bluuebunny/crossref_metadata_2025 huggingface dataset:
A - 120 Case Report on Functional Resilience Amidst Alzheimer’s Disease Pathology and Global Neuropsychological Deficits
Authors: Ramirez Sofia , Haddock Yanelee Perez , Ortega Alexandra , Neer Emory , Ortiz Juliana , Encarnacion Triana Abel , Crenshaw Kirsten , Carballea Denise , Crocco Elizabeth , Curiel Cid Rosie E , Loewenstein David E
Published: September 2024

Objective

This case report study shows the concept of functional resilience in individuals diagnosed with Alzheimer’s Disease (ad) despite the presence of neurodegenerative pathologies and impaired neuropsychological performance. Current literature addresses the disjunction between ad pathologies and their clinical manifestations, suggesting that delays in ad clinical manifestations may be attributed to lifestyle factors such as cognitive and social activities, as well as an increased cognitive reserve.

Method

A 58-year-old White Hispanic female with 14 years of education presents a five-year history of gradual and progressive cognitive changes. Cognitive symptoms include forgetting conversations, past facts, and appointments, repetitiveness, and misplacing items. She presents with tandem gait disturbances, dysmetria, and dysdiadochokinesia. She is semi-independent in activities of daily living (ADLs) and serves as a caregiver for her mother with ad. She underwent a comprehensive neuropsychological evaluation as part of a research battery and completed an amyloid PET scan.

Results

The results indicated moderate-to-severe impairments across various cognitive domains, including memory, language, attention, executive function, and visuospatial constructional ability. PET Scan results are suggestive of the presence of ad pathology (BAPL score of 3).

Conclusion

The patient’s ability to manage ADLs while serving as a primary caregiver, despite facing considerable challenges related to cognitive performance, highlights her adaptability and independence. Identifying factors like implicit memory and psychosocial elements that support compensatory functional skills sheds light on enhancing independence and possibly the quality of life in individuals with ad. It emphasizes holistic dementia care, acknowledging and utilizing patients’ inherent resilience to navigate ad challenges.
A - 121 A Comparison of Phonemic and Semantic Fluency among Individuals with Vascular Encephalopathy (VaE), Alzheimer’s Disease (ad), and Healthy Controls (HC)
Authors: Dabbagh Dania , Smith Deja , Jones Macy , Bennett Ryan
Published: September 2024

Objective

To examine the performance of individuals with vascular encephalopathy, Alzheimer’s disease, and healthy controls on phonemic and semantic fluency tasks.

Method

Participants (N = 485) were categorized based on their diagnosis: VAE (n = 129, Mage = 76, 54.26% male); ad (n = 191, Mage = 75.67, 31.41% male); and HC (n = 165, Mage = 69, 26.67% male). Quade ANCOVAs were employed to probe differences in phonemic fluency and semantic fluency across the three groups while accounting for age and education.

Results

Statistically significant findings were observed for the overall model for phonemic and semantic fluency, indicating strong relationships between diagnosis and task performance (Phonemic: F(4, 480) = 115.017, p < 0.001, ηp2 = 0.489; Semantic F(4, 480) = 280.779, p < 0.001, ηp2 = 0.701). A contrast analysis revealed significant differences when comparing ad to HC [Phonemic: -165.300 (SE = 12.512, t = −13.21, p < 0.001); Semantic −238.003 (SE = 9.583; t = −24.83, p < 0.001)]. A similar pattern emerged when comparing the VAE and HC groups [Phonemic: -126.471 (SE = 13.833, t = −9.14, p < 0.001); Semantic −181.446 (SE = 10.595, t = −17.12, p < 0.001)].

Conclusion

Cognitive impairment type significantly influenced phonemic and semantic fluency scores, even after adjusting for age and education. ad individuals showed the lowest performance in both tasks compared to VaE individuals, who in turn performed worse than HCs. Assessing differences in phonemic and semantic fluency between disease groups is crucial for differential diagnosis and understanding specific cognitive deficits, which can guide personalized treatment strategies. These evaluations help monitor disease progression and contribute to research that may lead to improved therapeutic approaches.
A - 122 Neuropsychological Case Study: Late-Onset Huntington’s Disease
Authors: Kim Emily H , Mattis Paul J , Quinn Crystal G
Published: September 2024

Objective

We present the neuropsychological profile of a 65-year-old male diagnosed with late-onset Huntington’s Disease (HD) in April 2024. In the context of very subtle chorea movements over the past several years, he started experiencing mood disturbances (e.g., increased irritability and social withdrawal) starting in June 2023. These changes were followed by cognitive difficulties, which led to a hospitalization for autoimmune encephalitis workup in February 2024. He described difficulties with learning and memory for future events, concentration, and executive functions (e.g., organizing and problem-solving).

Method

Referral from neurology to conduct a comprehensive neuropsychological evaluation to characterize his cognitive functioning. Exam, chart review, and clinical interviews were conducted.

Results

The cognitive profile was largely preserved, with mild attentional and executive difficulties, as well as mild challenges retrieving unstructured verbal information. This indicated subtle frontosubcortical network disruption. Self-report questionnaires indicated mild hopelessness but minimal anxiety and mood concerns. During the course of the neuropsychological evaluation, he underwent genetic testing, which was consistent with a diagnosis of HD (41 CAG repeats in the HTT gene). From a neuropsychological perspective, his psychiatric and cognitive disruption were also consistent with a diagnosis of HD.

