Verbal Memory

In subject area: Neuroscience

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Verbal memory is defined as the ability to recode and store information in a verbal format, allowing individuals to remember events through language regardless of the original form of presentation. It plays a critical role in human cognition and can be influenced by factors such as articulatory suppression.

AI generated definition based on: Learning and Memory: A Comprehensive Reference, 2017

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1. Introduction to Verbal Memory in Neuro Science

Verbal explicit memory encompasses the storage and retrieval of information in a linguistic or language-based format. This includes the ability to remember and recall words, sentences, stories, and any information that is primarily conveyed through language. It is a complex process by which individuals learn, retain, and retrieve specific verbal information, and is often evaluated with tests of recall and/or recognition of word lists or storylines. Explicit memory can further be distinguished into episodic memory, which refers to a temporal serial storage of personal experiences or events, and semantic memory, which represents general concepts, meaning, and environmental knowledge.

Explicit memory is further divided into verbal and non-verbal explicit memory. The assessment of verbal memory is more complex than simply remembering lists of words; it entails testing memory for lists of words, pairs of words, sentences, and short stories, using both immediate recall, delayed recall, and recognition paradigms. Common neuropsychological tests used to assess verbal memory include the California Verbal Learning Test (CVLT), Wechsler Memory Scale (WMS), Rey Auditory Verbal Learning Test (RAVLT), Hopkins Verbal Learning Test (HVLT), and the Brief Assessment of Cognition in Schizophrenia (BACS).

Assessment of verbal memory provides enough data to analyze fully specific deficits in cognitive abilities that may be shared by multiple processes and allows for a finer discrimination of abilities and impairments. It is relevant across various neurological and psychiatric conditions, including bipolar disorder, schizophrenia, depression, and Alzheimer’s disease, where impairment of verbal memory is a consistently identified neurocognitive deficit in bipolar disorder, and is closely associated with schizophrenia, depression, and Alzheimer’s disease.

2. Neural Substrates and Mechanisms of Verbal Memory

Verbal memory relies on a distributed network of brain regions, including the hippocampus, medial temporal lobes, prefrontal cortex, and temporal lobes. The hippocampus, particularly its subfields CA2, CA3, dentate gyrus, and subiculum, is activated during encoding of face-name and object-name pairs, while the subiculum is involved in retrieval processes. The hippocampus aids retrieval by reactivating neurons involved in learning, and is central to the encoding, storage, and retrieval of memories, with the prefrontal cortex and medial temporal lobe structures forming a critical network for verbal learning and memory. Functional connectivity analyses show that the superior temporal cortex (area Spt) is strongly connected with dorsolateral and posterior prefrontal cortex, and the midportion of the superior temporal sulcus is tightly coupled with Brodmann areas 12 and 47 of the ventrolateral prefrontal cortex. Anterior prefrontal regions are associated with conceptual-semantic aspects, while posterior regions are linked to phonological-articulatory processing. The study of the neural basis of verbal working memory has proceeded from a large body of human neurological evidence pointing to the critical role of anterior regions (e.g., Broca’s area) in speech production and posterior regions (e.g., temporoparietal cortex) in perceptual and mnemonic aspects of speech processing.

Neuroimaging and electrophysiological studies demonstrate that verbal learning and memory are subserved by the prefrontal cortex and medial temporal lobe, including the hippocampus, parahippocampus, and parts of the inferior and medial temporal gyri. The prefrontal cortex is involved in planning, organizing, and manipulating information in short-term memory, while the hippocampus consolidates information from short-term to long-term memory. These regions contain abundant cannabinoid receptor type 1 (CB1) receptors, and neuroanatomic alterations in these areas are observed among regular cannabis users. The cerebellum is implicated in verbal working memory, with cerebellar lesions leading to deficits in silent recirculation of verbal information, phonemically related retrieval strategies, and articulatory monitoring. The right superior cerebellum contributes to the articulatory control system during encoding, and the right inferior cerebellum supports the phonologic store during maintenance.

Intracranial electroencephalography (iEEG) connectivity analyses reveal dynamic interactions and oscillatory activity supporting verbal memory. For example, ripple oscillations (80–120 Hz) couple the medial temporal lobe and temporal association cortex during verbal episodic tasks, and phase-locking theta (4–8 Hz) activity indicates successful encoding and retrieval. Frequency-specific coherent oscillatory activity between different brain areas is associated with successful retrieval and identification of task-relevant network nodes. Synaptic plasticity and long-term potentiation (LTP) are key neurobiological mechanisms underlying memory consolidation and retrieval. Early phase LTP depends on N-methyl-D-aspartate (NMDA) and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) glutamate receptor activation, while late phase LTP requires new protein synthesis and synaptic modifications. Protein inhibitors administered after learning impair memory, and expression of activity-regulated cytoskeletal-associated protein (Arc) during consolidation is a key component of LTP. Opioid withdrawal increases Arc activity in the hippocampus and amygdala, and administration of NMDA receptor antagonists or calcium channel blockers inhibits cellular excitability and blocks hippocampal LTP.

Baddeley’s multicomponent working memory model describes the phonological loop as a verbal subsystem with a passive phonological store and an active articulatory rehearsal process, both under the control of the central executive. The phonological store holds verbal information for brief periods, while the articulatory process refreshes its contents. The episodic buffer integrates multimodal sensory information from the phonological loop and visuospatial sketchpad, supporting the binding of information from other working memory components and long-term memory. Behavioral evidence supports the dissociation between short-term and long-term verbal memory systems, with parallel input into both systems and independence between processing systems for long- and short-term memory. This differentiation has been hypothesized, at least for verbal memory, to represent cognitive distinctions between the active rehearsal component of the phonological loop and a passive storage component, that are included in Baddeley's model. Baddeley’s model also distinguishes episodic memory, which is typically recalled visually and has emotional valence, from semantic memory, which involves memorizing facts or details. The prefrontal cortex is believed to play a role in controlled aspects of episodic memory, such as recall, source monitoring, temporal order memory, and metamemory judgments.

3. Development, Plasticity, and Modulating Factors of Verbal Memory

Neural maturation and plasticity in regions such as the prefrontal cortex and hippocampus play key roles in acquisition and retrieval of new information, and age-related changes in these regions are associated with declines in verbal memory performance. Critical periods for language acquisition are characterized by enhanced neural plasticity, and experience shapes neurocognitive development of language, including grammar and semantics, but this evidence pertains to language acquisition broadly rather than verbal memory specifically. Age-related decline in verbal memory is associated with changes in brain activation patterns, including hemispheric asymmetry reduction in older adults (HAROLD model), where older subjects who recruit the prefrontal cortex bilaterally during verbal memory tasks manifest performance levels similar to younger subjects with lateralized activation. The compensation-related utilization of neural circuits hypothesis (CRUNCH) posits that older adults recruit additional regions in both hemispheres to maintain performance. Imaging studies have shown that age is associated with reductions in prefrontal white matter volume in old participants, and the volume of white matter in the right prefrontal cortex predicts neuropsychological test performance, including verbal memory.

Sex and gender differences influence verbal memory performance and neural strategies. Women consistently outperform men on verbal memory tasks such as the Controlled Oral Word Association Test and the Rey Auditory Verbal Learning Test across the lifespan, possibly due to greater use of semantic clustering in recall. However, meta-analyses indicate that men may modestly outperform women in some cognitive domains, and sex differences appear to be task dependent. The female advantage in verbal memory is attenuated postmenopause, with higher estradiol levels associated with better memory performance in women. Cognitive reserve mechanisms, including compensatory recruitment of bilateral prefrontal regions, may mask underlying decline, and evidence suggests that this may delay clinical diagnosis of mild cognitive impairment specifically in women.

Physical activity is a modulating factor, with vigorous-intensity activity in women associated with enhanced verbal memory performance, while no direct effect is observed in men. Estrogen replacement therapy in postmenopausal women has demonstrated better verbal memory performance compared to controls, and in vitro studies have proposed that estrogen-related enhancement of cellular mechanisms may provide neuroprotection. Sleep deprivation affects executive functions and attention, which are relevant for verbal memory, but direct evidence for impaired encoding or altered brain activation specific to verbal memory is limited. Variability in aging trajectories is influenced by individual differences in cognitive reserve and neural compensation, and evidence suggests that sex and gender differences in cognitive reserve may contribute to delayed clinical detection of impairment in women.

4. Verbal Memory Impairments in Neurological and Psychiatric Disorders

Verbal memory deficits are among the most consistent and severe neuropsychological impairments in schizophrenia, with effect sizes versus comparison populations often in the 1.0–1.5 standard deviation range, and are closely associated with dysfunction in the prefrontal cortex and hippocampus. These deficits are present at different phases of the disorder, including the prodrome, prior to frank psychosis, and after remission from psychotic symptoms. Studies have shown that verbal learning and memory relies on a network including the prefrontal cortex and medial temporal lobe structures, with the hippocampus being important for acquisition of new information. Deficits in acquisition are particularly vulnerable to schizophrenic illness, and verbal memory indicators describe an impairment distinct from attention–vigilance defects.

In bipolar disorder, verbal memory is a complex process by which individuals learn, retain, and retrieve specific verbal information, and most studies report poorer performance in verbal memory in bipolar disorder patients compared to healthy controls. Patients with bipolar disorder tend to perform worse during learning and acquisition of memory compared to retention and recall.

Temporal lobe epilepsy, especially with left hippocampal sclerosis, is associated with verbal memory impairments, with deficits apparent in immediate recall of short stories and delayed recall in both verbal and non-verbal memory tasks. Verbal memory impairments are most often observed in people with mesial temporal lobe epilepsy who have a predominant left seizure focus, and severity is influenced by seizure frequency, age of onset, and duration. Disrupted consolidation processes are frequently observed after mesial temporal lobe damage.

Alzheimer’s disease is characterized by early and progressive verbal memory deficits, especially in acquisition and consolidation, with patients showing difficulty in free recall and aided retrieval of recently learned information. In very early Alzheimer’s disease, initial learning may be relatively well-preserved, but deficits in both acquisition and consolidation are present, along with a shallower learning curve. Individuals with vascular dementia outperform those with Alzheimer’s disease on verbal memory tasks, while frontotemporal dementia typically preserves episodic memory until late in the disease.

Neuropsychological assessment of verbal memory commonly employs list learning tasks, story recall, immediate and delayed recall, recognition, and cued recall. Instruments such as the Wechsler Memory Scale, California Verbal Learning Test, Rey Auditory Verbal Learning Test, and Hopkins Verbal Learning Test are widely used to measure verbal memory. Assessment strategies include testing memory for lists of words, pairs of words, sentences, and short stories using both immediate and delayed recall and recognition paradigms.

5. Conclusion and Future Directions

Verbal memory is a complex process by which individuals learn, retain, and retrieve specific verbal information, and is commonly evaluated using recall and recognition tasks such as word lists and storylines from standardized neuropsychological batteries including the Wechsler Memory Scale, California Verbal Learning Test, and the Brief Assessment of Cognition in Schizophrenia. The neural substrates of verbal memory involve a distributed network encompassing the medial temporal lobe, temporal cortex, and frontal cortex, which serve as correlates of declarative memory function. Synaptic plasticity mechanisms, including glutamatergic neurotransmission and changes in gene expression mediated by neurotrophic factors such as cyclic adenosine monophosphate response element binding protein and brain-derived neurotrophic factor, are potentially involved in the learning and memory processes underlying verbal memory. The encoding, consolidation, and retrieval of verbal episodic memory are mediated by multiple neurological pathways and systems, with the hippocampus in the medial temporal lobes being a primary structure linked to episodic memory learning. Neuropsychological assessments of verbal memory, such as list-learning and paragraph recall tasks, are useful in differentiating problems with memory consolidation from those due to memory retrieval.

References (42)

