bluuebunny/crossref_metadata_2025 huggingface dataset:
A-154 Chromosome 18q Deletion & Chromosome 18p Duplication: A Neuropsychological Case Study
Authors: Newkirk Bailey
Published: August 2022

Objective: The client presents with partial deletion of chromosome 18q and partial duplication of chromosome 18p, occurring in 1 in 55,000 individuals and less than 1 in 1,000,000 individuals, respectively. Deletions of chromosome 18q are often characterized by hypotonia, seizures, psychomotor retardation, and intellectual disability. Duplications of chromosome 18p are characterized by intellectual disability, epilepsy, hypotonia, developmental delay, and attention deficits.

Method: The client is a 5-year-old male, who was diagnosed with the above-mentioned genetic disorders and Chiari malformation at age 2. Additionally, the client presents with a speech delay and low muscle tone. The client’s parents sought testing to clarify his cognitive and emotional functioning in light of his genetic disorders to inform treatment and supports.

Results: Nonverbal intellectual assessment was in the average range. Academic achievement noted low average reading skills, impaired math abilities, and borderline impaired spelling. Neuropsychologically, impairments were noted in verbal memory, simple auditory attention, semantic fluency, visual perception, motor coordination, visual motor integration, and affect recognition. Mild to moderate inefficiencies were in visual memory, auditory comprehension of instructions, response inhibition, fine motor dexterity, and perspective taking. Otherwise, the client performed in the average range on tasks of behavioral inhibition and persistence, expressive language, and receptive language.

Conclusions: Given the limited literature, it is expected these genetic disorders will be associated with intellectual disabilities and attentional difficulties. However, the client’s IQ is in the average range, and he presents with potential learning disorders in reading, writing, and mathematics with associated attention, memory, visual-motor, verbal fluency, and social perception difficulties.
A-165 Selective Mutism in Pediatric Opsoclonus-Myoclonus Syndrome: A Case Study
Authors: Choate Alyssa Zwicker , Wahlberg Andrea
Published: August 2022

Objective: Opsoclonus-Myoclonus Syndrome (OMS) is an extremely rare (1 per 5 million estimated incidence), subacute movement disorder characterized by myoclonus and/or ataxia, opsoclonus, and behavioral disturbance with or without neuroblastoma. Many pediatric patients will experience long-term cognitive, behavioral, and motor sequelae. This case study describes deficits associated with a rare course of OMS and will present a poly-etiologic hypothesis for the observed profile. Improved understanding of the phenotypic variance in atypical OMS may promote diagnostic clarity and subsequent intervention for a rare presentation that is scientifically underserved.

Method: Patient presented with viral infection at 2 years of age that led to loss of motor and speech functioning and ultimately a diagnosis of OMS. Patient exhibited typical features of cerebellar mutism syndrome (mutism, emotional lability, motor impairment), with rapid recovery of gross motor skills. Patient’s mutism has persisted for several years despite immunomodulatory treatment and normal neuroimaging findings.

Results: Neuropsychological results indicated below average performance across intellectual, language, motoric, and academic domains. Functional and adaptive impairments secondary to social anxiety and separation distress were also exhibited. Diagnostic criteria for Selective Mutism and Social Anxiety Disorder were met. Significant anxiety, post-event stress, attachment needs, altered speech/language development, and personal temperament are all probable contributors to her prolonged mutism.

Conclusions: This case study examines OMS with prolonged mutism. Mutism, while not uncommon in some cerebellar disorders or post surgically, is not well documented in the OMS literature and may represent a rare outcome. These findings add to the phenotypic variability, developmental course, and profile of atypical cerebellar presentations.
A-173 Grey Matter Volume, Psychotic Disorders, And Heredity of Alcohol Use Disorder: Reconceptualization by B-SNIP Biotypes
Authors: Pietrzykowski Malvina O , Waters Abigail B , Gansler David A , Jerram Matthew , Pearlson Godfrey D , Tamminga Carol A , Clementz Brett A , Keshavan Matcheri S , Gershon Elliot S
Published: August 2022

Objective: Bipolar and Schizophrenia Network for Intermediate Phenotypes (B-SNIP) researchers have proposed three Biotypes that show advantages of a dimensional approach to classification, revealing different levels of dysfunction severity through EEG and various forms of cognitive testing. Although preliminary work has been done showing neuroanatomical differences among the biotypes and patterns of heredity, more research is required to investigate the contribution of significant co-morbid factors such as alcohol misuse. Objective. Neuroanatomical data were used to further understand the biomarker of grey matter volume (GMV) in relation to the B-SNIP Biotypes and the interacting influence of family history of alcohol use disorder (FH-AUD).

Method. Biotype, FH-AUD, and demographic variables (age, sex, education, and ethnicity) were used in hierarchical regression analyses for prediction of total volume and two key regions (superior parietal cortex and posterior cingulate cortex) in stable probands (n = 347) and their healthy first-degree relatives (n = 346) separately. Prediction was also analyzed in the context of conventional diagnosis of psychotic disorders (schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features). Structural data were analyzed using FreeSurfer.

Results. Biotype was shown to be a more robust predictor of GMV than diagnosis both generally and specifically in relevant regions (p < .05). A pattern of GMV reduction based on severity was observed both in probands and relatives. Effects of FH-AUD and its interaction with Biotype were occasionally observed.

