bluuebunny/crossref_metadata_2025 huggingface dataset:
A-16  Latent Item Response Theory Regression Using Neuropsychological Tests to Predict Functional Ability
Authors: Goette W , Carlew A , Schaffert J , Rossetti H , Lacritz L
Published: August 2020

Objective

Examine prediction of functional ability with neuropsychological tests using latent item response theory.

Method

The sample included 3155 individuals (Mage = 69.72, SD = 9.41; Median education =13.15, SD = 4.40; white = 92.81%; female = 62.03%; MCI = 25.13%; Dementia = 28.87%) from the Texas Alzheimer’s Research and Care Consortium who completed functional and cognitive assessments [Mini Mental State Examination (MMSE), Logical Memory (LM), Visual Reproduction (VR), Controlled Oral Word Association Test (COWAT), Trail Making Test (TMT), Boston Naming Test, and Digit Span]. Functional measures [Clinical Dementia Rating Scale, Physical Self Maintenance Scale, and Instrumental Activities of Daily Living)] were combined into a single outcome variable using confirmatory factor analysis. Item response theory (IRT) was used to fit the data, and latent regression to predict the latent trait score using neuropsychological data.

Results

All three functional scales loaded onto a single factor and demonstrated good construct coverage and measurement reliability (Supporting Figure). A graded response IRT model best fit the functional ability composite measure. MMSE (b = −1.08, p < .001), LM II (b = −0.58, p < .001), VR I and II (b = −0.09, p = .02 and b = −0.43, p < .001, respectively), COWAT (b = −0.10, p = .003), and TMT-B (b = −0.30, p < .001) all significantly predicted functional abilities, as did age (b = 0.61, p < .001) and education (b = 0.31, p < .001).

Conclusions

Global cognition, memory and executive function tests predicted functional abilities while attention and language tasks did not. These results suggest that certain neuropsychological tests meaningfully predict functional abilities in elderly cognitively normal and cognitively impaired individuals. Further research is needed to determine whether these cognitive domains are predictive of functional abilities in other clinical disorders.
A-025 Subjective Cognitive Decline and Likelihood of Participation Across Home-Based Cognitive Assessment Modalities
Authors: M Splonskowski , S Smith , C Jacova
Published: August 2020

Objective

Individuals with subjective cognitive decline (SCD) are approximately twice as likely to develop dementia and less likely to seek cognitive assessment. Home-based cognitive assessment (HBCA) could reduce many practical and emotional barriers associated with in-person cognitive testing. We aimed to explore the relationship between SCD and likelihood of HBCA participation across various modalities.

Method

A nation-wide sample of 483 community-dwelling adults age 50 years and older (M = 63.61 ± 5.47) were recruited via Amazon Mechanical Turk, an online crowdsourcing website, to complete a survey. SCD was measured using the SCD-MyCog Questionnaire. A score of 7/24 endorsed symptoms classified respondents into SCD and non-SCD. Likelihood of participation in HBCA was measured using 4 likert-scale items (e.g., “How likely would you be to participate in HBCA via computer?”). Total likelihood was calculated by summing items.

Results

Regression revealed SCD symptom burden predicted likelihood of participation in HBCA [F(1, 481) = 12.42, B = .097, [.043–.150], p < .001, r^2 = .025]. Likelihood was higher in SCD (15.25 ± 3.3) than non-SCD (14.23 ± 3.5). When looking at specific HBCA modalities, SCD were more likely than non-SCD to participate in computer and videoconferencing modalities (1.36 ± 0.6 vs1.68 ± 0.87, p < .001; 2.26 ± 1.11 vs 2.58 ± 1.16, p < .001). There was no relationship with iPad or smartphone modalities.

Conclusion

SCD endorsement was associated with increased likelihood of engagement in HBCA. It is possible that HBCA can help overcome barriers to help-seeking in this group. SCD may prefer videoconferencing and computer modalities.
A-027 Differentiating HIV-Associated Neurocognitive Disorder from Alzheimer’s Disease: A Neuropsychological Profile
Authors: D Eilenberger
Published: August 2020

Objective

This meta-analysis examined the potential for executive function, episodic memory, and motor function to differentiate HIV-associated neurocognitive disorder (HAND) from Alzheimer’s disease (AD), in an attempt to aid in accurate differential diagnosis.

Data Selection

The literature search identified records investigating neuropsychological test performance associated with HAND and AD. Databases used were: PsycINFO, Academic Search Complete, and Medline with Full Text. Eligibility was assessed using the following inclusion criteria: (a) study examines HAND or AD, (b) diagnosis is determined using standard diagnostic criteria, (c) study contains data regarding executive function, episodic memory, and/or motor function, (d) study published in English, (e) study is quantitative, and (f) study contains statistical information for effect size calculations. A total of 947 relevant studies were initially identified. Twenty studies were included.

Data Synthesis

Group difference effect sizes were converted/calculated using Cohen’s d and Cohen’s (1998) conventions. Three weighted effect sizes were calculated for constructs of interest for each disorder. Weighted effect size for executive function was large for each group (HAND d = 1.28; AD d = 1.57). A large weighted effect size for episodic memory in AD (AD d = −2.17) and a medium effect size for HAND (HAND d = −0.65) were calculated. A large weighted effect size was determined for motor function in AD (d = 3.60), while a small effect size was calculated for HAND (d = 0.27).

