bluuebunny/crossref_metadata_2025 huggingface dataset:
A-11 The Contribution of Psychological Stress to Adolescent Post-Concussive Symptoms Across Recovery
Authors: Tarkenton T , Presley C , Meredith-Duliba T , Caze T , Hynan L , Didehbani N , Silver C , Cullum M
Published: August 2020

Objective

The aim of this study was to explore whether less commonly explored injury factors account for variance in post-concussive symptoms across recovery.

Method

Participants aged 12–18 (n = 440) who reported to clinic within 14 days of concussion sustained in either sport injury, MVA, fall, or hit were selected from the ConTex registry. A PCS log, PHQ-8, and GAD-7 were completed at initial visit and 3-month follow-up. Separate hierarchical linear regressions determined predictors of PCS scores at both time points. Demographic, premorbid, injury, and psychological factors were entered in Step 1–4, respectively. A sample subset completed the PTSD Checklist (PCL-5) at initial (n = 58) and 3-month visits (n = 27). Exploratory analyses added the PCL-5 to determine whether post-traumatic stress symptoms contributed to the model.

Results

At initial visit, sex, post-traumatic amnesia (PTA), PHQ-8, and GAD-7 significantly predicted PCS total scores (p < .001), accounting for 43% of the variance. At 3-month follow-up, PTA dropped out of the model, and psychiatric history and mechanism of injury became significant, explaining an additional 15% of the variance in PCS scores (R2 = .58, p < .001). In exploratory analyses, when PCL-5 scores were added to the final models, demographic, premorbid, and injury factors did not remain significant, and the PCL-5 significantly contributed to the variance in PCS scores at both initial (p = .01) and 3-month follow-up (p < .001).

Conclusions

Psychological stress and context of injury may be strong predictors of PCS in addition to demographic and premorbid factors. These findings warrant continued investigation of less explored injury factors contribution to initial mTBI presentation and recovery.
A-13 Demographic Differences in Performance Validity Test Failures
Authors: Braun S , Fountain-Zaragoza S , Halliday C , Horner M
Published: August 2020

Objective

The present study aimed to investigate demographic differences in performance validity test (PVT) failure in a Veteran sample.

Method

Data were extracted retrospectively from neuropsychological evaluations at a southeastern Veterans Affairs (VA) Medical Center. Only male Veterans who were either European American/White (EA) or African American/Black (AA), and for whom complete data were available were included in the study (N = 1271). We investigated whether performance on two frequently used PVTs, the Test of Memory Malingering (TOMM) and the Medical Symptom Validity Test (MSVT), significantly differed by age, education, race, and VA service connection using separate logistic regressions.

Results

Veterans with younger age, less education, and VA service-connected disability were significantly more likely to fail both PVTs. Race was not a significant predictor of MSVT failure, but AA patients were significantly more likely than EA patients to fail the TOMM. For all significant demographic predictors in the models, effects were small. In a subsample of patients who were given both PVTs (n = 467), the pattern of differences based on race remained; 46% of AA patients and 36% of EA patients failed the TOMM, while 44% of AA patients and 43% of EA patients failed the MSVT.

Conclusions

Performance on the TOMM and MSVT systematically differed based on demographics. Results were not consistent across PVTs, with performance on the TOMM differing between EA and AA patients, but performance on the MSVT did not differ by race. These results suggest that demographic factors may play a small but measurable role in performance on specific PVTs.
A-018 Informant and Participant-Report of Functioning Predicts Performance on Objective Cognitive Screening
Authors: A Stanley , I Mohebpour , B Auman , B Christine , T Virden , K O'Connor , M Callan , J Mansoor , B Evans , J Kiefer , L Roye , C Cline , N Moorley , J Nosker , A Atri
Published: August 2020

Objective

Montreal Cognitive Assessment (MoCA) and Alzheimer’s Disease 8 questionnaire (AD8) are widely used measures for clinical screening of dementia related disorders. Previous research on MoCA and AD8 has been solely focused on participant-report AD8 measures without consideration of informant reports. We hypothesize informant reported AD8 and participant MoCA scores will be inversely related, participant-reported AD8 will be weakly associated with MoCA performance, and informant reported AD8 will more reliably predictor cognitive performance.

Methods

Participants (N = 212) were seen from 2018 to 2020 through a free community screening service (Brain Health Check-In) at Banner Sun Health Research Institute in Arizona. First and second hypotheses were analyzed with Spearman’s Rho (r), third hypothesis utilized a linear regression.

Results

Both participant and informant reported AD8 directly correlated with overall cognitive performance classification (r = 0.639 [informant] confidence interval [CI] = .0552–0.712, p < .000; r = 0.610 [participant] CI = 0.518–0.688, p < .000). Informant reported AD8 ratings were significantly inversely correlated with MoCA performance (r = −0.497, p < .000). Participant reported AD8 ratings also inversely correlated with overall MoCA scores with a weaker association (r = −0.296, p < .000). Neither participant nor informant reported AD8 were able to reliably predict categorical cognitive performance classification, but informant reported AD8 (r = −.686, p < .000) did emerge as a reliable predictor of MoCA performance.

