bluuebunny/crossref_metadata_2025 huggingface dataset:
B-37 Examining Self-Reported Depressive Symptoms: A SPECT Exploratory Analysis
Authors: Horne K , Gilmore M , Datoc A , Trinidad B , Golden C , Amen D , Willeumier K , Taylor D
Published: August 2019

Objective

To examine regional cerebral blood flow (rCBF) differences between those with self-reported high and low levels of depressive symptoms.

Method

Participants were selected from a de-identified archival SPECT database. Depressive symptoms were determined by self-reported factors related to depression which included eight questions rated on a six point Likert scale. Groups were separated into highest and lowest 20% of ratings on this scale. Low reported depressive symptoms group (n = 2453,Mage = 42.85,SD = 18.35,male = 64%,Caucasian = 67%); high reported depressive symptoms group consisted (n = 2673,Mage = 38.52,SD = 13.44,male = 58%,Caucasian = 70%). Differences between groups were assessed across 17 brain regions at baseline.

Results

One-way ANCOVAs were conducted (p < .001) controlling for age and gender across 17 brain regions. Significant differences were found between groups in the left cerebellum (F[1,5122] = 19.396,p < .001),left frontal(F[1,5122] = 17.870,p < .001),right frontal (F[1,5122] = 22.175,p < .001),left motor sensory(F[1,5122] = 28.974,p < .001),and right motor sensory(F[1,5122] = 31.534,p < .001),such that the low depressive symptoms group exhibited higher rCBF in the left and right frontal and left and right motor sensory,whereas, the high depressive symptoms group exhibited higher rCBF in the left cerebellum.

Conclusion

Results indicate increased self-reported depressive symptomatology may be associated with decreased frontal lobe. The motor sensory region can result in deficits involving encoding or motor output showing slower motor/sensory processing in those with increased self-reported depressive symptoms. Research has shown increased activity in the cerebellum during sadness which may explain the higher rCBF in the depressed group. These findings demonstrate that neurological differences exist between varying degrees of self-reported depressive symptom severity. As a result, SPECT may be a useful objective measure to monitor and assess self-reported depressive severity throughout the course of treatment.
B-38 Gamified Mobile Cognitive Tests: Preliminary Feasibility and Acceptability in Persons with Bipolar Disorder
Authors: Filip T , Kamarsu S , Lomas D , Eyler L , Depp C , Moore R
Published: August 2019

Objective

Current measurements of cognitive functioning are time-consuming and costly, often done as point-in-time assessments. We examined the feasibility and acceptability of six newly developed smartphone-based mobile cognitive tests (MCTs), completed in the real-world, among persons with bipolar disorder (BD) and healthy controls (HC).

Methods

Thirteen community-dwelling participants (seven BD and six HC), aged 18-65, completed in-person neurobehavioral assessments at baseline and our MCTs three times daily for the following 14 days. The MCTs measure cognition in the following domains: reaction time, executive functions, attention, processing speed, working memory, and learning and memory. Our protocol delivered 1-2 MCTs per session, and each test was only administered once daily. Timing of the MCTs was adjusted according to individual sleep/wake schedules.

Results

MCT adherence was, on average, high (82.38%). The two groups did not differ in terms of adherence (p = 0.45, 95% CI = -29.51, 13.96) or average completion time (5.21 mins, SD = 1.54 min per each assessment period; t(11) = 1.12, p = .29, 95% CI = -0.91, 2.81). There was no relationship between age and adherence (r = .296, p = .326). Acceptability was measured at follow-up via a Likert-scale rating from 0 = not at all to 4 = very much; mean likeability was high (M = 3.0, SD = 1.28). Most participants noted a high willingness to complete additional MCT testing in the future.

Conclusion

Our preliminary findings indicate mobile cognitive testing is feasible and accepted among bipolar disorder and comparison participants. The implications of using smartphone-based MCTs are far reaching, including increased visibility of cognitive changes over time as well as examining real-time temporal relationships between cognition and other lifestyle and environmental factors.
B-43 Adolescent Recovery Following TBI: Moderators of Change Over Time
Authors: Lima E , Ashwal S , Nichols J , Pivonka-Jones J
Published: August 2019

Objective

The study aimed to assess (1) whether the severity of a TBI affects performance on a measure of memory, and (2) whether FSIQ, VIQ, and PIQ moderate recovery following TBI, over time, after controlling for severity of injury.

Method

TBI patients (n = 60) were recruited from admissions to the Loma Linda University Children’s Hospital (LLUCH). Indicators of memory and learning were assessed with the CMS for all the children (ages 6 to 16), while overall cognitive abilities were assessed with the WASI-II. These data are a component of a larger neuropsychology assessment battery collected at 3 and 12 months post-injury.

Results

Simple Linear Regression was conducted in SPSS. Results indicated that severity of injury explained a significant amount of the variance in participant’s performance on overall memory at the initial evaluation (R2 = .154). As severity of injury increased by one-point, general memory declined by .392 points, 95%CI [.820, 3.233] (p < .001). Three moderation analyses using model one of the PROCESS macro for SPSS were conducted to assess whether FSIQ, VIQ, or PIQ moderated recovery from TBI over time. We controlled for the severity of injury. FSIQ, VIQ, and PIQ did not significantly moderate verbal, nonverbal, or general memory recovery of moderate-to-severe TBI over time (ps > .05).

