bluuebunny/crossref_metadata_2025 huggingface dataset:
A-14 Propensity Scores in Neuropsychological Research: Four Aspects of Digital Clock Drawing Distinguish Individuals with Non-Dementia Idiopathic Parkinson’s Disease from Matched Controls
Authors: Frank B , Dion C , Hizel L , Crowley S , Price C
Published: August 2020

Objective

In situations in which randomized experiments are impossible or unethical, propensity score matching offers a method to reduce bias on causal effect estimates (Thoemmes & Kim, 2011). In this study, we examined differences on the digital clock drawing test (dCDT; Souillard-Mandar et al., 2016) between individuals with idiopathic non-dementia Parkinson’s disease (PD) and matched controls.

Method

This study involved a retrospective analysis of two federally funded investigations (NSF-13-543; R01-NS082386). The sample included 261 participants (110 PD, 151 non-PD). Participants were matched according to demographic covariates, as well as measures of mood, comorbidity, and premorbid functioning. The PD group and matched controls were compared using logistic regression in a Bayesian framework, with projection predictive variable selection implemented to obtain a parsimonious model (Piironen, Paasiniemi, & Vehtari, 2018). All effects were standardized.

Results

Of 261 participants, 212 were matched using nearest neighbor matching (Figure 1). The final, parsimonious model included four variables from the dCDT: total strokes (command condition), total time (command condition), and area (command and copy conditions). While all effects were retained, positive to strong evidence was found for dCDT total time (βMedian = 0.91, βSD = 0.25, 95% CI [0.44, 1.42], Bayes factor [BF] = 97.80) and dCDT area (copy condition; βMedian = −0.52, βSD = 0.19, 95% CI [−0.90, −0.17], BF = 4.78).

Conclusions

Propensity scores can be employed in causal comparative studies to match control participants and reduce bias from nuisance covariates. Four aspects of dCDT performance were optimal in distinguishing individuals with PD from matched controls.
A-01 Dementia Care Ecosystem: Health Care Utilization at Six Months
Authors: A laRoche , B Arredondo , A Devito , A Bailey , B Mizuki , A Boettcher , E Brickell , J Sawyer
Published: August 2020

Objective

This study implemented the University of California, San Francisco (UCSF) Care Ecosystem Program, a Persons with Dementia (PWD)- and Caregiver (CG)-centered model of dementia care designed to improve quality of life and reduce the cost of care associated with emergency department (ED) visits and hospitalizations.

Method

Community-dwelling PWD and CGs at a southern regional medical system who had a diagnosis of dementia and at least one hospitalization or ED visit in the previous 12 months were prospectively enrolled in a mixed method study. These dyads (N = 54) completed monthly visits for six months, including behavior management, financial and advanced care planning, caregiver well-being, and navigating community and healthcare resources. PWD were predominantly Caucasian (70.4%; 30% African American) and female (53.7%), with an average age of 80.26 (SD = 6.99). CGs were demographically similar, but younger [M(SD) = 66.18(12.89)].

Results

ED utilization decreased by 41% (51 visits in 6 months prior to enrollment vs. 30 visits post enrollment); [pre-M(SD) = 0.94(1.57); post-M(SD) = 0.56(1.11); 95% Confidence Interval − 0.09—0.86; t = 1.64, p > .05; Cohen’s d = 0.28]. On a paired samples t-test, there was a small effect despite not reaching statistical significance. Hospitalizations decreased by 43% (30 in 6 months prior to enrollment, 17 post enrollment); [pre-M(SD) = 0.56(1.09); post-M(SD) = 0.31(0.77); 95% Confidence Interval − 0.03—0.51; t = 1.79, p > .05; Cohen’s d = .26]. Again, there was a small effect despite not reaching statistical significance.

Conclusions

Preliminary results suggested a trend toward reduced hospital utilization. Future analysis on cost savings and other benefits of this type of program will be crucial to sustainability.
A-016 The Relationship between Visual Memory and Performance in Virtual Reality Among Older Adults
Authors: E Flores , R Gutierrez , S Shorter , K Mollenkopf , L Childers , J Flair , R Donell , M Barnett
Published: August 2020

Objective

Over the past fifty years, many traditional paper-and-pencil neuropsychological tests have been translated to new computerized devices (Canini et al., 2014). Virtual reality offers neuropsychologists an opportunity to observe patients’ neurocognitive functioning in an immersive, lifelike environment, rich in visual stimuli (Morganti, 2004), yet relatively little is known about the relationship between visual memory and performance on learning and memory tasks in virtual reality environments. The purpose of this study was to investigate, among older adults, the relationship between visual memory, as measured by a traditional paper-and-pencil test, and procedural learning and memory performance in a virtual reality environment simulating meal preparation tasks.

Methods

Older adults (N = 73) ages 55-90 (M = 72.77, SD = 7.87) were administered the Weschler Adult Intelligence Scale-Fourth Edition (WMS-IV) Visual Reproduction Immediate Recall and the Virtual Kitchen Protocol (VPK), a virtual reality-based measure of learning and memory for meal preparation tasks.

Results

Participants performance on the immediate portion of WMS-IV, visual reproduction, correlated with their performance on the VPK teaching trial (r = .65, p = 0.01), immediate recall (r = .51, p = 0.01), delayed recall (r = .58, p = 0.01), and forced choice recognition ( r = ..54, p = 0.01) of Job Sim.