Conclusion

The patient’s psychiatric and cognitive decline are now understood in light of his recent HD diagnosis. While cognitive difficulties are prevalent in individuals with HD, the low prevalence of late-onset HD makes the results of this case report particularly informative. This report contributes valuable insights into the neuropsychological presentation of older adults with HD.
A - 127 Semantic Fluency Performance as a Function of Race and Clinical Status
Authors: Ambeau Alexis , Brickell Emily , Lee Bern
Published: September 2024

Objective

Determine whether performance on animal naming (AN) differs between African American (AA) and Caucasian patients with no cognitive disorder (NCD) and suspected Alzheimer’s Disease (ad).

Method

AN raw scores were obtained from Caucasian (N = 409) and AA (N = 83) patients evaluated at a large Southern medical center. Two-way factorial analysis of covariance was conducted focusing on the interaction among and differences between racial (AA, Caucasian) and clinical (ad, NCD) groups on AN. Covariates included age, education, and premorbid reading level (PRL) measured via Test of Premorbid Functioning (TOPF) raw score.

Results

Winsorization was used for outliers. The ad group (9.97[5.53]) produced significantly fewer words on average than the NCD group (18.99[5.15]), F(1, 485) = 46.01, p < 0.001. There was no significant main effect of race after controlling for age, education, and PRL, F(1, 485) = 0.42, p = 0.517. However, there was a significant interaction between race and clinical group, with the difference between clinical groups greater among Caucasian patients, F(1, 485) = 13.89, p < 0.001. Specifically, among NCD patients, Caucasians averaged higher scores (19.41[5.15]) than AAs (16.61[4.5]), despite controlling for age, education, and PRL, T(1,353) = 3.72, p < 0.001. Among patients with ad, AAs (10.9[7.01]) and Caucasians (9.72[5.06]) scored similarly (p > 0.05).

Conclusions

Results suggest differences in AN between ad and NCD are less pronounced for AA patients due to lower NCD AN scores among AAs. Evaluation of socioeconomic conditions (e.g., Area Deprivation Index), geographic linguistic patterns, and item-level error analysis could provide insight into differential AN performance.
A - 128 Informant Characteristics Impact Clinical Dementia Rating Scale Sum of Boxes in Mild Cognitive Impairment
Authors: Kaser Alyssa N , Thakkar Vishal J , Kronenberger Oscar R , Cullum C Munro , González Deborah M , Walls Brittany D , Lacritz Laura
Published: September 2024

Objective

The Clinical Dementia Rating (CDR) Scale is an informant-based instrument widely used in clinical and research settings to stage dementia severity. Informant-based reports of functioning have been shown to be influenced by informant characteristics, indicating a potential source of bias. The current study adds to this growing area of research by exploring the differential impact of informant characteristics on CDR Sum of Boxes (CDR-SB) among non-Hispanic White (NHW), non-Hispanic Black (NHB) and Hispanic older adults with mild cognitive impairment (MCI).

Method

Participants included 2775 older adults diagnosed with MCI from the National Alzheimer’s Coordinating Center Uniform Data Set. Multiple linear regression models with forward selection evaluated the extent to which various informant characteristics predicted CDR-SB scores in the whole sample and NHW (n = 2170), NHB (n = 495), and Hispanic (n = 110) groups, covarying for participant demographics and cognition (MoCA).

Results

Informant sex, education, age, relationship type, and cohabitation status significantly predicted CDR-SB scores in this sample (R2 = 0.096, p < 0.001). Models stratified by race and ethnicity accounted for 20.2%, 10.3%, and 6.9% of the variance in CDR-SB scores in Hispanic, NHB, and NHW groups, respectively (ps < 0.001). Variability in model predictors was observed across groups, with informant characteristics accounting for more model variance than participant demographics in Hispanic and NHB groups. Results remained significant after adjusting for multiple comparisons.

Conclusions

Informant characteristics and relational factors may influence perceptions of participant functioning on the CDR-SB and may particularly affect scores among Hispanic older adults with MCI, though further validation in community-based cohorts with adequate racial and ethnic representation is warranted.
A - 129 Healthcare Disparity between Dominant English Versus Spanish-Speaking Deep Brain Stimulation Candidates with Parkinson’s Disease
Authors: Kim Doyen , Hart Roland P , Bradley Hannah , Palmese Christina A
Published: September 2024

Objective

The existence of healthcare disparities is well documented, although data regarding mental health disparities in pre-surgical deep brain stimulation surgery (DBS) patients with Parkinson’s disease (PD) remains emergent. In this study, we compare mood, apathy, and quality of life (QoL) in dominant English and Spanish-speaking PD-DBS candidates. We hypothesized that presurgical PD-DBS Spanish-speakers would have greater disease burden and lower mood and QoL compared to native English-speakers.

Method

Demographic and disease specific characteristics including disease duration and severity (Unified Parkinsons Disease Rating Scale (MDS-UPDRS)), mood (Beck Depression Inventory-II (BDI-II), Starkstein Apathy Scale (SAS)), and QoL (Parkinson’s Disease Questionnaire-39 (PDQ-39)) were compared. Data were analyzed using independent t-tests and chi-square tests to identify group differences based on language dominance (English (n = 20), Spanish (n = 20)).

Results

Spanish-speakers had higher disease burden (MDS-UPDRS “on”: p = 0.018; “off”: p = 0.023), but no other statistical significance in demographic or clinical motor characteristics. There were significant group differences in mood (BDI-II: p = 0.046), PDQ-39 Total and subdomain scores (Total: p = 0.017; ADL: p = 0.005; Mobility: p = 0.007; Emotional Wellbeing: p = 0.029; and Bodily Discomfort: p = 0.007) with Spanish-speakers reporting poorer QoL. No significant group differences were found regarding apathy.

