bluuebunny/crossref_metadata_2025 huggingface dataset:
C-10 Interaction of ApoE4 and Gender in Neuropsychiatric Presentation in Probable Alzheimer’s Disease
Authors: Alexander C , Suhr J
Published: August 2019

Objective

Individuals with probable Alzheimer’s disease (pAD) often have neuropsychiatric symptoms; however, the relationship of these symptoms and ApoE4 status is unclear. Recent research suggests gender moderates the relationship of ApoE4 to AD. We examined how ApoE4 genetic status and gender predict neuropsychiatric symptoms in older adults with pAD.

Method

Data from the National Alzheimer’s Coordinating Centers (NACC) was utilized in the present study. We included only individuals diagnosed with pAD with collaterals who were judged reliable by clinical NACC staff and who saw the participant at least three times per week. The selected sample (N = 6943) was 52% male; 85.6% White, 10.2% African American; and 7.5% Hispanic. Average age was 73 years. The Neuropsychiatric Inventory-Questionnaire, completed by the participant’s collateral, was used to assess symptoms. Analyses controlled for age and cognitive impairment as measured by the Mini-Mental State Examination.

Results

The presence of at least one ApoE4 allele predicted higher severity of delusions, p = .04. Males had higher severity of agitation, apathy, and irritability; females had higher delusions, depression, and anxiety, all p’s < .05. Gender moderated the relationship of ApoE4 with disinhibition, night disturbances, and appetite, all p’s < .05. In all three cases, for males, scores were higher for non-carriers than for ApoE4 carriers; however, for females, differences did not exist between carriers and non-carriers.

Conclusions

Differences between ApoE4 carriers and non-carriers as well as between genders are demonstrated, and evidence supports the hypothesis that gender and ApoE4 status interact to predict some pAD neuropsychiatric symptomatology.
C-12 Race and Sex Differences in Cognitive and Neurobiological Markers of Alzheimer's Disease
Authors: O'Hara J , Norton D , Koscik R , Lambrou N , Wyman M , Johnson A , Bouges S , Zuelsdorff M , Flowers-Benton S , Jonaitis ECarlsson C , Johnson S , Asthana S , Gleason C
Published: August 2019

Objective

Intra-Individual Cognitive Variability (IICV) previously demonstrated predictive power similar to AD biomarkers (i.e., CSF and hippocampal volume (HV) loss). Previous work suggested sex differences in relative HV and IICV. Additionally, IICV differs in whites and underrepresented racial groups (URG). Our objective was to analyze these sex differences in white and URG participants.

Method

Baseline neurocognitive test and neuroimaging data from 335 cognitively healthy participants with ≥2 visits enrolled in the Wisconsin ADRC Clinical Core were included. Z-scores were calculated comparing individual performance to group performance by test (Rey Auditory Verbal Learning Test (Learning and Delayed Recall), Trail Making Test (A and B), and either Boston Naming Test (BNT) or Multilingual Naming Test (MINT)). MINT scores were converted to BNT scores using the NACC Crosswalk Study. The standard deviation of z-scores across tests was calculated to determine IICV. Characteristics by race and sex were compared using Mann-Whitney, Fisher’s Exact, and Kruskal-Wallis tests. Spearman’s Rho was calculated to compare baseline IICV and relative HV.

Results

At baseline (Table 1), differences across racial groups in age, years of education, relative HV, and IICV were identified. Sex and racial group differences were identified (Table 2). A weak positive correlation between HV and IICV was seen in white females (Figure 1).

Conclusions

IICV has potential to become a cost-effective, non-invasive marker of preclinical AD. Again, correlation between HV and IICV was seen, but only in white females. Analyses suggest group differences between white and URG males and females. However, more data is needed to further explore these differences.
C-13 Sex Differences in Cognitive and Neurobiological Markers of Alzheimer's Disease
Authors: O'Hara J , Norton D , Koscik R , Lambrou N , Wyman M , Adrienne J , Bouges S , Zuelsdorff M , Flowers-Benton S , Jonaitis ECarlsson C , Johnson S , Asthana S , Gleason C
Published: August 2019

Objective

Previous work has demonstrated that intra-individual cognitive variability (IICV) has predictive power similar to traditional Alzheimer’s disease (AD) biomarkers, such as CSF or hippocampal volume (HV) loss. Genetic factors, such as sex, have been identified as predictors of cognitive decline. Analysis of sex differences in IICV and other biomarkers may elucidate additional dimensions of this metric.

Method

Baseline neurocognitive test and neuroimaging data from 335 participants with ≥2 visits enrolled in the Wisconsin Alzheimer’s Disease Research Center Clinical Core were included. Z-scores were calculated comparing individual performance to group performance by test (Rey Auditory Verbal Learning Test (Learning and Delayed Recall), Trail Making Test (A and B), and either Boston Naming Test (BNT) or Multilingual Naming Test (MINT)). MINT scores were converted to BNT scores using the NACC Crosswalk Study. The standard deviation of z-scores across tests was calculated to determine IICV. Characteristics by sex were compared using Mann-Whitney and Fisher’s Exact tests. Spearman’s Rho was calculated to compare IICV and HV (relative to intercranial volume).

