bluuebunny/crossref_metadata_2025 huggingface dataset:
A - 94 Comparing Framingham Risk Score and Cognitive Performance in a Black/African American Cohort
Authors: Frydman Alexia J , Bosworth Brooke , Neer Emory , Ortega Alexandra , Correa Rebecca , Carballea Denise , Crenshaw Kirsten Horne , Crocco Elizabeth A , Loewenstein David , Curiel Cid Rosie E
Published: September 2024

Objective

Past research indicates that higher Framingham Cardiovascular Disease Risk Scores (FCVDRS) is associated with decreased cognitive function. Cardiovascular risk factors are strongly associated with cognitive decline, and previous research shows that individuals with a greater number of risk factors have increased levels of cognitive impairment that may manifest well in advance before apparent clinical symptoms. Despite a higher prevalence of cardiovascular risk factors among Black/African Americans (B/AA), research on FCVDRS in this group is lacking. This study explores potential links between FCVDRS and cognitive function in B/AA older adults.

Method

76 B/AA’s (37 female) from a Registry for African American Older Adults at the University of Miami were studied. Data on Framingham Hard Coronary Heart Disease (10-year-risk) and demographic variables were collected. FCVDRS was categorized as low (20%). Cognitive performance was assessed across multiple measures.

Results

There were statistically significant correlations between FCVDRS and performance on 9 of 17 measures of cognition. Specifically, results showed high-risk FCVDRS scores were related to poor performance on measures of general cognition, structured and unstructured verbal memory, processing speed, working memory, phonemic fluency, and visuo-constructional tests.

Conclusion

Previous studies have shown that FCVDRS could be a predictive tool for cognitive decline. However, most research has focused on non-Hispanic White subjects with a higher socioeconomic status. Understanding the association between FCVDRS and cognition across various ethnic groups can inform screening protocols for heterogeneous populations. This study adds to the limited literature on the relationship between FCVDRS and cognition in underserved communities.
A - 98 Physical Activity and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in Older Adults with Dementia with Lewy Bodies (DLB) and Alzheimer’s Disease (ad)
Authors: Orr Victoria L , Brown Karl , Dean Pamela , Hu Shu-Ching , McRae Sharon , Payne Sarah , Seto Edmund , Shutes-David Andrew , Wilson Katherine , Tsuang Debby
Published: September 2024

Objective

Past studies have suggested an association between physical activity and neuropsychological scores in cognitively healthy older adults, but similar studies in adults with dementia have been inconsistent. This pilot study is one of the first to consider dementia subtypes and the relationship between daily physical activity and cognitive performance on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).

Methods

We administered the RBANS to participants with DLB (n = 11) and ad (n = 8) and then measured physical activity using triaxial wGT3X-BT actigraphy devices for two weeks. Two-sample t-tests were performed comparing participants with DLB and ad on physical activity, RBANS domains, and UPDRS scores (see Table 1). Linear mixed models with a random intercept were used to assess the association between activity counts and RBANS scores, adjusting for dementia subtype.

Results

Compared to participants with DLB, ad participants were significantly more active (p = 0.035) and had lower UPDRS Part III scores (p < 0.001). We found no significant association between daily activity counts and total RBANS scores (Beta = −2.77, 95% CI -6.0, −0.47, p = 0.091).

Conclusions

To our knowledge, this is the first study to compare differences between physical activity and RBANS scores, accounting for dementia subtypes. Participants with DLB were less physically active than participants with ad; this is unsurprising given that parkinsonian signs and symptoms are a core DLB feature. We found no significant associations between daily activity and cognitive performance, but we lacked the sample size to account for potential contributory variables. Larger explorations of physical activity, RBANS domain score, and dementia subtype are necessary.
A - 99 Examining the Relationship between Adverse Childhood Experiences, Neuropsychological Functioning, and Neurocognitive Status among Older Adults
Authors: Jones Mackenze , Newkirk Bailey O , Rubright Colin , Jennette Kyle J , Soble Jason R , Phillips Matthew S
Published: September 2024

Objective

Adverse childhood experiences (ACEs) are associated with poorer cognitive and mental health outcomes in adulthood. However, there is limited research elucidating the relationship between ACE severity and specific neuropsychological outcomes among examinees with cognitive impairment. This study assessed the relationship between ACE exposure and cognitive and psychiatric outcomes among older adults with and without cognitive impairment.

Method

This cross-sectional study included 75 patients (64% female; MAge = 67, SD = 8.6; MEducation = 12.8, SD = 3.2) undergoing neuropsychological evaluation at an academic medical center. Analyses of variance (ANOVAs) compared high versus low ACE groups on specific tests of verbal fluency, processing speed, working memory, executive functions, and on depression and anxiety measures. Groups were formed based on neurocognitive status (i.e., no diagnosis, mild cognitive impairment, dementia) and ANOVAs were re-run for each diagnosis.

Results

No significant differences were detected on neurocognitive measures among the overall group or when groups were subdivided by diagnosis. Among the overall sample, significant group differences were detected for depression and anxiety symptoms, F(1,73) = 16.696, p < 0.001 and F(1,73) = 12.268, p = 0.001 respectively, such that higher ACE groups endorsed significantly more psychiatric symptoms. Among the no-diagnosis group, depressive symptoms were bordering insignificance, p = 0.048, and no differences were detected for anxiety. By contrast, higher ACEs were associated with greater anxiety among the mild cognitive impairment group and greater depression among the dementia group.