Conclusions. This study contributes to the efforts of psychobiological research to establish a more valid conceptualization of psychological disorders through biological mechanisms.
A-174 Measurement invariance reveals Brief Assessment of Cognition in Schizophrenia (BACS) Token Motor subtest differs in U.S.-based black and white samples
Authors: Dykins Madison , Khan Aaminah , Hill Scot K , Miller Steven A
Published: August 2022

Objective: The Brief Assessment of Cognition in Schizophrenia (BACS) is widely used to assess cognition in schizophrenia spectrum disorders (SZ). However, norms were developed using a sample of 85% white and 15% black participants. Validation of the BACS across cultures have yielded mixed results suggesting that subtests may function differently. Measurement invariance can be used to assess item consistency across groups. The present study examined the measurement invariance of six BACS subtests using models with increasing constraints across 2 different U.S.-based cultural groups (i.e., black and white).

Methods: Participants were 429 black and 475 white individuals diagnosed with SZ from the Bipolar Schizophrenia Network for Intermediate Phenotypes consortium.

Results: The Comparative Fit Index (CFI) was used to assess model fit. A change in CFI between models of increasing constraint (i.e., </= 0.01) is acceptable (Cheung & Rensvold, 2002). Baseline configural invariance (CFI=.983) was achieved. The CFI of the weak model (CFI=.967) exceeded the cut-off difference suggesting subtests do not achieve weak invariance. Partial invariance tests revealed that the Token Motor subtest was not equivalent across groups, leading to a 5-subtest partial weak invariance model.

Conclusions: With the exception of the Token Motor subtest, findings suggest that subtests function similarly across these two racial groups. The Token Motor subtest has both the lowest internal consistancy and factor loadings on the BACS and has been removed from the BACS composite score. Future research should examine the utility of the Token Motor test across clinical and cultural groups.
A-176 Regional Cerebral Blood Flow in Self-Reported Post-Traumatic Stress Disorder in Adults
Authors: Geller Rachel T , Golden Charles , Stafford Claire , Jubran Madeline , Jaramillo Cristina , Amen Daniel , Willeumier Kristen
Published: August 2022

Objective: The aim of this study is to identify regional cerebral blood flow (rCBF) differences between adults who self-reported high symptoms of Post-Traumatic Stress Disorder.

Method: Subjects were selected from a de-identified database for adult SPECT scans. Scores were standardized to T-scores for each database. Twenty percent of the sample from each database were selected on the basis of self-reported levels of PTSD symptoms using the Amen Adult General Symptom Checklist (Amen, 1997). The final sample consisted of 350 Adults [Mage=36.70, majority-white (65.4%) and female (56.9%)]. Significant differences existed between groups for age. A MANOVA was utilized to test the difference in concentration rCBF between adults controlling for age.

Results: Groups were compared across 17 variables representing different areas of the brain. Significant differences (p<.05) in rCBF were found in high levels of self-reported PTSD. Specifically, significant differences were noted in the left and right limbic areas with adults reporting high levels of PTSD having increased rCBF in these regions. Differences were also significant in the left and right basal ganglia regions with those reporting higher levels of PTSD having increased rCBF.

Conclusion: Results indicate that there are significant differences in rCBF between adults with high self-reported levels of symptoms of PTSD. This suggests that adults with PTSD experience increased rCBF in the limbic and basal ganglia which both play a role in memory, emotions, and anxiety. Clinicians can use this information in the future to identify individuals that are at a high-risk for developing PTSD.
A-185 Influence of Improved Lifetime TBI History Ascertainment on Clinical Outcomes
Authors: Sandino Adriana , Milano Jordan , Asken Breton M , Bauer Russell M , Bove Jessica
Published: August 2022

Objective: History of TBI/concussion earlier in life may have implications for long-term health. It is important to understand factors that influence retrospective reports of TBI/concussion history in the clinic. We examined whether providing a formal TBI/concussion definition affected self-reported TBI/concussion history and evaluated association of TBI/concussion history with current mood symptoms.

Methods: Participants were 12 individuals (5 M, 7 F, average age = 40.4) seen in an interdisciplinary TBI/concussion clinic. Non-parametric Mann-Whitney-Wilcoxon tests compared the total number of reported TBI/concussions before and after providing patients a formalized definition for TBI/concussion in the overall sample and then separately for males and females. A secondary analysis used Pearson’s correlation to examine the relationship between total number of TBI/concussions and self-reported anxiety using Generalized Anxiety Disorder (GAD-7) total score.

Results: Participants reported an average of 3.1 more concussions after being informed of the definition of a TBI/concussion. This result was primarily seen in men, who reported 5.8 more TBI/concussions (women = 0.5 more TBI/concussions) after the definition was provided (W = 1.5, p = 0.05). Further, there was a positive, strong correlation between total number of reported lifetime concussions post TBI/concussion definition and anxiety severity (r = 0.67, p = 0.05).

Conclusions: Providing a definition of TBI/concussion increases reports of lifetime concussion, primarily in males. Higher trait anxiety may also be associated with self-reported concussion history. Larger sample sizes are needed to better understand factors that drive retrospective injury reports in those who seek concussion care.
A-211 The Impact of Task Novelty on a Virtual Reality-Based Procedural Learning Task
Authors: Dube Jeanne M , Persin Michael J , Bass Danica P , Prentice Kailee P , McKinney Brandee A , Morales Yenifer L , Guillory Logan A , Coldiron Allyson M , Barnett Michael D
Published: August 2022

Objective: Psychologists have long used nonsensical information in the study of learning and memory (Ebbinghaus, 1885). Nonsensical information makes it difficult to rely on previous learning and thus increases task novelty (Quent et al., 2021). Little extant research has investigated the impact of task novelty in everyday activities, which are often overlearned. The purpose of this study was to investigate the impact of task novelty on a procedural learning and memory task in virtual reality.

