bluuebunny/crossref_metadata_2025 huggingface dataset:
Soroxchi after Traveling to South America: Cognitive and Neurobehavioral Changes in a Patient with Bilateral Globus Pallidus Lesions
Authors: Baena E , Strutt A M
Published: August 2019

Objective

Soroxchi/Acute Mountain Sickness (AMS) is a condition that can result in cerebral and pulmonary hypoxia. Neuropsychological research on AMS is minimal and the long-term effects on cognition and behavior are unclear. AMS is associated with cognitive impairments in processing speed, attention, and executive functions as well as neurobehavioral symptoms. This case study delineates the neuropsychological and neurobehavioral changes secondary to bilateral globus pallidus (GP) lesions associated with AMS.

Case Description

Patient is a 51-year old, primarily Spanish-speaking, male of Mexican descent with 9 years of education, and who had traveled to La Paz, Bolivia (4,070 MASL) for work. Upon arrival, fatigue and dizziness led to hospitalization to treat acute pulmonary edema and hypoxia. Brain MRI revealed hyperintense bilateral GP lesions. Medical history was notable for hyperlipidemia. Psychiatric history was unremarkable. Neuropsychological assessment 4 months post-AMS revealed impairments in visuo-conceptual and speeded complex visuospatial abilities, executive functions, and confrontation naming. Cognitive improvements were noted in delayed recall of non-contextual verbal information and confrontation naming ten months post-AMS. Significant mood and personality changes were reported; patient endorsed anhedonia, fatigue, alexithymia, avolition, and sleep difficulties. Family described patient as depressed, apathetic, and socially withdrawn. Pharmacological and psychotherapy treatments were recommended and initiated.

Diagnostic Impressions and Outcomes

Findings were consistent with a diagnosis of Mild Neurocognitive Disorder. His family denied neurobehavioral improvements post interventions.

Discussion

This case study is the first to characterize the long-term neuropsychological and neurobehavioral changes following bilateral GP lesions secondary to AMS. Declines in visual-conceptual abilities reveal a new finding for this type of cerebral incident.
Informal Neuropsychological Evaluation of English Learning Aptitude in Linguistically, Educationally, and Epidemiologically Diverse Populations
Authors: Judd T
Published: August 2019

Immigration generates the need to acquire mastery of the English language for education, employment, citizenship, and other needs. Many immigrants bring with them unrecognized neuropsychological disabilities that hinder such learning. Neuropsychologists may be asked to evaluate such clients with respect to: Disability exemptions from mandatory language instructionInstructional strategies, compensations, and accommodationsStrategies, compensations, and accommodations to facilitate optimal communication and learning in the workplace, court, health care, and other settings.

Immigrants often do not have remote medical or educational records documenting historical cognitive difficulties. Many speak languages for which pertinent language ability testing is not available. Furthermore, developmental language learning disorders often have distinctive presentations in different writing systems. When documented history and formal evaluation of native language abilities are not available, informal evaluations become the next best alternative. This poster will present a suite of techniques that can facilitate this process, including: Researching the linguistics and writing system of the native languageQuestions regarding personal history that can give indications of developmental disabilities, even in the uneducatedTechniques for testing and interpreting native language literacyTechniques for evaluating English knowledge and capacityTechniques for evaluating English phonemic aptitudeTechniques for evaluating English phonemic learning aptitudeTechniques for evaluating potential for using translation technologies

The poster will also outline compensations and accommodations for learning and communication that neuropsychologists can recommend for such populations.
Barriers and Concerns Regarding Board Certification in Clinical Neuropsychology: A Program Evaluation
Authors: Reyes A , Tureson K , Arias J , Peraza J , Gonzalez D A , Lerner D , Santos C
Published: August 2019

Objective

The Relevance 2050 Initiative’s Student Pipeline Subcommittee and the Board Certification Promotion Committee of the American Academy of Clinical Neuropsychology, in collaboration with the American Board of Clinical Neuropsychology, produced the first installment of a free webinar series to promote early education on board certification (BC) in clinical neuropsychology. A pre-webinar survey was given to inform future webinar topics and initiatives, including identification of specific barriers/concerns about BC.

Method

A total of 197 respondents completed the survey and self-identified as White (61%), Asian (16%), Hispanic (11%), African American (6%) and Multiracial (6%). Respondents’ demographics, type of doctoral program, program accreditation status, level of interest in pursuing BC, and specific barriers/concerns about BC were collected. Respondents self-identified with the following diverse groups: first-generation college student (19% White, 38% Asian, 18% Hispanic, 16% African American, 41% Multiracial), low SES (8% White, 6% Asian, 36% Hispanic, 33% African American, 33% Multiracial) and sexual gender minority (6% White, 6% Asian, 9% Hispanic, 43% Multiracial).

Outcomes

Qualitative data analysis of barriers/concerns identified the following themes: money, time, knowledge about BC, training flexibility, breadth of knowledge, training/mentor opportunities, international issues, and documentation. The top three barriers included training/mentor opportunities, training flexibility, and knowledge about BC. More than half of non-White trainees (60%; χ2 = 3.864, p = .049) endorsed training/mentor opportunities as a barrier relative to White trainees (41%), particularly among Hispanic trainees (82%) relative to other minority trainees.