Conclusions

Findings reinforce the impact of ACEs on psychiatric symptoms among older adults. Although there were no significant cognitive differences, further research is necessary to better understand the relationship between ACEs, neurocognitive impairment, and psychiatric functioning.
A - 112 Complex Attention and Frontotemporal Dementia Severity: the Role of Age and Gender in Trails a Performance
Authors: Brett Jonathan , Carrano Samantha , Bennett Ryan , Dabbagh Dania
Published: September 2024

Objective

To investigate frontotemporal dementia (FTD) impact on attention using Trails A test.

Method

Participants (N = 3265) from a deidentified FTD database were stratified by Clinical Dementia Rating scores for severity: Normal (n = 1689, Mage = 47.15, Medu = 15.87, 59.8% female), Very Mild (n = 947, Mage = 63.54, Medu = 15.98, 44.7% female), Mild (n = 528, Mage = 64.9, Medu = 16.12, 38.1% female), Moderate–Severe (n = 101, Mage = 66.35, Medu = 16.59, 41.6% female). Stepwise regression analyzed Trails A scores’ predictive power for symptom severity.

Results

Stepwise regression indicated significant predictive relationship in Trails A and CDR category, accounting for 30.6% of the variance in CDR severity (R2 = 0.306, F(1, 3263) = 1441.094, p < 0.001). Including age as a predictive variable in the second model resulted in increased explained variance to 41.2% (R2 = 0.412, F(2, 3262) = 1142.653, p < 0.001). The inclusion of gender into the model resulted in minimal increase in variance explained to 41.8% (R2 = 0.418, F(3, 3261) = 781.027, p < 0.001). In the final model, the Trails A Z-score had a coefficient of −0.157 (SE = 0.006, p < 0.001), age had a coefficient of 0.020 (SE = 0.001, p < 0.001), and gender had a coefficient of −0.134 (SE = 0.023, p < 0.001).

Conclusion

Trails A, age, and gender predict FTD severity. Diminished Trails A performance indicates higher dementia severity, with age as a critical factor and gender showing nuanced differences in severity presentation. This supports personalized treatment approaches, emphasizing early cognitive assessments like Trails A for diagnosing and monitoring FTD-related declines in complex attention.
A - 113 Assessing the Feasibility of Machine Learning to Predict Frontotemporal Dementia Severity from Neuropsychological Assessments
Authors: Brett Jonathan , Bennett Ryan , Carrano Samantha , Dabbagh Dania
Published: September 2024

Objective

To assess the feasibility of utilizing machine learning (ML) of neuropsychological assessment data in determining the severity of frontotemporal dementia (FTD) as classified by the Clinical Dementia Rating (CDR).

Method

A Random Forest classification model was employed using a deidentified FTD dataset. Participants’ (N = 3023) were stratified based on CDR scores for severity: Normal (n = 1646, Mage = 46.95, 59.66% female), Mild (n = 855, Mage = 63.06, 57.08% female), Moderate–Severe (n = 522, Mage = 64.57, 62.45% female). Participants were than randomly stratified into a training set (80%) and a testing set (20%) for model evaluation. The model was then trained on the training set using participant data including age, gender, verbal fluency, digit span forward, digit span backward, trails A, trails B, and the MOCA total score. The model was then evaluated on the testing set.

Results

The model achieved an accuracy of 74.55% on the testing set. Detailed performance metrics revealed a precision of 86%, recall of 91%, and F1-score of 89% for the normal category, 56% precision, 56% recall, and 56% F1-score for mild, and 65% precision, 52% recall, and 58% F1-score for moderate–severe. The most salient features were verbal fluency and age, with assigned importance scores of 0.174 and 0.150, respectively.

Conclusions

Although the Random Forest model demonstrated potential in predicting FTD severity from neuropsychological data, its moderate performance for mild and severe categories indicates it’s not yet clinically viable. This study offers a foundational framework, suggesting further model refinement and larger datasets are necessary to enhance accuracy and clinical utility. Future research should focus on including diverse variables and populations.
A - 123 Word List Task Outperforms Cognitive Screener in Neurocognitive Disorder Detection
Authors: Griffin Rebekah A , Zamora Joel A , DiGiovanna Ben J , Motley John E , Gamino Denise , Arreola Langarica Ashley L , Carter Ericka , Barnett Michael D
Published: September 2024

Objective

The California Verbal Learning Test II (CVLT II) demonstrated utility in characterizing neurocognitive disorders (Webber et al., 2018). The Mini-Mental State Examination (MMSE) is considered the most widely used assessment tool in screening for possible neurocognitive disorders (Tsoi et al., 2015). The purpose of this study was to establish which cognitive assessment tool, MMSE or CVLT II, better-identified individuals at risk for neurocognitive impairment.

Method

Older adults (n = 113; age 60–90, M = 73.53, SD = 7.16) from the general community received a comprehensive neuropsychological evaluation. We performed ROC curve analysis using SPSS to assess the predictive performance of two test variables, MMSE (M = 26.37; SD = 3.68) and CVLT LDFR (M = −0.14; SD = 1.45), in predicting whether the participant has a neurocognitive disorder.

