Federation of the European Societies of Neuropsychology)/GNP (Gesellschaft Fur¨ Neuropsychologie) September 12–14, 2013 Berlin, Germany

Abstracts from the

Joint Meeting of the FESN (Federation of the European Societies of Neuropsychology)/GNP (Gesellschaft fur¨ Neuropsychologie) September 12–14, 2013 Berlin, Germany

4th Meeting of the FESN 28th Meeting of the GNP

Conference president Michael Niedeggen Behavioural Neurology 27 (2013) 297–461 297 DOI 10.3233/BEN-139900 IOS Press

Symposia

Keynote 1: Functional neuro-anatomy of spatial ne- Keynote 2: Modulating the neural mechanisms of glect visuo-spatial attention

Patrik Vuilleumier1,2,3 Gereon Fink 1Laboratory for Neurology and Imaging of Cognition, Department of Neurology, University Hospital Colo- Department of Neurology and Department of Neuro- gne, Cologne, Germany science, University Medical School and Hospital of Geneva Keynote 3: Cognitive rehabilitation for people with 2Center for Neuroscience, University of Geneva early-stage dementia 3Swiss Center for Affective Sciences, University of Geneva Linda Clare School of Psychology, Bangor University, UK Spatial neglect is generally defined by various deficits in processing information from one (e.g. left) side People in the early stages of Alzheimer’s disease (AD) of space contralateral to focal (e.g. right) hemisphere face the challenge of adjusting to living with progres- damage. The talk will review evidence that the clini- sive cognitive impairment. Methods and techniques cal syndrome of neglectis likely to reflect a combina- from neuropsychological rehabilitation can be applied tion of disorders that may co-occur due to concomitant to assist in managing the impact of memory difficul- damage affecting juxtaposed brain areas and their con- ties. This talk describes the initial application of neu- nections, and that such lesions may induce functional ropsychological rehabilitation methods for people with disturbances in structurally intact areas through losses AD and the development of an individually-tailored, of top-down control from fronto-parietal cortical areas. client-centred cognitive rehabilitation (CR) approach. Improved knowledge in these functional anomalies at CR involves identifying meaningful goals relating to the network levelalso points to new approaches for areas of everyday activity where the person with AD rehabilitation strategies. In particular, I will illustrate experiences difficulty due to changes in memory and how theattentional deficits associated with neglect can other cognitive abilities, and wishes to see improve- at least partly be alleviated by manipulations influenc- ments. The person with AD and carer work with a ther- ing perceptual processing throughpathways outside the apist over a number of sessions to address these goals, damagedfronto-parietal network, including emotional for example by improving the use of memory aids conditioning or reward learning, or by using methods and strategies, relearning skills, resuming previously- that may help restore top-downattention signalssuch- enjoyed activities or developing new activities. The prism adaptation or neurofeedback. sessions take place in participants’ homes and involvement of a carer helps to ensure that the benefits are Correspondence address: Professor PatrikVuilleumier, carried over into daily life. Evidence from the first Labnic/Neufo, CMU, Michel Servet 1, University of randomised controlled trial of CR will be presented. Geneva, 1205 Geneva, Switzerland. E-mail: patrik. Participants with early-stage AD were able to identify [email protected] personally-relevant goals and to rate their performance in these areas. Goals reflected a range of domains, with memory-related goals featuring most prominently. Par- ticipants who received the CR intervention significantly improved their self-reported goal performance

ISSN 0953-4180/13/$27.50 c 2013 – IOS Press and the authors. All rights reserved This article is published online with Open Access and distributed under the terms of the Creative Commons Attribution Non-Commercial License. 298 Symposia and satisfaction with performance following treatment, long-term longitudinal studies have shown that mild compared to participants in control conditions. CR also cognitive disorders can be observed even before the had beneficial effects on cognition, mood and quality MCI stage, it could be useful to characterize the nature of life for participants with AD, and led to reduced of these pre-clinical subtle cognitive disorders, to iden- stress and better quality of life for carers. These find- tify the targets of possible disease-modifying pharma- ings indicate that individual, goal-oriented neuropsy- cological trials. chological rehabilitation is feasible in early-stage AD and provide preliminary support for the clinical efficacy of CR. A larger-scale, definitive trial is now in Symposium 1: Advances in the neuropsychological progress. assessment of cognitive impairment in the elderly

Keynote 4: Neuropsychological predictors of con- Andreas Monsch, Michael Ehrensperger, Kirsten Tay- lor, Panagiota Mistridis and Irene Beck version from Mild Cognitive Impairment to Memory Clinic, Dept. of Geriatrics, Basel, Switzerland Alzheimer’s Disease Neuropsychological assessments play a critical role in Guido Gainotti early detection and diagnosis of cognitive impairments Center for Neuropsychological Research of the in the elderly. The first talk will present a new screen- Catholic University of Rome, Italy ing tool for cognitive impairment (ie, BrainCheck) as an iPhone/iPad app to be used by health care pro- The MCI construct has been proposed by Petersen et fessionals. Alzheimer’s disease neurofibrillary pathol- al. (1999) to identify patients at risk of developing ogy begins in perirhinal cortex before entering the a dementia of the Alzheimer’s type (DAT). A simple entorhinal cortex and hippocampus. Thus, functional set of criteria has been proposed for the identification and structural measures of perirhinal cortex function- of MCI patients, but only a limited part of patients ing may identify AD patients earlier than correspond- defined as MCI on the basis of these criteria evolve ing measures of the entorhinal cortex and hippocam- to a DAT, whereas many more patients remain sta- pus. The second talk will describe the results of innova- ble and some revert to a normal status. Two solutions tive cognitive neuroscience research, which has tested have been proposed to solve this unsatisfactory situ- this hypothesis. The third talk will address the ques- ation. The first has consisted in distinguishing 4 dif- tion whether dissociable MTL regions (i.e. hippocam- ferent forms of MCI: (a) amnestic single domain; (b) pus and perirhinal cortex) support recall and recogni- amnestic multiple domain; (c) non-amnestic single do- tion performance, respectively (dual process models), main and (d) non-amnestic multiple domain. This dis- and whether the left and right prefrontal cortices dif- tinction has allowed to show that the highest percent- ferentially support learning and memory performance, age of conversions to DAT is observed in amnestic respectively (HERA model) by correlating behavioral multiple domain MCI patients, whereas non-amnestic measures of verbal episodic learning and memory per- MCI patients tend to convert to other forms of demen- formance with VBM measures of regional whole brain gray matter integrity and a priori defined anatomical tia. The second solution has consisted in substituting regions of interest in patients with different forms of the construct of MCI (based on clinical and neuropsy- dementia. The fourths talk will present the results of chological criteria) with the construct of ‘Prodromal analyses to determine the base rates for the German Alzheimer’s disease’ based on the integration of these Consortium to Establish a Registry for Alzheimer’s criteria with other neurogenetic, neuroimaging and Disease – Neuropsychological Test Battery (CERAD- CSF biomarkers, that take into account both a specific NTB) – one of the most widely used dementia assess- pattern of cognitive changes and structural/biological ment instruments in the United States and in German- evidence of Alzheimer’s pathology. Since these patho- speaking Europe – in the norming sample using differ- physiological criteria are more useful for ‘research’ ent cut-off scores. than for ‘clinical’ purposes, we think that the predictive value of the amnestic MCI construct could be in- Correspondence address: Prof. Dr. Andreas Monsch, creased with a more strict definition of the memory Memory Clinic, Department of Geriatrics, Schanzen- tests (in particular of delayed recall measures) and of strasse 55, CH-4031 Basel, Switzerland. Tel.: +41 the cut-off points most appropriate to identify patients 612653193; Fax: +41 612653794; E-mail: Andreas. who will probably progress to AD. Furthermore, since [email protected] Symposia 299

Lecture 1: BrainCheck: A new screening tool for Lecture 2: Perirhinal cortex functioning cognitive impairment in the elderly – combining patient assessment with caregiver information Kirsten Taylor and Andreas Monsch Memory Clinic, Dept. of Geriatrics, Basel, Switzerland Michael Ehrensperger, Andreas Monsch and Stefan Bläsi Alzheimer’s disease (AD) neurofibrillary pathology Memory Clinic, Dept. of Geriatrics, Basel, Switzerland begins in perirhinal cortex (PRc) before entering the entorhinal cortex and hippocampus. Thus, functional Cognitive disorders are frequently underdiagnosed. and structural measures of perirhinal cortex function- General practitioners (GPs) are in need of an effec- ing may identify AD patients earlier than correspond- tive screening instrument for cognitive change, which ing measures of the entorhinal cortex and hippocam- would help them GPs decide whether patients should pus. This talk describes our cognitive neuroscience re- be evaluated more extensively or ‘watchful waiting’ is search which has tested this hypothesis. indicated. The current study developed a new, quick and easy-to-administer screening tool, BrainCheck, Correspondence address: Dr. Kirsten Taylor, Memory which combines patient and informant assessments, Clinic, Dept. of Geriatrics, Schanzenstrasse 55, CH- and detects early cognitive decline associated with 4031 Basel, Switzerland. Tel.: +41 612658942; Fax: MCI and early stages of dementia. Patients with early +41 612653794; E-mail: [email protected] Alzheimer’s disease (AD) (N = 185), MCI (N = 80), and cognitive impairment related to major depression (N = 23) were recruited from six memory clin- Lecture 3: Functional neuroanatomy of verbal ics in Switzerland (54% w, age = 76.6 ± 7.9 y, edu- episodic learning and memory impairments in cation = 12.0 ± 2.6 y). These patients and cognitively dementia healthy individuals (NC; N = 126, 40% w, age 75.2 ± 8.8 y, education = 12.5 ± 2.7 y) completed a patient- Andreas Monsch, Irene Beck and Kirsten Taylor directed tool (‘MEMENTool’) consisting of three self- Memory Clinic, Dept. of Geriatrics, Basel, Switzerland reported questions about the participant’s memory and the Clock Drawing Test. Correct classification rates (CCRs) of the MEMENTool were calculated from this Episodic memory impairments are a cardinal feature sample. Additionally, a subsample of 113 patients with of the majority of dementia syndromes. Many voxel- MCI or early AD (53% w, age = 77.3 ± 7.2 y, educa- based morphometry (VBM) studies have shown that tion = 11.7 ± 2.5 y) and 70 NC subjects (29% w, age dementia patients’ verbal episodic learning and mem- = 77.2 ± 8.9 y, education = 12.5 ± 2.9 y) were ad- ory performance is significantly associated with medial ministered the very short Informant Questionnaire on temporal lobe (MTL) atrophy. However, controversies Cognitive Decline in the Elderly (IQCODE, 7 item ver- exist as to whether dissociable MTL regions (i.e. hip- sion). BrainCheck CCRs were calculated combining pocampus and perirhinal cortex) support recall and MEMENTool and IQCODE data. The patient-directed recognition performance, respectively (dual process MEMENTool demonstrated a sensitivity of 83.3%, a models), and whether the left and right prefrontal cor- specificity of 79.4%, and a CCR of 81.3%. In the NC, tices (PFC) differentially support learning and memory MCI and AD subsample, the BrainCheck (ie, com- performance, respectively (HERA model). The present bined MEMENTool (subsample CCR = 79.9%) and study aimed to address these issues by correlating IQCODE (subsample CCR = 78.6%)) achieved a CCR behavioral measures of verbal episodic learning and of 89.4%. memory performance with VBM measures of regional BrainCheck, a screening tool combining patient and in- whole brain gray matter integrity and a priori defined formant information, can be administered within a few anatomical regions of interest (ROI) in patients with minutes and achieved a CCR of 90% accuracy. different forms of dementia. The whole-brain analyses demonstrated that the entire MTL system is associated Correspondence address: Dr. Michael Ehrensperger, with all aspects of verbal episodic learning and mem- Memory Clinic, Dept. of Geriatrics, Schanzenstrasse ory performance, consistent with the declarative mem- 55, CH-4031 Basel, Switzerland. Tel.: +41 612653731; ory model. ROI analyses further demonstrated that Fax: +41 612653794; E-mail: Michael.Ehrensperger@ the integrity of the hippocampus and perirhinal cortex usb.ch were significantly related to recall and recognition per- 300 Symposia formance, respectively, as hypothesized by dual pro- more ‘pathologic’ scores in the normative sample were cess models. Finally, the distributed network underpin- found. For example, when a cut-off score of −1.28 (i.e. ning recognition memory performance appeared to ex- the 10%ile) was used, 60.6% of healthy individuals ob- tend to a disproportionate reliance on the right over tained 1/10 ‘pathologic’ scores. These findings illus- the left PFC, in partial support of the HERA model. trate the importance of considering the prevalence of These brain-behavior relationships allow inferences to low (‘pathologic’) scores in normal individuals. be made about the sites of brain atrophy, and thus the potential cause of dementia, based on the pattern of an Correspondence address: M.Sc. Panagiota Mistridis, individual patient’s episodic learning and memory per- Memory Clinic, Dept. of Geriatrics, Schanzenstrasse formance. 55, CH-4031 Basel, Switzerland. Tel.: +41 612653193; Fax: +41 612653794; E-mail: panagiota.mistridis@ Correspondence address: Prof. Dr. Andreas Monsch, usb.chch Memory Clinic, Dept. of Geriatrics, Schanzenstrasse 55, CH-4031 Basel, Switzerland. Tel.: +41 612653193; Fax: +41 612653794; E-mail: Andreas.Monsch@ Symposium 2: Social cognition deficits and be- unibas.ch haviour in brain damaged patients

Maarten Milders Lecture 4: Base Rates for the Consortium to Heriot-Watt University, School of Life Sciences, Edin- Establish a Registry for Alzheimer’s Disease, burgh, United Kingdom Neuropsychological Test Battery (CERAD-NTB) Deficits in social cognition have been observed in pa- Panagiota Mistridis1, Andreas Monsch1, Michael Ehr- tients with brain damage due to various etiologies. So- ensperger1 and Grant Iverson2 cial cognition refers to those cognitive functions in- 1Memory Clinic, Dept. of Geriatrics, Basel, Switzer- volved in understanding other people (e.g. their inten- land tions or emotion) and the self. An important possibil- 2University of British Columbia, faculty of Medicine, ity is that deficits in social cognition, unlike deficits Dept. of Psychiatry, Vancouver, Canada in standard cognitive functions, could underlie and explain changes in social behaviour following brain dam- Early and accurate diagnosis of mild cognitive image. Such behavioural changes are linked to poor psy- pairment (MCI) and dementia can be achieved with chosocial outcome. comprehensive neuropsychological test batteries. The This symposium will bring together research in dif- Consortium to Establish a Registry for Alzheimer’s ferent populations of brain damaged patients that at- Disease – Neuropsychological Test Battery (CERAD- tempts to relate deficits in social cognition to patients’ NTB) is one of the most widely used instruments in social behaviour. Williams et al. will show that alex- the United States and in German-speaking Europe. ithymia is associated with aggressive behaviour in pa- The CERAD-NTB consists of five subtests yields ten tients with traumatic brain injury (TBI). Patients who demographically-adjusted standard scores. The Ger- were less able to identify and describe their feelings man version has been normed with over 1,000 healthy had stronger aggressive tendencies. Allain will report elderly individuals. The aim of the current study was impairments in the ability to understand other people’s to determine the base rates for the German CERAD- intentions and feelings in patients with Huntington’s NTB subtests in this norming sample. The prevalence disease (HD). These impairments could be the basis rates of ‘pathologic’ scores on the German CERAD- for the behavioural changes seen in patients with HD. NTB subtests defined by using a range of different Spikman et al. will present one of the first reports of cut-off scores (i.e., −0.67 (25%ile), −0.84 (20%ile), an association between emotion recognition in patients −1.00 (16%ile), −1.13 (13%ile), −1.28 (10%ile), with TBI and post-injury behaviour, as rated by a sig- −1.48 (7%ile), −1.64 (5%ile), −1.96 (2.5%ile), −2.32 nificant other of the patient. This finding is in line (1%ile)) were calculated from the normative sample with suggestions that social cognition deficits underlie (n = 1,081; 407 women, 674 men; age: 68.6 ± changes in behaviour following brain injury. Milders 7.83 (range: 49–92); years of education 12.51 ± 3.0 will continue on this theme and shows, in a different (range 7–20)). Relatively high percentages of one or sample of TBI patients, that the correlation between Symposia 301 emotion recognition and behaviour is selective, i.e. tionship failure, social isolation and poor psychosocial is not explained by injury severity or other cognitive outcomes. deficits. Finally, Yeates will discuss current approaches in the rehabilitation of social cognition deficits in pa- Correspondence address: Dr. Williams Claire, Swansea tients with acquired brain injuries with the view to pre- University, Department of Psychology, Swansea, SA2 vent or reverse maladaptive social behaviour and neg- 8PP Swansea, United Kingdom. E-mail: Claire. ative psychosocial outcome. [email protected]

Correspondence address: Dr. Maarten Milders, Heriot- Watt University, School of Life Sciences, Riccar- Lecture 2: Huntington’s disease is associated with ton, EH14 4AS Edinburgh, United Kingdom. E-mail: deficits in cognitive and affective theory of mind [email protected] Philippe Allain Université d’Angers – Laboratoire de Psychologie des Lecture 1: The relationship between alexithymia Pays de Loire, Angers, France and aggression following Traumatic Brain Injury Huntington’s disease (HD) is a neurodegenerative dis- Williams Claire, Rodger Woods and Mandy Saville order, with predominant involvement of the striatum. Swansea University, Department of Psychology, This condition gives rise to altered social conduct and Swansea, United Kingdom breakdown in interpersonal relationships, although the factors underlying these changes remain poorly de- Aggression is a frequent legacy following TBI which fined. This study investigated whether individuals with can have an adverse impact on interpersonal relation- HD exhibit impairments in the understanding of other ships and psychosocial recovery. The nature and sever- people’s cognitive and affective mental states, two ity of aggression has been linked to a variety of fac- main aspects of Theory of Mind (ToM). Eighteen HD tors, but very little research has examined the rela- patients, early in the course of the disease, and eigh- tionship between aggression and deficits of social cog- teen healthy volunteers matched by age and educa- nition. To this end, the aim of the study was to ex- tional levels were given a non verbal cognitive ToM amine the relationship between alexithymia and ag- task assessing attribution of intentions to others and a gression following TBI. A total of 39 individuals with revised version of the ‘Reading the Mind in the Eyes’ TBI and 60 demographically matched controls com- test, which is an affective ToM task assessing the un- pleted the 20-Item Toronto Alexithymia Scale (TAS- derstanding of other people’s feelings from their eyes. 20) and The Aggression Questionnaire (TAQ). In the To analyze relationships between executive functions TBI group, significant other ratings on the TAQ were and ToM, participants also completed seven executive also obtained. Results revealed significantly higher measures tapping spontaneous and reactive flexibility, alexithymia scores in the TBI than control group. TAQ inhibition, set shifting, executive planning, rule detec- ratings were also higher in TBI group, with ‘Anger’ tion and working memory. The two measures of ToM subscale scores differing significantly across the TBI were indicative of a significant impairment of ToM and control groups. Significant positive correlations abilities in patients with HD patients. HD patients also were found between TAS-20 and TAQ total scores in exhibited executive dysfunction, but there was reduced both groups, with TAS-20 total scores explaining a sig- evidence that executive impairments were related to nificant amount of variance in TAQ scores. However, cognitive and affective ToM deficits. Our results are the relationship between alexithymia and aggression consistent with the idea that both cognitive and affec- was strongest in the TBI group. To conclude, the re- tive aspects of ToM are impaired in HD patients, indi- sults of this study found evidence to suggest that the cating that cortico-subcortical circuits participate to the presence of alexithymia is an important factor affect- mediation of higher social functions such as ToM. Our ing aggression following TBI. Therefore, rehabilitation results are also consistent with the idea that ToM diffi- workers need to remain alert to the possibility that in- culties appear relatively independent of executive pro- dividuals with TBI may exhibit some form of emotion cesses dysfunction. They also provide a basis for the deficit disorder that can have an adverse impact on be- understanding of disorganised behaviour and break- haviour, which in turn, may increase the risk of rela- down in interpersonal relationships in daily life in HD. 302 Symposia

Correspondence address: Dr Philippe Allain, Univer- rating. However, there were significant correlations be- sité d’Angers, Laboratoire de Psychologie des Pays tween the FEEST total score and the DEX proxy and de Loire, Angers, 49045 Cedex 01 Angers, France. DEX difference scores. In particular, the perception of E-mail: [email protected] Sadness was significantly related to these latter DEX scores. CONCLUSION: Deficits in emotion recognition after Lecture 3: Impaired emotion recognition in TBI in TBI are related to behavioral problems, rated by sig- relation to behavioral changes and impaired nificant others, as well as to impaired self-awareness. self-awareness Correspondence address: Dr. Joke Spikman, Univer- Joke Spikman1, Maarten Milders2 and Annemarie sity Medical Center Groningen, Department of Clin- Visser-Keizer3 ical Neuropsychology, Hanzeplein, 9700 RB Gronin- 1University Medical Center Groningen, Department of gen, Netherlands. E-mail: [email protected] Clinical Neuropsychology, Groningen, Netherlands 2Heriot-Watt University, School of Life Sciences, Ed- inburgh, United Kingdom Lecture 4: Social cognition neuro-rehabilitation 3Groningen University, Department of Clinical and strategies: An overview Developmental NeuropsychologySciences, Groningen, Netherlands Giles Yeates Buckinghamshire NHS PCT, Community Head Injury OBJECTIVE: After moderate to severe TBI behav- Service, Aylesbury, United Kingdom ioral changes, involving inadequate social-emotional behavior, are common. It has been put forward that BACKGROUND and AIMS: Social cognition defi- deficits in social cognition, of which the ability to rec- cits are now recognised as ubiquitous sequelae of many ognize facial affect is an important element, might be forms of acquired brain injury (ABI), and have been an underlying mechanism. In a range of studies deficits linked to a range of negative psychosocial outcomes in emotion recognition were demonstrated in TBI pa- (including unemployment, family and couples rela- tients, but to date, these have not been related to behav- tionship problems and individual survivor distress). ioral deficits. Measurement of behavioral changes can However the current interest in the neurobiological ba- be complicated because another frequent consequence sis of social cognitive processes can be contrasted in a of TBI is impaired self-awareness, causing patients to dearth of fully developed and evaluated rehabilitation provide an unrealistically positive report of their own strategies. functioning. We investigated whether impaired emo- METHOD and RESULTS: This presentation reviews tion recognition after TBI was related to behavioral the main social cognition intervention types that have changes and impaired self-awareness. been researched with ABI to date: generic social skills METHOD: 51 patients with moderate to severe TBI training, specific mentalising and emotional recogni- and a group of 31 healthy controls were assessed with tion skills training, embodied simulation training, in- the FEEST (Facial Expressions of Emotion-Stimuli terventions targeting adjunctive cognitive control pro- and Tests) testing perception of emotional expressions cesses and couples therapy interventions. These ap- on faces, as well as with the DEX (Dysexecutive Ques- proaches are described (including video examples) and tionnaire) measuring behavioral problems. For all par- their theoretical assumptions contrasted. ticipants, there was also a proxy rated version of the CONCLUSIONS: A common underlying assumption DEX. The difference score between DEX-Self and that deficits can be remediated through explicit training DEX-proxy was used as indication of self-awareness. or feedback protocols, which is incongruent with con- RESULTS: Patients performed worse on the FEEST temporary theoretical and experimental foci on non- total score as well as on the Anger, Disgust, Fear and explicit processes central to social cognition, such as Sadness subscores than healthy controls. They also had resonance, contagion and autonomic responsivity, The higher scores on the DEX self and proxy version, and impact of affective and relational factors has also been a higher DEX-difference score than the controls. Cor- neglected. Candidates for new intervention approaches relation analyses showed that there were no significant are considered. correlations of the FEEST scores with the DEX self Symposia 303

Correspondence address: Dr. Giles Yeates, Bucking- Correspondence address: Dr. Maarten Milders, Heriot- hamshire NHS PCT, Community Head Injury Service, Watt University, School of Life Sciences, Riccar- Jansel Square, HP21 7ET Aylesbury, United Kingdom. ton, EH14 4AS Edinburgh, United Kingdom. E-mail: E-mail: [email protected] [email protected]

Lecture 5: The selectivity of the association Symposium 3: Traumatic Brain Injury: Neuropa- between emotion recognition and post-injury thology, memory and outcome behaviour Eli Vakil Maarten Milders Bar Ilan University, Psychology, Ramat Gan, Israel Heriot-Watt University, School of Life Sciences, Edin- burgh, United Kingdom Symposium Description: Traumatic brain injury (TBI) is highly prevalent in industrialized countries, partic- BACKGROUND: Recognition of emotions in other ularly among young adults. It is the most common people has been proposed as a condition for adequate cause of brain damage resulting in long-term disabili- social behaviour. Impairments in emotion recognition ties. Characterization of the neuropathology following are frequently found in patients with traumatic brain TBI as well as the short and long term emotional, be- injuries (TBI) and these impairments might underlie havioral and cognitive effects of TBI, could contribute the changes in social behaviour post-injury. In line with to the assessment and rehabilitation of this patient pop- this suggestion, there have been some reports of asso- ulation. In this symposium, based on cutting-edge re- ciations between emotion recognition and post-injury search, new empirical findings will be presented that behaviour. However, questions remain regarding the highlight the complexity of the brain injury and its causal relationship. One requirement for a causal rela- consequences. Dr. Bigler will discuss the utilization tionship is that the association between emotion recog- of contemporary neuroimaging methods which provide nition and behaviour is selective and no manifestation us with a better understanding of the neuropathology of other deficits. following TBI. These methods include T1, T2, fluid METHODS: To examine the selectivity of this associ- attenuated inversion recovery (FLAIR), susceptibility ation data from 67 patients with TBI and 69 matched weighted imaging (SWI), magnetic resonance spec- healthy controls, were analysed. All participants had troscopy (MRS) and diffusion tensor imaging (DTI). completed tests of emotion recognition and various Memory is one of the most (if not the most) common cognitive tasks, including processing speed, which is and disabling impairments caused by TBI. It is well particularly vulnerable to brain injury. Self and proxy known now that the memory system is complex and ratings of post-injury behaviour were obtained using is composed of various types of memory (e.g., explicit the Neuropsychology Behavior and Affect Profile. vs. implicit) which are subserved by various brain sys- RESULTS: Emotion recognition and cognitive task tems. Dr. Vakil will present empirical data attempting performance were significantly impaired in the TBI to characterize the nature of the memory impairment group. Proxy ratings of behaviour revealed more prob- following TBI. Finally, Dr. Ponsford will report on a lems in the patients than in the controls. Emotion long-term outcome study of patients with moderate to recognition was significantly correlated with commu- severe TBI that have been followed up at 1,2,3,5, 10 nication behaviour and inappropriate behaviour within and/or 20 years post-injury. The profile of outcome cre- the patient group. Importantly, these associations could ated based on this study will be described. not be explained by injury severity, cognitive impairments or face perception deficits. Correspondence address: Mr Professor Eli Vakil, Bar CONCLUSION: Emotion recognition was associated Ilan University, Psychology, Ramat Gan, D-52900 Ra- with behavioural problems following TBI. The asso- mat Gan, Israel. E-mail: [email protected] ciation between emotion recognition and behaviour was selective and not simply a reflection of other impairments. This finding strengthens the possibility that emotion recognition deficits may underlie problems in social behaviour after brain injury. 304 Symposia

Lecture 1: Neuropathology of traumatic brain real-time integrative methods to display lesion and net- injury: Neuroimaging findings work damage to assist the researcher and clinician in better understanding neuropsychological outcome. Erin David Bigler Brigham Young University, Psychology, Provo UT, Correspondence address: Mrs Professor Erin David USA Bigler, Brigham Young University, Psychology, 1001 SWKT, 84602 Provo UT, USA. E-mail: erin_bigler@ Advanced neuroimaging methods continue to provide byu.edu additional insights into the neuropathology of traumatic brain injury (TBI) and the relationship of pathological changes to neuropsychological outcome. Both Lecture 2: Memory impairment following human and animal studies integrating in vivo neu- traumatic brain injury roimaging with post-mortem histological analysis have greatly improved our understanding of what types Eli Vakil of pathologies are detected with neuroimaging tech- Bar Ilan University, Psychology, Ramat Gan, Israel niques. While neuroimaging methods readily identify obvious acute neuropathologies such as contusions, in- Deficient learning and memory are frequently reported traparenchymal hemorrhages, and edema these are but as a consequence of traumatic brain injury (TBI). Char- gross indicators of initial pathological change. Neu- acterization of the memory breakdown following TBI roimaging abnormalities from TBI especially in the could contribute to the assessment and rehabilitation first few months post-injury are dynamic and ever of this patient population. TBI frequently leads to changing. Fortunately contemporary neuroimaging is widespread, diffuse axonal injury. Nevertheless, the now capable of detecting and tracking TBI-related neu- most common vulnerable memory processes following ropathology. Using day-of-injury neuroimaging, which TBI very much resemble the memory deficits reported is typically based on computed tomography (CT) in patients suffering frontal lobe damage, e.g., difficul- as baseline information, a variety of neuropathologi- ties in applying active or effortful strategy in learning cal changes, if present, may be subsequently identi- or retrieval process. Because of the diffuse nature of fied and quantified using magnetic resonance imaging the injury, patients with TBI are not the ideal group (MRI). Classic neuropathological indicators as iden- for studying brain-behavior relations. But yet, studying tified at different timeframes post-injury will be re- this group could contribute to our understanding of the viewed including T1, T2, fluid attenuated inversion configuration of cognitive processes, which is a criti- recovery (FLAIR), susceptibility weighted imaging cal step towards better understanding of brain-behavior (SWI), magnetic resonance spectroscopy (MRS) and relations. diffusion tensor imaging (DTI). Using contemporary Breakdown of memory processes could help reveal un- automated image analysis techniques, like FreeSurfer, derlying independent sub-processes that seem insepa- all major brain areas may be quantified, yielding ob- rable in normal memory functioning. jective anatomical information about any region of in- Numerous studies demonstrate impaired performance terest. DTI permits identification and isolation of all on one memory type in some patients with TBI though of the major tracts of the brain. However, what may their performance is preserved on other different mem- be most important for neuropsychological outcome is ory types. Such findings are an indication of dissoci- how these neuroimaging identified lesions and association between these memory types. Examples of such ated pathologies disrupt neural networks. Contempo- dissociations are: declarative, priming and saving task rary neuroimaging provides a variety of methods that dissociation; preserved perceptual and impaired con- permit the identification of neural networks as well as ceptual priming; preserved implicit and impaired ex- their disruption from brain injury. Using DTI, func- plicit measures of contextual information; impaired tional MRI (fMRI) and resting state fMRI (rs-fMRI), baseline performance and learning rate preserved in functional connectivity maps of the normal and dam- skill learning tasks; and preserved tasks that require au- aged brain can be derived providing information about tomatic processes and impaired tasks that require ef- not just where lesions may be but how connections and fortful processes. With the continuing improvements of networks are damaged. All of these methods will be re- neuroimaging techniques, it is most probably become viewed, including 3-D imaging techniques that provide possible to apply the method of double dissociation Symposia 305 with cognitive processes and corresponding brain re- Centre, Epsworth Hospital, Melbourne, Australia. E- gions even on this population of individuals with TBI. mail: [email protected]

Correspondence address: Mr Professor Eli Vakil, Bar Ilan University, Psychology, Ramat Gan, D-52900 Ra- Symposium 4: Causes of cognitive and behavioural mat Gan, Israel. E-mail: [email protected] problems in Parkinson’s disease: Implications for rehabilitation?

Lecture 3: Long-term outcome following traumatic Andrew Mayes1 and Nicky Edelstyn2 brain injury 1Universirty of Manchester, Psychology, Manchester, UK Jennie Ponsford 2Keele Univeristy – Psychology, Keele, UK Monash University, Monash-Epsworth Rehabilitation Centre, Melbourne, Australia Parkinson’s disease (PD) is defined in terms of specific motor symptoms but PD patients also suffer from Traumatic brain injury (TBI) creates many unique a variety of mood, motivational and cognitive disor- challenges for several reasons. It occurs most often in ders that vary in severity, but tend to be progressive young people who are still establishing their indepen- and impair quality of life. As well as depression, these dence and relationships and completing educational or disorders include apathy and problems with impulse vocational training, and who may have pre-existing so- control, and deficits of executive functions, such as cial or psychiatric problems. It has diffuse and vari- set shifting, attention and working memory, and of able effects on the brain. And recovery occurs over long-term memory for events and specific stimuli. The a very lengthy timeframe. This means that the mea- causes of the disorders must be the progressive degen- surement of outcome and the rehabilitation process are erative changes that underlie PD, which most notably exceedingly complex. Through its Longitudinal Head involve the dopaminergic neurons of the midbrain. De- Injury Outcomes study the Monash-Epworth Rehabil- generation of these dopaminergic neurons may ad- itation Research Centre has created a profile of outcome in a series of patients with moderate to severe versely affect functional efficiency of the regions to TBI receiving rehabilitation at Epworth Hospital and which they project, such as the prefrontal cortex and followed up at 1,2,3,5, 10 and/or 20 years post-injury. medial temporal lobes as well as the basal ganglia. In Whilst these patients show good independence in mo- addition to dopaminergic drugs improving PD motor bility and personal activities of daily living, a signifi- functions, they can also improve motivational and cog- cant proportion experience problems with balance and nitive functions. However, given that PD patients’ var- fatigue. About 25–30% require supervision in com- ious functional deficits have partially non-overlapping munity based activities such as shopping or financial pathologies and can differ in severity, it is unsurprising management due to impairments of memory, atten- that, when drugs are optimized for their effects on motion, processing speed and executive function which, tor functions, they not only also improve some motiva- along with irritability and fatigue are the most com- tional and cognitive functions, but impair others. Opti- mon long-term cognitive and behavioural problems re- mization of treatment regimens depends on systematic ported by over 60% of these patients. Age, genetic sta- study of the deficits, their neural bases and the effects tus and duration of post-traumatic amnesia and cul- of different dopaminergic drugs. The three talks in this tural background impact on functional outcomes. Psy- symposium address these issues. Husain will focus on chiatric disorders, particularly anxiety and depression inattention, impulsivity, apathy and working memory are also common and these are associated with poorer deficits in PD in the context of drug effects and genetic outcomes. In order to improve patient outcomes it is risk in asymptomatic people. Edelstyn and Mayes will essential that we develop evidence-based methods of focus on recognition memory deficits, their functional addressing each of these issues, whilst also focusing on causes, disruptive drug effects on recollection and how individually meaningful goals. Our work towards this to avoid them. Duezel will focus on both structural and aim will be outlined. functional imaging, particularly of basal ganglia and midbrain, both in PD and in healthy ageing in relation Correspondence address: Mrs Prof Jennie Ponsford, to impaired memory and decision making. Monash University, Monash-Epsworth Rehabilitation 306 Symposia

Correspondence address: Mr Professor Andrew Mayes, 2University of Manchester, School of Psychological Universirty of Manchester – Psychology, Oxford rd, Sciences, Manchester, UK M13-9PL Manchester, UK. Tel.: +44 161 2752579; E- mail: [email protected] Two assumptions about the causes of impaired recall and recognition of past episodes and stimuli (episodic memory) in medicated Parkinson’s Disease (PD) are Lecture 1: Inattention, impulsivity and apathy in examined. The first assumption is that the progres- Parkinson’s disease sive decline in episodic memory frequently reported in PD results from a breakdown in prefrontally-mediated Masud Husain strategic memory circuits implicated in the generation University of Oxford, Nuffield Dept of Clinical Neuro- of encoding and retrieval strategies. The second as- sciences and Department of Experimental Psychology, sumption is that dopaminergic drugs do not affect pa- Oxford, UK tients’ episodic memory. These assumptions imply that (1) careful guidance in the use of externally provided Inattention, impulsivity and apathy are recognised as encoding and retrieval strategies should reduce or re- important syndromes associated with Parkinson’s dis- mediate episodic memory deficits, and (2) PD recol- ease (PD) that have a significant impact on patients’ lection should be the same ON and OFF medication. lives. Although there have been several experimental Two studies tested these predictions. The first used a studies that have investigated attention deficits in PD, source recognition memory task (RMT) with 3 con- we understand very little about the cognitive mech- ditions that compared spontaneous encoding and re- anisms underlying impulsivity and apathy. The goal trieval (condition 1) with provision of externally proof this talk will be to consider the relation of atten- vided guidance at encoding only (condition 2) and tion to working memory deficits in PD. I will present combined with retrieval (condition 3) on the assess- new findings which show how impairments in preci- ment of familiarity, source recollection and subjective sion of working memory recall are present at diagnosis recollection of episodic details in medicated PD and (when conventional clinical tests may be normal); are demographically matched healthy volunteers (HVs). In improved by dopaminergic medication; and can be de- the second study, patients completed 2 matched yes/no tected in asymptomatic individuals who have a genetic RMTs ON and OFF medication (dopamine agonists), risk of developing PD. In addition, I will present data and their recollection and familiarity performance was on impulsivity and apathy which shows that these as- compared to that of HVs. Study 1 showed that “act- pects of behaviour can, respectively, be manifestations ing as the frontal lobes” by providing optimal encod- of heightened sensitivity to reward or insensitivity to it. ing and retrieval strategies did not improve recollec- Moreover, they are also highly sensitive to dopaminer- tion significantly more in PD than in HVs. In study gic modulation. These considerations demonstrate that 2, one type of dopamine agonist increased the sever- cognitive deficits in PD are important aspects of the ity of a PD-dependent decline in episodic memory. The condition which can, crucially, be altered by dopamine studies challenge both assumptions and instead sug- levels in the brain. gest that not only may recollection deficits in PD be Correspondence address: Professor Masud Husain, ‘amnesia-like’ but that such deficits may be exacer- University of Oxford, Nuffield Dept of Clinical Neu- bated by specific medications. Future memory rehabil- rosciences and Department of Experimental Psychol- itation in PD will need to control expectations and drug ogy, John Radcliffe Hospital, OX3-9DU Oxford, UK. regimen carefully and consider drugs that reduce am- E-mail: [email protected] nesia. Correspondence address: Professor Nicky Edelstytn, Lecture 2: Challenging assumptions about Keele University, School of Psychology, Keele, ST5- memory in Idiopathic Nondementing Parkinson’s 5BG Staffordshire, UK. E-mail: n.edelstyn@keele. disease: Implications for rehabilitation ac.uk

Nicky Edelstytn1 and Andrew Mayes2 1Keele University, School of Psychology, Staffordshire, UK Symposia 307

Lecture 3: Imaging structural and functional The psychosocial consequences of dementing disor- abnormalities of the SN/VTA: Implications for ders are far-reaching, both for the patients themselves, cognitive deficits and rehabilitation and for their families and friends. Whereas diagnostic strategies have been improved and standardized over Emrah Duezel the past 25 years, psychosocial intervention strategies University College London, Institute of Cognitive Neu- were only recently considered in clinical research. As rosciences, London, UK no cure is currently available for the neurodegenerative dementias, there are, in the face of ongoing demo- Senescence and Parkinson’s Disease affect the ability graphic change, two main desiderates. First, the devel- to utilize information about the likelihood of rewards opment or adaptation of interventions that meet the pa- for optimal decision-making. In a first study, we show tients’ and their caregivers’ needs, and second, the de- that PD patients and older adults have an abnormal velopment of appropriate methods to quantify the ef- functional magnetic resonance imaging (fMRI) signal fects of these interventions. of expected reward value. In a second study in older In our symposium, we will discuss recent advances in adults we show that structural connectivity between the research on psychosocial interventions. In the first lec- SN/VTA and the striatum measured with diffusion ten- ture, a patient-centered intervention for anxiety in de- sor imaging (DTI) was linked to interindividual differ- mentia is presented. The two following lectures present ences in the fMRI expected reward value signal and studies on caregiver interventions, using modern com- that the dopamine precursor L-DOPA restored the neu- munication tools and therapy techniques. The two fi- ral signals associated with reward prediction errors and nal lectures address methodological issues that are rel- improved decision making performance. Under more evant for research on psychosocial interventions in de- complex cognitive demands, when appropriate behav- mentia, the choice of outcome measures and gender- iors to obtain rewards and avoid punishments need to fair sampling. be learned concurrently, older adults are better at learning to act (‘go’) for reward, but better at learning to not Correspondence address: Prof. Dr. Katja Werheid, act (‘no-go’) to avoid punishment. However, partici- Humboldt Universität zu Berlin, Department of Psy- pants with greater structural integrity of the SN/VTA chology, Unter den Linden 6, D-10099 Berlin, Ger- and the adjacent subthalamic nucleus can overcome many. Tel.: +49 30 2093 9360; Fax: +49 30 2093 9361; this asymmetry. Finally, we show that the dopamine E-mail: [email protected] precursor L-DOPA given to older adults during encoding improves episodic memory performance, i.e. the ability to recollect information, after a long retention interval of 6 hours. However, this effect is confined to Lecture 1: CBT for anxiety in dementia: A pilot a narrow dose-range whereby randomised controlled trial

Correspondence address: Mr Professor Emrah Duezel, Aimee Spector University College London – Institute of Cognitive University College London, Clinical Psychology, Neurosciences, Queen Square, WC1N-3AR London, London, Germany UK. E-mail: [email protected] Many people with dementia experience anxiety that can cause or exacerbate problems including decreased Symposium 5: Managing the psychosocial conse- cognitive function, high physical dependency, relation- quences of dementia ship difficulties, behavioural problems and increased admittance to care homes. Nonetheless, there is a Managing the psychosocial consequences of dementia paucity of research and lack of understanding of psychological approaches for anxiety in dementia, of- Katja Werheid1 and Alexander Kurz2 ten leading to inappropriate and sometimes problem- 1Department of Psychology, Humboldt Universität zu atic use of medication. Cognitive Behavioural Ther- Berlin, Berlin, Germany apy (CBT) focuses on the interplay between thoughts, 2Department of Psychiatry and Psychotherapy, Tech- feelings and behaviour. Small studies have previously nische Universität München, München, Germany evaluated CBT for anxiety in dementia, all reporting clinically meaningful reductions in anxiety and other 308 Symposia changes including improved mood. However, to date METHODS: A randomized controlled trial (N = 229) there are no robust RCTs evaluating its effectiveness. was conducted to compare treatment group CBT inter- Our team at UCL developed a CBT for anxiety in de- vention, treated control group (relaxation techniques) mentia manual, through identifying the existing evi- and untreated control group. Outcome measures were dence; which was modelled through a consensus pro- physical complaints, depressive symptoms, caregiver’s cess. We then assessed the feasibility of the interven- perceived health and well-being. All measures were tion through a single-blind, pilot RCT. 50 people with administered before treatment (pre), after treatment mild to moderate dementia and anxiety, and their car- (post), six month and two years after treatment (follow- ers; were recruited to a two-armed RCT and receive ei- up). ther CBT or treatment as usual. The adapted CBT in- RESULTS: Caregivers of the CBT intervention group tervention involved 10 weekly sessions that teach peo- show positive long-term effects on health outcomes ple new skills to manage their anxiety, with the sup- such as significant increases perceived health and well- port of their carer. Blind assessments were conducted being and reduction in body complaints and depres- at baseline, 15-weeks and at 6 months follow-up, to de- sion. Taken into account participants’ evaluation of tect changes in anxiety, quality of life, cognition, be- the intervention, CBT participants reported a higher havioural function, mood and relationship with carer. effect concerning overall satisfaction with the treat- Qualitative interviews were used to gather service- ment, pointing to intervention specific effects com- users’ perspectives on the intervention. Issues includ- pared to the general effects of an intervention, which ing acceptability, compliance, recruitment and reten- have been controlled by the introduction of an active tion were explored. This presentation will describe the control group (PMR). CBT for anxiety in dementia programme, illustrate it CONCLUSION: Discussion focuses on limitations using case examples, and report the quantitative and and challenges of the investigation of long-term-effects qualitative findings. in this population. Considerations will be undertaken about the evaluation of specific intervention modules Correspondence address: Dr. Aimee Spector, Univer- and the implementation of this specific psychotherapy sity College London, Clinical Psychology, 1-19 Tor- for caregivers into the health system. rington Place, GB-WC1E 7HB London, Germany. Tel.: +49 02076791844; E-mail: [email protected] Correspondence address: Prof. Dr. Gabriele Wilz, Frie- drich-Schiller-Universität Jena, Department of Psy- chology, Humboldtstraße 11, D-07743 Jena, Germany. Lecture 2: Long-term evaluation of a Tel.: +49 3641 945170; Fax: +49 3641 945172; E-mail: randomized-controlled telephone therapy for family caregivers of persons with dementia [email protected]

Gabriele Wilz1, Denise Schinköthe2 and Renate Soell- ner3 Lecture 3: Internet-based supportive interventions 1Friedrich-Schiller-Universität Jena, Department of for caregivers of people with dementia Psychology, Jena, Germany 1 2 2Friedrich-Schiller-Universität, Jena Marjolein De Vugt , Lizzy M.M. Boots , Gertrudis 2 2 3Universität Hildesheim I.J.M. Kempen and Frans Verhey 1Maastricht University, Alzheimer Center Limburg, GOALS: Meta-analyses indicate that interventions for School for Mental Health and Neuroscience, Maas- family caregivers of persons with dementia show het- tricht, Germany 2 erogeneous and moderate to low positive effects and University of Maastricht investigations of long-term effects are rare. Thus, the development and long-term evaluation of adequate and BACKGROUND: Due to the expected increase of de- effective interventions is still needed to prevent phys- mentia patients, no cure for the patient in sight, and ical and mental illness of the caregivers. Therefore, in the rising cost of care, there is a growing need for this study we focused on the evaluation of long dura- effective caregiver interventions. Internet-based inter- tion effects of a cognitive-behavioral (CBT) telephone ventions hold a considerable promise for meeting the intervention adapted to the special situation of family educational and support needs of dementia carers at re- caregivers. duced expenses. Symposia 309

OBJECTIVES: The current study aims to (1) give a duced abilty to carry out usual activities of daily living. systematic overview of the literature on Internet inter- The measures that are commonly used to capture these ventions for caregivers of people with dementia (PwD) dimensions constitute the classic oucome triad of clin- (2) develop a prototype of an Internet-based self- ical drug trials and longitudinal studies. The psychoso- management programme to provide dementia care- cial consequences of dementia involve both the patient givers the skills they need to undertake and succeed in and the informal carer. On both sides, subjective and the caregiver role. objective impacts can be distinguished. Subjective con- METHODS: The first objective was addressed by a sequences are similar for patients and carers and in- systematic search of the literature published up to Jan- clude mood, quality of life, self-efficacy, sense of mas- uary 2013. Twelve studies were identified. The qual- tery and marital satisfaction. Objective consequences, ity of the included studies was assessed according to on the other hand, are partly different between demen- the Cochrane Level of Evidence (LOE) and Cochrane tia sufferers and carers. On the patients’ side these re- Back Review Group criteria. For the second objec- fer to independence, attainment of personally relevant tive an iterative process was used with expert and con- goals, activity and participation and legal capacity. On sumer input to develop the initial prototype of a self- the carers’ part consequences refer to time spent on management program for caregivers of PwD. caring, working hours, financial income, leisure time RESULTS: The included studies in the review dif- and social activity. For each one of these consequences fered widely in terms of intervention type, dosage, du- assessment instruments are available that can be ap- ration, and methodological quality. Outcomes showed plied in studies. Obviously, the appropriate set of out- that Internet interventions can improve various aspects comes must be selected in relation to the study objec- of caregiver well being, e.g. burden, depression and tives. self-efficacy, provided they comprise of multiple components, are individually tailored, and include interac- Correspondence address: Prof. Dr. Alexander Kurz, tion with other caregivers. Nine thematic modules were Technische Universität München, Department of Psy- selected and included in a phase I prototype: ‘accep- chiatry and Psychotherapy, Möhlstr. 26, D-81675 Mün- tance’, ‘insecurity’, ‘focus on the positive’, ‘communi- chen, Germany. Tel.: +49 8941404201;Fax: +49 89414 cation’, ‘balance in activities’, ‘stress and relaxation’, 04860; E-mail: [email protected] ‘social support’, ‘a changing partner’, and ‘care management strategies’. CONCLUSION: Results from the literature study and Lecture 5: Effectiveness of psychosocial development study provide support to move forward interventions in early dementia: Evidence of with a feasibility and cost-effectiveness study of an gender bias Internet-based support program for caregivers in dementia. Katja Werheid1, Stefanie Baron2 and Ingun Ulstein3 1 Correspondence address: Dr. Marjolein de Vugt, Maas- Humboldt Universität zu Berlin, Department of Psy- tricht University, Alzheimer Center Limburg, School chology, Berlin, Germany 2Humboldt-Universität zu Berlin for Mental Health and Neuroscience, Dr. Tanslaan 12, 3 D-6229 Maastricht, Germany. Tel.: +31 43 3877445; National Center of Aging and Health, Oslo, Norway Fax: +31 43 3875444; E-mail: m.devugt@maastrich tuniversity.nl BACKGROUND: Alzheimer’s disease affects twice as many women than men. Gender differences in symptom profile, living conditions, coping style and treat- Lecture 4: Outcome measures for patient- and ment response might affect the outcome of psychoso- carer-centered interventions in dementia cial interventions for patients with Alzheimer’s disease (AD) or Mild cognitive impairment (MCI). Neglecting Alexander Kurz this variable in clinical trials could lead to biased re- Technische Universität München, Department of Psy- sults and thereby diminish the external validity of find- chiatry and Psychotherapy, München, Germany ings on treatment effectiveness. METHODS: A systematic review of high-ranking, Dementia is multi-dimensional concept defined by im- randomized-controlled clinical trials on psychosocial pairment of cognition, alterations of behaviour and re- interventions in AD and MCI was conducted by 310 Symposia searching electronic databases (PubMed, Medline and (meta-) cognitive processes. The investigation of meta- PsycINFO, 2000–2012). The studies were analysed for cognitive processes is also important for clinical work. their gender proportion and for gender differences re- Current research has repeatedly shown a clear associa- ported. tion between metacognition and cognitive functioning RESULTS: Sixty-two percent of the available stud- with poor metacognitive ability to have prognostic va- ies reported the male:female ratio for each treatment lidity for impaired cognitive functioning. The present group and were included in a stepwise analysis. They symposium provides an introduction in the neuropsy- deviated from the prevalence-based gender ratio in the chology of metacognition and four empirical studies control groups, with significantly less females than ex- investigating different aspects of metacognition. pected. Nineteen percent of the reviewed study pool reported analyses of gender differences. In this subgroup Correspondence address: Mr Prof. Siegfried Gauggel, of studies, females were underrepresented in treatment University Hospital RWTH Aachen, Medical Psychol- and control groups. Six of these studies showed signif- ogy and Medical Sociology, Pauwelsstrasse 19, D- icant differences in out-come between the genders. In 52074 Aachen, Germany. Tel.: +49 0241 8089000; E- these studies, the gender ratio was in accordance with mail: [email protected] prevalence rates, in contrast to the studies in which no gender effects were found. CONCLUSIONS: Our review provided evidence for a Lecture 1: Neuropsychology of metacognition: An selection bias resulting in female underrepresentation introduction in high-ranking studies on psychosocial interventions Siegfried Gauggel in AD/MCI. Moreover, a systematic linkage of fe- University Hospital RWTH Aachen, Medical Psychol- male underrepresentation and reports of analysed gen- ogy and Medical Sociology, Aachen, Germany der differences suggests a reporting bias. OBJECTIVE: In this introduction a short overview of Correspondence address: Prof. Dr. Katja Werheid, current research in the neuropsychology of metacogni- Humboldt Universität zu Berlin, Department of Psy- tion is provided. chology, Unter den Linden 6, D-10587 Berlin, Ger- METHODS: A systematic review of the research liter- many. Tel.: +49 30 2093 9360; Fax: +49 30 2093 9361; ature is performed considering major studies and theo- E-mail: [email protected] retical papers. RESULTS: A large number of empirical and theoretical paper could be identified focusing on the (a) Symposium 6: Neuropsychology of metacognition neural basis of unawareness of cognitive, behavioural and motor impairments, (b) functional architecture of Siegfried Gauggel and Effi Volz-Sidiropoulou metacognitive processes, (c) development of reliable University Hospital RWTH Aachen, Medical Psychol- and valid assessment procedures to measure metacog- ogy and Medical Sociology, Aachen, Germany nitive processes and disorders of unawareness, and (d) treatment of disorders of awareness of deficits in pa- The interest in the investigation of metacognitive pro- tients with an ABI and other mental disorders. cesses has been considerable increased in recent years. CONCLUSION: Many theories have been proposed to Metacognition refers to higher order thinking which account for disorders of awareness (especially anos- involves active control over one’s cognitive processes. ognosia). However, none of these theories appear sat- Research in metacognition have been carried out by (a) isfying. Further research is needed integrating not cognitive and social psychologists who have addressed only neuropsychological methods and findings, but the mechanisms of metacognitive processes, and (b) also concepts like self-concept, self-serving bias, so- neuropsychologists and neurologists who have high- cial cognition, self-enhancement, self-protection etc. lighted the associations between impairments in specific areas of the brain or limitations in the awareness Correspondence address: Prof. Siegfried Gauggel, Uni- of cognitive functioning and deficits in specific cog- versity Hospital RWTH Aachen, Medical Psychology nitive processes (e.g., executive functions). Synthesiz- and Medical Sociology, Pauwelsstrasse 19, D-52074 ing the outcomes of both approaches would be very Aachen, Germany. Tel.: +49 0241 8089000; E-mail: fruitful for understanding the nature and neural basis of [email protected] Symposia 311

Lecture 2: Self-Awareness in children and OBJECTIVE: Older individuals who recognize their adolescents with attention deficit hyperactivity cognitive difficulties are more likely to adjust their ev- disorder: Further evidence of the positive illusory eryday life to their actual cognitive functioning, par- bias ticularly when they are able to estimate their abilities accurately. Effi Volz-Sidiropoulou, Maren Böcker and Siegfried METHODS: We assessed self- and spouse-ratings of Gauggel memory and attention difficulties in everyday life of University Hospital RWTH Aachen, Medical Psychol- healthy, older individuals and compared them with the ogy and Medical Sociology, Aachen, Germany respective test performance. Eighty-four older individuals (women’s age, M = 67.4 years, SD = 5.2; men’s OBJECTIVE: This study aimed to examine the ac- age, M = 68.5 years, SD = 4.9) completed both the curacy of self-reports of children and adolescents self and the spouse versions of the Attention Deficit with attention-deficit/hyperactivity disorder (ADHD) Questionnaire and the Everyday Memory Question- in evaluating their competence in every-day activities. naire and completed two neuropsychological tests. Us- METHOD: Self-reports of children and adolescents ing the residual score approach, subjective metacogni- n = with ADHD ( 89) were compared with those of tive measures of memory and attention were created n = non-referred children ( 94), and also to parental and compared with actual test performance. reports of their children’s competence in performing RESULTS: Significant associations between subjec- daily activities. Competence was measured with a 34- tive and objective scores were found only for men and item rating scale. Behavioural disorders were docu- only for episodic memory measures. Men who under- mented with the Child Behaviour Checklist. reported memory difficulties performed more poorly; RESULTS: Children and adolescents with ADHD men who overreported memory difficulties performed were much more likely than controls to overestimate better. Men’s recognition performance was best pre- their competence in certain daily life activities rela- dicted by subjective measures (R2 = 0.25), followed tive to their parents’ reports, demonstrating a posi- by delayed recall (R2 = 0.14) and forgetting rate tive illusory bias. The positive illusory bias was found (R2 = 0.13). to be moderated by coexisting behavioural problems CONCLUSION: The results indicate gender-specific and was pronounced in activities that were expected to differences in metacognitive accuracy and predictive be affected by ADHD symptoms. Overestimated self- perceptions of competence were more likely to be ac- validity of subjective ratings. companied with externalizing problems such as aggression. Correspondence address: Dr. Effi Volz-Sidiropoulou, CONCLUSION: Results support the presence of the University Hospital RWTH Aachen, Medical Psychol- positive illusory bias also in the domain of everyday ogy and Medical Sociology, Pauwelsstrasse 19, D- life activities. In behavioural treatment programs, im- 52074 Aachen, Germany. Tel.: +49 0241 8089002; E- provement of self-evaluation of competencies should mail: [email protected] also become a focus of treatment.

Correspondence address: Dr. Effi Volz-Sidiropoulou, Lecture 4: Content matters: Degree of University Hospital RWTH Aachen, Medical Psychol- patient-proxy agreement is moderated by the ogy and Medical Sociology, Pauwelsstrasse 19, D- measured construct 52074 Aachen, Germany. Tel.: +49 0241 8089002; E- mail: [email protected] Maren Böcker, Effi Volz-Sidiropoulou and Siegfried Gauggel University Hospital RWTH Aachen, Medical Psychol- Lecture 3: Do subjective measures of attention and ogy and Medical Sociology, Aachen, Germany memory predict actual performance? Metacognition in older couples OBJECTIVE: Impaired awareness of motor, cognitive and behavioral impairments and disabilities is a Effi Volz-Sidiropoulou and Siegfried Gauggel quite serious and prevalent problem in patients ac- University Hospital RWTH Aachen, Medical Psychol- quires brain injuries (ABI). As reduced awareness has ogy and Medical Sociology, Aachen, Germany been shown to negatively influence rehabilitation out- 312 Symposia come, the assessment of possible awareness deficits is OBJECTIVE: Metacognitive monitoring has repeat- of high importance. One way to measure lack of aware- edly been studied, especially concerning memory en- ness is the comparison of a patient’s self rating with coding and retrieval and deficits. Regarding the mon- a rating made by significant others or staff members. itoring and accurate of the perception of body pro- However, it has been shown that the rater agreement cesses, especially one’s own heartbeat, it has been can be very inconsistent and might be influenced by shown that better cardiac awareness (i.e., higher con- factors as e.g. intrahemispheric locus of the lesion or gruence between subjectively experienced and objec- the construct itself. tively measured heart rate) is related to better per- METHODS: In the present study we investigated the formance in cognitive tasks. The relation between degree of patient-proxy agreement for five different as- metacognitive monitoring of memory processes and pects of the ICF-domains activities and participation. monitoring of body processes such as heartbeats has For this purpose a consecutive sample of 94 ABI outpa- not been studied yet. In this presentation the available tients (39 female, 55 male; mean age: 45.5 (14.1)) was literature on metacognitive monitoring of memory pro- assessed in four different German outpatient rehabili- cesses and cardiac awareness will be reviewed and first tation facilities. Self and proxy (spouse or next of kin) empirical data on its relationship will be presented. ratings were assessed by means of the five newly devel- METHODS: Healthy participants performed the oped subscales of the Aachen Functioning Item Bank heartbeat perception task and a Judgment of Learn- (AFIB), namely mobility, fine motor function, gross ing paradigm which measures the metacognitive accu- motor function, cognition I (attention, memory, orien- racy regarding memory processes. The sequence of the tation, communication) and cognition II and partici- two paradigms were be balanced and results were con- pation (executive functions, emotion regulation, inter- trolled for age, sex, body mass index, physical fitness, personal interactions, work). All five AFIB-subscales etc. Until now, pilot data from 9 participants have been were developed conforming to the Rasch model and collected. items for this study were selected in a way that no RESULTS: Preliminary data show a positive correla- Rater-Differential Item Functioning existed. tion between cardiac awareness and metacognitive ac- RESULTS: Results indicate that patient-proxy agree- curacy for memory processes (r = 0.42). ment was good and of similar size for the subscales CONCLUSION: Findings suggest a general and not mobility, fine and gross motor function with correla- domain specific metacognitive ability provided that tions between self and proxy rating ranging from 0.68 this result will be confirmed in the larger sample with to 0.72. However, patient-proxy agreement was sub- sufficient power. stantially lower for cognition I (r = 0.52) and especially for cognition II and participation (r = 0.39). Correspondence address: PD Dr. Thomas Forkmann, CONCLUSION: Implications of these results for the University Hospital RWTH Aachen, Medical Psychol- clinical assessment disorders of awareness are dis- ogy and Medical Sociology, Pauwelsstrasse 19, D- cussed. 52074 Aachen, Germany. Tel.: +49 0241 8089003; E- mail: [email protected] Correspondence address: Dr. Maren Böcker, Univer- sity Hospital RWTH Aachen, Medical Psychology and Medical Sociology, Pauwelsstrasse 19, D-52074 Symposium 7: Symptom Validity Tests In Neu- Aachen, Germany. Tel.: +49 0241 8088235; E-mail: ropsychology: No Excuse For Not Using Them. [email protected] Brechje Dandachi-FitzGerald University of Maastricht, Maastricht, Netherlands, Lecture 5: Metacognitive monitoring and somatic School for Mental Health and Neurosciences (MHeNS), awareness: Same or different? Maastricht, Netherlands

Thomas Forkmann, Judith Meessen, Verena Mainz and An important aspect of neuropsychological assess- Siegfried Gauggel ment is its contribution to both clinical and forensic University Hospital RWTH Aachen, Medical Psychol- decision making. This decision making can become ogy and Medical Sociology, Aachen, Germany distorted when patients or defendants produce non- credible symptoms. Over the past years, the body of Symposia 313 knowledge about symptom credibility has grown to a chiatric literature as it relates to malingering, facti- degree that ignoring the issue of symptom credibility tious disorder, and somatoform complaints. We con- is incompatible with evidence-based practice. The fo- ducted a survey among neuropsychologists (N = 515) cus of this symposium will be on symptom credibil- from six European countries (Germany, Italy, Den- ity in neuropsychological assessment. Currently, neu- mark, Finland, Norway, and The Netherlands). Re- ropsychologists have several tools for examining the spondents were asked questions about the tools they credibility of reported symptoms and test performance use to evaluate symptom credibility in clinical and at their disposal. When it comes to symptom credibil- forensic assessments and about other issues related to ity, there are no arguments left to rely on clinical im- symptom validity testing. The majority of respondents pression alone. exhibited technical knowledge about symptom valid- How European neuropsychologists address symptom ity, although a sizeable minority was found to rely on credibility in their neuropsychological assessment will outdated notions (e.g., the idea that clinicians can de- be discussed in the paper of Brechje Dandachi-Fitz termine symptom credibility on the basis of intuitive Gerald et al. This paper presents data of a large- judgment). Little consensus exists among neuropsy- scale survey among neuropsychologists in six Euro- chologists as to how to instruct patients when they are pean countries. An elegant experimental study on de- administered symptom validity tests (SVTs) and how tecting feigned amnesia by Peter Giger et al. illus- to handle test failure. Our findings indicate therefore trates the importance of using a combination of tools that the issues of how to administer SVTs and how to for evaluating symptom credibility. This multi-method communicate their results to the patients warrant sys- approach is also an important feature in the research tematic research. of Rudolf Ponds et al., which indicates that symptom credibility is not only relevant to the forensic, but also Correspondence address: Mrs Brechje Dandachi-Fitz to the clinical domain. In his presentation, he will dis- Gerald, University of Maastricht, School for Men- cuss the prevalence of non-credible symptoms in gen- tal Health and Neurosciences (MHeNS), P.O. Box eral hospital patients, and how this impacts standard 616, NL-6200 MD Maastricht, Netherlands. E-mail: clinical test results. In the final presentation, Harald b.fi[email protected] Merckelbach will present data illustrating that non- credible symptoms do not only represent a complication of diagnostic assessment, but may eventually be- Lecture 2: The assessment of feigned memory come real for the person who engages in feigning of impairment: An example of a multi-method symptoms. approach

Correspondence address: Mrs Brechje Dandachi-Fitz Peter Giger Gerald, University of Maastricht, Maastricht, Nether- University of Bern, Switzerland, Section of Psychology lands, School for Mental Health and Neurosciences and Law, Maastricht, Switzerland (MHeNS), Kapelstraat 12, NL-6226 EB Maastricht, Netherlands. E-mail: b.fitzgerald@maastrichtuniver The assessment of reported memory impairment is a sity.nl common task for neuropsychologists. In cases where secondary gain is at stake the possibility of symptom exaggeration or malin-gering has to be always kept in Lecture 1: Symptom validity and mind. This is particularly true in criminal forensic set- neuropsychological assessment: A survey of tings where feigned crime-related amnesia is a strategy practices and beliefs of neuropsychologists in six of offenders to avoid criminal responsibil-ity. There European countries are numerous tests available that can help experts to identify false amnesia claims (so-called symptom va- Brechje Dandachi-FitzGerald lidity tests; SVTs). However, there are two main prob- University of Maastricht, School for Mental Health lems that cannot be ignored: First, malingering is a and Neurosciences (MHeNS), Maastricht, Netherlands multidimensional phenomenon, and consequently different strategies may be employed by individuals who Symptom validity has become an important topic over feign mental disorders, and second, the question of cor- the past decade in the neuropsychological and psy- rect classifications or diagnostic accuracy. The primary 314 Symposia goals of the current study were to investigate how well patients passed both tests, 30% failed either the ASTM feigned amnesia can be detected using a multi-method or the SIMS, and 25% failed both tests. We examined approach and to what extent this approach can reduce how groups performed on the Rey’s Verbal Learning false classifications. In an experi-mental study, 60 par- Task (VLT) and the Brief Symptom Inventory (BSI). ticipants were instructed to commit a mock crime and The group that failed the ASTM (n = 44) recalled on were then as-signed to three conditions: responding average 39 words over trial 1–5 of the VLT, whereas honestly; feigning amnesia; feigning amnesia with a the group that passed the ASTM (n = 48) obtained warning not to exaggerate. A test battery consisting of a mean total recall trial 1–5 of 48 words (t = 3.58, tests of underperformance and symp-tom exaggeration p<0.01). Also, the delayed recall differed signifi- was administered. High specificity rates were found for cantly between the ASTM fail group (mean = 9.9) and all tests, with sensi-tivity rates ranging from 45 to 88 the ASTM pass group (mean = 7.3) (t = 3.22, p< percent. Five of seven tests correctly classified all hon- 0.01). The group that scored deviant on the SIMS ob- est participants, and not one naïve malingerer passed tained a higher average BSI item score (n = 24, mean all SVT. Only three warned malingerers went unde- item score = 0.68) than the group that scored within tected throughout the test battery. The results demon- the normal range (n = 66, mean item score = 1.67) strate that promising instru-ments exist to support de- (t = 5.4, p<0.01). These results will be further dis- cision making about feigned memory problems. More- cussed in light of the demographic characteristics (e.g. over, a multi-method approach increases the diagnos- diagnosis upon referral, social situation, involvement tic accuracy and keeps the risk of misclassifying hon- in legal procedures). est responders at an adequate level. The findings may Our results indicate that in a general hospital setting, serve as an example of how two disciplines, neuropsy- non-credible symptom reports occur in a substantial chology and forensic psychology, can learn and benefit minority of neuropsychological evaluations and when from each other. it occurs it has a significant impact on test outcomes. Our findings call for routinely assessing symptom va- Correspondence address: Mr Peter Giger, University lidity in a neuropsychological evaluation in hospital of Bern, Switzerland, Section of Psychology and Law, patients without obvious cognitive impairment. Hochschulstrasse 4, Swiss-3012 Maastricht, Switzer- land. E-mail: [email protected] Correspondence address: Mr Rudolf Ponds, Maastricht University Medical Center, Department of Medical Psychology, P.O. Box 5800, NL-6202 AZ Maastricht, Lecture 3: Non-credible symptom reports of Netherlands. E-mail: [email protected] patients referred for neuropsychological assessment in a general hospital Lecture 4: Residual effects of symptom fabrication Rudolf Ponds Maastricht University Medical Center, Department of Harald Merckelbach Medical Psychology, Maastricht, Netherlands Maastricht University, Forensic Psychology Section, Maastricht, Netherlands The current study looked at the prevalence of non- credible symptom reports during neuropsychological In this presentation, I will argue that symptom fab- assessment in a general hospital setting. Patients with rication is more than just a complication of the di- obvious cognitive impairment (e.g., dementia, acute agnostic process. That is, symptom fabrication itself psychosis, M. Parkinson) were excluded. All patients tends to produce residual symptoms that the person (N = 93) were routinely referred for neuropsycholog- experiences as genuine. In one recent experiment, we ical assessment. Neuropsychological assessment in- had two experimental groups (n = 15 each) that were cluded two symptom validity tests (SVTs): the Ams- given a legal scenario with the option to exaggerate terdam Short Term Memory test (ASTM) measuring symptoms. Compared to a control condition (n = 15), underperformance and the Structured Inventory of Ma- both groups scored significantly higher on the Struc- lingered Symptomatology (SIMS) tapping into over- tured Inventory of Malingered Symptomatology. Next, reporting symptoms. Using the recommended cut-offs, one group was confronted in a sympathetic way about prevalences of SVT failure were as follows: 45% of the their symptom validity test failure, whereas the other Symposia 315 group was confronted in a neutral manner. Both groups Correspondence address: Mr Professor Arash Sahraie, subsequently completed the Brief Symptom Inventory University of Aberdeen, School of Psychology, Kings (BSI). BSI scores of both feedback groups remained College, GB-AB23 8UL Aberdeen, UK. E-mail: a. significantly higher than those of control participants. [email protected] Participants who had been provided with sympathetic feedback or neutral feedback did not differ in their BSI scores. Even participants who indicated during the exit Lecture 1: Computer-based assessment of visual interview that they had given up symptom exaggera- functions tion attained significantly higher BSI scores than controls, indicating that exaggeration has residual effects Michael Niedeggen that are resistant to corrective feedback. Our findings Freie Universität Berlin, Experimental Psychology and accord well with various research lines that show that Neuropsychology, Berlin, Germany other-deceptive acts (e.g., symptom fabrication) tend to develop into self-deception (e.g., believing that you do The rehabilitation of visual deficits critically depends suffer from symptoms). Why is that the case? I will dis- on a detailed examination of the different functions, cuss cognitive dissonance as a model for understand- i.e. color, object, or motion processing. However, clin- ing residual effects of symptom exaggeration and also ical neuropsychological routine is often restricted to address the implications for assessment and follow-up the examination of the visual field. We developed a interventions. computer-based assessment of visual functions (CAV) based on force-choice procedures in order to reduce Correspondence address: Harald Merckelbach, Maas- mnestic and linguistic demands. Subtests can be sum- tricht University, Forensic Psychology Section, P.O. marized to estimate (1) apperceptive and associative Box 616, NL-6200 MD Maastricht, Netherlands. object perception, and (2) perceptual and cognitive E-mail: [email protected] space perception. The CAV was applied to a sample of 30 neurological patients with posterior lesions, and data were compared with the normative data available Symposium 8: Progress in rehabilitation of visual (n = 150 healthy subjects). With respect to object per- deficits after brain injury ception, apperceptive deficits (PR < 10: 6/30 patients) were more frequently observed as compared to asso- Arash Sahraie < University of Aberdeen, School of Psychology, Ab- ciate deficits (PR 10: 4/30 patients). Visuo-spatial erdeen, UK deficits with a perceptual component (i.e. line orientation) were less frequent (PR < 19: 5/30 patients) than Visual deficits following brain injury range from minor deficits with a cognitive component (i.e. line bisection, < disturbances of brightness perception to full blindness PR 10: 8/30 patients). The results indicate that the in one or both hemifields, often affecting oculomotor prevalence of object agnosia or visuo-spatial deficits control, reading, and visual attention. Similar to lan- is probably underestimated. In patients with posterior guage and motor deficits after brain injury, vision can lesions these deficits might affect the success of neu- benefit from clinical intervention leading to partial or ropsychological rehabilitation. full recovery of the deficit, improving patients’ quality of life. The sympsosium is intended to highlight the re- Correspondence address: Mr Professor Michael Niede- cent progress in this field. Results from clinical studies ggen, Freie Universität Berlin, Experimental Psychol- using home based eye-movement interventions will be ogy and Neuropsychology, Habelschwerdeter Allee presented. Following an introduction on the computer- 45, D-14195 Berlin, Germany. E-mail: niedegg@zedat. based assessment of visual deficits (Niedeggen), re- fu-berlin.de cent findings on reading interventions and the effect of hemianopia on reading will be discussed (Schenk). Methods and recent findings of changes in visual sensitivity following systematic stimulation will be outlined (Sahraie) together with novel approaches on using multi-sensory integration for rehabilitation purposes (Ladavas). 316 Symposia

Lecture 2: Efficacy and feasibility of a home-based 2University of Aberdeen, School of Medicine and Den- computer training for individuals with tistry, Aberdeen, UK homonymous visual field defects In hemianopic patients, Blindsight type I refer to de- 1 2 2 Thomas Schenk , Lina Aimola , Alison R. Lane , tection within field defect in the absence of any aware- 2 3 2 Daniel T Smith , Georg Kerkhoff and Gary Ford ness, whereas type II blindsight refers to above chance 1 University of Erlangen, Cognitive Neurology, Erlan- detection with reported awareness, but without seeing gen, Germany per se. Systematic sensory stimulation is the princi- 2 University of Durham, Department of Psychology, ple approach in many sensory and motor impairments Durham, UK in brain damaged patients. The parameters for visual 3 University of Saarland, Department of Psychology/ stimulation are crucial in mediating any change. In de- Neuropsychology, Saarbrucken, Germay tailed case studies, evidence for dependency of awareness responses on the stimulus properties will be pre- Homonymous visual field defects (HVFDs) are one sented. In addition in a number of cases it appears that of the most common consequences of stroke. Effec- the detection ability at early stages of training varies as tive compensatory training has been developed which a function of distance of the stimulated area from the helps such individuals to function more successfully sighted field border. There is a lack of detection ability by encouraging them to develop more efficient eye- at retinal locations deep within the field defect. Never- movements. However, such training is typically un- theless following repeated stimulation and after 5,000 dertaken in clinical settings, or at home with supervi- to 10,000 trials, the detection performance improves. sion, which can be both time-consuming and costly. Therefore, there appears to be a continuum of per- We developed and evaluate the efficacy and feasibility formance from no detection, to blindsight type I, and of an unsupervised home-based computer training for eventually type II detection. Recent findings of eye- individuals with HVFDs, which includes both reading movement dependent visual sensitivity changes will and visual exploration components. Seventy individu- also be presented together with discussion of possible als with HVFDs were randomly assigned to one of two mechanisms for recovery of function. groups: experimental or control. The former received 35 hours of combined reading and exploration training, Correspondence address: Mr Professor Arash Sahraie, and the latter 35 hours of a control attention training. University of Aberdeen, School of Psychology, Kings Visual and attentional abilities were assessed both be- College, GB-AB23 8UL Aberdeen, UK. E-mail: a. fore and after training using perimetry, visual search, [email protected] reading, activities of daily living, the Test of Every- day Attention, and a Sustained Attention to Response task. Patients in the experimental group showed con- Lecture 4: Audio-visual perceptual learning in the siderably more improvements in tests of exploration and reading than patients in the control group. We will hemianopic field discuss whether home-based training is a cheap and ac- cessible rehabilitation option for patients with HVFDs. Elisabetta Ladavas, C. Bertini and N Dundon University of Bologna, Department of Psychology, Correspondence address: Professor Thomas Schenk, Bologna, Italy University of Erlangen, Cognitive Neurology, Schwab- achanlage 6, D-91054 Erlangen, Germany. E-mail: The human brain possesses a flexible audio-visual sys- [email protected] tem, which interprets and guides responses to external events according to spatial alignment, temporal synchronization and effectiveness of unisensory sig- Lecture 3: Effect of systematic training on vision nals. Here we explore the possibility that such a sys- loss caused by post-geniculate brain injury tem might represent the neural correlate of sensory compensation when a sensory modality has been dam- Arash Sahraie1, Amelia Hunt1,CeriT.Trevethan1, aged by a cerebral lesion (patients with hemianopia). Kay Ritchie1 and Mary-Joan MacLeod2 We will examine on-line and off-line effects of audio- 1University of Aberdeen, School of Psychology, Ab- visual stimulation on the visual and spatial impair- erdeen, UK ments following damage to the geniculo-striate path- Symposia 317 way. We will demonstrate that an improvement in Lecture 1: Not seeing the pain in patients with spatial orienting can be obtained not only when an dementia on-line response is required, but also after either a brief or a long adaptation to audio-visual stimulation. Miriam Kunz These findings suggest that the mechanisms subserv- University of Munich, Biological Psychology, Munich, ing audio-visual perceptual learning are still active af- Germany ter a damage to the geniculo-striate pathway; this perceptual learning is probably driven by recruitment of Given the limited ability of patients with dementia to the retino-colliculo-extrastriate pathway. communicate pain verbally (due to the cognitive decline across the course of dementia), observation of Correspondence address: Mrs Professor Elisabetta La- non-verbal pain behavior (especially the facial expres- davas, University of Bologna, Department of Psychol- sion) is essential when trying to assess pain. However, ogy, Bologna, GB-AB23 8UL Bologna, Italy. E-mail: when pain assessment is solely based on non-verbal [email protected] pain behavior, misjudgment often occurs. “Observers” mostly tend to not see the pain encoded in the facial expression of the individual suffering from pain and Symposium 9: Pain in dementia: the miserable se- thus underestimate the pain. In this talk, experimen- quence of not seeing, not believing and not acting tal evidence will be presented on judging pain in patients with different degrees of dementia (as well as in Stefan Lautenbacher young and older individuals) based on their facial ex- University of Bamberg, Physiological Psychology, pression. It will be discussed to which degree the age Bamberg, Germany and the cognitive status of the individual in pain, affect the ability of others to see their pain. Moreover, data on The symposium aims at providing a conception of the different types of observers (e.g. young and old, elderly difficulties involved in assessing and treating pain in care nurses, male and females) will be presented that patients with dementia. The audience should become emphasize that even long-standing professional expe- aware that the difficulties may arise at any stage of the rience with elderly patients in pain does not necessar- process (i) starting from the failed detection of pain, ily improve the pain detection. Clinical implications of (ii) continuing with misleading diagnosis and (iii) end- these experimental findings will be discussed. ing with the reluctance of using all available treatment options (e.g. erroneous prescription of only too weak analgesics or psychotropic drugs). In other words, a Correspondence address: Prof. Miriam Kunz, Univer- main objective is the acquisition of professional sensi- sity of Munich, Biological Psychology, Leopoldstr. 13, tivity to the miserable sequence of not seeing, not be- D-80802 Munich, Germany. Tel.: +49 089 2180 6927; lieving and not acting when faced with pain in demen- Fax: +49 089 2180 5233; E-mail: miriam.kunz@lmu. tia. Presented information should help to understand de that each of the three stages contains particular problems, which may limit the quality of the next stage, but that each stage produces problems ex novo. Accord- Lecture 2: How misjudgment and misbelieve ing to the latter, not even valid diagnoses result neces- prevents adequate pain diagnostic and treatment sarily into sufficient treatment. Improved awareness of in patients with dementia these caveats will better know the prerequisites to reduce suffering from pain in demented patients but also Sandra Zwakhalen how to ameliorate concurrent neuropsychological and Maastricht University, Contact Health Services Re- -psychiatric symptoms and to avoid unnecessary psy- search, GT Maastrich, The Netherlands chotropic drug prescription. Previous research has identified knowledge deficits and Correspondence address: Prof. Stefan Lautenbacher, misbeliefs about pain in dementia among nurses, who University of Bamberg, Physiological Psychology, play an important role in decision-making for pain Markusplatz 3, D-96045 Bamberg, Germany. Tel.: +49 management. Such misconceptions may also prevent 0951 863 1851; Fax: +49 0951 863 1976; E-mail: the adequate use of diagnostic procedures. It has yet [email protected] been unclear as to what extent the use of standardized 318 Symposia pain assessment relieves interventions undertaken by these vulnerable elderly people. Not only are behav- nurses. To determine the relationship between the ini- ioral symptoms associated with pain, treatment of pain tiation of intervention and the use of standardized pain may indeed also decrease cognitive deficits and be- diagnosis in demented patients, an observational scale havioural disturbances. named PACSLAC-D was used in a longitudinal study. Data were collected during a six-week period (twice a Correspondence address: Prof. Wilco Achterberg, week). Interventions undertaken as result of a critical LUMC, Postbus 9600, NL-2300 RC Leiden, The pain score were recorded. Compliance was evaluated Netherlands. Tel.: +31 0715268412; E-mail: w.p. with the nursing staff involved. In total, 264 pain as- [email protected] sessments were conducted; 60 observations resulted in a critical pain score, which did however not necessarily lead to any intervention. In sum, although there was Symposium 10: Neuropsychology and Neuroimag- a high compliance with using the standardized pain ing of the bilingual brain scale, pain relieving interventions were not frequently applied when necessary; nurses’ attitudes played an Marco Calabria and Alber Costa important role in decision-making about initiation of a Center for Brain and Cognition, Pompeu Fabra Uni- pain treatment. versity, Department of Technology and Communica- tions, Barcelona, Spain Correspondence address: Dr. Sandra Zwakhalen, Maastricht University, Contact Health Services Re- Nowadays more than half of the world’s population search, Duboisdomein 30, NL-6229 GT Maastrich, is bilingual and the number of people speaking more The Netherlands. Tel.: +31 043 38 8408; Fax: +31 043 than one language is increasing. Therefore, the study 38 8416; E-mail: [email protected] of the ‘bilingual brain’ has become a relevant topic in the fields of neuroimaging and neuropsychology. The aim of this symposium is to bring together re- Lecture 3: Impact of pain treatment on cognitive searchers who illustrate the neural aspects (structural deficits and behavioural disturbances in nursing and functional one) of language processing in bilin- home patients with moderate and severe dementia guals and the neural changes associated to the benefits of bilingualism. The five papers presented here cover Wilco Achterberg different research fields of bilingualism using different LUMC, RC Leiden, The Netherlands approaches: from neuroimaging to clinical neuropsychology. Anna J. Simmonds will focus on cortical and Pain is common amongst elderly due to the increased subcortical functions associated with non-native vocal prevalence of age-related diseases like osteoporosis, learning in English participants using functional mag- arthritis and cardiovascular diseases. The prevalence of netic resonance imaging (fMRI). Jubin Abutalebi will pain amongst elderly living in nursing homes varies talk about the neurological basis for why bilinguals around 50%. Patients with dementia seem to expe- outperform monolinguals on many attentional control rience the intensity and affective component of pain tasks, both in healthy individuals and in patients with different from patients with intact cognition. In addi- cognitive decline. Brendan Weekes will present a re- tion, due to loss of language skills, pain is often not view of published cases of bilingual aphasia by consid- communicated as such in more severe stages of de- ering several variables explaining the language recov- mentia. In these patients, pain is often expressed in ery patterns in bilingual speakers. Swathi Kiran will specific behaviour, such as agitation or withdrawal. talk about three experiments examining the interaction The presentation will point out this still prevalent dis- between facilitation and interference in the context of astrous situation, in which pain in dementia is mis- bilingual aphasia rehabilitation and she will frame the taken as a psychiatric condition and treated conse- results within the current models of bilingual produc- quently by psychotropic drugs. The combination of tion. Finally, Marco Calabria will present a case of multiple morbidity and poly-pharmacy increases the pathological language switching due to neurodegener- chance of side-effects and complications. Meanwhile, ative disease in a Catalan-Spanish bilingual individual. there is some evidence that pharmacological and non- Correspondence address: Mr PhD Marco Calabria, pharmacological pain interventions can be effective in Center for Brain and Cognition – Pompeu Fabra Uni- Symposia 319 versity – Department of Technology and Communi- Correspondence address: Mrs PhD Anna J. Simmonds, cations, C. Tanger, 122-140 (room 55124), ES-08018 Imperial College – Division of Brain Sciences, Depart- Barcelona, Spain. Tel.: +34 93 542 2629; E-mail: cal- ment of Medicine, South Kensington Campus, UK- [email protected] SW7 2AZ London, UK. E-mail: anna.simmonds08@ imperial.ac.uk