Conclusion

Results suggest that visual memory aids healthy older adults in procedural learning and memory tasks in the Virtual Kitchen Protocol, a virtual reality environment simulating meal preparation tasks. These results suggest that visual memory ability is germane to performance in virtual reality environments that are rich in visual stimuli.
A-020 Advancing Reliable Measurement in Alzheimer’s Disease and Cognitive Aging (ARMADA): Extension of the NIH Toolbox in Healthy Cognitive Aging 86 years and Beyond
Authors: T Karpouzian-Rogers , D Peipert , J Slotkin , V Ustsinovich , K Wortman , C Nowinski , R Gershon , S Weintraub
Published: August 2020

Background

Early detection of cognitive decline in older individuals can be accomplished with brief, computerized measures in diverse settings. The goal of the ARMADA study is to validate the NIH Toolbox for Assessment of Neurological and Behavioral Function (NIHTB) in the neurological aging spectrum from cognitively normal to dementia, and to extend the age range to allow for longitudinal assessment of the oldest individuals. Here, we present baseline data from general population individuals over 85 years of age without cognitive impairment compared with those 65 to 85.

Method

ARMADA is a multi-site study recruiting participants from established research cohorts. Participants included cognitively average-for-age individuals between the ages of 65–85 (n = 82) and another group 86 and older (n = 105). Baseline characteristics and preliminary data are presented for the Cognition, Emotion, Motor and Sensation modules of the NIHTB.

Results

Analysis of preliminary baseline data revealed that mean uncorrected standard scores of most cognitive, motor, and sensation measures differed among the groups in the expected direction, such that individuals 65–85 had better performance than individuals 86 and older. Conversely, group scores were similar on most emotion measures.

Conclusions

This analysis of preliminary baseline data from ARMADA provides initial evidence for the utility of the NIHTB in individuals over age 85 without cognitive impairment, who, as a group, scored lower than those from age 65–85. These results demonstrate the importance of establishing cohort-specific norms relevant to the oldest age group. Longitudinal follow-ups over two years will track cognitive, motor, emotion, and sensory functioning in this group.
A-024 The Relationship Between Levels of Insight and Memory Performance in Patients with Dementia
Authors: C Cohen , L Guidotti Breting , K Klipfel , E Geary , J Sweet
Published: August 2020

Objective

Impaired awareness of cognitive and functional decline is common in dementia syndromes. Insight into cognitive changes is often assessed during a clinical interview, questioning of independent activities of daily living, or via self-report measures of functional abilities. Few studies have examined patient insight in a neuropsychological test performance. The current study investigated the relationship between memory performance on the Wechsler Memory Scale Fourth Edition(WMS-IV) and the Hopkins Verbal Learning Test-Revised(HVLT-R) with level of insight in patients with dementia. Insight was determined from the clinician-based insight rating item on the Behavioral Dyscontrol Scale-II(BDS-II).

Method

Patients with dementia (ages 50–91) from an outpatient clinic referred for memory testing were divided into groups based on their BDS-II insight score: intact(n = 52), moderate(n = 30), and none/poor(n = 29). One-way ANOVA and post hoc analyses examined the insight differences for immediate recall(IR) and delayed recall(DR) trials on the WMS-IV Visual Reproduction(VRI/II) and Logical Memory(LMI/II) subtests and the HVLT-R. No group differences were found for age or education.

Results

Analyses revealed significant group differences on the HVLT-R IR [F(2,96) = 5.33,p < .01] and VRI [F(2,100) = 4.88,p < .01], with no significant differences for LM. Post hoc analyses demonstrated poorer performance in the none/poor insight group compared to the moderate (HVLT:p < .05,Cohen’s(d) = .95;VR:p < .05,d = .67) and intact insight groups (HVLT:p < .05,d = .75;VR:p < .05,d = .71). Performance between moderate and intact groups did not differ. There were no significant group effects in the three DR measures.

Conclusions

Findings suggest that patients with poor insight performed worse on IR measures. The presence of poor insight, in the context of impaired IR performances, may assist in recommendations regarding future functional supports.
A-029 The Clinical Utility of the Trail Making Test- Part B Efficiency Score in a Memory Disorder Clinic
Authors: K Grueninger , M Yousif , A Denny , R Sohoni , F Webbe , A Logalbo
Published: August 2020

Objective

Trail Making Test—Part B (TMTB) is a common neuropsychological instrument measuring aspects of executive functioning such as set shifting and cognitive flexibility. Typically, TMTB is discontinued if not completed within 300 seconds, limiting variability in interpretation for individuals who discontinue. This study aims to alleviate this limitation by examining whether a TMT-B Efficiency (TMT-Be) score can provide useful clinical information in a memory disorder clinic population.

Methods

TMTB was administered to 167 patients (101 females, 66 males) as part of a neuropsychological evaluation. Diagnostic groups included: Alzheimer’s Disease (AD; N = 83), Mild Cognitive Impairment (MCI; N = 58), and Normal Cognition (N = 26). Ages ranged from 65–94. Participants completed TMTB according to standardized instructions. TMT-Be scores accounted for time, number of errors, and number of incomplete moves.