Results

ROC curve analysis demonstrated that both variables, MMSE and CVLT LDFR, significantly predicted the presence of a neurocognitive disorder, with AUC values of 0.84 and 0.89, respectively. The variable CVLT LDFR shows a higher AUC value, indicating slightly better discriminatory power to the variable MMSE.

Conclusions

CVLT II’s long-delay free recall trial directly assesses verbal memory retention and recall. Memory impairment, particularly delayed recall deficits, is a hallmark feature of many neurocognitive disorders. This specificity aligns with the involvement of the hippocampus, a brain region crucial for memory consolidation, which is often dysfunctional in neurocognitive disorders. Therefore, a test targeting this aspect of memory function may offer greater sensitivity and specificity in detecting neurocognitive impairments compared to more general cognitive screening tools like the MMSE.
A - 133 The Clinical Utility of Large Language Models in Diagnosing Neurocognitive Disorders among NACC Participants
Authors: Su Charlie , Rafiuddin Hanan , Dimmick Allan A , Cicero David
Published: September 2024

Objective

Our study aimed to investigate ChatGPT’s ability to diagnose neurocognitive disorders in older adults based on neuropsychological interviews and test results and compare its accuracy with neuropsychologist consensus diagnosis.

Methods

We prompted ChatGPT-4 to provide provisional diagnoses (normal changes, mild cognitive impairment, or dementia) for each case. We also asked ChatGPT to diagnose the underlying etiology. We evaluated interrater reliability (IRR) with Cohen’s kappa and a chi-square test. Receiver operating characteristic (ROC) curves and area-under-the-curve (AUC) values were computed to explore measures predicting diagnostic agreement.

Results

Participants were 15,048 older adults (Mage = 69.13, 56.7% female) assessed in Alzheimer’s Disease Core Centers across the United States. For cognitive diagnoses, Cohen’s kappa demonstrated fair agreement (κ = 0.42; p < 0.001). The chi-square test [χ2 (6) = 7896.51, p < 0.001] revealed a significant and strong association (Cramer’s V = 0.51, p < 0.001) between ChatGPT and clinicians’ diagnoses. For the underlying etiology, Cohen’s kappa demonstrated fair agreement on specific diagnoses (κ = 0.38; p < 0.001). The chi-square test [χ2 (24) = 5353.04, p < 0.001] revealed a significant and strong association (Cramer’s V = 0.30, p < 0.001) between ChatGPT and clinicians’ diagnoses. ROC curves demonstrate that no variables predicted diagnostic agreement at above chance.

Conclusion

Our findings demonstrate the potential clinical utility of integrating LLMs into neuropsychology. While significant IRR was found between ChatGPT and the neuropsychologist diagnosis, further research is needed prior to the adoption of LLMs into clinical practice, given ongoing developments of artificial intelligence in the field of medicine.
A - 135 A Case Study of a Multilingual Individual with Primary Progressive Aphasia: Diagnostic Considerations and Implications for Language Reorganization
Authors: Kelly Brianna , Schulze Evan , Shehab Al Amira Safa
Published: September 2024

Objective

This study reports a case of primary progressive aphasia (PPA) in a multilingual Haitian-American individual. Earlier literature has suggested that cases of PPA in multilingual individuals are relatively rare. Several factors complicate the assessment of language dysfunction and diagnosis of PPA in multilingualism, including age of language acquisition, degree of proficiency, language reorganization in the bilingual brain, and limited availability/validity of tests/norms for bilinguals.

Method

This is a 69-year-old right-handed trilingual (French/English/Haitian Creole) Haitian-American female with 16 years of education. Difficulties with word finding and speech production emerged two years prior to evaluation. Language was assessed with select subtests of the Boston Diagnostic Aphasia Examination (BDAE-3), Boston Naming Test (BNT), and Verbal Fluency. PET-CT imaging displayed large areas of hypometabolism in the left and right frontal, temporal, and parietal lobes, left areas being more greatly impacted.

Results

Neuropsychological testing showed impairments in visual and auditory naming, verbal fluencies, sentence repetition and word reading. Reading comprehension and repetition of single words were relatively spared. There were deficits in learning/memory, visuospatial functioning and processing speed. Speech was notably dysfluent with occasional agrammatism and mild dysarthria.

Conclusion

Overlapping characteristics of both logopenic and non-fluent/agrammatic variants of PPA were evident. Patient’s neuroimaging findings and clinical presentation suggest an advanced PPA syndrome. Cognitive/brain reserve and language reorganization, theorized in bilingual individuals, could be considered as contributors to the trajectory of her deficits. This case study contributes to the growing literature on PPA in diverse populations and multilingual individuals.
A - 146 Psychiatric Drugs Can Precipitate Neuropsychological Predicates of Homicide
Authors: Singer Raymond
Published: September 2024

Objective

A man inexplicably killed his beloved wife. He had no history of violence, was a prominent member of the community, and gave no indications of the impending horrific act. He had been recently commenced treatment with psychiatric drugs, and his condition deteriorated, culminating in homicide. After his incarceration, he stopped taking psychiatric drugs and his mental health improved. Many practitioners are not aware that psychiatric drugs can create a risk for violence - or precursors of violence - such as anger, hostility, and agitation. This risk is often described on the product label.

