bluuebunny/crossref_metadata_2025 huggingface dataset:
B - 10 Performance Validity Test Failure Base Rates among Presurgical Epilepsy Referrals
Authors: Newkirk Bailey , Jaramillo Ruthie , Rubright Colin , Soble Jason R , Ulrich Devin M
Published: September 2024

Objective

Patients with epilepsy undergoing presurgical workup are generally considered a population without clear incentive to perform invalidly during neuropsychological evaluation. This study investigated the base rates of performance validity test (PVT) failure among a sample of presurgical epilepsy patients. Participants and.

Methods

Data were collected from 68 consecutive patients with epilepsy undergoing outpatient neuropsychological evaluation for surgical candidacy. The sample included 33 males/35 females, had a mean age of 36.29 (SD = 12.07), mean education of 12.51 (SD = 2.23), and was racially and ethnically diverse. All patients were administered a number of freestanding (Test of Memory Malingering [TOMM], Dot Counting Test [DCT], Coin-in-Hand [CIH]) and embedded (Rey Auditory Verbal Learning Test-Forced Choice [RAVLT-FC], Wechsler Memory Scale–3rd Edition Digit Span Reliable Digit Span [WMS-III DS RDS]) PVTs within a comprehensive neuropsychological assessment battery.

Results

Overall, 9% of the sample failed ≥2 PVTs, suggesting invalidity. An additional 22% failed 1 PVT. However, a large portion of the sample (69%) passed all freestanding and embedded PVTs. Among the freestanding PVTs, the failure rates were TOMM: 4%, DCT: 21%, and CIH: 3%. Failure rates on embedded PVTs were RAVLT-FC: 15% and WMS-III DS RDS: 3%.

Conclusions

Although there is not an expected incentive for suboptimal neuropsychological performance among presurgical epilepsy patients, results show a critical need for objective validity assessment to guard against inaccurate surgical prognostication from invalid test data for patients undergoing high-stakes presurgical evaluations. Given the high invalidity rate on some individual PVTs, further research is necessary to cross-validate established PVT cut-scores in epilepsy-specific populations.
B - 11 Alien Limb and Corticobasal Degeneration: a Neuropsychological Case Study
Authors: Newkirk Bailey , Jimenez Alexis , Fink Joseph
Published: September 2024

Objective

The patient presented with alien limb, frequently associated with corticobasal degeneration, an atypical parkinsonian syndrome with rigidity, akinesia, dystonia, cortical sensory deficit, and apraxia. Subjective memory complaints are also common. Neuropsychological performance typically includes poor performance on verbal fluency and measures tapping into executive functioning, but confrontation naming and verbal comprehension are initially well-preserved.

Method

The patient is a right-handed 69-year-old male who developed the sensation of alien limb in his left arm 2 years prior, in which his left hand did not feel “real.” Additionally, the patient presented with memory difficulties, mild word-finding problems, and physical/motor complaints (i.e., limb apraxia, tremor, bradykinesia, occasional limb dystonia, and postural instability) for approximately 2 years. The patient sought neuropsychological assessment to clarify his cognitive functioning in light of his neurologic symptoms.

Results

Premorbid functioning was in the exceptionally high range, with 18 years of education. Neuropsychologically, immediate memory was generally average, and generally low average delayed memory and recognition abilities. Mild inefficiencies were observed in executive functioning and semantic fluency. Otherwise, the patient performed generally average across other tasks of language, including confrontation naming, and attention.

Conclusions

In light of the literature, it is expected that corticobasal degeneration will be associated with subjective memory difficulties, executive dysfunction and poor verbal fluency. The patient presented with generally intact memory, mild executive dysfunction, and poor semantic fluency abilities. Given the patient’s high intelligence, he may be more sensitive to cognitive lapses. Neuropsychological results, along with his reported parkinsonian features, are fairly consistent with possible incipient corticobasal degeneration.
B - 12 Differences in Quality of Life in Students with Functional Neurological Disorders by School Setting
Authors: Escalante Natalie R , Wilkinson-Smith Alison
Published: September 2024

Objective

Attending school in person for students with Functional Neurological Disorder (FND) has been recommended for improved functioning and reduced symptoms. There is little to no research measuring the impact of school setting on quality of life. This study investigates whether school setting impacts parent-perceived quality of life (QoL) in children with FND.

Method

The study included 142 patients (ages 7–19 years old) diagnosed with FND that were seen in an outpatient clinic at Children’s Medical Center, Dallas. Patients were classified as either participating in homeschool, regular in-person schooling, or in-person schooling with an Individualized Education Plan (IEP) or Section 504 accommodations. This did not include children being homeschooled solely due to COVID-19 school closures. A parent or guardian completed the PedsQL questionnaire. A single factor ANVOA was utilized to identify significant differences between groups. Post hoc comparisons using the Tukey HSD test were then conducted.

Results

Results revealed overall significant differences between groups (p0.1).

Conclusions

Results of this study support the recommendation of attending school in person, with or without formal support. Participation in typical daily routines may improve overall impact of pediatric FND.
B - 14 NEO Personality Inventory-Revised (NEO-PI-R) Domains Compared across BSNIP-2 Biotypes for Psychosis Spectrum Disorders
Authors: Reis Jacqueline P , Dykins Madison M , Hill Scot K
Published: September 2024

Objective

The NEO Personality Inventory-Revised (NEO-PI-R) is commonly used to assess the Big Five personality traits: Neuroticism (N), Extroversion (E), Openness (O), Conscientiousness (C), and Agreeableness (A). This study compared NEO-PI-R personality factor composite scores across novel biological and neuropsychological characterizations of psychotic spectrum disorders (“biotypes”) derived by the Bipolar Schizophrenia Network for Intermediate Phenotypes (B-SNIP) consortium. Understanding personality patterns in more specific characterizations of psychotic spectrum disorders may shed light on behavioral patterns, including help-seeking in psychosis spectrum disorders.

