bluuebunny/crossref_metadata_2025 huggingface dataset:
A-125 The Impact of Bilingualism on Symbol Digit Modalities Test Performance Following Traumatic Brain Injury
Authors: Munoz Raelynn , Lopez-Hernandez Daniel W , Rugh-Fraser Rachel A , Sidhu Jasman , Litvin Pavel Y , Hernandez Juan P , Nordberg Bethany A , Bueno Alexis , Mangassarian Selina , Olmos Winter , Hardy David J , Vespa Paul , Plurad David , Hovda David A , Woo Ellen , Fuster Joaquin M , Budding Deborah , Wright Matthew J
Published: August 2021

Objective

Traumatic brain injury (TBI) survivors exhibit cognitive deficits. Research suggests that multilingualism can influence neurocognitive performance. We examined the effects of TBI and bilingualism/monolingualism on a test of attention and cognitive speed (i.e., Symbol Digit Modalities Test; SDMT).

Method

The sample consisted of 55 healthy comparison (27 Spanish-English bilinguals; 28 English-monolinguals), 34 acute TBI (14 Spanish-English bilinguals; 23 English-monolinguals), and 27 chronic TBI (13 Spanish-English bilinguals; 12 English-monolinguals) participants. Acute TBI participants were tested 6 months post-injury; chronic TBI participants were tested 12 months or more post-injury. A series of 3X2 ANOVAs were conducted to determine the effect of TBI and language on SDMT written and oral performance.

Results

ANOVAs revealed the healthy comparison group outperformed both TBI groups on SDMT written, p = 0.000, ηp2 = 0.21. Also, the healthy comparison and chronic TBI groups outperformed the acute TBI group on SDMT oral, p = 0.000, ηp2 = 0.13. Interaction effects emerged between TBI and bilingualism/monolingualism. On SDMT written and oral, acute TBI English-monolinguals outperformed acute TBI Spanish-English bilinguals; meanwhile, chronic TBI Spanish-English bilinguals outperformed chronic TBI English-monolinguals, p < 0.05, ηp2 = 0.09–0.10.

Conclusion

The acute TBI group performed worse than healthy comparison adults on both SDMT tasks. Furthermore, the chronic TBI group demonstrated better SDMT oral abilities compared to the acute TBI group. Relative to monolinguals with TBI, our findings suggest better cognitive recovery of attention and cognitive speed in bilingual TBI participants. Future studies with larger sample sizes should examine if learning English first or second impacts Spanish-English bilingual TBI survivors’ SDMT performance compared to English-monolingual TBI survivors.
A-127 The Interplay of Social Perception and Psychiatric Symptoms in a Case of Traumatic Brain Injury
Authors: O'Hara John B , Young Kevin P
Published: August 2021

Objective

Acquired impairment in social perception (SP) is relatively common following moderate to severe traumatic brain injury (TBI), with up to 39% of these individuals experiencing deficient facial affect recognition. Formal assessment of SP is not common practice, despite evidence of this as a predictor of social functioning. We present the case of a 35-year-old, Caucasian male with new onset paranoid/delusional (P/D) thought processes in the context of prior TBI.

Method

The patient’s TBI (unknown severity) occurred 17 years prior and resulted in prolonged (>1 year) hospitalization, followed by intensive rehabilitation services. He reported residual, stable difficulties with attention, processing speed, executive functioning, and memory. Post-TBI, he was living independently with few external supports. Following a traumatic encounter with a family member (nine months prior), the patient developed P/D thought processes and a marked decline in functioning, resulting in three psychiatric hospitalizations. Brain MRI (Figure 1) revealed encephalomalacia and gliosis in the bilateral inferior frontal lobes anteriorly, high frontoparietal lobes, and bilateral (L > R) temporal lobes. Neuropsychology was consulted to clarify diagnosis/etiology and assess functional status.

Results

(Table 1). Evaluation results revealed non-amnestic memory impairment and variable language and processing speed. Performances on measures of SP revealed a notable weakness in the context of current intellectual performances.

Conclusions

This case highlights the importance of formally assessing SP in cases of TBI. Underlying SP difficulties in the context of a traumatic event may have increased vulnerability to psychiatric decompensation. Evaluation of SP allowed for enhanced understanding of the interplay between cognitive and psychiatric symptoms.
A-136 The Transfer of Cognitive Training to Real-World Functioning: Results of our First Six Pilot Subjects at Six-Month Follow-Up
Authors: Blake Jason A , Mitchell Brandon , McKay Staci , Uswatte Gitendra , Taub Edward
Published: August 2021

Objective

Currently, the majority of cognitive training research measures treatment efficacy using in-laboratory measures, with minimal focus on real-world treatment changes. This case series demonstrates the feasibility of transferring cognitive improvements from the laboratory into the everyday life setting.

Method

This case series includes 6 chronic post-stroke participants; mild to moderate cognitive impairment. The intervention combines cognitive training with behavioral techniques, known as the Transfer Package (TP). The TP involves components that target functionality on IADLs in the real-world. Performance on cognitively-based IADLs in the real world are measured pre-treatment, post, and 6-month follow-up. Measures of real-world ability are the: Canadian Occupational Performance Measure (COPM), Cognitive Task Activity Log (CTAL) and Inventory of Improved and New Abilities (INCA). In-laboratory measures included the D-KEFS and Timed IADL assessments.