Method

The subject was an intensive care nurse who became exhausted and despondent serving long hours during the Covid epidemic, when many of his patients were put on ventilators and died. He had suffered panic attacks from his difficulty breathing through the respiratory masks. He temporarily left employment and sought psychiatric assistance for his professional “burn-out” condition. After three doses of venlafaxine, he reported side effects including increased anxiety, blood pressure and heart rate. He was then prescribed escitalopram without tapering of the venlafaxine. As his anxiety progressed, he was prescribed escitalopram once daily and buspirone three times daily, yet he continued to deteriorate until the homicide.

Results

Expert genetic analysis found susceptibility to the psychiatric drugs prescribed. The neuropsychological evaluation, months post-homicide, found excellent neuropsychological function, although psychomotor and processing speed was deficit. Personality testing found no disorders, with a profile inconsistent with violent behavior.

Conclusions

Prescribers need to monitor patients carefully for potentially adverse and violent outcomes of treatment.
A - 147 Patient-Centric Considerations for Selecting the Language of Procedure Administration in Candidates for Epilepsy Surgery: Implications for Data Interpretation, Prognostication and Outcomes
Authors: Bender Heidi A , Beattey Robert A , Katsman Kseniya , Lokai Andrew , Sacks-Zimmerman Amanda , Spat-Lemus Jessica S
Published: September 2024

Objective

Selecting the language of pre-surgical neuropsychological testing (NPT), intracarotid amobarbital procedure, and intra/extra functional language mapping (ESM) in bi−/multi-lingual patients is a high-stakes neuropsychological decision point. Though a patient’s self-selection of language is an integral consideration, both patient and provider must fully understand the potential implications of language selection on a patient’s data interpretation and overall case conceptualization.

Method

A 26-year-old, right-handed, bilingual (L1 = Mandarin-, L2 = English-speaking) female received pre-operative NPT, Wada test, and ESM to guide resective surgery targeting medically-refractory epilepsy involving the right superior temporal gyrus (STG) and mesial (MTL) temporal lobe. All procedures were conducted in English at the patient’s request with alternate forms of verbally-mediated NPT administered in Mandarin.

Results

Confrontation naming and verbal fluencies were impaired in both English and Mandarin. Wada testing administered in English revealed bilateral language and greater left hemisphere memory support. Following considerable psychoeducation regarding possible functional language loss in Mandarin post-operatively, the patient agreed to ESM in L1 with auditory and picture naming disruption after right STG stimulation.

Conclusion

Despite strong English-language fluency, assessment in Mandarin was of critical importance, as eloquent cortices essential for tonal language production may have been resected if mapping procedures were completed in English-only, as requested. Balancing factors informed by functional and structural neuroanatomy, patient worldview, and cross-cultural neuropsychology requires a tailored, patient-centric approach to case conceptualization.
B - 5 The Clinical Utility of Neuropsychological Assessment in Combatting Resource Misappropriation in the Social Media Era: a Case Series
Authors: Fisher Thomas L , Lewandowski Alan , Romano Lucie M , Keniston Alyssa , Cole Jolynn
Published: September 2024

Objective

Following the rise in popularity of social media applications such as TikTok, Instagram, and X, young adults are being exposed to more mental health-related content, particularly related to Autism Spectrum Disorder (ASD). Unfortunately, 30–84% of this content contains inaccurate or misleading information, which may be assimilated into personal accounts of psychological concerns reported to physicians (Borges do Nascimento et al., 2022; Bastiaens et al., 2024). This can contribute to misdiagnosis, resource misallocation, and inappropriate or contraindicated intervention. The present case series emphasizes the utility of neuropsychological assessment in assisting with proper diagnosis and subsequent treatment planning and intervention.

Method

This case series covers six patients ranging in age from 18 to 50, five of whom are female, who were referred for neuropsychological evaluation pursuant to self-suspected ASD based on symptom descriptions obtained via popular media. The comprehensive neuropsychological battery included both self-report measures of ASD symptomology (Social Responsiveness Scale) and the Autism Diagnostic Observation Schedule (ADOS-2).

Results

Neuropsychological testing reflects significant discrepancies between subjective and objective measures of ASD symptoms. These objective findings, combined with the patient’s history and objective measures of psychological functioning, support the accurate diagnosis of a variety of mental health disorders while ruling out ASD.

Conclusions

This case underscores the importance of neuropsychological assessment in providing meaningful and objective diagnostic data to combat a growing public health crisis of young adults overidentifying with ASD symptoms based on information presented online. Neuropsychological intervention is critical in aiding physicians in accurate differential diagnoses, providing psychoeducation and treatment recommendations, and conserving medical resources.
B - 7 Factor Structure of the Beck Depression Inventory-II in Epilepsy
Authors: Muller-Cohn Chantal , Brickell Emily , Boettcher Anneliese , Buckman Mark , Lee Bern G
Published: September 2024

Objective

This study aimed to explore the factor structure of the Beck Depression Inventory, Second Edition (BDI-II) in persons with epilepsy (PWE) and assess its correspondence with validated BDI-II cognitive and somatic-affective factors associated with depression in other populations.

Method

Retrospective data from 69 PWE (ages 18–72) who completed the BDI-II at a National Association of Epilepsy Centers level 4 epilepsy center were analyzed. Patients with diagnoses of bipolar disorder and schizophrenia spectrum disorders were excluded. An Exploratory Factor Analysis (EFA) using the psych package in R Studio was conducted, allowing factors to correlate with oblique factor rotation. The number of factors was determined using eigenvalues >1 and scree plots.

