bluuebunny/crossref_metadata_2025 huggingface dataset:
4 Advancing the science of recruitment and retention in ADRD clinical research among Hispanics/Latinos
Authors: Diaz-Santos Mirella
Published: December 2023

Objective:

Inequity in Alzheimer’s disease and related dementias (ADRD) clinical research is severely hindering our progress towards a cure for all, while inflating national costs. ADRD alone is currently costing United States 321 billion dollars in 2022, projected to increase to 1 trillion by 2050. Alzheimer’s disease disproportionately impacts Black, Hispanic, Asian or Native Americans. Yet, ADRD clinical research to date has not included equitable number of participants from communities of color to be representative of the U.S. population. Hispanic/Latinos currently represent 1% of ADRD clinical trials’ samples despite representing 18% of the US population.

Participants and Methods:

In our previous outreach and recruitment study with the Human Connectome Project - Aging, we attained a 11.35% recruitment success rate of Hispanics/Latinos living in Los Angeles County Districts. We implemented a comprehensive Spanish-English bilingual, multi-method, multi-setting community-academic engagement, outreach, and recruitment protocol with a focus on brain health literary and ADRD biomarker research literacy.

Results:

Whereas community educational engagement and outreach was the most efficient and highest interest turn-out recruitment strategy, 61% of engaged and interested Hispanic/Latinos (50 years old and older) were automatically excluded during the telephone screening due to English-language proficiency/fluency. Highest enrollment success rate was from UCLA mailing list, clinical registries, and referrals. Hispanics/Latinos successfully recruited were bilingual or multilingual, 83% identified white as their racial background, 85% attained higher education, and 70% resided in middle-to-high income levels areas.

Conclusions:

Our results captured institutional barriers leading to a recruitment bias towards affluent Hispanics/Latinos with access to healthcare systems. Our applied science of recruitment and retention requires significant improvements in study design and methodology, tailored and targeted to communities’ socio-ecological context. It also requires the extrapolation of generalizable theoretically informed mechanisms of successful engagement, recruitment, and retention strategies for replication and/or modification in other settings/locations, and countries.
15 The Role of Race and Adverse Childhood Experiences on Predicting Cognitive Ability on the Montreal Cognitive Assessment (MoCA).
Authors: Koralewski Veronica , Phillips Matthew S. , Arora Ayesha , Song Woojin , Pliskin Neil , Soble Jason R. , Resch Zachary J. , Jennette Kyle
Published: December 2023

Objective:

Awareness of risk factors associated with any form of impairment is critical for formulating optimal prevention and treatment planning. Millions worldwide suffer from some form of cognitive impairment, with the highest rates amongst Black and Hispanic populations. The latter have also been found to achieve lower scores on standardized neurocognitive testing than other racial/ethnic groups. Understanding the socio-demographic risk factors that lead to this discrepancy in neurocognitive functioning across racial groups is crucial. Adverse childhood experiences (ACEs), are one aspect of social determinants of health. ACES have been linked to a greater risk of future memory impairment, such as dementia. Moreover, higher instances of ACEs have been found amongst racial minorities. Considering the current literature, the purpose of this exploratory research is to better understand how social determinants, more specifically, ACEs, may play a role in the development of cognitive impairment.

Participants and Methods:

This cross-sectional study included data from an urban, public Midwestern academic medical center. There was a total of 64 adult clinical patients that were referred for a neuropsychological evaluation. All patients were administered a standardized neurocognitive battery that included the Montreal Cognitive Assessment (MoCA) as well as a 10-item ACE questionnaire, which measures levels of adverse childhood experiences. The sample was 73% Black and 27% White. The average age was 66 (SD=8.6) and average education was 12.6 years (SD=3.4). A two-way ANOVA was conducted to evaluate the interaction of racial identity (White; Black) and ACE score on MoCA total score. An ACE score >4 was categorized as “high”; ACE <4 was categorized as “low.”

Results:

There was not a significant interaction of race and ACE group on MoCA score (p=.929) nor a significant main effect of ACE score (p=.541). Interestingly, there was a significant main effect of Race on MoCA (p=.029). White patients had an average MoCA score of 21.82 (sd=4.77). Black patients had an average MoCA score of 17.54 (sd=5.91).

Conclusions:

Overall, Black patients demonstrated statistically lower scores on the MoCA than White patients. There was no significant difference on MoCA score between races when also accounting for ACE scores. Given this study’s findings, one’s level of adverse childhood experiences does not appear to impact one’s cognitive ability later in life. There is a significant difference in cognitive ability between races, specifically Black and White people, which suggests there may be social determinants other than childhood experiences to be explored that influence cognitive impairment.
25 Delayed Cerebrovascular Response in Parkinson's Disease
Authors: Ryman Sephira G. , Nitschke Stephanie , Shaff Nicholas , Julio Kayla , Wertz Christopher , Mayer Andrew R. , Vakhtin Andrei A. , Cedeno Gerson Suarez , Deligtisch Amanda , Richardson Sarah Pirio
Published: December 2023

Objective:

Cardiovascular risk factors and white matter hyperintensities predict the progression and severity of cognitive symptoms in PD. While controversial, emerging evidence suggests that cerebrovascular dysfunction is an etiological driver of protein aggregation in neurodegenerative conditions, highlighting a need to understand how cerebrovascular function impacts cognitive function in PD. MRI cerebrovascular reactivity (CVR) paradigms provide an opportunity to measure the ability of the cerebral vessels to dilate or constrict in response to challenges. The current study evaluates whether whole brain CVR measures, degree of response (fit) and delay differ in PD with normal cognition (PD-NC) and PD with mild cognitive impairment (PD-MCI) relative to healthy controls (HC). Additionally, we evaluate if these metrics are associated with cognitive performance.