Results

At baseline (Table 1): (1) Males had more education than females; (2) females had both higher relative HV and IICV; and (3) in females, relative HV demonstrated a weak positive correlation with baseline IICV (Figure 1).

Conclusions

IICV has previously demonstrated potential as a cost-effective non-invasive marker of preclinical AD. In females, larger relative HV and its correlation with IICV may be due to differences in metabolic brain age or concurrent progression of HV and IICV through the AD process. Analyses of other biopsychosocial factors are needed.
C-16 Assessment of 9-Year-Old, Nonverbal Female with Spastic Cerebral Palsy & Seizure Disorder
Authors: Lennon J , Berreman L , DiMaggio E , Vincent K , Lambert A
Published: August 2019

Objective

Case serves to illuminate how complex medical/neurological/motor history can be assessed creatively/thoroughly while maintaining standardization in an effort to determine true abilities of young girl. Earlier evaluation suggested NVIQ scores in the 30th percentile, however more recent school testing suggested performance in 2nd percentile.

Method

Nine-year-old, Caucasian, right-handed female with diagnoses of spastic CP, recent seizures with LOC, GERD, assessing functioning/academic needs. Pt born 40-weeks gestation via c-section due to fetal heartbeat loss resulting in emergency CPR/NICU admission for six weeks. MRI suggests significant hypoxia-related prenatal damage to right frontal/temporal regions. Nerve/muscle development results in leftward preference permitting rightward movement. Pt is nonverbal, implanted gastrostomy tube, utilizes modified sign-language/augmentative, alternative communication device (AACD). Current behavioral concerns in multiple settings. Pt prescribed esomeprazole, baclofen, oxcarbazepine.

Results

Results suggest deficits in adaptive functioning, set-shifting, language. Sustaining gaze was difficult, with subsequent invalid scores on numerous measures. Even with incorrect responses, Pt understood TEACh tasks. Given tools (calculator) at her disposal, Pt scored in 30th percentile on Math Computation. Further, TONI-4 nonverbal index was stronger than school expectations (10th percentile). PTONI negatively impacted by motor deficits. AACD offered limited vocabulary – Pt appeared well-aware of missing words when they arose (small vs. thin). Pt demonstrated high frustration-tolerance and ability to joke with examiners.

Conclusions

Conclusions: Pt’s performance and motivation were highly impressive given circumstances. Even with limiting factors, standardized measures can be utilized with critical qualitative observations to acquire more representative test results, provide adequate recommendations for ongoing care/accommodations, thereby advocating for academic success and improving Pt well-being.
C-17 10 Minutes Too Late: Using the Clock Drawing Test in the Era of DSM-5
Authors: Gold D , Coolbrith N , Cobb R , Piryatinksy I
Published: August 2019

Objective

The Clock Drawing Test (CDT) is among the most researched measures of cognitive functioning and is frequently used by clinicians as a screening instrument for cognitive impairment. Nearly all the existing research on the CDT involves groups of patients diagnosed with a mild cognitive impairment (MCI) or dementia; however, recent updates to the diagnostic system (i.e., DSM-5) saw the creation of the mild and major neurocognitive disorders (NCD), designed to replace MCI and dementia diagnoses. These new diagnoses are similar to their predecessors, however, distinct differences exist that drastically alter the characteristics of these groups. Therefore, this study aimed to examine if qualitative errors on the CDT as described by Rouleau et al. (1992) are consistent with a diagnosis of mild or major NCD according to DSM-5.

Method

Data was retrospectively collected from a sample of patients seen at an outpatient clinic in eastern Massachusetts. CDTs from 14 healthy controls, 31 patients with mild NCD, and 18 patients with major NCD were made available for analysis.

Results

Contingency analysis revealed no significant differences in error frequencies when comparing mild NCD to healthy controls. Patients with major NCD committed significantly higher rates of specific stimulus bound (p = 0.021), conceptual (p = 0.026), and spatial/planning (p = 0.037) errors compared to others in the sample.

Conclusions

While CDT errors do not appear to distinguish mild NCD from healthy controls in our sample, our findings suggest that certain errors may serve as a warning sign to incipient major NCDs. Clinical implications and future directions are discussed.
C-18 A Distributional and Theoretical Analysis of Reaction Time in the Reversal Task Across Adulthood
Authors: Leclaire K , Osmon D , Driscoll I
Published: August 2019

Objective

Reversal learning (RL) tasks, known to be frontal-lobe dependent, are frequently used in experimental paradigms to assess components of executive function. Extant literature has historically focused on measures of accuracy as their primary outcome, but reaction time (RT) has not yet been well examined. The present study thoroughly examines RT in order to better characterize RL performance and how it changes with age.

Method

182 healthy aging participants completed a RL task, including 43 young (ages 18-30) and 139 community dwelling middle-aged adults (ages 40-61). In order to identify the best predictors of age among RL performance, an adaptive elastic net generalized regression with Poisson distribution modeling and Akakie information criteria (AIC) penalty was utilized. Variables were included from the Diffusion model (a, v, t0), ex-Gaussian distribution (mu, sigma, tau), Normal-3 Mixture distribution (location1-3, dispersion1-3, probability1-3), and RL trials-to-criterion.