Conclusions

Level of impairment in episodic memory and motor function can be used to differentiate HAND from AD. Executive function lacked differences needed for diagnostic differentiation. Future research should be done directly comparing neuropsychological performance between HAND and AD.
A-028 Utilizing Virtual Reality to Assess the Relationship between Prospective Memory and Processing Speed
Authors: J Sawyer , M Barnett , L Bennett , R Donnell , A Flair , A Haygood , C Markey , J Helphrey
Published: August 2020

Objective

Processing speed may partially mediate age-related differences in prospective memory (PM) abilities (West & Craik, 2001). The present preliminary study aimed to further investigate the relationships between prospective memory and processing speed by utilizing a novel virtual reality-based prospective memory measure. The task was designed to assess the impacts of a virtual environment would facilitate a deeper level of processing and enhance prospective memory performance.

Method

49 older adults (M = 73.87, SD = 8.24) and 39 younger adults(M = 18.87, SD =1.61) completed the Coding subtest of the Weschler Adult Intelligence Scale (WAIS- IV) as well as a virtual-reality prospective memory measure that utilized both time-based and event-based cues.

Results

Coding was strongly correlated with PM time-based cues (r = .43, p < .01) and event-based cues (r = .53, p < .001). There were no correlations between processing speed and prospective memory in the young adult sample.

Conclusion

This study suggests that processing speed is strongly related to virtual-reality based PM and suggests that processing speed is a crucial component in prospective memory outcomes in older adults. This novel task virtual reality task may provide construct validity against other prospective memory measures.
A-058 Test–Retest Reliability of the Grooved Pegboard Test in a Pediatric Medical Population
Authors: C David , M Vasserman , B Brooks , W Macallister
Published: August 2020

Objective

The Grooved Pegboard Test (GPT) is among the most commonly used fine motor tasks, though there is limited data on its basic psychometric properties in children and adolescents with medical conditions. The purpose of this study was to establish test reliability for the GPT within this group.

Method

Participants (N = 44; 22 males, 22 females) were children and adolescents clinically referred for neuropsychological evaluation. Diagnoses included epilepsy (n = 24), cardiac conditions (n = 13), other (n = 5). Each completed the GPT twice: once in the morning and once in the afternoon, ranging from 64-390 minutes apart (x-=263 min., SD = 60 min.). Spearman correlations assessed test–retest reliability for speed of completion for both dominant (DH) and non-dominant hands (NDH) trials and number of peg drops. Paired sample t-test assessed for practice effects between administrations.

Results

Ages ranged between 6.11 to 18.10 years (x-=12.52 yrs., SD = 3.19 yrs.). GPT raw scores for first presentation ranged from 25-296 seconds (DH x-=80.91, SD = 25.1; NDH x-=95.34, SD = 49.42). The GPT showed high test–retest reliability for DH (ρ = 0.80, p < 0.001) and NDH (ρ = 0.83, p < 0.001). Number of drops showed non-significant correlations across trials (DH ρ = −0.03, p = 0.87; NDH ρ = 0.11, p = 0.49). Practice effects were identified for the DH (t = −3.25, p = 0.002) but not NDH (t = −1.83, p = 0.074).

Conclusion

Strong test–retest reliability of the GPT speed of completion in this population supports stability of test results over time, though practice effects are seen at short intervals. Number of pegs dropped, however, lacks sufficient retest reliability and may be of lesser clinical utility. Overall, this study provides increased confidence for continued use of the GPT.
A-074 Evidence of Cognitive Decline in a Patient with CADASIL Without Major Stroke Event
Authors: J Burton , J Hertza , Z Repp , K Jupp
Published: August 2020

Objective

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a genetic disease that impacts small arteries in the brain and can result in ischemic strokes, seizures, and cognitive decline. This case study of a 61-year-old male illustrates the cognitive profile of an individual with CADASIL who has not suffered a major stroke event. Neuroimaging shows subcortical compromise in a diffuse manner.

Methods

The patient was assessed in an out-patient institutional practice. The individual was assessed with a clinical interview and comprehensive Neuropsychological Battery. The battery included cognitive and psychological measures with free-standing and imbedded validity measures.

Results

Cognitive testing demonstrated significant impairment in visuo-motor processing speed, executive planning, cognitive flexibility, verbal fluency, decision making, and visual memory, and suggests that the patients abilities show deterioration of subcortical regions, and is consistent with his CADASIL diagnosis. The patient was diagnosed with Mild Neurocognitive Disorder, due to medical condition.

Conclusion

Individuals with CADASIL often suffer from ischemic strokes and cognitive impairment. This study suggests that despite no major stroke event, individuals with CADASIL may still exhibit cognitive decline especially in subcortical regions. This case supports the theory that progressive cognitive decline in CADASIL patients does not begin as a result of a major stroke and can continue as a distinct cause of vascular neurocognitive disorder.
A-075 A Case Study of Anterograde Memory Impairment Following Forniceal Infarct– Neurocognitive Sequelae and Recovery
Authors: C Andrew , M Smith
Published: August 2020

Objective

To describe neurobehavioral consequences and recovery course in a case of acute infarct of the fornix superimposed on chronic subcortical cerebrovascular disease.

Method

We present a right-handed, 72-year-old, African American man with cardiovascular risk factors, chronic kidney disease, and history of CVA with no prior functional or cognitive difficulties. He was evaluated twice, first four days post and again two months post-infarct of the bilateral fornix.