Conclusions

Results of the study suggest that, after controlling for severity of injury, FSIQ, VIQ, and PIQ did not significantly moderate recovery following a TBI. Given that research suggests that higher premorbid IQ is associated with more favorable outcomes, further investigation is warranted.
B-44 An Examination of Balance Measurements in Predicting Post-Concussion Neurocognitive Dysfunction
Authors: DaCosta A , Crane A , Fasciana M , LoGalbo A
Published: August 2019

Objective

Previous research indicates that athletes experiencing concussions demonstrate acute balance deficits (Guskiewicz, 2011). Although it is hypothesized that balance performance is related to neurocognitive function in athletes experiencing a concussion (Guskiewicz, Ross, & Marshall, 2001; Broglio, Sosnoff, Ferrara, 2009), limited research exists regarding the clinical utility of baseline measures.

Method

68 collegiate athletes (ages 18-23; M = 19.62, SD = 1.44) were evaluated using the Balance error scoring system (BESS) and ImPACT at baseline and post-concussion. Multiple linear regressions were used to determine how BESS performance change across evaluations predicted post-concussion neurocognitive dysfunction compared to post-concussion performance alone.

Results

BESS performance changes from baseline to post-concussion significantly predicted post-concussion Verbal Memory (R² = .06, p = .05), Visual Memory (R² = .135, p = .002), Visual-Motor Speed (R² = .146, p = .001), Reaction Time (R² = .156, p = .001), and Total Symptom Scores (R² = .112, p = .005); while post-concussion BESS scores predicted Visual Memory (R² = .138, p = .002), Visual-Motor Speed (R² = .137, p = .002), and Reaction Time (R² = .145, p = .001). Therefore, assessing change in BESS performance is a more comprehensive predictor of neurocognitive dysfunction than solely post-concussion BESS performance.

Conclusions

Changes in BESS performance from baseline to post-concussion was found to be a more comprehensive predictor of neurocognitive dysfunction than post-concussion BESS scores alone. Therefore, our results support the clinical utility of evaluating balance at pre-participation to better understand neurocognitive risk factors.
B-45 Base Rates of Low Scores on a Traditional Battery of Neuropsychological Tests in Soldiers with and without Acute mTBI
Authors: Ivins B , Arrieux J , Cole W , Schwab K
Published: August 2019

Objective

It is not uncommon for healthy individuals to have one or more low scores on a battery of cognitive tests. The number of scores produced by the battery by itself can affect the probability of having low scores. The purpose of this study is to examine the rates of low scores on a battery of commonly used neuropsychological tests in soldiers with and without acute mTBI.

Methods

Data from 246 healthy soldiers and 177 soldiers evaluated within seven days of sustaining a mTBI and who had complete and valid data were used in this analysis. All soldiers completed the TOPF, WAIS-IV, CVLT-II, RCFT, DKEFS, and CPT-II. The CARB was used as a measure of effort. For each group, we determined the proportions of soldiers who had various numbers of scores that were 1.0 or more, 1.5 or more, 2.0 or more standard deviations below the normative means for each score. We used prevalence ratios to compare the proportions with low scores in each group.

Results

Low scores were common in both groups (93.1% and 96.0% of controls and mTBI cases, respectively, had at least one score 1.0+ SDs below norm, 57.7% and 79.1% had at least one score 1.5+ SDs below norm, while 30.5% and 48.0% had at least score 2.0+ SDs below norm). Low scores were more common in the mTBI group.

Conclusion

Examining rates of low scores can help identify clinically meaningful performance decrements across an entire battery when large numbers of scores are available.
B-46 Caring for a Service Member or Veteran following Traumatic Brain Injury Influences Caregiver Mental Health.
Authors: Brickell T , French L , Lippa S , Lange R
Published: August 2019

Objective

To examine factors related to poor mental health in a sample of caregivers assisting service members/veterans (SMV) following a traumatic brain injury (TBI).

Methods

Caregivers (N = 201, 96.0% female; 86.1% spouse; Age: M = 39.2 years, SD = 10.2) of SMVs following a mild, moderate, severe, or penetrating TBI were recruited from Walter Reed National Military Medical Center (Maryland) and community outreach to participate in the Defense and Veterans Brain Injury Center 15-Year Longitudinal TBI Study (Sec721 NDAA FY2007). Caregivers completed the SF-36v2 Health Survey (SF-36v2), Caregiver Appraisal Scale (CAS), Mayo-Portland Adaptability Inventory-4 (MPAI-4), and Caregiver Questionnaire. The sample was divided into two mental health groups: Poor (n = 108) and Good Mental Health (n = 93).

Results

A higher proportion of caregivers in the Poor Mental Health group reported worse functioning on the SF-36v2 and CAS scales (d = .43 to d = 2.09), except CAS Ideology; helping with symptoms of depression, post-traumatic stress disorder (PTSD), and physical expressions of irritability, anger, or aggression (p’s < .01); less time for themselves (d = .42); more unmet needs (d = .87); an impact on employment (p = .00); and burdensome out-of-pocket caregiving expenses (p = .04). A higher proportion of SMVs of caregivers in the Poor Mental Health group had a mild TBI; worse scores on the MPAI-4 scales (d = .29 to d = .64); PTSD, depression, or other anxiety; received mental health and physical rehabilitation treatment; and did not have significant hospitalization post-injury (p = .04 to p = < .001).