Conclusion(s)

Spanish-speakers demonstrated greater disease burden and endorsed significantly lower QoL and depression symptoms compared to English speakers. These data add to our understanding of healthcare disparities among presurgical PD-DBS candidates and suggest that underrepresented groups, such as dominant Spanish-speakers, may have less access to early intervention, missed PD symptomology, and/or cultural apprehension about seeking medical care, thus increasing disease burden and impacting QoL over time.
A - 132 Perceptions of Functional Competency in Persons with Subjective Memory Complaints, Mild Cognitive Impairment, and Early Dementia of the Alzheimer’s Type
Authors: Coddaire Katelyn C , Prigatano George P
Published: September 2024

Objective

This study evaluated whether persons with Subject Memory Complaints (SMC) perceive their overall functional abilities differently than persons with known memory impairments. We predicted SMC persons would describe themselves as less functionally competent compared to persons with objective memory impairments while relatives would perceive them as more functionally competent than what they report.

Method

As a part of an ongoing study evaluating cognitive and motor correlates of SMC, Mild Cognitive Impairment (MCI), and early Alzheimer’s disease (ad), 10 persons with SMC, 14 with MCI, and 11 with early ad completed the Patient Competency Rating Scale (PCRS). A family member or significant other completed the Patient Competency Rating Scale-Relative Form. Subjects were matched on age, education, and sex.

Results

Self-reported competency varied across groups (p < 0.05), with the SMC group reporting less competency than the MCI group but at a level of competency similar to the ad group. Relatives’ ratings were also significantly different across groups (p < 0.05). SMC persons were considered by relatives as more functionally competent than the MCI and ad groups. Discrepancy scores between the PCRS and PCRS-R differed across groups (p < 0.05). SMC persons underestimated their functional abilities while persons with MCI and ad overestimated their abilities.

Conclusion

The findings support the predictions and are compatible with reports in the literature. The PCRS and PCRS-R provide clinically relevant information regarding both a person’s functional abilities in everyday life (according to a relative) while also detecting potential disturbances in self-awareness. SMC patients appear to overstate their functional limitations in many domains in addition to memory.
A - 136 Clinical Features of Agrammatism in Spanish Speakers with Non-Fluent/Agrammatic Variant of Primary Progressive Aphasia (Nappa): a Case Study Analysis
Authors: Arias Elsie , Provencio Augustine , Peery Shelley , Rengifo Johanna
Published: September 2024

Objective

A clinical diagnosis of naPPA includes presence of agrammatism and effortful speech (Gorno-Tempini et al., 2011). Agrammatism, specifically verb agreement, has emerged as a key clinical feature distinguishing PPA subtyping in English (Thomson et al., 2012). Patterns of agrammatism in English are well-established and were thought to extend to other languages (Gorno-Tempini et al., 2004; Benedet et al., 1998). Agrammatism in post-stroke Spanish patients has unique linguistic characteristics including gender-object agreement errors (Benedet et al., 1998; Reznik et al., 1995, Ardila, 2001). Research assessing agrammatism in PPA Spanish speakers is limited (Gonzalez et al., 2022). These three cases describe gender agreement errors as a clinical feature of agrammatism in Spanish speakers with naPPA.

Method

Three Spanish-dominant patients with primary speech deficits underwent neuropsychological evaluation across three outpatient clinics and were diagnosed with naPPA (all had brain MRI, two had FDG-PET). Narrative language samples were analyzed to explore patterns of agrammatic language production.

Results

Patients made few to no verb agreement errors. Instead, common errors included inconsistent speech sounds and gender disagreement within common object-article pairings, including substitutions in Spanish-language articles like “el” or “la” (e.g., “el silla”).

Conclusions

These cases revealed gender-object agreement errors as a consistent clinical feature of agrammatism in Spanish naPPA patients. Research assessing the linguistic profiles and agrammatisms of Spanish-speaking PPA patients, with confirmatory neuroimaging and biomarker correlates, is needed to aid clinicians in differentiating PPA subtypes among Spanish speakers. This is especially important with emergence of new disease modifying treatments specifically helpful in some but not all subtypes.
A - 138 Subjective to Objective: Evaluating the Relationship of Subjective Word-Finding Complaints to Performance on Objective Measures of Language
Authors: Render Rebecca C , Marceaux Janice C , McCoy Karin , Collier Marissa
Published: September 2024

Objective

Individuals undergoing neuropsychological evaluation may report word-finding complaints (WFC). Low performance on naming and fluency measures has been described as indicative of word-finding difficulties; studies examining correspondence of subjective complaints with objective test performance are limited. This study aimed to assess if language test scores differed based on the presence/absence of WFC and if test scores predicted report of WFC.

Method

One-hundred eleven monolingual-English veterans who passed the TOMM and completed language measures of interest were included. Measures included Auditory Naming Test, Visual Naming Test, Boston Naming Test, Neuropsychological Assessment Battery Naming subtest, and verbal fluency measures. Sample characteristics included 86.5% men, 71.2% White/Caucasian, 9.9% Hispanic/Latino, 17.1% Black/African American, and 52.2% diagnosed with neurocognitive disorder. Seventy-five (67.6%) participants self-reported WFC. Multivariate analysis and Mann–Whitney U tests compared measures across word-finding groups. Binomial logistic regressions examined each language measure as predictors of word-finding complaints (covariates: age, education, depression; chosen based on extant research reporting association with WFC).