Methods

Participants were 1086 individuals with a psychosis spectrum disorder grouped by biotype rather than DSM diagnosis who completed the NEO-PI-R.

Results

One-way ANOVAs were used to assess potential biotype group differences regarding NEO-PI-R traits. Post-hoc comparisons revealed that healthy controls endorsed more extroverted, agreeable, conscientious and less neurotic personality traits compared to the biotypes collectively. Traits of openness differentiated biotypes such that Biotype 3 endorsed more openness than Biotypes 1, 2 and Healthy Controls.

Conclusions

In addition to normal range cognitive abilities, less symptomatology, and fewer electrophysiological/imaging abnormalities, the present findings indicate that the Biotype 3 group endorsed more openness than the other patient groups. Like the Biotype 1 and 2 groups, internalizing symptomatology was present in the Biotype 3 group (less agreeableness, more neuroticism, less conscientiousness). Increased executive functioning, flexibility, problem-solving, and/or self-monitoring could be important factors contributing to the greater openness of the Biotype 3 group.
B - 15 Symptom Presentation on the Neurobehavioral Symptom Inventory and Post Traumatic Stress Disorder Checklist for DSM-5 in a Cohort of Explosive Ordnance Disposal Veterans
Authors: Tschida Sherri , Summers Angela , Chacko Thomas , Breneman Charity , Brewster Ryan , Reck Lily , Killy Owen , Allen Nathanial , Costanzo Michelle , Reinhard Matthew
Published: September 2024

Objective

This preliminary research examined symptom differences on the Neurobehavioral Symptom Inventory (NSI) and Post Traumatic Stress Disorder Checklist DSM-5 (PCL-5) for Explosive Ordnance Disposal (EOD) and Non-EOD Veterans receiving care at the Washington DC-War Related Illness and Injury Study Center (DC-WRIISC) Veterans Administration Medical Center. EOD Veterans have extensive repetitive blast-exposure histories, exposure to environmental toxins, and operated under high-stress/allostatic load throughout their careers. Therefore, we aim to understand how these unique occupational exposures influence long-term health outcomes for EOD Veterans.

Method

Eligible participants (N = 39, Mage = 51 years (SD = 9.5 years); EOD, n = 21) completed comprehensive interdisciplinary evaluations, self-report questionnaires, were combat deployed, and experienced traumatic brain injury. Total and component scores for the NSI (affective, cognitive, somatic, vestibular, and validity-10) and PCL-5 (criterion B-E symptom clusters), and total score for the Holmes-Rahe Life Stress Inventory, (HRLSI) were included.

Results

Regression analysis revealed overall NSI severity was positively correlated to PCL-5 total scores for both groups (EOD: F(1,19) = 25.30, p < 0.001); (Non-EOD: F(1,16) = 25.48, p < 0.001). However, significant differences in symptom presentation were noted between groups. NSI Cognitive scores were positively correlated with PCL-5 component scores for Criterion B for EOD (F(3,17) = 8.40, p < 0.001) and Criterion E for Non-EOD (F(3,14) = 24.32, p < 0.001). Post-hoc analysis suggested stress/resiliency may further contribute to group differences (HRLSI; Non-EOD, F(2,12) = 33.96, p < 0.001).

Conclusion

DC-WRIISC Veterans often present with cognitive concerns and complex medical presentations. Our findings suggest the presence of unique symptom presentations that may improve diagnostic formulation, treatment planning, and engagement. These findings highlight the need for continued research examining the influence occupational exposures have on Veteran health.
B - 16 Neurocognitive Training to Boost Reward Sensitivity Modulates Positive Affect in Individuals with Generalized Anxiety Disorder: a Proof-of-Concept Study
Authors: Hovren Hanna L , Scramaglia Tyler , Dun Danielle , Harlé Katia
Published: September 2024

Objective

Anhedonia (i.e., reduced positive affect and decreased sensitivity to rewards) is observed in many psychiatric conditions, including generalized anxiety disorder (GAD). We tested the usefulness of a cognitive training program aimed at boosting reward responsiveness (a multi-arm bandit task; MAB) to decrease anhedonia in individuals with anxiety and depressive symptoms.

Methods

Individuals (N = 50; 54% Female; 18–65 yo) with high levels of anhedonia as measured by the Positive and Negative Affect Scale (PANAS; score < 25) and diagnostic levels of depression and/or anxiety (Patient Health Questionnaire-8/PHQ-8 or General Anxiety Disorder-7/GAD-7 score ≥ 10) were randomly assigned to a high-reward MAB training with either high variance (HV) or low variance (LV) in reward rates. The HV condition was expected to boost reward maximization and decrease anhedonic symptoms. State anhedonia levels as measured by the PANAS were collected before and after completing MAB training.

Results

Individuals with both higher baseline anhedonia (PANAS positive affect score < 18) and a GAD diagnosis who underwent the HV vs the LV training MAB exhibited a decrease in anhedonia when compared to pre-training levels (odds ratio/OR: 1.65, 95% CI = [1.16,2.35], t = 2.8, p = 0.027). This effect was not seen in individuals with GAD and lower levels of anhedonia (PANAS positive affect score > 18) or in those who did not meet diagnostic criteria for GAD (ps > 0.05).