Conclusions

Services for caregivers helping SMVs with comorbid mental health problems are required to ensure the burden of care does not undermine the caregiver’s health and impact the SMV’s recovery and reintegration.
A-13 Sustained Attention, Impulsivity, and Tangentiality of Speech Among Young Adults and Older Adults
Authors: Helphrey J , Smith L , Rodriguez D , Rose III D , Sawyer J , Edzards S , Fierro L , Moore J , Parsons T , Barnett M
Published: August 2019

Objective

Previous research has linked off-topic verbosity (OTV) among older adults with lower performance on neuropsychological tests tapping attention and executive functioning. However, most of this research has utilized relatively brief neurocognitive measures. Continuous performance tests (CPTs) measure sustained attention and impulsivity. The purpose of this study was to investigate relationships between sustained attention, impulsivity, and tangentiality of speech among young adults and older adults.

Method

Young adult college students (age 18-29; n= 61) and healthy, community-dwelling older adults (age 60-99; n = 81) were administered the Conners’ Continuous Performance Test – 3 and provided a sample of speech (one episodic memory and one procedural memory). These speech samples were transcribed and rated for tangentiality by three independent reviewers.

Results

Among all participants, greater tangentiality of speech was associated with omission errors (r = .22, p = .01) but not with commission errors. This same pattern was found among older adults: omission errors (r = .23, p = .04) were associated with greater tangentiality but commission errors were not. Among young adults, these relationships were not statistically significant.

Conclusions

Results suggest that tangentiality of speech is associated with inattentiveness but not impulsivity, and this relationship may be more marked among older adults than young adults. OTV among older adults may stem from difficulty sustaining attention over time rather than diminished capacity for inhibiting impulses.
B-48 Effects of Anxiety on Response to a Subsymptom Threshold Exercise Program for Treatment of Persistent Post-Concussive Symptoms: A Pilot Randomized Clinical Trial
Authors: Meyer J , Briskin S , Tangen C , Hoffer S , Dundr J , Brennan B , Smith P , Lissemore F , Bailey C
Published: August 2019

Objective

There is a growing literature to support the use of subsymptom threshold exercise for treatment of both acute and chronic post-concussion symptoms. The present study aimed to explore the influence of anxiety on response to exercise intervention for patients with persistent post-concussive symptoms.

Methods

Sixteen adolescents (ages 14-18) with persistent (>1 month) concussion symptoms were randomized into a light, home exercise group and a subsymptom threshold exercise group performed by PT’s (modeled after Leddy et al.,2019). Participants underwent intervention for 6 weeks and completed evaluations at Baseline, Mid-Point, and Follow-up after treatment; evaluations included State-Trait Anxiety Inventory (STAI), the Post-Concussive Scale-Revised (PCS-R), as well as additional measures of emotional functioning, balance disturbance, and neuropsychological functioning.

Results

Average PCS-R endorsement improved by 21 points from Baseline to Follow-up across treatment groups (PCS-R Total Change M = -21.29,SD = 13.54). There were meaningful Baseline differences between intervention groups in STAI state anxiety (p < .05) and STAI trait anxiety (p = 0.51); STAI variables were used as covariates in an ANOVA comparing mean PCS-R Percent Change between treatment and control groups. After removing the influence of anxiety, the intervention groups significantly differed and showed large effect (F(3,13) = 6.94,p < .05,partial eta2 = .41), with the intervention group improving (PCS-R Percent Change M = -63.3,SD = 17.4) more than the control group (PCS-R Percent Change M = -56.8,SD = 27.8).

Conclusion

Exercise intervention appears to be more effective than standard-of-care light activity in the treatment of persistent symptoms in adolescents; however, anxiety may alter response to intervention. Complimentary mental health treatment may augment response to exercise intervention and optimize concussion recovery trajectory in patients with persisting symptoms.
B-49 Family Expectations regarding Functional Disability following Moderate/Severe Traumatic Brain Injury
Authors: Fedio A , Sexton J , Dekarchuk M , Roper C , Cummings S , Thomas M , Patel N , Lebedun A , Fedio P
Published: August 2019

Objective

The present study explored self-concept and treatment motivation in individuals with traumatic brain injury (TBI) based on what their family members recalled having been told by health care professionals to expect about functional changes following brain injury.

Method

Adult family members (76% female) of nineteen individuals with moderate/severe TBI (mean age 38; 4 yrs post) were asked about expected functional changes. Patients completed the Tennessee Self-Concept Scale (TSCS:2) and Motivation for Rehabilitation Treatment Questionnaire. Patients and families completed the Neurobehavioral Functioning Inventory (NFI). Results of point biserial correlational analyses (p < .05) are reported.

Results

NFI and TSCS:2 results placed within the average range. Patients expressed stronger interest in rehabilitation when their families had been told that they might not have survived or that they would not recover to their premorbid levels (r = .43-.47). When families had not been told to expect changes, patients were more self-critical and evidenced lower personal self-concept if not warned specifically about cognitive problems (r =.44 ). When families were told not to expect recovery, patients acknowledged lower family and personal self-concept (r = .53-.64) and poorer self-satisfaction (r = .66).

