bluuebunny/crossref_metadata_2025 huggingface dataset:
A-104 The Effect of Apathy on Semantic Category Fluency Performance in Alzheimer’s Disease Patients with MCI
Authors: Peart Zachary , Nunez Christina , Arias Brittny , Golden Charles
Published: August 2022

Objective: To investigate the effect of apathy on performance on a task of semantic category fluency in a sample of Alzheimer’s disease (ad) patients with mild cognitive impairment (MCI).

Method: The sample (N = 3951) was selected from the Alzheimer’s Disease Research Centers database by the National Institute on Aging. Individuals with diagnosed ad and an MMSE score from 19 to 24 were included. Groups consisted of no apathy (n = 2393,Mage = 75.68,58% female), mild apathy (n = 833,Mage = 74.99,55% female), moderate apathy (n = 567,Mage = 74.72,47% female), and severe apathy (n = 158,Mage = 75.19,53% female). Participants were administered the vegetable and animal naming semantic category fluency tasks. Multiple ANCOVA were conducted while controlling for education, gender, and MMSE score to test whether the presence of apathy had an effect on performance on these measures.

Results: Significant differences were found in performance on the vegetable (F(3,3800) = 2.91,p = 0.033,η2 = 0.002) and animal (F(3,3852) = 5.70,p < 0.001,η2 = 0.004) naming tasks, suggesting that individuals endorsing apathy scored lower on average than those without apathy.

Conclusion: Results indicated modestly lower performance on measures of semantic category fluency in a sample of ad, MCI and apathy persons. While apathy has been associated with functional impairment, more research is needed to determine its impact on cognitive ability. These findings suggest that the apathy syndrome may be related to lower cognitive performance and highlight the importance of managing apathy in behavioral interventions for ad. Future research should investigate interventions that target apathy and its link to other cognitive domains.
A-108 Inflammatory Biomarkers Link Perceived Stress With Metabolic Dysregulation
Authors: Jurgens Savana M , Prieto Sarah , Hayes Jasmeet P
Published: August 2022

Objective: Psychological stress has been identified as a risk factor for several metabolic diseases, including cardiovascular disease and type II diabetes. However, the intermediate pathways underlying this relationship are not well understood. Inflammatory responses may be one process by which stress leads to metabolic dysregulation. Prior work has shown that chronic stress is associated with elevated systemic inflammation and that altered inflammatory activity contributes to the pathogenesis of metabolic disease. The current analyses tested this theory by examining inflammation as a pathway by which perceived stress affects metabolic health.

Methods: Data from the Midlife in the United States Study (MIDUS) (N = 863; Mean age = 52.72) provided measures of perceived stress, inflammatory biomarkers [C-reactive protein (CRP), interleukin-6 (IL-6)] and metabolic health markers. Confirmatory factor analysis (CFA) was used to confirm the fit of a hierarchical model of metabolic dysregulation in our sample. Structural equation modeling (SEM) was used to test the assumption that stress is linked to metabolic dysregulation through inflammation.

Results: The CFA of metabolic dysregulation demonstrated excellent goodness of fit [RMSEA = 0.040 (95% CI = 0.036–0.062); CFI = 0.973; SRMR = 0.082]. SEM supported the proposed model which included perceived stress, inflammation and the metabolic latent variable with age and sex as covariates [RMSEA = 0.082 (95% CI = 0.075–0.089); CFI = 0.898, SMSR = 0.085]. The indirect pathway linking stress to metabolic dysregulation via inflammation was significant [B = 0.029, z = 2.812, p < 0.01].

Conclusions: These results suggest that inflammatory biomarkers are a viable pathway for explaining how experiencing stress may result in metabolic dysregulation. Inflammatory processes may be an important target for future research investigating stress and adverse health outcomes.
A-112 Cognitive Reliability and Time to Failure Rate Theory and Genetics
Authors: Poreh Amir M , Baker Essence , Miller Makayla
Published: August 2022

Objective: In this study, we utilized the cognitive reliability intact the failure theory toward an understanding of the impact of genetics and more specifically APOE-4 on cognitive decline. This method allows for the identification of the threshold as well as the decline rate in groups with different levels of education.

Method: Data was obtained from the National Alzheimer’s coordination center(NACC). Following Brickell et al, 2020 we focused on the Trail Making Test part B (number of seconds to complete the task) and semantic fluency (animals) tests.

Results: The study shows higher performance on the TMT B among those without the E4 allele emerging already at the age of 65. The decline rate however remains identical across the 3 groups. On the Semantic Fluency, Taskwe compared high school and college-educated subjects. Those without copies of the E4 allele exhibit stable functioning until about the age of 75 and then show a rapid exponential decline. Those with one copy exhibit an earlier threshold at about the age of 55. Those with a college education have a higher asymptote and show a decline before the age of 45 With the rate of decline has a linear characteristic.

Conclusion(s): The present study demonstrates the utility of the reliability intent of failure theory for the study of cognitive decline across the lifespan. They show that the distinction between threshold decline rates could serve as an important factor in examining the impact of genetics.
A-115 Identifying Factors Related to High Healthcare Utilization in a Group Of Persons with Dementia and their Caregivers
Authors: Pereira Carolina , Arredondo Beth , Boettcher Anneliese , Brickell Emily , Sawyer R John
Published: August 2022

Objective: Identify factors related to high healthcare utilization in dementia patients to determine a high-risk profile and tailor the Care Ecosystem Program to subgroup needs.