Conclusions

These results suggest a role for HV MAB training in decreasing anhedonia in individuals with GAD. Targeting anhedonia for these individuals during treatment may help improve clinical outcomes.
B - 17 Cognition, Social and Occupational Functioning, and Symptom Severity as Predictors on Family Burden in First Episode Psychosis
Authors: Gates-Woodyatt Jessie J , Done Monica E , Collins Delaney , Condray Ruth , Allen Daniel N
Published: September 2024

Objective

Individuals with first episode psychosis (FEP) are often dependent on family members to assist with recovery following diagnosis. Family members frequently become caregivers, helping with scheduling and transportation to appointments, medication management, and tasks of daily living. However, such caregiving responsibilities can impact financial resources, employment, family routine, and cause higher rates of stress within the family. The following study examined cognitive, demographic and symptom predictors of self-reported caregiver burden in FEP.

Methods

Participants included 61 individuals experiencing their first episode of psychosis (26.2% female; mean age = 20.7). IQ was assessed with the WASI-II. Psychosis symptom severity over the past 7 days was assessed using the Structured Clinical Interview for DSM-5 Disorders. Demographic data and social and occupational functioning were also collected. The Family Assessment Scale was completed by the primary caregiver to assess different domains of family burden (e.g., finance, employment, recreational activities, leisure time, stigma, and emotions).

Results

Multiple regression analyses indicated that severity of delusions was a significant predictor of caregiver burden. However, IQ, race, age, and social and occupational functioning were not significant predictors.

Conclusions

Current results indicate that for FEP, delusions severity is a stronger predictor of caregiver burden than other factors expected to impact burden, such as IQ and social and occupational functioning. Results provide preliminary evidence indicating that early in the course of psychotic illness, active delusions play a key role in increased caregiver burden.
B - 20 The Role of Fatigue, Anxiety, Depression, and Stress (FADS) in Executive Functioning Following COVID-19
Authors: Nemanim Natasha , Angelini Sofia , Roth Alyssa , Hansen Gabrielle , Perez Veronica B
Published: September 2024

Objective

Evidence indicates COVID-19 may residually impact executive functioning (EF). Despite disproportionately higher rates of COVID-19 amongst people of the global majority (PGM), there is limited research on ethnoracial disparities in neuropsychological and psychiatric outcomes following COVID-19. This study compares fatigue, anxiety, depression, and stress (FADS), as well as neurocognitive complaints (NC) and neuropsychological functioning in PGM versus non-PGM groups with and without a history of COVID-19. We expected PGM to report more severe FADS with a COVID-19 history than non-PGM, and for FADS to relate to task performance.

Method

Ninety-nine participants without a history of COVID-19 (52 PGM, 47 non-PGM) and sixty-six participants with a history of COVID-19 (22 PGM, 44 non-PGM) completed neuropsychological measures (e.g., WAIS-IV Digit Span, Oral Trail Making Test, WCST-64, and D-KEFS Color Word Interference), the Everyday Cognition Scale (scale of NCs), the Depression Anxiety Stress Scale, and the Multidimensional Fatigue Inventory.

Results

ANOVA revealed a main PGM-affiliation effect for FADS. Although no interaction between COVID-19 and PGM-affiliation on EF were found, significant interactions were demonstrated in anxiety (p = 0.023) and stress (p = 0.007) and were marginal for depression (p = 0.06), but not fatigue. Stress significantly covaried EF performance.

Conclusions

While there may not be significant interactions between ethnoracial identity and COVID-19 on objective EF tasks, NCs, anxiety, depression, and stress appear to vary according to ethnoracial identity depending on COVID-19 history. Therefore, PGM may be more affected on EF when experiencing elevated FADS. Future research should aim to inform treatment for those experiencing NC and psychiatric distress following COVID-19.
B - 22 Self-Reported Traumatic Brain Injury and its Biopsychosocial Risk Factors in Siblings of Individuals with Neurodevelopmental Conditions
Authors: Wolff Brittany , Glasson Emma , Babikian Talin , Pestell Carmela
Published: September 2024

Objective

Siblings of individuals with neurodevelopmental conditions (NDCs) are situated within a complex system of transdiagnostic risk and resilience factors for poor psychosocial, cognitive and behavioral outcomes. Many such factors experienced by NDC siblings overlap with risk for traumatic brain injury (TBI) and correlate with poorer recovery trajectories.

Method

With data from an online self-report survey, the present study used Bayesian analyses to characterize and compare TBI and biopsychosocial risk factors amongst 632 siblings (207 NDC, 425 controls; mean age 20.54 years, range 10–30, 78.48% female), and examine correlations between clinical, biological, and social determinant of health variables.

Results

NDC siblings had a higher self-reported lifetime history of TBI compared to controls (14.98% versus 6.35%), with most NDC siblings reporting more than one TBI, and at an earlier mean age. TBI history was associated with psychiatric diagnoses and subclinical NDC features, including hyperactivity and impulsivity, inattention, conduct problems, and autistic traits. Family and structural factors related to TBI included poorer parent–child relationship, NDC diagnoses of autism or fetal alcohol spectrum disorder, minority ethnicity and lower income.

Conclusions

Findings have important clinical and policy implications for health literacy, TBI education and screening, development of prevention and intervention strategies, and implementation of family support to target social and structural determinants of health impacting NDC sibling wellbeing.
B - 23 Surveying Public Perceptions about the Coverage of Sports Concussion in the Media
Authors: Sullivan Karen
Published: September 2024

Objective

Public awareness of sports concussion is key for injury management. This awareness is shaped by media reporting and has been critiqued for different reasons by health professionals and sport stakeholders. The community’s view about this reporting is unknown.

