bluuebunny/crossref_metadata_2025 huggingface dataset:
C-57 Prematurity and Perinatal Insult: Examining the relationships between parent and teacher ratings of executive functioning and academic readiness
Authors: Gore C , Hill D , Lee S
Published: August 2019

Objective

Extremely preterm children and those with a history of perinatal insult (e.g., hemorrhage, hypoxic-ischemic injury) show higher rates of cognitive and academic problems, including executive functioning (EF). EF becomes increasingly important in elementary school as curriculum demands increase. The current study examines the relationship between parent- and teacher-reported EF and early academic performance in this population at school-age.

Method

This study reviewed retrospective neuropsychological evaluations in a sample of 135 patients (ages 3:9-10:5 years, M = 5.8) from an outpatient neurodevelopmental follow-up program for children with perinatal complication. Parent and teacher measures included: Behavior Assessment Scale for Children (BASC-2, 3) and Behavioral Rating Inventory of Executive Functioning (BRIEF, P, 2). Standardized child measures included: Bracken School Readiness (BBCS-III), and subtests from Wechsler Individual Achievement Test (WIAT-III) and Comprehensive Test of Phonological Processing (CTOPP-2).

Results

BRIEF parent ratings of working memory (p = 0.34) and emotional control (p = .025) were negatively correlated with school readiness. BRIEF teacher inhibition and working memory ratings were negatively correlated with math performance (p = .004 to p = .044), as well as rapid naming (p = .002 to p = .047) and school readiness (p = .048). BRIEF teacher ratings of planning/organization (p = .027), shifting (p = .024), and emotional control (p = .010) were negatively correlated with pre-reading measures. A 95% confidence interval was used.

Conclusions

Parent and teacher ratings of EF were significantly correlated with measures of academic readiness, early math skill, and pre-reading measures in this sample of children with a history of perinatal complications. Caregiver ratings can be useful in identifying children at-risk for academic problems upon school entry and requiring further neuropsychological evaluation.
C-67 Cognitive Function in an 8-Year-Old Girl with Gray Matter Heterotopia Without Evidence of Seizures
Authors: Shapiro S , Irani F
Published: August 2019

Objective

Heterotopia is a rare condition typically identified in the context of seizures. This case study presents a cognitive profile in a child with a history of heterotopia and hearing problems but without any known seizure history.

Method

An 8-year-old referred for evaluation by her neurologist due to concerns about persistent academic and social difficulties. Medical history was remarkable for small size, hearing problems, multiple pressure equalization tube placements, food allergies, and a left lateral ventricle gray matter heterotopia found on brain MRI. EEG was normal. Genetic testing found no dysmorphia. Developmental history was remarkable for delayed speech and early intervention, as well as social delays. She began receiving special education for learning disability and speech/language impairment in first grade.

Results

WISC-V IQ was Low Average and significantly lower than GAI. WMI was Below Average and PSI was Low. Language performance was variable. Visual scanning was Below Average. Verbal memory ranged from Below Average to Impaired, with worse performance on WRAML-2 Story Memory subtests. Attention and hyperactivity deficits were found on a continuous performance task. Executive function was Average to Above Average on phonemic fluency, category switching and Stroop tasks. BASC-3 parent ratings indicated greatest concerns in areas of atypicality, withdrawal, and adaptive skills. ABAS-3 indicated Low conceptual skills and Average to Low Average skills on other composites.

Conclusions

Aside from language deficits likely related to hearing problems, these findings indicated deficits in visual scanning, attention/hyperactivity, visually-based processing speed, and memory in the context of heterotopia without seizures. Social delays may be multifactorial.
A-29 The Mediating Effects of Personality on Sleep Quality and Executive Dysfunction
Authors: Harrell M , Taylor S , Beach J , Aita S , McCaskey V , Calamia M , Hill B
Published: August 2019

Objective

This study examined the relationship between personality traits, sleep quality, and executive dysfunction.

Method

Participants were 195 college students (65.6% female; 53.8% Caucasian, 33.3% African American, 4.1% Asian,; age range 17 – 46 years, Mage = 19.58 years, SD = 3.41; 73.3% no psychological diagnosis) who completed the following attention tasks: 120-item IPIP Neo (NEO), the Pittsburgh Sleep Quality Index (PSQI), and the Barkley Deficits in Executive Functioning Rating Scale-IV (BDEFS-IV).

Results

Mediation analyses were tested using 5000 bootstrapping resamples with bias-corrected 95% confidence estimates to investigate if personality traits mediated the effect of sleep quality on executive dysfunction. The total effect between PSQI and BDEFS-IV was significant, F(1,193) = 15.80, p < .001, r2 = .08, 95% CI = 1.79, 5.31). The model was significant when examining the relationship between the independent variable, mediators, and dependent variable, F(6,188) = 29.31, p < .000, r2 = .48. Three of the five mediators demonstrated significant indirect effects: neuroticism, (B = 1.07, t (188) = 5.39, p = .000, 95% CI = .68, 1.46), extraversion (B = .63, t (188) = 3.46, p = .000, 95% CI = .27, .99), and conscientiousness (B = -1.91, t (188) = -7.46, p = .000, 95% CI = -2.42, -1.41). The direct effect of PSQI and BDEFS-IV was not significant (B = .731, t (188) = .99, p = .32, 95% CI = -.72, 2.18) when controlling for all five mediators, confirming a full mediation.

