bluuebunny/crossref_metadata_2025 huggingface dataset:
1619: The Danger of a Single Origin Story
Authors: Wright Michelle M
Published: August 2020

The 1619 Project, directed by Nikole Hannah-Jones, may well be doing more harm than good. By amputating the history of Indigenous Americans, by broadly ignoring the central roles played by Black women and queers in the centuries-long struggle for equality, and by failing to address US Blacks whose ancestries do not come out of the Middle Passage, The 1619 Project is replacing one series of ghastly untruths with new ones.
A-07 Race, SES, and IQ Test Score Differences: The Case for Social Justice
Authors: Weiss L
Published: August 2020

Objective

To quantify potential mediators of observed IQ test score differences of Whites with Hispanics and African Americans in the WISC-IV, WISC-V, and WAIS-IV standardization data sets.

Method

Mediators included parent education, income and academic expectations for children and adolescents; and self-education, income and occupation for adults. Observed IQ score means are presented by race and ethnicity, unadjusted for demographics. A series of regressions quantify the variance in IQ test scores accounted for by race/ethnicity before and after controlling for SES related mediators.

Results

SES related mediators accounted for substantial portions of IQ score variance in all group comparisons and age ranges, but least for African Americans and adults.

Conclusions

The critical influence of cognitively enriching and impoverishing environments on the neurocognitive development of children, and the unequal distribution of these influences across social and economic groups are discussed as complementary with interpretations of acculturation and heredity.
A-15 Mental Health Practitioners’ Immediate Practical Response to the COVID-19 Pandemic
Authors: Reilly S , Zane K , Mccuddy W , Soulliard Z , Scarisbrick D , Miller L , Mahoney J
Published: August 2020

Objective

This paper examined how mental health practitioners adjusted their practices during COVID-19. The authors hypothesized that practitioners would transition services to telehealth but that this would differ by provider type.

Method

English-speaking adult mental health practitioners (N = 910) were recruited via professional listservs, personal emails, and social media. Data were collected 03/30/2020–04/10/2020 via an online Qualtrics survey asking about demographics and practice adjustments in response to COVID-19. Most practitioners were psychologists/doctoral-level therapists (41%), social workers/masters-level therapists (17%), and neuropsychologists (16%). The majority was employed in an academic medical center (19%) or private practice (22%). Differences among provider types were examined using chi-square tests with Bonferroni corrections and one-way ANOVAs with post-hoc Tukey tests. Preliminary Results (see Table 1): Most mental health practitioners adjusted their practices, primarily by transitioning to telehealth. The majority reported having easy access to information technology (IT) services. Although telehealth implementation was neutral to somewhat difficult, participants were neutral to somewhat likely to provide telehealth in the future. Compared to other practitioners, neuropsychologists saw fewer patients; were more likely to cancel, reschedule, or restrict appointments; were less likely to implement telehealth; and reported greater difficulty doing so. Findings related to other group differences (e.g., between settings) will also be presented.

Conclusions

During the COVID-19 outbreak, mental health practitioners rapidly shifted to telehealth, but neuropsychologists were less likely to do so and reported greater difficulty doing so. This may be related to the difficulty of administering neuropsychological tests remotely and has implications for neuropsychologists’ ability to meet patients’ needs during COVID-19.
A-010 Traumatic Brain Injury, APOE, and Age at Diagnosis of Alzheimer’s Disease
Authors: C Alexander , J Suhr
Published: August 2020

Objective

Traumatic brain injury (TBI) is potentially a risk factor for Alzheimer’s disease (AD). This relationship may depend on the severity of TBI as well as other risk factors including APOE. We examined whether TBI status affects age of onset of AD, while improving on prior literature’s methodological issues.

Method

Data from the National Alzheimer’s Coordinating Centers were used. Inclusion criteria included: normal cognition at baseline; eventual diagnosis of AD; adults aged 50 and older; at least 3 years of follow-up data. Covariates included age at baseline and history of TIA, stroke, or hypertension. The resulting sample (N = 485) was 65.2% female; 89.1% White, 9.1% Black; and 4.5% Hispanic; 8% with TBI; and 42% with APOE4. Average age at baseline was 79.2 (SD = 7.6). ANCOVAs were used to determine whether TBI status (no TBI; TBI with brief LOC; TBI with extended LOC) was associated with earlier age of diagnosis for AD, controlling for age at baseline and health factors. APOE status was added to a second ANCOVA.

Results

Age at baseline (p < .001), but not health history (p = .777), was related to age of AD diagnosis. TBI status was not associated with age of AD diagnosis (p = .737). When APOE and the interaction between APOE and TBI status were added to the model, neither was significant (p’s = .150, .647).

Conclusions

When controlling for baseline cognition, age at baseline, and health factors, there was no relationship between TBI status and age of diagnosis of AD. However, use of more stringent inclusion criteria as compared to previous studies may have reduced power significantly.
A-019 Predictors of Memory Strategy Use in Healthy Older Adults
Authors: K Pizzonia , J Suhr
Published: August 2020

Objectives

Older adults often use memory strategies to assist with age-associated memory changes, and interventions targeting successful memory strategy use may promote independence. However, individuals vary in their use of memory strategies. We investigated individual difference factors involved in memory strategy use in older adults.