Results

TMT-Be scores differed significantly across diagnostic groups (ANOVA, F (2, 164) = 44.81, p < .001). Post-hoc tests using the Bonferroni correction revealed TMT-Be scores in the AD group (M = 17.48, SD = 9.23) were significantly higher than scores of the MCI group (M = 7.91, SD = 5.68) and WNL group (M = 4.65, SD = 1.67). Significant correlations between TMT-Be score and other neuropsychological measures were also found and will be presented and discussed.

Conclusion

Results support clinical utility of TMT-Be scores for diagnostic purposes, such as differential diagnosis of normal cognition, MCI, and AD. Further research with a larger number of participants and other populations may lend further support to the clinical utility of the TMT-Be scoring method.
A-030 Sensitivity and Specificity of Measures for Dementia with Lewy Bodies
Authors: A Duarte , J Alcina , M Rodriguez
Published: August 2020

The present review aimed to examine sensitivity and specificity across neuropsychological tests for Dementia with Lewy Body (DLB), to enhance diagnostic utility. A systematic search of the literature was conducted. Databases used: PsycInfo, Discovery Service for Carlos Albizu University-Miami, PsycARTICLES. Data selection criteria entailed articles from 2010–2020. Search terms included: Dementia with Lewy body, sensitivity, specificity, neuropsychological assessment, neuropsychological testing. Original search yielded 27 results, from those, only 8 articles contained sensitivity and specificity regarding DLB. The target population of review were older adults 65 and older. The assessment measures analyzed were the BSID, HVLT, MMSE QSPT, SAI, MMSE, and ICS, and others. Findings of eight studies were evaluated regarding sensitivity and specificity across neuropsychological assessments for DLB. Among the most specific and sensitive measures were the Alba Screening Instrument (ASI; sensitivity 90.7%, specificity 93.6%), and a combination of the Auditory Verbal Learning Test (AVLT) percent retention, Block Design, Trail Making Test--Part A, and Benton Visual Form Discrimination (specificity 96.1% and sensitivity 88.6%). Lower specificity and sensitivity were found in Illusory contour (ICs-4; specificity and sensitivity of 37.1% and 88.6%) and the Minimental State Examination-Pentagon Test (MMSE-QSPT; specificity 78.67% and sensitivity 70.29%). Other tests and combinations were explored. Specificity ranged from 76% to 96.1%, while sensitivity ranged from 37.1% to 90.7% throughout the neuropsychological tests examined. One major limitation across the studies constituted lack of pathological, post-mortem, confirmation. Additionally, while the use of cutoff scores across assessments appeared to enhance the sensitivity and specificity, it seemed to compromise the diagnostic accuracy of AD.
A-038 Aggressive Behaviors in Dementia
Authors: N Kaplan , J Caldwell
Published: August 2020

Objectives

The present study investigated neural correlates of caregiver-reported aggression/agitation in older adults with memory complaints. We hypothesized that individuals rated as more aggressive/agitated would exhibit poorer executive and daily skills functioning, and show reduced volumes in brain structures implicated in aggressive behavior.

Methods

We examined 1207 patients (mean age = 66.91; 587 women) who completed neuropsychological evaluation at the Cleveland Clinic Lou Ruvo Center for Brain Health due to memory complaints. A subset of 252 also had brain MRI scans within six months of neuropsychological testing. Mann–Whitney and Chi Square tests examined association of caregiver-reported agitation/aggression on the Neuropsychiatric Inventory (NPI) with daily skills functioning (Activities of Daily Living Questionnaire), executive function (Delis-Kaplan Executive Function System (D-KEFS) Color-Word Inhibition (CWI), Color-Word Inhibition/Switching (CWIS), Category Switching (CS), and Trail Making Test Part IV (TMT4)), and volume or thickness of brain regions associated with developmental presentations of aggressive behavior, including the hippocampus (HC), amygdala, lateral and medial orbitofrontal cortex (OFC), frontal poles, and insula.

Results

Greater caregiver-reported agitation/aggression was associated with poorer multitasking (TMT4: z = −2.222, p = 0.026; CS: z = −3.014, p = 0.003), inhibition (CWI: z = −4.211, p < 0.001), and inhibition with embedded multitasking (CWIS: z = −2.898, p = 0.004). More caregiver-reported agitation/aggression also related to poorer daily skills functioning (X2(N = 1207,1) = 96.454, p < 0.001) and thinner bilateral medial OFC (Left: z = −2.040, p = 0.041; Right: z = −2.246, p = 0.025), right frontal pole (z = −2.993, p = 0.003), and right insula (z = −2.185, p = 0.029).

Conclusions

Present findings show similarities between cognitive and neural correlates of caregiver-reported agitated/aggressive behavior in individuals with memory concerns and individuals with developmental aggressive behavior.
A-039 Adherence and Executive Functioning in an Elderly Population with Type 2 Diabetes in México
Authors: C Ibarra , A Giudicessi
Published: August 2020

Objective

Diabetes is a prevalent chronic illness that can impact Executive Functioning (EF). Adherence to treatment is an important aspect in diabetes management however little published research addresses the relationship between adherence and EF in individuals with Type 2 Diabetes Mellitus (T2DM). The objectives of this study are: compare the levels of adherence and EF between T2DM and a control group. Analyze the relationship between adherence and EF in individuals with T2DM.