Conclusion(s)

This study extends and reaffirms prior research about AD8 and suggests both informant- and participant-reports are valuable; however, informant often provides more clinically useful information related to cognitive functioning.
A-02 Comparing Rate of Change in MoCA and MMSE Scores Over Time in an MCI and AD sample
Authors: A Carlew , W Goette , K Womack , L Hynan , L Lacritz
Published: August 2020

Objective

The Montreal Cognitive Assessment (MoCA) and Mini-Mental Status Exam (MMSE) are used for tracking cognitive change in mild cognitive impairment (MCI) and Alzheimer’s disease (AD), despite limited empirical support for this purpose. This study compared longitudinal change in MMSE and MoCA scores to investigate their applicability for tracking cognitive change.

Method

Inclusion criteria were: diagnosis of MCI or AD (CDR global = .5) by consensus conference, administration of the MoCA and MMSE across ≥3 visits, and no reversion to normal (n = 59; Mage = 70.81; Meducation = 14.97; 56% male; 76.3% Caucasian; 80% MCI at baseline). Testing sessions occurred ~ 12 months apart (M = 12.59, SD = 3.43, range 5–28 months). Change in MMSE and MoCA scores was modeled using multilevel regression. A 95% bootstrap confidence interval (BCI) for the slopes of both tests was computed and used to evaluate whether the tests measured significantly different change.

Results

Controlling for age and education, the MoCA demonstrated significantly more change over time (95% BCI [−0.06, −0.02]; MoCA Visit 1 M = 24.00, Visit 4 M = 21.88) than the MMSE (95% BCI [−0.03, 0.01]; MMSE Visit 1 M = 27.83, Visit 4 M = 27.50). MoCA scores significantly declined over the study period (but did not exceed the reliable change index), while MMSE scores did not.

Conclusions

The MMSE did not show significant change over time, while the MoCA did in this heavily MCI sample. Although statistically significant, clinical significance of change in the MoCA is unclear. Increasing MoCA use calls for additional research to understand what constitutes a clinically significant change and whether it is appropriate for tracking cognitive trajectories.
A-021 Normative Data on Montreal Cognitive Assessment Total Scores in Healthy Controls
Authors: L Ratcliffe , C Marker
Published: August 2020

The Montreal Cognitive Assessment (MoCA) is considered to be a suitable, sensitive, and specific cognitive screening tool for detecting mild cognitive impairment. Research has reported variable cutoff scores for the MoCA based upon geographical location. The aim of the present study is to provide normative data in a sample of cognitively healthy adults. Data was collected through the National Alzheimer’s Coordinating Center (NACC). A population of healthy adults (N = 3610) was examined (66% female, 78% Caucasian, 16% African American, 6% Other). MoCA normative data were derived from age and education, which were found to be weakly but significantly associated with age (r = −.203, p = .000) and more strongly correlated with education (r = .402, p = .000). Total scores (M = 26.25, SD = 2.75) were at the suggested cutoff for impairment (< 26). Based on an ANOVA, age had a significant effect on MoCA scores (F (6, 3603) = 25.30, p < .001). A second ANOVA revealed that education also had a significant effect on MoCA scores (F (2, 3582) = 290.56, p < .001). Individuals with higher levels of education obtained higher MoCA scores. Performance was also found to decrease slightly with age. Therefore, clinicians should use caution when applying the recommended cutoff scores.
A-022 Brief Test of Adult Cognition by Telephone to Examine Changes in Cognitive Functioning
Authors: J Hansel , J Roberts , K Stypulkowski , R Thayer
Published: August 2020

Objective

The purpose of this study was to examine changes in cognitive function over time as measured by a telephone-delivered cognitive assessment.

Method

Cognitive and biomarker data from the Midlife in the United States (MIDUS) study were used. Missing data were excluded through listwise deletion resulting in a final sample of 2,378 adult respondents with MIDUS 2: Cognition data available at baseline (T1; Mage = 53.49, SD = 10.63) and 9-year follow up (T2; Mage = 63.64, SD = 11.35). Cognition was measured using Brief Test of Adult Cognition by Telephone (BTACT) composite z-scores (“severe” = <−2.01 SD; “mild” = −1.01 to −2.00 SD; “normal”= > −1.00 SD).

Results

A Two-Way Repeated Measures ANOVA revealed main effects for time (F1, 2,375 = 46.73, p < .001) and group (F2, 2,375 = 499.34, p < .001). BTACT scores at T1 (M = -1.06, 95% CI[−1.21, −0.92]) were significantly lower than scores at T2 (M = -0.70, 95% CI[−0.82, −0.59]). As expected, BTACT scores for the normal group (M = 0.39, 95% CI[0.35, 0.42]) were significantly greater than both the mild (M = -1.33, 95% CI[−1.36, −1.30]) and severe (M = -2.25, 95% CI[−2.33, −2.16]) groups. A significant interaction effect was observed between time and group (F2, 2,375 = 204.10, p < .001). Bonferroni post-hoc comparisons indicated that cognitive function scores significantly declined for those in the normal group, but significantly improved for those in the mild and severe groups (all ps < .001). A regression model using biomarkers as predictors of cognitive change for the impaired groups was nonsignificant.

Conclusion(s)

Improvement in the mild and severe groups was unexpected and could not be explained by cardiovascular or metabolic risk factors at T1. These findings suggest cautious interpretation of cognition scores obtained via telephone measures.
A-04 The Relationship of ApoE Status and Cognition in Non-demented Older Adults
Authors: N Hawley , J Caldwell , J Miller , G Shan , A Salazar , J Kinney , C Wong
Published: August 2020

Objective

Apolipoprotein (ApoE)-e4 is well established as a genetic risk factor for Alzheimer’s disease (AD) as well as a predictor for the rate of cognitive decline in AD. Among older adults without dementia, some research has found that e4 carriers have worse episodic memory compared to e4 non-carriers, whereas others have not found this association. The present study examined differences in cognitive performance between ApoE-e4 carriers and non-carriers.

