The neural mechanisms of cognitive dysfunctions in neurological diseases remain poorly understood. Here, we conjecture that this unsatisfying state-of-the-art is in part due to the non-specificity of the typical behavioral indicators for cognitive dysfunctions. Our study addresses the topic by advancing the assessment of cognitive dysfunctions through computational modeling. We investigate bradyphrenia in Parkinson’s disease (PD) as an exemplary case of cognitive dysfunctions in neurological diseases. Our computational model conceptualizes trial-by-trial behavioral data as resulting from parallel cognitive and sensorimotor reinforcement learning. We assessed PD patients ‘on’ and ‘off’ their dopaminergic medication and matched healthy control (HC) participants on a computerized version of the Wisconsin Card Sorting Test. PD patients showed increased retention of learned cognitive information and decreased retention of learned sensorimotor information from previous trials in comparison to HC participants. Systemic dopamine replacement therapy did not remedy these cognitive dysfunctions in PD patients but incurred non-desirable side effects such as decreasing cognitive learning from positive feedback. Our results reveal novel insights into facets of bradyphrenia that are indiscernible by observable behavioral indicators of cognitive dysfunctions. We discuss how computational modeling may contribute to the advancement of future research on brain–behavior relationships and neuropsychological assessment.

The Wisconsin Card Sorting Test (WCST) represents a widely utilized neuropsychological assessment technique for executive function. This meta-analysis examined the discriminant validity of the WCST for the assessment of mental shifting, considered as an essential subcomponent of executive functioning, against traditional psychometric intelligence tests. A systematic search was conducted, resulting in 72 neuropsychological samples for the meta-analysis of relationships between WCST scores and a variety of intelligence quotient (IQ) domains. The study revealed low to medium-sized correlations with IQ domains across all WCST scores that could be investigated. Verbal/crystallized IQ and performance/fluid IQ were indistinguishably associated with WCST scores. To conclude, the WCST assesses cognitive functions that might be partially separable from common conceptualizations of intelligence. More vigorous initiatives to validate putative indicators of executive function against intelligence are required.

Objective Extraglandular neurological manifestations of Sjögren’s syndrome are increasingly recognized, defining the disease entity of Neuro‐Sjögren. Neuropsychological assessment of patients with Sjögren’s syndrome has hitherto been performed on predominantly rheumatological cohorts. These studies revealed a wide variety of prevalence rates for cognitive impairment (22–80%), while variable cut‐off criteria for detection of cognitive impairment were applied. Attentional functions have not yet been thoroughly investigated in these patients, although they clearly represent relevant aspects of cognitive functioning in daily life. Methods We therefore conducted extensive neuropsychological assessment based on two neuropsychological test batteries [i.e., the extended German version of the Consortium to Establish a Registry for Alzheimer’s Disease Neuropsychological Assessment Battery (CERAD‐PLUS), and the test battery for attentional performance (TAP) as a well‐established assessment of attentional functions in the German‐speaking part of Europe]. Results Sixty‐four patients with Neuro‐Sjögren, who were treated at our university hospital between December 2016 and January 2019, were included. Evidence for the presence of cognitive impairment was found in 55% of patients with Neuro‐Sjögren. The degree of cognitive impairment ranged from mild (38%) to severe (17%). Attentional and mnemonic subtests showed pronounced cognitive impairment in patients with Neuro‐Sjögren. Interpretation Our results suggest that a substantial proportion of patients with Neuro‐Sjögren suffer from cognitive impairment, putatively as a corollary of attentional deficits, which might exert adverse effects on occupational abilities, other cognitive functions, and social role functioning.

Zusammenfassung Hintergrund Schwerhörigkeit ist ein relevanter Risikofaktor einer Demenz. Bisher kann eine kognitive Beeinträchtigung oder Demenz von Personen mit Hörbeeinträchtigungen (HB) wegen des eingeschränkten Sensoriums von gängigen kognitiven Screeningverfahren nicht adäquat erfasst werden. Deshalb besteht ein Bedarf eines solchen an Hörgeschädigte angepassten Screenings. Ziel der Studie war es, ein kognitives Screening für Menschen mit HB zu entwickeln und zu evaluieren. Material und Methoden Hierzu wurden drei Aufgaben, eine Wortflüssigkeitsaufgabe, der Trail Making Test A (TMT-A) und eine Subtraktionsaufgabe in einem neuen kognitiven Screening, dem O‑DEM, zusammengefasst. Dieser wurde in einem ersten Schritt an 2837 Patient*innen ohne subjektive HB und anschließend an 213 Patient*innen mit objektiv erfassten HB evaluiert und mit dem Hearing-Impaired Montreal Cognitive Assessment (HI-MoCA) verglichen. Ergebnisse Es zeigte sich, dass jeder O‑DEM-Subtest signifikant zwischen keinen, leichten und mittleren bis ausgeprägten kognitiven Beeinträchtigungen unterscheiden kann. Basierend auf dem Mittelwert und der Standardabweichung der Menschen ohne kognitive Beeinträchtigungen wurde eine Transformation der Rohwerte vorgenommen und ein Gesamtscore mit einer maximalen Ausprägung von 10 festgelegt. Ebenso zeigte die Untersuchung an den hörgeschädigten Patient*innen, dass der O‑DEM genauso sensitiv wie der HI-MoCA zwischen Menschen mit und ohne kognitive Beeinträchtigungen differenzieren kann. Schlussfolgerungen Der O‑DEM ist gegenüber anderen Verfahren ein vergleichbar schnell durchzuführendes Screening zur Detektion von leichten und mittleren kognitiven Beeinträchtigungen bei Menschen mit HB.