bluuebunny/crossref_metadata_2025 huggingface dataset:
88 Considering Lateralization and Localization of Neurosurgical Intervention for Predicting Treatment Response to Computerized Cognitive Remediation (CCR) Targeting Attention and Working Memory: A Case Series
Authors: Muhareb Samer , Seger Madison A. , Koenigsberg Julie , Sacks-Zimmerman Amanda , Cornwell Melinda A.
Published: December 2023

Objective:

Lateralization and localization of neuropathology helps determine the extent to which eloquent cortex and diseased brain tissue share loci, important information for neurosurgical decision-making, and predicting neurocognitive outcomes. Emerging data suggest that lateralization and localization can inform specific neurorehabilitation approaches following acquired brain injury (ABI). In recent years, computerized cognitive remediation (CCR) of attention and working memory (WM) has been included among treatment guidelines to enhance cognition in post-acute recovery following ABI. Although CCR has shown promise for improving attention and executive functioning in ABI, it is unknown how treatment response may be predicted by locus of ABI. Even less is known about the effects of CCR following neurosurgery. The current study explores neurosurgical lateralization and localization as potential variables for predicting treatment response to CCR.

Participants and Methods:

Adult patients with a variety of neurological diagnoses (N = 17; ∼47% women) completed a full course of Cogmed Working Memory Training (CWMT) s/p neurosurgical intervention. All participants engaged in 30 sessions of CWMT over eight weeks, as well as neuropsychological (NP) assessment at pre-training baseline, immediate post-training, and at 3-month follow-up. Objective and subjective indices of attention, working memory, executive functioning, and emotional well-being were evaluated at three time-points. Neurosurgical loci included left-hemisphere frontal, temporal, and temporoparietal lobes, as well as right-hemisphere frontal, frontotemporal, and temporal lobes.

Results:

NP data were reviewed and yielded a clinical impression of cognitive and affective functioning for a cohort of patients with heterogeneous diagnoses (e.g., brain tumor, epilepsy, NPH). Preliminary NP findings suggested that treatment response to CCR for WM was consistent with extant literature on brain-behavior relationships according to lateralization and localization of neurosurgical intervention.

Conclusions:

Neurosurgical patients experience neurocognitive and affective dysfunction that may respond well to cognitive rehabilitation (CR) that includes CCR. Additionally, it is possible that lateralization and localization of surgical intervention may contribute to individual differences in treatment response. Further neurorehabilitation research is warranted to identify patients most likely to benefit from CCR and better tailor CR modalities to optimize recovery s/p neurological surgery.
96 Short-Term Blood Pressure Variability and Cerebrovascular Health in OlderaAdults
Authors: Sible Isabel J , Yew Belinda , Kapoor Arunima , Jang Jung Y , Alitin John Paul M , Dutt Shubir , Li Yanrong , Blanken Anna E , Ho Jean K , Marshall Anisa J , Shenasa Fatemah , Gaubert Aimee , Nguyen Amy , Rodgers Kathleen E , Sturm Virginia E , Nation Daniel A
Published: December 2023

Objective:

Blood pressure variability (BPV), independent of traditionally targeted average blood pressure levels, is an emerging vascular risk factor for stroke, cerebrovascular disease, and dementia, possibly through links with vascular-endothelial injury. Recent evidence suggests visit-to-visit (e.g., over months, years) BPV is associated with cerebrovascular disease severity, but less is known about relationships with short-term (e.g., < 24 hours) fluctuations in blood pressure. Additionally, it is unclear how BPV may be related to angiogenic growth factors that play a role in cerebral arterial health.

Participants and Methods:

We investigated relationships between short-term BPV, white matter hyperintensities on MRI, and levels of plasma vascular endothelial growth factor (VEGF) in a sample of community-dwelling older adults (n = 57, ages 55-88) without history of dementia or stroke. Blood pressure was collected continuously during a 5-minute resting period. BPV was calculated as variability independent of mean, a commonly used index of BPV uncorrelated with average blood pressure levels. Participants underwent T2-FLAIR MRI to determine severity of white matter lesion burden. Severity of lesions was classified as Fazekas scores (0-3). Participants also underwent venipuncture to determine levels of plasma VEGF. Ordinal logistic regression examined the association between BPV and Fazekas scores. Multiple linear regression explored relationships between BPV and VEGF. Models controlled for age, sex, and average blood pressure.

Results:

Elevated BPV was related to greater white matter lesion burden (i.e., Fazekas score) (systolic: OR = 1.17 [95% CI 1.01, 1.37]; p = .04; diastolic: OR = 2.47 [95% CI 1.09, 5.90]; p = .03) and increased levels of plasma VEGF (systolic: ß = .39 [95% CI .11, .67]; adjusted R2 = .16; p = .007; diastolic: ß = .48 [95% CI .18, .78]; adjusted R2 = .18; p = .003).