Reference 1
Book series Chapter
Physical activity and verbal memory performance: Mediating effects of resting-state brain activity
Looser V.N., Gerber M., Ludyga S.
Progress in Brain Research , 2024 pp 33-66
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Related quote(s)1 / 6
"... The intricate process of memory encoding occurs during the experience of an event, and can be described as the cognitive process whereby sensory information or experiential data is converted into a neurobiological format, enabling its retention and subsequent retrieval within the brain's memory systems . Its accuracy is highly influenced by the allocation of attentive resources during the experience of a stimulus . Encoded information on an experienced stimulus is then consolidated through the synthesis of communication-enhancing proteins among neurons, and via strengthened communication between the main site, the hippocampus, and other neocortical regions, in order to store information for future retrieval . Memory can be divided into sensory, short-term, working, and long-term memory . Sensory memory refers to the encoding and maintenance of sensory experiences . Short-term memory encompasses the ability to maintain a limited amount of information in an instantly accessible state for a brief duration, spanning from several seconds to a matter of a few minutes . Short-term memory is to be distinguished from working memory, given that the latter is characterized by a manipulation and updating of stored information for a short period of time . For a detailed overview on working memory please refer to Baddeley et al. (1998) . Through the process of consolidation, informational content is transferred from short-term to long-term memory . Long-term memory can be referred to as unlimited cognitive storage which maintains information for long periods of time . It can be divided into distinct forms: explicit and implicit memory. Explicit memory refers to the representation of facts and events, which are recalled in a continuous manner . Implicit memory, on the other hand, is retrieved in a procedural fashion, representing internalized sequences of behavior, as seen in motor skills and physical actions. Explicit memory is further divided into verbal and non-verbal explicit memory. Verbal explicit memory encompasses the storage and retrieval of information in a linguistic or language-based format. This includes the ability to remember and recall words, sentences, stories, and any information that is primarily conveyed through language. 1 ..."
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"... Explicit memory refers to the representation of facts and events, which are recalled in a continuous manner . Implicit memory, on the other hand, is retrieved in a procedural fashion, representing internalized sequences of behavior, as seen in motor skills and physical actions. Explicit memory is further divided into verbal and non-verbal explicit memory. Verbal explicit memory encompasses the storage and retrieval of information in a linguistic or language-based format. This includes the ability to remember and recall words, sentences, stories, and any information that is primarily conveyed through language. Non-verbal explicit memory, however, refers to the storage and retrieval of sensory and perceptual stimuli, which are not primarily processed using language, such as visual or spatial information . Explicit memory can further be distinguished into episodic memory, which refers to a temporal serial storage of personal experiences or events, and semantic memory, which represents general concepts, meaning, and environmental knowledge . There is extensive empirical research investigating sex differences in memory performance in humans, with results indicating better explicit memory performance in women compared to men . Studies further tend to support advantages for women in episodic memory tasks, involving both verbal and non-verbal (visuospatial) processing, as well as in face-recognition tasks, indicating a slight general advantage in episodic memory performance . This advantage could be amplified by women's superiority over men in verbal expression. Nevertheless, for non-verbal memory, specifically in visuospatial tasks, males seem to display higher levels of proficiency compared to women . Even though young adults are at their peak of verbal memory development, women and men seem to have different reserves for adaptations . 1 ..."
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"... Physical activity and recall performance The results of this study show different associations between physical activity and verbal memory performance for male and female participants. Sex differences in verbal memory have been described in previous research . Additionally, the importance of physical activity for maintenance of verbal memory abilities during aging has previously been demonstrated by a prospective study in women . Verbal memory is a crucial neurocognitive function, enabling language acquisition, comprehension, and production, and is therefore a core component of social interaction . Physical activity might therefore facilitate the enhancement of verbal memory, when activities are coupled with social interaction (e.g., physical activity programs in group settings). Studies on physical activity preferences in young adults have shown that women tend to prefer exercising in structured exercise classes in a group setting, while men show preferences for individual exercise, thus limiting opportunities for social interaction . Therefore, women might encounter more frequent opportunities for socially engaging physical activity, resulting in enhanced promotion of verbal memory performance. Nevertheless, the results of our study show that among female participants, enhancement of verbal memory performance was positively associated with physical activity at vigorous intensity, which displays a limited capacity for simultaneous social interaction, such as talking. Given that higher intensity of physical activity was associated with improved verbal memory performance, a physiological pathway seems more plausible as underlying mechanism. Intense physical activity contributes to a lower risk for cardiovascular events and disease, and is considered to be a protective factor for brain health . High blood pressure and suboptimal high-density lipoprotein (HDL) cholesterol levels have been shown to be negatively associated with verbal memory performance, and are considered risk factors for cognitive health . The results in women indicate a moderation of physical activity intensity on verbal memory performance, which might be attributable to activity-induced changes in the cardiovascular profile. Results for male participants differed, as no direct effect of physical activity on verbal memory performance was detected. There is empirical evidence pointing toward age and sex interactions on verbal memory performance during young adulthood. For instance, whereas verbal memory performance declines with age from young adulthood for men, women maintain their verbal memory abilities until after menopause . 1 ..."
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"... Discussion The key finding of the present study is that sex had a moderating effect on the association between physical activity and verbal memory performance. Specifically, direct effects of physical activity on verbal memory performance were found in female participants only. Results indicated that female participants recalled one additional word correctly for every additional 3 min and 42 s spent in vigorous-intensity physical activity for immediate free-recall and for every additional 3 min and 5 s of vigorous-intensity physical activity for delayed free-recall. In contrast, this association was not observed in male participants. However, male participants' moderate physical activity levels were positively related to IAPF, whereas their vigorous physical activity levels were negatively related to IAPF. In both sexes, resting-state IAPF showed no mediating role due to the absence of an association with free-recall memory performance. 4.1 Physical activity and recall performance The results of this study show different associations between physical activity and verbal memory performance for male and female participants. Sex differences in verbal memory have been described in previous research . Additionally, the importance of physical activity for maintenance of verbal memory abilities during aging has previously been demonstrated by a prospective study in women . Verbal memory is a crucial neurocognitive function, enabling language acquisition, comprehension, and production, and is therefore a core component of social interaction . Physical activity might therefore facilitate the enhancement of verbal memory, when activities are coupled with social interaction (e.g., physical activity programs in group settings). Studies on physical activity preferences in young adults have shown that women tend to prefer exercising in structured exercise classes in a group setting, while men show preferences for individual exercise, thus limiting opportunities for social interaction . Therefore, women might encounter more frequent opportunities for socially engaging physical activity, resulting in enhanced promotion of verbal memory performance. Nevertheless, the results of our study show that among female participants, enhancement of verbal memory performance was positively associated with physical activity at vigorous intensity, which displays a limited capacity for simultaneous social interaction, such as talking. Given that higher intensity of physical activity was associated with improved verbal memory performance, a physiological pathway seems more plausible as underlying mechanism. 2 ..."
Related quote(s)5 / 6
"... Intense physical activity contributes to a lower risk for cardiovascular events and disease, and is considered to be a protective factor for brain health . High blood pressure and suboptimal high-density lipoprotein (HDL) cholesterol levels have been shown to be negatively associated with verbal memory performance, and are considered risk factors for cognitive health . The results in women indicate a moderation of physical activity intensity on verbal memory performance, which might be attributable to activity-induced changes in the cardiovascular profile. Results for male participants differed, as no direct effect of physical activity on verbal memory performance was detected. There is empirical evidence pointing toward age and sex interactions on verbal memory performance during young adulthood. For instance, whereas verbal memory performance declines with age from young adulthood for men, women maintain their verbal memory abilities until after menopause . Moreover, these results are in line with earlier studies linking enhanced verbal memory performance to pre- and postmenopausal estrogen levels . Furthermore, postmenopausal women undergoing an estrogen replacement therapy have demonstrated better verbal memory performance compared to women in the control groups . In vitro studies have even proposed the possibility of neuroprotection through estrogen-related enhancement of cellular mechanisms associated with memory . As a result, women's advantage in verbal memory tasks might be mediated through levels of estrogen and might therefore be especially pronounced during young adulthood. In addition, neuroimaging studies have shown age-related cortical and hippocampal atrophy in young male adults . Findings suggest that men may experience earlier and more extensive age-related atrophic changes in cortical gray matter compared to women . Furthermore, these disparities in atrophy appear to be more pronounced in the left hemisphere, which is thought to play a pivotal role in verbal memory . Accordingly, the neurobiological aging process might be stronger than the sensitivity to neurophysiological changes induced by physical activity in young male adults. Therefore, the adaptation reserve or capacity that can be recruited by physical activity might simply be lower in men compared to women, which in turn presents in lower verbal memory performance even at young adult age. 2 ..."
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"... Moreover, these results are in line with earlier studies linking enhanced verbal memory performance to pre- and postmenopausal estrogen levels . Furthermore, postmenopausal women undergoing an estrogen replacement therapy have demonstrated better verbal memory performance compared to women in the control groups . In vitro studies have even proposed the possibility of neuroprotection through estrogen-related enhancement of cellular mechanisms associated with memory . As a result, women's advantage in verbal memory tasks might be mediated through levels of estrogen and might therefore be especially pronounced during young adulthood. In addition, neuroimaging studies have shown age-related cortical and hippocampal atrophy in young male adults . Findings suggest that men may experience earlier and more extensive age-related atrophic changes in cortical gray matter compared to women . Furthermore, these disparities in atrophy appear to be more pronounced in the left hemisphere, which is thought to play a pivotal role in verbal memory . Accordingly, the neurobiological aging process might be stronger than the sensitivity to neurophysiological changes induced by physical activity in young male adults. Therefore, the adaptation reserve or capacity that can be recruited by physical activity might simply be lower in men compared to women, which in turn presents in lower verbal memory performance even at young adult age. Nevertheless, free-recall performance of both men and women in this study was fairly high, with more words being recalled immediately after presentation compared to delayed recall, as seen in previous studies employing this verbal memory task . Levels of physical activity were also high compared to normative studies in young adults, which might have resulted in a limited range of variability in this measure . 2 ..."
Reference 2
Review article
Shared and divergent neurocognitive impairments in adult patients with schizophrenia and bipolar disorder: Whither the evidence?
Kuswanto C., Chin R., Sum M.Y., Sengupta S., Fagiolini A., McIntyre R.S., Vieta E., Sim K.
Neuroscience & Biobehavioral Reviews , 2016 pp 66-89
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"... Neurocognitive domains implicated in SCZ and BD 3.2.1 Verbal memory Verbal memory is a complex process by which individuals learn, retain and retrieve specific verbal information . It is often evaluated with tests of recall and/or recognition of word lists or storylines. These largely include components from the Wechsler Memory Scale (WMS), California Verbal Learning Test (CVLT), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Verbal Memory section of the Brief Assessment of Cognition in Schizophrenia (BACS). There were 27 studies which assessed verbal memory in SCZ and BD patients. Overall, most of the studies reported poorer performance in verbal memory in SCZ and BD patients when compared to HC. Within these studies, there were 17 reports for worse verbal memory function in SCZ patients compared to BD patients, as well as 15 reports for comparable degree of verbal memory impairments between them ( Table 2 ). Patients with SCZ tended to perform worse during learning and acquisition of memory compared to BD patients, and yet displayed comparable degree of impairments during retention and recall. There was no study that reported worse verbal memory function in BD patients compared to SCZ patients. 3.2.2 Working memory Working memory is a cognitive domain that involves maintenance of relevant information where it can be processed or manipulated for problem-solving or goal-guided behavior . The majority of the studies employed digit span (forward and backward), digit sequencing, and letter-number sequencing tasks to assess working memory. Out of the 21 studies that assessed working memory, only four studies found no significant main effect of diagnosis . Studies which reported significant main effect of diagnosis reported worse working memory in patients groups compared to HC group. However, 16 of these studies reported no significant difference between patients groups after controlling for covariates of clinical and socio-demographic factors. Studies that found significant difference between patients groups reported significantly lower scores in SCZ compared to BD patients during working memory tasks , although one study reported that this difference had a small effect size . Of note, SCZ patients generally performed worse compared to BD patients when performing digit span forward, yet BD and SCZ patients were similarly impaired when performing digit span backward . ..."
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"... Verbal memory Verbal memory is a complex process by which individuals learn, retain and retrieve specific verbal information . It is often evaluated with tests of recall and/or recognition of word lists or storylines. These largely include components from the Wechsler Memory Scale (WMS), California Verbal Learning Test (CVLT), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the Verbal Memory section of the Brief Assessment of Cognition in Schizophrenia (BACS). There were 27 studies which assessed verbal memory in SCZ and BD patients. Overall, most of the studies reported poorer performance in verbal memory in SCZ and BD patients when compared to HC. Within these studies, there were 17 reports for worse verbal memory function in SCZ patients compared to BD patients, as well as 15 reports for comparable degree of verbal memory impairments between them ( Table 2 ). Patients with SCZ tended to perform worse during learning and acquisition of memory compared to BD patients, and yet displayed comparable degree of impairments during retention and recall. There was no study that reported worse verbal memory function in BD patients compared to SCZ patients. ..."
Reference 3
Book Chapter
Neuropsychological Testing
Stebbins G.T.
Textbook of Clinical Neurology , 2007 pp 539-557
View chapter