Results

Initial inpatient testing revealed impaired verbal memory characterized by rapid forgetting (HVLT-R Delay T = < 20) with some benefit from recognition cues, and subtle deficits in constructional praxis and practical judgement. On repeat evaluation at four months post-stroke, he demonstrated memory impairment across modalities (HVLT-R Delay T = < 20, BVMT-R Delay T = < 20) with marginal benefit from context and cues. He required assistance with multiple instrumental activities of daily living (e.g., financial and healthcare management) and displayed anosognosia of both cognitive and functional deficits.

Conclusion

This case illustrates the role of the fornix in the process of memory encoding and self-awareness. Literature describing the neurobehavioral role of the fornix is sparse, however, it has been implicated in episodic memory functions due to hippocampal connectivity. This case study further implicates the fornix in declarative memory formation and will add to the literature by detailing a specific cognitive profile that may inform planning for recovery and rehabilitation.
A-076 Acute Pontine Infarction and Deep White Matter Lesioning: Poly-etiologic Factors and Clinical Correlation with Neuropsychological Impairment and Neuroradiographic Findings
Authors: P Pimental , E Chatten , J Cart , A Ciampanelli
Published: August 2020

Objective

Pontine infarction may include motor and sensory disturbances, eye movement disorders, cranial nerve palsies, vestibular system symptoms, dizziness, ataxia, transient loss of consciousness, tetraparesis, acute pseudobulbar palsy, and severe sensory-motor deficits (Kumral, Bayülkem, & Evyapan, 2002). Studies of clinical/. neuroradiological correlation are not abundant in the literature (Kim, Lee, Joo, Im, & Lee, 1996).

Methods

The present case involves a 67-year-old, right-handed Caucasian female with a medical history of hypertension, headaches, hypothyroidism, cardiovascular disease (triple bypass), chronic obstructive pulmonary disease, diabetes mellitus, and abdominal aortic aneurysm. She was referred for neuropsychological testing to evaluate deficits. related to her acute pontine stroke.

Results

Neuropsychological testing revealed neuropsychological impairment characterized by visual-perceptual motor and visual memory deficits, executive dysfunction, lack of concern/awareness of deficits (anosodiaphoria), decreased impulse control and disinhibition. Bi-hemispheric, cortical/subcortical pathway elements, and a preponderance of right hemisphere involvement correlated with neuroradiographic evidence. MRIs revealed a punctate acute infarct within the right paracentral pons, a. small focus of gradient susceptibility within the parasagittal right parietal lobe, and a left pons and deep ischemic white matter lesioning of the posterior left frontal lobe.

Conclusion

The present case provided a rare look at poly-etiologic factors associated with acute pontine infarct and associated deep ischemic white matter changes.Neuropsychological testing elucidated the severity and type of neuropsychological impairment which correlated with MRI neuroradiographic findings, and was instrumental in patient interventions. Neurocognitive rehabilitation and formal driving evaluation, given the patient’s visual-perceptual motor and visual memory difficulties and lack of concern/awareness of deficits, protected the patient, family and public.
A-077 Relationship Between Mental Health and Physical Health and Neurocognitive Function among Latinx People Living With HIV
Authors: E Breen , M Aghvinian , J Stiver , M Savin , A Summers , A Slaughter , K Fidaleo , D Byrd , M Rivera Mindt
Published: August 2020

Objective

The relationship between self-reported mental health (MH), physical health (PH), and neurocognition (NC) is vastly understudied among Latinx people living with HIV (PLWH). Evidence of increased somatization in this group suggests that self-reported MH and PH may contextualize cognitive outcomes among Latinx PLWH. Thus, this study examines the relationship between self-reported MH/PH and NC in a sample of Latinx PLWH.

Method

This study included 76 Latinx PLWH (33% female; M age = 46.0, SD = 7.08) who completed the Medical Outcomes Study HIV Health Survey (MOS-HIV) and a comprehensive neurocognitive battery. MH and PH were defined by the MOS-HIV, where higher MH and PH summary scores indicate better perceived health. Demographically-corrected T-scores were used to compute average global NC and domain scores.

Results

Within Latinx PLWH, partial correlations controlling for age and education found PH was associated with better processing speed (r = .28, p = .03), and MH was related to better global NC, fluency, learning, and processing speed (ps < .05). A series of multiple regressions (Step 1: age, education, Step 2: MH, PH summary scores) were used to predict NC domain scores. MH (R2 = .11–.15) significantly predicted better attention/working memory (β = .26, p = .03) and global NC at the trend level (β = .19, p = .07). PH did not predict any NC domains.

Conclusions

Findings indicate that MH and PH correlated with global and domain-specific NC within Latinx PLWH. Better self-reported MH may improve attention/working memory and global NC in Latinx PLWH. Somatization is important when considering MH/PH and cognition within Latinx PLWH; physicians should consider the impact of patients’ self-reported MH/PH on NC in Latinx PLWH.
A-08 Predictors of Everyday Problem Solving in Subtypes of Mild Cognitive Impairment
Authors: J Moreno , W Olmos , J Simons , C Nayares , L Alving , J Tran , E Woo
Published: August 2020

Objective

The Everyday Problems Test (EPT) evaluates problem solving ability needed to complete activities of daily living (ADLs), such as medication and financial management. This study assessed the contributions of executive functioning and subtypes of memory on everyday problem solving in healthy aging, amnestic mild cognitive impairment (MCI), and non-amnestic MCI.