Conclusions:

Findings suggest short-term BPV may be related to cerebrovascular disease burden and angiogenic growth factors relevant to cerebral arterial health, independent of average blood pressure. Understanding the role of BPV in cerebrovascular disease and vascular-endothelial health may help elucidate the increased risk for stroke and dementia associated with elevated BPV.
12 Traumatic Brain Injury as a Moderator on Apolipoprotein-E Risk Associated with Earlier Onset of Alzheimer's Disease
Authors: Hollman Christina M , Pyykkonen Benjamin
Published: December 2023

Objective:

Prior studies have determined the Apolipoprotein-E (ApoE) ε4 allele presents a greater risk for developing Alzheimer's disease and for earlier onset of cognitive decline compared to individuals without the gene. Research has also recognized that traumatic brain injuries (TBIs) with loss of consciousness increase the risk for earlier development of the disease. This study sought to determine the moderating factor of TBI history on ApoE-ε4 risk associated with earlier Alzheimer's disease onset.

Participants and Methods:

Participants included 9,585 individuals with autopsy confirmed Alzheimer's disease pathology, that had available ApoE genotype data, TBI data, and clinician determined age of cognitive decline, representing disease onset. A 2x3 factorial ANOVA was conducted to compare the main effects of ApoE-ε4 status and TBI history and the interaction effect between the two on disease onset. The analyses used three ApoE-ε4 groups and two TBI groups. The groups included: (1) no ApoE-ε4 allele; (2) one ApoE-ε4 allele; (3) two ApoE-ε4 alleles; (4) no TBI history, (5) positive TBI history.

Results:

Results indicated a significant interaction effect between ApoE-ε4 status and TBI history. Secondary analyses determined the driving force behind the interaction was the effect of ApoE-ε4, which had a significant impact on the age of onset in both TBI groups, while TBI history only significantly impacted onset in individuals without an ApoE-ε4 allele.

Conclusions:

Contrary to prior research, these findings did not indicate TBI was significant in determining earlier onset. However, it is important to consider the large variability within the TBI group from the lack of differentiation between mild, moderate, and severe TBIs. Overall, these findings underline the greater risk and stronger impact that ApoE-ε4 poses for Alzheimer's disease onset compared to TBI. The results of this study emphasize the importance of evaluating ApoE-ε4 status for determining risk of earlier onset AD. Clinicians can better determine risk by considering patients' ApoE-ε4 status alongside TBI history.
20 Global and Local Semantic Coherence of Spontaneous Speech in Persons with Alzheimer's Disease and Healthy Controls
Authors: Burke Erin M , Gunstad John , Hamrick Phillip
Published: December 2023

Objective:

Growing evidence demonstrates that subtle changes in spontaneous speech can be used to distinguish older adults with and without cognitive impairment, including those with Alzheimer's disease (AD). Recent work suggests that quantification of the meaningful connectedness of speech - termed semantic coherence - may be sensitive to cognitive dysfunction. The current study compared global coherence (GC; the degree to which individual utterances relate to the overall topic being discussed) and local coherence (LC; the degree to which adjoining utterances relate meaningfully to each other) in persons with AD and healthy controls.

Participants and Methods:

Speech transcripts from 81 individuals with probable AD (Mage = 72.7 years, SD = 8.8, 70.3% female) and 61 healthy controls (HC) (Mage = 63.9 years, SD = 8.5, 62.2% female) from Dementia Bank were analyzed. All participants completed the Cookie Theft and MMSE as part of that larger project. Machine learning analyses of GC and LC were conducted and models evaluated classification accuracy (i.e., AD vs HC) as well as ROC-AUC. Relationships between coherence indices and MMSE performance were also quantified.

Results:

Though no significant group differences emerged in LC (Estimate = 0.012, p = 0.32), persons with AD differed from healthy controls in GC (Estimate = 0.03, p = 0.006) and produced less semantically coherent speech. GC indices predicted AD diagnoses with 65% accuracy. Interestingly, coherence indices showed only modest correlation with MMSE scores (r = .19).

Conclusions:

GC metrics of spontaneous speech differentiated between persons with AD and controls, but did not strongly correlate with MMSE performance. Such findings support the notion that many aspects of language are impacted in persons with AD. In addition to replication, future work should evaluate whether GC is also disrupted in persons with pre-clinical AD and its potential to assist with early detection.
55 The Indirect Effect of Positive Aspects of Caregiving on the Relationship between Dementia Severity and Caregiver Burden
Authors: Cousins-Whitus Elizabeth A , Patrick Karlee , Chapman Kimberly , Drost Jennifer , Spitznagel Mary Beth
Published: December 2023

Objective:

Caregiver burden tends to worsen as severity of dementia increases, and elevated burden can lead to negative consequences for dementia caregivers. In contrast, positive aspects of caregiving, such as feelings of being useful, needed, or appreciated as a caregiver, are associated with better outcomes. Caregivers reporting fewer positive experiences robustly demonstrate greater burden, suggesting that a lack of positive aspects of caregiving could be a key component of the relationship between dementia severity and burden. This study investigated whether an indirect effect of positive aspects of caregiving would be observed on the association between dementia severity and burden.