Method

91 non-demented individuals (age range: 55–87) were genotyped for ApoE (41 e4 carriers, 49 e4 non-carriers) and completed neuropsychological testing as a part of a longitudinal study at the Center for Neurodegeneration and Translational Neuroscience. Cognitively normal (CN) and mild cognitive impairment (MCI) participants were included (41 CN, 49 MCI). Group differences between e4 carriers and non-carriers were compared across cognitive measures after controlling for age, gender, and education.

Results

In the total sample, e4 carriers performed significantly worse across measures of verbal and nonverbal memory, as well as on the Boston Naming Test and Symbol Digit Modalities Test (all p’s < .05). No significant group differences were observed across visuospatial or executive function tasks. When diagnostic subgroups were examined, e4 carriers had worse verbal memory than non-carriers in the MCI group, but there was no effect of e4 status on cognition among CN participants.

Conclusion(s)

These findings support that ApoE-e4 positivity is associated with worse cognitive performance, especially on tasks related to medial temporal lobe function, among non-demented older adults. In MCI, worse verbal memory in e4 carriers likely reflects increased progression of underlying AD pathology.
A-042 Incongruence Between Self- and Parent- Report Measures of Executive Function on the Behavior Rating Inventory of Executive Function (BRIEF) in Adolescents with Attention Deficit Hyperactivity Disorder
Authors: A Garagozzo , S Hunter , D Smith
Published: August 2020

Objective

Research has demonstrated that adolescents with ADHD show executive dysfunction, although they do not always endorse such difficulties. We investigated inter-rater agreement between parent- and self-reported executive function (EF) in adolescents with ADHD, using the BRIEF. We also sought to investigate the relationship between scores on parent and self-report EF measures with performance on objective EF measures.

Method

Utilizing a clinical database, we identified 75 participants (13-17 years; Mage = 14.9; 60% male; 27% African American, 63% White, 3% Hispanic, 7% Other) with a diagnosis of ADHD. We examined inter-rater reliability between parent and self-reported factors on the BRIEF. We then examined the association between parent and self-report BRIEF Inhibition scores and the D-KEFS Color Word Interference (CWI) Inhibition trial, and parent and self-report BRIEF Shift scores and the D-KEFS CWI Inhibition/Switching trial and Trails Letter Number Sequencing trial.

Results

Significant associations were found between parent and self-ratings on BRIEF Inhibition (ICC = .22; 95% CI = -.24-.50), Shift (ICC = .24; 95% CI = -.21-.52), Emotional Control (ICC = .45, 95% CI = .137-.655), Plan/Organize (ICC = -.143; 95% CI = -.81–28), and Working Memory (ICC = -.193; 95% CI = -.89-.25) subscales. Correlation comparisons were significant for BRIEF self-report Inhibition and CWI Inhibition (r(73) = −.405, p = .000) only.

Conclusion

Results support standing findings regarding poor interrater reliability between parent and self-ratings of daily executive functioning in adolescents with ADHD. Self-report was seen to correlate with performance on objective EF tasks. Clinically, these results highlight the need for multidimensional assessment of ADHD in adolescents.
A-044 Are Memory Deficits in RD and ADHD Accounted for by Depressed Mood?
Authors: J Schlak , M Kibby
Published: August 2020

Objective

There is a well-established relationship between depression and memory functioning in adults (Perini et al., 2019) and children (Weir et al., 2012). There is a high rate of comorbidity between ADHD, reading disorders (RD; Wilcutt & Pennington, 2000) and depression (Meinzer et al., 2014) as well. Hence, this study sought to determine whether RD and ADHD are still related to short-term (STM)/working memory (WM) functioning when controlling for depressed mood.

Method

Participants included 187 children (55% male, 86% Caucasian), ages 8-12 years, with a diagnosis of ADHD, RD, comorbid RD/ADHD or were controls. They participated in a larger, NIH-funded study (R03HD048752, R15HD065627), representing a community sample. Memory was assessed with the WISC-IV LNS and DSF and the CMS Sequences subtests. Mood was measured with CDI Total score.

Results

2x2 MANOVA/MANCOVA was used, with and without controlling for mood. The MANOVA was significant for ADHD (Wilks’ lambda = .93) and RD (Wilks’ lambda = .66; ps < .01); the interaction showed a trend (Wilks’ lambda = .96; p = .07). For ADHD, significance was driven by LNS and Sequences (ps < .01). In contrast, for RD all three variables were significant (ps < .001). The LNS interaction was significant (p = .02). The CDI was related to DSF and LNS (ps < .01). The MANCOVA findings were similar to the MANOVA’s except the significance was slightly reduced overall.

Conclusion(s)

Findings suggest depressed mood may affect verbal STM and WM performance in children with ADHD and/or RD. As MANCOVA findings were significant, there likely are other factors that affect memory performance in these diagnostic groups as well.
A-045 Sluggish Cognitive Tempo in Youth: An Examination of Executive Functioning and Self-Reported Internalizing Symptoms
Authors: N Coultis , J Hopkins , E Heideman , A Kirsch
Published: August 2020

Objective

Sluggish cognitive tempo (SCT) is a group of attention-related symptoms that are characterized by slowed behavior and thinking, excessive daydreaming, mental confusion or fogginess, and drowsiness.4 Studies have shown that SCT is related to higher rates of anxiety, depression, and social isolation.4 Additionally, recent publications have indicated that aspects of executive functioning (EF) may be impacted in children with SCT.2,5 Meta-analysis confirmed that most SCT research has focused on parent and teacher report.1,3,4 There is an increased need for studies examining SCT with self-report.5 This study will examine how SCT is related to EF and self-reported internalizing symptoms in youth with Attention-Deficit/Hyperactivity Disorder (ADHD).

