Nonverbal memory tests revisited: Neuroanatomical correlates and differential influence of biasing cognitive functions

Nadia Mock; Christian Balzer; Klemens Gutbrod; Lutz Jäncke; Jasmin Wandel; Leo Bonati; Wiebke Trost

doi:10.1016/j.cortex.2023.03.012

Nonverbal memory tests revisited: Neuroanatomical correlates and differential influence of biasing cognitive functions

Cortex. 2023 Jul:164:63-76. doi: 10.1016/j.cortex.2023.03.012. Epub 2023 Apr 26.

Authors

Nadia Mock¹, Christian Balzer², Klemens Gutbrod³, Lutz Jäncke⁴, Jasmin Wandel⁵, Leo Bonati⁶, Wiebke Trost²

Affiliations

¹ Research Department, Reha Rheinfelden, Rheinfelden, Switzerland; Department of Psychology, University of Zurich, Zurich, Switzerland; Department of Neurology, Zurich University Hospital, Zurich, Switzerland. Electronic address: nadia.mock@usz.ch.
² Research Department, Reha Rheinfelden, Rheinfelden, Switzerland.
³ Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Neurozentrum Bern, Switzerland.
⁴ Department of Psychology, University of Zurich, Zurich, Switzerland.
⁵ Institute for Optimisation and Data Analysis, Bern University of Applied Sciences, Switzerland.
⁶ Research Department, Reha Rheinfelden, Rheinfelden, Switzerland; Department of Neurology, Department of Clinical Research, Basel University Hospital, Switzerland.

PMID: 37201378
DOI: 10.1016/j.cortex.2023.03.012

Abstract

The detection of right temporal lobe dysfunction with nonverbal memory tests has remained difficult in the past. Reasons for this might be the potential influence of other biasing cognitive functions such as executive functions or the verbalisability of nonverbal material. The aim of this study was to investigate three classic nonverbal memory tests by identifying their neuroanatomical correlates with lesion-symptom mapping (LSM) and by probing their independence from verbal encoding abilities and executive functions. In a cohort of 119 patients with first-time cerebrovascular accident, memory performance was assessed in the Nonverbal Learning and Memory Test for Routes (NLMTR), the Rey Complex Figure Test (RCFT), and the Visual Design Learning Test (VDLT). Calculating multivariate LSM, we identified crucial brain structures for these three nonverbal memory tests. Behavioural analyses were performed to assess the impact of executive functions and verbal encoding abilities with regression analyses and likelihood-ratio tests. LSM revealed for the RCFT mainly right-hemispheric frontal, insular, subcortical, and white matter structures and for the NLMTR right-hemispheric temporal (hippocampus), insular, subcortical, and white matter structures. The VDLT did not reach significance in LSM analyses. Behavioural results showed that amongst the three nonverbal memory tests the impact of executive functions was most pronounced for RCFT, and the impact of verbal encoding abilities was most important in VDLT. Likelihood-ratio tests confirmed that only for NLMTR did the goodness of fit not significantly improve by adding executive functions or verbal encoding abilities. These results suggest that amongst the three nonverbal memory tests the NLMTR, as a spatial navigation test, could serve as the most suitable marker of right-hemispheric temporal lobe functioning, with the right hippocampus being involved only in this test. In addition, the behavioural results propose that only NLMTR seems mostly unaffected by executive functions and verbal encoding abilities.

Keywords: Clinical neuropsychology; Lesion-symptom mapping; Neuropsychological marker; Nonverbal memory; Right temporal lobe.

MeSH terms

Cognition
Epilepsy, Temporal Lobe*
Executive Function
Humans
Memory
Memory Disorders* / psychology
Neuropsychological Tests