Results

The real-world outcome measures used in this study were the COPM and two measures developed for this study, the CTAL and INCA. The mean change from pre to post on the COPM Performance Scale was 2.18 (SD = 1.33) and the mean change on the COPM Satisfaction Scale was 2.70 (SD = 1.27). The mean change on the CTAL was 1.96 (SD = 0.93). On the INCA, the mean number of improved real-world cognitive activities was 11.8 (SD = 4.9) and the mean number of new cognitive activities was 7.6 (SD = 3.9). Follow-up reported near-perfect retention on CTAL and continued improvement on the INCA. There were minimal changes on in-laboratory measures.

Conclusions

This case series provides a framework for achieving the transfer of cognitive training treatment effects in the real-world life situation by overcoming behavioral barriers to functioning.
A-15 PTSD Symptoms Are Related to Cognition Following Complicated Mild and Moderate TBI, but Not Severe and Penetrating TBI
Authors: Lippa Sara M , Brickell Tracey A , French Louis M , Lange Rael T
Published: August 2021

Objective

Despite the strong evidence suggesting post-traumatic stress disorder (PTSD) symptoms negatively impact cognition following mild traumatic brain injury (TBI), little is known about this relationship in more severe TBI. This study investigates the relationship between PTSD symptoms and cognitive performance following complicated mild, moderate, severe, and penetrating TBI.

Methods

Participants were 137 U.S. military service members and veterans (SMVs) with a history of complicated mild or more severe TBI prospectively enrolled in the Defense and Veterans Brain Injury Center (DVBIC)/Traumatic Brain Injury Center of Excellence (TBICoE) 15-Year Longitudinal TBI Study. Participants were divided into two groups: complicated mild/moderate TBI (n = 64) and severe/penetrating TBI (n = 73). Participants completed a neuropsychological assessment, including the PTSD Checklist-Civilian Version one year or more post-injury. Six neuropsychological composite scores and an overall test battery mean (OTBM) were considered. Participants who failed symptom validity tests were excluded. Hierarchical linear regressions were conducted evaluating neuropsychological performance.

Results

TBI severity (βs:-0.163 to −0.253, ps < 0.04) and PTSD symptoms (βs:-0.189 to −0.212), ps < 0.03) were related to neuropsychological performance in the overall sample. Within the severe/penetrating TBI group, PTSD symptoms were unrelated to cognitive performance. Within the complicated mild/moderate TBI group, PTSD symptoms were significantly related to processing speed (R2Δ = 0.080, β = −0.284, p = 0.016), immediate memory (R2Δ = 0.204, β = −0.453, p < 0.001), delayed memory (R2Δ = 0.180, β = −0.426, p < 0.001), executive functioning (R2Δ = 0.102, β = −0.319, p = 0.007), and the OTBM (R2Δ = 0.170, β = −0.413, p < 0.001).

Discussion

PTSD symptom severity was significantly related to neuropsychological performance in SMVs with complicated mild/moderate TBI. PTSD symptoms should be considered when evaluating patients with a history of complicated mild to moderate TBI.
A-143 Sorry, I Wasn’t Paying Attention. The Moderating Role of Auditory Attention on the Relationship between Age and Verbal Learning
Authors: Laique Aamir , Khan Humza , Hizel Loren P , Breting Leslie Guidotti , Geary Elizabeth , Sweet Jerry J
Published: August 2021

Objective

Attentional difficulties are known to negatively impact learning (Hervey et al., 2004; Alderson et al., 2013). This study builds upon previous work examining the effect of sustained visual attention as a moderator of age and learning (Thomas et al., 2019) by examining performance on an auditory attention measure as a moderator of the relationship between age and performance on a verbal list-learning task.

Method

Archival data from 424 adults (Mage = 36.01, SD = 15.13) were collected at an outpatient clinic. Auditory attention was assessed via the Brief Test of Attention (BTA) raw score. Learning was assessed via the California Verbal Learning Test (CVLT-II) total T-Score (Trials 1–5).

Results

Results of a hierarchical linear regression indicated a significant effect between BTA and learning, (β = 0.287, F(1, 422) = 17.993, p < 0.001, ΔR2 = 0.078). There was no significant effect between age and learning, (β = 0.022, F(1, 422) = 0.204, p = 0.652, ΔR2 = 0.000). Additional results from a simple moderated regression analysis indicated a significant overall model between age, learning and BTA (F(3, 420) = 15.749, p < 0.001, ΔR2 = 0.1011) with BTA having a significant positive interaction effect on the relation between age and learning (β = 0.816, F(1, 420) = 10.436, p = < 0.001, ΔR2 = 0.022).

Conclusion

Sustained attention has been shown to be an important consideration when assessing verbal learning and memory performance. Present results demonstrate that when accounting for age, auditory attention is a significant positive predictor of performance on measures of verbal learning. Additionally, confirming prior research, performances on auditory attention and verbal learning measures are positively correlated.
A-150 Comparison of a Traditional and a Novel Measure of Executive Functioning in Predicting Daily Task Performance
Authors: Brothers Stacey , Suchy Yana
Published: August 2021

Objective

Executive functioning (EF) is known to be associated with performance of instrumental activities of daily living (IADLs). However, traditional EF assessment takes place in the lab under ideal circumstances, which does not take into account the complexity of daily life, such as the need to interleave tasks. The present study aimed to examine whether a novel ecologically valid measure of EF that requires interleaving of activities, the “Night Out Task” (NOT), better predicted daily at-home IADL performance than a traditional EF measure.