Method

Participants were youth aged 8 to 18-years with ADHD (N = 130) referred for neuropsychological testing. Participant demographics: males (N = 82, 63.1%). Measures included the Wechsler Intelligence Scale for Children/Wechsler Adult Intelligence Scale (WISC-V/WAIS-IV) Processing Speed Index (PSI), Conners Continuous Performance Test (CPT) Hit Reaction Time (HRT), Delis-Kaplan Executive Function System Color Word Identification (CWI) and Tower subtests, Behavior Assessment Systems for Children (BASC) self-report scales, and Personality Assessment Inventory-Adolescent (PAI-A) scales.

Results

Bivariate correlations showed that the PSI was significantly correlated with CWI Inhibition (r = 0.52, p < .01), CWI Inhibition/Switching (r = 0.53, p < .01), Tower (r = −0.20, p < .05), and Social Isolation (r = −0.19, p < .05), with Depression approaching significance (p = .06). The CPT HRT was also significantly correlated with CWI Inhibition (r = −0.19, p < .05) and CWI Inhibition/Switching (r = −0.22, p < .05), with Depression approaching significance (p = .05).

Conclusions

SCT is associated with EF and self-reported internalizing symptoms and should be included when considering interventions.
A-050 Association between Executive Functioning Performance and Resting State Connectivity in Pediatric Survivors of Acute Lymphoblastic Leukemia
Authors: V Seghatol-Eslami , A Stewart , T Tucker , E Lee , K Reddy , D Murdaugh
Published: August 2020

Objective

To explore differences between executive functioning (EF) and resting-state functional connectivity (rs-FC) of the executive control network (ECN) in survivors of acute lymphoblastic leukemia (ALL) compared to healthy controls.

Method

ALL participants (age 9-18) from Children’s of Alabama Hospital were ≥ 5 years post-diagnosis treated with chemotherapy only. Eleven ALL survivors and twelve controls were administered the Delis-Kaplan Executive Function Scale (D-KEFS) and Behavior Rating Inventory of Executive Function (BRIEF-2) self- and parent report. Using seed-to-voxel rs-FC analyses, we examined ECN regions (e.g., medial and dorsolateral prefrontal cortex [MPFC; dlPFC]). Within group multiple regression analyses were conducted to correlate EF scores to rs-FC z-scores.

Results

No significant differences were found on EF scores between ALL and control groups. rs-FC analyses indicated ECN hyperconnectivity in ALL survivors compared to controls (p < .05, FDR corrected). In ALL survivors, significant positive correlation was found between the average of Inhibit and Shift scores on the BRIEF-2 self-report and the MPFC (r = .926, p = .024), and negative correlation between D-KEFS Verbal Fluency and left dlPFC (r = −.869, p = .012). In controls, significant negative correlation was found between D-KEFS Design Fluency and left dlPFC (r = −.671, p = .012).

Conclusions

ALL survivors show hyperconnectivity of the ECN that is also correlated with both subjective and objective measures of EF. However, EF task performance was not significantly different between the two groups. This may indicate increased utilization of network regions to overcome network disruption specific to the ALL group in order to perform similarly to peers.
A-053 Importance of Neuropsychological Assessment in a Patient with DiGeorge Syndrome
Authors: A Lord , J Biedzycki , G Sarlo
Published: August 2020

Objective

22q11.2 Deletion Syndrome, (DiGeorge Syndrome), is a genetic disorder which commonly causes heart defects, a submucosal cleft palate, and other health conditions, in addition to developmental delays. Individuals with DiGeorge Syndrome are more likely to have Attention-Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD), with research also supporting a high risk for developing schizophrenia in adulthood.

Method

In this case study, a 22-year-old woman presented with DiGeorge Syndrome and trunkus arteriosus at the Department of Human Services (DHS) for employment services. Additionally, the patient’s parents reported concerns about behavioral outbursts and emotional regulation difficulties for the last three years. The patient completed a full neuropsychological, cognitive, and emotional assessment battery to help understand any neurocognitive and psychological limitations in obtaining and maintaining employment.

Results

On neurocognitive testing, she performed in the Severely Impaired range on measures of attention, processing speed, working memory, verbal memory, visual memory, visuospatial ability, motor functioning, and nonverbal problem solving. While performing in the Moderately Impaired range for tactile memory, verbal fluency, and cognitive flexibility. However, the patient exhibited a personal strength on the Verbal Comprehension Index of the Wechsler Adult Intelligence Scale—Fourth Edition (WAIS-IV). On emotional functioning testing, she did not display early signs of schizophrenia nor psychosis. However, the patient did express emotional and behavioral signs of ADHD and ASD.

Conclusion

This case study emphasizes the need for neuropsychological testing and ongoing psychological monitoring for individuals with DiGeorge Syndrome, as it relates to treatment recommendations and planning.
A-054 Deficit in Custained Attention in Children Born with Hypoxic-ischaemic Encephalopathy
Authors: E Mirzajonova , S Kiselev
Published: August 2020

Objective

There are evidences that children, born with Hypoxic-ischaemic Encephalopathy (HIE), have a delay in the development of neurocognitive functions, specifically they have a deficit in executive abilities. Do they have global or specific deficit in executive abilities? The goal of this research was to examine the hypothesis that children, born with HIE, have a deficit in sustained attention.

