bluuebunny/crossref_metadata_2025 huggingface dataset:
B-72 The Relationship between Anxiety and Postconcussive Symptomology in patients with Mild Traumatic Brain Injury
Authors: Cornett K
Published: August 2019

Objective

Research literature has demonstrated the role that pre-morbid anxiety has in prolonging recovery from mild traumatic brain injury (mTBI). The aim of this investigation is to clarify the degree of the relationship between anxiety and postconcussive symptomology in patients with mTBI.

Method

This study compared scores from a patient-report measure of anxiety, the General Anxiety Disorder-7 (GAD-7), to scores from a patient-report measure of postconcussion symptom severity, the Neurobehavioral Symptom Inventory (NSI). Participants were recruited from September 2018 to December 2019 who had been referred for clinical evaluation to Rehabilitation Institute of Washington’s Brain Injury Services (a privately-run, interdisciplinary, outpatient clinic). 39 adult participants (30 males and nine females) completed both the GAD-7 and NSI. No control group was used. Injury severity level was ascertained via review of the medical records. Patients underwent an abbreviated evaluation with a clinical neuropsychologist. As a part of this initial evaluation, patients completed an intake packet, which included the NSI and GAD-7.

Results

The relationship between the ordinal variables (i.e., anxiety and postconscussive symptomology) was assessed using spearman’s rho. Anxiety had a strong, statistically significant relationship with postconcussive symptomology (rho = 0.670, p = 0.000).

Conclusions

Anxiety and postconcussive symptomology severity are associated in this population of patients with mTBI. Limitations of this current investigation include a small sample size and no control group. This study indicates the need for controlled studies in future research to address the above-encountered limitations. Nevertheless, this study lends support to the prevalence of anxiety in those with elevated postconcussive symptomology and the need to monitor this in assessment and treatment.
B-77 Buddha's Brain: A Systematic Review of Mindfulness-Based Interventions in the Rehabilitation Context
Authors: Smart C , Ali J , Silveira K , Viczko J
Published: August 2019

Objective

The current study was intended to provide a rigorous systematic review of the evidence to date regarding the efficacy of mindfulness-based interventions (MBIs) in persons with neurologic illness/injury, a form of treatment that may be particularly well suited to the rehabilitation context due to its holistic approach.

Data Selection

The search was conducted in accordance with the PRISMA guidelines for systematic reviews. We included any controlled trials of MBIs conducted in a neurological population, employing the specific practice of mindfulness meditation. A search protocol was created and executed by three of the authors to promote reliability and obtain the initial list of abstracts (n = 35). Two authors independently reviewed and extracted data from the final 30 full-text articles.

Data Synthesis

A majority (83%) of studies used randomized designs, with the most frequent diagnoses of interest being aging/ neurodegenerative diseases (n = 10), followed by MS (n = 6), TBI (n = 5), and ADHD (n = 5). Most trials that assessed psychological variables found significant benefits (n = 24), including variables such as fatigue, self-reported cognitive function, and specific neurological symptoms. Comparatively fewer studies looked at cognitive and/or neural outcomes (n = 18) such as attention or processing speed, although most did tend to find significant benefits in these outcomes as well.

Conclusions

Results of this review indicate promising evidence for the application of MBIs in the rehabilitation context. Further work is needed to determine whether targeting MBIs to certain symptom clusters as opposed to diagnoses would enhance observed clinical benefit.
C-03 The sensitivity and specificity of the Montreal Cognitive Assessment is Age Dependent for Amyloid Positivity in a Mixed Clinical Sample
Authors: Hawley N , Bennett L , Ritter A
Published: August 2019

Objective

The Montreal Cognitive Assessment (MoCA) is a widely-used screening tool for neurodegenerative disorders. Despite widespread use, there have been few investigations into correlations between MoCA and biomarkers of Alzheimer's disease pathology. This study examined the relationship between MoCA performance and the presence of amyloid as detected by positron emission tomography (PET).

Methods

Sensitivity and specificity for the total MoCA score were determined for 76 individuals (26 amyloid-negative, 50 amyloid- positive) who were between the ages of 55 and 90 and diagnosed with MCI or mild dementia with a CDR score of 0-1 and were participating in a longitudinal, observational study at the Cleveland Clinic Lou Ruvo Center for Brain Health. All individuals underwent an amyloid PET scan and cognitive screening.

Results

Sensitivity and specificity for the total score were determined using amyloid positivity as the standard. A cutpoint of 25 yielded the best balance between sensitivity and specificity (74% and 74%, respectively). A total score of 27 was required to achieve 90% sensitivity to identify amyloid positive individuals (i.e. only a 10% risk that individuals with a score of 28-30 have a positive scan). A score of 26 was required in individuals over the age of 75.

Conclusions

With the emergence of new diagnostic biomarkers, there is need to define the utility of affordable, widely-available screening tools. In this mixed clinical sample, the MoCA score showed good sensitivity for detecting amyloid pathology but with low specificity. Thus a total MoCA score of 28 is needed to confidently rule out risk for AD pathology.
A-17 Category Test performance in individuals with alcohol versus methamphetamine dependence
Authors: Walker A , Hauson A , Sarkissians S , Pollard A , Flora-Tostado C , Stelmach N , Holt A , Wollman S , Hall M
Published: August 2019

Objective

The Category Test (CT) has consistently been found to be sensitive at detecting the effects of alcohol on the brain. However, this test has not been as widely used in examining the effects of methamphetamine. The current meta-analysis compared effect sizes of studies that have examined performance on the CT in alcohol versus methamphetamine dependent participants.