Methods: Cross-sectional data on persons with dementia (PWD) and caregivers (CG) enrolled in a branch of the Care Ecosystem Program (memory.ucsf.edu/Care-Ecosystem) were used. PWD had one emergency department (ED) visit or hospitalization prior 12-months. Data for 273 dyads included sociodemographics, healthcare utilization, dementia severity (Quick Dementia Rating Scale), and emotional wellbeing (i.e., Short-Form Zarit Burden Interview, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7). High utilizers (HU) were more than two standard deviations above the mean for ED visits (N = 40) or hospitalizations (N = 42). Analyses included descriptive, frequencies, independent sample t-tests, and negative binomial regressions.

Results: Mean age was 80 years for PWD and 64 years for CGs. Both were predominantly female (PWD = 60%, CG = 78%) and white (64%) with high school education or higher (PWD = 83.5%, CG = 97.4%). Dementia severity was mild to moderate (QDRS M = 11.4; SD = 6). ED-HU had higher/more dementia severity (p = 0.03, d = 6.2), medical comorbidities (p < 0.001, d = 2.4), medications (p = 0.047, d = 4.5), and preventable (p = 0.013, d = 0.7) and unpreventable (p < 0.001, d = 1.5) visits. Hospitalization HU presented increased neuropsychiatric severity (p = 0.048, d = 6.5) and medications (p = 0.012, d = 4.4). Negative binomial regression model for ED visits (p = 0.025) showed increased comorbidities as the only predictor (p = 0.034), while the model for hospitalizations (p = 0.010) was associated with Black race (p = 0.004), younger PWD (p = 0.033), and more medications (p < 0.001).

Conclusions: Increased medical complexity was associated with HU for ED visits and hospitalizations in PWD-CG dyads. Additional research and possible need for variation in care management services are warranted.
A-120 Cognitive Function and VO2max following HIIT Exercise Intervention
Authors: Myers Terina L , Norling Amani , Gerstenecker Adam , Buford Tom , Lazar Ronald M
Published: August 2022

Objective: To determine if an 8-week HIIT exercise intervention would improve VO2max and cognitive function in older sedentary women.

Method: Eleven women between the ages of 60 and 75 participated in an 8-week HIIT exercise intervention. At baseline, participants were administered a VO2max test and a neuropsychological battery, which assessed both global functioning as well as specific domains of processing speed, visual memory, attention, language and executive function. Composite scores for each domain were calculated using average z-scores. Procedures performed at baseline were conducted again following intervention.

Results: Following the intervention, there was a mean VO2max increase of 3.89 ml/kg/min (p<.0001) compared to baseline. Cognitive data showed the total cognitive composite z-score significantly improved from baseline (M=-0.71, SD=0.58) to follow-up (M=0.20, SD=0.61). Visual memory baseline (M=-0.37, SD=1.97) also showed significant increase at follow-up (M=0.27, SD=0.83) along with a language domain improvement from baseline (M=-0.04, SD=0.60) to follow-up (M=0.25, SD=0.59), all p <.05. In addition, VO2max was significantly correlated with the total cognitive composite z-score (r= 0.65; p< .05) and visual memory (r=.66; p<.05).

Conclusions: We found that 8-weeks of HIIT was sufficient to increase VO2max in older sedentary women. Total composite z-scores and specific domains of visual memory and language also showed significant improvement after intervention. Total cognitive composite scores and visual memory were also correlated with VO2max. These findings highlight the need to explore further the mechanisms that drive exercise effects on cognition across diverse populations.
A-121 Drinking Behavior and Impulsivity in College Students
Authors: Hatch Oliver J , Agbaroji Hannah A , Valencia Estefania , Hardy David J
Published: August 2022

Objective: Individuals with chronic alcohol abuse have been shown to be more impulsive. Our objective in the present study was to assess drinking behavior in healthy college students and examine potential relationships between these drinking habits and impulsive behavior.

Method: College students (n = 22) completed a survey about drinking behaviors, the Barratt Impulsiveness Scale (assessing various subscales of impulsivity), and the Color-Word Inference Test portion of the Delis Kaplan Executive Function System (DKEFS). The Color-Word Inference Test is a variation of the Stroop Test, testing the ability to inhibit prepotent responses.

Results: We found a significant relationship (r = 0.428, p = 0.047) between total number of drinks per week (M = 5.59, SD = 5.70) and the Barratt motor impulsiveness subscale (M = 2.12, SD = 0.455). Looking for behavioral evidence of this relationship, we examined this same group with the DKEFS Color-Word Inference Test and found total number of self-corrected errors (M = 0.909, SD = 1.02) was positively associated with total number of drinks consumed per week (r = 0.446, p = 0.037).