Methods

The experimental group included 20 children aged 5-6 years (mean age = 5.7). They were born full-term with perinatal Hypoxic-ischaemic Encephalopathy. The control group included 20 typically developing children. The children from experimental and control group were matched for gender and age. Children from both groups were assessed with 4 subtests from NEPSY (Tower, Auditory Attention and Response Set, Visual Attention, Statue) which are designed to assess the executive abilities in children.

Results

One-way ANOVA has revealed group differences (p < .05) in two subtests from NEPSY. Children with perinatal HIE have shown the weaknesses in performing Auditory Attention and Response Set and Visual Attention subtest. We did not reveal the significant differences (p < .05) in performing Tower and Statue subtest.

Conclusion

In view of the obtained results it can be assumed that the Hypoxic-ischaemic Encephalopathy has a specific (not global) negative effect on the development of executive abilities, particularly children with perinatal HIE have a deficit in sustained attention at the age of 5-6 years.
A-061 Early Childhood Prefrontal Cortex Stroke and Changes in Connections to Other Regions
Authors: J Hertza , J Burton , K Jupp , Z Repp
Published: August 2020

Objective

Sickle-cell anemia is a leading congenital cause of stroke in childhood. Such strokes can lead to cognitive deficits, stroke in the prefrontal cortex leading to inattention, impulsivity, and poor executive control. This case study examines a 23-year-old African American male who suffered from a stroke in his prefrontal cortex at age 3. Neuroimaging confirmed stroke location, but the patient had an atypical pattern of reported cognitive deficits.

Method

The patient was assessed in an out-patient 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 visuospatial processing speed, visual abilities, and decision making and executive control. This pattern of impairment suggests that the patient is still suffering from his stroke, which likely damaged the connective tissue of the occipital and parietal lobes, and the prefrontal cortex. The patient was diagnosed with Mild Neurocognitive Disorder in perceptual-motor and executive functioning.

Conclusions

These results suggest that despite the neuroplastic abilities of the brain at early ages, the neurodevelopment of individuals who suffer from stroke in early childhood is likely to be altered and contributes to cognitive impairments in early adulthood. Long-term cognitive sequelae in the form of deficits in visual perceptual skills, suggest that frontal connections to other regions in the brain may be impacted. Therefore, this case highlights that even a localized stroke in a child can lead to broader deficits if that area of the brain interacts with other areas.
A-064 Executive Functioning in an Acute Pediatric Neurocritical Care Population Recently Discharged from the PICU: Exploring the Associations among Parent Report and Individual Performance Measures
Authors: E Holding , K Bradbury , S Leonard , E Turner , C Williams , T Hall
Published: August 2020

Objective

An emerging literature has identified that PICU survivors face a host of long-term physical, cognitive, emotional, and psychosocial difficulties that stem from the underlying concern and side effects of critical care intervention. Research shows that executive functioning (EF) is particularly vulnerable to sequelae. This study sought to understand associations between parent-report of daily life EF and performance-based measures following neurocritical care.

Method

Twenty-three children ages 8–16 (M = 12.66 years; 39% male) were screened as part of an integrated (neuropsychology and pediatric critical care) acute phase (3–6-week post-discharge) follow-up clinic. Injuries included children with traumatic brain injury (n = 19), or acquired brain injury (i.e., anoxic brain injury, AVM, acute cerebellitis, hemorrhagic stroke; n = 4). EF outcomes were assessed using the Behavior Rating Inventory of Executive Functioning, Second Edition (BRIEF-2), Delis-Kaplan Executive Function System (D-KEFS) Trail Making Test and Verbal Fluency Test, Children’s Memory Scale Digits Backwards, and Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V) Coding and Symbol Search subtests. Bivariate correlations were used to examine associations among parent-report of EF and performance-based measures of EF in our neurocritical care population.

Results

Analyses demonstrated significant (□ = .05) correlations between the WISC-V Coding subtest and the BRIEF-2 Shift scale (r = −.44) and Global Executive Composite (GEC; r = −.59). Correlations between D-KEFS Category Fluency and BRIEF-2 Initiate (r = −.51), Working Memory (r = −.44), and GEC (r = −.55) were significant. Inverse correlations demonstrate agreement.

Conclusion

In the acute recovery phase following neurocritical care, parent-report and specific performance-based measures are only moderately associated, demonstrating the importance of multi-method assessment to detect potential acquired deficits to inform rehabilitation.
A-068 Case Study: Neurodevelopment of Late Identification and Treatment of Nonsyndromic Multisutural Craniosynostosis
Authors: R Fleischer , V Chang , V Culotta
Published: August 2020

Objective

Craniosynostosis, the premature closure of cranial sutures, is frequently associated with intracranial hypertension, neurocognitive deficits, and neuromotor deficits. Younger age at treatment is associated with improved outcomes. This case study will expand upon the existing literature by characterizing the neurodevelopment of an individual whose nonsyndromic multisutural craniosynostosis was identified and treated late, when the patient was nearly three years old.

Method

A 7-year, 1-month old male with a history of bicoronal and sagittal craniosynostosis was seen for neuropsychological assessment. Diagnosis and cranial vault reconstruction occurred just before his third birthday. Evidence of increased intracranial pressure was found on presurgical CT scan, and by the appearance of his dura at surgery. His development after reconstruction was notable for articulation disorder, expressive language disorder, executive dysfunction, and adaptive skills deficits.