Data selection

Three researchers independently searched nine databases (e.g., PsycINFO, Pubmed, ProceedingsFirst), extracted required data, and calculated effect sizes. Inclusion criteria identified studies that had (a) compared alcohol or methamphetamine dependent groups to healthy controls and (b) matched groups on either age, education, or IQ (at least 2 out of 3). Studies were excluded if participants were reported to have Axis I diagnoses (other than alcohol or methamphetamine dependence) or comorbidities known to impact neuropsychological functioning. Sixteen articles were coded and analyzed for the current study.

Data synthesis

Alcohol studies showed a large effect size (g = 0.745, p < 0.001) while methamphetamine studies evidenced a moderate effect size (g = 0.406, p = 0.001); both without statistically significant heterogeneity (I2 = 0). Subgroup analysis revealed a statistically significant difference between the effect sizes from alcohol versus methamphetamine studies (Q-between = 5.647, p = 0.017).

Conclusions

The CT is sensitive to the effects of both alcohol and methamphetamine and should be considered when examining dependent patients who might exhibit problem solving, concept formation, and set loss difficulties in everyday living.
C-08 Hippocampal Volume in a Cognitively Healthy Population Scoring Within Normal Limits on Cognitive Tasks
Authors: Staley Shumaker B , Amano S , Nolty A , Harrington M
Published: August 2019

Objective

Our aim was to investigate hippocampal volume in a cognitively healthy aging population that scored within normal limits on neuropsychological testing. Decreased hippocampal volume was expected to predict decreased memory performance, and not expected to predict executive function.

Method

A cross-sectional design was conducted from archival data at Huntington Medical Research Institutes. The sample consisted of 35 older adults (63-89 years) with college degrees or higher. Hippocampal volume and intracranial volume were obtained via MRI, and neuropsychological assessment measures included Wechsler Memory Scale, 3rd edition (WMS-III), California Verbal Learning Test, 2nd edition (CVLT-II), and the Stroop Color and Word Test.

Results

Total hippocampal volume was a good predictor of Logical Memory delayed (LM-II) scores (Figure 1), such that a larger hippocampus was associated with poorer LM-II performance (p < .01). Consistent with the above, both left hemisphere (LH) (p = .03), and right hemisphere (RH) hippocampal volume (p < .01), were found to be good predictors of LM-II scores, and a larger RH or LH hippocampus was associated with poorer performance. Neither CVLT-II nor Stroop C Interference sores were significantly related to total hippocampal volume.

Conclusion(s)

Unexpectedly, participants with a larger hippocampus performed more poorly on the LM-II task. These results might be explained by the effects of neuroinflammation in early Alzheimer’s disease pathology. However, given that the MRI volumes did not account for atrophy or damaged cortical tissue, inference is limited. Future research investigating the early pathology of brain aging in the hippocampus in cognitively healthy individuals is recommended.
A-18 Executive Dysfunction is Associated with Suicidal Ideation in Iraq/Afghanistan-era Combat-exposed Veterans
Authors: Crocker L , Keller A , Jurick S , Merritt V , Hoffman S , Jak A
Published: August 2019

Objective

Suicidal ideation (SI) is highly prevalent in Veterans and reducing Veteran suicide is a national priority. The present study examined factors associated with SI in combat-exposed Veterans in order to inform suicide prevention efforts.

Method

Combat-exposed Iraq/Afghanistan-era Veterans (N = 77) completed questionnaires detailing demographic characteristics and combat-related experiences, as well as structured interviews assessing history of mild traumatic brain injury (mTBI), current posttraumatic stress disorder (PTSD), and suicidality in the past month. Veterans also underwent a comprehensive neuropsychological assessment. Analyses examined differences between endorsers versus non-endorsers of current SI, as well as predictors of SI, with a focus on cognitive variables.

Results

There were no SI group differences in demographic variables, levels of combat exposure, or rates of PTSD, or mTBI history. However, independent samples t-tests indicated that those who endorsed SI demonstrated worse executive functioning relative to those who denied SI (t(75) = 2.74, p = .008), whereas no group differences were observed on measures of attention/processing speed or memory. A logistic regression analysis predicting SI indicated that executive functioning remained a significant predictor of SI (B = .94, OR = 2.55, p = .047) even when adjusting for age, years of education, level of combat exposure, history of mTBI, and PTSD diagnosis.

Conclusions

Executive dysfunction may make it difficult for Veterans to inhibit maladaptive negative thoughts (particularly suicidal thoughts), regulate emotions, and problem solve in stressful situations, thus contributing to suicidality. Interventions addressing executive dysfunction in combat-exposed Veterans with SI may be a promising adjunct to current suicide prevention efforts.
C-23 Impact of Social Support on Cognitive Vascular Risk Factors in Latino Older Adults
Authors: Conde K , Alioto A , Cahn-Weiner D , Salazar-Villanea M , Moncada-Jimenez J , Johnson D
Published: August 2019

Objective

Central Americans have a cardiovascular disease (CVD) health advantage, as they are half as likely to carry CVD as European Americans, despite having an equivalent degree of vascular risk factors (VRFs). We examined the impact of social support on this paradox and the relationship to cognitive decrements among Costa Rican older adults.