Discussion

Results highlight the need to increase awareness and information about the BC. Also suggested is prioritization of resources for training/mentor opportunities, particularly for minority trainees.
A-04 Evaluating Race-Related Differences in Performance of Two App-based Cognitive Tasks
Authors: Evans S , John S , Willis-Parker M , Loring D , Goldstein F
Published: August 2019

Objective

Increased participation of African Americans (AA) in Alzheimer’s disease (AD) clinical research is a national priority given their increased risk for developing AD. Removal of logistical barriers, such as time and travel costs, may increase AA participation. We developed two racially unbiased smartphone applications to assess cognition adapted from traditional tasks, the computerized Flanker test and paper-based Symbol Digit Modalities Test (SDMT). This study evaluated baseline performance and construct validity of the tasks in Non-Hispanic White (NHW) and AA participants.

Method

A sample of AA (n = 47) and NHW (n = 50) cognitively normal, middle-age and older adults (Mage = 60.73, SDage = 7.65) completed an in-clinic visit that included traditional assessments, as well as two app-based measures, Arrows and Number Match. Racial differences in group performance were evaluated with independent samples t-tests. Construct validity was assessed through inter-version correlations between traditional and app-based measures.

Results

There were no statistically significant differences between races on any metric of overall performance: Number Match (t(84) = 1.912, p = .06, 95% CI [-.130, 6.672]), Arrows average reaction time (RT) for incongruent trials (t(93) = -1.496, p = .14, 95% CI [-278.94, 39.27]), average RT for congruent trials (t(93) = -1.751, p = .083, 95% CI [-356.64, 22.44]), or average RT across all trials (t(93) = -1.691, p = .09, 95% CI [-298.21, 23.89]). The overall sample demonstrated small to moderate statistically significant inter-version correlations, from r = 0.39 to r = 0.55, ps < .01, with Number Match and SDMT showing a stronger association than Arrows and Flanker.

Conclusions

Preliminary data suggest no performance differences between races. Future research will evaluate the tasks’ ability to discriminate between clinical populations.
B-29 REM Sleep Behavior Disorder in Non-Demented Parkinson’s Disease is Related to Poorer Cognitive Performance
Authors: Mahmood Z , Van Patten R , Nakhla M , Twamley E , Filoteo J , Schiehser D
Published: August 2019

Objective

Rapid eye movement sleep behavior disorder (RBD) affects 33-46% of patients with Parkinson’s Disease (PD) and may be a risk factor for neuropsychological impairment. However, the cognitive profile in PD patients with RBD has yet to be fully determined. This study examined differences in neuropsychological performance among non-demented PD patients with (PD/RBD+) and without RBD (PD/RBD-), and healthy controls (HC).

Methods

One hundred seventy-five participants, including 45 PD/RBD+ patients, 78 PD/RBD- patients, and 52 HC, completed the RBD sleep questionnaire and underwent a comprehensive neuropsychological battery assessing attention/working memory, language, visuospatial function, verbal and visual learning and memory, and executive function.

Results

The PD/RBD+ group demonstrated significantly poorer global neuropsychological performance compared to both the PD/RBD- and HC groups (p’s < .003; η_p^2 = .16). MANOVA demonstrated significant group differences on all individual cognitive domains (p’s < .001), except visuospatial function (p = .10). Both PD/RBD+ and PD/RBD- patients had significantly lower scores compared to the HCs in the domains of attention/working memory, language, learning, and memory. Additionally, the PD/RBD+ group had significantly lower executive functioning scores compared to the HCs, and poorer learning performance compared to the PD/RBD- group.

Conclusions

Compared to PD patients without RBD, PD/RBD+ patients have greater levels of cognitive impairment specific to the acquisition of new information. Moreover, PD/RBD+ patients have greater executive dysfunction compared to HCs, underscoring the importance of RBD assessment for improved detection and treatment of neuropsychological impairment (e.g., targeted cognitive interventions). Longitudinal investigations are needed to determine the enduring effects of RBD in PD.
B-33 Cognitive Mechanisms Associated with Emotion-Focused Pulling in Trichotillomania
Authors: Carlson E , Haaga D
Published: August 2019

Objective

A revised version of the Milwaukee Inventory for Subtypes of Trichotillomania-Adult (MIST-A) provides scores for two distinct behavioral patterns of hair pulling in trichotillomania: emotion and intention pulling. The current study explored the relationship between these scales and several cognitive domains.

Method

This study used baseline data from a randomized controlled trial of a cognitive-behavior therapy intervention for trichotillomania. Participants from the general community were eligible if they met diagnostic criteria for trichotillomania. Thirty-two individuals were enrolled and completed baseline measures. The sample was 78% female, and the mean age was 34. At baseline, participants completed diagnostic interviews, self-report symptom questionnaires, and tasks from the Cambridge Neuropsychological Test Automated Battery (the stop-signal test, the intra/extra dimensional shift task, and the Cambridge gambling task ). These provided scores of intra and extra dimensional set-shifting, response inhibition, decision making quality, and sensitivity to risk. Correlational analyses were conducted comparing each cognitive score to each MIST-A score.

Results

Analyses revealed significant negative correlations between emotion pulling score and decision making quality r (30) = -.383, = .031 and emotion pulling score and sensitivity to risk r (30) = -.396, p = .025.