Conclusions

Key findings underscore detrimental impact on TBI patients when their families did not expect functional changes during recovery. Patients expressed greater interest in rehabilitation when their families had been told they would not recover to their premorbid baseline. Results suggest that health professionals should inform families about potential physical, cognitive, and emotional changes following moderate/severe TBI; negative residua of not doing so may persist in patients for years into recovery.
B-52 Improvements in Cognitive Functioning in Inactive Professional Fighters
Authors: Bennett L , Bernick C , Ng W
Published: August 2019

Objective

Repetitive head injuries common in combat sports have been associated with increased risk for cognitive dysfunction. Interestingly, the Professional Fighter’s Brain Health Study (PFBHS) team has observed improvements in fighters’ cognitive performance following their transition to inactive fighting status. As this phenomenon was explored, it was hypothesized that fighters’ cognitive performance will initially improve following their discontinuation of fighting.

Methods

Longitudinal demographic, fighting history, and cognitive functioning data from 31 fighters who discontinued fighting during their participation in the PFBHS. Cognitive functioning was assessed via CNS Vital Signs and C3/iComet computerized batteries. Number of professional fights, as well as inactive fighting status, was determined using published professional online records. Fighters were considered inactive if they had gone two or more years without a professional match.

Results

Paired-samples t test was conducted to evaluate cognitive functioning in fighters at time 1 (actively fighting) and time 2 (inactive fighting status). When comparing cognitive function at across time points, performance on CNS Vital Signs measures of verbal memory, processing speed, psychomotor speed, and reaction time, as well as C3/iComet measures of set-shifting and complex reaction time, significantly improved at time 2 (all p’s < 0.05). Interestingly, performance did not improve across time points on a C3/iComet measure of processing speed (Trailmaking Test Part A).

Conclusions

Cognitive performance improved on most measures when fighters transitioned to inactive fighting status. Given the limited sample size, future analysis is necessary to evaluate the relationship between fighting status and cognitive performance in a larger sample size.
B-53 Inefficient Clock-Checking is Associated with Reduced Prospective Memory Performance in Veterans with Blast-Related Mild Traumatic Brain Injury
Authors: Sorg S , Walsh M , Werhane M , Holiday K , Clark A , Merritt V , Bondi M , Schiehser D , Delano-Wood L
Published: August 2019

Objective

We investigated whether clock-checking frequency during a prospective memory (PM) task differed between Veterans with reported histories of blast-related mild traumatic brain injury (mTBI) and Veteran Controls (VCs) without a history mTBI. We hypothesized that, compared to controls, the mTBI group would less frequently clock check. Additionally, we expected that reduced clock-checking would contribute to poorer time-based PM performance in the mTBI group.

Method

Twenty-seven Veterans (9 mTBI and 18 VC) with sufficient effort testing completed a structured TBI history interview, the Post-Traumatic Stress Disorder Checklist (PCL) and the Memory for Intentions Test (MIST) as a PM task. During MIST administration, examiners recorded clock-checking behavior each time a participant physically turned a digital clock to observe the current time.

Results

Compared to VCs, the mTBI group performed worse on the Time subscale of the MIST [Mean (SD) VC = 6.7 (1.1), mTBI = 5.7 (1.1), p < .05], and demonstrated significantly fewer clock-checks over the duration of the test [VC = 14.2(4.7), mTBI = 10.2 (3.4), p < .05]. Clock-checking significantly correlated with MIST Time subscale performance (r = .38, p < .05). Groups did not significantly differ in PCL scores, and PCL scores did not significantly correlate with clock-checking counts.

Conclusion

Our preliminary results are the first to show that clock-checking behavior may contribute to reduced performance on time-based PM tasks in Veterans with histories of mTBI. Specifically, our findings demonstrate that participants with mTBI employ an inefficient time monitoring strategy wherein infrequent clock checking contributes to poorer test performance. These findings suggest that strategies to improve clock checking may improve PM performance.
B-55 Performance of ImPACT Validity Indices for Athletes with Neurodevelopmental Disorders
Authors: Hussey J , Kuwabara H , Ng W , Kinsora T , Ross S , Allen D
Published: August 2019

Objective

Research demonstrates neurodevelopmental diagnoses may increase likelihood of failing scores on ImPACT embedded validity indicators that flag questionable effort. New criteria have been proposed to enhance sensitivity of these indicators although their utility in athletes with neurodevelopmental diagnosis have not been thoroughly examined. This study investigates the effect of neurodevelopmental history on frequency of invalid performance on the standard and three proposed validity indicators.

Methods

Participants included 41,214 high school athletes (Mage = 15.1; 44.2% female; Meducation = 9.1) who completed baseline ImPACT testing. Athletes included these groups: ADHD (3.7%), Learning Disability (LD; 1.5%), Autism (0.2%), ADHD+LD (0.6%), Autism+ADHD/LD (0.1%), athletes with special education history but no diagnosis reported (SpEd; 2.8%), and healthy athletes (91.1%). Odds ratios were calculated to determine differences in invalid performance by both standard and proposed cutoffs.

Results

Neurodevelopmental disorder was associated with increased invalid performance using standard and proposed cutoffs with odds ratios ranging from 1.32 to 3.25. Invalid performance differed significantly across groups for both standard and two sets of proposed criteria (chi square p < .00001). For standard cutoffs, athletes with ADHD, LD, and ADHD/LD were significantly more likely than healthy athletes to have invalid performance. This pattern remained similar across the two sets of proposed criteria.