Results

A Generalized R2=.83 demonstrated good prediction of age with 7 of 17 variables being significant predictors, including, in order of significance: Mu, Sigma, Dispersion1, Location1, Dispersion2, t0, and Tau. Only two of those predictors had Independent Resampled Variable Importance values greater than .1 (Mu=.645, Dispersion1=.221), indicating older age is associated with slower and more variable efficient responding.

Conclusions

RT adds unique variance to explaining age differences in reversal learning performance which suggests it’s important to measure RT as a fractionated construct. Older adults showed slower efficient mean RT and increased intra-individual variability, which has been linked to poorer frontal lobe processes and age-related cognitive decline.
C-19 An fMRI Study of Age-Associated Changes in Basic Visual Discrimination
Authors: Seider T , Porges E , Woods A , Cohen R
Published: August 2019

Objective

The study was conducted to determine age-associated changes in functional brain response, measured with fMRI, during visual discrimination with regard to three elementary components of visual perception: shape, location, and velocity. A secondary aim was to validate the method used to isolate the hypothesized brain regions associated with these perceptual functions.

Method

Items from the Visual Assessment Battery (VAB), a simultaneous match-to-sample task, assessed visual discrimination in 40 healthy adults during fMRI. Participants were aged 51-91 and recruited from a larger community sample for a study on normal aging. The tasks were designed to isolate neural recruitment during discrimination of either location, shape, or velocity by using tasks that were identical aside from the perceptual skill required to complete them.

Results

The Location task uniquely activated the dorsal visual processing stream, the Shape task the ventral stream, and the Velocity task V5/MT. Greater age was associated with greater neural recruitment, particularly in frontal areas (uncorrected voxel-level p < .001, family-wise error cluster-level p□.05).

Conclusions

Results validated the specialization of brain regions for spatial, perceptual, and movement discriminations and the use of the VAB to assess functioning localized to these regions. Anterior neural recruitment during visual discrimination increases with age.
C-22 Examining the Factor Structure of the Clock-In-the-Box in Older Adults
Authors: Sabbah-Talasazan L , D'Orio V , Grande L
Published: August 2019

Objective

To investigate the factor structure of the Clock-In-the-Box (CIB), a cognitive screening measure, and compare it to the original CIB subscores (Working Memory and Planning/Organization) that were created based on clinical observations. The new factor structure was used to determine the predictive validity of the CIB subscores, in predicting cognitive diagnosis in an older veteran population.

Methods

Neuropsychological evaluations conducted at VA Boston Healthcare System were reviewed. Exploratory factor analysis (EFA) and logistic regression were employed to determine the predictive validity of the new CIB subscores compared to the original subscores.

Results

The cohort had a mean age of 69.77 years (SD = 10.12), 97% male and mainly white (84.9%). EFA revealed a best fit two-factor model, explaining 60% of the variance (Factor 1 - 46% and, Factor 2 - 14% of the variance). Factor 1 reflected conceptual items (i.e., numbers, resembles clock) while Factor 2 reflected planning/organizational items (i.e., hand length, number spacing). Factors were moderately correlated (r = .456). Logistic regression revealed the original and new subscores were equivalent in predicting cognitive impairment when controlling for age and education; correctly classified 82% of the cases. When controlling for age and education, only Factor 2 remained predictive of impairment.

Conclusions

Analysis of specific task items resulted in subscores that differ from those initially generated based on clinical experience, with both providing clinically useful information. The CIB is a brief instrument with good predictive validity of cognitive impairment and clinically useful as a first line screening to inform the need for further assessment.
C-25 Neurocognitive Correlates of Chronological and Subjective Age Differences in Persons Living with HIV compared to those without HIV
Authors: Kohli M , Kamalyan L , Pasipanodya E , Moore R , Letendre S , Jeste D , Moore D
Published: August 2019

Objective

Investigate the discrepancy between subjective and chronologic age by HIV-serostatus, and the association of this discrepancy with subjective neurocognitive functioning (NCF) and objective NCF.

Methods

One hundred nineteen persons living with HIV (PWLH) and 98 HIV-uninfected (HIV-) adults (Mage = 50.9; SDage = 7.9) completed a comprehensive neurobehavioral battery. Subjective age was assessed using a single-item question (i.e., “how old do you feel?”). The difference between chronologic and subjective age resulted in subjective age discrepancy scores (SADS). Subjective NCF was measured using the Patient’s Assessment of Own Functioning Inventory; objective NCF was measured using global demographically-corrected T-scores. Linear regressions examined the association between subjective and objective NCF with SADS, covarying for significant PLWH and HIV- group differences (i.e., education, sex, ethnicity, and lifetime Major Depressive Disorder).

Results

PLWH reported lower SADS (indicating closer correspondence between chronologic and subjective age) than their HIV- counterparts, who reported feeling much younger (p = .05; 95% CI: -5.4, .001). Among PLWH, better subjective NCF was significantly related to greater SADS (p = .0002; 95% CI: -.48, -.16). Objective NCF was not associated with SADS among persons with and without HIV.