Participants and Methods:

8 PD-NC, 11 PD-MCI and 11 age and sex-matched healthy controls (HC) participated in the study. PD participants were diagnosed with MCI based on the Movement Disorders Society Task force, Level II assessment (comprehensive assessment). Participants were asked to inhale gas enriched in CO2 to elicit a vasodilatory response while undergoing bold oxygen level-dependent magnetic resonance image (MRI). Whole brain fit to an end-tidal CO2 regressor and delay were used to quantify CVR in each participant. An analysis of covariance (ANCOVA) was used to evaluate group differences between HC, PD-NC, and PD-MCI in the whole brain fit and delay CVR measures accounting for age, sex, and education. Multiple regressions were conducted for each cognitive variable with whole brain fit and delay as the dependent variables adjusting for age, sex, and education.

Results:

A significant main effect of group was observed for whole brain CVR latency (F(2, 23) = 4.227; p = 0.027). Post hoc tests were not significant, though indicated a trend that PD-NC (18.14 ±1.94) and PD-MCI (18.15 ± 1.55) patients exhibited longer delays relative to HC (15.84 ± 2.37). Regression results indicated limited relationships between CVR measures and cognitive functioning.

Conclusions:

PD patients (PD-NC and PD-MCI) exhibited longer CVR delays relative to HC, suggesting a delayed vasodilatory response in PD. Examination of the association between CVR metrics and cognition were not significant, though these results should be interpreted with caution given the small sample size.
31 Finding the Link Between Inflammatory Biomarkers and Cognitive Functioning in People with Multiple Sclerosis
Authors: Ward Katherine , Collette Christopher , Norling Amani M. , Freeman Hyun , Myers Terina , Bashir Khurram , Lazar Ronald M. , Lazar Ronald M. , Gerstenecker Adam
Published: December 2023

Objective:

To investigate the relationship between systematic inflammatory biomarkers and cognition in patients with Multiple Sclerosis (MS).

Participants and Methods:

We recruited 36 patients diagnosed with MS (31 with relapsing-remitting and 5 with progressive) who presented for treatment at the University of Alabama at Birmingham (UAB). Patients underwent a comprehensive neuropsychological battery, and serum blood samples were collected. Cognitive data was divided into an overall Cognitive Composite score and seven cognitive domains (i.e., Attention, Verbal Memory, Visual Memory, Visuospatial Ability, Language, Processing Speed, and Executive Function) using z-score averages. Pearson's product-moment correlations were conducted to determine the relationship between cognitive performance and 14 inflammatory biomarkers specifically chosen for their potential role in MS.

Results:

Granulocyte Colony Stimulating Factor (G-CSF) was significantly correlated with Executive Function (r= -.355; p=.039) and Processing Speed (r= -.528; p= .001) scores. Additionally, Interleukin-10 (IL-10) was significantly correlated with Visual Memory (r= -.346; p= .041) scores. Finally, Tumor Necrosis Factor (TNF-a) was significantly correlated with Visual Memory (r= -.347; p= .041).

Conclusions:

Studies investigating associations between inflammation and cognition in MS are lacking. In our sample of persons with Multiple Sclerosis, G-CSF biomarkers were negatively correlated with Executive Function as well as Processing Speed. In addition, IL-10 and TNF-a biomarkers were negatively correlated with Visual Memory scores. These findings in a representative sample of patients with MS highlight the need for further research exploring the relationship between systematic inflammatory biomarkers and cognition in MS.
50 Effects of Cerebrovascular Risk Factors and Alzheimer’s Disease Pathology on Executive Function and Memory Changes: Analysis of the National Alzheimer’s Coordinating Center Cohort
Authors: Chatterjee Ankita , Lee Shannon , Diaz Valentina , Casaletto Kaitlin B , Staffaroni Adam M , Kramer Joel H
Published: December 2023

Objective:

A common assumption in clinical neuropsychology is that cerebrovascular risk is adversely associated with executive function, while Alzheimer’s disease (AD) primarily targets episodic memory. The goal of the present study was to determine the cross-sectional and longitudinal validity of these assumptions using validated markers of cerebrovascular and AD burden.