Conclusion

These findings provide initial insight into some of the cognitive mechanisms associated with emotion focused pulling. Individuals who pull their hair with the aim of reducing negative emotions (e.g. boredom, anxiety) showed themselves on the gambling task to be more willing to bet on an unlikely outcome, and less willing to adjust their betting amount according to the likelihood of an outcome.
B-41 SPECT Differences between Obsessive Compulsive Disorder and Post-Traumatic Stress Disorder (PTSD)
Authors: Lopez Palacios D , Lopez A , McDonald B , Golden C , Amen D , Willeumier K , Taylor D
Published: August 2019

Objective

To assess whether diagnosed Obsessive Compulsive Disorder (OCD) and Post Traumatic Stress Disorder (PTSD) interactively alter brain activity, as measured by a Single Photon Emission Computed Tomography (SPECT) imaging.

Method

The sample included adults diagnosed with OCD (n = 915) with a mean age of 34.65 and predominantly male (68.6%) and adults with PTSD (n = 1,481) which had a mean age of 41.33 and was predominantly female (57.2%). Significant differences were observed for gender . Multiple ANCOVAs were conducted to determine differences between cerebral blood flow (CBF)in 17 different brain regions.

Results

Results showed hyper-perfusion in the PTSD group as compared to the OCD group in the pariental L/R[F(1,2393) = 6.47,p < 0.01/F(1,2393) = 12.31,p < .01], motor sensory L/R[F(1,2393) = 19.33,p < .001/F(1,2393) = 17.32,p < .01] and temporal left [F(1,2393) = 12.49,p < .01].

Conclusion

Significantly higher rCBF in the pariental and motor sensory for OCD individuals may be due to visual-constructive and controlled fluency which are usually associated with compulsion. Due to the hyperalert nature related with OCD rituals, these areas are more active when compared to PTSD. Hyperfusion was reported for PTSD in the left temporal lobe compared to OCD, this region is usually associated with registering potential threasts in the environment. This can be explained by the hypervigilant conduct seen in individuals with PTSD. Overall, it appears that individuals with OCD struggle with continual inability to inhibit repetitive thoughts and behaviors due to the over activation in the motor sensory and parietal region. Alternatively, the activation in PTSD individuals can be a result of a way to help them cope with threats in the environment.
B-74 Using Rates of Low Scores to Assess Agreement between ANAM4 TBI-MIL and a Traditional Battery of Neuropsychological Tests
Authors: Ivins B , Arrieux J , Cole W , Schwab K
Published: August 2019

Objective

The Automated Neurological Assessment Metrics (Version 4) Traumatic Brain Injury Military (ANAM4 TBI-MIL) battery is widely used by the US military to assess cognitive function. We compare intra-individual agreement between ANAM4 TBI-MIL and a battery of traditional neuropsychological tests using rates of low scores.

Methods

Complete and valid data from 246 healthy soldiers and 177 soldiers ≤7 days from sustaining mild TBI (mTBI) were used in this analysis. All soldiers were consecutively administered ANAM4 TBI-MIL and a traditional test battery consisting of: TOPF, WAIS-IV, CVLT-II, RCFT, DKEFS, and CPT-II. We performed base rate analyses of both batteries to determine the proportions of soldiers who had various numbers of scores that were 1.0+, 1.5+, and 2.0+ standard deviations below the normative mean. We used those rates to place Soldiers into a “low score hierarchy” ranging from the least poor (i.e. ~≥10th %ile) to the worst overall performance (i.e. ~≤10th %ile). We then compared agreement between the batteries at each of those levels.

Results

More soldiers with mTBI had low scores than healthy soldiers on both batteries. Of the soldiers who performed at the worst level on one battery, 88.1% from ANAM and 100% from traditional had some level of poor performance on the other battery. However, of the soldiers who performed at the worst level on either battery, only 58.3% from ANAM and 50.0% from traditional also performed at the worst level on the other battery.

Conclusion

These batteries similarly identify poor performance to a degree, though with some potentially meaningful differences still present.
C-45 A Descriptive Analysis of Change in Concussion Knowledge in Collegiate Student-Athletes Participating in a Novel Peer Concussion Education Program
Authors: Wenke B , Ernst W , Kneavel M , McCarthy K
Published: August 2019

Objective

This pilot study investigated the effect of a novel peer concussion education program on concussion knowledge in a sample of collegiate student-athletes.

Method

A pre-posttest design was employed to determine the effect of the program on concussion knowledge in a sample of 50 student-athletes (34 Men’s Lacrosse and 16 Women’s Soccer) participating at the NCAA Division II level of competition. Male participants made up 68% of the sample (n = 34). The majority of participants were white (88%). Concussion knowledge was assessed with a checklist adapted from Gioia and Collins’ (2006) Acute Concussion Evaluation and McLeod et al.’s (2007) questionnaire. This checklist included 19 actual symptoms and 8 false symptoms.

Results

A repeated-measures T Test was conducted to analyze pre-test and post-test scores of total concussion symptom knowledge. The results revealed a significant increase in concussion symptom knowledge after participation in the program, t(48) = 4.2, p < 0.001, d = 0.59. A domain analysis indicated that at baseline, cognitive symptoms were accurately identified at a rate ranging from 68 to 90%, sensory/physical at a rate ranging from 74 to 98% and affective ranging from 42 to 68%. At posttest, these ranges increased to 92-98% for cognitive, 88 to 100% for sensory/physical and 84 to 88% for affective symptoms. Non-symptoms were incorrectly endorsed at a rate ranging from 54 to 92% at baseline and 56 to 76% at posttest.