Methods

157 community volunteers completed an online survey, including a purpose-built multi-item measure of perceptions of sports concussion media portrayal (PoSCoMP). The PoSCoMP score was compared for groups based on concussion history, concussion education, concussion knowledge, playing a concussion-risk sport, or regular sports media consumption. Item consensus (endorsement by >50% of the sample) and free-text responses were descriptively analysed.

Results

The PoSCoMP had acceptable internal consistency (α > 0.79). One statistically significant group difference was found (p < 0.05). Compared to people with no concussion history, people with a concussion history had a more negative perception of the media coverage (Cohen’s d = 0.53 [medium effect]). There were nine commonly agreed perceptions (e.g., important for player safety), and four commonly disagreed perceptions (e.g., ignored in some sports). The free-text responses urged change in the media coverage of sports concussion, with some perceiving this as already underway.

Conclusion

Community members’ views about the media portrayal of sports concussion are largely unaffected by individual differences and share commonalities with the views of sport stakeholders and health professionals. Future efforts to improve public awareness of concussion through media reporting should consider the public’s position on this coverage. This could lead to changes that have the public’s support and are more effective in increasing public injury awareness.
B - 27 Images and Distorted Facts: Seeing beyond the Concussion in Patients with Persisting Symptoms after Concussion
Authors: O'Reilly Molly A , Hammond Jared B , Marschall Kelsea P , Barros Kathleen , Lichtenstein Jonathan D
Published: September 2024

Objective

Persisting symptoms after concussion (PSaC) present significant challenges in clinical practice, with up to 30% of youth experiencing prolonged difficulties beyond one-month post-injury. This project aimed to characterize a sample of patients referred for neuropsychological evaluation due to PSaC and explore factors contributing to persisting symptoms.

Method

Data were retrospectively collected from 54 patients referred for neuropsychological evaluation at a rural academic medical center. On average, they were aged 16.35 ± 2.81 years (range = 7–24) with FSIQ of 105.39 ± 15.41 (range = 75–146). The sample was predominantly White (90.7%) and female (59.3%). Correlations with bootstrapped linear and logistic regressions were used to analyze relationships.

Results

Three-quarters (75.9%) of patients experienced symptoms attributable to factors other than concussion, and 90.7% did not receive/follow evidence-based recommendations (EBR) post-injury. Pre-existing migraines, anxiety, depression, and other psychiatric disorders, significantly correlated with symptom burden. Linear regression including anxiety, depression, migraines, other psychiatric disorders, and a lack of EBR predicted the number of symptoms reported [R2 = 0.314, F(5, 48) = 4.40, p = 0.002]. Any history of psychiatric disorders predicted current number of symptoms [R2 = 0.121, F(1, 52) = 7.129, p = 0.010]. Binomial logistic regression with migraines (Nagelkerke R2 = 0.389, p = 0.000) and depression (Nagelkerke R2 = 0.124, p = 0.033) significantly predicted non-concussion etiology. Non-concussion etiology was better predicted by robust logistic modeling of anxiety, depression, migraines, other psychiatric disorders, and not following EBR (Nagelkerke R2 = 0.575, p = 0.000).

Conclusions

Our findings, though limited in generalizability, underscore the need for individualized PSaC management. Early involvement of neuropsychology in concussion care may facilitate accurate diagnosis, tailored interventions, and improved outcomes, mitigating the risk of iatrogenic effects and optimizing patient recovery via EBR.
B - 28 Overcoming Access Challenges: Exploring Affordable Options for Pediatric Concussion and Vestibular Dysfunction Diagnosis
Authors: Gordon Taryn , Thorne Shaylyn , Franke Michelle , Burkhart Scott
Published: September 2024

Objective

Sport and recreation-related head injuries, numbering 1.3 to 2.2 million annually in the US, lead to vestibular dysfunction in up to 80% of pediatric concussions. While the Gaze Stabilization Test (GST) is widely used for identifying such dysfunction, its cost and requirement for specialized equipment limit its accessibility. This study explored the effectiveness of utilizing the Vestibular/Ocular Motor Screening (VOMS) and the Dizziness Handicap Inventory (DHI) in clinical concussion testing among student athletes as more accessible options.

Methods

Patients receiving care at a concussion clinic were screened for study inclusion. Patients were included if they received a confirmed diagnosis of concussion, were injured playing a sport, and were seen by the vestibular-trained physical therapist within seven days of their injury. Patients completed the GST, VOMS, and DHI as part of an initial clinical assessment. Sensitivity, specificity, and AUC were analyzed for the VOMS and DHI compared to the GST.

Results

Thirty-one student-athletes (15.3 ± 1.5 years; 19 male, 12 female) were included. Participants who reported a symptom increase of two or more after completing the VOMS (+2 VOMS) exhibited a sensitivity of 0.879, a specificity of 0.261, and an AUC of 0.586. Specificity increased as symptoms increased (+3 VOMS and + 4 VOMS). In comparison, DHI scores at or above the clinical cut-off yielded a sensitivity of 0.500, a specificity of 0.696, and an AUC of 0.598.