Participants and Methods:

19271 longitudinally-followed participants from the National Alzheimer Coordinating Center (NACC) database (Mean age= 72.25; SD age= 10.42; 58% women; 51.6% CDR= 0, 33.7% CDR= 0.5, 14.7% CDR> 1) were included. Cognitive outcomes were a composite memory score and an executive function composite score (UDS3-EF; Staffaroni et al., 2020). Baseline presence of cerebrovascular disease was indexed by the presence of moderate to severe white matter hyperintensities or lacunar infarct on brain MRI (yes/no), while baseline AD pathology was indexed by the presence of a positive amyloid PET scan or elevated CSF AD biomarkers (yes/no). We used linear mixed effect models to assess the effects of baseline cerebrovascular disease, baseline AD pathology, and their interactions with time in study (years post baseline) controlling for baseline age, sex, education, and baseline MoCA score.

Results:

Baseline cerebrovascular disease was significantly associated with a lower intercept on executive functioning (between-person effect) (p < -0.001, 95% CI -0.37, -0.14) but not memory, while presence of AD biomarkers was associated with a lower memory intercept (p < -0.001, 95% CI -0.52, -0.39) but not executive function. However, only presence of AD pathology at baseline was associated with faster longitudinal decline on both memory and executive functioning over time. Baseline cerebrovascular disease did not independently relate to rate of cognitive decline.

Conclusions:

Consistent with widely held assumptions, our between-person analyses showed that MRI evidence of cerebrovascular disease was associated with worse executive functioning but not memory, while biomarker evidence of AD pathology was associated with worse memory but not executive function. Longitudinally, however, AD is the primary driver of decline in both executive and memory function. These results extend our understanding of how pathology impacts cognition in aging cohorts and highlight the importance of using longitudinal models.
58 Parent Ratings of Internalizing and Externalizing Behaviors in Children with NF1 Across Childhood: A Longitudinal Investigation
Authors: Pardej Sara K , Lee Kristin M , Klein-Tasman Bonita P
Published: December 2023

Objective:

The purpose of the present study is to characterize the trajectory of internalizing and externalizing behaviors in children with NF1 longitudinally from the early childhood period to the school age period on a broad psychosocial norm-referenced measure using linear mixed model growth curves.

Participants and Methods:

Children with NF1 (n=28) were seen at least once between the ages of 3-8 years old and then again between the ages of 9-13 years old. Parents completed the Behavior Assessment System for Children (BASC) Second Edition; the version of the BASC administered depended on age (i.e., preschool form or child form). Linear mixed model growth curve analyses were used to examine the developmental trajectories of children with NF1 on the following scales, which were selected due to findings in the literature: Externalizing Problems, Internalizing Problems, Hyperactivity, Anxiety, Depression, Attention, and Executive Function. T-scores (M=50, SD=10) were used. Higher scores indicate more challenges.

Results:

By using loess lines to qualitatively describe the patterns of ratings across time, it is evident that most scales (Externalizing Problems, Internalizing Problems, Hyperactivity, Attention Problems, Executive Function) demonstrated curvilinear trajectory patterns, with scores peaking in the 8-10-year-old range, then decreasing again. However, there was no statistically significant effect of age on any of the scales. Notably, trajectories largely included standard scores within the normative range (T-scores between 45-55).

Conclusions:

Overall, the models also suggest that most children with NF1 are within the average range of functioning on all scales examined across the childhood period. Furthermore, with the exception of the Depression and Anxiety scales, ratings tend to peak around the 8-10-year period, and then decrease into early adolescence. Thus, when working with patients with NF1, it may be the case that clinicians note relative increases in challenges across these domains in late childhood, though these challenges may decrease over time during this age range. Linear growth curve modeling identified that the developmental trajectories of internalizing and externalizing behaviors of children with NF1, as rated by parents, remain stable across the childhood period. Importantly, low power may have contributed to the lack of observed age effects. Longitudinal research would be beneficial to capture patterns that may emerge in adolescence or adulthood.
3 Associations Between Exercise Type, Fluid Intelligence, and Processing Speed in the Oldest-Old
Authors: Ho Brian , Gullett Joseph , Anton Stephen , Alexander Gene , Jessup Cortney , Levin Bonnie , Rundek Tatjana , Visscher Kristina , Woods Adam , Cohen Ronald
Published: December 2023

Objective:

Exercise elicits a variety of physiological responses in the body. In the brain, exercise can modulate levels of neurotransmitters and other neurochemicals as well as sparking neurogenesis and structural changes. Downstream psychological effects of exercise include changes in mood and cognition. These changes vary depending on the type of exercise conducted (e.g., running versus strength training). While much is known about the effects of exercise in animals and adult humans, literature on the oldest-old (>= 85 years old) is sparse. The present cross-sectional study explores the relationship between exercise and cognition in the oldest-old.

Participants and Methods:

The final sample includes 194 cognitively healthy participants (106 females, MoCA mean score = 24.75) aged 85 to 99 years old (mean = 88.48). Each participant completed the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire and a cognitive battery comprising of the NIH Toolbox, digit coding, symbol search, verbal fluency, and Stroop task. Three groups (sedentary, cardio, and cardio plus strength training) were derived from responses on CHAMPS.