Method

The present study included 10 participants with T2DM and 10 control participants with Hypertension (HTN) all between the ages of 61–76. Participants were recruited through “Casa del Abue” a public center offering medical/social services to geriatric populations in Puebla, México. Neuropsychological Battery of Executive Functions and Frontal Lobes was administered to all participants, along with adherence measures specific to diagnosis: Summary of Diabetes Self-Care Activities or Hypertension Self-Care Activity Level Effects. Informed consent was obtained prior to participation.

Results

Results show significant differences in adherence between T2DM and HTN U = 1.0 p = < 0.001 and also between groups in EF measures related to medial Orbitofrontal cortex (OFC) U = 21.0 p = < 0.05. The relationship between adherence and EF in T2DM participants was moderately correlated r(10) = 0.32, p = 0.36. Descriptive statistics found in Table 1.

Conclusion

T2DM participants demonstrate significantly lower adherence levels and deficits in EF compared to the control group as expected. Given only a moderate correlation between adherence and EF was found, further research including a larger sample and more precise adherence measures such as HbA1c is suggested to further understand this relationship.
A-046 The Need to Regulate Affect and Behavior Before Prescribing Stimulants
Authors: K M Chustz , C Capps , D G Nemeth
Published: August 2020

Objective

The 3q29 Deletion Syndrome, first described in 2005, is a rare chromosomal disorder which results in a wide array of symptoms. Affected individuals present with complex neuropsychiatric profiles. The associated phenotype for this syndrome may include developmental delay, intellectual disabilities, attentional deficits, behavioral disturbances, and social and emotional issues. These individuals are at a higher risk of developing autism or schizophrenia. This case study describes the neuropsychological profiles of two fraternal twin girls, age 7, only one of whom was diagnosed with 3q29 Deletion Syndrome.

Methods

Both girls received comprehensive neuropsychoeducational evaluations to compare and contrast the following dimensions: Neurocognitive, Intellectual, Educational, Attentional, School Behavioral, Affective, and Personality Functioning.

Results

Twin 1, positive for 3q29 Deletion Syndrome, exhibits significant affective, behavioral, and cognitive difficulties secondary to her chromosomal disorder, which included learning disabled and oppositional presentations and emotional dyscontrol. Twin 2 exhibited superior intellectual and social functioning.

Conclusions

This study contributes to the understanding of the clinical presentation of 3q29 Deletion Syndrome by examining the relationship between fraternal twin sisters. Findings are consistent with earlier reports of the chromosomal disorder’s phenotype, yielding neurocognitive, emotional, and behavioral difficulties. Though the twins have widely different neuropsychological profiles, they have a close relationship. Twin 2, who models excellent prosocial behaviors, will be an asset to Twin 1 in all spheres. Ongoing efforts to improve Twin 1’s neuropsychological, social/emotional, and behavioral functioning will be facilitated via both psychological and psychopharmacological interventions.
A-047 Examining the relationship between Learning Diagnoses and Social Skills Deficit subscales within the Personality Inventory for Children, Second Edition
Authors: B Trinidad , L Stebbins , C Golden
Published: August 2020

Objective

The present study examined the relationship between the Social Skills Deficit (SSD) subscales obtained on the Personality Inventory for Children, second edition (PIC-2), and diagnoses of three major Learning Disorders (LD) of Math, Reading, and Writing.

Method

Participants in the present study consisted of 523 children from a mixed clinical sample who were between the ages of 3 to 17 years (M = 9.897, SD = 3.130). Participants were referred to a south Florida neuropsychology community assessment center and completed a full neuropsychological battery. Males composed 64% of the sample. Measures included SSD subscales, limited peer status and conflict with peers, within the PIC-2.

Results

To evaluate the relationship between scores on SSD subscales from the PIC-2 on three LD diagnoses, a Pearson Correlation with 2-tailed significance was used. Limited peer status was significantly correlated with a LD of Reading (r = −.160, p = .001) and Writing (r = −.160, p = .001). Additionally, conflict with peers was significant correlated with a LD of Reading (r = −.139, p = .001) and Writing (r = −.125, p = .004). There were no SSD subscales that were significantly correlated with a diagnosis of LD of Math.

Conclusion

From these results, the SSD subscale had the strongest correlation with diagnosis of a LD of Reading followed by LD of Writing. This study explicates the issue of reduced language-based skills and its impact on social skills. Due to the association between reading and writing and social skills, academic intervention should also include social skills training to increased peer interactions and reduce peer conflict.
A-048 Semantic, Not Phonetic, Working Memory Performance Predicts Variation in Reading Comprehension in a Mixed Sample
Authors: L Bandel , H Travis-Judd , J Schlak , M Kibby
Published: August 2020

Objective

Reading comprehension (RC) is the result of a combination of interrelated abilities including decoding, linguistic processing, and higher-order cognitive functions such as working memory (WM). Problems with RC are associated with deficits in verbal WM, especially on tasks involving semantic processing. Hence, this study’s aim was to determine which is the better predictor of RC when controlling for basic reading ability: semantic or phonetic WM. Semantic WM was hypothesized to be the better predictor.

Methods

Participants included 258 children (aged 8-13 years) with ADHD, reading disability (RD), or comorbid ADHD/RD, and typically developing controls (53.6% Male, 87.8% Caucasian). Participants completed a neuropsychological battery as part of a larger, grant-funded study (R03HD048752, R15HD065627), including the WJ-III Letter-Word Identification and Passage Comprehension subtests that were utilized to assess basic reading and RC, respectively. Participants also completed the Rhyming Words and Semantic Association subtests of the Swanson-Cognitive Processing Test, which measure phonetic WM and semantic WM, respectively.