Conclusions

Neuroticism, Extraversion, and Conscientiousness significantly mediated the relationship between self-reported sleep quality and executive dysfunction.
A-42 Case of Persistent Amnestic Syndrome due to Small Right-Sided Retrosplenial Lacunes
Authors: Inkelis S , Thomas K , Bangen K , Weigand A , Thayer R , Delano-Wood L , Bondi M
Published: August 2019

Objective

Lesions to the retrosplenial cortex secondary to acute stroke or tumor have been shown to disrupt Papez’s circuit due to disconnection between the anterior thalamus and hippocampus, via the posterior cingulate, producing an amnestic syndrome. This case demonstrates how small but strategic lacunes in this region may produce memory deficits.

Method

The patient is a 52-year-old, right-handed, African-American woman with 18 years of education who reported memory changes over the last 8 years (e.g., misplacing items, forgetting details of conversations). Her medical history was notable for BMI of 31 and borderline diabetes. She completed structural magnetic resonance imaging 6 years prior to, and concordant with, her neuropsychological evaluation. Both scans showed two small (2-3 mm) right-sided retrosplenial lacunes, without evidence of hippocampal or global volume loss over the 6-year span.

Results

Her neurocognitive profile was characterized by impairments in both verbal (stories, word-list) and figural memory, with relative strengths in attention, processing speed, and executive functioning. Across memory measures, she performed in the low average-to-mildly impaired range on immediate recall, mildly-to-severely impaired range on delayed recall, and did not benefit from yes-no recognition format. She demonstrated additional features of an amnestic profile, including flat learning slope, recency effect, elevated cued recall intrusion errors, and very elevated false positive errors on recognition.

Conclusions

Findings expand upon the existing literature to show that chronic, small retrosplenial lacunes can disrupt the connection between the anterior thalamus and hippocampus, resulting in a clinical presentation of circumscribed memory impairment that persists years beyond acute vascular changes.
A-53 Exploring the Relationship between Spoken Language and Verbal Short-term Memory Assessment Tasks
Authors: Davis M , Moses J , Rivera J , Guerra A , Hakinson K
Published: August 2019

Objective

Examine whether performance on spoken language assessment measures may be associated with performance at different phases of verbal learning and recall tasks.

Method

The assessment records of 222 American Veterans with diverse neuropsychiatric conditions were analyzed using Exploratory Factor Analyses. There were no exclusion criteria. All participants completed the Visual Naming (VisNam), Sentence Repetition (SenRep), Controlled Word Association (COWA), and Token Tests of the Multilingual Aphasia Examination (MAE), and Benton Serial Digit Learning Test – 8 Digits (SDL8). Individual assessment instruments were factored using Principal Component Analyses (PCA). A three-factor solution of the SDL-8 was co-factored with the spoken language components of the MAE to identify common sources of variance.

Results

A three-factor solution of the SDL8 separated trials into three overlapping factors consisting of early (SDL8_Early), middle (SDL8_Middle), and late (SDL8_Late) trials. Co-factoring the three new scales with the verbal components of the MAE produced a five-factor model explaining 84.563% of the shared variance: 1) SDL8_Early loaded with SenRep, 2) SDL8_Middle loaded with SenRep, 3) SDL8_Late loaded with Token, 4) SDL8_Late loaded with COWA, and 5) VisNam alone formed the fifth factor.

Conclusions

The results suggest that rote repetition is largely associated with early trials and slightly associated with middle trials, while late trials are largely associated with auditory comprehension and slightly associated with verbal fluency. This may be indicative of a shift in use of spoken language abilities to accommodate increasing levels of complexity in presented verbal short-term memory tasks and thus reflective of a change on learning strategy to optimize performance.
A-69 A Follow Up Study of Reliable Digit Span Performance in Children with Academic Difficulties
Authors: Pease L , Ernst W , Kneavel M , Brosof A
Published: August 2019

Objectives

This study sought to describe reliable digit span (RDS) performance in a sample of children referred for evaluation due to academic difficulties and provide preliminary information regarding its utility as a performance validity test (PVT) in this population.

Methods

The sample included 110 children (M = 11.91, SD = 3.34, Range = 6-16) evaluated in a college affiliated psychological services clinic. Measures included the WISC-IV or WISC-V and the WIAT-III. A subset of the sample (n = 30) was administered the Test of Memory Malingering (TOMM).

Results

The average RDS performance was 8.2 (SD = 2.0, Range 4-15). Using the previously established adult cutoff of ≤7, 55.5% of the sample passed. At a cutoff of ≤6, 86.4% of the sample passed, which approaches a 90% pass rate recommended in prior literature. RDS was correlated with age r(n = 110) = .53, p < .001, education r(n = 110) = .50, p < .001, FSIQ r(n = 110) = .31, p < .01, the WIAT Reading Composite r(n = 110) = .34, p < .001, and the WIAT Mathematics Composite r(n = 110) = .29, p < .01. The TOMM pass rate was 100% and all children in that subset scored above the RDS cutoff of ≤6.