Results

Presence of WFC was comparable across diagnostic groups (ꭓ2 = 2.49; p = 0.115). Multivariate analysis found no difference in language performance across word-finding groups, Pillai’s Trace = 0.047, p = 0.786, ηp2 = 0.047); group distributions were equivalent across measures. Logistic regressions were non-significant for the neurocognitive disorder group. In the no neurocognitive disorder group, depression (but not language measures) was a significant predictor across models.

Conclusion

Results indicate presence of subjective WFC is not associated with language test performance, and test performance was not predictive of WFC. Depression emerged as a significant predictor of complaints among those without a neurocognitive disorder, warranting further investigation.
A - 141 The Relationship of Tumor Location and Treatment on Cognition in Long-Term IDH-Mutant Glioma Survivors
Authors: Gross Hana , Faria Caylin , Lanman Tyler , Dietrich Jorg , Shih Helen A , Parsons Michael
Published: September 2024

Objective

Isocitrate dehydrogenase 1 mutation (IDH-M) denotes a distinct subtype of glioma which has a relatively favorable prognosis but nevertheless requires treatment including surgery, radiation and/or chemotherapy and the tumors inevitably recur. Factors influencing cognition in long-term survivors (LTS) of IDH-M have not been well characterized. We investigated factors affecting cognition in a cohort of well characterized of IDH-M LTS.

Method

Patients (N = 65; 98.5% Caucasian; 47.7% female; Mage = 47.51; Medu = 16.06) who were at least 3 years post-IDH-M diagnosis who completed neuropsychological assessment in the Neuro-oncology division at Massachusetts General Hospital were included. Tests of processing speed, working memory, episodic memory, and executive function were analyzed along with tumor, treatment, and individual difference factors relevant to cognition. Exploratory analyses were conducted to generate hypotheses regarding factors of interest.

Results

Tumor hemisphere affected delayed recall of word list learning Z-score (F = 4.00; p = 0.024; left = −1.41; right = −0.59). Tumor lobe affected visual learning (F = 3.11; p = 0.054; frontal = −0.594; temporal = −0.807; parietal = −1.983). There were no effects of treatment type (photon vs proton radiation; single vs multi-agent chemotherapy), presence of seizures, psychiatric diagnosis, tumor subtype (oligodendroglioma/astrocytoma), grade (2,3,4) or disease duration (Mean = 9.5y; min = 3y; max = 28.8y) on cognition.

Conclusions

In this heavily treated group of IDH-M glioma LTS referred for neuropsychological evaluation, typical lateralizing/localizing cognitive deficits were revealed. However, simple dichotomies may fail to capture relevant contributors to cognitive impairment. Integration with individual factors including premorbid cognition, radiation dosimetry and brain network connectivity may be necessary to predict cognitive trajectories and outcomes.
B - 1 Cognitive Flexibility Moderates the Relationship between Trauma Symptoms and Cognitive Proficiency
Authors: Romano Lucie , Fisher Thomas , Keniston Alyssa , Lewandowski Alan , Cole JoLynn
Published: September 2024

Objective

This study aims to lend additional empirical support for the relationship between cognitive proficiency and trauma. Importantly, the study seeks to advance our understanding of this relationship by investigating the possible moderating role of cognitive flexibility (CF). It was hypothesized that the relationship between trauma and cognitive proficiency would be stronger for individuals with less CF.

Method

Data were collected from 75 adult participants in a private practice. The sample was predominantly White and female, and all consented to a comprehensive neuropsychological assessment following referral for inattention and personal trauma. Relevant measures included the focused anxiety-trauma subscale of the Personality Assessment Inventory, the Cognitive Processing Index of the Weschler Adult Intelligence Scale, and Trails B to determine the correlation between trauma symptoms and cognitive proficiency and to evaluate whether CF moderated the relationship.

Results

Results indicated that greater trauma symptoms were associated with lower cognitive proficiency (B = −0.448, SE = 0.090, β = −0.554, p < 0.001). The interaction between trauma symptoms and CF was also significant (B = 0.007, SE = 0.002, β = 0.506, p < 0.001), suggesting the effect of trauma on cognitive proficiency depended upon the level of CF. Together, the variables accounted for approximately 30% of the variance in cognitive proficiency (R2 = 0.299, F(2, 73) = 15.574, p < 0.001).

Conclusion

This study supports the hypothesis that the impact of psychological trauma on cerebral efficiency is partially dependent on CF. These findings spotlight CF as a potential target for intervention to mitigate the cognitive effects of trauma.
B - 2 Life-Changing Treatment, Lifelong Challenges: a Case Study on the Neuropsychological Impact of Remission of Multiple Sclerosis Following Clinical-Trial Treatment
Authors: Romano Lucie , Fisher Thomas , Keniston Alyssa , Lewandowski Alan , Cole JoLynn
Published: September 2024

Objective

The impact of neurodegenerative diseases on cognitive functioning is well documented; however less is known about the lasting impacts following remission of diseases with previously limited treatability. The present case uses neuropsychological assessment in furthering the understanding of the brain-behavior relationship in a case of multiple sclerosis (MS) in remission subsequent to clinical-trial treatment complicated by a history of medical comorbidities, childhood trauma, underlying psychiatric conditions, and preexisting learning disabilities.