Method

Participants were 49 healthy, community-dwelling older adults aged 60–95 (Mage = 69.35, SD = 6.51, 63.3% female, 100% non-Hispanic White). Participants completed both a traditional (Delis Kaplan Executive Function System; D-KEFS) and a novel measure (Night Out Task; NOT) of EF. Over the course of the next 18 days, they completed IADL tasks at home daily as part of the Daily Assessment of Independent Living and Executive Skills (DAILIES) protocol.

Results

Planning time on the NOT predicted, above and beyond the D-KEFS (p = 0.007, CI = −0.053 to −0.009), whether the DAILIES tasks were completed at all and whether they were completed during a required time frame. NOT accuracy was predictive of how accurately daily tasks were completed, but not above and beyond the D-KEFS (p = 0.131, CI = −0.266 to 1.99).

Conclusions

The NOT is a novel ecologically valid measure of EF that demonstrated incremental utility beyond the D-KEFS. While the NOT and D-KEFS predicted task accuracy, only the NOT planning time predicted whether participants completed a task.
A-151 Cognitive Impairment in Amyotrophic Lateral Sclerosis
Authors: Navarro Etiane , Golden Charles J
Published: August 2021

Objective

Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease caused by degeneration of the upper and lower motor neurons. This literature review examines the recurring etiology of cognitive impairments in ALS through empirical literature. The current study explores ALS across different subtypes and potential cognitive impairments. Two classifications are primarily examined ALS, and ALS with frontotemporal dementia (ALS-FTD). Involving three categories: familial inheritance pattern, genetic mutation, or sporadic. Neuropsychological studies affirm cognitive impairments in individuals diagnosed with ALS and ALS-FTD.

Data Selection

Data was culled from the American Psychological Association (PsycInfo), PubMed, Google Scholar. Terms used in this literature review include cognitive impairment in ALS and ALS-FTD, executive function deficiencies in ALS, neuropsychology in ALS, neuropsychological deficits in ALS, neuropsychological assessments for ALS, cognitive impairments in familial ALS, genetic ALS, and sporadic ALS, familial ALS, sporadic ALS, genetic mutations involved in ALS. Search dates December 20–23 of 2020 and March 3–4 of 2021. A total of 40 studies were examined.

Data Synthesis

ALS-patients demonstrate a significant cognitive impairment. However, influencing comorbidities accompanying the disease may be contributing to these impairments. Researchers employed neuroimaging and neuropsychological batteries to further understand influencing factors involved in ALS and cognition.

Conclusions

Researchers now understand ALS as a multi-symptomatic disorder and acknowledge the presence of cognitive impairments at various encased levels. There are limitations in neuropsychological batteries that accommodate for executive dysfunctions observed in ALS patients. Future studies should explore neuropsychological assessments that accommodate for motor deficits and dysarthria when assessing cognitive impairment in ALS patients.
A-16 Impact of Modifiable Mood and Health Factors on Cognitive Functioning among Veterans with History of Mild Traumatic Brain Injury
Authors: Wisinger Amanda , Stika Monica , Gonzales Christopher , Cladek Andrea , Ellison Rachael , Riordan Patrick , Herrold Amy , Kletzel Sandra , Aaronson Alexandra , Lindsey Andre , Bender-Pape Theresa
Published: August 2021

Objective

Veterans presenting to neuropsychology clinics with subjective cognitive complaints often attribute these complaints to history of mild Traumatic Brain Injury (mTBI). However, many of these Veterans also have co-occurring mood, sleep, and pain concerns – all of which negatively impact cognition, but are also modifiable. Here, we investigated the relative contributions of demographic factors, behavioral health and mood symptoms, and history of mTBI on neuropsychological test performance.

Method

Across three Veterans Affairs Polytrauma Network Sites, 250 Veterans who deployed to Iraq and/or Afghanistan conflicts and had not received treatment for concussion in the preceding 30 days were enrolled between 8/1/2010 and 9/30/2011. Separate multiple regression models were used to examine specified predictor variables (estimated pre-injury IQ, demographics, behavioral health ratings, insomnia, alcohol use, pain, positive mTBI history, anxiety, depression, presence of Posttraumatic Stress Disorder [PTSD]) and their impact on neuropsychological test performances.

Results

When predicting cognitive functioning, history of mTBI was not a significant predictor in any of the cognitive models. Rather, presence of PTSD was a significant predictor for both immediate (p < 0.001) and delayed (p < 0.001) memory performance on the California Verbal Learning Test – 2nd Edition. Additional analyses found that mood symptoms, insomnia, and pain were also significant predictors of cognitive functioning.

Conclusion

Modifiable factors may play a greater role in objective cognitive abilities (i.e., performance on neuropsychological tests) than mTBI history. These findings inform ongoing efforts to improve patient education regarding the expected recovery course from mTBI and the relationship between mood and health on daily cognitive efficiency.
A-152 Behavioral Correletes of a Short Form Test of Executive Functioning
Authors: Horton Arthur M , Reynolds Cecil R
Published: August 2021

Objective

This poster explores behavioral correlates of a recently developed Short-Form Test of Executive Functioning.