Conclusions

RDS is potentially useful as an embedded PVT for children referred for evaluation due to academic difficulties. Key variables including age, FSIQ, and academic performance correlated with RDS, which requires consideration of those variables when interpreting RDS performance. Additional research is needed to determine appropriate cutoff scores given the potential influence of variables such as FSIQ and age on RDS performance for this population.
A-76 Specificity of the Repeatable Battery for the Assessment of Neuropsychological Status Digit Span as a Validity Indicator in Patients with Mild Cognitive Impairment and Dementia
Authors: Quattlebaum J , Martin P , Moltisanti A , Clark H , Schroeder R
Published: August 2019

Objective

The current study sought to examine the specificity of Digit Span (DS) scaled score from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) as a performance validity test (PVT) in older adults with Mild Cognitive Impairment (MCI) or dementia.

Method

Archival data were utilized and included 195 patients (mean age = 72.8; mean education = 13.2) who underwent outpatient neuropsychological evaluations. Cases that had missing data, did not meet criteria for a neurocognitive disorder, or whose performance was deemed invalid were excluded. Participants were classified according to their evaluation diagnosis of MCI (n = 72; mean RBANS total score = 86.8) or dementia. Those diagnosed with dementia were divided by MoCA performance and categorized as mild dementia (n = 90; MoCA≥15; mean RBANS Total Score = 71.0) or moderate dementia (n = 33; MoCA < 15; mean RBANS Total Score = 55.9). Scaled score frequencies were analyzed to calculate specificity for each group.

Results

An RBANS DS scaled score of ≤4 occurred infrequently in older adults with MCI and mild dementia, resulting in specificity values of 0.93 and 0.90, respectively. In moderate dementia, specificity fell to 0.68 when using a scaled score of ≤4, with a cutoff of ≤2 required to maintain adequate specificity.

Conclusions

Findings suggest utility of RBANS DS scaled score as a PVT in dementia evaluations provided use of appropriate cutoffs. A more stringent cutoff was required in examinees with moderate dementia relative to patients with MCI and mild dementia. Future research should examine the RBANS DS sensitivity to invalid performance, as well as DS specificity across specific etiologies of MCI and dementia.
A-80 Global Neuropsychological Assessment (GNA): Preliminary Evidence of Clinical Utility
Authors: Raines J , Carroll A , Morra L , Schretlen D
Published: August 2019

Objective

The Global Neuropsychological Assessment (GNA) is an 18-minute cognitive test battery with seven subtests that is being translated into multiple languages and standardized worldwide. This study seeks to evaluate the GNA’s ability to discriminate patients from healthy controls.

Data Selection

We are recruiting adults who are referred to the Johns Hopkins Medical Psychology Clinic for neuropsychological assessment, along with caregivers or family members who accompany them for this ongoing study. We have administered the GNA to 10 patients with mild cognitive impairment or another disorder and 22 healthy controls to date.

Data Synthesis

Patients and healthy controls did not differ on age, sex, or years of education.Independent samples t-tests showed that patients performed worse than healthy controls (p < 0.05) on 14 measures derived from five of seven GNA subtests. These included measures of episodic memory, processing speed, semantic verbal fluency, set-switching, and spatial working memory. Cohen’s d effect sizes of 1.0 to 2.2 were observed. The groups did not differ on tests of digit repetition or an anxiety/depression screener (Patient Health Questionnaire-4) although these revealed small to medium group differences (Cohen’s ds = 0.27 to 0.71) as well.

Conclusions

Five of seven GNA subtests effectively discriminated controls from patients with mixed cognitive disorders. If effect sizes found for the other two GNA subtests persist, they also will show significant group differences as the sample sizes increase. In related studies, we are examining inter-form equivalence and other psychometric properties of the GNA.
B-13 Differences in Language Function Between Patients with Nonepileptic Seizures (NES) and Epilepsy on an Epilepsy Monitoring Unit
Authors: Garrett R , Gerkin R , Pardini J
Published: August 2019

Objective

To examine potential differences in language function among nonepileptic seizures (NES) and epilepsy patients.

Method

Data were acquired via IRB approved retrospective chart review. Subjects were 60 patients who completed an inpatient stay in the Epilepsy Monitoring Unit of a southwestern hospital. 33 were diagnosed with NES, 13 were diagnosed with epilepsy originating in right hemisphere (ER), and 14 were diagnosed with epilepsy originating in the left hemisphere (EL). Patients were 65.9 % female, with a mean age of 40.5 (SD = 13.7). As part of a standard inpatient neuropsychological test battery, participants completed language tests that consisted of verbal fluency (FAS and Animals), Boston Naming Test, Wechsler Test of Adult Reading (WTAR), and Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-2) Similarities and Vocabulary subtests.

Results

ANOVA testing revealed significant between group differences in scores on the Animals verbal fluency test (F = 7.72, p = .008 for linear trend). Other measures did not achieve significance. NES participants had the highest Animal fluency scores (mean T = 49.28), followed by ER (47.73) then EL patients (43.27). WTAR score did not moderate this effect. Gender did moderate the effect, with male ER and EL subjects demonstrating lower Animal naming scores than their female counterparts (p = .037).