Conclusion(s): Preliminary results show a relationship between alcohol consumption and motor impulsivity. We propose that greater alcohol consumption may be an indicator that our subjects made errors on the Color-Word Inference Test due to impulsive tendencies and are then catching and correcting their errors soon after they are made. These findings are of interest considering the population examined are young and otherwise healthy college students, suggesting fairly mild but acute effects of moderately heavy alcohol consumption.
A-126 Social Determinants Measures: Dichotomous or Dimensional?
Authors: Tse Phoebe Ka Yin , Shields Allison N , Chang Fini , Wisinger Amanda M , Stocks Jane K , Bing-Canar Hanaan , Khan Humza , Lapitan-Moore Franchezka , Jennette Kyle J , Soble Jason R , Resch Zachary J
Published: August 2022

Objective: The study aimed to examine the use of dichotomous versus dimensional scores across two social determinant measures regarding their ability to predict cognitive and psychiatric outcomes in a diverse, urban, clinical sample. The goal was to better guide clinicians in the selection of appropriate research methodology pertaining to the use of cut-scores versus dimensional constructs.

Method: The study included 215 adults referred for outpatient neuropsychological evaluation. Patients were classified into at-risk/low-risk groups based on predetermined Rapid Estimate of Adult Literacy in Medicine - Revised (REALM-R) and Adverse Childhood Experiences (ACE) cut-scores. Nine cognitive tests and two psychiatric self-report scales were administered. A series of hierarchical regression models were conducted to investigate the predictive power of dichotomous scores alone, and account for the incremental predictive power of dimensional scores.

Results: For REALM-R, dichotomous scores alone accounted for significant variance, demonstrating robust predictive power across all cognitive tests (p < 0.001 to p < 0.05), but not for psychiatric outcomes. Dimensional scores provided significant incremental variance in five cognitive tests (p < 0.001to p < 0.05) during which the parameter estimate for the dichotomous scores was reduced to non-significance. Regarding ACE, dichotomous scores were positively associated with psychiatric symptoms (p < 0.001), but not with cognitive outcomes. The addition of dimensional scores did not predict significantly more variance.

Conclusion: This study demonstrated the robust predictive power of dichotomous scores in REALM-R and ACE. Further, dimensional scores provided potent incremental predictive power for REALM-R and should be used to enhance clinical decision-making when applicable.
A-139 Language and Communication Skills in Children with Different Fetal Alcohol Spectrum Disorder Diagnoses
Authors: Williams Brittney M , Bothe Denise , Lipman Catherine , Tangen Rachel
Published: August 2022

Objective: Children with Fetal Alcohol Spectrum Disorders (FASD) exhibit language deficits, but there has been limited investigation of differences in language and every day communication abilities between FASD diagnostic subgroups. Objective: First, it was hypothesized that children across FASD diagnoses would show deficits in expressive and receptive language and parent rated communication compared to the normative sample. Second, it was hypothesized that language and communication scores would get significantly worse as the severity of FASD diagnosis increased.

Method: 90 children (Mean Age = 8 years; 58% Male) were assessed through FASD multidisciplinary clinic using the 4-digit code (Astley, 2004). Fourteen participants met criteria for full/partial Fetal Alcohol Syndrome (FAS), 29 for Static Encephalopathy (SE), and 47 for Neurobehavioral Disorder (ND). Language skills were assessed with Clinical Evaluation of Language Fundamentals Formulated Sentences, NEPSY-2 Comprehension of Instructions, and Vineland-III Communication subtest.

Results: The FASD group performed significantly worse than the normative sample on expressive language (p <.001; 95% CI [-5.72, -2.63]), receptive language (p<.001; 95% CI [-3.33, -2.12]) and communication tasks (p <.001; 95% CI [-24.70, -20.30]). The expressive language score was significantly different between groups: F (2, 30.208) = 5.355, p = .020. The ND group performed significantly better (p = .048) 95% CI [.04, 9.96] than other groups. No other significant differences were found.

Conclusions: Children with FASD have language deficits on objective measures and parent ratings, which should be a focus of intervention. Expressive but not receptive language or communication skills were impacted by diagnostic severity; therefore, other factors impacting communication should be examined.
A-141 Pediatric Epilepsy Severity Relates to Adverse Childhood Experiences
Authors: Schweitzer Hannah , Bush Joseph , Emick Jessica
Published: August 2022

Objective: The impact of acute stress on seizure frequency and severity is well documented in pediatric epilepsy (van Campen et al., 2012). The extent to which specific chronic stressors such as Adverse Childhood Experiences (ACES) impact epilepsy severity is unknown. This study aims to examine the impact of specific ACES on epilepsy severity.

Method: Data from the 2019-2020 National Survey of Children’s Health, a nationally representative, cross-sectional survey, were used. Variables for epilepsy severity were recoded to exclude responses from subjects without epilepsy (remaining responses were recoded 0 for Mild, 1 for Moderate and Severe) (N=457). Chi square tests were run with ACES categories that had dichotomous variables, and independent t-tests were run for ones with ordinal variables.

Results: A statistically significant relationship was found between epilepsy severity and the child’s parent or guardian serving time in jail [X₂ (1, N= 451) = 6.16, p= .013], with a small effect size (.11), and between epilepsy severity and difficulty covering basic needs on family income [t(457)= -2.00, p= .046]. Other ACES did not significantly relate to epilepsy severity.