Conclusions

Adults without HIV reported feeling younger than their chronologic age, whereas PLWH felt significantly closer to their chronologic age. SADS were negatively associated with only subjective NCF, among only PLWH. This suggests perceived cognitive functioning has a greater impact on psychological well-being among this group. Future research is warranted to delineate the relationship between HIV, subjective neurocognition, and psychosocial factors related to daily functioning to improve successful aging outcomes among this vulnerable population.
C-26 Neuro-Exergaming for Older Adults with Mild Cognitive Impairment: A Single Bout of Interactive Physical and Cognitive Exercise (iPACES v2.5)
Authors: Puleio A , Wall K , Anderson-Hanley C
Published: August 2019

Objective

Mild Cognitive Impairment (MCI) may be a precursor Alzheimer’s disease and related dementias (ADRDs). Identifying effective interventions to prevent or remediate cognitive decline is imperative given the increasing older population. Prior research has shown benefits to cognition of physical exercise, but only a fraction of older adults actually achieve recommended levels. Researchers have explored the use of potentially more motivating exergames and found benefits above and beyond physical exercise alone, perhaps due to synergistic effects of physical and mental engagement. The current study attempts to replicate and extend prior research by examining the impact on cognition of a single bout of a neuro-exergame in which older adults engaged interactive Physical and Cognitive Exercise (iPACES v2.5).

Method

The iPACES neuro-exergame (v2.5) involves pedaling an under-table elliptical while playing an iPad-based videogame, which simulates an everyday function of independent living: running errands and retracing one’s path home. Eighteen older adults (mean age = 68.4 years old) were assessed pre- and post-exercise with neuropsychological tests of executive function (Stroop and Trails) as well as verbal memory (ADAS Word Recall).

Results

A repeated measures ANOVA (controlling for age) indicated significantly greater benefit to verbal memory for MCI participants in contrast with normative older adults (p = .008; Figure 1).

Conclusion

Further research is needed to confirm this finding in a larger sample, but it is consistent with some prior research on single bouts of exercise benefiting cognition of MCI more than normative older adults. Follow-up trials are needed to examine long-term use, factors affecting outcomes, and underlying mechanisms.
C-27 Neuropsychological Differences in 10 Year Long-Term Stable Mild Cognitive Impairment and Converting Mild Cognitive Impairment
Authors: Sharma M , Varatharajah B , Wall A , Callahan B
Published: August 2019

Objective

To examine baseline differences in neuropsychological performance between long-term stable mild cognitive impairment (sMCI) and those who convert from MCI to dementia (cMCI), hypothesizing sMCI will perform better on memory measures. While conversion has been previously examined, none examined sMCI with over 10 years follow-up.

Method

Data from the National Alzheimer’s Coordinating Center were used. Participants were defined as sMCI (n = 29) if cognitive status was MCI at first visit and at least 9 subsequent visits (10 total) and cMCI (n = 1887) if cognitive status was MCI at first visit and the participant converted to dementia at any subsequent visit. Participants with any history of stroke, traumatic brain injury, alcohol or drug abuse, or other neurological disorder were excluded. Participants completed neuropsychological measures of global cognition, immediate and delayed verbal memory, working memory, mental manipulation, semantic fluency, processing speed, and confrontational naming. Depressive symptoms were assessed using the Geriatric Depression Scale. The Mann-Whitney-U non-parametric test was used to compare both groups at baseline on all measures. Predictors of sMCI were explored using binomial logistic regression.

Results

Participants did not differ significantly in age, level of education, or depressive symptoms. Comparison between groups at baseline indicate sMCI participants performed significantly better than cMCI on global cognition U = 13673,p < .001, delayed verbal memory U = 14549,p < .001, and semantic fluency U = 15538.5,p < .001. Of these significant measures, none predicted sMCI.

Conclusions

As hypothesized, sMCI performed better on delayed verbal memory, but also semantic fluency and global cognition, though none predicted sMCI. Future research must examine neuropsychological measures of other cognitive domains and their predictive value.
A-19 Inhibition in Metabolic Syndrome and its Relationship to Orbitofrontal Cortex Activation During Sucrose Evaluation
Authors: Slonim T , Jacobson A , Haase-Alasantro L , Marvin M , Frank C , Murphy C
Published: August 2019

Objective

Metabolic syndrome(MetS) is associated with disinhibited eating,executive dysfunction,and increased risk of dementia. The orbitofrontal cortex(OFC) has been implicated in literature as an area involved with decision making and reward. Decreased OFC volume has been linked to disinhibited eating and poorer executive functioning skills.However,research examining executive functioning in individuals with MetS fails to address the role of inhibition as it pertains to consumption and risk of developing MetS. We examined the relationship between neuropsychological performance and OFC activation after receiving and rating a sucrose stimulus to determine if OFC activation is associated with executive functioning deficits that may lead to developing MetS.

Method

Participants were categorized by MetS status(n = 46) and Control(n = 34) with mean age of 49.13±20.29years. During an fMRI session, the Blood-Oxygenation-Level-Dependent(BOLD) response of OFC was recorded while participants rated the pleasantness of an aqueous sucrose solution. Participants were administered the Color-Word Interference Test outside the scanner. Partial Correlation analyses controlling for age examined the relationship between OFC activation during hedonic ratings of sucrose and cognitive performance.