Methods

We identified predictors of the CVD health advantage (VRFs in the absence of CVD: Heart Attack, MI, Stroke). Hypertension (HTN) and CVD were coded as present or absent based on medical history. Of 315 participants, 146 (46%) had HTN but no CVD, 59 (19%) had CVD, and 110 had neither HTN nor CVD. To estimate ROC curves, we applied canonical discriminant analysis to item groups based on the discipline cluster. The discriminant analysis identified items that maximally differentiated the diagnostic groups in a step-wise fashion.

Results

Social support and social engagement were stronger predictors of the health advantage than subjective memory complaints. Social Support was a reliable indicator of CVD health advantage (accuracy = 93%, sensitivity = 93%, specificity = 89%). Social Engagement was a reliable discriminator of diagnostic groups (accuracy = 84%, sensitivity = 88%, specificity =75%) versus subjective memory complaints (accuracy = 79%, sensitivity of 82%, specificity of 74%).

Conclusion

Our exploratory analyses suggest that social support is an important predictor of living with VRFs but not developing CVD. Current studies are underway to examine the contribution of these risk factors to the development of dementia and cognitive impairment to maximize cost-effective interventions.
C-24 Longitudinal Trajectories of Working Memory Performance in Typically Aging Older Adults
Authors: Gonzalez Catalan M , Lindbergh C , Staffaroni A , Walters S , Casaletto K , Walker N , Kramer J
Published: August 2019

Objective

Cross-sectional studies have shown age-related differences in working memory (WM), but the trajectory is unclear due to the scarcity of longitudinal studies. Additional research is needed to better characterize the course of age-related changes in WM in older adults. The present study sought to address this gap in the literature by conducting serial assessments of WM in a longitudinally followed cohort of typically aging adults. We hypothesized a significant age × time interaction, such that WM would show pronounced declines with advancing age.

Methods

640 functionally intact participants in an aging cohort (clinical dementia rating = 0; age range 52-99, mean age = 75) completed a computerized WM measure, Running Letter Memory (RLM), every ~15 months for up to 8.5 years (mean follow-up = 1.9 years). Longitudinal changes in RLM scores were analyzed using linear mixed effects models, allowing for random slopes and intercepts. All models were adjusted for sex and education.

Results

RLM performance did not significantly decline over time (b = -.14, p = .43). As hypothesized, there was a significant age × time interaction predicting RLM scores (b = -.08, p = .006). Specifically, RLM performance remained relatively stable (or slightly improved) until around age 75, beyond which increasingly precipitous declines were observed with advancing age.

Conclusion

The present results suggest that WM performance does not evidence declines until the mid-70s in typically aging adults, at which point increasingly steep decline trajectories are observed with advancing age. These findings highlight that cognitive aging does not occur at a constant rate in late life.
C-29 Sleep and Cognition Among Older Adults: Objective Performance versus Subjective Complaint
Authors: Reohr P , Dorenkamp M , Vik P , Irrgang M
Published: August 2019

Objective

Although poor sleep has been hypothesized to contribute to cognitive difficulties, a review by Scullin & Bliwise (2015) suggested that poor sleep has little impact on older adults’ cognition. Nevertheless, older adults express subjective concerns about both their sleep and cognition. The purpose of this study was to test associations between self-reported sleep, cognitive performance, and subjective cognitive concerns.

Method

Twenty-three women and 18 men, aged 55 to 83 (M = 68), completed a 3-hour test battery that included global, memory, executive, and verbal measures. Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). Subjective cognitive complaints were measured using the Frontal Systems Behavior Scale (FrSBe), which provided a total and three subscale scores (Apathy, Disinhibition, Executive Dysfunction).

Results

PSQI scores were consistent with means of older non-diagnosed older adults (Bush et al., 2012; M = 6.34, SD = 3.70). Cognitive test scores did not correlate with PSQI scores or FrSBe scores; however, Total PSQI correlated with Total FrSBe (r = .397; CI = .099 to .741) and two of the three FrSBe subscales: Apathy (r = .472; CI = .190 to .683) and Executive Dysfunction (r = .395; CI = .097 to .629), but not Disinhibition (r = .231; CI = -.086 to .505).

Conclusions

As previously found, cognitive test scores were unrelated to sleep measures; however, associations were found between poor sleep and subjective cognitive concerns, particularly avolition and executive dysfunction. Findings may indicate distress characteristic among older adults that involves sleep disturbance and cognitive worry.
C-41 Functional Impairments in Girls with Attention-Deficit Hyperactivity Disorder
Authors: Quimby H , Nissley-Tsiopinis J , Lazar M , Rourke M , Zarabba J
Published: August 2019

Objective

ADHD is a neurodevelopmental disorder known to cause functional impairments. Few studies have identified impairments specific to girls with ADHD. The objective of this study was to explore the relationship between ADHD subtypes and measures of functional impairment in girls.

Method

Participants were chosen from a sample of girls ages 5 – 18 years old, diagnosed with ADHD at an outpatient ADHD clinic at a large children’s hospital (N = 303). Measures included parent and teacher BASC subscales of adaptability, homework problems, and comorbid clinical diagnoses based on the diagnostic interview for children and adolescents-revised parent version (DICA-R). Potential relationships between impairment measures and ADHD subtypes were assessed using multiple and logistic regressions to control for age and socioeconomic status (SES).