Method

As part of a larger study on stress and aging, 123 healthy community-dwelling adults over the age of 50 completed various assessments. The present analyses included 91 participants (54% female, mean age 60.80, SD = 8.75) who had completed all measures of interest. Reported external and internal memory strategy use and anxiety about memory ability were measured by the Metamemory in Adulthood (MIA) questionnaire. Psychological variables were measured by the Geriatric Depression Scale, Perceived Stress Scale, and MIA. Memory and working memory performance were assessed using the RBANS, Auditory-Verbal Learning Test, and Auditory Consonant Trigrams.

Results

Within the context of our model, we found that education (p = .036) and anxiety about memory performance (p = .010) predicted internal memory strategy use, while gender (p = .011), education (p < .001), and anxiety about memory ability (p = .011) predicted external memory strategy use. None of the other variables were related to memory strategy use.

Conclusions

Though cross-sectional in nature, our results have implications for understanding successful memory strategy use. Regarding demographics, female gender and higher education predicted external memory strategy use, while only education predicted internal memory strategy use. Also, anxiety about memory performance predicted the use of internal and external memory strategies rather than objective memory performance.
A-023 Comparison of Informant Reports of Daily Functioning to Objective Neurocognitive Performances: Activities of Daily Living Questionnaire versus Lawton Activities of Daily Living/Instrumental Activities of Daily Living Scale
Authors: C Roberts , J King
Published: August 2020

Objective

Informant reports of daily functioning are often useful when assessing functional skill impairments in neuropsychological dementia evaluations, given potential biases with self-reporting from low insight and/or a reluctance to endorse reduced independence. Two measures of informant functional skill assessments were compared within patients relative to their objective neurocognitive performances.

Method

Participants included 19 (32% male, 68% female; 21% Hispanic, 69% Caucasian) outpatient older adult dementia evaluations aged 60 to 90 years (Mean age = 74, SD = 7.7) who were accompanied by a family member or caregiver informant. The Activities of Daily Living Questionnaire (ADLQ) and the Lawton Activities of Daily Living and Instrumental Activities of Daily Living Scale (ADL/IADL) informant reports were compared relative to performances on the Hopkins Verbal Learning Test delayed recall trial (HVLT), Trail Making Test Part B (TMTB), CLOX: An Executive Clock Drawing Task (CLOX1), and the Controlled Oral Word Association Test, FAS and Animals (COWAT).

Results

Simple linear regression analyses indicated the ADLQ significantly predicted both TMTB (β = −.52, 95% CI [−.81, −.23], p < .01; R2 = .47) and HVLT (β = −.38, 95% CI [−.67, −.08], p < .01; R2 = .31) performances. The ADL/IADL scale significantly predicted TMTB performances (β = −.70, 95% CI [−1.1, −.30], p < .01; R2 = .46). A significant correlation was observed between ADLQ and ADL/IADL informant reports (r(17) = .60, p < .01).

Conclusion

There was a significant linear relationship between both ADLQ and ADL/IADL informant reports with TMTB performances. The ADLQ reports also significantly predicted HVLT performances. No significant relationships were observed between either ADLQ and ADL/IADL reports, and participants’ CLOX1 or COWAT FAS/Animals performances.
A-031 Early Childhood Quality of Education and Late-Life Cognitive Function in a Population-Based Sample from Puerto Rico
Authors: C Barba , A Dávila-Roman , O Clay , V Wadley , R Andel , A Garcia Gurucharri , M Crowe
Published: August 2020

Objective

Education quality may be related to disparities in late-life cognition in the U.S. We examined whether years of education and indicators of childhood quality of education (QOE) are associated with cognitive decline and cognitive impairment (CI) in older Puerto Ricans.

Method

Participants included 3,883 community-dwelling older adults aged 60+ years from the Puerto Rican Elderly: Health Conditions Study without CI at baseline. A composite of QOE included school year length, student-teacher ratio, attendance, and literacy levels for each municipality from Census and education reports (1926–1945). Cognitive functioning was measured by the minimental Cabán (MMC) at baseline and four-year follow-up. CI was assigned when MMC score was < 11 points. Covariate-adjusted logistic and linear regression models were used to examine incident CI and decline, respectively.

Results

Participants reported 8 years of education on average. Years of education (OR = 0.84; 95% CI = 0.79, 0.90; p = < .0001) was associated with a lower risk of incident CI but QOE was not (p = .37). In covariate-adjusted models, QOE (F(8, 2482) = 96.87, p < .05, R2 = .24) was significantly associated with cognitive decline. However, when years of education was added to the model, QOE was no longer statistically significant (p = .34).

Conclusions

This study provides further evidence that years of education and QOE are important factors for understanding risk of negative cognitive outcomes in older age, and that for this older Puerto Rican sample, years of education and literacy largely explained associations between QOE and late-life cognition.
A-034 Improvement in Cognitive Functioning Post Cardiovascular Event—A Case Study
Authors: A Witbeck
Published: August 2020

Objective

To evaluate changes in cognitive functioning over time following a cardiovascular event evidenced by a series of neuropsychological evaluations. This data adds to the limited research on episodes of vascular induced dementia and demonstrates how a patient that suffers a cardiovascular event can show improvements in cognitive abilities over time.