Method

Participants included healthy older adults (n = 56) and individuals with MCI (amnestic MCI n = 25; non-amnestic MCI n = 36). Composite scores were derived for Executive Functioning (Trail Making Test-B and FAS), Immediate Memory (short delayed recall scores from the California Verbal Learning Test-II and the Brief Visuospatial Memory Test-Revised) and Delayed Memory (long delayed recall scores from both memory tests). The EPT was the measure of everyday problem solving.

Results

We found that for the control group and the entire MCI group (both amnestic and non-amnestic MCI), executive functioning, immediate memory, and delayed memory predicted problem solving. When examining the separate MCI subtypes, executive functioning and delayed memory predicted problem solving in non-amnestic-MCI, but not amnestic MCI.

Conclusions

Findings suggest that healthy older adults engage a range of cognitive skills (executive and memory skills) when they engage in everyday problem-solving. Executive and memory skills are also utilized for those with non-amnestic MCI when performing ADLs. Interestingly, in those exhibiting memory impairment and with increased risk for the Alzheimer’s type of dementia, memory and executive functions do not predict ADL problem solving. These findings indicate that people with amnestic-MCI may benefit from being given compensatory strategies to support their memory difficulties when they must perform everyday problem-solving.
A-086 When to Consider Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS) in Ambiguous Obsessive–Compulsive Disorder (OCD) Presentation
Authors: M Ferris
Published: August 2020

Objective

Recent literature has illustrated a need for a neuropsychological “endophenotype” in children with OCD. Further, the diagnostic issue of PANDAS appears to be one of the most controversial in the OCD literature. The following case illustrates the lack of diagnostic clarity in a comorbid presentation with ambiguous etiology.

Method

A 9-year-old male presented for neuropsychological testing due to difficulty controlling his anger, becoming physically aggressive, sleep disturbances, and a recent decline in academic performance. The patients biological parents noted recent instances of PICA and ritualistic behavior. No clear onset was disclosed. The examiners noticed hyperactivity, poor self-control, sensory seeking behaviors, vocal tics, and the inability to emotionally regulate in intake. Family history was negative for learning, social, or emotional disorders. Medical history was positive for numerous bouts of streptococcal pharyngitis. Results (included but not limited to): T.O.V.A (Attention Performance Index = −3.23). WISC-V: Working Memory Index = 72; 3rd percentile. Wisconsin Card Sorting Task: Unable to Complete. DKEFS: Trail Making Test: Condition 4 Number-Letter Switching: Profound Deficit. WISC-V: Visual Spatial Index = 67, 1st percentile. RCFT: Copy = < 1st percentile. CVLT-C: Correct Recognition Hits = 1/15, < 0.1 percentile. Symptoms of OCD are frequently hidden or poorly articulated, especially in younger children. Further, according to the OCD literature, fewer diagnostic issues appear to be as controversial as that of PANDAS. This case illustrates the importance of increasing our diagnostic understanding of PANDAS and the need for diagnostic clarity in co-morbid, severe psychopathology pediatric patients.
A-097 The Phenomenological Experience of Posttraumatic Stress Within an Electrical Injury Sample
Authors: M Obolsky , Z Resch , J Soble , J Paxton , J Fink , R Lee , N Pliskin
Published: August 2020

Objectives

The symptom phenomenology of posttraumatic stress is poorly understood among electrical injury (EI) patients, despite the high prevalence of posttraumatic stress disorder (PTSD) diagnoses after EI. This study explored how EI patients experience posttraumatic stress using the 3 symptom-cluster subscales from the PTSD Checklist-Civilian Version (PCL-C).

Method

Cross-sectional analyses measured PTSD symptom severity and frequency using the PCL-C among 19 adult EI patients referred for neuropsychological evaluation. The sample was 79% male, 68.4% Caucasian, 15.8% African American, 15.8% Hispanic, with mean age of 46.3 years (SD = 8.45) and mean education of 12.3 years (SD = 2.6).

Results

Mean PCL-C total score was 54.3 (SD = 12.4, range: 31–76). Fifteen participants had total scores exceeding the recommended cut-score of ≥44, indicating that they met criteria for presumptive PTSD diagnoses. On average, Cluster D (hyperarousal) symptoms were the most severe (M = 3.5/5) followed by Cluster C (avoidance/numbing) (M = 3.3/5) and Cluster B (re-experiencing) (M = 2.8/5). The most frequently endorsed symptoms were loss of pleasure (84%), sleep disturbance (84%), and difficulty concentrating (84%), which also were the most severe symptoms (M = 4.0/5; M = 3.9/5; M = 4.0/5, respectively). The two symptoms endorsed least often were repeated disturbing dreams of the stressful experience (42%) and reexperiencing the traumatic event (37%), and they were also the least severe (M = 2.6/5; M = 2.3/5, respectively).