Method

The patient is a 45-year-old right-handed male with nine years of education, diagnosed with MS (in remission) complicated by cerebrovascular disease, myocardial infarction, cerebral vascular accident, past substance-abuse, and multisource childhood trauma., He was referred for neuropsychological evaluation by his primary-care physician pursuant to learning, attention, and emotional concerns impacted by his medical history.

Results

Neuropsychological testing reflects global cognitive deficits evidenced by difficulties with intellectual functioning, motor abilities, complex sequencing, executive functioning, problem-solving, phonemic fluency, and variable attention, which affects learning and recall tasks. A self-report of psychological functioning revealed emotional difficulties associated with anxiety, depression, health concerns, hypersensitivity, emotional discord, a history of self-harm, cognitive inefficiency, and difficulty managing anger and past and present stressors. Findings were most consistent with cognitive decline associated with medical conditions, learning difficulties, and attention deficit disorder.

Conclusions

This neuropsychological case study provides an example of the long-term consequences of neurodegenerative diseases across multiple areas of neuropsychological functioning and quality of life, even when ground-breaking and innovative medical interventions result in remission. It further emphasizes the complex interactions between neurological disease and biopsychosocial factors.
B - 4 The Neuropsychological Impact of Myocardial Infarction Induced Cerebral Hypoxia and Acute Encephalitis Following Electrocution: a Case Study
Authors: Fisher Thomas L , Romano Lucie , Keniston Alyssa , Lewandowski Alan , Cole Jolynn
Published: September 2024

Objective

Cerebral hypoxia and acute encephalitis subsequent to myocardial infarction (MI) are often associated with a decline in cognitive functioning (Wang et al., 2022; Caplan, 2004). While this relationship is well documented in existing literature, less research has investigated the potential nuanced cognitive and behavioral impacts of hypoxia and encephalitis due to electrocution-induced atrial fibrillation (AFib). The present case study uses neuropsychological assessment to clarify further the impact of significant electrocution and subsequent morbidities on cognition.

Method

We present a case study of a 30-year-old right-handed transgender female with 12 years of education who was referred for neuropsychological assessment pursuant to mental status changes manifested by disorientation and amnesia (the patient believed it was ten years prior) following the MI due to electrocution complicated by an estimated period of 10–15 minutes of non-responsiveness and anoxic encephalopathy.

Results

Neuropsychological assessment revealed difficulties with cognitive efficiency, language functioning, sequencing, problem-solving, complex attention, and semantic fluency. Overall, performance was inconsistent with education-weighted norms and estimated premorbid functioning. An objective measure of psychological functioning reflected a negative self-evaluation, depression, thoughts of self-harm, anxiety, and personality difficulties marked by fluctuating emotions. Findings supported a diagnosis of cognitive impairment and altered mental status associated with anoxic brain injury from the above-noted MI.

Conclusion

This case highlights the consequences of anoxic encephalopathy from MI subsequent to electrocution on cognitive, emotional, and behavioral functioning. Neuropsychological assessment provided clear evidence of cognitive impairment beyond the initial diagnoses, and further defined cognitive and behavioral correlates not explained by other dispositional variables.
B - 6 The BRIEF-2A Pattern of Self and Informant Executive Functioning Difficulties in Adults with Epilepsy
Authors: Heydari Nahal D , Sady Maegan , Moncrief Grant G , Graefe Anna C , Roth Robert M
Published: September 2024

Objective

People with epilepsy (PWE) commonly have executive functioning (EF) difficulties on objective testing. However, less is known about subjective EF difficulties in everyday life. We examined self- and informant-rated EF in PWE using the Behavior Rating Inventory of Executive Function for Adults-2 (BRIEF-2A). We hypothesized that PWE and their informants would endorse greater EF difficulties relative to healthy participants.

Method

Participants included 43 PWE who completed comprehensive clinical neuropsychological evaluation at a large Northeastern academic medical center, which included BRIEF-2A Informant and Self Report Forms (Age M = 40.4 ± 17.2 years, 53% female, Education M = 13.0 ± 1.8 years). Twenty-four participants completed self-reports, while 19 had both self and informant reports. The comparison sample included 43 age- and gender-matched healthy controls (HC). We analyzed BRIEF-2A subscales using MANOVAs, where elevated T scores indicated worse EF. Repeated measures ANOVAs compared self and informant ratings. Multi-rater comparisons (90% CIs) and chi-squares analyzed patterns of discrepant ratings.

Results

Self-reported EF difficulties in PWE were elevated across all scales, compared to HC (p’s0.25), with greatest difference observed for working memory (PWE = 69.7 ± 12.7, HC = 44.5 ± 16.7, ηp2 = 0.61). Similar elevations across all scales were observed for PWE informant reports (p’s0.14). PWE rated greater self-monitoring (p = 0.03, ηp2 > 0.23) and emotional control (p = 0.08, ηp2 > 0.16) difficulties than informants. There was 42.1–68.4% concordance between self and informant reports for PWE, compared to 84–95% in HC. Patterns of self and informant ratings were similar between PWE and HC for initiation, planning/organization, and task-monitoring (p’s > 0.20).

Conclusions

PWE and their informants report high, yet relatively similar, levels of EF difficulties in daily life.
B - 9 Implications of Cognitive Reserve (CR) in Pre-Surgical Epilepsy Patients: a Case Series
Authors: Lokai Andrew , Ginalis Christine , Alluri Priyanka , Shavel Katie , Vaidya Shreya , Bender Heidi , Spat-Lemus Jessica , Sacks-Zimmerman Amanda
Published: September 2024

Objective

Localization-related epilepsy is a chronic neurological condition for which neurosurgical interventions are effective. The pre-surgical evaluation process requires careful analysis of neuropsychological data to localize and lateralize areas of underlying neuropathology to guide surgical planning and post-operative prognostication. While it is well-described throughout the literature that global impairments may obscure patterns of discernable neurocognitive strengths and weaknesses, specifically in pre-surgical epilepsy evaluations, less is known about the impact of cognitive reserve (CR). CR, often described in the aging literature, refers to high levels of mental reserve acquired from educational, vocational and intellectual capacities, with the potential to guard against neurocognitive decline.