Lecture 1: The anterior striatum in non-native vocal learning Lecture 2: Bilingualism across lifespan: Structural and functional brain consequences Anna J. Simmonds1, Robert Leech1,RichardJ.S. Wise1 and Paul Iverson2 Jubin Abutalebi 1Imperial College, Division of Brain Sciences, Depart- University San Raffaele Milan, Italy ment of Medicine, London, UK 2University College London, Division of Psychology Culture, education and of other forms of acquired ca- and Language Sciences, London, UK pacities act on individual differences in skill to shape how individuals perform cognitive tasks such as atten- We investigated cortical and subcortical function asso- tional and executive control. Of interest, bilingualism ciated with human vocal learning. Adult monolingual also appears to be a factor that shapes individual per- native English participants were scanned using func- formance on tests of cognitive functioning. Indeed, re- tional magnetic resonance imaging (fMRI) while researchers have shown that a bilingual can have better peating non-native (Spanish, German and Mandarin) attention and executive control capacities than mono- bi-syllabic words, with no feedback received. They lingual speakers and this is argued to be due the abil- then underwent training on the pronunciation of half ity to inhibit one language while using another. Be- the words for one week, before a second fMRI scan- yond behavioural differences, bilingualism seems to ning session. The baseline condition was repetition of affect brain structure as well. During my presentation bi-syllabic native non-words: novel word forms com- I will show how bilinguals develop more grey matter prised of familiar (English) phonemes. In the anterior in crucial brain areas responsible for executive control, striatum there was a Language (non-native words and hence, providing a neurological basis for why bilin- native non-words) X Session (before and after train- guals outperform monolinguals on many attentional ing) interaction. Both trained and untrained non-native control tasks. Furthermore, it has been postulated that words showed a between-session decline in activity, this cognitive advantage offers protection to bilinguals even though improved accuracy of pronunciation only against cognitive decline (dementia) in aging. Bilin- occurred with the former. Even within the ﬁrst ses- gualism affords a cognitive reserve (CR) in the form sion, striatal activity for repeating non-native words of a set of skills that allows some people to cope with declined after the ﬁrst of three runs. In contrast, activ- cognitive decline such as mild cognitive decline (MCI) ity in sensory perisylvian cortex when repeating non- or Alzheimer’s disease (AD) better than others. The native words correlated negatively with improved ac- primary aim of this presentation is to illustrate how curacy and an increased signal-to-noise ratio (SNR); the bilingual brain becomes resistant to cognitive de- notably in a left high-order auditory area for Man- cline. New structural and functional neuroimaging re- darin tones and in left ventral somatosensory cortex for sults from comparative studies between bilinguals and German vowels, which depend on novel tongue move- monolinguals during lifespan (i.e., covering children, ments. The response of the anterior striatum, unrelated adults and seniors) will be illustrated in order to pro- to measures of accuracy of non-native word repetition, vide an overview of how bilingualism induces a neu- indicates its involvement is not related solely to ac- rocognitive advantage and how this advantage offers tivity in premotor and motor cortico-striatal loops, but protection against cognitive decline. is modulated by additional processes, which may be as diverse as motivation and self-perception of perfor- Correspondence address: Mr MD Jubin Abutalebi, mance. University San Raffaele Milan, Via Olgettina, 60, I- 20132 Milan, Italy. E-mail: [email protected] 320 Symposia

Lecture 3: Bilingual aphasia: A cognitive Lecture 4: The nature of facilitation and neuropsychological account interference in the rehabilitation of bilingual aphasia Brendan Weekes and Ekaterina Kuzmina Faculty of Education, University of Hong Kong, Swathi Kiran, Teresa Gray, Mel Lo and Caitlin Keane Speech and Hearing Sciences, Hong Kong, China Boston University, Speech Language and Hearing Sci- ences, Boston, US Studying cases of bilingual speakers with aphasia allows tests of hypotheses derived from models of bilin- I will talk about three experiments examining the inter- gual language processing by investigating the impor- action between facilitation and interference in the con- tance of endogenous variables (language status and text of bilingual aphasia rehabilitation. The first exper- dominance, mode of language acquisition, language iment investigated the nature of within- and between- proficiency and preference) relative to exogenous fac- language generalization in 17 participants with Span- tors (language type, word frequency, concreteness, ish/English bilingual aphasia who received seman- cognate status and grammatical class) in bilingual lan- tic naming treatment. Participants received therapy guage processing. We present a review of published in either English or Spanish and treatment outcomes cases of bilingual aphasia including reports that are not were compared for: trained items, within-language se- published in English. Reports were analysed accord- mantically related untrained items, between language ing to three dimensions: age of acquisition of the sec- translations of trained and between-language transla- ond language (L2), language dominance and linguis- tions of untrained semantically related items. Treat- tic distance between the spoken languages (e.g. Indo- ment for naming on Set 1 items resulted in signifi- European vs. Sino-Tibetan). Analyses found that ap- cant improvement on the trained items in 14/17 par- proximately 50% of patients show a pattern of differ- ticipants. Within-language generalization to semanti- ential impairment whereby the first acquired language cally related items was observed for 10 participants. is better preserved relative to other languages spoken Between-language generalization to the translations of with 25% showing the opposite pattern. In all the other trained items was observed for 5 participants; whereas cases, there was no differential impairment. When the between-language generalization to the translations of cases are grouped according to linguistic distance be- the untrained semantically related items for 6 partici- tween spoken languages, the pattern of differential im- pants. In other study, a Chinese-English bilingual indi- pairment was similar i.e. the majority of cases have vidual with aphasia was trained in Chinese and showed more impairment in the later acquired language. For between-language generalization to the untrained En- those patients with greater impairment in the first ac- glish language. In a third study, a French-English- quired language, L2 is the dominant language in daily Amharic trilingual individual with aphasia, was trained life for all cases. One finding from the review is differ- first in French and then in English. This individual ential effects of task on performance i.e. impairment is showed no within or between-language generalization greater in L2 on some tasks and in L1 for others. We and showed several instances of cross-language inter- argue all effects can be understood with reference to ference. Results of these studies illustrate that within- a computational model of bilingual language process- and between-language patterns are variable across par- ing first proposed by Dijkstra and colleagues (2001) ticipants and these differences are indicative of the in- that assumes a shared architecture for all languages. terplay between facilitation (generalization) and inhi- Furthermore, we show that effects of psycholinguistic bition. The discussion addresses these results within variables such as word class (nouns versus verbs), age current theoretical models of lexical access and the in- of acquisition and imageability on performance can fluence of rehabilitation on these models. Rehabilita- be explained with reference to a language independent tion outcomes also appear to be influenced by language cognitive framework. proficiency, use, and the patient’s current language environment. Correspondence address: Mr Professor Brendan Weekes, Faculty of Education, University of Hong Correspondence address: PhD Swathi Kiran, Boston Kong, Speech and Hearing Sciences, Hospital Road, University, Speech Language and Hearing Sciences, 34, CHN-999077 Hong Kong, China. E-mail: weekes Commonwealth Aveneu, 635, US-02101 Boston, US. @hku.hk E-mail: [email protected] Symposia 321

Lecture 5: Lost in translation: A case-study of 2NRZ Neurologisches Rehabilitationszentrum Leipzig, pathological language switching Bennewitz

1 1 2 Marco Calabria ,PaulaMarne , Lucía Romero-Pinel , For most people, driving is an integral part of their 2 1 Montserrat Juncadella and Alber Costa mobility and independence affecting physical, social 1 Center for Brain and Cognition, Pompeu Fabra Uni- and economic well-being. Thus professionals who are versity, Department of Technology and Communica- concerned with the quality of life of their patients are tions, Barcelona, Spain inevitably confronted with issues of fitness to drive. 2 Hospital Universitari de Bellvitge, Barcelona, Spain A comprehensive assessment and counseling of patients with neuropsychological impairments is of great Bilingual speakers are usually quite good at restrict- relevance in clinical practice. In our symposium, we ing their lexicalization output to the desired language will focus on various topics of fitness to drive of pa- while preventing all sorts of language intrusions from tients with neuropsychological dysfunction. From a the language not in use. However, brain damage can af- methodological point of view, there is a great defect these abilities of language control, leading to strik- bate whether laboratory or clinical tests can reliably ing and flagrant linguistic behaviors, such as patholog- predict on-road driving performance. Niemann and ical language mixing (pLS) and switching (pLM). Hartje focus on this topic. A new approach in as- In this paper we report the performance a Catalan- sessing fitness to drive is the use of driving simula- Spanish bilingual individual (RRT) who, due to a neu- tors. Kenntner-Mabiala and co-workers present new rodegenerative disease and subcortical lesions, shows simulation techniques for testing and training fitness pLS. We tested RRT in several tasks of language pro- to drive of patients with neuropsychological impair- duction and control, such as: picture naming (objects ments. The demographic change in western industrial and actions), word translation, blocked naming and nations points to another field of importance. Espe- language switching task. cially for the elderly, mobility is essential. Much less We found several interesting results. First, cross-langu- is known about skills that are relevant for safe driving age intrusions were present much more frequently in older drivers (Köster and colleagues). Last but not when the RRT was asked to speak in her first (and dom- least, psychopharmacological treatment is common in inant) language (Catalan) than when she was asked to patients with a neuropsychiatric disorder. Among psy- do so in the non-dominant language (Spanish). Sec- chotropics, antidepressants are the most frequent ones ond, the results provide evidence suggesting that damage to certain subcortical structures may lead to prob- prescribed. Brunnauer et al. present data of the effects lems in controlling the language output during verbal- of newer antidepressants on driving performance in pa- ization in bilingual speakers. Finally, we observed that tients with depressive symptoms. RRT seemed to show more difficulties in language control with verbs. The results are discussed in relation Correspondence address: Dr. Alexander Brunnauer, to other findings of pLM and pLS in published single- kbo-Inn-Salzach-Klinikum, Neuropsychology, Haus case reports. 13, D-83512 Wasserburg, Germany. Tel.: +49 8071 71224; Fax: +49 8071 743; E-mail: alexander.brunnau Correspondence address: PhD Marco Calabria, Cen- [email protected] ter for Brain and Cognition, Pompeu Fabra Uni- versity, Department of Technology and Communica- tions, C. Tanger, 122-140 (room 55124), ES-08018 Lecture 1: Neuropsychological assessment of Barcelona, Spain. Tel.: +34 93 542 2629; E-mail: fitness to drive and on-road driving tests in the [email protected] rehabilitation of patients with brain damage

Hendrik Niemann1 and Wolfgang Hartje2 1 Symposium 11: Neuropsychological impairments NRZ Neurologisches Rehabilitationszentrum Leipzig, and driving performance Neuropsychology, Bennewitz, Germany 2NRZ Rehabilitationszentrum Leipzig, München Alexander Brunnauer1 and Hendrik Niemann2 1kbo-Inn-Salzach-Klinikum, Neuropsychology, Wass- Abstract: The data of 494 brain-damaged patients erBurg, Germany whose driving ability was examined during inpatient 322 Symposia rehabilitation were retrospectively analysed. The sam- ing and training can be systematically designed, pre- ple was comprised of 394 males (mean age 51.0 yrs.) sented and reproduced. As in real traffic, subjects can and 100 females (mean age 43.1 yrs.). Time since in- practice compensatory strategies. Neither subjects nor jury ranged from one month to several years. Most pa- other road users are compromised. Due to high face- tients suffered from cerebrovascular accidents (49%) validity simulation is well-accepted by subjects. How- or traumatic brain injury (21%). The neuropsycholog- ever, some methodological issues have to be specif- ical tests included measures of alertness, selective and ically addressed when using simulators. Firstly, the divided attention, flexibility, and visual scanning. Pa- test scenarios should be both representative for real tients, who did not meet the criteria of neurocogni- driving and sensitive to the condition to be investi- tive functioning based on German guidelines of fit- gated. Furthermore, driving performance should be as- ness to drive, participated in a semi-standardized on- sessed as a whole by various endpoints that refer to road driving test. Various aspects of driving behaviour the operational and tactical level of the driving task. and overall safety were rated by the driving instructor Finally, the simulated driving test has to be validated. and a neuropsychologist. 28% of the patients failed the The software package “Driver Fitness and Ability” of- driving test. Discriminant function analyses based on fers test scenarios that are representative for real driv- neuropsychological test scores resulted in hit rates being, alcohol-validated and sensitive for psychotropic tween 76% and 77% depending on variables included. substances and neuropsychological conditions. Out of Positive predictive values ranged from 64% to 69%, more than 50 scenarios, adaptive training sessions as and negative predictive values ranged from 78% to well as test courses can be compiled comfortably via 80%. Of 14 test scores, the following subtests of the drag and drop. The assessment of fitness to drive is Test of Attentional Performance (TAP) were selected conducted holistic and semi-automatic by means of a for best discriminant function: Alertness (simple visual tablet computer. The scenario package can be run on reaction time) and Visual Scanning (reaction time and simple PC-simulations as well as on high-end solutions omissions). In addition, the Trail Making Test Part A with motion system. A detailed demonstration of the was also included. Test scores and aspects of driving scenarios and the procedure of assessing driving ability behaviour loaded on separate orthogonal factors. The will be given in the presentation. outcome of the on-road driving test could not be reliably predicted from the psychometric measures. Correspondence address: Mrs Dr Ramona Kenntner- Mabiala, WIVW Würzburger Institut für Verkehrswis- Correspondence address: Dr. Hendrik Niemann, NRZ senschaften, Raiffeisenstraße 17, D-97209 Veitshöch- Neurologisches Rehabilitationszentrum Leipzig, Neu- heim, Germany. E-mail: [email protected] ropsychology, Muldentalweg 1, D-0428 Bennewitz, Germany. E-mail: [email protected] Lecture 3: Abilities relevant for safe driving in healthy older drivers Lecture 2: New solutions for testing and enhancing fitness to drive of neuropsychological patients with Nina Köster, Tatjana Edelmann, Mehmet Gövercin and driving simulation: Elisabeth Steinhagen-Thiessen Forschungsgruppe Geriatrie der Charite, Universitäts- Ramona Kenntner-Mabiala, Yvonne Kaussner, Sonja medizin Berlin, Germany Hoffmann and Alexandra Neukum WIVW Würzburger Institut für Verkehrswissenscha- Driving places is a highly complex and demanding ften, Veitshöchheim, Germany task. Abilities essential for safe driving change due to normal aging, age-associated diseases, and medication. Due to the growing need for mobility in our age- However, driving is an important aspect of mobility ing society, testing and enhancing fitness to drive in old age, as it helps maintaining independent living of patients suffering from neuropsychological con- and hence a higher quality of life. So far there is no ditions becomes more and more important. Modern consensus on which skills are most relevant, how ex- driving simulators combine the advantages of clas- actly these abilities change, how they interact, and how sical psychometric test batteries and on road drives deficits can be compensated for. This is also true for as- and solve the shortcomings. Driving scenarios for test- sessment tools. The DrivingHealth Inventory (DHI) Symposia 323 is a computerized screening of visual, motor, and cog- METHODS: A sample of 75 depressive inpatients di- nitive abilities associated with an increased crash risk. agnosed according to DSM-IV criteria were randomly The objective of this study, conducted within the col- assigned to treatment with either mirtazapine (n = 25), laborative project SmartSenior was to collect norma- escitalopram (n = 25) or reboxetine (n = 25). Par- tive data on senior drivers’ abilities relevant for safe ticipants were tested before pharmacologic treatment driving. Since there is also a controversy regarding se- (t0), and on days 7 (t1) and 14 (t2) with computer- niors’ ability to adequately assess their own driving ized tests related to car driving skills. Data were col- performance, a secondary objective was to assess driv- lected with the Act and React Testsystem (ART 90) and ing behavior and attitudes. the Wiener-Testsystem (WTS) measuring visual per- A German version of the DHI was completed by ception, reactivity, stress tolerance, concentration and 116 healthy senior drivers (M = 67.7 years old, SD vigilance. Besides patients underwent various risk sim- 3.23, 67.2% male, 67.2% with high level of educa- ulations on a static driving simulator. tion). A comprehensive medical and neuropsychologi- RESULTS: Patients showed significant improvements cal examination, including the Test of Attentional Per- in most functional domains related to driving ability formance – Mobility Version were also administered. skills and also in driving simulator performance after Participants completed simulator drives in which they 14 days of treatment with newer antidepressants. Espe- were confronted with unexpected hazard events. They cially in concentration, reactivity and stress-tolerance also filled in questionnaires asking about their driving a clear advantage could be demonstrated in contrast to behavior, sense of security driving, attitudes towards the untreated phase. Statistically significant differences regulations on driving in old age, and crash involve- between treatment groups could not be shown. ment. CONCLUSIONS: Partly remitted depressive patients According to the DHI results, 77.9% of participants treated with mirtazapine, escitalopram or reboxetine had at least one deficit, 18.3% in two or more tasks. showed a better test performance in driving related Most prevalent were difficulties concerning cognitive skills than untreated patients. Especially in the case of flexibility. 25% could not turn their head around to newer, selective antidepressant results have important look over their shoulder. Variability of simulator per- implications for risk calculations within legal require- formance was low. Simulator performance was lowly ments. associated with assessment results. Correspondence address: Dr. Alexander Brunnauer, Correspondence address: Mrs Nina Köster, Forschung- kbo-Inn-Salzach-Klinikum, Neuropsychology, Haus sgruppe Geriatrie der Charite, Universitätsmedizin 13, D-83512 Wasserburg, Germany. Tel.: +49 8071 Berlin, Reinickendorferstraße 61, D-13347 Berlin, 71224; Fax: +49 8071 743; E-mail: alexander.brunnau Germany. E-mail: [email protected] [email protected]

Lecture 4: Driving simulator performance and Symposium 12: To the left and to the right: How psychomotor functions under newer non-invasive brain stimulation techniques inﬂuence antidepressants motor and cognitive functions

Alexander Brunnauer1, Gerd Laux2 and Verena To the Left and to the Right: How Non-invasive Brain Buschert1 Stimulation Techniques influence motor and cognitive 1kbo-Inn-Salzach-Klinikum, Neuropsychology, Wass- functions erburg, Germany 2kbo-Inn-Salzach-Klinikum, Wasserburg Paola Marangolo1, Agnes Floel2, Friederich Hummel3 and Giacomo Koch4 OBJECTIVES: Driving a car is vital for the functional 1University Politecnica delle Marche, of Experimental autonomy of patients to take part in activities of daily and Clinical Medicine, Ancona, Italy living. Although the therapeutic efficacy of newer an- 2Charité, Department of Neurology, Universitatsmedi- tidepressants has been demonstrated in various studies zin Berlin, Berlin, Germany there is only little research available about patients’ fit- 3Department of Neurology, University Medical Center ness to drive under newer antidepressants. Hamburg-Eppendorf, Hamburg, Germany 324 Symposia

4University Hospital Tor Vergata, Neurology, Rome, Lecture 1: tDCS-enhances language recovery – Italy new challenges in aphasia rehabilitation?

The past decade of neuroscience research has provided Paola Marangolo considerable evidence that the adult brain can undergo University Politecnica delle Marche, of Experimental substantial reorganization following a stroke [1]. A and Clinical Medicine, Ancon, Italy growing body of evidence have already indicated that noninvasive brain stimulation techniques (NIBS), such Recently, the progress of new technologies have made as Transcranial magnetic stimulation (TMS) and tran- new tools available for professional therapists. In the scranial direct current stimulation (tDCS), can modu- field of aphasia, one area is central for a positive out- late brain plasticity in the healthy and brain-damaged come in language rehabilitation: the use of noninvasive populations [2,3]. These methods have shown promis- brain stimulation techniques. A growing body of evi- ing results in promoting functional recovery of the dence have already indicated that TMS and tDCS can most disabling conditions after stroke such as mo- have beneficial effects in the treatment of aphasia [1,2]. tor impairment, aphasia and neglect [4,5,6]. However, However, some studies, although have shown an im- there are still doubts regarding the areas to be stim- provement of lexical deficits, do not always confirm a ulated in the context of compensatory activation and persistency of the effects found [3]. Moreover, many of maladaptive plasticity in both the affected and un- these studies do not have a control condition to estab- affected hemispheres. Moreover, it is still an open is- lish the specificity of the stimulated area [3]. More re- sue if the effects found are persistent overtime and are cent studies have suggest that long-term effects might specific for the treated function or generalize to other be more easily obtained with repeated stimulations and domains. This symposium will directly address these during simultaneous specific language training [4,5,6]. crucial issues reporting the state of the art in the most Here, the development of these innovative approaches important neurological and cognitive domains in which as a potentially promising tools for aphasia rehabilita- NIBS is becoming a useful promising clinical tool. tion will be discussed together with an overview of the language deficits more suitable for these interventions. References [1] Dancause N, Nudo RJ. Shaping plasticity to enhance recovery References after injury. Prog Brain Res, 2011. [1] Naesser MA et al., Improved picture naming in chronic aphasia [2] Floel, A. et al. Non invasive brain stimulation improves language after TMS to part of right Broca’s area: an open-protocol study. learning. J. Cogn. Neurosci, 2008. Brain Lang, 2005. [3] Fiori, V. et al. Transcranial direct current stimulation improves [2] Fiori, V. et al. Transcranial direct current stimulation improves word retrieval in healthy and nonfluent aphasic subjects. J. Cogn. word retrieval in healthy and nonfluent aphasic subjects. J. Cogn. Neurosci, 2011. Neurosci, 2011. [4] Schulz R. et al (2013) Non-invasive brain stimulation in neuro- [3] Monti A. et al. Transcranial direct current stimulation (tDCS) logical diseases. Neuropharmacology, 2013 and language. J. Neurol. Neurosurg. Psychiatry, 2012. [5] Marangolo, P. et al. Differential involvement of the left frontal [4] Fridrikson J et al. Transcranial direct current stimulation im- and temporal regions in verb naming: a tDCS treatment study. proves naming reaction time in fluent aphasia: a double-blind, Restor. Neurol. Neurosci, 2013. sham-controlled study. Stroke, 2011. θ [6] Koch G et al. -burst stimulation of the left hemisphere acceler- [5] Marangolo P et al. Electrical stimulation over the left inferior ates recovery of hemispatial neglect. Neurology, 2012. frontal gyrus (IFG) determines long-term effects in the recovery of speech apraxia in three chronic aphasics. Behav Brain Res, 2011. Correspondence address: Mrs Professor Paola Maran- [6] Marangolo P et al., Differential involvement of the left frontal golo, University Politecnica delle Marche – of Experi- and temporal regions in verb naming: a tDCS study. Restor Neu- mental and Clinical Medicine, Via Tronto 10A, 60020 rol and Neurosci, 2013 Ancona, Italy. E-mail: [email protected] Correspondence address: Professor Paola Marangolo, University Politecnica delle Marche – of Experimental and Clinical Medicine, Via Tronto 10A, 60020 Ancon, Italy. E-mail: [email protected] Symposia 325

Lecture 2: tDCS-enhanced language training – Lecture 3: Non-invasive brain stimulation to proof- of- principle and neural correlates support neuroregeneration of the motor system after stroke Agnes Floel Charité, Universitatsmedizin Berlin, Neurology, Friederich Hummel Berlin, Germany University Medical Center Hamburg-Eppendorf, Neu- rology, Hamburg, Germany The rising proportion of elderly people worldwide will yield an increased incidence of age-associated cogni- Non-invasive brain stimulation has provided evidence tive impairments and dementia. Consequently, grow- for its potential to modulate brain plasticity in hu- ing interest emerged to evaluate new strategies to delay mans [1]. Based on these findings brain stimulation has or counteract cognitive decline in aging. Here, I will been used in neurological diseases to enhance neuro- discuss a series of studies aimed to assess the impact plasticity, adaptive processes and to prevent potential of anodal transcranial direct current stimulation (at- maladaptive ones to support functional recovery [2]. In DCS) on learning ability in young and older adults. In a stroke for instance sensorimotor and higher cognitive study, atDCS versus sham over left temporoparietal ar- impairment, such as aphasia and neglect, has been ad- eas enhanced learning of a novel vocabulary [1], while dressed to facilitate functional recovery. In the present learning of an artificial grammar was enhanced by at- presentation an update of the field of transcranial mag- DCS over Broca’s area [2]. We then went on to test netic stimulation (TMS) and transcranial direct current task-related activity of a semantic fluency paradigm stimulation (tDCS) as non-invasive brain stimulation and resting-state functional connectivity during atDCS techniques to improve motor functions in patients suf- over the ventral part of left IFG [3]. Improved behav- fering from focal brain lesions will be provided. Rather ioral performance was associated with selectively re- than attempting to be comprehensive in regard of the duced task-related activation in the left ventral IFG and reviewed scientific field, this presentation may be con- increased connectivity of the left IFG. In a group of sidered as a present day’s framework of the application healthy older adults improved behavioral performance of non-invasive brain stimulation on selected examples and increased network efficiency and specificity was of common neurological diseases. At the end open con- found4. These results have important clinical implica- troversies and future directions of the field which has tions as they suggest the possibility to apply these pro- to be addressed in upcoming studies will be briefly dis- tocols to elderly people to delay their cognitive decline. cussed [3].

References References [1] Floel A et al. Noninvasive brain stimulation improves language [1] Hummel, F.C. & Cohen, L.G. Drivers of brain plasticity. Curr learning. J Cogn Neurosci. 2008; 20: 1415-1422. Opin Neurol 18, 667-674 (2005). [2] de Vries MH et al. Electrical stimulation of Broca’s area en- [2] Hummel, F.C. & Cohen, L.G. Non-invasive brain stimulation: A hances implicit learning of an artificial grammar. J Cogn Neu- new strategy to improve neurorehabilitation after stroke? Lancet rosci. 2010; 22: 2427-2436. Neurol 5, 708-712 (2006). [3] Meinzer M et al. Electrical brain stimulation improves cognitive [3] Hummel, F.C., et al. Controversy: Noninvasive and invasive cor- performance by modulating functional connectivity and task- tical stimulation show efficacy in treating stroke patients. Brain specific activation. J Neurosci. 2012; 32: 1859-1866. Stimul 1, 370-382 (2008). [4] Lindenberg R et al. Age-related effects of non-invasive inferior frontal cortex stimulation on resting-state connectivity. Orga- nization for Human Brain Mapping, 2013. Correspondence address: Mr Doctor Friederich Hum- mel, University Medical Center Hamburg-Eppendorf, Correspondence address: Mrs Professor Agnes Floel, Neurology, Martinistraße 52, 20251 Hamburg, Ger- Chariteé – Universitatsmedizin Berlin, Neurology, many. E-mail: [email protected] Chariteéplatz 1, D-10117 Berlin, Germany. E-mail: [email protected] 326 Symposia

Lecture 4: The hyperexcitability of the left intact Symposium 13: The Contributions of the prefrontal hemisphere: non-invasive brain stimulation model cortex to episodic memory of the unaffected hemisphere in neglect patients Sarah E. MacPherson Giacomo Koch University of Edinburgh, Department of Psychology, University Hospital Tor Vergata, Neurology, Rome, Edinburgh, United Kingdom Italy It is widely accepted that the frontal lobes play an im- The human brain is characterized by the lateraliza- portant role in memory. Frontal lobe lesions have been tion of cognitive functions. Multiple lines of evidence found to produce impairments on both verbal and vi- suggest that the deployment of visuo-spatial attention sual memory tests including free recall, memory for is controlled by a fronto-parietal network, with right contextual information, temporal order memory and hemisphere dominance. Among cortical areas included metamemory. Yet, some of the specific contributions of in the network, the right posterior parietal cortex (PPC) the prefrontal cortex to episodic memory still remain has been proposed to be a crucial node and has also a matter of debate, such as whether prefrontal lesions been implicated on clinical grounds. Here, I will pro- result in both recall and recognition memory impair- vide an overview of the existent literature giving evi- ments and the role of anatomical frontal subregions on dence to a functional asymmetry of the parietal cortices episodic memory. Therefore, the aim of this sympo- in directing visuo-spatial attention, focusing on those sium is to present some of the recent research investi- studies seeking to characterize the causal role of PPC, gating the prefrontal lobes and episodic memory. Pre- applying transcranial magnetic stimulation (TMS) and sentations will comprise studies comparing the role of its combination with imaging techniques, such as EEG the prefrontal cortex in recall and recognition, includ- and fMRI [1,2]. I will then discuss studies involving findings which demonstrate that inhibition of the ing neglect patients shedding light on the complex in- right dorsolateral prefrontal cortex modulates a domain terplay between left and right PPC, strongly support- general memory retrieval process. We will also present ing the hemispheric-rivalry theory [3]. These evidence the results of work investigating the involvement of have important clinical implications as shown by re- the ventromedial and orbitofrontal prefrontal regions cent findings demonstrating changes of neglect disor- on spontaneous confabulation and mental time travel ders following the non-invasive stimulation of the un- into the past and the future. Finally, we will discuss affected hemisphere. some recent neuroimaging data which suggests that the medial prefrontal cortex supports the ability to make References reality monitoring decisions. These presentations will [1] Koch G. et al. To the other side of the neglected brain: The provide an overview of the current state of the frontal Hyperexcitability of the left intact hemisphere, Neuroscientist, lobes and memory literature. 2012. [2] Koch et al., θ – burst stimulation of the left hemisphere acceler- ates recovery of hemispatial neglect. Neurology, 2012. Correspondence address: Dr. Sarah E. MacPherson, [3] Koch et al. Asymmetry of parietal interhemipheric connections University of Edinburgh, Department of Psychology, in humans. J. Neuroscience, 2011 7 George Square, UK-EH15 2QN Edinburgh, United Kingdom. Tel.: +44 131 650 9862; Fax: +44 131 651 Correspondence address: Mr Doctor Giacomo Koch, 3230; E-mail: [email protected] University Hospital Tor Vergata, Neurology, Viale Ox- ford 81, 00133 Rome, Italy. E-mail: g.koch@hsantalu cia.it Lecture 1: The Doors and People Test: The effect of frontal lobe lesions on recall and recognition memory performance

Sarah E. MacPherson1,MarthaS.Turner2, Marco Bozzali3, Lisa Cipolotti4 and Tim Shallice5 1University of Edinburgh, Department of Psychology, Edinburgh, United Kingdom 2University College London, Institute of Cognitive Symposia 327

Neuroscience, London, United Kingdom This study investigated the effect of repetitive tran- 3Santa Lucia Foundation, IRCCS, Neuroimaging Lab- scranial magnetic stimulation and inhibitory theta burst oratory, Rome, Italy stimulation on recognition memory performance of 4National Hospital for Neurology and Neurosurgery, healthy subject, MCI and AD patients. We applied Department of Neuropsychology, London, magnetic stimulation over left and right dorsolateral United Kingdom prefrontal cortex (DLPFC) at retrieval in recognition 5SISSA, Cognitive Neuroscience Sector, Trieste, Italy memory tests. We found that rTMS applied to the right DLPFC improved recognition memory performance in Memory deficits in frontal patients are most appar- healthy controls (HC). In contrast rTMS applied to ent on recall tasks that require the selection, initia- the left DLPFC had no effect on the HC’s recognition, and implementation of strategies, while recognition memory performance. Interestingly, iTBS excitation memory impairments are less well reported. How- tion of the right DLPFC of HC impaired recognition ever, few studies have compared recall and recognition memory performance whilst iTBS excitation of the within the same frontal group and those that have re- left DLPFC had no effect on HC’s recognition mem- port inconsistent findings. The Doors and People Test ory performance. Interestingly, rTMS inhibition of the was devised to directly compare recall and recogni- right DLPFC also improved the recognition memory tion performance within the same test, and yet, no performance of MCI and mild Alzheimer’s Disease. In studies have investigated frontal patients’ performance contrast, and similarly to the healthy control, the recog- on this memory battery. In the current study, 47 pa- nition memory performance of the MCI and mild AD tients with frontal lobe lesions due to tumour or stroke patients did not improve following inhibitory rTMS and 78 healthy controls performed the verbal and vi- over the left DLPFC. rTMS of the right or left DLPFC sual recall and recognition subtests from the Doors have no effect on the recognition memory performance and People Test. The results demonstrated that the of moderate Alzheimer’s Disease patients. These find- frontal group was significantly impaired on the ver- ings suggest that the inhibition of the right dorsolateral bal and visual recall subtests as well as the verbal prefrontal cortex modulates a domain general memory recognition subtest compared to healthy controls. The retrieval process. Moreover, it suggests that rTMS may comparison between frontal patients’ and healthy con- represent a promising therapeutic tool for memory im- trols’ performance on the visual recognition subtest ap- pairment. proached significance. The effect sizes for each subtest showed that the magnitude of the difference between the frontal and control groups did not significantly dif- Lecture 3: Confabulation and the frontal lobes fer between verbal recall and recognition or visual recall and recognition. Therefore, when recall and recog- Michael D. Kopelman nition memory tests are matched in terms of difficulty, King’s College London, Institute of Psychiatry, Lon- they do not differ in their ability to identify frontal pa- don, United Kingdom tients. This talk will briefly review the evidence that sponta- Correspondence address: Dr Sarah E. MacPherson, neous confabulation is related to ventro-medial frontal University of Edinburgh, Department of Psychology, and orbito-frontal lobe damage, as well as current the- 7 George Square, UK-EH15 2QN Edinburgh, United ories of confabulation. It will report new findings ex- Kingdom. Tel.: +44 131 650 9862; Fax: +44 131 651 amining Schnider’s theory of confabulation, and also 3230; E-mail: [email protected] the role of affective and motivational factors in confabulation. Twenty-four confabulating brain-injured patients were compared with 11 non-confabulating brain- Lecture 2: The contribution of the PFC to injured patients and 6 healthy controls with follow-up recognition memory: Evidence from TMS studies over 9 months. Findings will be reported, and their implications for current theories discussed. Lisa Cipolotti National Hospital for Neurology and Neurosurgery, Department of Neuropsychology, London, United Kingdom 328 Symposia

Lecture 4: Mental time travel following lesion to rived from the outside world by perceptual processes. the ventromedial prefrontal cortex Healthy volunteers exhibit greater fMRI activity in this region when performing reality monitoring tasks than Elisa Ciaramelli, Chiara Tesini and Elena Bertossi other tests of recollection, evidence that we have re- University of Bologna, Department of Psychology and lated both to clinical conditions in which the ability Centre for Studies and Research in Cognitive Neuro- to distinguish reality from imagination appears to be science, Cesena, Italy disturbed, and to inter-subject variability in the general population. The medial prefrontal region identi- Functional neuroimaging studies have suggested that fied overlaps closely with one of the areas that tends both remembering the past and imagining the future to be functionally disrupted in schizophrenia, and re- activate a ‘default’ network of brain regions includ- duced activity in the region in healthy individuals is ing the ventromedial prefrontal cortex (VMPFC). Al- associated with the kinds of specific misattribution er- though patients with damage to the prefrontal cortex rors often seen in the disorder. I will discuss evidence are often described as impulsive, “blind to the future suggesting that variability in medial prefrontal cortical consequences of their choices”, and “locked into im- folding patterns might provide a specific structural ba- mediate space and time”, it is unclear whether and sis for these performance differences. how the VMPFC mediates mental time travel into the past and the future. Six patients with lesion to the VMPFC (VMPFC patients) and 12 healthy controls re- Symposium 14: Psychotherapy after aquired brain membered past events and imagined future events in injury response to cue words. Event transcriptions were segmented into distinct details, and classified as either in- Cornelia Exner ternal (episodic) or external (non-episodic) according University of Leipzig, Institute of Psychology, De- to the scoring method of the Autobiographical Inter- partment of Clinical Psychology and Psychotherapy, view. Preliminary results show that VMPFC patients Leipzig, Germany exhibit deficits in both remembering past events and imagining future events, generating fewer internal de- Acquired brain injury (ABI) often results in emotional tails than healthy controls. In contrast, external details and behavioural adjustment problems and is associated were comparable between patients and controls. These with an increased risk for comorbid mental disorders. results indicate that the VMPFC is a critical node of a Emotional and behavioural disturbances interfere with system allowing transcending the present to re- or pre- rehabilitation efforts and decrease chances of ABI sur- experience alternative scenarios. vivors for independence, participation and wellbeing in everyday life. Many comprehensive neuropsychological programs today incorporate psychotherapeutic Lecture 5: Getting a grip on reality: The role of strategies and techniques to ameliorate psychological medial prefrontal cortex in source recollection functioning after ABI. Psychotherapy techniques are mostly based on standard cognitive-behaviour therapy Jon Simons protocols. Although the use of these techniques seems University of Cambridge, Department of Psychology, plausible there is a need for controlled trials to evaluate Cambridge, United Kingdom the merits of additional psychotherapy components for rehabilitation outcomes. Much previous research has characterised the involve- Contributions in this symposium from four different ment of lateral prefrontal cortex in recollecting the European countries and thus four different health care context in which previous events were experienced. In systems will focus on the combination of neuropsy- this talk, I will present evidence addressing the role chological and psychotherapeutic approaches in reha- that medial prefrontal cortex might play in such source bilitation efforts after ABI. The symposium program recollection. Our data suggest that regions of medial will include an overview on key clinical issues relat- prefrontal cortex support the ability to make “reality ing to the use of additional psychotherapy techniques monitoring” decisions, distinguishing information that in neuropsychological rehabilitation with special em- was generated by internal cognitive functions such as phasis on which patients will benefit from it and which thought and imagination from information that was de- modifications to standard psychotherapy practice are Symposia 329 necessary. Four different controlled clinical trials will sity Health Board NHS Wales and Bangor University, be presented that use psychotherapy within neuropsy- Hesketh Road, LL29 8AY Colwyn Bay, UK. E-mail: chological rehabilitation programs to reach individ- [email protected] ual treatment goals, to foster self-awareness and emotional adjustment and to reduce symptoms of depression and anxiety. Results will show that incorporating Lecture 2: Does an integrative psychotherapy in neuropsychological services presents neuro-psychotherapy program foster the a valuable treatment options for persons with long- adjustment in depressed patients with an acquired term emotional and behavioural adjustment problems brain injury? after ABI. Methodological and clinical issues of these combined treatment approaches will be discussed. Helene Hofer1, Martin Grosse Holftforth2, Franziska Stalder-Lüthy3, Eveline Frischknecht3,RenéMüri4 Correspondence address: Prof. Dr. Cornelia Exner, and Hansjörg Znoj3 University of Leipzig, Institute of Psychology, De- 1University Hospital of Bern, Department of Neurol- partment of Clinical Psychology and Psychotherapy, ogy, Bern, Switzerland Seeburgstr. 14-20, D-04103 Leipzig, Germany. Tel.: 2University of Zürich, Department of Psychology, +49 341 9735931; Fax: +49 341 9735939; E-mail: Zürich, Switzerland [email protected] 3University of Bern, Department of Psychology, Bern, Switzerland 4University of Bern, Department of Neurology, Bern, Lecture 1: The role of psychotherapy in long-term Switzerland brain injury rehabilitation: key clinical issues GOALS: The main goal of this study was to investigate Rudi Coetzer whether an integration of neuropsychological and psy- North Wales Brain Injury Service, Betsi Cadwaladr chotherapeutic techniques offers benefits in the process University Health Board NHS Wales and Bangor Uni- of coping with the effects of an acquired brain injury. versity, Colwyn Bay, UK METHOD: The study was conducted in an outpatient setting. Patients meet the diagnosis of an ad- Over the past decades psychotherapy has increas- justment disorder. The patients were randomly as- ingly been incorporated as an aspect of some multi- signed to two treatments. One treatment, the so- disciplinary rehabilitation programmes for persons called standard neuro-psychological treatment based with acquired brain injury. An overview of a few key on conventional recommendations for neurorehabilita- psychotherapy approaches currently used to augment tion. The second treatment, the integrative program, long-term neuro-rehabilitation after acquired brain in- added techniques from cognitive behavior therapy, jury is provided. The design and development of re- the clarification-oriented and emotion-focused psy- habilitation services conducive to incorporating psychotherapy in addition. Whereas the research question chotherapy approaches are discussed. While some may and design have remained unchanged, some adjust- be helped, not all persons with acquired brain injury ments became necessary. On the basis of these context benefit from psychotherapy as an additional approach factors and developments, the former standard neu- to their rehabilitation. Clinical case vignettes are used ropsychological treatment was modified. to illustrate some of the obstacles encountered in prac- RESULTS: In total, 25 patients were recruited into tice. Specific emphasis is placed on potential modifica- the study. Time since injury ranged between 4 and 80 tions to clinical practice that may sometimes be used months (M = 17). The mean value of the BDI of the by the clinician working in this continually develop- pre-measurement was 20. The patients received an av- ing field within neuropsychological rehabilitation. Psy- erage of 20 therapy sessions. The results show large ef- chotherapy may be one of the few available treatment fects across all treatment groups on symptoms of de- options for persons with long-term emotional adjust- pression, quality of life, therapy goals, and fatigue and ment difficulties after brain injury. a small to medium effect regarding acceptance of the consequences of the disability. Correspondence address: Dr. Rudi Coetzer, North CONCLUSION: Neurorehabilitative interventions Wales Brain Injury Service, Betsi Cadwaladr Univer- aim at actively helping patients to cope with their 330 Symposia impaired functions and can be seen as instances of (DEX-t). The discrepancy between self and other rat- optimizing the patient’s mastery efforts. However, a ings on the DEX is considered to be an indication of change factor that is not yet systematically represented self-awareness. We hypothesized that increased self- in neurorehabilitative programs is motivational clarifi- awareness after treatment would express itself in a de- cation including a systematic focus on the emotional crease of the difference between self and other ratings aspects of coping with the adjustment. The findings of only for those patients who underwent the multifaceted our study suggest that the integration of neurorehabil- treatment. itation with psychotherapeutic interventions can foster RESULTS: Repeated Measures analysis showed a sig- the process of coping with the adjustment to the con- nificant decrease of the difference between the self and sequences of an acquired brain injury. therapist rating only, for those patients who underwent the multifaceted treatment, including Awareness train- Correspondence address: Dr. Helene Hofer, University ing. Hospital of Bern, Department of Neurology, Freiburg- CONCLUSION: We conclude that a combination of strasse, CH-3010 Bern, Switzerland. E-mail: helene. psychoeducation and awareness exercises can improve [email protected] self-awareness in patients with acquired brain injury and executive dysfunction, indicated by ratings of professionals only. Lecture 3: A therapeutic approach to improve self-awareness in brain injury patients with Correspondence address: Prof. Dr. Jacoba M. Spik- executive dysfunction man, University of Groningen, Department of Clinical and Developmental Neuropsychology and University Jacoba M. Spikman Medical Center Groningen, Department of Neurology, University of Groningen, Department of Clinical and Poortweg 4, NL-9700 Groningen, The Netherlands. E- Developmental Neuropsychology and University Med- mail: [email protected] ical Center Groningen, Department of Neurology, Groningen, The Netherlands Lecture 4: Restore4Stroke: Augmented cognitive OBJECTIVE: Executive dysfunction is a frequent and behavioural therapy for post-stroke depression disabling consequence of acquired brain injury, impair- with or without anxiety ing patient’s abilities to function independently in daily life. Consequently, there is a need for effective neu- Joyce Kootker1, Luciano Fasotti2, Sascha MC ropsychological rehabilitation interventions that im- Rasquin3, Caroline M Van Heugten4 and Alexander prove executive functions in daily life. However, many CH Geurts5 patients with dysexecutive problems have impaired 1Radboud University Nijmegen Medical Centre, De- self-awareness, which is associated with poor compli- partment of Rehabilitation, Nijmegen Centre for Evi- ance with rehabilitation. We have developed a multi- dence Based Practice, Nijmegen, The Netherlands faceted treatment protocol for executive dysfunction 2Radboud University Nijmegen, Donders Institute for andprovedittobeeffectiveinanRCT.Animpor- Brain, Cognition and Behaviour, Nijmegen, tant ingredient of this treatment protocol was the Infor- The Netherlands mation and Awareness module. This consisted of psy- 3Adelante Rehabilitation Foundation Limburg, The choeducation and awareness-exercises, aimed to en- Netherlands hance self-awareness and hence motivation for treat- 4Maastricht University, Faculty of Health, Medicine ment. and Life Sciences, Maastricht, The Netherlands METHOD: The effects of the Awareness training were 5Radboud University Nijmegen Medical Centre, De- investigated in an RCT, comparing the multifaceted partment of Rehabilitation, Nijmegen, The Netherlands treatment with a control computer treatment. A group of 70 patients with acquired brain injury were ran- Depression and anxiety are common after stroke. Their domly assigned to either treatment, resulting in 35 pa- prevalence varies, but in general 25 percent of all tients in each condition. Patients filled in the Dysex- stroke survivors experience depression with or with- ecutive Questionnaire (DEX) pre- and posttreatment, out anxiety. Currently, there are no evidence-based as well as their proxies (DEX-p) and their therapists treatments available. In a pilot study, Rasquin (2011) Symposia 331 showed that cognitive behavioural therapy positively treatment approaches. However, evidence from con- influences depression complaints. Restore 4 stroke de- trolled trials on the merits of standard psychotherapy signed a multicentre randomized controlled trial to in- protocols e.g. cognitive-behavioraltherapy after ABI is vestigate the effectiveness of a similar treatment. We still sparse. We report preliminary data from an ongo- intend to include minimally N = 53. The treatment ing randomized wait-list controlled trial of combined program was derived from a former depression pro- neuropsychological and cognitive-behavioral therapy tocol (Cuijpers, 2004), and specifically adapted for for outpatients in the post-acute phase of recovery from stroke survivors. The protocol consists of 5 stages that ABI. 62 participants were included into the study and coincide with the motivational phases from the trans- were randomly assigned to receive either the treatment theoretical model of behavior change (Prochaska & Di- at once or after a waiting period of five months. The Clemente, 1998). The stages consist of building rap- treatment protocol included three neuropsychological port; optimizing activity levels; recognizing negative modules aiming at compensation for deficits in atten- thoughts and changing cognitions; consolidating and tion, memory and executive functioning. Three addi- relapse prevention. The treatment is given by both psy- tional cognitive-behavior psychotherapy modules tar- chologists and occupational therapists and consists of geted negative emotions such as anger and depres- 13 to 16 sessions within 4 months. Occupational thera- sion and supported adjustment of self-concepts and pist or movement therapist are involved in the protocol life goals after ABI. Based on a comprehensive di- to optimize activity levels taking into account individ- agnostic battery and establishment of shared treat- ual capacity and needs. The inclusion phase ends June ment goals each subjects got assigned 3–4 modules 2013. The outline and content of the treatment proto- depending on his individual rehabilitation needs. Par- col will be presented. Next to that, preliminary results ticipants received an average of 30 therapy sessions. with regard to the trial will be discussed. Outcome variables included measures of neuropsychological functioning, mental disorders, daily activities, Correspondence address: M.Sc. Joyce Kootker, Rad- participation and quality of life and were administered boud University Nijmegen Medical Centre, Depart- to participants before and after treatment and after a ment of Rehabilitation, Nijmegen Centre for Evi- 6-months follow-up. Preliminary pre-post analyses of dence Based Practice, Reinier Postlaan 2, NL-6525 45 participants who have already completed treatment Nijmegen, The Netherlands. E-mail: J.Kootker@reval. show medium treatment effects on symptoms of de- umcn.nl pression and general psychopathology, improvement of daily functioning and participation and increase in subjective quality of life. Lecture 5: Integrating neuropsychological and cognitive-behavioral treatment approaches for Correspondence address: Prof. Dr. Cornelia Exner, outpatients with cognitive and University of Leipzig, Institute of Psychology, De- emotional-motivational difficulties after acquired partment of Clinical Psychology and Psychotherapy, brain injury Seeburgstr. 14-20, D-04103 Leipzig, Germany. Tel.: +49 341 9735931; Fax: +49 341 9735939; E-mail: Cornelia Exner1, Bettina Doering2, Nico Conrad2, [email protected] Anna Künemund2, Sarah Zwick2 and Winfried Rief2 1University of Leipzig, Institute of Psychology, De- partment of Clinical Psychology and Psychotherapy, Symposium 15: Attention and executive functions Leipzig, Germany in pediatric neurology 2University of Marburg, Department of Clinical Psy- chology and Psychotherapy, Marburg, Germany Karen Lidzba University Children’s Hospital, Pediatric Neurology After acquired brain injury (ABI) the risk for comor- and Developmental Medicine, Tübingen, Germany bid mental disorders is notably increased. Especially comorbid depression reduces psychosocial functioning Attention and executive functions are impaired in pa- and jeopardizes the progress of rehabilitation efforts. tients with a wide range of neurological disorders, and Treatment of these complex conditions requires the the dysexecutive syndrome is a well established con- combination of neuropsychological and psychotherapy cept for adult patients. In child neuropsychology, how- 332 Symposia ever, the pattern is not as clear: Due to the long devel- development of attention and the linkages between opmental trajectory of executive and complex attention prematurity, specific attention functions, self- regula- functions, it may be very difficult to identify deficits in tion and global cognitive performance. In our study these functions in young children. On the other hand, we analysed the relationship between focused attention executive or attentional dysfunction may be an un- (FA), observed global cognitive performance and self- specific component of global intellectual impairment. regulation derived from parental reports in preterm and Lastly, in clinical child psychology, problems in atten- term born infants. tion and executive functions are the hallmarks of atten- METHOD: At seven months corrected age (ca) 93 in- tion deficit-/hyperactivity disorder (ADHD), which is fants born preterm and 40 term born infants were ex- a known comorbidity of a range of conditions in pedi- amined with an object examination task. FA was de- atric neurology. rived from the videotaped sequences as the duration In this symposium we will present data on attention of examination of the presented toy over three tri- and executive functions in a range of neurological con- als of 20 seconds each. Cognitive performance was ditions of children, illustrating commonalities, speci- assessed at 7 months and 24 months (ca) with the ficities and comorbidity. Two talks will present data Bayley-II cognitive scale (MDI). Questionnaires on on attention and executive functions in former preterm self-regulation were answered by the parents at both children, focussing on the developmental aspect by il- assessment times (Infant Behavior Questionnaire re- lustrating very early precursors of attention in toddlers vised IBQ-R and Early Child Behavior Questionnaire (Reuner) and by examining age-effects on executive ECBQ). Correlations between variables were analysed. functions in school-children (Everts). The impact of at- A possible mediation effect of FA on the relationship tention deficit on the cognitive development of children between prematurity (gestational age) and cognitive with Neurofibromatosis type 1 will illustrate a “dual performance was analysed. hit” situation, where a labile neural system is further RESULTS: Focused attention correlated significantly hampered by attention problems (Lidzba). Similarly, in with both prematurity (p<0.05) and MDI at 7 months children with lesional brain damage, such as children of age (p<0.01) but not with later MDI. With respect with cerebral palsy (Di Lieto) or traumatic brain injury to parent rating of infant’s self-regulation there were (Benz), executive functions seem to be a core deficit, no significant interrelations in infancy, but those with which is, in the case of TBI, predictive of longterm higher FA were rated less impulsive at 24 months ca. cognitive outcome. Mediation analysis supports the hypothesized mediation effect of FA only in the preterm group (p<0.05). Correspondence address: Dr. Karen Lidzba, Univer- CONCLUSION: Findings suggest that individual dif- sity Children’s Hospital, Pediatric Neurology and De- ferences in focused attention emerge very early and velopmental Medicine, Hoppe-Seyler-Str. 1, D-72076 play an important role for later cognitive development Tübingen, Germany. Tel.: +49 70712980881; Fax: +49 and self-regulation in preterm born infants. Further- 7071295236; E-mail: [email protected] more, results are discussed with respect to differences gen.de between behavioural and questionnaire data.

Correspondence address: Dr. Gitta Reuner, Univer- Lecture 1: Focused attention in preterm and term sity Children’s Hospital, Neuropediatrics, Im Neuen- born infants. Relationship with cognition and heimer Feld 430, D-69120 Heidelberg, Germany. Tel.: self-regulation in early and later infancy +49 62215632012; Fax: +49 6221565222; E-mail: [email protected] Gitta Reuner1, Andrea Weinschenk1, Anna C. Fields1, Sabina Pauen2 and Joachim Pietz1 1University Children’s Hospital, Neuropediatrics, Hei- Lecture 2: Executive functions in children born delberg, Germany preterm – deﬁcit or delay? 2University of Heidelberg, Department of Psychology, Heidelberg, Germany Regula Everts and Barbara Ritter Childrens University Hospital, Division of Neuropae- AIM: Infants born preterm are at high risk for later diatrics, Development and Rehabilitation, Bern, deﬁcit in attention but little is known about the early Switzerland Symposia 333

AIM: This study examined executive functions of 8 1University Children’s Hospital, Pediatric Neurology to12 year old children born very preterm or at very low and Developmental Medicine, Tübingen, Germany birth weight in comparison to executive functions of 2Department of Neurology, University Medical Centre same-aged term-born controls. In particular, we inves- Hamburg-Eppendorf, Hamburg, Germany tigated whether preterm born children perform persis- tently poorer than controls in tasks of executive func- AIM: A common comorbidity of Neurofibromatosis tions (deficit hypothesis) or whether preterm born chil- Type 1 (NF 1) is Attention Deficit with or without dren are able to catch up with increasing age (delay Hyperactivity (AD(H)D). While NF 1 is associated hypothesis). with problems in cognitive development, comorbid METHODS: According to the executive function AD(H)D represents an additional risk factor for cogni- model of Miyake et al. (2000), three core execution, as shown in an IQ difference between children af- tive functions were assessed in the preterm and term- fected by NF 1 with or without AD(H)D. In this study, born population in a cross-sectional study design: in- we tested the hypothesis that permanent medication hibition, working memory, and shifting. Seventy-two with Methylphenidate can rescue cognitive problems preterm born children with no or minimal neonatal in children with NF 1 and comorbid AD(H)D. brain lesions and no or minimal neurodevelopmental METHOD: We retrospectively analysed data of a clin- impairment and 50 healthy term-born controls were re- ical sample of children and adolescents with NF 1 cruited. All children completed well-known and com- with or without comorbid AD(H)D, who underwent monly used neuropsychological tasks of inhibition, standardized neuropsychological diagnostics (WISC, working memory, and shifting. T.O.V.A.) twice (age range: T1 6 – 14 years; T2 7 – RESULTS: Results revealed that preterm born children 16 years; mean time interval 49.09 months). 16 chil- showed the same developmental pattern of executive dren without AD(H)D (7 males) were compared to 14 functions as controls, with a large performance gain unmedicated children with AD(H)D (6 males) and to between the ages of 8 to 12 years in shifting, medium 13 medicated children with AD(H)D (11 males). A re- performance gain in working memory and only small peated measures analysis of covariance (rmANCOVA) performance gain in inhibition. Interestingly, the per- was used to test for effects of medication and attention formance differences between preterm children and on cognitive outcome (full-scale IQ). controls in inhibition, working memory and shifting RESULTS: When controlling for gender effects, we declined with age. found a significant interaction between time and group, CONCLUSION: These data point towards a catch-up i.e., medicated children with NF 1 improved signifi- in executive functions of preterm born children; be- cantly in full-scale IQ from T1 to T2 (IQT1 = 80.38, tween the ages of 8 to 12 years, preterm born chil- IQT2 = 98.38, CIdiff: −25.59 to −10.40, p<0.0001), dren seem to steadily approach the performance level while this effect was not evident for the other groups of controls. Consequently, we provide preliminary ev- (ADHD-/MPH-: IQT1 = 97.88, IQT2 = 96.63, 95% idence that poor performance in inhibition, working CIdiff: 6.13 to 8.63, p = 0.723; ADHD+/MPH-: memory and shifting of young preterm born children IQT1 = 86.71, IQT2 = 90.64, CIdiff: −8.65 to 0.797, with no or minimal brain lesions and no or minimal p = 0.096). The interaction remained significant when neurodevelopmental impairment might reflect a delay adding attention improvement (T.O.V.A.: change in re- of executive functions rather than a persistent executive action time variability from T1 to T2) as covariate. deficit. CONCLUSION: Cognitive development of children and adolescents with NF 1 and comorbid AD(H)D may Correspondence address: PD Dr. Regula Everts, Chil- drens University Hospital, Division of Neuropaedi- profit from MPH medication. As improvements in at- atrics, Development and Rehabilitation, Inselspital, tention do not seem to be a very strong source of this CH-3010 Bern, Switzerland. Tel.: +41 316329424; effect, future prospective studies will have to evaluate Fax: +41 316329500. E-mail: [email protected] the mechanisms behind it. Correspondence address: Dr. Karen Lidzba, Univer- Lecture 3: Neurofibromatosis Type 1: The complex sity Children’s Hospital, Pediatric Neurology and De- interplay of cognition and attention deficit velopmental Medicine, Hoppe-Seyler-Str. 1, D-72076 Tübingen, Germany. Tel.: +49 70712980881; Fax: +49 Karen Lidzba1, Sofia Granström2, Jorge Lindenau2 7071295236; E-mail: [email protected] and Viktor-Felix Mautner2 en.de 334 Symposia

Lecture 4: Attention and executive functions in with neuroimaging data and degree of motor impair- children with congenital spastic diplegia: ment. Contribution of the NEPSY-II Correspondence address: Maria Chiara Di Lieto, IR- Maria Chiara Di Lieto1, Paola Brovedani1,Chiara CCS Stella Maris, Department of Developmental Neu- Pecini1, Anna Maria Chilosi1, Vittorio Belmonti2, roscience, Via dei Giacinti 2, I-56018 Calambrone, Franco Fabbro3,CosimoUrgesi3 and Giovanni Cioni1 Pisa, Italy. Tel.: +39 50886315; Fax: +39 5032214; E- 1IRCCS Stella Maris, Department of Developmental mail: [email protected] Neuroscience, Calambrone, Pisa (Italy) 2University of Pisa, Department of Developmental Neuroscience, Pisa, Italy Lecture 5: “Growing into deﬁcit” in young patients 3University of Udine, Department of Human Sciences, with Paediatric Traumatic Brain Injury (TBI) as a Udine, Italy possible consequence of impaired executive functions?

AIM: The literature on executive functions and at- 1 2 tention in children with congenital spastic diplegia is Barbara Benz and Annegret Ritz 1Goethe Universität Frankfurt am Main, Department scant. Deficits in tasks measuring response inhibition, of Developmental Psychology, Frankfurt am Main, task switching, sustained attention and visual search Germany have been reported and have not been systematically 2ZNS Hannelore Kohl Stiftung, Bonn, Germany correlated with neuroimaging data and severity of motor impairment. The aim of this preliminary study is to AIM: In children, compromised cognitive develop- describe the performance in the attentional and execu- ment after early TBI has been suggested by recent em- tive functions domain at the NEPSY-II (Developmen- pirical data. This presentation is focussing on the role tal Neuropsychological Assessment) in relation to abil- of executive functions as part of a study of long-term ities in the other cognitive domains, in children with outcome of paediatric TBI-patients. spastic diplegia and periventricular leukomalacia. METHODS: 141 subjects of an in-patient neurolog- METHODS: NEPSY-II is a comprehensive battery ical rehabilitation unit for children and adolescents, comprising 33 tests measuring attention/executive fun- 94% having suffered severe TBI according to interna- ctions, language, memory, sensory-motor skills, visuo- tional classification, were re-examined at the age of spatial processing and social perception. Twelve pa- 16–23 years with a comprehensive neuropsychological tients with spastic diplegia and periventricular leuko- test battery. Mean age at injury was 9.3 yrs (SD 2.3), malacia, aged 7–13 years were selected from a larger assessment took place 9.95 yrs (SD 3.3) post trauma. sample of children with cerebral palsy referred to our Executive functions were assessed by the Controlled tertiary care hospital. Inclusion criteria were: available Word Association Test (COWA), Ruff Figural Fluency brain MRI, absence of drug-resistant epilepsy, psychi- Test (RFFT), Wisconsin Card Sorting Test (WCST), atric disorders or severe sensory deficits, IQ 80 in and Trail Making Test (TMT-B/TMT-A ratio). Group either verbal or non-verbal domains. means of subjects with intact vs. impaired executive RESULTS: The preliminary results on the one hand functions were compared with respect to all other neu- confirm the visual-spatial and visual-perceptual deficits ropsychological domains and effects of site of lesion, consistently found in the literature in the presence trauma severity and age at trauma were analysed. of average performance in the language domain and RESULTS: Patients with scores less than 1 SD be- in verbal memory subtests. More importantly, the low the reference mean for executive skills were most NEPSY-II results reveal a specific deficit in perfor- severely impaired on all neuropsychological measures mance in the attention/executive functions domain es- including IQ (German version of Wechsler Scales pecially in terms of information processing speed. WAIS-R). When trauma severity was controlled, nega- CONCLUSION: Slow information processing could tive effects of early age at trauma persisted in the clin- represent a core deficit in patients with spastic diple- ical sample in most neuropsychological domains, such gia and contribute to the interpretation of the impaired as attention (p<0.042), memory (p<0.005), verbal performance in executive function and attention tasks, competence (p<0.000) and executive functions (p< found by some authors. A larger sample size is needed 0.012). None of the other variables had a significant to confirm this hypothesis and to correlate the results effect. Symposia 335

CONCLUSION: Type of persisting or emerging neu- chology, De Crespigny Park, SE58AF London, UK. E- ropsychological impairment has to be taken into ac- mail: [email protected] count when calculating a patient’s individual risk factor for long-term outcome. In this sample of paediatric TBI patients, the level of executive skills in late adoles- Lecture 1: Implicit adaptation in Alzheimer’s cence or early adulthood was found to be the most ef- disease despite unawareness of performance fective criterion for the separation of groups with good 1 2 3 vs. poor cognitive outcome. Daniel Mograbi ,RichardBrown, Christian Salas and Robin Morris2 1 Correspondence address: Mrs Barbara Benz, Goethe Institute of Psychiatry, King’s College/PUC-Rio, Psy- chology, London, UK Universität Frankfurt am Main, Department of De- 2 velopmental Psychology, Grüneburgplatz 1, D-60323 Institute of Psychiatry, King’s College, Psychology, London, UK Frankfurt am Main, Germany. Tel.: +49 6979835267; 3 Fax: +49 6979876335267; E-mail: barbara.benz@ Bangor University, Psychology, Bangor, UK unitybox.de Lack of awareness about performance in tasks is a common feature of Alzheimer’s disease (AD). Nev- Symposium 16: Implicit awareness in anosognosia: ertheless, clinical anecdotes have suggested that pa- Clinical and experimental evidence tients may show behavioural responses to the experience of failure despite expressing limited awareness. We explored this question experimentally using novel Implicit awareness in anosognosia: clinical and exper- success/failure manipulation paradigms. Computerised imental evidence tasks which expose participants to systematic success 1 2 3 or failure were developed in which performance suc- Daniel Mograbi , Robin Morris , Paul Jenkinson and 4 cess was titrated for each participant and then difficulty Valentina Moro 1 was set either above or below this level to establish in- Institute of Psychiatry, King’s College/PUC-Rio, Psy- dividually success and failure levels. Two experiments chology, London, UK were carried out: the first, investigated immediate emo- 2Institute of Psychiatry, King’s College, Psychology, tional responses to failure; and the second, long-term London, UK task avoidance in a follow-up session. Results of the 3University of Hertfordshire, Psychology, London, UK first study indicated that, relative to controls, AD pa- 4Università di Verona, Phylosophy, Education and tients exhibited impaired awareness of performance, Psychology, Verona, Italy but comparable differential reactivity to failure relative to success tasks, both in terms of self-report and facial Unawareness of deficits caused by brain damage or expressions. Long-term adaptation in the second study neurodegeneration, termed anosognosia, has been de- was correlated with awareness in the first session, even monstrated in a number of different neurological con- though AD patients had no memory of doing the tasks. ditions. Clinical observation suggests that unawareness These findings are discussed in relation to current the- paradoxically can be accompanied by signs of under- ories of consciousness which emphasise access as its standing or representation of deficit, but not explicitly main feature. expressed. Such ’implicit awareness’ is implied by or inferred from actions or statements of the person with Correspondence address: Dr Daniel Mograbi, Institute neurological disorder. Although there is no consensus of Psychiatry, King’s College/PUC-Rio, Psychology, about the nature or cause of this type of awareness, De Crespigny Park, SE58AF London, UK. E-mail: there is convincing evidence to suggest its occurrence [email protected] in a variety of neurological conditions. The current symposium will have 4 talks presenting experimental studies which explored ‘implicit awareness’ in either Lecture 2: Dissociation between self-reported dementia or hemiplegia, followed by a discussion of awareness and objective performance during the theoretical implications of the findings. reaching movements in anosognosia for hemiplegia

Correspondence address: Mr Dr Daniel Mograbi, In- Paul Jenkinson1, Catherine Preston2 and Roger New- stitute of Psychiatry, King’s College/PUC-Rio, Psy- port3 336 Symposia

1University of Hertfordshire, Psychology, Hertford- 1Institute of Psychiatry, King, Psychology, London, UK shire, UK 2Institute of Psychiatry, King’s College, Psychology, 2 Karolinska Institutet, Department of Neuroscience, London, UK Solna, Sweden 3Institute of Psychiatry, King’s College/PUC-Rio, Psy- 3 University of Nottingham, School of Psychology, Not- chology, London, UK tingham, UK OBJECTIVES: Lack of awareness of illness or neu- The ‘comparator’ model of motor control and aware- ropsychological deficit in people with Alzheimer’s dis- ness proposes that an ongoing comparison of predicted ease (AD) has been shown to have some dissociation and actual sensory feedback forms the basis of mo- with awareness of symptoms when viewing the symp- tor awareness, via the detection of sensorimotor discrepancies. This model has also been used to explain toms of other people. The presented study investigated anosognosia for hemiplegia (AHP; i.e. unawareness of emotional reactivity when viewing film material de- paralysis following stroke), in terms of a failure to picting a person with AD, comparing this to viewing detect such discrepancies combined with a patholog- other film material. The correlates with anosognosia ically exaggerated reliance on motor intentions to in- were explored. form awareness. In this talk I will discuss recent work PARTICIPANTS/METHODS: A film depicting a per- by Preston, Jenkinson and Newport (2010), which as- son with Alzheimer’s disease was shown. Emotional sessed the proposed failure to detect sensorimotor dis- reactivity was compared to that following two other crepancies in a patient with AHP (GG), using the non- films, one including material from a UK light comedy paralysed arm. In so doing, we aimed to provide direct television program that was predicted to produce posi- empirical evidence regarding the operation of the mo- tive mood and another film about a person with cancer, tor comparator(s). Goal-directed reaching movements predicted to induce negative mood. Emotional reactiv- made by GG using the non-paralysed (right) arm were ity in each case was measured using before and after either modified by a computer or left unperturbed. measurement of mood state and also by filming par- Comparison with hemiplegic and young, healthy con- ticipant facial expressions with Facial Affect Coding trols revealed that GG was unable to detect computer- (FAC) ratings. generated visual perturbations as large as 20◦. Remark- RESULTS: The level of emotional reactivity was ably, GG claiming on all occasions that his movements were unperturbed, uncorrected or accurate, and slightly less in people with Alzheimer’s disease than he also failed to notice large corrective movements that in normal control participants, including the negative he made when attempting to compensate for the vi- mood state associated with viewing the film about the sual perturbations. These results suggest that the com- person with Alzheimer’s disease. Facial reaction was parators implicated in AHP are functioning at a sub- negatively correlated with the degree of awareness the optimal level, and that monitoring of both the right and people with Alzheimer’s disease had in relation to their left arms might involve a common right-hemisphere own illness. Emotional reaction to other film material network. Furthermore, the presence of large corrective was not associated with this awareness. movements, despite verbal reports of perfect perfor- CONCLUSIONS: In the early stage of AD, there was mance, reveals a dissociation between subjective self- emotional reactivity to the film material inducing pos- reports of motor awareness and objective performance itive and negative mood, including the Alzheimer film. in this case of AHP. The negative correlation with awareness of illness is interpreted as suggesting that heightened emotional re- Correspondence address: Dr. Paul Jenkinson, Univer- action on confronting Alzheimer’s disease symptoms sity of Hertfordshire, Psychology, College Lane, Hat- might be predictive of less awareness due to emotion- field, AL10 9AB Hertfordshire, UK. E-mail: p.jenkin ally induced inhibition. Alternative explanations for [email protected] this finding are also considered.