Conclusions

In EI patients, general symptoms of psychological distress were more prominent than more prototypical trauma-related symptoms (e.g., re-experiencing, intrusive thoughts). Future research should examine if these symptoms of distress are unique to EI patients’ experiences of posttraumatic stress compared to other clinical populations.
A-105 Post-Concussive Symptom Endorsement and Symptom Attribution Following Remote Mild Traumatic Brain Injury in Combat-Exposed Veterans
Authors: V Merritt , S Jurick , M Sakamoto , L Crocker , M Sullan , S Hoffman , D Davey , A Jak
Published: August 2020

Objective

The purpose of this study was to examine rates of “post-concussive” symptom endorsement and symptom attribution in Veterans with a history of mild traumatic brain injury (mTBI). We also explored the relationship between symptom endorsement and symptom attribution and assessed correlates of each.

Method

This cross-sectional study included 48 combat-exposed Iraq/Afghanistan Veterans with remote history of mTBI. All Veterans completed clinical interviews and self-report questionnaires assessing sociodemographic factors, injury and combat-related variables, psychiatric distress, self-efficacy, and coping style. To assess symptom endorsement and symptom attribution, a modified version of the Neurobehavioral Symptom Inventory was administered.

Results

Results showed that the most commonly endorsed “post-concussive” symptoms were several non-specific symptoms, and the symptoms most frequently attributed to mTBI included forgetfulness, poor concentration, and headaches. Furthermore, although there were some overlapping correlates of both symptom endorsement and symptom attribution, unique variables were associated with each domain. Specifically, symptom endorsement was uniquely associated with measures of psychiatric distress, while symptom attribution was uniquely associated with having a history of loss of consciousness and a greater degree of combat exposure.

Conclusions

Taken together, results suggest that endorsement of symptoms may be significantly impacted by the presence of mental health comorbidities, but that perceptions or beliefs as to why symptoms are occurring are related more to mTBI and combat-related characteristics. Findings offer potential avenues for therapeutic intervention, emphasize the importance of psychoeducation, and highlight the need to consider using alternate terminology for these symptoms that promotes recovery and minimizes misattribution of symptoms.
A-111 The Relationship between Bilingualism and Perceived Workload on the Symbol Digit Modalities Test in Traumatic Brain Injury Survivors
Authors: D Lopez-Hernandez , P Litvin , R Rugh-Fraser , R Cervantes , F Martinez , S Saravia , F Zakarian , S Fatoorechi , O Uguru , H Rad , A Arzuyan , D Hardy , D Budding , P Vespa , D Hovda , D Mcarthur , D Plurad , J Fuster , E Woo , M Wright
Published: August 2020

Objective

We evaluated perceived workload (measured by the NASA Task Load Index; NASA-TLX) as related to Symbol Digit Modalities Test (SDMT) performances in monolingual and bilingual traumatic brain injury (TBI) survivors and healthy comparison participants (HC).

Method

The sample consisted of 28 TBI survivors (12 monolinguals & 16 bilinguals) and 50 HC (20 monolinguals & 30 bilinguals). SDMT written (SDMT-W) and SDMT oral (SDMT-O) were used to evaluate group differences.

Results

ANCOVA, controlling for age, revealed that the HC group outperformed the TBI group on SDMT-W, p = .001, and SDMT-O, p = .047. Furthermore, bilinguals outperformed monolinguals on SDMT-W, p = .017. On the NASA-TLX, an interaction emerged on temporal demand rating, p = .023, with TBI bilinguals reporting higher temporal demand on SDMT tasks compared to TBI monolinguals, while the HC monolingual participants reported higher temporal demands ratings compared to HC bilingual participants. Furthermore, monolingual participants showed higher levels of frustration with regard to the SDMT task compared to bilingual participants, p = .029.

Conclusion

Our data revealed TBI survivors underperformed on both SDMT trials compared to the HC participants. Also, bilingual participants demonstrated better SDMT-W performances compared to monolingual participants. Furthermore, our TBI bilingual sample reported themselves to be more rushed to complete the SDMT compared to monolingual TBI sample, but they were less frustrated. Meanwhile, our HC monolingual sample felt more rushed to complete the SDMT tasks compared to HC bilingual participants, but they were less frustrated. While we observed differences in workload ratings between language groups, it is unclear if language use, and/or other variables are driving these results.
A-116 Predicting Chronic Neurobehavioral Symptoms based on Acute Injury Characteristics and Symptoms in U.S. Military Service Members with and without history of TBI
Authors: S Lippa , J Bailie , T Brickell , L French , L Hungerford , R Lange
Published: August 2020

Objective

Recovery following traumatic brain injury (TBI) is complex. Often following mild TBI, recovery occurs within days or weeks, though this is not always the case. Following more severe TBI, some recover quickly, while many never fully recover. This study examines acute predictors of chronic neurobehavioral symptoms in U.S. military service members (Age: M = 33.9 years, SD = 10.2) without injury (n = 86), or with history of uncomplicated mild traumatic brain injury (TBI; n = 56), complicated mild, moderate, or severe TBI (mod-sev TBI; n = 43), or bodily injury (n = 25).

Method

Participants completed the Neurobehavioral Symptom Inventory (NSI), Posttraumatic Stress Disorder Checklist, Alcohol Use Disorder Checklist, Combat Exposure Scale, and TBI Quality of Life and passed symptom validity tests at 0–8 months and ≥ 2 years post-injury. Forward stepwise logistic regression included 26 potential predictors (demographics, injury characteristics, military characteristics, and self-report measures at baseline) of International Statistical Classification of Diseases and Related Health Problems-10 Postconcussional Syndrome (PCSy) at follow-up.