Conclusions

The program appears to have potential for increasing knowledge of actual concussion symptoms; however, incorrect endorsement of non-symptoms persisted at a relatively high rate despite participation in the program.
C-69 Neuropsychological Functioning in a Patient with an Unspecified Pediatric Movement Disorder Without Abnormal Brain MRI
Authors: von Buttlar A , Butcher B
Published: August 2019

Objective

Neuropsychological profiles of patients with pediatric movement disorders are not fully understood, though research suggests greater impairments in cognitive processes reliant on white matter functional integrity. Interpretation of neuropsychological data in these patients is often informed by imaging data that suggests specific areas of brain abnormality. The purpose of this presentation is to discuss the neurocognitive profile of a patient with an unspecified, progressive movement disorder with onset in middle childhood with no observable brain abnormality.

Method

The patient is an 11-year-old, right-handed male with a history of spastic diplegia and ataxia, onset at seven years of age, in the context of a normal brain MRI and genetic anomaly of unclear clinical significance. Patient has since experienced progressive weakness and spasticity of his bilateral lower limbs, and increasing inflammation in the upper thoracic region. He also has a history of auditory hallucinations.

Results

His neuropsychological profile was indicative of white matter and right hemispheric dysfunction in the brain with well-preserved left hemisphere functions. He demonstrated stronger verbal reasoning and verbally-based executive functioning abilities compared to visual-spatial reasoning and visual perception. Deficits in sustained attention, vigilance, working memory, and processing speed were also noted. Psychomotor coordination and planning was impaired bilaterally, with more pronounced left-hand deficits. He also demonstrated significant speech dysarthria and dyspraxia. He denied experiencing auditory hallucinations in the past six months.

Conclusions

This patient’s neurocognitive profile is largely consistent with literature on neuropsychological functioning in pediatric movement disorders despite the absence of an identifiable region of brain abnormality.
A-47 Self-reported Difficulties in Retrospective Memory Predict Poor Verbal Memory Performance
Authors: Stypulkowski K , Roberts J , Robledo A , Maxfield M
Published: August 2019

Objective

Prospective and retrospective memory complaints are common among older adults with mixed results regarding their relationship with objective memory performance. This study investigated how subjective memory reports relate to objective memory function in a clinical sample.

Method

Participants (N = 139, Mage = 69.9, SD = 9.2) completed a cognitive screen at a university clinic. The assessment included the Hopkins Verbal Learning Test (verbal memory), the Brief Visuospatial Memory Test – Revised (visual memory) and the Prospective and Retrospective Memory Questionnaire, a subjective memory measure with higher scores indicating greater perceived difficulties. Correlations and linear regressions were used to evaluate the relationship between subjective and objective memory (a priori p-value = .01).

Results

Retrospective memory was correlated with immediate (r = -.35, p < .001) and delayed verbal memory (r = -.31, p < .001) but unrelated to visual memory (p > .05). Prospective memory was not correlated with performance on visual or verbal memory tasks (p > .05). Retrospective memory accounted for 12.3% of the variation in immediate (adjusted R2 = 11.6%; medium effect size), and 9.3% of the variation in delayed verbal memory (adjusted R2 = 8.6%; small effect size). Retrospective memory significantly predicted immediate [F(1, 132) = 18.48, p < .001, 95% CI = -1.04 to -0.38] and delayed verbal memory scores [F(1, 132) = 13.51, p < .001, 95% CI = -1.09 to -0.33].

Conclusions

Subjective reports of retrospective memory may be a better indicator of objective verbal memory performance than prospective memory in a clinical sample of older adults.
A-54 Greater Time Spent Watching TV is Related to Worse Real-Time Neurocognitive Performance in Older Adults With and Without HIV
Authors: Kamarsu S , Campbell L , paolillo E , Filip T , Swendsen J , Depp C , Moore R
Published: August 2019

Objective

There is a need to identify determinants of neurocognitive impairment among older persons living with HIV (PLHIV). Utilizing smartphone-based Ecological Momentary Assessment (EMA) and mobile cognitive testing, we examined the relationships between daily life activities and real-world neurocognitive performance among older PLHIV and HIV-uninfected adults.

Method

Ninety-one participants (58 PLHIV; Mage = 59.4, SD = 6.4), 70.3% male, 65.9% non-Hispanic white, completed four smartphone-based EMA surveys of daily activities and one mobile color-word interference test (mCWIT) per day for 14 days. Daily activities were grouped into five categories: activities of daily living (ADLs, IADLs), cognitively demanding activities, socially-engaging activities, physical activity (PA), and passive leisure activity (watching TV). Data was collapsed across the 14 days to examine between-person effects of the proportion of time reportedly spent on each activity on neurocognitive outcomes (the average correct responses and completion time for the mCWIT).

Results

No effect was found for engaging in activities by HIV status; however, PLHIV had significantly longer times on the mCWIT compared to persons without HIV (t = 2.49; 95% CI: 0.60, 5.37; p = 0.02). In a multivariable regression model accounting for HIV status, a greater proportion of time spent watching TV was associated with slower average mCWIT performance (beta = 9.41; 95% CI: 1.88,17.0; p = 0.01). There were no relationships between other domains of daily life activities and mCWIT performance.