Conclusion

Animal naming was the only language-based variable found to differ in this sample of NES and epilepsy patients. Those with EL had the lowest scores on this measure, consistent with prior research that has found language deficits in this population.
B-14 Differences in Performance of Memory Tasks in HIV + Cocaine and Methamphetamine Users
Authors: Nemanim N , Hinkin C , Singer E
Published: August 2019

Objective

Approximately 1.2 million people in the U.S. are infected with HIV (HIV+), many of whom use stimulants. Recent meta-analytical work supports differing neurocognitive profiles associated with methamphetamine and cocaine use in seronegative individuals, especially in the domain of memory. Both substances are associated with deficits in verbal working memory, while only methamphetamine is associated with deficits in delayed contextual verbal memory and delayed visual memory. This study serves to replicate these findings amongst an HIV+ sample.

Methods

The performance of 88 HIV+ cocaine users and 49 HIV+ methamphetamine users were compared on the Hopkins Verbal Learning Test–Revised and Brief Visuospatial Memory Test–Revised. Participants were actively enrolled in National Neurological AIDS Bank and over the age of 18. Chi-square and Analysis of Variance (ANOVA) were used to compare group equivalence. Groups differed on gender and race but not on age, virologic variables, or education. ANOVA and Independent T-tests were used to compare performance.

Results

Both groups exhibited deficits on visual, verbal, and delayed verbal memory tasks but differences between the two groups were not significant (p>.05). Methamphetamine users performed significantly worse than cocaine users on the delayed visual memory task (F (1,131) = 9.27, p = .003, η² = .066).

Conclusions

Consistent with findings in seronegative individuals, HIV+ methamphetamine users performed more poorly than cocaine users on tasks involving delayed visual memory. However, this study did not replicate findings involving delayed verbal memory. Further work is necessary to understand the impact of methamphetamine and cocaine use in HIV+ individuals.
B-15 Engagement in Cognitively-Demanding Activities in Daily Life is Associated with Neurocognitive Test Performance and Perceived Cognitive Difficulties Among Adults With and Without HIV
Authors: Paolillo E , Hussain M , Moore R , Moore D , Heaton R
Published: August 2019

Objective

Assessing daily activities is important for understanding how cognitive abilities affect everyday functioning. We evaluated a new measure capturing engagement in cognitively-demanding activities among people with and without HIV, and examined associations with neurocognitive test performance and perceived cognitive difficulties.

Method

Participants included 79 adults (59 HIV+, 20 HIV-) enrolled in studies at UCSD (mean age = 55.1; SD = 13.1). Domain-specific composite scaled scores measured neurocognitive functioning as continuous variables. Demographically-corrected global deficit scores determined neurocognitive impairment. Perceived cognitive difficulties were self-reported via the Everyday Cognition scale (ECog). The newly created, self-report Frequency and Difficulty of Activities Scale (FDAS) measured frequency of engagement in 27 cognitively-demanding activities [0 = Never to 10 = Once a day or more] in the last month. FDAS “total frequency score” sums all frequency ratings. Participants also rated difficulty performing each FDAS activity [0 = Not at all to 10 = Extremely]. FDAS “difficult-activity score” sums frequency ratings only for activities that participants identified as difficult for them (i.e., difficulty rating >75th percentile of sample).

Results

Higher FDAS total frequency scores correlated with better verbal fluency (r = 0.26, p = 0.019) and processing speed (r = 0.24, p = 0.030). Multiple regression revealed a significant interaction between cognitive impairment and frequency of engagement in difficult activities (b = 0.34, 95%CI = 0.18-0.50, p < 0.001), such that higher FDAS difficult-activity scores related to more perceived cognitive difficulties only among cognitively impaired participants.

Conclusion

This study explored use of a new measure of complex daily activities to aid neuropsychological interpretation. Results suggest that effects of neurocognitive impairment on perceived cognitive difficulties may only be apparent if individuals are attempting to perform challenging everyday tasks.
Automated scoring of the Rey-Osterrieth Complex Figure Test using a deep-learning algorithm
Authors: Vogt J , Kloosterman H , Vermeent S , Van Elswijk G , Dotsch R , Schmand B
Published: August 2019

Objective

To validate a fully automated scoring algorithm for the Rey-Osterrieth Complex Figure Test (ROCFT) by comparing the scoring results of the algorithm to the results of human raters.

Method

The algorithm consisted of a cascade of deep neural networks which were trained on human rater scores to extract the 18 segments of the figure, and to quantify the patient’s performance. Algorithm results were compared to six expert raters for 303 drawings. We tested whether the average correlation between algorithm scores and scores by all human raters was equivalent to the average inter-rater correlation (with equality bound Δr < .05). The immediate and delayed recall trial were used; the copy trial showed a strong ceiling effect.

Results

The mean Pearson correlation between raters was .94 (SD = 0.01). The correlation between to algorithm and the raters was .88 (SD = 0.02). A two-one-sided t-tests (TOST) equivalence test showed that these correlations were not strictly equivalent, t(5) = 4.02, p = .995, 95% CI [0.35, 0.52].

