bluuebunny/crossref_metadata_2025 huggingface dataset:
A - 108 Understanding Cognitive Deficits in Hashimoto’s Encephalopathy
Authors: Rios Guevara Linda V , Alcina Jorge , Duarte Andres , Gonzalez Dayron , Perez-Haddock Yanelee , Villafana Mei-Ling
Published: October 2023

Objective

The systematic review aims to explore areas of cognitive impairment in patients diagnosed with Hashimoto’s Encephalopathy (HE).

Method

A systematic review of current HE literature was conducted from 2013 to 2023. We conducted a bibliographical search of peer-reviewed articles through PubMed and Google Scholar using keywords Hashimoto, encephalopathy, and cognitive deficit. The review also included articles designated as “case reports” or “case studies” published in English and within the same time frame noted above. From the initial search results, 100 articles were extracted for initial review. Following this search, 9 articles were retained. The excluded articles were not in English and did not have HE as the main diagnostic criteria.

Results

The literature highlighted classic clinical manifestations, including acute to subacute onset of cognitive confusion with alteration of consciousness. Cognitive deficits and generalized seizures were the most common manifestations in diagnosis.

Conclusions

While HE is a rare clinical condition presenting in patient populations between their 50s and 60s, it should be considered in any patient presenting acute or subacute encephalopathy of unknown etiology or in patients with diffuse cognitive decline with an intermittent or progressive course. While the medical condition can be treated with immunosuppressive therapy, around 2–5% of patients may not respond to medical treatment. The treatment of the neurocognitive presentation in HE patients has yet to be evaluated. Limitations of the present review include scarce empirical literature in this area of study and small sample sizes of some of the available studies.
A - 109 Language and Executive Function Outcomes in Bilingual Versus Monolingual Stroke Patients
Authors: Rios Guevara Linda V , Alcina Jorge , Duarte Andres , Gonzalez Dayron , Haddock Yanelee Perez , Villafana Mei-Ling
Published: October 2023

Objective

This systematic literature review sought to investigate the impact of bilingualism versus monolingualism on language and executive function outcomes in adult patients diagnosed with strokes.

Method

A review of the current literature was conducted from 2013 to 2023. We conducted a bibliographical search of peer-reviewed articles through Google Scholar, PubMed, and Taylor&Francis Online using the keywords language outcomes, executive function outcomes, bilingual vs. monolingual, and stroke patient bilingual outcomes. From the initial search results, 20 articles were extracted for an initial review. Following this search, 4 articles were retained. Articles excluded were not peer-reviewed, did not have a stroke or bilingual vs. monolingual outcomes as the main criteria, and were not originally in or translated to English.

Results

The literature identified bilingualism as an independent predictor of post-stroke cognitive impairment. However, when assessing the bilingual groups, contradicting results across the literature were found. It was indicated that when testing bilingual patients in their secondary language, their language and executive performance are most likely to decrease after a stroke.

Conclusions

Although literature comparing language and executive function in bilingual and monolingual stroke patients is limited, results have demonstrated that bilingualism is associated with better cognitive outcomes post-stroke when patients are evaluated in their primary language. Nonetheless, persistent executive function deficits are suggestive of a cautionary interpretation of a potential bilingual advantage in the acute stage of the condition.
A - 112 Subjective and Objective Cognition in Patients Driving with Multiple Sclerosis
Authors: Schecter Rachel , Foley Frederick
Published: October 2023

Objective

Multiple sclerosis (MS) is a disease of the central nervous system that results in focal lesions of demyelination, inflammation, and axonal damage to the brain and spinal cord. MS affects nearly one million people in the United States. Drivers with MS have been characterized by shorter disease durations, milder disabilities and greater awareness of their deficits compared to non-drivers. Cognitive function can impact MS patients’ driving abilities, specifically their processing speed, attention and visuospatial deficiencies.

Method

This study evaluates whether subjective cognitive decline (SCD) can predict objective cognitive functioning to improve identification of patients at risk for impaired driving. All participants were patients at an MS Center, and had a diagnosis of MS based on the McDonald criteria. One hundred and eight MS patients were included in the study, and all participants completed the symbol digit modality test (SDMT).

Results

The majority of patients were female (75.9%), and only 19.4% of study participants reported having SCD that impact their driving ability. Participants with poorer processing speed had endorsed cognitive difficulties impacting their driving, U = 503.00, p = 0.001. Results suggest that slower SDMT scores may likely predict SCD.

