Category and letter verbal fluency assessment is widely used in basic and clinical research. Yet, the nature of the processes measured by such means remains a matter of debate. To delineate automatic (free-associative) versus controlled (dissociative) retrieval processes involved in verbal fluency tasks, we carried out a psychometric study combining a novel lexical-semantic retrieval paradigm and structural equation modeling. We show that category fluency primarily engages a free-associative retrieval, whereas letter fluency exerts executive suppression of habitual semantic associates. Importantly, the models demonstrated that this dissociation is parametric rather than absolute, exhibiting a degree of unity as well as diversity among the retrieval measures. These findings and further exploratory analyses validate that category and letter fluency tasks reflect partially distinct forms of memory search and retrieval control, warranting different application in basic research and clinical assessment. Finally, we conclude that the novel associative-dissociative paradigm provides straightforward and useful behavioral measures for the assessment and differentiation of automatic versus controlled retrieval ability.

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Our findings suggest, that the prevalence of prodromal PD in patients undergoing diagnostic colonoscopies may be higher compared to the general elderly population, although this should be confirmed in further studies including also matched controls not undergoing colonoscopy. The real prevalence of prodromal PD in this cohort will have to be confirmed in longitudinal follow-up. Patients undergoing diagnostic colonoscopies may be good candidates for multistep screening and inclusion in prospective trials.

Objectives: An extraordinary incidence of genetic Creutzfeldt-Jakob disease (gCJD) appearing in clusters in the Slovak Republic was described in the 1990's. The aim of the study was to analyse data of CJD cases obtained from surveillance in Eastern Slovakia (ES) (2004-2016), the region outside the described geographical clusters. Methods: The database set in the project was the source for epidemiological and clinical analysis of CJD cases. Results: The incidence of CJD in ES (2004-2016) was 1.7/million person-years (95% CI 1-2.4); the incidence increase in the last five years (2012-2016) was comparable to the whole country. Twenty seven of 29 reported CJD cases were available for analysis (mean age 59 years, F/M 15/12). The proportion of gCJD (E200K mutation) cases remained dominant (78%), with 9 familiar cases originating in 4 families. Analysis of the clinical features revealed shorter duration of the symptomatic phase in sporadic CJD (sCJD) (3.4 months) versus gCJD (5.15 months). Cognitive/ behavioural changes, insomnia, and sensory disturbance were more pronounced in the early symptoms of gCJD. Periodic EEG discharges were more frequent in sCJD (83%) than gCJD (56%), all 19 available MR findings were CJD specific and localisation of abnormalities varied amongst the CJD forms. Conclusions: The surveillance of CJD in ES (2004-2016) showed an increased incidence of CJD in ES, reaching the incidence rate of the whole country, with a permanent proportion of 70% gCJD cases based on the E200K mutation. Clinical, electrophysiological and MR features of sCJD and gCJD cases were in conformity with already published data. Epidemiological analysis of CJD in ES shows increasing detection of CJD but also suggests that current routine surveillance systems for CJD may underestimate the true burden of disease, especially sporadic cases in Slovakia.