformation by incorporating new cultural tools into “neural niches,” consequently altering individual cognition. In the case of technological tools, it has been established that they reduce the cognitive demand needed to solve tasks through a process called “cognitive offloading.” In this theoretical article, three hypotheses were proposed via forward inference about how algorithms such as ChatGPT and similar models may influence the cognitive processes and structures of upcoming generations. Conclusions: By forecasting the neurocognitive effects of these technologies, educational and political communities can anticipate future scenarios and formulate strategic plans to either mitigate or enhance the cognitive influence that these factors may have on the general population. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
An examination of semantic performance in mild cognitive impairment progressors and nonprogressors.
Objective: Mild cognitive impairment (MCI) is a risk factor for developing Alzheimer’s disease (AD), and about half of older people with MCI will progress to AD within the next 5 years. The aim of the present study was to compare the semantic performance of MCI progressors (MCI-p) and nonprogressors (MCI-np). The hypothesis was that MCI-p would present with poorer semantic performance relative to MCI-np at baseline, indicating that semantic deficits may increase the risk of future decline toward AD. Method: Fifty-six MCI participants (aged 65–89) from the Consortium for Early Identification of Alzheimer’s Disease–Quebec study were analyzed, with 18 progressing and 38 remaining stable over 2 years. Analysis of covariance assessed their initial semantic and nonsemantic cognitive performance, and mixed analyses of variance gauged longitudinal patterns of cognitive decline at the 2-year follow-up. Results: In the semantic domain, MCI-p performed significantly worse than MCI-np at baseline on two semantic tests (category fluency and object decision). In other cognitive domains, MCI-p performed worse than MCI-np on a test of executive functions (cognitive flexibility) but showed similar performance on a test of episodic memory. There were no significant differences between groups in the rates of progression on semantic tests over the 2-year period, but a steeper decline was observed in MCI-p at follow-up on tests of global cognition, episodic memory, and processing speed. Conclusion: This suggest that MCI patients who present with semantic memory impairment in addition to episodic memory impairment are at greater risk of future progression to AD. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Language switching and speaking a nondominant language challenge executive control: Preliminary data for novel behavioral markers of Alzheimer’s risk in Spanish–English bilinguals.
Objective: The present study explored psycholinguistic analysis of spoken responses produced in a structured interview and cued linguistic and nonlinguistic task switching as possible novel markers of Alzheimer’s disease (AD) risk in Spanish–English bilinguals. Method: Nineteen Spanish–English bilinguals completed an Oral Proficiency Interview (OPI) in both languages, cued-switching tasks, and a battery of traditional neuropsychological tests (in a separate testing session). All were cognitively healthy at the time of testing, but eight decliners were later diagnosed with AD (on average 4.5 years after testing; SD = 2.3), while 11 controls remained cognitively healthy. Results: Past studies showed picture naming was more sensitive to AD in the dominant than in the nondominant language, but we found the opposite for a composite measure of spoken utterances produced in the OPI that included revisions, repetitions, and filled pauses (RRFPs), which were especially sensitive to AD risk in the nondominant language. Errors produced on language switch trials best discriminated decliners from controls (in receiver operating characteristic curves), and though the nonlinguistic switching task was also sensitive to AD risk, it elicited more errors overall and was also negatively affected by increased age and low education level. Conclusions: Speaking a nondominant language and errors in cued language switching provided sensitive and specific markers of pending cognitive decline and AD risk in bilinguals. These measures may reflect early decline in executive control abilities that are needed to plan and monitor the production of connected speech and to manage competition for selection between languages. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Association between neuropsychological assessment and amyloid status in a clinical setting.
Objective: Large research cohorts show robust associations between neuropsychological tests and Alzheimer’s disease (AD) biomarkers, but studies in clinical settings are limited. The increasing availability of AD biomarkers to the practicing clinician makes it important to understand the relationship between comprehensive clinical neuropsychological assessment and biomarker status. This study examined concordance between practicing clinical neuropsychologists’ diagnostic impressions and AD biomarker status in patients seen at an outpatient medical center, with a secondary aim of defining the characteristics of discordant cases. Method: Participants (N = 79) seen for clinical neuropsychological assessment who subsequently underwent lumbar puncture or amyloid positron emission tomography imaging were identified via retrospective chart review. Concordance between clinical neuropsychological diagnosis (non-AD, indeterminate, possible/probable AD) and AD biomarker status (negative, indeterminate, positive) was determined. Individual test score data were used to examine between-group differences based on amyloid status. Results: AD biomarker positive and negative patients did not differ on individual neuropsychological tests after correcting for multiple comparisons, though the small number of AD biomarker indeterminate individuals performed better than biomarker positive patients. However, there was 76.7% concordance between neuropsychologists’ diagnostic impressions and AD biomarker status (88% sensitivity and 55% specificity of neuropsychological assessment in detecting AD biomarker status). AD biomarker negative patients diagnosed as possible/probable AD (discordant) versus non-AD (concordant) had significantly lower Neuropsychological Assessment Battery Story Delayed Recall, higher Wechsler Adult Intelligence Scale–Fourth Edition Coding, and higher Trail-Making A (i.e., an amnestic memory profile). Conclusions: Comprehensive neuropsychological assessment showed modest concordance with AD biomarker status in patients seen in an outpatient medical center for routine clinical care. Low specificity for the clinical diagnosis of AD could be explained by the multiplicity of etiologies that cause memory impairment (i.e., TAR DNA-binding protein 43, suspected non-AD pathology). (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Effect of multiple sclerosis and aging on prospective memory using the ecological test of prospective memory.