Methods

Patient A is a 78-year-old, right-handed, Caucasian, male, with a medical history significant for congestive heart failure with subsequent cognitive, emotional, and behavioral changes. Comprehensive neuropsychological evaluations were performed two weeks, three weeks and seven months post cardiovascular event to monitor changes in cognitive functioning. All background information was obtained from a clinical interview with Patient A and his daughter, as well as a review of available medical records.

Results

The initial evaluation revealed cognitive deficits across domains, whereas the most recent evaluation showed improvements in all domains except for isolated declines in areas of memory and visual planning and organization. The most recent results evidenced his memory performance was notable for greater encoding deficits for both verbal information and visual information. Attention, executive functioning, language, and visual acuity remained stable or improved from previous evaluations.

Conclusions

The series of evaluations showed a general improvement in Patient A’s cognitive functioning, however, isolated declines were noted in memory and visual planning and organization. This data suggests that following a cardiovascular event, an individual’s functioning may improve over time and allow clinicians to see the isolated areas of decline to provide a more accurate and thorough diagnosis.
A-037 Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarctions and Leukoencephalopathy: A Neuropsychological Case Review
Authors: S Greco , K Nicewicz , S Kirk , E Shephard , M Raymond
Published: August 2020

Objectives

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarctions and Leukoencephalopathy (CADASIL) is a rare genetic disorder. It is caused by a mutation in the NOTCH3 gene on chromosome 19 which damages vascular smooth muscle cells resulting in impaired cerebral blood flow and a progressive vascular dementia. Onset typically occurs by the mid-30’s but varies widely. This case study describes a unique case of rapid disease progression.

Methods

The patient was a 58-year-old right-handed male. Initial symptom onset occurred at the age of 53, with blurred vision, severe headache, and difficulty speaking. Brain imaging (CT, MRI) showed significant white matter degeneration and cortical volume loss. Multiple sclerosis was hypothesized. Following the development of seizures and a right hemisphere stroke, the patient underwent genetic testing and was diagnosed with CADASIL. Initial neuropsychological evaluation revealed deficits in perceptual reasoning, working memory, processing speed, memory, and executive functioning. Serial evaluation included intelligence testing, academic achievement, the Meyers Neuropsychological Battery, and psychological functioning.

Results

Intellectual functioning and the overall neuropsychological test battery mean were one and a half to two standard deviations below his estimated premorbid functioning. Executive functioning declined from prior evaluation. Psychologically, the patient reported mild anger, irritability, and interpersonal difficulties. His wife endorsed significant increases in apathy and disinhibition and decline in executive functioning. The patient passed away approximately six months post-evaluation.

Conclusion

Findings were consistent with moderate-to-severe diffuse and lateralized deficits (RCH > LCH) resulting from subcortical/higher cortical vascular dementia due to CADASIL and its medical sequelae, with quite rapid symptom onset and decline.
A-043 Preschool Children with Attention Deficit Have Weakness in Reproducing the Rey-Osterrieth Complex Figure in Delayed Recall Condition
Authors: S Kiselev
Published: August 2020

Objectives

It was known that children with attention deficit (AD) have also weakness in working memory. In our previous research we have revealed that ADHD children have deficit in visual and verbal memory in delayed recall condition in comparison to immediate condition (Kiselev, 2018). The goal of this research was to examine the hypothesis that preschool children with AD have a deficit in reproducing the Rey-Osterrieth Complex Figure in delayed recall condition.

Methods

The experimental group included 13 children with AD at the age of 5-6 years. The control group included 13 typically developing children. The children from groups were matched for IQ, gender and age. Children from both groups were assessed with Rey–Osterrieth complex figure test (ROCF). This test is designed to assess reproducing the complex figure in immediate and delayed recall conditions. ANOVA with repeated measures was used to reveal group differences in reproducing the figure in two conditions.

Results

We have not revealed significant differences between children from experimental and control group in reproducing the figure in immediate condition. However, the interaction of condition type and group was significant (p < .05). Children with AD had weakness in the accurate reproduction and placement of specific design elements of Rey-Osterieth Complex Figure in Delayed Recall condition.

Conclusions

In view of our previously received results in children with attention deficit, we can propose that deficit in memory in delayed recall condition can be one of the key symptoms in this disorder.
A-051 Identifying Autism in Children With a History of Extreme Prematurity: A Case Series
Authors: B Brukilacchio , M Brinster , A Fleming
Published: August 2020

Objective

Children with a history of prematurity are at increased risk for neurodevelopmental disorders, including autism. This case series describes four patients with comparable prenatal and divergent neonatal histories who were referred for comprehensive autism evaluations between 21-36 months of age by a NICU follow-up program.

Method

Patients were born at approximately 25 weeks gestation (i.e. extremely premature) following otherwise uncomplicated pregnancies and weighed less than 1000 grams at birth (i.e. extremely low birth weight). Patients A and B experienced significant neonatal complications (e.g. hemorrhage, respiratory failure). Children were later evaluated for autism by an interprofessional team affiliated with a children’s hospital.

Results

Patient A had average intellectual, motor, and language abilities with mild symptoms of autism on a standardized rating scale. Patient B had impaired intellectual, motor, and language abilities with severe symptoms of autism on the same rating scale. Patient C had average intellectual abilities, borderline language and motor abilities, and did not display autism features. Patient D had borderline intellectual abilities, low average receptive and expressive language, and also did not display autism features.