Conclusion

In the absence of robust assessments such as the GST, utilizing the combination of the VOMS and the DHI may provide important diagnostic insights regarding vestibular dysfunction.
B - 30 Influence of Military Blast Exposure on Subjective Post-Concussion Symptom Reporting
Authors: Nixon Tana , Bare Kailyn , Ramanauskas Brian , Ulrich Devin , Phillips Matthew , Soble Jason
Published: September 2024

Objective

Repeated subconcussive blast exposure associated with explosive breaching, mortars, and shoulder-fired artillery weapons is commonly seen in the military/veteran population and has been found to contribute to adverse neurological outcomes; however, the extent is not fully understood. The aim of this study was to assess the effects of blast exposure during military or other training exercises on neurobehavioral symptom endorsement.

Method

Cross-sectional data from 48 nonclinical post-deployment Operation Enduring Freedom/Operation Iraqi Freedom veterans prospectively-recruited for a study examining posttraumatic stress and cognitive correlates at an urban VA Medical Center were examined (M age = 36.02; SD = 6.12; M years of education = 14.94; SD = 1.84). The sample was 96% male, 41% White, 39% Black, 4% Asian, and 16% Other. The Neurobehavioral Symptom Inventory (NSI) was used to assess self-reported vestibular, somatosensory, cognitive, and affective post-concussion symptoms, and the Boston Assessment of Traumatic Brain Injury-Lifetime semi-structured clinical interview assessed military-related blast exposure.

Results

There was a significant difference in neurobehavioral symptoms based on blast exposure, F(4,43) = 3.49, p = 0.015; Wilk’s Λ = 0.755, partial η2 = 0.25. Follow-up analyses showed that veterans with history of blast exposure endorsed significantly higher levels of somatosensory (F(1,47) = 7.69, p = 0.008, η2 = 0.143); affective (F(1,47) = 12.66, p < 0.001, η2 = 0.216); cognitive (F(1,47) = 5.97, p = 0.018, η2 = 0.115); and vestibular (F(1,47) = 7.21, p = 0.010, η2 = 0.136) post-concussive symptoms on the NSI compared to those without history of military blast exposure.

Conclusion

Veterans with blast exposure during military service reported significantly greater levels of post-concussion symptoms. This demonstrates the need to assess history of blast exposure, implement prevention measures through safeguards and decreased exposure when possible, and establish treatment modalities to improve outcomes.
B - 31 Factor Analysis of Neuropsychological Attention Measures with Mild Traumatic Brain Injury Patients
Authors: Mateer Elizabeth M
Published: September 2024

Objective

Mild traumatic brain injury (mTBI) often leads to attentional deficits, yet the neuropsychological tests traditionally used may not adequately reflect the cognitive impairments these patients experience. This study aimed to critically evaluate the construct validity and factor structure of attention-related neuropsychological tests in mTBI patients to better understand and diagnose attentional deficits.

Method

The research utilized a battery of neuropsychological tests used to assess attention among a sample of 269 adults with mTBI including the NAB Numbers & Letters Test, PASAT, Trail Making Test, and WAIS Digit Span, Coding, and Arithmetic subtests. Exploratory factor analysis was employed to investigate the factor structure of the test battery and to test the hypothesis concerning the dimensionality of attention constructs.

Results

The analysis revealed that attentional measures did not converge on a single latent factor but instead reflected four distinct factors. These factors were identified as 1) Visual Attention/Psychomotor Speed, 2) Auditory Working Memory, 3) Visuospatial Scanning/Search, and 4) Disruption.

Conclusions

This exploratory factor analysis unveiled a distinction between auditory and visual attention mechanisms within this population. This separation suggests that attentional processes are not monolithic but rather encompass distinct auditory and visual domains and corroborates the existing literature, including Mirsky’s (1991) model of attention, which posits multiple components of attention, albeit with a focus on differentiating processes rather than sensory modalities. The study highlights the complexity of attentional impairments in mTBI and underscores the need for a nuanced approach to the neuropsychological assessment of attention among mTBI patients.
B - 35 Recall of the Injury Event in Moderate–Severe Traumatic Brain Injury
Authors: Nadir Suhaah , Duff Melissa C , Padilla Victoria-Grace , Tanguay Annick
Published: September 2024

Objective

Autobiographical recall can be impoverished in Traumatic Brain Injury (TBI). We explored whether the recall of the TBI event was unique to this trend since the event is both self-defining and traumatic.

Methods

We recruited 30 non-injured comparison participants (NC) and 30 participants in the chronic phase of a moderate–severe TBI from the Brain Injury Patient Registry at Vanderbilt University Medical Center. Participants in the TBI group recalled their TBI event and a self-selected event from 0–5 years before the TBI. The NC group recalled a self-selected event that matched the pre-injury’s temporal distance. We used the Autobiographical Interview scoring system to test whether events differed in the amount and type of details.

Results

Compared to the pre-injury event, the injury event had a higher number of episodic-like, p = 0.002, and external details (e.g., repetition and meta-comments), p = 0.011. The injury and pre-injury events had a similar proportion of episodic-like details (relative to all details), p = 0.295, indicating events were similarly supplemented with extraneous/inferential information. Further, the pre-injury event of the TBI group had a smaller number of episodic-like details, p < 0.001, and a lower proportion of episodic-like details, p = 0.002, than the events from the NC group.

Conclusion

Whereas the recall of injury events may be unique due to their higher number of episodic-like details, they were also similar to general autobiographical memory recall in the preponderance of supplementary details. A confluence of factors, like personal relevance, compromised encoding due to loss of consciousness at the time of injury, and general difficulties in retrieval, may explain the findings.
B - 36 Investigating High-Definition Transcranial Direct Current Stimulation for Remediating Word Finding Difficulty in Civilians with a History of Chronic Traumatic Brain Injury: a Pilot Study
Authors: Adhikari Ashna , Devora Paulina , Vintila Tyler , Mathews Amy , Nguyen Benjamin , Motes Michael , Lobue Christian , Cullum Monroe , Hart John , Chiang Hsueh-Sheng
Published: September 2024

Objective

Verbal-retrieval deficits often occur after traumatic brain injury (TBI), but no effective treatment is available. In this study, High-Definition Transcranial Direct Current Stimulation (HD-tDCS) was applied to examine its potential effects on cognitive, especially verbal-retrieval, performance in individuals with chronic TBI.