Participants and Methods:

Data were extracted from the medical records of 724 patients enrolled for services at an outpatient memory clinic. Caregiver-care recipient dyads were included based on a clinically supported patient diagnosis on the dementia spectrum following a comprehensive geriatric evaluation and having fully completed assessments from an informal caregiver. Caregivers completed the Zarit Burden Interview (ZBI) and the Positive Aspects of Caregiving (PAC) measures. The Montreal Cognitive Assessment and Mini-Mental State Exam were used to estimate dementia severity, standardized to create a single variable. Multiple potential covariates (e.g., age, gender, education, nature of dyadic relationship) were considered for inclusion in the model. A cross-sectional mediation analysis using the Hayes PROCESS macro explored presence of an indirect effect of PAC on the relationship between dementia severity and ZBI using 5000 bootstrap samples.

Results:

Of the proposed covariates, only caregiver age was correlated with any of the primary variables; this variable was controlled in subsequent analyses. Significant relationships emerged between dementia severity and ZBI (r=-.12, p<.001), between PAC and ZBI (r=-.23, p<.001), and between dementia severity and PAC (r=-.07, p<.05). An indirect effect of positive aspects of caregiving on the relationship between dementia severity and ZBI was statistically significant (B= .0092, BC 95% CI [.0008, .0185]), accounting for 14.4% of the variance in the model.

Conclusions:

A small but significant indirect effect of positive aspects of caregiving was observed on the association between dementia severity and burden. Results suggest that as dementia severity worsens, a caregiver who experiences greater positive aspects of caregiving will sustain less burden. Longitudinal examination of these relationships is needed to fully understand causality. Findings may help healthcare providers tailor treatment to alleviate caregiver burden.
6 Graph Analysis of Resting State Functional Brain Networks and Associations with Cognitive Outcomes in Survivors on Pediatric Brain Tumor
Authors: Semmel Eric , Calhoun Vince , Hillary Frank , Morris Robin , King Tricia
Published: December 2023

Objective:

Adolescent and young adult survivors of pediatric brain tumors often live with long-term neuropsychological deficits, which have been found to be related to functional and structural brain changes related to the presence of the tumor itself as well as treatments such as radiation therapy. The importance of brain networks has become a central focus of research over recent decades across neurological populations. Graph theory is one way of analyzing network properties that can describe the integration, segregation, and other aspects of network organization. The existing literature using graph theory with survivors of brain tumor is small and inconsistent; therefore, more work is needed, particularly in survivors of pediatric brain tumors. The present study used graph theory to determine whether functional network properties in this population differ from healthy controls; whether graph metrics relate to core cognitive skills: attention, working memory, and processing speed; and whether they relate to a cumulative measure of neurological risk.

Participants and Methods:

31 survivors and 31 matched controls completed neuropsychological testing including measures of attention, working memory, and processing speed. They also underwent resting state functional magnetic resonance imaging. Resting state data were preprocessed and spatially constrained independent component analysis was completed to construct connectivity matrices. Finally, graph metrics were calculated utilizing an area under the curve method, including global efficiency, clustering coefficient, betweenness centrality, and small-worldness. Group differences and associations between graph metrics, cognitive outcomes, and neurological risk were analyzed using SPSS version 28.0.

Results:

Results revealed a significant difference such that brain tumor survivors exhibited less small-world properties in their functional brain networks. This was found to be related to working memory, such that less smallworldness in the network was related to poorer performance. There were no significant relationships with neurological risk, but there were nonsignificant correlations of small-moderate effect size such that lower global efficiency and clustering coefficient were associated with greater neurological risk. Comparisons to structural network analysis from a similar sample and additional post-hoc analyses are also discussed.

Conclusions:

These findings reveal that survivors of pediatric brain tumor indeed display significant differences in functional brain networks that are quantifiable by graph theory. It is also possible that, with further work, we might better understand how metrics such as smallworldness can be used to predict long-term cognitive outcomes and functional independence in adulthood.
5 Antihypertensive Medication Use and Cognition in Older Adults
Authors: Moll Allison C , Woodard John L
Published: December 2023

Objective:

Hypertension is a common disorder that has been inconsistently associated with worse cognition in older adults. Antihypertensive medications offer treatment for high blood pressure but previous studies on the association between blood pressure, antihypertensive use, and cognitive performance in older adults have yielded inconsistent findings. Individuals without high blood pressure may also take antihypertensive medications for other medical conditions, including migraines. It is unclear whether antihypertensive medications have any effect on cognitive performance in older adults, and whether the differences, if any, are similar in hypertensives and normotensives.

Participants and Methods:

4,969 participants from the National Alzheimer Coordinating Center (NACC) database were included in this study (Mage=72.4 years, SD=7.3 years). Cognitive assessment included Letter Fluency, Category Fluency (animals and vegetables), Trail Making Test A & B, Digit Ordering (forward and backward), and MoCA total score. Participants were included if they had a clinician diagnosis of hypertension or normotension and recorded history of whether they take any antihypertensive medication. Participants with a history of stroke were excluded. Cognitive differences between medication groups were investigated in hypertensive participants and normotensive participants using Bayesian Mann-Whitney tests.

Results:

Bayesian Mann-Whitney tests in hypertensive individuals showed no cognitive differences between those taking antihypertensive medications and those not taking antihypertensives (all BF10s < 3). Bayesian Mann-Whitney tests in normotensive individuals showed individuals taking antihypertensive medications performed worse on Trail Making Test B compared to individuals not taking antihypertensives (123.6 seconds vs 108.8 seconds; BF10 = 35.1), with a small effect size (d=-.156).