Conclusions

Results indicate increased incidence of invalid ImPACT performance based on standard and proposed validity indicators in athletes who self-report neurodevelopmental disorders. Findings indicate current and proposed cutoffs may not accurately capture low effort for neurodevelopmental populations. Future research should examine utility of separate cutoff criteria and expanded norms for athletes with neurodevelopmental history.
B-56 Personal and Family Psychiatric Histories and Self-Report of Post-Concussive Symptoms in Concussed Children and Adolescents with Prolonged Recovery
Authors: Hassara K , Pulsipher D , Stanford L , Schneider B , Krapf E
Published: August 2019

Objective

This study seeks to examine whether personal psychiatric history (PPH) and/or family psychiatric history (FPH) are related to prolonged concussion recovery and increased post-concussive symptoms (PCs) in concussed children and adolescents. We hypothesized that individuals with PPH/FPH would endorse a greater number of and more severe PCs relative to those with concussion only or concussion with either PPH or FPH.

Methods

Data from 255 concussed 8 to 18-year-olds (median = 15.50 years, range = 10.25 years) were retrospectively examined from a clinical database excluding patients with confounding medical comorbidities. PCs (i.e., total symptom count and severity [frequency, intensity, and duration of symptoms]) were compared among four groups (concussion only [n = 80], concussion + PPH [n = 14], concussion + FPH [n = 125], and concussion + PPH/FPH [n = 36]) using a multivariate Kruskal-Wallis test and post-hoc Mann-Whitney U tests.

Results

The omnibus analysis indicated group differences for injury interval (p = 0.05) and PCs severity (p = 0.002). Post-hoc analyses indicated patients with concussion + PPH/FPH reported greater PCs severity than those with concussion only (U = 726.00, p = 0.0001, r = 0.36) and those with concussion + FPH (U = 1203.00, p = 0.003, r = 0.23). Injury interval was greater for patients with concussion + FPH than those with concussion alone (U = 3474.50, p = 0.007, r = 0.19). Other group differences were non-significant.

Conclusions

All groups reported a similar number of PCs. FPH contributes to severity of symptoms when combined with PPH. PPH alone did not significantly affect PCs severity. Findings suggest that providers should screen for both PPH and FPH at the time of concussion diagnosis. Early identification of risk factors may lead to targeted intervention, therefore reducing persistent PCs.
B-59 Prevalence of Pseudobulbar Affect Symptoms in Professional Fighters
Authors: Durant J , Bennett L , Bernick C , Miller J
Published: August 2019

Objective

Pseudobulbar Affect (PBA) is defined as dysregulation of emotional expression and is characterized by sudden, uncontrollable, laughing and/or crying that is discordant with the present mood or social context. This study sought to establish the prevalence of PBA symptoms in individuals with a high incidence of sports-related head injuries and explore the relationship between two rating scales designed to measure PBA symptoms.

Methods

Sixty-three professional fighters (age: M = 44.7, SD = 10.0; 98% male) underwent neurological and neuropsychological assessment including completion of the Pathological Laughing and Crying Scale (PLCS) and the Center for Neurologic Study – Lability Scale (CNS-LS). Diagnostic criteria for PBA were reviewed during the neurological exam to establish the prevalence of the clinical syndrome. Prevalence statistics for item endorsement on the rating scales and diagnostic status were calculated. To investigate the rate of agreement between rating scales, concordance correlation coefficient (CCC) and root mean square difference (RMSD) were calculated.

Results

Eleven percent of participants met clinical criteria for PBA diagnosis, 25% of participants endorsed clinically significant PBA symptoms on the CNS-LS (M = 10.9, SD = 4.9), and 8% endorsed significant symptoms on the PLCS (M = 3.1, SD = 6.5). The rating scales were significantly positively correlated (r = .58; p < .01), though overall agreement was low (CCC = 0.55; RMSD = 5.4).

Conclusions

This study demonstrates that the prevalence of PBA symptoms in a sample of professional fighters is not uncommon. Although both the CNS-LS and PCLS are designed to measure PBA symptoms, they appear to be measuring unique aspects of PBA that may provide complimentary, rather than redundant information.
B-63 Subacute Cognitive Sequelae of Mild Traumatic Brain Injury on the Cambridge Neuropsychological Test Automated Battery (CANTAB) and Traditional Neuropsychological Tests
Authors: Stenberg J , Karlsen R , Saksvik S , Iverson G , Karr J , Vik A , Skandsen T
Published: August 2019

Objective

This study examined cognitive functioning at approximately two weeks following mild traumatic brain injury (MTBI) and explored whether tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) revealed greater differences between patients with MTBI and controls than traditional neuropsychological tests.

Method

Patients with MTBIs (n = 177) according to the World Health Organization criteria, trauma controls with orthopedic injuries (n = 79), and community controls (n = 81) were assessed with 18 neuropsychological tests an average of 17 days post injury (SD = 3 days). The tests consisted of both traditional, well-established, paper and pencil tests (9 tests, 11 outcome measures) and tests from the CANTAB battery (9 tests, 14 outcome measures).

Results

Of the 25 outcome measures, the groups only differed significantly on the Coding subtest from the WAIS-IV battery (uncorrected Kruskal-Wallis test: p = 0.025), with lower performance in the MTBI group compared to the community control group (Cliff’s delta = -0.20). Effect sizes of the differences between patients with MTBI and community controls ranged from -0.16 to 0.01 on the CANTAB tests and -0.20 to 0.00 on the traditional tests. Effect sizes of the differences between patients with MTBI and trauma controls ranged from -0.13 to 0.06 on the CANTAB tests and -0.15 to 0.02 on the traditional tests.