Method: Healthy young adults (N = 41; ages 18–25, M = 18.73, SD = 1.38) completed the Virtual Kitchen Protocol (VKP; Barnett, Parsons, & Childers, 2021), a virtual reality-based measure of learning and memory for meal preparation of both regular (e.g., cooking an egg) and nonsensical (e.g., placing a menu in a toaster) dishes.

Results: Results of a Wilcoxon signed-rank test found that in immediate recall, participants demonstrated better recall for preparing regular dishes (M = 31.51, SD = 3.33) than nonsensical dishes (M = 26.68, SD = 4.75); z = 4.699. p < 0.001.; after a 20-minute delay, participants still had better recall for preparing regular dishes (M = 32.81, SD = 2.44) than the nonsensical ones (M = 27.32, SD = 4.38); z = 5.288, p < 0.001.

Conclusions: Task novelty had a negative impact on recall for everyday procedural tasks in virtual reality. Overlearned behaviors may affect performance on measures of everyday activities, but the use of nonsensical analog tasks may provide a means of controlling for task familiarity.
A-214 A Novel Computerized Cognitive Test for the Detection of MCI and its Association with Neurodegeneration in Alzheimer’s Disease Prone Brain Regions
Authors: Nahmias Leeron , Ortega Alexandra , Beaulieu Ashleigh N , Curiel Cid Rosie E , Zheng Diane , Kitaigorodsky Marcela , Adjouadi Malek , Crocco Elizabeth A , Georgiou Mike , Gonzalez-Jimenez Christian , Goryawala Mohammed Z , Nagornaya Natalya , Pattany Pradip M , Sfakianaki Efrosyni , Visser Ubbo , Loewenstein David
Published: August 2022

Objective: First, to determine whether a digitized cognitive stress test, the Loewenstein-Acevedo Scales for Sematic Interference and Learning, Brief Computerized Version (LASSI-BC) could differentiate between Cognitively Unimpaired (CU) and amnestic Mild Cognitive Impairment (aMCI) groups. Second, to correlate LASSI-BC performance to volumetric reductions in Alzheimer’s disease (AD)-prone regions.

Methods: 111 elders underwent a clinical and neuropsychological evaluation, along with the LASSI-BC. All participants were independent community-dwellers, had knowledgeable informants, and did not meet DSM-V criteria for any active neuropsychiatric disorder, Mood Disorder or Psychotic Disorder. Eighty-seven participants (51 CU; 36 aMCI) underwent MRI imaging. The volumes of 12 AD-prone regions were related to LASSI-BC and other memory indices correcting for False Discovery Rate (FDR).

Results: After adjusting for initial learning ability, the failure to recover from proactive semantic interference (frPSI) of LASSI-BC successfully differentiated between groups. Measures of frPSI were associated with volumetric reductions in AD-prone regions (hippocampus, amygdala, inferior temporal-lobes, precuneus and posterior cingulate) in aMCI cohort. A combination of maximum learning capacity and frPSI on the LASSI-BC yielded an area under ROC curve of 0.876 with greater sensitivity and specificity when compared to other traditional tests (e.g., HVLT).

Conclusions: Performance on the LASSI-BC successfully discriminated between diagnostic groups and is significantly associated with volumetric loss among aMCI individuals. This is significant as diagnostic cognitive tests of preclinical and prodromal AD should also be required to exhibit sensitivity to biomarkers of AD (e.g., amyloid, tau, and neurodegeneration in AD-prone regions), which may address some of the most critical challenges facing clinical trials.
A-216 Construct Validity of The National Institutes of Health Toolbox- Cognition Battery (NIHTB-CB) in Children and Adolescents with Cerebral Cavernous Malformation, Type 1 (CCM-1) and their Non-Affected Relatives
Authors: Petranovich Christine , Campbell Richard , Gill Darbi , Hart Blaine , Morrison Leslie , Wilson Kevin
Published: August 2022

Objective: This study assessed the convergent validity of the NIHTB-CB in a sample of children and adolescents with CCM-1 and non-affected relatives.

Method: Twenty-two participants with CCM-1 and 7 non-affected relatives completed the NIHTB-CB and traditional neuropsychological measures. The following domains were assessed: memory (NIHTB-CB Picture Sequencing Memory and Child and Adolescent Memory Profile- Screening Index), word reading (NIHTB-CB Oral Reading and Wide Range Achievement Test-4th Word Reading [WRAT-4 WR]), processing speed (NIHTB-CB Pattern Comparison and Symbol Digit Modalities Test), and attention/working memory (NIHTB-CB List Sorting and Digit Span).

Results: The non-affected group scored higher than the CCM-1 group on WRAT-4 WR (t = 2.68, p = .02) and NIHTB-CB Oral Reading (t = 2.18, p = .05). The groups did not differ on the other measures (p > .05). Pearson’s correlations ranged from .45 for memory to .81 for word reading, demonstrating adequate construct validity for memory, processing speed, and attention/ working memory and good to very good for word reading. The NIHTB-CB was more likely to identify participants as impaired for memory (17.2% vs 6.9%) and processing speed (62.1% vs. 3.4%). The traditional attention/working memory measure was more likely to identify participants as impaired (27.6% vs 3.4%). Impairment rates were similar for the word reading measures.