Conclusions

All patients presented with developmental delays in at least one domain. Those who experienced complications in the NICU met DSM-5 criteria for Autism Spectrum Disorder. However, patients with similar prenatal histories who did not face additional complications in the NICU presented with comparatively intact social communication and behavior. This case series suggests the relative importance of peri- and neonatal factors in the etiology of autism in children with a history of extreme prematurity.
A-056 WISC-V Profiles in Children with Congenital Heart Disease: Is the WISC-V Sensitive to Cognitive Impairment in CHD?
Authors: M Vasserman , S Virani , T Fay-Mcclymont , L Medlin , S Mish , W Macallister , B Brooks
Published: August 2020

Objective

Prior research on intellectual development in children with congenital heart disease (CHD) yielded inconsistent findings. No study has yet examined the Wechsler Intelligence Scale for Children—Fifth Edition (WISC-V). Given its revised factor structure, it is unknown if the WISC-V performs similarly to prior versions in children with CHD.

Methods

Twenty children (6-13 years) with CHD received the WISC-V; children with co-morbid neurological illness (i.e., stroke, epilepsy) were excluded. Five children underwent the Fontan procedure. Means, standard deviations, and percent impaired (< 5th percentile) were calculated for composites. Effect size estimates compared children with and without the Fontan procedure.

Results

Mean age was 10.3 (SD = 2.5; 30% male). The mean Full Scale IQ (FSIQ) was 77.8 (SD = 13.7, range = 46-108). No sex difference in age or IQ were observed. The Visual Spatial Index was the lowest composite (VSI; Mean = 78.7, SD = 18.0), followed by the Fluid Reasoning Index (FRI; Mean = 82.0, SD = 15.6), Working Memory Index (WMI; Mean = 82.4, SD = 16.0), Verbal Comprehension Index (VCI; Mean = 84.80, SD = 15.29), and Processing Speed Index (PSI; Mean = 85.6, SD = 14.6). The FRI was most frequently impaired (50% of sample), followed by WMI (40%), VSI (35%), and VCI/PSI (20%). Although children who underwent the Fontan procedure did not differ in FSIQ (Cohen’s d = .06, negligible effect size), they performed more poorly on the PSI (Cohen’s d = .87, large effect size).

Conclusions

The WISC-V detects deficits in visual perceptual abilities commonly seen in CHD. However, FSIQ for our sample was lower than previously reported. Children with a history of Fontan procedure may show slower processing speed.
A-07 Examining the Performance of Depressed Patients with Transient Ischemic Attack (TIA) on a Delayed Memory Task
Authors: D Lopez , A Lopez , A Quintana , D Gibson , S Arguelles-Borge
Published: August 2020

Objective

To determine whether depression plays a role in delayed memory in patients with a history of Transient Ischemic Attacks (TIA).

Method

The data from this study was derived from a large de-identified database from the National Alzheimer’s Coordinating Center containing neuropsychological information for transient ischemic attack (TIA) patients (1,585) who completed a Logical Memory-Delay. The sample was divided into two groups: those that related to depression (n = 473; mean age = 84.61; SD = 6.01) as determined by the etiologic diagnosis of the cognitive disorder-Depression and those that did not (n = 769; mean age = 87.47; SD = 6.37).

Results

An Independent-sample-t-test showed a performance difference in performance between those who endorsed depressive symptomatology [F(1,043) = 4.96,p < 0.001], than those who did not report depressive symptoms.

Conclusions

These findings suggest a link between Transient Ischemic Attack (TIA), depression and poor performance on delayed memory among older adults. Logical Memory-Delayed assesses long-term narrative memory. Based on research, depressive symptoms endorsed after a TIA can affect cognitive functioning. Specifically, studies have found that a decline in verbal memory can be in part, attributed to late-life depression. This cognitive decline may result from impaired executive functioning during the learning phase of the recall task, which then impacts their delayed recall. Given that cognitive weaknesses and psychological distress can impact considerably a patient after TIA, future studies should focus on understanding their relationship in terms of treatment outcomes. Additionally, since the effects of TIAs are typically short-lasting, future research should examine whether the observed cognitive effects are maintained over time when depression continues to be present.
A-070 Parental Perception of the Utility of Pediatric Neuropsychological Evaluation: A Systematic Review
Authors: T Deluco , N Katz , P Spano , C Stein , D Montalto
Published: August 2020

Objective

Pediatric neuropsychological evaluations are intended to support children in their development and ability to function successfully in their everyday settings; however, limited efforts have been made to synthesize the available literature regarding the utility of these evaluations. To improve the impact of pediatric neuropsychological evaluations, a systematic review was conducted to identify components of the assessment and feedback process that are associated with parents’ perception of helpfulness (help parent understand child), usefulness (provide actionable information/elicit change) and overall parent satisfaction.

Data Selection

We followed PRISMA guidelines to conduct a systematic review of the literature to identify research on parental perception of the utility of pediatric neuropsychological evaluations for children aged 3–21 years. We searched PubMed, PsychINFO, Cochrane Library, and Web of Science databases using the terms “neuropsychology,” “pediatric,” “neuropsychological evaluation,” “neurodevelopmental disorders,” “perceived utility,” and “parental utility.”