Conclusions

Patients with MTBI did not have significantly lower cognitive test performance than trauma controls or community controls on a large number of tests two weeks after injury. Further, differences between patients with MTBI and controls were similar for the CANTAB battery and traditional tests.
B-64 Symptom Reporting and Cognitive Functioning in Middle School Athletes with Past Concussions
Authors: Terry D , Maxwell B , Zafonte R , Berkner P , Iverson G
Published: August 2019

Objective

We examined the association between past concussions and current preseason symptom reporting and cognitive performance in boys participating in school sports.

Method

A sample of 2,582 boys ages 11-13 completed neurocognitive testing prior to participating in a school sport, using ImPACT®, between 2009-2015. A minority reported prior concussions: 0 (n = 2,244, 86.9%), 1 (n = 261, 10.1%), and ≥2 (n = 77, 3.0%).

Results

There was a significant difference in total symptom scores across groups (Kruskall-Wallis = 10.75, p = .005). Those with ≥2 prior concussions reported more symptoms than those with 0 concussions (p = .004, Cohen’s d = 0.41). A multivariate regression examining the contribution of concussion history and developmental/health history to symptom reporting was significant [F(7, 2,267) = 16.80, p < .001]. The following were independent predictors of symptoms scores (in descending order of strength): treatment for a psychiatric condition, treatment for headaches, history of learning disability, age, and history of ADHD. Prior concussion history was not a significant independent predictor in this multivariate model. There was a very small omnibus difference in visual motor speed (ANOVA, F = 4.10, p = .02); athletes with 1 prior concussion performed worse than those with no prior concussions (Tukey p = .01; d = 0.19). There were no significant differences on the other cognitive variables.

Conclusions

Boys with two or more prior concussions reported more symptoms than those with no prior concussions, but performed similarly on cognitive testing. The strongest predictors of current symptom reporting were a prior history of treatment for mental health problems or headaches, and a personal history of learning disability.
B-66 The Effect of Bilingualism on Boston Naming Test Performance in Traumatic Brain Injury Survivors and Healthy Adults
Authors: Lopez Hernandez D , Knight J , Litvin P , Rugh-Fraser R , Bueno A , Cervantes R , Mangassarian S , Fatoorechi S , Rico M , Arzuyan AMcElwee C , Hardy D , Carranza E , Vespa P , Plurad D , Hovda D , Woo E , Fuster J , Budding D , Wright M
Published: August 2019

Objective

The Boston Naming Test (BNT) is a lexical-retrieval task. It has been documented that those with a history of traumatic brain injury (TBI) have reduced performance on the BNT. Bilingualism is also known to impact BNT performances. We examined the relationship of TBI and bilingualism/monolingualism on BNT performances.

Method

The sample (N = 95) consisted of 36 healthy controls (19 bilingual; 17 monolingual), 32 acute TBI participants (12 bilingual; 20 monolingual), and 27 chronic TBI participants (16 bilingual; 11 monolingual). Acute TBI participants were tested 6 months post-injury and chronic TBI participants were tested 12 months or more post-injury. All participants passed performance validity testing. A 3X2 ANOVA was conducted to determine the effect of TBI and bilingualism/monolingualism on BNT performance.

Results

A main effect was found for group (i.e., control, 6 month TBI, and 12 month TBI), p < .001, ηp² = .21. Pairwise comparisons revealed that acute TBI participants performed worse than the control and chronic TBI groups. A main effect for bilingualism/ monolingualism was found, p < .001, ηp² = .14; monolinguals performed better on the BNT. No interactions were found between TBI and bilingualism/monolingualism.

Conclusions

BNT performance improves overtime in TBI and the pattern of improvement post-TBI is not statistically different between bilingual/monolingual groups. Relative to monolinguals, bilingual participants demonstrated worse BNT performance.
B-67 The Effect of Bilingualism on Executive Functioning Performance in Traumatic Brain Injury Survivors and Healthy Adults
Authors: Cervantes R , Lopez Hernandez W , Knight J , Litvin P , Bueno A , Rugh-Fraser R , McElwee C , Bichlmeier A , Arzuyan A , Hardy DMangassarian S , Torres E , Fatoorechi S , Vespa P , Plurad D , Hovda D , Woo E , Fuster J , Budding D , Wright M
Published: August 2019

Objective

Traumatic brain injury (TBI) survivors often exhibit problems with executive function (EF). Language use can also impact EF test performances. We examined the effects of TBI and bilingualism/monolingualism on several EF tests.

Method

The sample (N = 94) consisted of 37 healthy controls (19 bilingual; 18 monolingual), 30 acute TBI participants (10 bilingual; 20 monolingual), and 27 chronic TBI participants (16 bilingual; 11 monolingual). Acute TBI participants were tested 6 months post-injury and chronic TBI participants were tested 12 months or more post-injury. Stroop Color-Word (SCW), Delis-Kaplan Executive Function System Letter Fluency (DKEFS-LF), Trail Making Test part B (TMT-B) and a EF global composite (EF-GC) were used to assess EF. All participants passed performance validity testing. 3X2 ANOVAs were conducted to determine the effect of TBI and bilingualism/monolingualism on EF performances.