Results

Assessment revealed average non-verbal cognitive skills and low average verbal cognitive skills. Receptive language was below average. Exceptionally low scores were found on tasks of oromotor sequencing, verbal list learning, and immediate visual memory. Teacher ratings of executive functioning suggest below average skills. Measures of attention and impulsivity suggest mild weaknesses. Academically, he earned below average and exceptionally low scores on measures of reading and writing, with low average to average mathematics scores.

Conclusions

The neurodevelopment of children with late diagnosis/treatment of craniosynostosis is not well characterized and may confer increased risks. Late diagnosis is presumed to lead to more significant neurocognitive impairments due to the impact of prolonged intracranial pressure. Neuropsychological assessment and follow-up is critical for monitoring and intervention planning.
A-094 Isocitrate Dehydrogenase Status and Cognition in Glioma Patients
Authors: S Park , A Giles , M Liberatore , K Morgan , C Debruhl , C Cramer , R Strowd , M Chan , G Lesser , A Laxton , S Tatter , T Cummings
Published: August 2020

Objective

In gliomas, isocitrate dehydrogenase-wildtype (IDH-wt) is associated with poorer prognosis and is correlated with lower brain connectivity, implicating cognitive impairment. Little is known about the impact of IDH-wt on cognition. This study aimed to explore the relationship between IDH-wt and cognition.

Method

Thirty-eight patients (Age M = 48.73 ± 14.98; 50% female) diagnosed with a glioma (29% grade II, 16% grade III, 21% grade IV; Karnofsky Performance Status score (KPS) M = 88.75 ± 14.24) were selected from a retrospective data cohort. 34.2% of patients had left hemisphere tumors, 34.2% of tumors were in the frontal lobes, and 15.8% were temporal lobe tumors. Patients were assessed via abbreviated neuropsychological battery following surgical resection prior to radiation and/or chemotherapy.

Results

The overall cognitive composite was not statistically significant via independent samples t-test (IDH-wt+: M = 42.37; IDH-wt-: M = 39.29; p = 0.897). Subdomains for attention/executive functioning (p = 0.625), memory (p = 0.923), and language (p = 0.501) were not significantly different. Logistic regression was conducted to investigate how IDH status predicts cognitive status. The coefficient has a Wald statistic equal to 0.042 which is not significant (critical value of 0.837) [df = 1]. Of those with IDH-wt+, 57% were impaired and 43% remained intact.

Conclusion

We did not find a significant association between IDH status and cognition though sample size is a significant limitation of the present study. More investigations are needed given it is possible that cognitive performance is related to IDH status and knowledge in this area could improve patient care/patient education.
A-100 Neuropsychological Findings in a Case Involving a Rare Genetic Anomaly (de novo 6q24.2-q25.2 deletion on paternal chromosome 6) Associated with Intrauterine Growth Restriction (IUGR), Autism, OCD and Schizoaffective Disorder
Authors: L Bakry-Becker , E Goldberg
Published: August 2020

Objective

Individuals with deletions of the long arm of chromosome 6 have been known since 1975 with just over 100 cases reported as of 2015. Individuals with deletions involving band 6q25 have a high incidence of intrauterine growth retardation, intellectual disability, dysmorphic features, growth failure, and medical complications (Stagi et al, 2015). Findings will add to the literature base on this genetic anomaly.

Methods

A 21-year-old male was assessed to differentiate between obsessive vs. psychotic thinking. His history was notable for being born weighing 2300 grams at term, and having feeding, learning and social/emotional difficulties which progressed to OCD in later childhood. At age 15, he was determined to have a de novo 3.7 Mb microdeletion at 6q24.3.

Results

Neuropsychological assessment of attention, motor and executive functions reveal a variable profile with pockets of strengths relative to his own performance as well as significant normative impairment. Findings represented a significant decline from prior testing at age 10. His verbal memory was below average and his overall attention capacity was impaired. JT’s executive functioning, visual-motor integration, motor speed, and his verbal abstract reasoning were all below average. His non-verbal abstract reasoning and visual perception were intact. On results of objective, projective and neurocognitive testing, JT met criteria for diagnoses of Autism, Obsessive Compulsive Disorder, and Schizoaffective Disorder.

Conclusions

JT’s developmental history and symptom presentation are complex, revealing significant comorbidity; this case study describes the progression of JT’s difficulties over his lifespan, beginning with feeding difficulties, diagnoses of autism and OCD and progressing to a psychotic disorder.
A-101 PTSD and Personality Traits Influence the Relationship Between Memory Complaints and Memory Performance
Authors: P Armistead-Jehle , E Mattson , N Nelson , S Disner
Published: August 2020

Objective

Previous research has shown that post-traumatic stress disorder (PTSD) symptomatology may mediate the association between subjective cognitive complaints and objective cognitive performance, however, the precise nature of this mediation is not well understood. The present study aims to expand on these findings by focusing on memory processes and exploring the influence that personality variables may have on the mediational role of PTSD symptoms.

Methods

In a sample of 196 U.S. military service members and veterans, we administered the PTSD checklist (PCL), Personality Assessment Inventory (PAI), Memory Complaints Inventory (MCI), and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).