Conclusions:

These results suggest that antihypertensive use in older adults with normal blood pressure may be associated with worse executive functioning. Antihypertensive use in normotensive older adults may lower blood pressure and reduce cerebral perfusion, resulting in worse cognitive functioning. Future studies should investigate long-term antihypertensive use and associated cognitive changes in both hypertensive and normotensive individuals.
27 Aging Affects Cordoba Naming Test Performance
Authors: Sidhu Jasman , Sivaramakrishnan Krithika , Cervantes Raymundo , Saravia Sarah , Estrada Luz , Garcia Dulce , Barrio Alexia , Munoz Isabel D. , Lopez Enrique , Victor Tara L. , Fernandez Alberto L. , Lopez-Hernandez Daniel W.
Published: December 2023

Objective:

The Cordoba Naming Test (CNT) is a 30-item confrontation naming test developed in Argentina. A common confrontation naming task used in the United States is the Boston Naming Test (BNT). Research shows that age affects BNT performance in the 60-item long form. In fact, studies show that scores on confrontation naming tasks increase in childhood and continue to improve until approximately 40 years of age. However, after this period, scores start to subsequently decline, and especially so after 70 years of age. On the other hand, some studies have reported that older adults maintain high BNT performance despite advancing age. To our knowledge, no study has investigated the aging effects of the CNT across various age groups. We expected CNT scores to increase significantly from young adulthood to mid-adulthood and then significantly decline with advancing age.

Participants and Methods:

The present study sample consisted of 272 neurologically and psychologically healthy participants with a mean age of 27.06 (SD = 12.21) with 14.29 years of education completed (SD = 2.46). Participants were divided into six different age groups: 18-19-year-old group, 20-29-year-old group, 30-39-year-old group, 40-49-year-old group, 50-59-year-old group, and 60-69-year-old group. All participants consented to voluntary participation and completed the CNT and a comprehensive background questionnaire in English. The CNT consisted of 30 black and white line drawings, ranging from easy to hard difficulty. An ANCOVA, controlling for gender, was used to evaluate CNT performance between the six age groups. We used a threshold of p < .05 for statistical significance.

Results:

Results revealed significant group differences between the six age groups on the CNT, p = .000, ηp2 = .14. A post-hoc test revealed that the 30-39-year-old group outperformed the 18-19-year-old, 20-29-yearold, and 60-69-year-old groups on the CNT. Finally, the 40-49-year-old group outperformed the 18-19-year-old and 60-69-year-old groups on the CNT.

Conclusions:

As we predicted, participants demonstrated steady improvement in the CNT until the age of 40. However, we found that until the age of 60, CNT performance started to decline significantly. Our data suggests that CNT performance declines significantly at the age of 60 compared to previous research using the BNT. Research shows other demographic variables (e.g., gender, linguistic factors) influence BNT performance. Future investigations on the CNT using a healthy sample should use a multivariate statistical analysis method to help explain influencing factors across aging. This research can have the potential to improve public health to better support and understand individuals from diverse backgrounds.
43 Mood and Everyday Function in Older Adults: Analyses of Self-report and Performance-based Measures of Everyday Function
Authors: Kaplan Marina , McKniff Moira , Pinksy Emma , Tassoni Molly , Simone Stephanie M , Hackett Katherine , Mis Rachel , Vallecorsa Giuliana , Holmqvist Sophia , Giovannetti Tania
Published: December 2023

Objective:

The relation between depressed mood and functional difficulties in older adults has been demonstrated in studies using self-report measures and has been interpreted as evidence for low mood negatively impacting everyday functional abilities. However, few studies have directly examined the relation between mood and everyday function using performance-based tests. This study included a standardized, performance-based measure of everyday action (Naturalistic Action Task, NAT) to test the prediction that report of depression symptoms are associated with self-report and performance-based tests of everyday function. Associations with anxiety symptoms and motivation/grit and everyday function also were explored.

Participants and Methods:

68 older adults without dementia were screened and recruited (n = 55, M age = 74.21, SD= 6.80, age range = 65 to 98) from the community and completed self-report measures of depression symptoms (GDS), anxiety (GAI), motivation (Short Grit-S), and everyday functioning (FAQ). Participants also performed the NAT, which requires completion of a breakfast and lunch task and is scored for task accomplishment, errors (micro-errors, overt, motor), and total time. Additionally, an informant also reported on the participant’s everyday function. Spearman correlations were performed and results showing a medium effect size or greater are reported.

Results:

Participant mood (GDS) was associated with self-reported function (FAQ; r =.45) but not performance-based measures of everyday function (NAT). Self-reported anxiety and motivation were not meaningfully associated with either self-reported or performance-based everyday function. Participant self-report (FAQ) and informant report of participant’s function (IFAQ) supported the validity of performance-based assessment as both were meaningfully associated with NAT performance (FAQ x NAT overt errors r = .34; I-FAQ x NAT micro-errors r = .34; I-FAQ x NAT motor errors r = .49).