Conclusions

Although not strictly equivalent to human ratings, the algorithm’s performance is high, approaching a level of reliability found among human raters. We expect that improved individual segment detection will bring the algorithm scoring accuracy on par with that of human raters. Algorithmic scoring of the ROCFT will likely save valuable time and lead to higher levels of standardization in clinical practice.
Artificial Intelligence and Machine Learning Algorithms For Informing the Diagnostic Process of Mild Cognitive Impairment and Dementia
Authors: Gardner J
Published: August 2019

Objective

Differentiating between a clinical diagnosis of Mild Cognitive Impairment (MCI) and dementia is difficult due to expansive data needs in concert with ambiguity of clinical criteria. Novel artificial intelligence (AI) and machine learning algorithms provide potential avenues for efficiently analyzing data sets and informing clinical judgment in distinguishing MCI from dementia. To date no formal meta-analysis of extant studies has been conducted to compare the efficacy of such procedures. A meta-analysis was conducted to synthesize the sensitivity and specificity of AI and machine learning programs in distinguishing between MCI and dementia as compared to traditional diagnostic protocols.

Data Selection

A search of studies using EBSCOhost databases using the keywords: “artificial intelligence,” “machine learning,” “MCI,” and “dementia” retrieved a total of 127 studies. Excluded were 106 studies due to non-reporting of sensitivity and specificity data. In total, 21 studies were included in the present meta-analysis.

Data Synthesis

Sensitivity and specificity data as well as the number of true-false categorizations were extracted and analyzed using OpenMeta[Analyst]. A bivariate correlation produced a summary point with sensitivity of 82% and specificity of 82%. A follow-up Rutter-Gatsonis multivariate correlation HSROC curve was created to correct for significant correlations (47%), and produced an adjusted mean specificity of 79% and sensitivity of 83%.

Conclusions

Results suggest AI and machine-learning algorithms are effective in distinguishing MCI from dementia. AI procedures have potential in aiding clinical judgment given a larger body of empirical research.
Academic Outcome in Pediatric Stroke: A Multifaceted Approach to Exploring Challenges and Achievements
Authors: Champigny C , Deotto A , Westmacott R , Desrocher M
Published: August 2019

Objective

An important cause of acquired brain injury in children, pediatric stroke can engender sequelae across a wide range of cognitive domains, including language, attention, memory, and processing speed. As a result, survivors are especially vulnerable to academic difficulties and face unique challenges compared to their peers. Despite this knowledge, pediatric stroke remains an understudied neurological condition, and its impact on school functioning is poorly understood. Addressing this gap in knowledge, the present clinical research study assesses academic outcome with a multifaceted approach.

Methods

This study evaluated youth with (n = 23) and without (n = 18) histories of stroke. Families were recruited at the Hospital for Sick Children in Toronto. Participants were administered an extensive battery of neuropsychological and psychoeducational tests, quality of life questionnaires, and behavior rating scales. Medical records and school report cards provided additional data.

Results

Compared to their peers, youth with stroke exhibited more deficits in processing speed and core academic skills and were more likely to have a learning disability, an Individual Education Plan, school accommodations, and access to assistive technologies. Controlling for the effects of intelligence, a hierarchical regression suggested that processing speed and reading skills predicted grades for youth with stroke. Finally, quality of life was similar between groups, indicating comparable experiences in school environment, peer support, and social acceptance.

Conclusions

This study makes a meaningful contribution to the field of pediatric stroke and promotes a nuanced understanding of the struggles that patients encounter, what impairments they tend to incur, and how these difficulties impact academic achievement.
The Colorado Cognitive Assessment (CoCA): Development of an Advanced Test of Cognitive Status
Authors: Gurnani A , Gavett B
Published: August 2019

Objective

Current brief tests of cognition provide a rough indication of overall cognitive functioning that assist with making gross clinical judgments (e.g., demented vs. not demented). The purpose of the present study was to develop and preliminarily validate a brief tool, The Colorado Cognitive Assessment (CoCA) to facilitate early and accurate diagnosis of mild and atypical presentations of dementia. A related goal was to compare its psychometric properties with The Montreal Cognitive Assessment (MoCA).

Method

Participants were 150 community dwelling adults over the age of 50 without a known mental health or neurological condition. Confirmatory factor analysis (CFA) was used to assess model fit of the CoCA and MoCA. Measurement invariance (MI) was evaluated using the multiple-indicators multiple-causes modeling (MIMIC) approach.

Results

The CFA model of the CoCA revealed excellent fit; χ2(44) = 47.506, p = .332; CFI = 0.987; TLI = 0.983; RMSEA = 0.023 (90% CI [0.000, 0.061]); SRMR = 0.048. MI analyses revealed that items on the CoCA were invariant to sex, age, education, and mood. In comparison, a CFA model of the MoCA had worse fit; χ2(14) = 28.536, p = .012; CFI = 0.817, TLI = 0.725; RMSEA = 0.083 (90% CI [0.038, 0.127]); SRMR = 0.062; and was biased by age, education, and depressive symptomatology. The global factor score reliability of the CoCA (r = .84) was better than the MoCA (r = .74).

Conclusion

Results provide preliminary evidence for the CoCA as a reliable and comprehensive cognitive instrument with further cross-sectional and longitudinal research needed for its validation.
Treatment using the Progressive Return to Activity Clinical Recommendation may return individuals with elevated symptomatology to normal levels at an expedited rate
Authors: Remigio-Baker R , Gregory E , Cole W , Ettenhofer M , Mullins L , Bailie J
Published: August 2019

Objective

To determine whether the use of a clinical recommendation (CR) for activity progression to treat concussion will benefit symptom profile months post-injury beyond what is seen with usual care.