Conclusion: Effective treatment of pediatric epilepsy involves holistic analysis of ongoing stressors in the family, and use of appropriate social services resources may aid in reducing epilepsy severity. Further research is needed on impacts of parental incarceration and financial instability over other adverse experiences.
A-142 The Impact of Temperament on Sleep in Term and Preterm Infants
Authors: Lobermeier Michelle , Lang Natasha , Lajiness-O'Neill Renee
Published: August 2022

Objective: Research has examined temperament’s effect on infant sleep. Poorer sleep has been associated with higher negative affectivity, lower surgency, and lower regulation. Limited research has examined gestational age in this association, despite findings that gestational age is individually related to temperament and infant sleep. Due to the increased risk associated with prematurity, we hypothesized that the aforementioned associations between temperament and poorer sleep would be stronger for children with lower gestational age.

Methods: Socioeconomically diverse term and preterm caregiver/infant dyads (N=571) were recruited in a longitudinal, multisite study. Temperament was measured at 9 months using the Infant Behavior Questionnaire. Infant sleep (IS) and parent perception of sleep (PP) were measured at 15 months using the Brief Infant Sleep Questionnaire. Correlational analyses examined associations between temperament and sleep, while regression analyses explored gestational age as a moderator in this association.

Results: Higher negative affectivity was associated with poorer IS and PP (r=-.18, r=-.20, respectively, p<.01). Higher surgency was only associated with poorer IS (r=-.16, p<.01), while higher regulation/orienting was only associated with better PP (r=.16, p<.01). Gestational age was not a significant moderator.

Conclusion: Lack of moderation suggests gestational age does not differentially affect the association between temperament and sleep. Higher negative affectivity and higher surgency were associated with poorer IS, suggesting a target group for intervention. Children with higher negative affectivity may be more likely to receive intervention than those with higher surgency, as parents view their sleep as problematic. Children with higher surgency may require increased monitoring to receive intervention when warranted.
A-143 Understanding the Heterogeneous Effects of MELAS: A Comparative Study of Juvenile Sisters
Authors: Harness James E , Reis Jacqueline P , Ismail Hajar A , Herby Cecily A , Hall Asia A , Rossing John C , Obolsky Maximillian A , Bylsma Frederick W
Published: August 2022

Objective: Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) is a rare syndrome resulting from mutations in mitochondrial DNA. A neuropsychological profile of MELAS typically shows deficits in executive function, attention, language, memory, visuospatial, and motor functioning. To our knowledge, MELAS has been studied in single cases only. Here we examine the neuropsychological profile of juvenile siblings with MELAS.

Participants and Methods: Biological sisters aged 13 (affected) and 11 (non-affected) years, concordant for MELAS mutation but discordant for disease status. Active disease in the affected sister was triggered by HGH treatment for small stature. They were referred for neuropsychological testing to determine the nature and severity of current cognitive, emotional, and functional deficits following MELAS diagnoses. Clinical difference in cognitive performance score was defined as a difference of >1 SD in standardized scores.

Results: Performance on 48 neuropsychological test measures consistent with the MELAS presentation were contrasted between the sisters. The unaffected sister performed in the average range on most measures. The affected sister performed >1 standard deviation lower on 21 measures compared to the unaffected sister -- specifically on measures of motor strength, motor speed, visuomotor integration, visuospatial abilities, executive functioning, broad math, academic applications, phonological awareness, and rapid symbolic naming.

Conclusions: The results of this study reveal differences in the cognitive profiles of juvenile siblings with the MELAS mutation but different disease status (affected vs. not affected). Results are generally consistent with previous research in revealing deficits in executive functioning, visuospatial abilities, motor functioning, and language in the affected sibling.
A-147 Neuropsychologist’s Role in Bringing Voice to African Americans with Multiple Sclerosis
Authors: Tozser Timea B , Ergun Gokce
Published: August 2022

Objective: While it has been known that Multiple Sclerosis (MS) is most diagnosed in a young white population emerging literature suggests that the incidence of MS may be higher in African American populations than previously suggested in the literature (Dong et al., 2019). In addition, cultural bias in the referral and establishing appropriate diagnosis and treatment is an ongoing obstacle (Amezcua et al., 2020). This poster highlights the diagnostic discrepancies in healthcare and research for multiple sclerosis in African American populations and neuropsychologists' value in advocating for changing the narrative for MS within medical settings.

Data Selection: Literature was obtained through various databases such as Google Scholar and OhioLink. Keywords include multiple sclerosis, neuropsychology, African American, advocacy, health disparities, diagnostic discrepancies, ethnicity.

Data Synthesis: Health and mental health disparities that AA clients face influence the delay of MS diagnosis and subsequent treatment services (Amezcua et al., 2020; Stuifbergen et al., 2021). In addition, the degree of disease course is far more aggressive for African American patients; therefore, support through neuropsychological assessment to track disease course and provide recommendations is critical in advocacy work (Khan et al., 2015).

Conclusions: There should be more effort put forth in neuropsychology to increase representation within clinical research and prioritize the care who experience health care disparities, such as AA clients with MS. A neuropsychologist holds unique power that can be used to advocate and raise awareness regarding delays in diagnosis and the unique course of the disease and provide community resources for patients (Khan et al., 2015).
A-150 Cognitive Impairment in Patients with Infratentorial Stroke Undergoing Acute Stroke Rehabilitation
Authors: Waldman Rachel , Jaywant Abhishek
Published: August 2022

Objective: Brainstem, pontine, and cerebellar (infratentorial) stroke has been associated with motor and cranial nerve dysfunction. However, case reports and clinical observations suggest that cognitive impairment may be present. Acute inpatient stroke rehabilitation is a critical time to implement cognitive interventions; however, intervention opportunities may be missed if rehabilitation providers are unaware of cognitive dysfunction and do not assess for deficits in patients with infratentorial strokes. Our objective was to evaluate cognition in individuals with infratentorial strokes undergoing acute inpatient rehabilitation.