Results

Cognitive Concerns (Exp(B) = .896, p = .001), Sleep (Exp(B) = 1.874, p < .001), Somatosensory Symptoms (Exp(B) = 1.194, p = .012), and mod-sev TBI (Exp(B) = 2.959, p = .045) significantly predicted follow-up PCSy. When baseline NSI symptoms were removed from the model, Cognitive Concerns (Exp(B) = .902, p < .001), Post-traumatic stress (Exp(B) = 1.173, p = .001), and Resilience (Exp(B) = .950, p < .031) significantly predicted PCSy. For all included measures in both models, higher symptoms at baseline predicted increased likelihood of follow-up PCSy. Both models correctly classified 81.3% of participants.

Conclusion

Findings suggest patients reporting psychological distress and cognitive concerns acutely should be targeted for treatment to mitigate prolonged neurobehavioral symptoms.
A-132 MMPI-2 Clinical Scales Relation to Acquired Brain Injury
Authors: L Stebbins , B Trinidad , J Garcia , C Golden
Published: August 2020

Objective

To determine whether MMPI-2 clinical scales are related to Acquired Brain Injury(ABI) compared to Healthy individuals.

Methods

Participants were selected by DSM-IV diagnoses from a de-identified, archival database. The sample(n = 75) included an ABI group(n = 34, Mage = 43, Medu = 13.4, 58.8% Males, 64.7% Cau.) that have had long-term chronic traumatic brain injury(TBI) and a control group(n = 41, Mage = 33, Medu = 14.2, 63.4% Males, 58.5% Cau.).

Results

Independent samples t-test analysis determined statistically significant differences between groups(p ≤ .01). Results revealed increases on clinical scale-1 (hypochondriasis; t(1,73) = 2.839, p = .006), scale-2 (depression; t(1,73) = 2.628, p = .01), and scale-8 (schizophrenia; t(1,73) = 2.570, p = .01) in ABI group compared to control group. No other significant differences were found.

Conclusion

Research has shown that TBI’s can create neurological and emotional dysfunction. The current elevations may be residual symptoms from the TBI. Research shows as a result of having a TBI, individuals suffer from depression, anxiety, PTSD, and substance abuse, which is analogous to current findings. For instance, scale-2 relates to symptoms of depression and worry and scale-1 to somatic and health complaints. These can be indirect symptoms of a TBI, in which individuals can have persistent symptoms related to physical health leading to problems with daily functioning and ultimately producing emotional distress. Additionally, research shows that individuals with persistent TBI often present with neurocognitive deficits in attention regulation, executive functioning, and memory. This can create increases in scale-8 that shows concerns related to impaired concentration/memory, impulse control, and motor/sensory complaints. Treatment of ABI’s should not only include cognitive rehabilitation, but also individual therapy due to the impact of traumatic injury on emotional functioning.
A-133 Understanding Caregiver Anxiety after Traumatic Brain Injury
Authors: C Burger , R Berger , L Sutcliff , K Hewitt
Published: August 2020

Objective

After an individual sustains a severe traumatic brain injury (sTBI), the recovery process continues, as there are often long-standing difficulties in cognitive, behavioral, and physical abilities. People who care for individuals living with sTBI experience unique challenges. The term to best explain these challenges is caregiver burden. More often than not in research, caregiver burden combines stress and the emotional toll with the most challenging behaviors they encounter. This systematic review aims to assess anxiety for sTBI caregivers.

Methods

A search for recent, peer-reviewed publications was conducted using GALILEO, which encompasses PsychINFO and PubMed, with the terms “caregiver burden,” “care recipient,” “caregiver,” “burden,” “anxiety,” “stress,” “strain,” “traumatic brain injury” which resulted in N = 1,013 total articles. After excluding irrelevant studies lacking anxiety and sTBI, N = 8 articles remained.

Results

A review of relevant studies revealed many psychosocial factors that contribute to anxiety including perceived stress/strain management, coping style, and level of care. When an individual had a dual diagnosis of sTBI and psychiatric disorder (e.g., depression) combined with behavioral disturbances (e.g., anger), caregivers showed increased anxiety. Similarly, caregivers’ anxiety increased depending on military career, gender, and relationship status. Protective factors for caregivers included social support and psychotherapeutic interventions, specifically brief structured psychoeducation.

Conclusions

The results of this systematic review highlight the specific challenges sTBI caregivers face and subsequent anxiety. Individuals with sTBI experience adjustment phases post-injury, and the caregivers experience the transitions alongside the survivor. Future research should investigate how to increase caregiver protective factors and manage the impact of caregiver anxiety on individuals with sTBI.
A-148 The Experiences of Partners of Elite Athletes Diagnosed with Post-Concussion Syndrome (PCS)
Authors: B Bruger
Published: August 2020

Objective

This study explored partners’ experiences of caring for an elite athlete who has post-concussion syndrome (PCS) or lingering symptoms of concussion. Until this point, the concussion literature has focused mostly on experiences of athletes (McCrory et al, 2017) and caregivers of non-athletes with brain injury. Literature on partners of athletes with PCS is woefully underrepresented. The purpose of this study is to examine the experience of partners of elite athletes with PCS to add to current concussion and caretaker literature.

Method

Conventional content analysis of semi-structured interviews was used for the inductive identification of common themes in the participants experience, with the coding categories directly derived from the text data.