Methods

This study included 58 individuals who participated in the Defense and Veterans Brain Injury Center Progressive Return to Activity (PRA) Study. Eligibility included sustaining a concussion within 72 hours of study enrollment and no previous concussion within 12 months of injury. Poisson regression with robust error variance was used to evaluate the relationship between treatment group assignment (usual care versus PRA-CR) and having normal symptomatology (Neurobehavioral Symptom Inventory score below the upper 10th percentile) at the 1-, 3-, and 6-month follow-up. Participants with normal symptomatology within 72 hours post-injury were excluded from analyses.

Results

Among participants with abnormal symptoms within 72 hours post-concussion, those receiving the PRA-CR to treat concussion had a 70% (CI = 1.06, 2.72) greater prevalence of normal symptomatology by 1 month post-injury, and a 39% (CI = 1.04, 1.87) greater prevalence of normal symptomatology by 3 months post-injury compared to those receiving usual care. By 6 months post-injury, there was no difference in the prevalence of having normal symptoms between groups.

Conclusion

The findings of this study show that participants with abnormal symptomatology decreased in symptom level to normal at a faster rate among those receiving the PRA-CR compared to those receiving usual care, providing evidence for the use of the PRA-CR as a means to enhance treatment of patients with concussion.
The Role of Potentially Malleable Factors in Post-Concussive Symptoms and Objective Cognitive Outcomes in Iraq and Afghanistan Veterans with History of Mild TBI
Authors: Jurick S , Merritt V , Crocker L , Iverson G , Hoffman S , Keller A , Jak A
Published: August 2019

Objective

We examined whether potentially malleable factors are associated with post-concussive symptoms (PCS) and cognition in Veterans with mild traumatic brain injury (mTBI) histories.

Method

Combat-exposed Iraq and Afghanistan Veterans with remote history of mTBI (N=48) completed a neuropsychological assessment and self-report questionnaires. Hierarchical linear regressions predicting PCS (Rivermead Post-Concussion Symptoms Questionnaire) and objective cognition included relevant demographic, injury, and psychiatric symptom variables in the first block and five malleable factors (TBI knowledge, self-efficacy, coping style, attribution of symptoms to mTBI, and uncommonly-endorsed symptoms [mild Brain Injury Atypical Symptoms (mBIAS) scale]) in the second block. Those with valid performance validity tests (n = 42) were included in the cognitive test analyses.

Results

With psychiatric symptoms and lifetime history of mTBIs entered first, malleable factors accounted for 14-17% of additional variance in PCS (p < .001). Lower self-efficacy (B = -.53, p < .001) and greater attribution of symptoms to mTBI (B = .21, p = .05) were associated with higher PCS, whereas an approach style of coping, TBI knowledge, and the mBIAS were not (p’s>.05). Regarding cognition, the malleable factors block accounted for 25% of additional variance in executive functioning (p = .04) with premorbid intelligence entered first. Specifically, higher mBIAS scores significantly predicted worse executive functioning (B = -.50, p = .004). No significant associations emerged when predicting attention/processing speed or memory (p’s>.05).

Conclusions

In combat-exposed Veterans with mTBI histories, potentially malleable factors contribute to clinical outcomes even after accounting for psychiatric symptoms. These malleable features are prime targets to augment during psychoeducation (e.g., uncommonly-endorsed symptoms, attribution of symptoms) and cognitive behavioral therapy (e.g., self-efficacy) in the context of chronic PCS.
Culturally Sensitive Normative Data for the Color Trails Test in the Indian Population
Authors: Indorewalla K , Lanca M , Osher J , Kartik R , Vaidya N , Moncata S
Published: August 2019

Objective

The Color Trails Test (CTT) is a neuropsychological measure tapping into frontal and executive functioning, while at the same time minimizing the cultural and language barriers inherent in similar neurocognitive measures such as the Trail Making Test (TMT). This study generates culturally-appropriate normative data for the CTT in an adult Indian population.

Method

Six-hundred and sixty-nine cognitively healthy, community dwelling Indian individuals between ages 18 and 69 participated in the study. Eligible participants were stratified on the basis of age, gender, and educational attainment. Participant performance on the CTT and TMT were correlated to establish concurrent validity.

Results

Significant correlations were found between TMT-part A and CTT-part 1 (r = .61) and between TMT-part B and CTT-part 2 (r = .66). In addition to generating culturally-appropriate normative data, the current study found that age and educational attainment significantly impacted participant performance on CTT-Part 1 [F(4, 649) = 4.395, p = .002], whereas gender, along with age, and educational attainment significantly impacted performance on CTT-Part 2 [F(4,649) = 2.446, p = .045]. In general, younger participants with more educational attainment performed better on both parts of the CTT. Interestingly, older female participants with lower educational attainment performed better than their younger counterparts on CTT-Part 2, whereas no such findings were noted for male participants.

Conclusions

Age, gender, and educational attainment are important factors to consider when interpreting CTT completion times in the Indian population. Normative data generated from this study has important clinical implications and contributes to the growing body of culturally-appropriate normative data available for the Indian population.
Demographically Adjusted Norms for the Trail Making Test in Native Spanish Speakers from the U.S.-Mexico the U.S.-Mexico Border Region.
Authors: Suarez P , Diaz-Santos M , Marquine M , Umlauf A , Franklin D , Rivera-Mindt M , Heaton R , Cherner M
Published: August 2019

Objective

Despite the wide use of the Trail Making Test when assessing Spanish-speakers in the United States (US), there is a lack of normative data to interpret level of performance in this population. Here we describe the generation of regional norms for the Trail Making Test for native Spanish-speakers residing in the Southwest Mexico-Border Region of US.