Results

Statistical support is strongest for a one-factor solution with eigenvalue 7.91; however, a two-factor solution (Factor two eigenvalue = 1.16) also met criteria. These factors accounted for 30% and 10% of the variance, respectively. Due to the low eigenvalue, few item loadings (3), and low variance explained by the second factor, item-level considerations were implemented to determine whether a two-factor solution added clinically relevant information.

Conclusion

Although a one-factor solution was best supported by the data, a second factor including sadness, feeling of punishment, and suicidal thoughts may be clinically relevant given elevated suicide risk and qualitative research reporting punishment feelings among PWE.
B - 25 Documenting the Prevalence of Sleep Disturbances among TBI Survivors: a FITBIR Study
Authors: Caicedo Mariana Rincon , Punt Stephanie E , Hamilton Nancy
Published: September 2024

Objective

The objective of this study is to utilize data from the Federal Interagency Traumatic Brain Injury Research (FITBIR) database to document the short-term prevalence of sleep disorders among a sample of mild Traumatic Brain Injury (mTBI) survivors.

Method

Data was extracted from the FITBIR website. Adult individuals who sustained an mTBI (Rivermead Post Concussion Symptoms Questionnaire; RPQ6) and had a data collection timepoint within 10 days of the injury were included. Measures of demographic characteristics and sleep problems (Pittsburgh Sleep Quality Index; PSQI) were utilized. A total of 74 participants (97% male, 73% white, mean age = 22.49 SD = 11.25) were included. Descriptive analysis were conducted to document the prevalence of sleep problems among this sample.

Results

Across our sample, broad sleep difficulties were common (PSQI Mean = 7.014, Median = 5, SD = 7.56). 47.29% of participants reported severe sleep difficulties (PSQI >5). 14(23.3%) individuals met criteria for insomnia based on their component 5 scores. Among individuals with a bed partner, only 3(7%) endorsed long breathing pauses, suggestive of Central Sleep Apnea (CSA), 16(40%) endorsed snoring, suggestive of Obstructive Sleep Apnea, and 16(22%) endorsed leg twitching, possibly indicative of Restless Leg Syndrome.

Conclusion

This study highlights the prevalence of sleep problems as a salient issue among mTBI patients. The FITBIR is a valuable tool to further TBI research. Future studies should examine the temporal trajectory of sleep problems and its relationship to other outcomes and include more diverse samples.
B - 29 Exploring Sex Differences in Concussion Symptom Reporting between Parents and Children
Authors: Gordon Taryn , Franke Michelle , Thorne Shaylyn , Black Jacy , Burkhart Scott
Published: September 2024

Objective

Concussion evaluation often entails patient completion of symptom checklists and questionnaires. Prior research indicates children often report higher concussion-related symptoms than parents (Johnson et al., 2020; Liu & Hicks, 2020). Furthermore, research indicates sex differences in reported symptoms among children and adolescents. (Preiss-Farzanegan et al., 2009; Frommer et al., 2011). This study aimed to explore these differences and the relationship between self-reported and parent-reported concussion symptoms by sex.

Methods

Children who sustained a concussion were examined in an acute concussion clinic for diagnosis and treatment of injury. In addition to the physical examination, parents were given the Post-Concussion Symptom Inventory Parent Assessment Form (PCSI-P) and children were given the appropriate version of the PCSI based on their age.

Results

44 children (M = 14.05, SD = 2.49; sex: 12 male, 32 female) and 36 parents were included for analysis. Parents reported higher tiredness (M = 3.4, SD = 1.72) than children self-report (M = 2.57, SD = 1.88; t(34) = 2.84, p = 0.007), and higher irritability (M = 3.03, SD = 2.07) children self-report (M = 2.06, SD = 2.17; t(34) = 2.78, p = 0.009). In male and female self-report, males reported higher levels of feeling dazed (M = 3.33, SD = 1.75) than females (M = 1.58, SD = 1.74; t(28) = 2.20, p = 0.036),and higher levels of slowed response (M = 4.00, SD = 1.23) than females (M = 2.13, SD = 1.96; t(27) = 2.04, p = 0.05). No differences were found between parent reports of male and female children.

Conclusion

Our findings highlight discrepancies between parent and child reports of concussion-related symptoms, emphasizing the need for self and parent report assessments in clinical concussion evaluations. Furthermore, sex differences in self-reported symptoms underscore the importance of considering sex-related factors in concussion management and treatment.
B - 34 Brain Network Organization over Time after TBI
Authors: Mullin Hollie AC , Hillary Frank G
Published: September 2024

Objective

Resting-state functional magnetic resonance (rsfMRI) has identified that brain networks become less specialized through declining network segregation as people age. Yet, it is unclear how segregation progresses over time after traumatic brain injury (TBI). This study evaluated segregation in older adults (M = 64.17 years) over a 2-year time period to better understand this phenomenon.