Results:

The cardio plus strength training group performed significantly better on the cognitive measures compared to the sedentary group. For two measures, digit coding and symbol search, the cardio plus strength training group also performed significantly better than the cardio group. Cardio group did not significantly differ from the sedentary group on the cognitive measures. All at p < 0.05 and adjusted for multiple comparisons.

Conclusions:

Our findings suggest exercise in the oldest-old is linked with higher fluid intelligence and better performance on cognitive measures of processing speed and that there may be an additive effect of exercise types on cognition.
5 Large-Scale Network Connectivity and Cognitive Function after Exercise Training in Older Adults
Authors: Smith J. Carson , Nielson Kristy A. , Won Junyeon
Published: December 2023

Objective:

Despite growing evidence regarding the association between exercise training (ET) and functional brain connectivity, little is known about the effects of ET on within- and between-network functional connectivity (FC) of core brain networks. We investigated the effects of ET on within- and between-network functional connectivity of the default mode network (DMN), frontoparietal network (FPN), and salience network (SAL) in older adults with intact cognition (CN) and older adults diagnosed with mild cognitive impairment (MCI). We further examined whether the ET-induced changes in FC were associated with changes in cognitive performance.

Participants and Methods:

33 older adults (78.0±7.0 years; 16 MCI and 17 CN) participated in the present study. Before and after a 12-week walking ET intervention, participants underwent cardiorespiratory fitness tests, the Controlled Oral Word Association Test (COWAT), the Rey Auditory Verbal Learning test (RAVLT), a narrative memory test (logical memory; LM), and a resting-state fMRI scan. We examined the within- and between-network connectivity of the DMN, FPN, and SAL before and after ET. We also used linear regression to examine associations between ET-related changes in the within- and between-network connectivity and cognitive function.

Results:

There were significant improvements in VO2peak, COWAT, RAVLT, and LM after ET across participants. Significant increases in within-network connectivity of the DMN and SAL were observed in response to ET across participants. FC between the DMN-FPN, DMN-SAL, and FPN-SAL were also increased after ET. Moreover, greater SAL within connectivity and FPN-SAL between connectivity were associated with enhanced LM immediate recall performance after ET. There were no significant interactions between Time (before vs after ET) and Group (CN vs MCI) for network connectivity or cognitive function.

Conclusions:

Our findings suggest that increased within- and between-network connectivity following 12-weeks of walking exercise may subserve improvements in memory performance in older individuals with intact cognition and in those diagnosed with MCI.
23 The Wandering Mind: Variability in Mindfulness is Associated with Improved Aspects of Executive Functioning.
Authors: Campbell Ivan A , Ikonomou Vasilios C , Myers Melissa A , Hawley Nanako A , Pizer Jasmin H , Wagaman Bailey , Hill Benjamin D
Published: December 2023

Objective:

Research evaluating mindfulness and cognition has produced mixed results. However, variability in mindfulness has not been previously evaluated as a predictor of cognitive ability. This study evaluated the relation between intra-individual variability (IIV) in mindfulness and cognitive performance.

Participants and Methods:

274 university participants (M=19 years old, SD=1.5; 72.6% female, 67.2% White, 25.6% African American, 3.3% Asian American, 1.1% Hispanic American) completed the Five Facet Mindfulness Questionnaire (FFMQ) and the CNS Vital Signs computerized test battery. IIV was computed from the FFMQ facet T-scores. Additionally, high and low cognitive performance groups were formed from the top and bottom 16% of the sample using the neurocognition index (NCI) score from CNS Vital Signs (N=52 high NCI performance and N=46 low NCI performance).

Results:

Pearson r correlations were used to evaluate the relation between mindfulness IIV and CNS Vital Signs domains. Mindfulness IIV was negatively associated with performance on the domains of psychomotor speed [r=-.18; p=.003], composite memory [r=-.14; p=.023] and verbal memory [r=-.15; p=.015]. For the high NCI group, IIV mindfulness was positively associated with cognitive flexibility [r=.31; p=.024], executive functioning [r=.33; p=.016] and was negatively related to visual memory [r=-.28; p=.043]. For the low NCI group, IIV mindfulness was negatively related to psychomotor speed [r=-.49; p<.001], composite memory [r=-.32; p=.033] and verbal memory [r=-.31; p=.038]. There was no relation found for individual FFMQ facet scores and CNS Vital Sign domains.

Conclusions:

Increased consistency in self-reported mindfulness (lower IIV) was associated with greater processing speed and memory performance in the overall sample. However, the relation been mindfulness IIV and cognitive performance changed greatly in high NCI performers compared to low NCI performers. The low NCI group may be a proxy for poor effort which would explain why more variable self-reported mindfulness was associated with worse performance for processing speed and memory and this could be driving the results for the overall sample. However, our findings for the high NCI performance group are unique and suggest an association between increased variability in mindfulness facets and improved cognitive flexibility and executive functioning. Further study of mindfulness variability and aspects of executive functioning is warranted.
74 Embedded Performance Validity Utilizing the WISC-V Figure Weights Subtest
Authors: Butt Sakina , Sellers Austin , Ghazarian Sharon , Katzenstein Jennifer
Published: December 2023

Objective:

This study aimed to explore the possibility of using the Figure Weights subtest of the Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V) as an embedded validity test (EVT).