Results

Number of inattentive ADHD symptoms correlates positively with DICA diagnosis of ODD (x2 = 4.008, p = 0.045) and homework problems (r = 0.227, p = 0.0001). Number of combined ADHD symptoms is positively associated with DICA diagnosis of ODD (x2 = 26.812, p = 0.0001) and homework problems (r = 0.171, p = 0.0001) and negatively associated with parent reported social skills (r = 0.092, p = 0.006), adaptability (r = 0.146, p = 0.001) and teacher reported adaptability (r = 0.057, p = 0.01), after controlling for age and SES.

Discussion

Girls with ADHD exhibit functional impairments in the domains of comorbid diagnoses, homework problems, parent and teacher report of adaptability, and parent report of social skills. Additional research should include self-reports of functional impairment to determine self-perception of impairment.
C-42 Is “Clinical Impairment” Normative in College Populations? Identifying Base Rates of Self-Reported Impairment in a Non-Treatment Seeking Population
Authors: Johnson E , Suhr J
Published: August 2019

Objective

Individuals presenting with concerns of Attention Deficit Hyperactivity Disorder (ADHD) report impairment and may seek academic or disability accommodations related to perceived impairment. Problematically, the legal definition of impairment remains poorly understood by clinicians, and there is little consensus regarding credibility of self-reported impairment. Furthermore, many impairments reported by individuals seeking evaluation for ADHD appear to be general and non-specific, but base rates of reports of these impairments in non-treatment seeking populations remain unclear. We examined base rates of impairment associated with ADHD in a sample of non-treatment seeking college students.

Method

Participants were undergraduate students who completed online surveys (N = 175). Participants who failed measures of validity, reported a past diagnosis of ADHD, or endorsed clinically significant symptoms of ADHD were excluded from analyses (final N = 89). Participants largely identified as white (88.8%) and female (85.4). Participants completed measures of impairment (Barkley Functional Impairment Scale) and ADHD symptoms (Conners’ Adult Attention Rating Scale). Base rates of clinically significant impairment among this sample were analyzed.

Results

Clinically significant levels of impairment were reported at high levels within the following categories; at home (15.1%), interacting with strangers (13.5%) and friends (20.2%), performing daily self-care (7.9%), and managing health (12.4%).

Conclusions

Base rates of clinically significant self-reported impairment are high among a non-clinical, non-treatment seeking sample of college students without ADHD symptoms. Results raise questions about the validity of self-reported impairment in diagnostic decision making, suggesting that experiences of difficulty in these areas may be normative among college populations and not specific to ADHD.
C-44 Exploring the Criterion Validity of the WISC-IV in a Clinically Referred Sample of Children in Mexico
Authors: Giudicessi A , Ibarra C , Visconti V , Zenit A , Pelayo H
Published: August 2019

Objective

The Weschler Scale of Intelligence (WISC-IV) is one of the most commonly used measures in the neuropsychological evaluation of children. Little published research utilizes the WISC-IV in diverse populations outside the US. The objective of this study was to examine the criterion validity of the WISC-IV’s subtests and index scores in a clinically referred sample in Mexico.

Methods

The present study included 86 participants, 35 clinical patients referred for neuropsychological evaluation for persistent learning difficulties at a public clinic and 51 healthy control children enrolled in public school with a GPA of 3.0-4.0 in Puebla, Mexico. Participants were between the ages of 7-12. None of the children in our clinical group had a formal diagnosis of any learning or behavior disorder, this was the first experience seeking neuropsychological evaluation. The WISC-IV was administered to all participants as part of the evaluation process. Informed consent was obtained prior to evaluation.

Results

Independent sample T-Tests show no significant differences in Full-Scale IQ average (FSIQ) between the clinical sample (M = 75.40, SD = 11.81) and control group (M = 79.73, SD = 10.36). Descriptive statistics for indices and subtests can be found in Table 1.

Conclusions

Our results demonstrate low average IQ for both groups, indicating further research is needed in understanding the criterion validity of the WISC-IV when applied to clinical populations in Mexico. Furthermore, because we were unable to explain below average scores in the control group by any confounding variable, future studies comparing the Mexican standardization of the WISC-IV with our data before utilizing as clinical evaluation tool is recommended.
C-51 Long Term Neuropsychological Follow-Up of Radiation Induced Cognitive Decline (RICD) in Cerebellar Medulloblastoma
Authors: Giles A , Moore DeBruhl C , Liberatore G , Strowd R , Lesser G , Tatter S , Laxton A , Feldman J , Sam M , Chan M , Cramer C , Cummings T
Published: August 2019

Objective

We expanded upon an early case study suggesting long-term, sequential neurocognitive evaluation and academic interventions following pediatric cerebellar medulloblastoma. This five-year-old patient (now forty) has indeed undergone lifespan assessment and clearly benefitted from appropriate interventions to date.

Method

This left-handed, white, male is status post (s/p) gross total resection and whole brain radiation. In adulthood, he developed radiation necrosis with hemorrhage and refractory seizures (s/p right temporal lobectomy). More recently, radiation induced bilateral parietal meningiomas were identified (s/p gamma knife).