Method

Four adults (mean age 48 years; 3 females) with self-reported word-finding difficulty confirmed by objective measures following mild to moderate non-military TBIs sustained over a year ago underwent a double-blind, cross-over, randomized, sham-controlled trial. Each participant received 10 sessions of active HD-tDCS and sham stimulation over the superior medial frontal cortex. A battery of neuropsychological tests was administered including verbal-retrieval measures (i. e. letter fluency, category fluency, Boston Naming Test/BNT) at baseline, immediately, and 8 weeks post-treatment. Post-treatment performance was compared to baseline using 2-tailed paired t-tests.

Results

Improvements on letter fluency were observed between baseline and immediate assessments post active HD-tDCS, approaching statistical significance (p = 0.076, Cohen’s d = 0.957, 7.5 ± 5.7 more items). No immediate effects with sham HD-tDCS (p > 0.10, 1.5 ± 3.5 more items) and no sustained effects (8 weeks after) were found with either active or sham HD-tDCS (ps > 0.10). Additionally, no significant changes were observed for category fluency or BNT (all ps > 0.10).

Conclusion

While our pilot study suggests a potential benefit for improved letter fluency immediately following active HD-tDCS compared to sham, the lack of sustained improvement after 8 weeks and the observed variability across different tests acknowledges the need for future larger-scale investigation across multiple cognitive domains.
B - 40 Sleep Mediates Anxiety and PTSD Symptoms in Service Members with a History of Mild Traumatic Brain Injury
Authors: Hershaw Jamie , Wilcox Steven
Published: September 2024

Objective

Depression, anxiety, and post-traumatic stress disorder (PTSD) are prevalent in individuals with a history of mild traumatic brain injury (mTBI). US military service members (SMs) are at increased risk of sleep deficiency, which may influence the relationship between mTBI and psychological outcomes. This analysis examines the interaction of sleep quantity and mTBI on symptoms of depression, anxiety, and PTSD.

Method

A sample of 177 non-treatment seeking SMs completed the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the Post Traumatic Stress Disorder Checklist (PCL-5) and reported the number of hours slept the prior night (“sleep quantity”). The sample included SMs with and without a self-reported history of mTBI. Hierarchical regressions on BDI, BAI, and PCL-5 total scores were computed with group and sleep quantity (model 1) and their interaction (model 2) as predictors and age as a covariate.

Results

The interaction of mTBI and sleep quantity on BAI (p = 0.019) and PCL-5 (p = 0.070) total scores was significant and marginally significant, respectively, wherein the negative association between sleep quantity and symptom reporting was stronger in the mTBI group than controls. No interaction between mTBI and sleep quantity was observed for BDI total score (p = 0.578).

Conclusion

Worse psychological symptoms in SMs with a history of mTBI is related to lower sleep quantity. It may benefit these SM to address sleep deficiency or other sleep problems to improve these symptoms. Improving sleep may provide a means of indirectly targeting the adverse psychological outcomes common among SMs with mTBI, particularly anxiety-related problems.
B - 44 Examining Test–Retest Reliability and Mean Score Differences in Self-Reported Neuropsychological Symptoms in Active-Duty and Veterans with Mild Traumatic Brain Injury (Mtbi)
Authors: Albertorio Arianna D , Herring Tristan T , Ingram Paul B , Armistead-Jehle Patrick , Shura Robert D , Turkstra Lyn , Lu Lisa O , Curtiss Glenn , Bowles Amy O , Eapen Blessen C , Cooper Douglas B
Published: September 2024

Objective

Test–retest reliability is a foundational psychometric property of tests, providing a means through which tests may be assessed for time invariant interpretation. This study evaluated the test–retest reliability of several self-report instruments commonly employed in a veteran/military neurocognitive rehabilitation setting.

Method

Repeat administration of the Neurobehavioral Symptom Inventory (NSI), Key Behaviors Change Inventory (KBCI), Veterans RAND 12 Item Health Survey (VR12), C4 Inventory, Center for Epidemiologic Studies-Depression, Post-traumatic Checklist-DSM-5 (PCL-5), and the Epworth Sleepiness Scale (ESS) was collected across baseline, one, four, and twelve week timepoints. Interclass correlation coefficients and a two-way mixed ANOVA was conducted on 31 Veteran and 22 Active-duty participants (71.5% male).

Results

Most measures demonstrated a significant mean difference during follow-up, with reductions across the 1- and 4-week follow-ups. ICC ranged from good to excellent (0.76–0.93) across the measures. Correlations between time points on measures were high (e.g., PCL-5 Baseline/4wk r = 0.93), suggesting high reliability for measures despite changing scores after treatment completion.