Participants and Methods:

We conducted a retrospective cohort study of patients seen in the Johns Hopkins All Children’s Hospital (JHACH) Neuropsychology program between 2015 and 2019. Patient age ranged from 6-15 years (median age 11 years). All patients were administered the WISC-V as a portion of their neuropsychological evaluation. The sample included 75 patients who were generally male (63%), White (77%), English dominant (97%), and right-handed (81%).

Results:

Effort determination based on RDS identified more patients as having invalid effort. Clinicians identified only 7% of patients with invalid effort; whereas, 16% of patients with invalid effort were identified using the WISC-V RDS. Although patients having valid effort generally performed better on all WISC-V subtests, no significant differences between groups were found. Over 90% of patients were able to get items 1-10 correct on the WISC-V Figure Weights subtest regardless of their effort determination. WISC-V Figure Weights item analysis showed participants in the invalid group sometimes answered more difficult questions correctly while failing easier items which supports inconsistent effort. Further statistical analyses, including discriminant validity tests, were unable to be completed given the study was underpowered due to significant disparity between effort groups.

Conclusions:

This study shows support for WISC-V Figure Weights subtest items 1-10 as an embedded EVT given these items were sufficiently easy to pass regardless of whether participant gave valid or invalid effort. As this is an exploratory study, results will need to be replicated in other pediatric samples. Additionally, the discriminant ability of the WISC-V Figure Weights subtest EVT will need to be further investigated.
88 Determining the Eye-Tracking Strategies Used in the Game “Spot the Missing Object (SMO)” by Simulator Malingerers, ADHD, and Non-ADHD
Authors: Aguerrevere Luis E , Gerhold Maximilian , Austin Stephen F.
Published: December 2023

Objective:

Typical evaluations of adult ADHD consist of behavior self-report rating scales, cognitive or intellectual functioning measures, and specific measures designed to measure attention. Boone (2009) suggested monitoring continuous effort is essential throughout psychological assessments. However, very few research studies have contributed to malingering literature on the ADHD population. Many studies have reported the adequate use of symptom validity tests, which assess effortful performance in ADHD evaluations (Jasinski et al., 2011; Sollman et al., 2010; Schneider et al., 2014). Because of the length of ADHD assessments, individuals are likely to become weary and tired, thus impacting their performance. This study investigates the eye movement strategies used by a clinical ADHD population, non-ADHD subjects, and malingering simulators when playing a common simple visual search task.

Participants and Methods:

A total of 153 college students participated in this study. To be placed in the ADHD group, a participant must endorse four or more symptoms on the ASRS (N = 37). To be placed in the non-ADHD, participants should have endorsed no ADHD symptoms (N = 43). Participants that did not meet the above criteria for ADHD and not-ADHD were placed in an Indeterminate group and were not included in the analysis. A total of 20 participants were instructed to fake symptoms related to ADHD during the session. A total of twelve Spot the Difference images were used as the visual picture stimuli. Sticky by Tobii Pro (2020) was used for the collection of eye-movement data was utilized. Sticky by Tobii Pro is an online self-service platform that combines online survey questions with an eye-tracking webcam, allowing participants to see images from their home computers.

Results:

Results indicated on the participants classified as Malingering had a significantly Visit Count (M = 17.16; SD= 4.99) compared to the ADHD(M = 12.53; SD= 43.92) and not-ADHD groups (M =11.51; SD=3.23). Results also indicated a statistically significant Area Under the Curve (AUC) = .784; SE = .067; p -.003; 95% CI = .652-.916. Optimal cutoffs suggest a Sensitivity of 50% with a False Positive Rate of 10%.

Conclusions:

Results indicated that eye-tracking technology could help differentiate simulator malingerers from non-malingerers with ADHD. Eye-tracking research’ relates to a patchwork of fields more diverse than the study of perceptual systems. Due to their close relation to attentional mechanisms, the study’s results can provide an insight into cognitive processes related to malingering performance.
CE Workshop 12: Magnetic Resonance Spectroscopy for in vivo Assessment of Neurochemistry in Neuropsychology Research
Authors: Near Jamie
Published: December 2023

Abstract & Learning Objectives:

Magnetic resonance spectroscopy (MRS) is an imaging technique closely related to magnetic resonance imaging (MRI) that allows non-invasive measurement of tissue chemistry and metabolism in vivo. One important application of MRS is in the human brain, where few alternative methods for neurochemical/metabolic measurement are available. MRS has demonstrated clinical value in several brain conditions, including the diagnosis and staging of cancers, neurodegenerative diseases, and creatine deficiency disorder. But beyond its clinical value, MRS has tremendous potential as a research tool. In the context of neuropsychological research, MRS provides an important tool to help understand how neurochemistry and metabolism are associated with everyday cognitive functions including sensory and motor function, perception, memory, decision making, and mood. In this educational workshop, I will focus on magnetic resonance spectroscopy and its use in neuropsychology research. I will begin by introducing the basics of how MRS data are collected, processed, and analyzed I will discuss the advantages of MRS as well as its limitations. Finally, I will provide a selected summary of current literature involving the use of MRS in neuropsychological research. Upon conclusion of this course, learners will be able to:

1.

