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Abstract Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete cessation of breathing during sleep and increased effort to breathe. This study examined patients who underwent overnight polysomnographic studies in a major sleep laboratory in Saudi Arabia. The study aimed to determine the extent to which intermittent hypoxia, sleep disruption, and depressive symptoms are independently associated with cognitive impairments in OSA. In the sample of 90 participants, 14 had no OSA, 30 mild OSA, 23 moderate OSA, and 23 severe OSA. The findings revealed that hypoxia and sleep fragmentation are independently associated with impairments of sustained attention and reaction time (RT). Sleep fragmentation, but not hypoxia, was independently associated with impairments in visuospatial deficits. Depressive symptoms were independently associated with impairments in the domains of sustained attention, RT, visuospatial ability, and semantic and episodic autobiographical memories. Since the depressive symptoms are independent of hypoxia and sleep fragmentation, effective reversal of cognitive impairment in OSA may require treatment interventions that target each of these factors.

Virtual reality (VR) applications are developing rapidly, becoming more and more affordable, and offer various advantages for learning contexts. Dynamic visualizations are generally suitable for depicting continuous processes (e.g., different movement patterns), and particularly dynamic virtual 3D-objects can provide different perspectives on the movements. The present study investigated through a low immersive (desktop “VR”, Study 1) and a high immersive virtual environment (immersive VR; Study 2) the effectiveness of different interaction formats to view 3D-objects from different perspectives. Participants controlled either the orientation of the 3D-objects (Study 1, mouse interaction; Study 2, hand interaction via VR controllers) or their viewpoint in relation to the 3D-objects (Study 1, camera position; Study 2, position of participants’ own body). Additionally, the moderating influence of learners’ visuospatial ability was addressed. Dependent variables were pictorial recognition (easy, medium, difficult), factual knowledge, presence, and motion sickness. Results showed that higher-visuospatial-ability learners outperformed lower-visuospatial-ability learners. In Study 1, higher-visuospatial-ability learners showed higher recognition performance (difficult items) by controlling the camera position, whereas lower-visuospatial-ability learners suffered from this interaction format. In Study 2, higher-visuospatial-ability learners achieved better recognition performance (easy items) by controlling the 3D-models, whereas lower-visuospatial-ability learners tended to profit from moving around the 3D-objects (medium items). The immersive VR yielded more presence and higher motion sickness. This study clearly shows that different interaction formats to view 3D-objects from multiple perspectives in Desktop-VR are not transferable on a one-to-one basis into immersive VR. The results and implications for the design of virtual learning environments are discussed.

Background The cognitive trajectories of cognitively normal (CN) individuals rapidly progressing to Alzheimer’s disease dementia (AD) have not been investigated. Aim To explore the preclinical pattern of cognitive performance heralding the rapid progression from normal cognition to AD. Methods The HELIAD cohort underwent comprehensive neuropsychological assessments (memory, language, attention, executive and visuo-perceptual functions) at baseline and after approximately 3-year intervals. The cognitive trajectories of those with normal cognition at baseline were explored according to the follow-up diagnosis using adjusted generalised estimating equations analyses. Results A total of 932 predominantly female (61%), older (72.9 ± 4.9), CN participants were followed for 3.09 (± 0.83) years. Among them, 761 individuals remained CN, 29 progressed to AD and 142 developed MCI (33 single-domain amnestic, 41 multidomain amnestic, 37 single-domain non-amnestic and 31 multidomain non-amnestic). Those progressing to AD were already performing worse than the healthy reference in every single cognitive domain at baseline. Cognitive deficits ranged between ~ 0.5SD (attention, executive function and language) and ~ 1.0SD (memory and visuo-perceptual skills). Throughout the 3-year follow-up, memory constantly exhibited the most prominent impairment compared to the remaining cognitive domains while executive function diminished in the most abrupt fashion (~ 0.19SD yearly) separating from the remaining three cognitive functions before the development of full-blown AD. Heterogeneous patterns of cognitive decline clearly differentiated those progressing to MCI from those rapidly converting to AD, as well. Discussion Poor performance in every cognitive domain may characterise cognitively normal individuals at high risk of fast progression to AD. Conclusion Strict neuropsychological cut-offs fail to detect a considerable number of individuals at high risk of rapid progression to AD.