Method

Four right-handed patients (ages 24–44) with localization-related, medically-refractory epilepsy with left hemisphere onset (2 temporal and 2 extra temporal onset) underwent a comprehensive neuropsychological evaluation as part of a comprehensive pre-surgical workup.

Results

The CR conglomerate for these four patients (i.e., educational, vocational attainment and scores on premorbid cognitive metrics) fell in the Very High range. Three out of four patients did not evince the clinically-significant pattern of deficit (>1.5 SD lower than premorbid estimate) on verbally-mediated tasks often seen in right-handed individuals with left-sided seizure onset (i.e., diminished naming and verbal learning).

Conclusion

The reasons underlying the manifestation of definitively localizing or lateralizing neuropsychological profile differs from patient-to-patient (i.e., handedness, duration of epilepsy, structural lesion, language(s) spoken); however, CR should also be considered an important confound when interfacing with data of questionable clinical utility and prognostic value.
B - 13 Effects of Individual and Community-Level Adverse Childhood Experiences and Current Psychopathology among Monolingual Spanish-Speaking Adult Neuropsychology Referrals
Authors: Jaramillo Ruthie , Abalos Steven A , Newkirk Bailey O , Soble Jason R
Published: September 2024

Objective

The link between adverse childhood experiences (ACEs) and higher rates of psychopathology in adulthood has been well-established, though far less analogue research has examined this relationship among Latinx patients. This study assessed the relationship between ACEs and symptoms of anxiety, depression, and perceived stress among monolingual Spanish-speaking neuropsychology referrals.

Method

Data were culled from 27 adult neuropsychology referrals (mean age = 61.70; mean education = 8.59) neuropsychological referrals administered the ACE Questionnaire, Beck Depression Inventory (BDI-II), Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), and Perceived Stress Scale (PSS). Linear regression analyses examined the effect of exposure to individual (e.g., emotional, physical, sexual abuse, neglect, domestic violence) and community-level ACEs on depression, anxiety, and perceived stress symptom endorsement.

Results

Endorsement of more individual ACEs predicted higher levels of anxiety (R2 = 0.281; p = 0.009) and depression (R2 = 0.127; p = 0.075) symptoms, but not perceived stress levels (R2 = 0.037; p = 0.365. By contrast, endorsement of more community-level ACEs marginally predicted higher anxiety symptoms (R2 = 0.124; p = 0.071), but not depression symptoms (R2 = 0.020; p = 0.568) or perceived stress levels (R2 = 0.045; p = 0.319).

Conclusions

Experiencing more individual-level ACEs predicted greater anxiety and, to a lesser extent, depressive symptoms, whereas community-level ACEs did not predict similar levels of endorsement of active psychopathology among monolingual Spanish-speaking adults referred for neuropsychological evaluation. Findings emphasize the need of neuropsychologists to consider routinely assessing patient’s childhood trauma history and current psychopathology symptoms during evaluation to improve diagnostic accuracy and recommendations for Latinx patients.
B - 18 Effect of Automatic Approach Tendency on Neural Dynamics in Heavy Drinkers: an ERP Study
Authors: Verma Adarsh K , Kumar Adith D , Chivukula Usha , Kumar Neeraj
Published: September 2024

Objective

Automatic alcohol approach/avoidance tendencies play a major role in alcohol dependence, but associated interventions are seen to have negligible effects on relapse prevention due to a limited understanding and lack of focus on modulating associated neuro-cognitive mechanisms. The current work explores the automatic tendencies-based behavioral and event-related potential (ERP) differences and probes into the neurocognitive processes and responsible brain regions.

Method

The study was conducted in a laboratory setting on 19 heavy drinkers (Alc) and 20 non-drinkers (NAlc) males recruited using snowball sampling, where participants performed an Alcohol Approach-Avoidance Task (AAT), a task for assessing/categorizing participants with automatic approach (AAppr) and avoidance (AAvoi) tendencies toward alcohol during EEG recording. A 2 (group: Alc, NAlc) x 2 (automatic tendencies: approach, avoidance) ANOVA for behavioral outcomes and ANOVA with planned contrasts for Alc and NAlc, and AAppr and AAvoi groups comparisons were performed on early, mid, and late ERP measures.

Results

The group-tendency interaction significantly influenced behavioral AAT scores. At the neural level, the Alc and NAlc group differences were present at the occipital, parietal, and frontal sites. However, the AAppr and AAvoi group differences were only present at the frontal regions, and prominent for N100–200 and N350–450 amplitudes at the F4 electrode, an electrode sitting over the right dorsolateral prefrontal cortex (dLPFC), responsible for modulating attention, response inhibition, and decision-making processes.