Method

45 participants with TBI (mild-complicated, moderate, and severe) and 41 healthy controls (HCs) received a 20-minute rsfMRI scan at timepoint one, and 25 TBI and 15 HCs received a scan at timepoint two. Data were preprocessed with fMRIPrep. XCP_D was used to divide the brain into 274 regions (19 networks) and 1000 regions (17 networks) using the Brainnetome and Schaefer 1000 atlases. Fisher r-to-z transformed connectivity matrices were used to calculate segregation (strength of connections within a network relative to strength of connections between networks).

Results

Segregation didn’t differ significantly (p > 0.05) between the TBI and HC groups at either timepoint, nor did segregation differ between the TBI group’s first and second timepoint. Segregation did significantly decline between the HC group’s first and second timepoint, but this was only observed using the Schaefer 1000 atlas, t(21.46) = −2.09, p = 0.049 95% CI [−0.049, −0.0001].

Conclusions

The results indicate that brain network segregation remains relatively stable after TBI but declines in healthy, older adults over time. This suggests brain network organization is less flexible post-injury and could potentially serve as a brain biomarker. However, it’s worth noting that choice of brain atlas affects the observation of this finding.
B - 38 Concussion Clinical Outcomes and Recovery Time in Individuals with Pre-Existing Anxiety and/or Depression
Authors: Kegel Nathan E , Anish Eli J , Zynda Aaron J , Giordano Elizabeth G , Todd Madeleine G , Miller Maggie E , Collins Michael , Kontos Anthony P
Published: September 2024

Objective

Post-injury anxiety and mood difficulties are common symptoms following concussion. However, limited research has explored the impact of anxiety and/or depression history on individuals’ clinical outcomes and recovery time post- concussion. This study aims to determine the influence of anxiety and/or depression history on individuals’ clinical outcomes and examine outcomes of those with both anxiety and depression history.

Method

We conducted a retrospective review of 297 concussed patients. All participants completed a clinical interview, Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), Clinical Profile Screen (CP-Screen), and Vestibular/Ocular-Motor Screening (VOMS). Participants were categorized into one of three anxiety-depression subgroups — no anxiety or depression history (NONE), anxiety or depression history (EITHER), or anxiety and depression history (BOTH)— based on clinical interviews.

Results

The BOTH group reported higher symptom burden (CP Screen Total Score; p < 0.001) and performed worse on ImPACT Visual Memory (p = 0.03) compared to NONE and EITHER groups. Overall, recovery time differed significantly between groups (p = 0.006). The NONE group recovered significantly faster than the EITHER group (p = 0.04), and the BOTH group (p = 0.03). However, no significant difference in recovery time was noted between the EITHER and BOTH groups (p = 0.58).

Conclusions

Our results suggest that anxiety/depression history is associated with more severe post-concussion symptoms, worse visual memory, and longer recovery times when compared to those with no history of anxiety or depression. These findings highlight the importance of screening for anxiety and depression history in clinical settings and exploring ways to improve concussion recovery for individuals with anxiety and/or depression history.
B - 39 Resilience in Active Duty US Military Service Members: Factor Analysis and Prediction of Psychological Symptoms in a Mild Traumatic Brain Injury Sample
Authors: Hershaw Jamie , Tra John
Published: September 2024

Objective

The factor structure of the Connor-Davidson Resilience Scale (CD-RISC) varies between cultures, settings, and samples, yet has not been assessed in an active-duty United States (US) military sample. We used factor analysis to characterize resilience in a generalizable sample of active-duty service members (ADSMs) and explored its associations with self-reported psychological outcomes in ADSMs with a history of mild traumatic brain injury (mTBI).

Method

Exploratory factor analysis (EFA) of the 25-item CD-RISC was performed on a non-clinical convenience sample of 212 active duty SMs followed by a confirmatory factor analysis (CFA) for model validation. Hierarchical regressions compared the relationships among the resulting factors and total scores on the Post Traumatic Stress Disorder Checklist (PCL-5), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) between subgroups with self-reported history of mTBI (n = 60) and TBI-negative controls (n = 54).

Results

EFA returned a 4-factor, 19-item solution. After modifications to improve model fit, CFA validated a 4-factor, 17-item solution: Fortitude, Resoluteness, Decisiveness, and Dedication. The interaction of TBI history with the Decisiveness and Dedication factors significantly predicted BDI and PCL-5 total scores (p < 0.05), but not BAI total scores. Fortitude and Resoluteness did not differentially predict any psychological outcomes between groups.

Conclusion

Four latent factors of resilience that are unique to ADSMs were identified and validated from the 25-item CD-RISC. Decisiveness and Dedication more strongly predicted depressive and PTSD symptoms in ADSMs with a history of mTBI than in controls, suggesting these factors of resilience are especially critical for better psychological outcomes following mTBI in military populations.
B - 55 Diffusion Tensor Imaging Analysis of Former American Football Players Exposed to Repetitive Head Impacts
Authors: Wickham Alana , Adler Charles , Alosco Michael , Arciniega Hector , Balcer Laura , Bernick Charles , Bouix Sylvain , Cummings Jeffrey , Koerte Inga , Lin Alexander , Reiman Eric , Shenton Martha , Stern Robert , Breedlove Katherine , Carrington Holly , Coleman Michael , Daneshvar Daniel , John Omar , Jung Leonard , Kim Nicholas , Tripodis Yorgos , Tuz-Zahra Fatima , Wiegand Tim
Published: September 2024

Objective

Exposure to repetitive head impacts (RHI) has been linked to Chronic Traumatic Encephalopathy (CTE) and neuropathological alterations such as white matter shear injuries. In this study, we use diffusion-tensor imaging (DTI) to investigate in vivo white matter alterations among former American football players. We also investigate how age and factors associated with RHI exposure influence white matter integrity.