Results

We analyzed cognitive, medical/oncological, imaging and interventional data at developmentally meaningful time points and found consistent declines in intellectual skills and cognitive function spanning attention/concentration, processing speed, visual perceptual/organization and visually based learning/memory; however, we noted stabilization and even improvement in important areas. Areas of age-appropriate functioning were noted in expressive vocabulary, verbal abstract reasoning, delayed verbal memory, and problem-solving, among others.

Conclusions

Although some studies have addressed long-term outcomes in pediatric medulloblastoma, we provide a unique perspective to the literature by documenting serial neurocognitive findings in addition to interventions across the lifespan. Our findings suggest that appropriate academic interventions/neurocognitive rehabilitation strategies are in fact meaningful at the individual level and propose that a focus on strengths can improve outcomes. We propose that this previously recommended model of assessment/intervention truly become the available standard of care in all pediatric oncologic populations.
C-52 Neuropsychological Sequelae of Hypernatraemic Dehydration in Neonates – Working Towards the NHS England Five Year Forward View
Authors: Starza-Smith A , Beveridge A , Talbot E
Published: August 2019

Objective

Neonatal breastfeeding is reported to have advantages for both physical and psychological well-being, including decreased incidence of infections, improved neurodevelopmental outcomes and a variety of lifelong health benefits. In some cases inadequate breastfeeding can lead to malnutrition and hypernatraemic dehydration. While the impact on physical health from hypernatraemic dehydration is well reported, the longer neurocognitive and quality of life (QoL) outcomes are rarely documented.

Method

We present neurocognitive profiles of two paediatric cases of hypernatraemic dehydration where significant brain damage had occurred. Neuropsychological assessments (Wechsler Intelligence Scale for Children, Children’s Memory Scale, Rey-Osterrieth Complex Figure Test, Delis-Kaplan Executive Function System and Wechsler Non-Verbal Scale of Ability, Strengths & Difficulties Questionnaire) were administered within detailed clinical interview.

Results

Both children displayed cognitive performance within broad average level but with specific problems identified in working memory and processing speed, as well as immaturity and marked dysexecutive problems reported at home and school. These profiles are consistent with scan findings of injuries to the brain, including the frontal lobe.

Conclusions

We discuss the potential role for Pediatric Neuropsychologists in line with the NHS 5-year plan, in educating professionals involved in the care of pregnant women and their young babies regarding the impact of breastfeeding malnutrition and hypernatraemic dehydration on cognitive development and QoL. Education modules would aim to highlight implications of the potential devastating neuropsychological effects where malnutrition and hypernatraemic dehydration is severe, with the aim of increasing awareness of consequences and reducing the incidence of breastfeeding malnutrition and hypernatraemic dehydration and its potential lifelong neuropsychological effects.
C-59 Sex Differences as Predictors for Executive and Intellectual Functioning in Juvenile Huntington’s Disease Patients
Authors: Zwicker A , Cederberg C , Espe-Pfeifer P , Nopoulos P
Published: August 2019

Objective

Juvenile Huntington's Disease (JHD) is an extremely rare autosomal dominant neurodegenerative disease with onset in childhood or teenage years. Although there are many similarities with the adult form of the disease, JHD has a clinically distinct presentation. Some common symptoms include behavioral problems and cognitive decline. However, given the rarity of juvenile presentations, limited research exists regarding sex difference performances on executive and intellectual functioning in a JHD population. Thus, exploratory research was conducted to investigate such findings.

Method

Data from the Kids HD research study was analyzed (N = 58; mean age = 15.5, 50.8% female). Preliminary bivariate partial correlations, independent t-tests, and one way ANOVA tests were used to examine differences in executive and intellectual functioning between male and female participants.

Results

Performance significantly differed on several aspects of executive and intellectual functioning between sexes, including shifting attention (p = 0.007), verbal intellect (p = 0.019), and general ability intellect (p = 0.041). Significant differences were also observed regarding inhibition (p = 0.003), verbal categorical fluency (p = 0.021), and sorting (p = < 0.001).

Conclusions

Results suggest that there are significant differences in executive and intellectual functioning between sexes. In particular, males had more difficulty shifting attention, despite higher verbal intellect and higher general ability intellect. Females demonstrated greater inhibition, while males demonstrated stronger verbal categorical fluency and abstract reasoning. Between sexes, results indicate evidence of performance differences across tasks of executive and intellectual functioning. Such findings are consistent with a subcortical neurodegenerative process, such as HD.
C-62 The Physiological Effects of Infant Massage Techniques in a 17-month-old Patient with Bohring-Opitz Syndrome
Authors: Herd B , Chiang J , Patterson M , Regueiro V
Published: August 2019

Objective

Bohring-Opitz syndrome (BOS) is a rare congenital disorder with approximately 60 documented cases worldwide. Distinguishing characteristics include a complex phenotype with associated feeding intolerance, emesis, sleep difficulties, respiratory complications, seizures, and failure to thrive. Infant massage is a supportive intervention with documented positive effects in medically-fragile infants, suggesting its potential as a non-pharmacological treatment in BOS. Limited data exists regarding the clinical management of patients with BOS. To initiate this effort, we report the effects of infant massage on a male with BOS.