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"... For example, the assessment of verbal memory, a form of cognition, may be assessed by simply asking patients to remember a list of words. This approach to testing is inadequate by itself, however, because verbal memory is more complex than simply remembering lists of words. Therefore, assessment of verbal memory entails testing memory for lists of words, pairs of words, sentences, and short stories, using both immediate recall, delayed recall, and recognition paradigms. Such an assessment strategy provides enough data to analyze fully specific deficits in cognitive abilities that may be shared by multiple processes and allows for a finer discrimination of abilities and impairments. The complexity and depth of knowledge about brain‐behavior relationships are reflected in the vast number of volumes devoted to their description. This chapter provides an overview of adult clinical neuropsychology with the aim of assisting practitioners in the use and interpretation of neuropsychological data. ..."
Reference 4
Book Chapter
Specialized Neuropsychological Assessment Methods
Glenn J. Larrabee
Handbook of Psychological Assessment , 2000 pp 301-335
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"... Assessment of Verbal Learning and Memory A variety of methods exist for evaluating verbal learning and memory, including immediate and delayed recall of brief passages of prose (Logical Memory subtest of the WMS-R), digit supraspan learning , forced-choice recognition memory for words previously seen (Recognition Memory Test) , and supraspan word-list learning (multiple-trial list-learning tasks, such as the Rey Auditory Verbal Learning Test (RAVLT), California Verbal Learning Test (CVLT), and Verbal Selective Reminding Test (VSRT) . Paired Associate Learning is another modality of verbal memory testing in which the patient on the presentation trial hears a list of pairs of words, followed by a test trial in which the first word of the pair is presented, to which the patient must provide the second word . Three of the more widely used supraspan verbal list-learning procedures in clinical and research applications of neuropsychology are the RAVLT, CVLT, and VSRT. All three require the subject to learn a supraspan list of words over several trials, with testing of delayed recall and testing of recognition. The RAVLT requires the subject to learn a list of 15 unrelated words over five trials, followed by a second list to serve as interference and subsequent short- and long-delay recall of the original list . Lezak (1995) has also provided a 50-word list (containing the acquisition list, interference list, and 20 more words) for recognition testing following the delayed-recall trial . Analysis of patterns of performance can yield information on serial-position effect, proactive interference, retroactive interference, and forgetting over time . Performance on the RAVLT is affected by a variety of conditions including temporal lobectomy , hydrocephalus , vertebrobasilar insufficiency and early Alzheimer-type dementia . Powell, Cripe, and Dodrill (1991) found that the RAVLT, particularly trial 5, was more sensitive to discriminating a group of normal subjects from a mixed neurologic group than any other single test on the Halstead-Reitan or Dodrill batteries. ..."
Related quote(s)2 / 2
"... Assessment of Verbal Learning and Memory A variety of methods exist for evaluating verbal learning and memory, including immediate and delayed recall of brief passages of prose (Logical Memory subtest of the WMS-R), digit supraspan learning , forced-choice recognition memory for words previously seen (Recognition Memory Test) , and supraspan word-list learning (multiple-trial list-learning tasks, such as the Rey Auditory Verbal Learning Test (RAVLT), California Verbal Learning Test (CVLT), and Verbal Selective Reminding Test (VSRT) . Paired Associate Learning is another modality of verbal memory testing in which the patient on the presentation trial hears a list of pairs of words, followed by a test trial in which the first word of the pair is presented, to which the patient must provide the second word . Three of the more widely used supraspan verbal list-learning procedures in clinical and research applications of neuropsychology are the RAVLT, CVLT, and VSRT. All three require the subject to learn a supraspan list of words over several trials, with testing of delayed recall and testing of recognition. The RAVLT requires the subject to learn a list of 15 unrelated words over five trials, followed by a second list to serve as interference and subsequent short- and long-delay recall of the original list . Lezak (1995) has also provided a 50-word list (containing the acquisition list, interference list, and 20 more words) for recognition testing following the delayed-recall trial . Analysis of patterns of performance can yield information on serial-position effect, proactive interference, retroactive interference, and forgetting over time . Performance on the RAVLT is affected by a variety of conditions including temporal lobectomy , hydrocephalus , vertebrobasilar insufficiency and early Alzheimer-type dementia . Powell, Cripe, and Dodrill (1991) found that the RAVLT, particularly trial 5, was more sensitive to discriminating a group of normal subjects from a mixed neurologic group than any other single test on the Halstead-Reitan or Dodrill batteries. 2 ..."
Reference 5
Review article
Cognitive impairment in major depression
Marazziti D., Consoli G., Picchetti M., Carlini M., Faravelli L.
European Journal of Pharmacology , 2010 pp 83-86
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"... Verbal memory is usually assessed by the California Verbal Learning Test (CVLT), the Wechsler Memory Scale (WMS) and the Rey Auditory Verbal Learning Test (RAVLT). Non-verbal (visuo-spatial) memory can be evaluated by two neuropsychological tests, the Rey–Osterrieth Complex Figure Test (ROCFT) and the Benton Visual Retention Test (BRVT). These instruments assess visual perception, visual memory, and visuo-constructive abilities, as well as perception of spatial relations and memory for newly learned material. Depressed patients show particular difficulties with memory tasks requiring sustained effort, such as list learning and free recall, which are qualitatively different from tasks carried out automatically (e.g., memory for spatial events). Memory deficits seem to be independent from the patients' current mood state, but they are trait-related or linked to the course . Data of short-term memory assessment in depression are equivocal. Some studies reported minimal impairment, while others described short-term memory problems . However, a wide agreement exists that it is secondary to other dysfunctions, such as attentional deficit, cognitive interference, negative schemata, lack of motivation and impaired cognitive initiative, rather than the ability of short-term memory storage . Several studies reported a decreased ability to acquire new information, without a reduction in the ability to retain it in MD patients, because depressed states are frequently accompanied by intrusive, irrelevant and/or pessimistic thoughts that decrease memory . Impaired verbal learning was described in both unipolar and bipolar patients: this has been interpreted as reflecting an inability to transfer information from short-term to long-term storage , but it remains unclear if these deficits represent a state-dependent changes or reflect underlying trait characteristics. 1 ..."
Reference 6
Review article
Longitudinal neuroimaging and neuropsychological changes in bipolar disorder patients: Review of the evidence
Lim C.S., Baldessarini R.J., Vieta E., Yucel M., Bora E., Sim K.
Neuroscience & Biobehavioral Reviews , 2013 pp 418-435
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"... Verbal learning, memory and speed of processing Verbal memory refers to memory of words or other representation involving language. Impairment of verbal memory is a consistently identified neurocognitive deficit in cross-sectional studies of BD patients . Pavuluri et al. (2009) reported verbal learning impairments early in the course of BD. and Mur et al. (2008a) found enduring impairments over time. However, Arts et al. (2011) found that deficits in verbal memory in BD subjects improved with treatment over two years of follow-up. Processing speed refers to ability to process, comprehend and learn a task requiring a motor response as well as intact attentional and executive functions. Neuropsychological tests used to assess processing speed include the CPT) and associated reaction time, Trail Making Test-A (TMT-A), Digit-Symbol Substitution Test. Several studies have reported deficits in processing speed among young-adult and older BD patients . Mur et al. (2008a,b) and Xu et al. (2012) found stable deficits in processing speed which did not seem to worsen over time in adult BD patients. In addition, Gildengers et al. (2009) and Delaloye et al. (2011) noted impaired information processing speed in adult BD patients, suggesting that it may be a stable, enduring neurocognitive deficit in BD. ..."
Reference 7
Book Chapter
Neuropsychology in the Diagnosis and Treatment of Dementia
Sewell M.C., Vigario A., Sano M.
Brocklehurst's Textbook of Geriatric Medicine and Gerontology , 2010 pp 402-410
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"... 24 The DSM-IV-TR criteria require impairment in memory and in one other area of cognition (e.g., apraxia, aphasia, agnosia, executive function, attention, visuospatial ability), with concomitant functional impairment (either social or vocational). The NINCDS-ADRDA also includes criteria that the progression is insidious and that other diseases that could cause cognitive decline have been ruled out. AD, characterized by damage (plaque and neurofibrillary tangles, synapse loss, atrophy) beginning in the medial temporal lobe (hippocampus and entorhinal cortex), is usually marked by a slow and steady progression. The dementia associated with these neuropathologic changes includes significant memory loss as the central core, with other impairments in language (semantic and phonemic fluency, naming), executive function (parallel processing, planning, switching cognitive sets, abstraction), and later in the illness, attention, and visuospatial function. Recent neuropsychological research has focused on identifying the very earliest cognitive impairments associated with AD, usually episodic memory. Verbal memory is most commonly assessed with either word lists (e.g., CVLT, RAVLT) or stories (e.g., logical memory), and normative data for initial and delayed recall along with recognition is well-established on these tests across age and education categories well into the ninth decade. A substantial amount of research has indicated that AD is associated with a particular pattern of cognitive deficits that distinguish it from normal aging, 25 and, in some cases, from other forms of dementia. The ability to learn and retain verbal information distinguishes between those with mild AD and healthy elders. 26–31 Neuropsychological performance on verbal memory tests is marked by difficulty not only in the free recall of recently learned information, but in the aided retrieval of that information with cues. 32 In very early AD, initial learning may be relatively well-preserved, though, compared to normal controls, deficits in both acquisition and consolidation of information may still be present, along with evidence of a shallower learning curve. 1 ..."
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"... Recent neuropsychological research has focused on identifying the very earliest cognitive impairments associated with AD, usually episodic memory. Verbal memory is most commonly assessed with either word lists (e.g., CVLT, RAVLT) or stories (e.g., logical memory), and normative data for initial and delayed recall along with recognition is well-established on these tests across age and education categories well into the ninth decade. A substantial amount of research has indicated that AD is associated with a particular pattern of cognitive deficits that distinguish it from normal aging, 25 and, in some cases, from other forms of dementia. The ability to learn and retain verbal information distinguishes between those with mild AD and healthy elders. 26–31 Neuropsychological performance on verbal memory tests is marked by difficulty not only in the free recall of recently learned information, but in the aided retrieval of that information with cues. 32 In very early AD, initial learning may be relatively well-preserved, though, compared to normal controls, deficits in both acquisition and consolidation of information may still be present, along with evidence of a shallower learning curve. 33,34 Deficits in both encoding and delayed recall become more severe as the disease progresses. 35 Examination of specific patterns of responses on delayed recall suggests that normal controls tend to recall words equally from the beginning and end of a list but AD patients rely heavily on words only from the end of the list (recency effect), arguing that the AD patient, not having transferred the information from primary to secondary memory, has not really “learned” the words at all. 36,37 AD patients are sensitive to interference, 38 and this is evidenced by a high number (relative to normal controls) of intrusions (e.g., when words from a second list of words appears while the patient is attempting to recall words from a previously learned list), and repetitions. 39 This finding is observed on tests of both word lists and stories. 40 Very recent research has focused on clarifying other aspects of episodic memory problems, highlighting the attentional and organizational skills required that may help better characterize the deficits in very mildly impaired patients. 2 ..."
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"... 33,34 Deficits in both encoding and delayed recall become more severe as the disease progresses. 35 Examination of specific patterns of responses on delayed recall suggests that normal controls tend to recall words equally from the beginning and end of a list but AD patients rely heavily on words only from the end of the list (recency effect), arguing that the AD patient, not having transferred the information from primary to secondary memory, has not really “learned” the words at all. 36,37 AD patients are sensitive to interference, 38 and this is evidenced by a high number (relative to normal controls) of intrusions (e.g., when words from a second list of words appears while the patient is attempting to recall words from a previously learned list), and repetitions. 39 This finding is observed on tests of both word lists and stories. 40 Very recent research has focused on clarifying other aspects of episodic memory problems, highlighting the attentional and organizational skills required that may help better characterize the deficits in very mildly impaired patients. 41 Visual memory may also be assessed, although there is some evidence that visuospatial skills naturally deteriorate with age, making these tasks less discriminatory. However, some recent studies have identified nonverbal memory impairments in very mildly impaired AD patients compared with normal controls. For example, performance on the recall portion of the Rey-Osterrieth Complex Figure Test (RCFT) has been shown to be impaired even in very mild AD patients. 42 Difficulties with executive functioning may be the first symptom to appear after episodic memory impairments. 43 Those with AD exhibit marked difficulty relative to normal controls with various executive functions including cognitive flexibility, problem solving, parallel processing, planning, set shifting, and abstract thinking. These deficits, which worsen as the disease progresses, are observed on lower than expected performance on common tests of executive function including phonemic fluency, card sorting, and trail-making. The careful measurement of various executive abilities is important in those with early AD because deficits in this area have been consistently related to poorer functional ability, 44 ability to manage finances, 45 and higher need for care. 2 ..."
Reference 8
Review article
Declarative memory deficits and schizophrenia: Problems and prospects
Stone W.S., Hsi X.
Neurobiology of Learning and Memory , 2011 pp 544-552
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"... Declarative memory deficits in schizophrenia Deficits in verbal declarative memory (VDM) are among the most consistent and severe neuropsychological deficits in schizophrenia . The putative ‘endophenotype’ usually refers to performance on tests of learning and memory that assess the abilities to learn, retain and retrieve specified information consciously. Its association with the illness is robust. Effect sizes versus appropriate comparison populations are often large, in the 1.0–1.5 standard deviations range . Deficits in VDM are thus associated closely with schizophrenic illness. Visual declarative memory is also impaired in schizophrenia, although methodological differences between studies contribute to less consistent estimates of the magnitude of the deficit . Deficits in VDM are also stable. They occur at different phases of the disorder, including the prodrome and prior to frank psychosis, and after remission from psychotic symptoms . Mesholam et al. showed a large effect size (−1.20) for an Immediate Verbal Memory composite score in their meta-analysis at the time of the first episode, and even larger effect sizes for specific test measures . Among these, immediate recall of short stories on the Wechsler Memory Scale (WMS) Logical Memory Test was −1.47, while the total number of words recalled correctly over the course of five trials on the California Verbal Learning Test (CVLT) was −1.34. One of the largest evaluations of this same measure of learning on the CVLT was performed at seven sites as part of the Consortium on the Genetics of Schizophrenia (COGS), with 509 control subjects, 309 subjects with schizophrenia, 449 sibling relatives and 232 parent relatives . The effect size for subjects with schizophrenia was again large, consistent with the results obtained by Mesholam et al. Moreover, studies that followed subjects longitudinally before and after the onset of illness show an exacerbation of deficits in memory around the time of the prodrome and development of psychosis, followed by relatively stable levels of deficits afterwards ( Lewandowski, Cohen, & Ongur, in press ). 1 ..."
Reference 9
Review article
Verbal learning and hippocampal dysfunction in schizophrenia: A meta-analysis