Conclusion

Patients with MS with poorer processing speed were also likely to report a SCD, and had a higher incidence rate of motor vehicle accidents. This relationship needs to be further assessed to aid in the safety of patients of MS and understanding if barriers such as lack of social support or work obligations that require them to continue driving.
A - 113 Strengths-Based Neuropsychology in Neurological Surgery: a Neuropsychiatric Case Study of Treatment Refractory Right-Sided Focal Seizures
Authors: Seger Madison , Sacks-Zimmerman Amanda , Bender Heidi A , Kandula Padmaja
Published: October 2023

Objective

Psychiatric comorbidity is high among patients with epilepsy, found more frequently with right-sided seizure foci. Neurosurgical intervention is often the standard of care for refractory epilepsy; unfortunately, psychiatric symptoms can impact a patient’s compliance and participation in the pre-surgical process. This pre-surgical epilepsy case illustrates the importance of neuropsychological evaluation in clarifying the relationship between cognitive functioning and long-standing psychiatric comorbidities to inform surgical candidacy.

Method

A 20-year-old, left-handed, bilingual Caucasian female with seven years of education with cortical dysplasia associated with intractable right-hemisphere localization-related epilepsy underwent neuropsychological evaluation for progressive short-term memory and word-finding difficulty as part of a pre-surgical workup. A clinical interview, neuropsychological testing, and comprehensive review of available electronic medical records (EMR) were completed.

Results

Neuropsychological estimates of current intellectual functioning were low average but variable, revealing a relative strength in non-verbal learning and memory compared to verbal abilities. Self-report emotional measures evidenced clinically elevated levels of anxiety and depression and reduced quality of life due to epilepsy. Psychiatric diagnoses included attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, oppositional defiant disorder, and panic attacks. EMR and clinical interview indicated medication non-compliance, alcohol intoxication, dysregulated sleep hygiene, seizure-related injuries, and history of status epilepticus.

Conclusion

Consistent with the literature, this pre-surgical case demonstrated significant psychiatric symptoms in the context of right-sided treatment refractory epilepsy. While psychiatric comorbidities contributed to non-adherence with medical recommendations, under-functioning in vocational goals, and general hopelessness, the neuropsychological evaluation revealed strengths that impacted surgical candidacy and rapport-building that facilitated patient engagement and understanding of the surgical process.
A - 116 Wernicke’s Encephalopathy in the Setting of Cacosmia Secondary to COVID-19
Authors: Szczepkowski Kirk , Pinjala Maya , Kuwabara Hana
Published: October 2023

Objective

Olfactory and gustatory dysfunction are common symptoms in COVID-19, with some individuals developing persistent parosmia/cacosmia despite resolution of acute infection. There have been few case reports of Wernicke’s encephalopathy (WE) resulting from complications of COVID-19, including malnutrition due to significant emesis and parosmia/cacosmia. This case presents a neuropsychological profile of a patient with WE following COVID-19.

Method

Patient is a 40-year-old female who acquired COVID-19 in early 2021 that did not require significant intervention. She developed anosmia that resolved in about 2 weeks but developed cacosmia upon return of sensation, resulting in near daily nausea, emesis, and anorexia. She experienced intermittent periods of confusion and bilateral lower extremity paresthesia. Over a year later, she presented to the hospital due to altered mental status, oculomotor dysfunction, and gait ataxia. She was deficient in thiamine, folic acid, and copper. MRI was significant for increased T2/FLAIR signal involving the mammillary bodies, periaqueductal gray matter, and medial thalami bilaterally. She was hospitalized for 7 days and in acute rehabilitation for 9 days, with ongoing rehabilitative therapies. Neuropsychological evaluation was conducted 10 months post hospitalization.

Results

Neuropsychological testing was significant for memory difficulties (both verbal and visual information), predominantly encoding/retrieval deficits with evidence of decreased efficiency of consolidation. She also demonstrated difficulty with select aspects of executive functioning. Her profile was otherwise unremarkable. Diagnosis was Mild Neurocognitive Disorder.

Conclusions

This case demonstrates neurocognitive sequela of WE in the unique setting of cacosmia secondary to COVID-19. Patients with persistent olfactory/gustatory complications may be at risk for cognitive sequela of malnutrition/WE.
A - 120 Fatigue Moderates the Relationship between Negative Attributional Style and Depression Symptoms in Multiple Sclerosis
Authors: Verkuilen Alexa , Bradson Megan , Arnett Peter
Published: October 2023

Objective

To investigate whether fatigue moderates the relationship between negative attributional style and depression symptoms in persons with Multiple Sclerosis (PwMS).