Method: Participants were recruited as part of an ongoing clinical trial on an acute inpatient rehabilitation unit. Participants (N=7; Median age=69 years (range 53-88); Median education=16 years (range: 6-20); 4 female) with recent onset infratentorial stroke were administered the Tablet-based Cognitive Assessment Tool on admission to the unit. Performance was evaluated via normative comparison (impairment defined as ≤1.5 SD below the normative mean) and by direct comparison to participants with supratentorial strokes (N=17) using Mann-Whitney U tests.

Results: Participants with infratentorial stroke demonstrated impairment across tasks of attention/working memory, set-shifting, and inhibition (Median age-normed z-score ranged from -2.35 to -3.86). No statistically significant differences were observed between patients with infratentorial and supratentorial strokes on any cognitive tasks (all p’s>.25).

Conclusions: In acute inpatient rehabilitation, infratentorial stroke may cause impairment in attention, working memory and executive functioning similar to the impairment seen in patients with supratentorial stroke. Although follow-up analyses with larger samples are warranted, results suggest that early identification and intervention for cognitive deficits should be part of rehabilitation for patients with infratentorial strokes.
A-157 G Syndrome in Adulthood: A Case Report
Authors: Scull Sara , Marschall Kelsea P , Plotnik Lisa , Stark Aleksandra , Thorp Karen , McLaren Jennifer , Lichtenstein Jonathan D
Published: August 2022

Objective: FG syndrome is an X-linked recessive disorder (p.R961W MED12 mutation) affecting phenotypic males and is characterized by intellectual disability, multiple congenital anomalies, hypotonia, constipation, and hyperactivity. Existing literature about syndromic presentations in adulthood is limited. This case study presents an adult with FG syndrome.

Method: Patient is a 39-year-old White cisgender male with FG syndrome and confirmed p.R961W mutation. Pertinent history includes agenesis of corpus callosum, moderate intellectual disability, communication disorder, Tourette’s syndrome, attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, bipolar disorder not otherwise specified, and posttraumatic stress disorder. Previous neuropsychological assessments found a generalized pattern of impairment. In early adulthood, the patient’s motor skills deteriorated, and he was hospitalized for aggression. At age 37, the patient was “declining” despite a normal CT scan (except for agenesis of corpus callosum) and development of intermittent paranoia and auditory and visual hallucinations.

Results: An interdisciplinary evaluation, performed via telehealth, was completed at an academic medical center. Cognitive changes were denied. Hyperactivity, angry outbursts, affability, and talkativeness were reported. Behavioral and psychiatric symptoms decreased since a change in residence and homecare providers.

Conclusions: Little is known about adults with FG syndrome. This case suggests that the behavioral phenotype of FG syndrome remains consistent into adulthood. While cognitive changes were not evident, a decline in motor function and the development of psychotic symptoms did occur. This case increases awareness about FG syndrome in adulthood and can inform clinical practice. Adults with FG syndrome can achieve meaningful goals with proper support from community services, supervised living, and therapeutic interventions.
A-158 Levels of Systemic Inflammation is Associated with Cognitive Function in People with Multiple Sclerosis
Authors: Collette Christopher W , Norling Amani M , Ward Katherine , Freeman Hyun , Myers Terina , Bashir Khurram , Lazar Ronald M , Gerstenecker Adam
Published: August 2022

Objective: To investigate the relationship between systematic inflammatory biomarkers and cognition in patients with Multiple Sclerosis (MS).

Method: We recruited 36 patients diagnosed with MS (31 with relapsing-remitting and 5 with progressive) who presented for treatment at the University of Alabama at Birmingham (UAB). Patients underwent a comprehensive neuropsychological battery, and serum blood samples were collected. Cognitive data was divided into an overall Cognitive Composite score and seven cognitive domains (i.e., Attention, Verbal Memory, Visual Memory, Visuospatial Ability, Language, Processing Speed, and Executive Function) using z-score averages. Pearson's product-moment correlations were conducted to determine the relationship between cognitive performance and 14 inflammatory biomarkers specifically chosen for their potential role in MS.

Results: Matrix Metalloproteinase-9 (MMP-9) was significantly correlated with Visual Memory (r= -.424; p=.01), Language (r= -.425; p= .01), and Cognitive Composite (r= -.380; p= .022) scores. Additionally, Insulin-like Growth Factor-1 (IGF-1) was significantly correlated with the overall Cognitive Composite (r= -.346; p= .039) score.