Antoniades M., Schoeler T., Radua J., Valli I., Allen P., Kempton M.J., McGuire P.
Neuroscience & Biobehavioral Reviews , 2018 pp 166-175
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"... Introduction Schizophrenia (SCZ) is a complex disorder with widespread neuroanatomical and neurofunctional deficits. It is associated with a substantial cognitive impairment that affects working memory, processing speed, attention and verbal memory . Such cognitive deficits have been shown to be present in children and adolescents who later develop schizophrenia, long before they develop any overt symptoms . Cognitive deficits have also been detected in the prodromal stage of the illness and in first-episode patients . Furthermore, studies have consistently found that verbal learning has shown the greatest impairment throughout the disease stages . The most common way to assess verbal learning is through the use of word list learning tasks such as the Rey Auditory Verbal Learning Task , the California Verbal Learning task , the Hopkins Verbal Learning Test or with the Logical Memory Stories test of the Wechsler Memory Scale . All of these tasks provide a measure of immediate and delayed recall. Factor analysis of the RAVLT revealed three basic factors: acquisition, storage and retrieval . Thus, measures of immediate recall may reflect the cellular process of encoding and delayed recall may reflect the processes of storage and retrieval . Verbal learning and memory relies on a network of regions including the prefrontal cortex and medial temporal lobe (MTL) structures, where the hippocampus is important for the acquisition of new information . More specifically, studies have shown that the CA2, CA3 and dentate gyrus were activated during encoding of face-name and object-name pairs whereas the subiculum was activated during retrieval . In shorter time periods, the hippocampus is thought to aid retrieval by reactivating neurons that were involved in learning . The combination of these findings and results from many other studies highlight the importance of the hippocampus in the encoding, storage and retrieval of memories. The hippocampus is thought to be one of the key regions implicated in the pathophysiology of schizophrenia . 1 ..."
Reference 10
Reference works Chapter
Short-term and working memory systems
Buchsbaum B.R., D'Esposito M.
Learning and Memory: A Comprehensive Reference , 2008 pp 237-260
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"... Buchsbaum et al. (2005) have shown with fMRI time series data that, consistent with the monkey connectivity patterns, the most posterior and dorsal part of the superior temporal cortex, area Spt, shows the strongest functional connectivity with dorsolateral and posterior (premotor) parts of the PFC, whereas the midportion of the STS is most tightly coupled with BA 12 and 47 of the ventrolateral PFC (see Figure 9 ). Moreover, in a gross distinction between anterior (BA 47) and posterior (BA 44/6), parts of the PFC have been associated with conceptual-semantic and phonological-articulatory aspects of verbal processing . Earlier we posed the question of how a lesion in posterior sylvian cortex, an area of known importance for online language processing, could occasionally produce an impairment restricted to phonological STM. One solution to this puzzle is that subjects with selective verbal STM deficits from posterior temporal lesions retain their perceptual and comprehension abilities due to the sparing of the ventral stream pathways, whereas the preservation of speech production is due to an unusual capacity in these subjects for right-hemisphere control of speech. The STM deficit arises, then, from a selective deficit in auditory-motor integration – or the ability to translate between acoustic and articulatory speech codes – a function that is especially taxed during tests of repetition and STM . The study of the neural basis of verbal working memory has proceeded from a large body of human neurological evidence pointing to the critical role of anterior regions (e.g., Broca’s area) in speech production and posterior regions (e.g., temporoparietal cortex) in perceptual and mnemonic aspects of speech processing. This contrasts rather sharply with neurobiological investigations of spatial working memory, which was initially driven almost entirely by studies in the monkey and, in addition, posited a direct role for lateral PFC in mnemonic storage . 1 ..."
Reference 11
Review article
Acute effects of partial CB1 receptor agonists on cognition – A meta-analysis of human studies
Zhornitsky S., Pelletier J., Assaf R., Giroux S., Li C.-S.R., Potvin S.
Progress in Neuro-Psychopharmacology and Biological Psychiatry , 2021 pp 110063
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"... Discussion The present meta-analysis examined the acute effects of administration of partial CB 1 receptor agonists relative to placebo on cognition among non-psychiatric adult populations. We found that these compounds impaired all aspects of cognition, including verbal learning, verbal memory, working memory, speed of processing, attention, executive function, and impulsivity, relative to placebo. Meta-regression analysis showed that a greater ratio of males to females was associated with greater cannabinoid-induced deficits in speed of processing and impulsivity. However, the mean age of participants had no impact on the results. We found that that the largest negative impact of partial CB 1 receptor agonist administration was on verbal learning, verbal memory, and working memory. While a previous systematic review also found that verbal learning and memory were robustly disrupted by acute cannabinoid administration , previous systematic reviews on the potentially detrimental effects of acute cannabinoids on working memory have shown inconsistent results . Our findings are thus important in that they revealed that impairment of working memory induced by partial CB 1 receptor agonists was associated with a moderate effect size (0.514). Verbal learning / memory and working memory are functions subserved by the prefrontal cortex and medial temporal lobe (including the hippocampus, parahippocampus, and some parts of the inferior and medial temporal gyri) . The prefrontal cortex is involved in planning, organizing, and manipulation of information in short-term memory required to guide future thoughts or actions . The hippocampus is involved in the consolidation of information from short-term to long-term memory . These regions contain an abundance of CB 1 receptors and structural imaging studies show neuroanatomic alterations among regular cannabis users in these regions . Functional neuroimaging and electrophysiological studies have shown deleterious effects of partial CB 1 receptor agonists on brain activity during tasks of verbal and working memory, even when the effects did not manifest in performance. 1 ..."
Reference 12
Handbook Chapter
The role of cerebellum in the child neuropsychological functioning
Dellatolas G., Camara-Costa H.
Handbook of Clinical Neurology , 2020 pp 265-304
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"... Verbal working memory and articulatory subvocal rehearsal There is converging evidence for the involvement of the cerebellum in verbal working memory, but there is a diversity of views about the nature of the link between verbal working memory and subvocal rehearsal or inner (internal) speech, in case of cerebellar damage. Subjects with cerebellar lesions present deficits in working memory . These deficits have been related to impaired silent recirculation of verbal information , impaired phonemically related retrieval strategies , deficient articulatory monitoring process , impaired ability to sequence , deficient initial phonologic encoding and/or strengthening memory traces , and deficient prediction, error-driven adjustment, and internal timing . The role of the cerebellum in associative learning and prediction might account for its role in working memory . The cerebellum may participate in a prearticulatory verbal code subserving online sequencing of syllables and temporal organization of internal speech and in articulatory monitoring during working memory . Silent counting activated the cerebellum , and young schoolchildren with cerebellar lesions showed delayed acquisition of silent reading and silent counting . Transcranial magnetic stimulation over the right cerebellum disturbed the phonologic loop . Numerous neuroimaging studies using working memory tasks reported connections between the cerebellum and cerebral phonologic processing areas , activation lobules VII–VIII of the posterior cerebellum , different clusters of cerebellar activation during encoding, memory, and retrieval , different regions of the cerebellum supporting the central executive and the phonologic loop , and activation of the dorsal “motor” dentate during encoding but activation of the ventral “cognitive” dentate during retrieval ( Marvel and Desmond, 2010a ). According to Desmond et al., the right superior cerebellum contributes to the articulatory control system (encoding phase) of working memory and the right inferior cerebellum (lobules VIIB/VIIIA) to the phonologic store (maintenance phase) . 1 ..."
Reference 13
Reference works Chapter
Intracranial studies of cognition in humans
Hesse E.
Encyclopedia of Behavioral Neuroscience, 2nd edition , 2022 pp 203-219
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"... Information sharing between regions, quantified through connectivity measures, has been examined in memory processes in several iEEG studies. For example, converging evidence obtained through time-lagged correlation analysis, phase synchronization, and Granger causality showed that hippocampal activity was inhibited through a top-down relationship by the dorsolateral prefrontal cortex (DLPFC) ( Fig. 6 ). In a verbal episodic task, ripple oscillations (80–120 Hz) dynamically coupled involved the MTL and temporal association cortex (anterior temporal lobe and middle temporal gyrus -MTG), characterized by a correlated increase in ripple oscillation in the MTG 50 ms after an increase in MTL that is linked to the reinstatement of neural activity present during encoding . Another study focused on the functional connections within the MTL during a verbal memory task, and found that phase-locking theta (4–8 Hz) activity indicated successful memory encoding and retrieval . In a virtual reality spatial navigation task the magnitude of the phase synchronization between hippocampus and lateral temporal cortex predicted the quality of reinstatement . Lastly, frequency-specific coherent oscillatory activity between different brain areas associated with successful retrieval was used to identify nodes in a task-relevant network for a spatiotemporal memory retrieval task and later confirmed through DES . Together, these findings reflect how connectivity measures applied to iEEG recordings can provide precise insights of information sharing between regions. Multiple studies on memory focus on creating models to decode memories from neural activity registered during encoding using signals from different brain regions, and/or different target frequencies, and sometimes through connectivity measures . For example, for recognition memory decisions HFA in the intraparietal sulcus and left superior parietal lobule enabled single-trial decoding of the subjects' memory state . Another approach used multivariate models to identify common patterns of spectral power that were able to predict successful encoding and retrieval in a free-recall task. 1 ..."
Reference 14
Review article
Opioid withdrawal and memory consolidation
Baidoo N., Wolter M., Leri F.
Neuroscience & Biobehavioral Reviews , 2020 pp 16-24
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"... 4.2.5 Long term potentiation Long term potentiation (LTP), a process by which synapses are strengthened due to recurrent excitability, is thought to underlie the formation of many forms of memory and has been implicated in many neurocognitive disorders . LTP also plays a key role in memory consolidation through related neurochemical processes: early phase LTP is dependent on NMDA and AMPA glutamate receptor activation, while late phase LTP requires synthesis of new proteins and modifications of synapses . Therefore, it has been demonstrated that post-training administration of NMDA and AMPA antagonists impair memory , and that protein inhibitors administered shortly following learning impair memory for a variety of tasks . As well, expression of activity-regulated cytoskeletal-associated protein (Arc) during the consolidation of new learning is a key component of LTP . Consistent with the thesis of this review, opioid withdrawal could also promote memory consolidation by facilitating LTP. Therefore, it has been demonstrated that applying naloxone to hippocampal slices of morphine-dependent animals increases LTP as measured by theta-frequency primed-burst tetanic stimulations . This has been confirmed in another study by Ito et al. (2001) , who reported that withdrawal from chronic morphine administration enhanced LTP in cell synapses of the dentate gyrus (DG) of the hippocampus. Moreover, LTP enhancement induced by opioid withdrawal is associated with intracellular changes that promote synaptic excitability , and administration of an NMDA receptor antagonist or a voltage-dependent calcium channel blocker inhibit cellular excitability and block hippocampal LTP induced by morphine withdrawal . Finally, opioid withdrawal increases Arc activity in the hippocampus and amygdala . 4.2.6 A test of the hypothesis The hypothesis that opioid withdrawal can influence memory consolidation has recently been tested in rodents by combining several methods commonly employed in behavioural pharmacology . 1 ..."
Reference 15
Review article
Alzheimer's Disease: Prototype of Cognitive Deterioration, Valuable Lessons to Understand Human Cognition
Noroozian M.
Neurologic Clinics , 2016 pp 69-131
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"... Working memory Miller and colleagues 100 coined the term working memory and used it in 1960 in their classic book Plans and the Structure of Behavior ; it was used in 1968 by Atkinson and Shiffrin 101 in an influential article and afterward adopted as the title for a multicomponent model by Baddeley and Hitch. 102 Working memory refers to the system or systems that are thought to be essential for keeping things in mind while such complex tasks as reasoning, comprehension, and learning are being performed. The term working memory evolved from the earlier concept of short-term memory. These two terms are sometimes still used interchangeably ( Box 10 ). It has been proposed by Baddeley and Hitch 102 that working memory could be categorized into 3 subsystems. (1) the first subsystem is concerned with verbal and acoustic information (the phonological loop);. (2) the second subsystem is the visuospatial sketchpad providing its visual equivalent; whereas both are dependent on (3) the third attentionally limited control system, called the central executive. Baddeley 103,104 later discussed the modification of his first model in a comprehensive article and has added a fourth component: the episodic buffer ( Fig. 5 ). 103 The Central Executive The central executive is the most complex component of working memory. As presented in the original model, it was assumed to be capable of attentional focus (eg, during dual tasks performed on 2 different modalities: one verbal, involving recalling digit sequences, and the other requiring visuospatial tracking), storage, and decision making. The Phonological Loop The phonological loop is the verbal subsystem that functions when people attempt to keep phonological information (speech, sign, lip reading, music, environmental sounds) in conscious awareness; for instance, when people mentally rehearse a phone number that they have just obtained from an operator. The verbal subsystem consists of 2 components that are interactive: a reservoir that stores phonological information and a rehearsal mechanism that keeps the stored information active for as long as it is needed. 1 ..."
Reference 16
Book Chapter
Working Memory and Language
Buchsbaum B.R.
Neurobiology of Language , 2016 pp 863-875
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"... The Phonological Loop As noted, the Working Memory model entails a separation of domain-specific mechanisms of memory maintenance and domain-general mechanisms of executive control ( Figure 69.1 ). Thus, the verbal component of working memory, or the phonological loop, is regarded as a “slave” system that is under the supervisory control of the central executive component. Within the phonological loop, two interacting components—the phonological store and the articulatory rehearsal process—enable verbal representations to be maintained in an active state. The phonological store is a passive buffer wherein verbal information can be stored for brief (approximately 2 s) periods. The articulatory control process serves to refresh the contents of the store, thereby allowing the system to maintain sequences of verbal items in memory over some interval of time. This division of labor between two interlocking components, one an active process and the other a passive store, is crucial to the model’s explanatory power. For instance, when the articulatory control process is interfered with through the method of articulatory suppression (e.g., by requiring subjects to say “hiya” over and over again), items in the store rapidly decay and recall performance suffers greatly. The phonological store, then, lacks a mechanism of reactivating its own contents but possesses memory capacity, whereas the articulatory rehearsal process lacks an intrinsic memory capacity of its own but can exert its effect indirectly by refreshing the contents of the store. The phonological loop model of verbal working memory has stood the test of time, largely because it explains many of the behavioral phenomena associated with verbal memory performance in a simple and intuitive way. It is important to briefly note what these core behavioral phenomena are and how the phonological loop model accounts for them. The appeal of the model comes partly from its parsimony—with only a very minimal set of functional specifications, it is able to account for a large number of behavioral findings. It therefore provides a benchmark that any competing model, whether neural or purely cognitive, must be able to match. 1 ..."