Conclusions

This study found good test–retest reliability across the three follow-up timelines, supporting the use of the included measures in neurocognitive rehabilitation settings. Reliability and post-treatment changes in symptoms observed across these measures will be further discussed.
B - 47 Assessing Subjective Cognitive Outcomes in Military Veterans: a Comparative Study of Million Veteran Program Participants with and without TBI History and PTSD
Authors: Ozturk Erin ,   Million Veteran Program (MVP), Chanfreau-Coffinier Catherine , Goodman Zachary T , Merritt Victoria C
Published: September 2024

Objective

We examined the distinct impacts of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) on subjective cognitive symptoms in Iraq/Afghanistan-era military Veterans who enrolled in the Million Veteran Program (MVP) and completed the Veterans Affairs TBI Screening and Evaluation Program.

Method

Veterans initially screened for possible deployment-related TBI (Screen+/Screen-). If a Veteran screened positive, they completed the Comprehensive Traumatic Brain Injury Evaluation to establish TBI diagnosis (CTBIE+/CTBIE-). Self-reported PTSD status (PTSD+/PTSD-) was collected from the MVP baseline survey. Veterans also completed the Medical Outcomes Study Cognitive Functioning Scale (MOS-Cog-R), a self-report measure of cognitive symptoms (6 items with total score 6–36). Veterans (N = 7774; 77.4% male) were categorized into six exclusive diagnostic groups based on screening, TBI diagnosis, and PTSD status: (1) Screen-/CTBIE-/PTSD- (n = 7537); (2) Screen-/CTBIE-/PTSD+ (n = 747); (3) Screen+/CTBIE-/PTSD- (n = 380); (4) Screen+/CTBIE-/PTSD+ (n = 633); (5) Screen+/CTBIE+/PTSD- (n = 397); and (6) Screen+/CTBIE+/PTSD+ (n = 1080). ANCOVAs adjusted for sociodemographic characteristics evaluated the association between diagnostic group and MOS-Cog-R total score.

Results

Results showed a significant association of diagnostic group with MOS-Cog-R total score (p < 0.001, $\square{\!\!\!?}\, $p2 = 0.29). Post-hoc analyses showed that all groups endorsed significantly greater symptoms than the Screen-/CTBIE-/PTSD- group (p’s < 0.001, $\square{\!\!\!?}\, $p2 = 0.04–0.31). Additionally, each PTSD+ group endorsed significantly greater symptoms compared to their counterpart PTSD- groups (p’s < 0.001, $\square{\!\!\!?}\, $p2 = 0.08–0.11).

Conclusions

This is the first study to investigate distinct impacts of TBI and PTSD on subjective cognitive symptoms using TBI Screening and Evaluation Program data. Results reinforce prior work suggesting that PTSD greatly contributes to subjective cognitive distress, supporting that interventions should prioritize mental health treatment in this unique population.
B - 48 Gender-Based Network Comparisons of the Post-Concussion Symptom Scale at Acute Post-Concussion
Authors: Salva Christine E , Goodwin Grace J , Jarvis Sierra A , Kinsora Thomas F , Ross Staci R , Allen Daniel N
Published: September 2024

Objective

Prior literature suggests there may be gender-based differences in Post-Concussion Symptom Scale (PCSS) scores, with girls reporting more symptoms than boys at pre- and post-concussion. PCSS network analysis comparisons on gender have been conducted at pre-concussion but not post-concussion, which can determine whether gender-based differences in symptom relationships exist post-concussion. We conducted network comparisons between boys and girls from a sample of high school athletes at acute post-concussion to analyze differences in symptom relationships.

Method

Separate network analyses were conducted on acute post-concussion PCSS scores (within 72 hours post-suspected concussion) for boys (n = 2032) and girls (n = 1246), with nodes representing PCSS items and edges representing partial correlations between them. Expected influence was calculated to determine node importance in each network. Network Comparison Tests were used to compare network structure, global connectivity, and expected influence.

Results

Both networks’ expected influences and edge weights were stable and interpretable. There were no significant differences in network structure, connectivity, and expected influence between the groups. Networks consisted of positive and negative edges; strongest edges connected symptoms within similar domains (e.g., light and noise sensitivity).

Conclusions

Current results suggest that prior reports of gender-based differences in PCSS scores following concussion do not appear to be accounted for by differences in how PCSS items interact and influence each other. Differences may reflect actual differences in type and severity of post-concussion symptoms experienced by boys and girls or reflect differences in symptom reporting based on cultural influences. Future research could examine cultural or societal factors that influence gender-based differences in symptom reporting.
B - 49 A-Head of the Game: a Preliminary Meta-Analytic Review of Neuropsychological Performance in Individuals Exposed to Repetitive Head Impacts
Authors: Campbell Ivan , Aita Stephen L , Wagaman Bailey N , Ikonomou Vasilios C , Hernandez Katherine A , Hawley Nanako A , Pizer Jasmin , Del Bene Victor , Alosco Michael , Hill Benjamin D
Published: September 2024

Objective

We conducted a meta-analysis of the extant neuropsychological literature within individuals exposed to repetitive head impacts (RHI) in order to determine the impact of RHI on neuropsychological ability.

Method

Standardized search terms were applied in Embase, Scopus, Cochrane, PsycINFO, and PubMed. The search interval covered articles published from 1946 to October 2023. Analyses were random-effects models. Hedge’s g was used as a bias-corrected estimate of effect size. Between-study heterogeneity was assessed using Cochran’s Q and I2. Publication bias was assessed with Duval and Tweedie’s Trim-and-Fill method to identify evidence of missing studies.

Results

The initial omnibus literature search yielded 2143 studies. 35 studies (10,343 RHI exposed and 5211 referents) met our inclusion criteria of having RHI exposed participants and neuropsychological outcomes. Preliminary results showed RHI exposed individuals demonstrated significantly worse performance overall when compared to referents (k = 35, g = −0.20, p = 0.003; Q = 154.63) with a small effect size. Multiple moderation analyses were conducted examining specific cognitive domains, age, and RHI subgroups, among others. Trim-and-fill procedure estimated seven studies to be missing due to publication bias (adjusted g = −0.06, 95% CI = -0.20, 0.08).