Hand dexterity impairments in patients with stroke reduce activities of daily living (ADL) and quality of life. Visuospatial ability is associated with motor learning, but this has not previously been reported in patients with subacute stroke. We aimed to investigate whether visual terminal feedback (FB) affected motor learning of hand dexterity and the relationship among visuospatial ability. Overall, 17 subacute stroke patients (age: 66.1 ± 13.8 years) with mild upper limb motor impairment were included. The experimental task was the grasping force control task. The visuospatial task was the Rey–Osterrieth Complex Figure Test (ROCFT). The experimental protocol was conducted in 2 consecutive days: day 1 consisted of a pre-test (PRE), practice, and short-term retention test (SRT), and day 2 consisted of a long-term retention test (LRT) and the ROCFT. Grasping errors were significantly decreased in the SRT and LRT than in the PRE. Furthermore, ROCFT scores (copy and recall) and LRT grasping errors were moderately negatively correlated (ρ = -0.51 and − 0.53). In conclusion, visuospatial ability is an important factor associated with motor learning in subacute stroke patients. Future studies should use visual terminal FB, and training programs for visuospatial ability should be considered in stroke rehabilitation.

IntroductionIt was shown that children with specific language impairments (SLI) have deficits not only in producing and understanding language but also in visuospatial abilities (Kiselev et al., 2016). We assume that training programs that are aimed to develop the visuospatial abilities can help children with SLI.ObjectivesThe goal of this study was to assess the impact of visuospatial training on the language abilities in 6–7 years old children with SLI.MethodsThe participants were 20 children aged 6–7 years with SLI. Children were randomly assigned to the intervention and comparison group. Children from intervention group participated in 8 weeks of visuospatial training. This programme trains the child to do different visuospatial exercises both on motor and cognitive level. This programme is built on the conceptual framework derived from the work of Luria’s theory of restoration of neurocognitive functions (Luria, 1963, 1974). We used the subtests from Luria’s child neuropsychological assessment battery to assess language abilities in children before and after the intervention period.ResultsAnalysis of covariance tested the effect of visuospatial training programme on five language subtest from Luria’s child neuropsychological assessment battery. Group differences (p<.05) were found for subtest that assess understanding prepositions that describe the spatial relations between objects. Posttest mean for the intervention group were significantly (p<.05) greater than the control group.ConclusionsIt can be assumed that visuospatial training in children with SLI benefits specific language abilities for understanding sentences with spatial prepositions.

In backward immediate serial recall, participants recall lists of items immediately after their presentation by beginning with the last presented item and ending with the first presented one. Despite the similarities with forward recall in which participants recall the items from the first to the last presented, benchmark memory phenomena reliably found in forward recall are not constantly observed in backward recall. Here, we proposed a new framework called the encoding-retrieval matching (ERM) hypothesis to account for backward recall. The ERM retains the main features of the visuospatial hypothesis and the item-order trade-off hypothesis, the two dominant accounts of backward recall. According to the ERM, output modality and foreknowledge of recall direction influence the availability of visuospatial representations and the weight devoted to item and order processing. We tested the ERM with irrelevant speech, a well-known working memory factor disrupting forward recall. In two experiments, we manipulated recall direction (forward vs. backward), irrelevant speech (control vs. irrelevant speech), and response modality (manual vs. oral). As predicted by the ERM, when recall direction was unpredictable in Experiment 1, the magnitude of the irrelevant speech effect was larger in backward manual recall than in backward oral recall. In Experiment 2, recall direction was predictable. As predicted by the ERM, in backward recall, the irrelevant speech effect was reduced with a manual response and absent with an oral response. We concluded that ERM effectively accounts for the complex interplay between response modality, foreknowledge of recall direction, and benchmark memory effects in backward recall. Lors du rappel sériel immédiat dans l'ordre inverse, les participants doivent se remémorer des listes d'éléments immédiatement après qu'on leur ait présenté ceux-ci, du dernier élément présenté au premier. Malgré les similitudes avec le rappel dans l'ordre, où les participants doivent se remémorer les éléments du premier au dernier présenté, les phénomènes de mémoire de référence que l'on observe de manière fiable lors du rappel dans l'ordre ne sont pas constamment observés lors du rappel dans l'ordre inverse. Nous proposons ici un nouveau cadre - appelé hypothèse d'« appariement par encodage/remémoration » (encoding-retrieval matching, ou ERM) pour rendre compte du rappel dans l'ordre inverse. L'ERM conserve les principales caractéristiques de l'hypothèse visuospatiale et de l'hypothèse du compromis item-ordre de présentation, les deux éléments prépondérants à l'œuvre lors du rappel dans l'ordre inverse. Selon l'hypothèse de l'ERM, la nature de la modalité de réponse et le fait de connaître à l'avance la direction du rappel (dans l'ordre ou dans l'ordre inverse) influent sur la disponibilité des représentations visuospatiales, ainsi que sur le poids accordé aux éléments donnés et au traitement de l'ordre dans lequel ces éléments sont présentés. Nous avons mis à l'essai l'ERM en recourant au discours hors sujet, un facteur de la mémoire primaire bien connu pour son effet perturbateur dans le rappel dans l'ordre. Lors de deux expériences, nous avons manipulé la direction du rappel (dans l'ordre ou dans l'ordre inverse), le caractère du discours (contrôlé ou hors sujet) et la modalité de réponse (manuelle ou orale). Comme prédit par l'hypothèse de l'ERM, lorsque la direction du rappel était imprévisible durant l'expérience 1, l'amplitude de l'effet du discours hors sujet était supérieure en rappel manuel dans l'ordre inverse par rapport au rappel oral dans l'ordre inverse. Lors de l'expérience 2, la direction du rappel était prévisible. Comme prédit par l'hypothèse de l'ERM, lors du rappel dans l'ordre inverse, l'effet du discours hors sujet se trouvait diminué en réponse manuelle, et absent en réponse orale. Nous en avons donc conclu que l'ERM traduit efficacement l'interaction complexe des effets de la modalité de réponse, de la prescience de la direction du rappel, et de la mémoire de référence lors du rappel dans l'ordre inverse. Public Significance Statement For more than a century, backward immediate recall, requiring participants to recall the sequence of to-be-remembered items from the last to the first presented one, has been used as a measure of memory span in intelligence and neuropsychological tests. However, the processes involved remained misunderstood. Here, we present a novel theoretical framework called the encoding-retrieval matching (ERM) hypothesis which highlights the importance of visuospatial representations, output modality, and foreknowledge of recall direction. Our novel hypothesis can successfully account for the complex set of findings observed in immediate backward recall.