Conclusions: Of the domains considered, convergent validity was best established for word reading. Although correlations were adequate, rates of impairment differed for memory, processing speed, and attention/ working memory, suggesting that caution is warranted when comparing the NIHTB-CB to traditional measures in these areas.
A-217 Convergent Validity Between the Motor Domains of Pediatractm, and the Ages And Stages Questionnaire – 3rd Edition (ASQ-3)
Authors: Lasutschinkow Patricia C , Bo Jin , Le Doux Gabrielle N , Warschausky Seth , Lajiness-O’Neill Renée
Published: August 2022

Objective: PediaTracTM is a web-based tool for tracking infant/toddler development (Lajiness-O’Neill et al., 2021). This study evaluated convergent validity between PediaTracTM Motor domain and motor domains of Ages and Stages Questionnaire (ASQ-3, Squires & Phillips, 2009).

Method: Participants were 515 term and preterm (< 37 weeks gestation) infant/caregiver dyads in a multi-site validation study of PediaTracTM. Data from 2-, 4-, 6-, and 9-month waves on PediaTracTM and ASQ-3 were included (age corrected for pre-term).

Results: At 2-months, PediaTracTM and ASQ-3 fine motor were moderately correlated in term (r(299) = 0.46, p < 0.001) and preterm (r(216) = 0.30, p < 0.001) infants. Similar relationships were found at 4-months (r(291) = 0.36, p < 0.001 and r(211) = 0.41, p < 0.001, respectively) and 9-months (r(271) = 0.30, p < 0.001 and r(180) = 0.44, p < 0.001, respectively). At 2-months, gross motor assessments were moderately correlated in term (r(299) = 0.48, p < 0.001) and preterm (r(216) = 0.45, p < 0.001) infants. At 4-months, moderate correlations were found. Strongest associations were at 9-months in term (r(271) = 0.63, p < 0.001) and preterm (r(180) = 0.68, p < 0.001) infants. Similar relationships were not found at 6-months (-0.06 < r < 0.08).

Conclusion(s): This study supports convergent validity for the PediaTracTM Motor domain at multiple time points. The lack of association at 6-months may stem from the known lack of sensitivity to motor delays in the ASQ-3 in infancy highlighting the need for further validation of PediaTracTM Motor with direct assessments at each time point.
A-219 Development of the Nonverbal Test of Cognition for Hospital Inpatients
Authors: Lee Bern , Smetana Racheal , Broshek Donna
Published: August 2022

Objective: There are few neuropsychological measures available for valid assessment of hospital inpatients who are intubated or otherwise unable to communicate verbally. The Nonverbal Test of Cognition in Hospitals (NoTCH) was developed to provide a brief inpatient assessment that does not require verbal responses. The objective of this study was to describe the NoTCH and determine its tolerability and practicality among hospitalized patients, to justify normative data collection.

Method: The NoTCH contains 10 subsections and was designed to assess domains of attention, working memory, learning and memory, receptive language, orientation, and suboptimal engagement. The test was developed and then administered to a small cohort of four neuropsychologists and health psychologists to pilot the measure and refine the test. Thirteen participants with epilepsy undergoing monitoring on the epilepsy monitoring unit then completed the NoTCH. Participants answered a series of prompts by holding up fingers, tapping, and pointing to objects in their room. Means and standard deviations of test performance were examined to identify ceiling effects.

Results: The NoTCH took an average of 16 minutes to administer and was well tolerated by all patients. The overall measure was reasonably difficult on average (56/96; SD = 6.76) and four sections had notable ceiling effects. No tests had floor effects that would preclude detection of low scores.

Conclusions: The NoTCH was well-tolerated in the inpatient setting, quick to administer, and demonstrated preliminary indication of sensitivity to cognitive functioning across domains. Future research will develop normative data for the measure and a companion outpatient form.
A-252 A Suspected Case Of Limbic-Predominant Age-Related TDP-43 Encephalopathy (LATE) in an Older Adult
Authors: Smith Alphonso , Eaton James E , Darby Richard R
Published: August 2022

Objective: LATE is a common but underrecognized neuropathology that causes a progressive amnestic syndrome in older adults which mimics an Alzheimer’s disease (AD) clinical profile.

Method: A 75-year-old female with a history of progressive cognitive impairment presented to a multidisciplinary neurology clinic. Neurocognitive screening during her neurological exam showed an amnestic memory profile. A work-up for medical causes for her cognitive impairment was negative. She had prominent hippocampal atrophy on MRI with a negative amyloid PET scan, raising concerns for LATE. She was referred for a comprehensive neuropsychological evaluation.

Results: Neuropsychological testing confirmed an amnestic mild dementia profile in the context of her other cognitive skills (e.g., attention, executive functioning, processing speed, word finding, and visuospatial abilities) being largely preserved. On self-report questionnaires, the patient denied having any significant symptoms of depression or anxiety.

Conclusions: LATE is described as causing a primarily amnestic neurocognitive profile with associated hippocampal atrophy and this was well demonstrated in our patient. While the diagnosis of LATE cannot be definitively made until autopsy, the absence of amyloid on her PET scan highly suggests a non-AD pathology like LATE. A limitation of the evaluation is that tau biomarker tests were not performed, making primary age-related tauopathy (PART) another possible pathology or co-pathology. Overall, this case study illustrates the importance of multidisciplinary assessment to help facilitate differential diagnosis for neurodegenerative conditions associated with amnestic cognitive impairment, especially when a non-AD pathology is suspected.
A-257 The Relationship between BMI, Sleep Quality, and Cognitive Performance among Overweight Adults
Authors: Illam Shashonk , Lee Grace , Rajaram Sujatha , Sabate Joan
Published: August 2022

Objective: The primary objective is to examine the main effects of Body Mass Index (BMI) and sleep quality on cognitive performance.