Results

There was a significant negative relationship between left OFC activity and Color-Word Interference:Inhibition performance for Controls(r(42) = -.365, p = .015) as compared to MetS(r(30) = .141,p > .05).

Conclusions

Less activity in the OFC during sucrose hedonic rating was associated with better performance on the Inhibition condition for Controls. We speculate that decreased activation in the OFC after sucrose consumption reflects intact executive functioning and perhaps even a preventative factor to developing MetS. Alternatively, it could indicate that Controls are actively inhibiting hedonic responses to sucrose which improves their ability on a test of inhibition.
C-31 A Meta-analysis Examining Fluency Measures in Depressed Elderly
Authors: Barlet B , Hauson A , Connors E , Colonna-Moseley A , Reszegi K , Sarkissians S , Walker A
Published: August 2019

Objective

Late-life depression (LLD) has been associated with cognitive impairments in domains such as memory, processing speed, and executive functions (e.g., initiation). However, it is unclear whether or not LLD is associated with language fluency difficulties that are often seen in some forms of dementia. Broadly, letter fluency is often observed to be associated with frontal deficits while category fluency is thought to be linked to temporal lobe dysfunction. Both tests are commonly used to assess language in older adults. The current meta-analysis examined potential differences between letter and category fluency in LLD and the robustness of previous findings in this population.

Data Selection

Investigators searched eight databases including PubMed and PsycINFO using terms such as “neuropsychol*,” “late-life,” and “depression.” Studies were excluded if participants were diagnosed with severe mental illness, neurological or other medical conditions that impact neurocognition.

Data Synthesis

Independent coders extracted data from 27 studies (k = 10 letter fluency, k = 17 semantic fluency). The effect size for semantic fluency was g = 0.64 (p < 0.001) with significant heterogeneity I² = 73.53% (Q = 60.45, df = 16, p < 0.001). The effect size for letter fluency was g = 0.49 (p < 0.001) also with significant heterogeneity I² = 52.08% (Q = 18.78, df = 9, p < 0.027).

Conclusions

Depressed individuals exhibited poorer performance on both category and letter fluency when compared to controls. This may indicate that depressed elderly individuals have difficulty with initiating verbal responses regardless of whether these responses rely on semantic networks or executive control.
C-32 A Neuropsychological Case Study of Very-Late-Onset Psychosis
Authors: Sekunda V
Published: August 2019

Objective

Studies have established a relationship between earlier-onset (< 40 years of age) and late-onset (between 40 and 60 years of age) psychosis symptoms on cognitive functioning, but little is known about the neurocognitive profile of very-late-onset psychosis (≥60 years of age) (Sharma et al., 2014; Howard et al., 2000). This case highlights the neuropsychological profile in an older adult with very-late-onset psychosis.

Method

84-year-old, right-handed, Caucasian female with no significant medical or psychiatric history prior to 2013. Onset of delusions, paranoia, and tactile, auditory, and visual hallucinations initially beginning in 2013 with no identifiable trigger and worsening symptoms in 2018. Labs within normal limits and urine drug screen was negative.

Results

Her estimated premorbid verbal functioning fell within the average range which fell slightly below her score as predicted by her demographic history (i.e., education, occupation, region, sex, and race/ethnicity), which fell within the high average range. Her overall objective testing indicated that she demonstrated relative weaknesses encoding increasingly complex auditory and visual information and reliably retrieving the information from her long-term memory on command. She demonstrated intact orientation, impaired performance on a cognitive switching task, and a visuospatial task.

Conclusions

The patient demonstrated grossly intact performance across many cognitive domains. This paradox highlights the need for further investigation of the neuroanatomical correlates of psychosis in older-adults and its longitudinal neurocognitive profile as often, individuals are presumed to be suffering from a neurodegenerative disorder such as Alzheimer’s type dementia or Dementia with Lewy bodies (Assche et al., 2018).
C-34 An Investigation into the Multicultural Properties of the Clock Drawing Test: Findings from a Russian-speaking Sample
Authors: Coolbrith N , Gold D , Cobb R , Piryatinksy I
Published: August 2019

Objective

The Clock Drawing Test (CDT) is a screening instrument for cognitive impairment known for its quick and easy administration style. Studies have examined if different qualitative errors on the CDT discriminate cognitive impairment from normal aging. Moreover, current research has investigated qualitative errors on the CDT in various populations (i.e. Brazil, Japan, Korea). To the best of the authors’ knowledge however, there has been no previous research on qualitative errors seen on the CDT within Russian-speaking populations. To address this gap, the present study examined qualitative errors committed on the CDT by native Russian-speakers compared to English-speaking counterparts.

Method

Data was retrospectively collected from a sample comprised of 13 Russian-speaking immigrants and 29 English-speakers. All participants were seen for neuropsychological testing at an outpatient clinic in eastern Massachusetts and diagnosed with major neurocognitive disorder.

Results

Contingency analysis revealed no significant differences in qualitative errors when comparing Russian-speakers with major neurocognitive disorder to English-speakers diagnosed with the same.