Method

Forty-seven PwMS (39 Female) completed a comprehensive neuropsychological test battery and psychosocial questionnaires. The Attributional Style Questionnaire was utilized to create internal, stable, and global attribution dimension scores, and an overall attributional style score combining the three dimensions. Overall, physical, psychosocial, and cognitive fatigue were measured using the Fatigue Impact Scale (FIS). The Beck Depression Inventory-Fast Screen was used to measure depression symptoms. Separate regressions with depression symptoms as the outcome were conducted with attributional style, each type of fatigue, and their interactions included as predictors.

Results

Regression analyses revealed that the interaction between attributional style and overall fatigue significantly predicted depression symptoms (p = 0.049). Simple effects tests showed that overall attributional style significantly predicted depression symptoms when overall fatigue was high (p = 0.008). The interactions between attributional style and both physical fatigue (p = 0.003) and psychosocial fatigue (p = 0.039) also significantly predicted depression symptoms. Simple effects tests showed that attributional style was associated with depression symptoms only in PwMS with high physical fatigue (p < 0.001) and high psychosocial fatigue (p = 0.018).

Conclusions

Fatigue moderated the relationship between overall attributional style and depression symptoms in PwMS. Specifically, attributional style was only significantly associated with depression symptoms in PwMS reporting high levels of overall, physical, and psychosocial fatigue. Interventions aimed at targeting fatigue may reduce the risk that negative attributional style will lead to depressive symptoms in MS.
A - 125 Posttraumatic Stress Disorder Symptom Severity and its Relationship to Performance on the Test of Memory Malingering in a Veteran Sample
Authors: Marceaux Janice C , Bain Kathleen M , Andrews Anthony P , Valencia Julianna P
Published: October 2023

Objective

To examine relationships between Posttraumatic Stress Disorder (PTSD) symptom severity and performance on the Test of Memory Malingering (TOMM) trials in veterans without a diagnosis of neurocognitive disorder.

Method

A sample of 47 clinically-referred veterans (80.9% male; Mage = 57.47, SD = 14.83; Medu = 13.91, SD = 2.5) who did not meet criteria for a neurocognitive disorder completed the PTSD Checklist for DSM-5 (PCL-5) and the TOMM. Primary diagnoses included PTSD (48.9%), no diagnosis (23.4%), and depression (19.1%). A cutoff of 45 was used for each trial; 47 completed Trial 1 (TOMM-T1), 17 completed Trial 2 (TOMM-T2), and 10 completed Retention Trial (TOMM-Ret). Nine participants (19.1%) failed the TOMM. Analyses included Pearson correlation, Spearman correlation, and independent-samples t-tests. Age was negatively correlated with PCL-5 and positively correlated with TOMM-T1; therefore, relevant partial correlations were conducted.

Results

TOMM-T1 demonstrated a moderate, negative correlation with PCL-5, rs(45) = −0.469, p < 0.001, 95%CI(−0.688,-0.248). A moderate non-significant correlation was found between TOMM-T2 and PCL-5, rs(15) = −0.405, p = 0.053, 95%CI(−0.775,0.014). PCL-5 and TOMM-Ret were not correlated. Controlling for age, the correlation between PCL-5 and TOMM-T1 remained significant (rs[44] = −0.426, p = 0.002). Those who passed TOMM (M = 38.45, SD = 16.48) had significantly lower PCL-5 scores compared to those who failed (M = 57.67, SD = 13.83), t(45) = −3.231, p = 0.001, Cohen’s D = 16.04.

Conclusions

Among veterans, PTSD symptom severity was related to TOMM scores and/or failure. Findings highlight a need to consider the role PTSD symptoms may play in neuropsychological assessment. Findings further support recommendations for trauma-focused treatment before formal neuropsychological testing, as psychiatric symptoms may interfere with obtaining a valid assessment of cognition.
A - 126 Cognitive Performance in Individuals with Major Depressive Disorder and no Diagnosis
Authors: Molina Karla , Abinader Melodie , Nunez Christina , Golden Charles
Published: October 2023

Objective

To compare performance in neuropsychological assessments between a sample of individuals with Major Depressive Disorder (MDD) and those with no diagnosis.

Methods

The MDD group (n = 77; Mage = 34.69, SD = 12.80; Med =13.41, SD = 2.45) had 41.6% male, 69.7% White, 10.5% Black, 17.1% Hispanic, and 2.6% other race). The undiagnosed group (n = 83, Mage = 33.39, SD = 11.82; Med =13.62, SD = 3.02) had 56.6% male, 56.6% White, 18.1% Black, 16.9% Hispanic, and 8.4% other. Participants were selected from a de-identified outpatient clinical database. The groups did not differ significantly in age, years of education, race, or gender (p values >0.05).