Reference 17
Reference works Chapter
Working memory
Gathercole S.E.
Learning and Memory: A Comprehensive Reference , 2008 pp 33-51
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"... 2.04.2.1.4 Summary The phonological loop model advanced by Baddeley (1986) , consisting of a short-term store and a subvocal rehearsal process, is the most influential current account of verbal short-term memory. Convergent evidence for the model is provided from a range of research traditions including experimental cognitive psychology, developmental psychology, neuropsychology, and neuroimaging. A similar diverse range of findings indicate that the phonological loop plays a key role in vocabulary acquisition . The successful implementation of the model in the form of a connectionist network by Burgess and Hitch (1992) is an important development that has stimulated competing computational models of serial recall with distinct architectures. The network model has also been further developed to simulate learning of novel sequences by the phonological loop . The availability of detailed models of short-term memory and the reciprocal stimulation of empirical findings and computational simulations is a sign of advanced theoretical development that is in large part due to the guiding influence of the phonological loop concept on this field over many years. 1 ..."
Reference 18
Book Chapter
Short-Term Memory
Rosaleen A. McCarthy, Elizabeth K. Warrington
Cognitive Neuropsychology , 1990 pp 275-295
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"... In normal subjects there is a clear “serial position effect,” with recall being best for items at the beginning and end of the list (the primacy and recency effect). He showed normal levels of performance with early and middle items on the list, but his “recency” effect was reduced to one item. This pattern is to be expected on theoretical grounds if verbal long-term memory is intact (primacy and middle portions of the list) but short-term memory is impaired (the recency effect). A fourth test of long-term memory, which is more like everyday learning, is that of story recall (Wechsler “logical memory”). The patient was read a short passage and asked to recall as much as possible about its content. His recall was as good as that of normal control subjects. These four tests of verbal learning and verbal retention have been attempted by three other cases with impaired auditory-verbal short-term memory. In these patients, at least, verbal long-term memory has been shown to be at entirely normal levels . These findings effectively eliminate the “gateway” model of memory processing. Were short-term memory a gateway to longer-term storage, it follows that an impairment in short-term memory tasks should necessarily lead to an impairment in verbal learning tasks. Since long-term memory can be normal in span-impaired cases, there must be a degree of independence between the processing systems which are involved in long- and short-term memory. Shallice & Warrington (1970) proposed a model of the relationship between long- and short-term verbal memory which allowed for parallel input into both systems (see Fig. 13.4 ). Working Memory Baddeley and his colleagues have developed a model in which the ability to hold verbal material verbatim plays an important role in problem solving . The working-memory model consists of three major components: the “articulatory loop,” the “visuospatial sketchpad” (or “scratch pad,” see above), and the “central executive.” Performance on auditory-verbal span tasks requires the operation of this articulatory loop under the directing control of the central executive system. 1 ..."
Reference 19
Book series Chapter
Verbal and Spatial Working Memory In Humans
Jonides J., Reuter-Lorenz P.A., Smith E.E., Awh E., Barnes L.L., Drain M., Glass J., Lauber E.J., Patalano A.L., Schumacher E.H.
Psychology of Learning and Motivation , 1996 pp 43-88
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"... Dissociation of Verbal Storage from Rehearsal A BEHAVIORAL EVIDENCE Consider the classic proposal about the architecture of verbal working memory, attributed to Baddeley, Thomson, and Buchanan (1975) originally, and elaborated by Baddeley (1986) , among others. The central claim is that verbal working memory is mediated by two subsystems. One is a storage buffer of limited capacity and short duration that is specialized for the storage of information in a phonological code (as opposed to a visuospatial code). The other is a mechanism that is responsible for recirculating the stored information to refresh it. The idea is that recirculation of this information causes its activation to increase, thereby offsetting the decay that afflicts information in the storage buffer. A common example used to motivate this proposal is looking up a number in a telephone book. One finds the number, stores it in the buffer, and then repeats it either aloud or silently until it is dialed. The repetition is identified with this recirculation process, a process sometimes called “rehearsal,” “maintenance rehearsal,” or “articulatory control.” Whatever name is applied to it, this process is typically assumed to be like a tape-recorder loop that runs repeatedly on the material stored in the buffer. The analogy to a tape loop raises a prediction about rehearsal that was tested by Baddeley et al. (1975) : They reasoned that if rehearsal is like a tape loop of limited length, then the number of items one should be able to rehearse should be limited by the length of the items . Baddeley et al. (1975) confirmed this prediction in an extensive series of experiments whose composite result was that lists of longer words were more poorly remembered than lists of shorter words (with the same number of words each), where length was measured in either number of syllables or time of articulation by speakers. Quantitative analysis of their results led Baddeley et al. (1975) to conclude that the duration of the tape loop that corresponds to rehearsal is between 1.5 and 2 s. 1 ..."
Reference 20
Review article
Genetic influence on the working memory circuitry: Behavior, structure, function and extensions to illness
Karlsgodt K.H., Bachman P., Winkler A.M., Bearden C.E., Glahn D.C.
Behavioural Brain Research , 2011 pp 610-622
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Reference 21
Book Chapter
Parietal lobe expansion, its consequences for working memory, and the evolution of modern thinking
Frederick L. Coolidge
Cognitive Archaeology, Body Cognition, and the Evolution of Visuospatial Perception , 2023 pp 181-194
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"... The precategorical aspect meant that sounds could be temporarily stored without regard to their meaning, that is, regardless of whether they might be meaningful (yet not recognized as such), nonsense syllables, or foreign language words. Crowder and Morton also hypothesized that PAS could only hold sounds for a few seconds, yet long enough to determine their meaning (e.g., familiar or novel). Thus conceptually, PAS presaged Baddeley's phonological loop (although he objects to the comparison [personal communication]). Baddeley also hypothesized that the phonological loop also contained vocal and subvocal articulatory processors that acted as rehearsal mechanisms. In it, sounds or words could be repeated in order to store them in long-term memory. Again, subvocal rehearsal mechanisms have been proposed as early as 1965 ; however, Baddeley's multicomponent working memory model was unique in viewing all of these cognitive functions as a functioning, comprehensive, and highly interactive entity. Baddeley's executive function's second subsystem, the visuospatial sketchpad , temporarily holds visual and spatial information, and it can recall and even simulate story-like memories (also known as episodic memory). In addition to the two subsystems, Baddeley proposed a memory component serving at the behest of the central executive. He labeled it the episodic buffer , a kind of short-term memory that integrated multimodal sensory information from the phonological loop and the visuospatial sketchpad. Again, Tulving's concept of episodic memory presaged Baddeley's episodic buffer. Tulving established a firm delineation between memorizing facts or details (i.e., declarative/semantic memory) and recalling scenes from one's past, as if viewing a movie clip (i.e., an episodic memory). Episodic memories are typically recalled visually and usually have an important emotional valence attached, either positive or negative, like the recall of joyous or traumatic events. 1 ..."
Reference 22
Reference works Chapter
The Medial Temporal Lobe and Episodic Memory
LaRocque K.F., Wagner A.D.
Brain Mapping , 2015 pp 537-541
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"... Network Contributions to Episodic Memory MTL contributions to episodic memory are situated within broader large-scale network interactions. Here, we briefly highlight the roles of sensory, frontal, and parietal cortices in episodic memory. Sensory regions support the representation of event content during encoding and retrieval: During encoding, the magnitude of activation in sensory regions that are sensitive to specific event content predicts later memory for this event content , and during retrieval, neural signatures of this event-specific content are recapitulated in these same cortical areas . Moreover, the finding that MTL damage impairs retrieval of recent memories while leaving retrieval of remote memories relatively spared suggests that the role of the MTL in episodic memory is time-limited , and it is believed that enduring episodic memories ultimately undergo a process of consolidation by which they are transferred from the MTL to high-level sensory regions that serve as the final storage site for remote memories (for review, see, e.g., Squire & Alvarez, 1995 ; but see Nadel & Moscovitch, 1997 , for an alternative perspective). The prefrontal cortex is believed to play a role in controlled aspects of episodic memory . Although less severe than the global episodic memory impairments following lesions to the MTL, lesions to the frontal lobes produce impairments in controlled aspects of episodic memory, such as recall, source monitoring, temporal order memory, and metamemory judgments . Moreover, fMRI studies have demonstrated that lateral prefrontal activity during encoding predicts later memory success; this activity is posited to reflect roles for prefrontal cortex in goal-directed selection, maintenance, elaboration, and organization of cortical representations of event content that are passed to the MTL. Neuroimaging studies have also demonstrated lateral prefrontal activity during memory retrieval; this activity is posited to reflect controlled retrieval of sought event attributes, postretrieval selection between multiple event attributes, memory monitoring, and decision demands. 1 ..."
Reference 23
Review article
Brain aging modulates the neuroprotective effects of estrogen on selective aspects of cognition in women: A critical review
Sherwin B.B., Henry J.F.
Frontiers in Neuroendocrinology , 2008 pp 88-113
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"... Normal human cognitive aging There is now a considerable amount of evidence to suggest that changes in cognition occur with normal aging. Although longitudinal studies have generally failed to identify age-related cognitive decline before the age of 60 years cross-sectional studies of cognitively healthy people have found linear declines in cognition across the lifespan, specifically in processing speed, working memory and episodic memory. In longitudinal studies, the age-related changes between ages 20 and 60 years are small or nonexistent, with speed of processing showing the largest decline while the slope of decline after the age of 60 years approximates that seen in cross-sectional studies . From a clinical perspective, the fact that nondementia memory decline can interfere with an older person’s daily functioning renders it a meaningful clinical issue . It has also become clear that age-related cognitive changes are selective rather than diffuse. Across cognitive domains, memory performance, in particular, undergoes decline with increasing age [207,241] . While there is little evidence that declines occur in tests of language, visuospatial ability and abstract reasoning, memory for the acquisition and early retrieval of new information and working memory become somewhat compromised with increasing age. Well-practiced tasks or tasks that involve knowledge show little or no decline in performance until very late in life while short-term memory ability declines slightly until the age of 70 years and more sharply thereafter . The accelerated declines in these cognitive functions during late life may be due to the increasing influence of disease processes in the elderly . Since the acquisition and retrieval of new information is mediated by the hippocampus, and because working memory is primarily a function of the prefrontal cortex, interest in cognitive aging has largely focused on these two brain regions. Neuroanatomical evidence and findings from imaging studies suggest that the integrity of some brain areas is more vulnerable than others to aging processes. Changes tend to occur most profoundly in the prefrontal cortex, in the hippocampus and in the parietal regions of the brain . These same anatomical locations subserve the specific cognitive functions that decline with normal aging, including verbal memory and working memory. 1 ..."
Reference 24
Review article
Sensitive periods in cortical specialization for language: insights from studies with Deaf and blind individuals
Cheng Q., Silvano E., Bedny M.
Current Opinion in Behavioral Sciences , 2020 pp 169-176
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"... Introduction Unlike learning calculus, political science or learning to cook, language acquisition proceeds more quickly and effectively in childhood. Lenneberg was one of the first proponents of the idea that language acquisition follows a critical period, akin to those found in sensory systems [ 1 ]. Critical or sensitive periods are windows during the lifespan where neural systems exhibit enhanced plasticity, resulting in enhanced learning capacities as well as enhanced vulnerability to negative environmental influence. Perhaps the best studied sensitive period is that of visual cortex in amblyopia. Monocular deprivation during, but not before or after, the sensitive period causes the ‘good eye’ to take over cells that would normally respond to input from the deprived eye [ 2 , 3 ]. In recent decades, there has been tremendous progress in uncovering the neurochemical mechanisms that mediate the opening and closing of sensitive periods in sensory systems. For example, maturation of inhibitory gamma-aminobutyric acid (GABA) circuits, itself partially experience-dependent, is a key step in sensitive period opening and molecular breaks, such as perineuronal nets mediate sensitive period closure [ 4 ]. At present it is not possible to measure cellular properties of language related cortical circuits in humans. Whether putative sensitive periods for language acquisition are mediated by similar neural mechanisms to those found in sensory systems is not known. Nevertheless, studies of behavior and cortical function in humans strongly suggest that the juvenile brain is optimally suited to language acquisition. Evidence for the sensitive period hypothesis in language comes from a variety of sources, including second language acquisition, language training with children and adults and acquisition of language by children with early brain damage [ 5–7 ]. The current review centers on recent evidence from studies with individuals who are born either deaf or blind, focusing specifically on higher-order aspects of language, including grammar and semantics [see Refs. 8 , 9 for reviews of sensitive periods in speech perception]. Studies of sensory loss provide unique insights into how experience shapes the neurocognitive development of a first language. 1 ..."
Reference 25
Review article
Asymmetrical Brain Plasticity: Physiology and Pathology
Esteves M., Ganz E., Sousa N., Leite-Almeida H.
Neuroscience , 2021 pp 3-14
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"... Aging Age-related decline of such functions as processing speed and encoding of episodic memories is well-recognized . It has been observed, however, that such decline is highly variable from subject to subject, a finding which has been attributed to individual variation in the (in)ability to recruit additional regions to compensate for loss of function. Cabeza and colleagues reported that older subjects who recruit the PFC bilaterally during the performance of a verbal memory task, manifest performance levels similar to younger subjects, in whom activation is lateralized . Those older subjects manifesting lateralized recruitment, on the other hand, show decreased performance. The findings suggest that age-related contralateral activation has an adaptive role, and gave rise to the Hemispheric Asymmetry Reduction in Older Adults (HAROLD) model . However, when a whole-brain analysis is performed, the observed bilateral activation seems to be relatively unspecific. Older subjects recruit additional regions in both hemispheres in order to achieve higher performance, to the formulation of an alternative explanation, known as the Compensation Related Utilization of Neural Circuits Hypothesis (CRUNCH) . Regardless of model specifics, it seems clear that the ability to plastically adapt, and to bring about the recruitment of additional regions, including those in the contralateral hemisphere, plays a significant role in the maintenance of functions that are normally found to be lateralized in younger subjects. Additional evidence relating to asymmetry in the elderly comes from manipulation studies. In one such experiment, disruption of the ipsilateral motor cortex using cathodal transcranial direct current stimulation (ctDCS) slowed learning of a complex unimanual motor task in aged, but not young subjects . When the aged cohort was further stratified, the disruption was more prominent in the eldest participants . In a naming test, repetitive magnetic transcranial stimulation (rTMS) was used to investigate the asymmetrical recruitment of the left dorso-lateral prefrontal cortex. Greater differences between left and right involvement of this structure was correlated with superior performance. 1 ..."