Method

Born at 32 weeks gestation, the patient presented with chronic respiratory failure, tracheostomy, and ventilator dependence. Development was complicated by chronic infections, autonomic instability, feeding intolerance, seizures, and prolonged sedation wean. Clinicians provided infant massage (~15 minutes/week) to the patient’s hands and feet from the ages of 12-20 months, with the goal of decreasing heart rate. Heart rate was measured after each massage session over a 3-month period (14 sessions total) during hospitalization.

Results

Decreased heart rate was recorded following all massage sessions, with an average decline of 10.4 beats per minute. Decreased non-purposeful body movements, increased tactile orientation, increased feeding tolerance, and timely discharge from the hospital were also noted.

Conclusion

This case study offers initial support for the use of infant massage for hospitalized patients with BOS. Infant massage was associated with lowered heart rate and improved hospitalization course. While the researchers propose integration of infant massage within the clinical management of patients with BOS, further research is warranted to elucidate its implications for improved health outcomes.
C-66 Limited Access to Pediatric Neuropsychological Evaluations for Non-English Speakers
Authors: Bridges R , Smedley D , Hall M , Powell J
Published: August 2019

Objective

The aim of this empirical study was to examine the accessibility of pediatric neuropsychological evaluations in the state of Arizona for non-English speaking children. To date, there is very limited research that analyzes the accessibility of neuropsychological evaluations. Diversity variables, such as primary language, can negatively impact assessment scores (Norbury & Sparks, 2013), leaving diverse individuals at risk of misdiagnosis when an assessment is not conducted in one’s primary language, nor normed on similar individuals (Mindt et al., 2008). The Center for Immigration Studies (2017) found 28% of school-age children in Arizona speak a foreign language, warranting a need for culturally-appropriate evaluations.

Method

Arizona pediatric neuropsychologists in non-hospital settings were identified via electronic resources: AzNS, AAPdN, AzPA, CSN, and AACN provider lists; LinkedIn; Google search. Participants met criteria for inclusion if “pediatric neuropsychological” evaluations were provided by a neuropsychologist on staff. “Pediatrics” is defined as 0-17. Neuropsychologists were contacted directly via phone for survey participation; verbal informed consent was obtained.

Results

Seventeen pediatric neuropsychologists were found in the state of Arizona, and 52.9% consented to participate in the survey (n = 9). All participants (100%, n = 9) stated they provide evaluations in English only, and refer-out for non-English evaluations.

Conclusions

There is a severe disparity in the access to care with respect to availability of culturally-appropriate evaluations in Arizona: a state with a large population of non-English speakers. The current study adds to the limited literature in this area, and sets the stage for continued professional advocacy efforts. Goals for future national research is critically discussed.
A-23 Mental Illness and Emotional Functioning as Moderated by Executive Functioning: Incarcerated Population
Authors: Spies-Upton S , Gade S , Gonzalez J , Choi E , Becker C , Creekpaum M , Lucas E , Escher C , Gomez R
Published: August 2019

Objective

The purpose of this study is to investigate whether executive functioning will moderate the relationship of a history of mental illness on aggression in a male forensic population.

Method

Using an archival database from a larger study, 232 male inmates (ages 21 and 49 years old) from three medium/maximum Maryland Correctional facilities were recruited using a pseudo-random selection process during intake. Participants were administered three EF tasks (Cambridge Decision Making Task, Logan Stop-Signal Task, and Stroop Interference Task), history of mental illness was obtained using the Symptom Checklist-90, and aggression was assessed with the Novaco Reaction to Provocation Questionnaire.

Results

Hierarchical multiple regressions were conducted. For overall aggression reactivity, inhibition moderated depression (IR2 = .025, F(3, 224) = 9.977, p < .001, β = -.246, p = .015) and psychoticism (IR2 = .019, F(3, 224) = 8.216, p < .001, β = -.136, p = .031). For reactive aggression subtype, inhibition moderated depression (IR2 = .025, F(3, 224) = 2.679, p = .048, β = .071, p = .017). For proactive aggression subtype, cognitive flexibility moderated anxiety (IR2 = .018, F(3, 224) = 4.731, p = .003, β = -.014, p = .039); and depression (IR2 = .022, F(3, 224) = 3.888, p = .010, β = -.017, p = .025).

Conclusions

Overall, there was mixed findings for inhibition. On Cambridge Decision Making task, inhibition moderated the predictive relationship of depression on reactive aggression and psychoticism and overall aggression but not for other measures of inhibition. For another inhibition task (Stroop), inhibition did not significantly moderate any mental illness on severity of aggression. Cognitive flexibility moderated the predictive relationships of anxiety and depression on proactive aggression. Findings suggest targeting cognitive flexibility for inmates diagnosed with anxiety depression, and psychosis when treating aggression in a male forensic population.
A-28 Stroop Performance in Bilingual Veterans
Authors: Fullen C , Marceaux J , Dozier M , Phillips J
Published: August 2019

Objective

The Stroop Color and Word Test is a well-known measure of executive functioning. The aim of this study is to determine if Stroop performance is impacted by bilingualism.

Method

A clinic-referred sample of veterans (n = 245; Mage = 55.84; Medu = 13.87) in whom a cognitive disorder diagnosis was ruled out were selected for inclusion. Participants self-identified as monolingual English (n = 192) or bilingual English/Spanish (n = 53) and were deemed appropriate for completing neuropsychological evaluation in English. All participants were administered the Stroop as part of a larger battery of tests. Analysis of covariance (ANCOVA) was used to examine Stroop scores across monolingual/bilingual groups, controlling for age.