Results

Main effects were found between groups (control and TBI groups) on SCW, p = .046, ηp² = .07, TMT-B, p = .042, ηp² = .07, and EF-GC, p = .005, ηp² = .13; the 6-month TBI group performed worse than controls on TMT-B and EF-GC. Main effects were found for bilingualism/ monolingualism on SCW, p = .012, ηp² = .07, and TMT-B, p = .034, ηp² = .05; monolingual participants performed better than bilingual participants. No significant interactions between TBI and language were found.

Conclusion

The TBI group underperformed on SCW, TMT-B, and EF-GC compared to controls; relative to monolinguals, bilinguals underperformed on the SCW and TMT-B only. In conclusion, our findings seem to suggest that monolinguals have better cognitive flexibility compared to bilinguals that result in better EF performances.
B-75 A Preliminary Investigation of Predictors of Employment and Perception of Ability to Work in Combat-Exposed Veterans
Authors: Merritt V , Jurick S , Crocker L , Keller A , Hoffman S , Jak A
Published: August 2019

Objective

The purpose of this study was twofold: (1) to evaluate whether perception of one’s ability to work (a subjective rating) predicts employment status (an objective marker of functioning) in a sample of combat-exposed Veterans, and (2) to examine predictors of employment status and perception of work ability to determine whether the same sets of variables that predict employment status also predict perception of one’s ability to work.

Method

Combat-exposed Operation Enduring Freedom/Operation Iraqi Freedom Veterans (N = 83) completed self-report questionnaires assessing demographic characteristics, combat-related experiences, and psychiatric and neurobehavioral/health-related symptoms. Veterans also underwent a comprehensive neuropsychological assessment. Primary outcomes of interest were employment status (unemployed versus employed) and Veterans’ rating of a perceived decline in work ability (yes versus no).

Results

Logistic regression analyses showed that perception of work ability significantly predicted employment status (p = .046). Moreover, psychiatric and neurobehavioral/health-related symptoms significantly predicted employment status and perception of work ability (p = .001-.017), whereas demographic characteristics (i.e., service-connection disability rating) and combat-related experiences (i.e., number of traumatic brain injuries) only predicted perception of work ability (p = .010-.029). Cognition was not significantly associated with employment status or perception of work ability (p’s > .05).

Conclusions

Altogether, these findings support the notion that perception of one’s ability to work plays an important role in employment-related outcomes in combat-exposed Veterans. Future studies using larger samples are needed to confirm these findings, but our preliminary results suggest that perception of work ability may be a particularly important treatment target in this population.
A-16 Behavior Rating Inventory of Executive Function - Preschool Version (BRIEF-P) Scores are Associated with Pre-Reading Skills in Preschoolers
Authors: Figuccio M , Falconi A , Priefer R
Published: August 2019

Objective

Executive function (EF) skills are an array of cognitive abilities that have been linked to future scholastic achievement. The Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P) is used to assess EF in young children. The aims of the current study are to assess whether males and females differ in BRIEF-P scores, and to measure the relationship between EF and pre-reading skills.

Method

11 typically developing males (M = 53.13 months, SD = 3.74) and 12 typically developing females (M = 54.71 months, SD = 3.14) participated in the study. Children completed a cognitive-linguistic battery, while parents completed the BRIEF-P. Independent sample t tests were employed to investigate differences between males and females, and Pearson correlations were employed to examine the relationship between BRIEF-P and cognitive-linguistic scores.

Results

Males scored significantly higher than females on the Blending Words subtest t(21) = 2.97, p = .007, 95% CI [5.83, 32.92]. Males and females also significantly differed in BRIEF-P scores: Shift t(21) = 6.43, p < .001, 95% CI [36.42, 71.26] and Emotional Control t(21) = 3.02, p = .006, 95% CI [11.44, 61.86]. In males, Blending Words was associated with Inhibit r = -.77, p = .005, Emotional Control r = -.75, p = .008, and Plan/Organize r = -.638, p = .035. In females, Memory for Digits subtest was associated with Inhibit r = -.632, p = .027, and Plan/Organize r = -.595, p = .041.

Conclusions

Male and female preschoolers differed in Blending Words, Shift, and Emotional Control. Interestingly, EF was associated with pre-reading measures in both males and females; however, EF measures were associated with Blending Words in males and Memory for Digits in females. This study adds to the body of research suggesting the importance of EF in early development.
B-79 Trauma through the Neuropsychologist's Eyes: A Systematic Review of Standardized Test Results after Trauma
Authors: Silveira K , Garcia-Barrera M , Smart C
Published: August 2019

Objective

Approximately 90% of adults in the United States have been exposed to trauma (Kilpatrick et al. 2013). Among clients seen for neuropsychological services, trauma may be an etiological or co-occurring factor, especially with traumatic brain injury. Understanding neuropsychological impact is essential to trauma-informed assessment, diagnosis, and rehabilitation. Prior reviews were limited to between-group statistical differences rather than clinically significant results. In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses, this review evaluated studies of standardized neuropsychological test scores among adults with trauma histories and psychopathology.

Data Selection

Terms for “neuropsychology” and “trauma” were searched within peer-reviewed empirical studies from PsycINFO, MedLine with Full Text, and Published International Literature on Traumatic Stress from 1/2013-8/2018. 2350 initial records were ultimately reduced to 21 articles, after removing duplicates and ineligible articles (e.g., no standardized neuropsychological tests or scores, baseline treatment assessments, studies where age groups were not stratified, non-clinical samples). Extracted data included demographic, neuropsychological, and clinical characteristics, and potential study biases.