Method

Subjects were 23 adults referred by neurologists and psychiatrist for neuropsychological testing to a private practice. All subjects signed informed consent documents. Subjects included 12 males and 11 females, 20 subjects were Caucasians and 3 were African-Americans, 22 were right handed. Diagnoses included Stroke-12, Traumatic Brain Injury-6, Alzheimer’s disease-2, Multiple Sclerosis-1, Parkinson’s disease-1 and Epilepsy-1. All subjects were administered neuropsychological testing including the Short-Form Test of Executive Functioning (SF-TEF) and the AD8 was independently completed by a family member or in one case a family friend. The Sf-TEF is composed of 3 card sorting subtests of the Test of Verbal and Conceptual Fluency (TVCF) but rather than administering 116 cards only 58 are administered and full scales scores prorated to save time. The scales are Number Correct, Perseveration Errors and Number of Categories. The AD8 is a widely used questionnaire assessing behavioral functioning (handling medications and finances). The 3 short form subjects were each correlated with the AD8 scores.

Results

The correlations between the Number Correct, Perseveration Errors and Number of Categories scores and the AD8 scores were − 0.215, −0.225 and − 0.256 which were all non-significant at the P,0.05 level of statistical significance. It might be noted that if the study sample size were significantly increased then statistical significance could have been obtained.

Conclusions

While the results were not statistically significant, further study with a larger sample size might demonstrate better results.
A-156 Reliability of the Oral Trail Making Test in a Teleneuropsychology Testing Environment
Authors: Helphrey Jessica H , Livingstone Julia R , Longoria Anthony J , Conley Michael A , Sawyer Jennifer D , Carlew Anne R , LoBue Christian , Cullum Munro M
Published: August 2021

Objective

Despite the growing interest and literature supporting the validity and reliability of teleneuropsychology during the COVID-19 pandemic, little research exists on the reliability of the Oral Trail Making Test (OTMT) administered via videoconference. Previous work examining telephone administration of OTMT found good reliability across formats for Part B, but not Part A, suggesting further reliability studies on OTMT are needed.

Method

119 healthy aging controls and 84 individuals with mild cognitive impairment or dementia (M age = 68.37, SD = 9.57; 63% female; M education = 14.08, SD 2.73 years) were administered a brief neuropsychological battery including OTMT in counterbalanced face-to-face (FF) and videoconference (VC) conditions. T-tests and intraclass correlations (ICC’s) were used to compare results between testing conditions across groups.

Results

Among controls, the mean differences (MD) between conditions on OTMT-A (MD = -1.6, SD = 1.96) and B (MD = 1.6, SD = 54.77) were small, but statistically significant for OTMT-A; p < 0.001 but not OTMT-B (p = 0.749). ICC’s reflected good (0.85) and moderate (0.66) agreement on OTMT-A and B, respectively. Within the cognitively impaired group, mean differences across conditions on OTMT-A (MD = 22.74, SD = 155.44) and OTMT-B (MD = 46.87, SD = 240.65) were nonsignificant (p = 0.18 and 0.08, respectively). ICC’s showed moderate agreement on OTMT-A (0.66) and B (0.53).

Conclusions

While similar mean OTMT scores were seen across test conditions, SD’s were large. ICC’s were only moderate, and scores on OTMT-A were even more variable than OTMT-B, similar to previous reports. Results support the utility of using the OTMT in teleneuropsychological assessment, but suggest cautious interpretation of findings given the variability in scores seen.
A-159 Attention and Executive Function Predict Immediate and Delayed Verbal Memory in Healthy Youth: A Structural Equation Modeling Approach
Authors: Thompson Ryan C , Deneen Aubrey L , Markiv Yelena , Hall Aidan , Hirst Rayna B
Published: August 2021

Objective

Previous neuropsychological assessments have sought to understand the interrelatedness of cognitive functions when interpreting neuropsychological test performance (e.g., Delis-Kaplan Executive Function System; DKEFS), given that they rarely function in isolation. Test results may be misinterpreted if not contextualized within individuals’ overall cognitive profiles; therefore, the present study evaluated the impact of attention and executive function (EF) on verbal learning and memory (VLM) in a sample of healthy youth.

Method

Participants (n = 166, M age = 12.0 years, 79.5% male, M FSIQ = 109.6) completed a two-hour neuropsychological battery, including the Wide Range Assessment of Learning and Memory, 2nd Edition List Learning (LL), DKEFS Trail Making Test (TMT), and Wechsler Intelligence Scale for Children, Fourth Edition Digit Span (DS) and Letter-Number Sequencing (LNS). Structural equation modeling was used to evaluate the impact of attention and EF on immediate and delayed VLM.

Results

Latent factors were estimated for attention/EF (DS Forward, DS Backward, LNS, and TMT Condition 4) and VLM (LL Trials 1–4), and the model converged with adequate model fit statistics (RMSEA = 0.064; CFI = 0.975; TLI = 0.963, SRMR = 0.039). Attention and EF predicted performance on both immediate and delayed VLM (ps < 0.001) when accounting for age.

Conclusions

The results demonstrated that attention and EF predicted immediate and delayed VLM in youth, suggesting that participants’ performance on VLM may be impacted by weaknesses in attention and EF. As a result, clinicians are recommended to examine patterns of performances across multiple cognitive domains when interpreting individual test scores. This is especially important in pediatric populations given the developmental changes the brain undergoes during childhood and adolescence.
A-168 Neural Network for the Virtual Environment Grocery Store for Detection of Neurocognitive Impairment among Older Adults
Authors: Persin Michael J , Hardesty Danielle , Lee Diamond C , Tran Nancy , Bayer Cameron , Childers Lucas G , Moore Jenna M , Parsons Thomas D , Barnett Michael D
Published: August 2021

Objective

Virtual reality-based neuropsychological tests offer the ability to capture a variety of data while enabling standardized administration. The purpose of this study was to create an artificial neural network to examine the predictability of the Virtual Environment Grocery Store (VEGS) for neurocognitive impairment among older adults.