Conclusion

The results clarify the role of frontal and right dLPFC areas in driving the differences in automatic tendencies by significantly suppressing the neural responses in heavy drinkers with approach but not avoidance tendencies.
B - 19 Neuropsychiatric Determinants of Cognitive Complaints Following COVID-19: a Comparative Study
Authors: Nemanim Natasha , Roth Alyssa , Angelini Sofia , Hansen Gabrielle , Perez Veronica B
Published: September 2024

Objective

Fatigue, anxiety, depression, and stress (FADS) may co-exist with neurocognitive complaints (NC) of “brain fog” reported beyond the acute phase of COVID-19. FADS have been implicated in NC in other conditions. This study aims to elucidate the relationship between FADS and NC following COVID-19 and speak to the relationship between NC and time since acute illness. Moreover, given disproportionately higher rates of COVID-19 amongst people of the global majority (PGM), this study highlights differences between PGM and non-PGM participants in these trends. It is expected that FADS will correlate with NC and vary according to PGM-affiliation.

Method

Sixty-six participants with a history of COVID-19 within the past eight months (22 PGM, 44 non-PGM) completed the Everyday Cognition Scale (modified scale of NC), the Depression Anxiety Stress Scales, and the Multidimensional Fatigue Inventory.

Results

In PGM participants, significant Pearson correlations were observed between NCs and fatigue (r = 0.57, p = 0.009), anxiety (r = 0.87, p < 0.001), depression (r = 0.70, p < 0.001), and stress (r = 0.68, p = 0.001). Non-PGM NCs were also associated with anxiety (r = 0.53, p < 0.001), depression (r = 0.59, p < 0.001), and stress (r = 0.27, p = 0.007), but not fatigue. The relationship between subjective neurocognitive concerns and time since acute illness was not significant for either group.

Conclusions

FADS relates to NC across PGM and non-PGM groups. Neuropsychologists evaluating patients presenting with subjective cognitive complaints following COVID-19 should assess for FADS in their comprehensive evaluations. Targeting interventions for FADS (as applicable) may yield a decline in NC.
B - 21 11-Year Longitudinal Study of a Competitive Swimmer Following a Severe TBI
Authors: Getz Maia , Getz Glen E
Published: September 2024

Objective

Symptoms of severe traumatic brain injuries (TBIs) are oftentimes significant, long lasting, and treated by a variety of medications and therapies. Although exercise is known to be beneficial for brain health, the effects of substantial exercise on recovery following severe TBI (sTBI) in female athletes are undiscovered.

Method

This case study examines a 51-year-old woman who sustained a sTBI, involving multiple hemorrhagic contusions to the right cerebellum, inferior bilateral frontal lobes, anterior left temporal lobe, and diffuse axonal injury on 8/5/13 from a bicycle accident, resulting in a 13-day coma and cognitive impairment. She underwent 6 brain surgeries, an artificial skull implant and intensive therapies. Before the accident, she was a competitive swimmer and triathlon racer. Despite being told that she would never swim again, she resumed swimming on 09/1/14. She swims 6 days a week for 90-minutes a day, winning open water races.

Results

Examination from four neuropsychological assessments over 11 years provide substantial longitudinal data. Results revealed improvement over the 4 testing periods particularly on processing speed, verbal fluency, and Boston Naming Test with t-score differences ranging between 8 and 24. Additionally, she performed in the average range on General Abilities Index, NAB Mazes, and Trail Making Test across all four assessments.

Conclusion

This longitudinal case study provides evidence that extensive swimming is associated with cognitive recovery from sTBI in a female athlete and documents her return to high level exercise and competition. Evidence suggests that carefully tailored and monitored exercise programs can benefit long term cognitive following from sTBI.
B - 24 Assessing Cognitive Impairment within a High-Blast Risk Military Force
Authors: Baginski Julia , Darr Andrew , Basham Angela , Bailie Jason , Babakhanyan Ida
Published: September 2024

Objective

Explosive Ordinance Disposal (EOD) is a military occupational specialty that is particularly high risk for blast exposures as well as psychologically traumatic combat experiences. We explore cognitive performance, symptom profiles, and blast exposure history of this group.

Methods

Participants were recruited from an active duty TBI rehabilitation center. Of 123 participants, 12 were EOD (Other N = 111). Learning and memory (HVLT-R), sustained attention (PASAT) and executive functioning (DKEFS) were assessed. A Global Deficit Score (GDS) was calculated to determine impairment. Neurobehavioral symptoms (NSI), PTSD and depressive symptoms (PCL-M and PHQ-8), combat (CES) and blast exposures (BETS) history were also assessed.

Results

When comparing EOD to Other, age, number of mTBIs, and blast exposures were comparable (p’s > 0.05). There was a trend for EOD to report fewer symptoms and more combat deployments. EOD reported greater exposure to combat (CES p = 0.004, d = 0.90) and performed stronger cognitively. HVLT-R-Total (EOD M = 48.50, SD = 9.46; Other M = 39.13, SD = 11.67; p = 0.008, d = 0.82), HVLT-R-Delayed (EOD M = 45.75, SD = 11.11, Other M = 38.61, SD = 13.76; p = 0.09, d = 0.53) and PASAT (EOD M = 54.10, SD = 7.37; Other M = 46.56, SD = 10.21; p = 0.014, d = 0.76). 50.4% of the overall sample and 16.7% of the EOD sample were determined to have cognitive impairment (GDS p = 0.015).