Data Synthesis

We identified 1,029 abstracts and after full review included 9 articles in our qualitative synthesis.

Conclusions

Parents generally reported high levels of satisfaction with their child’s evaluation. The research has also suggested that parents find evaluations and feedback helpful for understanding their child’s pattern of strengths and weaknesses. Recommendations from the neuropsychologists provided useful information for obtaining support and eliciting change. Limitations of the studies reviewed included small sample size, variability in methods, and reduced generalizability of results.
A-071 Latent Classes of Cognitively Normal Individuals have Unique Relationships between Demographic and Neuropsychological Variables
Authors: W Goette , J Schaffert , A Carlew , H Rossetti , L Lacritz
Published: August 2020

Objective

Determine whether clinically normal (CN) individuals represent a single homogeneous group prior to normative adjustment.

Method

Data from 1,055 CN participants (Mage = 68.0, SD = 8.68; Meducation = 14.9, SD = 2.90; white = 92.7%) from the Texas Alzheimer’s Research and Care Consortium were used. Participants had no recorded neurological, cognitive, or psychiatric diagnoses. Raw scores from the AMNART, Animal Fluency, Boston Naming Test (BNT), CERAD verbal learning test, CLOX1 and CLOX2, MMSE, and Trail Making Test (TMTA and B) were examined with finite mixtures of general linear regression models using age, education, race, and gender as predictors. Each test was modeled with up to 10 latent classes with the Bayesian Information Criterion used to select best fit.

Results

Animal Fluency, CLOX2, and TMT A errors were best fit by 1 underlying group. The remaining tests required 2 (CERAD, CLOX1, MMSE, and TMT-B errors), 3 (BNT and TMT-A), and 5 (AMNART and TMT-B) latent classes. Generally, latent classes for tests differed in coefficients for race, gender, and intercepts, though results differed from test-to-test (Supporting Figure).

Conclusions

Latent classes of CN individuals were identified for which the predictive power of certain demographic variables differed depending on the latent class. Further research is needed to identify who may belong to distinct latent classes so the appropriate regression-based norms are used. Different latent class coefficients for race and gender suggest heterogeneity within these variables that can be addressed to produce more accurate models. Findings suggest that regression-based norms could be improved by identifying latent classes and finding ways of predicting who belongs to which latent class.
A-082 SPECT Cerebral Blood Flow Differences between Self-Reported Low and High Feelings of Pessimism
Authors: B Trinidad , L Stebbins , C Golden , D Amen , D Taylor , K Willeumier
Published: August 2020

Objective

To assess which brain areas, as measured by SPECT, are related to self-reported feelings of pessimism.

Method

Using a symptom checklist, participants were determined based on their self-reported feelings of pessimism. The participants were part of a large archival de-identified database. A total of 7,661 individuals were categorized into a low level of pessimism group (N = 3,495) and a high level of pessimism group (N = 4,166) who were primarily male (60.7%) with a mean age of 40.00 (SD = 15.69). Participants were placed in their respective groups based on whether their responses fell at or below the 25th percentile or at or above the 75th percentile of the sum of responses that indicated having problems related to pessimism. The two groups were then compared in 17 brain areas at baseline.

Results

Results from an Independent samples t-test showed mean differences in blood flow. Hyper-perfusion was seen in the group with high level of pessimism in the left Frontal t(7659) = −1.668, p < .007 and bilateral Parietal, left t(7659) = −1.333, p < .001 and right t(7659) = −1.159, p < .013.

Conclusion

Results indicate that individuals who report high levels of pessimism have an increased blood flow to several areas, increasing behavioral, cognitive, and emotional arousal. The increase of blood flow to the left frontal area suggests an over activation of cognitive reasoning and judgement, inhibiting a clear understanding of feelings of powerlessness and fear. The overwhelming feelings activate bilateral parietal lobes in carrying out motor behaviors to try and reduce feelings of hopelessness and fear.
A-088 Case Report: Neuropsychological Assessment of Giant Axonal Neuropathy in Adulthood
Authors: M Kloeris , J Birath
Published: August 2020

Objective

Giant axonal neuropathy (GAN) is a progressive condition marked by abnormally large/dysfunctional axons. Childhood neurological symptoms (e.g., ataxia, loss of sensation, strength, and reflexes in limbs, and visual and hearing problems) eventually lead to central nervous system impairment (e.g., seizures, paralysis, and cognitive decline). The scant literature on cognition in GAN is mixed, with findings from no impairment all the way to dementia. We present a case of an adult GAN patient with milder symptoms.

Method

A 55-year-old Hispanic male with 13 years of education was referred from outpatient neurology for neuropsychological evaluation in a county hospital setting. He was symptomatic in childhood, but was not diagnosed with GAN until 2018. A comprehensive neuropsychological evaluation was conducted. His presentation was notable for anxious and restricted affect, rapid speech, and intense gaze. He appeared immature and at times guarded about his symptoms and history.

Results

Cognitive test results were valid and indicated normal-range IQ and generally intact cognitive abilities with mixed performances (and mild deficits) in visual memory and executive functioning. The MMPI-2-RF was invalid due to elevations on multiple validity scales, possibly due to limited insight and/or impression management (L-r highest).