Describe how magnetic resonance spectroscopy experiments are conducted, including methods of data acquisition, processing, analysis and interpretation.

2.

List examples from recent literature of how MRS has been used in neuropsychological research.

3.

Apply and devise new experiments involving the use of MRS for neuropsychological research.
3 Towards Detecting a Pre-clinical Signature of Dementia: Accelerated Forgetting in Healthy Older Samples -Implications for Methodology, Future Ageing Studies and Early Identification of Dementia
Authors: Jansari Ashok
Published: December 2023

Objective:

Accelerated long-term forgetting (ALF) has been reported in healthy older individuals, and is a possible early marker for risk of developing Alzheimer’s disease (AD). The Verbal Associative Learning & Memory Test (VALMT; McGibbon & Jansari, 2013) addresses methodological weaknesses in existing clinical tests and has detected ALF in epilepsy within an hour. We used VALMT to investigate learning and forgetting in healthy older participants.

Participants and Methods:

Older (60-69yrs) and Younger (19-31yrs) participants were compared. Using VALMT, unrelated word-pairs were learned to criterion, then cued-recall was tested at delays of 5, 30 and 55 minutes. Unique pairs were tested at each delay. Subjective memory complaints data were gathered, and the Wechsler Memory Scale Logical Memory test (WMS-LM; a standard clinical measure) was administered.

Results:

VALMT identified a significant difference in delayed recall between Younger and Older groups by 55 minutes (d = 1.32). While 'fast-learning’ Older participants scored similarly to Younger participants, 'slow-learning’ Older participants were impaired at all delays. Forgetting rates suggested degradation of memory starts during early synaptic consolidation rather than later system-level consolidation. Increased subjective memory complaints were associated with reduced VALMT scores. By contrast, WMS-LM failed to identify significant differences between any groups, and did not correlate with memory complaints.

Conclusions:

We conclude VALMT may be better able than WMS-LM to identify subtle impairments in healthy older adults within a single clinical visit, and VALMT results better reflect subjective experience. Older slow-learners forget faster and report more subjective memory complaints, which may indicate a group at risk of developing AD.
Symposium 13: Addressing Challenges in the Digital Assessment of Cognition: The Mobile Toolbox for Monitoring Cognitive Change
Authors: Nowinski Cindy
Published: December 2023

Summary Abstract:

Cognitive Impairment (CI) is estimated to affect more than 16 million people, the majority of whom are 65 and older (Centers for Disease Control and Prevention, 2011). Moreover, there are about 5.8 million Americans currently living with the most common type of dementia, Alzheimer’s Disease, which is projected to increase to 13.8 million people by 2050 (Alzheimer’s Association, 2020). Clearly, the ability to detect early indicators of and risk factors for brain disease AND differentiate these from typical cognitive aging is crucial to supporting healthy aging. To date, there are few sensitive assessment tools for detecting normal and abnormal cognitive change that can be widely deployed in diverse research designs and populations. In addition, clinicians and researchers struggle to conduct assessments with some of the most vulnerable populations because of access issues (e.g., rural communities, rare disease populations), which exacerbates healthcare disparities for these groups. Remote digital assessments can help overcome these barriers by enabling repeated testing in naturalistic conditions, reducing participant burden and expense, and increasing research accessibility for under-represented populations.

This symposium will begin with an overview of the Mobile Toolbox (MTB), an app-based assessment tool and technology platform developed to address challenges in conducting longitudinal cognitive assessments over the adult lifespan. MTB enables completely remote, self-administered assessment using participants’ own smartphones with additional capabilities for study set-up and data management and analysis. Our second presentation describes the initial evidence for the reliability and validity of the eight core Mobile Toolbox Cognitive tests, as well as associations with age in a healthy population. The third presentation will describe one site’s experience using the MTB platform in a large, remote longitudinal study. The final presentation will consider the issues involved when studies utilize both in-person and remote assessment. Using the NIH Toolbox V3 Examiner version, from which several of the MTB tests were inspired, we will review the advantages and disadvantages of including remote assessments alone and in combination with face-to-face examination. To conclude, we will summarize the state of the current research and recommendations for neuropsychologists interested in using MTB in their future work.
4 Continuum of Measurement: Reviewing the Advantages and Disadvantages of Self-Administered Remote Cognitive Tests and Their Examiner Administered Alternatives
Authors: Hook Julie , Nowinski Cindy J. , Gershon Richard
Published: December 2023

Objective:

To describe advantages and disadvantages of using digital assessments remotely and in-person to inform clinical and research practice.