Results

Major themes created from the coding of interviews included a) the lack of literature available and provided to the general public on concussions and PCS is minimal, b) there is a sense of ambiguity for partners and their post-concussed loved ones regarding duration of symptoms and what to expect, c) partners turned to non-credible sources of information and at times, adding undue stress, and d) feeling as if the dynamics of their relationship had not changed, and if they had, quite minimally, following a concussion(s) sustained by their loved one. Evidence for mild caregiver burden was found and participants identified unexpected and exhausting emotional difficulties.

Conclusion

Findings were consistent with current literature on caregivers of non-athletes with brain injury. This study extended current literature to include literature on partners of athletes with PCS.
A-149 Boy with Rolandic Epilepsy Benefited from Visuospatial Training
Authors: N Kiseleva , S Kiselev
Published: August 2020

Objective

Children with epilepsy can have delay in the development of neurocognitive abilities. It is important to receive the evidence for efficiency of different treatments that are aimed to help children with epilepsy. The goal of this study was to assess the impact of 16 weeks of visuospatial training on the visuospatial abilities in 7 years of age child with Rolandic epilepsy.

Methods

The child is 7 year old boy with Rolandic epilepsy. The neuropsychological assessment of child has revealed the deficit in visuospatial abilities. Child participated in 16 weeks of visuospatial training. A total of 42 therapy sessions lasting 50 minutes were performed. This training trains the child to do different visuospatial exercises both on motor and cognitive level. This training is built on the conceptual framework derived from the work of Luria’s theory of restoration of neurocognitive functions (Luria, 1963, 1974).

Results

Neuropsychological assessment of child after the intervention period has revealed apparent progress in performance of 3 subtests from Luria’s neuropsychological assessment battery for children which designed to asses visuospatial functions (Head subtest, mental rotation, design copying).

Conclusion

According to result of this case report it can be assumed that visuospatial training can be used as a prospective approach for development of visuospatial functions in children with Rolandic epilepsy. However, we need to prove this result using visuospatial training for children with Rolandic epilepsy who suffer from deficit in visuospatial abilities.
A-155 Association of Feigned Attentional Symptoms with Intra-Individual Variability in Intellectual Functioning
Authors: M Myers , M Harrell , S Taylor , J Beach , S Aita , B Hill , M Calamia
Published: August 2020

Objective

The association between feigned Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms and intellectual functioning was examined in a sample of undergraduate students instructed to simulate ADHD.

Method

90 undergraduate students completed the Wechsler Adult Intelligence Scale (WAIS-IV), b Test, and Green’s Word Memory Test (WMT) as part of a larger study [mean age 19.23 years (SD 1.67), range 17–26 years old; mean 12.47 years of education (SD .86); 58.9% female; 58.9% Caucasian, 32.2% African American, 8.9% Other]. Intra-individual variability (IIV) was calculated as standard deviation of the overall test battery mean for the 10 core WAIS-IV subtests.

Results

A moderate association was found between WAIS-IV IIV and b Test E-score (r = .397, p < .05). WAIS-IV IIV was also moderately associated with b Test errors (d errors r = .299, p < .05; commissions r = .284, p < .05; omissions r = .463, p < .01) and completion time (r = .332, p < .05). No significant relationships were found between WAIS-IV IIV and WMT performance.

Conclusions

Given that IIV within intellectual functioning was correlated with performance on b Test but not WMT, this suggests the variability in objectively measured intelligence for simulators is associated with feigned attentional symptoms but not feigned memory symptoms. These findings implicate detection of malingered symptom presentation for ADHD to be more sensitive in the attentional domain compared to memory. Therefore, performance validity tests assessing attentional abilities may be more applicable in diagnostic settings aimed at detection of ADHD.
A-158 The Effect of Adverse Childhood Experiences on Attentional Bias
Authors: R Owens , S Smith , S Lindsey , C Marker , B Robinson
Published: August 2020

Objective

This study aims to investigate the relationship between Adverse Childhood Experiences (ACEs, specifically household dysfunction) and attentional bias. Research has shown that ACEs can induce psychological stress and result in greater risk for neuropsychological difficulties among children who experience them (Raver and Blair., 2016). Therefore, we hypothesize that children with higher levels of ACE exposure will show higher levels of attentional bias overall.

Data Selection

Data was obtained through the longitudinal Adolescent Brain Cognitive Development Study. The broader dataset was narrowed to include variables related to household dysfunction: Parent Family Environment Scale—Family Conflict Subscale Modified from PhenX and Parent Neighborhood Safety/Crime Modified from PhenX. Attentional bias was measured via the Youth Emotional Stroop Test.

Data Synthesis

Data was analyzed using a Bivariate correlation between predictor variables and participant latency on incongruent items within the Youth Emotional Stroop Test. Neighborhood crime and response latency were significantly correlated at r(4838) = −.041, p < .001. Neighborhood crime and family conflict were significantly correlated at r(4838) = −.040, p < .001. Additionally, we used linear regression to examine the roles of neighborhood crime and family conflict as predictors of attentional bias (N = 4838). The two variables together significantly predicted attentional bias, F(2, 4835) = 4.50, p = .012, r2 .002.