Method

Older adults (N = 71; age 55–90, M = 74.38, SD = 8.32; 13 with a neurocognitive diagnosis and 58 without) completed the VEGS as part of a neuropsychological evaluation.

Results

The multilayer perceptron found a model which had a 3.4% error rate. The VEGS sum of the learning trials was the most important predictor of this model (i = 0.45).

Conclusion

Results suggest that the VEGS is sensitive to detecting neurocognitive impairment among older adults, with the sum of the learning trials making a substantial contribution to the model’s accuracy.
A-170 Socioeconomic Status as a Predictor of Fine Motor and Graphomotor Outcomes in Patients with Pediatric Brain Tumor
Authors: Carmona Viannae , Kong Dianne , Whitaker Ashley M
Published: August 2021

Objective

As the field of neuropsychology strives to provide equitable care among diverse and disadvantaged populations, disparities in treatment and long-term outcomes continue to disproportionately impact individuals of lower socioeconomic status (SES). Motor deficits are common following pediatric brain tumor (PBT) diagnoses. However, while the relationship between SES and cognitive outcomes in this population is well documented, the role of SES in predicting more basic motor outcomes is not yet understood. This retrospective cross-sectional study was designed to determine the impact of SES on fine motor and graphomotor outcomes in PBT patients to ensure appropriate interventions and accommodations for those at higher risk.

Method

225 patients with PBT (52.9% male; $ \overset{-}{\textrm{x}} $ age = 12 yrs; SD = 5.3 yrs) underwent neuropsychological evaluation, including assessment of graphomotor speed/coordination, visual-motor integration, and fine motor dexterity. Estimated median household income was used as a proxy for SES ($ \overset{-}{\textrm{x}} $=$71,543; SD = $23,480). Linear regression analyses were used to explore the role of SES in predicting motor outcomes.

Results

Lower SES predicted poorer graphomotor speed, F(1,96) = 5.205, p = 0.013, graphomotor coordination, F(1,60) = 3.890, p = 0.027, visual-motor integration, F(1,88) = 8.116, p = 0.003, and fine motor dexterity, F(1,166) = 3.755, p = 0.027. All analyses were significant even after implementing false discovery rates.

Conclusions

Consistent with lower SES predicting poorer cognitive late effects, SES also plays a role in motor-related outcomes of PBT. Unfortunately, lower SES is also associated with barriers in accessing formal evaluations and services required to mitigate such deficits. Therefore, patients with lower SES should be considered higher risk and receive interventions and accommodations even in the absence of formal assessment to prevent delays in care.
A-171 An Evaluation of Remotely Administered Reaction Time Subtests
Authors: Nunez Christina , McDonald Bailey , Spagna Samantha , Golden Charles
Published: August 2021

Objective

Due to the COVID-19 pandemic, many services attempted to quickly transition to a remote format. A need to incorporate and evaluate a remote delivery of neuropsychological measures arose. TestMyBrain (TMB) from the Many Brains Project has been utilizing teleneuropsychology in research since 2017.

Method

Volunteer research participants (N = 176, Mage = 29, Medu = 15 years, 64.7% white, 54.2% female, 83.2% right-handed) were administered TMB Simple Reaction Time and Choice Reaction Time subtest as part of a larger battery via zoom. Participants were able to choose between completing these measures using a keyboard, mouse, or a touch screen. There were no significant differences among demographic variables across the different completion methods.

Results

An ANCOVA indicated there was not a significant difference in simple reaction time across the different response F(2,168) = 0.482, p = 0.618, ηp2 = 0.006. There was however a significant difference in choice reaction time across the different response methods F(2,168) = 11.486, p < 0.001, ηp2 = 0.120.

Conclusion

Results suggest different response methods maybe suitable for simpler tasks, yet there lacks consistency in response methods for more complex tasks. This medium effect size may have occurred as a result of the lack of sensitivity for devices to detect taps on different portions of the screen as effectively as various keys on a keyboard. Administrators must be aware of the limitations response methods may introduce into results. Limitation to this analysis include limited samples and not controlling for other factors that may potentially influence reaction time such as internet connection. Future research should focus on creating a standardized method for teleneuropsychology administration.
A-180 Predictors of Performance on the ImPACT Validity Indices at Baseline
Authors: Greenberg Liora , Merritt Victoria , Arnett Peter
Published: August 2021

Objective

To circumvent “sandbagging”, the ImPACT, a widely used computerized program in sports-related concussion evaluations, contains five embedded validity indices (VIs). This study aimed to identify variables associated with invalid performance (i.e., scoring beyond the trigger-warning threshold) on at least one VI.

Method

Analysis derived from 1287 college students was conducted utilizing a binary logistic regression. The dependent variable (the five VIs) was dichotomized into “Fail” (n = 71; 76.1% male, 66.2% Caucasian) and “Pass” (n = 1216; 69.8% male, 78.4% Caucasian) groups. Any athlete with invalid performance on one or more VIs was classified into the “Fail” group; athletes with valid performance across all five VIs were classified into the “Pass” group. Independent variables included age, sex, concussion history, depression, estimated FSIQ, learning disability, ADHD, and “post-concussion” symptoms. A SMOTE was applied to balance the dataset and 1000 iterations of the regression were applied.