Conclusions: Studies investigating associations between inflammation and cognition in MS are lacking. In our sample of persons with Multiple Sclerosis, serum IGF-1 and MMP-9 biomarkers were moderately negatively correlated with the overall Cognitive Composite scores. MMP-9 was negatively correlated with Visual Memory and Language cognitive domain scores. These findings in a representative sample of patients with MS highlight the need for further research exploring the relationship between systematic inflammatory biomarkers and cognition in MS.
A-163 Neuropsychological Profile of Early Onset ADEM and AMSAN
Authors: Palmeri Maria J , Bronshteyn Diana , Facchini Ronda , Masur David , McGinley John , Weiss Erica
Published: August 2022

Objective: We present the neuropsychological profile of a 9-year-old girl with a history of waxing and waning ataxia, initially diagnosed at 18 months of age, with Acute Disseminated Encephalomyelitis (ADEM), later thought to be axonal motor sensory neuropathy (AMSAN). ADEM is a rapid onset neuroinflammatory disease typically seen in children ages 3-10 following infection, which results in demyelinating lesions. AMSAN is a rare variant of Guillain-Barre´ syndrome causing muscle/sensation difficulty. Common long-term cognitive correlates of ADEM include attention, processing speed and internalizing problems in the context of average overall cognition.

Method: Comprehensive neuropsychological evaluation referral by neurology to assist with continued workup given atypical history and unclear academic difficulties. Initial symptom workup revealed signal changes in spinal cord and demyelinating lesions in the left frontal lobe and upper cervical spine. She was treated with intravenous immunoglobulins (IVIG), but symptoms returned several months later and then again. Subsequent improvements with therapy for ataxia, speech and feeding difficulties.

Results: Overall cognitive functioning in the low average range with notable and extensive attentional limitations requiring continual prompting. Evaluation also revealed below grade and age level performance in all academic areas, significant oromotor and gross motor coordination difficulties, and mild self-esteem issues in this child who presented much younger than her chronological age.

Conclusions: This case demonstrates the importance of neuropsychological evaluation in pediatric paraneoplastic motor/sensory motor syndromes. While underlying cause of demyelination and ataxia in this case remains unclear, cognitive findings revealed significant areas that require intervention which could have been identified and supported earlier in her development.
A-170 Cognitive Functioning and Default Mode Network as Predictors of Smoking Severity in Adults
Authors: Fleischmann Holly , Hogan Kassidy S , Hargraves Tegan , Sarles-Whittlesey Heidi L , McIntyre-Wood Carly , Amlung Michael T , MacKillop James , Sweet Lawrence H
Published: August 2022

Objective: Smoking is a leading cause of avoidable death, with the best cessation treatments yielding only 10-30% abstinence. Limited neurocognitive research is available on the best predictor of cessation: addiction severity. We investigated whether smoking severity is associated with stronger resting functional connectivity and cognitive functioning.

Method: A community sample of 33 adult smokers (mean age=40.77, 72.73% female, 27.27% Black, >10 cigarettes per day [CPD]) completed 8-minutes of resting state functional MRI and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Default network (DN) functional connectivity was conducted using four seed/target regions. RBANS total score was operationalized as overall cognitive function. Smoking severity was operationalized as CPD.

Results: Mean RBANS scores were in the average range (mean=89.76, SD=11.68) and predicted CPD (mean=20.14, SD=9.33), accounting for 20.30% of the variance (see Table). Associations between RBANS and CPD were significantly moderated by mean target region synchrony with three of four seed regions: posterior cingulate cortex (PCC), left posterior precuneus (LPP), and right posterior precuneus (RPP). Medial prefrontal cortex (MPFC) synchrony did not add to the prediction. Repeating these regressions, controlling for age, yielded the same pattern. The three DN seeds continued to yield mean target region effects that exhibited strong interactions with the RBANS to predict severity (see Table).

Conclusions: DN synchrony moderates the association between cognitive function and smoking severity, such that the negative relationship between overall cognitive functioning and smoking severity is only present for those with lower levels of DN synchrony. These markers may improve understanding of neurocognitive mechanisms of smoking severity.
A-172 Evaluating Associations Between the Five Negative Symptom Domains and Cognition in Schizophrenia
Authors: Woodyatt Jessica J , Allen Daniel N , Goodwin Grace , Paul Nina , Salva Christine , Strauss Gregory
Published: August 2022

Objective: Recently, factor analysis has supported a five-factor model of negative symptoms in schizophrenia (anhedonia, avolition, alogia, asociality, and blunted affect). Associations between these unique negative symptom domains and neurocognition are yet to be examined. The following study investigates relationships between the five distinct negative symptoms and cognitive functioning.

Methods: Outpatients diagnosed with schizophrenia (n=245) were assessed during periods of clinical stability for negative symptom severity using the Brief Negative Symptom Scale (BNSS). The MATRICS Consensus Cognitive Battery (MCCB) was used to assess seven domains of neurocognition, including processing speed, working memory, verbal learning, visual learning, reasoning, problem solving, and social cognition. To evaluate external correlates, the five-domain negative symptoms were correlated with measures of neurocognition.

Results: Greater negative associations were found between the five negative symptom domains with processing speed, attention, working memory, social cognition, and overall MCCB scores. Correlational analyses demonstrated the strongest negative relationships between the domain of attention with alogia and blunted affect.