Lecture 3: Anosognosia and reactivity to Correspondence address: Mr Prof Robin Morris, In- dementia-related material in Alzheimer’s disease stitute of Psychiatry, King, Psychology, De Crespigny Park, SE58AF London, UK. E-mail: robin.morris@ Robin Morris1,RichardBrown2 and Daniel Mograbi3 kcl.ac.uk Symposia 337

Lecture 4: How many forms of anosognosia? relevant for further directions on research about se- Residual forms of awareness in anosognosia for mantic memory (e.g. Kiefer and Pulvermüller, 2012). hemiplegia The presentations will cover the neural pathways of semantic processes, the contribution of the anterior tem- Valentina Moro poral lobes to semantic memory and the behavioral Università di Verona, Phylosophy, Education and Psy- and neural correlates of the representation of concrete chology, Verona, Italy and abstract concepts. Implications for cognitive models of semantic memory and for understanding differ- Anosognosia for hemiplegia (AH) is characterized by ent semantic memory disorders will be particularly dis- a lack of awareness of motor disorders and appears as- cussed. sociated with fronto-temporal-parietal damage. It is a specific syndrome which cannot be explained by con- Correspondence address: Mr J. Frederico Marques, comitant neurological deficits such as sensory deaf- University of Lisbon, Faculty of Psychology, Alameda ferentation, presence of contralesional spatial neglect, da Universidade, 1649-013 LISBOA, Portugal. E-mail: mental confusion or deficits in frontal lobe functions. [email protected] In addition, it appears as an “inconsistent” syndrome, which may concern different aspects of deficits and be fluctuating in time. Lecture 1: Neural correlates of phonological versus In this complex frame, we will show the existence of semantic dichotomy explored with intra-cerebral “dissociations” in anosognosia and the existence of electrodes and cortical stimulation possible “residual” forms of awareness in AHP. The specific neuroanatomical correlates will be discussed Jean François Démonet as well. University of Lausanne, Lausanne, Switzerland Finally, the impact of these results in neuropsychological assessment and rehabilitative training will be GOAL: A striking feature of the functional organiza- demonstrated by means of the results of specific exper- tion of brain structures supporting language functions imental trainings. consists in their dual-route organization so that sublexical processing is supported by a parietal-frontal Correspondence address: Prof Valentina Moro, Univer- network while the lexical semantic one depends on sità di Verona, Phylosophy, Education and Psychology, a ventral temporal pathway. Direct evidence of this Lungadige Porta Vittoria 17, 37129 Verona, Italy. E- global functional pattern was brought up directly by mail: [email protected] invasive explorations in patients while performing language tasks. METHODS: ERP and high-frequency oscillations re- Symposium 17: New advances in semantic memory: cording were obtained from patients who suffered from Neuropsychological and neuroimaging intractable epilepsy and benefited from SEEG explo- research ration at the pre-surgical stage. Direct cortical stimulation was used to map language functions in other pa- New advances in Semantic Memory: Neuropsycholog- tients before removal of low grade gliomas. ical and neuroimaging research RESULTS: A consistent pattern of results observed at the single-subject level, showed that specific recording J. Frederico Marques1 and Stefano Cappa2 sites respond to either sublexical or semantic tasks. In 1University of Lisbon, Faculty of Psychology, LISBOA, the latter, cortical localizations were observed in the Portugal left middle temporal and fusiform gyri, close to the 2Vita Salute San Raffaele University and San Raffaele basal temporal language area. Scientific Institute, Milan, Italy CONCLUSION: The significance of these findings will be discussed in the framework of the recent SUMMARY: This symposium presents new advances conceptualizations regarding distributed versus centric in semantic memory research. The main goal is to conceptualizations of the neural correlates of semantic present new neuropsychological and neuroimaging processes. data on different topics that have been signaled as most 338 Symposia

Correspondence address: Mr J. Frederico Marques, Lecture 3: What about abstract concepts? Imaging University of Lisbon, Faculty of Psychology, Alameda and neuropsychological evidence da Universidade, 1649-013 LISBOA, Portugal. E-mail: [email protected] Stefano F. Cappa1 and Gabriella Vigliocco2 1Vita Salute San Raffaele University and San Raffaele Scientific Institute, MILAN, Italy Lecture 2: Convergent evidence for the basal 2University College, London, United Kingdom temporal semantic area GOAL: Abstract concepts are generally held to be lin- Matthew Lambon-Ralph guistically coded, in line with imaging evidence of University of Manchester, MANCHESTER, greater engagement of the left perisylvian language United Kingdom network for abstract than concrete words. According to a recent hypothesis, based on behavioural studies, ab- GOAL: A considerable body of neuropsychological stract concepts, in addition, entail affective processing and neuroimaging research from semantic dementia to a greater extent than concrete concepts. has implicated the anterior temporal lobes in the repre- METHODS AND RESULTS: In a fMRI experiment sentation of coherent, transmodal concepts. Given that we found that abstract processing, compared to con- the temporopolar region implicated in semantic de- crete processing shows greater engagement of rostral mentia is relatively large and contains multiple cytoar- anterior cingulate cortex, an area associated with emo- chitectural and connectivity differences, it becomes tion. important to explore the roles that each subregion has CONCLUSION: Within the framework of embodi- in semantic representation. ment views of semantic representation, the idea that METHODS: In neurologically-intact participants, in affective experience is crucial in the grounding of ab- vivo MR tractography was used to explore the intra and stract concepts is also starting to be tested in neuropsy- inter-temporal lobe connectivity to the rostral tempo- chological studies involving acquired and developmen- ral region; distortion-corrected fMRI was used to in- tal brain disorders. vestigate the semantic-task responsivity of various subregions and how these vary across modalities of input; in patients with temporal lobe epilepsy, implanted Correspondence address: Mr J. Frederico Marques, grid electrodes were used to explore task-related local University of Lisbon, Faculty of Psychology, Alameda field potentials and to assess the effect of direct cortical da Universidade, 1649-013 LISBOA, Portugal. E-mail: stimulation on semantic performance. [email protected] RESULTS: The convergent picture that emerges from these studies is that anterior superior temporal regions are implicated in semantic processing that is greater for Lecture 4: The representation of abstract and auditory and verbal materials than picture-based tasks. concrete concepts: Insights from semantic In comparison the ventral anterior temporal area (ante- dementia and a new ‘old’ task rior ITG and fusiform) is implicated in transmodal se- 1 2 mantic processing for receptive and expressive tasks. J. Frederico Marques and Annik Charnallet 1 These results fit closely with the differential pattern of University of Lisbon, Faculty of Psychology, LISBOA, white-matter connectivity to these regions and the dis- Portugal 2 tribution of ATL atrophy observed in semantic demen- University of Grenoble, France tia (which disproportionately affects the ventral and polar regions). GOAL: The present study addresses the ongoing con- CONCLUSION: The ventral temporal region – the troversy of the contribution of the anterior temporal “basal temporal semantic area” – is a centrepoint for lobes to the representation of concrete and abstract the representation of coherent concepts. concepts. In particular, it investigates how the nature of the associations to these concepts observed in healthy Correspondence address: Mr J. Frederico Marques, individuals is affected in patients with Semantic De- University of Lisbon, Faculty of Psychology, Alameda mentia (SD). da Universidade, 1649-013 LISBOA, Portugal. E-mail: METHODS: For this purpose we studied a group of [email protected] SD patients and a group of matched healthy individ- Symposia 339 uals using a standard free association task where we and the psychopathological self-relevance of social and orthogonally manipulated concept imageability (more affective stimuli. The study of Toepper et al. focused vs. less imageable) and concept frequency (low fre- on “fMRI correlates of spatial working memory in quency vs. high frequency), while controlling for a healthy subjects and MCI patients”. Patients with mild number of other important variables. cognitive impairment (MCI) showed decreased work- RESULTS: The classification of the associations ing memory performance and reduced brain activation showed that while in healthy individuals more lan- in the left premotor cortex. In their study “The ef- guage associations were observed for abstract concepts fects of 5-HTTLPR polymorphisms on cognitive con- and more sensorimotor associations were observed for trol in healthy subjects at genetic risk for depression” concrete concepts, in SD patients language associa- Landrø et al. investigated healthy individuals with or tions were strongly affected independently of concept without genetic risk for depression. Individuals at risk type. In addition, SD patients made more non-related showed an impaired inhibitory control. The authors answers and omissions for low frequency concepts. concluded that ineffective inhibitory control might be a CONCLUSION: These results favor an interpretation promising intermediate phenotype for the genetic risk of the role of the anterior temporal lobes in seman- for depression. Beblo investigated “Subjective mem- tic memory that is independent of concept type and ory complaints and ‘objective’ memory performance in that sensorimotor associations are more robust than patients with borderline personality disorder (BPD)”. language associations in the face of general semantic While patients reported severe memory deficits in ev- degradation. eryday life, they did not show memory tests impairments. The results may indicate that memory deficits in Correspondence address: Mr J. Frederico Marques, BPD are related to factors that are present in everyday University of Lisbon, Faculty of Psychology, Alameda life but not during neuropsychological testing. da Universidade, 1649-013 LISBOA, Portugal. E-mail: [email protected] Correspondence address: PD Dr. Thomas Beblo, Ev. Hospital Bielefeld, Clinik for Psychiatry und Psy- chotherapy Bethel, Remterweg 69-71, D-33615 Biele- Symposium 18: Determinants of neuropsychologi- feld, Germany. Tel.: +49 521 77278512; E-mail: cal impairments in mental disorders [email protected]

Thomas Beblo1 and Nils Inge Landro2 1Ev. Hospital Bielefeld, Clinik for Psychiatry und Psy- Lecture 1: Neurobiological underpinnings of chotherapy Bethel, Bielefeld, Germany cognition-emotion interaction in schizophrenia 2University of Oslo, Department of Psychology, Oslo, Norway Kristina Hennig-Fast1, Dominik Meißner2, Anna Bu- chheim3, Sandra Dehning2, Janosch Blautzik4,Nor- Neuropsychological impairments in mental disorders bert Mueller2, Peter Zill2, Maximilian Reiser4 and have been increasingly investigated. Recent studies Hans-Juergen Moeller2 have demonstrated that these deficits were influenced 1LMU Munich, Department of Psychiatry and Psy- by several factors. In our symposium, Determinants chotherapy, München, Germany of neuropsychological impairments in mental disor- 2LMU Munich, Department of Psychiatry and Psy- ders, we focus on the associations between neuropsy- chotherapy, Munich, Germany chological functioning on the one hand and brain 3Department of Psychology, University of Innsbruck, functioning, serotonin transporter polymorphisms and Innsbruck, Austria everyday cognitive functioning on the other. In the 4LMU Munich, Department of Clinical Radiology, Mu- study of Fast et al., “Neurobiological underpinnings nich, Germany of cognition-emotion interaction in schizophrenia”, the authors investigated brain activation during affec- Emotion theorists have long time posited the criti- tive attachment, affective perspective taking and af- cal role for affect in the modulation of behavior and fective regulation and found dysfunctions of a fronto- cognition. When considering the adaptive function of temporal-occipital network. These findings may ex- emotion and cognition and their interaction both can plain the patients’ difficulties in self-other distinction be posited to function as control systems to regulate 340 Symposia behavior. Patients with schizophrenia often demon- lead to increasing cognitive impairment and severe strate profound functional dysregulation compared to deficits in daily routine. The prodromal phase of AD healthy subjects especially in fronto-temporal-limbic is most commonly defined as amnestic mild cogni- brain areas. These functional anomalies are related to tive impairment (aMCI). Previous research points to- the clinical symptomatology of the patients. In the wards a specific inhibitory dysfunction in AD that al- present fMRI study 3 experiments on affective attach- ready exists in aMCI. Due to the heterogeneity of the ment, affective perspective taking and affective regu- concept MCI itself and different methodological ap- lation were conducted in patients with schizophrenia. proaches, our knowledge about the functional cere- In accordance to our hypotheses ocytocin level and bral mechanisms underlying this inhibitory dysfunc- behavioral socio-emotional functions in schizophre- tion is far from complete. Functional magnetic res- nia were reduced. When analysing conjunctive brain onance imaging (fMRI) was used to examine brain activation of all 3 experimental paradigms a fronto- activation during the Corsi-Block-Tapping-Test (CBT; temporal-occipital network was found to be dysfunc- Corsi, 1972) and a modified version of the block sup- tional in patients including brain areas that are crit- pression test (BST; Beblo et al., 2004). The CBT re- ical for episodic autobiographical memory, mirror- quires the encoding, maintenance and retrieval of se- ing other’s emotions, self-reflection, affective risky rially presented target locations. The BST addition- decision-making and painful information processing. ally requires the inhibition of spatial distractors dur- The findings are presented in relation to oxytocin levels ing CBT encoding. Our study included 7 aMCI pain patients with schizophrenia (ICD-10: F20; PANSS tients and 18 healthy volunteers matched with regard to < n = 78) and healthy subjects (each group: males, age, gender, and education. All patients met the criteria < 20, IQ 85). Our findings can explain the difficulties of aMCI (Petersen et al., 2004). Activation differences in self-other distinction and the psychpathological self- were analyzed for BST retrieval (BST minus CBT ac- relevance of social and affective stimuli in schizophre- tivation) including all, and only correct trials. Com- nia. pared to healthy controls, aMCI patients showed decreased BST performance accuracy and increased re- Correspondence address: PD Dr. Kristina Hennig- sponse durations. Moreover, aMCI patients showed re- Fast, LMU Munich, Department of Psychiatry and duced activation intensity during BST retrieval, partic- Psychotherapy, Nußbaumstraße 7, D-80336 München, ularly within left premotor cortex. Interestingly, group Germany. E-mail: [email protected]. differences disappeared when only correct trials were de included into brain data analysis. Our results reveal aMCI-associated changes within the cerebral network Lecture 2: Neural correlates of impaired inhibitory that is known to be recruited during BST performance. processes in mild cognitive impairment MCI patients particularly showed reduced left premotor cortex activation that seems to be at least partly as- Max Toepper1, Hans J. Markowitsch2, Leona Kater2, sociated with impaired inhibitory functioning on the Helge Gebhardt3, Thomas Beblo4,EvaBauer3,Stefan behavioural level. Kreisel4, Friedrich G. Woermann5, Christine Thomas4, Martin Driessen4 and Gebhard Sammer3 Correspondence address: Dr. Max Toepper, Ev. Hospi- 1Ev. Hospital Bielefeld, Clinic for Psychiatry und Psy- tal Bielefeld, Clinic for Psychiatry und Psychotherapy chotherapy Bethel, Bielefeld, Germany Bethel, Remterweg 69-71, D-33615 Bielefeld, Ger- 2University of Bielefeld, Department of Psychology, many. E-mail: [email protected] Bielefeld, Germany 3Justus-Liebig-University of Giessen, Cognitive Neu- roscience at Center for Psychiatry, Giessen, Germany Lecture 3: The effects of 5-HTTLPR 4Ev. Hospital Bielefeld, Clinic for Psychiatry and Psy- polymorphisms on cognitive control in healthy chotherapy Bethel, Bielefeld, Germany subjects at genetic risk for depression 5Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany Nils Inge Landro University of Oslo, Department of Psychology, Oslo, Alzheimer’s disease (AD) is characterized by differ- Norway ent structural and functional cerebral changes which Symposia 341

A number of studies have documented impaired cog- ory deficits. Existing studies indicate - if ever – small nitive control in patients with current major depressive impairments of memory test performance. However, it disorder (MDD). It has also been shown that cogni- was shown in patients with related disorders, such as tive control impairments persist during remission from depression, that self-reported impairment overtop test depression, suggesting that impaired cognitive control malfunction. The present study aimed at investigating could be a trait marker for depression. However, such memory performance of BPD patients as assessed by findings cannot be interpreted as evidence of a vulner- memory tests and a questionnaire for memory func- ability factor because they might be the result of “scar- tioning in everyday life. Thirty-two patients with BPD ring” or residual effects after the depressive episode. A and 62 healthy control subjects were included into the logical approach to this important question is therefore study. Both groups of subjects were similar with re- compare healthy individuals with or without genetic spect to age, education and gender. Subjects completed risk. The gene that codes for the serotonin transporter verbal and nonverbal memory tests as well as the ev- is particularly relevant. A relatively common polymor- eryday memory questionnaire (EMQ). BPD patients phism (5-HTTLPR) in the promoter region of the hu- reported severe memory deficits in everyday life but man 5-HTT gene (SLCA4) results in 2 common al- did not show memory tests impairments. The results leles or variants. The short allele is associated with a remained stable even when all BPD patients with acute nearly 50% reduction in 5-HTT availability, as com- or lifetime depression comorbidity were excluded from pared to the long variant, and there are key reports of analyses. These data indicate memory impairment of associations between the short allele and risk for de- BPD patients for everyday life. However, it can not pression. In this study 157 healthy subjects, carefully to be ruled out that increased memory complaints re- screened for psychopathology, were genotyped. They sult from patients’ negative self perception. Future re- were tested on three tasks tapping distinct dimensions search needs to clarify reasons for memory complaints of cognitive control from CANTAB; Inhibitory con- of BPD patients. trol (Stop Signal Reaction Time; SSRT), Mental flexibility (Intra/Extra dimensional set shifting) and Work- Correspondence address: PD Dr. Thomas Beblo, Ev. ing memory (Spatial Working Memory). The results Hospital Bielefeld, Clinic of Psychiatry and Psy- showed that carriers with the short variant of the gene chotherapy Bethel, Remterweg 69-71, D-33615 Biele- have significantly less ability to inhibit a pre potent re- feld, Germany. Tel.: +49 521 77278512; E-mail: sponse on the SSRT task, as compared to long allele [email protected] carriers, whereas there were no significant gene effects on set shifting and working memory. This pattern of findings indicate that less effective inhibitory control Symposium 19: Neurofeedback training for chil- might be a promising intermediate phenotype for the dren with ADHD: Recent advances and new appli- genetic risk for depression. cations

Correspondence address: Prof. Dr. Nils Inge Lan- Renate Drechsler dro, University of Oslo, Department of Psychology, University Clinic of Child and Adolescent Psychiatry, Forskningsveien 3A, Nor-0373 Oslo, Norway. E-mail: University of Zurich, Zürich, Switzerland [email protected] Neurofeedback training (NF) has found increasing acceptance as a non-pharmacological treatment for chil- Lecture 4: Subjective memory complaints and dren with Attention Deficit Hyperactivity Disorder “objective” memory performance in patients with (ADHD). NF aims at the regulation of electrical brain Borderline Personality Disorder activity patterns. In the first talk, a summary of the most influential multicentre training study of the re- Thomas Beblo cent years will be given, including long-term out- Ev. Hospital Bielefeld, Clinic of Psychiatry and Psy- come data and results from new follow-up studies with chotherapy Bethel, Bielefeld, Germany the application of NF to Tic Disorder (H. Heinrich). “Classic” protocols of NF frequency training, which It is still a matter of debate whether patients with Bor- are aimed at the improvement of attentional control, derline Personality Disorder (BPD) suffer from mem- feed back activity of theta or beta bands. The feed- 342 Symposia back of gamma-band activity is a new approach (T. Results: In this trial, NF was superior to the control Bogen). Though technically challenging, gamma-band training in reducing severity of ADHD symptoms at NF promises to be an efficacious treatment for emotion post-training as well as at 6-month follow-up (medium regulation deficits, a frequent comorbidity of children effect size). Parents of both groups did not differ on with ADHD. evaluation scales which were applied to control for at- The third presentation introduces tomographic neuro- tributional effects. At the neurophysiological level, dif- feedback training for children with ADHD (D. Bran- ferential patterns for SCP and theta/beta training were deis). In tomographic NF, the activation of a deter- obtained. In a second study on SCP training, a signif- mined brain region is calculated and fed back to the icant relationship between regulation skill and clinical individual, in contrast to conventional NF, which uses outcome was obtained. In a third study, SCP training electrical activity at the scalp surface. was superior to a theta/low-beta (12–15 Hz) training Finally, the importance of choosing an appropriate in reducing ADHD behaviour in children with tic dis- control condition for the analysis of NF treatment orders. Mainly, hyperactive/impulsive symptoms were specificity will be discussed in the last talk (R. Drech- observed to be reduced probably due to the fact that sler). A differential EMG (electromyogram) biofeed- transfer into daily life focused on inhibition of be- back training is proposed as control condition that haviour (i.e. tic suppression). seems preferable from an ethical point of view to sham CONCLUSIONS: There is clear evidence for specific NF control. effects of NF (SCP and theta/beta training) in ADHD so that NF based on these standard protocols may be Correspondence address: Dr. Renate Drechsler, Uni- supported as a treatment for ADHD. However, medium versity Clinic of Child and Adolescent Psychiatry, effect sizes indicate that NF should not be seen as a University of Zurich, Neumuensterallee 9, CH-8032 stand-alone intervention but rather as a module within Zürich, Switzerland. Tel.: +41 43 499 27 66; E-mail: a multimodal treatment tailored to the needs of a child. [email protected] Correspondence address: PD Dr. Hartmut Heinrich, Heckscher-Klinikum, München; Dept. of Child and Lecture 1: Standard neurofeedback protocols in Adolescent Mental Health, University Hospital of Er- children with ADHD: Methodical introduction and langen, Schwabachanlage 6+10, D-91054 Erlangen, results from clinical studies Germany. Tel.: +49 09131/8539122; E-mail: hartmut. [email protected] Hartmut Heinrich Heckscher-Klinikum, München, Dept. of Child and Adolescent Mental Health, University Hospital of Er- Lecture 2: Gamma-band neurofeedback: langen, Germany Challenges in developing a new approach for the treatment of emotion regulation deficits GOALS: Neurofeedback (NF) may be interpreted as a neuro-behavioural treatment for attention-deficit/hy- Thorsten Bogen, Tanja Legenbauer and Martin Holt- peractivity disorder (ADHD) where children learn to mann modulate specific brain electrical activity patterns and LWL-University Hospital for Child and Adolescent how to apply their neuroregulation strategies in daily Psychiatry, Ruhr-University Bochum, Hamm, Germany life. Training of slow cortical potentials (SCPs) and theta (4–7 Hz)/beta (13–20 Hz) training are considered GOALS/BACKGROUND: Neurofeedback (NF) of as standard protocols. slow cortical potentials (SCP) has been demonstrated METHODS: At the conference, the methodical basis to be an efficient treatment for symptoms of inatten- of these protocols integrated into a hypothetical model tion and hyperactivity in attention deficit/hyperactivity of ‘active ingredients’ will be presented. NF studies disorder (ADHD). Despite the fact that ADHD dur- of our group will be reflected with a focus on the up- ing adolescence is often accompanied by deficits of to-now largest randomised controlled trial (about 100 emotion regulation, an efficient treatment for this co- children included) comparing NF (combination of SCP morbidity does not exist. In this study we are investi- and theta/beta training) with a computerised attention gating whether NF can also be used for the treatment of training. emotion regulation deficits. The rationale for this ap- Symposia 343 proach was influenced by evidence from meditation re- deficit/hyperactivity disorder) often fail to distinguish search since high-amplitude gamma-band activity and unspecific contributions from specific ones due to long-distance phase synchrony were associated with learned regulation of neurophysiologicalmeasures. To- high levels of emotional stability. In a pilot study, we pographic EEG and source localization allows real use NF instead of meditation to induce high-levels of time estimation and feedback of activity from specific gamma-band activity. It is assumed that this allows ac- dysfunctional regions. We targeted regulation in the cessing cognitive resources that are otherwise inacces- anterior cingulate (ACC), a deep brain region affected sible for emotion regulation processes. in ADHD, as a new approach to increase specificity. METHODS: The feasibility of gamma-band NF in a METHODS: In a tomographic neurofeedback (tNF) clinical population of 40 children and adolescents with study, 13 ADHD children trained bidirectional regula- ADHD shall be investigated. In particular its further tion of their ACC brain activity during 36 lessons for use for the additional treatment of emotion regula- theta and beta frequency bands and for slow cortical tion deficits in a multimodal inpatient treatment set- potentials (SCP). The ACC activity and its change over ting shall be evaluated. Before and after the NF inter- the course of the training and rest phases were com- vention patients complete a comprehensive test-battery puted using sLORETA (low-resolution electromag- including measures of emotion regulation strategies, netic tomography) of the 30-channel EEG. neuropsychological tests and behavioural parameters. RESULTS: Despite reducing ADHD symptoms and RESULTS: Difficulties exist particularly with regards EEG-artefacts control over ACC activity was learned to generating a robust feedback signal. The filtering only in one SCP condition providing simple feedback. of artefacts appears complex as muscle activity and Instead, the ACC frequency distribution at rest normal- saccadic eye-movements mask the gamma-band sig- ized over the course of the training. nal. First experiences with gamma-band NF will be re- CONCLUSIONS: Clinical improvement and artefact/ ported on the basis of single-cases. movement reduction followed ACC-tNF without sub- DISCUSSION: The implementation of gamma-band stantial learning of control, but with stabilisation and NF appears challenging. The talk shall present possible normalisation of oscillatory ACC activity at rest. Fur- solutions for the problems encountered with this new ther studies need to test whether tNF can induce learn- protocol. Ideas for further application of gamma-band ing in brain regions implicated in ADHD. The assump- NF will be discussed. tion that targeting impaired brain regions in clinical groups for self regulation improves learning and out- Correspondence address: Mr M.Sc. Thorsten Bogen, comes also motivates NIRS- or fMRI-neurofeedback, LWL-University Hospital for Child and Adolescent and still requires critical evaluation. Psychiatry, Ruhr-University Bochum, Heithofer Allee 64, D-59071 Hamm, Germany. E-mail: thorsten.bogen References [email protected] [1] Liechti, M., Maurizio, S., Heinrich, H., Jäncke, L., Meier, L., Steinhausen, H. C., Walitza, S., Drechsler, R., & Brandeis, D. (2012). First Clinical Trial of Tomographic Neurofeedback in Attention-Deficit/Hyperac- tivity Disorder: Evaluation of Volun- Lecture 3: Tomographic neurofeedback in ADHD tary Cortical Control. Clin. Neurophysiol., 123, 1989–2005.

Daniel Brandeis1,2 and Renate Drechsler3 Correspondence address: Prof. Dr. Daniel Brandeis, 1Department of Child and Adolescent Psychiatry and Dep.of Child and Adolescent Psychiatry and Psy- Psychotherapy, Cenntral Institute of Health, Univer- chotherapy, Cenntral Institute of Health, University sity of Mannheim, Germany of Mannheim, Germany, University Clinic of Child 2University Clinic of Child and Adolescent Psychiatry, and Adolescent Psychiatry, University of Zürich, Neu- University of Zürich, Switzerland muensterallee 9, CH-8032 Zürich, Switzerland. E- 3University Clinic of Child and Adolescent Psychiatry, mail: [email protected] University of Zurich, Zürich, Switzerland

GOALS: Controlled EEG-neurofeedback studies reporting sizeable clinical effects on ADHD (attention- 344 Symposia

Lecture 4: Efficacy of neurofeedback training in Correspondence address: Dr. Renate Drechsler, Uni- ADHD: the importance of appropriate control versity Clinic of Child and Adolescent Psychiatry, conditions University of Zurich, Neumuensterallee 9, CH-8032 Zürich, Switzerland. Tel.: +41 43 499 27 66; E-mail: Renate Drechsler1 and Daniel Brandeis2,3 [email protected] 1University Clinic of Child and Adolescent Psychiatry, University of Zurich, Zürich, Switzerland 2Dep. of Child and Adolescent Psychiatry and Psy- Symposium 20: Compensatory mechanisms in vi- chotherapie, Central Institue of Health, University of sual neglect Mannheim, Germany 3 University Clinic of Child and Adolescent Psychiatry, Mario Bonato1 and Paolo Bartolomeo2 University of Zürich, Switzerland 1University of Ghent, Department of Experimental Psychology, Ghent, Belgium GOALS: Although the beneficial effects of neurofeed- 2INSERM, UMRS 975, Brain and Spine Institute, De- back (NF) training on ADHD symptoms are beyond partment of Psychology, Catholic University, Paris and doubt, the mechanisms leading to these effects remain Milan unclear. Control conditions are critical to determine specific effects of NF in randomized controlled tri- Recent evidence suggests that neglect syndrome is in- als. The majority of controlled studies have included timately linked to compensatory mechanisms. semi-active or active control conditions where NF is The mere fact that neglect can spontaneously improve compared to treatments such as medication, computer- with time from stroke onset raises the question of based cognitive programs or behavioural therapy. Only whether this improvement is substantial or to what ex- a minority of studies have used “sham” NF as control tent it might be due to a more efficient implementation condition. The methodological and ethical problems of of compensatory strategies. A better understanding of these studies, which failed to demonstrate the superi- the interplay of these compensatory mechanisms with ority of “genuine” compared to “sham” NF, will be neglect phenomenology would be conducive to a better discussed. Other biofeedback methods, such as elec- understanding of neglect and of normal attentional pro- tromyogram biofeedback (EMG-BF) are presented as cesses, with the consequent deep theoretical and clini- alternatives. cal consequences. METHODS: A differential EMG-BF protocol which The present symposium encompasses three talks ad- feeds back activity from arm muscles involved in fine dressing these issues. motor skills such as writing and grip was developed as Paolo Bartolomeo (Inserm, Paris and Catholic Univer- a control condition for a complex tomographic neuro- sity, Milan) will provide an introductory overview to feedback protocol. Two groups of children with ADHD the symposium briefly reviewing the past studies high- were trained with EMG-BF or NF over the same period lighting the role of compensatory strategies in neglect. of time, using the same training software and matching – protocols. Mario Bonato (Ghent University, Belgium) will fo- RESULTS: A clinically relevant reduction of ADHD cus on recent evidence that, in the post acute and symptoms was observed in both groups of children. chronic phases after a stroke contralesional spatial Specific effects were found for the EMG-BF group in awareness can be severely impaired by the request neuropsychological tests related to fine motor skills to perform a concurrent, resource-demanding task, and bimanual coordination. Only trends were found for regardless of its nature (e.g. visual or auditory). specific electrophysiological treatments effects in the – Charlotte Russell (Brunel University, West London, NF group. UK) will present evidence for enduring deficits after DISCUSSION: EMG-BF represents a valuable con- the resolution of visuo-spatial neglect. trol condition with a meaningful motor coordination – Marine Lunven (INSERM, Brain and Spine Insti- and skill training for children with ADHD. Ethical as tute, France) will talk about anatomical predictors of well as methodological aspects have to be considered neglect compensation. when conducting clinical trials conform to standards of The general discussion will address the clinical and evidence-based medicine. theoretical relevance of these empirical findings. Symposia 345

Correspondence address: Dr. Mario Bonato, Univer- Lecture 2: Evidence for enduring deficits after the sity of Ghent, Department of Experimental Psychol- resolution of visuo-spatial neglect ogy, Henry Duntalaan 2, B-9000 Ghent, Belgium. Tel.: +39 3284341010; E-mail: [email protected] Charlotte Russell Brunel University, Centre for Cognition and Neu- roimaging and Department of Psychology, London, Lecture 1: Neglect: Diagnostic value of tasks where UK compensation is prevented Neglect frequently resolves spontaneously-however Mario Bonato many patients continue to suffer from a number of University of Ghent, Department of Experimental Psy- important and frequently overlooked deficits. These chology, Ghent, Belgium residual deficits involve a number of critical functions associated with parietal cortex: attention; remapping Across a series of studies we have increased the atten- of spatial information across saccades; spatial aspects tional demands required by a spatial task. We asked of long-term memory. First, patients with resolved ne- right-hemisphere damaged patients either only to mon- glect appear to suffer from a pathological loss of at- itor visual space for the appearance of lateralized tar- tention capacity. We have shown this by modulating gets (single-task) or to perform also a concurrent task the difficulty of a task at fixation and assessing the (dual-task conditions). The nature of the dual-task ma- impact of this manipulation on perception across the nipulation was either visual or auditory, and both led to visual field. Patients with right parietal lesions – but similar, severe, impairments for contralesional hemis- without neglect – are impaired in detecting contrale- pace with respect to the single-task condition, even in sional stimuli only when central task difficulty is high. patients performing errorless in paper and pencil tests Further, this impairment extends temporally leading to for neglect. A longitudinal study also showed that se- a spatiotemporal ‘attentional blink’ in which patients vere deficits for contralesional hemispace can still be are unable to detect contralesional stimuli for a lag detected, by reducing target size, also in the putative of up to 500 ms (Russell et al, 2004; Russell et al, chronic phases (e.g. > 2 yrs from stroke). In some 2012). Second, after neglect has resolved a consider- patients, dual-task manipulations might also lead to able number of patients continue to suffer from con- the spatial mislocalization of the position of appear- structional apraxia, such that they are unable to copy ance of contralesional targets, in the form of alloesthe- drawings or 3D constructions. We have assessed spa- sia and synchiria. Psychophysiological (ERP and pupil tial remapping across saccades in these individuals and dilation) correlates characterizing the performance of have shown a specific impairment in remapping lo- healthy participants under dual-task conditions will be cation information, as compared to pattern informa- related to the clinical findings above described. tion (Russell et al, 2010). Recently, in recovered ne- In summary, data show that contralesional spatial glect patients with right parietal damage we have as- awareness can be severely impaired by the request sessed whether deficits in spatial representation can be to perform a concurrent, resource-demanding task, re- revealed in tests of long-term memory. This has proved gardless of its nature (e.g. visual or auditory). These to be the case as, despite having no memory deficits findings suggest that paper and pencil tests, allowing in standard neuropsychological tests, when examined compensatory strategies to be systematically imple- with a paradigm designed to examine personal spa- mented, are not sufficiently sensitive to reveal the true tial perspective within episodic memory, patients with degree of impairments suffered by patients in the post- right parietal damage are greatly impaired. The results acute and chronic phases after a stroke. Only resource- of these three lines of research will be discussed in re- demanding tasks where no compensations is allowed lation to enduring dysfunction following right parietal seem to be an appropriate diagnostic option to unveil damage, and how this might relate to the neglect syn- neglect at these later stages. drome itself.

Correspondence address: Dr. Mario Bonato, Univer- Correspondence address: Dr Charlotte Russell, Brunel sity of Ghent, Department of Experimental Psychol- University – Centre for Cognition and Neuroimaging ogy, Henry Duntalaan 2, B-9000 Ghent, Belgium. Tel.: and Department of Psychology, Uxbridge, UB8 3PH +39 3284341010; E-mail: [email protected] London, UK. E-mail: [email protected] 346 Symposia

Lecture 3: Anatomical predictors of neglect prieties of white matter in the middle branch of the su- compensation perior longitudinal fasciculus (SLF II) was associated to persistent neglect (Thiebaut de Schotten et al, Cere- Marine Lunven1, Michel Thiebaut de Schotten2, bral Cortex 2012). We present a longitudinal study of Christophe Duret3, Clémence Bourlon3, Raffaella 37 patients with right-hemisphere damage, tested at the Migliaccio4, Gilles Rode5 and Paolo Bartolomeo6 acute/subacute phase and at more than 1 year after the 1INSERM-UPMC UMR S 975; Service de Neuroréé- stroke. Each patient underwent MRI with diffusion se- ducation, clinique Les Trois Soleils (Boissise-Le-Roi); quences. Voxelwise statistical analysis of the fractional Inserm U1028, Paris and Bron, France anisotropy (FA) data was carried out using tract-based 2Inserm U1028 CNRS UMRS292, Equipe ImpaAct; spatial statistics. Twenty-seven patients had signs of Natbrainlab, Department of Forensic and Neurodevel- neglect in the acute phase, of whom only 10 had recov- opmental Sciences, Bron and London ered at follow-up. In acute/subacute neglect, lower FA 3Service de Neurorééducation, clinique Les Trois values occurred along the middle and ventral branches Soleils (Boissise-Le-Roi), France of the right superior longitudinal fasciculus (SLF II and 4INSERM-UPMC UMR S 975, Paris, France III). In chronic neglect, there was an additional impli- 5Inserm U1028 CNRS UMRS292, Equipe ImpaAct; cation of the splenium and of the forceps major. A sig- Hospices Civils de Lyon, Hôpital Henry Gabrielle, nificant FA decrease in the posterior segment of the Bron and Lyon, France arcuate fasciculus also occurred in patients with per- 6INSERM, UMRS 975, Brain and Spine Institute; De- sistent neglect when compared to patients without ne- partment of Psychology, Catholic University, Paris and glect in the chronic phase. Our data confirm a key role Milan of fronto-parietal disconnection in the emergence and chronic persistence of neglect. Moreover, these results Left neglect appears to spontaneously recover during suggest a role for inter-hemispheric compensation in the first weeks after a vascular stroke in about two- neglect recovery; on the other hand, chronic neglect thirds of stroke patients. Are there anatomical predic- may at least in part result from the activity of an iso- tors of spontaneous recovery from (or compensation lated left hemisphere. of) neglect on paper and pencil tests? Previous studies have indicated various grey matter structures, such Correspondence address: Mrs Marine Lunven, as the superior and middle temporal gyri, the infe- INSERM-UPMC UMR S 975; Service de Neurorééd- rior parietal lobule, the temporo-occipital junction or ucation, clinique Les Trois Soleils (Boissise-Le-Roi); the basal ganglia, as lesional correlates of chronic ne- Inserm U1028, 47, bd de l, 75013 Paris and Bron, glect. More recently, alteration of microstructural pro- France. E-mail: [email protected] 347

Posters

P1.01 P1.02

Prediction in perception: How foreknowledge Memory for Intentions Screening Test: Relation- changes neural processing ship to other tests of executive and memory functioning Floris P. de Lange Donders Institute for Brain, Cognition and Behavior Ondrej Bezdicek1, Jiri Michalec2,TomasNikolai1, Radboud University Nijmegen, Netherlands Sarah Raskin3 and Evzen Ruzicka1 11st Faculty of Medicine, and General University Hos- One of the most fundamental functions of the human pital in Prague, Charles University in Prague, De- brain is to predict future events on the basis of the re- partment of Neurology and Centre of Clinical Neuro- cent past. Prediction plays a prominent role in models science, Prague, Czech Republic of seemingly disparate cognitive functions such as per- 21st Faculty of Medicine, and General University Hos- ception, motor control, and language processing. We pital, Charles University in Prague, Department of often only become aware of these predictions when Psychiatry, Prague, Czech Republic they are violated. For example, when opening the door 3Trinity College, Department of Psychology and Neu- of our house does not result in the expected auditory roscience, Hartford CT, USA squeak, we are immediately surprised, whereas if we hear the expected squeak at the expected time, we usu- Prospective memory (PM) tasks require complex men- ally fail to notice it. Although there is ample behav- tal activity, which is based on, at least, the following ioral evidence for the predictive nature of perception, processes: monitoring, intention retention, time/place the incorporation of prior knowledge in the neural pro- perception, intention recall and execution. Hence, processes underlying perception is still poorly understood. spective memory (PM) is not a unitary construct. The In my lecture, I will review recent work on how prior aim of our study is to test the hypothesis that a clini- expectations (‘priors’) about the sensory world change cal tool for testing PM, the Memory for Intentions Test the neural computations that give rise to perception. (MIST) will have significant relationships with other I will highlight recent neuroimaging data (MEG and measures of executive and memory functioning. fMRI) and methods (multivariate classification tech- Twenty healthy older adults were investigated using niques) that show how stimulus expectations reduce the MIST Czech version (11 F, 9 M; mean age 68 ± neural activity in early sensory cortex, but boost the SD5, mean education 16 ± 2) and a neuropsycholog- amount of information that can be “read out” from ical battery: working memory using Digit and Spa- these areas. This suggests that predictions may sharpen tial Span and Letter-Number Sequencing (DS, SS and the sensory representation, thereby speeding up per- LNS WMS-III); retention using the Auditory Verbal ception of expected items. Learning Test (AVLT) and Family Pictures (FP WMS- III) and Memory Capacity Test (MCT); executive func- Corresponding author: Floris de Lange, Donders In- tions using the Victoria Stroop Test (VST), Trail Mak- stitute for Brain, Cognition and Behavior, Nijmegen, ing Test (TMT), verbal fluency (COWAT), Wisconsin Netherlands. E-mail: fl[email protected] Card Sorting Test (WCST-64) and Tower of London (ToL). There were no significant relationships between age and education and MIST measures. The correlation between Prospective Memory Total (PMT) was signif- 348 Posters icant only with DS, SS forward, MCT and VST de- OBJECTIVE: The present study investigated how vi- rived index C/D (rho > 0,5, all p<0,05). The cor- suospatial systems support verbal WM using the vi- relation between the retrospective component of the suospatial bootstrapping paradigm across older and MIST (2- and 15-minute delay) was significant only younger adult samples, an issue that has not yet been with MCT and COWAT (rho > 0,5, p<0,05). MIST researched. errors scores, namely loss of content and loss of time MATERIALS AND METHODS: Two different sam- were significantly related to COWAT (rho = 0,7, ps < ples were recruited: younger adults (18–35 years) and 0,05). older adults (55–75 years). Each participant was as- These findings indicate that using the MIST Czech ver- sessed with a brief neuropsychological battery of tests sion, PMT is predominantly related to measures of in- and the assessments of bootstrapping. The latter tasks terference and sustained attention. Regarding the PM compared immediate serial recall performance across retrospective component as well as PM errors, these three visual display conditions: single digit presenta- are notably related to measures of mental flexibility. tions, standard keypad arrays and random (unfamiliar) This conclusion supports further a non-unitary con- keypad arrays without suggestion as to what memory cept of PM and shows that MIST performance is based strategy to use. = on basic memory (interference) and executive (mental RESULTS: 64 subjects were tested (N 32 younger = flexibility) processes in healthy aging. adults, N 32 older adults). The results indicate the presence of a bootstrapping effect in the group of Keywords: Memory and Learning, Aging, Neuropsy- young people and a substantial main effect suggestive chological Assessment and Psychometrics of bootstrapping across the two groups. CONCLUSIONS: Visuo-spatial Bootstrapping is investigated for the first time in a group of older adults. Correspondence address: M.A. Ondrej Bezdicek, 1st Preliminary analysis indicates a significant improve- Faculty of Medicine, and General University Hospital ment in memory in the standard keypad condition in Prague, Charles University in Prague, Department across young and older adults. of Neurology and Centre of Clinical Neuroscience, Katerinska 30, 128-21 Prague, Czech Republic. Tel.: Keywords: Memory and Learning, Aging, Neuropsy- +420 731 478 794; E-mail: [email protected] chological Assessment and Psychometrics P1.03 Correspondence address: Mrs Clara Calia, Queen Mar- garet University, Division of Psychology and So- Visuospatial Boostrapping in older and younger ciology, Queen Margaret University Drive, Mussel- adults burgh„ UK-EH21 6UU Edinburgh, UK. Tel.: +44 07906194175; E-mail: [email protected] Clara Calia1, Stephen Darling1, Richard J. Allen2 and 2 Jelena Havelka P1.04 1Queen Margaret University, Division of Psychology and Sociology, Edinburgh, UK 2 What are memory binding tests telling us about University of Leeds, Institute for Psychological Sci- cognition in healthy ageing? Implications for neu- ences, Leeds, UK ropsychology

BACKGROUND: Recent studies on verbal immediate Mario Parra1, Sara Fernández-Guinea2,MarioA. serial recall (Darling and Havelka, 2010; Darling et Parra1, Anna Frank3, Maria Luisa-Delgado3 and Ser- al., 2012) shows evidence of the integration of infor- gio Della Sala1 mation from verbal and visuospatial short term mem- 1University of Edinburgh, Psychology, Edinburgh, UK ory (STM) with long term memory (LTM) representa- 2Complutense University of de Madrid, Psychology, tions. This so-called ‘visuospatial bootstrapping’ pat- Madrid, Spain tern, in which verbal serial recall is improved when 3Hospital La Paz, Health Research Institute, IDIPAZ, the information is arranged in a familiar spatially dis- Madrid (Spain) tributed pattern, such as a telephone keypad, is consistent with the existence within working memory (WM) BACKGROUND: Not all cognitive functions decline of an episodic buffer (EB; Baddeley, 2000). with age at the same pace. Cognitive functions which Posters 349 do not decline with age would be interesting for neu- We study here frailty and vulnerability factors iden- ropsychologists assessing age-related diseases. tified in the “well-aging consultation” of the geri- AIM: The present study addressed this issue by study- atric unit. Patients were aged from 47 to 85 years ing memory binding in healthy young participants and old and consulted in order to obtain advices on their cognitively intact healthy older adults. health. During this geriatric consultation, the patient’s METHODS: Participants (21 younger and 19 older initial complaint and his results to the IOWA Self- adults) were asked to perform a battery of traditional Assessment Inventory and to 5 neuropsychological neuropsychological tests and a battery of tests which tests (MMSE, Frontal Assessment Battery, 5 words investigate binding functions in short-term memory memory test, clock drawing test and Stroop test) are and in long-term memory using recall and recognition systematically evaluated. According the frailty and procedures. vulnerability profile identified, a more complete neu- RESULTS: Traditional neuropsychological tests con- ropsychological assessment is proposed. The data pre- firm that the impact of age on cognition is significant sented here describes the characteristics of 222 pa- for memory, attention, speed of processing and execu- tients. The median age is 64 years old and most of the tive control. Similarly, free and cued recall of bindings patients ask questions about successful ageing around made of overlearned stimuli (e.g., objects or words), the beginning of their retirement. Sixty-three percent as wells as tasks assessing learning of bound stimuli of patients have a high level of education (A-levels or (i.e., associations), all lead to a pronounced age effect. more). Most of ageing concern is related to presence On the contrary, short-term memory binding tasks, par- of a mnesic complaint in 38% of patients, to vascu- ticularly those assessing recognition of novel stimuli, lar and/or dementia family history in 26% of cases, proved insensitive to age. to depressed symptoms in 9% of cases, and to being CONCLUSIONS: These findings have important im- a family caregiver in 8% of patients. After the “well- plications for the selection of memory tests to be used aging consultation”, a more complete neuropsycholog- in the assessment of elderly populations at risk for de- ical assessment was proposed to 19% of the patients. mentia, and suggest that short-term memory binding The analyses comparing the groups with and with- tasks, being insensitive to age effects, would be an in- out neuropsychological assessment show that the first teresting candidate as aid to diagnosis of dementia. group significantly differs from the second one on age (are older), mood (more frequently show depressive Keywords: Memory and Learning, Aging, Neuropsy- symptoms) and quality of life data (feel themselves in chological Assessment and Psychometrics poor health). They also differ in all neuropsychological tests: their performances are worse and their process- Correspondence address: Dr. Mario Parra, University ing speed is higher, excepted in the first free recall con- of Edinburgh, Psychology, 7 George Square, EH8-9JZ dition of the 5 words test and the interference Stroop Edinburgh, UK. Tel.: +44 0 1316508385; Fax: +44 0 condition. However, the two groups do not differ in ed- 1316513230; E-mail: [email protected] ucational level and in other IOWA scores. According to these results, we discuss the impact of frailty and vul- P1.05 nerability factors in cognitive ageing and in neuropsychological assessment. Influence of frailty and vulnerability factors in cognitive ageing and its consequences on neuropsycho- Keywords: Memory and Learning, Aging, Neuropsy- logical assessment chological Assessment and Psychometrics

Frederique Bozon-Auclair1, Audrey Rieucau2, Malika Correspondence address: Dr. Frederique Bozon-Aucl- Gmiz1, Isabelle Fromentin1, Samia Lakroun1,Feriel air, Emile Roux Hospital, APHP, Geriatric Unit 3, Av- Menasria1,HenriNaga1 and Jean-Philippe David1 enue de Verdun, 1, F-94451 Limeil-Brevannes, France. 1Emile Roux Hospital, APHP, Geriatric Unit 3, Limeil- E-mail: [email protected] Brevannes, France 2University Paris Descartes and Emile Roux Hospi- tal, Laboratoire de Psychopathologie et Processus de Santé, EA 4057, Paris, France 350 Posters

P1.06 side neurocognitive deﬁcits, the signiﬁcance of emotions in the pathogenesis of confabulation as well as The challenge of false memories in rehabilitation: A the role of false memories in preserving self-identity case report and self-esteem.

Alberta Lunardelli1, Mara Serra2, Claudia Barbera2, Keywords: Memory and Learning, Amnesia, Neu- Marina Mascagni1, Gianfranco Scrivo1, Gianfranco ropsychological Rehabilitation Dalla Barba3 and Valentina Pesavento1 1Azienda Ospedaliero-Universitaria Ospedali Riuniti Correspondence address: PhD Alberta Lunardelli, Trieste, Medicina Riabilitativa, Trieste, Italy Azienda Ospedaliero-Universitaria Ospedali Riuniti 2Università degli Studi di Trieste, Dipartimento di Trieste, Medicina Riabilitativa, Piazza Ospitale N. 1, I- Scienze della Vita, Trieste, Italy 34134 Trieste, Italy. E-mail: alberta.lunardelli@gmail. 3Centre de Recherche de l, UMR-S97, Paris, France com

Confabulation, or the production of false memories, is P1.07 a pervasive disorder that may follow brain damage. Pa- tients are typically unaware of their memory errors and Prosopamnesia: a dysconnexion syndrome? may be so convinced of their truthfulness that they may act upon them. Given the patients’ poor insight the per- Claire Bindschaedler1 and Philippe Maeder2 sistence of confabulation in chronic cases is generally 1CHUV,Service de Neuropsychologie et de Neuroréha- associated with lessened ability for independent living bilitation, Lausanne, Switzerland and thus with increased need for supervision (Mills, 2CHUV, Service de Radiodiagnostic et Radiologie In- Karas, and Alexander, 2006). Despite the great bur- terventionnelle, Lausanne, Switzerland den posed on caregivers and confabulation’s correlation with poor rehabilitation outcomes, there are no A few case reports suggest that episodic memory im- systematic studies focusing on its rehabilitation, possi- pairment can affect selective categories of visual mate- bly because most patients eventually stop confabulat- rials while sparing others, independently of any prob- ing, lem in perceptual processing. Such dissociations have Here we report a single case intervention study of been attributed to either a dysconnexion between initial a 61-year-old woman (IG) who developed a persis- encoding mechanisms and domain-specific represen- tent confabulatory syndrome following the rupture of tations (Tippet et al., 2000) or differential damage to a right internal carotid siphon aneurysm. Consistent segregated paths within the hippocampus (Carlesimo with hypotheses suggesting that confabulations may et al., 2001). We report a case of prosopamnesia sec- serve important functions of self-coherence and self- ondary to a small post-traumatic haemorrhage centred enhancement in spite of their poor correspondence to on the collateral sulcus within the right temporal lobe. reality (i.e. Fotopoulou, 2008), treatment was tailored Overall cognitive functions, face recognition (Benton on the emotional content of false memories rather than face matching test, recognition of famous faces) and directed on confrontation with her incongruent or inac- visual declarative memory (Rey complex figure, Doors curate claims. To evaluate the influence of rehabilita- test, Camden topographical recognition test, faces sub- tion on IG’s tendency to confabulate or on other cogni- test of the Rivermead Behavioural Memory Test, faces tive domains, a modified version of the Confabulation subtests of the MEM-III, continuous recognition test Battery (Dalla Barba, 1993) together with a compre- for words, faces and landscapes) were assessed using hensive neuropsychological assessment were adminis- mostly well-standardised tools at 3 weeks, 2 and 6 tered before and after a 9-months period of individual months post-injury. There was no impairment in ob- training sessions. Even though IG maintained a quali- ject, colour and famous face recognition neither in tatively similar pattern of confabulations that focused matching of unknown faces. The patient performed on childhood or adulthood, the amount of false memo- normally on the memory tasks mentioned above ex- ries decreased over time (from 56.70 to 32.12 mean% cept on various memory tests involving faces. More- of confabulations at the Confabulation Battery). Re- over, his difference score between faces and landscapes sults may provide clinical support for the efficacy of re- on the continuous recognition task was clearly outside habilitation interventions that take into account, along- the range of both a large sample of 180 control subjects Posters 351 and a subset of 20 controls matched for age and educa- presenting visual arrays of stimuli which consisted of tion (Bindschaedler et al., 1996). Careful MRI exami- shape-colour relations (shape-colour pairs) or shape- nation revealed that the fusiform face area (FFA) and colour conjunctions (coloured shapes). After a short re- the parahippocampal place area were spared, the lesion tention interval they were asked to recall the relations lying more anterior and affecting predominantly the or conjunctions or to reconstruct them by selecting the parahippocampal cortex. We hypothesise that parahip- shapes and their corresponding colours from two sepa- pocampal damage disconnected the FFA from the hip- rate sets. pocampal formation while sparing incoming informa- RESULTS: As compared to healthy controls, the pation from other cortical areas involved in processing tient was impaired in holding relations of shapes and landscapes or geometric drawings. colours in WM whereas he could retain the conjunctions similarly to controls. Keywords: Memory and Learning, Amnesia, Neu- CONCLUSIONS: These results lend support to the ropsychological Assessment and Psychometrics role of the hippocampus in supporting WM for inter- item associations but not WM for conjunctions of fea- Correspondence address: Dr. psych. MER Claire Bind- tures which define objects’ identity. schaedler, CHUV, Service de Neuropsychologie et de Neuroréhabilitation, avenue Decker, CH-1011 Lau- Keywords: Memory and Learning, Amnesia, Neu- sanne, Switzerland. Tel.: +41 21 3141313; Fax: +41 21 ropsychological Assessment and Psychometrics 3141319, E-mail: [email protected] Correspondence address: Dr. Mario Parra, University P1.08 of Edinburgh, Psychology, 7 George Square, EH8-9JZ Edinburgh, UK. Tel.: +44 0 1316508385; Fax: +44 0 What memory binding functions is the hippocam- 1316513230; E-mail: [email protected] pus responsible for? P1.09 Mario Parra1, Mario A. Parra1, Katia Fabi2, Simona Luzzi2, Roberto Cubelli3 and Sergio Della Sala1 Categorization processing of natural categories in 1University of Edinburgh, Psychology, Edinburgh, UK Autism Spectrum Disorder: The effects of typical- 2Polytechnic University of Marche, Clinical Neurol- ity. ogy, Ancona, Italy 3Department of Psychology and Cognitive Sciences, Joana Carmo1, S. Pinhho2, C. Filipe3 and J.F. University of Trento, Trento, Italy Marques1 1University of Lisbon, Faculty of Psychology, Lisbon, BACKGROUND: The role of the hippocampus in Portugal binding information in working memory (WM) is lit- 2CADIN, Centro de Apoio ao Desenvolvimento Infan- tle understood. When complex experiences comprise til, Cascais, Portugal associations between different pieces of information 3New University of Lisbon, Faculty of Medical Sci- such as objects and locations (relational binding), the ences, Lisbon, Portugal function of the hippocampus is required to hold them in WM. However, recent evidence suggests that if the Recently, several studies (e.g. Bowler, Graigg and to-be-associated information leads to the formation of Gardiner, 2008; Bowler, Limoges and Mottron, 2009; integrated objects such as coloured shapes (conjunctive Sumiyoshi et al., 2011) show that semantic memory binding), the hippocampus is less involved in holding processes differ in key aspects from those of neurotyp- temporary representations of these complex events in ical individuals and cast some dough on whether se- WM. mantic memory and categorization processes are truly AIMS: We investigated the relational and conjunctive intact in individuals with Autism Spectrum Disorder binding hypotheses of the hippocampal functions in (ASD). a patient with right hippocampal damage. Methods. In this study we aim at understanding if deficits in The patient and controls were asked to perform a bat- semantic processing regarding memory tasks are due tery of neuropsychological tasks and a battery of mem- to an impairment of semantic processing per se, or ory binding tasks. Memory binding was assessed by due to the use of atypical conceptual categories. For 352 Posters that end we have tested a sample of high-functioning gory membership; where the better the category ex- adults with ASD (n = 22) and a sample of control emplar the more features that are shared with other participants (n = 22) matched for age, IQ and educa- category members and the fewer that are shared with tion level on two tasks. First, in order to evaluate the nonmembers. Moreover, knowledge of typical exem- content and composition of conceptual categories we plars and shared features is relatively preserved in face adapted a task from Lambon-Ralph (2010) where er- of the degradation of semantic knowledge observed in rors on typical, atypical and pseudo-typical items can dementia patients. This is at least the case at the su- be observed. Additionally, in an implicit categorization perordinate level. This study extends the analysis of task (Release from Proactive Interference paradigm) typicality data to the domain level, the level at which we have assessed whether recollection from memory category-specific deficits are usually reported. can be disrupted by the activation of typical and atypi- METHODS: We collected typicality norms across both cal semantic stimuli. superordinate and domain levels. Ten superordinate In the task where the explicit access to the semantic categories across 280 items were studied. categories is evaluated we have found that individu- RESULTS: Results indicate that the brain categorizes als with ASD make more errors not only in atypical according to animate/inanimate domains rather than items, but also in typical and pseudo-typical items. In living/nonliving and that the domain level of catego- the release from proactive interference task we found rization is independent of the more specific superordi- that, together with a overall decrease in memory per- nate domain, as domain typicality correlates with the formance for the ASD group, the amount of the build prevalence of an item’s feature types, but not feature up (disruption of memory performance within a trial) sharing among category members. for typical trials was smaller as compared to the control CONCLUSION: Typicality at domain level supports group, to the level of atypical trials. a feature type explanation of category-specific deficits Differences found between processing of conceptual where the animate vs. inanimate distinction is better categories in individual with ASD and controls are dis- able to capture domain contrasts. cussed, taking into account the implicit and explicit nature of the different tasks used. Keywords: Memory and Learning, Dementia, Other Methods Keywords: Memory and Learning, Autism, Neuropsy- chological Assessment and Psychometrics Correspondence address: Mr J. Frederico Marques, University of Lisbon, Faculty of Psychology, Alameda Correspondence address: Dr. Joana Carmo, University da Universidade, 1649-013 LISBOA, Portugal. E-mail: of Lisbon, Faculty of Psychology, Alameda da Cidade [email protected] Universitária, 1649-013-Lisbon Lisbon, Portugal. E- mail: [email protected] P1.11

P1.10 Abeta 1–42 diminish the capacity to benefit from performance enhancing memory strategies Typicality at superordinate and domain level: Implications for understanding category-specific Ingo Uttner, Jonas Kösel, Johannes Brettschneider, deficits Hayrettin Tumani and Christine Von Arnim Universität Ulm, Neurologische Klinik, Ulm, Germany J. Frederico Marques1, Andrea Santi2 and Ana Raposo3 INTRODUCTION: Although Abeta 1–42 is believed 1University of Lisbon, Faculty of Psychology, Lisboa, to disrupt synaptic function in AD, traditional psy- Portugal chometric tests, however, do not correlate with this 2University College, London marker. Abeta deposits involve at first neocortical ar- 3University of Lisbon, Lisboa eas, especially the frontal lobes that have been associated with the ability to use strategies. This suggests GOALS: The present study evaluates the role of typ- that a strategy-based test procedure such as the Testing- icality in explaining category-specific deficits. Typi- the-Limits paradigm (TtL), which combines the classi- cality ratings demonstrate the graded nature of cate- cal measurement of cognitive state (pre test) with the Posters 353 one after exposure to performance-enhancing condi- SPECIFIC GOALS OF THE STUDY: Based on the tions (post test), should be suitable to depict the rela- clinical cases and the other authors, Schnider (2008) tion between the neuronal and the behavioral level. considered fantastic mnesic confabulation which have METHODS: 44 subjects [23 females, 21 males; age no basis in reality and are intrinsically nonsensical, il- (median, interquartil range): 72, 7.5 y] presented to the logical and implausible in content. Fantastic confab- Memory Clinic with a suspected AD [Mini-Mental- ulations was described as a much less common phe- State-Examination (MMSE) score (median, range): nomenon that other forms of mnesic confabulations. 26, 18-30] were assessed. A PC-based recognition The aim of this study was to describe the frequency of paradigm consisting of a pre- and two post-test condi- fantastic confabulations and to provide more empirical tions with an interposed encoding instruction was ad- evidence on fantastic confabulations in a group of Mild ministered. Cognitive plasticity was operationalized by Alzheimer’s Dementia. the recognition failures made in one or both of the post METHODS: Thirty-three subjects with mild Alzhei- tests. CSF t-tau and Abeta-1-42 levels were determined mer’s dementia and 37 elderly without dementia be- using a sandwich ELISA (Innogenetics, Zwijndrecht, tween 65 to 85 years of age participated in this study. Belgium). We used the Spanish version of Dalla Barba provoked RESULTS: Abeta ranged from 277 to 1778 (median: confabulation’s interview and other neuropsychologi- 833.5) ng/L, tau from 112 to 1426 (median: 336) ng/L. cal tests or interview: an structured interview of spon- TtL-failure rates were (median) 11.5 (range: 3–24) in taneous confabulations carried out to caregivers; the the pre test, 7 (0–24) in post test 1 and 9 (0–24) in post Spanish version of Grober and Buschke memory test; test 2. Correlation analysis (Spearman-Rho) reveals a two tasks of semantic memory and the Spanish ver- negative association between abeta and the failure rates sion of the Mattis dementia rating scale. We divided the in post test 1 (p = 0.023). Pre test and post test 2 per- patients group into provoked confabulators and non- formance do not correlate with abeta (p = 0.744 and confabulators using a statistical criterion. p = 0.083). No association was found between recog- RESULTS: Thirty percent of the patients compared nition performance and tau (p-range = 0.104–0.245). to eight percent of controls have fantastic confabu- CONCLUSION: Our findings underline the sensitivity lations in Dalla Barba provoked confabulation’s in- of dynamic test procedures as an early indicator for a terview (p = 0.04). Provoked confabulators group dysfunction of the frontal lobe networks and corrobo- presented more fantastic confabulations that the el- rate the influence of abeta as a state marker for synaptic p = plasticity. derly without dementia ( 0.01) but no that non- confabulators group (p = 0.62); really, when analyzing Keywords: Memory and Learning, Dementia, Neu- the results individually, only two patients, provoked ropsychological Assessment and Psychometrics confabulators, obtained a number two fantastic confabulations, which is considered above the cut-off. Correspondence address: Prof. Dr. Ingo Uttner, Uni- CONCLUSION: In mild Alzheimer’s dementia, fan- versität Ulm, Neurologische Klinik, Oberer Eselsberg tastic confabulations are not frequents. They seem 45, D-89081 Ulm, Germany. Tel.: +49 0731 177 0; E- anecdotal and associated with patients considered pro- mail: [email protected] voked confabulators. We would like to note that mnestic fantastic confabulations refer to the content of con- P1.12 fabulation, not the methodology of how to get the confabulation (provoked or spontaneous). Fantastic mnesic confabulation in content is not common in mild Alzheimer’s dementia. Keywords: Memory and Learning, Dementia, Neu- ropsychological Assessment and Psychometrics Ana Llorente1, Claire Bindschaedler2 and Adolfo Jarne3 Correspondence address: Dr. Ana Llorente, Benito 1Benito Menni Psychiatric Hospital, Sant Boi Llobre- Menni Psychiatric Hospital, Carrer Doctor Antoni Pu- gat, Spain jadas, 38, Spain-08830 Sant Boi Llobregat, Spain. Tel.: 2Service de neuropsychologie et de neuroréhabilita- +34 619181459; E-mail: [email protected] tion, Hôpital Nestlé CHUV, Lausanne, Switzerland 3Department of Personality, Barcelona University, Barcelona, Spain 354 Posters

P1.13 Keywords: Memory and Learning, Dementia, Neu- ropsychological Assessment and Psychometrics Gender speciﬁc differences in cognitive proﬁles of patients with Alzheimer dementia. Results of the Correspondence address: Mrs phd Gisela Pusswald, Prospective Dementia Registry Austria (PRODEM- Medical University of Vienna, Neurology, Währinger Austria) Gürtel 18-20, a-1090 Vienna, Austria. E-mail: gisela. [email protected] Gisela Pusswald1, Lehrner1,Del-bianco1,Benke2, Marksteiner3, Ransmayr4 and Schmidt5 P1.14 1Medical University of Vienna, Neurology, Vienna 2Medical University of Innsbruck, Neurology, Inns- Differences between patients with hydrocephalus bruck and alzheimer on learning and memory 3Hospital in Hall in Tirol, Psychiatry and Psychother- apy, Hall Oget Oktem Tanor 4AKH in Linz, Neurology and Psychiatry, Linz Istanbul University, IstanbulFaculty of Medicine, Neu- 5Medical University of Graz, Neurology, Graz rology, Istanbul, Turkey

GOALS: Gender differences have been well docu- GOAL: This study aims to investigate the differ- mented for healthy individuals in several cognitive ences between neuropsychological performances of a tasks. Recent investigations suggested that gender may group of patients with hydrocephalus and a group of be an important modifying factor in the development Alzheimer disease patients on certain parameters of a and progression of Alzheimer‘s disease (AD). We here Turkish verbal learning and memory test. examined gender-specific differences in the pattern of METHOD: 233 patients with normal pressure hy- cognitive dysfunction of patients with mild to moder- drocephalus, 120 patients with early-stage Alzheimer ate AD. disease, and 779 normal controls were included in METHODS: We examined 417 individuals (mean age this study. A 15-word standardized list learning test 83 (+8.1) years, 59% females) of the prospective reg- named “Oktem Verbal Learning and Memory Pro- istry on dementia in Austria (PRODEM), an ongoing cesesses Test” (Oktem Sözel Bellek Surecleri Testi) longitudinal multi-center cohort study , conducted in was performed to all three groups. The evaluated pa- 12 Austrian memory clinics. We analyzed differences rameters included Learning Score, Highest Learning, in the cognitive profile between male and female AD Delayed Recall, Delayed Total Remembering (Re- patients on the CERAD-Plus test battery. call+Recognition) and False Recognition. RESULTS: We found gender related differences in RESULTS: Learning Score and Highest Learning the neuropsychological domains of verbal learning, Score differed significantly between the three groups. delayed recall, recognition and intrusion errors; the When compared for the Delayed Recall, both pa- women tended to perform worse than men. There were tient groups performed significantly lower than nor- no significant differences between the two groups in mals. As for the Delayed Total Remembering, there constructional praxis. Comparing the performance of was no significant difference between the normals and the group of patients with possible to those with prob- the patients with hydrocephalus; however, Alzheimer able AD, men and women with probable AD differed group’s performance was significantly lower than both only in their verbal learning performance. Controlling groups. Alzheimer patients were also the only group the stage, the duration of dementia and the level of ed- that had significantly higher False Recognition scores. ucation a gender effect of verbal episodic memory re- DISCUSSION: Our results suggest that the changes in mained. the pressure of CSF in the anterior horns of the lateral CONCLUSION: There is an interaction between gen- ventricules may interfere with the domain of attention der and cognitive function, most notable in verbal in patients with Hydrocephalus, impairing both imme- episodic memory; female patients with AD performed diate and delayed recall. As their hippocampus is in- worser on verbal episodic memory than men. This intact as opposed to Alzheimer’s group, the patients with dicates that the gender specificities of neuropsycholog- hydrocephalus are able to register all 15 words, and ical functions should be given careful consideration in although they have problems with spontaneous recall, clinical diagnosis of dementia. they can recognize the remaining words. However, the Posters 355 pathology in hippocampus of the Alzheimer group im- showed mental retardation (IQ < 60) as well as signif- pairs both recalling and recognizing ability, as demon- icant cognitive impairment concerning working mem- strated by their failure to register the words in the first ory, attention and language; MRI showed more ex- place; the high false recognition scores in this group tensive bilateral PNH. Fractional PNH volumes were can also be explained by the same failure. 0.68%, 1.18% and 1.97%. CONCLUSION: Our data illustrated a remarkable Keywords: Learning and Memory, Hydrocephalus, variation of cognitive functions within the family and Alzheimer showed a graduation from the unimpaired father to daughter II with significant impairment, contrasting Correspondence address: Prof.Dr. Oget Oktem Tanor, findings about PNH patients being normal or mildly Istanbul University,IstanbulFaculty of Medicine, Neu- impaired. Cognitive profiles correlated roughly to the rology, Millet caddesi, Capa, TR-34093 Istanbul, degree of PNH, but whether differences are explained Turkey. Tel.: +90/535 668 60 84; Fax: +90/212/533 85 by extent of PNH, epilepsy severity, antiepileptic drugs 75; E-mail: [email protected] or other factors remains to be clarified. A more systematic approach to neuropsychological testing in patients P1.15 with PNH is of high importance.

Neuropsychological proﬁles in familial periventric- Keywords: Memory and Learning, Epilepsy, Neu- ular nodular heterotopia ropsychological Assessment and Psychometrics

Katrin Kurzbuch1, Elisabeth Pauli1,BernardS. Correspondence address: Mrs Dipl.-Psych. Katrin Kur- Chang2,LinseyM.Walker2 and Burkhard S. Kasper1 zbuch, Department of Neurology, University of Erlan- 1Department of Neurology, University of Erlangen- gen-Nürnberg, Epilepsy Center, Schwabachanlage 6, Nürnberg, Epilepsy Center, Erlangen, Germany D-91054 Erlangen, Germany. E-mail: katrin.kurzbuch 2Dept. of Neurology, Harvard Medical School, Beth Is- @uk-erlangen.de rael Deaconess Medical Center, Boston, USA P1.16 PURPOSE: Periventricular nodular heterotopia (PNH) is a developmental cerebral malformation caused by Improvement in delayed visual memory in people neural migration failure and often accompanied by with mild Alzheimer disease after one year of cog- epilepsy. Knowledge about cognitive functioning of nitive stimulation program these patients remains incomplete and is generally described as normal, except for reading impairment. In Glòria Chico1, Noemí Cerulla2, Maite Garolera3, this study, neuropsychological profiles and anatomical Cristina Borras2, Mariona Rodriguez-Querol2,Esther features of an exceptional family with paternal trans- Tomas2 and Carme Civit2 mission of PNH are reported. 1Consorci Sanitari de Terrassa, Hospital Sant Llàtzer, METHOD: Three family members with PNH due to Terrassa, Spain FLNA-mutation and seizures, the father (62), daughter 2Consorci Sanitari de Terrassa, Hospital Sant Jordi, I (31) and daughter II (30), were studied with extensive Terrassa, Spain neuropsychological assessment of intelligence, mem- 3Consorci Sanitari de Terrassa, Hospital de Terrassa, ory, language, attention and executive functions, as Spain well as structural magnetic resonance imaging (MRI) and volumetrics. The efficacy of the cognitive stimulation in dementia is RESULTS: Neuropsychological assessment revealed well established. The research of cognitive stimulation interesting individual cognitive profiles and signifi- in Alzheimer’s disease has been always criticized be- cant differences between family members. The father cause it’s assumed that the impairment in memory pro- showed above-average intelligence and overall intact cesses in neurodegenerative diseases is irreversible, but cognitive functions; MRI displayed scattered hetero- in fact most of the studies are focused in the assessment topic nodules. Daughter I showed normal intelligence of verbal memory, leaving aside the assessment of the and specific deficits in working memory and reading; visual memory. The aim of this study is to compare the MRI demonstrated mild bilateral PNH. Daughter II performance in delayed visual memory evaluation in 356 Posters people with mild Alzheimer disease after their partici- In neuropsychological research (A. Luria syndrome pation in a cognitive stimulation program for one year analysis) cognitive functions were evaluated in chil- provided at a day hospital. The present study consisted dren and teenagers with focal epilepsy at the age of 6– in a pre-experimental design with a pre and post inter- 16 years of age. Qualitative and quantitative analysis of vention measurement that was conducted in a day hos- different factors influencing cognitive functions (such pital memory facility. 55 patients with mild Alzheimer as age of the child, age of the disease onset, epileptic disease (30 women, 25 men) were assessed with mem- center localization, etiology of the disease) was carried ory scales from Repeatable Battery of Neuropsycho- out. logical Assessment (RBANS) before they started the Presence and severity of some of the cognitive symp- cognitive program and after a year of treatment. The toms in focal epilepsy depends on the age of the child. t-test for paired samples in PASW statistics version 20 The comparison of neuropsychological research re- was used to assess the statistical significance of the dif- sults in two age groups: 6–10 and 11–16 year old ferences between memory measures, we set the alpha proved that there is irregular reduction of the sever- level to 0.05 and we estimated the effect size (Cohen’s ity of certain symptoms. The reduction is particularly d) to measure the magnitude of mean differences. Sig- evident in symptoms related to the first brain unit nificant differences were found on the measure of de- (arousal and inactivation). However regardless of the layed visual memory [t (51) = −3.14, p = 0.03] with epileptic center localization the symptoms related to an effect size d that was 0.29, indicative of small ef- verbal-acoustic and visual-spatial perception does not fect and no differences were observed on the measure decrease. Neither do the symptoms of audio and visual of verbal memory [t (54) = −0.80, n.s.] after a year of memory disorders (the second brain unit – modal and cognitive training. These results suggest the benefit of material specific factors). cognitive stimulation programs not only in stabilizing More severe cognitive disorders were observed in chil- cognitive impairment in mild Alzheimer’s disease, but dren with early manifestation of the disease (in the age also in improving the performance in delayed visual groups of 0–3 and 3–6). This regularity is clearly seen memory. One limitation of this study is the type of de- in the juxtaposition of the symptoms connected to the sign and the results have to be considered preliminary, deficiency of all three brain units. In children with later it needs further investigations to reassure this effect. manifestation of the disease the symptoms were less pronounced. Keywords: Memory and Learning, Dementia, Neu- The disease etiology (symptomatic temporal and id- ropsychological Rehabilitation iopathic temporal) influences the specifics and severity of cognitive disorder. Cognitive disorders in idio- Correspondence address: Mrs Glòria Chico, Consorci pathic focal epilepsy are less pronounced than in symp- Sanitari de Terrassa, Hospital Sant Llàtzer, plaça Doc- tomatic epilepsy. tor Robert, 1, S-08221 Terrassa, Spain. Tel.: +34 937367067;Fax: +34 937831555; E-mail: gchico@cst. Keywords: Memory and Learning, Epilepsy, Neu- cat ropsychological Assessment and Psychometrics

P1.17 Correspondence address: Mrs Tinatin Gogberashvili, The Russian National Research Medical University The conditions affecting cognitive functions in chil- named after N.I. Pirogov (RNRMU), Department of dren with focal epilepsy Clinical Psychology, Ostrovityanova st.1, +7-117997 Moscow, Russia. E-mail: [email protected] Tinatin Gogberashvili and Yuri Mikadze Department of clinical psychology, The Russian Na- P1.18 tional Research Medical University named after N.I. Pirogov (RNRMU), Moscow, Russia The timescale of accelerated long-term forgetting in patients with Transient Epileptic Amnesia Cognitive deﬁcits are one of the most frequent symptoms in pediatric epilepsy. Research on the factors Serge Hoefeijzers1, Michaela Dewar1, Christopher affecting cognitive disorders in children with focal Butler2, Sergio Della Sala1 and Adam Zeman3 epilepsy is of great importance for diagnostics, prog- 1University of Edinburgh, Human Cognitive Neuro- nosis of cognitive development, and rehabilitation. science, Edinburgh, United Kingdom Posters 357

2University of Oxford, Nuffield Department of Clinical P1.19 Neurosciences, Oxford, United Kingdom 3University of Exeter, Cognitive and Behavioural Neu- Implicit sequential learning in patients with rology, Peninsula Medical School, Exeter,United King- epilepsy-interim results dom Anke Hermsen1, Yu-Ming Chen1, Silke Leonhard2, 1 1 1 Accelerated Long-term Forgetting (ALF) is the pro- Marcus Belke , Susanne Knake and Felix Rosenow 1 cess whereby initially intact memories are forgotten Philipps-Universität and UKGM Marburg, Neurol- more rapidly than usual over periods longer than stan- ogy, EZH, Marburg, Germany 2 dard testing intervals (> 30 minutes). ALF has been Neurologische Klinik Westend, Bad Wildungen associated with epilepsy, in particular with Transient Epileptic Amnesia (TEA). Previous work shows that Introduction Epilepsy is frequently accompanied by ALF is apparent 24 hours – 1 week after initial mem- cognitive deficits, especially memory. Explicit and im- ory acquisition. It is unclear however if ALF is appar- plicit memory (ExM, ImM) form the long term mem- ent even earlier. This study investigates when ALF first ory. Mesial temporal lobe (mTL) structures -especially becomes apparent. 16 TEA patients and 16 matched the hippocampus- are important for ExM; hippocampal controls were presented twice with 4 categorical word sclerosis (HS) often leads to memory deficits in mTL lists, each of which was recalled at a different delay in- epilepsy (mTLE). The same structures are discussed terval: 30 minutes, 3 hours, 8 hours and 24 hours. One as contributing to ImM. Surprisingly, an animal model week after acquisition participants were asked to recall of mTLE-rats showed better sequential learning (SL, all four word lists again and to complete a word recog- a subform of ImM) performance than control animals. Data on ImM in mTLE-patients is lacking. SL, a form nition test. TEA patients’ initial learning of word lists of ImM, is investigated here with SRTT (Serial Reac- and their recall at the 30-minute delay interval were tion Time Task) in epilepsy patients with (+)/without normal. Recall became impaired 3 hours after acqui- (−) mTLE. sition and declined significantly until the 8-hour de- Method In two studies we investigated 1) preoperative lay interval. Recall performance of TEA patients re- patients with focal epilepsy (TLE+HS, TLE-HS, ex- mained poorer at the 24-hours and 1-week delay inter- traTLE (eTLE)), as well as 2) postoperative mTLE- val. Though, the 8-hour to 1-week forgetting pattern patients (selective Amygdalohippocampectomy (sA- was similar to that of controls. That is, no forgetting HE); sAHE+ Gyrus parahippoc.; TL-Resection; eTLE; was observed over the 8-hour to 24-hour interval whilst planned: resp. n = 84, n = 96). Included are clinical recall performance over the 24-hour to 1-week interval variables, standardized neuropsychological diagnostic dropped similarly between groups. Moreover, TEA pa- and SRTT. tients performed significantly poorer on the word list Results of an interim analysis Patients (n = 29, study recognition test one week after acquisition. These find- 1: n = 17, study 2: n = 12): female 55%, 14 +HS, 11 ings show that ALF in TEA becomes apparent within –HS, 4 unknown with respect to HS. Overall, we found hours of acquisition in the case of word recall. ALF learning in SRTT (F = 6,941, p<0.001). Performance cannot be accounted for by disrupted memory mecha- on first vs. last sequence-bloc revealed a significant in- nisms during nocturnal sleep but is more likely due to teraction effect (F(1,27) = 4,82, p = 0.048) meaning a deficit in early memory consolidation. that eTLE achieve higher speed than TLE. Explorative analysis: ExM (t-Test): +HS (n = 7) were worse than– Keywords: Memory and Learning, Epilepsy, Neu- HS (n = 8) while showing similar ImM. There was no ropsychological Assessment and Psychometrics gender or hemispheric difference in ImM. Discussion The ImM can be measured by SRTT and all Correspondence address: Mr Serge Hoefeijzers, Uni- patient groups showed a learning effect. Patients with versity of Edinburgh, Human Cognitive Neuroscience, eTLE showed better performance in ImM than with 7 George Square, UK-EH8 9JZ Edinburgh, United TLE. TLE-patients with HS are, by explorative anal- Kingdom. E-mail: [email protected] ysis, worse in ExM than TLE without HS, but not in ImM. Future Outlook: To correlate this data with MRI- lesion/postoperative size of resection to identify necessary structures for ImM and predict the risk for postoperative deficits in ImM. 358 Posters

Keywords: Memory and Learning, Epilepsy, Neu- later consolidation stages are at least partially intact ropsychological Assessment and Psychometrics in patients with aMCI and mild AD. Minimal sensory stimulation techniques could be useful in the rehabili- Correspondence address: Mrs Anke Hermsen, Philipps tation of memory disorders, by allowing patients to re- -Universität and UKGM Marburg, Neurology, EZH, tain new key material over the short term and the long Baldingerstr, D-35043 Marburg, Germany. E-mail: term. [email protected] Keywords: Memory and Learning, Amnesia P1.20 Correspondence address: Mrs Jessica Alber, Univer- Minimising sensory stimulation boosts memory sity of Edinburgh, Psychology, Human Cognitive Neu- over 7 days in patients with amnestic MCI and early roscience, 7 A Gayfield Square, UK-EH1 3NT Edin- Alzheimer’s Disease burgh, UK. Tel.: +44 07972327683; E-mail: j.l.alber @sms.ed.ac.uk Jessica Alber, Sergio Della Sala and Michaela Dewar University of Edinburgh, Psychology, Human Cogni- P1.21 tive Neuroscience, Edinburgh, UK GOOD OR BAD responders? Markers of clini- A brief rest following new learning can boost mem- cal response to cognitive stimulation therapy in ory over short delays in patients with memory disor- Alzheimer’s disease ders, including amnestic Mild Cognitive Impairment (aMCI) and mild Alzheimer’s Disease (AD). Here Maite Garolera1, Maria del Mar Martinez2,Noemí we investigated whether a brief rest following new Cerulla3,GloriaChico3, Laura Igual4, Maria del Mar learning could boost memory over much longer de- Vila4 and Carme Civit3 lays in such patients. 14 patients with aMCI/mild 1Hospital de Terrassa-Consorci sanitari de Terrassa, AD and 14 healthy controls were presented with 2 Neuropsychology Unit, Terrassa-Barcelona, Spain short stories. One story was followed by a 10-minute 2Consorci Sanitari de Terrassa, Brain, Cognition and period of wakeful resting (minimal sensory stimu- Behaviour Research Group Unitat d’Investigació lation), the other story was followed by a 10-min biomèdica Universitat Autònoma de Barcelona-CST period during which participants played a spot-the- (UIB), Terrassa (Barcelona), Spain difference game (sensory stimulation). Retention of 3Consorci Sanitari de Terrassa, Sant Jordi Day Hospi- the two stories was assessed after a standard delay tal, Terrassa, Barcelona, Spain (15–30 minute) as well as after a much longer de- 4Universitat de Barcelona, Departament Matematica lay (7 days). As in our previous studies, patients Aplicada, Barcelona, Spain were able to recall significantly more material after 15–30 min when story learning had been fol- There is a long tradition of psychological therapies for lowed by the wakeful-resting period than when story people with dementia, but rarely have they been evalu- learning had been followed by the spot-the-difference ated in terms of clinical response. The purpose of this period. Importantly, this memory boost via a post- study was to classify patients as “responder” or “non- learning rest persisted over the 7-day delay. This long- responder” to a cognitive stimulation program (CSP) lived memory enhancement via post-learning rest- offered to patients with Alzheimer’s disease (AD) on ing is remarkable given that patients with aMCI/ the basis of clinical significance criteria and to identify mild AD often forget new material over just a few min- which factors may differentiate both groups of respon- utes. These results strengthen our hypothesis that much ders. 62 patients with mild AD (56%women, mean of the severe forgetting in aMCI and mild AD is associ- age at baseline 75 SD 6.4) participating, to a one year ated with excessive memory interference during early day hospital CSP, undergone an assessment at the be- memory consolidation stages, caused by new sensory ginning of the intervention with: Geriatric Depression stimulation. When such sensory stimulation is reduced Scale (GDS), Barthel scale (BS), Lawton and Brody immediately after learning, new memories can be con- Scale (LB) and memory scales from Repeatable Bat- solidated to a much higher degree and retained over tery Assessment (RBANS). The response to CSP was the long term. This long-term persistence suggests that assessed by a measure of time related changes on the Posters 359

Mini Mental State Examination (MMSE after one year The spinocerebellar ataxias (SCAs) are inherited neu- treatment minus baseline); this allowed distinguishing rodegenerative disorders, characterized by prominent Good from Bad responders. T-test independents sam- ataxia and cerebellar atrophy. SCA type 3 (SCA3) may ples were used to assess whether groups of responders present additionally with a broad spectrum of non- differed on baseline measures (alpha level = 0.05). cerebellar symptoms. Cognitive dysfunction in SCA3 24% of patients were classified following the assess- is common, but it is unknown whether cognition dete- ment of change (MMSE 2 points increase after com- riorates with disease progression. We therefore studied pleting the training) as clinical Good responders. At cognitive function in SCA3 prospectively. baseline, Non-responders had not a significant higher Eleven patients with SCA3 (male 7, age M = 40.0, SD depression (p = 1); less functional capacity: BS (p = 9.3 years (y)) and a matched control group were as- 0.40), LB (p = 0.057) or worse cognitive functioning: sessed using an extensive neuropsychological test bat- delayed story memory (p = 0.53), delayed list learn- tery. SCA3 patients were retested after 3.5 ± 0.4 y ing (p = 0.41), MMSE (p = 0,16) than responders. and rated according to the Scale for the Assessment In conclusion: in 24% of mild AD CPS is effective in and Rating of Ataxia (SARA). The neuropsychologi- slowing down the apparent clinical progression of AD. cal test battery covered verbal and figural memory, ver- However, mood, functional status and memory previ- bal fluency, naming, reaction time, interference, motor ous treatment outcomes could not discriminate even- control, and evaluation of depressive symptoms. We tual “good” and “poor” responders after 12 months of performed comparison in cognitive tests between pa- cognitive treatment. Further research is needed to char- tients and controls, and within the patient group by re- acterize the profile of those patients who improve in repeated measurement multivariate analysis of variance sponse to treatment; it will be useful to ameliorate the (MANOVA; pcorr < 0.05). rehabilitation intervention and its clinical efficacy. At baseline, only fine motor coordination differed between SCA3 patients and controls. At follow up, SCA3 Keywords: Memory and Learning, Neurodegenerative patients had compared to controls significant cognitive Diseases, Neuropsychological Rehabilitation impairment in verbal learning. Within the patient group MANOVArevealed a significant deterioration of ataxia Correspondence address: Mrs Doctor Maite Garol- symptoms as well as cognitive function, including ver- era, Hospital de Terrassa-Consorci sanitari de Ter- bal learning, verbal memory, figural memory and mo- rassa (CST), Neuropsychology Unit, ctra. torrebonica tor control during the follow-up period. Fine motor co- s/n, Spain-08227 Terrassa-Barcelona, Spain. Tel.: +34 ordination correlated with the increasing SARA-score. 7310007, E-mail: [email protected] No correlation between the deterioration in ataxia and in cognitive tests or an increase of depressive symp- P1.22 toms was observed. The cognitive deterioration with disease progression Cognitive dysfunction in Spinocerebellar Ataxia suggests that cognitive dysfunction is an integral part Type 3: A longitudinal analysis of SCA3 and cannot be attributed to progressive cerebellar ataxia as the memory tests did not require mo- Sandra Roeske1, Ina Filla2,StefanHeim3,Katrin tor responses. It can be explained either by extracere- Amunts3, Christoph Helmstaedter4, Ullrich Wüllner2, bellar pathology or by disruption of cerebellar-cerebral Michael Wagner5, Thomas Klockgether1 and Martina circuitries. Minnerop2 1DZNE, Clinical Research, Bonn, Germany Keywords: Memory and Learning, Neurodegenerative 2University Hospital Bonn, Neurology, Bonn, Ger- Diseases, Neuropsychological Assessment and Psy- many chometrics 3Research Centre Juelich GmbH, Institute of Neuro- science and Medicine, Juelich, Germany Correspondence address: Dr. Sandra Roeske, DZNE, 4University Hospital Bonn, Epileptology, Bonn, Ger- Clinical Research, Ernst-Robert-Curtius-Str. 12, D- many 53117 Bonn, Germany. Tel.: +49 228 43302 814; Fax: 5University Hospital Bonn, Psychiatry and Psycho- +49 228 43302 801; E-mail: [email protected] therapy, Bonn, Germany 360 Posters

P1.23 network after a short memory training and provide evidence for the high functional plasticity of the child’s Neural effect of memory training in children brain.