Method

Participants were 252 healthy native Spanish speakers, 58% women, between the ages of 19 and 60, and ranging in education from 0-20 years, recruited in San Diego, CA and Tucson, AZ. All received instructions translated into Spanish. Demographic effects on test performance were examined univariably. T-scores were calculated using fractional polynomial equations to account for linear and any non-linear effects of age, education, and sex.

Results

Older age and lower education were associated with worse scores on both Trails A and Trails B. The newly derived T-Scores showed no association with demographic variables and displayed the expected 16% rates of impairment using a -1 SD cutpoint based on a normal distribution. By comparison, published norms for English-speaking non-Hispanic whites yielded impairment rates of 28% for Trails A and 35% for Trails B while norms for African Americans resulted in 18 % impairment for Trails A and 20% impairment for Trails B.

Conclusions

Demographically adjusted regional norms improve the utility and diagnostic accuracy of the TMT for use with native Spanish speakers in the US-Mexico Border region.
African Enculturation and Performance on the African Neuropsychological Battery
Authors: Ikanga J , Braggs P , Howard C , Stringer A
Published: August 2019

Objective

To test a core assumption of the African Neuropsychology Battery (ANB) that greater African enculturation is associated with better performance.

Method

Subjects were 27 African immigrants to the U.S. [mean age = 39 (SD = 11.5), mean education = 16.3 years (SD = 2.9)], 32 African-Americans [mean age = 34.0 (SD = 11.2), mean education = 16.2 (SD = 2.5)], and 21 U.S. Caucasians [mean age = 45.7 (SD = 13.8), mean education = 17.2 (SD = 2.3)]. All subjects completed a questionnaire on familiarity with elements of African culture. The ANB was administered one-on-one, by trained technicians, in English, in a single session. ANB tests measured visuospatial perception, naming, memory, and abstract reasoning utilizing content drawn from sub-Saharan African cultures.

Results

Groups differed significantly in age (p < .05), but not education or gender, and age was used as a covariate in subsequent group comparisons. African immigrants showed highest African enculturation, followed by African Americans, and Caucasians [F(2, 74) = 36.16, p < .000], with all groups differing significantly from one another in post-hoc comparisons (p < .02). African enculturation correlated significantly only with ability to identify pictures of African fruits (Pearson r = .58, p < .001) and objects (r = .25, p < .03). Analysis of Covariance followed by Bonferroni post-hoc comparisons confirmed that African immigrants were superior to Caucasians (p < .001) and African-Americans (p < .001) in identifying fruits, with the latter two groups not differing significantly from one another. African immigrants were superior to Caucasians in object identification (p < .05), but did not differ significantly from African-Americans.

Conclusions

African enculturation influences performance on some ANB tests and results support the potential of the ANB to assess performance in a less culturally-biased manner in African immigrants.
Atrophy of Basal Forebrain Initiates with Tau Pathology in Individuals at Risk for Alzheimer’s Disease
Authors: Cantero Jose L , Atienza Mercedes , Lage Carmen , Zaborszky Laszlo , Vilaplana Eduard , Lopez-Garcia Sara , Pozueta Ana , Rodriguez-Rodriguez Eloy , Blesa Rafael , Alcolea Daniel , Lleo Alberto , Sanchez-Juan Pascual , Fortea Juan ,   Alzheimer’s Disease Neuroimaging Initiative
Published: August 2019

Evidence suggests that the basal forebrain (BF) cholinergic system degenerates early in the course of Alzheimer’s disease (AD), likely due to the vulnerability of BF cholinergic neurons to tau pathology. However, it remains unclear whether the presence of tauopathy is the only requirement for initiating the BF degeneration in asymptomatic subjects at risk for AD (AR-AD), and how BF structural deficits evolve from normal aging to preclinical and prodromal AD. Here, we provide human in vivo magnetic resonance imaging evidence supporting that abnormal cerebrospinal fluid levels of phosphorylated tau (T+) are selectively associated with bilateral volume loss of the nucleus basalis of Meynert (nbM, Ch4) in AR-AD individuals. Spreading of atrophy to medial septum and vertical limb of diagonal band Broca (Ch1–Ch2) occurred in both preclinical and prodromal AD. With the exception of A+, all groups revealed significant correlations between volume reduction of BF cholinergic compartments and atrophy of their innervated regions. Overall, these results support the central role played by tauopathy in instigating the nbM degeneration in AR-AD individuals and the necessary coexistence of both AD proteinopathies for spreading damage to larger BF territories, thus affecting the core of the BF cholinergic projection system.
Non-invasive monitoring of adrenocortical physiology in a threatened Australian marsupial, the western quoll (Dasyurus geoffroii)
Authors: Jensen Melissa A , Moseby Katherine E , Paton David C , Fanson Kerry V
Published: August 2019