Conclusions: The present study examined unique associations between cognitive abilities and the five negative symptom domains. Strong negative associations were found between negative symptoms and distinct measures of neurocognition, indicating a unique variance in cognitive performance correlates with severity of negative symptoms. Results suggest greater severity of negative symptoms is associated with greater impairments in select neurocognitive domains. Further research using analytic approaches would offer additional support for this hypothesis. Findings have implications for developing differential treatments targeting the five negative symptom domains separately, as they may have distinct underlying pathophysiological and neurocognitive mechanisms.
A-175 Regional Cerebral Blood Flow in Self-Reported Anxiety in Adults versus Children
Authors: Geller Rachel T , Golden Charles , Nunez Christina , Stafford Claire , Jaramillo Cristina , Amen Daniel , Willeumier Kristen
Published: August 2022

Objective: The aim of this study is to identify regional cerebral blood flow (rCBF) differences between children and adults with high levels of self-reported anxiety.

Method: Subjects were selected from two independent clinical outpatient databases for child and adult SPECT scans. Scores were standardized to T scores for each database. The highest 20% of self-reported anxiety was selected from each database. The final sample consisted of 3226 Adults [Mage=37.78, majority-white (68.7%) and male (54.7%)] and 545 children [Mage=13.58, majority-white (48.6%) and male (59.3%)] Significant differences existed between groups for gender and race. An ANCOVA was utilized to test the difference in concentration rCBF between adults and children controlling for these t covariates.

Results: Groups were compared across 17 variables representing different areas of the brain (p<.05). Children had significantly higher rCBF than adults in the limbic [left: F(1,3767)=15.893, p<.001 and right: F(1,3767)=48.699, p<.001], basal ganglia [left: F(1,3767)=30.138, p<.001 and right: F(1,3767)=61.191, p<.001], frontal [left: F(1,3767)=142.244, p<.001 and right: F(1,3767)=112.273, p<.001], motor sensory right F(1,3767)=679.063, p=.008, and vermis F(1,3767)=50.025, p<.001 regions. Adults had significantly higher rCBF than children in the parietal regions [left: F(1,3767)=42.235, p<.001 and right: F(1,3767)=82.708, p<.001].

Discussion: There are significant differences in rCBF between children and adults with high self-reported levels of anxiety. This indicates that different neuronal mechanisms in adults and children are involved when experiencing high levels of anxiety. These findings can help clinicians better understand differences in how anxiety is expressed neurologically between children and adults.
A-177 Relationship between Subjective Well-Being and Interpersonal Relationships in the sheltered workshop
Authors: Yamada Taigou , Okutani Ken , Hayashi Naoki
Published: August 2022

Objective: The purpose of this study was to examine the influence of social participation on subjective well-being, especially among those who used employment support facilities, based on the understanding of subjective well-being in inpatient and psychiatric day care settings.

Methods: Subjects were clinically stable individuals diagnosed with endogenous psychosis. A total of 40 individuals were hospitalized (n=14), in psychiatric day care (n=10), or in a supportive employment facility (n=16). There were 18 women. The Japanese version of the Short Version of the Subjective Well-being Scale under Antipsychotic Treatment (SWNS-J) was used to assess subjective well-being. The Brief Psychiatric Symptom Rating Scale (BPRS) was used to assess the severity of psychiatric symptoms. The WHO DAS2.0 Japanese version (WHODAS2.0) was used for the social life assessment scale. Spearman's rank correlation was used for statistical analysis.

Results: The SWNS-J scores for subjective well-being were 75.7 (standard deviation=21.2) for inpatient, 71.2 (±22.6) for psychiatric day care, and 68.2 (±15.3) for employment support facilities. In employment support facilities, relatively low correlations were found between the SWNS-J and the WHODAS2.0 sub-items such as "understanding and communication," "independence," "self-care," and "daily life (family)," especially in interpersonal relationships (getting along with others: ρ = -0.65, P < 0.01) was significantly correlated with the SWNS-J.

Conculsion: The results suggest that it is important for occupational therapists to be aware of some daily stressors in interpersonal interactions when working with people in employment support facilities, and to give appropriate consideration to these stressors.
A-180 Clinical Outcome Following Concussion Among Children and Adolescents with a History of Prior Concussion: A Systematic Review
Authors: Cook Nathan E , Gaudet Charles E , Van Patten Ryan , Kissinger-Knox Alicia , Iverson Grant L
Published: August 2022

Purpose: This systematic review examined the association between prior concussion history and clinical outcomes following concussion among children and adolescents.

Data Selection: This review was registered with PROSPERO database for systematic reviews (protocol ID: CRD42016041479 & CRD42019128300) and adhered to PRISMA guidelines. Three searches of nine online databases were conducted: (a) database inception to June of 2016; (b) January 1, 2016 to February 1, 2019; and (c) February 1, 2019 to May 15, 2021. We screened 5,118 abstracts and 51 studies were reviewed. We utilized a likelihood heuristic to assess evidence for an association between concussion history and clinical outcomes. Risk of bias was assessed using the Newcastle-Ottawa scale and level of evidence was appraised using the Oxford Classification for Evidence-Based Medicine.

Data Synthesis: Concussion recovery or outcome was reported for 26,643 youth. A median of 36% had a prior history of concussion. Across all studies and outcomes, the majority (k=37, 72.5%) did not find a statistically significant association between lifetime history of concussion and outcome from a subsequent concussion. Important methodological limitations in the literature were identified (e.g., many studies were underpowered and/or coded prior concussion history as a binary variable as opposed to the number of prior concussions).