Reference 26
Book Chapter
Sex and gender differences in neuropsychological symptoms for clinical diagnosis of Alzheimer’s disease
Emnet Z. Gammada, Rhoda Au, Nancy S. Foldi
Sex and Gender Differences in Alzheimer's Disease , 2021 pp 163-185
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"... Sex/gender differences in cognitive reserve mechanisms Cognitive compensation may mask underlying cognitive decline through greater activation or broader recruitment of brain regions. The hemispheric asymmetry reduction in older adults (HAROLD) model differentiates reserve, maintenance, and compensation as neurological functions change in old age, which shift to mechanisms that maintain optimal aging. The prefrontal region and its interconnectivity may allow for alternate strategies to complete executive tasks. Cabeza and colleagues suggest that this model may result from a global reorganization of neurocognitive networks as well as from regional neural changes. Furthermore, bilateral activity in older adults may reflect compensatory processes as well as dedifferentiation processes. Berlingeri, Danelli, Bottini, Sberna, and Paulesu (2013) revisited this model and found that the HAROLD model captured only some of the age-related changes of brain pattern observed in aging. These researchers expand the HAROLD-like pattern to regions outside the prefrontal cortex, including temporal regions and parieto-occipital regions. Moreover, in a study examining participants with MCI, Lenzi et al. (2011) found that, in addition to the selective memory deficit, these patients also showed changes of brain activity within networks associated with language and attention, suggesting the presence of compensation mechanisms in patients at the earliest clinical stages of AD. These findings suggest that the compensation mechanisms may become progressively reduced with the evolution of the disease, until a critical “clinical threshold” is overcome. Whether these age-related compensatory processes differ by sex/gender is a new question. To address this, Berger, Demin, Holtkamp, and Bengner (2018) examined men and women with temporal lobe epilepsy and frontal lobe epilepsy to investigate women’s verbal memory advantage. These researchers surprisingly found verbal memory advantage in women with temporal lobe epilepsy, but not in women with frontal lobe epilepsy. 2 ..."
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"... When ( Kramer, Delis, and Daniel (1988) examined performance of healthy older men and women, women scored significantly higher than men across the five learning trials, and for both immediate and delayed free recall conditions. Importantly, women demonstrated higher instances of semantic clustering in their responses, suggesting they had self-initiated semantic categorization during learning and recall. In contrast, men were more likely to use passive organization, recalling items following the original serial presentation or serial clustering. Examination of cognitive trajectories from clinically healthy older adults replicated these sex/gender differences, wherein women outperformed men in immediate and delayed recalls of the CVLT. On a verbal paired-associates list learning task, sex/gender differences were examined in young adulthood and adolescence , and again, women out-performed men on a task that did not explicitly indicate or require elaboration. Yet, when researchers encouraged strategy use and elaboration to both men and women, sex/gender differences disappeared; this study suggests self-generated initiation of in-depth semantic processing may be a more intuitive strategy to promote better encoding and retrieval. Sex/gender differences in verbal memory in mild cognitive impairment It is important to determine whether these sex/gender differences persist in the early stages of disease development. In a seminal series of studies , Sundermann and colleagues examined sex differences in memory of verbal list-learning material in women and men diagnosed with mild cognitive impairment (MCI) using the Rey Auditory Verbal Learning Test (RAVLT) , which lacks explicit semantic categories. They found that women outperformed men on total word recall at learning and at delay recall, despite equal levels of brain pathology; yet, both groups presented with comparable hippocampal volume atrophy and with hypometabolism quantified by decreased temporal lobe glucose metabolic rates. A posited alternate access to semantic associations could aid in processing and retrieving verbal information; but, in turn, this could obscure the degree of actual underlying pathological load. Supportive performance was also seen in an even older sample , where women appear to use verbal skills to maintain performance. 2 ..."
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"... Sundermann, Maki, et al. (2016) proposed that women may have greater availability of a sex-specific cognitive reserve , which may underlie and support performance in verbal memory domains, or may. However, if women are circumventing the effects of actual disease pathology, it may be masking what otherwise would be a diagnosis of MCI. These important findings suggest that those women who subsequently transition from MCI to AD had superior cognitive reserve; however, it delayed their clinical diagnosis. The role of cognitive reserve and resilience is complicated as it is linked to years of education or rate of change and may be not fully explain conversion to disease (see also Chapter 12 ). Sundermann, Biegon, et al. (2016) and Sundermann, Maki, et al. (2016) have underscored that the magnitude of the female advantage in verbal memory may vary on severity of atrophy. That is, women’s advantage in verbal memory was evident despite minimal to moderate temporal hypometabolism and minimal to moderate hippocampal atrophy; however, this advantage was attenuated when hypometabolism or atrophy levels were more severe. The proposed argument is that women show better verbal memory performance than men, despite comparable levels of brain pathophysiology as measured by structural and functional neuroimaging, particularly in the early stages of disease. These findings suggest that MCI may only be clinically detected at a more advanced disease stage in women compared to men, because women are better able to compensate for greater underlying neuropathology during the early stages of the disease process. It is also possible that compensatory strategies are masked by insensitivity of standard neuropsychological tests to detect them. In either case, the consequence is that women receive a diagnosis of MCI later in the disease course, and when they transition to AD, they may have greater underlying pathology than men. These findings help to explain the paradoxical sex differences in MCI and AD prevalence . Sex/gender differences in verbal memory in AD When meeting criteria for an AD diagnoses, findings suggest that women perform worse than men on verbal recall memory tasks. 2 ..."
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"... Memory Introduction Memory pertains to the ability to learn, retain, recall, or recognize information in any primary modality of visual, auditory, tactile, or olfactory modalities. The focus of this discussion is primarily on AD disease-related deficits of episodic and semantic memory functions. Development of AD pathology in medial temporal lobe structures (e.g., hippocampus, entorhinal, and perirhinal cortex) disrupts neural networks underlying both episodic and semantic memory functions. The profile of memory decline, along with an inability to learn and retain new information (i.e., anterograde amnesia), has long been a clinical hallmark of AD pathology . Patients with AD are impaired on episodic memory tasks found in a variety of cognitive procedures (e.g., free recall, recognition, paired-associate learning) across multiple modalities (e.g., auditory, visual, or olfaction) . It is widely accepted that the episodic memory deficits in AD are due to ineffective consolidation and storage of new information . However, the literature has only begun to capture sex/gender-specific differences using verbal measures from standard list learning tasks [e.g., Rey Auditory Verbal Learning Test , California Verbal Learning Test , or the Consortium to Establish a Registry for Alzheimer's disease ]. Qualitative metrics of impaired processing of information detail why the consolidation is susceptible; sex/gender differences will be instructive in these processes as well. Verbal memory, in particular, has key qualitative, long-standing sex/gender differences, as described below. Sex/gender differences in verbal memory in healthy adults Particular verbal memory list-learning tasks have captured sex/gender differences. The California Verbal Learning Test requires the participant to learn a wordlist over several trials. The list is purposely constructed with embedded semantic categories, which could elicit an organization strategy. 2 ..."
Reference 27
Review article
A right hemisphere role in cognitive reserve
Robertson I.H.
Neurobiology of Aging , 2014 pp 1375-1385
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"... In another study , involving letter matching tasks which could be carried out within and/or between hemispheres, it was found that while the young showed a clear right hemifield/left hemisphere advantage, the old adults showed no such advantage, leading the authors to conclude that there had been greater age-related declines in right over the left hemisphere function. A number of imaging studies have also provided results suggesting that the right hemisphere theory of aging should not be rejected. The Dallas lifespan brain study found that, when young and old participants were compared, the old had significantly lower cerebral blood flow, particularly in the right prefrontal region, compared with young participants . Another study discovered that healthy 50–84 year old adults who were apolipoprotein E (APOE-4) positive showed a positron emission tomography-measured cerebral metabolic decline over a 2 year period while APOE-4 negative participants did not. This decline was particularly marked in the right hemisphere of the brain, and there was an associated drop in episodic memory performance. Notably, the size of the drop in performance over 2 years was significantly correlated with metabolic rates in the right inferior parietal lobule only in the APOE-4 positive group, but not in the APOE-4 negative group. A further study examined white matter (WM) volumes in a large group of old and young participants and found that age was associated with particularly large reductions in prefrontal WM volume in old participants. Strikingly, they found that it was the volume of WM in the right prefrontal cortex, which predicted neuropsychological test performance, including verbal memory, verbal fluency, and attentional tests. A 6 year follow up of a cohort of healthy old adults unusually studied longitudinal patterns in functional magnetic resonance imaging performance on incidental episodic encoding task. In contrast to common cross-sectional findings whereby older adults show increased putatively compensatory recruitment in frontal regions as would be in line with the HAROLD model, Nyberg et al., showed that the opposite was the case when the same participants were followed up over a 6- year period. 1 ..."
Reference 28
Review article
Why women see differently from the way men see? A review of sex differences in cognition and sports
Li R.
Journal of Sport and Health Science , 2014 pp 155-162
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"... Verbal memory Two kinds of general measures of verbal memory have been used in most studies to identify sex differences. One is the Controlled Oral Word Association Test (COWAT) to test verbal fluency and another is the Rey Auditory Verbal Learning Test (RAVLT), also known as the California Verbal Learning Test (CVLT), which has participants recall a list of words. 3.2.1 Sex differences in verbal memory Women outperform men in both measures. Interestingly, the female advantage in verbal memory is consistent throughout the lifespan, 59,60 suggesting circulating sex hormone independency. Women generally score higher than men on verbal memory tasks, possibly because women tend to use semantic clustering in recall. Studies showed that the sex differences in recall and semantic clustering in the verbal learning test diminished with a shorter word list in a relative small sample study. 61 A 10-year longitudinal study of over 600 nondemented adults, aged 35–80 years, found stable sex differences across five age groups—women outperformed men on verbal memory, verbal recognition, and semantic fluency tasks, while men demonstrated better visuospatial ability. 62 Some studies showed that healthy elderly women have better immediate word learning, 63 verbal memory, and episodic memory compared to age-matched men. 64 However, a recent meta-analysis of neurocognitive data from 15 studies ( n = 828 men; 1238 women) showed that men modestly but significantly outperformed women in all of the cognitive domains been examined, including verbal and visuospatial tasks and tests of episodic and semantic memory, while age and mini-mental state examination (MMSE) were not associated with the male-advance in memory. 65 Some also reported better visual memory, 66 working memory, 67 and episodic memory 67 in elderly men than women. Furthermore, others have also reported no sex differences in the elderly for verbal memory. 68 So, there exists no clear pattern of sex advantages for memory in the healthy elderly, and any sex differences appear to be task dependent. 2 ..."
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"... Sex differences in verbal memory Women outperform men in both measures. Interestingly, the female advantage in verbal memory is consistent throughout the lifespan, 59,60 suggesting circulating sex hormone independency. Women generally score higher than men on verbal memory tasks, possibly because women tend to use semantic clustering in recall. Studies showed that the sex differences in recall and semantic clustering in the verbal learning test diminished with a shorter word list in a relative small sample study. 61 A 10-year longitudinal study of over 600 nondemented adults, aged 35–80 years, found stable sex differences across five age groups—women outperformed men on verbal memory, verbal recognition, and semantic fluency tasks, while men demonstrated better visuospatial ability. 62 Some studies showed that healthy elderly women have better immediate word learning, 63 verbal memory, and episodic memory compared to age-matched men. 64 However, a recent meta-analysis of neurocognitive data from 15 studies ( n = 828 men; 1238 women) showed that men modestly but significantly outperformed women in all of the cognitive domains been examined, including verbal and visuospatial tasks and tests of episodic and semantic memory, while age and mini-mental state examination (MMSE) were not associated with the male-advance in memory. 65 Some also reported better visual memory, 66 working memory, 67 and episodic memory 67 in elderly men than women. Furthermore, others have also reported no sex differences in the elderly for verbal memory. 68 So, there exists no clear pattern of sex advantages for memory in the healthy elderly, and any sex differences appear to be task dependent. A cross-sectional analysis of the association between sex hormones, metabolic parameters, and psychiatric diagnoses with verbal memory in healthy aged men showed that higher levels of serum sex hormone binding globulin (SHBG) were associated with a worse verbal memory, 69 suggesting levels of free testosterone influence male verbal memory. However, findings of sex differences in verbal memory in young adults or early adolescents are contradictory. Studies showed no association between the sex-dependent verbal memory and age, level of sex hormone, or puberty development in teenage boys and girls. 2 ..."
Reference 29
Review article
Sex differences in cognitive impairment and Alzheimer's disease
Li R., Singh M.
Frontiers in Neuroendocrinology , 2014 pp 385-403
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"... Successful performance using an allocentric place strategy was observed in young participants, while older participants were able to recall the route when approaching intersections from the same direction as during encoding and failed to use the correct strategy when approaching intersections from new directions . Aging specifically impairs switching navigational strategy to an allocentric navigational strategy. 2.1.1.3 A traditional object location memory task A traditional object location memory task is designed by presenting different arrays of common objects between the training phases. The test requires participants to identify the difference between the 2 selections. In human studies, the medial temporal lobe and perirhinal cortex are impaired in various types of object location tasks, but only when the objects have a high number of overlapping features. Meanwhile, patients with medial temporal lesions that are confined to the hippocampus showed normal performance on object location tasks regardless of the level of feature ambiguity . Significant female advantages have been observed in several studies of object location memory . This is opposed to mental rotation and navigation tasks, suggesting that object location differs from other spatial tasks in terms of its cognitive demands. Similarly, females relying on an array of local objects for navigational cues has been reported in several well-studied phenomenon in the laboratory through animals using the radial arm maze, such as female rats showing impaired performance if local landmarks are removed . 2.1.1.4 Verbal memory Two kinds of general measures of verbal memory have been used in most studies to identify sex differences. One is the Controlled Oral Word Association Test (COWAT) to test verbal fluency and another is the Rey Auditory Verbal Learning Test (RAVLT), also known as the California Verbal Learning Test (CVLT) which has participants recall a list of words. Women outperform men in both measures. Interestingly, the female advantage in verbal memory is consistent throughout the life span , suggesting circulating sex hormone independency. Women generally score higher than men on verbal memory tasks, possibly because women tend to use semantic clustering in recall. 2 ..."