Conclusions

The results add to the limited literature on cognition in GAN by describing a milder case. Our patient demonstrated some mixed cognitive difficulties as well as idiosyncrasies in personality that could reflect immaturity and/or reduced insight. In addition to further exploring its cognitive effects, future research into GAN should include the evaluation of personality and insight/metacognition in patients with milder symptoms.
A-092 Behavioral Phenotypes of Childhood Idiopathic Epilepsies
Authors: A Kessler-Jones , D Almane , K Dabbs , C Gundlach , D Hsu , M Seidenberg , C Stafstom , A Struck , B Hermann , J Jones
Published: August 2020

Objective

To characterize the presence and nature of discrete behavioral phenotypes and their correlates in a cohort of youth with new and recent onset focal and generalized epilepsies (YWE).

Methods

The parents of 297 YWE (age 8–18; n = 183) and typically developing participants (n = 107), completed the Child Behavior Checklist. The 8 behavior problem scales were subjected to hierarchical clustering analytics to identify behavioral subgroups. Factors examined included: demographics, neuropsychological data, history of academic problems, epilepsy characteristics, parental IQ and education, cortical thickness, daily executive functioning, and number of lifetime-to-date DSM-IV diagnoses.

Results

Hierarchical clustering identified three behavioral phenotypes which included: no behavioral complications (Cluster 1, 67% of YWE), internalizing problems (Cluster 2, 11% of YWE), and combined internalizing and externalizing problems (Cluster 3, 22% of YWE). These behavioral phenotypes were characterized by orderly differences in the factors analyzed. Cluster 1 was most similar to controls across most metrics while Cluster 3 was the most abnormal. Epilepsy syndrome was not a predictor of cluster membership.

Conclusion

YWE fall into 3 distinct behavioral phenotypes associated with a variety of co-occurring features and comorbidities. This approach identifies important phenotypes of behavior problem presentations and their accompanying factors that serve to advance clinical and theoretical understanding of the behavioral complications of children with epilepsy and the complex conditions with which they co-occur.
A-096 Reliable Change Indices as a Measure of Neurocognitive Change following Deep Brain Stimulation for Essential Tremor
Authors: G Lee , S Kielb , L Boxley , C Nguyen
Published: August 2020

Objective

Deep brain stimulation (DBS) is a widely used treatment for essential tremor (ET). To assess for neurocognitive decline following DBS, most studies use statistical methods that directly compare changes in test scores between pre- and post-surgical evaluations. By contrast, reliable change scores are calculated using regression-based models that account for practice effect and systematic error that can occur between repeat test administrations. We sought to determine the utility of reliable change scores in monitoring neuropsychological function following DBS.

Method

Twenty-eight ET patients (M age = 70.2 ± 6.3, 57% female) completed neuropsychological evaluations at an outpatient clinic 6.4 ± 3.6 months before and 6.7 ± 1.9 months after DBS placement within the ventral intermediate nucleus of the thalamus (71% left-sided). Wilcoxon signed rank tests were used to identify differences in performance using absolute change versus reliable change scores.

Results

There were no significant absolute differences between pre- and post-surgery scores on tests of attention, processing speed, executive function, object naming, verbal fluency, or learning and memory. By contrast, significant differences in reliable change scores from zero were identified on tests of phonemic fluency (p < .001), semantic fluency (p = .05), and verbal learning (p = .005).

Conclusions

Analyses that used reliable change scores identified post-surgical declines that were not evident in traditional statistical comparisons. Results suggest that reliable change indices are useful tools for monitoring changes in neurocognitive functions that can occur following DBS and related neuromodulation treatments.
A-110 Are Invalid Baselines More Frequent in those with Concussion History?
Authors: J Maietta , N Hopkins , L Maietta , S Flood , L Johnson , H Kuwabara , T Kinsora , S Ross , D Allen
Published: August 2020

Objective

The Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) is a commonly utilized measure for sports concussion. Across the literature we have reviewed there is an abundance of information that focuses on invalid baselines and the effects of concussions. Yet, no previous studies have investigated the effect of a history of concussion on frequency of invalid baselines. The current study examined these effects within high school athletes.

Methods

Participants included 47,874 high school athletes (mean age = 15.0, SD = 1.2; mean education = 9.0; SD = 1.5; 42.6% female). These athletes were selected from a larger database of athletes who completed baseline ImPACT testing from 2008–2016. Self-reported history of concussion (none vs. 1+) was obtained from the demographic section of the ImPACT. Invalid performance was based on standard ImPACT criteria (“Baseline++”).

Results

Chi-square tests of homogeneity were performed to assess differences in invalid baselines between those with and without a history of concussion. Results revealed significantly more invalid baselines for those with a history of concussion (p < .01).

Conclusions

Results indicate that high school athletes with a self-reported history of concussion may be more likely to have invalid baseline test performance. Based on these preliminary results, clinicians who are managing return-to-play decisions may want to take into account concussion history when interpreting baseline data. Future research should, of course, investigate whether this result is consistent in other samples and, if so, whether alternative validity criteria may be needed. Future investigations of athletes with confirmed clinical diagnosis of concussion is an important next step in investigating differences in rates of invalid baselines.
A-118 SCAT5 Cognitive Screening Performance by Athlete Sex: Implications for Clinical Interpretation
Authors: C Bailey , J Meyer , C Tangen , R Deane , S Briskin , J Gunstad , P Fastenau , P Smith , M Solomon , A Weiss Kelly
Published: August 2020

Objective

To examine sex differences in performance on SCAT-5 Cognitive Screening indices.