Regula Everts1, Ines Mürner-Lavanchy1,Barbara Keywords: Memory and Learning, Other Disorder/ Ritter1, Schroth Gerhard2 and Maja Steinlin1 Samples, Functional and Structural Neuroimaging/ 1Children’s University Hospital, Inselspital, Division NIRS of Rehabilitation, Development and Neuropediatrics, Bern, Switzerland Correspondence address: Dr. Regula Everts, Children’s 2University Hospital Inselspital, Institute for Diagnos- University Hospital, Inselspital, Division of Rehabil- tic and Interventional Neuroradiology, Bern, Switzer- itation, Development and Neuropediatrics, Inselspi- land tal, CH-3010 Bern, Switzerland. E-mail: regula. ev- [email protected] It is still unclear whether memory training decreases or increases the effect size of a functional activation dur- P1.24 ing a memory task. The aim of the present study was to investigate differences in percent signal change (PSC) Body Schema manipulation through the activation of the visual working memory network after mem- of the “body” Working Memory ory training in children born preterm. Formerly very preterm born children (7–12 years) underwent a mem- Gerardo Salvato, Anna Sedda and Gabriella Bottini ory training using restitution (20 × 10 min of work- University of Pavia, Department of Brain and Be- ing memory training, n = 8) or compensation (4 × havioural Sciences, Pavia, Italy 60 min of memory strategy training, n = 9), or no memory training (controls, n = 5). Before the train- Body Representations (BR) are dynamic, depending ing (TP1) and after the training (TP2), memory func- on the integration of internal sensory signals and envi- tions were assessed and fMRI of the visual working ronmental information. The Body Schema (BS) is an memory (WM) network was performed. PSC was cal- unaware component of BR concerning body parts po- culated over four regions of interest (ROI: left/right sition. Working Memory (WM) permits to manipulate frontal; left/right parietal). short term information of different categories of stim- Both training groups significantly improved memory uli, including body parts. Given the high domain speci- performance in different memory domains (resti: ver- ficity of WM, one might hypothesize the existence of bal recognition p = 0.03; visual WM p = 0.05; comp: a selective WM storage for BR. We used a dual-task verbal learning p = 0.004; verbal recall p = 0.03; vi- paradigm to explore whether these two components sual learning p = 0.004; visual recall p = 0.002; ver- might interact. In the Stocking Test (ST), that concerns bal WM p = 0.004). No changes in memory perfor- body exploration, 12 healthy blindfolded subjects were mance and no differences in PSC occurred in controls required to search for targets attached to their body between TP1 and TP2. In both training groups, PSC surface while performing a Backward Spelling Task was significantly lower at TP2 in the left frontal ROI (BST). Half of the subjects were required to manipu- (resti: p = 0.008; comp: p = 0.047) and in the right late body parts names and half objects names. Our data frontal ROI (resti: p = 0.008). The magnitude of PSC demonstrate that the group performing the WM task difference between TP1 and TP2 correlated negatively with body related material shows a greater accuracy at with changes in WM performance between TP1 and the ST (F(1,9) = 5.941; p = 0.038; partial η2 = 0.398). TP2 (right frontal r = − 0.493, p = 0.031, left pari- On the contrary, the group performing the object WM etal r = −0.508, p = 0.027), indicating more activa- test shows an opposite pattern, with a negative influ- tion decrease in children with stronger improvement of ence of the dual task on the accuracy at the ST. These WM performance after the training. preliminary results suggest that body domain-specific Memory training can lead to a decrease of the inten- WM positively influences visual imagery skills associ- sity of cerebral activation during a visual WM task, ated with body exploration, indicating a semantic ac- most pronounced in children whose WM performance cess to BR. This specific interaction could be taken into clearly improved through the training. These data point account for selective rehabilitation of body representa- towards a practice-related change of the cerebral WM tion impairments. Posters 361

Keywords: Memory and Learning, Other Disorder/ on the relationship between molecular defects, cerebral Samples, Other Methods structural abnormalities and neuropsychological features in this disorder. Recognition of special pattern of Correspondence address: Mr Gerardo Salvato, Depart- disabilities can help designing proper treatment strat- ment of Brain and Behavioural Sciences, University of egy. Pavia, Piazza Botta, 11, IT-27100 Pavia, Italy. E-mail: [email protected] Keywords: Memory and Learning, Other Disorder/ Samples, Neuropsychological Assessment and Psy- P1.25 chometrics

Cognitive function in facioscapulohumeral muscu- Correspondence address: Mrs Gyurgyinka Gergev, De- lar dystrophy partment of Pediatrics, Semmelweis University Bu- dapest, Práter 26. 4/5., Hungary-1083 Budapest, Hun- Gyurgyinka Gergev1, Ágnes Herczegfalvi2, Veronika gary. Tel.: +36 302262644; E-mail: gyurgyinka@ Kercagi3 and László Sztriha4 gmail.com 1Department of Pediatrics, Semmelweis University Bu- dapest, Budapest, Hungary P1.26 2Semmelweis University, Budapest 3National Institute of Environmental Health, Budapest Automatic vs. strategic mechanisms in prospective 4University of Szeged memory: An fMRI study

OBJECTIVE: Cognitive impairment is a well-known Francesco Barban1, Giovanni Augusto Carlesimo2, feature of several muscular disorders, such as Duche- Francesco Scalici1, Emiliano Macaluso3, Carlo Cal- nne muscular dystrophy and myotonic dystrophy. Fa- tagirone2 and Alberto Costa1 cioscapulohumeral muscular dystrophy is the third 1IRCCS Santa Lucia Foundation, Clinical and be- most common muscular dystrophy; however our know- havioural neurology, Rome, Italy ledge about its cognitive features is rather poor. It is an 2IRCCS Santa Lucia Foundation; University of Rome autosomal dominant muscle disorder caused by con- “Tor Vergata”, Clinical and Behavioural Neurology; traction of a critical number of D4Z4 repeats on chro- Institute of Neurology, Rome, Italy mosome 4q35. Previous MRI studies have suggested 3IRCCS Santa Lucia Foundation, Neuroimaging Lab- central nervous system involvement with grey matter oratory, Rome, Italy loss in the prefrontal cortex and white matter hyperintensities. The aim of this work was to explore the INTRODUCTION: Prospective memory (PM) is a cognitive pattern in four patients with facioscapulo- cognitive process that allows the realization of inten- humeral muscular dystrophy. tions in the future and the hypothesis was advanced METHODS: Four patients (2 boys and 2 girls) with that it may be subserved by automatic or strategic mean age of 15 years were included in the study. The mechanisms. Neuroimaging data document that PM diagnosis was confirmed by molecular genetic tests. performance is related to the activity of frontal and The patients did not have any major psychiatric or so- parietal brain regions. However, poor is known about matic illness. The cognitive functions were assessed in brain networks differentially involved in above PM detail by means of a neuropsychological battery. mechanisms. This study was aimed at investigating the RESULTS: The cognitive profile varied between nor- functional neural correlates of automatic and strategic mal abilities and mild intellectual disability. All pa- processes within PM with functional magnetic reso- tients however showed deficit in verbal working mem- nance (fRMI). ory and they had reduced learning capacity. METHOD: Fourteen healthy subjects were adminis- CONCLUSION: In agreement with a few previous tered an event-based PM paradigm in which auto- data in the literature some degree of heterogeneity can matic vs. strategic demands were manipulated. This be observed in the cognitive abilities of patients with was made by fitting conditions in which the PM cues facioscapulohumeral muscular dystrophy and they can were congruent (focal conditions) or incongruent (non- be affected by learning difficulties. Further studies and focal conditions) with the ongoing task. In particular, long-time follow up are required in order to shed light each trial included the presentation of two strings. In 362 Posters half of the trials they were real words, while, in the regions of the parietal cortex in studies of German- other half, one string was a neologism. Moreover, the French bilingual speaking undergraduates [1,2]. These two strings could represent in the centre the same or studies also suggest a possible role for attention in vo- different syllables. The ongoing activity was, in half cabulary learning. The aim of this study was to ex- blocks, a lexical decision task and, in the other half, a amine the role of serial order memory and attention syllables matching task. We also manipulated the PM in the learning of English expert words among Can- cues that could be in half blocks real words and, in the tonese native speakers. Participants were students in other half, syllables. the Division of Speech and Hearing Sciences at Hong RESULTS: We analysed behavioural and imaging data Kong University. There were 2 phases of data collec- comparing focal vs. nonfocal conditions. As expected, tion. In Phase 1, expert word learning (via a lexical behavioural results showed faster response times (p< decision task), attentional control, verbal STM, gen- 0.001) and better accuracy (p<0.05) on focal than eral cognitive ability, visuo-spatial memory and gen- nonfocal conditions. Whole brain fMRI analyses high- eral language knowledge were assessed. In Phase 2, lighted a main effect of congruency (nonfocal > focal, expert word learning was re-assessed six months later. p-corr < 0.05) selectively in the left intraparietal sul- The results indicate that serial order memory is the cus. strongest predictor of L2 expert word learning as well CONCLUSIONS: The present findings document, for as number of hours exposed to academic materials. As- the first time, a specific recruitment of left parietal cor- sociations were also observed between attentional con- tex in nonfocal PM paradigms, likely suggesting a role trol and STM measures and between attentional con- for this region in the mediation of strategic mecha- trol and new word learning. We will also report new nisms subserving PM. data from neuroimaging (fMRI, EEG and TMS) showing an association between memory for serial order, Keywords: Memory and Learning, Other Disorder/ new word learning and brain activation in the left infe- Samples, Functional and Structural Neuroimaging/ rior parietal lobe. NIRS References Correspondence address: PhD Francesco Barban, IR- [1] Majerus, S., Poncelet, M., van der Linden, M. & Weekes, B.S. CCS Santa Lucia Foundation, Clinical and behavioural (2008a). Lexical learning in bilingual adults: the prevailing im- neurology, Via Ardeatina 306, I-00179 Rome, Italy. portance of serial order short-term memory mechanisms. Cog- nition, 107, 395-419. Tel.: +39 06 51501547; E-mail: f.barban@hsantalucia. [2] Majerus, S., Belayachi, S., De Smedt, B., Leclercq, A.L., Mar- it tinez, T., Weekes, B., Maquet, P. (2008b). Neural networks for short-term memory for order differentiate high and low profi- P1.27 ciency bilinguals. NeuroImage, 42(4), 1689–713.

Serial order memory, attentional control and the Keywords: Memory and Learning, Other Disorder/ learning of English expert words by native Can- Samples, Other Methods tonese speakers Correspondence address: Mr Professor Brendan Brendan Weekes1, Jose Cheng2, Loan Vuong2 and Weekes, University of Hong Kong, Laboratory for Steve Majerus3 Communication Sciences, University of Hong Kong, 1University of Hong Kong, Laboratory for Communi- D-1111 Hong Kong, China. E-mail: [email protected] cation Sciences, Hong Kong, Hong Kong 2University of Hong Kong, Hong Kong, China P1.28 3University of Liege, Belgium Predictors of prospective memory impairment in Past research in neuroimaging has shown a strong pulmonary diseases association between phonological short-term memory and vocabulary learning in first and second (L2) lan- Marta Witkowska guage. Specifically, memory for serial order indepen- University of Gdansk, Institute of Psychology, Gdansk, dently predicts the acquisition of a second language Poland (French) for tertiary students and also activates specific Posters 363

Pulmonary disorders, such as asthma (AS) and chronic P1.29 obstructive pulmonary disease (COPD) are chronic diseases which lead to respiratory failure. Decreased Low frequency rTMS on the right parietal cortex at transportation of oxygen to the brain may affect mental retrieval increases recognition memory in healthy efficiency, especially prospective memory (PM), which subjects impairment prevents the patient from living an inde- 1 2 pendent and fulfilling life. Patrizia Turriziani , Massimiliano Oliveri , Daniela 2 2 2 Prospective memory, PM, is a set of processes or abil- Smirni , Renata Mangano and Lisa Cipolotti 1 ities to formulate, store and implement the purposes Deparment of Psychology, University of Palermo, Palermo, Italy and intents in a set time frame or situation and its func- 2 tioning can be influenced by various factors, related Department of Psychology, University of Palermo, both to the respiratory failure, the number of cigarettes Palermo, Italy smoked per day and the use of mnemonics. The main objective of the research was to establish the Neuroimaging and lesion studies have led to contrast- general characteristics of PM in pulmonary patients. ing findings regarding the potential role of the pari- And as a result - to specify the hypothetical predictors etal lobe in episodic memory. Imaging studies strongly of their prospective memory impairment. suggest an important participation of the posterior pari- Several tests (i.e. a quasi-experiment based on the etal cortex (PPC) in episodic memory, whereas lesion studies are not conclusive at this regard. Cambridge Prospective Memory Test & BDI) were ad- Using off-line 1 Hz rTMS paradigm, we conducted 2 ministered to adult patients with allergic rhinitis (AL, experiments to investigate the role of PPCs in recog- n = 27), AS (n = 27), COPD (n = 32) and control nition memory. Real or sham rTMS were applied over subjects (n = 30). the left or the right PPC (P3 and P4 of the 10–20 EEG COPD group (mean = 21.97; SD = 5.75) compared system) of healthy subjects before encoding (Exper- with other groups, obtained lower scores in PM tasks iment 1) and just before retrieval (Experiment 2) of (F(3,112) = 38.55; p<0.001). At the same time the forced-choice non verbal recognition memory tasks. higher the rate of FEV1 (less respiratory failure), fewer rTMS over the left and the right PPC at encoding did cigarettes smoked per day and lower level of depres- not modulate memory performance. Conversely, rTMS = = sive symptoms of COPD (R2 0.71; F(1,30) 16.5; over the right (p<0.02) but not left (p<0.3) PPC p< = = 0.001) and AS patients (R2 0.77; F(2,27) at retrieval significantly improved recognition memory p< 44.32; 0.001) the better functioning of the PM. performance. Also the use of mnemonics explained 32% of PM vari- These findings suggest that PPC is involved at retrieval = = p< ation in COPD (F(1,30) 13.85; beta 0.57; but not at encoding of recognition memory. Inhibition 0.01) and AS patients (F(1,28) = 13.41; beta = 0.57; of the right PPC at retrieval enhances memory func- p<0.01) and 43% in the control group (F(1,25) = tion in healthy subjects. These findings are in line with 18.62; beta = 0.65; p<0.001). our recent work showing that rTMS inhibition of the There is a significant relationship between the PM right dorsolateral prefrontal cortex (DLPFC) enhanced and type of illness. The level of respiratory failure, recognition memory in healthy subjects as well as in the number of cigarettes smoked per day and the use patients with mild cognitive impairment. of mnemonics directly affects prospective memory of We propose that the right DLPFC and the right PPC pulmonary patients and their ability to cope with the may be part of a neural network recruited during recog- disease. nition memory retrieval. Temporary inhibition of these regions enhances memory performance suggesting a Keywords: Memory and Learning, Other Disorder/ cognitive benefit when there is a reduced activity in Samples, Neuropsychological Assessment and Psy- these regions during recognition memory tasks. chometrics Our findings may give support to an inhibitory control account of the interactions between the DLPFC – PPC Correspondence address: Mrs Marta Witkowska, Uni- and the medial temporal lobe during retrieval of mem- versity of Gdansk, Institute of Psychology, Bazyn- ory information. skiego 4, 80-952 Gdansk, Poland. Tel.: +48 6046885 02; E-mail: [email protected] Keywords: Memory and Learning, Other Disorder/ Samples, TMS/TCDS 364 Posters

Correspondence address: Mrs Dott Patrizia Turriziani, Keywords: Memory and Learning, Other Disorder/ Deparment of Psychology, University of Palermo, Samples, Neuropsychological Rehabilitation Viale delle Scienze,Ed 15, I-90144 Palermo, Italy. E- mail: [email protected] Correspondence address: Dr. Regula Everts, Children’s University Hospital, Division of Rehabilitation, De- P1.30 velopment and Neuropediatrics, Inselspital, CH-3010 Bern, Switzerland. E-mail: [email protected] Improving children’s cognitive performance – effect of a memory strategy training in children P1.31 born very preterm Cognitive decline in patients with heart failure Regula Everts1, Barbara Ritter2 and Maja Steinlin2 1 Children’s University Hospital, Division of Reha- Friederike Thiel1,StefanFrisch2, Andrej Teren3,Frank bilitation, Development and Neuropediatrics, Bern, Beutner3, Joachim Thiery4, Arno Villringer5 and Switzerland 4 2 Matthias L. Schroeter Children’s University Hospital, Inselspital, Division 1University Hospital Leipzig, Germany, Dayclinic for of Rehabilitation, Development and Neuropediatrics, Cognitive Neurology, Leipzig Bern, Switzerland 2University Hospital Frankfurt 3Heart Center Leipzig To examine the effect of memory strategy training 4 University Hospital Leipzig on different aspects of memory in children born very 5 Max Planck Institute for Human Cognitive and Brain preterm and to determine whether there is a generaliza- Sciences, Leipzig tion of the training effect to non-trained functions. The influence of individual factors such as age and perfor- About 30–60% of heart failure patients suffer from mance level on the training success will be determined. cognitive impairments; most frequent are memory In a randomized, controlled and blinded clinical trial, 46 children born very preterm (aged 7–12 years) and attention deficits followed by slowed psychomo- were allocated to a memory strategy training (MEMO- tor speed and impaired executive functions. The N- Training, n = 23) or a control group (n = 23). Neu- terminal prohormone of brain natriuretic peptide (NT- ropsychological assessment was performed before, im- proBNP) is valuable for the diagnosis and the progno- mediately after the training and at a 6-month follow- sis of heart failure. Despite prior research that has iden- up. In the MEMO-Training, five different memory tified associations between cognitive deficits and the strategies were introduced and practiced in a one- NT-proBNP, findings are not conclusive. In this study, to-one setting (4 hour-long training sessions over 4 we thoroughly examined subjective as well as objec- weeks, 20 homework sessions). tive cognitive deficits in heart failure and compared pa- A significant training-related improvement occurred in tients with acute increased NT-proBNP plasma levels trained aspects of memory (verbal and visual learning to those with normal values. and recall, verbal working memory) and in non-trained 46 patients diagnosed with heart failure underwent functions (inhibition, mental arithmetic). No perfor- a broad neuropsychological assessment including test mance increase was observed in the control group. At for attention, memory, executive functions as well as six months follow-up, there was a significant training- self-report measures. A cardiological examination and related improvement of visual working memory. Age a blood sample were included. The neuropsychological and performance level before the training predicted the test results were converted to standard values based on training success significantly. an age matched normative control group. NT-proBNP Teaching memory strategies is an effective way to was rated as increased or normal according to the lab- improve different aspects of memory but also non- oratory’s normative reference values. trained functions such as inhibition and mental arith- Patients reported worsening of cognitive and men- metic in children born very preterm. Age and perfor- tal domains predominantly in drive (25%), antero- mance level influence the success of memory strat- grade memory (20%), mood (15%) and short-/long- egy training. These results highlight the importance of term concentration (10%). In psychometric tests heart teaching children memory strategies to reduce scholas- failure patients showed increased deficits in short-term tic problems. and long-term memory, in complex problem solving as Posters 365 well as in complex attention demands. The 21 subjects cue. These results indicate that only the semantic cue with acute increased NT-proBNP values did not differ induces activations that are congruent with the neural significantly in cognitive measures from subjects with processes instantiated during encoding. This suggests current normal NT-proBNP values. an important relationship between retrieval cue and en- Both subjective and objective results replicate the ex- coding task and highlights the critical role of seman- istence of cognitive impairments among heart failure tic cues in source retrieval. Overall, these findings may patients. Increased NT-proBNP values do not seem to elucidate how memory difficulties in amnesic patients be closely associated with cognitive deficits. and older adults can be partially overcome when the information to be retrieved is prompted by a semantic Keywords: Memory and Learning, Other Disorder/ cue. Samples, Neuropsychological Assessment and Psy- chometrics Keywords: Memory and Learning, Other Disorder/ Samples, Functional and Structural Neuroimaging/ Correspondence address: Mrs Friederike Thiel, Uni- NIRS versity Hospital Leipzig, Germany, Dayclinic for Cog- nitive Neurology, Liebigstraße 16„ D-04103 Leipzig. Correspondence address: Mrs Sofia Frade, University E-mail: [email protected] of Lisbon, Faculty of Psychology, Alameda da Uni- versidade, 1649-013 Lisbon, Portugal. E-mail: sofia.t. P1.32 [email protected]

Encoding task and retrieval cue effects on the neu- P1.33 ral networks involved in source memory Air flow limitation during sleep and verbal memory Sofia Frade, Mara Alves, J Frederico Marques and Ana in Fibromyalgia Raposo University of Lisbon, Faculty of Psychology, Lisbon, A. Campabadal1,A.Soler2,M.J.Masdeu3,L.Vigil3, Portugal C. Galisteo3, M. Larrosa3 and M. Jódar3 1Universitat Autònoma de Barcelona, Psicologia Remembering the context, or source, of a particu- Clínica i de la Salut, Barcelona, Spain lar event is a fundamental ability that is highly sus- 2Universitat Autònoma de Barcelona ceptible to disruption in aging and brain disorders. 3Corporació Sanitària Parc Taulí, Sabadell Source memory depends on processes that take place both at encoding and retrieval, but the conditions that OBJECTIVE: Some studies have described slight improve such memory are not well-established. This memory difficulties in fibromyalgia patients (FM) in fMRI study aims to explore how the retrieval cue and comparison with healthy population. Executive deficits the encoding task interact during source memory re- and problems with interference management seem to trieval. In the encoding phase healthy participants per- explain these differences. Besides, many works have formed a semantic task (pleasant word?) or a percep- found alterations in FM sleep, such as respiratory tual task (more than 6 letters?) in a set of words. Dur- anomalies. The aim of this study is to examine the pres- ing retrieval the probe was presented with either a se- ence of air flow limitation (AFL) during sleep and to mantic cue (pleasant task?) or a perceptual cue (letter asses verbal memory in FM. task?). Participants had to decide if that probe appeared METHOD: The sample includes: 30 FM, 25 chronic in that specific task. The results revealed an encoding pain patients (CP) and 26 healthy subjects (HS). Ver- task effect during context retrieval. Retrieving probes bal memory was assessed using Rey Auditory-Verbal previously encoded in a semantic manner was associ- Learning Test (AVLT) and Logic Memory from WMS- ated with significant activation in medial temporal and III (LM). AFL percentage was measured during an all medial frontal regions, whereas the retrieval of probes night polysomnography. encoded in a perceptual manner was linked to poste- RESULTS: Statistical analysis using an ANOVA with rior occipital activations. Critically, this effect was only a Bonferroni post-test shows no significant differences found when source memory was elicited by the se- between groups in: AVLT short-term, AVLT long- mantic retrieval cue, but not by the perceptual retrieval term, AVLT recognition, LM learning slope, LM reten- 366 Posters tion percentage and LM recognition. Significant differ- The importance of the hippocampus for declarative ences were found between HS and FM in: AVLT first memory processes is firmly established. Poor mem- trial (p = 0.02), AVLT total learning (p = 0.02), AVLT ory has been related to small hippocampal volume in interference (p = 0.05); And between HS and both pa- several neurologic disorders. However, the relationship tients groups in: LM immediate memory (p = 0.00, between memory and hippocampus has not been stud- p = 0.05), LM delayed recall (p = 0.00, p = 0.00). FM ied in cerebral palsy (CP). Moreover, the hippocampus scores were slightly lower in all variables. Finally, sig- can be bilaterally damaged after perinatal asphyxia; nificant differences were found between FM and both one of the most frequent causes of dyskinetic CP. But other groups in AFL (p = 0.00, p = 0.00). A general this type of CP is poorly studied from a neuropsycho- lineal model reveals impact of AFL in simple immedi- logical perspective due to motor severity and commu- ate memory. nication difficulties. The aim of this study is to investi- CONCLUSION: The current work finds greater AFL gate if there is a relationship between memory perfor- during sleep in FM in comparison with CP and HS. mance and hippocampal structure in people with dysk- In addition, FM shows difficulties in interference man- inetic CP. agement, in immediate verbal memory and in a ver- Fifteen term-born subjects diagnosed with dyskinetic bal memory task that requires executive functions. Pain CP secondary to perinatal asphyxia (mean age: 26.2; could explain strategy problems in verbal memory, sd: 12.04) underwent a neuropsychological test and since CP and FM share this difficulty. However, AFL a T1-weighted resonance magnetic imaging. Specifi- during sleep could be related with FM specific verbal cally, we selected a memory test in which verbal com- memory deficit. New researches should investigate the munication was not necessary: Pattern Recognition relation between sleep disorders and cognitive impair- Memory test of Cambridge Neuropsychological Test ment in FM. Automated Battery (CANTAB). Standardized measures were used in order to control for age effects. Hip- Funded by the Fundació La Marató de TV3 pocampal structure was analyzed using voxel-based morphometry technique after applying a region of in- Keywords: Memory and Learning, Other Disorder/ terest through the SPM program. Family-wise-error Samples, Neuropsychological Assessment and Psy- correction for multiple comparisons was used (p< chometrics 0.05). Results showed a significant positive correlation be- Correspondence address: Mrs A. Campabadal, Univer- tween memory measures and hippocampal volumes. sitat Autònoma de Barcelona, Psicologia Clínica i de Long term memory bad performance was associated la Salut, Edifici B Campus UAB, D-08193 Barcelona, with a greater atrophy in left hippocampus (left hip- Spain. E-mail: [email protected] pocampus: t = 5.02, p = 0.01, cluster size = 143 voxels), and short term memory bad performance was re- P1.34 lated to a greater atrophy in hippocampal regions bilaterally (left hippocampus: t = 4.04, p = 0.042, clus- First evidence of the relationship between mem- ter size = 5 voxels; right hippocampus: t = 4.14, p = ory and hippocampal volume in dyskinetic cerebral 0.041, cluster size = 7 voxels). These preliminary re- palsy sults show a relationship between memory and hippocampal volume in term-born subjects with dyski- Júlia Ballester-Plané1, Olga Laporta-Hoyos1, Elida netic CP secondary to perinatal asphyxia. Vázquez2, Ignacio Delgado2, Leire Zubiaurre-Elorza1, Idoia Marqués-Iturria1, Ana Narberhaus1, Alfons Ma- Keywords: Memory and Learning, Other Disorder/ caya2, Pilar Póo3, Mar Meléndez2, Teresa Castelló2, Samples, Functional and Structural Neuroimaging/ Violeta Tenorio4,Ma Eugenia Russi3,Ma Dolors NIRS Segarra1 and Roser Pueyo1 1Universitat de Barcelona, Spain Correspondence address: Mrs Júlia Ballester-Plané, 2HospitaldelaValld\Hebron, Barcelona, Spain University of Barcelona, Psychiatry and Clinical Psy- 3Hospital de Sant Joan de Déu, Barcelona, Spain chobiology, Campus Mundet. Edifici de Ponent. Pg. 4Hospital Clínic i Provincial, Barcelona, Spain Vall d\’Hebron 171, D-08035 Barcelona, Spain. E-mail: [email protected] Posters 367

P1.35 Correspondence address: Mr Master Gustavo Siquara, Federal University of Bahia, Psychology Institute, Relationship between working memory and aca- Salvador-Bahia, Bra-44701035 Salvador, Brazil. Tel.: demic performance of children +55 7193699262; E-mail: gustavosiquara@hotmail. com Gustavo Siquara, Lais Vilas-Boas, Cassio Lima, Paulo Nascimento, Carolina Sunnano and Neander Abreu P1.36 Federal University of Bahia, Psychology Institute, Sal- vador, Brazil Contribution of working memory to skills learning in schizophrenic patients. The working memory (WM) refers to our ability to store and manipulate information for a period of time. Arantzazu Herran-Boix1, Bernardo Pardo-Ayuso2, The cognitive model used was the multicomponent Mireia Gonzalez-Rodriguez1, Sergio Bodas1,Mar Baddeley. There is evidence of extensive relationship Ariza3 and Maite Garolera1 between WM and learning. The aim of this study 1Hospital de Terrassa-Consorci Sanitari de Terrassa, was investigate the relationship between WM and aca- Neuropsychology Unit, Terrassa-Barcelona, Spain demic performance. Individual neuropsychological as- 2Parc Sanitari Sant Joan de Déu., Department of Men- sessment was performed following specific protocol. tal Health, Sant Boi de Llobregat, Spain All testing occurred on school shift in classes of chil- 3Brain, Cognition and Behaviour Research Group. dren participants. The study included 116 children Universitat Autònoma de Barcelona-CST (UIB), Uni- = = aged 7 to 12 (M 9.82, SD 1.36) years, 58 females tat d’Investigació biomèdica, Terrassa-Barcelona, from two private schools in Salvador, Bahia, Brazil. Spain To evaluate the academic performance were used Aca- demic Performance Test (APT) with subtests in read- Accumulating evidence indicates that working mem- ing, writing and arithmetic. In the evaluation of the ory (WM) deficit is a core feature of schizophre- components of WM and short-term memory were used nia (SC). On the other hand, some studies exam- backward and forward Digit Span and the backward ining non-declarative learning in patients with SC and forward Corsi block-tapping. One test was used have demonstrated impaired skills learning (SL). Re- to assess the attention concentrated under the name cent studies have shown that WM contributes to mo- “test of visual attention”. The statistical tests used were linear regression analysis (stepwise) and Pearson cor- tor learning process, although this relationship has relation. Results showed that, best model to explain not been evidenced in schizophrenic patients. In the the academic performance predictors were Corsi Block present study, we tested the hypothesis that WM im- Backward, Digit Span Backward, Reaction Time and pairment contributes to performance on motor learn- Digit Span Forward tasks. It was checked the hypothe- ing for schizophrenic patients. The participant sample sis of non-multicollinearity and verified that constructs consisted of 105 patients who met DSM-IV criteria for were independent (VIF < 10 and Tolerance > 0,20. SC (74% males; 93% right-handed; mean age 32 (SD The explained variance of the model for academic per- 8.2); mean years of SC evolution 9 (SD 8.2); mean esti- formance was ΔR = 0,46. The correlations between mated premorbid intelligence-Vocabulary scalar score the components of WM showed high and significant 10.4 (SD 2.6) and mean education years 9.8 (SD 2.7). correlations with the APT. WM test (Digit Span Back- Patients were all receiving antipsychotic medication ward + Corsi Block Backward) and APT had corre- and they were clinically stable (Positive and Nega- lation (r = 0.63∗∗). The results indicate initially that tive Symptoms Scale total score mean 58.3 (SD 15.8)) WM is a good predictor of academic performance. Ini- at the time of testing. Using computers we assessed tially this study is consistent with others in the point WM with a subcomponent of the Test of Attentional where the WM as a predictor of learning or the poten- Performance (TAP) and SL with a rotor pursuit task tial for learning. It appears that WM is a process that is (RPT). Partial correlations were used to control the the basis of the ability to learn. influence of age, illness evolution, premorbid IQ and education (Alpha level = 0.01). We identified signifi- Keywords: Memory and Learning, Other Disorder/ cant correlation between performance on TAP, specif- Samples, Neuropsychological Assessment and Psy- ically in missing and errors of WM (standard score), chometrics and total time of contact on RPT. Missing were cor- 368 Posters related with time of contact on RPT [r = 0.254, p = RESULTS: During the follow-up different immediate 0.010] and with time out of contact [r = −0.255, p = verbal memory functions showed similar patterns of 0.010]. Errors were correlated with time of contact on recovery, as did different delayed verbal memory func- RPT [r = 0.325, p = 0.001] and with time out of tions. Both verbal and visual delayed memory func- contact [r = −0.326, p = 0.001]. The relationship tions showed similar patterns of recovery. There was found between WM and SL suggests that in SZ fail- also a positive correlation between the memory test ure in WM processes affects acquisition of new mo- scores at the acute phase and at six-month follow-up, tor skills. These findings are consistent with functional indicating successful recovery of memory functions in neuroimaging data demonstrating overlapping neural the whole patient group during the follow-up phase. substrates (dorsolateral prefrontal cortex and striatal CONCLUSION: It seems that similar memory func- circuitry) for the performance of both cognitive tasks. tions show similar patterns of recovery after ischemic stroke. In general the results suggest that memory func- Keywords: Memory and Learning, Psychopathology, tions recover within six months of stroke. Interestingly, Neuropsychological Assessment and Psychometrics some memory functions (e.g. repetitive memory) did not seem to recover in the same way as other memory Correspondence address: Mrs Arantzazu Herran-Boix, areas. This area needs more investigation with larger Hospital de Terrassa-Consorci Sanitari de Terrassa, patient groups. Neuropsychology Unit, Crta.Torrebonica s/n, 08227 Terrassa-Barcelona, Spain. Tel.: +34 937310007 Keywords: Memory and Learning, Stroke, Neuropsy- (1557); E-mail: [email protected] chological Assessment and Psychometrics P1.37 Correspondence address: Mrs Sarita Soikkeli, Univer- sity of Tampere, School of social sciences and human- Do similar memory functions show similar recovery ities, psychology, Tammelan puistokatu 14-16 B 89, patterns after stroke? FIN-33100 Tampere, Finland. Tel.: +35 8400651714; E-mail: sarita.soikkeli@uta.fi Sarita Soikkeli, Eija-Inkeri Ruuskanen, Laura Nurmi and Mervi Jehkonen P1.38 University of Tampere, School of social sciences and humanities, psychology, Tampere, Finland Memory impairment in stroke patients without OBJECTIVE: This study assesses the recovery of functional disability memory functions in stroke patients during a six- 1 1 1 month follow-up and compares the results of different Marja Hietanen , Hanna Jokinen , Raija Ylikoski , Tarja Pohjasvaara2 and Timo Erkinjuntti2 memory tests. We wanted to find out whether similar 1 memory functions (e.g. verbal and visual memory) re- Helsinki University Central Hospital, University of cover similarly after stroke. We also wanted to find out Helsinki, Unit of Neuropsychology, Department of Neurology, Helsinki, Finland whether there is a positive correlation between mem- 2 ory test scores during the follow-up phase. Helsinki University Central Hospital, University of METHODS: The study group consisted of 50 consecu- Helsinki, Department of Neurology, Helsinki, Finland tive patients with a first brain infarct. Neuropsycholog- ical and neurological examinations were performed on The aim of our study was to investigate the frequency two occasions: at the acute phase within six days of on- and nature of memory impairment in a cohort of pa- set and at six months. Severity of stroke was evaluated tients with first-ever ischemic stroke and without func- by a neurologist using the National Institute of Health tional disability. Stroke Scale. An MRI examination was carried out to In Helsinki Stroke Ageing study 409 consecutive pa- determine the localization of the infarct. The memory tients ages 55–85 years were evaluated with a compre- functions examined were immediate and delayed ver- hensive neuropsychological examination three months bal and visual memory. They were assessed with Log- post-stroke. The following cognitive domains were ical Memory and the Word List subtests of the WMS- assessed: attention and executive functions, memory, III, Digit Span subtest of the WAIS-III and the Rey- visuoconstructive and spatial skills, abstract think- Osterrieth Complex Figure test. ing, aphasia, neglect, agnosia, calculation, reading and Posters 369 writing. The modified Rankin Scale (mRS) was used (Cowan et al. 2004; Della Sala et al. 2005; Dewar et al. to evaluate the degree of functional disability and de- 2007, 2009, 2012). This benefit is thought to reflect su- pendence in the daily activities. perior memory consolidation of recent memory traces Of 131 patients with first-ever stroke (N = 332) and during post-learning wakeful rest (Dewar et al. 2009, without any functional disability (mRS 0–1, mean age 2012). In everyday life we also use our memory system 68.8) being able to carry out all usual activities 65 in an internally directed manner, e.g. recalling the past (50%) showed memory impairment. These clinically and imagining future scenarios. well recovered patients with memory impairment did AIM: We explored whether internal memory activities not significantly differ from those without memory im- interfere with the consolidation of recent verbal mem- pairment in age, sex, education or vascular risk fac- ory traces. tors. The patients with memory impairment performed METHOD AND RESULTS: We conducted two exper- significantly worse than normal controls in all mem- iments in which word learning was followed by three ory components studied (immediate and delayed re- nine minute delay conditions: (I) Wakeful resting, (II) call, implicit, semantic and working memory). The pa- Visual search task, (III) Cued recall/imagination task tients with memory impairment had significantly (p< succeeded by a surprise delayed recall test for learned 0.000) more decrements also in attention and executive words. A significantly lower level of material was re- functions (82%) as well as in visuoconstructional and tained when new learning was followed by both visual spatial skills (77%) than those without memory. search and cued recall/imagination tasks compared to In conclusion, half of the first-ever stroke patients resting wakefully. Two follow up experiments demon- without any functional disability have memory impair- strated that presentation of familiar sound cues without ment. Memory impairment in these patients is often instruction to imagine, automatically triggered the rec- a part of a larger cognitive symptomatology includ- ollection of autobiographical memories and imagina- ing deficits especially in attention and executive function of future scenarios providing a significantly higher tions. This refers to the importance of neuropsycho- level of interference than both wakeful rest and presen- logical evaluation in stroke patients without any func- tation of inconsequential “bang” cues. tional disability taking into account multiple cognitive CONCLUSION: Various activities of the episodic domains at risk. memory system are detrimental to memory consolidation of recent verbal memory traces. When such activ- Keywords: Memory and Learning, Stroke, Neuropsy- ities are minimised, an enhancement in memory reten- chological Assessment and Psychometrics tion is observed.

Correspondence address: Dr. Marja Hietanen, Helsinki Keywords: Memory and Learning University Central Hospital, University of Helsinki, Unit of Neuropsychology, Department of Neurology, Correspondence address: Mr Michael Craig, Univer- Paciuksenkatu 21/P.O.Box 302, FIN-00270 Helsinki, sity of Edinburgh, Human Cognitive Neuroscience, 7 Finland. Tel.: +358 9 471 73871; Fax: +358 9 471 George Square, EH8-9JZ Edinburgh, Scotland, UK. 74088; E-mail: marja.hietanen@hus.ﬁ Tel.: +44 07805645317; E-mail: [email protected]. ac.uk P1.39 P1.40 Recalling the past and imagining the future inter- feres with verbal memory consolidation Is dementia prediction better with age and educational level corrections? The PAQUID cohort study Michael Craig, Michaela Dewar and Sergio Della Sala 1 1 1 University of Edinburgh, Human Cognitive Neuro- Hind Mokri , Céline Meillon , Catherine Helmer , 2 1 science, Edinburgh, Scotland Jean Bouisson , Jean-François Dartgues and Hélène Amieva1 1 BACKGROUND: People remember a higher level of Bordeaux Segalen University, INSERM U 897, Bor- new information when learning is followed by a brief deaux, France 2 period of wakeful rest than if they attend to other Bordeaux Segalen University, EA 4139, Bordeaux, new incoming external information during this time France 370 Posters

There is a well-known effect of demographic variables, P1.41 such as age and education level on cognitive scores in older population. Cognitive scores of individuals with Spatial working memory impairments predict re- advanced age or low education level could be spuri- cancellation behaviour in right brain damaged pa- ously considered as impaired. Thus, it is common to tients assume that corrections for age and schooling level would improve classification accuracy and reduce error Robert McIntosh1 and Nicoletta Beschin2 in diagnosis. However, age and education level are ma- 1University of Edinburgh, Psychology, Edinburgh, UK jor risk factors in dementia. Thus, contrary to common 2Hospital S. Antonio Abate, Clinical Neuropsychology intuition regarding the use of demographic corrected Unit, Rehabilitation Department, Gallarate, Varese, norms for diagnosis of dementia, some studies sug- Italy gest that corrections for demographic variables do not improve dementia classification accuracy. The purpose Right brain-damaged patients with neglect omit items of our study is to assess dementia prediction accuracy on the left side in cancellation tasks, and may also comparing cognitive test scores with and without age re-visit and re-cancel items on the right. Recancella- and education corrections. Analyses were conducted in tions and target omissions are exacerbated in ‘invis- a sample of 1104 non-demented subjects aged 65 years ible’ cancellation tasks, in which no mark is left on and over, gathered from the fourth follow-up of the visited items. It has been proposed that recancellation PAQUID study, a population-based cohort study con- behaviour arises from impairments of spatial working ducted in Southern-Western France. Within the 1104 memory, which prevent patients from keeping track subjects, 92 became demented in the fifth follow-up. of visited locations. This is consistent with the find- Cognitive performances were assessed using the Isaacs ing of non-lateralised spatial working memory impair- Set test, a verbal fluency test and dementia prediction ments in patients with neglect. However, it has not yet accuracy was assessed using sensibility and specificity been demonstrated that recancellation rates are pre- indexes. The sample was stratified by age (< 80 years dicted by spatial working memory impairments across versus 80 years and over) and education level (without patients. This is important, because a range of alter- school certificate versus school certificate and over). native factors might also explain recancellation (e.g. Results show that for lower educated and older sub- rightwards magnetic attraction, perseveration, disor- jects, dementia is predicted with a better specificity dered search planning). We tested 27 patients with when the scores are corrected for age and education but right hemisphere stroke on touch-screen-based visible with a better sensitivity when the scores are not cor- and invisible cancellation tasks. As expected, recan- rected. However, for younger subjects with high level cellations and omissions increased dramatically under of education, dementia is predicted with a better sensi- invisible conditions. Moreover, the magnitude of the bility when the scores are corrected but a better speci- increase correlated negatively with performance on a ficity when the scores are not corrected. Thus, proceed- non-lateralised assessment of spatial working memory ing to demographic corrections reduces dementia pre- (rho (27) = −0.69; p<0.0005). This supports the diction accuracy for subjects with advanced age and proposal that spatial working memory problems are a low education level. principal driver of recancellation behaviour.

Keywords: Other Functions/Disorders, Dementia, Keywords: Visuospatial Abilities, Stroke, Neuropsy- Neuropsychological Assessment and Psychometrics chological Assessment and Psychometrics

Correspondence address: Mrs MSc Hind MOKRI, Correspondence address: Dr. Robert McIntosh, Uni- Bordeaux Segalen University, INSERM U 897, 146 versity of Edinburgh, Psychology, 7 George Square, rue Leo Saignat, D-33076 Bordeaux, France. Tel.: +33 UK-EH89JZ Edinburgh, UK. Tel.: +44 131 6503444; 557571173;E-mail: [email protected] E-mail: [email protected] Posters 371

P1.42 Keywords: Other Functions/Disorders

Training of working memory in healthy elderly sub- Correspondence address: Mrs Dipl. Psych. Juliane We- jects – a randomized controlled trial icker, Max-Planck-Institute for Human Cognitive and Brain Sciences Leipzig, Neurology, Stephanstr. 1a, D- Juliane Weicker1, Nicole Hudl2, Enely Marichal2, 04103 Leipzig, Germany. Tel.: +49 3419940171; E- Karsten Müller3, Jöran Lepsien3, Sabrina Trapp4, mail: [email protected] Stephan Frisch5 and Angelika Thöne-Otto2 1Max-Planck-Institute for Human Cognitive and Brain P1.43 Sciences Leipzig, Neurology, Leipzig, Germany 2University of Leipzig, Clinic of Cognitive Neurology, Computerized training of working memory for pa- Leipzig, Germany tients with acquired brain injuries – a randomized 3Max-Planck-Institute for Human Cognitive and Brain controlled trial Sciences Leipzig, Germany 4Max-Planck-Institute for Human Cognitive and Brain Juliane Weicker1, Enely Marichal2, Nicole Hudl2, Sciences Leipzig, Psychology, Leipzig, Germany Karsten Müller3, Jöran Lepsien3, Sabrina Trapp4, 5J.W. Goethe University, Neurology, Frankfurt/Main, Stephan Frisch5 and Angelika Thöne-Otto2 Germany 1Max-Planck-Institute for Human Cognitive and Brain Sciences Leipzig, Neurology, Leipzig, Germany Working memory plays a key role in many higher order 2University of Leipzig, Clinic of Cognitive Neurology, cognitive functions, hence its functioning affects sub- Leipzig, Germany stantially the quality of everyday life (Johansson and 3Max-Planck-Institute for Human Cognitive and Brain Tornmalm, 2012). A recent meta-analysis by Weicker Sciences Leipzig, Germany and Thöne-Otto (2012) showed that training can sus- 4Max-Planck-Institute for Human Cognitive and Brain tainably increase working memory capacity and pro- Sciences Leipzig, Psychology, Leipzig, Germany duce beneficial effects in cognitive control as well as 5J. W. Goethe University - Neurology, Frankfurt/Main, the appraisal of everyday life functioning. However, Germany despite the wide range of existing interventions there is still a lack of theoretically motivated training pro- Working memory often is impaired as a consequence grams. Furthermore, crucial task characteristics and of brain injury with major impact on everyday func- the concrete mechanisms of transfer are largely un- tioning and quality of life (Johansson and Tornmalm, known. To approach these issues, in cooperation with 2012). A recent meta-analysis by Weicker and Thöne- HASOMED GmbH we developed a computer-based Otto (2012) indicated that especially patients bene- training program which is able to differentially exer- fit from training, showing not only increased work- cise specific aspects of working memory (e.g. storage ing memory capacity but also improved cognitive con- or manipulation of items) in a playful way on the ba- trol and reduction of disorder symptoms. However, de- sis of a card game. The effectivity of the training was spite an increasing number of studies within the last evaluated in a randomized controlled trial with clini- years, there are only few trials with brain injured pa- cally healthy elderly subjects aged 60 to 75. In a pre- tients and most of them lack of methodical quality. Fur- /post-test design the adaptive working memory training thermore, current training programs provide no ade- was compared to a placebo training and a no-training quate adaptivity mechanisms for patients and fail to of- condition. Training took place 3 times a week for 45 fer a theoretical framework why transfer effects may minutes over one month. Before and after the training occur. To approach these issues, in cooperation with all subjects accomplished a broad neuropsychological HASOMED GmbH we developed a computer-based test battery which assessed the effect of the training on training program which is able to differentially exer- working memory functions as well as on related do- cise specific aspects of working memory (e.g. stor- mains. By the time of abstract submission data collec- age or manipulation of items) and adapts difficulty in tion was still in progress, but it will be completed in very fine steps to be appropriate for patients. Training July so that we will be able to present statistically valid effectivity was evaluated in a randomized controlled results. trial with brain injured patients suffering from stroke or traumatic brain injury. Subjects were included when 372 Posters brain injury occurred at least three month ago and Respondents were asked to identify which of 20 cog- when they showed reduced working memory perfor- nitive symptoms are more commonly associated with mance. Exclusion criteria were severe memory or lan- either the right or left cerebral hemisphere, or non- guage deficits as well as constricting acute diseases. lateralised. Six physical symptoms were included as The adaptive working memory training was compared control questions. Data was collected from 226 medics to a placebo training condition in a pre-/post-test de- and health professionals, the majority of whom work sign. Both trainings took place 3 times a week for 45 directly with stroke patients. minutes over one month, the measurements before and RESULTS: As anticipated, the most widely recog- after the training consisted of a broad neuropsycho- nised cognitive symptom was aphasia, with 95% of re- logical test battery which assessed training effects on spondents correctly identifying it as a typically left- working memory as well as on related domains. Trans- hemisphere problem. This was followed by neglect fer to everyday life functioning was assessed by multi- and anosognosia, with 64% of respondents associating ple questionnaires. By the time of abstract submission these with right hemisphere lesions. However, many data collection was still in progress, but it will be com- other cognitive symptoms were poorly recognised, in pleted in July so that we will be able to present statis- some cases only at chance levels. Aphasia aside, this tically valid results. was equally true of right and left hemisphere symptoms, with no overall significant difference between Keywords: Other Functions/Disorders, Traumatic conditions. Brain Injuries CONCLUSION: These preliminary findings suggest that there does seem to be a lack of knowledge of cog- Correspondence address: Mrs Dipl. Psych. Juliane We- nitive symptoms among medical professionals and that icker, Max-Planck-Institute for Human Cognitive and many neuropsychological findings are not being into Brain Sciences Leipzig, Neurology, Stephanstr. 1a, D- assimilated into clinical practice. 04103 Leipzig, Germany. Tel.: +49 3419940171; E- mail: [email protected] Keywords: Stroke

P1.44 Correspondence address: Mrs Elizabeth Fowler, Uni- versity of Edinburgh, Human Cognitive Neuroscience, Cognitive deﬁcits after stroke: What do medics Psychology, 7 George Square, EH8-9JZ Edinburgh, know about neuropsychology? UK. E-mail: [email protected]

Elizabeth Fowler1,SimonHart2, Sergio Della Sala1 P1.45 and Robert D McIntosh1 1University of Edinburgh, Human Cognitive Neuro- The cerebellar role in cognition: Evidence from science, Psychology, Edinburgh, UK voxel based morphometry and diffusion imaging 2Royal Inﬁrmary of Edinburgh, Stroke Unit, Edin- 1 2 3 burgh, UK Giusy Olivito , Michael Dayan , Valentina Battistoni , Silvia Clausi4, Marco Molinari5, Maria Leggio4 and 3 GOALS: Despite the widespread and often persis- Marco Bozzali 1 tent cognitive problems experienced by stroke patients, Department of Psychology, “Sapienza”’ University neuropsychological screening is not routine procedure of Rome; Ataxia Laboratory, Santa Lucia Foundation, in acute stroke care. Given the marginal status of cog- Rome, Italy, Rome, Italy 2 nitive assessment, we were interested in determining Neuroimaging Laboratory, Santa Lucia Foundation, what levels of neuropsychological knowledge are pos- Department of Radiology, Weill Cornell Medical Col- sessed by medics and health professionals who work lege, Rome, New York, Italy, United States of America 3 with stroke patients. In particular, it was hypothesised Neuroimaging Laboratory, Santa Lucia Foundation, that the less immediately observable cognitive prob- Rome, Italy 4 lems, particularly those associated with right hemi- Department of Psychology, “Sapienza” University of sphere lesions, would have lower recognition levels Rome, Ataxia Laboratory, Santa Lucia Foundation, than left hemisphere language deﬁcits. Rome, Italy 5 METHOD: To investigate this, a questionnaire was de- Ataxia Laboratory Santa Lucia Foundation, Rome, vised and distributed at a major UK stroke conference. Italy Posters 373

Over the last decades, the cerebellar role in cognition P1.46 has been extensively investigated. From an anatomical point of view, strictly contralateral interconnec- Non-pharmacological treatment in cognitive de- tions link the cerebellum to the cerebral cortex. It has cline: Cognitive and behavioural outcomes been hypothesized that in this network the cerebellum plays a modulatory role in cognitive functions by mod- Valentina Manfredi, Serena Oliveri, Annalisa Parente, ulating the cerebral cortex activity. However, the ex- Letizia Schifano, Alfredo Raglio and Anna Rita Gio- act cortico-cerebellar interaction mechanisms in sub- vagnoli serving higher level functions still remain unclear. As Fondazione IRCCS Istituto Neurologico C. Besta, De- the cerebellum has major afferent and efferent fibers partment of Diagnostics and Applied Technology, Mi- to cerebral cortex areas through the middle (MCP) and lan, Italy superior cerebellar peduncle (SCP), the aim of this study was to assess the specific contribution of cere- INTRODUCTION: Brain functions can change sub- bellar white matter (WM) damage to cortical grey mat- stantially as a result of practice and experience but ter (GM) modifications, and to evaluate the impact of there is poor evidence of the influence of non-pharma- focal cerebellar lesions on cerebral GM. Using diffu- cological treatment on cognitive decline. sion imaging and voxel-based morphometry (VBM), GOALS OF THE STUDY: This study compared the we attempted to clarify the cerebro-cerebellar interac- effects of Active Music Therapy (AMT) and Cognitive tion mechanisms and their anatomo-functional corre- Training (CT) on cognitive and behavioural aspects in lates in a cohort of patients with left or right cerebellar patients with cognitive decline. lesion as compared to normal controls. MCP and SCP METHODS: Patients with early-stage cognitive de- were reconstructed by diffusion tractography, while cline were serially assigned to CT or AMT. Each treat- cortical GM atrophy was assessed by VBM. From the ment included 30, 45-minutes group sessions. CT ses- reconstructed tracts, measures of microscopic damage sions included exercises stimulating attention, infor- were assessed, while GM volumetrics was investigated mation processing, executive functions, and memory. voxel-wise. Surprisingly, WM analyses showed that ATM sessions used a non-verbal approach and free diffusivity changes affected the cerebellar tracts bilat- sound-music interactions, using rhythmical-melodic erally in most patients. Accordingly, significant reduc- instruments. tions of GM volume were found in the cerebral cortex RESULTS: After CT, the mean test scores in verbal ipsilaterally as well as contralaterally to the cerebel- initiative and episodic memory significantly improved, lar lesion. We speculate that impaired transmission via while mood and social relations showed no significant cortico-cerebellar pathways as expressed by bilateral change. After AMT, mood and social relations tended diffusivity changes in WM tracts, accounts for bilateral to improve, while no significant changes emerged in alterations in the cerebral cortex. This evidence could cognitive aspects. justify the bilateral cognitive impairments observed in CONCLUSIONS: Results reveal that non-pharmaco- cerebellar patients despite the presence of unilateral le- logical treatment can contribute to improve cognitive sions. and behavioural aspects in patients with chronic cognitive impairment. Such treatment may contribute to the Keywords: Functional and Structural Neuroimaging/ clinical care of adult and elderly patients. NIRS Keywords: Other Functions/Disorders, Dementia, Correspondence address: Mrs Dr Giusy Olivito, De- Neuropsychological Rehabilitation partment of Psychology, “Sapienza” University of Rome; Ataxia Laboratory, Santa Lucia Foundation, Correspondence address: PhD Valentina Manfredi, Rome, Italy, Via Dei Marsi, 78; Via Ardeatina, 306, Fondazione IRCCS Istituto Neurologico C. Besta, De- 00185 Rome, Italy. E-mail: [email protected] partment of Diagnostics and Applied Technology, Via Celoria, 11, I-20133 Milan, Italy. E-mail: valentina. [email protected] 374 Posters

P1.47 significantly associated anymore with immediate word recall, (B = −1.03, P = 0.13), delayed word recall Skin autofluorescence as a marker of tissue ad- (B = −0.38, P = 0.07), and response inhibition (B = vanced glycation endproducts, type 2 diabetes, and 0.03, P = 0.06). There was no significant interaction cognitive performance: Preliminary results of The between SAF and diabetes on any cognitive score. Maastricht Study CONCLUSION: After adjustment for demographics, diabetes, smoking, alcohol use, and comorbid condi- Peggy Spauwen1, Marcelle Van Eupen2, Casper Scha- tions, SAF, as a marker for tissue AGEs, was not sig- lkwijk2, Miranda Schram3, Coen Stehouwer3,Frans nificantly associated with cognitive performance. Our Verhey 1, Martin Van Boxtel1 results might indicate that tissue AGEs are not inde- 1Maastricht University Medical Center, Department pendently associated with the development of cogni- of Psychiatry and Neuropsychology, School for Men- tive impairment in T2D. tal Health and Neuroscience (MHeNS), Maastricht, Netherlands Keywords: Other Functions/Disorders, Dementia, 2Maastricht University Medical Center, Laboratory Neuropsychological Assessment and Psychometrics for Metabolism and Vascular Medicine, Department of Internal Medicine, Cardiovascular Research Institute Correspondence address: Mrs MSc Peggy Spauwen, Maastricht, The Netherlands Maastricht University Medical Center, Department of 3Maastricht University Medical Center, Department of Psychiatry and Neuropsychology, School for Mental Internal Medicine, Cardiovascular Research Institute Health and Neuroscience (MHeNS), Dr.Tanslaan 12, Maastricht (CARIM), Maastricht, The Netherlands 6220 MD Maastricht, Netherlands. Tel.: +31 4338810 49; E-mail: [email protected] GOALS: Type 2 diabetes (T2D) is associated with an increased risk of cognitive impairment and dementia. P1.48 However, the underlying mechanisms are not clear yet. One proposed mechanism involves the accumulation Health numeracy in patients with Mild Cognitive of advanced glycation end-products (AGEs). The aim Impairment (MCI) of this study was to examine whether skin autofluorescence (SAF), i.e. a non-invasive marker of tissue Marie-Theres Pertl1, Thomas Benke2,LauraZamar- AGEs, is associated with lower cognitive performance ian2, Caroline Martini3, Thomas Bodner2, Elfriede and whether this association is dependent on diabetes Karner2 and Margarete Delazer2 status. 1Medical University Ínnsbruck, Clinical Department METJODS: 862 participants from The Maastricht for Neurology, Innsbruck, Austria Study (aged 40–75 y) were included, of whom by de- 2Medical University Innsbruck, Clinical Department sign 253 (29.3%) had T2D. SAF was measured with for Neurology, Innsbruck, Austria the AGE reader (DiagnOptics, Groningen) (N = 831). 3Leopold Franzens University Innsbruck, Department Associations between SAF and performance on tests for Psychology, Innsbruck, Austria of global cognitive functioning, information processing speed, immediate and delayed word recall, and Patients with Mild Cognitive Impairment (MCI) are response inhibition were measured and adjusted for by definition still autonomous in daily life and there- demographics (age, sex, education), diabetes, smok- fore make their own decisions, for example, concerning, alcohol use, and comorbid conditions (hyperten- ing their own or their partners’ health care. Health care sion, cardiovascular disease, body mass index, and es- information typically contains complex mathematical timated glomerular filtration rate (eGFR)). constructs like proportions, probabilities and survival RESULTS: After adjusting for demographics and dia- rates, which are difficult to understand even for healthy betes, SAF was significantly associated with scores for older adults. The purpose of this study was to inves- immediate word recall (B = −1.39, P = 0.03), de- tigate if patients with MCI have difficulties with un- layed word recall (B = −0.47, P = 0.02) and with derstanding health numeracy questions and to explore (log-transformed) scores for response inhibition (B = the impact of declining cognitive functions. The per- 0.03, P = 0.02). Other cognitive scores were not as- formance of 29 patients with MCI in a health numer- sociated with SAF. After full adjustment, SAF was not acy questionnaire was compared to the performance Posters 375 of a control sample including 164 healthy older adults GOALS OF THE STUDY: To provide an operational matched in age and educational level. Participants were description of active music therapy (AMT) and its ben- asked to convert percentages, assess different probabil- efits on cognition and behaviour. ities, or understand the dosage of a short patient infor- METHODS: A patient with cognitive decline associ- mation leaflet. Additionally neuropsychological back- ated with Vascular Cognitive Impairment-No Demen- ground tests were administered (CERAD plus). tia (VCI-ND) underwent a four-months AMT based Patients with MCI answered less items correctly in on creative and interactive music playing. The therapy the health numeracy questionnaire than controls (Mdn was conducted simultaneously to the pharmacological 6.0 vs. 8.0). None of the patients reached a ceiling- therapy. Behavioural, socio-emotional, and cognitive effect (in comparison 7,9% of the controls). A cor- aspects were assessed before and after treatment us- relation analysis showed significant associations being a comprehensive neuropsychological and psycho- tween performance in the health numeracy task, years behavioural battery. of education, mental arithmetic, executive functions, RESULTS: The baseline cognitive pattern was charac- naming to confrontation and figural recall, respec- terized by deficits in object and figure naming, seman- tively. In a regression analysis a model with two pre- tic verbal fluency, short and long-term verbal mem- dictor variables emerged (psychomotor speed, plan- ory, short-term spatial memory, selective attention, and ning/conceptualization) accounting for 42,2% of the visuo-motor coordination. The patient reported a ten- variance. dency to feel tense, nervous, and angry and diffi- Patients with MCI show problems in understanding nu- culties in verbal memory and visuo-spatial abilities, merical information concerning health care. They even frequently accompanied by attention drops. The so- had difficulties in understanding a simple dosage in- cial network was an habitual component of the pa- struction. Since patients with MCI are confronted with tient’s life, but not a source of sharing personal ex- several health care decisions, information has to be periences, safety, or comfort. After completing AMT, presented in an easily understandable way (e.g. pic- the cognitive profile significantly improved in the do- tograms). mains of attention, visuo-motor coordination, and verbal and spatial memory. All of these improvements Keywords: Other Functions/Disorders, Mild Cognitive were confirmed three months after the end of the ther- Impairment, Neuropsychological Assessment and Psy- apy, demonstrating a stability of the results. A marked chometrics increase of interpersonal interactions and reduction of state anxiety were observed at the two follow-ups. Correspondence address: Mrs Mag. Marie-Theres CONCLUSIONS: These results suggest that a struc- Pertl, Medical University Ínnsbruck, Clinical Depart- tured AMT may have positive effects on cognition and ment for Neurology, Anichstraße 35, A-6020 Inns- social interactions. In neurological patients with cog- bruck, Austria. E-mail: [email protected] nitive decline, these effects may facilitate the partici- P1.49 pation to standard pharmacological and rehabilitation treatments. Active music therapy influences cognition and behaviour in chronic vascular encephalopathy: A case Keywords: Other Functions/Disorders, Mild Cognitive report Impairment, Other Methods

Serena Oliveri, Valentina Manfredi, Annalisa Parente, Correspondence address: Mrs PhD Serena Oliveri, Letizia Schifano, Alfredo Raglio and Anna Rita Gio- Fondazione IRCCS Istituto Neurologico C. Besta, vagnoli Department of Diagnostics and Applied Technology, Fondazione IRCCS Istituto Neurologico C. Besta, De- Via Celoria, 11, I-20133 Milan, Italy. E-mail: serena. partment of Diagnostics and Applied Technology, Mi- [email protected] lan, Italy

INTRODUCTION: Recent literature supports music therapy as a promising non-pharmacological approach to the behavioural and psychological symptoms in cognitive, social and emotional rehabilitation. 376 Posters

P1.50 cognitive impairment. When compared with the three other screening tools, the PANDA-F exhibits the high- COGNITIVE screening in parkinson’s disease: nor- est AUC for both MCI and dementia. The PANDA-MQ mation and validation of the panda-f, and compari- has a strong concurrent validity with the GDS (p< son with 3 other scales 0.001). CONCLUSION: the PANDA-F is a useful screening Anne-Isabelle Gasser1,ElkeKalbe2, Pasquale Cala- tool showing, with the same cut-off scores as the Ger- brese3, Joseph Kessler4 and Philippe Rossier1 man version, good sensitivity and specificity for de- 1Hôpital fribourgeois, Rehabilitation Unit, Billens, mentia and MCI in PD patients. Switzerland 2University of Vechta, Institute of Gerontology and Keywords: Other Functions/Disorders, Neurodegener- Center for Neuropsychological Diagnostics and Inter- ative Diseases, Neuropsychological Assessment and vention (CeNDI), Vechta, Germany Psychometrics 3Neurocenter of Southern Switzerland, Lugano, Switzerland Correspondence address: Mrs Anne-Isabelle Gasser, 4University Clinic Cologne, Department of Neurology, Hôpital fribourgeois, Rehabilitation Unit, Rue de Cologne, Germany l’Hôpital 1, CH-1681 Billens, Switzerland. E-mail: an- [email protected] INTRODUCTION: the Parkinson Neuropsychometric Dementia Assessment (PANDA) is a new screening P1.51 tool, validated in German, to assess cognition and Is the Rank Order of WAIS-subtest Scores typical mood in Parkinson’s disease (PD). It includes 5 cog- to the Locus of Brain Lesion? An example of the use nitive tasks and a short mood questionnaire (PANDA- of diagnostic data base MQ). AIMS: to translate the PANDA into French, normalise it, determine cut-off scores for mild cogni- Harri Koski tive impairment (MCI), dementia and depression and PGI Koski, TAMPERE, Finnland to compare it with MMSE, Mini Mental Parkinson (MMP) and clock test (CT). The aim of this study was to examine, do the local brain METHODS: the normation was conducted with 61 lesions produce a locus typical rank order of WAIS- control subjects, who were compared to the original subtest scores and to report the utility of the diagnostic study’s control group. Afterwards, 51 patients with PD data base in neuropsychological assessment. were administered the French version of the PANDA The patients were a) adults, b) right-handed, c) the le- (PANDA-F), the MMSE, the MMP and the CT. They sion was limited to the left or right temporal or pari- n = were classified as either having normal cognition ( etal lobe and d) eight subtest (similarities, arithmetic, n = n = 15), MCI ( 20) or dementia ( 16) on the basis vocabulary, digit span, picture completion, picture ar- of an extensive neuropsychological battery of tests ad- rangement, block design and digit symbol) from WAIS ministered by an examinator blinded to the above men- or WAIS-R were done. WAIS -subtest rank order of the tioned screening test results. The concurrent validity of patients (N = 57), including 47 examples from litera- the PANDA-MQ was determined against the Geriatric ture, was compared to the results published by McFie Depression Scale (GDS). (Journal of Nervous and Mental Disease, 1960, 131, RESULTS: our results show that the PANDA-F can 383–393). The comparison group (N = 162) was from be used with the same transformation algorithms as Finnish WAIS-R standardisation material (age 15–73, the German version, adding a correction for educa- no neurological diseases). Spearman rank order cor- tion. The PANDA-F total score produced excellent dis- relation was used to test the compatibility between crimination of PD patients with dementia from those individual test profile and different profiles of lesion without (area under the curve [AUC] = 0.97) and of groups and a comparison profile. Comparison profile PD patients with cognitive impairment (MCI and de- was the averages of standard scores. The highest corre- mentia) from those without (AUC = 0.90). With the lation between test profile and McFie-lesion group was cut-off scores proposed for the German version, the used to describe the compatibility. PANDA-F has a specificity of 94% and a sensitivity of The results indicate a statistically very significant con- 100% for PD-D and, respectively, 100% and 72% for nection between patients subtest scores and diagnos- Posters 377 tic data base (McFie lesion groups). The sensitivity ativity (MMN) paradigm in the end of the same day. and the specificity were examined. The profiles of pa- The subjects with severe burnout blinked more often tient groups reached to the adequate lesion group pro- already in the beginning of the day as compared to the files and were statistically different from the compar- control and the mild burnout groups, suggesting that ison group. There were differences in selectivity be- the subjects with severe burnout experience heightened tween patient groups. The adequacy to clinical assess- stress and fatigue already in the beginning of the work- ment was discussed critically. day. Moreover, the blinking rate increased throughout The results demonstrate that local brain lesions pro- the day in all groups, with the most increase in the duce a locus typical rank order of WAIS -subtest group with severe burnout. However, in the beginning scores. Because the sample was quite narrow and the of the last task of the day both burnout groups blinked data base would require updating, we should to be less than controls, possibly due to paying extra effort. careful with further conclusions. However it would be But by the end of this task, the blinking rate of the se- useful to collect up-to-date data bases of specific brain vere burnout group had again exceeded the rate of the lesion cases. controls and the mild burnout group. These results suggest that severe burnout is associated with heightened Keywords: Other Functions/Disorders, Other Disor- stress and fatigue already in the beginning of the day der/Samples, Neuropsychological Assessment and and that these detrimental symptoms become stronger Psychometrics with the day passing and the work load increasing. In- terestingly, subjects with burnout seem to be able to Correspondence address: Mr L.A. Psych. Harri Koski, suppress these symptoms temporarily, which may ex- PGI Koski, Kehräsaari B V 9, FI-33200 TAMPERE, plain why their condition is not always revealed in brief Finnland. Tel.: +35 8405012161, Fax: +35 832238989; testing situations. E-mail: harri.koski@pgikoski.fi Keywords: Other Functions/Disorders, Other Disor- P1.52 der/Samples, Electrophysiology (EEG/ERP)

Blinking behaviour during cognitively demanding Correspondence address: Mrs Marianne Leinikka, tasks in work-related burnout Finnish Institute of Occupational Health, Haartmanin- katu 1 A a, FIN-00290 Helsinki, Finland. E-mail: Marianne Leinikka, Laura Sokka, Satu Pakarinen, marianne.leinikka@ttl.ﬁ Jussi Korpela, Andreas Henelius and Minna Huoti- lainen P1.53 Finnish Institute of Occupational Health, Helsinki, Finland Baseline cognitive functions among elderly localized breast cancer patients Electroencephalogram (EEG) measurement is highly sensitive towards both subject- related and environ- Marie Lange1, Florence Joly2,SabineNoal3,Nat- mental artefacts. Typically these artefacts are un- acha Heutte4, Aurélie Daireaux5, Chantal Rieux5,Jo- wanted and removed from the data by various meth- han Le Fel6, Olivier Rigal7, Vincent Roy6, Bénédicte ods. Sometimes, however these subject-related arte- Clarisse5, Francis Eustache8 and Bénédicte Giffard8 facts, such as eyeblinks, can provide relevant informa- 1INSERM U1077 et U1086, Université de Caen Basse- tion on the physiological state of the individual. Men- Normandie, Ecole Pratique des Hautes Etudes, UMR- tal load, fatigue and anxiety are examples of the men- S1077, CHU de Caen, CAEN, France tal and emotional factors increasing blinking activity. 2INSERM U1086, Unité de recherche clinique Centre In this study, we compared the eye blinking behaviour François Baclesse, CHU de Caen, Service d’oncologie, of currently working subjects suffering from different Caen, France levels of burnout (mild: N = 24; severe: N = 14) 3INSERM U1086, Unité de recherche clinique Centre and their healthy controls (N = 24). The eye blinking François Baclesse, CHU de Caen, Unité de Recherche rate (blinks/sec), and number of blinks were calculated Clinique,Centre François Baclesse, Caen, France from a 4-min. baseline recording in the beginning of 4INSERM U1086, Unité de recherche clinique Centre a stressful day, and a 30-min. passive mismatch neg- François Baclesse, UFR de sciences pharmaceutiques, 378 Posters

Caen, France Keywords: Other Functions/Disorders, Other Disorder 5Centre François Baclesse, Unité de recherche clin- /Samples, Neuropsychological Assessment and Psy- ique, Caen, France chometrics 6Université de Rouen, EA4306, Rouen, France 7Centre Henri-Becquerel, Département d’oncologie Correspondence address: Mrs Marie LANGE, IN- médicale, Rouen, France SERM U1077 et U1086, Université de Caen Basse- 8INSERM U1077, Université de Caen Basse-Norman- Normandie, Ecole Pratique des Hautes Etudes, UMR- die, Ecole Pratique des Hautes Etudes, UMR-S1077, S1077, CHU de Caen, Centre François Baclesse, IN- CHU de Caen, France SERM 1086, 3 Av. Généréal Harris, FRANCE-14000 CAEN, France. E-mail: [email protected] BACKGROUND: Cognitive deficits (CD) are reported among cancer patients receiving chemotherapy (CT), P1.54 but can also be observed before treatment. Elderly patients are poorly studied although they are more prone The neuropsychological assessment of cognitive to present age-related CD and CD onset or enhance- deficits in consideration of various measures of ment during CT. This study assessed baseline cognitive variability functions – i.e. before adjuvant treatment therapy – in 1 1 elderly localized breast cancer (LBC) patients. Celine Tanner-Eggen , Christian Balzer and Klemens Gutbrod2 METHODS: Results concern 123 elderly LBC pa- 1 tients (71 ± 4 years): planned treatment included CT Reha Rheinfelden, Neuropsychology, Rheinfelden, and radiotherapy (RT) for 61 patients and RT only Switzerland 2University Hospital Inselspital Bern – Neuropsychol- for 62 patients. Episodic memory, working memory, ogy, Bern, Switzerland executive functions and information processing speed were assessed by Grober and Buschke procedure, Rey- In neuropsychological assessment, not only single test Osterrieth complex figure test, Working Memory In- scores, but also entire performance profiles should be dex – WAIS III, Trail Making test, and verbal flu- considered to identify cognitive deficits. Moreover, not encies. Validated questionnaires assessed subjective only mean levels of performance, but also intrain- CD, anxiety, depression and fatigue (FACT-Cog, STAI, dividual performance variability should be examined BDI, FACIT-F). Geriatric assessment was also realized when interpreting neuropsychological profiles. There (ADL, IADL, GDS). Objective CD were defined as a is growing evidence that variability is prevalent also score less than 1.5 standard deviation (SD) of norma- in healthy individuals. Analysing the large normative > tive data on 2 tests, or less than 2 SDs on 1 test. sample (n = 569) of a comprehensive neuropsycho- RESULTS: Before any adjuvant treatment, objective logical test battery (Materialien und Normwerte für die CD were observed in 40% of patients (46% in CT neuropsychologische Diagnostik; MNND), the pur- group, episodic memory mainly impaired, and 37% in pose of our study is to improve the awareness of nor- RT group, executive functions and information pro- mal variability by discussing various types of perfor- cessing speed mainly impaired). No relation was ob- mance variability. One goal is to exhibit information served between cancer stage, geriatric frailty and ob- about the number of low scores in a healthy population. jective CD. Twenty nine percent of patients presented A second goal is to provide base rate information about fatigue, 6% anxiety and 10% depression. These vari- different levels of dispersion across cognitive abilities. ables were not related to objective CD but they were A third goal of the study is to determine the magnitude related to subjective CD. of laterality patterns (i.e., performance discrepancies CONCLUSIONS: More than 40% of elderly LBC pa- between verbal and non-verbal tests or domains). The tients presented objective CD before any adjuvant ther- base rates of low scores were calculated using differ- apy that is higher than observed among younger pa- ent cutoffs for abnormality. Dispersion levels were ex- tients (20–30%). It is important to take account in the amined by the intraindividual standard deviation (ISD) decision making of adjuvant treatment in elderly pa- score. The base rates of different performance discrep- tients. More systematic cognitive assessments should ancies were analysed forming contrast scores. The re- be provided in the initial oncological assessment. sults of the analyses showed that intraindividual performance variability is common in the normative sam- Posters 379 ple of MNND. The educational level had a significant nitive training, based on neuroscience knowledge, can effect on the number of low scores and on the perfor- increase the cognitive resources and allow to develop mance discrepancies. Therefore, these base rates were of meta-cognitive abilities and cognitive self-activation stratified by years of education. The base rates are pre- skills. sented in user-friendly tables, allowing clinicians additional interpretive methods to improve accurate identi- Keywords: Other Functions/Disorders, Other Disorder fication of cognitive deficits in neuropsychological as- /Samples, Neuropsychological Assessment and sessment. Psychometrics

Keywords: Neuropsychological assessment, normal Correspondence address: Mr Ph.D. Giuseppe Alfredo variability, base rates, Other Functions/Disorders, Iannoccari, Assomensana Association, via Caronni 2, Other Disorder/Samples, Neuropsychological Assess- I-20900 Monza, Italy. Tel.: +39 26360914; E-mail: ment and Psychometrics [email protected]

Correspondence address: Mrs lic.phil. Celine Tanner- P1.56 Eggen, Reha Rheinfelden, Neuropsychology, Salinen- strasse 98, CH-4310 Rheinfelden, Switzerland. Tel.: Predictors for improvement of cognition in patients +41 795125510; E-mail: [email protected] with idiopathic normal pressure hydrocephalus

P1.55 Sandra Michaela Lettner and Andreas Kampfl Department of Neurology, Ried im Innkreis, Hospital Longevity and neuropsychology. An experimental of the Sisters of Charity Ried, Austria study about cognitive empowerment in old adults SPECIFIC GOAL: The main goal was to define ch- Giuseppe Alfredo Iannoccari, Sara Eralti and Adriana anges in specific neuropsychological functions in pa- Bortolotti tients with idiopathic normal pressure hydrocephalus Assomensana Association, Monza, Italy (iNPH) before and after singular lumbar puncture (sLP) and evacuation of cerebrospinal fluid (CSF). Cognitive stimulation is a neuropsychological inter- METHOD: All patients with iNPH had a cerebral mag- vention strategically oriented toward the general well- being of each one. It allows to reinforce and to main- netic resonance tomography (MRT) before sLP. The tain the cognitive agility and flexibility by tasks that cognitive testing battery before sLP and at points in involve different functions: language, problem solv- time day 1–9 after sLP included: memory, attention, ing, memory, attention, etc. The present study explored motor activity, reaction time and verbal fluency. All pa- the effect of annual cognitive training by evaluative tients had cerebrospinal fluid (CSF) evacuation of 40– test of cognitive efficiency (SPM- Standard Progres- 50 mls by sLP. sive Matrices, TMT A-B, CAiG). Meetings happened SUMMARY OF RESULTS: 64 inpatients were in- in group once a week. During these sessions, subjects cluded in the study. 40,6% were female, the mean age were trained with paper-pencil exercises with manage- was 86,45 years (SD 12,75 years). The following neu- ment of a neuropsychologist. 194 subjects (M = 64, ropsychological deficits correlated with the diagnosis 34; SD = 6,99) participated to the experiment, shared of an iNPH: memory, attention, motor activity, reaction in two groups: one experimental that adhered to the time and verbal fluency. Improvement in motor activ- sessions of cognitive stimulation and one of control ity, verbal fluency and reaction time was observed in that, instead, exclusively participated in the evaluative all patients at day 4–9 after CSF evacuation by sLP. meetings. By comparison of two groups, many mean- CONCLUSION: Our data suggest that specific cogni- ingful differences occur: repeated measures ANOVA tive testing is helpful in establishing the diagnosis of between subjects found a performance increase in at- an iNPH. In particular, our results indicate that motor tentional and linguistic tasks, of nonverbal intelligence, activity, verbal fluency and time of reaction improve of short and long-term memory, of working memory only at specific time points after sLP in patients with and of speed in spatial exploration from the experi- iNPH. mental group. In conclusion, we suggest that a cog- 380 Posters