Results

Significant associations across 1000 iterations of logistic regressions were found: Concussion history (p < 0.05, 992/1000), estimated FSIQ (p < 0.05; 997/1000), and depressive symptomatology (p < 0.05; 1000/1000) were negatively associated with “Fail” group membership. Learning disability (p < 0.05; 1000/1000) and post-concussion symptoms (p < 0.05; 1000/1000) were positively associated with “Fail” group membership. No associations were identified with sex or ADHD and group membership.

Conclusion

Results suggest that those with fewer concussions, lower estimated FSIQ, fewer depressive symptoms, learning disability, and more severe post-concussion symptoms may be more likely to show invalid test performance (or trend toward sandbagging) at baseline. Results have important clinical implications for identifying premorbid characteristics that may be indicative of sandbagging.
A-186 Preliminary Development of an Embedded Measure of Effort on the Memory Module of the Neuropsychological Assessment Battery (NAB)
Authors: Rodriguez Alexandra , Carrillo Alicia , Fasnacht-Hill Lisa , Iwanicki Sierra , Lechuga David
Published: August 2021

Objective

The Neuropsychological Assessment Battery (NAB) is an integrated neuropsychological battery for assessing cognitive skills in adults. The current study utilizes performance validity tests (PVTs) to interpret poor effort for scores on the NAB.

Method

Sample consisted of 306 adult civil litigants referred for a neuropsychological evaluation aged 18 to 85 years with a mean age of 43 years. Education ranged from 8 to 20 years with a mean of 14 years of education. Poor effort was denoted by “failing” 2 or more PVTs versus individuals who did not fail any PVTs (“pass”).

Results

Independent-samples t-tests were run to determine if there were differences in NAB Memory Module scores between the “pass” and “fail” groups. Multiple scores on NAB Memory Module yielded statistically significant differences. Scores were then used in subsequent ROC curve analyses to determine appropriate cutoff scores with an intent to maximally balance sensitivity and specificity. ROC curve analyses were favorable (i.e., AUC > 0.70) and yielded cut scores for List Learning A Immediate Recall (≤ 18), List Learning A Short Delayed Recall (≤ 6), List Learning A Long Delayed Recall (≤ 4), Shape Learning Immediate Recognition (≤ 15), Daily Living Memory Immediate Recall (≤ 39), Daily Living Memory Delayed Recall (≤ 11), List Learning A Discriminability (≤ 7), and Name/Address/Phone Delayed Recall (≤ 4) with sensitivity values ranging from 0.70 to 0.78 and specificity values ranging from 0.70 to 0.84.

Conclusion

Results provide preliminary evidence of suggested cutoffs to identify suspected poor effort for various scores in the NAB Memory Module.
A-194 TOMM Cutoff Scores Using a Large Sample of Military Personnel
Authors: Doddato Felicity R , Wang Yishi , Forde Jessica , Puente Antonio
Published: August 2021

Objective

The purpose of this study is to investigate the TOMM cutoff scores obtained in a large sample of military personnel. This study examines the traditional scores and proposes potential new ways to classify malingering using confidence intervals.

Method

The TOMM was administered as part of a neuropsychological battery a total of 1110 times, with the majority being one time. The battery contained 18 demographic variables and 15 neuropsychological tests. Participants were referred by military neurologists and medical officers for evaluation. Individuals had an initial clinical interview with a neuropsychologist prior to the battery being administered.

Results

TOMM scores from this sample ranged from 9 to 50. The majority of participants (N = 621, 79.60%) scored between 45 and 50. 26 participants (3.32%) received a 45, and 27 participants (3.46%) received a 44. Confidence intervals using means were calculated for each trial (95% CI [43.81, 44.74], [47.53, 48.28], 47.25, 48.10], respectively). The confidence interval for the average of all three trials was determined as well (95% CI [46.16, 46.95]).

Conclusions

These findings provide a description of the use of the TOMM with a large military sample. Further, the use of a confidence interval was added to provide a more robust assessment of effort. Future research should consider fitting scores to a probability distribution to determine the likelihood each participant is malingering based on the score they receive.
A-10 Role of Fluid Cognitive Status in the Association of Frontoparietal Control and Cingulo-Opercular Networks with the Useful Field of View Task: Implications for Cognitive Training in Aging
Authors: Hardcastle Cheshire , Hausman Hanna K , Kraft Jessica N , Albizu Alejandro , O'Shea Andrew , Evangelista Nicole D , Boutzoukas Emanuel , Van Etten Emily J , Bharadwaj Pradyumna K , Song Hyun , Smith Samantha G , Porges Eric , DeKosky Steven , Hishaw Georg A , Wu Samuel , Marsiske Michael , Cohen Ronald , Alexander Gene E , Woods Adam J
Published: August 2021

Objective

Training in a divided attention/speed-of-processing task called Useful Field of View (UFOV) reduced dementia risk in older adults. Higher connectivity in resting-state networks involved in attention/inter-network modulation (cingulo-opercular network(CON); frontoparietal control network(FPCN)) relates to better UFOV performance. Cognitive status relates to CON connectivity and UFOV performance. Therefore, it may be an important third variable to consider. This study assessed the mediation of cognitive status on the relationship between CON/FPCN connectivity and UFOV performance.