Background: High blood pressure has been associated with an increased risk of developing cognitive impairment. However, this relationship is unclear. This study aims to systematically review the effects of blood pressure on executive functioning, language, memory, attention and processing speed. Methods: The review process was conducted according to the PRISMA-Statement, using the PubMed, PsycINFO, PsycARTICLES and MEDLINE databases. Restrictions were made by selecting studies, which included one or more cognitive measures and reported blood pressure recordings. Studies that included participants with medical conditions or people diagnosed with dementia, psychiatric disorders, stroke and head trauma were excluded. The review allows selecting fifty studies that included 107,405 participants. The results were reported considering different cognitive domains separately: global cognitive functioning, attention, processing speed, executive functions, memory and visuospatial abilities. Results: Higher blood pressure appears to influence cognitive performance in different domains in the absence of dementia and severe cardiovascular diseases, such as strokes. This relationship seems to be independent of demographic factors (gender and education), medical co-morbidity (diabetes), and psychiatric disorders (depression). Furthermore, it presents different patterns considering ageing. In the elderly, a sort of “cardiovascular paradox” is highlighted, which allows considering higher blood pressure as a protective factor for cognitive functioning. Conclusions: The results underline that higher blood pressure is associated with a higher risk of cognitive decline in people without dementia or stroke. These findings highlight the need to introduce early management of blood pressure, even in the absence of clinical hypertension, to prevent the risk of a decline of cognitive functioning typically associated with ageing.

Spatial abilities contribute to life and occupational competencies, and certain spatial skills differ, on average, between males and females, typically favoring males when differences occur. Factors contributing to spatial skills could include prenatal as well as experiential/cultural influences, with biological and social influences likely interacting and difficult to disentangle. This meta-analysis examined the potential influence of prenatal androgen exposure on spatial skill by examining studies of patients with congenital adrenal hyperplasia (CAH). CAH involves elevated adrenal androgens prenatally, with overall androgen concentrations higher for females with CAH versus same-sex controls but with little overall difference between males with CAH versus controls. We hypothesized that, if androgens contribute prenatally to neurobehavioral development in humans as in many other species, females with CAH would show spatial enhancement versus control females, but with no definitive hypothesis for males. Meta-analysis of 12 studies examining overall spatial skill and three spatial subcategories failed to support enhanced spatial performance for females with CAH; males with CAH showed lower spatial ability compared to control males, at least for the category of overall spatial skill. Although statistical logic precludes accepting the null hypothesis for females, the meta-analysis failed to support the idea that prenatal exposure to androgens explains spatial gender/sex differences in humans. Alternative explanations for average gender/sex differences in some spatial tasks could include androgen exposure at other times, such as mini-puberty, or different social factors experienced by males and females. We also discuss possible explanations for the different outcomes seen in females versus males with CAH.