Method

A multisport baseline sample was composed of 727 uninjured Division I collegiate athletes (52% female) who were administered the SCAT5 before the 2017–2018 seasons. Repeat baseline testing was completed by 273 uninjured athletes (48% female) at 1 year (days M = 352.56;SD = 56.03) who were then included in the repeated measure analyses. SCAT5 Cognitive Screening indices included the SAC Total, Immediate Recall, and Delayed Recall, at both baseline testing sessions.

Results

A 3-factor mixed repeated measure MANOVA (SCAT5 Cognitive Index x baseline administration x sex) was completed. Significant between-subject differences were noted across SCAT5 measures and baselines by sex (F(1, 271) = 26.38,p < .001,partialη2 = 0.09). Significant practice effects on all SCAT5 indices between Baseline administrations were observed for all athletes (F(1,271) = 103.68,p < .001,partialη2 = 0.28) and a small but significant interaction was noted where females demonstrated slightly larger practice effects than males (F(1,271) = 6.24,p = .015,partialη2 = 0.02). Descriptive statistics for SCAT Total highlight these findings: males (M = 34.10,SD = 5.10) and females (M = 36.05,SD = 4.66) at Baseline 1; males (M = 36.07,SD = 4.59) and females (M = 38.90,SD = 4.79) at Baseline 2.

Conclusions

Significant differences on the SCAT5 Cognitive Screening between male and female athletes were evident, with the females generally outperforming their male counterparts (medium effect). Substantial practice effects were noted for all athletes (large effect), with slightly larger practice effects noted for female athletes relative to males (small effect). These findings support the use of sex-specific SCAT5 normative data for interpretation, which may be of increased importance if using reliable change methodology requiring multiple administrations.
A-119 Neurocognitive Profile of Adult Patient with Shaken Baby Syndrome
Authors: K Jupp , J Hertza , Z Repp , J Burton
Published: August 2020

Objective

Shaken baby syndrome is a form of traumatic brain injury which occurs following physical shaking of an infant. This commonly leads to lasting neurological symptoms, such as seizures, cognitive deficits, with full symptoms often not apparent until later in life. The objective of this case study is to examine the correlation between a single episode of verified shaking as a 17-month-old child and corresponding cognitive functioning in a young adult individual. Neuroimaging confirming significant brain trauma will be included.

Method

The individual was shaken once as a 17-month-old and had sequalae life-long cognitive deficits. Cognitive ability was assessed with a clinical interview, neurobehavioral observations, comprehensive Neuropsychological Battery. Emotional functioning was assessed by questionnaires given to the individual’s grandmother.

Results

Neuropsychological testing indicated severe and pervasive cognitive deficits. The individual could not write letters or numbers and had difficulty following basic instructions, despite being cooperative with testing, due to severe attentional issues. Functionally the patient could not care for himself and needed assistance with activities of daily living. Despite his cognitive impairment, the individual had a positive attitude. Clinical interview with the patient’s family indicated a strong supportive network for the individual.

Conclusion

This case highlights the destructive and life-long effects of shaken baby syndrome, but also demonstrates the importance of a supportive environment for such an individual. A single instance of shaking rendered the individual unable to function independently and severely cognitively impaired. However, because of the individual’s social support, he maintains a high quality of life and is set to graduate high school at a delayed pace.
A-124 Acute Predictors of Chronic PTSD Symptoms Following TBI in U.S. Military Service Members
Authors: S Lippa , J Bailie , T Brickell , L Hungerford , R Lange , L French
Published: August 2020

Objective

Post-Traumatic Stress Disorder (PTSD) has been shown to be a major contributor to poor outcome after Traumatic Brain Injury (TBI). Understanding the factors that contribute to PTSD symptoms may lead to improved clinical management of PTSD and TBI. This study examines acute predictors of self-reported PTSD symptoms after TBI in military service members.

Method

Participants included 210 U.S. military service members (Age: M = 33.9 years, SD = 10.2) without injury (n = 86), or with history of uncomplicated mild TBI (n = 56), complicated mild, moderate, or severe TBI (n = 43), or bodily injury (n = 25) assessed at 0–8 months and ≥ 2 years post-injury. At both assessments, participants completed the PTSD Checklist (PCL-C), Neurobehavioral Symptom Inventory, Alcohol Use Disorder Checklist, Combat Exposure Scale, and TBI Quality of Life and passed symptom validity tests. Stepwise linear regression included 26 potential predictors (demographics, injury characteristics, military characteristics, and self-report measures at baseline) of PCL-C Total at follow-up.

Results

In this model, (F(4,188) = 68.0; p < .001; R2 = .591), baseline PCL-C (R2Δ = .52) was the main predictor of follow-up PCL-C Total, followed by Cognitive Concerns (R2Δ = .04), number of deployments (R2Δ = .01), and injury severity (R2Δ = .02). When baseline PCL-C was excluded as a predictor, somatosensory symptoms (R2Δ = .361), Emotional/Behavioral Dyscontrol (R2Δ = .067), Sleep (R2Δ = .033), Combat Exposure (R2Δ = .024), and Cognitive Concerns (R2Δ = .017) predicted follow-up PCL-C (F(5,187) = 37.7; p < .001; R2 = .502). Semipartial correlations revealed that most of the explained variance was shared among self-report predictors.