Keywords: Other Functions/Disorders, Other Disorder Stories CMS (all p<0.01), suggesting a lack of un- /Samples, Neuropsychological Assessment and derstanding of the stories. Performances on attention, Psychometrics executive functioning and visual episodic memory require a more detailed interpretation. Correspondence address: Mag. Dr. Sandra Michaela Our findings highlight the presence of cognitive im- Lettner, Hospital of the Sisters of Charity Ried, De- pairments in adolescents hospitalized in For-K units partment of Neurology, Schlossberg 1, A-4910 Ried im and confirm the necessity of developping appropriate Innkreis, Austria. Tel.: +43 676 420 8229; Fax: 0043 intervention methods. 7752 95044, E-mail: [email protected] Keywords: Other Functions/Disorders, Psychopathol- P1.57 ogy, Neuropsychological Assessment and Psychomet- rics Cognitive performances of adolescents hospitalized in a For-K Unit Correspondence address: Mrs Gaëlle Grajek, Centre Hospitalier Jean Titeca, Unité Karibu B3, Rue de la Gaëlle Grajek1, Stéphanie Charles2, Audrey Pauwels2 Luzerne 11, B-1030 Brussels, Belgium. E-mail: gaelle. and Laurent Servais2 [email protected] 1Centre Hospitalier Jean Titeca, Unité Karibu B3, Brussels, Belgium P1.58 2Centre Hospitalier Jean Titeca, Brussels, Belgium Validity of cognitive screening tests in mild acute As patients with schizophrenia often present cognitive stroke disorders (e.g. Medalia and Choi, 2009), it seemed interesting to focus on the neuropsychological function- Klaus Hess1 and Claudia Jansen2 ing of our population, namely juvenile offenders with 1Universitätsklinik Heidelberg, Neurology, severe psychotic disorders. Heidelberg, Germany Therefore, we systematically evaluated the cognitive 2Universitätsklinik Heidelberg, Neurologie, functioning of all patients admitted in the For-K units Heidelberg, Germany of the CHJ Titeca (Brussels) since november 2010. All patients (N = 37) were male adolescents aged 15 to Cognitive screening instruments are widely used in 18 years, suffering from severe psychiatric disorders stroke patients. Still the sensitivity and specificy of and under judicial measure. As a part of the therapeu- these instruments in comparison to a complete neu- tic support in the units, all adolescents were evaluated ropsychological testing remains unclear. with a full cognitive assessment one month after the METHOD: To examine the validity of three Screen- admission to objectivate and quantify the presence and ing Instruments we applied the Montreal Cognitive extent of cognitive deficits and to integrate them in Assessment (MoCA) and the Addenbrooks Cognitive the multidisciplinary therapeutic process. The obtained Examination-Revised (ACE-R) in addition to a stan- scores were converted to standardized z scores based dard neuropsychological testing. In a prospective de- on published norms for the tests. One sample t-tests sign we included n = 60 patients with mild (mean were used to compare stardardized scores with norms. NIHSS: 3,6; range: 0–18) acute stroke who were ad- All performances on tests evaluating visual treatment mitted to the Department of Neurology of the Univer- and processing speed (Rey’s Complex Figure, Wech- sity Hospital Heidelberg. Excluded were patients with sler’s subtests Picture Completion, Block Design and neurological deficits that interfered with the testing, Coding) were significantly lower than norms (all p< and patients with obvious cognitive deficits like apha- 0.001). Patient’s scores on verbal working memory sia, visual neglect, and patients with depression. The (Digit Span) were also significantly lower than norms mean age was 60 years (range 32–83). Most frequently (p<0.001). Their performances on a verbal episodic patients suffered from a stroke of the MCA (n = 25; memory task were not different from norms when eval- 41%), followed by stroke of the PCA (n = 16; 26,7%). uated with the California Verbal Learning Test (all p> Our standard test battery was comprised of the Hooper 0.05), while they scored significantly lower than norms Verbal Learning Test (HVLT); Rey Complex Figure, on the delayed recall and delayed recognition of the Trail Making Test A + B, Letter-Digit-Test (WAIS), Posters 381

Block Tapping, and a german word fluency test (RWT (2) validate the Cantonese version of the BCoS by Animals). A cognitive deficit was defined by a per- comparing the scores on BCoS with scores in the Hong centile < 10 in selected parameters of each test with Kong version of the Montreal Cognitive Assessment the exception of the HVLT (percentile < 5). A pa- Test (MoCA), Cantonese version of the MMSE and tient was classified as having a cognitive deficit if he the Cantonese Aphasia Battery (CAB); and (3) evalu- scored lower than this cutoff in at least two test param- ate the ability of BCoS to differentiate between stroke eters. For the screening tests we used common cutoffs: survivors and healthy individuals matched in age, ed- MMSE < 27, MoCA < 26 and ACE-R < 88. ucation and gender. Twenty two subjects with aphasia RESULTS: The ACE-R showed the highest sensitivity (fourteen male and eight female) were recruited. Sub- (71%), followed by MoCA (58,1%), and the MMSE jects had a post-onset time of at least 6 months on first (35%). On the other hand, specifity ranged from 86,2% assessment day and were all native speakers of Can- (MMSE), 65,5% (MoCA), to 69,0% (ACE-R). tonese. Controls were recruited if they had no history CONCLUSION: No Screening Instrument can sub- of stroke and matched with each subjects in age, edu- stitute a good clinical practice testing in mild acute cation and gender. Results showed concurrent validity stroke. In this study the ACE-R showed the highest of the BCoS using scores obtained from the sections sensitivity and specifity using the common cutoffs. The of orientation, naming, attention, immediate recall, de- MMSE should no longer be applied in patients with layed recall, language, visuospatial ability, reading and mild acute stroke. writing when compared against scores obtained from the corresponding tasks in CAB, C-MMSE and HK- Keywords: Other Functions/Disorders, Stroke, Neu- MoCA, according to the Pearson correlation coeffi- ropsychological Assessment and Psychometrics cients. Inter-rater and intra-rater reliability of the BCoS was established using videos of four subjects reviewed by 2 native Cantonese speakers. Test-retest reliability Correspondence address: Dr. Klaus Hess, Universität- of the BCoS was confirmed by inviting 5 patients to sklinik Heidelberg, Neurology, INF 400, D-60123 complete the BCoS twice within three months (T2) of Heidelberg, Germany. E-mail: [email protected] the first BCoS assessment session with identical in- heidelberg.de structions. Discriminant validity of the BCoS was indicated by the ability of the BCoS to differentiate be- P1.59 tween stroke survivors and controls of a similar age using. We conclude that the Cantonese version of the Development of a Cantonese version of the Birm- BCoS is a reliable and valid instrument. ingham Cognitive Screen BCoS for stroke survivors

1 2 2 Keywords: Other Functions/Disorders, Stroke, Neu- Brendan Weekes , John Chan ,DianaHo,Pinky ropsychological Assessment and Psychometrics Lam2, Glyn Humphreys3, Jane Riddoch3 and Anthony Kong4 1 Correspondence address: Mr Professor Brendan University of Hong Kong, Laboratory for Communi- Weekes, University of Hong Kong, Laboratory for cation Sciences, Hong Kong, China 2 Communication Sciences, University of Hong Kong, University of Hong Kong, Laboratory for Communi- D-1111 Hong Kong, China. E-mail: [email protected] cation Science, Hong Kong, China 3 Department of Experimental Psychology, University P1.60 of Oxford, Oxford, UK 4 Department of Communication Disorders, University Quality of life after stroke: Impact of cognitive of Central Florida, Orlando, US deﬁcits

The Birmingham Cognitive Screening Test (BCoS) is Clemence Bourlon, Marine Lunven and Christophe designed to isolate a wide range of cognitive functions Duret in patients with brain injuries including the assessment Clinique Les Trois Soleils, Neurology, Boissise le Roi, of aphasia, apraxia, attention, memory and spatial ne- France glect. The purpose of the present study was to (1) develop a Cantonese version of BCoS by translation with Stroke is one of the leading causes of long-term dis- cultural modiﬁcations of the English version of BCoS; ability and quality of life (QoL) in adults (Bonita, 382 Posters

1992). In recent years, several stroke-specific assess- 3Department of Neurology, University Hospital, Lau- ments have been developed that include scales de- sanne, Switzerland signed to measure, among other health concepts, the concept of communicative functioning (Doyle et al. Patients with carotid artery stenosis (CAS) present 2004). However, most stroke outcome measurement reduced blood flow to the brain. It is under debate tools are focused on neurologic symptom status, phys- whether CAS directly relates to cognitive impairment ical aspects of functioning (Duncan et al. 2003), social or whether CAS is rather a marker for underlying risk functioning (Weissman et al.1981), psychological dis- factors, themselves influencing cognition. We deter- tress (Burke et al. 1991), pain (Daut et al. 1983), fa- mined cognitive performance level and the emotional tigue (Yellen et al. 1997) and rarely assess other impor- state of patients with CAS and hypothesized that the tant components of health like cognitive functionning. underlying symptoms, the hemispheric side of stenosis We proposed a QoL scale modified from Burden of and the degree of stenosis influence performance level. Stroke Scale (BOSS, Doyle et al. 2004) and devel- Sixty-eight patients (52 male; mean age 68.7, range oped a more details assessment of cognitive burden 51–85), all presenting CAS of 70% (right-sided n = of stroke (memory, executive functions, language, per- 29, left-sided n = 27, bilateral n = 12) were included. ception and attention). We assessed 49 consecutive pa- Fifty-one patients were asymptomatic (no clinical his- tients with stroke (1 year after hospital discharge) and tory of stroke or transient ischemic attack, TIA), 17 pa- 22 controls. tients suffered from stroke or TIA (symptomatic). All Results showed significant differences between com- patients underwent assessment of language, visual and parison groups (Patients vs. Controls) for total score verbal memory, processing speed, executive functions, and particularly for mobility, self-care and social rela- motor speed, anxiety and depression. tions. Moreover patients reported more significant dif- Patients with CAS showed significantly more often ficulties in language and attentional abilities, related to impairments in executive functions (processing speed the psychological distress. p<0.001; interference control p<0.001), word pro- These findings support the importance of individual’s duction (p = 0.021), verbal and visual learning (p = perceptions of their functioning in all cognitive do- 0.001, p = 0.014), visual recall (p = 0.014) and mo- mains. Quality of life is also dependent on specific cog- tor speed (p<0.001) than expected from a norma- nitive processing. tive sample. Anxiety was significantly increased in the patient group (p = 0.048). Bilaterality of stenosis in- Keywords: Other Functions/Disorders, Stroke, Neu- fluenced processing speed significantly (p = 0.036), ropsychological Assessment and Psychometrics with worst processing speed in patients with bilateral stenosis. Grade of stenosis and underlying symptoms Correspondence address: Mrs Dr. Clemence Bour- (symptomatic versus asymptomatic) was not associ- lon, Clinique Les Trois Soleils, Neurology, Rue du ated with cognition or mood. Château, F-77310 Boissise le Roi, France. Tel.: +33 Cognitive impairment often occurs in patients with 1689855558; E-mail: [email protected] CAS and anxiety is increased. The missing link between cognitive impairment and degree of stenosis and P1.61 underlying symptoms (symptomatic versus asymptomatic) challenges the view that CAS per se leads to Influence of carotid artery stenosis on cognitive cognitive impairment. It is likely that underlying risk functions and emotional state factors additionally contribute to the pattern of cognitive impairment in patients with CAS. Regula Everts1, Manuela Wapp2, Yuliya Burren2, Frauke Kellner-Weldon2, Marwan El-Koussy2,Patrik Keywords: Other Functions/Disorders, Stroke, Neu- Michel3 and Schroth Gerhard2 ropsychological Assessment and Psychometrics 1Children’s University Hospital, Division of Reha- bilitation, Development and Neuropediatrics, Bern, Correspondence address: Dr. Regula Everts, Children’s Switzerland University Hospital, Division of Rehabilitation, De- 2University Hospital Inselspital, Institute for Diagnos- velopment and Neuropediatrics, Inselspital, CH-3010 tic and Interventional Neuroradiology, Bern, Switzer- Bern, Switzerland. E-mail: [email protected] land Posters 383

P1.62 Correspondence address: Dr. Erik Matser, Polikliniek Neuropsychologie, Zandstraat 96, NL-5705AZ Hel- Talent identification and cognitive functioning mond, the Netherlands. Tel.: +31 492476003, E-mail: [email protected] Erik Matser Polikliniek Neuropsychologie, Helmond, The Nether- P1.63 lands Cognitive effects of pain and psychiatric symptoms Experts in professional soccer approach player selec- in fibromyalgia tion mainly in a subjective manner, in which, next to physical characteristics, there is growing emphasis on A. Soler1, A. Campabadal2, C. Galisteo3,M.Larrosa3, a player’s mental capacity. This mental capacity can M.J. Masdeu3, L. Vigil3 and M. Jódar3 be objectively measured by using neuropsychological 1Universitat Autònoma de Barcelona, Psicologia tests. To provide better understanding in the use of Clínica i de la Salut, Barcelona, Spain these tests as a selection method, it is studied if suc- 2Universitat Autònoma de Barcelona cessful soccer players perform significantly better on 3Corporació Sanitària Parc Taulí, Sabadell neuropsychological tests than less successful soccer players. Two studies were conducted to test this hy- OBJECTIVE: The present study aims to assess atten- pothesis. Data was obtained from players in the Dutch tion, memory and executive function in females with National Team and a prominent European team. fibromyalgia (FM), and to explore the relationship with In both studies, an independent-measures between affective symptoms and pain. METHODS: The sam- group experimental design was used. In using Mann- ple includes 25 FM patients, 25 chronic pain patients Whitney U-tests, the scores on various neuropsycho- (CP) and 25 healthy controls (HC). All participants logical tests of successful and less successful soc- completed neuropsychological tasks of verbal and vi- cer players are compared. In the first study, data of sual memory (RAVLT, Logical Memory and RCFT), entry-level players was evaluated 10 years later to as- immediate and working memory (Digit Span, Spatial sess if the earlier obtained test scores are associated Span, Letter Number and PASAT) and executive func- with career success in later life (domains: memory, vi- tioning (Stroop test and FAS). Effort was measured by sual speed of processing, planning, response inhibi- the TOMM. Level of anxiety and depression was eval- tion, simple response speed). In the second study, the uated using the HAM-A and the BDI. Level of pain scores of a team’s first team players were compared to was measured by the VAS. the scores of reserve team players (domains: working RESULTS: Groups do not differ in mean age or edu- memory, mental speed). cation. None of the participants failed the effort test. Results of the first study show that successful play- Statistical analysis using an ANOVA shows significant ers performed significantly better than less successful group differences in anxiety and depression. There are players on various neuropsychological tests in the do- no significant differences in related pain level between mains working memory and visual speed of process- both patient groups. Compared to HC, FM and CP pa- ing. No differences in other domains were found. The tients show significant poor performance in Digit Span, results of the second study supported the results of the PASAT and RCFT copy. FM group differ from HC in first study. RAVLT first trial, RCFT short-term recall, immediate The main finding of the present studies is that success- and delayed Logical Memory recall, Spatial Span to- ful soccer players perform better than lower level soc- tal score, Letter Number and Stroop interference in- cer players on tests that measure working memory and dex. Patients with CP perform significantly worse in visual speed of processing. These functions can be ob- FAS. After controlling for anxiety and depression us- jectively measured and are useful tools in the selec- ing an ANCOVA, all differences in cognitive perfor- tion of professional soccer players. The results of these mance disappear, except in RCFT copy and FAS (p< studies provide new insight in talent identification. 0.00). CONCLUSION: Since FM patients show more dif- Keywords: Other Functions/Disorders, Other Disorder ficulties than other CP patients in most of the tasks /Samples, Neuropsychological Assessment and Psy- managed, but they do not perform statically differ- chometrics ent, pain seems to explain part of cognitive decline 384 Posters in patients with FM. The addition of factors associ- Keywords: Other Functions/Disorders, Stroke, Neu- ated with the disorder, such as affective symptoms, ex- ropsychological Rehabilitation plain deficits in attention, verbal immediate and working memory, visual short-term memory and informa- Correspondence address: Mrs phd sascha rasquin, tion management difficulties in verbal memory. Short Adelante-Rehabilitation Centre, Brain Injury, Zand- and long-term consolidation of verbal information is bergsweg 111, 6432-cc hoensbroek, The Netherlands. not affected. Tel.: +31 455282828; Fax: +31 455282627; E-mail: [email protected] Funded by the Fundació La Marató de TV3. P1.65 Keywords: Other Functions/Disorders, Other Disorder /Samples, Neuropsychological Assessment and Psy- Industry studies report larger effects: A meta anal- chometrics ysis of donepezil RCTs

Correspondence address: Mrs A. Soler, Universitat Lewis Killin1,TomRuss2, Sharon Abrahams1, John Autònoma de Barcelona, Psicologia Clínica i de la Starr2 and Sergio Della Sala1 Salut, Edifici B Campus UAB, D-08193 Barcelona, 1University of Edinburgh, Psychology, Edinburgh, Spain. E-mail: [email protected] United Kingdom 2University of Edinburgh, Alzheimer Scotland Demen- P1.64 tia Research Centre, Edinburgh, United Kingdom Course of cognitive functioning during stroke reha- Donepezil hydrochloride (trade name Aricept) is cur- bilitation rently prescribed to patients with mild to moderate Alzheimer’s disease (AD). This practice is founded Sascha Rasquin1, Caroline Van Heugten2 and Juul on meta-analyses that demonstrate its efficacy over Welten2 placebo. However, these analyses do not consider the 1Adelante-Rehabilitation Centre, Brain Injury, Hoens- relationship between trial funding and reported ef- broek, The Netherlands 2 fects as a possible source of bias. We investigated University Maastricht, Neuropsychology and Psychi- whether there is a difference in the effect size of atry, Maastricht, The Netherlands donepezil in AD between industry-funded and inde- OBJECTIVE: To determine the course of cognitive pendent trials by using a random-effects meta-analysis functioning within the subacute phase (< 4 months) of standardised cognitive outcomes (MMSE, ADAS- after stroke during rehabilitation. cog). We updated the 2011 UK National Institute of METHODS: Stroke patients admitted to a rehabilita- Health and Clinical Excellence technical appraisal of tion centre were submitted to a neuropsychological donepezil through a PubMed search. Inclusion crite- examination on admission (1 month post stroke) and ria were double-blind, placebo-controlled trials of any upon discharge (4 months post stroke). Cognitive do- length comparing patients diagnosed with probable mains: attention, executive functioning, memory and AD (according to NINCDS-ADRDA/DSM-III/IV cri- visual attention. teria) taking any dosage of donepezil. With these se- RESULTS: Forty-two patients (mean age 57.1 years lected studies (N = 14; 10 industry) donepezil was (sd 7.7)) participated. At admission more than half of observed as being significantly more effective than the patients showed deficits in attention and memory. placebo. Critically, industry trials reported a larger ef- Patients improved significantly on these domains; the fect size on standardised cognitive tests than indepen- largest improvement was seen in the domain of vi- dent trials (Standardized mean difference; 95% CI; sual attention, while executive functioning did not im- p: industry 0.46; 0.37–0.55; < 0.001 vs. independent prove significantly. Receiving cognitive rehabilitation 0.33; 0.18–0.48; < 0.001). A sensitivity analysis re- was not a predictor for improvement. stricted to trials up to 12 weeks duration did not al- DISCUSSION: A differential course of cognitive func- ter the pattern of our results (industry 0.44; 0.34–0.53; tioning was found in the subacute phase after stroke. < 0.001 vs. independent 0.35; 0.18–0.52; < 0.001), The prognosis of visual attention is the most promi- suggesting that the discrepancy does not exist because nent. of different trial durations between industry and in- Posters 385 dependent studies. Our study therefore demonstrates each other, three matched subsamples (N = 24) were that the results of donepezil studies appear to be bi- subsequently drawn from the two patient groups and ased by funding source. This complies with a robust the healthy controls. phenomenon in pharmaceutical research that can and RESULTS: Selective differences in cognitive func- should be identified when treatment effects are re- tion between controls and both clinical subsamples ported. were found. Patients with depression performed significantly less well than the control sample on figural Keywords: Other Functions/Disorders, Dementia, memory, response inhibition and working memory. Pa- Other Methods tients with schizophrenia performed significantly less well on measures of the aforementioned dimensions as Correspondence address: Mr Lewis Killin, University well as on planning, cognitive flexibility and process- of Edinburgh, Psychology, George Square, UK-EH8 ing speed. Schizophrenic patients were significantly 9JZ Edinburgh. United Kingdom. Tel.: +44 079687225 more severely impaired than patients with depression 41; E-mail: [email protected] on attention, memory and executive functions. CONCLUSION: This study indicates two distinct cog- P2.01 nitive profiles for patients suffering from depression and schizophrenia. The results suggest that COGBAT Validation of the computerized Cognitive Basic As- is a promising tool for assessing cognition deficits in sessment test battery (COGBAT): Differences in psychiatric patients and highlight the importance of the neuropsychological test profiles of patients with assessment of a cognitive profile in clinical practice. schizophrenia and depression Keywords: Attention, Depression, Neuropsychological Johanna Egle1, Steffen Aschenbrenner2, Marcel Ber- Assessment and Psychometrics thold1, Rudolf Debelak1, Franziska Pisch1, Katlehn Rodewald3, Daniela Roesch-Ely3, Marco Vetter1 and Correspondence address: Mrs Mag. Johanna Egle, Matthias Weisbrod3 Schuhfried GmbH, Psychology, Hyrtlstraße 45, A- 1Schuhfried GmbH, Psychology, Moedling, Austria 2340 Moedling, Austria. Tel.: +43 22364231548; E- 2SRH Klinikum Karlsbad Langensteinbach, Psychia- mail: [email protected] try, Karlsbad, Germany 3Heidelberg University Hospital, Psychiatry, Heidel- P2.02 berg, Germany Cognitive impairment in a cohort of patients with OBJECTIVES: Cognitive dysfunction is common in multiple sclerosis undergoing inpatient rehabilita- various psychiatric diseases and is linked to impaired tion social, functional and rehabilitation outcomes. The thorough assessment of a patient’s neuropsychological Susanne Glatzl1,ReginaAnker2, Judith Bidner2,Chr- profile is an important first step for planning an inter- istine Hechenberger2, Melanie Klingler2, Christian vention. The Cognitive Basic Assessment test battery Brenneis2 and Rainer Ehling2 (COGBAT) is a new computerized neurocognitive test 1Reha-Zentrum Münster, Austria battery that was developed for routine clinical assess- 2Reha-Zentrum Münster, 6232 Münster, Austria ment. It provides a comprehensive cognitive profile in a short time. The goal of the present study was to eval- BACKGROUND: Multiple sclerosis (MS) is a com- uate the validity of COGBAT by comparing the cogni- plex and heterogeneous disease associated with long- tive profiles of patients with schizophrenia and depres- term disability. Depending on age, disease subtype, sion with those of healthy controls. disease duration and testing battery cognitive dysfunc- PARTICIPANTS AND METHODS: The COGBAT tion is found in 45 to 65 percent of patients with was administered to 65 patients with schizophrenia and MS (pwMS) (Rao et. al. 1997). Processing speed is 65 healthy controls as well as to 32 patients suffer- most often affected, other particularly vulnerable func- ing from depression and their 32 healthy counterparts. tions include memory, complex attention and execu- Each control group was matched for age, gender and tive functions, whereas generalized dementia is rare in educational level. To compare the three groups with pwMS. 386 Posters

OBJECTIVE: In a first step to acquire data on cogni- The ability to respond to multiple simultaneously pre- tive impairment in pwMS undergoing inpatient reha- sented targets is an essential and distinct human skill, bilitation; in a second step to establish a tailored cog- as is dramatically demonstrated in stroke patients suf- nitive test battery. fering from visual extinction. The neural correlates un- METHODS: Extensive neuropsychological testing in- derlying this ability are the topic of continuing debate, cluded memory tests (verbal learning memory test with some studies pointing towards the TPJ whereas and visual memory), tests for executive performance other studies suggest a role for the IPS. We performed (working memory, word fluency, verbal flexibility) and an fMRI study to test the hypothesis that whereas attention test (alertness, divided attention) as well as the IPS is associated both with the top-down direc- questionnaire for depression. tion of attention to multiple target locations and the RESULTS: 65 pwMS (64.6% female) with various dis- bottom-up detection of multiple targets, the TPJ is ease subtypes (clinically isolated syndrome 1.5%, re- predominantly associated with the bottom-up detec- lapsing remitting (RRMS) 40.0%, secondary progres- tion of multiple targets. We used a cued target de- sive (SPMS) 36.9% and primary progressive (PPMS) tection task with a high proportion of catch trials to 21.5%) had a mean disease duration of 13.5 years separately estimate top-down cue-related and bottom- (STD 8.6%) and a mean EDSS of 4.7 (STD 2.4). 84% up target-related neural activity. Both cues and tar- of the pwMS exhibited any cognitive impairment. 44% gets could be presented unilaterally or bilaterally. We of patients showed deficits in verbal long-term mem- performed conjunction analyses to determine the neu- ory (36% RRMS, 58% SPMS, 35% PPMS). Moreover ral anatomy specifically associated with bilateral situa- we found impairments in divided attention 32% (24% tions. Whereas we found no evidence of target-related RRMS, 45% SPMS, 21% PPMS), alertness 28% (28% neural activation specific to bilateral situations in the RRMS, 25% SPMS, 36% PPMS), working memory TPJ, we found both cue-related and target-related neural activation specific to bilateral situations in the right 41% (44% RRMS, 37% SPMS, 41% PPMS) and word IPS, suggesting that both top-down attending to and fluency 30% (44% RRMS, 25% SPMS, 28% PPMS). bottom-up detection of multiple simultaneously pre- CONCLUSION: Using extensive neuropsychological sented targets are governed by the right IPS. testing, about 84% of pwMS undergoing inpatient rehabilitation is suffering from any type of cognitive im- Keywords: Attention, Neglect, Functional and Struc- pairment. In accordance with previous studies deficits tural Neuroimaging/NIRS in verbal long-term memory and executive functions are most common. Percentages of different deficits do Correspondence address: Mrs Bianca de Haan, Zen- not vary between different disease courses. Based on trum für Neurologie, Sektion Neuropsychologie, these data a tailored cognitive test battery for pwMS Hoppe-Seyler-Str 3, D-72076 Tübingen, Germany. undergoing inpatient rehabilitation will be established. Tel.: +49 070712985661; E-mail: bianca.de-haan@ klinikum.uni-tuebingen.de Keywords: Attention, MS/Demyelination, Neuropsy- chological Rehabilitation P2.04

Correspondence address: Mrs Mag. Dr. Susanne Dissociation in optokinetic stimulation sensitivity Glatzl, Reha-Zentrum Münster, Gröben 700, A-6232 between omission and substitution reading errors Münster, Austria. Tel.: +43 5337200045319; E-mail: in neglect dyslexia [email protected] Lisa S. Arduino1, Andrea Albonico2, Manuela Mala- P2.03 spina2, Marialuisa Martelli3, Silvia Primativo3 and Roberta Daini2 Top-down attending to and bottom-up detection of 1University LUMSA and ISTC-CNR, Human Sciences, multiple simultaneously presented targets are gov- Rome, Italy erned by the right IPS 2University Milano-Bicocca, Department of Psychol- ogy, Milan, Italy Bianca De Haan and Hans-Otto Karnath 3University of Rome “La Sapienza” and IRCCS Fon- Zentrum für Neurologie, Sektion Neuropsychologie, dazione Santa Lucia, Department of Psychology, Tübingen, Germany Rome, Italy Posters 387

SPECIFIC GOAL: Although omission and substitu- and hemianopia. Since there is a wide agreement in im- tion errors in neglect dyslexia patients (ND) have been plicit information processing for patients with neglect, always considered as different manifestations of the we hypothesized that a priming word in the neglected same acquired reading disorder, recently, a new dual field should determine a semantic activation effect even mechanism model has been proposed (Martelli et al., when it is not consciously perceived by the patient. On 2011). While omissions are related to the exploratory the contrary if the priming word occurs in a blind hemi- disorder that characterizes unilateral spatial neglect field this should not determine any facilitation effect. (USN, Primativo et al., under revison), substitutions As first step we tested a “locally-dependent” priming are due to a perceptual integration mechanism known effect on healthy subjects in a semantic categorization as crowding (Martelli et al., 2011). A consequence of task. this hypothesis is that specific training for omission- We conducted four experiments in which we modu- type ND would aim at restoring the oculo-motor scan- lated the presence of a string of “X” contralaterally to ning and should not improve reading in substitution- prime position, prime duration (150 vs 300 ms) and type ND. distance from monitor (50 cm vs 100 cm). Prime oc- METHOD: According to this aim we administered curred in six different positions while target appeared an optokinetic stimulation to two brain-damaged pain the center of the screen. Three different prime-target tients with both unilateral spatial neglect and neglect conditions were present: related, unrelated and neutral. dyslexia, MA and EP, who showed ND deficits mainly Twenty healthy subjects took part to the first experi- characterized by omissions and substitutions, respec- ment (prime at 150 ms, 50 cm from monitor); 17 to the tively. MA also showed an impairment in oculo-motor second (prime at 150 ms without contralateral string of behaviour in a non-reading task, while EP did not. X, 50 cm distance); 15 to the third (prime at 300 ms, RESULTS: The two patients presented a dissociation 50 cm from monitor) and 17 to the fourth (prime at 300 with respect to their sensitivity to optokinetic stimula- ms, 100 cm from monitor). Results: we obtained a sig- tion (OKS), so that, as expected, MA was positively nificant main effect of semantic relation (p<0.001) in affected while EP was not. all experiments but not in the first one. We then found CONCLUSION: Our results confirm a dissociation be- a significant main effect of position (p<0.05); in the tween the two mechanisms underlying omission and fourth experiment (prime at 300 ms) this was signif- substitution reading errors in ND patients. Moreover, icant for all the positions of the prime (p = 0.001). they suggest that such a dissociation may extend to the Moreover we observed that priming duration signifi- effectiveness of rehabilitative procedures. cantly affects subjects’ performance with slower RTs. No significances arose between the two distances from Keywords: Attention, Neglect, Neuropsychological monitor. These first results confirmed significant se- Rehabilitation mantic activation effect for different prime positions, specifically a higher prime duration seems to provide a Correspondence address: Mrs Associate Professor Lisa more sensitive task to be used as differential between S. Arduino, University LUMSA and ISTC-CNR, Hu- neglect and hemianopia. man Sciences, P.zza delle Vaschette 110, RM-00195 Rome, Italy. E-mail: [email protected] Keywords: Attention, Neglect, Neuropsychological Assessment and Psychometrics P2.05 Correspondence address: Dr. Matteo Sozzi, Casa di How to differentiate between neglect and hemi- Cura del Policlinico, Dept. of Neuro Rehabilitative anopia. Four experiments on healthy subjects Sciences, via Dezza, 48, I-20144 Milan, Italy. E-mail: [email protected] Matteo Sozzi1, Silvia Pagani2 and Michela Balconi2 1Casa di Cura del Policlinico, Dept. of Neuro Rehabil- P2.06 itative Sciences, Milan, Italy 2Catholic University of Milan, Research Unit in Neu- What is the impact of visuo-spatial neglect on motor ropsychology of Language, Milan, Italy recovery of the upper paretic limb after stroke?

One of the most frequent difﬁculty in neuropsycholog- Tanja C.W. Nijboer1, Boudewijn J. Kollen2 and Gert ical assessment is the differentiation between neglect Kwakkel3 388 Posters

1Utrecht University, Rehabilitation Center de Hoog- P2.07 straat, Experimental Psychology, Helmholtz Institute, Utrecht, The Netherlands The neural basis of reflexive and volitional sac- 2 University of Groningen, University Medical Center cades: evidence from lesion-symptom mapping with Groningen, Department of General Practice, Gronin- stroke patients gen, The Netherlands 3 VU University Medical Center, Rehabilitation Cen- Stephanie Rossit1, Linn Olsen2, Stephen Butler3, Keith tre READE, Department of Rehabilitation Medicine, Muir4 and Monika Harvey2 Department of Neurorehabilitation, Amsterdam, The 1University of East Anglia, School of Psychology, Nor- Netherlands wich, UK 2University of Glasgow, School of Psychology, Glas- The aim of the current study was to investigate the lon- gow, UK gitudinal relationship between improvements of syner- 3University of Strathclyde, Department of Psychology, gism and strength of the upper paretic limb (i.e. mea- Glasgow, UK sured with the Fugl-Meyer-arm (FM-arm) and Motric- 4Southern General Hospital, Institute of Neurological ity Index arm (MI-arm), respectively) and visuo-spatial Sciences, Glasgow, UK neglect during the first 52 weeks post-stroke. The longitudinal association between neglect and motor im- The anti-saccade task is an important task for investi- pairment were measured in an intensive repeated mea- gating the flexible control that we have over behaviour. surement design including 18 measurement sessions In this task, participants must suppress the reflexive for each subject. Neglect was assessed using the let- urge to look at a visual target that appears suddenly in ter cancelation test applied in a prospective cohort of the peripheral visual field and must instead look away 101 ischemic, first-ever, hemispheric stroke patients. from the target. This task has been widely demon- Of these 101 patients, 51 patients showed neglect. All strated to be extremely sensitive to brain injury. Previ- time-dependent measures were taken weekly, starting ous electrophysiology and human neuroimaging stud- within 14 days post stroke. From week 10 to 20 bi- weekly measurements are obtained. The longitudinal ies suggest that the frontal eye fields (FEF) might be relationship of (bi)weekly time on improvement of mo- more involved in anti-saccades than pro-saccades. In tor functions and recovery of neglect was investigated the current study we investigated pro- and anti-saccade using random coefficient analysis and trend analyses. performance in right-hemisphere stroke patients with Results suggest not only that neglect patients show and without left neglect as well as healthy controls. In more severe impairment of motor function (i.e. syner- addition, lesion-symptom mapping was used to inves- gism and strength) at stroke onset, but also that time- tigate the neural basis of the deficits we observed. As dependent recovery of motor impairment follows a dif- expected, we found that neglect patients took signifi- ferent pattern with less improvement for neglect pa- cantly longer to initiate a pro-saccade to a left target tients. Conspicuously, the seemingly inhibitory effect when compared to the healthy and non-neglect groups. of neglect on motor recovery appears to take place However, surprisingly, we found a non-lateralized im- mainly within the time window of spontaneous neu- pairment specific to neglect in the anti-saccade task: in rological recovery of first 10 weeks post-stroke. This response to both left and right targets neglect patients study is the first to disentangle the unique impact presented a high number of erroneous pro-saccades of perceptual-attention networks on the longitudinal when compared to healthy controls and patients with- courses of motor functions in the first months post out neglect. Lesion-symptom analysis revealed that stroke. whilst the pro-saccade deficit was associated with posterior lesions, involving the intraparietal sulcus going Keywords: Attention, Neglect, Neuropsychological into the lateral occipital and angular gyri, the anti- Assessment and Psychometrics saccade deficit was associated with more anterior lesions. In particular, poor anti-saccade performance was Correspondence address: Mrs Tanja C.W. Nijboer, related to lesions in and around the inferior frontal sul- Utrecht University, Rehabilitation Center de Hoog- cus, encompassing white matter in the vicinity of the straat, Experimental Psychology, Helmholtz Institute, FEF, the insula and supramarginal and superior tempo- Heidelberglaan 2, 3584CS Utrecht, the Netherlands. E- ral gyri. These results indicate that neglect is specifi- mail: [email protected] cally accompanied by inhibitory/volitional deficits that Posters 389 are not spatially lateralized. Moreover, it also expands that partially different (attentional) mechanisms under- our understanding of the brain regions critically in- lie the different bisection tasks, and underline the im- volved in the control of reflexive and volitional sac- portance of taking the direction of the initial bias into cades. account when investigating the sensitivity of the attentional bias to prismatic adaptation. Keywords: Attention, Neglect, Neuropsychological Assessment and Psychometrics Keywords: Attention, Neglect, Neuropsychological Assessment and Psychometrics Correspondence address: Mrs Stephanie Rossit, Uni- versity of East Anglia, School of Psychology, EDU Correspondence address: PhD Mariagrazia Ranzini, Building, Norwich Research Park, NR4-7TG Norwich, Université Libre de Bruxelles (ULB,FNRS,CRCN), UK. E-mail: [email protected] Avenue Franklin Roosevelt, 50, 1050 Bruxelles, (Bel- gium). E-mail: [email protected] P2.08 P2.09 Different mechanisms underlie bisection tasks: A prismatic adaptation study Neuropsychological functioning in children with migraine 1 2 Mariagrazia Ranzini , Remy Schmitz , Sophie Anto- 1 1 3 1 Dragana Vucinic and Gordana Mijalkovic-Stojiljko- ine , Sarah Buck and Wim Gevers 2 1Université Libre de Bruxelles (ULB,FNRS,CRCN), vic 1Clinic of Neurology and Psichiatry for Children and Bruxelles, Belgium 2 Youth, Child neurology, Belgrade, Serbia University of Hong Kong, HONG KONG, China 2 3 Clinic of Neurology and Psychiatry for Children and Université Libre de Bruxelles (ULB), Bruxelles Youth, Child Neurology, Belgrade, Serbia Three main tasks are commonly used to evidence a Migraine is associated with alterations in brain struc- consistent leftward visuospatial bias within the healthy ture that are detected via conventional and experi- population. On average, line midpoints are shifted mental imaging techniques. The clinical significance slightly toward the left in the line bisection task (LB), of these abnormalities is not yet clear. The frequency pre-bisected lines are processed as longer on their left and chronicity of the disorder have drown attention side in the landmark task (LDM), and the left side of not anly to the therapeutic issues, but also to progno- equiluminescent mirror pairs of stimuli are perceived sis, particularly to the possible cognitive consequences. as darker on the left in the greyscales task (GS). In- Several neuropsychological studies reported cognitive divudual differences do exist, with some participants changes in children and adolescents with migraine, but showing initial rightward biases. It is also not clear the findings are controversial. whether the different bisection tasks are equally sen- AIM: The aim of the study was to investigate the possi- sitive to prismatic adaptation (PA), a procedure used ble cognitive disfunction in children with migraine, to to shift artificially the visual field and affecting the vi- determine the type and intensity of cognitive dysfunc- suospatial bias both in healthy participants and in ne- tion, and to compare the results with controls. glect patients. Here, we investigated the relation be- METHODS: We investigate 35 children with migraine, tween the different bisection tasks by taking into ac- aged 10-18 years, diagnosed according to the Inter- count the direction of the initial attentional bias, and by national Headache Society criteria. 24 children have looking at the influence of leftward and rightward pris- migraine without aura, and 11 children migraine with matic deviation. Spatial biases were highly consistent aura. The patients were compared with a control group across different measurement moments within a task. of 32 children without headache, mached for age, sex However, no systematic relation between the different and intelligence level based on Wechsler Intelligence bisection tasks was observed. Also the initial bias had Scale for Children (WISC). The battery of neuropsi- an important role. Participants showing an initial left- chological tests was designed to investigate different ward bias were more sensitive to prismatic adaptation cognitive functions. than participants showing an initial rightward bias, as RESULTS: The performance of our patients was not revealed by LB and LDM task. Our results demonstrate homogenous. One third of patients scored within nor- 390 Posters mal limits on all tests. The other migraine patients have can affect spatial representations. Indeed we found that lower cognitive performance on tasks evaluating sus- a leftward aftereffect distorted time toward an under- tained attention, verbal memory and information pro- estimation, while a rightward aftereffect distorted time cessing speed. No strong association of clinical param- toward an overestimation. eters (including frequency of migraine attacks and dis- The posterior parietal cortex (PPC) has been associated ease duration) with results was concluded. either with different processes of PA procedure or with CONCLUSION: Migraine in children is associated the formulation of the spatial representation of time. with mild impairment in several cognitive domains. Thus, the aim of the present study was to investigate Migraine with aura patients display more prominent whether the PPC would have a role in mediating the cognitive changes. The presence of an association be- effects of PA on the spatial representation of time. tween cognitive problems and migraine headacke may Twenty-four right-handed adults performed a time task impact academic learning and daily activities on the (reproducing a duration pressing a key with the right long term. index finger), before and after PA inducing a leftward or a rightward aftereffect, adapting with the right up- Keywords: Attention, Other Disorder/Samples, Neu- per limb. Moreover subjects were stimulated with in- ropsychological Assessment and Psychometrics hibitory rTMS on the left or right PPC before PA. We found an abolition of the effects of PA on time Correspondence address: MD Dragana Vucinic, Clinic when rTMS was delivered on the left and not on the of Neurology and Psichiatry for Children and Youth, right PPC. To exclude that this lateral effect of the left Child neurology, Dr Subotica 6-a Str, SRB-11000 Bel- PPC was due to the fact that subjects responded and grade, Serbia. E-mail: dragana.vucinic.npk@gmail. adapted with their right limb, we conducted a control com experiment where subjects responded and adapted with their left limb. Again the inhibition of the left PPC P2.10 only, abolished the effects of PA on time. This results suggest a direct involvement of the left The left posterior parietal cortex mediates the ef- PPC in mediating the effects of PA on the spatial rep- fects of prismatic adaptation on the representation resentation of time that does not depend on motor proof time durations cesses.

Barbara Magnani1, Francesca Frassinetti2, Giuseppa Keywords: Attention, Other Disorder/Samples, TMS/ Renata Mangano3 and Massimiliano Oliveri4 TCDS 1IRCCS Fondazione Santa Lucia, Department of Clin- ical and Behavioral Neurology, Rome, Italy Correspondence address: Mrs DR Barbara Magnani, 2University of Bologna, IRCCS Fondazione Maugeri, IRCCS Fondazione Santa Lucia, Department of Clini- Castel Goffredo, Department of Psychology; Clinica cal and Behavioral Neurology, Via Ardeatina, 306, D- del Lavoro e della Riabilitazione, Bologna; Castel 00143 Rome, Italy. E-mail: barbara.magnani2@unibo. Goffredo, MN, Italy it 3University of Palermo, Department of Psychology, Palermo, Italy P2.11 4University of Palermo; IRCCS Fondazione Santa Lu- cia, Department of Psychology; Department of Clini- Effects of instructions on hemispheric differences in cal and Behavioral Neurology, Palermo; Rome, Italy preparatory attention

In our previous studies we provided evidence for an Laura Gabriela Fernandez1, Caroline Bichon1 and Eric ascending left-to-right spatial representation of time Siéroff2 durations by means of Prismatic Adaptation (PA). PA 1EA 4468, Neuropsychologie du vieillissement, Paris procedure requires to adapt to the visual shift induced Descartes University, Boulogne-Billancourt, France by prismatic lenses with repeated pointing movements. 2EA 4468, Neuropsychologie du vieillissement, Paris After the adaptation participants show a pointing er- Descartes University, Institut Universitaire de France, ror to the opposite direction of the visual shift (after- Boulogne-Billancourt, France effect) associated with a shift of spatial attention that Posters 391

Preparatory attention (PA) to an impending target- P2.12 stimulus improves its subsequent processing, preventing the interference from distracting events. The inten- Modulation of attention-related EEG parameters sity of PA to a target can be reinforced by a simple by means of attention training? and appropriate instruction. We investigated the capacity of the left and right cerebral hemispheres to rein- Tilmann Klein1, Hellmuth Obrig2, Angelika Thöne- force PA, using a lateralized version of the Attentional Otto3, Arno Villringer2 and Stefan Frisch4 Preparation Test (APT), developed by LaBerge, Au- 1Max-Planck-Institute for Human Cognitive and Brain clair, and Siéroff (2000). We hypothesized that the left Sciences, Neurology, Leipzig, Germany hemisphere plays a crucial role in this instructional re- 2Day Care Clinic for Cognitive Neurology/Max-Planck inforcement by enhancing the distinction between tar- -Institute for Human Cognitive and Brain Sciences, get and distractors and the attentional activity directed Leipzig to the selected target location. Sixty-six neurologically 3Day Care Clinic for Cognitive Neurology, Leipzig healthy subjects participated in this study. A target 4Clinic of the J.W. Goethe-University, Frankfurt (black dot), appearing in the right (RVF) or left visual field (LVF), had to be detected. A distractor might ap- Attention plays a critical role in many different cog- pear in the RVF or LVF, thus directly projecting to the nitive domains. In case of brain damage very often contralateral hemisphere (Experiment 1), or at fixation, deficits in attention can be observed thereby impos- thus projecting to both hemispheres (Experiment 2). ing a need for training of these functions also to allow The proportion of trials containing a distractor varied training in neighboring cognitive domains. The ques- in three blocks (0%, 33%, 67%), in each experiment. tion however, whether or not attention training leads to The intensity of PA directed to the target was manipu- changes in attention-related electrophysiological pro- lated by instruction: weak (simple task description), or cesses, remains mostly unaddressed. strong (reinforcing attention). Responses times (RTs) We therefore included N = 27 participants in our train- were faster under the strong than the weak instruction. ing study (N = 14 training, N = 13 control). Subjects Also, RTs in the strong instruction were faster in the underwent two sessions of EEG (3-stimulus visual RVF than in the LVF when the distractor was lateral- oddball paradigm and Eriksen flanker task) and cog- ized, and were similar in both visual fields when the nitive testing (attention, memory and executive func- distractor was located at fixation. The reinforcement of tions). In between subjects of the training group per- PA by instruction is more efficient in the RVF than the formed 10 sessions of an adaptive computer based LVF, specifically when both targets and distractors are training for selective attention. lateralized. A possibility is that the LH may be crucial While subjects improved their performance in the to enhance PA to a selected spatial location, and to re- training task in terms of a reduction of reactions times duce the interference from distractors. The cooperation (in combination with an increase in false positive re- between hemispheres might ameliorate this process in sponses) no effect of training on the cognitive abili- the RH when the distractor is located at fixation, thus ties of the participants was observed. Amplitudes of the projecting to both hemispheres. P300 were also not sensitive to training. However mi- nor differences in peak latency related to Target stim- Keywords: Attention, Other Disorder/Samples, Other uli at electrode Pz were observed between training and Methods non-training group. Correlation-analysis revealed differential relationships between P300 amplitude and la- Correspondence address: Mrs Laura Gabriela Fernan- tency and measures of cognitive function and training dez, EA 4468, Neuropsychologie du vieillissement, performance. Paris Descartes University, 71 avenue Edouard Vail- It might be speculated that duration and intensity of the lant, F-92774 Boulogne-Billancourt, France. E-mail: attention training might have been not sufficient to pro- [email protected] mote changes in attention-related electrophysiological processes. Also inclusion of healthy participants might have limited the amount of possible improvements. An alternative explanation might be that the task used for deriving P300 amplitudes was too easy so no benefit from training could be inferred. Replication of the 392 Posters study using more complex tasks and a sample of pa- negative scale and PANSS general psychopathology). tients suffering from attention deficits is planned. Many studies have demonstrated that schizophrenic patients show deficits in their day living functioning. Keywords: Attention, Other Disorder/Samples, Elec- Our research found significant correlations between trophysiology (EEG/ERP) this functioning and sustained attention performance. So, we suggest that attention deficits could explain part Correspondence address: Dr. Tilmann Klein, Max- of this impairment and would be a good measure to Planck-Institute for Human Cognitive and Brain Sci- predict poor outcome. ences, Neurology, Stephanstrasse 1a, D-04103 Leipzig, Germany. E-mail: [email protected] Keywords: Attention, Psychopathology, Neuropsycho- logical Assessment and Psychometrics P2.13 Correspondence address: Mr Sergio Bodas, Consorci Sustained attention and real world daily living skills Sanitari de Terrassa, Doctor Pearson, 85 2nd 1, Spain- in schizophrenic patients 17527 Terrassa, Spain. Tel.: +34 669931045; E-mail: [email protected] Sergio Bodas1, Arantzazu Herran-Boix1, Mireia Gon- zalez-Rodriguez1,MarAriza2 and Maite Garolera1 P2.14 1Consorci Sanitari de Terrassa, Spain 2Unitat d’Investigació biomèdica Universitat RevArte Visual Search Task: A sensitive computer- Autònoma de Barcelona-CST (UIB), Terrassa, Spain ized visual search test using touch-screen technology Schizophrenia is a highly disabling disorder that hampers the social functioning of the affected individuals. Christophe Lafosse1,IlkeDeSmet1, Ben Vaessen2 and It is well known that cognitive impairment, particularly Lut Dereymaeker3 in the attention domain, is related to this poor outcome, 1Rehabilitation Hospital RevArte and KU Leuven – but more research is needed to understand the nature Neuropsychology, Edegem, Belgium and implications of this association. Therefore, the aim 2Diagnoseis – Assessment and technology, Maastricht, of this study was to explore the relationship between The Netherlands sustained attention and real world daily living skills in 3Rehabilitation Hospital RevArte – Medicine, Edegem, these patients. This was a cross-sectional study, car- Belgium ried out with clinically stable patients meeting DSM- IV criteria of schizophrenia. 67 schizophrenic patients INTRODUCTION: Computer-based tasks provide (73% males), treated with neuroleptics and stabilized, more sensitive and accurate measurements of different mostly single (79%) and unemployed (85%), with a performance indexes or parameters. We developed a mean age of 33 (SD 8 years), were enrolled. Sustained computerized visual search (RVST) task by which the attention was assessed using the Continuous Perfor- patient has to search the presence of some predefined mance Test (CPT), while daily living functioning was target patterns in a visual display consisting of many explored with the Living Skills Profile (LSP). Addi- distractor-stimuli. As target detectability depends on tional demographic and clinical information (Positive the spatial properties of the target and the positional and Negative Syndrome Scale, PANSS) was collected uncertainty and the number of distractor stimuli, we to discriminate eventual confusional effects. After pro- hypothesize that the RVST is sensitive for hemispatial cessing all data, strong correlations were found be- differences as a result of lateralized attentional disfunc- tween LSP total score and CPT omission errors r = tions in the contralesional hemifield. −0.491 (p = 0.0001), CPT commission errors r = METHOD: 20 patients with either a left or right hemi- −0.382 (p = 0.001), CPT perseverations r = −0.282 spheric stroke, with and without evidence for unilat- (p = 0.021) and CPT detectability r = 0.336 (p = eral neglect, participated in the study. All visuomotor 0.006). All these results (except for the CPT commis- responses were registrated in peri-personal space using sion errors) remained significant even after being con- a 22 inch digital tablet (DIN A3) (www.diagnoseis.nl). trolled by the intellectual level (vocabulary, WAIS-III) For each trial, subjects were instructed to indicate all and clinical symptoms (PANSS positive scale, PANSS the (contrabalanced) predefined target patterns in a vi- Posters 393 sual display. For each trial, response times and spatial etal (conflict) slow positivity (SP)) were expected to be co-ordinates of the touched patterns were recorded and altered by the cue validity. The behavioral data analy- registrated. This allowed for the calculation of numer- sis did not show an advantage for valid cues, presum- ous indexes, such as accuracy and latency indexes, as ably due to a ceiling effect. In contrast to invalid cues, well as a record of the exploratory pathway in function valid cues resulted in an N450-like component but no of the left and right hemifield. conflict SP. The absence of the conflict SP may suggest RESULTS: ANOVA, independent sample t-tests and that conflict processing could successfully be inhibited Chi-squared tests on the response times and spatial at an early stage of information processing. This find- co-ordinates of the touched patterns, discriminated being corroberates the assumption that focused feature- tween the different patient groups with and without ne- based attention might lead to more effective attention glect or contralesional inattention. selectivity. CONCLUSION: The RVST is able to provide quantitative coefficients related to the spatio-temporal as- Keywords: Attention, Electrophysiology (EEG/ERP) pects of the visuo-motor exploratory behavior of the subjects, which are sensitive for lateralized spatial at- Correspondence address: M.Sc. Julia Siemann, De- tentional imbalances. partment of Neuropsychology and Behavioral Neuro- biology, University Bremen, Hochschulring 18, 28359 Keywords: Attention, Stroke, Neuropsychological As- Bremen, Germany. Tel.: +49 0421 218 68743; E-mail: sessment and Psychometrics [email protected]

Correspondence address: Prof. Dr. Christophe Lafosse, P2.16 Rehabilitation Hospital RevArte and KU Leuven, Neu- ropsychology, Drie Eikenstraat 659, B-3500 Edegem, Does lateralized neglect change towards general- Belgium. Tel.: +32 32106090; E-mail: Christophe. ized inattention during a six-month follow-up? [email protected] Laura Nurmi and Mervi Jehkonen P2.15 University of Tampere, School of Social Sciences and Humanities, University of Tampere, Finland Feature-based attentional cueing modulates neural patterns of conflict processing in the Stroop Task OBJECTIVE: The aim was to find out whether lateralized neglect changes towards generalized inattention Julia Siemann, Manfred Herrmann and Daniela Gala- during a six-month follow-up by comparing the loca- shan tion of omissions in Behavioural Inattention Test (BIT) Department of Neuropsychology and Behavioral Neu- cancellation tasks in two neglect groups after brain in- robiology, University Bremen, Bremen, Germany farct. METHODS: The study included 33 infarct patients The traditional view on interference effects induced by with visual neglect and 62 healthy subjects (H). The irrelevant distractors focuses on parallel processing of location of omissions was compared in three BIT can- incoming information and a late locus of attentional cellation tasks. Based on location a laterality index selection. However, recent studies have shown that the ranging from 0 to 1 was calculated for each subject interference effect will decrease when a cue stimulus at the acute phase and at six months. The neglect pa- indicates the relevant stimulus location. In the present tients were divided into two groups according to their study, the efficacy of feature cues directing attention to acute phase laterality index. LN group patients showed one feature of a multidimensional stimulus array was lateral performance, while in the NLN group perfor- examined. A variant of the color-word Stroop task was mance was symmetrical. The sum scores of the three applied, and the color of the target stimulus was validly BIT cancellation tasks were compared between the or invalidly cued. It was hypothesized that previous three groups to determine the severity of inattention. knowledge about the relevant dimension would lead to RESULTS: The LN group included 12 patients and the an earlier inhibition of processing of irrelevant infor- NLN group 21 patients. At the acute phase sum scores mation. EEG data from 12 participants were analyzed. were significantly lower in the LN group than in the Both Stroop-related ERP components (N450 and pari- NLN group. The laterality indices of the LN and the 394 Posters

NLN groups differed significantly at the acute phase, Oliveri et al. have conducted numerous studies focused but no longer at six months. The LN group showed on ameliorating the symptoms of neglect in brain dam- a significant change from lateral towards symmetrical age patients both with single pulse TMS (e.g. Oliv- performance during the follow-up. However, no gener- eri et al., 1999; Oliveri et al., 2000) and rTMS (e.g. alized inattention was found in the LN group after six Oliveri et al., 2001; Brighina et al., 2003). Applying months, as the sum scores for the LN group and the H high rTMS online protocol, they observed that rTMS group did not differ significantly after the follow-up. In over parietal intact hemisphere reduced symptoms in the case of two LN patients who according to the sum neglect patients (Oliveri et al., 2001). scores still showed visual inattention after six months, Brighinia et al. (2003) employed low frequency rTMS performance changed from lateral towards symmetri- and applied it to neglect patients over two weeks. The cal during the follow-up. performance in attentional tasks was better after treat- CONCLUSION: In most patients, lateral neglect re- ment and this improvement remained stable 15 days covered fully during the follow-up and neither lat- later. eralized nor generalized inattention was found after Shindo and co-workers (2006) and Song et al. (2009) six months. However, in those cases where inatten- also found a significant improvement with low fre- tion was still present at six months, lateralized neglect quency rTMS in attentional tasks and daily living ac- had changed towards generalized inattention during tivities in neglect patients. These benefits lasted 2–6 the follow-up. weeks. Although there is quite evidence for consider TMS Keywords: Attention, Neglect, Neuropsychological as a new therapeutic tool, further research with both Assessment and Psychometrics healthy subjects and clinical samples remains essential to know the real TMS potential in the rehabilitation of Correspondence address: Mrs MA Laura Nurmi, Uni- neglect. versity of Tampere, School of Social Sciences and Hu- manities, Kalevantie 5, D-33014 University of Tam- Keywords: Attention, Neglect, TMS/TCDS pere, Finland. Tel.: +358 0503549432; E-mail: laura.j. nurmi@uta.fi Correspondence address: Mrs Elena M. Marron, Uni- versitat Oberta de Catalunya, Psychology-Neuroscien- P2.17 cies, Roc Boronat 117, D-08018 Barcelona, Spain. E- Transcranial magnetic stimulation: A new rehabil- mail: [email protected] itation tool for neglect P2.18 Elena M. Marron1 and Diego Redolar-Ripoll2 1Universitat Oberta de Catalunya, Psychology-Neuro- Linguistic and visuo-perceptual modulations in sen- sciencies, Barcelona, Spain tence bisection: Evidence from patients with spatial 2Universitat Oberta de Catalunya, Neurosciences, neglect Barcelona, Spain Laura Veronelli1, Maria T. Guasti2, Lisa S. Arduino3 and Giuseppe Vallar2 For many years clinical research has been conducted to 1 develop new and effective rehabilitation strategies for Casa di Cura Privata del Policlinico, Neuro-Rehabili- neglect. Nowadays, rTMS is an important tool in this tative Sciences, Milan, Italy 2 regard, and it should be considered as a therapeutic in- University of Milano-Bicocca, Psychology, Milan, tervention in combination with conventional therapeu- Italy 3 tic approaches. Lumsa University, Rome, Italy The positive outcomes of treatment of neglect and extinction based in the stimulation over the contralesional In a line bisection task right-brain-damaged patients hemisphere started in the last 90’ and first years of the with unilateral spatial neglect (USN) show a rightward XXI century (e.g. Brighina et al., 2003; Oliveri et al., deviation with respect to the objective midpoint of the 2001) and they still continue (e.g. Koch et al., 2008; stimulus. By contrast, unimpaired participants (UP) re- Nyffeler et al., 2009; Shindo et al., 2006; Song et al., port a slight leftward bias (‘pseudoneglect’). Recent 2009). studies with USN patients and UP (Arduino et al., Posters 395

2010; Veronelli et al., in press) suggested the existence Job burnout is a significant cause of decreased work- of partially independent mechanisms involved in word ing capacity, concerning over 25% of working peo- bisection, not only linguistic but also visuo-perceptual. ple. In working life, demands on various cognitive Furthermore, the linguistic information contained in functions such as attention and working memory are the final part of a word was shown to modulate the bi- present on a daily basis. However, studies on cogni- section performance in both UP and USN patients. The tion and burnout are scarce, and have mainly concen- present study investigated whether and how linguis- trated on traditional neuropsychological assessment tic features modulate manual bisection of sentences methods. The findings reported have been non-specific in USN patients. In Experiment I, 8 USN patients to burnout. Studies on neural mechanisms in burnout (N+), 8 right brain-damaged patients without neglect are almost absent. In our research, we studied atten- (N-) and 8 matched controls (C) were asked to set tion and memory, by means of neuropsychological the subjective mid-point on sentences differing in their tests, and by recording electroencephalogram/event- syntactic structure (wh- questions with the mandatory related potentials (EEG/ERP) with a series of ERP object in final or initial position of a sentence, yes- paradigms. The participants (N = 67) were currently no questions, affirmative sentences), as well as let- working people from two groups: burnout (N = 41), ter strings and lines of comparable length, as control and healthy controls (N = 26). The groups were conditions. In Experiment II, 6 N+ patients and 6 C matched on age, gender, education, and working expe- were required to bisect affirmative clauses, interroga- rience. For pre-attentive auditory processing, a newly tive clauses, sentences with lexical and syntactic vio- modified version of the multi-feature MMN paradigm lations, as well as letter strings and lines. In both ex- was used to record change-detection responses to var- periments, N+ patients showed an overall rightward er- ious changes in natural speech sounds. In addition, we ror, larger than that exhibited by controls, modulated added novelty-like emotional variants of the standard by stimulus type. Post-hoc tests revealed strong right- to achieve an attention-catching effect. The ERP reward deviations with lines, moderate with letter strings sults showed that, between the two groups, there were and slight with all types of sentences, even those in differences in the P3a amplitudes and latencies, but not which lexical and syntactic violations were introduced. in the MMN responses. In neuropsychological tests, In conclusion, the linguistic nature of the stimulus in- performance in recalling a word list after hearing it duces facilitation in USN patients during bisection, re- only once was significantly impaired in the burnout ducing the rightward bias found with lines. Globally, group as compared with the controls. No other differ- both linguistic and visuo-perceptual mechanisms influences were found between the groups in working mem- ence the bisection of sentences in spatial neglect. ory, arithmetic tasks, vocabulary or delayed recall. We conclude that the pre-attentive change-detection is in- Keywords: Attention, Neglect, Neuropsychological tact, whereas the attention allocation to novel auditory Assessment and Psychometrics information is altered in burnout. The results indicate that the current clinical neuropsychological methods Correspondence address: Mrs Laura Veronelli, Casa seem to be insensitive to verify the subjectively expe- di Cura Privata del Policlinico, Neuro-Rehabilitative rienced symptoms of job burnout, but the reduced at- Sciences, via Dezza 48, I-20144 Milan, Italy. E-mail: tention allocation can be shown by methods of brain [email protected] research.

P2.19 Keywords: Attention, Other Disorder/Samples, Elec- trophysiology (EEG/ERP) Attention allocation is impaired in job burnout Correspondence address: Mrs MA (Psych.), Resear- Laura Sokka, Satu Pakarinen, Marianne Leinikka, cher Laura Sokka, Finnish Institute of Occupational Jussi Korpela, Kiti Müller and Minna Huotilainen Health, Brain and Technology, Topeliuksenkatu 41 a Finnish Institute of Occupational Health, Brain and A, FIN-00250 Helsinki, Finland. Tel.: +358 43 824 Technology, Helsinki, Finland 5039; E-mail: laura.sokka@ttl.ﬁ 396 Posters

P2.20 Keywords: Attention, Other Disorder/Samples, Func- tional and Structural Neuroimaging/NIRS Frontal volume reductions related to inattention and impulsivity in obese adolescents Correspondence address: Mrs Idoia Marqués-Iturria, University of Barcelona, Pg Vall d’Hebron 171, 08035 Idoia Marqués-Iturria1, I. García-García1, P. González- Barcelona, Spain. E-mail: [email protected] Tartière1,M.A.Jurado1, M. Garolera2, B. Segura1,M. Vernet 2, M.J. Sender2 and R. Pueyo1 P2.21 1University of Barcelona, Spain 2Consorci Sanitari de Terrassa Effects of broken affordance on visual extinction

Increasing evidence suggests frontal dysfunctions re- Melanie Wulff1 and Glyn W. Humphreys2 lated to obesity. In addition, eating disorders present 1University of Birmingham, School of Psychology, comorbidity for inappropriate attention and impulsive- Birmingham, United Kingdom ness. The aim of this study was to assess frontal 2Department of Experimental Psychology, University brain volumes in adolescent obesity and to investigate of Oxford, Oxford, UK whether frontal structure was related to attention and impulsivity. Twenty-five adolescents (16 obese and 9 Previous studies have shown that visual extinction can controls) between 12 and 19 ages (obesity: 13.88 ± be reduced if two objects are positioned to ‘afford’ 2.16 years, 5 males/11 females; control: 14.78 ± an action (Riddoch, Humphreys, Edwards, Baker and 2.22 years, 4 males/5 females) participated in this Willson, 2003). Here we tested if this affordance ef- study. Frontal volumes were obtained with the auto- fect was disrupted by ‘breaking’ the affordance – if the mated procedure implemented on Freesurfer for cor- object actively used in the action had a broken handle. tex parcellation and then corrected dividing each vol- We assessed the effects of broken affordance on re- ume by corresponding intracranial volume. Number of covery from extinction in five neuropsychological pa- omissions and commissions on the Continuous Per- tients with pairs of objects positioned for left-handed formance Test were used as attention and impulsiv- and right-handed actions. Patients viewed object pairs ity scores. There were no group differences on demo- that were or were not commonly used together. In the graphic characteristics, yet age was included as co- unrelated pair conditions, either two tools or two ob- variate in all analyses in order to minimize its effect jects were presented. To disrupt the effect of action re- on adolescent changing brain. Frontal volumes were lations, we presented object pairs either with or with- compared between groups by ANCOVA, and partial out a broken handle. In line with previous research correlation analyses were performed to assess atten- (e.g., Riddoch et al., 2006), recovery from extinction tion/impulsivity scores’ relation with frontal structure. was greater for action-related than for unrelated pairs. Results with p 0.01 were considered significant. Interestingly, the advantage for action-related objects Lateral orbitofrontal, medial orbitofrontal and pars or- over unrelated tools was apparent only when both han- bitalis in right hemisphere were reduced in obese group dles were intact (unbroken handle condition) but not compared to controls. Regarding attention/impulsivity, when the tool handle was broken (broken handle condi- there were no group differences in CPT performance tion). Notable the advantage for action-related objects (obesity: omissions = 11.88 ± 12.75, commissions = over unrelated objects was not affected by the handle 23.69 ± 7.19; controls: omissions = 3.33 ± 3.00, com- completeness. In addition, patients reported more pairs missions = 17.78 ± 8.18). In obese group medial or- when the stimuli were oriented for left-handed (in- bitofrontal and pars orbitalis were negatively related congruent) than for right-handed (congruent) actions, to number of commissions (r = −0.705, p = 0.003; regardless of the object pair condition. Surprisingly, r = −0.693; p = 0.004), while lateral orbitofrontal the effect of hand congruence was absent with broken volumes were negatively related to number of omis- stimuli. The data provide further support for visual and sions (r = −0.641; p = 0.010). All in all, our study motor-related responses to affordance, with the effect shows reduced frontal brain regions related to inatten- being sensitive to handle completeness. tion and impulsivity that could be explained by a deficient cognitive control mechanism evident in obese Keywords: Attention, Stroke, Neuropsychological As- adolescence. sessment and Psychometrics Posters 397

Correspondence address: Mrs Melanie Wulff, Univer- ship between the elevated PCS ratings of parents of sity of Birmingham, School of Psychology, Edgbaston, mTBI children and working memory performance at UK-B15 2TT Birmingham, United Kingdom. E-mail: T3 might indicate that in everyday life working mem- [email protected] ory problems actually may exist and possibly affect school performance in some children. P2.22 Keywords: Attention, Traumatic Brain Injuries, Neu- Subtle attentional problems and elevated postcon- ropsychological Assessment and Psychometrics cussive symptoms in children after mild traumatic brain injury Correspondence address: Mrs Martina Studer, Depart- ment of Pediatric Neurology, Development and Re- Martina Studer1, Barbara Goeggel Simonetti2, Alexan- habilitation, University Children, Inselspital, CH-3010 der Joeris2, Steffen Berger2, Maja Steinlin2, Claudia Bern, Switzerland. E-mail: [email protected] Roebers3 and Theda Heinks2 1Department of Pediatric Neurology, University Chil- P2.23 dren, Development and Rehabilitation, Bern, Switzer- land Functional impairment of lateral occipital cortex 2University Children’s Hospital, Bern contralateral to the lesion in a patient with visual 3University of Bern object agnosia

Although recent studies have repeatedly shown that Radek Ptak1, Francois Lazeyras2, Armin Schnider2, mild traumatic brain injuries (mTBI) only subtly affect Stephane Simon2 and Marie Di Pietro2 children’s neurocognitive functioning, there is growing 1University Hospital Geneva, Division of neuroreha- evidence, that children with mTBI display more post- bilitation, Geneva 14, Switzerland concussive symptoms (PCS) in terms of somatic, cog- 2University Hospital Geneva, Switzerland nitive and emotional complaints in the weeks after injury. The aim of this ongoing prospective short-term BACKGROUND: Patients with visual object agnosia longitudinal study was to focus on working memory (VOA) fail to recognize the identity of visually pre- and attentional skills as well as on the trajectory of PCS sented objects despite preserved semantic knowledge. in children (age 6–16 years) after mTBI and mild or- Current accounts of the disorder postulate subtle visual thopedic injuries (OI). PCS were rated by the parents impairments, a deficit of form integration, or a seman- of mTBI children (n = 46, mean age at injury: 10.9 tic deficit confined to visual information. Though most years) and OI children (n = 35, mean age at injury: patients have damage involving right or left occipito- 10.3 years) at four points in time T0 = at injury, T1 temporal cortex it is unknown to what extent specific = 1 week after, T2 = 4 weeks after, T3 = 16 weeks extrastriate areas contribute to the expression of VOA. after injury. Working memory performance and sus- METHODS: We tested 4 healthy participants age- tained attention were measured at T2 and T3. Prelimi- matched to patient AL, who has VOA following a nary results of this study reveal that in the first weeks stroke affecting the left fusiform, lingual and inferior after the injury, parents of children after mTBI ob- occipital gyri. We measured fMRI BOLD responses serve significantly more PCS compared with parents of evoked by objects, faces or scrambled pictures. the OI patients. While working memory performance RESULTS: The patient identified 46% of 260 visually is comparable between mTBI and OI children at both presented line drawings, compared to 95% correct re- times (T2, T3), mTBI children present with more com- sponses to verbal description of the same items. He mission errors during the sustained attention test. Fur- produced satisfactory copies of objects that he was un- thermore, a significant negative relationship between able to identify. When asked to decide which of three the PCS score and working memory performance at objects belonged to the same category (e.g. two fruits), T3 has been found for the mTBI group only. The re- he was biased toward choosing the two visually similar sults of this study show that in the weeks following objects (e.g. an orange and a ball). In addition, when the incident, mTBI children present with subtle atten- asked to indicate whether an array of objects contained tional problems but no working memory impairment in a given item (e.g. a button), he mostly chose a visual standardized cognitive testing. The negative relation- distracter (e.g. a wheel), but rarely a semantic or neu- 398 Posters tral distracter. While healthy participants showed ro- mit more errors in mirror reading and reading back- bust activations of the lateral occipital cortex (LO) to wards text on paper, in executing directional actions, objects as compared to scrambled pictures no such ac- and in left-right discrimination, nor did she perform tivation was observed either in the left (damaged) or differently when asked to write under the surface of a right (preserved) LO of AL. table or in writing with transparent titles. However, un- CONCLUSION: These results show that VOA is asso- der dictation (8 words) she reversed two individual let- ciated with a bilateral dysfunction of the LOC, even if ters and one whole word, whereas the performance of structural damage is unilateral. The finding that visual the controls was flawless. identification errors mainly reflected global visual sim- CONCLUSION: MW is a rare occurrence in MCI. The ilarity suggests that the LOC contains representations case of F.C. cannot be interpreted as resulting from a of distinct object classes organised according to their perceptual impairment, her performance is more easily form. accounted for by a deficit in the motor transformation of the engrams to be written with the non dominant Keywords: Perception, Agnosia, Functional and Struc- hand or an impairment of the monitoring of directional tural Neuroimaging/NIRS errors.

Correspondence address: Mr PhD Radek Ptak, Univer- References sity Hospital Geneva, Division of neurorehabilitation, [1] McIntosh R.D., Della Sala S. (2012). Mirror-writing. The Psy- 26, av. de Beau-Sejour, CH-1211 Geneva 14, Switzer- chologist, 25: 742–6 [2] Balfour S, Borthwick S, Cubelli R, and Della Sala S. (2007). land. Tel.: +41 223823524; Fax: +41 223828338; E- Mirror writing and reversing single letters in stroke patients and mail: [email protected] normal elderly. Journal of Neurology, 254: 436–441

P2.24 Keywords: Perception, Mild Cognitive Impairment, Neuropsychological Assessment and Psychometrics Mirror writing in MCI patients and normal elderly

1 2 Correspondence address: Mrs Clara Calia, Queen Mar- Clara Calia , Robert D McIntosh ,MariaFaraDe- garet University, Division of Psychology and So- 3 2 Caro and Sergio Della Sala ciology, Queen Margaret University Drive, Mussel- 1 Queen Margaret University, Division of Psychology burgh„ UK-EH21 6UU Edinburgh, UK. Tel.: +44 and Sociology, Edinburgh, UK 07906194175; E-mail: [email protected] 2University of Edinburgh, Human Cognitive Neuro- science, Psychology„ Edinburgh, UK P2.25 3University of Bari, Department of Basic Medical Sci- ences, Neurosciences and Sense Organs, Bari, Italy Effects of repetitive galvanic vestibular stimulation on neglect OBJECTIVE: The aim of this study was to evaluate the presence of MW in patients with Mild Cognitive Ingo Keller1 and Katharina Volkening2 Impairment (MCI) compared to elderly volunteers 1Schoen Klinik Bad Aibling, Neuropsychology, Bad MATERIALS AND METHODS: 24 MCI and 21 Aibling, Germany healthy controls underwent a screening for MW. 2Ludwig-Maximilians University, Department of Gen- RESULTS: No group difference emerged. MW of indi- eral and Experimental Psychology, Munich, Germany vidual letters was observed in 3 MCI patients, but also in 6 controls. However, one individual (F.C.) with MCI Patients suffering from spatial neglect, exhibit none showed overt and severe MW when writing with her or deﬁcient orienting and responding to stimuli in left hand. She (50 y. old, 7 y. of education) was not contralesional space. This greatly hampers the reha- an outlier in terms of severity of cognitive impairment bilitation process. Recent studies have demonstrated or any other clinical or demographic variable. She and that symptoms are alleviated during galvanic vestibular a matched control group of 6 women were further as- stimulation (GVS). However, only online and single- sessed with a comprehensive battery of tests aimed at session effects were examined. This randomized con- investigating her MW. She was much slower than the trolled study investigated the effects of repetitive GVS controls but as accurate in all tests. She did not com- on spatial neglect. Posters 399

Treatment consisted of 10–12 sessions of GVS (1.5 mentation. There is no obvious connection between mA, 20 min) and simultaneous visual search training, cognitive symptoms of Parkinson’s Disease and event with three stimulation conditions: cathode on the right segmentation. mastoid (CR), on the left mastoid (CL) and sham stim- The present study therefore tested the hypothesis that ulation. Stimulation effects were assessed with the fol- PD patients are not disorganized or compromised in lowing measures: Behavioral Inattention Test (BIT), a their segmentation behaviour. To that end, 16 PD pa- visual-tactile search task (VST), the subjective visual tients - tested both on and off L-Dopa medication - and (SVV) and tactile vertical (STV). Measures were as- 16 healthy matched controls repeatedly segmented a sessed before, immediately after, as well as 2 and 4 set of action movies in an internally guided self-paced weeks after the stimulation period. fashion. Preliminary results of 16 patients (6 CL, 5 CR, 5 For each movie, we estimated the probability of a re- Sham) show similar improvements on the BIT and sponse at any given time, using a Fourier basis to gen- VST immediately after treatment. However, additional erate the probability density function. To avoid a null- improvements were found for both GVS conditions un- hyopthesis testing fallacy, we then trained a collection til 2 weeks after stimulation. Repetitive left-, and right- of common classifiers (e.g. support vector machines) cathodal GVS combined with visual search training on these probability functions, and tested their pre- led to immediate and long-term alleviations of neglect dictive accuracy through cross-validation. Additionally symptoms. Hence, transmastoid GVS seems to be a we calculated within session correlations for healthy promising approach to treat spatial neglect. controls and PD patiens on and off – medication. The classifier results indicate that the PD patient’s re- Keywords: Perception, Neglect, TMS/TCDS sponse behaviour is not different from healthy controls and does not differ according to medication status. Correspondence address: Prof. Dr. Ingo Keller, Schoen The high correlation values show that segmentation be- Klinik Bad Aibling, Neuropsychology, Kolbermoor- haviour is not less organized in PD, challenging the no- erstrasse 72, D-83043 Bad Aibling, Germany. Tel.: +49 tion that action segmentation depends on dopaminergic 8061 -9031590; E-mail: [email protected] prediction errors. P2.26 Keywords: Perception, Neurodegenerative Diseases, Neuropsychological Assessment and Psychometrics PD patients show intact action segmentation – a su- port vector machine approach on clinical data investigating uncompromised abilities Correspondence address: Dr. Anne-Marike Schiffer, Department of Experimental Psychology, University of Anne-Marike Schiffer1, Alejo J Nevado-Holgado1 and Oxford, South Parks Road, GB-OX13UD Oxford, UK. Ricarda I Schubotz2 E-mail: [email protected] 1Department of Experimental Psychology, University of Oxford, Oxford, UK P2.27 2Westfaelische Wilhelms – Universitaet – Institut fuer Psychologie, Muenster, Germany Unseen fearful faces influence early facial encoding

1 2 2 In extention of predictive accounts of perception it has Caterina Bertini , Roberto Cecere , Martin Maier and 2 been proposed that segmenting the incoming sensory Elisabetta Làdavas 1 stream into discrete events relies on a mismatch be- Department of Psychology, University of Bologna, tween current predictions and the sensory input. In ref- Bologna, Italy 2 erence to dopaminergic reward prediction errors, it has University of Bologna, Italy been suggested that the hypothesized mismatch signals are dopamine-dependent. Since Parkinson’s Dis- Threat-related signals are processed not only via stri- ease (PD) results from a loss of dopaminergic midbrain atal cortical areas, but also via a subcortical colliculo- cells, PD patients could be impaired in event segmen- pulvinar-amydala pathway, which presumably meditation. ates implicit processing of fearful stimuli. To investi- However, midbrain dopaminergic or striatal activity gate the role of implicit fear processing mediated by has never been reported in fMRI studies on event seg- the subcortical pathway at the early stages of facial 400 Posters encoding, we examined the ERPs elicited by fearful MS treatment (Bolognini et al, 2005) to a sample of and happy faces presented to the intact visual field of seven hemianopia participants for 4 hours daily, over right and left hemianopic patients, while fearful, happy a period of nearly 2 weeks and we collected both be- or neutral faces were concurrently presented in their havioural and electrophysiological data, before and af- blind field. The results showed that in patients with le- ter the intervention, in order to index the stimulation sions to the left hemisphere, the N170 amplitude was effects. The results showed an improvement of visual significantly increased only when a fearful face was oculomotor exploration that allowed patients to effi- presented in the blind visual field concurrently with ciently compensate for the loss of vision. In addition, a happy face in the intact visual field. This enhance- amplitudes of P3 event related potentials elicited by a ment of facial encoding suggests a specialization of the simple visual detection paradigm were significantly re- subcortical pathway in processing unseen fearful stim- duced after the treatment when the stimuli were pre- uli. In addition, the lack of modulation with concur- sented to the intact field. The behavioural improvement rent seen fearful faces reveal that the conscious per- in the hemianopic field, and ERP amplitude reduction ception of fear might inhibit the activation of the sub- in the intact field, can be explained as driven by a shift cortical pathway. The modulation was only observed in spatial attention away from the hyperactivated intact in patients with left hemisphere lesions, which favors visual field. the hypothesis that implicit processing of fearful signals (mediated by the subcortical pathway) is possible Keywords: Perception, Other Disorder/Samples, Elec- only when the right hemisphere is intact. trophysiology (EEG/ERP)

Keywords: Perception, Other Disorder/Samples, Elec- Correspondence address: Mrs Caterina Bertini, De- trophysiology (EEG/ERP) partment of Psychology, University of Bologna, Viale Berti Pichat 5, D-40127 Bologna, Italy. E-mail: cate- Correspondence address: Mrs Caterina Bertini, De- [email protected] partment of Psychology, University of Bologna, Viale Berti Pichat 5, D-40127 Bologna, Italy. E-mail: cate- P2.29 [email protected] Interhemispheric transmission in hemianopic pa- P2.28 tients: A role in visual recovery?

