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Background Verbal fluency (VF) measures are sensitive markers of advanced cognitive decline; however, the utility of the discrepancy score remains underexplored in the early stages of cognitive decline, such as subjective cognitive decline (SCD). This study evaluated semantic fluency (SF) and phonemic fluency (PF), as well as discrepancy score sensitivity, in clinical populations with SCD, mild cognitive impairment (MCI), and dementia. Methods In this cross-sectional study, 193 older adults (72 healthy controls, 67 with SCD, 16 with MCI, and 38 with dementia) were consecutively recruited from the Nyírő Gyula National Institute of Psychiatry and Addictology, Hungary. Each participant underwent a comprehensive neurological interview and neuropsychological assessments. Semantic and phonemic fluency, along with their discrepancy, served as the primary outcome measures, defined as the number of correct words generated in one minute for each fluency type and the difference between them. Group differences were assessed using one-way ANCOVAs that controlled for age and education, and diagnostic classification performance was evaluated using a multinomial logistic regression model-based metric. Results Relative to healthy controls, SCD showed significantly lower SF scores (β = − 2.267, p  = .009) but no difference in PF ( p  = .493). Both fluency types were reduced in MCI and dementia, with semantic declines being especially pronounced. Multinomial logistic regression model identified dementia most accurately using SF (balanced accuracy = 0.81) and SCD using the discrepancy score (balanced accuracy = 0.61), while MCI classification was poor, likely due to a small sample size. These results underscore the potential of SF and its discrepancy with PF for early detection and differentiation of cognitive decline. Conclusions This study demonstrates that individuals with SCD have deficits in semantic—but not phonemic—fluency, and that VF discrepancy scores detect SCD more effectively than semantic fluency alone. However, accuracy is only moderate and insufficient for use as a standalone clinical test.

This exciting new text offers a comprehensive, engaging, and readable overview to the dynamic field of medical speech-language pathology. It is the first medical speech-language pathology textbook that is not focused on the various disorders, but instead examines the scope and key concepts of the profession, such as clinical reasoning, interprofessional practice, and the continuum of care. The book provides an in-depth overview of health care workplace settings (acute care, inpatient rehabilitation, skilled nursing, home health, outpatient care, pediatric service delivery, pharmacology, and neuroimaging).

Trait anxiety is thought to be associated with pathological anxiety, and a risk factor for psychiatric disorders. The present study examines the brain mechanisms associated with trait anxiety during the performing of verbal fluency tasks. The aim is to show how trait anxiety modulates executive functions as measured by verbal fluency, and to explore the link between verbal fluency and anxiety due to the putative negative biases in high-anxious individuals. Seven tasks of verbal fluency were used: letter \"k,\" \"f,\" verbs, \"animals,\" \"vehicles,\" \"joy,\" and \"fear.\" The results of 35 subjects (whole sample), and 17 subjects (nine men, eight women) selected from the whole sample for the low/high-anxious groups on the basis of Trait Anxiety scores were analyzed. The subjects were healthy, Polish speaking, right-handed and aged from 20 to 35 years old. fMRI (whole-brain analysis with FWE corrections) was used to show the neural signals under active participation in verbal fluency tasks. The results confirm that trait anxiety slightly modulates neural activation during the performance of verbal fluency tasks, especially in the more difficult tasks. Significant differences were found in brain activation during the performance of more complex tasks between individuals with low anxiety and those with high anxiety. Greater activation in the right hemisphere, frontal gyri, and cerebellum was found in people with low anxiety. The results reflect better integration of cognitive and affective capacities in individuals with low anxiety.

Amyloid-related decline in semantic memory was recently shown to be observable in the preclinical period of Alzheimer's disease. Cognitive composites designed to be sensitive to cognitive change in preclinical Alzheimer's disease (e.g., preclinical Alzheimer's cognitive composite [PACC]) and currently used in secondary prevention trials do not currently integrate measures of semantic processing. Our objective was to determine whether a standard semantic measure (i.e., category fluency [CAT] to animals, fruits, and vegetables) adds independent information above and beyond Aβ-related decline captured by the PACC. Clinically normal older adults from the Harvard Aging Brain Study were identified at baseline as Aβ+ (n = 70) or Aβ− (n = 209) using Pittsburgh compound B–positron emission tomography imaging and followed annually with neuropsychological testing for 3.87 ± 1.09 years. The relationships between PACC, CAT, and variations of the PACC including/excluding CAT were examined using linear mixed models controlling for age, sex, and education. We additionally examined decline on CAT by further grouping Aβ+ participants into preclinical stage 1 and stage 2 on the basis of neurodegeneration markers. CAT explained unique variance in amyloid-related decline, with Aβ+'s continuing to decline relative to Aβ−'s in CAT even after controlling for overall PACC decline. In addition, removal of CAT from the PACC resulted in a longitudinal Aβ+/− effect size reduction of 20% at 3-year follow-up and 12% at 5-year follow-up. Finally, both stage 1 and stage 2 participants declined on CAT in comparison with stage 0, suggesting CAT declines early within the preclinical trajectory. Addition of CAT to the PACC provides unique information about early cognitive decline not currently captured by the episodic memory, executive function, and global cognition components and may therefore improve detection of early Aβ-related cognitive decline. •Semantic fluency decline occurs early in the preclinical Alzheimer's disease trajectory.•Adding semantic fluency to the PACC provides unique information about Aβ-related decline.•Inclusion of more than one semantic category is preferable for maximizing Aβ group differentiation.