Results

Stroop Word (raw) was significantly lower among bilingual participants (M = 79.13, SD = 18.24) compared to monolingual participants (M = 85.22, SD = 16.7), F = 4.48, p = .035. Although Color (F = 3.01, p = .084) and Color-Word Interference trials (F = 2.36, p = .125) were not significantly different across groups, there was a trend. When scores on the Color-Word Interference subtest were corrected using the Golden Equation, there were no significant group differences (F = .002, p = .966).

Conclusions

Bilingualism was related to reduced performance on speeded word-reading. Although there were no statistical differences on color-naming or inhibition, the sample size may have impacted statistical power. Despite this, there was no evidence of even a trend towards significance when applying the Golden Equation to correct for speed of word-reading and color-naming. Findings indicate Stroop is a valid measure of inhibitory control among bilingual individuals who are appropriate for completing testing in English, so long as adjustments are made to account for speed on the Word, Color, and Color-Word trials.
A-30 The Relationship Between Mood, Cognitive Shift, and Perseverative Responses in Cognitively Impaired Geriatric Patients
Authors: Osman C
Published: August 2019

Objective

The current study investigated the relationship between age, sex, vocabulary scores, the number of comorbid medical conditions, cognitive shift scores, perseveration scores, dementia severity, and self-reported anxiety. It was hypothesized a) cognitive shift scores, age, and vocabulary would be inversely related to anxiety b) perseveration scores and dementia severity would be positively correlated to mood.

Data Selection

Utilizing archival data from a private medical clinic, a sample (N = 114) of Euro-American older adults ages 65-89, presenting for neuropsychological evaluations was obtained. Data included scores from the Wisconsin Card Sorting Test -64 computerized version, the Beck Anxiety Inventory, the Geriatric Depression Scale- short form, and the WAIS-IV vocabulary subtest.

Data Synthesis

This study utilized a multiple regression analysis. The results suggested age, sex, cognitive shift scores, perseveration scores, and dementia severity had no relationship to anxiety. However, vocabulary was moderately positively correlated with anxiety. It is possible that those with greater vocabulary scores were less severely impacted by their dementia and consequently more aware of their symptoms.

Conclusions

Focus on neuropsychological data alone was insufficient to understand this complex and dynamic relationship. It is recommended that future research focus on the process itself to gain insight into this bidirectional relationship and various confounding factors, which might have influenced anxiety levels, such as sleep quality and dementia type. The results of this study highlight the importance of understanding the dynamic relationship between cognitive decline due to neurodegenerative diseases and anxiety and the impact the diseases may have on one’s emotional well-being.
A-32 Interpreting Change on the Neuropsychological Assessment Battery
Authors: Greene J , Messer M , White T
Published: August 2019

Objective

The Neuropsychological Assessment Battery (NAB) is a comprehensive, modular battery of neuropsychological tests assessing of a wide array of cognitive skills and functions in adults. The purpose of the current study is to provide additional statistical evidence to support interpretation of NAB score changes over time.

Method

Participants were healthy community-dwelling adults, ages 18 to 97 years, from the NAB standardization sample that was assessed on the NAB a second time (n = 95). Reliable change index scores were calculated for the five domain indexes and the total index at several levels of significance. Base rates of score differences between Time 1 and Time 2 were examined.

Results

Across the indexes, significant score differences (at p < .05) ranged from 17 to 28 standard score points for adults (ages 18 to 59 years) and from 13 to 23 standard score points for older adults (ages 60 to 97 years). Approximately 67-89% of adult participants had Time 1 and Time 2 scores within 1 standard deviation (SD) of each other, while older adults ranged from 73-97%. Only 0-4% of adults and older adults had a large decline on any score (greater than 2 SDs). 1-2% of adults and 3-5% of older adults had a large improvement on any score (greater than 2 SDs).

Conclusions

These data allow clinicians to determine the statistical significance of NAB score differences, as well as quantify the frequency of the observed differences.
A-35 Assessing the Impact of Expressive Language on Performance on Conners’ Continuous Performance Test 3rd Edition (CPT3) in Inpatients with Aphasia
Authors: Bare M , Cernokova I , Robbins J
Published: August 2019

Objective

The current study examined the impact of expressive language difficulties, assessed by the Neuropsychological Assessment Battery (NAB) naming subtest, on the Conners’ Continuous Performance Test-Third edition (CPT3) in an inpatient acquired brain injury (ABI) population.

Method

A sample of 19 individuals (female n = 3, male n = 16) was evaluated through an inpatient ABI rehabilitation program. Two groups based on diagnosed aphasia (n = 7) versus no aphasia (n = 12) were used. Ages ranged from 15 to 67 (M = 38.37, SD = 16.55) and had an average level of education of 14.9 years.

Results

One-way ANOVAs were used to determine how expressive language impacts performance on the CPT3. As expected, statistically significant results revealed that having aphasia yields a lower score on NAB naming F(1,17) = 11.435, p = .004. Individuals who did not have aphasia had a higher number of Perseverations, F(1,17) = 5.295, p = .034. No differences were noted between Omissions F(1,17) = 2.060, p = .169, Commissions F(1,17) = 3.090, p = .097, and Hit Reaction Time F(1,17) = .434, p = .519.