Conclusion

Findings suggest acute psychological distress impacts future PTSD symptomatology, whereas TBI characteristics, such as TBI severity and number of TBIs, have minimal influence.
A-125 An Analysis of the Traumatic Brain Injury Outcomes and Needs of People in Urban, Rural and Remote Areas
Authors: K Sullivan , M Hennessy
Published: August 2020

Objective

Little is known about the traumatic brain injury (TBI) outcomes for people returning to urban versus rural communities. These communities typically differ in terms of the availability of formal and informal supports. We compared patient-reported TBI outcomes for three communities (urban, rural, and remote) and modelled their predictors.

Method

Six hundred and sixty-two cases with mild-to-severe TBI were identified from hospital records. These individuals received a mail-out survey comprised of standardized outcome measures. The measures assessed: symptoms, quality-of-life, service obstacles, unmet needs, mental health, and community integration. Ninety-one people who were less than two years post-injury returned a usable survey (18% response rate). The location of communities was coded using the Accessibility Remoteness Index of Australia (urban n = 22, rural n = 43, remote n = 26).

Results

There were no differences in the outcomes due to location (p’s > .05). The significant individual predictors of five of the six outcomes were the participant’s sex, age, and the injury severity; but location did not play a role. TBI outcomes were typically worse if the injury was severe, or if the injured person was older or female. For one outcome (community integration) males fared worse than females.

Conclusion

Contrary to expectations, location did not affect patient-reported TBI outcomes. This could indicate that the same supports are available to patients, despite their location or; that the different supports were relied on to achieve the same outcomes. The overall findings urge continued investment in TBI rehabilitation, particularly for the subgroups that experienced the worst outcomes.
A-138 Lifetime Repetitive Blast Overpressure Exposure Has Negative Impact on Quality of Life after Traumatic Brain Injury
Authors: J Bailie , T Brickell , L French , L Hungerford , R Lange , S Lippa
Published: August 2020

Objective

The objective of this study was to i) address the impact repetitive blast exposure (RBE) has on recovery from TBI in service members and veterans (SMVs), ii) determine if the relative amount of blast exposure in a career changes this effect, iii) determine if any effects of blast exposure are different than known pre-existing neurotrauma such as pre-injury TBI history (piTBIHx) defined as previous TBI that occurred before the index injury for the study.

Methods

341 SMVs with an uncomplicated mild, complicated mild, moderate, or severe TBI. piTBIHx was based on a structured interview and RBE was based on self-report. Participants were divided into six cohorts based on RBE and piTBIHx and given the TBI-Quality of Life (TBI-QOL). Four multivariate analysis of variance were completed for each domain separately (Emotional, Physical, Cognition, and Positive) to correct for multiple comparisons.

Results

Results indicate that HeavyRBE, in the absence of piTBIHx, was associated with worse QOL on measures of Anger (p = 0.032), Anxiety (p = 0.008), Explosive Behavior (p = 0.038), Headache (p = 0.030), Pain (p = 0.016), Cognitive Complaints-Executive Functioning (p = 0.009), and Cognitive Complaints-General (p = 0.013). ModerateRBE in the absence of piTBIHx was associated with more Cognitive Complaints-Executive Function (p = 0.005). ModerateRBE did not differ from the Heavy RBE group regardless of piTBIHx.

Conclusion

QOL after a TBI may be negatively impacted by a history of RBE. A lifetime of HeavyRBE was associated with worse QOL on numerous measures, however, Moderate RBE was only associated with worse cognitive complaints related to executive functioning.
A-144 Mild Traumatic Brain Injury and Sleep Disturbances in Military Service Members as Predictors of Days Missed from Duty
Authors: J Higa , L Lu , M Reid , B Khokhar , R Seegmiller , J Kennedy
Published: August 2020

Objective

Duty-limiting pain impacts military readiness. Conditions such as mild traumatic brain injury (mTBI), stress-related disorders (Acute Stress Disorder (ASD)/PTSD), depression, anxiety and sleep disturbance occur frequently among military service members and can be associated with pain-related time off from duty. The purpose of this study was to explore which of these conditions best predict time off duty.

Method

Time off duty was categorized into low (0–3 days), medium (3–30 days) and high (more than 30 days). After excluding participants undergoing a Medical Evaluation Board (MEB) or with potentially invalid symptom reporting, 364 military service members were included. An ordinal regression analysis was conducted with presence or absence of mTBI, ASD/PTSD, depression/anxiety and sleep disturbance as predictors.

Results

The regression model was significant (χ2 = 21.93, p < .001), with mTBI status and sleep disturbance emerging as significant predictors of pain-related time off duty. Those with a history of mTBI were five times more likely to miss duty days than those without mTBI (Odds Ratio (OR) = 5.09 [p = .04]). Presence of ongoing sleep disturbance conveyed two times the risk of more missed duty (OR = 2.09 [p = .04]).

Conclusion

This suggests that treating mTBI and sleep disturbances in military service members can reduce pain-related absenteeism and consequently improve military readiness.