Results

Hierarchical linear regression analyses revealed that worse performance on the semantic WM task was associated with poorer RC (Beta = 0.15; p < 0.001) above and beyond basic reading (R2 change = 0.02, p < .001). Phonetic WM was not related to RC when decoding was controlled despite the zero-order correlation being significant (p < .001), showing much of phonetic WM’s relationship to RC may be due to basic reading requiring this skill.

Conclusion

Findings suggest differences in RC may be related to semantic WM functioning in children with and without RD, but not phonetic WM, when basic reading is controlled. Replication with a longitudinal design is warranted.
A-05 Dyadic Influence on Levels of Depression in Individuals with Alzheimer’s Disease
Authors: K Conniff , R Gomez
Published: August 2020

Objective

Two people who are significantly linked, such as in a husband and wife relationship, are known as a dyad. Dyadic units are helpful to look at as members influence the function of one another. This study looks at families where one member is the caregiver and the other has Alzheimer’s disease and receives care (labeled here as Alzheimer’s disease care recipient or CR). Symptoms of Alzheimer’s include cognitive and functional impairment, social withdrawal, impaired judgment, and mood changes. Notably, there is little research examining how Alzheimer’s dyads influence one another’s level of depression. This study examines how the influence of cognitive and psychosocial variables from the dyad impact depression severity in CRs.

Method

Archival data of 670 Alzheimer’s disease community-dwelling care recipients from several major cities throughout the United States from the Resources for Enhancing Alzheimer’s Caregivers Health II (REACH II) study was analyzed. The measures included: Mini Mental State Examination (MMSE), Revised Memory and Behavior Problems Checklist (RMBPL), Activities of Daily Living/Instrumental Activities of Daily Living (IADL), Caregiver Burden, Social Support, and Positive Aspects of Caregiving.

Results

A multiple regression found that caregiver burden (β = 0.34, p < .001), IADL (β = 0.14, p < .001), and positive aspects of caregiving (β = 0.10, p = .02) significantly predicted CR depression ratings.

Conclusion

Increased positive aspects of caregiving, caregiver burden, and higher levels of CR functional decline were associated with significantly increased levels of depression in CRs. Increased CR depression could correspond with higher levels of awareness during earlier stages of the disease process regarding their impairment and impact on their caregiver.
A-059 Gender-Related Behavioral Differences in Children with Partial or Complete Agenesis of the Corpus Callosum: Exploring Attention, Rule Breaking, and Aggressive Behaviors
Authors: N Rich-Wimmer , R Tanios , Y Qu , G Andrews
Published: August 2020

Objective

Gender-related connectivity differences result from variability in structure of the corpus callosum in children 8 years and up (Ingalhalikar et al., 2014). However, children with complete or partial agenesis of the corpus callosum (ACC) exhibit structural differences that disrupt the connectivity of cerebral hemispheres, causing behavioral challenges (Young et al., 2019). We explored the relationship of behavioral differences across genders, partial and complete ACC diagnoses, and age.

Method

Initial data included the completed Child Behavior Checklist (CBCL) provided by care-providers (ages 2 to 17) diagnosed with ACC. Follow-up data was obtained four-years later from the original sample (n = 29), which included 20 males (12 complete, 8 partial) and 9 females (5 complete, 4 partial).

Results

A repeated measures MANOVA was conducted with attention problems, rule-breaking, and aggressive behavior for gender, age, and diagnosis (i.e., partial or complete ACC). A significant interaction diagnosis by gender interaction over time was found for each dependent variable.

Conclusion

Results indicate females with partial ACC exhibit worsening attention problems with age, while males with partial ACC decrease over time. Complex social interactions among females pose greater challenges due to difficulties integrating information between cerebral hemispheres. Additionally, females are at higher risk of developing internalizing problems (Eaton et al., 2012) when navigating social interactions. Nevertheless, females with partial ACC exhibited significant reductions in aggressive behaviors over time. This perhaps resulted from lower social tolerance of aggressiveness in females, as well as expectations of compliance and obedience. Consequently, mood-related difficulties decrease executive functioning skills, specifically attention and concentration (APA, 2013).
A-06 MRI and Neuropsychological Change During Conversion from Normal/MCI to Alzheimer’s Disease
Authors: J Paredes , T Prince , A Simpson , M Daniel
Published: August 2020

Objective

Analyze neurocognitive and structural brain changes associated with conversion from normal cognition/MCI to Alzheimer’s disease (AD).

Method

Thirty-two participants from the National Alzheimer’s Coordinating Center included 22 women; mean (SD): age = 77.06 (8.1); education = 14.59 (3.5). All had either normal cognition or MCI at first visit when MRI was obtained and were diagnosed with AD at follow-up MRI; mean time between MRI’s = 4.1 years. Imaging of Dementia & Aging lab performed calculations for MRI structural change using Linux-based software. Participants took neuropsychological tests within three months of each MRI visit.