Conclusions

Results highlight the importance of baseline assessment for higher functioning specialized populations. EOD performed better than general forces on cognitive measures, including memory domains previously identified to be impacted by blast exposures. EOD presents with greater kinetic combat experiences that expose them to psychologically traumatic events despite reporting fewer symptoms. Most notable is the high rate of cognitive impairment in an active military force.
B - 26 Exploring the Relationship between Traumatic Brain Injury History and Cognitive Impairment in a Diverse Community-Based Sample
Authors: Lee Diamond , Longoria Anthony , Kaser Alyssa , Kronenberger Oscar , Lacritz Laura
Published: September 2024

Objective

Research suggests that traumatic brain injury (TBI) with/without loss of consciousness (LOC) may impact cognition later in life; however, there is a paucity of research investigating this association in diverse samples. This study evaluated whether a history of TBI and LOC is associated with neurocognitive impairment in a racially diverse, community-based sample.

Methods

Participants from a population-based multiethnic cohort (N = 769; Mage = 61.8; Meduc = 14.5; 61% Female; 45% Black, 40% White, 10.6% Hispanic/Latinx, and 1.6% Asian) completed a brief neurocognitive assessment and the Texas Evaluation of Concussion History (TECH) survey. Descriptive statistics were gathered to determine the prevalence of concussion history (+/− LOC) across ethno-racial groups. Multiple logistic regression analyses examined whether concussion history +/− LOC was associated with a later consensus diagnosis of cognitive impairment.

Results

Thirty-two percent of the sample reported concussion history (Mconcuss = 2.55), 49.5% of which involved LOC. Fewer Black individuals reported concussion (25.3%) and LOC (35.7%) compared to their White (43.3%, LOC = 55.7%) and Hispanic/Latinx (33.1%, LOC = 58.1%) counterparts (ps < 0.01). Self-reported concussion history (OR = 1.12, 95%CI = [0.79–1.6], p = 0.53) and LOC (OR = 1.3, 95%CI = [0.75–2.3], p = 0.34), controlling for age, sex, education, and ethno-racial background, did not predict later cognitive diagnosis (impaired/not impaired).

Conclusion

Findings revealed differential rates of self-reported concussion among racial/ethnic groups, but history of concussion +/− LOC was not associated with subsequent cognitive diagnosis in this sample. Although concussion history was not associated with cognitive diagnosis in this sample, future research is needed to explore the impact of the number and severity of TBI on later cognition.
B - 32 Neurological Problems in Boxers during the 20th Century: a Review and Synthesis
Authors: Iverson Grant L , Kostelecky Nicolas , Ahrendsen Jared , Nassan Malik , Jamshidi Pouya , Castellani Rudolph J
Published: September 2024

Objective

There are no validated clinical diagnostic criteria for chronic traumatic encephalopathy or traumatic encephalopathy syndrome (TES). To understand the historical clinical condition, its applicability to modern day athletes, and the pathogenesis of clinical problems, we examined the literature in boxers from the 20th century, with specific attention to neurological findings and characteristics of clinical disease progression.

Data Selection

Data were extracted for 243 boxers included in 45 articles published between 1928 and 1999, including cases from articles originally published in German. The presence or absence of 22 neurological signs and features were extracted.

Data Synthesis

The most common neurological problems were slurring dysarthria (49%), gait disturbances (44%), and memory loss (36%), with several other problems that were less frequent, including hyperreflexia (25%), ataxia (22%), increased tone (19%), and extensor Babinski sign (16%). Frank dementia appeared in some cases (17%). There were significantly fewer neurological deficits reported in boxers who fought in the latter part of the 20th century compared to boxers who fought earlier in the century. For most cases, there were no comments about whether the neurological problems were progressive (145, 60%). A progressive condition was described in 71 cases (29%) and a stationary or improving condition was described in 27 cases (11%). Canonical neurodegenerative disease-like progression was described in 15 cases (6%).

Conclusions

Neurological problems associated with boxing-related neurotrauma during the 20th century are the foundation for present day TES. However, the clinical signs and features in the 20th century differ in most ways from the modern criteria for TES.
B - 33 A Preliminary Study of the Influence of Thoughts that Prevent Concussion Reporting in Female College Athletes
Authors: D'Andrea Alexandra N , Blakeslee Austin C , Dhawlikar Rina U , Ernst William , Kneavel Meredith E , McCarthy Kevin S
Published: September 2024

Objective

To quantify the influence of barriers that prevent intention to report concussions in female athletes. Hypothesis: NCAA Division 1 (D1) athletes will have higher overall reporting barrier scores than Division 3 (D3).

Method

Participants/Setting: 70 participants started the study and 13 were removed due to incomplete questionnaires, resulting in 57 participants (38 from D1). Athletes participating in contact sports (e.g., soccer) were recruited via email or flyers posted in training rooms. Measurement: A 21-item online questionnaire consisting of eight demographic questions and 13 questions related to barriers that prevent reporting. The barrier items were modified from themes derived from a published qualitative study of 503 collegiate athletes who completed a reporting worksheet. Participants rated agreeability [0 (strongly disagree) to 100 (strongly agree)] for the items that prevent reporting.

Results

Descriptive statistics indicated barriers likely to prevent reporting (e.g., Losing Playing Time; M = 78.02, SD = 22.61) and those less likely (e.g., Negative Reaction from Teammates; M = 44.75, SD = 31.63). The overall barrier to reporting score was not significantly different between D1 (M = 817.34, SD = 247.90) and D3 (M = 740.11, SD = 225.74), t (55) = 1.141, p = 0.259, d = 0.32. The internal consistency of the 13 barrier items was good, α = 0.852.

Conclusions

Barriers to reporting with greater saliency were identified, which may need to be prioritized during concussion education. The overall questionnaire score did not significantly differ between D1 and D3 suggesting that barriers operate similarly at different levels of competition. The questionnaire’s good internal consistency suggests it has potential as a research tool.