Results

Overall MCI score (reflecting subjective memory complaints) was associated with both RBANS immediate (β= −0.15, SE = 0.06, p = 0.01) and delayed memory performance (β= −0.13, SE = 0.06, p = 0.02), but PTSD severity mediated both of these relationships (95% CI -0.14, −0.01; 95% CI -0.14, −0.02, respectively). Trait depression moderated the mediation path between subjective memory complaints and PTSD severity (β= −0.02, SE = 0.004, p < .001), but not the path between PTSD and either immediate or delayed memory performance (all p > .05).

Conclusion

Results suggest that targeting PTSD and depressive symptoms may be a promising treatment for those with subjective memory complaints.
A-113 A Case Study: Utilization of C3 Logix in Serial Evaluation of Concussion in a Multidisciplinary Medical Setting
Authors: R Zill , H Dean-Hill , M Alcala , E Snell , G Getz
Published: August 2020

Objective

C3 Logix is a concussion assessment and management system addressing patient care, return to play standards, and rehabilitation or understanding of concussion. This case study demonstrates the utility of the C3 Logix screening measure with a concussion patient in a multidisciplinary medical setting. Repeat C3 Logix screening data was compared to reported symptoms on the Post-Concussion Symptom Scale (PCSS) and interpreted by a physician in medical setting. This case highlights the comparison of C3 Logix findings and a neuropsychological profile in a young adult with history of traumatic closed head injury.

Method

25-year old, right-handed, Caucasian man with no significant medical history prior to sustaining a parenchymal hemorrhage along the left anterior inferior frontal lobe and left temporal lobe, as well as a left anterior frontal subdural hematoma in 2019. The patient reported a premorbid history of generalized anxiety with panic, and elevated emotionality post-injury.

Results

Estimated premorbid verbal functioning was average, consistent with his score as predicted by demographic variables. The patient exhibited decreased concussion symptom severity and improved cognitive performance across repeat C3 Logix administrations. On comprehensive neuropsychological evaluation, he demonstrated intact performance across cognitive domains, with relative weakness consistent with localization of injury, sustained eye injury, and expected recovery duration.

Conclusions

Repeat cognitive screenings were generally consistent with comprehensive neuropsychological evaluation results. This case study highlights that the C3 Logix tool should be further considered as a brief cognitive screening measure to inform treatment of traumatic head injuries within a multidisciplinary medical setting.
A-114 Predicting Long-Term Cognitive Outcomes From Acute Orientation Performance After Traumatic Brain Injury
Authors: C Diblasio , R Kennedy , E Cook , A Fahey , T Novack
Published: August 2020

Objective

To evaluate how initial orientation, rate of change in orientation, and duration of post-traumatic amnesia (PTA) during inpatient rehabilitation predict cognitive functioning (overall cognition, episodic verbal memory, and executive function) 1 year and 2 years after sustaining a moderate-to-severe traumatic brain injury (TBI).

Methods

Participants were 101 adults aged 18–81 years (M age = 39 years; 67% male) receiving inpatient rehabilitation following new-onset moderate–severe TBI at a level I trauma center, acute inpatient hospital. Orientation data (initial orientation, rate of change in orientation, and duration of PTA) were collected during inpatient rehabilitation where each participant received serial assessments of their orientation with the Orientation Log (O-Log) during bedside rounds. The Brief Test of Adult Cognition by Telephone (BTACT) was administered to participants over the telephone at 1 year and 2 years post-injury to assess cognitive outcomes.

Results

Initial orientation during acute inpatient rehabilitation was significantly associated with overall cognition (p < .01), episodic verbal memory (p < .01), and executive function abilities (p < .01) at 1 year post-injury. Duration of PTA and rate of change in orientation were not significant predictors, and none of the orientation factors predicted cognition at 2 years post-injury.

Conclusion

Initial level of orientation is important to consider in the prediction of cognitive impairments one year following moderate–severe TBI. This supports the need to assess orientation early in the recovery process, particularly upon admission to acute rehabilitation.
A-121 Verbal Learning in Veterans with Mild Traumatic Brain Injury, Posttraumatic Stress Disorder, and Co-occurring Conditions
Authors: V Jessie , T Bender-Pape
Published: August 2020

Objective

The study examined how veterans with PTSD only, mTBI only, and co-occurring mTBI and PTSD acquire, encode, and consolidate verbal information at least three months post mTBI.

Method

This retrospective study examined 57 veterans (15 mTBI only, 6 PTSD only, 19 mTBI + PTSD, and 17 veteran controls) from a VA setting who were recruited through: polytrauma clinic referrals, introductory letters, and study flyers. The sample included male and female OIF/OEF veterans aged 18 to 70. Inclusion and exclusion criteria of participants were determined by the following measures: (a) Structured Interview for TBI Diagnosis, (b) Clinician-administered PTSD Scale, and (c) Letter Memory Test. One-way ANOVA evaluated group differences between the mTBI only, PTSD only, and mTBI + PTSD groups. A two-way ANOVA evaluated group differences between veterans with and without PTSD.

Results

The two-way ANOVA revealed that veterans with PTSD perform below the mTBI only and veteran control groups (F = 6.59, p = 0.01) on serial clustering forward strategy. The one-way ANOVA demonstrated that the mTBI + PTSD group performed below the mTBI only group on Trial 1 (F = 3.61, p = 0.04).