Conclusion

Our findings provide evidence that more time spent watching TV is associated with slower mCWIT performance. Future work examining the time-lagged relationships between these variables is needed to understand whether watching TV decreases real-time neurocognitive performance.
A-81 MoCA Cutoffs for English/ Spanish Bilingual Veterans Assessed in English
Authors: Phillips J , Marceaux J , McCoy K , Kraemer L , Fullen C
Published: August 2019

Objective

The Montreal Cognitive Assessment (MoCA) is a well-known screener of global cognitive functioning. Multiple studies have determined optimal cutoff scores for detection of cognitive impairment in various clinical populations. This study aims to determine appropriate cutoff scores in a clinically mixed bilingual (English/Spanish) sample.

Methods

A sample of n = 57 self-identified bilingual veterans referred for neuropsychological evaluation at a VA hospital completed the MoCA as part of a full battery. All tests were administered in English. The majority were male (96.4%), Hispanic/Latinx, with 14.65 mean years of education. Only MoCA total score without adding one point for ≤12 years of education was included. Descriptive statistics were used for sample characterization. ROC curve analysis assessed diagnostic accuracy of the MoCA for classification of cognitive impairment (CI). The CI group (n = 40) included both major or mild neurocognitive disorder. The nonimpaired group (n = 17) included persons with no CI or psychiatric diagnosis.

Results

ROC curve analysis was significant (p < .001) with an AUC of .857 (95% confidence interval .746-.969). A cutoff score of ≤24 was yielded an optimal balance of sensitivity (.900) and specificity (.706). Follow-up independent samples t-test and ANOVA were conducted to examine differences between groups.

Conclusions

Among bilingual individuals, a cutoff of ≤24 on the MoCA maximized sensitivity and specificity of accurately identifying cases of cognitive impairment. Findings have implications for identifying patients requiring further neuropsychological assessment.
A-82 Neuropsychological Assessment in the Age of Technology: Comparing Traditional Paper versus Electronic Administration
Authors: Johnson E , Anderson-Hanley C , Puleio A , Wall K
Published: August 2019

Objective

As society becomes more interconnected with technology, it is important to examine how traditional “paper and pencil” administered neuropsychological tests can be utilized in digital electronic forms (e.g., computers, touch screen tablets, and smartphones). Literature has shown somewhat mixed outcomes for the validity of computerized tests. Gathering data electronically has been found to reduce human error in both test administration and in data collection itself. Digitizing carries benefits in the research field where electronic administration may make it possible to gather data on a larger scale numerically and geographically. However, in some conversions to digital versions of a task, changes may be made to the stimuli and procedure that might seemingly be benign, but could activate different cognitive responses, potentially compromising construct validity. This study examined the comparability of paper and electronic forms of the Stroop task, which is used widely and has been previously validated in paper form.

Method

Electronic Stroop tests were examined for concurrent validity with a paper version. Two touch-screen based apps were examined: BrainBaseline for the iPad and EncephalApp for smartphone. Young and older adults (n = 58) completed paper and an electronic version of the Stroop.

Results

Correlation analyses revealed a significant, but modest relationship between paper Stroop and the BrainBaseline version (r = .54; p = .001), while the EncephalApp correlation was non-significant (r = .44; p = .18).

Conclusions

These results need to be verified in a larger sample, but the implication is that some paper and electronic versions of cognitive tests are not necessarily interchangeable, and caution should be used.
B-03 Neurocognitive Outcome from Anaplastic Astrocytoma: A Case Study of Neural Compensation
Authors: Rolin S , Mullen C
Published: August 2019

Objective

Anaplastic astrocytoma is a rare malignant brain tumor occurring in adults aged 30 to 50, with an incidence of 5 to 8 people per 100,000. Cognitive dysfunction is a complication after tumor resection, resulting from neurotrauma of surgery, chemotherapy, and radiation treatment. Neural compensation and neuroplasticity can allow intact cognitive functioning after brain resection in brain areas expected to be impacted by the neurotrauma.

Method

The current case study is a 45-year-old female post -resection for dendritic cell vaccine clinical trial followed by adjuvant radiation of an anaplastic astrocytoma of the frontal lobe. MRI of the brain post right frontal craniotomy was indicative of extra-axial fluid communicating with the anterior aspect of the right lateral ventricle, hemosiderin along the medial resection margin, and T2/FLAIR signal abnormality in the left medial and right inferior frontal lobes.

Results

Test data revealed intact global cognitive functioning (WAIS-IV; FSIQ = 101 SS), with below expected performance on verbal comprehension (WAIS-IV; VCI = 98 SS). Consistent with the area of resection, she had impairments in visuoconstruction and executive functioning specific to mental generativity. However, performances with regard to math achievement were intact (WIAT; Math Problem Solving = 110 SS; Numerical Operations = 104 SS), despite significant neurotrauma to the prefrontal cortex. She also produced left lateralized fine motor weakness.

Conclusions

Accommodations for work, outpatient therapies, and psychotherapy were recommended. This case enhances the understanding of neurocognitive performance after neurotrauma involving tumor resection and radiation treatment in rare malignant brain tumor, and highlights the impact of neural compensation after resection.
B-05 Age of Seizure Onset Predicted Categorical Fluency Switching and Anxiety in People with Temporal Lobe Epilepsy
Authors: Faerman A , Lalani S , Spies-Upton S , Teague A , Kopald B
Published: August 2019

Objective

To examine whether demographic variables can assist in predicting executive dysfunction in individuals with temporal lobe epilepsy (TLE).