Results

MRI structural degeneration occurred in: left (d = .46) and right (d = .47) entorhinal cortical thickness; left (d = .82) and right (d = .95) hippocampal volume; left (d = .74) and right (d = .43) middle temporal gray matter volume; left parahippocampal cortical thickness (d = .55); total white matter volume (d = .55); total brain volume (d = .78); and total CSF volume (d = 1.14). Significant neuropsychological decline included Animal fluency (d = 1.02), Vegetable fluency (d = .69), Digit Symbol (d = .53), Trails B (d = .42), and Digit Span Backward (d = .56). There was not a significant change in Logical Memory.

Conclusions

Participants who converted from normal cognition/MCI to AD showed MRI degeneration in medial temporal structures as well as generalized atrophy and white matter loss. These structural changes accompanied a significant decline in semantic verbal fluency, working memory, and processing speed. There was not a significant change in verbal memory.
A-065 Weakness in Holistic Processing in Preschool Children is a Risk for SLI
Authors: S Kiselev
Published: August 2020

Objectives

Children with specific language impairment (SLI) have difficulties with producing and understanding language. It is important to search for the risk factors for this deficit in children. The goal of this research was to examine the hypothesis that children at the age of 5 with weakness in holistic processing have a risk for emerging deficit in grammar understanding at the age of 7.

Methods

98 children at the age of 5 were assessed with the Rey-Osterieth Complex Figure Test to reveal children with weakness in holistic processing. It was proposed that part-oriented strategy in copying Complex Figure is related to weakness in holistic processing (Luria, 1973). We have revealed 19 children with weakness in holistic processing. These children were included in the experimental group. The control group included 19 children with typical level of holistic processing. Children from experimental and control group were matched for IQ and gender. Children at the age of 7 from both groups were assessed by Grammar Understanding Test from Luria’s neuropsychological assessment technique.

Results

One-way ANOVA has revealed significant differences [p ≤ 0,05] between groups for scores in Grammar Understanding Test. Children from the experimental group showed a lower level of grammar understanding.

Conclusion

This research has shown that weakness in holistic processing can predict the delay in development of grammar understanding in children. The received results shed light into underlying nature of SLI. It can be assumed that weakness in holistic processing is one of the risk factors for emerging deficit in grammar understanding in children.
A-066 Recovery in Elementary-Age Children at Three Months Post-Concussion
Authors: T Tarkenton , S Bunt , C Hicks , L Hynan , H Rossetti , N Didehbani , C Silver , M Cullum
Published: August 2020

Objective

Inclusion of broad age ranges in most pediatric concussion studies limits understanding of recovery in elementary-age children. This study’s aim was to investigate the most commonly reported symptoms at 3-months post-concussion in children age 6–10 and determine if factors from initial clinic visit predict prolonged recovery.

Methods

Participants (n = 73) age 6–10 who reported to clinic within 30 days of concussion (M = 10.4, SD = 7.8 days) were selected from the North Texas Concussion Registry (ConTex). Chi-square and independent t-test were used to examine symptoms at 3 months. Participants were then divided into early (14 days post-injury, n = 29) and late (1 month post-injury, n = 35) recovery groups based on days to symptom resolution. Logistic regression was used to identify significant predictors for prolonged recovery. Variables considered for the final model included sex, ethnicity, presence of LD/ADHD, mechanism of injury, and initial post-concussive symptoms.

Results

For the late recovery group, total symptom score at 3 months was 8.3/132 (SD = 14.8, Range = 0–61). The most common symptoms were heightened emotionality (34.3%), headache (31%), and noise sensitivity (31%). The final logistic regression model (2 = 15.7(3), p = .003) included mechanism of injury and initial emotional symptoms as significant predictors for prolonged recovery. For every 1-point (out of 5) increase in emotional symptoms, participants were 1.4x more likely to be in the late recovery group. Concussions sustained by hit or fall were 6x more common in the late recovery group (p = .006).

Conclusions

Similar to adolescents, emotional symptoms play a role in predicting delayed recovery in elementary-age children. Mechanism of concussion may also impact recovery.
A-067 Behavior and Blood Biomarker Differences for Children with Fragile X Syndrome and Idiopathic Autism
Authors: D Sokol , D Miller , C Westmark , D Lahiri
Published: August 2020

Objective

A clearer understanding of behavioral and blood biomarker differences in individuals with Fragile X Syndrome (FXS) and idiopathic autism is necessary as advancement in gene therapies and medication targeted to the FXS single gene abnormality are being trialed in autism. Our primary objective is to determine Autism Diagnostic Interview-Revised (ADIR) item/domain differences in children with FXS and autism, controlling for age, IQ, and autism severity. Our secondary objective is to demonstrate blood protein biomarker group differences.

Method

Participants were drawn from a larger study examining amyloid precursor protein (APP) metabolite levels in children with FXS (n = 18) and autism (n = 21) from Indiana University Riley Hospital Clinics. Complete data were available for children with full FXS mutations (n = 9, and autism (n = 9, one girl), matched for age, MSEL IQ, and CARS severity scores. ADI-R was administered to mothers by staff trained to research reliability. Western blot for APP and fragile X mental retardation protein (FMRP) were performed on peripheral blood mononuclear cells.

Results

No significant group differences are seen via Mann–Whitney U after Bonferroni multiple comparison, likely due to low power. However, two trends in our data corroborate recent reports: social smiling (item 51) is more intact for FXS [U(18) = 20.5,Z = -1.76,p = 0.085, 95%CI = -0.15–1.93,r = 0.41] and Restricted Behavior Scale [U(18) = 21,Z = -1.72,p = 0.09,95%CI = -0.57–2.79,r = 0.40] was more pronounced in autism. Western blot showed variations in APP and FMRP between FXS, autism and controls (Figure 1).