Aims Verbal Fluency is sensitive to brain damage and is employed to assess language abilities like the size of vocabulary and the semantic‐lexical networks’ integrity and executive functioning abilities particularly inhibition, working memory, and self‐monitoring. Various studies revealed oscillatory changes related to word retrieval during different tasks. However, there are not enough studies on electroencephalographic characteristics of word retrieval routes (phonological or semantic pathway) during free recall. The purpose of our study was to investigate electroencephalography power relationship with semantic and phonological word finding routes during verbal fluency. Methods In this within‐subject study, the electroencephalography of 20 healthy participants was recorded during written category and letter fluency tasks and compared with the rest state. Absolute power of the signals in delta (1‐3.5 Hz), theta (4‐7.5 Hz), alpha (8‐12 Hz), and beta (12.5‐30 Hz) was calculated in three lobes (frontal, parietal, and temporal). Results A repeated measures ANOVA showed significant interaction of condition × lobe × frequency × side (P < .001). Post hoc test for each lobe showed significant changes in the absolute power of delta, theta and beta for frontal, delta and theta for parietal, and theta and beta for temporal lobes (P‐values < .05). Conclusion Searching the words by phonological entries is associated with decreased beta and increased theta in left frontal lobe. These changes are not necessary for semantic word retrieval strategy. Word retrieval either by phonological entries or semantic categories is accompanied by increased delta in frontal and parietal lobes. Decreased beta and increased theta bands in the left frontal lobe are associated with phonological word retrieval strategy while during semantic word finding, increased beta was observed in the left temporal lobe.

Bipolar disorder (BD) patients with psychotic symptoms (BDp) worsens prognosis and decreases rates of recovery. The study investigated cognitive performance and brain function between BD patients in depressive episode with and without psychotic symptoms to find potential neurobiological markers associated with psychotic features of BD patients in depressive episode. Thirty-one patients without psychotic symptoms and 29 patients with psychotic symptoms diagnosed with bipolar I disorder with a current depressive episode were included in the present study. The neural function of prefrontal cortex (PFC) and cognitive performance among BDp, BD patients without psychotic symptoms, and 23 healthy controls (HC) were examined using near-infrared spectroscopy during verbal fluency task (VFT). 1) Both the BD groups exhibited significantly worse performance of VFT and lower activation of oxygenated hemoglobin (oxy-Hb) changes in the bilateral ventrolateral PFC compared with the HC group. 2) Within the BD group, VFT performance was not significantly different. 3) The prefrontal activation of oxy-Hb changes in the BDp patients was significantly lower than that in the BD patients without psychotic symptoms in the right dorsolateral PFC. 4) Activation of oxy-Hb changes in right dorsolateral PFC was negatively correlated with the severity of psychotic symptoms in BDp patients. The prefrontal function differs between BD patients in depressive episode with or without psychotic symptoms measured with near-infrared spectroscopy.