Conclusions: Available studies do not provide compelling evidence that children and adolescents with a history of concussions are at increased risk for worse clinical outcome following a subsequent concussion. Clinicians are cautioned against routinely treating children and adolescents with one or more prior injuries more conservatively. Doing so, in some cases, might be counterproductive.
A-188 The Effect of Traumatic Experiences on Identity Among People With Expressive Language Disorders
Authors: Wagaman Bailey , Berman Steven
Published: August 2022

Objective: To examine the effects of traumatic brain injury (TBI) on identity functioning.

Method: TBI survivors’ recollections of their sense of identity before and after they acquired a TBI were compared. Participants (N = 15, Mage = 52.67) recruited from rehabilitation and support groups completed two clinical interviews, as well as the Trauma Impacts of Identity Functioning Scales (Waterman, 2020) and Identity Distress Scale (Berman et al., 2004). They were mostly stroke survivors with aphasia. The majority of the participants were White (53.3%). The time since they acquired an expressive language disorder ranged from 2 to 21 years ago (M = 7.33).

Results: A paired samples t-test revealed a significant increase in identity distress from pre- to post-brain injury (t(14) = -3.11, p = .008, 95% CI). A ONEWAY ANOVA revealed that ratings of how important their career is to their sense of identity significantly decreased post-TBI (F(1, 13) = 17.47, p = .001, λ = .427, 95% CI). During the clinical interviews, many TBI survivors reflected that they lost a large part of themselves because they could no longer pursue their careers, and they experienced drastic changes in their relationships and life roles. Participants had identity development delays, trauma-centered identity, identity loss, identity threat, and identity affirmation.

Conclusion: Identity changes post-TBI varied greatly from one survivor to another, and time since trauma was not significantly correlated with identity functioning nor identity distress, suggesting the need for future research to determine which factors influence why TBI survivors’ experience post traumatic identity disruption and/or post-traumatic growth.
A-190 Posterior Electrode Angle Predicts Post-DBS Apathy Increases in Parkinson’s Disease Patients
Authors: Schmitt Taylor R , Hurd Zachery , Askari Asra , Patil Parag G , Chou Kelvin L , Persad Carol C
Published: August 2022

Objective: The literature has consistently shown that Parkinson’s disease (PD) patients tend to experience increases in apathy following deep brain stimulation of the subthalamic nucleus (STN-DBS). While surgical variables, i.e., active contact location and lead angle, have previously been found to predict post-DBS cognitive changes, it has yet to be studied whether these variables also impact post-DBS apathy.

Method: Data was retrospectively analyzed from 42 individuals with idiopathic PD who underwent bilateral STN-DBS. Forty-two individuals completed patient-report versions of the Marin Apathy Scale, and 27 had accompanying caregiver reports. Pearson’s correlations and linear regressions were conducted to examine the impact of active contact location (in X, Y, and Z axes) and lead angle (in anterior/posterior and medial/lateral directions) on post-DBS apathy changes. Covariates included disease duration, age, and change in motor symptoms (as measured by the MDS-UPDRS).

Results: Increases in caregiver-reported apathy post-DBS were explained by more posterior angles of the leads in both hemispheres (right: R2 = .33, F(3,23) = 3.79, p = .02, sr2 = .32; left: R2 = .37, F(3,23) = 4.56, p = .01, sr2 = .36). Although a significant correlation was identified between worse patient-reported apathy and more medial active contact location in the right hemisphere, this effect was no longer significant with inclusion of covariates.

Conclusions: Findings indicate that lead angle, but not active contact location, has a significant impact on post-DBS increase in apathy. This is consistent with prior studies predicting post-DBS verbal fluency changes and may suggest an adverse effect on frontostriatal neurocircuitry.
A-191 The Relationship between Demographic and Injury-Related Factors and Return to Driving following Holistic Milieu-Oriented Neurorehabilitation
Authors: Maffett Anissa , Klonoff Pamela , Johnson Spring , Roth-Roemer Sari , Koberstein Edward
Published: August 2022

Objective: Return to driving (RTD) following an acquired brain injury (ABI) positively impacts an individual’s productivity, quality of life, and community re-integration. Research illustrates that the return to driving is a complex process influenced by personal, cognitive, psychological, medical, neurological, and environmental factors. This study examined the association between demographic and injury factors and RTD at discharge following intensive neurorehabilitation.

Method: This retrospective study analyzed the medical records of 178 individuals with heterogeneous acquired brain injuries who participated in a holistic milieu-oriented outpatient neurorehabilitation program from 2012 to 2022. Demographic information (age, education, race/ethnicity), injury history (injury type, age at injury, chronicity), program participation variables (length of program participation, age at participation), and driving status at discharge were collected.

Results: Individuals with more chronic injuries were less likely to present with a RTD goal at admission, (p = .004). 71% (N = 88) of individuals met their RTD goal by discharge. There was no significant relationship between age at injury, age at admission, chronicity, days in treatment, or education and successful RTD at discharge. Type of brain injury (traumatic brain injury, stroke, or other [i.e., anoxia, seizure, and infection]), gender, and race/ethnicity were not related to successful RTD at discharge.

Conclusions: The majority of ABI survivors met their RTD goal at discharge. Findings illustrate that the holistic milieu-oriented treatment approach is effective with regard to addressing RTD goals across a variety of brain injury etiologies, demographics factors, and injury variables.