Participants and Methods:

As part of a larger study,1120 adults completed a battery of remotely administered tests (Mobile Toolbox) and a subset of this sample completed examiner administered in-person testing (NIH Toolbox® Cognition Battery). Attention was given to making the sample reflective of the US 2020 Census during participant recruitment. Of the 1120 participants, the majority of the sample were female (57%) and Caucasian (72%) and had a mean age of 45 (SD = 21). In terms of education, equal percentages had high school (34%) or some college (34%).

Results:

NIH Toolbox cognitive tests of processing speed, language, executive function, attention, and episodic memory were administered via a trained examiner and correlates of these tests were self-administered remotely via a smartphone. Using examples, we will show which aspects of cognitive assessment had the best correlations between remote self-administration and face-to-face examination and which had lower correlations.

Conclusions:

Digital remote assessments can help overcome barriers by enabling repeated testing in naturalistic conditions, reducing participant burden and expense, and increasing research accessibility for populations currently under-represented. Moreover, the ubiquity of internet-connected devices vastly increases opportunities to remotely monitor other dimensions relevant to cognition using smartphone apps and wearable sensors. In addition to improving access to testing, digitally administered assessments dramatically improve some individual’s tolerance to testing with shorter tests that can be administered via computer adaptive testing (CAT). Despite these benefits, some aspects of the cognitive assessment cannot be adequately replicated remotely and thus yield lower correlations to their examiner-administered alternatives. Clinical and research implications are discussed.
13 Money versus Feedback: Comparing Reward Types and Frequency on Cognitive Fatigue
Authors: Erani Fareshte , Stoll Harrison , Patel Darshan , Schultheis Maria T , Medaglia John D
Published: December 2023

Objective:

Cognitive fatigue (CF) is a common, yet poorly understood symptom in neurological disorders (e.g., multiple sclerosis, Parkinson’s disease, stroke). Studies show that reward plays a central role in CF. For instance, introducing or increasing reward often improves task performance. It is less clear, however, how reward affects subjective (self-reported) CF (SCF). This study examined the effect of reward type (monetary or performance feedback) and frequency (infrequent or frequent) on SF.

Participants and Methods:

In an online between-subjects study, 400 participants completed a computerized cognitive switching task and were randomly grouped into one of the five possible groups based on reward condition: [1] infrequent monetary reward, [2] frequent monetary reward, [3] infrequent performancefeedback reward, [4] frequent performance feedback reward, and [5] a no-reward group. SCF was assessed using the Visual Analog Scale of Fatigue (VAS-F) during the task. Mixed effects models were used to estimate the influence of reward type and frequency on task performance and SCF.

Results:

We found that the monetary groups were significantly faster (p<.001) compared to the feedback and no-reward groups, and that the frequent group was faster (p=.05) compared to the infrequent group. Reward type and frequency did not have a significant effect on VAS-F scores. However, when we looked at each reward group, we found that the monetary-infrequent reward group was associated with a decrease in VAS-F scores on average compared to the no-reward group (p=.04).

Conclusions:

The type and frequency of reward influence aspects of task performance (response time but not accuracy). Findings suggest that money had a greater effect on response time and may decrease SCF in cognitively healthy individuals when provided infrequently. Future studies should examine how these findings translate to clinical populations. Continued work is needed to understand how and which specific behavioral reward manipulations reduce fatigue, which could eventually lead to improved assessment and our ability to target fatigue across clinical populations.
48 Associations Between Cognitive Function and Social Networks in Older Adults: Quality and not Quantity?
Authors: Timblin Holly , Brown Lily F. , Landry Madison , Mosca Caroline , MacAulay Rebecca K.
Published: December 2023

Objective:

Larger social networks are linked to better cognitive function. However, little is known about the association of cognitive function with the composition of these networks in terms of the varying levels of closeness and supportive relationships. The present study explored whether social network size at different levels was differentially associated with cognitive function in a group of community-dwelling older adults.

Participants and Methods:

119 older adults (Mage= 70.71) from the Maine Aging Behavior Learning Enrichment Study completed a neuropsychological test battery measuring language, verbal memory, visuospatial memory, working memory, executive function, and processing speed abilities. The number and closeness of participants' relationships was measured using a Hierarchical Mapping Technique based on the Social Convoy model, in which participants included the names of people in their relational network within inner (closest), middle (close), and outer concentric circles.

Results:

Correlational analyses found that social network size at the total and middle-to-outer levels were statistically associated with education and better performance on measures of language, verbal memory, visuospatial memory, and executive function. However, no relationship emerged between the size of the innermost network level and cognitive function. Furthermore, statistically significant findings did not survive adjustments for the effect of education.