Conclusions

Due to similar frequencies of qualitative errors between these groups, these results suggest that the CDT may have broad utility for assessing gross cognitive functioning regardless of a patient’s native language or cultural background.
C-37 Music and Cognitive Aging Across Species
Authors: Dorman K , Kauffman R
Published: August 2019

Objective

Recent research has revealed that dogs suffer from bestial boredom, which is the degeneration of the brain due to lack of stimulation. To prevent this we looked at everyday stimulation owners could leave for their dogs, such as different types of audio. Within music there are various types that effect dog behavior differently. We not only looked at this stimulation within dogs to help prevent bestial boredom, but then connected this to Alzheimer's patients. There are multiple studies out that show the benefits of music before and during the onset of Alzheimer’s. We find this to be true with dementia in dogs too. A review of the research reveals there to be a lack of consensus regarding the efficacy of music in psychological practice. We believe this is because different music serves different functions, and because of familiarity.

Data Selection

Articles chosen for the meta analysis had to show the connection between music and canines, music and Alzheimer’s patients, and neurodegeneration in humans and within canines.

Data Synthesis

We conducted a meta analysis to review and analyze whether researchers have taken different forms/styles of music into account in their studies.

Conclusions

Music is a significant factor for cognitive functioning and aging in both dogs and humans. There are not many studies out there about the effect of music on dogs. The few studies that are out there used kenneled dogs, therefore studies should also be conducted on dogs with homes to see if familiar music has more of an effect.
A-20 Metabolic Syndrome and Executive Functioning in Young, Middle-Aged, and Older Adults
Authors: Slonim T , Haase-Alasantro L , Murphy C
Published: August 2019

Objective

Metabolic syndrome (MetS) is associated with increased rates of mortality and increased risk for developing dementia. Changes in brain structure and executive functioning have been reported within the literature. However, research examining cognitive performance in individuals with metabolic syndrome focuses primarily on older cohorts. As such, the effect of metabolic syndrome on cognitive functioning earlier in the lifespan is unclear. This research examined neuropsychological test performance and self-report measures in young, middle-aged, and older adults with and without MetS.

Method

Participants (n = 128) were categorized by age and metabolic status as follows: Young: n = 42, 52.4% Metabolic; Middle-Age: n = 41, 56.1% Metabolic; Older: n = 45, 51.1% Metabolic. Participants were administered the following cognitive assessments as part of a larger study: Delis-Kaplan Executive Function System (DKEFS) Color-Word Interference Test and Trail Making. Multivariate analyses of variance were used to examine the relationship between age group, metabolic status, and cognitive performance.

Results

As expected, older adults performed more poorly than young and middle-aged adults across neurocognitive assessments (p < .05). MetS adults performed more slowly on Color-Word Interference: Inhibition [F(1,114) = 5.26, p = .024, η2 = .05]; however, there were no additional significant differences between groups on cognitive tests in this sample size.

Conclusions

These findings suggest that aspects of inhibition might be impaired in MetS adults. Future studies aimed at investigating relationships between metabolic risk factors and inhibition may provide insight into effective intervention targets to delay or prevent metabolic syndrome.
C-40 Effects of Treatment Expectancy on Self-Report and Neuropsychological Outcomes in Neurofeedback for Young Adults Seeking Treatment for Attention-Deficit/Hyperactivity Disorder (ADHD)
Authors: Lee G , Suhr J
Published: August 2019

Objective

Though there is evidence that expectancy can impact outcomes of heath treatments, the role of expectancy in neurofeedback (NFB) for ADHD remains unclear. A pilot study found large expectancy effects on self-reported symptoms in NFB, but mixed evidence for sustained attention performance. We further investigate the effects of treatment expectancy on self-reported ADHD symptoms and neuropsychological performance in NFB.

Method

Young adults seeking treatment for ADHD expected to receive active NFB, but instead were randomly assigned to receive sham treatment with false feedback indicating above average (positive expectancy; n = 26), below average (negative expectancy; n = 23), or average (neutral expectancy; n = 24) attentive states. Primary outcomes were report of ADHD symptoms, and performance on a sustained attention test and working memory test.

Results

Mixed ANOVAs revealed a significant interaction for ADHD symptom report (p < .001). Groups did not differ in pre-NFB symptom report (p = .56). Symptom report by the positive expectancy group decreased over time (p < .001) but increased among negative (p = .02) and neutral (p = .02) groups. Post-NFB symptom report was higher for negative expectancy relative to positive (p < .001) and neutral (p = .002) groups. There was no significant difference between positive and neutral groups (p = .37).There were no significant interactions for sustained attention and working memory.

Conclusion

Results indicate that treatment expectancies impact self-report of ADHD symptoms and should therefore be considered in clinical trials of NFB that measure outcomes via symptom report. Future studies examining expectancy effects on measures of other neuropsychological domains are necessary.
C-49 Externalizing Behavior Differences Between FASD and ACC: 11-13 Year Olds
Authors: van Asselt A , Price L , Underriner M , Richmond A , Andrews G
Published: August 2019

Objective

Investigate the externalizing behaviors of rule breaking and aggression among children ages 11-13 years with partial (pACC), full Agenesis of the Corpus Collosum (ACC) or Fetal Alcohol Spectrum Disorders (FASD) in order to broaden our understanding of the behaviors found in pre- and young adolescents with these diagnoses.