Demands involving the scheduling and interleaving of multiple activities have become increasingly prevalent, especially for women in both their paid and unpaid work hours. Despite the ubiquity of everyday requirements to multitask, individual and gender-related differences in multitasking have gained minimal attention in past research. In two experiments, participants completed a multitasking session with four gender-fair monitoring tasks and separate tasks measuring executive functioning (working memory updating) and spatial ability (mental rotation). In both experiments, males outperformed females in monitoring accuracy. Individual differences in executive functioning and spatial ability were independent predictors of monitoring accuracy, but only spatial ability mediated gender differences in multitasking. Menstrual changes accentuated these effects, such that gender differences in multitasking (and spatial ability) were eliminated between males and females who were in the menstrual phase of the menstrual cycle but not between males and females who were in the luteal phase. These findings suggest that multitasking involves spatiotemporal task coordination and that gender differences in multiple-task performance reflect differences in spatial ability.

While in society mathematics is often thought of as formal and rigid, mathematicians themselves frequently consider the discipline creative and visual. To challenge stereotypes, we focus on visuo-spatial thinking by research mathematicians (n = 232). Via the Object-Spatial Imagery and Verbal Questionnaire (Blazhenkova & Kozhevnikov, 2009), together with open questions, we ask the following: (1) Are mathematicians visuo-spatial thinkers? (2) Is the degree of visual thinking correlated with mathematical subdiscipline? (3) Which role does visual thinking play in mathematical research? The Object-Spatial Imagery and Verbal Questionnaire results indicate that mathematicians are more strongly visuo-spatial thinkers than scientists, humanities researchers or visual artists. The degree of visuo-spatial thinking does not correlate to how 'visual' the mathematical subdiscipline is as measured by average figure environment per article, obtained through text mining 3,799 arXiv articles. In open questions, two thirds of respondents (n = 222) report using visual mental imagery during mathematical research. Some mathematicians mention metaphors for research that refer to spatial movement, such as rock climbing, moving through a jungle or attacking the problem like an insect. Our study contributes to the research agenda set by Alcock et al. (2016), which aims to improve our understanding of mathematical cognition for the purpose of elucidating the nature of mathematical thinking and inform policymakers to address challenges in mathematics education. We conclude that visualisation plays an important part in the practice of mathematics, contrary to common belief. As Hadamard wrote in 1945: 'deductions in the realm of numbers may be, at least in several mathematical minds, most generally accompanied by images'. Bien que les mathématiques soient fréquemment perçues comme une science formelle et rigide dans la société, les mathématiciens les voient souvent comme une discipline créative et visuelle. Afin de combattre les stéréotypes, nous analysons la pensée visuospatiale des chercheurs en mathématiques (n = 232). Le questionnaire OSIVQ (Blazhenkova & Kozhevnikov, 2009) évalue les styles cognitifs visuel-verbal et distingue l'imagerie spatiale de l'imagerie d'objet. Il s'accompagne de questions ouvertes pour poser les questions suivantes : (1) Les mathématiciens sont-ils des penseurs visuospatiaux? (2) Le degré de pensée visuelle est-il corrélé à la sous-discipline mathématique? (3) Quel rôle joue la pensée visuelle dans la recherche mathématique? Les résultats du questionnaire OSIVQ indiquent que les mathématiciens sont davantage des penseurs visuospatiaux que les scientifiques, les chercheurs en sciences humaines et les artistes visuels. Le degré de pensée visuospatiale n'est pas en corrélation avec le caractère « visuel » de la sous-discipline mathématique, tel que mesuré par le nombre moyen d'environnements de figures par article, obtenu par l'exploration textuelle de 3 799 articles arXiv. Dans les questions ouvertes, deux tiers des répondants (n = 222) déclarent utiliser l'imagerie mentale visuelle pendant la recherche mathématique. Certains mathématiciens utilisent des métaphores liées au mouvement spatial, comme l'escalade, les déplacements dans la jungle ou l'attaque d'un problème à la manière d'un insecte. Notre étude contribue au programme de recherche établi par Alcock et al. (2016), qui vise à améliorer notre compréhension de la cognition mathématique dans le but d'élucider la nature de la pensée mathématique et d'informer les responsables des politiques sur les défis liés à l'enseignement des mathématiques. Nous concluons que la visualisation joue un rôle important dans la pratique des mathématiques, contrairement aux idées reçues. Hadamard écrivait en 1945 que les déductions mathématiques sont souvent accompagnées d'images dans l'esprit des mathématiciens. Public Significance Statement We asked more than 200 mathematicians about their thinking processes. Through a variety of measures and questionnaires, we found a pervasive role for visualisation in the work of most research mathematicians. This suggests that visuo-spatial skills may deserve attention when designing educational mathematics curricula and in future research in mathematical cognition, in particular on how experts do advanced mathematics.