Objective: Prospective memory (PM) is the ability to remember to produce an action at a specific moment in the future signaled by the occurrence of a specific event (event-based [EB] condition), a time or a time interval (time-based [TB] condition). Detection of the appropriate moment corresponds to the prospective component, while production of the appropriate action corresponds to the retrospective component. Although PM difficulties have been reported in healthy aging and in association with multiple sclerosis (MS), PM has not been examined in older persons with MS (PwMS). The main objective of this study was to investigate whether the decline in PM performance with advancing age is influenced by the presence of MS. This study also aimed to clarify the type of PM impairment (prospective vs. retrospective component in TB and EB conditions) in MS as a function of age. Method: A total of 80 participants were recruited and separated into four groups: older PwMS (n = 20), younger PwMS (n = 20), older controls (n = 20), and younger controls (n = 20). PM and its components were measured using the Test Ecologique de Mémoire Prospective (TEMP), an experimental ecological tool using naturalistic stimuli developed by our laboratory that has been validated in previous studies. Results: On the TEMP total score, a two-way analysis of covariance showed a main effect of age, a main effect of the presence of MS, as well as a significant Age × Disease interaction. Direct comparison between EB and TB conditions revealed that for the prospective component, only older PwMS had more difficulty in the TB than in the EB condition, whereas the retrospective component score was significantly lower in the TB than in the EB condition in all groups except in younger controls. Conclusions: The TEMP revealed a marked impairment in PM in older PwMS compared to older controls and young PwMS. This impairment was particularly evident on the prospective component in the TB condition. Retrospective difficulties noted in the TB condition in all, but younger controls reflect the arbitrary nature of the cue–action link that is particularly sensitive to episodic memory difficulties often observed in aging and MS. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Processing speed in first episode of psychosis and first-degree relatives: A candidate endophenotype of spectrum schizophrenia disorders.
Objective: The processing speed (PS) is highly impacted in individuals experiencing their first episode of psychosis (FEP). Conducting family studies can help to determine whether PS can serve as an endophenotype of schizophrenia spectrum disorders (SSDs), offering valuable insights into the prevention and diagnosis of SSDs. Method: A comprehensive cognitive battery, encompassing tests for PS, verbal memory, visual memory, working memory, executive functions, motor dexterity, and attention, was administered to a sample consisting of 133 FEP patients, 146 parents, 98 siblings, and 202 healthy controls (HCs). Univariate analyses (analysis of covariance [ANCOVA]) were conducted to compare the different cognitive domains between groups, utilizing sex, age, and years of education as covariates and Bonferroni corrections. Effect sizes (ESs) were calculated for estimating the magnitude of differences between groups. Results: Group comparisons revealed significant differences in all cognitive domains. PS was the most impaired function in patients. Parents and siblings had intermediate PS performance between FEP patients and HC. Large ES were observed in PS between FEP versus siblings, FEP versus controls, parents versus controls, and parents versus siblings. Conclusions: Despite not meeting all the necessary criteria, the PS observed in FEP patients and their first-degree relatives suggests its potential as a promising endophenotype of SSDs. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
The relationship between working memory and anxiety in individuals with early treated phenylketonuria (PKU).
Objective: Although early diagnosis and treatment prevent the severe impairments associated with untreated phenylketonuria (PKU), individuals with early treated PKU (ETPKU) nonetheless experience significant neurocognitive and psychological sequelae, including difficulties in working memory (WM) and increased risk of anxiety. The primary objective of the present study was to examine the extent to which anxiety may moderate the relationship between ETPKU and WM performance. Method: A sample of 40 adults with ETPKU and a demographically comparable sample of 40 healthy adults without PKU completed a comprehensive assessment of WM performance and anxiety symptomatology. Data were collected using a variety of remote assessment methods (e.g., web-based neurocognitive tests, semistructured interview, report-based measures). Results: The ETPKU group demonstrated significantly poorer WM performance as compared to the non-PKU group. The groups did not differ significantly in anxiety; however, high anxiety was more common in the ETPKU group (53% of sample) than the non-PKU group (33%). A significant interaction between anxiety, metabolic control (as reflected by Phe levels), and WM performance was observed for the ETPKU group. Individuals with high anxiety and/or high Phe levels (> 360 μmol/L) performed poorer than the non-PKU group. Individuals with low anxiety and relatively low Phe levels (< 360 μmol/L) performed comparably to the non-PKU group. Conclusions: Anxiety was found to moderate the relationship between Phe levels and WM performance in individuals with ETPKU. This finding underscores the importance of accounting for anxiety when evaluating neurocognitive performance in individuals with ETPKU whether for research or clinical purposes. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Neuropsychology - Vol 38, Iss 4