Conclusions:

Mood, but not anxiety or motivation, was associated with self-reported everyday function but not performance-based function. When considered alongside the meaningful relations between self/informant-report of function and everyday task performance, results suggest mood does not impact everyday function abilities in community-dwelling older adults without dementia. We suggest that frameworks to be reconceptualized to consider the potential for mild functional difficulties to negatively impact mood in older adults without dementia. Additionally, interventions and compensatory strategies designed to improve everyday function should examine the impact on mood outcomes.
52 Association Between COVID-19 Coping Strategies and Cognitive Function in Older Adults
Authors: Tallman Morgan D , Timblin Holly , Brown Lily , MacAulay Rebecca L
Published: December 2023

Objective:

Cognitive function may underlie the use of more adaptive as compared to maladaptive coping strategies to manage pandemic-related stress in older adults. As the composition of coping strategies varies with context, we investigated the factor structure of 14 established coping strategies. We then aimed to determine whether specific coping strategies were associated with cognitive function.

Participants and Methods:

141 adults aged 50-90 years old completed the study via Zoom. The National Alzheimer’s Coordinating Center TCog battery assessed cognitive function. The Brief Cope, adapted to evaluate COVID-19, measured 14 specific coping strategies.

Results:

Based on our factor analyses, Avoidant (e.g., denial and substance use) and Approach (e.g., planning, instrumental and emotional support systems) coping composite scores were formed. Regression analyses, adjusted for age and education, indicated that 12.9% of the variance in the use of Avoidance coping strategies was explained by worse performance on measures of episodic memory, executive attention/processing speed, working memory, and verbal fluency. A closer examination indicated that verbal fluency was not a statistically significant contributor to the model. 9.1% of the variance in Approach coping strategies was related to cognitive function with working memory and verbal fluency being statistically significant contributors to the model.

Conclusions:

Older adults with better performance on higher-order cognitive testing may utilize more effective coping strategies in older adults. These results have implications for attenuating pandemic-related stress and warrant developing brief interventions to help facilitate problem-solving and reduce emotional distress in those with lower cognitive resources.
60 The Impact of Retirement Status on Cognitive Dysfunction in Alzheimer’s Disease
Authors: Loza Sandra S , Lee Lisa J , Liu Stephanie M , Sainz Ysmara H , Tabaza Raghad , Morin Ruth , Bennett Lauren L
Published: December 2023

Objective:

Prior research supports retirement may negatively impact cognitive functioning. The current study examined the relationship between retirement status and the level of cognitive dysfunction amongst individuals with Alzheimer’s disease (AD). For the purpose of this study, it was predicted that there would be significantly higher levels of cognitive dysfunction in retired participants after controlling for age.

Participants and Methods:

Participants (ages 65 to 91) were drawn from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). The sample included 110 participants who were retired and 111 participants who were not retired. Cognitive dysfunction was assessed using the cognitive subscale of the modified Alzheimer’s Disease Assessment Scale (ADAS). A one-way ANCOVA analysis was conducted with cognitive dysfunction as the dependent variable and the age of the participants as a covariate.

Results:

The results of the one-way ANCOVA showed being retired was a significant predictor of greater cognitive dysfunction amongst individuals with AD after controlling for age (F(df=1, 218) = 231.143, p = < .001, p < .05) and accounted for 52% of the variance in the level of cognitive dysfunction.

Conclusions:

Being retired is associated with higher levels of cognitive dysfunction in AD after accounting for the effects of age. As such, continued cognitive activity may slow the progression of cognitive declines amongst individuals with AD who are retired. There is a need for future longitudinal research to determine how late retirement may delay the progression of cognitive decline in AD by controlling for other moderator factors such as genetics and work-related stress.
67 Cognitive Reserve, Depressive Symptoms, and Functional Ability in Older Adults
Authors: Liu Stephanie M , Lee Lisa , Loza Sandra , Tabaza Raghad , Morin Ruth , Bennett Lauren
Published: December 2023

Objective:

Cognitive reserve has been linked to functional ability, and depression has been shown to be associated with more functional impairment in older adults. While cognitive reserve and depression are associated and have each been shown to impact functional impairment, the independent impact of cognitive reserve on functional ability after accounting for depressive symptoms has not been explored. For the purpose of this study, years of education served as a proxy for cognitive reserve, which is consistent with the literature. It was predicted that higher levels of education would be associated with better functional ability regardless of age and severity of depressive symptoms.

Participants and Methods:

Participants (ages 55 to 90) were drawn from the Alzheimer’s Disease Neuroimaging Initiative (N=3407); participants with major depression were not included. Subsyndromal depressive symptoms were measured using the Geriatric Depression Scale (GDS < 6) and functional impairment was assessed using the Functional Activities questionnaire. A three-stage hierarchical regression was conducted with functional ability as the dependent variable.

Results:

Age, entered at stage one of the regression model, was a significant predictor (F(1,1427) =49.75, p<.001) and accounted for 3.4% of the variance in functional ability. Adding depressive symptoms to the regression model led to a significant increase in variance explained (F(1,1426) = 64.57, p<.001), accounting for an additional 4.2% of the variance in functional ability. Adding years of education to the regression model explained an additional 1.4% of variance in functional ability and this increase in variance explained was significant (F(1,1425) = 22.53, p<.001).