Methods

We analyzed data from the DIAGNOSE CTE Research Project, focusing on former American football players (n = 166). The measures included whole-brain Fractional Anisotropy (FA), reflecting water diffusion directionality in white matter, and FreeWater-corrected FA (FAt) accounting for extracellular free water, using FSL Tract-Based Spatial Statistics (TBSS). We performed linear regressions on FA and FAt with age, age of first exposure to football, and estimates of cumulative head impact index (CHII) scores of frequency, linear acceleration, and rotational force controlling for age, body mass index, race, education, and APOE e4 allele presence as covariates.

Results

Both FA (p < 0.00001) and FAt (p < 0.00001) decreased as age increased. Moreover, FA (p < 0.01) and FAt (p < 0.01) were significantly lower with an earlier age of first exposure to football. Finally, FAt decreased as CHII linear acceleration (p < 0.04) and rotational forces (p < 0.02) increased.

Conclusion

Our study reveals age-related declines in both FA and FAt and highlights that the duration and intensity of exposure to RHI have an impact on white matter microstructure later in life. Overall, these results underscore the impact of prolonged exposure to RHI on white matter microstructure.
B - 56 Concussion Symptom Differences by Race/Ethnicity, Sex, and Age in Elementary-Age Children
Authors: Bunt Stephen C , Shurtz Logan , Didehbani Nyaz , Allen Tahnae , Hicks Cason L , Chowdhury Sebastian K , Hynan Linda L , Stokes Mathew , Miller Shane L , Silver Cheryl H , Cullum C M
Published: September 2024

Objective

The influence of race/ethnicity upon symptom presentation after concussion in young children is unclear, although adult studies suggest that white male participants may encounter fewer negative outcomes. This study’s objective was to compare symptoms in elementary-age children in the immediate post-concussion period by race/ethnicity, sex, and age.

Method

Children (N = 392) aged 5–12 years (m = 10.26, SD = 1.83) seen within 30 days of a concussion at a specialty concussion clinic. Participants completed the concussion symptom scale from the Sport Concussion Assessment Tool-5 (SCAT-5). The sample was 55.9% male with overall race/ethnicity 63.3% non-Hispanic White, 19.9% Hispanic/Latino, and 16.8% Black. Two-way (2x3) mixed-design ANOVA models examined number of endorsed SCAT-5 symptoms and total severity by racial/ethnic group, sex, and age. Participants were grouped by the following age ranges: 5–9 (N = 113), 10–11 (N = 143), and 12 years old (N = 134).

Results

Results showed no significant difference in total symptom count [F(2, 391) = 0.799, p = 0.460] nor symptom severity [F(2, 391) = 1.788, p = 0.169] across racial/ethnic groups. Females endorsed more symptoms [F(1, 391) = 20.383, p < 0.001] and greater severity of symptoms [F(1, 391) = 16.826, p < 0.001] than males. No significant symptom differences by age group were found.

Conclusion(s)

Comparison of concussion symptoms by race/ethnicity did not reveal differences for elementary-age children in this sample. As expected, females reported more symptoms than males. More research is needed with larger samples to examine sociodemographic aspects of concussion diagnosis, care, and recovery.
B - 59 Recreational Drug Use Predicts Self-Reported Attention, Memory, and Academic Problems
Authors: Rakichevich Emma , Rakichevich Emma , Bannout Zainab Y , Jacquin Kristine M
Published: September 2024

Objective

Our study examined the association between recreational substance use and neuropsychological impairments.

Method

Over 400 (N = 412) American adults (aged 18–75; M = 32.7, SD = 11.5) were recruited through Prolific to complete an online survey including the Drug Use Survey and Neuropsychological Impairment Scale. Participants reported being men (53.2%), women (42.7%), non-binary (2.2%), and other genders, and white (62.1%), African American/Black (17.0%), Asian/Asian American (8.0%), Hispanic/Latinx (6.8%), or other ethnicities (6.1%). We have no conflicts to report.

Results

Regression analyses showed that frequency of substance use significantly predicted self-reported inattention, F(11, 400) = 7.62, p < 0.001, adj. R2 = 0.15. The best predictors of inattention were cannabis use, non-medical use of prescription psychostimulants, and inhalant use. Similarly, substance use predicted memory problems, F(11, 400) = 4.68, p < 0.001, adj. R2 = 0.09. Strongest predictors of memory problems were cannabis, hallucinogen, and inhalant use. Likewise, cannabis use, inhalant use, and non-medical use of prescription psychostimulants significantly predicted academic problems, F(11, 400) = 3.89, p < 0.001, adj. R2 = 0.07.