Data Synthesis

Studies assessed combat trauma (n = 8), developmental trauma (n = 2), intimate partner violence and sexual assault (n = 2), accidental trauma (n = 2), refugee trauma (n = 1), and unspecified trauma (n = 6) in the context of various psychiatric conditions. Performance across neuropsychological domains ranged from low to high average, with one borderline verbal memory score.

Conclusions

Lack of clinically observable neuropsychological impairment suggests cognitive challenges are state-based, driven by intra-individual variability and the psychophysiological traumatic stress response. Client-centered rehabilitation emphasizing self-regulation is recommended. Future research can expand on assessment comprehensiveness and ecological validity.
C-04 Cognitive Status, Tau levels, and Depression in Older Adults
Authors: Jean K , Chummar S , Miller L
Published: August 2019

Objective

Worsening cognitive status has been related to depression in older adults. The purpose of this study was to examine the relation between cognitive status and depression and whether this relation was dependent upon tau levels, a biomarker for brain pathology related to Alzheimer’s disease (AD) and other dementias.

Method

This study consisted of 507 older adults with a mean age of 74. Participants were 40.9% female and 93.9% Caucasian. Neuropsychological assessments, collateral report, and clinician ratings were used to classify each participant by their cognitive status (i.e., cognitively normal (CN), early mild cognitive impairment (MCI), late MCI, or AD). Depression was based on the total score of the Geriatric Depression Scale (GDS). A hierarchical multiple regression was used to analyze the amount of variance explained in depression scores, controlling for age.

Results

There was a significant relation between cognitive status and GDS, with cognitive status explaining 2.8% of the variance (R-squared = .028, p < .001). Tau explained .6% of the variance in depression scores above and beyond what was explained by cognitive status and age (p = .089). The interaction between cognitive status and tau explained .4% of the variance in depression scores, ΔR-squared = .004, p = .160.

Conclusions

While this suggests cognitive status and depression may not be dependent upon tau levels in this sample, further research should be done to determine whether other sensitive measures of brain pathology, such as the ratio between phosphorylated tau and total tau, may be relevant in the prediction and diagnosis of depression in individuals with varying levels of cognitive status.
C-06 Differential and Dual Diagnosis of Alzheimer’s Disease and Personality Disorders: Performance on WAIS-IV Subtests
Authors: Berger R , Marker C , Burger C
Published: August 2019

Objective

Certain personality disorder (PD) diagnoses are related to the development of dementing disorders. There is a higher rate of comorbidity of PD in samples of patients with dementing disorders compared to healthy controls, which can lead to difficulties during the diagnostic process. The present study seeks to identify the neurocognitive correlates of those diagnosed with Alzheimer’s dementia (AD) compared to PD, potentially aiding in differential diagnosis.

Method

Data was collected as part of a large assessment outpatient clinical practice. The data contained 580 participants who came to the clinic with a variety of referral questions (e.g., neurological diagnosis, personality functioning, ADHD assessment). To measure cognitive functioning, participants were administered the WAIS-IV. Participants included 43 people diagnosed with AD and 18 with PD.

Results

Subtest scores for participants diagnosed with AD were lower than participants with PD. We adjusted the mean level difference using vocabulary. Using regression, we pulled out the variance associated with vocabulary as it is not susceptible to cognitive decline. Block design was significantly different for the two groups even after controlling for vocabulary (r-square = .06; p = .017). Matrix reasoning was significantly different for the two groups even after controlling for vocabulary (r-square = .09; p = .005).

Conclusions

The differential diagnosis of PD and dementing disorders is important, and thus these findings are important in beginning to understand the cognitive patterns in those with AD and PD. Past research has not controlled for intellectual functioning. However, additional research utilizing larger sample sizes and an extensive test battery is necessary.
C-09 Diastolic Blood Pressure and Executive Function in Healthy Older Adults
Authors: Staley Shumaker B , Wei Qi G , Amano S , Nolty A , Harrington M
Published: August 2019

Objective

Our aim was to investigate the effect of elevated diastolic blood pressure (DBP) within normal blood pressure range (NBPR) on an executive functioning task (Stroop C) in a cognitively healthy, high functioning, older adult population.

Method

Archival data at Huntington Medical Research Institutes provided 35 cognitively healthy, high functioning adults from 63 to 89 years of age (M = 76, SD = 7.0). The majority were female and Caucasian, and had college or higher degrees. A general linear model (GLM) regression analysis was performed to determine if the Stroop C Interference z score would be predicted by DBP NBPR when controlling for age, sex, education level, and ApoE4 genotype.

Results

The regression model for DBP NBPR on Stroop Interference z scores was significant, F(5, 29) = 1.56, p < .05, with increased DBP NBPR associated with decreased Stroop Interference z scores (slower completion time).

Conclusions

Increased DBP NBPR was negatively associated with executive functioning as indicated by Stroop C Interference performance, such that individuals with slower completion times had elevated DBP NBPR measurements. These results suggest that increased DBP NBPR may play a role in the reduction of executive functioning performance in cognitively healthy older adults and are consistent with prior findings identifying increased DBP as a risk factor for neurodegeneration (den Heijer et al., 2005; Kennelly et al., 2009). The current study highlights the need for increased attention to the role of DBP in neurodegeneration.