Reference 30
Review article
The middle-aged brain: biological sex and sex hormones shape memory circuitry
Jacobs E.G., Goldstein J.M.
Current Opinion in Behavioral Sciences , 2018 pp 84-91
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"... Sex differences and sex hormones shape memory function in midlife adults Epidemiological surveys indicate that many women report increased forgetfulness and ‘brain fog’ during the menopausal transition [ 20 ]. Sex differences in memory performance, particularly verbal material, emerge post-puberty and are retained into adulthood. Although women's performance attenuates with menopause, a small female advantage is maintained in the healthy aging brain through midlife and old age. Despite these findings, less is known about memory changes in women during the menopausal transition compared with age-matched men, or sex differences in specific memory domains early in the aging process. Rentz et al . [ 21 ] identified changes in memory function that occur in early midlife ( N = 212, ages 45–55) as a function of sex, reproductive stage, and sex steroid hormone concentrations. To identify memory domains related to the perceived memory complaints in midlife women, the authors selected tests that are sensitive to executive and temporo-limbic dysfunction in clinically normal adults, including the 12-item Face-Name Associative Memory Exam and the 6-trial Selective Reminding Test (SRT). Women outperformed age-matched men across all memory measures. This held true until postmenopause, when the female advantage was attenuated. Among women, higher estradiol levels were associated with better memory performance. In earlier work, the prospective Penn Ovarian Aging Study reported that reproductive senescence was associated with a decline in verbal fluency for midlife women [ 22 ]. In a systematic review of observational studies on cognitive performance in midlife women, Weber et al . [ 23 ] found that premenopausal and perimenopausal women outperformed postmenopausal women on measures of delayed verbal memory. In a large population study of sex differences in cognitive aging (Baltimore Longitudinal Study of Aging; N = 1065–2127; mean baseline age, ∼65), older women continued to outperform men on verbal learning and memory, and showed a slower rate of cognitive decline in visual memory [ 24 ]. 2 ..."
Reference 31
Book Chapter
Nonauditory Effects of Noise
Jos J. Eggermont
Noise and the Brain , 2014 pp 266-300
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"... This study suggested that sleep attenuates negative feedback inhibition within the HPA system, whereas wakefulness (or stage I sleep) reflects increased feedback sensitivity of this system. 10.3.4 Sleep Deprivation The majority of the sleep literature has focused on hormonal effects of total sleep deprivation. Thyroid activity is increased by sleep deprivation. 59 However, patterns of secretion may change even if the total amount of hormone secretion remains relatively unaltered. In summary, chronic sleep loss, including that related to chronic noise exposure, could lead to development of various problems, both centrally and peripherally, associated with glucocorticoid excess including memory deficits and insulin resistance. Glucocorticoids such as corticosterone and cortisol inhibit slow wave sleep, although large individual differences of the HPA axis in response to stress exist. Noise activates the HPA axis, which in turn may have an effect on sleep disturbances and long-term memory deficits, and adaptive responses to stress may be inefficient for some individuals and therefore facilitate the vulnerability to noise effects. 10.3.4.1 Behavioral Sleep deprivation affects human performance and neural functioning that are manifest at different levels of description. On a macroscopic level, sleep deprivation mainly affects executive functions, especially in novel tasks and reduced attention. On a microscopic level, sleep deprivation is associated with increased levels of adenosine, a neuromodulator that has a general inhibitory effect on neural activity. The inhibition of cholinergic nuclei appears particularly relevant, as the associated decrease in cortical acetylcholine seems to cause effects of sleep deprivation on macroscopic brain activity. 60 Apart from affecting performance, sleep loss invariably leads to a strong subjective feeling of sleepiness, negative mood, and stress. 61 The impact of sleep deprivation is prominent in tasks that strongly depend on attention. These behavioral effects point to the involvement of brain structures that have been associated with attention and arousal. 2 ..."
Reference 32
Review article
Meta-analysis and the science of schizophrenia: Variant evidence or evidence of variants?
Heinrichs R.W.
Neuroscience & Biobehavioral Reviews , 2004 pp 379-394
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"... There are also grounds for positing a verbal dysmnestic subtype of schizophrenia. The dysmnestic variant is distinguished by impaired acquisition of information, especially as demonstrated in cumulative learning of words over a sequence of trials. Investigators have reported that many schizophrenia patients show verbal memory impairments, but not the kind of abnormally rapid forgetting and defective recall of recent events seen in neurological patients with medial–temporal and diencephalic lesions [5,102,103] . Instead, it seems to be the acquisition stage of learning and memory that is most vulnerable to schizophrenic illness. Verbal memory indictors load on their own factor in principal components analysis and appear to describe an impairment distinct from attention–vigilance defects. Moreover, there is evidence that verbal learning deficits are not artifacts of treatment and clinical state and occur in first-episode patients . These deficits predict the development of schizophrenia-related psychosis in the offspring of patients [105,106] and can be found in their relatives [82,107] . 2 ..."
Reference 33
Review article
Epilepsy, psychosocial and cognitive functioning
McCagh J., Fisk J.E., Baker G.A.
Epilepsy Research , 2009 pp 1-14
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"... Temporal lobe epilepsy (TLE) MTLE is the most common focal epilepsy syndrome, and is characterised by focal seizures that cause epileptogenic mesial (medial) temporal lesions (usually hippocampal sclerosis) which are often resistant to AED therapy . MTLE is also typically characterised by an early age of onset and a history of febrile seizures . The range of cognitive functions that can be compromised in people with repeated MTLE seizures include intelligence, learning, visuo-spatial functions, problem solving, memory function and academic attainment . If the dominant hemisphere is affected then language deficits can also be apparent . People with TLE report word finding difficulties. For example, Mayeux et al. (1980) found that people with LTLE were impaired in comparison to a RTLE and a generalised epilepsy group. This lateralisation effect has been replicated in a number of studies . Early age of onset has also been associated with deficits in word finding in TLE . Due to the damage and loss of neurons that recurrent seizures cause to the hippocampal system, it is not surprising that memory dysfunction is one of the most documented deficits in MTLE . Deficits are apparent in the immediate recall of short stories in logical memory tasks and in delayed recall in both verbal and non-verbal memory tasks . In PWE who complained of memory problems the top five reported daily problems were, finding a word that was on the ‘tip of the tongue’, losing things, going back to check that one has done something, forgetting that one was told something or forgetting peoples names . Researchers have also identified differences in the type of memory impairment associated with right and left seizure foci. Verbal memory impairments are most often observed in people with MTLE who have a predominant left seizure focus while non-verbal or visuospatial impairments are typically found in those with a predominant right seizure focus . Research has also suggested that left hippocampal damage in MTLE may have more detrimental effects on memory function than right hippocampal damage . 2 ..."
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"... Verbal memory impairments are most often observed in people with MTLE who have a predominant left seizure focus while non-verbal or visuospatial impairments are typically found in those with a predominant right seizure focus . Research has also suggested that left hippocampal damage in MTLE may have more detrimental effects on memory function than right hippocampal damage . This may be because people with left hippocampal lesions also exhibit more extra-hippocampal damage rendering them more susceptible to cognitive dysfunction . Jokeit et al. (2001) suggest that seizures in the MTL may disrupt the consolidation of memory and this is why they have such an impact on memory function. Consistent with this proposition Blake et al. (2000) found that people with LTLE had accelerated long term forgetting of verbal material. This impairment may be indicative of the effect that seizures have on the consolidation of new information in the long term . Cognitive deficits have been found to be more severe in LTLE than RTLE. Moore and Baker (2002) found that people with LTLE were impaired in verbal intelligence, general intelligence, attention span and expressive language in comparison to those with RTLE. Specific demographic variables relevant to epilepsy have also been shown to effect memory. Kent et al. (2006) discovered that the longer the duration of MTLE and the younger the person was when they were diagnosed, the greater the impact on verbal memory. Their findings imply that early seizure control could help to reduce the long term impact that recurrent seizures have on memory function in TLE. Helmstaedter et al. (2003) did a longitudinal study investigating the long term impact of TLE on memory function in patients who were being treated with AED's or surgery. They concluded from their findings that memory deficits can cease or improve if seizures are adequately controlled. The impact that age of seizure onset and duration of MTLE have on memory function have been documented in a number of studies . Higher seizure frequency has also been another influential demographic factor in relation to memory deterioration . 2 ..."
Reference 34
Handbook Chapter
Epilepsy
Çiğdem Özkara, Eleonora Aronica
Handbook of Clinical Neurology , 2012 pp 621-639
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"... Neuropsychological findings MTLE-HS is characterized by impaired declarative memory . Episodic memory disturbance is a typical finding (long-term memory consolidation or recall of newly learned information). Involvement of semantic memory is uncommon. Patients who have earlier onset of seizures seemed to have lower IQs, which implies the influence of seizures or drugs on the cognitive development of the brain . With later seizure development, left TLE is associated with material specific impairment of verbal memory and learning; in particular, impaired delayed recall is more indicative of mesial temporal structures . Long-term memory may be influenced more than figural memory. Although verbal memory impairment may indicate the left hemisphere if the left side is dominant, the relationship between nonverbal memory disorder and the right hemisphere is less consistent. The main reason for this is that figural memory disorder can be compensated by verbalization techniques, atypical language dominance, and even gender differences . Memory impairment may be clinically progressive and correlates significantly with cell loss in the dominant CA3 and dentate granule cell density , which is thought to be related to the presence of a very early IPI which carries on interhemispheric reorganization . Also depression, side-effects of AEDs, and frequent seizures may affect the memory as they may give rise to attention deficit. 2 ..."
Reference 35
Handbook Chapter
Surgery procedures in temporal lobe epilepsies
Mathon B., Clemenceau S.
Handbook of Clinical Neurology , 2022 pp 531-556
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"... Cognitive outcome Postoperatively, global memory deficits occur rarely (1%), however, verbal memory may worsen after dominant hemisphere resection [25–51% of patients ]. Nonverbal memory decreased postoperatively in fewer patients . Poor outcomes for seizure control after MTLE-HS surgery were not associated with poor cognitive or psychiatric outcomes, suggesting that different networks are involved . Some studies have suggested that the SAH approach induces less cognitive deficit than ATL, especially in verbal memory and intellectual quotient . This deficit in verbal memory, especially in naming, can be attributed to the resection of lateral temporal neocortex . Others did not find SAH superior to ATL for the cognitive outcome . Memory deficits seem to differ little between transcortical and transsylvian approaches . Postoperative seizure freedom may be however associated with an improvement in language function . Hermann and Wyler (1988) even found that the patients operated on the temporal lobe in the dominant hemisphere showed significant improvement in receptive language comprehension and associative verbal fluency. Predictors of verbal memory impairment include a later age at seizure onset or at surgery, left hemisphere hippocampal sclerosis, and functional status of the mesial temporal lobe . Intuitively, resection of a structurally intact functional hippocampus should result in a greater deficit . Patients with good memory function and higher intellectual quotient before surgery report lesser postoperative memory decline . Predictors of nonverbal memory worsening are a later age of seizure onset, an advanced age at surgery, the functional status of the resected mesial temporal lobe and postoperative complications . To summarize, patients with good preoperative memory function in the context of unilateral MTLE should therefore be counseled regarding the likelihood of a significant postoperative decline in memory function following a mesial temporal lobe surgery. Psychiatric outcome MTLE syndromes are linked to psychiatric disorders . Depression may concern up to half of the patients after surgery ; while a quarter experienced long-term new and persistent psychiatric complications or an exacerbation of an existing condition . 2 ..."
Reference 36
Handbook Chapter
Neuropsychology of temporal lobe epilepsies
Samson S., Denos M.
Handbook of Clinical Neurology , 2022 pp 519-529
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"... This idea challenges the notion that verbal memory and nonverbal memory are homogeneous constructs . This has been initially based on the clinical observation that left hippocampal neuronal loss in mesial TLE predicts the ability to learn unrelated word pairs but not to recall a story . This dissociation can be explained by the particularity of the task involved. Whereas memory for unrelated word pairs is based on arbitrary associations requiring the function of the hippocampus, the memory for story events relying on semantically structured verbal material would rather depend on the lateral temporal lobe function. According to Saling (2009) , these two types of learning based on either arbitrary or semantic relationships can be related to mesial and to lateral temporal lobe regions, respectively. Delayed memory tasks are also sensitive to mesial TLE. Typically assessed 30 min after the learning phase, such difficulties suggest deficits in memory consolidation. However, in some patients with unilateral TLE, the recall of information after 30 min remains normal and starts decreasing over the following days and weeks indicating an accelerated long-term forgetting . These delayed memory deficits or accelerated long-term forgetting are due to disturbed consolidation processes, which seem to be more frequently observed after mesial than lateral temporal lobe damage . In addition to memory disorders, patients with mesial TLE can also present impaired emotional recognition. Problems with judging or recognizing fearful faces, voices, sounds, or objects, as well as anger, sadness, and disgust stimuli are frequently observed in these patients . Such difficulties have been attributed to damage involving the amygdala, with generally no clear evidence of lesion lateralization on these emotional skills. More generally, TLE with hippocampal sclerosis can interfere with other cognitive functions such as intellect , language and executive functions , abilities that are not specifically associated with the temporal lobe. Even if seizures in focal TLE originate from a discrete brain region termed the epileptogenic focus, the detrimental effects of seizures extend far beyond the temporal lobe . 2 ..."
Reference 37
Reference works Chapter
Dementia and language
Kemper S., Altmann L.J.P.
Reference Module in Neuroscience and Biobehavioral Psychology , 2017
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"... Thus, conversational speech is often relatively coherent until the moderate and late stages of the disease. Understanding conversational speech requires listeners to combine the meanings of many words, often across sentence boundaries; keep these in memory; and integrate the new information with past knowledge. Thus, it is an extremely demanding task. Individuals with Alzheimer dementia often miss a good deal of the information in a conversation; however, they may understand the gist of a conversation by relying on contextual cues. As the disease progresses, the appropriateness of language declines as behavior becomes increasingly disinhibited. Even mild-mannered individuals with Alzheimer dementia may become verbally abusive. Typically, speech output also declines as the need to communicate dwindles. Gradually, conversational speech disappears, eventually ending in mutism. Vascular dementia is a type of dementia that arises from reduced blood flow in the brain, often due to arteriosclerotic plaques. Vascular dementia frequently co-occurs with and can be difficult to differentiate from Alzheimer dementia without reliance on neuroimaging. Both syndromes display impairments in word finding, picture naming, and letter and category fluency. However, individuals with vascular dementia tend to be particularly poor at letter fluency relative to category fluency, and the reverse is true for individuals with Alzheimer dementia. Individuals with vascular dementia also outperform those with Alzheimer dementia on verbal memory tasks, such as free verbal recall, delayed verbal recall, and recognition memory of verbal material. Individuals with both vascular dementia and Alzheimer dementia show a range of attention, executive function, and working memory impairments, although these may be more pronounced in people with vascular dementia. Thus, the cognitive and linguistic characteristics of vascular dementia and Alzheimer dementia are very similar, and to date, there are no “cut-off” scores available to distinguish between these groups. 2 ..."