Conclusions

In our preliminary analysis, individuals exposed to RHI performed slightly worse on average when compared to referents, though this effect was attenuated by accounting for publication bias and differed when accounting for specific moderating variables. Improved methodological standardization within the RHI literature is needed as well as more data collection and greater implementation of longitudinal study designs.
B - 50 Traumatic Brain Injury in Patients with Psychogenic Non-epileptic Seizures and Functioning
Authors: Berube Amelia , Tocco Krista , Curt LaFrance W , VanPatten Ryan
Published: September 2024

Objective

Past studies reveal that many patients with psychogenic non-epileptic seizures (PNES) also have a traumatic brain injury (TBI) history, but the specific influence of prior TBI on patients is presently under examination. This study aims to investigate the relationship between patients with PNES with a TBI history and symptoms/functioning, compared to those without a TBI history.

Method

Data collected from patients seen for comprehensive neuropsychiatric evaluation was analyzed, including TBI history, TBI severity, and Global Assessment of Functioning (GAF) scores. The GAF scale allows assignment of a numerical rating to patients based on their psychological and social functioning.

Results

Patients with PNES without TBI (n = 120; mean age 51) had higher average GAF scores (52.4) compared to those with TBI (n = 164, mean age 54, mean GAF 50) (p = 0.0059). Across PNES patients with a history of TBI, those with mild TBI exhibited notably lower GAF scores (43.2) than those with moderate (48.87) or severe (50) history of TBI.

Conclusion

Patients with PNES and a history of TBI had lower (worse) GAF scores than those without TBI, and worse in cases of mild TBI. Further exploration of demographic variables, education, and employment status will address potential confounds. Understanding the complex interplay between PNES and TBI may improve diagnosis and management strategies, with further research in advancing clinical practice.
B - 53 Neuropsychological Functioning after a Bi-Parietal Penetrating Traumatic Brain Injury in a 28-Year-Old Hispanic Male
Authors: Alsina Eduardo A , Kumbhani Sheba R , Aguila-Puentes Gisela , Ireland Susan J
Published: September 2024

Objective

In the U.S. there are approximately 115,000 non-fatal firearm injuries each year, resulting in an annual cost of over $229 billion. Of these injuries, some result in penetrating brain injuries where an object enters and lodges within the cranial cavity, with the severity of damage determined by the shape, mass, and energy released of the projectile as it passes through the brain. This case follows a 28-year-old right-handed Hispanic male with no premorbid medical history, 16 years of education, who experienced bi-parietal lesions as a result of a gunshot wound to the head one year prior. This trajectory is rare, with little literature detailing the effects of penetrating injuries to both parietal lobes.

Method

The gunshot wound resulted in a bullet trajectory from the left frontoparietal region to the right parietal calvarium with multiple displaced ballistic fragments. Since the injury, he presented with resolving right-sided weakness and sensory changes, reduced balance, memory complaints, and bilateral parietally mediated findings.

Results

Neuropsychological testing showed right-sided suppression (tactile, auditory, and visual in the lower quadrant), reduced sensation in his right hand, alexia with agraphia, acquired apraxia of speech without aphasia, Gerstmann’s Syndrome, topographical disorientation, visuospatial dysgnosia, and constructional apraxia. There was also indication of inattentiveness, memory impairments, and processing speed deficits.

Conclusions

The present case study delineates the neuropsychological sequalae after a penetrating brain injury to the right parietal lobe and left frontoparietal region, resulting in significant cognitive deficits consistent with pronounced bilateral parietal lobe findings.
B - 54 Concussion Symptomology Reporting by Sport
Authors: Stafford Claire , Bennett Ryan , Slicer Kayley
Published: September 2024

Objective

To investigate whether post-concussion symptomology differs between the following sports: basketball, cheerleading, soccer, and volleyball.

Method

A multivariate ANCOVA was conducted between the four sports, basketball, cheer, soccer, and volleyball, on post-concussion symptom reporting. Sex, handedness, age, level of education, number of concussions, past psychiatric treatment, and diagnosis of ADHD, autism, and dyslexia were controlled for. The basketball group (N = 86, 37.3% male, 62.7% female, Mage = 19.89). The cheerleading group (N = 78, 22.9% male, 77.1% female, Mage = 19.73). The soccer group (N = 160, 44% male, 56.0% female, Mage = 19.47). The volleyball group (N = 52, 100% female, Mage = 19.47). Post-hoc analyses were conducted to see which sports significantly differed in symptom reporting.

Results

There were significant differences in post-concussion symptom reporting between the four sports on symptoms of “balance problems” (p = 0.018, ηp2 = 0.027), “trouble falling asleep” (p = 0.002, ηp2 = 0.040), and “sleeping less than usual” (p = 0.005, ηp2 = 0.035). Post-hoc analysis revealed that volleyball players had significantly higher reports of balance problems when compared to basketball players. Cheerleaders had significantly higher reports of “trouble falling asleep” than basketball, soccer, and volleyball players. Cheerleaders had significantly higher reports of “sleeping less than usual” when compared to basketball and soccer players following a concussion.

Discussion

The study revealed that concussion symptoms vary depending on the sport, likely due to differences in mechanics, collision frequency, and protective measures. This emphasizes the need for customized concussion management for athletes in different sports to enhance safety and well-being..