Conclusions

The mTBI + PTSD group performed worse than the mTBI only group on their ability to acquire verbal information. This result may suggest that the co-occurring effects of mTBI and PTSD negatively attribute to a veteran’s ability to focus and attend to new information. Veterans without PTSD were more likely to use a serial clustering strategy to recall information compared to Veterans with PTSD.
A-123 Effects of Ethnicity, Educational Attainment, and Severity of Traumatic Brain Injury on Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Index Scores
Authors: J Ryan , D Kreiner , A Myers-Fabian , S Gontkovsky
Published: August 2020

Objective

This study utilized a culturally diverse sample with traumatic brain injury (TBI) to examine effects of ethnicity on the Verbal Comprehension (VCI), Perceptual Reasoning (PRI), Working Memory (WMI), and Processing Speed (PSI) indices of the Wechsler Adult Intelligence Scale-Fourth Edition while controlling for education and injury severity. Hypotheses were that education and ethnicity would significantly influence all indices, the latter to a lesser extent, and injury severity would most strongly affect PSI scores.

Method

Participants were 43 trauma center admissions with documented head injury. Mean age and education were 32.16 and 13.88 years, respectively. There were 14 Euro-, 17 Hispanic-, and 12 African-Americans.

Results

ANCOVAs revealed significant effects for education across indices. Significant effects were found for ethnicity on the VCI and PRI and injury severity on the PSI. Post hoc comparisons indicated Euro- and Hispanic-Americans did not differ on VCI but performed significantly higher than African-Americans. Euro-Americans performed significantly better than African-Americans on the PRI, but comparable performance emerged between Euro- and Hispanic-Americans and between African- and Hispanic-Americans. Groups did not differ on the WMI or PSI.

Conclusions

Education and ethnicity accounted for most of the variance in VCI and PRI. Analysis of the WMI revealed education produced a significant effect, but ethnicity and injury severity did not. On the PSI, education and injury severity had significant effects. PSI was the only composite to which injury severity made a statistically significant contribution. Despite the small sample size, findings have important implications in the intellectual assessment of individuals with TBI.
A-129 An Effect of Pre-injury Factors on the Relationship between Severity of Acute Symptoms and Sleep Quality Among Recovered and Non-Recovered Adolescents following Concussion
Authors: H Fatima , T Caze , T Meredith-Duliba , N David , S Bunt , L Hynan , C Lobue , M Cullum
Published: August 2020

Objective

Sleep disturbance following concussion has been linked to more severe symptoms and longer recovery times. However, it is unclear whether this association may be affected by pre-injury and mood factors. This study examines whether acute symptom severity was associated with poorer sleep quality among recovered vs not-yet-recovered adolescents at 3-months following injury after adjusting for age, sex and anxiety.

Method

Adolescents aged 12–18 (N = 449) presenting □7 days to ConTex specialty concussion clinics were studied. Of these, 60 reported not being recovered at 3-month follow-up (Mage = 15.23, Nmales = 27, Nfemales = 33). Participants completed the Sport Concussion Assessment Tool-3rd Edition (SCAT-3) Symptom Checklist, Pittsburgh Sleep Quality Index (PSQI), and General Anxiety Disorder-7 (GAD-7). Hierarchical linear regressions assessed if initial symptoms as measured by the SCAT-3 total symptom score, predicted sleep quality at 3-month follow-up, controlling for initial data of age, sex, PSQI, and GAD-7.

Results

Initial total symptom scores did not predict higher PSQI scores at 3-months for either recovered or non-recovered subjects [F (1, 362, p = .550 and F (1,48), p = .307, respectively]. For recovered subjects, initial sleep ratings (p < .001) predicted 3-month sleep quality, while there was a trend for age (p = .054). For non-recovered subjects, only sex was associated with lower sleep quality at 3-months (p = .034).

Conclusions

Sleep disturbance was not associated with severity of concussion symptoms when accounting for age, sex, and initial sleep quality. These findings do suggest, however, that females were more likely to report lower sleep quality when experiencing longer recovery.
A-143 Neurocognitive Effects of Comorbid Affective Disorders in College Athletes
Authors: G Thomas , K Riegler , E Guty , P Arnett
Published: August 2020

Objective

The objective of the current study is to examine the effects of depression, anxiety, and comorbid depression/anxiety on neurocognitive performance in college athletes. We hypothesized a priori that the mood disorder groups would perform worse than healthy controls, with the comorbid group performing worst overall.

Method

831 (M = 620, F = 211) collegiate athletes completed a comprehensive neuropsychological test battery at baseline which included self-report measures of anxiety and depression. Athletes were separated into 4 groups (Healthy Control (HC) (n = 578), Depression Only (n = 137), Anxiety Only (n = 54), Comorbid Depression/Anxiety (n = 62)) based on their anxiety and depression scores. Athletes’ neurocognitive functioning was analyzed via z-score composites of Attention/Processing Speed, Memory, and Global Functioning.

Results

A one-way ANOVA comparing the means of the four groups revealed that, compared to athletes in the HC group (e.g. those with no affective symptoms), those in the depression only and anxiety only groups were not significantly different from one another or the HC group on neurocognitive outcomes. However, the comorbid group performed significantly worse than the HC group on Attention/Processing Speed, t(827) = −2.28, p = 0.023, d = 0.30, and Global Functioning, t(827) = −2.32, p = 0.020, d = 0.30, but not on the Memory composite.

Conclusions

Athletes in the comorbid group performed significantly worse than HCs on composites of Attention/Processing Speed and Global Functioning. These results show that collegiate athletes tested at baseline who have comorbid depression and anxiety should be identified, as their poorer cognitive performance at baseline could skew future/post-concussion comparisons.