Method

Data were collected from presurgical evaluations of 13 individuals with TLE (67% females, mean age 34 ± 12) at the University of California, San Francisco Epilepsy Center. Executive functions were assessed using subtests from the D-KEFS (Verbal Fluency and Color/Word Interference Tests) and the Trail Making Test B. Given that depression and anxiety symptoms have been previously shown to be associated with poorer executive performance in individuals with TLE (Paradiso et al., 2001), predictability of the BDI-II and BAI scores were also tested. Linear regression analyses were used to test predictive values of demographic variables (age, age at seizure onset [ASO], years of education, gender, and right vs. left temporal epileptogenic source).

Results

ASO (β = .75, p = .021), gender (β = .632, p = .041), and education (β = .555, p = .05) explained 66% of the variance in the Verbal Fluency Switching scaled scores (R²=.66, F(4,8)= 3.876, p = .049). Education (β = .772, p = .009) and ASO (β = .686, p = .023) explained 70% of the variance in Verbal Fluency Switching Accuracy scaled scores (R² = .708, F(4,8) = 4.844, p = .028). Age (β = -.862, p = .003) and seizure onset (β = .457, p = .049) explained 52% of the variance in BAI scores (R² = .525, F(4,16) = 3.319, p = .032).

Conclusions

ASO predicted category switching and anxiety severity, while none of the demographic variables explored in this study predicted visuomotor switching. Further research should explore the efficacy of early interventions to protect against future executive dysfunction in TLE.
The Relationship of Transcranial Doppler Ultrasonography with Attention, Motor, and Social-Emotional Functioning in Pediatric Sickle Cell Disease
Authors: Balderrama M , Merrill C , Whitaker A , Kayser K
Published: August 2019

Objective

Children with sickle cell disease (SCD) are at greater risk for certain neuropsychological deficits due to their medical condition and associated complications. Previous studies have explored the relationship between Transcranial Doppler (TCD) ultrasonography and various domains of neuropsychological functioning in pediatric SCD populations; however, these studies are dated, present variable and inconsistent findings, and are somewhat limited in scope. The goal of this study was to update and expand upon previous research by examining the predictive relationship of TCD results with measures of attention, motor, and social-emotional functioning.

Methods

Thirty-six patients ages 3-19 with SCD with no known history of stroke, with TCD completed within the past 12 months, underwent a brief neuropsychological exam. Attention, motor, and social-emotional functioning were assessed as appropriate for age using the Conners Continuous Performance Test (K-CPT2/CPT3), Purdue Pegboard, and PROMIS, respectively. TCD values were gathered via medical record review, using the highest value of most recent TCD.

Results

TCD significantly predicted certain aspects of attention and motor ability, but not social-emotional functioning. Specifically, TCD significantly predicted Detectability (p = .005), Omissions (p = .001), Commissions (p = .012), Perseverations (p = .035), and HRT SD (p = .046) on K-CPT2/CPT-3 and the non-dominant (p = .009) and bilateral (p = .024) trial scores on the Purdue Pegboard.

Conclusion

This study provides new evidence that TCD may be predictive of motor functioning in pediatric SCD. Results confirm that TCD is predictive of attentional function, though subdomains impacted varied from previous research. While no significant relationship between psychosocial symptoms and TCD were identified, further studies utilizing more comprehensive measurement within this domain is warranted.
PGR - 2 Neuropsychology’s Role in Identifying Functional Neurological Disorder
Authors: Mietchen J , Kessler-Jones A , Mission P
Published: August 2019

Objective

To outline the usefulness of neuropsychological evaluation in identifying functional neurological disorder. Functional neurological disorder accounts for an estimated 16% of neurology referrals and is a “crisis of neurology” (Edwards & Bhatia, 2012). Adolescents with a history of neurologic compromise, including autoimmune disorders, are at increased risk for comorbid functional neurological disorder (Reuber, Mitchell, Howlett, Crimlisk, & Grünewald, 2005).

Method

16-year-old female with a history of Hoshimoto’s encephalopathy referred by her neurologist. Following diagnosis and treatment, she developed a constellation of symptoms, including wide set gait, nystagmus, incontinence, and dystonic episodes. She also reported lapses in memory that lasted a few minutes at a time. During these episodes, she forgot who her mother was and forgot details about her home, which resulted in panic.

Results

Two neuropsychological evaluations were completed over two years. Psychometric intelligence declined by two standard deviations compared to previous testing one year before. Her performance on memory tasks declined dramatically as well. Despite these declines, there was no decline in activities of daily living. She failed embedded and stand-alone performance validity measures (RDS = 4; TOMM = 29, 30, 28). These findings were described to her neurologist and psychiatrist and we discussed the importance of identifying functional symptoms in the context of her medical history.