Conclusions:

Broader levels of support, rather than greater intimacy, were statistically associated with better cognitive performance. Consistent with previous research, greater education was associated with larger social networks. Future research is needed to understand whether higher levels of education or other factors mediate the observed relationship.
2 Vigilant Coping Moderates the Relationship between Discrimination and Memory among Black and Latinx Adults
Authors: Dixon Camryn , Avila-Rieger Justina F. , Manly Jennifer J
Published: December 2023

Objective:

In the U.S, Black and Latinx individuals disproportionately experience daily acts of discrimination. To counteract the psychological distress, many individuals develop coping mechanisms, like vigilant coping, where behaviors are modified to attempt to prevent discriminatory experiences. Researchers have investigated how coping mechanisms moderate the relationship between discrimination and psychological stress, but not their role in the relationship between discrimination and cognitive function. Prior research has shown a link between discrimination and poor episodic memory. The current study examined vigilant coping as a potential moderator in the relationship between discrimination and memory among Black and Latinx people.

Participants and Methods:

We partnered with 1317 non-Latinx Black (n= 291) and Latinx (n= 1026) individuals who participated in the Offspring Study of Racial and Ethnic Disparities in Alzheimer's Disease. Participants were assessed in English or Spanish, according to their preference. Experiences of discrimination were measured on two scales: Major (civil rights violations) and Everyday (daily hassles), and were coded according to yearly chronicity. Vigilance was measured among people with at least one reported experience of discrimination on either scale, using a 5-item survey which was dichotomized as low and high vigilant coping. The Selective Reminding Test, a 12-item word list task with 6 learning trials and a delayed recall trial, yielded scores for total immediate recall and delayed memory. Linear regression models were used to assess if vigilance moderated the relationship between discrimination and memory, with years of education and age as covariates.

Results:

Participants ranged in age from 27 to 91, with a mean age of 56.5 (SD=11.0) years, a mean education of 12.7 (SD=3.7) years, and were 67% women. High vigilant coping was associated with more experiences of major (b = 1.7, 95% CI = 0.9,2.5) and everyday (b = 90.3, 95% CI=66.2,114.3) discrimination. Memory was not associated with reported everyday discrimination, but lower delayed recall was observed among people who reported more experiences of major discrimination (b= -0.04, 95% CI = -0.07,-0.01). This relationship was moderated by vigilance, such that among people with low vigilant coping, major experiences of discrimination predicted lower memory (b= -0.06, 95% CI = -0.12,-0.01), but the association between discrimination and memory was weakened among people with high use of vigilant coping (b= -0.02, 95% CI = -0.05,0.01).

Conclusions:

This study builds on Black researchers' work that laid the foundations for examination of stress and coping in marginalized populations. Future studies on discrimination and cognitive health should consider coping mechanisms as key aspects of pathways linking structural racism and inequalities to cognitive health among Black and Latinx individuals.
5 Meta-Analysis of Cognitive Functioning Following Non-Severe COVID-19 Infection
Authors: Austin Tara A , Hodges Cooper , Darowski Emily , Thomas Michael L , Bergsmans Rachel , Parr Sarah , Lantrip Crystal , Twamley Elizabeth W.
Published: December 2023

Objective:

To effectively diagnose and treat cognitive post-COVID-19 symptoms, it is important to understand objective cognitive difficulties across the range of acute COVID-19 severity. The aim of this meta-analysis is to describe objective neuropsychological test performance in individuals with non-severe (mild/moderate) COVID-19 cases in the post-acute stage of infection (>28 days after initial infection).

Participants and Methods:

This meta-analysis was pre-registered with Prospero (CRD42021293124) and utilized the PRISMA reporting guidelines, with screening conducted by at least two independent reviewers for all aspects of the screening and data extraction process. Inclusion criteria were established before the article search and were as follows: (1) Studies using adult participants with a probable or formal and documented diagnosis of COVID-19 in the post-acute stage of infection; (2) Studies comparing cognitive functioning using objective neuropsychological tests in one or more COVID-19 groups and a comparison group, or one group designs using tests with normative data; (3) Asymptomatic, mild, or moderate cases of COVID-19. Twenty-seven articles (n=18,202) with three types of study designs and three articles with additional longitudinal data met our full criteria.

Results:

Individuals with non-severe initial COVID-19 infection demonstrated worse cognitive performance compared to healthy comparison participants (d=-0.412 [95% CI, -0.718, -0.176)], p=0.001). We used metaregression to examine the relationship between both average age of the sample and time since initial COVID-19 infection (as covariates in two independent models) and effect size in studies with comparison groups. There was no significant effect for age (b=-0.027 [95% CI (0.091, 0.038)], p=0.42). There was a significant effect for time since diagnosis, with a small improvement in cognitive performance for every day following initial acute COVID-19 infection (b=0.011 [95% CI (0.0039, 0.0174)], p=0.002). However, those with mild (non-hospitalized) initial COVID-19 infections performed better than did those who were hospitalized for initial COVID-19 infections (d=0.253 [95% CI (0.372, 0.134)], p<0.001). For studies that used normative data comparisons, there was a small, non-significant effect compared to normative data (d=-0.165 [95% CI (-0.333, 0.003)], p=0.055).

Conclusions:

Individuals who have recovered from non-severe cases of COVID-19 may be at risk for cognitive decline or impairment and may benefit from cognitive health interventions.