Conclusions

In our sample, patients with and without aphasia had similar reaction times and similar performances for omissions and commissions. The aphasia group, with significantly worse expressive language abilities, did not score significantly worse on any of the CPT3-related indices. Our study supports previous literature that CPT3 is an appropriate attention measure for individuals with aphasia but adds to the literature in providing evidence for use of the measure with an acute inpatient population with aphasia. While the results are promising, our sample is small and future research would be stronger with a larger sample with more specific information provided regarding the types of aphasia.
A-36 Cognitive Differences Between Children with New Onset Seizures and Those with Longer Seizure Histories
Authors: Gordon A , Bearden D , Drane D , Ono K
Published: August 2019

Objective

Epilepsy is associated with cognitive difficulties including language and memory problems. Studies examining cognitive function in children with new onset seizures have found that they have difficulties when compared to healthy controls, but less is known about how these difficulties compare to cognitive function in children who have had seizures for longer periods. Our study compared semantic memory and verbal fluency skills in a group of pediatric patients with new onset seizures (< 12 months) to a group of presurgical epilepsy patents who had seizures for more than 12 months.

Method

Participants included 12 new onset seizure patients (age 8–15 years old; M = 12.13 years, SD = 2.4; 58.3% male), and 14 presurgical epilepsy patients (age 8-18 years old; M = 13.26 years, SD = 3.3; 64.3% male) who underwent neuropsychological evaluations as part of their standard of care. All patients were recruited from a regional children’s hospital. Outcome variables included performance on the Boston Naming Test (BNT) and Delis-Kaplan Executive Function System Verbal Fluency test, Letter (LF) and Category (CF) Fluencies.

Results

Overall intellectual ability did not differ significantly between groups. No significant differences were found between the two groups on the BNT [F (17,2) = 1.012, p = .607], LF [F (8,16) = 1.375, p = .279], or CF [F (7,17) = .544, p = .790].

Conclusions

Findings indicating no significant differences on cognitive tasks between the two groups are consistent with previous research indicating that individuals with new onset seizures often exhibit cognitive difficulties at the time their seizures begin.
A-39 Predictors of Language Functioning Deficits in Pediatric Patients with Anti-NMDAR Encephalitis
Authors: Ratcliffe L , Howarth R , Blackwell L
Published: August 2019

Objective

This study aimed to examine predictors of language functioning in a sample of pediatric patients diagnosed with anti-N-methyl-D-aspartate receptor encephalitis (ANMDARE).

Method

Patient data was collected through retrospective chart review within a children’s hospital. Pediatric patients (N=16) treated for ANMDARE (12% male; 25% Caucasian, 50% African American, 25% Latino, mean age = 12.3) who completed a neuropsychological evaluation were identified (time since diagnosis M = 177.4;SD = 310.2). Language assessments included Wechsler Abbreviated Scale of Intelligence-II (WASI-II) Vocabulary; Wide Range Achievement Test- 4 (WRAT-4) Word Reading; Delis-Kaplan Executive Function System (D-KEFS) Verbal Fluency.

Results

Two independent-samples t-tests compared language functioning in patients with normal and abnormal MRI findings. Significant differences were found in vocabulary scores between patients with normal (M = 45.57, SD = 5.50) and abnormal MRIs (M = 36.67, SD = 5.35;t(11) = 2.94,p = 0.013). The magnitude of the differences in means (μd = 8.91,95%CI:2.25-15.56) was medium (η2 = 0.44). A significant difference in semantic fluency scores were also found (Normal MRI; M = 10.67, SD = 2.25 vs abnormal MRI; M = 6.13;SD = 1.23; t(12) = 3.89,p = 0.002). The magnitude of the differences in means (μd = 4.54, 95%CI:2.00- 7.09) was medium (η2 = 0.56). Additional analyses revealed a relationship between seizure presentation and vocabulary scores (t(11) = 2.50;p = 0.029).

Conclusions

Pediatric patients with abnormal MRIs demonstrate greater deficits in vocabulary and semantic fluency compared to those with normal MRIs. Moreover, patients who presented with seizures were more likely to have deficits in vocabulary. Previous research shows variability in prolonged deficits in language functioning in both children and adults. To the best of our knowledge, this is the first study to compare symptom presentation with language outcomes, thus potentially contributing to the clinical utility of MRI scans.
A-60 The Armed Services Vocational Aptitude Battery and Premorbid Intellectual Functioning
Authors: Trahan E , Good D , Seegmiller R
Published: August 2019

Objective

The objective of this study is to evaluate correlations between the Armed Services Vocational Aptitude Battery (ASVAB) with other measures of premorbid functioning to validate the use of the ASVAB as an estimate of premorbid intellectual functioning.

Method

This study utilized archival data. Data were retrospectively reviewed and correlational analyses were conducted between scores on the ASVAB and another measure of premorbid intellectual functioning (i.e., Test of Premorbid Functioning (TOPF)).

Results

Preliminary results (N = 83) revealed significant positive correlations between the ASVAB & TOPF (r2 = .75, p < .01), irrespective of current intellectual abilities and neurocognitive diagnosis.

Conclusion

The ASVAB is strongly correlated with the TOPF and may serve as a useful tool for estimating premorbid intellectual functioning in neuropsychological evaluations of active duty services members.