Conclusions

Our evaluation identified significant discrepancies between neuropsychological performance and daily cognitive functioning. The memory lapses she described were inconsistent with any known etiology or illness. Neuropsychological evaluation identified symptoms of a functional nature and assisted in appropriate treatment planning.
PGR - 3 Adapting Neuropsychological Evaluation for a Complex Pediatric Patient with Challenging Behaviors
Authors: McEachern D , Steed M
Published: August 2019

Objective

The detrimental impact of in utero substance use on developing fetuses manifests well into adolescence (Wu, Ju, & Lu, 2011; Minnes, Lang, & Singer, 2011). Likewise, the effects of early childhood neglect during critical developmental periods may be long lasting (de Bellis, et al., 2009; Hildyard & Wolfe, 2002). Factors such as these may require creative adaptation of assessment. This case illustrates the process of evaluating a child presenting with an unusual developmental history and extremely challenging behaviors and describes efforts to maintain engagement while eliciting valid data. Successful and unsuccessful interventions will be reviewed.

Method

Patient is a 12-year-old Caucasian male admitted to a state psychiatric hospital with a complex presentation of emotional, behavioral, and cognitive difficulties. Aggravating factors consist of likely in utero drug and alcohol exposure, early trauma, chronic neglect, and unusually small physical stature. Neuropsychological evaluation was completed over the course of five days. Testing sessions were brief, on a unit where no one was present, and were structured using both intermittent and scheduled reinforcement to maintain effort and engagement.

Results

Testing indicated significant and consistent weaknesses in executive functioning, learning, memory, and attention. Despite the use of stimulant medication, difficulty with vigilance, sustained attention, and impulsivity persisted. Diagnoses were Neurodevelopmental Disorder associated with prenatal substance exposure, Generalized Anxiety Disorder, Attention Deficit/Hyperactivity Disorder, Combined presentation, and Oppositional Defiant Disorder, Moderate.

Conclusions

Unconventional history warrants unconventional approach to assessment. Recommendations included not only approaches to improving his attention, but just as important, strategies to elicit his best performance in various settings.
EpiGraph: an open-source platform to quantify epithelial organization
Authors: Vicente-Munuera Pablo , Gómez-Gálvez Pedro , Tetley Robert J , Forja Cristina , Tagua Antonio , Letrán Marta , Tozluoglu Melda , Mao Yanlan , Escudero Luis M
Published: August 2019

Here we present EpiGraph, an image analysis tool that quantifies epithelial organization. Our method combines computational geometry and graph theory to measure the degree of order of any packed tissue. EpiGraph goes beyond the traditional polygon distribution analysis, capturing other organizational traits that improve the characterization of epithelia. EpiGraph can objectively compare the rearrangements of epithelial cells during development and homeostasis to quantify how the global ensemble is affected. Importantly, it has been implemented in the open-access platform Fiji. This makes EpiGraph very user friendly, with no programming skills required.

Availability and implementation

EpiGraph is available at https://imagej.net/EpiGraph and the code is accessible (https://github.com/ComplexOrganizationOfLivingMatter/Epigraph) under GPLv3 license.

Supplementary information

Supplementary data are available at Bioinformatics online.
CroP—Coordinated Panel visualization for biological networks analysis
Authors: Cruz António , Machado Penousal , Arrais Joel P
Published: August 2019

CroP is a data visualization application that focuses on the analysis of relational data that changes over time. While it was specifically designed for addressing the preeminent need to interpret large scale time series from gene expression studies, CroP is prepared to analyze datasets from multiple contexts. Multiple datasets can be uploaded simultaneously and viewed through dynamic visualization models, which are contained within flexible panels that allow users to adapt the workspace to their data. Through clustering and the time curve visualization it is possible to quickly identify groups of data points with similar proprieties or behaviors, as well as temporal patterns across all points, such as periodic waves of expression. Additionally, it integrates a public biomedical database for gene annotation. CroP will be of major interest to biologists who seek to extract relations from complex sets of data.

Availability and implementation

CroP is freely available for download as an executable jar at https://cdv.dei.uc.pt/crop/.
Illuminating Child Mortality: Discovering Why Children Die
Authors: Raghunathan Pratima L , Madhi Shabir A , Breiman Robert F
Published: August 2019

Current understanding of the causes of under-5 childhood deaths in low- and middle-income countries relies heavily on country-level vital registration data and verbal autopsies. Reliable data on specific causes of deaths are crucial to target interventions more effectively and achieve rapid reductions in under-5 mortality. The Child Health and Mortality Prevention Surveillance (CHAMPS) network aims to systematically describe causes of child death and stillbirth in low- and middle-income countries using minimally invasive tissue sampling. The articles in this supplement introduce the set of foundational epidemiologic, demographic surveillance, social behavioral science, and laboratory methods. Undergirding the CHAMPS surveillance system designed to determine causes of child mortality.
Association of Prophylactic Anti–Hepatitis B Virus Therapy With Improved Long-term Survival in Patients With Hepatocellular Carcinoma Undergoing Transarterial Therapy
Authors: Jang Jeong Won , Yoo Sun Hong , Nam Hee Chul , Jang Bo Hyun , Sung, Sung Pil Soo , Lee Won , Kwon Jung Hyun , Nam Soon Woo , Bae Si Hyun , Yoon Seung Kew , Choi Jong Young
Published: August 2019

Background

The effect of prophylactic antiviral therapy (AVT) on survival of patients with hepatitis B virus (HBV)–related hepatocellular carcinoma (HCC) remains unknown. This study aimed to determine whether prophylactic AVT could improve long-term survival in patients undergoing transarterial chemotherapy (TAC).