Method: Adults between the ages of 25-84 (n=217) were recruited for the Loma Linda University Healthy Avocado Trial study. Participants had a mean age of 49.61 (SD=13.13), mean education of 14.66 years (SD=2.44), and a mean BMI of 33.87 (SD=5.48). Sleep quality was measured using the Pittsburgh Sleep Quality Inventory (PSQI), and cognition was measured using a two-hour neurocognitive battery including tests of attention/working memory (WM), processing speed, executive function, and learning/memory. A hierarchical regression analysis was performed to examine the effects of BMI and sleep quality on cognitive performance, while controlling for age, sex, and education.

Results: There were no significant main effects of either BMI or sleep quality on cognitive performance. However, strong trends were observed for the effect of BMI on attention (b=0.127, t(211)=1.883, p=0.061) and learning/memory (b=0.126, t(211)=1.948, p=0.057). Trends were also observed for an effect of PSQI on executive function (b=-0.115, t(211)=-1.834, p=0.069) and processing speed (b=-0.106, t(211)=-1.774, p=0.077).

Conclusion(s): While it was expected that both BMI and poor sleep quality would be associated with reduced cognitive performance, significant main effects were not found. Trends were observed for an effect of BMI on attention and memory, and of sleep quality on executive function and processing speed. One hypothesis for these results is that the deleterious effects of BMI and poor sleep may not manifest until later adulthood and may be weaker or not detected in younger adults.
A-262 Cognitive and Occupational Status of Young Adult Survivors of Leukemia/Lymphoma Prior to Transition to Adult-Centered Care
Authors: Balderrama Melissa , Whitaker Ashley M , Mendoza Leanne
Published: August 2022

Objective: Treatment for pediatric acute lymphoblastic leukemia/non-Hodgkin’s lymphoma (ALL/NHL) confers risk of long-term cognitive sequelae, though many survivors lose access to neuropsychological monitoring once they transition to adult-centered care. The objective of this study is to describe the frequency/severity of cognitive concerns of ALL/NHL survivors who are about to transition care in relation to occupational status and school service utilization.

Method: Thirty-eight young adult (x ̅=19.5 years), primarily Latino, survivors of ALL/NHL underwent neuropsychological evaluation. Domains included working memory (Wechsler Adult Intelligence Scale–Fourth Edition [WAIS-IV] Digit Span [DS]), processing speed (Symbol Digit Modalities Test [SDMT]/WAIS-IV Coding), and sustained attention (Conners Continuous Performance Test–Third Edition [CPT-3]). Occupational status was determined during interview.

Results: Survivors exhibited lower working memory (z=-4.44, p=.00001) and processing speed (SDMT z=-3.82, p=.00014; CPT-3 Hit Reaction Time z=2.57, p=.01) compared to normative expectations. Nearly 90% of the sample was in school and/or working at the time of evaluation. Of those attending higher education (74%), over 35% performed at least one standard deviation below the mean across DS and SDMT/Coding (which is over twice as frequent as in the normative population), though less than 15% were receiving accommodations.

Conclusion: Despite increased risk of working memory and processing speed deficits, the majority of our sample was in school and/or working at the time of evaluation. While this confirms the resiliency of young adult survivors, their need for supportive services that address cognitive barriers may be under-recognized. Neuropsychological monitoring in this age group remains critical to create avenues for support during the transition to adult-centered care.
A-267 Pediatric Neuropsychology Genetic Consultation: Rare de novo GCK Mutation with Severe Persistent Congenital Hyperinsulinemia (CH/CHI)
Authors: Pimental Patricia , Ciampanelli Anna , Fields Caitlin
Published: August 2022

Objective: Chromosomal abnormalities may result in neurodevelopmental delay. Mutations in the gene encoding the enzyme glucokinase (GCK) have been shown to result in congenital hyperinsulinemia (CH/CHI) and hyperglycemia (Galcheva et al., 2019). GCK is important for both glucose metabolism and homeostasis (Kraslow et al., 2021).

Methods: The present case involves a 5-year-old, right-handed, Caucasian male, with a history of chromosomal abnormalities. DNA sequence analysis performed by PCR amplification of highly purified genomic DNA, followed by automated bi-directional DNA sequencing of coding regions of the genes revealed: GCK Variant 1: Transition T>C; Nucleotide position: 295; Codon position: 99; Amino acid change: Tryptophan>Arginine; DNA variant type: Disease-associated mutation, heterozygous; Inheritance: Autosomal Dominant; and Phenotype: CH. The patient had a history of severe persistent CH/CHI, obstructive sleep apnea, congenital chordee, cholelithiasis, and gross motor delay. He was referred for neuropsychological testing to ascertain the extent of his neurodevelopmental issues.

Results: Neuropsychological testing revealed a diagnosis of a neurodevelopmental disorder characterized by an attention-deficit/hyperactivity disorder—combined type, dysexecutive syndrome/executive functioning disorder, below average general intellectual functioning and retention of new information, and severe behavioral dysregulation.

Conclusion: Rare de novo GCK mutations with severe persistent CH/CHI are uncommon (Kraslow et al., 2021). According to Roper et al. (2020), roughly up to 48% of neonates affected with CH/CHI may exhibit sequelae of neurodevelopmental delay and intellectual disabilities. Analyses of GCK mutations and resultant neuropsychological deficits are rarely reported. Our case highlights the importance of pediatric neuropsychology genetic consultation in elucidating neurodevelopmental sequelae and academic and rehabilitation recommendations.
A-274 A Case Study of Progressive Supranuclear Palsy in a 68-year-old with Pronounced Frontal-Executive Deficits Complicated by Cerebrovascular Disease
Authors: Khan Mohammadi , Phillips Matthew S , Yang Jessica , Fink Joseph
Published: August 2022

Objective: Individuals with Progressive Supranuclear Palsy (PSP) often experience cognitive decline, repeated falls, restricted gaze, bradykinesia, and depression/behavioral changes. Despite having certain distinguishing features neuroanatomically and neurologically, PSP continues to be difficult to classify and distinguish from some other more well-known neurodegenerative and movement-related disorders.