The effects of a multisensory training for visual Alessia Celeghin1, Matteo Bendini2, Tommaso Posco- field defects on spatial attention liero1, Silvia Savazzi1 and Carlo Alberto Marzi1 1University of Verona, Department of Neurological, Caterina Bertini1, Neil Dundon2, Martin Maier2 and Neuropsychological, Morphological and Movement Elisabetta Làdavas2 Sciences, Verona, Italy 1Department of Psychology, University of Bologna, 2Treviso Hospital, Department of Neuroradiology, Tre- Bologna, Italy viso, Italy 2University of Bologna, Italy In the present study we assessed the possibility that The aim of the study is to assess the neural mecha- an important role for recovery of homonymous hemi- nisms underlying the recovery of visual function af- anopia resulting from damage to the visual cortical ar- ter multisensory stimulation (MS) in hemianopic pa- eas might be played by a cross-talk between the in- tients. As a result of a hyperactivation of the intact and the lesioned hemisphere through the cerebral tact hemisphere, with concurrent hypoactivation of the commissures. One specific question that we tackled damaged hemisphere, patients focus their attention on was the extent of interhemispheric transfer of visual the ipsilesional field and the contralesional field lacks information as a function of the location of the le- sufficient attentional resources. The unbalanced ex- sion causing hemianopia. Together with healthy con- citability of the two hemispheres can be restored by a trol participants, we tested two chronic hemianopic pa- multisensory stimulation, mediated by the collicular- tients: LS with a lesion roughly restricted to V1 and extrastriate pathway, which largely contributes to spa- AE with a more anterior lesion including V1 and ex- tial orienting behaviors. We administered a course of trastriate areas. The behavioural test used was the Pof- Posters 401 fenberger Paradigm that enables to measure interhemi- isfaction was found to be related to severe tactile body spheric transfer time with a simple manual reaction image disturbance in Anorexia Nervosa (Keizer et al., time to lateralized visual stimuli. During behavioural 2011). performance we recorded visual event-related poten- The aim of the present work was to observe possible tials (ERPs) to compare latency and amplitude of the disturbance in tactile aspects of body image in obese ERPs components evoked by the direct or the com- people, who were reported to show high level of dis- missural (callosal) pathway. We found that visual stim- satisfaction (Docteur et al., 2010). ulation of the intact hemifield evoked a normal P1- Morbid obese subjects (BMI > 40), severe obese sub- N1 response in the intact contralateral hemisphere of jects (range of BMI = 35–40) and healthy weight both patients. However, when recording the indirect subjects (range of BMI = 22–25) took part at the callosal response in the ipsilateral lesioned hemisphere present study. They were asked to estimate the distance we found a different result as a function of the site of between two simultaneous tactile stimuli using their the lesion. In LS there was a good indirect N1 response thumb and index finger, in absence of visual input; two similar to that of controls while this was not the case different body parts were tested: the arm and the ab- in AE. A likely explanation of this dissociation is that domen (Tactile Estimation Task – TET; Keizer et al., in LS the widespread callosal connections adjoining 2011). Moreover they were asked to state the level of the extrastriate areas in the two hemispheres are sub- satisfaction for their different body parts. stantially spared while they are damaged in AE. Evi- Preliminary results indicated that participants tended dence for that was provided by diffusion tensor imag- to overestimate perceptual distances on the arm com- ing (DTI). In conclusion, we think that the presence of pared to those on the abdomen; specifically morbid a good visual commissural input to a lesioned hemi- obese subjects appeared to be less precious respect to sphere indicates a favourable prognosis for recovery of the two other groups. About psychological component, visual function in hemianopia. Preliminary results with severe obese people expressed higher level of dissat- these patients are encouraging in this regard. isfaction respect to morbid obese subjects and healthy ones. Keywords: Perception, Other Disorder/Samples, Elec- In obesity, body image disturbance extended to so- trophysiology (EEG/ERP) matosensory perception; moreover affective components influence the construction of tactile body repre- Correspondence address: Mrs Alessia Celeghin, De- sentation. partment of Neurological, University of Verona, Neu- ropsychological, Morphological and Movement Sci- Keywords: Perception, Other Disorder/Samples, Other ences, Strada Le Grazie, 8, I-37134 Verona, Italy. E- Methods mail: [email protected] Correspondence address: Mrs PhD Federica Scarpina, P2.30 Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Psychology Research Lab, Via Cadorna, 90, Tactile body image in obesity Italy-28824 Piancavallo (Oggebbio), Italy. Tel.: +39 0323514353; E-mail: [email protected] Federica Scarpina1, Gianluca Castelnuovo2 and Enrico Molinari2 P2.31 1Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, Psychology Research Lab, Piancavallo Learning modulates temporo-parietal processes (Oggebbio), Italy during global recognition – from visual integration 2Department of Psychology, Catholic University of Mi- to object perception? lan, Milan, Italy Johannes Rennig1, Marc Himmelbach1, Elisabeth 2 1 Mental body representations are constructed from and Huberle and Hans-Otto Karnath 1 reciprocally influenced by bottom-up sensory input University of Tübingen, Division of Neuropsychology, (Serino and Haggard, 2010) and also by top-down cog- Tübingen, Germany 2 nitive and affective representations (Dijkerman and De Kantonsspital Luzern, Department of Neurology, Haan, 2007); for example higher level of body dissat- Luzern, Switzerland 402 Posters

Recent neuroimaging studies and reports from neuro- Approaching or looming sounds are potentially threat- logical patients with simultanagnosia suggested a cru- ening stimuli with particular impact on visual process- cial involvement of temporo-parietal brain areas in pro- ing. The early onset of crossmodal effects by looming cessing of hierarchical organized visual material. In sounds (Romei et al., 2009) and their impact on low- the present study we asked the question if activity level visual processing (Leo et al., 2011) suggests that in temporo-parietal brain areas associated with global these interactions may take place already within low- recognition can be modulated by extensive exposure level visual cortices. To investigate the contribution of to hierarchical stimuli. We performed an fMRI study early visual areas in mediating the effects of looming with 24 healthy subjects including two neuroimag- sounds on visual processing, we tested a patient with ing sessions (pre- and post-training) with four psy- bilateral occipital lesion and spared residual portions chophysical training sessions between them. In the two of V1/V2 (SDV). Accordingly, SDV’s visual perime- fMRI sessions four classes of stimuli were applied: try revealed blindness of the central visual field with two kinds of global recognition tasks and two addi- some residual peripheral vision. We tested the influ- tional tasks requiring recognition of local elements ence of looming, receding and static sounds on SDV and regular objects. In the perceptual training ses- line discrimination ability in the relatively preserved sions an adaptive psychophysical procedure with one visual field or in the blind visual field. We found that class of global stimuli was conducted. Subjects showed SDV’s visual orientation sensitivity was significantly improved behavioral performances in all four classes enhanced when visual stimuli were paired with loom- of stimuli with a particular advantage in both global ing sounds, compared to other types of sound or pre- recognition tasks. In a region of interest analysis in sented alone. Crucially, this selective crossmodal ef- temporo-parietal brain activation clusters derived from fect was found when visual stimuli were presented in the present investigation and a recent neuroimaging the relatively preserved visual field whereas no mod- study we found significant integration related activa- ulation in visual orientation sensitivity was found for tion changes. These activation changes were specific stimuli presented in the blind visual field. These re- to global stimuli while no systematic BOLD response sults provide direct evidence that primary visual areas changes were observable for recognition of local el- are critically involved in crossmodal modulation of vi- ements and regular objects. We address the observed sual sensitivity. Although visual pathways (e.g. retino- activity modulations to a more efficient or generally colliculo-extrastriate) bypassing V1 can mediate the different strategy of the brain in processing of global crossmodal enhancement of basic visual abilities such stimuli. We further conclude that perceptive learning of as detection of spots of lights (Làdavas, 2008), the complex figures may be the connection between visual crossmodal impact on more complex functions such as integration and object perception. line orientation discrimination require functional activation of early visual areas. Keywords: Perception, Other Disorder/Samples, Func- tional and Structural Neuroimaging/NIRS Keywords: Perception, Other Disorder/Samples, Other Methods Correspondence address: Mr Dipl.-Psych. Johannes Rennig, University of Tübingen, Division of Neu- Correspondence address: Mrs Làdavas, University of ropsychology, Hoppe-Seyler-Str. 3, D-72076 Tübin- Bologna, Viale Berti Pichat 5, D-40127 Bologna, Italy. gen, Germany. E-mail: johannes.rennig@uni-tuebin E-mail: [email protected] gen.de P2.33 P2.32 L-POST: development, validation and norming of a Occipital lesions disrupt the crossmodal enhance- new screening test for perceptual organization ment of visual orientation sensitivity by looming sounds: A case study Kathleen Vancleef1, Elia Acke1, Katrien Torfs2,Chri- stophe Lafosse3, Johan Wagemans1 and Lee De-Wit1 1 1 2 Làdavas , Roberto Cecere and Vincenzo Romei 1University of Leuven, Laboratory of Experimental 1 University of Bologna, Italy Psychology, Leuven, Belgium 2 University of Essex, Colchester, UK 2University of Louvain, Psychological Sciences Re- Posters 403 search Institute, Louvain-la-Neuve, Belgium P2.34 3University of Leuven, Belgium Cross-notational semantic priming between sym- Neuropsychological tests of visual perception mostly bolic and non-symbolic numerosity in children assess high-level processes like object recognition. Ob- ject recognition however, relies on distinct mid-level Mafalda Mendes and J. Frederico Marques processes of perceptual organization that are only im- Faculty of Psychology, University of Lisbon, Center for plicitly tested in classical tests. To fill this gap, we de- Psychological Research, Lisboa, Portugal veloped the Leuven Perceptual Organization Screening Test (L-POST), in which a wide a range of mid-level Behavioral and neuroimaging studies have shown that phenomena are measured as independently as possi- the precision of numerical representations increases ble. The L-POST consists of 15 sub-tests screening with age. Recent studies using the priming distance ef- for various aspects of perceptual organization, such fect (faster responses to numerical targets when they as shape perception, figure-ground segmentation, and are preceded by a numerical close prime) as a mea- is sensitive to several grouping cues, such as com- sure of numerical representations development, have mon fate, collinearity, proximity and closure. To re- found no differences in this effect between children duce cognitive load, a matching-to-sample task is used and adults for both symbolic and non-symbolic nota- for all test items. Our free online test can be admin- tion, when prime and target stimuli were of the same istered in 20–30 minutes, and a neglect-friendly ver- notation. In this study, we tested whether children and sion is available. The test has been validated with 40 adults exhibited cross-notation priming distance ef- n = brain-lesioned patients in which performance on the L- fects. Two groups of subjects, adults ( 23) and n = POST was compared to standard clinical tests of visual 9–10 years-old children ( 19) participated in this perception and other measures of cognitive function study. Three primed number comparison paradigms to evaluate convergent and divergent validity, respec- were performed in which subjects had to compare a tively. The L-POST showed high sensitivity to visual given numerical target to the standard numerosity five: (1) Non-symbolic, in which prime and target were both dysfunction and decreased performance was specific non-symbolic (2) Symbolic, in which prime and target to visual problems. In addition, we collected a norm- were both symbolic and (3) Cross-notation in which ing sample of more than 1200 healthy control partici- the prime and target were of different notation: prime pants. In this sample, we observed a decline of L-POST symbolic and target non-symbolic or vice-versa. Nu- scores with increasing age. No difference was observed merosities used as primes and targets were 1 to 9 (ex- between participants who filled in the test with and cept 5), presented as Arabic digits or collections of without supervision of a research assistant. We are now dots. The numerosities of prime and target pairs were exploring the use of the L-POST in other neurologi- manipulated in such a way as to create numerical dis- cal and psychiatric disorders that have been associated tances from 0 to 4. Results revealed that priming ef- with altered visual perception (e.g. schizophrenia, defects were present and were quantitatively similar in mentia, autism). In conclusion, the L-POST is a valu- both children and adults when the prime and target able screening test for perceptual organization. It of- were of the same notation and when the prime was fers a useful tool for researchers and clinicians to get symbolic and the target non-symbolic. However, when a broader overview of the mid-level processes that are the prime was non-symbolic and the target symbolic, preserved or disrupted in a given patient. priming only occurred in adults. Contrary to previous studies comparing priming effects in children and Keywords: Perception, Stroke, Neuropsychological adults, this study suggests that there may be subtle Assessment and Psychometrics differences in numerical representations between 10 years-old children and adults that were only evident Correspondence address: Mrs Kathleen Vancleef, Uni- from cross-notation priming effects. versity of Leuven, Laboratory of Experimental Psy- chology, Tiensestraat 102 box 3711, B-3000 Leuven, Keywords: Other Functions/Disorders, Other Disorder Belgium. E-mail: [email protected] /Samples, Other Methods

Correspondence address: Mrs Mafalda Mendes, Fac- ulty of Psychology, University of Lisbon, Center for 404 Posters

Psychological Research, Alameda da Universidade, Further exploration of the deficits of human body per- 1649-013 Lisboa, Portugal. E-mail: mmendes7@ ception and human body representation in children gmail.com may have important theoretical as well as clinical implications. P2.35 Keywords: Visuospatial Abilities, Epilepsy, Neuropsy- Body perception impairments in children with chological Assessment and Psychometrics parieto-occipital lobe epilepsy Correspondence address: Dr Laurent AUCLAIR, Uni- Laurent Auclair1, Christine Bulteau2, Olivier Delalan- versity Paris Descartes, INSERM U663, Institut of de3, Georg Dorfmuller3 and Isabelle Jambaque4 Psychology, Av. Edouard Vaillant, 71, F-92100 Boulo- 1University Paris Descartes, INSERM U663, Institut of gne-Billancourt, France. E-mail: laurent.auclair@ Psychology, Boulogne-Billancourt, France parisdescartes.fr 2Foundation Ophtalmologique Adolphe de Rothschild, Pediatric Neurosurgery Department and INSERM P2.36 U663, Paris, France 3Foundation Ophtalmologique Adolphe de Rothschild, Cognitive functioning of adolescents with multiple Pediatric Neurosurgery Department, Paris, France sclerosis 4University Paris Descartes, Institut of Psychology and INSERM U663, Paris, France Gordana Mijalkovic Stojiljkovic and Dragana Vucinic Clinic for neurology and psychiatry for children and OBJECTIVE: Neuropsychological studies consider youth, Child neurology, Belgrade, Serbia that human body processing involve distinct body representations. However, there are few systematic re- PURPOSE: Multiple sclerosis (MS) that starts in ado- searches on the development of the perception of the lescence makes problems of developmental changes human body and its deficits in children. Here we in- and neurological aspects of illness. Hronicity of MS vestigated whether children with epilepsy primarily af- needs focus on cognitive functions because of intensive fecting the parieto-occipital (PO) cortex exhibited im- tasks in school achievement, academic skills, learning pairments in body representations. and adaptation processes. METHODS: Twelve participants with PO lobe epile- AIM: Assessment of cognitive profile and abilities of psy (POLE) aged from 5 to 15 years were included All adolescents with MS in the start of illness. Results of them underwent presurgical or post surgical evalua- could be used in design of neuropsychological screen- tion for partial epilepsy. Epilepsy onset in the first year ing and treatment. of age (mean = 3 years) and originated from right (N METHODS: Global intellectual functioning in 16 MS = 6) or left side of the PO lobe. Their performances patients from Serbia was investigated. Adolescents were compared to matched control children. Differ- (male 5, female 11), aged 13–18 years, with patients ent tasks designed to assess multiple body represen- with MS duration > 2 years, and 2 groups depend- tations such as lexico- semantic body representation, ing on starting symptoms zone. Wecshler intelligence body structural representation and body schema were scales standardized in Serbian population were admin- proposed. The experimental tasks covered naming ob- istered: REVISK (up to 15;11 years) and VITI (from jets and body parts, left-right body localization, hand 16 years>). and finger postures imitation, assembling body parts, RESULTS: The testing performance was mostly in the body parts localization (with and without visual con- category of high average intelligence (11/16), with the trol), human figure drawing. mean score IQ tot-109 (IQ tot spread: from 84–126). RESULTS: We showed that 89% of patients were im- No strong association of clinical parameters with test paired relative to controls on at least one task. No clear results was concluded. The number of impaired test re- side differences emerged (left vs. right side epilepsy) sults correlates with acute phase of MS attack and du- for most of the task. However difficulties were more ration of recovery period. Approximately 10% young pronounced for right than for left POLE. patients showed impairment on 4 sub tests. Deficits CONCLUSION: Early-onset posterior epilepsy can were found on sub tests measuring visual analysis, per- compromise the development of body representations. ception accuracy, visual- constructive ability and cog- Posters 405 nitive speed. Better verbal achievements is evident in come measures include visual exploration abilities whole group of patients, and few error types were iden- (Neglecttest (Fels and Geissner, 1997), general atten- tified. tion (Testbatterie zur Aufmerksamkeitsprüfung (TAP) CONCLUSION: In this group of patients global cogni- (Zimmermann and Fimm, 2009)), reading (Saarbrüc- tive functioning of adolescents with MS are preserved ker Lesetexte (Kerkhoff, Wimbauer, Reinhart, 2012), and on high functional level in most of the patients. awareness (Catherine Bergego Scale (CBS) (Azouvi Difficulties are registered in visual analysis, cognitive et al., 1996)), activities of daily living (Stroke Impact processing speed and perception accuracy. Some in- Scale Version 3.0 (Duncan et al., 1999) and an assess- dicators of cognitive vulnerability during MS attack ment of depression (Hospital Anxiety and Depression and recovery period needs support and following. Neu- Scale – German Version (Herrmann-Lingen, Buss and ropsychological testing should be oriented to visually- Snaith, 1995). constructive and visually-spacial abilities with wider While data collection is ongoing, first results on about battery of test. half of the intended sample size show improvements depending on intervention method applied. As the SET Keywords: Visuospatial Abilities, MS/Demyelination treatment is similar in its nature to cancellation tasks, patients in this group show large benefits in visual Correspondence address: Mrs Gordana Mijalkovic Sto- paper-pencil exploration tasks, while patients in the jiljkovic, Clinic for neurology and psychiatry for chil- VMT intervention group improve most in computer- dren and youth, Child neurology, Dr Subotica 6a, RS- ized tasks assessing omissions. The VMT group mem- 381 Belgrade, Serbia. E-mail: [email protected] bers also benefit most in line bisection tasks. Reading abilities show the greatest improvement in both OKS P2.37 and SET patients, while OKS patients also become increasingly aware of their neglect symptoms. Comparing the effectiveness of Visuo-motor Train- Data from the remaining patients should strengthen the ing and Optokinetic Stimulation with Standardized reported effects and we also hope to demonstrate dis- Exploration Training in patients with hemispatial tinct effects on activities of daily living and depression. neglect Keywords: Visuospatial Abilities, Neglect, Neuropsy- Michael Opolka1, Monika Harvey2, Georg Kerkhoff3 chological Rehabilitation and Hendrik Niemann1 1Neurologisches Rehabilitationszentrum Leipzig – Correspondence address: Mr Michael Opolka, Neu- Neuropsychologie, Bennewitz, Germany rologisches Rehabilitationszentrum Leipzig – Neu- 2University of Glasgow, School of Psychology, Glas- ropsychologie, Muldentalweg 1, D-04828 Bennewitz, gow, UK Germany. Tel.: +49 03425 888231; E-mail: michael_ 3Universität des Saarlandes, Arbeitseinheit Klinische [email protected] Neuropsychologie, Saarbrücken, Germany P2.38 We are currently running a randomized controlled study aiming to compare the effectiveness of three dif- Prose reading in neglect ferent interventions aimed at rehabilitating hemispatial neglect: (1) Visuo-motor Training (VMT) (2) Optoki- Roberto Cubelli1,CarloCisari2, Sergio Della Sala3 netic Stimulation (OKS) and (3) Standard Exploration and Nicoletta Beschin4 Training (SET) (control group). 1University of Trento, Psychology and Cognitive Sci- A total of 60 patients with neglect following either ence, Rovereto, Italy stroke or intracerebral bleeding are recruited from a 2b) Physical and Rehab Medicine, Piemonte Orientale German Neurological Rehabilitation Centre and ran- University, Novara, Italy domly assigned to one of the three groups. Each inter- 3University of Edinburgh, c) Human Cognitive Neuro- vention consists of 10 training sessions conducted on science, Psychology, Edinburgh, UK 10 consecutive days. 4Hospital S. Antonio Abate Gallarate, d) Clinical Neu- Rehabilitation effects are measured immediately af- ropsychology Unit, Somma Lombardo (Va), Italy ter the training and at a 3-month-follow-up. Out- 406 Posters

BACKGROUND: Reading sentences or texts has been P2.39 shown to be a very sensitive measure of neglect [1]. However, most clinical and theoretical studies focused Displacement of small numbers on a vertical num- on reading single words or non-words [2] rather than ber line in spatial neglect prose reading (PR). AIMS: To assess PR in right hemisphere damaged pa- Urszula Mihulowicz1, Hans-Christoph Nuerk2, Elise tients and the relationship between PR and other mea- Klein3, Klaus Willmes4 and Hans-Otto Karnath5 sures of neglect and its severity, or between PR and 1University of Tübingen, Division of Neuropsychology, neglect dyslexia. Center of Neurology and Hertie Institute for Clinical METHODS: 30 stroke patients showing clear symp- Brain Research, Tübingen, Germany toms of spatial neglect were asked to read aloud a short 2Department of Psychology/IWM-KMRC Knowledge prose passage (130 words in 11 lines, 142 mm long) Media Research Center, University of Tuebingen, Tue- and 105 single words. They underwent 14 conventional bingen, Germany tests for spatial neglect. 3IWM-KMRC Knowledge Media Research Center,Tue- RESULTS: 21/30 participants (70%) omitted words or bingen, Germany letters at the beginning of the text (left end) show- 4University Hospital RWTH Aachen, Section Neu- ing PR neglect, they on average attended to 108.4 mm ropsychology, Department of Neurology, Aachen, Ger- of text omitting text on the left end side in 5.5 lines, many showing no top-bottom gradient in reading individual 5University of Tübingen, Division of Neuropsychology, lines. The two subgroups did not differ significantly Center of Neurology and Hertie Institute for Clinical in age, education, days post-onset, or MMSE, Verbal Brain Research, Tuebingen, Germany Judgments and Cognitive Estimations scores as well as presence of anosognosia. The anatomical substrates of Previous studies investigating the mental number line PR neglect are centered on the insula, putamen, supe- in neglect patients came to inconsistent conclusions rior temporal lobe and Rolandic operculum. No spe- about its spatial representation. This could be due to cific lesion emerged which differentiates individuals confounding factors of working memory or the indirect presenting with and without prose PR neglect. No spe- way of investigating magnitude representation in the cific tests assessing neglect could predict the presence number interval bisection paradigm. Here we explored of PR neglect, however neglect severity was associated the spatial representation of numbers independently of to PR neglect. Clear double dissociations emerged be- the working memory load. Moreover, due to the verti- tween PRN and neglect dyslexia. cal orientation of the number lines presented, physical CONCLUSION: A considerable proportion of patients and representational aspects could be disentangled. with spatial neglect omitted the beginning of the lines Sixty-six acute stroke patients (31 LBD, 29 RBD within reading text. The findings provide evidence for the out, and 6 RBD with neglect) performed a vertical functional independence of word processing and space number line task, in which they were asked to place 13 exploration while reading, and argue for the inclusion two-digit numbers on vertically oriented lines with 0 of prose reading in standard neglect assessment. marked at the bottom and 100 at the top. Performance of the LBD patients and RBD patients without neglect References did not differ at any of the number points. As com- [1] Caplan B. (1987) Assessment of unilateral neglect:a new reading test. JCEN, 9: 359-64 monly reported in the healthy adult population, the rep- [2] Vallar G. et al. (2010) Neglect dyslexia: A review of the neu- resentation was nearly linear, whereby numbers clos- ropsychological literature. Exp Brain Res, 206: 219-235 est to the provided (0 and 100) as well as to the strategic (50) anchors were indicated most precisely. In con- Keywords: Visuospatial Abilities, Neglect, Neuropsy- trast, RBD patients with neglect tended to overestimate chological Assessment and Psychometrics the position of numbers under 50, which are assumed to be placed on the left side of the mental number line, Correspondence address: Mr Prof Roberto Cubelli, thus corresponding to the idea of shifting them to the University of Trento, Psychology and Cognitive Sci- imaginary right side. Importantly, this was not the case ence, Via Rovereto, D-21020 Rovereto, Italy. E-mail: for numbers close to the anchors. For larger numbers [email protected] (right side of the mental number line), RBD patients with neglect did not differ from the other groups. Posters 407

The results argue for a spatial character of the men- may be due to online stimulation (and possible func- tal representation of numbers, which is, however, in- tional compensation during tDCS), we ran the same ﬂuenced by spatial-numerical task strategies. In case paradigm, but using off-line stimulation, in a further 6 of neglect patients, this representation seems to be bi- participants, which also failed to show effects. ased towards the ipsilesional side; the latter proves to We conclude that the dual parietal tDCS approach does be independent of the physical orientation of the task not necessarily give rise to clear effects on spatial bi- stimuli. ases, even if tDCS parameters are above previously effective parameters (2 vs 1 mA and 20 vs 15 min, in our Keywords: Visuospatial Abilities, Neglect, Neuropsy- vs Giglia et al.’s study). This indicates that tDCS ef- chological Assessment and Psychometrics fects are not linearly related to stimulation parameters. We hope that these ﬁndings will inform the design of Correspondence address: Mrs Urszula Mihulowicz, future attentional tDCS studies and are currently inves- University of Tübingen, Division of Neuropsychology, tigating different density and stimulation sites to also Center of Neurology and Hertie Institute for Clinical inform potential tDCS trials on patients suffering from Brain Research, Hoppe-Seyler-Str. 3, D-72076 Tübin- hemispatial neglect (see also Sparing et al., Brain, 132, gen, Germany. E-mail: urszula.mihulowicz@uni- 2009). tuebingen.de Keywords: Visuospatial Abilities, Neglect, TMS/ P2.40 TCDS

Bilateral 2mA tDCS stimulation induces only weak Correspondence address: Mrs Ms Gemma Learmonth, shifts in attentional bias University of Glasgow, School of Psychology, 58 Hill- head Street, UK-G12 8QB Glasgow, Scotland. E-mail: Gemma Learmonth, Christopher Benwell, Monika [email protected] Harvey and Gregor Thut University of Glasgow, School of Psychology, Glas- P2.41 gow, Scotland Limb Activation Treatment and Contralesional tDCS over parietal cortex induces transient, neglect- Arm Vibration: When two is better than one in re- like effects in healthy participants, and more so with ducing left-neglect signs dual parietal than right parietal tDCS, informing models of spatial attention (Giglia et al., Brain Stimulation, Marco Pitteri1, Giorgio Arcara1, Laura Passarini1, 4, 2011). Francesca Meneghello1 and Konstantinos Priftis2 We employed dual parietal tDCS to further study the 1IRCCS San Camillo Hospital, Laboratory of Neu- time-course of these effects using an online approach. ropsychology, Lido-Venice, Italy A computerised landmark task was presented to 18 2Department of General Psychology, University of right-handed adults, which involved deciding which Padova, Padova, Italy end of a pre-bisected horizontal line was shorter. Par- ticipants completed a total of 10 blocks (1 pre-tDCS, 6 One of the most disabling neuropsychological syn- on-line tDCS, 3 post-tDCS). Each subject performed 3 dromes following right-hemisphere lesion is left ne- sessions > 24 hrs apart: 1) Left-anode right-cathode 2) glect (LN). LN patients fail to respond, report, or ori- Left-cathode right-anode 3) Sham. TDCS consisted of ent to stimuli in the left contralesional side of space 2mA stimulation over P5/6 for 20 minutes. (Heilman et al., 2003). Although some spontaneous In contrast to Giglia et al. (2011), we only found a recovery occurs in the majority of LN patients after weak left to rightward shift in spatial attention driven stroke, LN signs remain severe in many patients and by the left-anode right-cathode montage compared to may persist in the chronic phase. Combining differ- Sham, as well as a slight increase in left bias with ent rehabilitation techniques may increase the effec- right-anode left-cathode montage. These small non- tiveness of cognitive treatments (e.g., Kerkhoff and significant effects were only briefly evident at the end Schenk, 2012). In the present study, we evaluated the of 20 min stimulation, and returned to baseline by the effects of the Limb Activation Treatment (LAT) alone subsequent block 4 min later. To study whether this and in combination with the Contralateral Arm Vibra- 408 Posters tion (CAV). We conceived them as techniques that both some spontaneous recovery occurs in the majority of prompt the joint activation of the lesioned right hemi- LN patients after stroke, LN remains severe in many sphere because of the activation (with the LAT as an patients and may persist in the chronic phase (Nijboer active technique) and the stimulation (with the CAV et al., 2013). Thus, LN is one of the major factors as a passive technique) of the left hemibody. To test underlying poor functional outcome (Buxbaum et al., the effect of the simultaneous use of these two tech- 2004). Over the past 60 years, many different treat- niques (i.e., LAT and CAV) on visuo-spatial aspects ments for rehabilitating LN have been conceived and of LN, we describe the case of an LN patient (GR), tested (Riestra & Barrett, 2013). We compared, for the who showed high intra-individual variability (IIV) in first time, the overall and possible differential effects performance. Given the high IIV of GR, we used an of three of the most widely-used LN treatments: Vi- ABAB, repeated-measures design to better define the sual Scanning Training (VST), Limb Activation Treat- effectiveness of combining LAT and CAV, as a func- ment (LAT), and Prism Adaptation (PA). Thirty-two tion of time. The results showed an improvement of LN patients were assigned in quasi-random order into GR’s performance on the Bells test during the com- the three groups (VST, LAT, PA). LN patients’ perfor- bined application of LAT and CAV with respect to mance on everyday life tasks was assessed four times: the application of LAT alone. No effect on line bisec- A1 and A2 (i.e., the two pre-treatment assessments); tion and on picture scanning tests was observed. Our A3 and A4 (i.e., the two post-treatment assessments). preliminary positive results might provide some new LN patients were treated for the same number of ses- evidence on the possibility to obtain additive effects sions (i.e., 20), for a period of two weeks. The results of cognitive rehabilitation procedures, if they share a showed that improvements were present in the ma- common theoretical framework and, consequently, a jority of the tests assessing the peripersonal space in common network of neural activation subserving the everyday life activities after each rehabilitation treat- target function. ment. No generalization of positive improvement to the personal and extrapersonal spaces was observed. Our Keywords: Visuospatial Abilities, Neglect, Neuropsy- findings were independent of unspecific factors and chological Rehabilitation lasted for at least two weeks following the end of the treatments. Nonetheless, there were no interactions be- Correspondence address: PhD Marco Pitteri, IRCCS tween LN treatments and assessments, suggesting that San Camillo Hospital, Laboratory of Neuropsychol- none of the three treatments is better than the others in ogy, Via Alberoni, 70, IT-30126 Lido-Venice, Italy. E- treating LN. We suggest that VST, LAT, and PA can be mail: [email protected] considered as valid rehabilitation interventions for LN and can be used for ameliorating LN signs. P2.42 Keywords: Visuospatial Abilities, Neglect, Neuropsy- Comparison among Visual Scanning Training, chological Rehabilitation Limb Activation Treatment, and Prism Adaptation for rehabilitating left neglect: No winner, all win- Correspondence address: Ph.D. Marco Pitteri, IRCCS ners in the competition San Camillo Hospital, Laboratory of Neuropsychol- ogy, Via Alberoni, 70, IT-30126 Lido-Venice, Italy. E- Marco Pitteri1, Laura Passarini1, Cristina Pilosio1, mail: [email protected] Francesca Meneghello1 and Konstantinos Priftis2 1IRCCS San Camillo Hospital, Laboratory of Neu- P2.43 ropsychology, Lido-Venice, Italy 2University of Padova, Department of General Psy- Object-centered spatial neglect: The effects of the chology, Padova, Italy principal axis and the canonical orientation

Left neglect (LN) is one of the most frequent and dis- Eric Siéroff1, Feriel Batouche2, Delphine Levy-Ben- abling neuropsychological syndromes following right- cheton3, David Nyckees1, Farah Stefano4 and David hemisphere damage. LN patients fail to report, orient Adams2 to, or verbally describe stimuli in the contralesional, 1Paris Descartes University, Institute of Psychology, left side of space (Heilman et al., 2003). Although Boulogne-Billancourt, France Posters 409

2Hopital Kremlin-Bicetre, Neurology, Kremlin-Bicetre, P2.44 France 3INSERM, Centre de Recherche en Neurosciences de A curious impairment of manual motor imagery in Lyon, France a skilled deliberate mirror-writer 4Paris Descartes University, Institute of Psychology, Paris, France Robert McIntosh, Yin-Wen Kuo and Sergio Della Sala University of Edinburgh, Human Cognitive Neuro- The coordinates of the spatial deficit in unilateral spa- science, Psychology, Edinburgh, UK tial neglect have been largely debated. Although most studies describe the deficit in terms of egocentric coor- KB is a man who has practiced mirror-writing for more dinates, several cases of patients have been described than fifty years. He writes fluently forward or back- with a deficit at the level of allocentric (or intrinsic) co- ward with either hand, both upright and inverted. He is ordinates. These cases are described as object-centered most practiced and adept at left-handed upright mirror spatial neglect, or object neglect. Such patients with writing. We explored whether his unusual motor abili- a right hemisphere lesion ignore the left part of ob- ties are associated with unusual performance on mental jects even if objects have been rotated, so that this rotation tasks. On a task requiring speeded judgments left part is at least partially located in the right space of whether letters at various orientations are forward of patients. In the present study, we evaluated the oc- or reversed, KB performed within age-matched limits. currence of object neglect in a group of 12 patients But when required to judge whether a picture of a hand showing left unilateral spatial neglect (diagnosed with or foot, presented at various orientations, was from the usual test batteries); 12 controls also participated to left or the right side of the body, he showed a surpris- the study. We used drawings of 40 objects, which con- ing impairment. He was abnormally slow and inaccu- tours were highlighted in different colors for each of rate at judging the laterality of hands, but not feet, and the 4 quadrants centered on the object; 16 possible col- this was reliable across multiple sessions. This lateral- ors were used. Objects were either presented in normal ity judgment task is widely used to assess motor im- orientation or rotated by 45◦ on the right. Participants agery, as it is known that people solve the task by men- had to name the different colors. By comparing nam- tally rotating their own hand or foot to confirm a match ing efficiency of the different quadrants in normal and to that in the picture. We tentatively suggest that KB’s rotated objects, we could determine the existence of some object neglect. Ten out of our 12 patients had ob- ability for (and/or history of) executing right hand ac- ject neglect, showing that this deficit is not rare. Also, tions with the left hand (i.e. mirror writing) may entail we used different types of objects, varying the princi- an abnormal degree of overlap in the neural motor rep- pal axis (vertical, horizontal or absent) and the strength resentations of his hands, creating introspective confu- of the canonical orientation (strong, like in a refrig- sion over which hand he has mentally rotated to make erator or a cup; or weak, like in scissors or a straw- the match. berry), with the hypothesis of stronger object neglect in objects showing a vertical axis, and a strong canon- Keywords: Visuospatial Abilities, Other Disorder/ ical orientation. However, results were rather hetero- Samples, Neuropsychological Assessment and Psy- geneous among the different patients. Finally, we se- chometrics lected in our sample the most appropriate drawings of objects for the diagnosis of object neglect, and pro- Correspondence address: Mr Dr Robert McIntosh, posed that this smaller sample could constitute a good University of Edinburgh, Human Cognitive Neuro- clinical test of object neglect. science, Psychology, 7 George Square, UK-EH89JZ Edinburgh, UK. Tel.: +44 131 6503444; E-mail: r.d. Keywords: Visuospatial Abilities, Neglect, Neuropsy- [email protected] chological Assessment and Psychometrics

Correspondence address: Mr Professor Eric Siéroff, Paris Descartes University, Institute of Psychology, 71, avenue Edouard-Vaillant, F-92100 Boulogne-Billan- court, France. Tel.: +33 1 55 20 59 29; E-mail: eric. [email protected] 410 Posters

P2.45 P2.46

Neuroanatomy of space, body and posture percep- Temporal dynamics of error correction in a dou- tion in patients with right hemisphere stroke blesteptaskinpatientswithalesiontothelateral intra-parietal sulcus Arnaud Saj1, Marc Rousseaux2, Jacques Honoré2 and 3 Patrik Vuilleumier Stefan Van der Stigchel1, Robert D. Rafal2 and Janet 1 University hospital of Geneva, Neurology, Geneva, H. Bultitude3 Switzerland 1Utrecht University, Experimental Psychology, 2 Department of Neuro-rehabilitation, Lille University Helmholtz Institute, Utrecht, The Netherlands Medical Center, Lille, France 2 3 Bangor University, School of Psychology, Bangor, Neuroscience Department, University of Geneva, United Kingdom Geneva, Switzerland 3University of Oxford, Centre for Functional Magnetic Resonance Imaging of the Brain, Oxford, United King- OBJECTIVE: To specify the neuroanatomical corre- dom lates of biases in the representations of the gravita- tional vertical (subjective vertical, SV) and body axis Five patients with lesions involving intra-parietal cor- (subjective straight ahead, SSA), as well as postural tex were tested in a rapid version of the double step difficulties, in patients with hemispheric stroke. paradigm to investigate the role of the intra-parietal METHODS: The analysis focused on right hemisphere cortex in the rapid, online, updating of a saccade pro- lesions in 21 neglect patients and 21 non-neglect gram. Saccades were executed to a single target in ei- patients (using MRIcro software) and related per- ther the contra- or the ipsilesional visual field. In two formance in two experimental tasks (SV and SSA) thirds of the trials, a step change in target position re- and a clinical balance assessment. Voxel-based lesion- quired that the saccade shifted to a new location within symptom mapping was used to highlight brain areas in the same field but in the contra- or the ipsilesional di- which lesions best explained the severity of task biases (p<0.01). rection, allowing us to investigate whether patients are RESULTS: The bias in the representation of body ori- able to update their saccade program given new exoge- entation was found to be strongly related (p<0.01) nous information about the required endpoint of the to lesions of the anterior parietal cortex and the mid- saccade. This set-up resulted in three types of initial dle part of the superior temporal gyrus. The SV errors saccades: saccades to the target on no-step trials, un- were associated with more widespread lesions of the corrected saccades to the original target location on posterior parietal and temporal cortices. Imbalance was step trials and corrected saccades to the new target preferentially associated with lesions of the posterior location on step trials. Furthermore, if the updating insula and the adjacent temporoparietal cortex. of the original eye movement program failed, patients CONCLUSION: This constitutes the first report of cor- performed a second saccade to the new target loca- tical dissociation of biases of body-centered and gravi- tion that required a rapid error correction. The analy- tational vertical representations, which may reflect the sis of the double-step task indicated that latencies for differential involvement of these brain regions in spa- all trial types were larger when saccades were directed tial information processing. The lesions involved in to the contralesional versus the ipsilesional field. Fur- representation biases (especially of the SV) and pos- thermore, longer latencies were required for patients tural difficulties overlapped to some extent in the tem- to initiate a corrective second saccade after making an poroparietal, superior temporal and posterior insular uncorrected first saccade in their contralesional com- regions of the cortex. pared to ipsilesional field. There were no differences in the ultimate landing positions of the eye movements Keywords: Visuospatial Abilities, Stroke, Functional for such corrected saccades. These results reveal that and Structural Neuroimaging/NIRS deficits in updating of saccade programs only seem to be present after the gaze shifts to a new location, point- Correspondence address: Dr Arnaud Saj, University ing to a role of intra-parietal cortex in the processes hospital of Geneva, Neurology, Rue Grabrielle-Perret- involved in updating information when a new refer- Gentil, CH-1820 Geneva, Switzerland. E-mail: ar- ence frame is required. In conclusion, the paradigm de- [email protected] ployed in the current study allows for a refinement of Posters 411 the role of the intra-parietal cortex in the updating of size. Results showed that the lesion influenced mo- saccade programs. tor imagery and visuo-motor imagery, but not visuospatial imagery. This finding reveals that these cerebral Keywords: Visuospatial Abilities, Stroke, Other Meth- structures, and in particular the precuneus, play a key ods role in simulation processes linked to motor imagery but not visuo-spatial imagery. The theoretical implica- Correspondence address: Mr Stefan Van der Stigchel, tions of these results will be discussed. Utrecht University, Experimental Psychology, Helmh- oltz Institute, Heidelberglaan 2, 3523PK Utrecht, the Keywords: Visuospatial Abilities, Stroke, Neuropsy- Netherlands. E-mail: [email protected] chological Assessment and Psychometrics

P2.47 Correspondence address: Mr Gennaro Ruggiero, De- partment of Psychology, Second University of Naples, Visuo-spatial and motor imagery impairments fol- Viale Ellittico, 31, D-81100 Caserta, Italy. E-mail: gen- lowing left posteromedial lesion: a case study [email protected]

Gennaro Ruggiero1, Francesca Frassinetti2, Alessan- P2.48 dro Iavarone3 and Tina Iachini1 1Department of Psychology, Second University of Egocentric impairment in episodic memory follow- Naples, Caserta, Italy ing parietal damage 2Department of Psychology, University of Bologna, Bologna, Italy Paresh Malhotra1, Anna Sofia Musil2,KorinaLi1 and 3Neurology and Stroke Unit, CTO Hospital, Napoli, Charlotte Russell2 Italy 1Imperial College London, Division of Brain Sciences, London, UK In this study we present a 69 year-old right-handed 2Department of Psychology, Brunel University, Lon- man (M.S.) who, after a stroke on the left hemisphere, don, UK reported lesions to the posteromedial areas, such as the posterior cingulate gyrus (BA 30) and the pre- Although there is a great deal of support from func- cuneus (BA 31). Left precuneus and its surrounding tional imaging studies for parietal lobe involvement in areas seem to be relevant in visuo-spatial processing, episodic memory, until now there has been very little action simulation, mental imagery and mental naviga- experimental evidence from neuropsychological stud- tion processes. Given the rarity of M.S.’s lesion and ies with patients suffering from focal parietal dam- due to his good performance on a wide-ranging neu- age to suggest that parietal integrity is necessary for ropsychological assessment, this patient may help us episodic memory function. Given the key role of fron- to shed more light on the role played by this neu- toparietal networks in visuospatial representation, we ral network in visuo-motor/visual/motor imagery pro- hypothesised that the parietal lobe may play a cru- cesses. To this end, the performance of M.S. and 12 cial role in episodic memory with respect to the rec- healthy controls were compared on three imagery tasks ollection of details from an egocentric perspective. We requiring different levels of visual and motor control. tested two patients with right parietal stroke, and com- After walking on a path (there were three paths of pared them with control subjects, on a novel experi- different length), participants were submitted to the mental task utilising a head-mounted camera to record three imagery tasks: (i) ‘imagine a disc moving on images from the participants’ perspective. This en- the path’ (i.e., visual mental scanning requiring visuo- abled us to directly evaluate the integrity of memory spatial control over a spatial trajectory); (ii) ‘imagine from the individuals’ own personal point of view. All walking on the path’ (i.e., visuo-motor imagery requir- participants also carried out standard episodic memory ing visuo-motor and motor cooperation); (iii) ‘imagine tasks. We found that parietal patients were able to re- running in place’ (motor imagery requiring action sim- call information as well as control subjects when they ulation without visuo-spatial control). Imagined move- were asked to recollect whether particular items had ment time was analyzed by means of Crawford and been present in an array or where items had been pre- Garthwaite’s modified t-test to small control sample sented in relation to each other. They were also equiva- 412 Posters lently accurate in all standard tests of episodic memory. that knowledge about similarities between trajectories However, these patients were severely impaired when of good and bad performers in the virtual supermarket attempting to judge from which perspective they had may give diagnostic information on visual-spatial ca- viewed the scenes. This specific impairment was strik- pabilities and executive functions complementing tra- ing and in contrast to the relative ease of this condi- ditional neuropsychological measures. We found that tion for the control groups. These results provide the similarity of trajectories increased across training days first evidence for a specific deficit in episodic memory for both patients and controls. Explorative analyses in- in patients with parietal damage, and highlight the im- dicated that similarity measures may differentiate be- portance of the original spatial context in this type of tween good and bad performers in the VR supermarket. memory. Similarity values did not correlate with standard neuropsychological measures. Although DTW data show Keywords: Visuospatial Abilities, Stroke, Neuropsy- some evidence that similarities of movement trajecto- chological Assessment and Psychometrics ries are relevant for the analysis of visual-spatial abilities it remains unclear how this finding can be inte- Correspondence address: Dr Paresh Malhotra, Imperial grated into neuropsychological approaches. We con- College London, Division of Brain Sciences, St Dun- clude that more detailed trajectory analyses are needed stan, W6-8RP London, UK. E-mail: P.malhotra@ im- to answer the question whether similarity between perial.ac.uk movement patterns can be considered as a key aspect in the diagnosis and treatment of visual-spatial dys- P2.49 functions. Bohil et al. Virtual reality in neuroscience research and therapy. Nat Rev Neurosci. (2011). Analysis of movement trajectories using a dynamic time warping algorithm: neuropsychological rele- Keywords: Memory and Learning vance of similarities of movement patterns Correspondence address: Mr Dipl.-Biol. David Flen- David Flentge1, Kohsik2,Dyck2, Schäbitz3, Hell- tge, University of Bielefeld, Faculty of Psychology bach4,Botsch2 and Piefke5 and Sports Science, CITEC, Universitätsstraße 21-23, 1University of Bielefeld, Faculty of Psychology and D-33615 Bielefeld, Germany. E-mail: flentge@gmail. Sports Science, CITEC, Bielefeld, Germany com 2University of Bielefeld 3Clinic for Neurology EvKB, Bielefeld P2.50 4University of Applied Sciences, Dresden 5Witten/Herdecke University, Witten/Herdecke Left ventral premotor cortex subserves matching of hand posture to object use There is evidence from clinical neuropsychology that visual-spatial abilities can be diagnosed and trained Guy Vingerhoets1,JoNys2, Pieterjan Honoré2, Elisa- with optimum experimental control using Virtual Real- beth Vandekerckhove2 and Pieter Vandemaele2 ity (VR) technologies (Bohil et al. 2011). The analysis 1Department of Experimental Psychology, Ghent Uni- of movement trajectories in real life-like VR scenar- versity, Ghent, Belgium ios may complement neuropsychological data by in- 2Ghent University, Ghent, Belgium troducing important information on strategies of nav- igation, spatial knowledge of the virtual environment, Visuomotor transformations for grasping have been as- and executive control of task performance. However, sociated with a fronto-parietal network in the monkey methods for the analysis of movement trajectories that brain. Whereas the human homologue of the parietal go beyond measures of the length of trajectories and monkey region (AIP) has been identified as the ante- the time needed to accomplish a task are still lacking. rior part of the intraparietal sulcus (aIPS), the putative We here used a dynamic time warping (DTW) algo- human equivalent of the monkey frontal region (F5) rithm for the analysis of similarities between move- is less well documented. Results from animal stud- ment trajectories in healthy human subjects (N = 7) ies suggest that monkey F5 is involved in the selec- and patients after stroke (N = 7) during an 8-day train- tion of appropriate hand postures relative to the con- ing of shopping in a VR supermarket. We expected straints of the task. The present study aimed to iden- Posters 413 tify modulation in brain areas sensitive to the difficulty age. Results showed specific memory deficits for the level of tool object – hand posture matching. Seven- emotional stimuli at encoding, and, even when encod- teen healthy right handed participants underwent fMRI ing was controlled for, at consolidation. Deficits how- while observing pictures of familiar tool objects fol- ever only appeared after a one week (but not one hour) lowed by pictures of hand postures. The task was to de- delay, showing the crucial involvement of amygdala cide whether the hand posture matched the functional in long-term consolidation of emotional stimuli. Va- use of the previously shown object. Mismatch condi- lence effects were observed, as only the negative (and tions were manipulated for level of difficulty. Com- not positive) words were impaired during encoding pared to a picture matching control task, the tool ob- whereas consolidation was impaired for both positive ject – hand posture matching conditions conjointly and negative stimuli. Finally, the role of the amygdala showed increased modulation in several left hemi- in processing the intensity (arousal) of the negative spheric regions of the superior and inferior parietal lob- stimuli could be evidenced, as only the high-arousing, ules (including aIPS), the middle occipital gyrus, and but not low-arousing, negative words were impaired. the inferior temporal gyrus. Comparison of easy ver- Although the negative words were not perceived as sus hard conditions selectively modulated the left infe- emotionally arousing by the patient, these words were rior frontal gyrus with peak activity located in its op- specifically poorly encoded and consolidated, suggest- ercular part (Brodmann area (BA) 44). The results of ing separate cerebral networks involved in emotional the present study support the ventral premotor cortex processing. (vPMC), in particular the opercular region, as the putative human homologue of monkey F5. We suggest Keywords: Emotion, Amnesia, Neuropsychological that in the human brain, vPMC/BA44 is involved in the Assessment and Psychometrics matching of hand posture configurations in accordance with visual and functional demands. Correspondence address: Dr Claire Mayor Dubois, CHUV, Pediatric Department, Rue du Bugnon 46, CH- Keywords: Other Functions/Disorders, Functional and 1011 Lausanne, Switzerland. E-mail: Claire.Mayor@ Structural Neuroimaging/NIRS chuv.ch

Correspondence address: Mr Prof. Dr. Guy Vinger- P2.52 hoets, Ghent University, Department of Experimental Psychology, Henri Dunantlaan 2, B-9000 Ghent, Bel- Body postures recognition in TLE: Beyond facial gium. E-mail: [email protected] expressions

P2.51 Anna Sedda1, Pina Scarpa2, Stefano Francione3,Gior- gio Lorusso3 and Gabriella Bottini2 Verbal emotional memory in a case of bilateral 1Departemnt of Brain and Behavioural Sciences, Uni- amygdala damage versity of Pavia, Pavia, Italy 2A.O. Niguarda Cà Granda, Cognitive Neuropsychol- Claire Mayor Dubois1, Sophie Déglise1, Claudia ogy Centre, Milano, Italy Poloni1, Philippe Maeder2 and Eliane Roulet Perez1 3A.O. Niguarda Cà Granda, Epilepsy Surgery Centre 1CHUV, Pediatric Department, Lausanne, Switzerland “C. Munari”, Milano, Italy 2CHUV, Radiology Department, Lausanne (Switzer- land) Facial emotion recognition (FER) has been widely investigated in Temporal Lobe Epilepsy (TLE). Studies The amygdala nuclei appear to be critically implicated highlighting prosodic recognition deﬁcits in TLE sug- in the modulation of emotional memory. Issues regard- gest that emotional impairments might not be modality ing the role of valence (i.e., the positive versus nega- dependent. However, much less is known – in TLE – tive nature of the stimuli) and of arousal (i.e. the af- about processing of emotions from postures. In this fective intensity of the stimulus) on amygdala emo- preliminary study, we administered a sample of 10 (4 tional processing remain however debated. We stud- left and 6 right) drug resistant TLE patients with a task ied verbal emotional memory (word list paradigm) in a comprising both facial expressions and body postures, young woman presenting with bilateral amygdala dam- that allows to directly compare the two sets of stimuli. 414 Posters

We also recruited a control group of 10 healthy individ- OBJECTIVE: Children’s ability to identify others’ uals, matched for gender, education and age. All par- emotions is fundamental to emotional regulation and ticipants have been administered with a facial emotion cognitive control. Research on the development of recognition task (Ekman and Friesen, 1976 Consulting emotion recognition has been dominated by studies Psychologists Press) and a body postures recognition on the processing of facial expression; however whole task – BEAST (de Gelder and Van den Stock, 2011 bodily expression is important for other representation Frontiers in Psychology). In both tasks, subjects were and also supports social perception. Children with tem- asked to choose which emotion was displayed among poral lobe epilepsy (TLE) frequently have emotional four possible alternatives: fear, anger, sadness and hap- and social disorders including autism spectrum disor- piness. Disgust is excluded as the BEAST does not ders. Here we assess emotional body categorization in contain this posture. Our results show that both right children presenting TLE. and left TLE patients are impaired respect to controls METHODS: Nine children with TLE aged from 8 to on fear, anger and happiness recognition, only at the 15 years old took part of the study. All were involved in BEAST task (Mann-Whitney U test, all ps < 0.05). No presurgical or post operative epilepsy surgery program. significant correlations between age at epilepsy onset Photos of emotional body expression (anger, fear, hap- and performance at the BEAST task have been found. piness, sadness and neutral) were displayed one at a These results suggest that full displays of facial ex- time on a computer screen. Children were instructed pressions might not be sensitive enough in TLE (Sedda to categorize the emotion expressed by the whole body et al. 2013 CABN). FER seems to be more related to stimuli in pointing to the corresponding smiley placed clinical variables such as age at onset and lateraliza- on the right side of the display. Patients’ performances tion contrary to body posture recognition which proba- were compared to matched healthy children. bly explored other aspects rather than basic emotional RESULTS: Children with TLE identified significantly processes. less emotional body postures than healthy children. Moreover, patient had more difficulties to recognize Keywords: Emotion, Epilepsy, Neuropsychological sadness body postures, followed by neutral, whereas Assessment and Psychometrics fear was the easiest. CONCLUSION: These preliminary findings showed Correspondence address: Dr Anna Sedda, Departemnt that early TLE could also modulate the perception of of Brain and Behavioural Sciences, University of bodily expressions. Results will be discussed in light of Pavia, piazza Botta 11, IT-27100 Pavia, Italy. Tel.: +39 the social perception difficulties observed in children 3490579823; E-mail: [email protected] with TLE.

P2.53 Keywords: Emotion, Epilepsy, Neuropsychological Assessment and Psychometrics Perception of body expression in school-aged children with temporal lobe epilepsy Correspondence address: Dr Laurent AUCLAIR, Uni- versity Paris Descartes, INSERM U663, Institut of 1 2 Laurent Auclair , Mélanie Rymer ,Clémence Psychology, Av. Edouard Vaillant, 71, F-92100 Boulo- 2 3 4 Lalande , Georg Dorfmuller , Christine Bulteau and gne-Billancourt, France. E-mail: laurent.auclair@ 5 Isabelle Jambaque parisdescartes.fr 1University Paris Descartes, INSERM U663, Institut of Psychology, Boulogne-Billancourt, France P2.54 2University Paris Descartes, Institut of Psychology, Boulogne-Billancourt, France Motivational conﬂict processing in patients with ju- 3 Foundation Ophtalmologique Adolphe de Rothschild, venile myoclonic epilepsy: Neurostructural corre- Pediatric Neurosurgery Department, Paris, France lates of social decision-making 4Foundation Ophtalmologique Adolphe de Rothschild, Pediatric Neurosurgery Department and INSERM Martin Peper1, Markus Ramm1, Marcus Belke2,Su- U663, Paris, France sanne Knake2 and Mira-Lynn Chavanon1 5 University Paris Descartes, Institut of Psychology 1Philipps-Universitaet Marburg, Department of Psy- and INSERM U663, Paris, France chology, Experimental and Biological Psychology, Posters 415

Neuropsychology Section, Marburg, Germany P2.55 2Philipps-Universitaet Marburg, Department of Neu- rology, Marburg, Germany Short term cognitive-behavioral therapy in pseudoepileptic seizures – preliminary results. Juvenile myoclonic epilepsy (JME) is the most com- 1 2 mon idiopathic generalized epilepsy and character- Urszula Stolarska-Werynska and Marek Kacinski´ 1 ized by structural and functional abnormalities of the Children’s University Hospital Cracow, Pediatric frontal lobes. It is charecterized by motivational and Neurology, Cracow, Poland 2 emotional abnormalities such as rapidly changing af- Children’s University Hospital Cracow, Head of the fect, unsteadiness, lack of drive and endurance. Ap- Department of Pediatric Neurology, Chair of Pediatric proach or withdrawal tendencies as well as motiva- and Adolescent Neurology, Cracow, Poland tional conflicts can be studied within the context of Reinforcement Sensitivity Theory (RST). Patients with In the Pediatric Neurology Department we encounter JME are expected to show elevated reward-related ac- various disorders demanding a differental diagnosis to tivity (Behavioral Approach System, BAS) and de- establish a possible psychogenic cause. Among those creased conflict processing (Behavioral Inhibition Sys- the diagnosis of pseudoepileptic seizures is one of the tem, BIS) being associated with poor behavioral in- most difficult and often controversial, especially in hibition. These changes are expected to be associated children with history of antiepileptic pharmacotherapy. Psychotherapy is considered the only effective treat- with structural brain integrity of the orbitofrontal cor- ment of psychogenic disorders, while we lack data sup- tex (OFC) and the anterior cingulate (ACC) as this porting the effectivenes of one therapeutic schedule is the basis of appropriate motivational functioning. over another. Current research argues that psychother- Here, we compared 12 patients with JME with 14 apy of conversion disorders is inevitably a long term matched controls. Motivation was assessed in the con- process, some of the cases remaining unsuccesfull. text of a cross-modal Pavlovian-Instrumental Trans- We challenge this statement by conducting a study on fer (PIT) paradigm inducing a conflict between instru- the effects of cognitive- behavioral therapy in pseu- mentally and classically conditioned cues (i.e., “So- doepileptic seizures. cial Talent Show Task” corresponding to a probabilistic GOAL OF THE STUDY: To establish whether short decision-making procedure). Regional brain volumes term cognitive-behavioral therapy is effective in pseu- were assessed with voxel-based MRT morphometry. doepileptic seizures. During conflict, participants with JME showed greater METHODS: Short term (8 to 10 sessions, 1 hour reward but no reduced BIS sensitivity. In JME patients, each) cognitive behavioral psychoterapy in teenagers mOFC white matter volume was associated with lower with pseudoepileptic seizures. Each patient undergoes distraction by conflictual cues (r = −0.60; p = 0.01; video-eeg with placebo trial, and a neuropsychologi- controls: r = −0.22). Performance differences during cal test battery. The psychotherapeutic sessions include conflict were associated with rostral ACC volume in behavioral and cognitive strategies, each session takes controls (r = 0.49; p<0.05), but not in JME (r = 60 minutes, one a day. 0.10). The results are compatible with the view that the MATERIAL: The study has so far included 12 in- structural integrity of ACC and mOFC is predictive of patients, aged 15–18, 11 girls, 1 boy Summary of reward sensitivity and motivational conflict in social the results: 11/12 patients left the ward without fur- decision-making. ther seizues as observed during the hospitalization, although only a long term follow up may possibly con- Keywords: Emotion, Epilepsy, Functional and Struc- firm the this result. Two of the children are seizure free tural Neuroimaging/NIRS for 12 months since finishing the treatment. CONCLUSION: The preliminary results are very pr- Correspondence address: Mr Prof. Dr. Dr. Martin omising, suggesting that an intensive, short term cog- Peper, Philipps-Universitaet Marburg, Department of nitive behavioral therapy may be an effective treatment Psychology, Experimental and Biological Psychology, of psychogenic non epileptic seizures. If proven so in a Neuropsychology Section, Gutenbergstr. 18, D-35032 long term follow up this would be one of the most cost- Marburg, Germany. Tel.: +49 6421 282 3830; E-mail: and time-effective treatment of a disorder that greatly [email protected] disables not only the patient but his family life, school and total everyday functioning. 416 Posters

Keywords: Emotion, Epilepsy, Neuropsychological cused the analyses on the significant results that we Assessment and Psychometrics initially found to be specifically impaired in the postoperative group compared to the pre-operative and Correspondence address: Mrs clinical neuropsychol- control groups. ogist Urszula Stolarska-Werynska, Children’s Univer- Results revealed that the biased ratings in the post- sity Hospital Cracow, Pediatric Neurology, Wielicka operative condition compared to the two other groups 265, Poland-30-663 Cracow, Poland. Tel.: +48 697608 were correlated to the maximum of loudness for fear 186; E-mail: [email protected] recognition while the biases for anger recognition were correlated to the standard deviation of intensity, the P2.56 mean, maximum, minimum, and SD of pitch. There is a significant influence of the relevant acous- Influence of the relevant acoustic features on the tic features on the disturbed emotional prosody recog- recognition of emotional prosody following subtha- nition following STN DBS in PD. Nevertheless, this lamic nucleus deep brain stimulation in Parkinson’s influence is not sufficient to explain the emotional disease prosody disturbances observed following STN DBS and suggest that higher levels of emotional prosody Julie Péron1, Sezen Cekic2, Claire Haegelen3,Paul processing are also impaired by this surgery. Sauleau3, Dominique Drapier3, Marc Vérin3 and Didier Grandjean2 Keywords: Emotion, Neurodegenerative Diseases, In- 1University of Geneva, Psychology and Swiss center vasive Techniques for Affective Sciences, Geneva, Switzerland 2Dprt of Psychology, and Swiss Center for Affective Correspondence address: Dr Julie Péron, university Sciences, Geneva University, CH., Geneva, Switzer- of Geneva, Psychology and Swiss center for Affec- land tive Sciences, 40 bd du Pont D’Arve, D-1205 Geneva, 3Behavior and Basal Ganglia EA4712 unit, Rennes Switzerland. E-mail: [email protected] 1 University and University Hospital of Rennes, F., Rennes, France P2.57

This study focus on the impact of several acousti- Reduction of neuropsychiatric symptoms in pa- cal features known to be important for the recogni- tients with Alzheimer’s disease following psychoed- tion of emotional prosody following subthalamic nu- ucation programs for their caregivers cleus (STN) deep brain stimulation (DBS) in Parkin- son’s disease (PD) and how STN DBS might impact at Tatiana Aboulafia Brakha1, Radek Ptak1 and Deborah different levels of emotional auditory processing. Suchecki2 The demonstration of the emotional effects of STN 1Hôpitaux Universitaires de Genève (HUG), Division DBS in PD pointed for the first time to the involve- of Neurorehabilitation- Department of Clinical Neuro- ment of the STN in the cerebral network subtending sciences, Geneva, Switzerland emotions and notably the recognition of emotion from 2Department of Psychobiology, Universidade Federal voices i.e., emotional prosody (see Péron, Frühholz et de Sao Paulo, Sao Paulo, Brazil al. in press for a review). Nevertheless, the exact contribution of the STN in emotional prosody remains to BACKGROUND: Neuropsychiatric symptoms such as be clarified, and the question of the influence of acous- aggressiveness, hallucination and delusion are com- tic features in the recognition of emotional prosody of monly found in patients in the moderate stage of STN DBS PD has not been adequately accounted for Alzheimer’s disease (AD). These symptoms are fre- to date. quently treated with neuroleptics and anxiolytics but We re-analyzed the performances in the recognition of patients may suffer from many unpleasant side effects. emotional prosody in the PD patients in a pre and in As an alternative, interventions for caregivers of AD a post-operative conditions and matched healthy con- patients have been shown to be useful in the manage- trols (Péron, Grandjean et al. 2010) including relevant ment of neuropsychiatric symptoms. acoustic features as dependent variables in our statisti- OBJECTIVES: To assess changes in neuropsychiatric cal modelisation (GLM zero inflated method). We fo- symptoms of patients with moderate AD after two Posters 417 types of psychoeducation interventions for their pri- 2Department of Biomedical Sciences “L. Sacco”, Uni- mary caregivers. versity of Milan, Milan, Italy METHODS: Twenty-four primary caregivers (relatives) were assigned to two types of programs that Neuroimaging and electrophysiological studies have consisted of once-a-week group sessions during eight shown the involvement of a fronto-temporo-occipital weeks: Group 1: psychoeducation only (n = 13), network in face processing, but the functional relation Group 2: psychoeducation with cognitive-behavioural among these areas remains unclear. We used transcra- therapy (n = 11). Before and after the interven- nial magnetic stimulation combined with electroen- tion, caregivers completed a semi-structured interview cephalography (TMS-EEG) to explore the local and (Behave-AD) assessing neuropsychiatric symptoms of global cortical excitability at rest and during two dif- the AD patient. ferent face processing behavioural tasks. Single-pulse RESULTS: A 2 × 2 ANOVA for Behave-AD scores TMS was delivered (100 ms after face stimulus on- revealed a significant effect of time (F (1,23) = 14.09, set) over the right medial prefrontal cortex (mPFC) p<0.01, etasq = 0.39, P = 94%), but no significant during a face identity or a face expression match- interaction between time and intervention. Indeed, in ing task, while continuous EEG was recorded using a both groups, neuropsychiatric symptoms significantly 60-channel TMS-compatible amplifier. We examined decreased after intervention (Psychoeducation only: F TMS effects on the occipital face-specific ERPs com- (1,12) = 12.96, p>0.001; Psychoeducation + CBT: ponent and compared TMS-evoked potentials (TEPs) F (1,10) = 5.36, p = 0.04). recorded during tasks performance and a passive point CONCLUSION: Psychoeducation for caregivers, re- fixation. TMS reduced the P1-N1 component recorded gardless of modality, may be useful to promote re- at the occipital electrodes. Moreover, performing face duction of neuropsychiatric symptoms in patients with tasks significantly modulated TEPs recorded at the moderate AD. This may be explained by an increased occipital and temporal electrodes within the first 30 understanding of the disease by caregivers, probably ms after right mPFC-TMS, with a specific increase leading to better interaction between them and the AD of temporal TEPs in the right hemisphere for the fa- patient, with more understanding and affect. These cial expression task. Furthermore, in order to test the findings have significant implications for the treatment site-specificity of the reported effects, TMS was ap- of neuropsychiatric symptoms in dementia, since it plied over the right premotor cortex (PMC) as a con- may reduce the need for administering psychotropic trol site using the same experimental paradigm. Re- medication. sults showed that TMS over the right PMC did not affect ERPs components in posterior regions during the Keywords: Emotion, Neurodegenerative Diseases face tasks and TEPs amplitude did not change between task and no task condition, either at fronto-central elec- Correspondence address: Mrs Tatiana Aboulafia trodes near the stimulation or at temporal and occipital Brakha, Hôpitaux Universitaires de Genève (HUG), electrodes. These findings support the notion that the Division of Neurorehabilitation, Department of Clin- frontal cortex exerts a very early influence over the oc- ical Neurosciences, AV. Beau-Séjour, 26, CH-1207 cipital cortex during face processing tasks and that ex- Geneva, Switzerland. E-mail: tatiana.aboulafia@ citability across right fronto-temporal cortical regions hcuge.ch is significantly modulated during explicit facial expression processing. P2.58 Keywords: Emotion, Other Disorder/Samples, TMS/ Top-down interference and cortical responsiveness TCDS in face processing: a TMS-EEG study Correspondence address: Mrs Mattavelli, University Mattavelli1,MarioRosanova2, Adenauer Casali2, of Milano-Bicocca, Department of Psychology, P.za Cosatanza Papagno1 and Leonor Romero Lauro1 Ateneo Nuovo 1, IT-20126 Milan, Italy. E-mail: g. 1Department of Psychology, University of Milano- [email protected] Bicocca, Milan, Italy 418 Posters

P2.59 P2.60 rTMS stimulation improves the facial mimicry and Conscious and unconscious face recognition is im- detection responses in an empathic emotional task proved by high-frequency rTMS on pre-motor cortex Michela Balconi and Ylenia Canavesio Department of Psychology, Catholic University of Mi- Balconi1 and Adriana Bortolotti2 lan, Milan, Germany 1Catholic university of milan, Milan, Germany 2Department of psychology, Catholic university of mi- Facial expression detection and facial mimicry behav- lan, Milan ior in response to an empathic situation were analyzed in the present research. We supposed a “simula- Simulation process and mirroring mechanism appear tion mechanism” may be related to empathic response, to be necessary to the recognition of emotional fa- and that it could be supported by prefrontal cortical cial expressions. Prefrontal areas were found to sup- structures. High frequency rTMS (repeated Transcra- port this simulation mechanism. The present research nial Magnetic Stimulation) was applied to MPFC to in- analyzed the role of premotor area in processing emo- duce an increased response to facial expression of emotional faces with different valence (positive vs. neg- tions when subjects (N = 16) were required to em- ative faces), considering both conscious and uncon- pathize with the emotional stimuli. The stimulus va- scious pathways. High-frequency rTMS (10 Hz) stim- lence was also varied (negative vs positive vs. neu- ulation was applied to prefrontal area to induce an ac- tral faces) to explore also the emotional content effect tivation response when overt (conscious) and covert on empathic behavior. Autonomic (facial zygomatic (unconscious) processing was implicated. Twenty-two and corrugator EMG subjective response) and detec- subjects were asked to detect emotion/no emotion tion (correct recognitions, CRs; RTs, response times) (anger, fear, happiness, neutral). Error rates (ERs) and measures were found to be modulated by MPFC ac- response times (RTs) were considered in response to tivity. Specifically, when prefrontal structures were ac- the experimental conditions. ERs and RTs decreased tivated (in comparison with sham effect and control in case of premotor brain activation, specifically in re- site stimulation) an increased performance was ob- sponse to fear, for both conscious and unconscious served in terms of increased CRs and reduced RTs for condition. The present results highlight the role of the face recognition from one hand; of increased emotion- premotor system for facial expression processing, sup- specific EMG response for the other hand. In fact, zy- porting the existence of two analogous mechanisms for gomatic muscle was more responsive in case of pos- conscious and unconscious condition. itive emotion (happiness), whereas corrugator activity was related to negative emotions (fear, anger, disgust). Keywords: Emotion, Other Disorder/Samples, TMS/ A higher effect was revealed for negative, and poten- TCDS tially aversive, faces in comparison respectively with positive and neutral faces. Finally, a direct correlation Correspondence address: Mrs balconi, catholic univer- was found between the autonomic and detection mea- sity of milan, largo gemelli 1, D-20123 milan, Ger- sures. Taken together, these results suggest a “simula- many. E-mail: [email protected] tion mechanism” underlying empathic situations that includes both EMG and behavioral responses. This P2.61 mechanism appears to be supported and regulated by MPFC area. Obesity modulates the relationship between COMT Val158Met gene and harm avoidance Keywords: Emotion, Other Disorder/Samples, TMS/ TCDS Isabel Garcia-Garcia1, Pilar González-Tartiere2, Idoia Marqués-Iturria2,RoserPueyo2, María Ángeles Jura- Correspondence address: Mrs prof michela balconi, do2, Bàrbara Segura2, Imma Hernán3, María Consuelo Department of Psychology, Catholic University of Mi- Sánchez-Garre3 and Maite Garolera3 lan, largo gemelli 1, D-20123 milan, Germany. E-mail: 1University of Barcelona, Psychiatry and Clinical Psy- [email protected] chobiology, Barcelona, Spain Posters 419

2University of Barcelona 2Aristotle University of Thessaloniki, 1st University 3Consorci Sanitari de Terrassa Psychiatry Clinic, Thessaloniki, Greece

Obesity is a health problem in modern societies which Deficits in facial emotion recognition (FER) in schizo- can be best summarized as the interaction of genetic phrenia are rather ubiquitous. While some studies have susceptibility and environmental factors. Dopamine suggested that these deficits reflect impaired affec- has been widely implicated in its aethiology. The tive processing, there is increasing evidence of the Val158Met polymorphism of the COMT gene is a contribution of attention impairment in poor FER in source of individual variations in dopamine avail- these patients. Our main objective was to explore ability at the prefrontal cortex. Both obesity and the this discrepancy employing interventions for either Val158Met polymorphism seem to have an impact on affect recognition or attention to crucial facial fea- personality measures, although their possible interac- tures, such as the eyes and mouth. Thirty nine out- tion has yet to be examined. We examined two dimen- patients with schizophrenia (DSM-IV-based diagno- sions of the Temperament and Character Inventory Re- sis; 19 men) were randomly assigned to one of three vised (TCI-R), novelty seeking and harm avoidance, groups: 1) facial emotion intervention (EI), 2) atten- in 67 participants with obesity (12–39 years, 60% fe- tion to facial features intervention (AI), 3) no interven- males) and 53 lean subjects (12–40 years, 64% fe- tion (NI). We assessed attention to faces (AF) through males). We also obtained COMT genotype from all the a series of stimuli we developed requiring the de- participants. Data was analyzed with a 2 (obese ver- tection of details in facial features; similarly, we as- × sus lean) 2 (Val+ versus Val-) analysis of variance. sessed FER with an additional set of newly developed In comparison with controls, participants with obesity stimuli consisting of photographs of faces with emo- p = scored higher on harm avoidance ( 0.047). We also tional expressions. All patients were assessed for AF found an effect of COMT in novelty seeking, with Val+ and FER pre- and post-intervention (with alternative p = subjects obtaining higher scores ( 0.022). Further- sets of stimuli). Although pre-intervention AF perfor- more, there was a ‘group’ x ‘COMT’ interaction on mance predicted FER accuracy, the AI did not result harm avoidance (p = 0.028). Examination of this in- in improved FER performance at post-intervention. teraction revealed that obesity altered the normative di- Repeated-measures ANOVAs (with time of assessment rectionality of the effect of COMT genotype on harm as the within-subject factor) showed that only the EI avoidance. This is the first study on the relationship be- group improved significantly with respect to FER ac- tween obesity, the COMT gene and personality traits. curacy, particularly on the perception of anger and fear; The results suggest that obesity is a modulatory fac- the AI group improved only on AF accuracy. We found tor for effect of COMT genotype on a temperament di- no improvement in affect processing (FER) speed in mension with a fundamental role in emotional equilib- any group. These findings highlight the prominence of rium. affect processing dysfunction in FER impairment in Keywords: Emotion, Other Disorder/Samples, Neu- schizophrenia. Despite the predictive value of attention ropsychological Assessment and Psychometrics to facial features in FER accuracy, attention impairment in patients with schizophrenia more likely aggra- Correspondence address: Mrs Isabel Garcia-Garcia, vates, rather than explains poor FER. In conclusion, as- University of Barcelona, Psychiatry and Clinical Psy- sessment of facial emotion recognition in patients with chobiology, Passeig Vall d\, D-08035 Barcelona, schizophrenia may prove a useful addition to any com- Spain. E-mail: [email protected] prehensive remediation program.