Methods

266 healthy older adults (age M = 71.4, SD = 5.18; 92% Caucasian) were recruited through a clinical trial at the University of Florida and the University of Arizona. Cognitive status was defined by the NIH Toolbox Fluid Composite score, assessing processing speed, attention/inhibition, executive functioning, and working/episodic memory. UFOV via the Double Decision assessment was administered. Participants underwent resting-state functional magnetic resonance imaging. Average within-network connectivity of CON and FPCN were extracted with the CONN Toolboxv18b via SPM12. Mediation of cognitive status on the relationship between CON/FPCN connectivity and UFOV performance was assessed controlling for sex, age, education, and site.

Results

Cognitive status fully mediated the indirect effect of CON on UFOV [b = −0.1776; 95%CI (−0.3194, −0.0684)] Figure 1, and FPCN on UFOV [b = −0.1461; 95%CI (−0.2934, −0.0342)] Figure 2.

Conclusions

Cognitive status accounted in part for the association between CON/FPCN connectivity and UFOV performance. Older adults with higher cognitive status had stronger functional connectivity and better UFOV performance. Future research should explore the influence of cognitive status on functional connectivity after UFOV training, and investigate which cognitive domains are most influential.
A-13 The Association of Specific Depression Factors and Cognitive Performance in Older Adults
Authors: Nash Allison , Rosenberg Raquel , Paxton Jessica
Published: August 2021

Objective

This study investigated whether particular dimensions of depression measured by the Geriatric Depression Scale (GDS) predicted memory and executive function performance in older adults. We hypothesized that the worry dimension would significantly predict both memory and executive function scores given findings from previous studies (De Vito et al., 2017).

Method

Participants included 534 individuals ages 50 through 85 (M = 63) from the Nathan Kline Institute’s Rockland community sample. The Rey Auditory Verbal Learning Test (RAVLT) was used to assess memory and the Tower Test subtest of the Delis-Kaplan Executive Function System (D-KEFS) assessed executive functioning. To assess different dimensions of depression, we computed variables for six dimensions of the GDS using the factor model validated by Adams et al. (2004).

Results

Regression analyses revealed that, controlling for age, none of the GDS factors significantly accounted for performances on RAVLT short or long delayed recall tests. The worry factor significantly predicted RAVLT Learning Trial 1 scores (β = −0.28, p < 0.05). Worry (β = −0.16, p < 0.05) and agitation (β = −0.18, p < 0.05) were the strongest predictors of total achievement scores on D-KEFS Tower Test.

Conclusion

These findings represent a deviation from expectations that depression symptoms would predict short and long-delay memory performances in an aging population. The particular role of worry in our other variables augments De Vito et al.’s (2017) findings, as we found that worry predicted short-term memory and executive functioning. These results demonstrate the importance of addressing worry symptoms in older adults for healthy executive functioning.
A-21 Neuropsychological Differentiation of Dementia with Lewy Bodies and Parkinson’s Disease Dementia
Authors: McDonald Bailey E , Spagna Samantha , Golden Charles
Published: August 2021

Objective

To determine whether or not distinct neuropsychological profiles could be created to aid in earlier detection in Dementia with Lewy Bodies (DLB) and Parkinson’s Disease Dementia (PDD).

Data Selection

A literature review was conducted informally to search for articles pertaining to neuropsychological testing with individuals with DLB or PDD that were dated within the past fifteen years.

Data Synthesis

Results indicated DLB typically has greater impairment in executive functioning, visuospatial, and attention in comparison to PDD. More specifically, individuals with DLB had significantly worse results on the Rey Complex Figure Test Copy Trial and Digit Span Forward than individuals with PDD. PDD was shown to typically have greater impairment in motor symptoms in comparison to DLB. These impairments, however, depend on the severity of disease progression.

Conclusions

In conclusion, DLB and PDD have very similar neuropsychological deficits, with greater deficits observed in executive functioning, visuospatial, and attention for individuals with DLB. Overall, majority of the literature is unsure of concrete diagnostic criteria for both individuals with DLB and PDD. This inconsistency has led the comparison of overall research to also been quite difficult as well. Future studies should try to control for medication and comorbidities, as well as include larger and more diverse samples with a full neuropsychological battery to include all domains of functioning. By doing this, the focus will shift more to on early detection and prevention of DLB and PDD and therefore reduce the financial burden of a neurocognitive disorder and the strain of caregiving that is usually placed within on the family.
A-25 Factors Predicting Trajectory in Daily Functioning Five Years Post Cognitive Training
Authors: Hansel Jamie , Thayer Rachel E
Published: August 2021

Objective

There is a bidirectional relationship between cognitive functioning and daily functioning. The current study aims to determine factors that are nonmodifiable and modifiable that predict trajectory of daily functioning.

Method

The ACTIVE database is a longitudinal study with participants aged 65 and older at baseline (M = 73.63, SD = 5.91) who were determined to be at risk for cognitive decline while still living independently. Participants’ self-reported and performance-based daily functioning scores at baseline were subtracted from their scores five-years later to determine daily functioning trajectories. Nonmodifiable factors (i.e., age, gender, race/ethnicity) and modifiable factors (i.e., education, BMI, cardiovascular risk factors, cognitive intervention, and booster sessions) were entered into hierarchical regression models to examine associations with daily functioning trajectories.

Results

Age was a significant predictor in four of five separate trajectory models (self-report measures f2 = 0.05, f2 = 0.11; performance-based measures f2 = 0.01, f2 = 0.01), and education contributed significant variance in self-reported independence (f2 = 0.03). Binary gender and race/ethnicity were statistically significant in the models but achieved negligible effect sizes. Physical health factors and cognitive training interventions were nonsignificant in predicting variance in daily functioning trajectories.