Method: A 68-year-old white male presented for a neuropsychological evaluation (2022) initially after his neurologist became suspicious of him having cerebellar degeneration or multisystem atrophy. He reported a progressive one-year decline in memory, motor abilities, and executive functions, along with having personality changes and a loss of independence in his activities of daily living (ADLs). To complicate the differential diagnosis, an MRI of his brain from six months prior simply concluded “age-related changes”. Upon revisiting this MRI and closer visual inspection, focal atrophy of the midbrain became apparent on a sagittal section, in addition to bilateral ischemic changes in the white matter. He was later diagnosed with PSP.

Results: Despite demonstrating adequate performance on simple cognitive screening measures, he displayed marked behavioral disinhibition, executive/attention problems, visuospatial concerns, decreased motor abilities, and variable memory functioning that were found to impact his ability to carry out instrumental and even some basic ADLs.

Conclusions: Cases such as this one requiring diagnostic clarification lend support to the “hummingbird sign” (midbrain atrophy) being a useful imaging marker in distinguishing PSP from other clinical disorders. Additionally, in contrast to other neurodegenerative disorders, frontal-executive deficits (e.g., disinhibition) were a particularly pronounced feature in his PSP neurocognitive profile, followed by milder difficulties in memory, language, and visuospatial functions.
A-284 A Systematic Review of Exercise for the Management of Post-Concussion Symptoms
Authors: Jaganathan Kannan Singaravelu , Sullivan Karen , Kinmond Sally , Berndt Sara , Street Steven , Haden Catherine , Greenslade Jaimi , McMahon Katie , Mitchell Gary , Kerr Graham
Published: August 2022

Objective: Exercise rehabilitation for post-concussion symptoms (PCS) has shown benefits, but a synthesis of evidence has been lacking. This systematic review aimed to review the evidence from randomised control trials (RCTs) of exercise-only interventions for PCS and identify the most promising parameters for further investigation.

Data Selection: Electronic databases (CINAHL, EBSCOhost, MEDLINE, etc) and trial registries (ProQuest Dissertation & Theses Global Database, etc) were searched from inception to November 2020. Keyword searches was carried out using terms specifying “mild traumatic brain injury”, “post-concussion symptoms”, and “exercise”. Only RCTs using solely exercise interventions and published in English were considered. Studies with multi-disciplinary interventions were excluded. Two independent researchers screened and reviewed the literature. Methodological quality was assessed using the Cochrane’s Risk-of-Bias-2 tool. Eight studies were identified for the final review.

Data Synthesis: The review found moderate support for exercise interventions to be effective in treating PCS. Based on the 8 studies, exercise programs that led to favourable outcomes commenced after an initial period of rest for 24-48 hours post-concussion, used progressive aerobic exercise for at least 4 times a week for 10-15 minutes during each session, required an intensity of at least 50% of the heart rate of the sub-symptom threshold, and lasted for at least 4 weeks or resolution of symptoms.

Conclusions: Exercise rehabilitation for PCS may be beneficial but further research is required on wider population groups apart from adolescents and athletes before more generalised recommendations can be made.
A-295 Visuospatial Skills of Adolescents Involved in Prostitution
Authors: Sipan Irene , Delano Nicole , Colon Juan , Nolty Anne A T , Amano Stacy S
Published: August 2022

Objective: Adolescents involved in prostitution are exposed to traumatic experiences with long-term adverse effects including symptoms of posttraumatic stress disorder (PTSD). Maltreated children tend to perform poorly on tasks of visuospatial orientation. We hypothesized that adolescents who had been involved in prostitution would have weak visuospatial skills and that those with a diagnosis of PTSD would have worse visuospatial skills than those without a diagnosis of PTSD.

Method: Due to academic concerns, comprehensive neuropsychological assessment was conducted in a community mental health center with 22 adolescents (21 female and one trans to female) who had been involved in prostitution. Visuospatial skills were measured using the Rey-Osterrieth Complex Figure Test (ROCF). IQ ranged from 72 to 112 (M = 85.4, SD = 13.27). Sixteen out of the 22 participants were diagnosed with PTSD.

Results: Adolescents involved in prostitution scored significantly lower on the copying trial of the ROCF (M = 24.2, SD = 7.89) than the normative sample (M = 33.6, SD = 2.98), t = -5.60, p <.001. However, the results revealed no significant difference on ROCF copy scores between participants diagnosed with PTSD (M = 24.69, SD = 6.41) and those not diagnosed with PTSD (M = 22.84, SD = 11.62), F(1, 20) = 0.23, p = 0.64, even controlling for age and intellectual functioning.

Conclusion: The findings suggest that adolescents who experienced the trauma of prostitution may have deficiencies in visuospatial functioning, regardless of PTSD diagnosis. Thus they may distort environmental information, leading to poor decision-making.
A-297 Analysis of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Cortical-Subcortical Deviation Index and Subtest Scores in Differentiating Between Cortical and Subcortical Dementia Profiles
Authors: Cecil Audrey L , Smotherman Jesse M , Glayat Kathryn , Arredondo Beth , Boettcher Anneliese , Brickell Emily
Published: August 2022

Objective: This study examines the utility, both broadly and at the subtest level, of the cortical-subcortical index (CSI) of the RBANS in classifying cortical and subcortical cognitive profiles.