Method

This sample was taken from two data sets; one with individuals with ACC, the other individuals with FASD. The data for both ACC and FASD studies were gathered using mailing lists. Packets included informed consent, the Child Behavior Checklist (CBCL), the FAS BeST with additional developmental questions, and a demographic questionnaire. Of the 511 ACC packets returned, 47 were analyzed. Of the nearly 50 FASD packets returned, 7 were analyzed (n = 54).

Results

A multivariate analysis of variance (MANOVA) of the 54 participant’s external behaviors of rule breaking and aggression were analyzed. Participants with diagnoses of FASD present with higher rates of externalizing behaviors than those with pACC and ACC. Aggressive behaviors have a small effect size (n2 = .151) and rule breaking behaviors present with a large effect size (n2 = .441).

Conclusions

Treatment plans for those with FAS and ACC differ greatly from the commonly provided misdiagnoses of Autism, Attention Deficit/Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder and Conduct Disorder, which can leave clients with FAS and ACC misunderstood and improperly treated. By examining the common and differing external behavioral traits of FAS and ACC, clinicians can have stronger evidence when considering differential diagnoses and treatment plans.
C-53 The Challenges of Neuropsychological Rehabilitation for Children Diagnosed with Multiple Sclerosis (MS) Due to Complex Diagnostic Factors
Authors: Starza-Smith A , Talbot E , Reynolds D
Published: August 2019

Objective

With an incidence of 9.83 per million children per year, paediatric onset multiple sclerosis (MS) is rare. It does, however, present challenges for differential diagnosis alongside other demyelinating syndromes, such as Acute Disseminated Encephalomyelitis (ADEM) and various recurrent acquired demyelinating conditions, making diagnosis complex in this population. We highlight the different trajectories related to diagnosis and the impact of this on the child, family and wider healthcare and education systems surrounding them.

Method

Serial neuropsychological assessment data (Delis-Kaplan Executive Function System; Wechsler Intelligence Scale for Children, Children’s Memory Scale, Behavior Rating Inventory of Executive Function) is presented for two children with an initial diagnosis of ADEM; one subsequently was diagnosed with MS later altered to Myelin Oligodendrocyte Glycoprotein (MOG) antibody associated relapsing demyelination.

Results

Case 1: presents with average IQ and memory, significant deficits in executive function, including behavioural regulation and hyperactivity. Diagnostic journey indicated as recurrent ADEM leading to diagnosis of MS at 16 years old, later changed to MOG antibody associated relapsing demyelination. Case 2: presents significant deficits in IQ and memory and executive function following ADEM diagnosis at young age.

Conclusions

We consider how recent advances in medical investigation have uncovered numerous demyelinating syndromes impacting on the challenge of diagnosis of ADEM, MS and other demyelinating conditions. We question whether we are meeting the neuropsychological needs of children/adolescents with ADEM, MS and other demyelinating conditions in paediatric neuropsychology practice due to limited understanding of the complex and differential diagnoses and discuss whether ADEM and MS form a diagnostic continuum.
C-54 Neuropsychological Testing Profiles of Rare Conditions: A Case of Twin-to-Twin Transfusion Syndrome (TTTS) in a “Donor” Twin
Authors: Pimental P , Christopher J , Vermillion A , Ciampanelli A
Published: August 2019

Objective

TTTS is a rare condition occurring in approximately 5-15% of monochorionic twins (sharing a single placenta), in which there is an abnormal arterio-venous connection resulting in excess blood flow to one fetus (“recipient”) and too little to the other (“donor”) (Graeve et al., 2012). Consequently, the “donor” develops in low amniotic fluid, while the “recipient” develops in high amniotic fluid. Neurologic and cardiogenic abnormalities have been identified in the neonatal period and in the long-term for both twins (Wagner, Repke, & Ural, 2013). In terms of neurodevelopmental morbidities, 11.6% of children (age 6) endure mild neurologic impairment and 8.9% experience severe neurologic impairment (Graeve et al., 2012).

Methods

The present case involves a 7-year-old, right-handed, single female with a medical history of TTTS (“donor”) referred for neuropsychological testing to explore challenges with learning, attention, memory, reading, and spelling. Upon initial neuropsychological consultation, there were suspected neurodevelopmental optometric deficits, so the patient was also referred for ocular/vision testing. This revealed a significant convergence insufficiency/binocular dysfunction (eye teaming), ocular motor dysfunction (tracking), and visual disturbance (visual sensory overload) deficiencies.

Results

Neuropsychological testing revealed a neurodevelopmental disorder characterized by a language learning disability with mixed-dyslexia, ADHD - combined type, an executive functioning disorder, and neuro-optometric deficiencies interfering with neurocognitive functioning.