Conclusions:

Cognitive reserve (operationalized as higher levels of education) was associated with higher functional ability even after accounting for age and depressive symptoms.
2 Neuropsychological Rehabilitation of Multiple Sclerosis Patients: Long-Term Effects on Everyday Functioning
Authors: Ferreira Inês , daSilva Ana Martins , Santos Ernestina , Samöes Raquel , Sousa Ana P , Cavaco Sara
Published: December 2023

Objective:

Cognitive difficulties in Multiple Sclerosis (MS) are important contributors to impairment in instrumental activities of daily living. A non-randomised controlled trial was conducted to explore the effects of a cognitive rehabilitation protocol on MS patients' daily life functionality.

Participants and Methods:

Seventy-five relapsing-and-remitting MS patients were recruited. Intervention Group (IG, n=31) underwent 16 individual rehabilitation sessions (1hx2/week; weeks 2-10), which included paper and pencil cognitive stimulation exercises and training memory strategies and external memory aids; and a booster session (week 37). Control Group (CG, n=44) received care as usual. These primary outcome measures were applied at baseline and at weeks 11, 36, and 62: Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ), Mental Slowness Questionnaire (MSQ), Mental Slowness Observation Test (MSOT), and Sydney Psychosocial Reintegration Scale-2 (SPRS-2). Score differences from baseline were calculated for all measures and follow-up time points except for SPRS-2, which was only applied twice (baseline and week 62). Linear regressions fitted with generalized estimating equations (GEE) were performed to verify the effects of time and group on the outcome measures. Baseline scores were included in the model as covariates for all outcome measure except SPRS-2. Chi-square and Mann-Whitney tests were applied to compare demographic and clinical characteristics of the groups.

Results:

Groups had similar demographic (i.e., sex, age, and education) and clinical (i.e., age at disease onset, disease duration, disease modifying treatments, and Expanded Disability Status Scale score) characteristics. IG's MSQ score progressively improved, whereas CG's score did not change from baseline (group x time effect: p<0.001) throughout follow-up. IG's MSNQ score improved from baseline at weeks 11 and 36, but not at week 62. CG's MSNQ score did not change from baseline throughout follow-up (group x time effect: p=0.025). Both IG's and CG's performance on the MSOT improved (time effects). Though, the IG showed greater improvement at follow-up (group effects) on MSOT score and time (both p<0.001). IG's SPRS-2 improved, whereas CG's score declined (group x time effect: p<0.001).

Conclusions:

Combining restorative techniques with strategy-based compensatory techniques may produce significant and persistent effects on MS patients' self-reported everyday functioning and on their objective performance of instrumental tasks.
4 Compensatory Functional Activation During Motion Discrimination in Parkinson’s Disease
Authors: Nitschke Stephanie R , Shaff Nicholas , Wertz Chris , Stone David , Vakhtin Andrei , Mayer Andrew , Festa Elena K. , Heindel William C. , Salmon David P. , Suarez Cedeno Gerson , Deligtisch Amanda , Pirio Richardson Sarah , Ryman Sephira G.
Published: December 2023

Objective:

PD patients commonly exhibit executive dysfunction early in the disease course which may or may not predict further cognitive decline over time. Early emergence of visuospatial and memory impairments, in contrast, are more consistent predictors of an evolving dementia syndrome. Most prior studies using fMRI have focused on mechanisms of executive dysfunction and have demonstrated that PD patients exhibit hyperactivation that is dependent on the degree of cognitive impairment, suggestive of compensatory strategies. No study has evaluated whether PD patients with normal cognition (PD-NC) and PD patients with Mild Cognitive Impairment (PD-MCI) exhibit compensatory activation patterns during visuospatial task performance.

Participants and Methods:

10 PD-NC, 12 PD-MCI, and 14 age and sex-matched healthy controls (HC) participated in the study. PD participants were diagnosed with MCI based on the Movement Disorders Society Task Force, Level II assessment (comprehensive assessment). Functional magnetic resonance imaging (fMRI) was performed during a motion discrimination task that required participants to identify the direction of horizontal global coherent motion embedded within dynamic visual noise under Low and High coherence conditions. Behavioral accuracy and functional activation were evaluated using 3 * 2 analyses of covariance (ANCOVAs) (group [HC, PD-NC, PD-MCI] * Coherence [High vs. Low]) accounting for age, sex, and education. Analyses were performed in R (v4.1.2(Team, 2013)).

Results:

PD-MCI (0.702± 0.269) patients exhibited significantly lower accuracy on the motion discrimination task than HC (0.853 ± 0.241; p = 0.033) and PD-NC (0.880 ± 0.208; p =0.039). A Group * Coherence interaction was identified in which several regions, including orbitofrontal, posterior parietal and occipital cortex, showed increased activation during High relative to Low coherence trials in the PD patient groups but not in the HC group. HC showed default mode deactivation and frontal-parietal activation during Low relative to High coherence trials that was not evident in the patient groups.