P2.62 Keywords: Emotion, Psychopathology, Neuropsycho- logical Assessment and Psychometrics A brief intervention for facial emotion recognition in schizophrenia Correspondence address: Mrs Stella Tsotsi, Aristo- tle University of Thessaloniki, Psychology, P.O.Box Stella Tsotsi1, Vassilios P. Bozikas2, Konstantinos D3030, 57001 Thessaloniki, Greece. Tel.: +30 694654 Fokas2 and Mary H. Kosmidis1 6922; E-mail: [email protected] 1Aristotle University of Thessaloniki, Psychology, Thessaloniki, Greece 420 Posters

P2.63 Keywords: Emotion, Psychopathology, Neuropsycho- logical Rehabilitation A differential effect of a brief intervention on facial affect recognition in patients with first psychotic Correspondence address: Mrs Stella Tsotsi, Aristo- episode tle University of Thessaloniki, Psychology, P.O.Box D3030, 57001 Thermi, Greece. Tel.: +30 6946546922; Vassilios P. Bozikas1, Stella Tsotsi2, Aikaterini Darda- E-mail: [email protected] gani2, Athanasios Lagoudis1, Eleni Nazlidou1,Aika- terini Giazkoulidou1 and Konstantinos Fokas1 P2.64 1Aristotle University of Thessaloniki, 1st Psychiatry Clinic, Thessaloniki, Greece Changes in perceived anger and psychophysiolog- 2Aristotle University of Thessaloniki, Psychology, ical response in TBI patients following different Thessaloniki, Greece anger regulation strategies: implications for psychotherapeutic treatment. Facial emotion recognition (FER) is deficient in schizophrenia (SCH) across all stages, including the first Tatiana Aboulafia Brakha and Radek Ptak episode. Although the importance of FER in SCH has Hôpitaux Universitaires de Genève (HUG), Division been emphasized by its mediation of the relationship of Neurorehabilitation, Department of Clinical Neuro- between cognition and social functioning, up-to-date sciences, Geneva, Switzerland no attempt to improve these deficits in patients with first psychotic episode (FP) has been reported. In this BACKGROUND: Excessive irritability and anger are context, our main goal was to investigate the effect of frequently reported following traumatic brain injury a brief facial emotion intervention in FP. The sample (TBI). From a cognitive-behavioural perspective, an consisted of 20 FP (9 men) and 12 healthy controls (4 emotion can be understood in relation to its context, men; HC), matched for age and education. The Pos- associated thoughts, behaviour and psychophysiologi- itive and Negative Symptom Scale (PANSS) was ad- cal reactions. A few experimental studies with healthy ministered for symptom severity. FER was assessed participants have shown that different cognitive strate- twice, before and after the intervention, via two alter- gies for anger regulation interfere with psychophysi- native sets of newly developed stimuli depicting ex- ological reactions and the perception of angry emo- pressions of the six basic emotions. Two scores were tion. Whether similar mechanisms affect pathological obtained: accuracy and reaction time. FER interven- anger following TBI is unknown. Objectives: To ver- tion comprised training to recognize changes in fa- ify experimentally whether angry feelings and associ- cial features, characteristic of certain emotion expres- ated psychophysiological reactions following TBI may sions. No significant correlation was noted between be modulated by alternative ways of thinking about an symptom dimensions and FER scores. As evidenced anger-inducing event. by repeated-measures ANOVAwith time as the within- METHODS: Nine TBI patients and eight healthy con- subject factor, both groups showed improved FER at trols participated in an anger recall task and were sub- post-intervention, particularly for angry and disgusted mitted to four experimental recall conditions: neutral, facial expressions. In sad faces only a group effect was spontaneous, rumination and reappraisal. Electroder- observed with HC performing better that FP. For fear, mal activity (EDA) was recorded during each condi- an interaction of group and time emerged; while HC tion, after which, participants answered a self-report performance improved significantly, FP exhibited sta- questionnaire on subjectively perceived anger (STAXI- ble performance between measurements. No improve- State). ment was observed in response speed. Overall, these RESULTS: One-way ANOVAs revealed a significant findings suggest that FP can benefit from brief inter- effect of condition in both groups, for both EDA (con- ventions for FER, especially in anger and disgust, in a trols: F (3,21) = 4.42, p = 0.015, TBI: F (3,24) = similar manner to HC. Yet, persistence of impairment 5.124, p<0.01) and STAXI-state (controls: F (3,21) in the recognition of fear by the FP is in line with pre- = 11.06, p<0.01, TBI: F (3,24) = 3.55, p = 0.03). vious studies, suggesting that poor recognition and ma- Paired-contrasts showed that EDA was similarly mod- nipulation of threat-related information may comprise ulated by recall conditions in both groups, but STAXI- a susceptibility factor for developing the full range of State scores were more differentiated in controls than schizophrenia symptoms. in TBI patients. Posters 421

CONCLUSION: Physiological correlates of angry fee- ing Pearson’s and Spearman’s tests. There were no lings may be influenced by the way one thinks about group differences in demographic variables. Compared the situation, in both TBI patients and controls, while with control participants, obese subjects showed higher TBI patients are less able to evaluate their subjec- scores on the three subscales of the TFEQ (all p< tive state of angry arousal. These findings suggest that 0.001). Basal ganglia volumes did not differ between TBI patients may potentially benefit from cognitive- groups. Uncontrolled eating was negatively correlated behavioural strategies to improve their anger manage- with right nucleus accumbens volume (r = −0.358; ment, such as the cognitive reappraisal of the anger- p = 0.035), and emotional eating was negatively corre- inducing situation. lated with left (r = −0.336; p = 0.049), right putamen (r = −0.374, p = 0.027) and right nucleus accumbens Keywords: Emotion, Traumatic Brain Injuries (r = −0.368; p = 0.030) volumes in the obese group. These relations were not found in the lean group. Re- Correspondence address: Mrs Tatiana Aboulafia Brak- sults show that higher scores in emotional and uncon- ha, Hôpitaux Universitaires de Genève (HUG), Di- trolled eating were related to lower basal ganglia vol- vision of Neurorehabilitation- Department of Clin- umes in obese people. Our results suggest the impor- ical Neurosciences, AV. Beau-Séjour, 26, CH-1206 tant role of the basal ganglia on eating behavior in obe- Geneva, Switzerland. E-mail: tatiana.aboulafia@ sity. hcuge.ch Keywords: Other Functions/Disorders, Other Disor- P2.65 der/Samples, Functional and Structural Neuroimaging/ NIRS Emotional and uncontrolled eating are associated with lower basal ganglia volumes in obese people Correspondence address: Mrs P. González-Tartière, Department of Psychiatry and Clinical Psychobiology, P. González-Tartière1, I. Marqués-Iturria2, I. García- University of Barcelona, Passeig Vall d’Hebron, 171, García2,M.Garolera3, R. Pueyo2, B. Segura2,M.J. D-08035 Barcelona, Spain. Tel.: +34 687817299; E- Sender3,M.Vernet3 and M.A. Jurado2 mail: [email protected] 1Department of Psychiatry and Clinical Psychobiol- ogy, University of Barcelona, Barcelona, Spain P2.66 2University of Barcelona 3Consorci Sanitari de Terrassa Fatigue in Multiple Sclerosis patients – a result of reduced histamine modulation in the brain? It is well established that basal ganglia mediate goal directed behaviors (Haber and Knutson, 2010), and are Katrin Hanken1, Anja Gossmann2,PiaLehmann2, known as key brain regions for food motivation and Helmut Hildebrandt2 and Andreas Kastrup2 reward (Lawrence et al., 2012). The aim of this study 1Department of Neuropsychology, University of Bre- was to assess the relations between eating behavior and men, Bremen, Germany basal ganglia volumes in obesity. The sample was com- 2Klinikum Bremen-Ost, Neurology, Bremen, Germany posed of 65 participants between 12 and 40 years of age, 35 of which were obese (11 males, 24 females; Although fatigue is one of the most common and dis- 24.97 ± 10.95 years of age; BMI) and 30 controls (13 abling symptoms of multiple sclerosis (MS), little is males, 17 females; 26.37 ± 9.24 years of age). known about its pathophysiology.The aim of this study Eating behaviors were determined using the Three Fac- was to investigate if the posterior hypothalamus (con- tor Eating Questionnaire (TFEQ), composed of three sidered as the wake center) is involved in the underly- subscales: cognitive restraint, uncontrolled eating and ing mechanisms of MS-related fatigue. The study eval- emotional eating. Basal ganglia volumes were esti- uated 49 patients with relapsing-remitting MS and 14 mated using the automated procedure proposed by healthy controls using diffusion tensor imaging (DTI) Freesurfer for subcortical structures, and then each to obtain information about fiber integrity. DTI param- volume was divided by its corresponding intracranial eters were calculated for fibers between the posterior volume. We performed group comparisons using Stu- (as well as anterior) hypothalamus and the prefrontal dent’s t and Mann-Whitney’s U, and correlations us- cortex, the mesencephalon and the pons. Fatigue sever- 422 Posters ity was assessed using the fatigue scale for motor and fects on brain structure and brain integrity. It was also cognitive functions. The level of alertness was inves- reported that these plastic changes are not strictly re- tigated using a testbattery for alertness and the Beck’s lated to language processing but generalize to other Depression Inventory (BDI) was used to determine a cognitive functions such as executive control (Abu- clinical relevant depression. In total 87.8% of patients talebi et al., 2012). suffered from cognitive fatigue, 89.8% reported mo- Structural grey matter plasticity associated to multilin- tor fatigue and 63.3% had an impaired alertness level. gualism has been highlighted already in young chil- Multiple analysis of variance showed significant differ- dren in a brain area not only involved in language ences in DTI parameters between groups, with fatigued processing but also recruited for attentional demands, patients revealing lower axial and radial diffusivity val- namely the left inferior parietal cortex (LIPL) (Della ues for fibers between the right posterior hypothala- Rosa et al., 2013). Interestingly, grey matter changes mus and the mesencephalon than non-fatigued patients in this area have been also related to the degree of pro- and healthy controls (cognitive fatigue: p = 0.047; mo- ficiency of second language in a group of early adult tor fatigue: p = 0.026). Considering alertness, patients bilinguals (Mechelli et al., 2004) . with normal alertness showed smallest values for axial In the present study we investigated by means of struc- and radial diffusivity regarding the same fibers (p = tural neuroimaging (MR imaging) a group of 34 ag- 0.048), but there was no difference between impaired ing bilingual subjects from Hong Kong. In detail, we MS patients and healthy controls. DTI parameters for explored with the VBM (voxel based morphometry) fibers of the anterior hypothalamus revealed signifi- technique the relationship between whole-brain white cant associations with the BDI (defined as covariate). matter density and language proficiency. We found that These findings suggest that reduced fiber integrity be- values in fiber tracts connecting LIPL correlated to the tween the right posterior hypothalamus and the mes- relative language proficiency of the aging population. encephalon might be involved in the pathophysiology This result shows that fiber tracts connecting LIPL to of MS-related fatigue. Also, there might be relation- both temporal and frontal language areas (i.e. the arcu- ship between the anterior hypothalamus and the level ate fasciculus) are influenced by second language ex- of depression. pertise and confirm the role of LIPL as a crucial area for multilingualism and its interface with other cogni- Keywords: Other Functions/Disorders, MS/Demye- tive functions. lination, Other Methods Keywords: Language, Aging, Functional and Struc- Correspondence address: Mrs Katrin Hanken, De- tural Neuroimaging/NIRS partment of Neuropsychology, University of Bremen, Hochschulring, D-28359 Bremen, Germany. E-mail: Correspondence address: Mr BS Matteo Canini, Uni- [email protected] versity San Raffaele, Center for Cognitive Neuro- science, Via Olgettina 59, IT-20100 Milan, Italy. E- P3.01 mail: [email protected]

Second language proﬁciency induces white matter P3.02 changes in the left parietal lobe in aging populations Second language naming performance predicts Matteo Canini1, Pasquale Della Rosa2,LoPing temporal pole integrity in aging bilinguals Sheung3, S.Brendan Weekes3 and Jubin Abutalebi3 1University San Raffaele, Center for Cognitive Neuro- Jubin Abutalebi1, Matteo Canini2, Pasquale Della science, Milan, Italy Rosa3, Lo Ping Sheung4, David W. Green5 and Bren- 2IBFM-CNR, Institute of Molecular Bioimaging and dan S. Weekes4 Physiology, Milan, Italy 1University of Hong Kong, Division of Speech and 3Department of Speech and Hearing Sciences, Univer- Hearing Sciences, Hong Kong, China sity of Hong Kong, Hong Kong, China 2University San Raffaele Milan, Centre for Cognitive Neuroscience, Milan, Italy There’s a growing body of evidence demonstrating that 3IBFM-CNR National Research Council, Milan, Italy mastering a second language (L2) exerts positive ef- 4The University of Hong Kong, Division of Speech and Posters 423

Hearing Sciences, Hong Kong, Hong Kong P3.03 5University College London, Cognitive, Perceptual and Brain Sciences, London, UK Effects of Transcranial Direct Current Stimulation (tDCS) on language and cognitive functions in pa- There is now abundant evidence showing that the left tients with Alzheimer’s disease: A pilot study temporal pole (TP) is involved in language processing, and especially in naming. The left TP is believed to Cristina Fonte1, Marialuisa Gandolfi1, Giorgia Corra- function as a hub for linking modality-specific concep- dini2,LucaAmbroso2, Elisabetta Verzini2, Valentina tual properties of objects (Jefferies and Lambon Ralph, Varalta1, Carlo Miniussi3 and Nicola Smania4 2006) and to be involved in lexical retrieval (Tranel, 1University of Verona, Department of Neurological, 2009). Interestingly, both TP structure (in terms of grey Neuropsychological, Morphological and Movement matter density) and naming abilities decrease in aging Sciences, Verona, Italy populations. 2University of Verona, Italy The purpose of the present study was to investigate in a 3IRCCS Fatebenefratelli, Brescia, Italy group of aging bilingual subjects whether the grey mat- 4Department of Neurological, Univerity of Verona, ter density of the TP is preserved and whether this is Neuropsychological, Morphological and Movement due because of their language proficiencies in L1 (first Sciences, Verona, Italy language) and L2 (second language). 36 aging bilinguals from Hong Kong (Cantonese- Alzheimer’s disease (AD) affects from 2 to 5.8% of English) and (Cantonese-Mandarin) bilinguals partic- subjects over the 65 years old and the prevalence in- ipated in this study and underwent structural neu- creases with age to reach 15–20% in subjects over 80 roimaging. Behavioral testing was conducted in or- years old. To date, several techniques have been used der to investigate their performance on picture nam- in order to attempt to slow down Alzheimer’s progress, inginL1andL2.Subjectswerealsoassessedonthe and stimulate the residual cognitive function. MMSE and the SES (Socio-Economical Status) was The aim of this study is to investigate the impact of determined. Grey matter density was analyzed with the both anodal tDCS and sham tDCS on language and VBM (Voxel based Morphometry) technique. cognitive functions in AD patients after brain stimula- Grey matter (GM) density in the left TP, as expected, tion on the left dorsolateral prefrontal cortex. The ef- negatively correlated with the age of the subjects. fects of tDCS on speech’s disorder, specifically naming However, there was a positive correlation between pic- and comprehension of objects and actions, have been ture naming performance overall and GM density in evaluated for the first time in this project, since they the left TP. Interestingly, this correlation was signifi- have never been assessed for this aim. Also, the effects cant only for L2 naming and not L1 naming. Notewor- of tDCS stimulation on the remaining cognitive func- thy, MMSE and SES scores did not correlate with the tions such as attention, short-term memory, working TP grey matter. memory, recognition memory and verbal fluency have In conclusion, our findings suggest that in bilinguals been investigated. the structural integrity of the left TP during aging may Each subject received both tDCS sessions, anodal be protected by better second language naming perfor- and sham, and performed a cognitive assessment pre- mances. stimulation, an assessment during stimulation, and one at 48 hours after the end of stimulation (follow-up). Keywords: Language, Aging, Functional and Struc- The patients were evaluated with two BADA’s subtest tural Neuroimaging/NIRS (comprehension and naming), backward and forward Digit Span, Rivermead Behavioral Memory Test, At- Correspondence address: Mr Prof Jubin Abutalebi, tentional Matrix Test and Phonemic Verbal Fluency. University of Hong Kong, Division of Speech and The preliminary analysis showed different results in Hearing Sciences, Pok Fulam, HK-00000 Hong Kong, the first three subjects; in particular the real tDCS tech- China. E-mail: [email protected] nique has proven to be more effective in improving language functions in subjects with moderate AD than in patients with mild AD. This study could have a great importance in the clinical setting since it would offer tools to slow the cognitive 424 Posters impairment’s progression in Alzheimer’s disease with tures were verbs without a nominal component and ob- a positive effect on maintaining autonomy in daily life. ject pictures were nouns without a verbal component. Finally, items were matched for critical psycholinguis- Keywords: Language, Aging, TMS/TCDS tic variables. The results revealed a greater impairment in action naming than object naming i.e. there was an Correspondence address: Mrs Cristina Fonte, Depart- effect of grammatical class on confrontation naming ment of Neurological, University of Verona, Neuropsy- with more impairment to spoken word production of chological, Morphological and Movement Sciences, verbs (actions) than nouns (objects) similar to reports piazzale L.A. Scuro 10, I-37134 Verona, Italy. E-mail: of other patients with DAT who speak languages in dif- [email protected] ferent linguistic families. Taken together with other evidence of neural specificity for verbs and nouns in brain P3.04 imaging studies (fMRI) of Chinese speakers, our conclusion is that grammatical class is a universal organ- Effects of grammatical class on confrontation nam- ising principle of the language system. ing in Chinese speakers with dementia Keywords: Language, Dementia, Other Methods Brendan Weekes1,DianaHo2, Anthony Kong3,LW Chu4 and Joyce Ha4 Correspondence address: Professor Brendan Weekes, 1University of Hong Kong, Laboratory for Communi- University of Hong Kong, Laboratory for Communica- cation Sciences, Hong Kong, China tion Sciences, University of Hong Kong, D-1111 Hong 2University of Hong Kong, Laboratory for Communi- Kong, China. E-mail: [email protected] cation Science, Hong Kong, China 3Department of Communication Disorders, University P3.05 of Central Florida, Orlando, US 4University of Hong Kong, Medicine, Hong Kong, Reading problems in children with Frontal Lobe China Epilepsy

Selective impairments to action and object naming are Emilio Verche1, Mariana Cairós1, Ruth Marrero-Abr- often observed in patients who have dementia of the ante2 and Sergio Hernández1 Alzheimer type (DAT). Typically, action naming is 1University of La Laguna, Psychobiology and Method- more impaired and declines earlier than object naming ology, La Laguna, Spain although the reverse dissociation is also reported in a 2Hospital Universitario de Canarias, Neurology, La handful of case studies. The dissociation between ac- Laguna, Spain tion and object naming in aphasia suggests that verbs and nouns are independent forms in the lexicon al- INTRODUCTION: Children with epilepsy show aca- though this is not a universally held view. These pat- demic difficulties, especially in arithmetic and read- terns of dissociation have been reported in Chinese ing. Antiepileptic drugs side effects could explain these speaking patients following stroke. However, no study deficits. However, we suggest a reading deficit directly has tested the hypothesis that action and object nam- related with the epilepsy, where the frontal focus could ing might be selectively impaired in Chinese speakers interfere in this basic instrumental skill. who have dementia. We tested this hypothesis with 50 OBJECTIVE: To study reading performance (speed, native Cantonese speakers who have DAT according to accuracy and comprehension) in children with frontal scores on Chinese versions of the MMSE, MOCA and lobe epilepsy (FLE). locally developed tests in Hong Kong. Patients ranged METHODS: 13 children with FLE and 13 healthy con- in age from 58 to 90 years. Males and females par- trols (aged 10–19) participated. They all completed 3 ticipated. Some patients were bilingual having learned subtests from “Batería de Evaluación de Procesos Lec- English or Mandarin as a second language. All pa- tores”: word reading task, pseudoword reading task tients were presented with action and object pictures and texts comprehension task. Trail Making Test-A for naming in Cantonese. Pictures were selected ac- was used as a covariable. In the reading tasks, the num- cording to several criteria. First, all items were famil- ber of words read correctly and the reading time was iar to native Chinese speakers. Second, all action pic- measured as well as an accuracy index was calculated. Posters 425

In the comprehension task, the number of correct an- items. The CSIE defines a linear increase in the naming swers to some questions about the text was registered. RTs which is function of the already named pictures RESULTS: We found significant differences in all the belonging to the same semantic category to which the variables, except in number of pseudowords correct named picture belongs. read, with a worse performance in FLE group and with RESULTS: CSIE was present in the healthy sam- no effect of the processing speed. ple and absent in the MCI/AD sample. Instead, both CONCLUSIONS: Results suggest reading problems in groups showed comparable repetition priming effects. children with FLE in both lexical and semantic level, CONCLUSION: The impairment in picture naming independently of the processing speed. This highlights exhibited by MCI/AD individuals is due to an ineffi- the need for early intervention in reading skills to pre- cient semantic access. vent these deficits and school failure. References Keywords: Language, Epilepsy, Neuropsychological [1] Faust, M. E., Balota, D. A., & Multhaup, K. S. (2004). Neu- Assessment and Psychometrics ropsychology, 18, 526-536. [2] Howard, D., Nickels, L., Coltheart, M., & Cole-Virtue, J. (2006). Cognition, 100, 464–482. Correspondence address: Mr Emilio Verche, Univer- sity of La Laguna, Psychobiology and Methodology, Campus de Guajara s/n, Spain-38071 La Laguna, Keywords: Language, Mild Cognitive Impairment, Spain. Tel.: +34 616865574; E-mail: evercheb@ull. Other Methods edu.es Correspondence address: Mr Claudio Mulatti, Uni- P3.06 versità di Padova, Dipartimento di Psicologia dello Sviluppo e della Socializzazione, via Venezia 8, I- The cumulative semantic interference effect in nor- 35131 Padova, Italy. E-mail: claudio.mulatti@gmail. mal and pathological ageing com

Claudio Mulatti1, Clara Calia2, Maria Fara De Caro3 P3.07 and Sergio Della Sala4 1Università di Padova, Dipartimento di Psicologia Dual task effect on mirror writing dello Sviluppo e della Socializzazione, Padova, Italy 1 2 2Queen Margaret University, Edinburgh, Scotland Natascia De Lucia , Rob Mcintosh and Sergio Della 2 3Università di Bari, Italy Sala 1 4University of Edinburgh, Scotland Second University of Naples, Psychology, Neuropsy- chology Laboratory, Caserta, Italy 2 BACKGROUND: People affected by Alzheimer De- University of Edinburgh, Human Cognitive Neuro- mentia (AD) or Mild Cognitive Impairment (MCI) science, department of Psychology, Edinburgh, UK present with impairments in lexical/semantic processing. Picture naming could be seen as a lexical/semantic INTRODUCTION: Mirror writing (MW) occurs task which rests on the activation of perceptual, seman- when the orientation and position of single letters or tic, and phonological representations. The poor perfor- whole words are reversed [1]. MW has been often de- mance of MCI/AD individuals in picture naming has scribed in young children or brain damaged patients. been accounted for in terms of deficits of either the per- Only a few studies have focused on normal healthy ceptual, semantic, or phonological stages (e.g., Faust, individuals. It has been suggested that left-handers Balota, and Multhaup, 2004) are better able to reverse writing direction than right- AIM: To disentangle the source of this deficit we handers [2]. We aimed to test whether left-handers compared the cumulative semantic interference effect were advantaged for MW compared to right-handers, (CSIE; Howard, Nickels, Coltheart, and Cole-Virtue, and to investigate the influence of a cognitively de- 2006) and the repetition priming effect (RPE) obtained manding concurrent task upon MW. with a sample of 20 healthy elderly to that obtained METHODS: We recruited 20 right-handed and 20 left- with a sample of 20 MCI/AD elderly. handed normal adults. Participants were required to METHOD: The RPE refers to an increase in per- write, to dictation, asymmetrical letters in forward formance for repeated items compared to unrepeated or mirrored direction with their preferred and non- 426 Posters preferred hand, in single-task and dual-task (combined METHODS: We described the case of K.B., an am- with an auditory 1-back task) conditions. Planning bidextrous German academic who deliberately prac- time and error rate were recorded. ticed MW with either hand for more than fifty years. RESULTS: Planning times and error rates increased We assessed K.B. with several handwriting tasks in for- when participants wrote in a mirrored direction, with ward and backward direction, vertically upright and in- their non-dominant hand, and in dual task conditions. verted, with his right or left hand acting alone and si- Error rates were especially high for MW in the dual multaneously. Naïve observers rated the similarity of task condition. No evidence was found to support the K.B.’s productions to his standard right hand forward view that left-handers are better at MW than right- handwriting. handers. RESULTS: K.B.’s Left-hand MW was rated as more CONCLUSION: Our findings suggest that MW ability similar to his normal writing (right hand forward) is unrelated to left-handedness, at least amongst nor- than was right-hand MW, in both upright and inverted mal adults. MW is a cognitively demanding task for writing. Moreover, when writing bimanually, K.B.’s normal adults, as indicated by the increased MW errors performance is improved when the two hands make in the dual task condition. mirror-image movement (producing opposite scripts) than if they work in the same direction to produce sim- References ilar scripts. CONCLUSION: Our findings are consistent with the [1] Della Sala S., Cubelli R. (2007). ‘Directional apraxia’: A unitary account of mirror writing following brain injury or as found in hypothesis that MW represents the untransformed left- normal young children. Journal of Neuropsychology, 1: 3-26 hand execution of learned right-hand actions. [2] Tankle R., Heilman K. (1983). Mirror-writing in right-handers and left-handers. Brain and Language, 19: 115-23 References [1] McIntosh R.D., Della Sala S. (2012). Mirror-writing. The Psy- Keywords: Language, Neuropsychological Assess- chologist, 25: 742-6 ment and Psychometrics [2] Della Sala S., Cubelli R. (2007). ‘Directional apraxia’: A unitary account of mirror writing following brain injury or as found in normal young children. Journal of Neuropsychology, 1: 3-26 Correspondence address: Mrs NATASCIA DE LU- CIA, Second University of Naples, Psychology, Neu- Keywords: Language, Neuropsychological Assess- ropsychology Laboratory, VIALE ELLITTICO, IT- ment and Psychometrics 80100 Caserta, Italy. E-mail: natascia.delucia@unina2. it Correspondence address: Mr Rob McIntosh, Univer- sity of Edinburgh, Human Cognitive Neuroscience, de- P3.08 partment of Psychology, George Square, UK-EH89JZ Edinburgh, UK. E-mail: [email protected] A detailed case of deliberate mirror writing P3.09 Rob McIntosh1, Natascia De Lucia2 and Sergio Della Sala1 1 Specifics of left neglect dyslexia? Word reading er- University of Edinburgh – Human Cognitive Neuro- rors in neglect patients and healthy controls science, department of Psychology, Edinburgh, UK 2 Second University Of Naples, Psychology, Neuropsy- Christiane Weinzierl1, Georg Kerkhoff2,LuciaVan chology Laboratory, Caserta Eimeren3, Ingo Keller4 and Prisca Stenneken1 1Bielefeld University, clinical linguistics, Bielefeld, INTRODUCTION: Mirror writing (MW) refers to Germany striking phenomenon of the production of letters or 2Saarland University, Clinical Neuropsychology Unit, words from right to left [1]. MW is mainly observed Saarbrücken, Germany in children learning to write and in left brain-damaged 3Department of Surgery, University of Western On- patients writing with their left hand [2]. Deliberate tario, Ontario, Canada MW has also been described in healthy individuals but 4Schön clinic Bad Aibling, Neuropsychology, Bad Aib- only anecdotally and a systematic analysis of deliber- ling, Germany ate MW has never been reported. Posters 427

OBJECTIVE: Left visuo-spatial neglect due to right P3.10 hemispheric lesions is often associated with neglect dyslexia (ND), a complex reading disorder. In word Neglect Dyslexia: A matter of good looking reading, ND can affect two aspects of visual word 1 2 3 recognition: processing of letter identity – resulting Silvia Primativo , Lisa S. Arduino , Maria De Luca , 4 1 in different error types, – and positional processing Roberta Daini and Marialuisa Martelli 1 of segmental information – resulting in different er- University of Rome “La Sapienza” and IRCCS Fon- ror positions. Patients with ND often show left substi- dazione Santa Lucia, Department of Psychology, tutions and left omissions of letters. The question re- Rome, Italy 2 mains which reading errors are specific for ND and University LUMSA and ISTC-CNR, Human Sciences, which are not just a sign of generally reduced read- Rome, Italy 3 ing performance. Since the number of reading errors in IRCCS Fondazione Santa Lucia, Neuropsychology healthy controls is usually too low for proper analyses, unit, Rome, Italy 4 this question was difficult to address so far. University Milano-Bicocca, Department of Psychol- METHODS: We present a study with quantitative ogy, Milan, Italy and qualitative analyses of reading errors in single word reading – both in 18 neglect patients and 11 STUDY GOALS: Right-sided brain-damaged patients healthy, age-matched controls. The task difficulty be- with Unilateral Spatial Neglect (USN) often make left- tween groups was matched via individually adjusted sided errors in reading single words or pseudowords durations of stimulus presentation in order to achieve (Neglect Dyslexia, ND). The more common read- comparable error rates in both groups. ing errors, omissions and substitutions, have been re- RESULTS: Results show an equal number of substi- cently shown to depend from two different mecha- tutions in both groups but a significantly higher num- nisms, the exploratory disorder which characterizes ber of omissions in ND than in controls. The spatial unilateral spatial neglect (USN) and a perceptual inte- distribution of reading errors over the letter positions gration mechanism, respectively (Martelli et al., 2011). The relation between ND and the more general unilat- within the word in ND followed an almost linear in- eral spatial neglect (USN) is still controversial (Vallar crease from the end to the beginning of the word. Re- et a., 2010, for a review). In the present study the pro- sults of controls replicate a typical, inverted u-shaped posal is made that both left neglect and low fixation ac- error gradient with most errors in the middle of the curacy account for reading errors in Neglect Dyslexia. word. METHOD: Eye movements were recorded in USN pa- CONCLUSION: The present study allows differentiat- tients with (ND+) and without (ND-) neglect dyslexia ing between error types associated with reduced word and in a matched control group of right brain-damaged reading performance in general and error types that are patients without neglect (USN-). Results. Unlike ND- characteristic of ND and thus highlight the underlying and controls, ND+ patients showed left lateralized mechanisms in impaired word reading. Omissions and omission errors and a distorted eye movement pattern left-sided reading errors clearly are specific for ND. In in both a reading aloud task and a non-verbal sac- line with well-established models of word recognition, cadic task. During reading, the total number of fixa- we assume a sublexical serial word processing deficit tions was larger in these patients independent of vi- in ND. sual hemispace, and most fixations were inaccurate. Similarly, in the saccadic task only ND+ patients were Keywords: Language, Neglect unable to reach the moving dot. A third experiment addressed the nature of the left lateralization in read- Correspondence address: Mrs Christiane Weinzierl, ing error distribution by simulating neglect dyslexia in Bielefeld University, clinical linguistics, Universitätss- ND- patients. ND- and USN- patients had to perform a traße 25, D-33615 Bielefeld, Germany. E-mail: speeded reading-at-threshold task that did not allow for [email protected] eye movements. When stimulus exploration was prevented, ND- patients, but not controls, produced a pattern of errors similar to that of ND+ with unlimited exposure time (e.g., left-sided errors). CONCLUSION: We conclude that the reading disorder in neglect dyslexia is the behavioural expression of 428 Posters the exploratory deficit in USN when the fine eye move- story narration. These differences may be attributed to ments required for reading are altered. differential tasks requirements in terms of executive constraints related to discourse planning and monitor- Keywords: Language, Neglect, Neuropsychological ing. Moreover, the association of anomic difficulties Assessment and Psychometrics (in the absence of semantic impairment) points out to the occurrence of mixed patterns of speech/language Correspondence address: Mrs Ph.D student Silvia Pri- disturbances in FTD. mativo, University of Rome “La Sapienza” and IR- CCS Fondazione Santa Lucia, Department of Psychol- Keywords: Language, Neurodegenerative Diseases, ogy, Via dei Marsi 1, RM-00185 Rome, Italy. E-mail: Neuropsychological Assessment and Psychometrics [email protected] Correspondence address: Dr Federica Lucchelli, Alzh- P3.11 eimer’s Center, via Settembrini 1, I-20017 Passirana di Rho, Italy. E-mail: fl[email protected] Spontaneous speech and discourse organization in fronto-temporal degeneration: A single case study P3.12

Federica Lucchelli and Eleonora Martini Reorganization of cerebral language-associated ar- Alzheimer’s Center, Passirana di Rho, Italy eas in a 65-year-old female with anaplastic astrocytoma as evidenced by functional magnetic reso- A deficit in discourse organization has been previously nance imaging and intraoperative direct electrocor- reported as the most striking deficit in cases of dy- tical stimulation sexecutive fronto-temporal degeneration (FTD) (Ash et al., 2006). We investigated language functions in Margit Jehna1, Gord Von Campe2, Markus Hoffer- a lady (AB) affected by FTD with prominent execu- mann2, Lukas Bruckmann2, Gernot Reishofer1,Franz tive impairment. A F18-FDG PET study showed left Payer3, Christian Enzinger3 and Franz Ebner1 temporal and less severe fronto-basal hypometabolism. 1Department of Radiology, Medical University of Relatives reported that onset, about one year before, Graz, Graz, Austria was characterized by “confusion” and inability to fol- 2Department of Neurosurgery, Medical University of low the thread while speaking. Speech abnormalities Graz, Graz, Austria were evident on clinical examination and consisted of 3Department of Neurology, Medical University of an abundant verbal production, with unfinished sen- Graz, Graz, Austria tences, sudden jumps from one point to another, inability to follow a logical sequence of arguments and to This is a case study of a right handed 65-year-old build up a coherent narrative, to the point that verbal woman with an anaplastic astrocytoma grade III in the communication became exceedingly laborious. Gen- superior frontal cortex with intra-axial extensions to eral cognitive assessment showed significant executive the corpus callosum. Presurgical functional MR imag- deficits, with relative sparing of memory. An extensive ing (fMRI) was done to visualize language network language assessment, carried out by standardized tests, distribution. Intraoperative direct cortical stimulation demonstrated significant naming difficulties on con- (DCS) was accordingly done to prevent eloquent func- frontation tests, with spared comprehension and repeti- tional regions from resection. FMRI results showed a tion. Spontaneous speech and discourse were sampled distributed language network including the left infe- by several tasks, including scene description, story re- rior frontal gyrus (pars opercularis), the left and right call, life narratives and picture story narration. Analy- frontal orbital cortices, the left insular cortex, the left ses of appropriateness of contents, story coherence and superior and middle temporal gyri, the left precen- completeness were performed; number of words, nar- tral and postcentral gyri, and the supplementary area. rative duration, occurrence of anomic or syntactic er- Additionally, statistically stable but unusual activation rors were also taken into account. The overall severity was found in the left superior frontal gyrus (SFG). of impairment varied among different tasks: life nar- During surgery, DCS demonstrated that the stimula- ratives turned out to be the most effective procedure tion of the SFG – involved in language function ac- to elicit discourse disorganization, followed by picture cording to the fMRI – led to anomic disturbances. Dur- Posters 429 ing the assessment of Boston Naming Test, the patient Participants to this study were trained on two differ- couldsay“Thisisa...”,buttheretrievalofwordswas ent lists of 10 nonwords each (participants were told disrupted. These deficits in word finding were persis- that these words belonged to a foreign language they tently reproducible when stimulating the same area. were unfamiliar with). Participants were trained to Afterwards, tumor removal was performed under nav- learn both the semantics and the phonology of words igation and fluorescence guidance as well as subcorti- in list 1 (they were taught the meaning of the word in cal electrostimulation, thus preserving eloquent motor the foreign language), while they were trained only on and language areas and tracts. Regarding the results of phonology for words in list 2. A list of 10 nonwords the fMRI and DCS in this patient, it can be speculated (list 3) was also included. After the training, partici- that the altered distribution of eloquent language areas pants completed three serial recall tasks, one on each could be the result of a tumor-induced reorganization list. process. This case study demonstrates that presurgical Preliminary results show that performances in serial fMRI was able to identify a localized unusual language recall on lists 1 and 2 are comparable, while perfor- network distribution, which was validated with direct mance on list 3 is significantly worse, indicating that cortical mapping during awake surgery. It underlines the phonological representation of a word, even in ab- the importance of careful presurgical planning, keep- sence of access to the semantics of the word itself, is ing in mind the limitations of all used methods. enough to give facilitation during a STM task. This suggests that long-term knowledge facilitates im- Keywords: Language, Other Disorder/Samples, Func- mediate serial recall due to familiarity with the phono- tional and Structural Neuroimaging/NIRS logical form of the word rather than with its meaning.

Correspondence address: Mrs PhD Margit Jehna, Med- Keywords: Language, Other Disorder/Samples ical University of Graz, Department of Radiology, Auenbruggerplatz 9, AUT-8036 Graz, Austria. E-mail: Correspondence address: Mrs Annalisa Benetello, De- [email protected] partment of Psychology, Universita di Milano-Bicocca, Piazza Ateneo Nuovo, 1, IT-20126 Milan, Italy. E- P3.13 mail: [email protected]

Phonology without semantics in immediate serial P3.14 recall Effects of the linguistic environment on the right vi- Annalisa Benetello, Carlo Cecchetto and Costanza Pa- sual field superiority in reading: A study in French- pagno Hebrew bilinguals Universita di Milano-Bicocca, Department of Psychol- ogy, Milan, Italy Nathalie Haehnel and Eric Sieroff Université Paris Descartes, Boulogne-Billancourt, The influence of long-term knowledge on verbal short- France term memory (STM) performance has been demonstrated in various studies. However, long-term knowl- A word is better identified when it is presented in edge facilitation could be of two different types: STM the right (RVF) than the left visual field (LVF). This performance could be enhanced only by familiarity RVF superiority (RVFS) might be explained by the role with the phonological form, or by semantic informa- of the left hemisphere (LH) in reading (direct projec- tion about the word. tion from RVF to LH, and/or attentional bias in the The aim of this study was to verify whether the pattern LH/RVF in a linguistic task). It might also be explained of verbal STM performance described for a patient suf- by the reading direction in left-to-right scripts, favor- fering from semantic dementia is found also in normal ing the visual field where reading progresses (atten- subjects. In particular, we wanted to replicate data from tional bias). However, several studies using Hebrew an SD patient, who did not differ in immediate serial words (right-to-left script) also obtained a RVFS, even recall of known words and words whose phonological though it was usually smaller than with words in left- form was available, but not the meaning (see Papagno to-right scripts. It has also been suggested that the lin- et al., 2012). guistic environment and the practice of the language 430 Posters have an effect on RVFS. In this study, we evaluated (transcranial direct current stimulation). The effect of RVFS with French and Hebrew words in 4 groups of tDCS when subjects processed congruent/incongruent 24 neurologically healthy participants each, all reading object-related actions (Experiment 1) or sentences (Ex- French and Hebrew as a first or second language: Na- periment 2) was verified by measuring changes in the tive French speakers in France, Native French speak- ERP (event-related potential) N400, ERs (Error Rates) ers in Israel, Native Hebrew speakers in Israel, Native and RTs (Response Times). In Experiment 1, thirty Hebrew speakers in France. All groups had equivalent subjects performed the detection task within a dy- knowledge of the second language. Words were tachis- namic context (video tapes representing a sequence toscopically presented in the RVF or the LVF. They of four action frames). In Experiment 2, twenty-eight had to be identified by naming the word or by report- subjects read sentences that represented object-related ing some of its letters. Results of correctly identified actions. The stimulation effect (a cathode applied to letters showed a RVFS for the 4 groups in both lan- the DLPFC and an anode to the right supraorbital re- guages. Also, RVFS was larger with French (RVFS of gion) was analysed by comparing the ER, RT and ERP 13.8%) than with Hebrew words (9.0%). However, the profiles before and after stimulation (or sham treat- RVFS was larger with French than Hebrew words only ment). A significant reduction of the N400 was ob- for the Native French speakers in Israel and the Native served for incongruent stimuli in the case of cathodal Hebrew speakers in France. For Native French speak- (inhibitory) stimulation of the DLPFC compared with ers in France, and for Native Hebrew speakers in Is- pre-stimulation conditions for Experiment 1, but not rael, no significant difference of RVFS were found be- Experiment 2. Moreover, ERs were increased, and RTs tween languages, and the RVFS was larger in France were reduced in response to incongruent conditions af- (15.5%) than in Israel (8.6%). These results are in fa- ter tDCS, but not after sham stimulation in Experiment vor of an effect of the linguistic environment on the 1. It was suggested that perturbation of the DLPFC RVFS. Whatever the exact nature of this effect, it may may limit the ability to analyse a semantically anoma- produce a modulation of attentional biases in reading. lous action sequence, with a reduced N400 ERP effect and increased random responses being observed. Fi- Keywords: Language, Other Disorder/Samples, Other nally, the contribution of the frontal area to the seman- Methods tic processing of action was discussed.

Correspondence address: Mrs Nathalie HAEHNEL, Keywords: Language, Other Disorder/Samples, TMS/ Université Paris Descartes, 71 avenue Edouard Vail- TCDS lant, F-92100 Boulogne-Billancourt, France. E-mail: [email protected] Correspondence address: Mrs Prof Balconi, Deprt- ment of Psychology, Catholic University of Milan, P3.15 largo gemelli 1, D-20123 milan, Italy. E-mail: michela. [email protected] Representation of the incorrect use of an object is supported by the DLPFC. The tDCS effect on ERP P3.16 N400 for visual and linguistic stimuli Proper name anomia after left temporal lobectomy: Balconi1 and Silvia Vitaloni2 A long-term effect of uncinate fasciculus resection 1Deprtment of Psychology, Catholic University of Mi- lan, Milan, Italy Federica Lucchelli1, Costanza Papagno2, Graziella 2Department Of Psychology, Catholic University of Ghirardi1, Paola Saletta1, Alessandra Casarotti2 and Milan, Milan Lorenzo Bello3 1AO G. Salvini, Servizio di Riabilitazione Neuropsico- In the present study, we explored the representation of logica, Passirana di Rho, Italy an incongruent action (instrumentally incorrect use of 2Università di Milano-Bicocca - Dipartimento di Psi- an object) in comparison with sentences ending with an cologia, Milan incongruent action word, taking into account the role 3Università degli Studi di Milano - Istituto Clinico Hu- of left dorsolateral prefrontal cortex (DLPFC) activa- manitas, Milan tion. This activity was appositely modulated by tDCS Posters 431

GDP, a 49-year-old lady, with a degree in Pharmaceu- P3.17 tics, underwent a left temporal lobectomy for a low grade mesio-temporal glioma. Pre-surgery neuropsy- Repetition priming in picture naming is mainly per- chological assessment was normal. Immediate post- ceptual surgery evaluation showed verbal memory impairment and generalized naming deficits. After 6 months, ver- Evelyn Mohr bal learning, though considerably improved, was still Durham University, Psychology, Hamburg, Germany impaired. By then, naming of objects, actions, concrete and abstract items was in the normal range, INTRODUCTION: We were interested whether the while her performance in famous face naming was still priming behavior of patients with aphasia during a re- significantly impaired. Moreover, she spontaneously peated naming task differs from that of healthy con- complained of persistent difficulties to retrieve proper trols. Pictures of common objects were manipulated by names of people as well as geographical names. An colour, congruency of the background, and by the time extensive evaluation of proper names was carried out, of the delay between study and test. including familiar/unknown judgment tasks, retrieval METHOD: We tested 25 German-speaking patients of semantic information and production of names with aphasia in the post-acute state who were diag- of celebrities in the visual modality (pictures) and nosed with a moderate-medium severe anomia and a on verbal description, as well as comprehension of control group of 10 healthy subjects matched in age proper names (pointing tasks). Geographical and fa- (Ø 55 y). The stimulus set consisted of a picture set mous monuments names were also investigated by containing 140 pictures of common objects of different picture presentation and in response to verbal defini- categories. Each of the pictures was presented in dif- tions. In contrast with her almost perfect performance ferent variations: colour vs gray scaled; plain vs noisy in familiarity judgment, retrieval of semantic infor- background; and congruent vs incongruent coloured mation and comprehension, GDP was specifically and background. We measured RTs at study and at test. The severely impaired when required to produce proper 25 German-speaking patients and the 10 healthy Ger- names, a pattern which qualifies as a post-semantic man controls named the pictures again after a delay of deficit. Geographical names were also affected, al- 10 days. In another part of the experiment, we used though to a much lesser extent than celebrities’ names. three groups of English-speaking participants (Ø 30 y) The profile appears to be stable after more than 9 with 20 participants in each group. The groups named months from surgery. The MRI study showed a large the same pictures again after a delay of one, three or six resection area involving the anterior and ventral por- months. We analyzed the priming effects of both parts tion of left temporal lobe. Diffusion-tensor imaging of the experiment according to: picture-design; cate- fibre-tracking technique (DTI-FT) demonstrated am- gory effects, subject variables, and time of the delay putation of the inferior part of the uncinate fasciculus using repeated measures ANOVAs. (UF) in its temporal portion. This case adds to the pre- RESULTS: Aphasic subjects showed the same priming viously published series by Papagno et al. (2011), fur- effects as the age matched control group and the three ther emphasizing the long-term effects of UF resection English groups with faster naming times of on average on proper names retrieval. 83ms. Priming effects were unaffected by the visual manipulations of the pictures and unrelated to the cat- Keywords: Language, Other Disorder/Samples, Neu- egory of the object. Furthermore, priming effects were ropsychological Assessment and Psychometrics unaffected by the time of the delay, by linguistic variables (English, German), by the difficulty to name the Correspondence address: Mrs dr Federica Lucchelli, picture, and by subject variables such as age, and apha- AO G. Salvini, Servizio di Riabilitazione Neuropsico- sia. logica, via Settembrini 1, I-20017 Passirana di Rho, CONCLUSION: Our results may indicate that prim- Italy. E-mail: fl[email protected] ing effects during repeated picture naming (of the same picture) are mainly perceptual and unaffected by linguistic variables.

Keywords: Language, Stroke, Neuropsychological As- sessment and Psychometrics 432 Posters

Correspondence address: Dr. phil. Evelyn Mohr, Dur- P3.19 ham University, Psychology, Olendörp 2, D-22335 Hamburg, Germany. Tel.: +49 4081987275; E-mail: dr. Normalization of the Verbal Fluency Test in Polish [email protected] population

P3.18 Daria Biechowska, Dariusz Dziegielewski and Ksenia Slawinska When ordered words make someone silent: A case Institute of Psychiatry and Neurology, Warsaw, Poland with selective difficulties in accessing the phonological output buffer when pronouncing ordinal infor- INTRODUCTION: Verbal fluency is the ability to mation form and express words compatible with required criteria. Verbal fluency is necessary for optimal commu- Jean-Philippe Van Dijck1, Katleen Vandeput2,Chris- nication and for normal social and occupational func- tophe Lafosse2,RobHartsuiker1 and Wim Fias1 tioning. The Verbal Fluency Test is a good indicator of 1Ghent University, Experimental Psychology, Ghent, frontal lobe dysfunction, particularly of the left frontal Belgium cortex. 2Rehabilitation Hospital Revarte, Scientific Unit, MATERIAL AND METHODS: The aim of the study Antwerp, Belgium was to compare verbal fluency in healthy subjects (n = 250), patients with organic lesions of the central ner- We describe a woman suffering from (subtle) damage vous system (CNS) (n = 100), and patients with type 2 to the white matter beneath the frontal cortex, who diabetes (n = 50). There were no differences between presented her to the rehabilitation hospital with severe male and female performance. Age was significantly word finding problems (i.e. complete blocking) in the related to performance in the Verbal Fluency Test. spontaneous production of spoken numbers. Standard- RESULTS: Healthy subjects and patients with diabetes ized evaluation revealed that these problems were also achieved the highest results in all categories of the Ver- present when reading Arabic digits aloud and also ex- bal Fluency Test. Patients with organic lesions of the tended to other information when assessed in an ordi- central nervous system achieved significantly lower re- nal context (e.g. backward recitation of days, months sults. Sten norms of the Verbal Fluency Test were de- and the retrieval of letters stored in serial order work- veloped for the general population. Using these norms ing memory). Interestingly, (number) word reading, it was found that subjects with organic lesions of the writing, comprehension and calculation were flawless. CNS had very poor results more often and very high re- More detailed investigations revealed an intact phono- sults less frequently compared to healthy subjects and logical (output) lexicon but a selective deficit access- also to patients with diabetes. ing the phonological output buffer. These findings ex- CONCLUSION: We have demonstrated that in pa- tend previous observations by demonstrating that not tients with type 2 diabetes verbal fluency is compara- only numbers but also other types of ordinal informa- ble with healthy subjects. The results are compatible tion have a special status up to the final levels of spoken to the literature and, thought preliminary, they may be language production. Currently she undergoes TDCS used as reference in research and clinical settings in therapy over the frontal cortices and on-going investi- our country. gations will evaluate whether or not this will improve these production difficulties. Keywords: Language, Stroke, Neuropsychological As- sessment and Psychometrics Keywords: Language, Stroke, Neuropsychological As- sessment and Psychometrics Correspondence address: Dr Daria Biechowska, Insti- tute of Psychiatry and Neurology, Sobieskiego 9, PL- Correspondence address: Jean-Philippe van Dijck, 02-957 Warsaw, Poland. E-mail: dbiechowska@ipin. Ghent University, Experimental Psychology, H. Dun- edu.pl antlaan 2, B-9000 Ghent, Belgium. Tel.: +32 9264264 33; E-mail: [email protected] Posters 433

P3.20 Correspondence address: Mr PhD Marco Pitteri, IR- CCS San Camillo Hospital, Laboratory of Neuropsy- The brainstem and cognitive (dys) functions: From chology, Via Alberoni, 70, IT-30126 Lido-Venice, neural disconnection to behavioral disregulation Italy. e-mail: [email protected]

Marco Pitteri1, Martina Garzon2 and Silvia Albanese2 P3.21 1IRCCS San Camillo Hospital, Laboratory of Neu- ropsychology, Lido-Venice, Italy Functional recovery in subcortical crossed and non- 2IRCCS San Camillo Hospital, Lido-Venice, Italy crossed aphasia

The traditional view on the link between brainstem le- Virginia Maria Borsa1, Pasquale Della Rosa2,Mat- sion and cognitive functions has recently been chal- teo Canini3, Stefano Francesco Cappa4 and Jubin lenged by results from neuroimaging and clinical stud- Abutalebi3 ies on groups (Baillieux et al., 2010) and single cases 1Vita-Salute San Raffaele University, Cognitive Neuro- (Maeshima et al., 2010). The potential for brainstem science, Milano, Italy lesions to produce severe and chronic cognitive im- 2IBFM-CNR, Institute of Molecular Bioimaging and pairments is not widely recognized. We describe a Physiology, Milan, Italy 46yearold, righthanded man (BS), with 13 years of ed- 3Vita-Salute San Raffaele University, Cognitive Neuro- ucation, who suffered from a lesion in the right pon- science, Milan, Italy tine area. In the postacute phase, BS presented with 4Neurorehabilitation Unit, San Raffaele Scientific In- dysarthria, diplopia, ataxic gait, deficit of fine motility stitute; Vita-Salute San Raffaele University, Clinical of the right hand, and a constellation of neuropsycho- Neuroscience; Cognitive Neuroscience, Milan, Italy logical deficits. These signs remained unchanged after physical and speech therapy. At about one year from le- Crossed aphasia usually defines an acquired language sion onset, MRI disclosed a small hemorrhage involv- disorder due to a lesion in the non-dominant right ing the right mesencephalic tegmentum and tectum, hemisphere in a natural right-hander with a structurally without affecting the red nucleus. The superior cere- intact left-hemisphere and with no familiar history of bellar peduncle was also involved, leading to pseudo- left-handedness, early brain damage or epilepsy. hypertrophy of the left inferior olivary nucleus because There are very few longitudinal studies in literature of transynaptic degeneration. A PET scan showed hy- (Heiss et al., 1999; De Boissezon et al., 2005) inves- pometabolism of the brainstem, the right cerebellum, tigating functional recovery in stroke patients affected and the left cerebral hemisphere, particularly in the tha- by subcortical lesions, and to the best of our knowledge lamus, the insula, and the frontal area. BS had cogni- there are no longitudinal follow up studies of subcorti- tive and behavioural disorders and mild speech defects. cal crossed aphasia. His prosody was altered in cadence and voice intona- The aim of our study was to investigate functional re- tion, suggesting a plausible foreign accent syndrome covery in a patient with subcortical crossed aphasia (Dankovicováˇ and Hunt, 2011). In addition, with re- and in an age-matched control patient with aphasia due spect to other cases already described in the literature, to a similar lesion but located in left subcortical ar- BS showed a pronounced pragmatic deficit, charac- eas. Both patients were severely anomic and underwent terized by difficulty taking turns in the conversation, the same type of speech therapy, i.e., a deficit specific scarce pertinence on the argument, poor exhaustivity speech therapy for approximately six weeks that was of verbal messages, and sudden changes of argument followed by a more general speech therapy (see Vitali during conversation. To the best of our knowledge, this et al., 2007, for details). Both patients were enrolled is the first report of a patient affected by severe prag- in the same follow-up protocol and were tested and matic disorder after brainstem lesion. We suggest that scanned with fMRI for three times (i.e. at T0 before diaschisis-related disorders should be carefully con- being enrolled in the experimental study, at T1 after templated in clinical practice. the deficit specific speech therapy and at T2 after the global speech therapy). Keywords: Language, Stroke, Neuropsychological As- fMRI results showed the similar pattern of reorganiza- sessment and Psychometrics tion (i.e. major involvement of contralateral language areas) of the neural substrates underlying overall nam- 434 Posters ing activations in both the crossed and uncrossed apha- such as transcranial magnetic stimulation (TMS) al- sia patient. Furthermore, fMRI results pointed out the low modulating cortical activity and may thereby of- grounding role for homologue naming-specific areas fer novel therapeutic opportunities. A repetitive TMS (i.e. LIFG or RIFG) in determining the progressive pat- protocol, the so-called theta burst stimulation (TBS), tern of behavioural naming recovery throughout differ- is increasingly used in clinical research. It has the ent disease phases. advantage of a short application time combined with Functional recovery paralleled with an improvement in prolonged aftereffects. In a previous study we found behavioural performance for naming in both crossed better naming performance in aphasic patients after and uncrossed aphasia, seems to be strictly related to the application of one train of TBS over the right recruitment of homologues language-specific areas in Broca’s homologue. Applying TBS trains repeatedly the hemisphere opposite to the lesion. can furthermore disproportionately prolong the effects, as was for example shown in neglect patients. The aim Keywords: Language, Stroke, Functional and Struc- of the present study is to evaluate the effects of re- tural Neuroimaging/NIRS peated TBS on several language tasks over a longer time span. Repeated trains of TBS are applied in a Correspondence address: Mrs phd student Virginia randomized, sham controlled, cross-over design. After Maria Borsa, Vita-Salute San Raffaele University, comprehensive baseline testing, eight TBS trains and Cognitive Neuroscience, via Olgettina 60, ITALY- eight sham stimulation trains are applied over the right 20100 Milano, Italy. E-mail: virginia.borsa@gmail. Broca’s homologue on two consecutive days separated com by one week. On the second days of stimulation, several short language tests are administered. A follow-up P3.22 with comprehensive language testing takes place one month after the stimulation. Preliminary results of this Effects of repeated theta burst stimulation on apha- ongoing study will be presented. sia recovery Keywords: Language, Stroke, TMS/TCDS Rahel Schumacher1, Dario Cazzoli2, Klemens Gut- brod1, Monica Koenig3, Tim Vanbellingen4, Thomas Correspondence address: Mrs Rahel Schumacher, In- Nyffeler5 and René Müri1 selspital Bern University Hospital, and University of 1Inselspital Bern University Hospital, and University Bern, Department of Neurology, Division of Cognitive of Bern, Department of Neurology, Division of Cogni- and Restorative Neurology, Freiburgstrasse, CH-3010 tive and Restorative Neurology, Bern Bern. E-mail: [email protected] 2University of Oxford, Nuffield Department of Clinical Neurosciences, Oxford, United Kingdom P3.23 3Spitalzentrum Biel, Logopädie, Biel, Switzerland 4Inselspital, Bern University Hospital and University The dual-route approach to object processing sup- of Bern, Department of Neurology and Department of ported by voxel-based morphometric (VBM) anal- Clinical Research, Perception and Eye Movement Lab- ysis: Evidence from the BCoS assessment oratory, Bern, Switzerland 5Luzerner Kantonsspital, Department for Internal Johnny King Lau1, Wing-ling Bickerton1,GlynHum- Medicine, Center of Neurology and Neurorehabilita- phreys2, Carmel Mevorach1 and Pia Rotshtein1 tion, Luzern, Switzerland 1University of Birmingham, Psychology, Birmingham, United Kingdom Aphasia is common after left-sided stroke and is char- 2University of Oxford, Experimental Psychology, Ox- acterized by partial or total loss of language func- ford, United Kingdom tions. Functional imaging studies examining language recovery after stroke often find an overactivation of Evidence from neuropsychological and imaging re- the non-damaged right hemisphere. One hypothesis search suggests that knowledge of actions regarding is that the overactivation is dysfunctional which is object manipulation (how an object is used) can disso- explained within the framework of interhemispheric ciate from knowledge of objects (what the object is). inhibition. Non-invasive brain stimulation techniques On the other hand, there is also evidence suggesting Posters 435 that both object recognition and retrieval of manipula- 1Neuromotor and Cognitive Rehabilitation Research tion information draw on a common pool of semantic Centre, Neurological, Neuropsychological, Morpho- representations. The aim of our study was to identify logical and Movement Science, University of Verona, the similarities and differences in neural correlates of Italy object recognition and actual object use. 247 right hand 2Neurological, Neuropsychological, Morphological sub-acute stroke patients (128F, 70.43 ± 14.51 yos) and Movement Science, University of Verona, Neuro- completed visual object naming (ObjN) and multi- logical, Neuropsychological, Morphological and object use (MOU) tasks taken from the BCoS battery. Movement Science, University of Verona, Italy Clinical neuroimaging data – CT scans were obtained to assess grey matter integrity. To isolate the under- Aphasia affects up to 38% of stroke survivors and it is lying cognitive components, we performed a princi- one of the major sources of disability after cerebrovas- pal component analysis (PCA) on the scores of the 2 cular accidents. Aphasia is persistent, debilitating and tasks. Correlations of grey matter and performances has wide-ranging negative impacts on the social and were tested using the raw task scores as well as the emotional well being of the stroke survivor, family and identified principal component scores. Performances community. Anomia is one of the most common and on the ObjN and MOU tasks were highly correlated disabling symptoms of aphasia. Recovery from apha- (r = 0.49, p<0.0001). PCA identified a shared com- sia following stroke varies considerably and current ponent that explained 74.5% of the data and a com- knowledge on its recovery is still not sufficient. Ac- ponent that distinguished between the two tasks accordingly, the identification of specific prognostic fac- counting for 25.6% of the data. Lesions to the left an- tors is important in determining the recovery of apha- terior temporal, left inferior frontal and medial visual sia. On this base, the aim of the present study is to in- cortices could lead to impairment in both tasks. Spe- vestigate the linguistic factors that predicted the recov- cific ObjN deficits were related to lesions to the left ery of anomia at one year after stroke. We conducted fusiform while deficits in the MOU task were predicted a retrospective study on 196 stroke patients with apha- by lesions to the left parieto-occipital junction. sia. We included the data of 59 patients who were as- CONCLUSION: Two object processing routes were sessed 3 times over one year by a standardized test for identified: 1) visual object naming was associated with the diagnosis of aphasia (Aachen Aphasia Test – AAT). lesions to ventral visual stream; 2) actual use of objects The linguistic performances have been analyzed as a was associated with lesions to dorsal visual stream. De- function of naming ability. The results shown a corre- spite these dissociated routes, lesions to semantic asso- lation between the language comprehension ability in ciated regions e.g. anterior temporal gyrus could lead the acute phase and recovery of anomia one year af- to impairment in both tasks. ter stroke. Thus the comprehension ability in the early stage after stroke may be a prognostic factor of nam- Keywords: Language, Stroke, Functional and Struc- ing recovery. This result could allow for a better eval- tural Neuroimaging/NIRS uation of the ability of the aphasic patient in the acute phase after stroke. Furthermore it could allow identify- Correspondence address: Mr Johnny King Lau, Uni- ing which language functions treat specifically to ob- versity of Birmingham, Psychology, Edgbaston, B15- tain the best recovery in aphasic patients. 2TT Birmingham, United Kingdom. Tel.: +44 0788193 7960; E-mail: [email protected] Keywords: Language, Stroke, Neuropsychological As- sessment and Psychometrics P3.24 Correspondence address: Mrs Valentina Varalta, Neu- Prognostic factors of aphasia recovery: A study on romotor and Cognitive Rehabilitation Research Cen- 196 stroke patients tre, Neurological, Neuropsychological, Morphological and Movement Science, University of Verona, Piaz- Valentina Varalta1, Marialuisa Gandolfi1,BarbaraDe zale LA Scuro, 10, IT-37134 Verona, Italy. E-mail: Giovannini2, Cristina Fonte1 and Nicola Smania1 [email protected] 436 Posters

P3.25 PWD in our case results from a pre-phonemic disorder due to a unilateral lesion of the left temporal lobe. Delimiting the borders of Pure Word Deafness: A Results invite the conclusion that left primary auditory single case report cortex implements the very first stages of processing of auditory language comprehension. Chiara Maffei1, Marco Catani2, Flavio Dell’Acqua3, Michel Thiebaut de Schotten4, Rita Capasso5, Giulia Keywords: Other Functions/Disorders, Agnosia, Other Cazzoli5 and Gabriele Miceli6 Methods 1Universita degli Studi di Trento, Cimec, Center for Mind/Brain Sciences, Rovereto, Italy Correspondence address: Mrs Chiara Maffei, Univer- 2Institute of Psychiatry, King, Forensic and Neurode- sita degli Studi di Trento, Cimec, Center for Mind/ velopmental Science, London, United Kindom Brain Sciences, Palazzo Fedrigotti, corso Bettini 31, 3Institute of Psychiatry, King, Forensic and Neurode- Rovereto (TN), Italy-38063 Rovereto, Italy. E-mail: velopmental Science Neuroimaging NIHR BRC for [email protected] Mental Health, London, United Kingdom 4Institute of Psychiatry, King, Natbrainlab, Depart- P3.26 ment of Forensic and Neurodevelopmental Sciences, London, United Kingdom A study on implicit and explicit self-voice recogni- 5Universita Degli Studi di Trento, Centro Interdiparti- tion mentale Mente/Cervello-CIMEC, Rovereto, Italy 6Universita Degli Studi di Trento, Dipartimento di Psi- Elisa Zamagni1, Francesco Ruotolo2, Michela Candi- cologia e Science Cognitive, Centro Interdipartimen- ni3, Santa Iachini2 and Francesca Frassinetti3 tale Mente/Cervello-CIMEC, Rovereto, Italy 1University Of Bologna, Psychology, Bologna, Italy 2Second University Of Naples, Laboratory Of Cogni- In rare cases, brain damage can result in so-called Pure tive Science And Immersive Virtual Reality, Depart- Word Deafness (PWD), ie, the selective loss of the ment Of Psychology, Napoli, Italy ability to recognise spoken language, in the absence of 3Department Of Psychology, University Of Bologna, a similar deficit for written language recognition and of Bologna, Italy relevant spoken and written production impairments. The disorder is of interest because of its high speci- In the ongoing debate about the notion of “self” a ficity and of its potential role in understanding the nor- dissociation between implicit and explicit self body mal mechanisms of language perception and their neu- knowledge has been demonstrated (Frassinetti et al., ral underpinnings. However, results of lesion studies 2011; Ferri et al, 2011). A facilitation in processing are inconsistent - lesions responsible for PWD are fre- visual images representing our body as compared to quently large and bilateral, typically involving the grey other people’s body emerges when an implicit but not and white matter of the temporal lobe, and the auditory when an explicit recognition of our own body is re- processing disorders underlying PWD vary across sub- quired. jects. As a consequence, even though several hypothe- Regarding other aspects of self-recognition, a recent sis have been put forward, the neurofunctional mecha- study on self face and self voice recognition showed nisms underlying PWD are still a matter of debate. that seeing one’s own face and listening to one’s own We combined structural and diffusion imaging with voice activate the same cerebral region, thus suggest- deterministic tractography to analyse a single case of ing that this region is concerned with processing self- a woman affected by Pure Word Deafness after left related stimuli across multiple sensory modalities and unilateral cerebrovascular accident. Contrary to other that it may contribute to an abstract self-representation cases, this patient presents with a very small lesion lo- (Kaplan et al., 2008). calised in the primary auditory cortex. The aim of the The aim of the present study was to verify whether study was to precisely delimit the cortical and sub- also for self voice recognition there is a dissociation cortical boarders of the lesion, with specific empha- between implicit and explicit self voice processing sis on the white matter pathways involved in language and whether a facilitation in discriminating self versus and auditory processing. Results from tractography re- other people’s voice emerges in implicit but not in the construction and neuropsychological tests suggest that explicit task. Posters 437

Healthy subjects were required to listen to couple of sues, functional magnetic resonance imaging (fMRI) stimuli (words or non-words) that could be pronounced and diffusion tensor imaging (DTI) were used to ex- by participant’s voice or by a familiar or unfamiliar amine brain activation during spatial working memory person. Afterwards, they had to judge if the voice was retrieval and white matter integrity in 18 older indi- the same or different (implicit task) and if his/her own viduals and 18 younger individuals. Spatial working voice was present or not (explicit task). Results showed memory was assessed with a modified version of the a dissociation in implicit and explicit self voice recog- Corsi Block-Tapping test (CBT) that requires the stor- nition, that is modulated by meaningful vs. meaning- age and reproduction of spatial target sequences. Ac- less stimuli (words vs non-words). tivation differences between the two age groups were analyzed for all and only correct retrieval attempts. Keywords: Other Functions/Disorders, Other Methods Functional connectivity analysis was performed using a seed region approach. DTI data were analyzed Correspondence address: Dr. PhD Elisa Zamagni, Uni- by tract-based spatial statistics (TBSS). Older individ- versity of Bologna, Psychology, Via Berti Pichat, 5, uals showed lower CBT performance accuracy than 40141 Bologna, Italy. E-mail: elisa.zamagni5@unibo. younger individuals. Brain data analyses revealed par- it ticularly right-hemispheric dorsolateral prefrontal ‘underactivation’ in older individuals. Moreover, older P3.27 individuals showed decreased functional connectivity between right dorsolateral prefrontal cortex and other Age-related reduction of prefrontal cortex integrity frontal brain regions as well as decreased white mat- during spatial working memory retrieval ter integrity of fronto-parietal and inter-hemispheric connections. The present results confirm a working Max Toepper1, Hans Markowitsch2, Christina Haag2, memory dysfunction in old age indicated by right- Bahar Saradjuk2, Helge Gebhardt3, Thomas Beblo1, hemispheric dorsolateral prefrontal ‘underactivation’ Eva Bauer3, Stefan Kreisel4, Friedrich Woermann5, and lower performance accuracy. Together with a de- Christine Thomas6, Martin Driessen7 and Gebhard creased functional and structural connectivity between Sammer3 different frontal brain regions in older individuals, 1Evangelic Hospital Bielefeld (EvKB), Research De- these findings suggest an age-related reduction of pre- partment, Bielefeld, Germany frontal cortex integrity which may restrict working 2Department of Psychology, University of Bielefeld, memory control processes. Bielefeld, Germany 3Justus-Liebig-University of Giessen, Cognitive Neu- Keywords: Executive Functions, Aging, Functional roscience at Centre for Psychiatry, Giessen, Germany and Structural Neuroimaging/NIRS 4Department of Gerontology, Evangelic Hospital Bielefeld, Bielefeld, Germany Correspondence address: Dr. Max Toepper, Evan- 5Mara Hospital, Bethel Epilepsy Center, Bielefeld, gelic Hospital Bielefeld (EvKB), Research Depart- Germany ment, Remterweg 69-71, D-33617 Bielefeld, Germany. 6Evangelic Hospital Bielefeld (EvKB), Department of E-mail: max.toepper@evkb Gerontology, Bielefeld, Germany 7Evangelic Hospital Bielefeld (EvKB), Department of P3.28 Psychiatry and Psychotherapy Bethel, Bielefeld, Ger- many Naturalistic multitasking: Effect of normal aging and CIND Healthy aging is accompanied by a spatial working memory decline that is related to functional and Thomas Benke structural cerebral changes within the spatial working Klinik für Neurologie, MUI, Innsbruck, Austria memory network. Ambiguity remains whether these changes reflect functional deficits or compensation and In multitasking (MT), multiple different tasks have to whether changes within prefrontal cortex particularly be completed in a limited time period and by switch- affect dorsolateral parts, ventrolateral parts, or their ing from one to another. Little is known about the connections to other brain regions. To address these is- demographical and cognitive correlates of MT in ag- 438 Posters ing subjects. MT was studied in a group of cogni- 2The University of Edinburgh, Human Cognitive Neu- tively normal controls (NCs; n = 374, age 66.4, edu- roscience, Department of Psychology, Edinburgh, cation 13.1, MMSE 28.9) and a group of nondemented United Kingdom subjects with slight cognitive impairment (cognitive 3The University of Western Australia, Neurocognitive impairment, no dementia/CIND; n = 42, age 74.6, Development Unit, School of Psychology, Perth, Aus- education 11.4, MMSE 26.6). Two naturalistic tasks tralia were used: 1) a shopping task (participants were given recipes and asked to find the cheapest ingredients from BACKGROUND: Goal Maintenance is the process by among 6 supermarket flyers and to calculate the ‘bar- which the rules that guide task-relevant behaviour are gain’ meal costs), and 2) a bus trip task (planning se- kept active so as to exert their control. When this pro- rial two-part bus rides in a virtual town to catch an ap- cess fails, an individual may ignore a rule while per- pointment). A prospective memory task was also informing the task despite being able to describe it after cluded (spontaneous report of information after 5 and task completion. Duncan and colleagues have shown 10 mins, respectively). The time limit for task achieve- that high fluid intelligence correlates with an improved ment was 15 min, and lapse of time was visible on a ability to maintain a complex set of rules, and neglect- clock located on the desk. Only properly solved tasks like errors increase with lower fluid intelligence abil- were scored. Bonus points were given if tasks from ities, particularly when the complexity of the task in- more than one category were resolved. Subjects with structions is high. CIND performed significantly poorer than NCs on all AIM: This study examined instructional complexity three MT tasks, including prospective memory. NCs independently of maintenance duration and task com- switched tasks significantly more often than CIND plexity. subjects. Multiple linear regression analyses showed METHODS: The first study involved 48 adults aged age, education and diagnostic group, but not depres- 40–70 years performing two sub-task blocks of a rapid sion, gender or independent living as significant pre- serial visual presentation task. In the second study, we dictors for MT performance (R2 = 0.42). Best neu- tested 37 younger (aged 18–35 years) and 35 older ropsychological predictors were Trail B, word fluency, (aged 60–80 years) adults where 3- or 4-instructions a health numeracy task, the FAB and a memory screen were given for one task block, with the extra instruc- score (R2 = 0.49). In sum, naturalistic MT showed tion being irrelevant to the task. substantial decrements related to age, education and RESULTS: In the initial study, we observed a sig- cognitive functions. A clear relationship of MT perfor- nificant interaction between fluid intelligence and in- mance and age related cognitive changes of memory, structional complexity, with low-intelligence individ- speed and executive functions was found. Patients with uals committing more neglect-like errors than high- CIND are significantly impaired in naturalistic MT as intelligence individuals but only when concurrently compared to normal aging subjects. maintaining instructions for both sub-task blocks. In contrast, there was no effect of instructional complex- Keywords: Executive Functions, Aging, Neuropsycho- ity in the second study. Despite significant main effects logical Assessment and Psychometrics of age group and intelligence group, there was no interaction between intelligence group and instructional Correspondence address: Prof.Dr. Thomas Benke, Ani- complexity in either age group. chstr. 35, A-6020 Innsbruck, Austria. E-mail: thomas. CONCLUSION: Goal Maintenance abilities may de- [email protected] cline with age, but fluid intelligence may not directly relate to the ability to maintain complex rules. P3.29 Keywords: Executive Functions, Aging Goal maintenance, fluid intelligence and cognitive ageing Correspondence address: Mr Matthew Iveson, The University of Edinburgh, Department of Psychology, Matthew Iveson1, Sarah E. MacPherson2, Mike Ander- George Square, EH8 9JZ Edinburgh, United Kingdom. son3 and Sergio Della Sala2 E-mail: [email protected] 1The University of Edinburgh, Department of Psychol- ogy, Edinburgh, United Kingdom Posters 439

P3.30 P3.30

Heterogeneity of cognitive functionind and its dis- Intraoperative monitoring of executive functioning orders in elderly people in brain tumor patients

Natalia Treder Martine Van Zandvoort1, Irene Huenges Wajer2,Carla University of gdansk, psychology, Gdansk, Poland Ruis2, Marike Broekman3, Anouk Smits2, Tom Snij- ders2 and Pierre Robe3 Neuropsychological literature suggests that there is a 1Utrecht University/University Medical Centre, Exper- link between changes occurring in one’s brain as a re- imental Psychology/ Neurology, Utrecht, Netherlands sult of aging and cognitive processes. Age-related cog- 2University Medical Centre, Utrecht, Neurology, nitive functioning variation does not follow a one spe- Utrecht, Netherlands cific pattern. The rate of aging of particular neurophys- 3University Medical Centre, Utrecht, Neurosurgery, iological and cognitive processes has interindividual Utrecht, Netherlands disharmonies and interindividual differences. The purpose of the study was to characterize the cognitive pro- Awake brain surgery allows extensive intraoperative cesses in the elderly people. monitoring of not only motor and sensory functions The presented research involves 79 people who are di- and language, but also of executive functioning. The vided into two groups: experimental and control one. Stroop effect is assumed robust and sensitive to the Experimental group (N = 44) consists of people who frontal cortex. Feasibility and implications of adapted are 65 years of age. Control group (N = 35) in- Stroop paradigm are investigated and related to neu- cludes the adults in the 40 to 55 age band.The meth- ronavigation screen captures and pre and post-surgery ods used in the research are popular neuropsychologi- neuropsychological examination. cal tests: Mini Mental State Examination, Rey Osterri- 52 patients (38 left and 13 right hemisphere primary eth Compex Figure Test, Controlled Oral Word Asso- brain tumors; 29 low-grade and 23 high-grade gliomas) ciation Test, Digit Span from the Wechsler Adult Intel- underwent debulking in an awake-awake-awake proce- ligence Scale, Block Designe Test from the Wechsler dure and had intraoperative cognitive monitoring ac- Adult Intelligence Scale, Trail Making Test. The the- cording to clinical care as usual. Patients are grouped sis shows a global level assessment of working, imme- on Stimulation effect (Stroop error (including slow- diate, long-term, visual-spatial memories functioning, ness) or not) and the influence of lesion side and site attention, executive processes and abilities of visual- (screen captures superimposed on normalized brain) spatial synthesis. and histotype will be analyzed (nonparametric). In In the presented research done profile analysis. Trans- addition, neuropsychological performance pre and 6 formation of the raw results into counted and expressed months post surgery will be taken into account (ajusted on standard scale. Cognitive problems were common anova ). in elderly people but they had individual and varied The Stroop paradigm was applied intraoperatively in character. There was regularity that in the elderly peo- 32 (10 right hemisphere) of 52 patients. In 13 patients ple was the prevalence of executive dysfunctions. The the Stroop was not feasible to pre-existing deficits (4 most problematic task was the one involving work- language impairments, 1 language barriere, 2 executive ing memory, the one requiring divisibility of attention, impairments, 1 fatigue) or clinical priorities on lan- switching and concentration of attention. guage or motor functioning. In 7 patients the Stroop was not applied (debulking of parietal/occipital tu- Keywords: Executive Functions, Aging, Neuropsycho- mors). Deficits on stimulation was found in 75% of the logical Assessment and Psychometrics patients and in 62% of the patients influenced resection. No significant differences are found between left Correspondence address: Mrs master Natalia Treder, and right hemisphere. Feasibility level was in favor of University of gdansk, psychology, Baz˙ynskiego´ 4, 80- low-grade gliomas. 952 Gdansk, Poland. Tel.: +48 660434667; E-mail: The intraoperative Stroop paradigm is feasible in both [email protected] high and low-grade frontal primary brain tumor patients in whom pre-operative Stroop is feasible. No differences in either feasibility nor elicited Stroop ef- 440 Posters fect between right and left frontal tumors was found. Keywords: Executive Functions, Dementia, Neuropsy- Findings with respect to site of the lesion and rela- chological Assessment and Psychometrics tion with overall neuropsychological functioning will be discussed. Correspondence address: PhD Munteanu Cornelia- Eugenia, CMDT - -, -, Ro– Bucharest, Romania. E- Keywords: Executive Functions, Other Disorder/ mail: [email protected] Samples, Invasive Techniques P3.32 Correspondence address: PhD Martine van Zandvoort, Utrecht University/ University Medical Centre, Ex- Neural processing of interference control in elderly perimental Psychology/Neurology, Heidelberglaan 2, males with and without amnestic mild cognitive im- NL-3584 CS Utrecht, Netherlands. E-mail: m.vanzand pairment [email protected] Margarethe Korsch1, Helmut Hildebrandt2, Sascha P3.31 Frühholz3 and Manfred Herrmann4 1Department of Neuropsychology and Behavioral Neu- The impact of institutionalization upon cognition robiology, Bremen University, Bremen, Germany and behavior in institutionalized patients with 2Oldenburg University, Oldenburg Alzheimer’s disease 3University of Geneva 4Bremen University, Bremen Munteanu Cornelia-Eugenia CMDT - -, Bucharest, Romania Amnestic Mild Cognitive Impairment (aMCI) represents a transitional state between healthy ageing and A family can hardly experience and handle the sudden clinical conditions such as dementia, and is character- news that a beloved is diagnosed with Alzheimer de- ized by predominant memory impairments. However, mentia (AD), and that the latter’s long-term care re- recent research also demonstrates executive dysfunc- quires patience, moral and physical energy and ex- tions to be highly affected in subjects with aMCI. Here, tended time. Where the family fails, institutionaliza- we mainly focused on interference processing as im- tion becomes a solution. This paper aims at spotting total care effects upon cognition and behavior in AD pairments of inhibition might cause or increase mem- patients. It is obvious the medical staff’s tendency to ory dysfunction. To investigate whether different as- overcame patients who are no longer allowed to do pects of interference control are altered in persons with what they could, thus inducing cognitive distortion “I aMCI, 9 elderly male participants with aMCI and 10 don’t know, I can’t”. 56 AD patients (M = 78.32 years, healthy male controls performed a combined Simon SD = 2.51 years) were functionally assessed at in- and Flanker task during fMRI recording. With regard stitutionalization and six months later, analyzing the to behavioral performance, no differences could be de- items to detect if patients could perform routine activi- tected between both groups. However, imaging data ties without help: eat and drink, stand up and sit down demonstrated group-related differences in frontal and on chairs or bed, use the bathroom, do their toilet, get parietal areas. These findings might indicate that the upstairs or downstairs, get dressed or undressed, use transition of healthy to pathological ageing goes along the remote control or the phone. Results indicated that with modulations of the neural networks supporting in- 72% of all AD institutionalized patients behaved ac- terference control. cording to the thought “I don’t know I can’t” and not as a consequence of cognitive deterioration. Time pres- Keywords: Executive Functions, Mild Cognitive Im- sure upon medical staff’s duty fulfillment causes a dis- pairment, Functional and Structural Neuroimaging/ torted reality to patients: they accept being fed instead NIRS of eating themselves, wearing diapers instead of going to toilet, etc. Care of AD institutionalized patients Correspondence address: Mrs Margarethe Korsch, De- must count what abilities they still have, let them per- partment of Neuropsychology and Behavioral Neu- form routine activities, and offer help only if necessary. robiology, Bremen University, Hochschulring 18, D- Patients must think and behave according to their own 28359 Bremen, Germany. E-mail: korsch@uni- reality and not to an induced one. bremen.de Posters 441