Conclusions

As hypothesized, our study found that substance use is a significant predictor of self-reported inattention, memory issues, and academic problems. Specifically, results suggest that cannabis users, non-medical users of prescription psychostimulants, and inhalant users experience more inattention and academic problems than non-users; these substance users and hallucinogen users experience more memory problems. The results of this study contribute to the growing body of literature highlighting the strong connection between recreational substance use and inattention, memory problems, and academic problems.
B - 76 Resilience and Executive Function: Protective Factors for Mental Health Professionals’ Eating Behaviors
Authors: Steinbaugh Ashlynn , Steinbaugh Ashlynn , Rousseau Alexandra , Rathke Laura , Adler Jennifer S , Kaswan Naomi , Hirst Rayna
Published: September 2024

Objectives

Eating disorders (EDs) affect 30 million individuals in the United States with serious health consequences, including fatality. Their impact on mental health professionals (MHPs) working with eating disorder (ED) populations remains understudied. This study aimed to examine the relationship between MHPs’ eating behaviors and potential protective factors.

Method

Professionals (N = 100) completed a survey of demographic information, ED symptoms, resilience, and executive functioning (EF) skills, and completed the Eating Disorder Examination Questionnaire (EDE-Q), the Connor-Davidson Resilience Scale (CD-RISC-10), and the Behavioral Rating Inventory of Executive Function - Adult Version (BRIEF-A).

Results

Nearly half of the participants (44%) indicated current work with ED populations and an average of 6.74 (SD = 9.76) years spent treating individuals with EDs. MHPs reported spending an average of 9% (SD = 16) of their current work-week with ED populations and endorsed ED work-specific stress as a contributor to their eating habits, with one third of MHPs endorsing sub-clinical ED behaviors. Resilience and EF appeared as significant protective factors against ED symptoms (ps < 0.05). GEC, BRI, and MI separately accounted for significant amounts of variance in EDE-Q scores (R2 = 0.12; R2 = 0.08; R2 = 0.13, respectively). There were no significant interactions between time working with individuals with EDs and EF scores on EDE-Q scores (p = ns).

Conclusions

This study is the first to examine ED behaviors, EF, and resilience in MHPs, revealing that resilience and EF serve as protective factors. Such qualities appear critical in preventing the development or exacerbation of professionals’ mental health symptoms.
B - 78 Examining how Adverse Childhood Experiences and the Underlying Processes of Trait and State Impulsivity Influence Suicidal Behavior
Authors: Duran Julia K , Naylor-Tincknell Janett M , Rieske Robert
Published: September 2024

Objective

This study sought to better understand how ACEs, suicidal behavior, and impulsivity are interconnected by first examining the relationships between reported ACEs and levels of trait and state impulsivity as well as how ACEs and multiple dimensions of trait and state impulsivity influence suicidal behavior.

Method

311 participants (19–67 years old; 49.2% male; 40.2% Caucasian) were recruited through Amazon’s Mechanical Turk. Adverse Childhood Experiences and suicidal behaviors were assessed using the ACE-Q and SBQ-R. The short version UPPS-P scale was used to measure negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and positive urgency whereas behavioral lab tasks were used to measure prepotent response inhibition, delay discounting, and distortions in elapsed time.

Results

Simple bivariate regressions revealed ACEs are a significant predictor of prepotent response inhibition and total S-UPPS-P scores as well as the specific subscales of negative urgency, positive urgency, and sensation seeking. Furthermore, a hierarchical regression found total ACE scores, poor time perception, and the tendency to act rashly while experiencing negative emotions (negative urgency) to be significant predictors of total suicidal behavior scores. Lastly, an ordinal logistic regression suggests a greater likelihood that individuals will go from suicidal ideation to planning, and from planning to attempting when they tend to act rashly while experiencing negative emotions, have less regard for consequences (lack of premeditation), and have experienced more ACEs.

Conclusion

By identifying the specific risk factors for suicidal behavior, we can recognize individuals at greater risk of attempting, as well as target and mitigate the effects of these behaviors through intervention.
B - 81 Teleneuropsychological Normative Data for the Spanish CERAD Wordlist for Puerto Rican Adults
Authors: Cintrón Ortiz Bianca P , Zambrana-Bonaparte Hjalmar
Published: September 2024

Objective

The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Wordlist is one of the most commonly used and sensitive tests to detect early cognitive decline (Seo et al., 2010). However, few studies have utilized it with the Puerto Rican population, and none have established normative data on its teleneuropsychological (TeleNP) use. Therefore, this study aims to establish normative data for the TeleNP version of the CERAD Wordlist among Puerto Ricans.

Method

124 cognitively healthy (MMSE: M = 28.9, SD = 1.4) Spanish-speaking Puerto Ricans (Female: 71.8%; Age M = 64.6, SD = 7.3; Education M = 15.9, SD = 3.5) completed an online version of the CERAD Wordlist via Zoom. The impact of age and education was investigated using analyses of variance (ANOVA) and Pearson correlations. Descriptive statistics were conducted to generate normative data stratified by statistically significant demographics. Concurrent validity was established between the delayed recall trials of the CERAD Wordlist and MMSE.

Results

Age and education significantly impacted CERAD Wordlist scores (p < 0.01) across all Learning Trials and Delayed Recall. All effect sizes were large, except for moderate sizes in Trial 1 and Wordlist Recognition. Age was inversely correlated to scores, while education was positively correlated. Concurrent validity with TeleNP MMSE was 0.43 (p < 0.001).

Conclusions

This study establishes normative data for Puerto Ricans using the TeleNP version of the CERAD Wordlist, which can improve diagnostic accuracy. Future research on the CERAD Wordlist via TeleNP should explore clinical validity and encompass a broader range of educational backgrounds.