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"... Individuals with Alzheimer dementia often miss a good deal of the information in a conversation; however, they may understand the gist of a conversation by relying on contextual cues. As the disease progresses, the appropriateness of language declines as behavior becomes increasingly disinhibited. Even mild-mannered individuals with Alzheimer dementia may become verbally abusive. Typically, speech output also declines as the need to communicate dwindles. Gradually, conversational speech disappears, eventually ending in mutism. Vascular dementia is a type of dementia that arises from reduced blood flow in the brain, often due to arteriosclerotic plaques. Vascular dementia frequently co-occurs with and can be difficult to differentiate from Alzheimer dementia without reliance on neuroimaging. Both syndromes display impairments in word finding, picture naming, and letter and category fluency. However, individuals with vascular dementia tend to be particularly poor at letter fluency relative to category fluency, and the reverse is true for individuals with Alzheimer dementia. Individuals with vascular dementia also outperform those with Alzheimer dementia on verbal memory tasks, such as free verbal recall, delayed verbal recall, and recognition memory of verbal material. Individuals with both vascular dementia and Alzheimer dementia show a range of attention, executive function, and working memory impairments, although these may be more pronounced in people with vascular dementia. Thus, the cognitive and linguistic characteristics of vascular dementia and Alzheimer dementia are very similar, and to date, there are no “cut-off” scores available to distinguish between these groups. Frontotemporal Dementias Frontotemporal dementia (FTD) has multiple variants that differ in their behavioral manifestation depending on the locus of damage. These include behavioral-variant FTD, primary progressive aphasia, and movement disorders including progressive supranuclear palsy. In contrast to Alzheimer disease, damage in FTD is relatively focal; consequently, episodic memory, spatial cognition, and orientation are usually preserved until late in the disease. Behavioral-variant FTD manifests primarily as social and behavioral impairments. 2 ..."
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"... Instead, the conversational speech of individuals with Alzheimer dementia is characterized by the overuse of general nouns (eg, “thing,” “stuff”) and verbs (eg, “get,” “do”) and by an over-reliance on pronouns. These phenomena decrease the amount of information conveyed and can make following their conversations difficult. Even so, in Alzheimer dementia, the fundamental building blocks of sentences are relatively intact; sentences contain noun and verb phrases and may also include complex grammatical constructions. Thus, conversational speech is often relatively coherent until the moderate and late stages of the disease. Understanding conversational speech requires listeners to combine the meanings of many words, often across sentence boundaries; keep these in memory; and integrate the new information with past knowledge. Thus, it is an extremely demanding task. Individuals with Alzheimer dementia often miss a good deal of the information in a conversation; however, they may understand the gist of a conversation by relying on contextual cues. As the disease progresses, the appropriateness of language declines as behavior becomes increasingly disinhibited. Even mild-mannered individuals with Alzheimer dementia may become verbally abusive. Typically, speech output also declines as the need to communicate dwindles. Gradually, conversational speech disappears, eventually ending in mutism. Vascular dementia is a type of dementia that arises from reduced blood flow in the brain, often due to arteriosclerotic plaques. Vascular dementia frequently co-occurs with and can be difficult to differentiate from Alzheimer dementia without reliance on neuroimaging. Both syndromes display impairments in word finding, picture naming, and letter and category fluency. However, individuals with vascular dementia tend to be particularly poor at letter fluency relative to category fluency, and the reverse is true for individuals with Alzheimer dementia. Individuals with vascular dementia also outperform those with Alzheimer dementia on verbal memory tasks, such as free verbal recall, delayed verbal recall, and recognition memory of verbal material. 2 ..."
Reference 38
Review article
Verbal memory measurement towards digital perspectives in first-episode psychosis: A review
Kilciksiz C.M., Keefe R., Benoit J., Ongur D., Torous J.
Schizophrenia Research: Cognition , 2020 pp 100177
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"... In order to measure verbal memory, a broad range of tasks are available including story recall, learning of word lists or sequences of paired words . Instruments used to measure verbal memory in psychiatric studies include Weschler Memory Scale (WMS), Rey-Auditory Verbal Learning Test (RAVLT), California Verbal Learning Test (CVLT), Hopkins Verbal Learning Test (HVLT), Buschke Selective Reminding Test (BSRT), Brief Assessment of Cognition in Schizophrenia (BACS), Cambridge Cognition Paired Associates Learning Test, and many others. While the literature shows the importance of verbal memory for early detection and intervention in first-episode psychosis, it is still not clear which tasks or tests are most widely used to measure verbal memory, what differential features they possess, and which may be most amenable to being translated to a digital format. There is a lack of information about the methods (computer, digital, pen-paper) used to administer these tests and frequency of follow-up measurements. In this systematic literature review, we aimed to find which verbal memory assessment tests are most widely used in first-episode psychosis (FEP) and could be applied via digital technologies (smartphone applications, chatbots etc.) with the goal of capturing dense and longitudinal data during this period of clinical and neurobiological transitions surrounding the first episode. 2 ..."
Reference 39
Reference works Chapter
Declarative Memory
Brianne Bettcher
Encyclopedia of the Neurological Sciences , 2025 pp 404-409
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"... Assessment of Episodic Memory Verbal episodic memory can be assessed in a variety of ways at the bedside. The most common approach to assessment involves the administration of either a list-learning task or paragraph recall. List-learning tasks entail auditory presentation of a list of words over a series of several trials (verbal learning); patients are typically required to recall as many words as they can remember after each trial, and they are subsequently tested again after short and long delay periods (verbal recall). In some verbal memory paradigms, participants are provided categorical cues to see if leveraging semantic information/grouping facilitates retrieval (referred to as “cued recall”). Finally, patients are often administered a forced-choice recognition trial (verbal recognition), which can be helpful in differentiating problems with memory consolidation vs problems due to memory retrieval. With the latter, patients may perform poorly on delayed recall trials, but they typically improve with recognition memory formats. Another type of verbal episodic memory test is story or paragraph recall. This entails the administration of a brief story, and patients are required to recall as many details of the story as they can, both immediately after presentation of the story and after a delay period. Visual episodic memory is typically assessed using nonverbal analogs of the aforementioned measures, and often includes visual learning, recall, and recognition of geometric designs or faces. 2 ..."
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"... Importantly, memories typically contain both episodic and semantic information, allowing for a more vivid representation of the memory. Assessment of Episodic Memory Verbal episodic memory can be assessed in a variety of ways at the bedside. The most common approach to assessment involves the administration of either a list-learning task or paragraph recall. List-learning tasks entail auditory presentation of a list of words over a series of several trials (verbal learning); patients are typically required to recall as many words as they can remember after each trial, and they are subsequently tested again after short and long delay periods (verbal recall). In some verbal memory paradigms, participants are provided categorical cues to see if leveraging semantic information/grouping facilitates retrieval (referred to as “cued recall”). Finally, patients are often administered a forced-choice recognition trial (verbal recognition), which can be helpful in differentiating problems with memory consolidation vs problems due to memory retrieval. With the latter, patients may perform poorly on delayed recall trials, but they typically improve with recognition memory formats. Another type of verbal episodic memory test is story or paragraph recall. This entails the administration of a brief story, and patients are required to recall as many details of the story as they can, both immediately after presentation of the story and after a delay period. Visual episodic memory is typically assessed using nonverbal analogs of the aforementioned measures, and often includes visual learning, recall, and recognition of geometric designs or faces. Neural Substrates of Episodic Memory Medial Temporal Lobes Episodic memory is a complex set of cognitive operations that can be influenced by attention/concentration and executive functions, in addition to memory consolidation processes. As such, episodic memory is mediated by multiple neurological pathways and systems. Extensive research with primate and neurological patients, however, has demonstrated that the key regions underlying one's ability to learn and consolidate information about events that occurred in the recent past are in the medial temporal lobes. The primary structure linked to episodic memory learning is the hippocampus, a small structure shaped like a seahorse tucked deep in the medial portion of each temporal lobe . 2 ..."
Reference 40
Reference works Chapter
Assessment
C. Munro Cullum
Comprehensive Clinical Psychology , 2016 pp 303-347
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"... Separate scores comparing working memory and immediate memory, auditory (previously referred to as “verbal”) and visual (previously “nonverbal”) memory, immediate and delayed recall, single-trial vs. multi-trial learning, and percent retention composites in each domain are now provided. Recognition memory procedures were also added to several of the WMS-III subtests. The subtests of the WMS-III include: Information and Orientation, Logical Memory, Verbal Paired Associates, Word Lists, Faces, Family Pictures, Visual Reproduction, Letter-Number Sequencing, Spatial Span, Digit Span, and Mental Control. Whereas this is a lengthy list of measures, five of the subtests (Information and Orientation, Word Lists, Visual Reproduction, Mental Control, and Digit Span) are supplemental or optional and do not contribute to the primary index scores. From various combinations of the core subtests, the primary index scores can be derived: Auditory Immediate, Visual Immediate, Immediate (combined), Auditory Delayed, Visual Delayed, Auditory Recognition Delayed, General Memory, and Working Memory. The WMS-III is obviously comprehensive in its scope, now including aspects of a variety of memory assessment stimuli and procedures. It is lengthy and overlaps with some other standard memory tests in common use, but contains some interesting new procedures based on research and clinical experience in neuropsychology. Because of its recent release, studies regarding its ultimate clinical utility in various settings and populations will be needed, in addition to the development of procedures for deriving short forms and estimating memory index scores. Perhaps even more so than with the WMS-R, it is anticipated that when administration of the entire test is not feasible, many clinicians will routinely utilize selected subtests of the WMS-III to fit their particular memory assessment needs. 4.11.4.8.4 Verbal memory tests (i) California Verbal Learning Test (CVLT) This is a 16-item word list-learning task that contains items from four semantic categories . 2 ..."
Reference 41
Review article
Toward Constructing an Endophenotype Strategy for Bipolar Disorders
Hasler G., Drevets W.C., Gould T.D., Gottesman I.I., Manji H.K.
Biological Psychiatry , 2006 pp 93-105
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"... Deficits in Verbal Learning and Memory Comparative studies on neuropsychological dysfunctions in severe psychiatric disorders showed that impairments were qualitatively similar in schizophrenia and BPD, with impairments being more severe in schizophrenia than in BPD; however, particularly poor performance on tests of verbal memory was consistently found as a characteristic of BPD . Brain lesion studies and functional imaging studies identified a brain-wide distributed network in the medial temporal lobe, the temporal cortex, and the frontal cortex as a neural correlate of declarative memory function . It has long been hypothesized that memory engrams of declarative knowledge in the cortex develop with structural reorganization of neural circuits. Neurobiological mechanisms that are potentially involved in the synaptic plasticity required for learning and memory include glutamatergic neurotransmission and changes in gene expression brought about by neurotrophic factors, such as cyclic adenosine monophosphate response element binding protein (CREB) and brain-derived neurotrophic factor (BDNF) . In healthy subjects, verbal learning and memory were found to have a particularly high heritability: a twin study on memory functions showed that the intraclass correlations between monozygotic and dizygotic twins were significantly different for verbal learning and memory, whereas they were not different for response discrimination, learning strategy, and recognition . Poor performance on measures of verbal learning and memory was found in euthymic bipolar patients irrespective of a history of alcohol abuse , thus providing evidence for the state independence of this dysfunction. Unaffected twins of bipolar patients performed significantly worse than normal control subjects on short-term and long-term verbal learning and memory tasks , and deficits in verbal long-delay free recall and verbal recognition were found in healthy siblings of BPD patients . Tryptophan depletion enhanced verbal memory deficits in unaffected relatives of BPD patients . Some studies, however, failed to show such impairment in relatives of subjects with BPD , suggesting mixed evidence for the association between verbal memory deficit and genetic risk of BPD. 2 ..."
Reference 42
Review article
The neuropsychological spectrum of anti-LGI1 antibody mediated autoimmune encephalitis
Griffith S.P., Malpas C.B., Alpitsis R., O'Brien T.J., Monif M.
Journal of Neuroimmunology , 2020 pp 577271
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"... Verbal memory Cognitive screening tests are commonly used to assess verbal memory in the acute stages. Several studies have reported low memory scores on screening tests such as the memory impairment screen , the Mini-Mental Status Examination (MMSE) and the Montreal Cognitive Assessment (MOCA) . Rather than containing objective psychometric findings, however, several research reports list only clinical impressions regarding memory impairment, which have included “dysfunction of temporal lobar functions” and “impaired memory” . The only two cases that have undertaken neuropsychological memory testing in this stage have not converged on a consistent picture . This inconsistency is also evident in the chronic phase of the disease. For example, Miller et al. (2017) did not find evidence for learning or immediate recall deficits in their cohort, although the relatively small sample size ( n = 17) might have rendered these analyses underpowered. Finke, 2017 , in contrast, reported episodic verbal memory deficits, which included significant impairments in verbal learning over repeated trials and post-interference recall. Both studies, however, did reveal impaired delayed recall in this population , which this is consistent with patient complaints of ongoing day to day memory difficulties . It is important to note, however, that spontaneous retrieval difficulties observed on delayed free recall tasks can occur secondarily to other cognitive and or psychological issues (e.g. executive functioning or anxiety). Tasks assessing recognition memory can assist in determining whether the retrieval difficulty on free recall is a secondary issue, or if it is reflective of primary memory difficulty. Again, the two previous studies in this area provide conflicting information. While Miller et al. (2017) found no evidence for impairments in verbal recognition memory, Finke, 2017 did find evidence for such impairments. Considered together, these findings raise the question of whether verbal memory impairment is indeed a typical feature of this condition, or whether such impairments are only observed in a subset of patients. 2 ..."

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