Abstract The objective of this study was to describe an adaptation to Brazilian Portuguese of the methodological criteria for analysis of clustering and switching in semantic verbal fluency (SVF) and phonemic verbal fluency (PVF) tasks. The adaptation process consisted of six steps, including the selection of the clustering and switching variables based on data from a sample of 419 children and the analysis of inter-rater reliability (six raters). The following variables were scored: the total number of words generated the raw number of clusters, the mean cluster size, and the raw number of switches. There was a significant association between raters (intra-class correlation coefficients between 0.95 and 0.99), showing that the analytical method was reliable. Our study provides an evaluation of SVF and PVF tasks that goes beyond the overall score, making it possible to investigate the cognitive processes underlying this neuropsychological function. Resumen Este artículo presenta una adaptación para el portugués brasileño de criterios metodológicos de análisis de estrategias de agrupación (clustering y switching) en tareas de fluidez verbal semántica (FVS) y fluidez verbal fonológica (FVF). El proceso de adaptación de estos criterios consiste en seis pasos, incluyendo el proceso de extracción de las variables de clustering y switching de una muestra formada por 419 niños y el análisis de fiabilidad entre seis jueces. Se investigaron las siguientes variables: número total de palabras generadas, número de grupos de palabras (clusters), tamaño medio de los grupos y número de saltos (switches). Hubo una fuerte asociación entre jueces (coeficientes de correlación intraclase entre 0,95 y 0,99), indicando así la fiabilidad del método analítico. Este estudio contribuye a la evaluación de la FVS y FVF más allá de la puntuación global, lo que permite investigar los procesos cognitivos subyacentes a esta función neuropsicológica. Resumo Este artigo objetiva apresentar uma adaptação ao português brasileiro dos critérios metodológicos para análises de clustering e switching em tarefas de fluência verbal semântica (FVS) e ortográfica (FVO). São descritas as seis etapas realizadas no processo de adaptação destes critérios, incluindo o processo de extração das variáveis de clustering e switching a partir de dados de amostras de crianças (N=419) e a análise da fidedignidade da concordância entre juízes (N=6). As variáveis avaliadas são número total de palavras evocadas, número de clusters, média do tamanho dos clusters e número de switches. Houve forte associação entre juízes (Coeficientes de Correlação Intraclasse entre 0,95 a 0,99) indicando fidedignidade do método de análise. Este estudo contribui com a avaliação da FVS e FVO para além do escore geral, permitindo investigar os processos cognitivos subjacentes a esta função neuropsicológica.

BackgroundIdentifying more homogenous subtypes of patients with obsessive–compulsive disorder (OCD) using biological evidence is critical for understanding complexities of the disorder in this heterogeneous population. Age of onset serves as a useful subtyping scheme for distinguishing OCD into two subgroups that aligns with neurodevelopmental perspectives. The underlying neurobiological markers for these distinct neurodevelopmental differences can be identified by investigating gyrification changes to establish biological evidence-based homogeneous subtypes.MethodsWe compared whole-brain cortical gyrification in 84 patients with early-onset OCD, 84 patients with late-onset OCD, and 152 healthy controls (HCs) to identify potential markers for early neurodevelopmental deficits using the local gyrification index (lGI). Then, the relationships between lGI in clusters showing significant differences and performance in visuospatial memory and verbal fluency, which are considered trait-related neurocognitive impairments in OCD, were further examined in early-onset OCD patients.ResultsThe early-onset OCD patients exhibited significantly greater gyrification than those with late-onset OCD patients and HCs in frontoparietal and cingulate regions, including the bilateral precentral, postcentral, precuneus, paracentral, posterior cingulate, superior frontal, and caudal anterior cingulate gyri. Moreover, impaired neurocognitive functions in early-onset OCD patients were correlated with increased gyrification.ConclusionsOur findings provide a neurobiological marker to distinguish the OCD population into more neurodevelopmentally homogeneous subtypes, which may contribute to the understanding of the neurodevelopmental underpinnings of an etiology in early-onset OCD consistent with the accumulated phenotypic evidence of greater neurodevelopmental deficits in early-onset OCD than in late-onset OCD.

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

How does the mind produce creative ideas? Past research has pointed to important roles of both executive and associative processes in creative cognition. But such work has largely focused on the influence of one ability or the other—executive or associative—so the extent to which both abilities may jointly affect creative thought remains unclear. Using multivariate structural equation modeling, we conducted two studies to determine the relative influences of executive and associative processes in domain-general creative cognition (i.e., divergent thinking). Participants completed a series of verbal fluency tasks, and their responses were analyzed by means of latent semantic analysis (LSA) and scored for semantic distance as a measure of associative ability. Participants also completed several measures of executive function—including broad retrieval ability (Gr) and fluid intelligence (Gf). Across both studies, we found substantial effects of both associative and executive abilities: As the average semantic distance between verbal fluency responses and cues increased, so did the creative quality of divergent-thinking responses (Study 1 and Study 2 ). Moreover, the creative quality of divergent-thinking responses was predicted by the executive variables—Gr (Study 1 ) and Gf (Study 2 ). Importantly, the effects of semantic distance and the executive function variables remained robust in the same structural equation model predicting divergent thinking, suggesting unique contributions of both constructs. The present research extends recent applications of LSA in creativity research and provides support for the notion that both associative and executive processes underlie the production of novel ideas.