Conclusions

Trends in behavioral ADI-R scores and blood biomarker APP differences exist between FXS and idiopathic autism. Further study of these preliminary results should inform appropriate treatment endpoints for autism and FXS.
A-069 Comparing Driving Errors in Young Adults with and without Autism Spectrum Disorder
Authors: M Showell , M Schultheis , K Patrick
Published: August 2020

Objective

Research has found differences in driving behaviors of individuals with and without autism spectrum disorder (ASD), though it is unclear whether differences translate to poorer driving. This study assessed whether ASD diagnosis, executive functioning, and regulation of driving speed and lane positioning predict errors during a simulated drive.

Method

Participants included 88 16–26 year-olds (45 ASD; 73 Male) who completed assessments of executive functioning and a simulated drive. The drive included a rural route without distractions, the same route with secondary tasks, a highway drive, and a residential drive. For the residential drive, coders documented drivers’ errors including driving onto a curb, crossing the center lane, turning from the wrong lane, running a red light or stop sign, illegally changing lanes, and hitting a person or car. A hierarchical regression included stepwise insertion of ASD diagnosis, neurocognitive performance, and speed and lane deviation as predictor variables and the square root of driving errors as the outcome variable.

Results

Drivers with ASD committed significantly more errors than non-ASD drivers, p = .03, R2 = .06. Neurocognitive performance added significant predictive value, p = .001, R2Adj = .15. Speed and lane regulation also added significant predictive value, p < .001, R2Adj = .39. The full model accounted for 46% of the variance in driving errors.

Conclusions

Novice drivers with ASD may be more likely than their peers to make overt, potentially dangerous, errors while driving. Assessment of executive function and less dangerous driving behaviors such as regulation of speed and lane positioning may help to identify individuals at highest risk for committing driving errors and inform driving interventions.
A-081 Cognitive Reserve Factors Influence Neuropsychological Performance in Alcohol Use Disorder
Authors: S Mcnally , S Syan , T Hargreaves , H Sarles Whittlesley , C McIntyre-Wood , B Surprenant , E Mackillop , J Mackillop , L Sweet
Published: August 2020

Objective

Cognitive reserve (CR) refers to the brain’s capacity to cope with pathology and preserve functioning. We investigated cognitive performance between individuals with alcohol use disorder (AUD) and healthy controls to examine whether CR, operationalized as education and psychosocial functioning, influences neuropsychological functioning.

Method

We recruited 45 AUD (DSM-V criteria) who reported drinking levels exceeding NIAAA guidelines (>14/7 drinks/week for men/women) and 30 healthy controls who did not. MANCOVAs controlling for CR were used to investigate between-group differences in neuropsychological performance, as measured by the NIH Toolbox. A series of linear regression analyses were also performed to evaluate effects of AUD and CR on neuropsychological performance. Psychosocial functioning, education, and AUD status were simultaneously entered as predictors of Flanker, Dimensional Change Card Sort, Picture Sequence, List Sort, and Processing Speed scores.

Results

MANCOVAs revealed a significantly slower processing speed in the AUD group compared to controls when controlling for CR (F = 4.30, p = .042). There were no significant group differences on other tests. Linear regressions showed only processing speed to be predicted by AUD (β = −.255, p = .042), while CR measures were not. Education predicted Picture Sequence (β = .245, p = .041) and Card Sort (β = .291, p = .009) performance, and psychosocial functioning predicted Flanker (β = .296, p = .021) and Card Sort (β = .316, p = .010) performance.

Conclusions

CR appears to contribute to higher-order cognitive functions, regardless of AUD status. Only processing speed, a domain typically susceptible to brain pathology, was significantly related to AUD. Thus, factors linked to CR may serve as important targets for future research and intervention in AUD to promote favorable cognitive outcomes.
A-085 Sports Anxiety Scale − 2: More Sensitive to College Athlete Anxiety
Authors: N Cherry , K Morgan , K Larson , K Shumway , G Andrews
Published: August 2020

Objective

Concussed student-athletes’ responses on two self-report questionnaires were recorded at two points within the semester in order to evaluate distinguishing changes in psychological symptoms.

Methods

A sample of (n = 21) collegiate athletes participated in a pre-post study. Student-athletes were recruited from various sports at a private University through the General Psychology course. The participants (age range 18–22, M = 19.38, SD) included 10 females, 11 males.. A pre-post study, mixed-methods experimental design was employed as part of a larger physiological study. The pre-measures included an informed consent, demographic questionnaire, self-report measures (Generalized Anxiety Scale-7 (GAD-7) and the Sports Anxiety Scale-2 (SAS-2)), and 5-time rating scale of performance. All responses were gathered in the neurocognitive lab of the graduate department.. The post-session occurred 5–6 weeks after the initial session, again gathering data on GAD-7 and SAS.

Results

A within-subject analysis of the data revealed a main effect for time with a moderate effect size (p = .026) in the decrease of SAS-2 total scores. This significant decrease in SAS-2 total scores occurred across groups and across genders in the post-intervention measures. For the GAD-7 measure, there were no significant changes.