Conclusions:

PD-MCI patients exhibited worse visuospatial performance on a motion discrimination task than PD-NC and HC participants and exhibited hyperactivation of the posterior parietal and occipital regions during motion discrimination, suggesting possible compensatory activation.
22 How Cultural Factors Affect CVLT Performance in Individuals from the Former Soviet Union
Authors: Gorenstein Kayla , Almaraz Seth M , Razani Jill
Published: December 2023

Objective:

Neuropsychological test norms are developed as a reference point for assessing normal and abnormal test performance (Manly & Echemendia, 2007; Mitrushina et al., 2005). However, these norms are often created without considering the cultural experiences that influence neuropsychological test performance in ethnically diverse individuals. Since the Soviet Union’s collapse, approximately 2.66 million people migrated to different countries, with one of the most popular destinations being the United States (Tishkov, Zayinchkovskaya, & Vitkovskaya, 2005). The objective of this study was to examine whether specific cultural factors can significantly influence Former Soviet Union’s neuropsychological test performance on the California Verbal Learning Test-Second Edition Short Form (CVLT-II-SF).

Participants and Methods:

A total of 66 fluent, English-speaking first- or second-generation healthy immigrants from the Former Soviet Union participants were recruited from the greater Los Angeles area for this study. Participants ranged in age from 18 to 75 years old. Participants were administered the CVLT-II-SF as part of a larger battery. This shorter version of the CVLT-II requires participants to learn 9 words that fall into 3 different categories over 4 learning trials. This is followed by distractor task, free recall of the 9 items and free recall of the items again after 10 minutes, followed by recall with cuing of the categories. A questionnaire designed to assess the participants’ various cultural experiences was given and include the amount of education that was obtained outside of the U.S. as well as the percentage of time they spoke English growing up. Finally, all participants completed an acculturation measure.

Results:

Correlation analysis was performed in order to assess which cultural factors significantly correlated with the CVLT-II-SF variables. The results revealed that two of the cultural factors (percentage of education that was obtained outside of the U.S. and the acculturation score) are significantly correlated with several neuropsychological variables. Stepwise regression analysis was then used to further examine the best cultural predictors of CVLT-II-SF variables. This analysis revealed that the percent of education obtained outside of the U.S. significantly predicted the total learning trial scores, the long free recall trial, and the long-cued recall trials, while the acculturation scores significantly predicted the short free recall trial.

Conclusions:

The results of this study indicate that specific cultural factors should be taken into account when interpreting the test results of immigrants of former Soviet Union individuals. More specifically, acculturation and the amount of education obtained outside of the U.S. are important factors to consider.
27 Examining the Relationship Between Spanish-English Bilingualism and Digit Span Performance
Authors: Ramirez Nathan R , Harris Robert N
Published: December 2023

Objective:

Bilingualism has shown to have significant implications for neuropsychological assessment, namely, the Digit Span task. Moreover, bilingual individuals have been shown to exhibit both advantages and disadvantages on Digit Span; however, the relationship between bilingualism and performance on this subtest is poorly understood. This research aims to better understand how Hispanic Spanish-English bilinguals perform on this commonly administered working memory subtest.

Participants and Methods:

Participants included 82 Hispanic Spanish-English bilinguals [Age: M=29.11 (SD=6.369); Education: M=15.68 (SD=2.255); 53.7% female]. The participants completed the Language and Social Background Questionnaire (LSBQ; composite factor scores) and the Wechsler Adult Intelligence Scale -Fourth Edition (WAIS-IV) Digit Span (raw scores) subtest via Zoom, an online video conferencing platform. A hierarchical multiple regression analysis was utilized to predict participants’ Digit Span performance based on their LSBQ composite factor scores. Hierarchical multiple regression analyses were conducted using SPSS Version 27.

Results:

LSBQ composite factor scores significantly predicted Digit Span Forward, F (3, 78) = 1.835, p < 0.43 (R2 = .030) and Longest Digit Span Forward, F (1, 78) = 4.02, p < 0.48 (R2 = .041) scores. LSBQ composite factor scores did not significantly predict Digit Span Backward, F (3, 78) = .344, p = .941, Digit Span Sequencing, F (3, 78) = .598, p = .731, Digit Span Total, F (3, 78) = .440, p = 0.296, Longest Digit Span Backward, F (3, 78) = .510, p = .666, or Longest Digit Span sequencing F (3, 78) = .200, p = .751 scores.

Conclusions:

Results suggest that Hispanic Spanish-English bilinguals perform worse on Digit Span Forward and Longest Digit Span Forward as their bilingual experiences increase. However, bilingual experiences did not significantly predict Digit Span Backward, Digit Span Sequencing, Digit Span Total, Longest Digit Span Backward, or Longest Digit Span Sequencing scores. The contrasts in Digit Span performance may be attributed to the different ways in which each condition of the subtest is cognitively processed. Therefore, clinicians and researchers should use caution when interpreting test data for Digit Span with Hispanic Spanish-English bilinguals.
77 Comparing the Performance of Videoconference and In-Person Neuropsychological Test Administration for People Living with Younger Onset Neurocognitive Disorders
Authors: Brown Aimee Denise , Kelso Wendy , Stolwyk Renerus
Published: December 2023

Objective:

People living with younger onset neurocognitive disorders (YOND) experience significant delays in receiving an accurate diagnosis. Although neuropsychological assessment can help assist in a timely diagnosis of YOND, several barriers limit the accessibility of these services. Utilising teleneuropsychology may assist with the service access gap. This study aimed to investigate whether similar results were found on neuropsychological tests administered using videoconference and in person in a sample of people living with YOND.