Methods: Outpatients in a southeast hospital were grouped by diagnosis: Alzheimer’s Disease (AD, n=33; age=77.03[6.04], ed=13.55[2.58], 88% female, 91% Caucasian), Subcortical (n=36, age=72.17[11.51], ed=12.63[3.70], 50% female, 75% Caucasian) and No Diagnosis (n=30, age=71.97[5.59], ed=13.24[3.04], 80% female, 70% Caucasian). The CSI formula ([visuospatial construction + attention]/2]–[delayed memory + language]/2)) was calculated for patients. Groups were compared on CSI score using one-way analysis of variance (ANOVA) and Tukey’s HSD. ROC analysis was used to identify CSI cutoff that optimizes classification. Independent t-tests for subtests comprising the CSI were run comparing Cortical/Subcortical groups, with stepwise regression to evaluate significant subtests.

Results: CSI differed significantly between groups (F[2, 96]=30.58, p<.001]). Tukey’s HSD found CSI was significantly different between Cortical/Subcortical (p<.001, 95% CI=16.38, 31.27) and Cortical/No Diagnosis (p<.001, 95% CI=9.62, 25.20), but not Subcortical/No Diagnosis (p=.118, 95% CI=-14.04, 1.22). ROC yielded a CSI cutoff of <-1 for optimal classification (AUC=.888, SE .039, p<.001, 95%CI .813-.964, Sensitivity=.750, Specificity=.909). Independent t-tests resulted in significance in 6 subtests. Stepwise regression using significant subtests revealed the best CSI-prediction model explained 28% of the variance (F[1,111]=44.06, p<.001) and included only List Recall (B=-2.96, p<.001).

Conclusions: CSI’s accuracy in classifying Cortical from Subcortical profiles was 81.6% using a cut score of -1. List Recall accounted for most of the variance in the CSI. Limitations included small sample size and using RBANS scores to determine original diagnostic category.
A-307 Relationship Between Nonverbal Measure of Intelligence and Achievement Performance in Rural, Latinx Youth
Authors: McMillen Taylor , Young Krysta , Carlson Katherine , Hamilton Elizabeth
Published: August 2022

Objective: This study examines the relationship between the Wechsler Nonverbal Scale of Ability (WNV) and achievement in rural Latinx youth. Although concurrent validity for the WNV with other intelligence measures is established, there is sparse research on its association with academic performance.

Methods: Participants (n=15) were Latinx youth, ages 8 to 17 years, including nine males and six females. Participants were administered the WNV and the Woodcock-Johnson IV Tests of Achievement (WJ-IV-ACH) as part of a psychoeducational battery. The WNV minimizes cultural/linguistic factors, providing a Full Scale score and four subtests: 1) Matrices, 2) Coding, 3) Spatial Span, and 4) Picture Arrangement. The WJ-IV-ACH includes Broad Achievement and academic cluster scores. Correlations analyzed relationships between WNV and WJ-IV-ACH scores.

Results: A moderate correlation was found between WNV Full Scale and Broad Achievement (r= .44). Matrices and Picture Arrangement were moderately related to Broad Achievement (r= .39, r= .39). Matrices was strongly correlated to reading fluency (r= .60), and moderately correlated to broad reading (r= .39) and math problem solving (r= .34). Coding was associated with math calculation (r= .48). Spatial Span was strongly correlated with math problem solving (r=.53) and linked to math calculation (r= .48). Picture Arrangement was moderately correlated with broad reading, reading comprehension, math problem solving, and written expression (r= .37, r= .31, r= .33, r= .30).

Conclusion: Despite the small sample size, results suggest that a diversity-informed measure of intellectual ability is related to youth’s broad achievement scores. Additionally, WNV subtest scores are differentially associated with academic domains.
A-309 Detecting Coached Malingerers: Validity of the Novel Tri-Choice Naming and Response Bias Measure
Authors: Huston Chloe , Poreh Amir
Published: August 2022

Objective: The prevalence of malingering following a personal injury is estimated to be more than 50% (Resnick, 1997). Thus, it is imperative to have malingering measures that are well-validated (Janaski et al., 2011). Ideally, malingering tests should have high sensitivity and specificity (Trevethan, 2017). The Tri-Choice Naming and Response Bias Measure (N-Tri) is a novel malingering test aimed at being less susceptible to coaching than existing tests. This study aimed to validate the N-Tri for detection of coached malingerers.

Methods: 282 neurotypical participants completed an online version of the N-Tri. The N-Tri consists of three blocks: a naming block, a study and forced-choice block, and a delayed forced-choice block. Participants were randomly assigned to either the coached simulators’ group or the control group. The coached group was instructed to perform as if they have a traumatic brain injury (TBI) and received a test-taking strategy.

Results: ROC curves were used to determine optimal cutoff values, which were chosen based off Youden’s index (Youden, 1950). Block 1 had a sensitivity of 92% and a specificity of 99%. Block 2 had a sensitivity of 95% and a specificity of 98%. Block 3 had a sensitivity of 96% and a specificity of 97%. Total score had a sensitivity of 97% and a specificity of 97%.

Conclusions: This study demonstrated that all blocks and total score of a novel malingering test, the N-Tri, were able to distinguish between coached malingerers and controls with high levels of sensitivity and specificity. Further research that utilizes patients with documented memory deficits are proposed.
A-311 WMS-IV Visual Reproduction Recognition as a Performance Validity Test (PVT) in Clinical and Forensic Settings
Authors: Smotherman Jesse , Cecil Audrey L , Glayat Kathryn , Arredondo Beth , Brickell Emily , Boettcher Anneliese
Published: August 2022

Objective: This study examined WMS-IV Visual Reproduction Recognition (VRRec) as an embedded PVT in clinical and forensic samples.