Conclusion

The significant findings for the SAS-2 total scores suggest it is a more sensitive measure of anxiety for healthy college athletes who have a concussion history than the GAD-7. Because of the limited number of participants, further research is necessary to confirm the applicability of the SAS-2.
A-089 The Role of Anxiety Severity and Neurocognitive Functions in Parkinson’s Disease
Authors: G Lee , J Suhr , L Boxley , C Nguyen
Published: August 2020

Objective

Parkinson’s disease (PD) is a neurodegenerative disorder characterized by motor and nonmotor symptoms. While much of the extant literature on neuropsychiatric symptoms and cognitive deficits have focused on depression, comparatively less have examined the role of anxiety among patients with PD. Here, we examined levels of anxiety severity (i.e., minimal, mild, moderate–severe) and cognition in this population.

Method

Fifty-six PD patients (M age = 60.8 ± 9.3; 69.6% male) being considered for surgical intervention were evaluated at an outpatient clinic. Inclusion criteria included no history of neurosurgical procedure and no other diagnosis of a neurodegenerative disorder. Participants completed a battery of neuropsychological tests and reported mood symptoms (Geriatric Depression Scale-15, Beck Anxiety Inventory). Those who scored above clinical cutoffs for depressive symptoms were excluded due to high comorbidity with anxiety. Motor symptom severity was rated by neurologists using the Unified Parkinson’s Disease Rating Scale.

Results

Analysis of covariance revealed significant group differences on tests of working memory (p = .03), set-shifting (p = .04), problem-solving (p = .05), and phonemic fluency (p = .03) when controlling for motor symptom severity. PD patients with moderate–severe levels of anxiety performed significantly lower than those with minimal or mild anxiety (p’s < .05). There were no other significant group differences in neuropsychological test performance.

Conclusions

These findings suggest measurable differences in neurocognitive functions associated with frontostriatal circuits among PD patients with varying levels of overall anxiety. Future work should consider the potential overlap between anxiety and PD symptoms as they relate to cognition.
A-09 Concussion History May Accelerate Cognitive Decline in Older Adults
Authors: S Bell , J Maietta , J Caldwell , N Hawley , A Ritter , J Cummings , J Miller
Published: August 2020

Objective

Concussion is a common occurrence among older adults, stemming largely from falls. Evidence suggests that history of moderate–severe traumatic brain injury (TBI) increases risk for cognitive decline and dementia; however, long-term outcomes associated with concussion remain unclear. This study aims to investigate longitudinal cognitive change among older adults with self-reported concussion history (CH).

Method

Older adults (n = 39) enrolled in an observational, longitudinal study by the Center for Neurodegeneration and Translational Neuroscience diagnosed with mild cognitive impairment or Alzheimer’s disease were studied, including 14 with CH. Participants completed baseline and one-year follow-up testing, including the Montreal Cognitive Assessment (MoCA). Repeated measures ANCOVA with age and education covariates assessed change in MoCA Total Scores from baseline to follow-up based on CH.

Results

Main effects for age, education, time, and CH were not significant; however, significant interaction for CH by time was revealed, F(1,34) = 4.46, p < .05 such that those with CH demonstrated significantly greater decline from baseline to follow-up than those without CH (p < .05). In the CH group, change over time was associated with an effect size of 1.20 (Cohen’s d) compared to an effect size of 0.22 in the non-CH group.

Conclusions

History of concussion may lead to accelerated rate of cognitive decline in those diagnosed with MCI and AD over a 1-year period, which is consistent with prior research in moderate–severe TBI. These results preliminarily support the notion that concussion may be associated with significantly worse cognitive outcomes among older adults. Confirmation of our findings in larger samples and prospective validation of the observation are warranted.
A-095 Processing Speed Indicators in Juvenile Huntington’s Disease: Assessing CAG Repeat, Age of Onset, and Mood
Authors: N Goecke , D Dawson , A Choate , K Boress , P Espe-Pfeifer , P Nopoulos
Published: August 2020

Objective

In adult onset Huntington’s Disease (HD), processing speed deficits and depression can be detected in the prodromal stages. These factors, along with CAG repeat length, may be predictive of age of symptom onset. However, less is known about the relationship between the aforementioned factors for patients diagnosed with Juvenile Huntington’s Disease (JHD). The current study aimed to investigate the relationships between age of symptom onset, CAG repeat, processing speed, and mood to improve prediction of symptom manifestation for JHD patients.

Method

Data was analyzed from the Kids HD study and included 30 participants (age at diagnosis M = 13.6, SD = 5.4, CAG repeat mean = 69, SD = 16). Bivariate partial correlations, independent t-tests, and regression analyses examined differences in processing speed across CAG repeat, age of onset, and depressive symptomology.

Results

CAG repeat length significantly predicted the natural log of age at diagnosis, β = −.59, t(25) = −3.59, p < .01, and significantly explained variance in the natural log of age at diagnosis, R2 = .35, F(1, 25) = 12.86, p < .01. Finally, results indicated that CAG repeat length also predicted processing speed abilities when controlling for depressed mood symptomology, R2 = .39, F(3,24) = 5.18, p < .01.

Conclusion

CAG repeat length holds predictive power for the age of diagnosis and for processing speed, even when accounting for covariate depressive mood indicators. Overall, results indicate evidence of impacted processing speed abilities given expansive CAG repeat numbers. This is consistent with a subcortical neurodegenerative process, such as HD.