Conclusions

Age, a nonmodifiable factor, was the only consistently significant predictor of daily functioning within the current study. Future research could examine mood, sleep, and social connectedness as predictors of daily functioning trajectory, especially among patients who experience some cognitive or daily functioning difficulties, to better locate possible targets for intervention and treatment.
A-29 Lack of Performance Differences on the RCFT between Administration Methods in Adults with ADHD
Authors: Martin Karli M , Cardenache Rene Hernandez , Tourgeman Isaac
Published: August 2021

Objective

The Rey Complex Figure Test (RCFT) has the potential to assess executive function deficits commonly associated with ADHD. While commonly scored using the visuospatial criterion established in the Qualitative Scoring System (QSS), alternative methods have incorporated administration using colored pencils to evaluate planning and organization. Existing literature has discouraged administration using the colored pencil approach given suggestion that distractibility will impair performance. The current study challenged the assumption that individuals with distractibility should not be exposed to color administration.

Methods

Data was extracted from files of ADHD individuals previously assessed at a southern Florida hospital. A total of 25 participants (11 females and 14 males) were included in the analysis. Methods of analysis included independent t-tests and ANOVA to explore moderating factors of age, sex, race and diagnostic presentation.

Results

This study found that performance across the various parts of the test were not significantly different based on administration method (t = −1.021, p = 0.318, 95% CI: −4.3755, 1.4845). Interestingly, an ANOVA revealed no significant differences between the broad demographic groups in their performance. Independent t-test did not indicate that the RCFT performance could differentiate between types of ADHD (t = 0.118, p = 0.907, 95% CI: −2.8420, 3.1862).

Conclusion

In contrast to the RCFT manual, the results of the data analysis revealed no significant differences between administration methods in a highly inattentive population group. This study provides the basis for the introduction of studying the RCFT as a diagnostic tool for re-assessing ADHD throughout adulthood.
A-30 Measures of Attention and Inhibitory Control: Comparing the TOVA to the NIH Toolbox Flanker Test in Children and Adolescents with ADHD
Authors: Schaefer Amber N , Nicholls Christopher J
Published: August 2021

Objective

The Attention Comparison Score for the Test of Variables of Attention (TOVA) was developed as a “single score” method of differentiating individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) from controls (Leark, Greenburg, Kindschi, Dupuy & Hughes, 2008). Recent literature has documented that a more nuanced interpretation of TOVA scores, including the Attention Comparison Score, Commission Errors, and Omission Errors, can be more useful in describing the nature of impairment (e.g., sustained attention and/or inhibitory control) experienced by individuals diagnosed with ADHD (Winstone, Logid, Foley & Nicholls, 2019). The NIH Toolbox Cognition battery also assesses attention and inhibitory control by means of a Flanker Test. The current study examines whether the TOVA Attention Comparison Score predicts performance on the NIH Toolbox Flanker Test, and if adding TOVA Commission Error and Omission Error variables would predict greater amounts of variance on the Flanker Test in a pediatric sample.

Method

A sample of 64 pediatric patients (62.7% male, 37.3% female) diagnosed with ADHD aged 4–17 years (M = 11.25; SD = 3.74) was administered the NIH Toolbox Cognition Battery and TOVA as part of a comprehensive neuropsychological evaluation in a private practice in Scottsdale, Arizona.

Results

Our data found support that the more nuanced approach of adding commission and omission information better predicted Flanker scores than the Attention Comparison Score alone.

Conclusion

Based on the findings, clinicians utilizing the TOVA as a means of assessing for ADHD in pediatric populations should consider omission and commission errors to better understand attention and inhibitory control abilities.
A-31 Distinguishing Neuro-Markers of Math Learning Disability Using EEG Coherence
Authors: Luedke Jessica , Decker Scott L
Published: August 2021

Objective

The current study evaluated brain connectivity in math learning disability (MLD) by examining intra- and interhemispheric electroencephalography (EEG) coherence in three groups of children with differing math profiles. Differential patterns of connectivity were evaluated during “at-rest” conditions and statistically evaluated across three groups.

Method

Testing occurred in a university laboratory setting. Participants were recruited through media and local agencies serving children with disabilities. The Woodcock Johnson cognitive and achievement tests were used to determine general intelligence and skills across all math achievement subtests. Additionally, 3-minute eye-closed EEG resting data was collected. Groups used in the current study were: neurotypical controls (NC) (n = 30), math learning disability (MLD) (n = 15), and lower achievement (LA) (n = 15). Participants’ mean age was 9.58 (SD = 1.38) with 53.3% being male.

Results

Intrahemispheric comparisons suggest MLD children demonstrated reduced left hemispheric coherence to NC’s (p = 0.006), not seen in LA children. Additionally, NC’s had greater beta coherence (p = 0.002). Interhemispheric analyses revealed the MLD group had reduced alpha occipital coherence compared to the LA group (p = 0.031).

Conclusion

The current study provides supporting evidence for implicating brain connectivity as an underlying cause of MLD. Specifically, left hemispheric differences in delta coherence were found in children with MLD not observed in children with LA profiles. Weaknesses in areas of visuo-spatial integration in the MLD group were also observed. Results suggest atypical patterns of brain connectivity in the default-mode network (DMN) in delta wavelengths may serve as a useful biomarker of MLD.