Conclusion

The present case provided further evidence of long-term neurodevelopmental sequelae associated with TTTS (“donor”). Neuropsychological testing elucidated the severity and type of neurodevelopmental impairments and was instrumental in the patient receiving an Individualized Education Program (IEP), which incorporated the accommodations contained in the neuropsychological diagnostic report.
C-60 The Efficacy of Weighted Blankets for Quantity and Quality of Sleep in Autism Spectrum Disorder: A Meta-Analysis
Authors: Hayduke D , Nye A
Published: August 2019

Objective

A meta-analysis was computed to assess the efficacy of weighted blanket therapy for improving sleep for children with autism spectrum disorder (ASD). Currently, pressure-based therapies are used to reduce ASD-related sensory concerns as well as to facilitate sleep in these patients; however, few studies have substantiated this use.

Data Selection

A search was conducted on EBSCO Host and Wiley in January 2019, using the terms ASD, weighted blanket, sleep, quality, sensory, anxiety, efficacy, and weighted. Salient selection criteria included: standardized pre- and post–treatment measures, randomized groups, and data that permitted calculations of effect sizes. Exclusion criteria included: bias represented and incomplete data due to participant attrition. The search resulted in 12 studies but following exclusion criteria, six remained. Pertinent data extracted included: sample size, number of nights studied, and pre– and post-measure data.

Data Synthesis

The results were obtained by first calculating the cumulative effect size for quantity and quality of sleep independently, and then comparing the effect sizes. Additionally, a funnel plot was used to identify any publication bias. Overall, quantity and quality of sleep had a small effect compared to controls. Further, there was a slightly higher effect for improved quantity over quality of sleep.

Conclusions

The current analysis slightly favors the use of weighted blankets for improved quantity and quality of sleep in those with ASD. A notable consideration is the substantially low number of studies included. Subsequently, the need for additional treatment research is paramount in order to reflect accurate outcomes and hopefully provide relief for patients with ASD.
C-61 The Molecular Basis of Autism, Amyloid Precursor Protein, and its Relevance to Neuropsychology: Case Study and Neuropathology of Boy with Autism
Authors: Sokol PhD , MD D , Lahiri D
Published: August 2019

Objective

Andrew (pseudoname) a boy with severe autism, participated in autism research at Indiana University School of Medicine. Andrew suddenly died in his sleep and his family donated his brain for further study at our institution. This case sparks the proposed discussion of the latest molecular underpinnings of autism which have been localized to genetic abnormalities at the synapse and in gene expression (translation and transcription). These mechanisms contribute to macrocephaly and microcephaly which are overrepresented in autism. The broad objective of this discussion will be to associate the molecular underpinnings of autism to brain anatomy and neuropsychological function. The specific aim will be to report results of Andrew's available psychological testing, plasma amyloid precursor protein (APP) profile, MRI volumetry, and neuropathological findings. Our published reports of APP profiles in plasma and brain tissue also will be reviewed.

Method

Andrew was a 13 yr old boy with severe autism (CARS-60), medically refractory seizures, and intellectual deficiency (MSEL49). The patient showed significant regression in speech (400 words down to 2) from age 5 to 13. He died from a presumptive seizure.

Results

Andrew's MRI volumetry showed increased white matter, including the left temporal lobe; neuropathology was significant for enlarged brain with cortical dysplasia. APP profile showed increased sAPPalpha with low ABeta protein, similar to what we reported in plasma and brain tissue studies.

Conclusions

Andrew is among the 20% of children with autism with macrocephaly with white >gray matter. Molecular underpinnings in relation to this finding and to the neuropsychology of autism will be discussed.
C-63 The Role of Neuropsychological Assessment in Congenital Diaphragmatic Hernia
Authors: Green V , Culotta V , Blackwell M
Published: August 2019

Objective

This case study examined the neurodevelopmental profile associated with congenital diaphragmatic hernia (CDH). CDH is primarily linked to chromosomal abnormality and results in pulmonary hypoplasia and significant respiratory difficulties. CDH occurs in 1 in 2,500 live births in the United States. More severe cases require extracorporeal membrane oxygenation (ECMO) and surgical hernia repair. Survivors are at risk of pulmonary hypertension, gastrointestinal disorders, structural brain abnormalities, and neurodevelopmental disorders. Past studies suggested early ECMO and surgical repair are associated with greater subsequent impairment.

Method

A 16-year-old male with a history of CDH presented for neuropsychological evaluation. History is remarkable for ECMO, surgical repair, pulmonary hypertension, and gastrostomy tube.

Results

Assessment revealed significant neurodevelopmental deficits impacting multiple domains including cognitive reasoning, visual construction, verbal memory, and executive functioning. Decoding and underlying phonemic awareness were preserved, while reading comprehension and applied math were significantly impaired, suggesting significant weaknesses in higher-order language. Social intent was strong despite weak social cognition. Elevated symptoms of anxiety and depression were evident.

Conclusions

CDH carries significant morbidity secondary to compromised respiratory functions and long-term pulmonary hypertension. Neurodevelopmental deficits are strongly associated with CDH and merit early detection, intervention, and follow-up. This case study illustrates the global neurodevelopmental difficulties in CDH requiring ECMO and surgical repair. This study illustrates escalating difficulties navigating academic and social demands as the need for higher order language and social cognition increase through adolescence. Serial neuropsychological assessments may be useful in facilitating and adapting interventions, assessing progress, detecting behavioral health symptoms, and contributing to optimal outcomes in CDH.