Conclusion

Although family conflict was not significantly related to attentional bias, our results support previous research and our hypothesis that higher levels of exposure to ACEs are significantly associated with an increase in attentional bias for environmentally threatening stimuli (Caldwell., Carter., and Minzenberg 2014).
A-160 Understanding the Validity of the Digit Span Sequencing Task: A Least Executive Demand Model
Authors: J Romano Morris , M Lazar , J Henry
Published: August 2020

Objective

This study aimed to explore the patterns of Longest Digit Span from the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V), including understanding the newest sequencing condition. While there is a large body of research discriminating the cognitive demands of the forward and backward conditions, there is less literature devoted to the cognitive underpinnings of the sequencing task, and no studies looking at the applicability of this task with children. Patterns observed clinically on these conditions have suggested that the sequencing condition may involve less executive demand than the backwards condition (Least Executive Demand model). Therefore, it was predicted that Longest Digit Span Backwards (LDSB) would predict the most amount of variance in Working Memory scores on the Comprehensive Executive Functioning Inventory (CEFI).

Method

Hierarchal multiple regression analysis controlling for FSIQ was completed utilizing an archival database (n = 38) of children and adolescences (ages 6–15) referred to a university-based neuropsychological assessment clinic.

Results

Longest digit span scores were not significant predictors of Working Memory scores on the CEFI [F (4, 27) =1.746, p = .169]. However, digit span capacity was weakly predictive of CEFI Attention scores [F (4, 27) = 2.818, p < .05; R2 = .295]; with sequencing capacity as the only significant predictor (beta = .62, p < .05).

Conclusions

While there was no evidence that working memory capacity predicts real world working memory skills, there was evidence that digit sequencing capacity is predictive of parent reported attentional difficulties. Poor performance on DSS in children may be due to difficulties concentrating, sustaining attention or with avoiding distractions.
A-161 Corticomedial Amygdala Volume Significantly Predicts Cognitive Fexibility in an Older Adult Sample
Authors: E Jones , E Jones , L Sweet
Published: August 2020

Objective

The present study examined the relationship between anxiety, corticomedial and basolateral amygdala volume, and cognitive flexibility among older adults (OA). We hypothesized that higher subclinical Beck Anxiety Inventory (BAI) scores would be associated with lower cognitive flexibility, assessed using the Delis-Kaplan Executive Function System (D-KEFS) verbal fluency. Additionally, we hypothesized that basolateral amygdala volume would negatively correspond to anxiety scores and exhibit a positive relationship with cognitive flexibility.

Method

Sixty-three OA (M age: 65; SD: 9; 59% female) were recruited via community advertising and cardiac clinics for a parent study on cardiovascular disease. Participants completed the D-KEFS and BAI as part of a comprehensive neuropsychological assessment prior to magnetic resonance imaging (MRI). Amygdala segmentation was completed with FreeSurfer version 6.0, using T1-weighted MPRAGE and T2-weighted FLAIR images. Data was analyzed using hierarchical multiple regression, controlling for age, sex, years of education, and intracranial volume.

Results

No significant relationship emerged between basolateral amygdala volume and BAI scores (r = .11, p = .41) or cognitive flexibility (r = .04, p = .76). However, a significant positive relationship was observed between corticomedial amygdala volume and cognitive flexibility after controls (β = 0.37, p < .01).

Conclusions

The previously reported relationship between high anxiety and basolateral amygdala volume does not appear to extend to subclinical levels. We conjecture that the significant relationship between the corticomedial amygdala and cognitive flexibility represents the upward slope between arousal and cognitive performance on the Yerkes-Dodson curve. These findings newly implicate corticomedial amygdala volume as a representative measure linking emotional arousal and cognitive performance in OA.
A-163 APOE ε4 Alters Self-Awareness of Executive Function in Cognitively Intact Middle Aged and Older Adults
Authors: S Evans , E Paitel , T Gregg , Z Ballard , C Otteman , K Nielson
Published: August 2020

Objective

Subjective cognitive complaints (SCC) may be an early indicator of future cognitive decline. Although early executive function (EF) decline in Alzheimer’s disease (AD) may be a sensitive predictor, the predicative utility of SCCs specific to EF is unknown. Thus, this study examined whether EF performance predicts SCCs of EF in healthy, well-educated middle aged and older adults, and whether carrying of APOE ε4 alters that prediction.

Method

Fifty-five cognitively intact middle aged to older adults (Mage = 64.1, range = 48–84, 19 e4+) completed the Frontal Systems Behavior Scale (FrSBe) Executive Dysfunction Scale (EXECDYS) to measure SCCs and an EF battery (Trail-making A&B, Symbol-digit Modalities Test, verbal fluency (letter, category), which principal components analysis (varimax rotation) reduced to a single EF factor. We examined whether SCCs (EXECDYS) were predicted by EF performance (age, depression covaried), and whether ε4 moderated that prediction (PROCESS 3.0).

Results

The model was significant (R2 = 0.31; p = 0.002), with a significant EXECDYS X ε4 interaction (ß = 4.24, t(55) = 2.37; p = .02), indicating that EF performance predicted EXECDYS, but in ε4-carriers only, those with poorer EF were less aware of that dysfunction.

Conclusions

Amongst APOE ε4-carriers, a group with high risk for AD, those with poorer EF had less accurate self-awareness of their EF, suggesting earlier formal assessment is needed in ε4-carriers to detect decline. Furthermore, as our study examined healthy, well-educated, cognitively intact adults from middle age, these findings suggest ε4-carriers are at particularly high risk for AD if their self-awareness and performance of EF are both low. Combining EF assessment with self-appraisal of EF may aid AD diagnostics.