Methods: VRRec was analyzed as a PVT in a forensic sample and in a hospital-based, outpatient clinical sample. Neither sample included any major neurocognitive disorders and well-established PVTs determined valid and invalid categories. T-tests (parametric and nonparametric) and ROCs were used to assess how accurately VRRec classified valid and invalid group-membership.

Results: Forensic and clinical (n=265, 84) samples differed in context (incentivized, non-incentivized), age (m=49.1, 60.6), race (Caucasian=17%, 89%), and gender (males=100%, 29%), respectively. VRRec scores were significantly different between valid and invalid groups in both the forensic sample (U=2404.0, p<.0001, d=-1.26; n=196, 69; m=5.57, 3.33; sd=1.29, 1.91) and the clinical sample (t=-2.39, p=.019, d=-.93; n=76, 8; m=4.99, 3.50; sd=1.68, 1.51). A cutoff score of < 3 yielded the following: Forensic: AUC=.822, sensitivity=.551, specificity=.944, 95%CI=.76-.88, p<.0001; and Clinical: AUC=.752, sensitivity=.500, specificity=.816, 95%CI=.61-.89, p=.019. For the clinical sample, < 2 improved specificity (.908) but decreased sensitivity (.250). When using a 15% estimated invalidity base rate in the clinical sample for < 3 and < 2 cutoffs, positive predictive power equaled .324 and .324 and negative predictive power equaled .902 and .873, respectively.

Conclusion: VRRec adequately differentiated validity groups in a forensic sample but was less valuable in a clinical sample. Its use as a PVT should only be considered within a larger group of multiple PVTs. Primary limitations included differences in demographics and specific criterion-PVTs used between samples. Future studies should assess VRRec as a PVT in similar populations.
Restoration Liposuction of the Abdomen: High-Definition Liposuction With Umbilicus and Lower Abdomen Improvement Using Polydioxanone Threads
Authors: Yu Arthur Y
Published: August 2022

Background

Abdominal high-definition liposuction has been practiced for many years. However, problems such as low-lying, “sad-looking” umbilici and lower abdominal “pooches” remain unresolved. Additionally, the waistline, as the pivotal point connecting the chest and hips, deserves more attention and improvement.

Objectives

The aim of this study was to use polydioxanone (PDO) threads after liposuction: (1) to improve the shape and position of the umbilicus permanently; (2) to tighten the lower abdomen permanently; and (3) to redefine “high-definition” liposuction.

Methods

All patients underwent high-definition liposuction of the abdomen and waist. After liposuction, bidirectional, barbed PDO threads were placed in the upper central abdomen. The threads were pulled to cinch the upper abdominal skin and then tied. The resulting umbilicus elevation was measured for up to 12 months. Higher waistlines were also created to match higher-positioned umbilici.

Results

Fifty-two female subjects were included. The range of umbilicus elevation at 12 months was 0.8 to 3.6 cm. Most umbilici were converted to vertical orientation, and lower abdomens became lengthened, flattened, and tightened. Moreover, the enhanced waistlines and body curves created better body proportions.

Conclusions

This technique results in permanent elevation and shape enhancement of both umbilicus and lower abdomen. In addition, because the umbilicus is raised, a higher waistline can be created without any discordance, making the lower limbs appear longer. Overall, the maneuvers contributed to the restoration/rejuvenation of the abdomen and created a better overall body shape and proportion.

Level of Evidence: 4
12-O-Tetradecanoylphorbol 13-acetate promotes proliferation and epithelial–mesenchymal transition in HHUA cells cultured on collagen type I gel: A feasible model to find new therapies for endometrial diseases
Authors: Hanaki Yusuke , Miyoshi Sena , Sugiyama Yasunori , Yanagita Ryo C , Sato Masashi
Published: August 2022

HHUA endometrial adenocarcinoma cells aggregated into spheroids when cultured on collagen type I gels. 12-O-Tetradecanoylphorbol 13-acetate, a PKC activator, disassembled the spheroids through epithelial–mesenchymal transition and increased their proliferation rate, while inducing cell death under monolayer culture conditions. These unusual behaviors of endometrial epithelial cells with collagen fibers could be a target for the treatment of some endometrial diseases.
Metabolites with antioxidant andα-glucosidase inhibitory activities produced by the endophytic fungiAspergillus nigerfromPachysandra terminalis
Authors: Yang Tao , Yang Kailing , Zhang Yu , Zhou Ruixi , Zhang Fuxin , Zhan Guanqun , Guo Zengjun
Published: August 2022

One new compound and 13 known compounds were isolated from Aspergillus niger, a plant endophytic fungus of Pachysandra terminalis collected from Qinling Mountains, Xi'an, China. The structure of new compound 1 was classically determined by extensive spectroscopic analysis. Compounds 5, 6, 8, and 14 were first reported from Aspergillus, while compound 2 was isolated from A. niger for the first time. All isolated compounds were further evaluated for their antioxidant and α-glucosidase inhibitory activities. Compounds 2 and 3 exhibited significant antioxidant activities with IC50 values of 31.64 μm and 24.32 μm, respectively, similar to the positive control ascorbic acid. Additionally, compound 1 displayed remarkable inhibitory activity against α-glucosidase with an IC50 value of 96.25 μm, which was 3.4-fold more potent than that of the positive control acarbose. Compound 1 has great potential for development as a new lead compound owing to its simple structure and remarkable biological activity.