We monitored faecal glucocorticoid metabolites (FGM) in 53 western quolls following capture. Using this stressor, we validated an assay for monitoring FGM in quolls. On average, FGM peak 24 hours after capture. Females exhibit higher baseline and peak FGM levels than males. Individuals vary in their physiological response to capture.
Seasonal and daily variations in primary and secondary metabolism of three maquis shrubs unveil different adaptive responses to Mediterranean climate
Authors: Gori Antonella , Tattini Massimiliano , Centritto Mauro , Ferrini Francesco , Marino Giovanni , Mori Jacopo , Guidi Lucia , Brunetti Cecilia
Published: August 2019

Maquis species play a central role in the maintenance of coastal ecosystems thanks to anatomical, physiological and biochemical features evolved to cope with severe stress conditions. Because the seasonal and daily dynamics of physiological and biochemical traits of maquis species are not fully addressed, we performed a field study on three coexisting Mediterranean shrubs (Pistacia lentiscus L. and Phillyrea latifolia L., evergreen schlerophylls, and Cistus incanus L., semi-deciduous) aiming at detecting the main adaptive differences, on a seasonal and daily basis, in primary and secondary metabolism along with the principal climatic determinants. These species differed in their physiological and biochemical responses especially on a seasonal level. In P. latifolia, a great investment in antioxidant phenylpropanoids contributed to maintain high photosynthetic rates throughout the whole growing season. In C. incanus, high carotenoid content associated with chlorophyll (Chl) regulation alleviated oxidative damage during the hot and dry summers and help recover photosynthesis in autumn. In P. lentiscus, high abscisic acid levels allowed a strict control of stomata, while fine Chla/Chlb regulation concurred to avoid photoinhibition in summer. Temperature resulted the most important climatic factor controlling the physiological and biochemical status of these coexisting shrubs and, thus, in determining plant performances in this Mediterranean coastal habitat.
Non-coding RNA in endothelial-to-mesenchymal transition
Authors: Hulshoff Melanie S , del Monte-Nieto Gonzalo , Kovacic Jason , Krenning Guido
Published: August 2019

Endothelial-to-mesenchymal transition (EndMT) is the process wherein endothelial cells lose their typical endothelial cell markers and functions and adopt a mesenchymal-like phenotype. EndMT is required for development of the cardiac valves, the pulmonary and dorsal aorta, and arterial maturation, but activation of the EndMT programme during adulthood is believed to contribute to several pathologies including organ fibrosis, cardiovascular disease, and cancer. Non-coding RNAs, including microRNAs, long non-coding RNAs, and circular RNAs, modulate EndMT during development and disease. Here, we review the mechanisms by which non-coding RNAs facilitate or inhibit EndMT during development and disease and provide a perspective on the therapeutic application of non-coding RNAs to treat fibroproliferative cardiovascular disease.
High-density lipoprotein remodelled in hypercholesterolaemic blood induce epigenetically driven down-regulation of endothelial HIF-1α expression in a preclinical animal model
Authors: Ben-Aicha Soumaya , Escate Rafael , Casaní Laura , Padró Teresa , Peña Esther , Arderiu Gemma , Mendieta Guiomar , Badimón Lina , Vilahur Gemma
Published: August 2019

Aims

High-density lipoproteins (HDLs) are circulating micelles that transport proteins, lipids, and miRNAs. HDL-transported miRNAs (HDL-miRNAs) have lately received attention but their effects on vascular cells are not fully understood. Additionally, whether cardiovascular risk factors affect HDL-miRNAs levels and miRNA transfer to recipient cells remains equally poorly known. Here, we have investigated the changes induced by hypercholesterolaemia on HDL-miRNA levels and its effect on recipient endothelial cells (ECs).

Methods and results

Pigs were kept on a high-fat diet (HC; n = 10) or a normocholesterolaemic chow (NC; n = 10) for 10 days reaching cholesterol levels of 321.0 (229.7–378.5) mg/dL and 74.0 (62.5–80.2) mg/dL, respectively. HDL particles were isolated, purified, and quantified. HDL-miRNA profiling (n = 149 miRNAs) of HC- and NC-HDLs was performed by multipanel qPCR. Cell cultures of porcine aortic ECs were used to determine whether HDL-miRNAs were delivered to ECs. Potential target genes modulated by miRNAs were identified by bioinformatics and candidate miRNAs were validated by molecular analysis. In vivo effects in the coronary arteries of normocholesterolaemic swine administered HC- or NC-HDLs were analysed. Among the HDL-miRNAs, four were found in different amounts in HC- and NC-HDL (P < 0.05). miR-126-5p and -3p and miR-30b-5p (2.7×, 1.7×, and 1.3×, respectively) were found in higher levels and miR-103a-3p and miR-let-7g-5p (−1.6×, −1.4×, respectively) in lower levels in HC-HDL. miR-126-5p and -3p were transferred from HC-HDL to EC (2.5×; P < 0.05), but not from NC-HDL, by a SRB1-mediated mechanism. Bioinformatics revealed that HIF1α was the miR-126 target gene with the highest predictive value, which was accordingly found to be markedly reduced in HC-HDL-treated ECs and in miR126 mimic transfected ECs. In vivo validation confirmed that HIF1α was diminished in the coronary endothelial layer of NC pigs administered HC-HDL vs. those administered NC-HDL (P < 0.05).

Conclusion

Hypercholesterolaemia induces changes in the miRNA content of HDL enhancing miR126 and its delivery to ECs with the consequent down-regulation of its target gene HIF1α.