P3.33 Keywords: Executive Functions, Mild Cognitive Im- pairment, Neuropsychological Assessment and Psy- The particular features of mental ontogenesis of chometrics preschool children with signs of subcortical brain structures dysfunction on electroencephalogram Correspondence address: Mrs Alfiya Sultanova, Rus- sian Academy of Education, Institute for psycholog- Alfiya Sultanova and Irina Ivanova ical and pedagogical problems of childhood, Eni- Russian Academy of Education, Institute for psy- seiskaya, 32-1-108, RU-129281 Moscow, Russia. Tel.: chological and pedagogical problems of childhood, +7 9057049353; E-mail: alfi[email protected] Moscow, Russia P3.34 Studies of the relationship between psycho-physiological characteristics of children and the features of Characterization of executive functions profile in children’s mental development are of high importance. patients with cerebellar damage This research is dedicated to the analysis of 5–7 years Silvia Clausi1, Claudia Iacobacci2, Anna Maria Tedes- old children with the most common EEG abnormali- 3 3 4 ties – dysfunctions of subcortical-stem structures of the co , Giusy Olivito , Marco Molinari and Maria Leggio3 brain. We applied the following research methods: bat- 1 tery of neuropsychological Luria’s tests, parental and Department of Psychology, “Sapienza” University of kindergarten personnel surveys, observational research Rome, Ataxia Laboratory, Santa Lucia Foundation, methods. 80 children have been examined: 40 children Roma, Italy 2Department of Psychology, “Sapienza” University of in the main group and 40 – in the control group (control Rome, Rome, Italy group – healthy children without any abnormalities in 3Department of Psychology, Sapienza University of EEG data). Rome, Ataxia Laboratory, Santa Lucia Foundation, According to the research data, the most common devi- Rome, Italy ations of the children in the main group were neurody- 4Ataxia Laboratory, Santa Lucia Foundation, Rome, namic disorders: fatigue, psychic inertness, decrease in Italy working capacity, fluctuation of speed, and efficiency of mental activity. Many of these children were show- “Executive functions” (EFs) refers to the ability to ing the signs of the deterioration of audio-verbal and orchestrate different cognitive tasks to attain specific visual memory, phonemic hearing retardation, disor- goals. There is a consensus that the lateral PFC and ders of spatial gnosis and praxis, tactile perception, basal ganglia together with the cerebellum play a crit- and motor development. Particularly, it should be noted ical role in EFs. The cerebellar involvement in EFs is that our research revealed the reduced self-control ca- supported by the existence of specific anatomical con- pability and the lag in the development of executive nections with the lateral PFC, but its nature remains functions carried out by the prefrontal cortex area in all unclear. the children (although the EEG data did not reveal the Aim of the present study was to extensively investigate failure of these brain structures). the EFs subcomponents in patients affected by cerebel- Consequently the results of the study are useful to lar damage to characterize the executive components specify the role of development (influence? interrela- that need of the cerebellar modulation. tionship?) of subcortical brain structures and frontal ar- Twenty-four patients affected by cerebellar atrophy eas of cortex. (CA) or focal cerebellar damage (FCD), and 44 The above-mentioned features lead to difficulties in matched healthy controls were studied. Each patient mastering a number of skills, developmental delay of underwent MRI examination and a motor scale. In- game activity, impede their social adaptation, and lead tellectual level (IL) and cognitive domains were as- to the risk of school failure in the future. sessed in all subjects by an extensive neuropsychologi- Thus, the functional failure of subcortical structures cal evaluation. A large EFs battery, also including eco- has a specific influence on the course of mental onto- logical tasks, was used to assess specific subcompo- genesis. nents: working memory, planning and problem solving, multitasking, and inhibition. A one-way Anova 442 Posters and Tukey’s post hoc test were performed; a Spear- deficits due to abovementioned triggers and panic at- man correlation between motor and cognitive scores tacks mostly later in the course of disease have been was also done. described. Thus, no study so far has systematically as- The patients showed good IL without significant corre- sessed cognitive functions and mood in episodic atax- lation between motor impairment and cognitive scores. ias. Five EA2 patients out of a genetically assigned In general, patients’ cognitive performances were in family agreed to be tested in a wide range of cog- line with Cerebellar Cognitive Affective Syndrome nitive functions. Performance was classified accord- (Schmahmann & Sherman, 1998) and Cerebellar Cog- ing to standardized norms. 4 out of 5 patients showed nitive Profile (Tedesco et al 2011) characteristics. good verbal intelligence, one patient had a verbal IQ Specifically regarding EFs, all patients were partic- of 70. All patients had variable impairments in execu- ularly affected in tasks that required new and more tive functions including verbal working memory, ver- complex strategies and sequencing processing. Fur- bal fluency, cognitive flexibility and set shifting. Addi- thermore, differences were observed between FCD and tionally, deficits were found in verbal and visual mem- CA groups, with the former performing worse than the ory, in attention, in visuo-constructional abilities, as latter. well as in fine motor manipulations and syllable repe- This is the first systematic study that describes the tition. Anxiety score was high in one patient, most pa- “cerebellar dysexecutive syndrome” and further sup- tients tended to have mild depression. Results of the ports the idea of sequencing as the basic operational present study suggest that EA2 is associated with cog- mode of the cerebellum (Molinari et al 2008). nitive deficits. These results are in line with other investigations showing that long-term functional impair- Keywords: Executive Functions, Neuropsychological ment of cerebrocerebellar circuits may lead to cogni- Assessment and Psychometrics tive deficits. Findings of the study suggest that patients affected by EA2 should undergo neuropsychological Correspondence address: Dr. Silvia Clausi, Depart- assessment. Still, more studies in larger patient groups ment of Psychology, “Sapienza” University of Rome; are needed to highlight the relationship between the Ataxia Laboratory, Santa Lucia Foundation, Via dei frequency of attacks and neuropsychological outcome. Marsi, 78; Via Ardeatina, 306, IT-00185 Roma, Italy. Tel.: +39 0651501115; E-mail: silvia.clausi@gmail. Keywords: Executive Functions, Neurodegenerative com Diseases, Neuropsychological Assessment and Psy- chometrics P3.35 Correspondence address: Mrs Master Elfriede Karner, Neuropsychological findings in Episodic Ataxia Innsbruck Medical University, Clinical Department of type2 Neurology, Anichstrasse 35, A-A Innsbruck, Austria. Tel.: +43 51250423869; E-mail: elfriede.karner@uki. Elfriede Karner, Wolfgang Nachbauer, Margarete De- at lazer and Sylvia Boesch Innsbruck Medical University, Clinical Department of P3.36 Neurology, Innsbruck, Austria Frontal white matter lesions contribute more than Episodic Ataxia type2 (EA2) belongs to the group of grey matter changes in determining cognitive defi- dominantly inherited neurodegenerative ataxias. It is cits in patients with non-amnestic mild cognitive characterized by recurrent attacks of ataxia often ac- impairment companied by nystagmus, which can last from several hours to several days. Attacks are often triggered by Mario Torso1, Laura Serra1, Roberta Perri2,Lucia stress or physical effort. Clinical overlap exists with Fadda3, Barbara Spanò1,NadiaTini2, Diana Castelli4, allelic disorders, namely familiar hemiplegic migraine Camillo Marra2, Carlo Caltagirone5 and Marco type 1 and spinocerebellar ataxia type 6, both char- Bozzali1 acterized by additional slowly progressive pure cere- 1IRCCS Fonsazione Santa Lucia, Neuroimaging Labo- bellar atrophy. Little is known about the cognitive and ratory, Roma, Italy behavioural impairments of episodic ataxias. Learning 2IRCCS Fonsazione Santa Lucia, Department of Clin- Posters 443 ical and Behavioural Neurology, Roma, Italy Correspondence address: Mr Mario Torso, IRCCS 3IRCCS Fonsazione Santa Lucia, Department of Neu- Fonsazione Santa Lucia, Neuroimaging Laboratory, roscience, University of Rome ‘Tor Vergata’, Roma, Via Ardeatina 306, D-00179 Roma, Italy. Tel.: +39 Italy 0651502547; E-mail: [email protected] 4Institute of Neurology, Università Cattolica, Roma, Italy P3.37 5IRCCS Fonsazione Santa Lucia, Department of Clini- cal and Behavioural Neurology, Department of Neuro- Impaired executive functioning in amyotrophic lat- science, University of Rome ‘Tor Vergata’, Roma, Italy eral sclerosis (ALS) with or without fronto- temporal dementia (FTD) BACKGROUND: Non-amnestic mild cognitive impairment (na-MCI) represents a peculiar clinical phe- Elisabeth Kasper1, Christina Schuster2, Judith Mach- notype that differs, in terms of clinical evolution, from ts3, Maria Veit3, Stefan Vielhaber4, Reiner Benecke5, the amnestic MCI form. White Matter Hyperintensities Stefan Teipel2 and Johannes Prudlo5 (WMHs) are more frequent in patients with MCI than 1German Center for Neurodegenerative Diseases in healthy subjects (HS). Nevertheless, their putative (DZNE), Site Rostock/Greifswald, Rostock, Germany role in neurodegeneration remains unclear. 2German Center for Neurodegenerative Diseases AIMS: To investigate the role of WMHs in account- (DZNE), Rostock, Germany ing for the clinical/neuropsychological features of na- 3German Center for Neurodegenerative Diseases MCI. (DZNE), Magdeburg, Germany METHODS: Fifteen na-MCI patients (all with execu- 4 < Department of Neurology, University of Magdeburg, tive dysfunctions and Hachinsky score 4)and15HS Magdeburg, Germany underwent clinical/neuropsychologicalassessment and 5 Department of Neurology, University of Rostock, Ro- MRI at 3T, including T1-weighted volumes for quan- stock, Germany tification of grey matter parenchymal-fraction (GMPF) and proton-density/T2-weighted scans for WMH ana- OBJECTIVES: Due to the understanding of ALS as tomical localization and volume (WMHvol) assess- multisystem disease and its overlap with FTD cogni- ments. WMHs were first classified as periventricu- tive and behavioural disturbances are considered in- lar (PVH) or deep (DWMH), and then as frontal creasingly (Goldstein, 2013). In particular, impairment (FWMH), temporo-insular (TIWMH), parieto-occipital of executive functions seems to be a negative prognos- (POWMH), or in the basal ganglia (BGWMH). Regres- sion models were used to assess the contribution of tic factor in the disease process (Elamin, 2011). Our GMPF, lesion characteristics, and vascular risk factors study aimed to characterize the cognitive profile and in accounting for patients’ characteristics. behaviour of ALS patients from a large cohort with RESULTS: na-MCI patients were not significantly dif- emphasis on executive functions and their relevance to ferent from HS in GMPF. Conversely, they showed a everyday’s functioning. significantly higher WMHvol in the whole brain, and a METHODS: We investigated 92 ALS patients and greater DWMH extension in the frontal lobes. Regres- 11 patients with ALS-FTD in comparison to 71 age sion analyses revealed the presence and extension of and education matched healthy controls, using a com- FWMH as best predictors for patients’ performance at prehensive neuropsychological test battery adapted to tests for executive functions. motor incapabilities, including a behavioural ques- CONCLUSION: The present study suggests a promi- tionnaire. Executive test variables were assigned to nent role for FWMH in the pathophysiology of na-MCI their corresponding level of cognitive regulation (ba- patients. This contribution is apparently unrelated with sic, complex, social and emotional) and frequency dis- patients’ demographic characteristics and vascular risk tribution has been analyzed. factors. Further studies, using quantitative MRI tech- RESULTS: 19% of patients without FTD and all with niques are needed to better clarify the relationship be- FTD showed executive function impairment. The ex- tween FWMH and neurodegeneration. tent of basic function disorders (e.g. shifting) ranged from 28% to 78% in patients without FTD, from 45% Keywords: Executive Functions, Neurodegenerative to 100% in ALS-FTD subjects. In contrast, complex Diseases, Functional and Structural Neuroimaging/ function disorders (e.g. monitoring) were much rarer NIRS (27% regardless of FTD), difficulties in problem solv- 444 Posters ing occurred even only in cases of FTD. Behavioural capacity to resolve cognitive conflicts. As to fMRI disorders (e.g. disorganization or disinhibition) were studies, Abutalebi et al. (2011) reported that bilingual apparent in 16% of ALS patients and 54% of subjects adults not only resolve cognitive conflicts with less with ALS-FTD. neural activity but their brain seems also to be better CONCLUSION: Executive dysfunctions have a sig- tuned to monitoring cognitive conflicts. nificant relevance in the disease process of ALS pa- However, the functional precursors in developmental tients. In contrast to a high frequency of basal regula- terms of the relationship existing between multilin- tory disorders, complex processes as well as dysexecu- gualism and the neural activity elicited for resolving tive behavioural disorders are affected much less. This cognitive conflicts (i.e. the conflict effect) still remain discrepancy can explain the relative moderate distur- to be identified. bances observed in clinical practice. These seem to be To this aim, we used a longitudinal event-related func- dependent on both the specific pattern of basic regula- tional magnetic resonance imaging (l-fMRI) to investi- tion deficits as well as the degree of complex regula- gate the effects of multilingual competence on the ex- tory disorders. ecutive control attentional network over two years (at T1 and T2) in a group of 15 multilingual children. Keywords: Executive Functions, Neurodegenerative SPM8 was used for slice-timing, coregistration, re- Diseases, Neuropsychological Assessment and Psy- alignment, unwarping and noise removal processes on chometrics all functional data for both time-periods prior to longitudinal subject-specific normalization and smoothing. Correspondence address: Mrs Elisabeth Kasper, Ger- A contrast coding the conflict effect independently at man Center for Neurodegenerative Diseases (DZNE) – T1 and T2 was first computed before creating differen- Site Rostock/Greifswald, Gehlsheimer Straße 20, D- tial time-period contrast images (T2-T1) and perform- 18147 Rostock, Germany. E-mail: elisabeth.kasper@ ing correlations with multilingual competence differ- dzne.de ential scores (T2-T1). fMRI data analysis revealed that lower levels of multi- P3.38 lingual competence at T2 correlated with higher functional brain activity in a frontal-subcortical loop, in- The functional precursors of the relationship be- volving the left dorsolateral frontal cortex, the head of tween multilingualism and cognitive control: A lon- left caudate nucleus and the left putamen, a network of gitudinal fMRI (l-fMRI) study in multilingual chil- brain regions which have been found to subtend cogni- dren tive control for both attention and language (Abutalebi and Green, 2007). Pasquale Della Rosa1, Matteo Canini2, Virginia Borsa2, Gerda Videsott3, David Green4, Rita France- Keywords: Executive Functions, Other Disorder/Sam- schini3 and Jubin Abutalebi2 ples, Functional and Structural Neuroimaging/NIRS 1IBFM-CNR, Institute of Molecular Bioimaging and Physiology, Milan, Italy Correspondence address: PhD Pasquale Della Rosa, 2University San Raffaele, Center for Cognitive Neuro- IBFM-CNR, Institute of Molecular Bioimaging and science, Milan, Italy Physiology, Via F.lli Cervi, 93, IT-20100 Milan, Italy. 3Free University of Bozen, Faculty of Education and E-mail: [email protected] Language Study unit, Bozen, Italy 4University College London, Cognitive, Perceptual P3.40 and Brain Sciences, London, England Disruption of social cognition in McArdle disease There is recent neuro-imaging evidence showing that experience in dealing with two or more languages may Nicky Edelstyn have a lifelong positive impact on the brain. For in- Keele University, Psychology, Staffordshire, England stance, Della Rosa et al. (2012) have highlighted the relationship between grey matter changes in the left in- McArdle disease (GSDV) is characterised by abnor- ferior parietal lobule and the interaction between the malities in glycogen accumulation in the muscles dur- natural development of a multilingual talent and the ing exercise. Glycogen is also an important energy Posters 445 source for neurons, and brain imaging evidence sug- P3.41 gests that abnormal glycogen accumulation also occurs in the centrum semiovale (CS), a white matter Executive function in first episodes of schizophre- tract linking the cerebellum, prefrontal and parietal ar- nia: A 1-year clinical stability eas (Salvan, Vion-Dury, Confort-Gourny et al., 1997). Structural abnormalities in the CS and impairments in Mireia Gonzalez-Rodriguez1,MarAriza2, Arantzazu social functioning have been reported in people with Herran-Boix3, Sergio Bodas3, Cristina Enero3 and autism spectrum disorder (Barnea-Goraly, 2004), rais- Maite Garolera3 ing the possibility that GSDV patients may display a 1Hospital de Terrassa, Consorci Sanitari de Terrassa, cognitive profile reminiscent of that reported in autism Neuropsychology Unit, Terrassa- Barcelona, Spain – impaired social cognition and executive dysfunction. 2Brain, Cognition and Behaviour Research Group, Three demographic- and IQ-matched groups were re- Unitat d’Investigació biomèdica Universitat Autònoma cruited, consisting of 9 patients with GSDV, 8 neu- de Barcelona CST (UIB), Terrassa- Barcelona, Spain romuscular control patients and 8 healthy controls 3Hospital de Terrassa-Consorci Sanitari de Terrassa, (HC). Both musculoskeletal patient groups had sig- Neuropsychology Unit, Terrassa-Barcelona, Spain nificantly higher scores on the Hospital Anxiety and Depression Scale and McGill Pain Questionnaire, and Longitudinal studies of first-Episode (FE) patients are were therefore covaried the subsequent statistical anal- of special relevance when it comes to evaluating the yses.All participants completed tests of verbal fluency, course of cognition in schizophrenia, since they pro- problem-solving, reasoning (Hayling-Brixton Tests), vide a baseline measure of cognitive performance and strategic memory (source memory), social functioning relevant confounders associated with chronicity are (Autism Quotient Questionnaire [AQQ]). also controlled. Impairment in executive functioning Compared to the HC, the GSDV group showed signif- is considered a primary deficit in schizophrenia. They icant impairments in strategic memory (source misat- occur early in the course of the disorder and there is tribution), and 3 subscales of the AQQ (social skill, at- still a lack of prospective data specifically describing tention switching, imagination, total quotient). There the trajectory of this executive deficit. The aim of this were no significant differences between the patient study was to examine the longitudinal course of ex- groups, although the GSDV patients’ performance was ecutive functioning in a group of patients with a di- consistently poorer. There were no other significant agnosis of FE. 27 patients (74% men; mean age at differences. baseline 25 (SD 6.4), education years 10 (SD 2.6) fol- These findings imply that GSDV is at one end of a con- lowing a DSM-IV schizophrenia diagnosis (made at tinuum of cognitive dysfunction with other neuromus- baseline and confirmed at 12-month follow-up) with- cular patients not as severely affected. A fully powered out comorbidity with other Axis I disorders (includ- study, which includes more sensitive tests of executive ing drugs). All patients were under antipsychotic treat- function and social cognition, and brain imaging, will ment and, were assessed after achieving clinical stabil- help explore these issues further. ity at baseline and one-year follow-up. Four standardized test measured executive functions of verbal flu- Keywords: Executive Functions, Other Disorder/Sam- ency, reasoning, planning and mental flexibility (Ver- ples, Neuropsychological Assessment and Psychomet- bal fluency, block design, Trail Making Test-B, Wis- rics consin Card Sorting Test). T-test for paired samples was used to assess the statistical significance of the dif- Correspondence address: Mrs Professor Nicky Edel- ferences between measures, and we estimated the ef- styn, Keele University, Psychology, Keele, ST5-5BG fect size (Cohen’s d) to measure the magnitude of mean Staffordshire, England. Tel.: +44 07951943078; E- differences. Alpha level was set at 0.01. Significant dif- mail: [email protected] ferences were found on verbal fluency (p = 0.002) with a medium effect size (0.54). Our results revealed a specific executive function improvement during early stages. It suggests a different timing in the evolution- ary changes of diverse executive functions. However, our study reveals limitations (e.g. practice-effect, short period of follow-up) to establish conclusions, it needs 446 Posters further investigation to discern the different patterns of concurrent n-back task. ERN amplitudes indicated an executive function changes over time in schizophrenia. intra-individual down-regulation of error monitoring in OCD patients as well as healthy individuals in the more Keywords: Executive Functions, Psychopathology, difficult flanker n-back condition. The present results Neuropsychological Assessment and Psychometrics suggest that changing the attentional focus can modifiy hyperactive action monitoring in OCD. On the basis of Correspondence address: Mrs Mireia Gonzalez-Rod- such findings new treatment approaches for OCD may riguez, Hospital de Terrassa- Consorci Sanitari de Ter- be developed, e.g. attentional trainings. rassa, Neuropsychology Unit, Ctra. torrebonica s/n, S- 08227 Terrassa-Barcelona, Spain. Tel.: +34 937310007 Keywords: Executive Functions, Psychopathology, 1557; E-mail: [email protected] Electrophysiology (EEG/ERP)

P3.42 Correspondence address: Mrs Julia Preuß, Humboldt- Universität zu Berlin, Clinical Psychology, Rudower Intra-individual modulation of action monitoring Chaussee 18, D-12489 Berlin, Germany. Tel.: +49 in patients with obsessive-compulsive disorder 01629621611; E-mail: [email protected]

Julia Preuß1, Julia Klawohn1, Tanja Endrass2,Rosa P3.43 Grützmann1,AnjaRiesel1 and Norbert Kathmann1 1Humboldt-Universität zu Berlin, Clinical Psychology, Profile-based analysis of dysexecutive syndrome in Berlin, Germany diabetic and after-stroke patients 2Otto-von-Guericke-Universität Magdeburg, Neuro- Daria Biechowska1 and Edyta Orłowska2 psychology, Magdeburg Germany 1Institute of Psychiatry and Neurology, Warsaw, Poland Obsessive-compulsive disorder (OCD) is a severe men- 2Institute of Psychology, University of Gdansk, Poland tal disorder, characterized by distressing intrusive thoughts (obsessions) and recurrent, ritualized behaviors Both diabetes and ischemic stroke are related to dy- (compulsions). Action monitoring has repeatedly been sexecutive syndrome. Though typologically different shown to be hyperactive in patients with OCD, as in- both involve vascular changes in the brain. Some stud- dexed by an enhancement of the error-related negativ- ies suggest different cause of poor results in executive ity (ERN) and the correct-related negativity (CRN) of functioning tests in diabetic and after-stroke patients, the event-related brain potential. These brain potentials as ischemic episode results in general slowing of men- are generated in the anterior cingulate cortex, a region tal processing. The goal of this study was to establish implicated in the pathophysiology of OCD. While ev- whether there are any differences in conduct of differ- idence suggests that this hyperactivity is independent ent tests measuring various aspects of executive func- of symptom-state in OCD, it remains unclear whether tions between type 2 diabetic and after-stroke patients. it can be modulated by situational requirements. In the Neuropsychological assessment was carried out on 30 current study, we tested whether ERN and CRN ampli- type 2 diabetic patients and 30 post-stroke patients in tudes can be reduced by manipulating attentional de- hospital environment up to 7 days after admission. Sev- mands. Therefore, patients and matched control partic- eral dysexecutive syndrome measures were used in- ipants were examined in a dual-task paradigm, com- cluding WCST, TMT and BADS. Age, education, gen- bining a response conflict flanker task and a work- der, mood and dementia were controlled factors. Statis- ing memory n-back task. In the single task condition, tical analyses showed few statistically significant dif- participants solely responded to compatible and inferences between groups in general measures mainly compatible flanker stimuli, while presented with al- in Six Elements Test and TMT part B. Quantitative ternating letters preceding each flanker trial. In the analysis showed however different types of mistakes dual task conditions, they additionally responded to made by diabetic and after-stroke patients including target letters of the n-back task and thus had to mon- time spent on planning and executing tasks, persevera- itor their actions simultaneously in two task contexts. tions, switching between tasks. Gathered results show We hypothesized that error monitoring in the flanker different patterns of executive functions deficit con- task would be reduced with increased difficulty of the nected with diabetes and ischemic stroke. Posters 447

Keywords: Executive Functions, Stroke, Neuropsycho- (< 0.001; TFCE corrected) only in the posterior limb logical Assessment and Psychometrics of the internal capsule (PLIC) when compared to HC. For the stroke group, reduced FA values were neg- Correspondence address: Mrs dr Daria Biechowska, atively associated with perseverations in the Rhythm Institute of Psychiatry and Neurology, Sobieskiego 9, subtest (rp = −0.576; p = 0.025), and positively asso- PL-02-957 Warsaw, Poland. E-mail: dbiechowska@ ciated with the Semantic Fluency Test (rp = 0.503; p = ipin.edu.pl 0.047) and the contrast 1 of the List of Words test (rp = 0.698; p = 0.006). Although damage to the PLIC has P3.44 been mostly proposed as a predictive marker of motor outcome after stroke, this study suggests that disrup- Structural damage to the posterior limb of internal tions to the right PLIC, due to its fronto-striatal con- capsule in stroke patients and its association with nections, may contribute to cognitive deﬁcits affecting cognitive functions executive and attentional functions.

Rosalia Dacosta1, Manuel GrañA2, Auer Tibor3,Ma- Keywords: Executive Functions, Stroke, Functional rina Fernandez-Andujar1, Monica Millan4,Elena and Structural Neuroimaging/NIRS Lopez-Cancio4, Cynthia Caceres4, Nuria Bargallo5, Maite Barrios6, Maite Garolera7, Imma Clemente8, Correspondence address: Mrs Rosalia Dacosta, Uni- Maria Hernandez9, Josep Munuera9, Antoni Davalos4 versity of Barcelona, Psychiatry and Clinical Psy- and Maria Mataro8 chobiology, Mundet, D-08227 Barcelona, Spain. Tel.: 1University of Barcelona, Psychiatry and Clinical Psy- +34 937870518; E-mail: [email protected] chobiology, BARCELONA, Spain 2University of the Basque Country, Group of Compu- P3.45 tational Intelligence, San Sebastian, Spain 3MRC Cognition and Brain Sciences Unit, Cambridge, Prevalence and long-term prognostic value of post- England stroke neuropsychological symptoms 4Hospital Germans Trias i Pujol, Neuroscience, Badalona, Spain Hanna Jokinen1, Marja Hietanen2,NikuOksala3,Jo- 5Hospital Clínic, Radiology, BARCELONA, Spain hanna Ojala-Oksala4, Susanna Melkas5 and Timo 6University of Barcelona, Methodology of Behavioural Erkinjuntti5 Sciences, BARCELONA, Spain 1Helsinki University Central Hospital and University 7Consorci Sanitari de Terrassa, Neuropsychology Unit, of Helsinki, Unit of Neuropsychology, Department of TERRASSA, Spain Neurology, HUS, Helsinki, Finland 8Univdersity of Barcelona, Psychiatry and Clinical 2Helsinki University Central Hospital and University Psychobiology, BARCELONA, Spain of Helsinki, Unit of Neuropsychology, Department of 9Hospital Germans Trias i Pujol - Institut de Diagnos- Neurology, Helsinki, Finland tic per la Imatge, Badalona, Spain 3Tampere University and Tampere University Hospital, Division of Vascular Surgery, Department of Surgery, Following a focal stroke, the region adjacent to the Tampere, Finland injury undergoes structural changes and anterograde 4University of Tampere, School of Medicine, Surgery, or retrograde degeneration of axons connecting dis- Tampere, Finland tant regions with the lesion may occur. Sixteen pa- 5Helsinki University Central Hospital and University tients with right hemispheric ischemic stroke and 18 of Helsinki, Department of Neurology, Helsinki, Fin- matched healthy controls (HC) underwent neuropsy- land chological assessment and diffusion tensor imaging (DTI) conducted at 3T. We performed a whole-brain Cognitive impairment is a common consequence of analysis with TBSS of the FA index for the two groups stroke, but the prevalence and long-term significance and Pearson correlations between the FA values ex- of the multifaceted neuropsychological symptoms are tracted from the tracts showing significant between- still not known in detail. We investigated the fre- group differences and the scores of the cognitive tests. quency and prognostic value of domain-specific cogni- Stroke subjects demonstrated significantly reduced FA tive deficits in a large cohort of elderly ischemic stroke 448 Posters patients. In total, 409 consecutive patients admitted to 2Universitat Autònoma de Barcelona, Psicología Clí- the Stroke Unit of the Helsinki University Central Hos- nica i de la Salud, Barcelona, Spain pital (Finland), aged 55-85 years, were evaluated with 3Sant Joan de Deu’s Hospital, Neurology’s Depart- a comprehensive clinical and neuropsychological as- ment, Barcelona, Spain sessments 3 months post-stroke. Functional independence was evaluated with the modified Rankin scale OBJECTIVE: Prenatal alcohol exposure can cause al- (mRS) 15 months after stroke, and survival of the pa- terations to neurodevelopmental brain. Several stud- tients was followed-up for up to 12 years. Of the to- ies have described difficulties in many cognitive func- tal sample, 339 (83%) patients showed impairment in tions and more specifically in IQ, attention and execu- at least one cognitive domain as evaluated against age- tive functions. Individuals with prenatal alcohol expo- appropriate normative data. 203 (50%) cases were im- sure are at increased risk for ADHD. According to the paired in multiple ( 3) domains. In cases with good ADHD ethology, children show different cognitive and clinical recovery at baseline (mRS 2), the preva- behavioral profiles. As reported, children with ADHD lence of any cognitive deficit was still 194/255 (76%). related to prenatal alcohol consumption show greater Most commonly, the affected cognitive domains were severity and incidence of social adjustment difficulties memory, visuoconstuctional/spatial skills and execu- in comparison to idiopathic ADHD. The present study tive functions. Only 29% of the total sample and 13% aims to assess working memory as well as behavioral < of the cases with good clinical recovery scored 25 in problems in children with FASD/ADHD in compari- the MMSE. Cognitive deficits at 3 months significantly son with idiopathic ADHD. predicted poor functional outcome in follow-up after METHODS: 17 adopted children diagnosed of FASD/ 15 months. Furthermore, they had independent predic- ADHD, age ranged between 6 and 10 years, were com- tive value for mortality. However, years of education pared with 17 idiopathic ADHD children. Both groups was related to a beneficial effect on survival. In con- were matched by the same subtype of ADHD, age clusion, cognitive deficits as evaluated with detailed and sex. Working memory was assessed using Dig- neuropsychological assessment are highly frequent in its, Letter and Number and Arithmetic subtests of the stroke survivors even with good clinical recovery. Typ- WISC-IV. Behavior problems were assessed using the ically multiple domains are impaired affecting com- Achenbach’s Child Behavior Checklist for Parents and plex cognitive abilities. MMSE is insensitive in detect- Teachers (CBCL). ing these symptoms. Cognitive deficits strongly predict RESULTS: Statistical analysis using T student shows functional dependence and mortality. However, educa- significant differences between both groups in Digits tional background has a protective effect as a surrogate p< p< marker for cognitive reserve. ( 0.004), Letter and number ( 0.003) and Arith- metic (p<0.000) WISC-IV subtest. In related to be- Keywords: Executive Functions, Stroke, Neuropsycho- havioral problems, we found only significant differ- logical Assessment and Psychometrics ences in social problems subscale in teacher’s CBCL (p<0,037). Correspondence address: Mrs Hanna Jokinen, Helsinki CONCLUSION: FASD/ADHD children tend to have University Central Hospital and University of Helsinki, more cognitive and behavioral problems compared to Unit of Neuropsychology, Department of Neurology, probable idiopathic ADHD. This profile is the one PO box 302, FIN-00029 HUS, Helsinki, Finland. Tel.: described in the Fetal Alcohol Spectrum Disorders. +35 8405942286; E-mail: hanna.jokinen@helsinki.fi These differences in neuropsychological profile can contribute to improve the differential diagnosis, the in- P3.46 tervention and outcome between both groups. We rec- ommend a routine monitoring FASD/ADHD to imple- Fetal alcohol spectrum disorders (FASD) children ment therapeutic interventions as early as possible. with adhd have imparied working memory and behavioral problems compared to idiopathic ADHD Keywords: Executive Functions, ADHD, Neuropsy- chological Assessment and Psychometrics Alba Corredera1, Anna Campabadal2, Cristina Boix3, Roser Colomé3, Anna López3 and Anna Sans3 Correspondence address: Mrs graduate alba corred- 1Universitat Autonoma de Barcelona, Psicología Clí- era, Universitat Autonoma de Barcelona, Psicología nica i de la Salud, Barcelona, Spain Clínica i de la Salud, Campues de Bellaterra-Edificio Posters 449

B, D-08193 Barcelona, Spain. Tel.: +34 619968865; bility, and dysexecutive function problems according E-mail: [email protected] to significant others. These factors are of great importance in designing rehabilitation to promote leisure P3.47 participation which can improve social interaction and feelings of enjoyment in aSAH survivors. Predictors of leisure participation after aneurysmal subarachnoid hemorrhage (aSAH) Keywords: Executive Functions, Stroke, Other Meth- ods Anne Buunk1, W.S. Veenstra1, R.J.M. Groen MD2 and J.M. Spikman3 Correspondence address: Mrs MSc Anne Buunk, Uni- 1University Medical Center Groningen, Neurology, versity Medical Center Groningen, Neurology, Hanze- Groningen, The Netherlands plein 1, 9700 RB Groningen, the Netherlands. Tel.: 2University Medical Center Groningen, Neurosurgery, +31 630418682; E-mail: [email protected] Groningen, The Netherlands 3University of Groningen, Clinical and Developmental P3.48 Neuropsychology, Groningen, The Netherlands Neuronatomical correlates of processing speed im- Occurring at a relatively young age with a peak inci- pairments related to a plasma marker of thrombo- dence between 40 and 60 yrs, aneurysmal subarach- sis noid hemorrhage (aSAH) can have an immense impact on the life of the patient (de Rooij et al., 2007). Julia Miralbell1, Juan Jose Soriano-Raya1,Elena Even patients with good neurological outcome experi- Lopez-Cancio2, Juan Francisco Arenillas3,NuriaBar- ence cognitive and psychosocial deficits which influ- gallo4, Amparo Galan5, Cynthia Caceres2, Maite Barr- ence daily functioning and life satisfaction. Leisure is ios6, Maite Alzamora7, Guillem Pera7, Pere Toran7, defined as freely chosen non-work activities which can Maite Garolera8, Antoni Davalos2 and Maria Mataro1 improve social interaction (Bundy, 1993), awareness, 1University of Barcelona, Psychiatry and Clinical Psy- and enjoyment, also in people who sustained brain in- chobiology, Barcelona, Spain jury (Lyons, 1993). The aim of this study is to describe 2Germans Trias i Pujol University Hospital, Neuro- leisure participation and to investigate the factors af- sciences, Barcelona, Spain fecting 3Neurology Service, Stroke Unit, Hospital Clinico Uni- participation in leisure activities after aSAH. 437 pa- versitario, Valladolid, Spain tients suffered from aSAH and were admitted to the 4Hospital Clinic, Radiology, Barcelona, Spain UMCG between 2002 and 2009. Of the 301 survivors 5Germans Trias i Pujol University Hospital, Biochem- 25 were excluded because of comorbidity. 206 patients istry, Barcelona, Spain were willing to participate (range 17–90 yrs, mean age 6University of Barcelona, Methodology and behaviou- 58.9 yrs, 36.4% male, 63.6% female). Cognitive com- ral sciences, Barcelona, Spain plaints, mood, anxiety and executive functioning in 7IDIAP Jordi Gol, Primary Healthcare Reseach Sup- everyday life were evaluated by using questionnaires port Unit Metropolitana Nord, Barcelona, Spain (HADS, HISC, DEX). Furthermore, all patients re- 8Consorci Sanitari de Terrassa, Neuropsychology Unit, ceived a semi-structured interview by telephone with Terrassa, Spain a focus on resumption of work, social, leisure activities and mobility (RRL). More than 50% of patients Plasma markers of thrombosis have been related to reported disrupted leisure participation. Changes con- white matter (WM) integrity loss and lower process- sisted of a reduction of activities, activities at a lower ing speed (Miralbell et al., 2011). Our aim is to as- level or more guided by others. Return to leisure activ- sess the specific WM tracts involved in the associa- ities is predicted by a higher HADS depression score, tion between a marker of thrombosis and cognition. 86 a greater change in mobility, and more executive prob- participants from the Barcelona-ASIA Neuropsychol- lems mentioned by significant others. ogy study were included. Subjects were 50-65 years Leisure participation is significantly reduced after old, free from dementia and without history of vascu- aSAH. Factors underlying restricted participation in lar disease. Plasma levels of Plasminogen Activator In- leisure activities are depressive mood, reduction in mo- hibitor −1 (PAI-1) were used as a marker of thrombo- 450 Posters sis. Processing speed was measured with the Grooved assessed with The Facial Expression of Emotion test Pegboard Test (Gpeg). First, we assessed correlations (FEEST), Boston Naming Test (BNT), categorical flu- of levels of PAI-1 and performance on Gpeg with frac- ency, figure copy and line orientation of the RBANS, tional anisotropy (FA) measurements of DTI. Second, Benton’s visual form discrimination test, Poppelreuter we investigated the overlap between tracts involved in figures and the Geriatric Depression Scale. We com- performance on Gpeg and those affected by higher lev- pared mean differences for two groups with indepen- els PAI-1. Results show that increasing levels of PAI- dent sample t-test and estimated the effect size (Co- I levels and lower performance on Gpeg were associ- hen’s d). Pearson Correlation was used to measure rela- ated with white matter (WM) integrity loss in cortico- tionship between cognitive results and bivariate partial thalamic pathways and association fibres of frontal and correlation to control the effect of other variables. We temporal lobes. WM tracts involved in Gpeg perfor- set the alpha level to 0.05 to define statistical signifi- mance overlapped with those affected by PAI-1. In cance. Significant differences between groups (AD and conclusion, our findings suggest that the location of controls) were found on all cognitive measures with a WM correlates of processing speed is largely consis- large and huge effect size, being the overall worse per- tent with those WM tracts affected by increased lev- formance on AD. In AD, total FEEST was correlated els of markers of thrombosis. This may provide the with BNT [r = 0.38, p = 0.038], figure copy [r = specific neuroanatomical basis underlying this associ- 0.449, p = 0.013] and Poppelreuter [r = 0.382, p = ation. 0.037]. After controlling for age and depression, total FEEST remained statistically significant correlated Keywords: Other Functions/Disorders, Stroke, Neu- with BNT [r = 0.391, p = 0.044] and figure copy [r = ropsychological Assessment and Psychometrics 0.445, p = 0.020] In conclusion, these results suggest that both semantic memory and visual perception are Correspondence address: Mrs PhD Julia Miralbell, involved in facial recognition impairment in AD. University of Barcelona, Psychiatry and Clinical Psy- chobiology, Pg. Vall d\, D-08300 Barcelona, Spain. Keywords: Social Cognition, Dementia, Neuropsycho- Tel.: +34 666118649; E-mail: [email protected] logical Assessment and Psychometrics

P3.49 Correspondence address: Mrs Noemí Cerulla, Con- sorci Sanitari de Terrassa, Sant Jordi Day Hospi- Facial emotion recognition capacity in mild Alzhei- tal, Edison, 15-37, s-08224 Terrassa, Spain. Tel.: +34 mer’s disease: Labelling or perceptive dysfunction? 937336253; Fax: +34 937831555; E-mail: ncerulla@ cst.cat Noemí Cerulla1,GlòriaChico1, Maite Garolera2,Cris- tina Borras1, Mariona Rodriguez-Querol1,Esther P3.50 Tomas1 and Carme Civit1 1Consorci Sanitari de Terrassa, Sant Jordi Day Hospi- Differential involvement of right anterior temporal tal, Terrassa, Spain lobe in processing social concepts: Convergent TMS 2Consorci Sanitari de Terrassa, Hospital de Terrassa, and neuropsychological evidence Spain Gorana Pobric1, Mathew Lambon Ralph2 and Roland Little is known about the underlying processes in- Zahn2 volved in facial emotion recognition in Alzheimer’s 1University of Manchester, Psychological Sciences, disease (AD). Two major hypotheses have been stud- Manchester, United Kingdom ied: 1) the impairment is associated to a semantic mem- 2University of Manchester ory deficit and 2) the impairment is related to deficit in visual perception. The aim of this research was to Studies of semantic dementia, imaging and repetitive study the relationship between the performance in fa- TMS have suggested that the bilateral anterior tempo- cial emotion, recognition and memory and visual per- ral lobes (ATLs) underpin a modality-invariant repre- ception tasks in mild AD. 30 mild AD patients (19 sentational hub within the semantic system. However, women, 11 men; age mean 76 SD 5.3) and 21 healthy questions remain regarding functional specialization controls (13 women, 8 men; age mean 68 SD 6.2) were across a variety of knowledge domains within the ATL Posters 451 region. Specifically, it has been proposed that right su- 2University Medical Center Groningen, Neurology/ perior anterior temporal cortex is crucial in processing Neuropsychology, Groningen, Netherlands of social concepts. The goal of this study was to pro- 3University Medical Center Groningen, Neurology, vide causal evidence for the functional relevance of su- Groningen, Netherlands perior ATLs. In the rTMS study, participants made syn- onym judgments about social and nonsocial abstract Children with epilepsy often show emotional and be- words. Both social and abstract words were matched havioral problems, which are thought to be caused by for psycholinguistic (frequency, imagibility and se- impaired social competence (Nassau & Drotar, 1997). mantic diversity) and behavioural variables. We also Golouboff et al. (2008) found that impaired recogni- examined performance on number magnitude judg- tion of fear is related to deviant behavior in children ment task as our control task. Offline rTMS was ap- with temporal lobe epilepsy. However, in neuropsycho- plied at 1 Hz for 10 min at 62% of machine output logical assessment of children with epilepsy, tests for over right superior ATL (53, 8, −13), left superior ATL emotion perception and social cognition are not com- (−52, 8, −13) and occipital pole as a control site. After monly used. The aim of the present study is to inves- right ATL TMS stimulation, performance was selec- tigate fear recognition in children with epilepsy in re- tively impaired for processing of social concepts, but lation to social behavior, reported by their parents. 55 not to equally demanding abstract concepts and non- children with diagnosed epilepsy underwent neuropsy- semantic cognitive tasks. In contrast, left ATL stimu- chological assessment in the University Medical Cen- lation slowed down both social and nonsocial process- ter of Groningen between 2007 and 2013. In 18 of ing. In the neuropsychology part of the study, we used these children, social behavior was measured with the a semantic discrimination task which probed knowl- Child Behavior Checklist 6–18 (CBCL; Achenbach, edge of social and animal function concepts in a pa- 1991). For 7 children (3 boys, 4 girls, M = 10.34, SD tient with right frontotemporal dementia RFTD (rATL = 2.42 range: 7.3–13.2 yrs) also a Dutch shortened hypometabolism) and another patient with SD (lATL version of the Facial Expression of Emotions – Stim- hypometabolism). Both patients were impaired on pro- uli and Tests (FEEST-36; Young et al. 2002) was used cessing social and animal concepts compared to age- with an age matched healthy control group (n = 64). matched controls. While the SD patient was equally Next to a variety of problems, 56% of the parents ob- impaired on processing both social and animal con- serve deviant social competences and social problems cepts, RFTD patient showed more pronounced impair- in their child. For all children at least one problem in ments on social concepts than the SD patient. These social behavior and aggression is reported. Concerning convergent TMS and patient findings confirm that right fear recognition, children with epilepsy are less accu- ATL is part of a neural network supporting social con- rate than healthy controls. This difference is not sig- ceptual knowledge. nificant but impaired fear recognition is significantly correlated with problems of social behavior, attention, Keywords: Social Cognition, Dementia, TMS/TCDS thought and total behavioral problems. In an explorative study of children with epilepsy, parents reported Correspondence address: Dr Gorana Pobric, Univer- social problems for all children, which were related sity of Manchester, Psychological Sciences, Oxford to impaired fear recognition. Impaired fear perception Road, M13-9PL Manchester, United Kingdom. E- can indicate problems understanding other people’s in- mail: [email protected] tentions, which can lead to problems in interpersonal interactions. P3.51 Keywords: Social Cognition, Epilepsy, Neuropsycho- Fear perception and social behavioral problems in logical Assessment and Psychometrics children with epilepsy: An explorative study. Correspondence address: Mrs BSc Maraike Coenen, Maraike Coenen1, Ceciel Aarnoudse2, Oebo Brouwer3 University of Groningen, Clinical and Developmental and Wencke Veenstra2 Neuropsychology, Grote Kruisstraat 2/1, NL-9712 TS 1University of Groningen, Clinical and Developmental Groningen, Netherlands. E-mail: m.a.coenen@umcg. Neuropsychology, Groningen, Netherlands nl 452 Posters

P3.52 Keywords: Social Cognition, Neuropsychological As- sessment and Psychometrics Cerebellar role in social cognition Correspondence address: Dr Anna Maria Tedesco, 1 1 1 Anna Maria Tedesco , Silvia Clausi , Giusy Olivito , Ataxia Laboratory, Santa Lucia Foundation, Depart- 2 1 Marco Molinari and Maria Leggio ment of Psychology, “Sapienza” University of Rome, 1 Ataxia Laboratory, Santa Lucia Foundation; Depart- via ardeatina 306; via dei Marsi 78, it-00179 Rome, ment of Psychology, “Sapienza” University of Rome, Italy. Tel.: +39 0651501116; E-mail: tedescoannam@ Rome, Italy libero.it 2Ataxia Laboratory, Santa Lucia Foundation, Rome, Italy P3.53

It is well known that the cerebellar function by far ex- Oscillatory brain activity in reaction to object- ceed motor coordination, involving also modulation of directed and object-averted gazes in infants cognitive and behavioural functions. Indeed, the cerebellum is part of a neural network including motor and Christine Michel1, Manuela Stets2, Eugenio Parise3, associative regions. Moreover, findings of bidirectional Vincent M. Reid4, Tricia Striano5 and Stefanie Hoehl6 pathways linking cerebellar and limbic structures have 1Heidelberg University, Heidelberg, Germany given rise to the suggestion that the cerebellum may 2Department of Psychological & Brain Sciences, Indi- play a role also in emotional processing. It is known ana University, Bloomington, USA that the limbic areas and specific portions of the frontal 3Central European University, Cognitive Development lobe are involved in Social Cognition. These findings Center, Budapest, Hungary have led to hypothesize a involvement of the cerebel- 4 Department of Psychology, Lancaster University, lum in this domain, but the studies carried out so far Lancaster, UK have not yet clarified whether and how the cerebellum 5 Department of Psychology, Hunter College, New is involved in specific aspects of social cognition. York, USA Aim of the study was to investigate the cerebellar role 6Department of Psychology, Heidelberg University, in some aspects of social cognition. In particular recog- Heidelberg, Germany nition of social emotions and inference of mental states have been analysed in cerebellar patients. A battery composed by 4 tasks has been administered: The direction of eye gaze is an important cue guid- the “Reading the mind in the eyes test” and “Emotion ing attention and facilitating object processing already attribution test” to assess the ability to recognize emo- early in life. tions; the “Theory of mind” task and the “Faux Pas” In an ERP study with 4-month-old infants, pictures of task to assess cognitive and affective components of a person looking at an object lead to greater positive the theory of mind. slow wave (PSW) activity than pictures of a person This battery has been administered to cerebellar pa- looking away from an object. Together with previous tients and healthy subjects well-matched for age and results, this suggests that infants build stronger mem- education. A T-test Student has been used to evaluate ory representations for gaze-cued objects compared to eventual differences between patients’ and controls’ objects that are not looked at (Hoehl, Reid, Mooney, & performances. Striano, 2008). Although the cerebellar damage impairs both the emo- In adults, alpha oscillations were recently associated tional recognition and the ability to attribute mental with access to a knowledge system in the human brain states, the patients showed significantly worse perfor- (Klimesch, 2012). Oscillations in the alpha range may mance than the control group specifically in “Faux thus be involved in infants’ encoding of novel objects. Pas” test. Here, alpha oscillations in reaction to object-directed These results indicate that the cerebellum plays a dif- and object-averted eye gaze were investigated in 16 4- ferent weight in processing different social cognition month-old infants. components, and that it is particularly involved in the Data from Hoehl et al. (2008) were reanalyzed with ability to attribute emotion, intentions and beliefs to regard to oscillatory brain activity. Infants were pre- other people in order to explain and predict their be- sented photographs of a person either looking at or haviour. looking away from an object and EEG was recorded Posters 453 continuously. Pictures were presented for 1000 ms and As for social cognition, the Faux Pas (FPT), Strange alpha band oscillations time-locked to stimulus onset Stories, and Reading the Eyes in the Mind (REMT), the were analyzed. Mean amplitude of the frequency range Emotion Attribution Task (EAT), and the Social Situ- 5–7 Hz, 400–600 ms after stimulus onset on fronto- ation (SST) and Moral/Conventional Distinction tasks central electrodes was used as the dependent variable. (MCDT) were administered. Desynchronization of alpha band activity in compari- The Beck Depression Inventory (BDI), State Trait son to the baseline was found for object-directed gaze Anxiety Inventory (STAI), and Symptom Check List- (t(15) = −2.2, p = 0.042), and no changes in alpha 90 (SCL-90) assessed depression, anxiety, and emo- band activity were found for object-averted gaze (t(15) tional-behavioral distress. The Multiple Ability Self- = −0.8, p = 0.497) in 4-month-old infants. Addition- report Questionnaire (MASQ) explored perceived ally, data of 2- 6- and 9-month-olds that are currently functioning. The Lubben’s scale assessed the number being analyzed will be presented. and efficacy of social relationships. Alpha desynchronization in infants may reflect pro- RESULTS: Neuropsychological examination evidenc- cessing of the relation between eye gaze direction and ed significant deficits in theory of mind (ToM), a com- related objects. Similar to the PSW, alpha desynchro- ponent of social cognition and verbal fluency, with nization might be a neural correlate of forming mem- preservation of all of the other functions. The invento- ory representations in infants, possibly through access ries yielded normal scores in mood and behavior. to a knowledge system as described in adults. CONCLUSIONS: The results demonstrate that acquired cerebellar damage can impair ToM, highlight- Keywords: Social Cognition, Other Disorder/Samples, ing a role for the cerebellum in the modulation of social Electrophysiology (EEG/ERP) cognition. This suggests a redefinition of the affective- cognitive cerebellar syndrome. Correspondence address: Mrs Christine Michel, Hei- delberg University, Hauptstraße 47-51, D-69117 Hei- Keywords: Social Cognition, Other Disorder/Samples, delberg, Germany. E-mail: Christine.Michel@ Neuropsychological Assessment and Psychometrics psychologie.uni-heidelberg.de Correspondence address: Mrs Annalisa Parente, Fon- P3.54 dazione IRCCS Istituto Neurologico C. Besta, De- partment of Diagnostics and Applied Technology, Via Selective theory of mind impairment and cerebellar Celoria, 11, I-20133 Milan, Italy. E-mail: annalisa. atrophy: A case report [email protected]

Annalisa Parente, Valentina Manfredi, Anna Tarallo, P3.55 Ettore Salsano, Alessandra Erbetta, Davide Pareyson and Anna Rita Giovagnoli Cognitive biases and neurocognition as indepen- Fondazione IRCCS Istituto Neurologico C. Besta, De- dent domains in first-episode schizophrenia pa- partment of Diagnostics and Applied Technology, Mi- tients lan, Italy Marc Turon1, Sol Fernandez-Gonzalo2, Esther Pousa3, INTRODUCTION: The cerebellum is important to the Diego Palao3 and Mercè Jodar4 modulation of affect and behavior, but there is scarce 1Parc Taulí Hospital, Research Department, Sabadell, knowledge of the cognitive pattern underlying psycho- Spain behavioral changes in cerebellar syndrome. 2Parc Tauli Hospital, Research Department, Sabadell, GOALS OF THE STUDY: This study describes a se- Spain lective association between social cognitive impair- 3Parc Tauli Hospital, Mental Health Department, ment and cerebellar atrophy in an 65 years old adult, Sabadell, Spain helping clarify the role played by the cerebellum in 4Parc Tauli Hospital, Neurology Department, cognitive disorders. Sabadell, Spain METHODS: The patient underwent detailed neuropsychological testing for executive functions, language Individuals with schizophrenia present specific cog- and memory. nitive biases that may play a role in the develop- 454 Posters ment and exacerbation of symptoms and may im- P3.56 pair overall functioning. In chronic schizophrenia samples, studies about the overlapping between these cog- A new social and non-social cognitive rehabilitation nitive biases with the neuropsychological functions computarized program for schizophrenia/schizoaf- have shown contradictory results. Therefore, in or- fective disorders in early stages: preliminary effi- der to shed light on the underpinnings of these bi- cacy findings ases, the present study aims at exploring the relationship between the most commonly studied cogni- Sol Fernandez-Gonzalo1, Marc Turon1, Esther Pousa2, tive biases (Jumping to Conclusions, JTC, and Bias Diego Palao2 and Mercè Jodar3 Against Disconfirmatory Evidence, BADE) and the 1Parc Tauli Hospital, Research Department, Sabadell, main deficits related to schizophrenia (executive func- Spain tions, attention and memory) in a first-episode remit- 2Parc Tauli Hospital, Mental Health Department, ted sample. Thirty-six first-episode schizophrenia pa- Sabadell, Spain tients were evaluated by a comprehensive battery of 3Parc Tauli Hospital, Neurology Department, neuropsychological and cognitive biases measures. A Sabadell, Spain Principal Component Analysis was performed to determine the pattern of relationships among cognitive People with schizophrenia and schizoaffective disor- biases (JTC and BADE) and neuropsychological mea- ders present neuropsychological deficits in almost ev- sures (abstraction, phonetic fluency, attention and ver- ery cognitive domain. These deficits are observed be- bal memory). The Principal Component Analysis with fore illness onset and they present a significant decline Varimax Rotation resulted in a three component solu- on the first episode. Neuropsychological deficits are tion that account for 76% of the total variance. The first linked with the daily-living functioning, but recently, component was dominated by high loadings on ver- authors have demonstrated that social cognitive impair- bal memory and phonetic fluency. Abstraction and at- ments have a greater impact in functional outcomes. tention loaded in the second component, whereas JTC Cognitive rehabilitation has demonstrated consistent and BADE loaded in a third component, independent effects improving cognitive performance as well as to other neuropsychological constructs. In our first- ameliorating symptoms and psychosocial functioning. episode schizophrenia sample, the principal compo- However, the active key of these interventions for gen- nent analysis showed the independence of cognitive bi- eralization remains unknown. The aim of this study is ases compared to other neuropsychological functions. to present the design and preliminary efficacy results This suggests that these cognitive biases could have a of a new social and non-social cognitive computerized neuroanatomical substrate independent of other neu- program for people with schizophrenia/schizoaffective rocognitive functions, and seem to result from think- disorder in early stages of the illness. ing distortions and unconscious processing preferences 16 patients that met inclusion criteria were randomized rather than impairment in neuropsychological func- between treatment and control groups. A comprehen- tions. sive assessment of social and non-social neuropsychological variables was carried out before and after treat- Funded by Fundació la Marató de TV3 ment. Mann-Whitney test showed significant differences be- Keywords: Social Cognition, Psychopathology, Neu- tween groups in Digits Span Backward (p<0.01), ropsychological Assessment and Psychometrics Logical Memory Learning Curve (p<0.01), Execu- tion Time of the Tower of London (p = 0.04), 2nd Or- Correspondence address: Mr MD Marc Turon, Parc der ToM Task (p = 0.03) and Bias Against Disconfir- Taulí Hospital, Research Department, Parc Tauli 1, D- matory Evidence (p = 0.04) 08208 Sabadell, Spain. E-mail: [email protected] A tendency to signification was observed in Digits Span Forwards (p = 0.07), Spatial Span Backwards (p = 0.08) and Violation Time of Tower of London (p = 0.07) This new intervention showed preliminary efficacy results for logical learning, verbal working memory, processing speed, theory of mind and cognitive biases Posters 455 as well as a tendency to improve attention and vi- hood and adolescence was also reported by other au- sual working memory. Social and non-social cogni- thors. In our case, it is worth noting that the intellec- tive rehabilitation in first-episode schizophrenia pa- tual development slowed down at the moment in which tients could be a relevant clinical tool improving cogni- more complex, abstract analogical reasoning should tive alterations and even preventing functional impair- appear, between 8 and 12 years old. Executive impairment. ments also appeared at that time. Damage to the frontal lobes would thus critically impair the development of Funded by Fundació la Marató TV3 abstract reasoning and executive functions expected to develop at that age. Finally, contrary to other reports, Keywords: Social Cognition, Psychopathology, Neu- our patient exhibited no behavior disorder. We ob- ropsychological Assessment and Psychometrics served however dissociated skills, with preserved everyday life’s behavior and poor socio-cognitive knowl- Correspondence address: Mrs MD Sol Fernandez- edge, suggesting separate socio-cognitive networks. Gonzalo, Parc Tauli Hospital, Research Department, Parc Tauli 1, D-08208 Sabadell, Spain. E-mail: msfer- Keywords: Social Cognition, Traumatic Brain Injuries, [email protected] Neuropsychological Assessment and Psychometrics

P3.57 Correspondence address: Dr Roxane Pizzo, CHUV – Pediatric, Bugnon 46, CH-1011 Lausanne, Switzer- Long-term follow-up after extensive bilateral land. E-mail: [email protected] frontal lesions: A case study P3.58 Roxane Pizzo, Thierry Deonna, Véronique Davidoff, Anne.Lise Ziegler, Eliane Roulet and Claire Mayor Neural underpinnings of impaired predictive motor Dubois timing in children with Developmental Coordina- CHUV – Pediatric, Lausanne, Switzerland tion Disorder

There are only a few longitudinal studies on children Julie Debrabant1,FrejaGheysen2, Karen Caeyen- who suffered from a severe TBI in early childhood, and berghs3, Hilde Van Waelvelde4 and Guy Vingerhoets2 the cognitive and behavioral long-term impact of early 1Ghent University, Rehabilitation siences and physio- extensive bilateral frontal lesions remains scarce. Fur- therapy, Ghent, Belgium thermore, controversial data are reported, especially 2Ghent University, Experimental Psychology, Ghent, regarding executive functions and moral, social behav- Belgium ior. We report a prospective longitudinal study of a boy 3Ghent University, Rehabilitation Sciences and Phys- presenting with an early severe TBI at 14 months old iotherapy, Movement and Sports Sciences, Ghent, Bel- resulting in extensive bilateral frontal lesions. The 9 gium successive assessments from 27 months to 21 years old 4Ghent University, Rehabilitation Sciences and Phys- included 1) the general intellectual development (de- iotherapy, Ghent, Belgium velopmental and intelligence scales) 2) the executive functions (inhibition, shifting, initiation, planning) and Developmental Coordination Disorder (DCD) is a clin- 3) socio-cognitive skills (behavior questionnaires, the- ical label that describes an impaired acquisition and ory of mind, social reasoning, and gambling task). Re- clumsy approach of motor activities including ball sults showed a borderline intelligence up to 7 years skills, writing, and sports. A dysfunction in predictive old whereas scores situated in the mild mental retar- motor timing is put forward to underlie DCD-related dation range were noted from 8 years old. Executive motor problems. Predictive timing allows for the pre- impairment also appeared at 8 years old and increased selection of motor programs in order to decrease pro- with time, with deﬁcits on all executive domains. There cessing load and facilitate reactions. Using functional were no social, moral or behavioral disorders at any magnetic resonance imaging (fMRI), this study inves- moment, but deﬁcits in social reasoning, TOM and tigated the neural correlates of motor timing in DCD gambling task were observed. Mild intellectual retar- (n = 17, mean age 9.4 ± 0.6 years) and typically de- dation, with stable intellectual quotients over child- veloping children (n = 17, mean age 9.2 ± 0.9 years). 456 Posters

The task involved motor responses to sequences of vi- asked to imagine themselves while performing a given sual stimuli with predictive or unpredictive interstim- action; conversely, in implicit M.I. tasks, subjects are ulus intervals (ISIs). DCD children responded with a involved in decisions that imply the mental simulation smaller reaction time (RT) advantage to predictive ISIs of an action. The implicit M.I. tasks most frequently compared to typically developing children. Typically used are the Hand Laterality Task (HLT: decisions are developing children exhibited higher activation in the made on whether a hand portrayed in a picture is a left right dorsolateral prefrontal cortex (DLPFC) and right or a right one) and the Grip Selection Task (GST: par- inferior frontal gyrus (IFG) for responses at unpredic- ticipants indicate the most natural grip for grasping an tive as opposed to predictive ISIs, whereas activations object). in DCD children were non-differentiable. Moreover, Here we tested the hypothesis that these two implicit DCD children showed less activation than typically de- M.I. tasks, normally treated as equivalent, are sub- veloping children in the right DLPFC, the left posterior served by partially dissociable brain systems. We com- cerebellum (crus I) and the right temporo-parietal junc- pared the brain patterns associated with HLT and GST tion (TPJ) for this contrast. Notably, activation in the in 13 healthy subjects (mean age: 26 years) in a event- right temporo-parietal junction (TPJ) positively corre- related fMRI experiment. lated with RT as an indicator of processing load in both We found that, beyond a common fronto-parietal net- groups. These data indicate that motor performance in work typically described in M.I. studies, there were DCD children requires extra processing demands due task specific brain activations: the HLT showed a wider to impaired predictive encoding. recruitment of occipital and sensorimotor regions (especially in the right hemisphere); the GST was specif- Keywords: Other Functions/Disorders, Other Disor- ically associated with the left fusiform gyrus in a re- der/Samples, Functional and Structural Neuroimag- gion previously associated with tool processing. Cor- ing/NIRS relations between fMRI and RT data confirmed these Correspondence address: MS Julie Debrabant, Ghent dissociations suggesting a direct link with the mental University, Rehabilitation siences and physiotherapy, manipulation time rather than earlier object identifica- Campus Heymans (UZ) De Pintelaan 185, B-9000 tion. Ghent, Belgium. Tel.: +32 478395799; E-mail: julie. Our results show the complexity of M.I.: motor simu- [email protected] lation relies on motor specific brain system and domain specific systems that can be dissociated depending on P3.59 the task in hand. In addition, we support and provide anatomical specificity to previous observations (1) on Dissociable neural systems in implicit motor im- brain damaged patients that suggested a double hemi- agery tasks spheric dissociation for these tasks.

Paola Invernizzi1, Laura Zapparoli1, Martina Gan- Reference 2 3 3 dola , Antonio De Santis , Alberto Zerbi , Giuseppe [1] Daprati et al (2010). Banﬁ3 and Eraldo Paulesu4 1 University of Milano-Bicocca, Psychology, Milan, Keywords: Other Functions/Disorders, Other Disor- Italy der/Samples, Functional and Structural Neuroimag- 2 University of Pavia, Brain and Behavioral Sciences, ing/NIRS Pavia, Italy 3 IRCCS Galeazzi, Milan, Italy Correspondence address: Mrs Paola Invernizzi, Uni- 4 University of Milano-Bicocca, Pyshcology, Milan, versity of Milano-Bicocca, Psychology, Piazza dell’ Italy Ateneo Nuovo, 20126 Milan, Italy. E-mail: paolainv81 @gmail.com Motor imagery (M.I.), the active cognitive process during which movements are mentally rehearsed without overt actions, is a useful paradigm for the study of different aspects of motor control. A variety of tasks have been used in behavioural and neurofunctional experiments. M.I. tasks may be explicit in that subjects are Posters 457

P3.60 of strategically placed brain lesions and the preceding residual neural activity of the fronto-parietal motor net- The physiology of motor delusions: Functional work. These ﬁndings provide evidence that the activity anatomical patterns in anosognosia for hemiplegia of motor cortices contributes to our beliefs about the status of our motor system. Martina Gandola1, Paola Invernizzi2, Laura Zappar- oli2, Margherita Verardi2, Roberto Sterzi3, Ignazio Keywords: Other Functions/Disorders, Stroke, Func- Santilli3, Maurizio Sberna4, Gabriella Bottini1 and Er- tional and Structural Neuroimaging/NIRS aldo Paulesu2 1Department of Brain and Behavioral Sciences, Uni- Correspondence address: Mrs Martina Gandola, Uni- versity of Pavia, Pavia, Italy versity of Pavia, Department of Brain and Behavioral 2Department of Psychology, University of Milano- Sciences, Piazza Botta 11, IT-27100 Pavia, Italy. E- Bicocca, Milano, Italy mail: [email protected] 3Neurology Department, Niguarda Ca’ Granda Hos- pital, Milano, Italy P3.61 4Neuroradiology Department, Niguarda Ca’ Granda Hospital, Milano, Italy Visual aids reduce framing effects in older adults

Patients with right brain damage might not complain Laura Zamarian, Angelika Kuprian, Veronika Prantner about left-sided paralysis, or they could deny that the and Margarete Delazer left side is paralysed or even claim that they have just Medical University Innsbruck, Clinical Department of Neurology, Innsbruck, Austria moved a paralysed limb. This condition is known as anosognosia for hemiplegia (Babinski, 1914). The de- BACKGROUND: Patients as well as healthy persons nial of the motor deficit has been explained on the need to be adequately informed to actively participate grounds that a focal lesion within the motor/premotor in medical care and make informed decisions. Framing system reduces intentional motor behaviour. If one has effects influence how people interpret information and no intention to move, he/she would not notice any dis- make choices. Typically, people show a more favorable crepancy between the missing intention and the con- attitude towards positively framed treatments (70% sequent lack of motion (Heilman, 1991; 1998). How- chance of survival) than towards negatively framed ever, it remains unclear how patients can claim that treatments (30% chance of mortality). In this study, we they have moved the paralysed limb unless one postu- investigated (a) whether positively framed medications lates that there is a residual and perhaps misinterpreted are rated more favorably than negatively framed medi- motor brain activity (Frith et al., 2000). These are cations, (b) whether this effect can be countered by us- the alternative hypotheses of two well-known models ing different types of visual aids (icon arrays vs. pies), of motor control in anosognosia. Behavioural experi- and (c) whether age modulates framing effects and the ments suggest that some residual intentionality might efficacy of visual aids. be present in patients with anosognosia (Berti et al., METHOD: Thirty young-old adults (age range 51–70 2007; Fotopoulou et al., 2008; Garbarini et al., 2012; years) and 30 old-old adults (age range 71–89 years) Pia et al., 2012). Here, we used functional magnetic rated medications on a color-based, 7-point scale from resonance imaging (fMRI) to study patients with and negative (red) to positive (green). Medications were without anosognosia for hemiplegia during the execu- described either in positive terms (e.g., 84% of the tion of a simple movement task. We provide the miss- cases taking medication XY showed improvement) or ing direct neuroimaging evidence that the delusional in negative terms (e.g., 16% of the cases showed wors- belief of having moved is preceded by brain activation ening). Framing effects were defined by the difference of cortical regions that are implicated in motor con- in ratings between positively framed conditions and trol in the intact hemisphere and in spared motor re- negatively framed conditions. Participants rated first gions of the right hemisphere; patients with hemiple- medications without any visual aid, then medications gia and without anosognosia did not present with the where either an icon array or a pie chart was added to same degree of activation of the cortical motor system. numerical information. We conclude that the false belief of movement in pa- RESULTS: Overall, there were no significant effects tients with hemiplegia is associated with a combination of age. Participants showed significant framing effects 458 Posters when no visual aid was presented. The use of visual tients were equivalent. Interestingly, these group dif- aids dramatically reduced framing effects. However, ferences were only found when the choices involved pie charts were more effective than icon arrays in de- medium to large amounts of money, suggesting that creasing the effect of framing. bvFTD patients do not show the typical ‘magnitude ef- CONCLUSIONS: Visual aids are a promising method fect’, whereby discount rates decrease with increasing to reduce framing effects and help older people to un- magnitude of reward. Overall, these findings suggest derstand medical information and make informed de- that bvFTD patients demonstrate impulsive decision- cisions. [Acknowledgements: TWF-2010-1-993.] making on a delay discounting economic decision- making task regardless of the reward magnitude em- Keywords: Decision making, Aging, Neuropsycholog- ployed, which corroborates the clinical symptoms of ical Assessment and Psychometrics the patients. By contrast, PD patients were not impaired on the delay discounting task, which suggests Correspondence address: Mrs Dr. Laura Zamarian, that this task is likely mediated predominately by ven- Medical University Innsbruck, Clinical Department of tromedial prefrontal dysfunction in bvFTD. Neurology, Anichstr. 35, AT-6020 Innsbruck, Austria. E-mail: [email protected] Keywords: Decision making, Dementia, Other Meth- ods P3.62 Correspondence address: Mrs Claire O’Callaghan, Exploring the fronto-striatal contributions to eco- Neuroscience Research Australia, Barker St, 2047 nomic decision-making Sydney, Australia. E-mail: [email protected]

Claire O’Callaghan1, S.J.G. Lewis2, Maxime Ber- P3.63 toux3, J.R. Hodges1 and Michael Hornberger1 1Neuroscience Research Australia, Sydney, Australia Decision making and numeracy – avoiding risks or 2Brain and Mind Research Institute, Sydney, Australia taking chances? 3University Pierre and Marie Curie, Paris VI, Sor- bonne Universités, Paris, France Margarete Delazer1,IdaGradl2, Nina Blume2,Marie- Theres Pertl2, Johannes Schiebener3 and Matthias Impulsive decision-making is a hallmark feature of Brand3 behavioural variant frontotemporal dementia (bvFTD) 1Medizinische Universität Innsbruck, Klinik für Neu- and is presumed to relate to pervasive ventromedial rologie, Innsbruck, Austria prefrontal degeneration in these patients; however, ob- 2Leopold Franzens Universität, Innsbruck jective tests of decision-making have not been exten- 3Universität Duisburg-Essen, Duisburg sively employed in this population. In contrast, Parkin- son’s disease (PD) patients have been shown to demon- Though a detrimental effect of low numeracy on de- strate impulsive decision-making related to striatal cision making has been described, the exact relation dysfunction. In the current study, we contrast these two between the two domains has not been investigated so disease groups using an economic decision-making far. The present study aims at estimating the effect of measure to assess for impulsive decision-making be- numerical abilities, executive functions and sensation haviour. Ten bvFTD patients, eighteen PD patients and seeking on decision making under risk. We used the fourteen age-matched Controls were administered a Game of Dice Task Double which assesses decision delay discounting task, which required them to choose making in two steps – first, selecting an alternative as- between varying amounts of money that were either sociated with different winning probabilities, second, immediately available or available at a certain point in betting on the chosen alternative (doubling the possi- the future. Individual discounting rate parameters (k ble gains/losses or not). This task allows us to distin- rates) were calculated, with larger k values correspond- guish between advantageous, but risk avoiding behav- ing to more impulsive choice. Results showed a sig- ior and optimal behavior with a higher bet. 120 healthy nificant overall group difference, with bvFTD patients participants aged between 18 and 65 took part in the having higher k values than both Controls and PD pa- study and performed tests of decision making, men- tients; however, the k values of Controls and PD pa- tal calculation, health numeracy, subjective numeracy, Posters 459 verbal working memory, numerical problem solving, eas. Therefore reversal learning seems a promising tar- psychomotor speed, set-shifting and sensation seek- get when investigating neuropsychological functions ing. Results of the decision making task suggest that in OCD. The aim of this study was to gain better un- participants are able to identify non-risky alternatives derstanding of reversal learning in OCD by investi- (79.38%) and often select the most advantageous al- gating electrophysiological correlates of feedback pro- ternative (46.06%) in the first step. However, they do cessing (the feedback related negativity, generated in not always optimize their choices in the second step the ACC). OCD patients and matched healthy controls and choose the best strategy in only 31.27% of all de- were examined with a modified probabilistic rever- cisions. Good cognitive capacities (numerical abilities, sal learning task. Subjects learned by feedback which executive functions) are associated with advantageous one of two geometrical stimuli was correct. After the and conservative decisions. Regression analysis shows choice of one stimulus was rewarded for an unpre- that performance in the numeracy task predicts avoid- dictable number of trials, this stimulus choice sud- ance of risky, disadvantageous choices, but not choos- denly received negative feedback, either attributable to ing the best option when this option is associated with a a stable change of reward contingencies or to a sin- higher bet. In conclusion, advantageous decision mak- gle invalid negative feedback. Probabilities of contin- ing of cognitively well performing individuals seems gency changes and invalid feedbacks were equal and to be grounded in rather conservative, risk avoiding be- therefore feedback validity was unpredictable. Behav- haviour. Good numerical abilities predict avoidance of ioral performance did not differ between OCD pa- disadvantageous risky choices. Future studies may ap- tients and healthy controls. However, in OCD patients, ply the Game of Dice Task Double in order to under- the feedback-related negativity was less modulated stand the specific difficulties of cognitively impaired by feedback valence than in controls, when they had patients. stayed with the previously selected stimulus after an initial negative feedback. This is interpreted as reduced Keywords: Decision making, Other Disorder/Samples, sensitivity to external feedback in trials with persever- Neuropsychological Assessment and Psychometrics ative responding. In conclusion, feedback processing during reversal learning appears to be affected not in Correspondence address: Mrs Prof. Margarete Delazer, general but only under specific circumstances. Medizinische Universität Innsbruck, Klinik für Neu- rologie, Anichstrasse 35, A-6020 Innsbruck, Austria. Keywords: Decision making, Psychopathology, Elec- Tel.: +43 0512 504 23870; E-mail: margarete.delazer@ trophysiology (EEG/ERP) i-med.ac.at Correspondence address: Mrs Marie Klippel, Depart- P3.64 ment of Psychology, Humboldt Universität zu Berlin, Rudower Chaussee 18, D-12489 Berlin, Germany. E- Electrophysiological correlates of probabilistic re- mail: [email protected] versal learning in obsessive-compulsive disorder P3.65 Marie Klippel1, Tanja Endraß2,AnjaRiesel1, Julia Gotthart1 and Norbert Kathmann1 Neuropsychological profile in asymptomatic chil- 1Department of Psychology, Humboldt Universität zu dren with Sickle Cell Disease Berlin, Berlin, Germany 1 2 2Department of Psychology, Otto-von-Guericke- Sophie Déglise , Roxane Pizzo , Valérie Leclair Rez- 3 3 4 Universität Magdeburg, II, Magdeburg, Germany bach , Cécile Jérôme Choudja , Maja Beck Popovic , Eliane Roulet Perez2 and Claire Mayor Dubois2 1 Obsessive-compulsive disorder (OCD) is associated CHUV, Pediatric Department, Lausanne, Switerland 2 with alterations in frontostriatal loops, involving the CHUV, Pediatric Departement, 1011 Lausanne, orbitofrontal cortex (OFC) and the anterior cingulated Switzerland 3 cortex (ACC). These brain regions play a specific CHUV, Pediatric Hematology Oncology Unit, 1011 role in reversal processing. In fMRI investigations of Lausanne, Switzerland 4 probabilistic reversal learning OCD patients repeat- CHUV, Pediatric Hematology Oncology Departe- edly showed reduced activity in the OFC and other ar- ment, 1011 Lausanne, Switzerland 460 Posters

Over the past years, studies on children with Sickle P3.66 Cell Disease (SCD) have well documented the cognitive impairments due to cerebral vascular injury (overt Psychometric Problems and possible solutions for strokes and silent infarcts). However, less is known the classification of mild cognitive impairment about the cognitive profile of children without cerebral damage and we therefore planned to investigate neuro- N. Bucholtz1,G.Lämmler1, E. Steinhagen-Thiessen1 logically asymptomatic paediatric patients with SCD. and M. Niedeggen2 Out of a cohort of 14 patients, we included eight 1Charité, Research Group on Geriatrics, Berlin, Ger- children (aged 5 to 13 years, mean = 7.8, 4 girls many and 4 boys) with HbSS genotype, living since their 2Freie Universität Berlin, Department of Education birth in Switzerland. We excluded children with men- and Psychology tal retardation (IAG<70, General Aptitude Index) and those with infarct and with abnormal/conditional Tran- The consideration of Mild Cognitive Impairment scranial Doppler Ultrasonography. Our assessment (MCI) as a prodromal stage of dementia has become included standard tests targeting general cognitive one main focus in neuropsychological research. How- functioning (Wechsler Intelligence scale), attention ever, MCI is a heterogeneous syndrome and has been skills (CPT-II), memory (CMS word-list, Rey Com- described distinctly in various concepts. To unify these plex Figure Test, Rey 15 signs-list), executive func- definitions Winblad et al. (2004) have introduced a tions (Stroop, Mazes, Color Trail, verbal and figu- model that contains different aspects of MCI. They dis- ral Fluency, multiple classification tests), academic tinguish a) amnestic and non-amnestic subtypes and b) achievement (BREV, ODEDYS), sensory motor skills if cognitive capacity is impaired in one or multiple do- (NEPSY, Purdue Pegboard). mains. Even so, there is no consensus in how to op- Cognitive results showed average to borderline quo- erationalize MCI. Studies still consider different cog- tients (PRI and VCI = average, PSI = low average, nitive abilities and use different test parameters to as- WMI = borderline). Seven out of the eight children sess these domains: For instance, problems of intercor- exhibited attention deficits, half of them had working relations and underlying latent factors of test parame- memory impairments, all but one showed a significant delay in their reading skills and all of them had poor ters have not been addressed. Therefore, the aim of this visuo-motor coordination. Moreover, we found corre- study is a comprehensive psychometric analysis of the lations between the hematocrit values and the atten- widely used test battery of the Consortium to Establish tional skills, verbal working memory and manual dex- a Registry for Alzheimer’s Disease (CERAD Plus). N = terity. Noteworthy, a few other studies also reported re- 1014 participants at the age of 60 years and older lationships between the IQ and hematocrit values. of the Berlin Aging Study II were assessed using the Our results showed thus that even asymptomatic chil- CERAD Plus battery consisting of 11 subtests (seman- dren with SCD are vulnerable to cognitive deficits and tic word fluency, Boston Naming Test, word list learn- are at risk for academic difficulties. Reduction in the ing, word list recall, word list recognition, word list oxygen-carrying capacity of red-blood cell may thus intrusions, constructional praxis, constructional recall, be responsible for such neuropsychological deficits ir- phonemic fluency, Trail Making Test A, Trail Mak- respective of brain infarction. ing Test B). Psychometric properties of the test battery were examined using exploratory (EFA) and con- Keywords: Other Functions/Disorders, Other Disorder firmatory factor analysis (CFA). Preliminary results of 2 /Samples, Neuropsychological Assessment and Psy- an EFA reveal best fit for a four factor solution (χ = chometrics 9.176, df = 6, p = 0.164, CFI = 0.998, RMSEA = 0.023). A model with four correlated factors could be Correspondence address: Mrs Sophie Déglise, CHUV, confirmed in CFA (χ2 = 92.009, df = 36, p<0.01, Pediatric Department, Rue Bugnon, CH-1011 Lau- CFI = 0.968, RMSEA = 0.039). Factors can be in- sanne, Switerland. Tel.: +41 213143682; E-mail: so- terpreted as verbal memory, contextual praxis, verbal [email protected] abilities and executive function. Based on these results we report prevalence rates compared to other studies and discuss implications for MCI classification. Posters 461

Correspondence address: Mrs Nina Bucholtz, Charité, tures: shape and color. We used an articulatory sup- Research Group on Geriatrics, Berlin, Germany. E- pression task during encoding and maintenance to mail: nina.bucholtz @charite.de study the effect of attentional resources. Thirty-one young adults (mean age 22.4), 30 middle-aged adults P3.67 (mean age 54.8) and 30 older adults (mean age 70.3) performed the task. We expected that ageing would af- Ageing-related changes in relational and conjunc- fect relational binding more than conjunctive binding. tive working-memory binding If attentional resources are the mediating factor, relational binding would be more affected by the interfer- Roy Kessels1, Bonnie Van Geldorp2 and Mario Parra3 ing task than conjunctive binding. Results show an ef- 1Radboud University Nijmegen, Neuropsychology and fect of age group F(2,88) = 14.7, p<0.001) and type Rehabilitation Psychology, Nijmegen, Netherlands of binding (F(1,88) = 16.5, p<0.01), but no interac- 2Radboud University Nijmegen, The Netherlands tion between type of binding and age (F(2,88) = 1.4, 3University of Edinburgh, UK p = 0.25). The interaction between type of binding and interference was significant (F(1,88) = 4.71, p = The ability to form associations (i.e. binding) is criti- 0.03). This suggests that relational binding requires cal for memory formation. Recent studies suggest that more attentional resources than conjunctive binding. ageing specifically affects some types of binding: re- We hypothesize that a general decline in WM resources lational binding (associating separate features, for ex- associated with frontal dysfunction underlies deficits ample object and location) declines with advancing in WM binding. age, whereas conjunctive binding (integrating features within an object) is insensitive to ageing. One possi- Keywords: Memory and Learning, Aging, Neuropsy- ble explanation is that functional integrity of the hip- chological Assessment and Psychometrics pocampus is required for relational binding, but not for conjunctive binding. However, this hippocampal in- Correspondence address: Prof. Dr. Roy Kessels, Rad- volvement may be explained by the use of spatial infor- boud University Nijmegen, Neuropsychology and Re- mation in most studies. Alternatively, relational bind- habilitation Psychology, Montessorilaan 3, NL-6533 ing may simply require more attentional resources than ZR Nijmegen, Netherlands. E-mail: r.kessels@ conjunctive binding. donders.ru.nl Both types of binding were examined in a working memory (WM) task using the same (non-spatial) fea-