Participants and Methods:

Participants with a diagnosis of YOND were recruited from the Royal Melbourne Hospital (RMH) Neuropsychiatry inpatient ward and outpatient clinic, and through community advertising. A randomised counterbalanced cross-over design was used where participants completed 14 tests, across two administration sessions: one in person and one using videoconference. There was a two-week interim between the administration sessions. The videoconference sessions were set up across two laptops using the Healthdirect Video Call platform and Q-Global. Repeated measures t-tests, intraclass correlation coefficients (ICC) and Bland-Altman plots were calculated to compare results across the test administration sessions.

Results:

Thirty participants (Mage = 60.23, SD = 7.05) completed both sessions. Huntington's disease was the most common YOND diagnosis (n = 8), followed by Alzheimer's disease (n = 6), mild cognitive impairment (n = 6) and frontotemporal dementia (n = 4). Preliminary results from the current study indicate no statistically significant differences, and small effect sizes, between the in-person or videoconference sessions. ICC estimates range from .69 to .97 across neuropsychological tests.

Conclusions:

This study provides preliminary evidence that performances are comparable between in-person and videoconferencemediated assessments for most neuropsychological tasks evaluated in people living with YOND. Should further research confirm these preliminary results, findings will support the provision of teleneuropsychology to address the current service gaps experienced by people with YOND.
Lifetime Achievement Award in Research Presentation
Authors: Anderson Vicki
Published: December 2023

The research landscape has changed dramatically over recent decades with the evergrowing opportunities facilitated by increasingly sophisticated technologies and statistical approaches, and complexity of governance and funding requirements, coupled with a relatively recent acknowledgement of the need to consider the impact of what we study and whether it addresses concerns that are shared by patients and consumers.

Over the past 20 years, the Melbourne Children's Brain and Mind team has followed children from the time of their brain injury as they have moved from infancy and childhood, through adolescence and into adulthood. With a backdrop of the myriad of changes in research approaches, over the life of this study, this presentation will describe the challenges and findings generated from our work and consider how key research questions have changed, whether the work has been impactful at a scientific and if it has impacted the outcomes of brain injury survivors.

Finally, given the critical importance of researchers, at any stage of their career, in the successful conduct of programs such as ours, learnings regarding ingredients supporting successful research careers will also be explored.
Symposium 08: Neuropsychological Considerations for Alzheimer's Disease Clinical Trials
Authors: Kiselica Andrew , Duff Kevin
Published: December 2023

Summary Abstract:

The 2011 National Institute on Aging and Alzheimer's Association (NIA-AA) criteria for the diagnosis of Alzheimer's disease (AD) focused on clinical signs and symptoms to make a diagnosis of probable or possible AD. Under these criteria, emphasis was placed on gathering objective evidence of cognitive decline, which gave neuropsychologists a central role as diagnosticians in AD clinical trials. The release of the 2018 NIA-AA research framework put greater emphasis on the use of biomarkers, especially measures of amyloid, tau, and neurodegeneration, to define AD. Once AD is defined based on these biomarkers, it is staged via clinical signs and symptoms. Thus, the role of neuropsychologists has shifted from being central to diagnosis to a possibly more ancillary role of staging the disease once it is determined to be present. The move away from clinical signs towards biomarkers only became more prominent with the recent, controversial Food and Drug Administration approval of Aducanumab as an AD treatment based on evidence of change in biomarkers without clear evidence of clinical benefit. In this landscape, the fit of neuropsychologists in AD clinical trial research has become less clear.

This symposium will address the role of neuropsychologists in modern AD clinical trial research. The presenters will highlight varied ways in which neuropsychologists can enrich and improve AD clinical trials. First, Dr. Dustin Hammers from Indiana University will discuss how neuropsychological methods can help us to understand which participants do, and perhaps more importantly, do not get enrolled in clinical trials. Second, Dr. Mirella Diaz-Santos from the University of California Los Angeles will summarize her work to enroll Hispanic individuals in the Human Connectome Project, improving inclusivity. Third, Dr. Tamar Gollan from the University of California San Diego will summarize her work on novel behavioral markers of AD risk discovered from the study of Spanish-English bilingual patients. Fourth, Dr. Andrew Kiselica from the University of Missouri will highlight psychometric considerations in interpreting clinically meaningfully change in AD clinical trials using data from the National Alzheimer's Coordinating Center. Fifth, Dr. Samantha John from the University of Nevada at Las Vegas will discuss the influence of race/ethnicity on how clinically meaningful change is defined using data from a diverse cohort.

Dr. Kevin Duff will serve as discussant for this series of studies. He will highlight the important roles that neuropsychologists can play in improving AD clinical trial screening processes, expanding inclusion of diverse patients into trials, and enhancing interpretation of the clinical meaningfulness of trial results. He will also reflect on the future of neuropsychology's role in the AD clinical trial landscape and encourage audience questions and responses to the research presented.