Methods

Between 2002 and 2016, 2860 newly diagnosed HBV-related patients with HCC treated with TAC were screened to analyze 2 groups based on prophylactic use of antivirals. Treatment effects were analyzed using propensity score (PS) matching (1:1) separately for the entire cohort and each subgroup. The primary endpoint was overall survival.

Results

A total of 1547 patients met the inclusion criteria and 1084 were PS matched for the 2 groups. Median follow-up duration was 16.55 months. In the entire unmatched cohort, patients receiving prophylactic AVT survived significantly longer than those who did not. Among AVT-untreated patients, baseline high viremia and HBV reactivation during treatment were significantly associated with shorter survival. Regarding types of antivirals, survival was significantly longer for patients receiving high-potency antivirals than those receiving low-potency antivirals. Survival differed with antiviral response. In the PS-matched cohort, the prophylactic AVT group survived significantly longer than the nonprophylactic group, irrespective of viral status or tumor stage. Prophylactic AVT remained an independent factor for survival. The association of prophylactic AVT with decreased risk of mortality persisted in patient subgroups after adjusting for baseline risk factors. Sensitivity analyses also confirmed estimated treatment effects.

Conclusions

Prophylactic AVT is associated with significantly improved long-term survival among patients undergoing TAC. High-potency antivirals are indicated for this approach.

Hepatitis B virus–associated morbidity is a well-known complication during transarterial chemotherapy (TAC). Our large-scale study demonstrated that prophylactic therapy with high-potency antivirals provides a significantly better survival in TAC-treated patients, irrespective of baseline viremia status or tumor stage.
Death with an implantable cardioverter-defibrillator: a MADIT-II substudy
Authors: Chernomordik Fernando , Jons Christian , Klein Helmut U , Kutyifa Valentina , Nof Eyal , Zareba Wojciech , Daubert James P , Greenberg Henry , Glikson Michael , Goldenberg Ilan , Beinart Roy
Published: August 2019

Aims

There are limited data regarding factors that identify implantable cardioverter-defibrillator (ICD) patients who will experience either ventricular tachyarrhythmic (VTA) or non-arrhythmic (NA) mortality, and the commonly used clinical classification of sudden cardiac death (SCD) vs. non-sudden cardiac death (NSCD) may not be accurate enough. We aimed to correlate clinical adjudication of mortality events to device interrogation data and to identify risk factors for VTA mortality in Multicenter Automatic Defibrillator Implantation Trial II (MADIT-II).

Methods and results

Of the 746 patients who received an ICD in MADIT-II, 44 died from cardiac causes and had available interrogation data at the time of death. Sudden cardiac death vs. NSCD was defined by an adjudication committee. Ventricular tachyarrhythmic and NA arrhythmic deaths were categorized by the presence or absence of ventricular tachycardia or fibrillation (VT/VF) during the terminal event. Mode of death was found to be inaccurate when validated by device interrogation for VTA events: 50% patients adjudicated as SCD did not have a VTA event at the time of death; and 25% of adjudicated NSCD were found to have VT/VF during the mortality event. Multivariate analysis showed that factors independently associated with VTA mortality included: VT/VF >72 h prior to the mortality event [hazard ratio (HR) 8.0; P < 0.001], hospitalization for heart failure (HR 6.7; P = 0.001), and a history of hypertension (HR 4; P = 0.04).

Conclusion

Current classification of SCD vs. NSCD fails to identify VTA events at the time of death in a significant proportion of patients, and simple clinical parameters can be used to identify ICD recipients with increased risk for VTA mortality.
Parental perceptions, attitudes and knowledge on European preschool children’s total screen time: the ToyBox-study
Authors: Miguel-Berges María L , Santaliestra-Pasias Alba M , Mouratidou Theodora , Flores-Barrantes Paloma , Androutsos Odysseas , Craemer Marieke De , Galcheva Sonya , Koletzko Berthold , Kulaga Zbigniew , Manios Yannis , Moreno Luis A
Published: August 2019

Background

Preschool children spend a significant proportion of their waking hours being sedentary. Parents play a critical role in developing and shaping their children’s lifestyle behaviours, particularly in the early years of life. This study aims to assess parental perceptions, attitudes and knowledge of their preschool children’s sedentary behaviours and the association with children’s television (TV)/video/DVDs viewing and total screen time.

Methods

Data were obtained from a sample of 4836 children (3.5–5.5 years), participating in the multi-centre ToyBox-study at baseline (T0) and at 1-year follow-up (T1) periods. Data on children’s sedentary behaviours were collected via a standardized proxy-administered primary caregiver’s questionnaire.

Results

Regarding total screen time, 66.6% of the children at T0 and 71.8% at T1 in the control group exceeded the recommendations, whereas the proportion in the intervention group varied from 69.7% at T0 to 72.5% at T1. The odds of exceeding total screen time recommendations were significantly higher when parental perceptions towards limiting the total screen time were negative [(both T0 and T1 and in the intervention and control groups (P < 0.05)]. Similarly, the odds of exceeding TV/video/DVDs viewing recommendations were significantly higher (both T0 and T1 is observed in both groups) when parental knowledge of recommendation were absent.

Conclusions

Preschool children whose caregivers stated rules limiting their sedentary screen time were less likely to spend a high amount of time watching TV/video/DVDs. Interventions to increase parental practices may be a promising approach to decrease total screen time of preschool children but studies are needed to confirm this.