Results

No significant differences were found in intellectual functioning or memory ability as measured by the WAIS-IV and WMS-IV, respectively (p values >0.05). At the group level, individuals diagnosed with MDD completed significantly fewer categories [t(137) = −2.15, p = 0.02] and made more errors [t(137) = 1.99, p = 0.02] and perseverative responses [t(135) = 2.66, p = 0.004] on the WCST than undiagnosed participants.

Conclusion

The increased number of errors and perseverative responses among individuals with MDD might be associated with difficulties sustaining attention, set-shifting, and abstract concept formation associated with depression. As expected, we did not observe differences in recognition memory or intellectual functioning, which tend to remain stable in the presence of mood disorders. Limitations of our study include the lack of a premorbid measure of intellectual functioning and MDD severity. Future research could explore the effect of MDD severity on cognitive performance.
A - 131 Social Adjustment and Functioning in Serious Mental Illness Is Predicted by Social Cognition
Authors: Gates-Woodyatt Jessica , Ringdahl Erik N , Standridge Jennifer , Collins Delaney , Goto Amber , Allen Daniel N
Published: October 2023

Objective

Deficits in social cognition (SC) and social functioning (SF) are prominent in schizophrenia. This study used standardized assessments to examine SC and SF to determine if similar deficits are present in persons diagnosed with bipolar disorders.

Method

The Awareness of Social Inference Test (TASIT) was used to assess emotion identification and social inference, and the Social Functioning Scale (SFS) to assess SF domains (Social Engagement, Interpersonal Communication, Independent Performance, Independent Competence, Recreation, Prosocial, and Employment). The TASIT and SFS were administered to individuals with schizophrenia (SZ; N = 22), bipolar disorder with psychotic features (BP+; N = 20) or without psychotic features (BP-; N = 21), and healthy controls (HC; N = 22). Mixed model ANOVA examined group differences and multiple regression determined if SC predicted SF.

Results

The SZ group showed significantly worse SF compared to all other groups. There was no significant difference between the BP+ and BP-, and both BP groups performed worse than HCs. For multiple regression, the three clinical groups (SZ, BP+, BP-) were combined to yield an overall SMI group (N = 63). TASIT emotion identification and social inference predicted performance on SFS domains of Independent Performance, Independent Competence, Recreation, Prosocial, and SFS total score. Emotion identification was the strongest predictor of the Independent Performance domain in comparison to social inference.

Conclusions

Performance on the TASIT predicted performance across several domains of SF in SMI. Differences were present based on the specific SC abilities and SF domains, suggesting SC abilities are more strongly associated with some functional domains but not others, which may help guide clinical decision making.
A - 132 Social Cognition Predicts Functional Outcomes in Serious Mental Illness
Authors: Gates-Woodyatt Jessica , Ringdahl Erik N , McGinty Kayla Fobian , Calip Gia , Done Monica , Allen Daniel N
Published: October 2023

Objective

Schizophrenia and bipolar disorder are leading causes of functional disability worldwide. Difficulty completing instrumental and more routine activities of daily living is one of the most limiting and overlooked features of these disorders. The current study investigated whether deficits in social cognition are associated with increased functional disability in overall serious mental illness (SMI).

Method

Individuals with schizophrenia (SZ; N = 22), bipolar disorder with psychotic features (BP+; N = 20) and without psychotic features (BP-; N = 21), and healthy controls (HC; N = 22) completed The Awareness of Social Inference Test (TASIT) to examine emotion identification and social inference, and The University of California, San Diego Performance-Based Skills Assessment (UPSA) to assess functional capacity. A mixed model ANOVA was performed to examine group differences and multiple regression was used to determine if social cognition predicted social functioning.

Results

The SZ group showed significantly worse UPSA functional performance compared to all other groups. The three diagnostic groups (SZ, BP+, BP-) were merged to yield an overall SMI group (N = 63). Multiple regressions indicated TASIT emotion identification and social inference predicted UPSA functioning in household maintenance, communication, finance management, and planning. Social inference was the strongest predictor of overall UPSA functioning, compared to emotion identification.

Conclusions

TASIT scores predicted performance across several domains of functioning in SMI. Since functional outcomes are a strong indicator of clinical recovery throughout the course of SMI, additional research may investigate the role that social cognitive abilities play in this recovery.
A - 143 Factor Structure of the Beck Anxiety Inventory in Mild Traumatic Brain Injury
Authors: Hayden Abigail M , Erickson Thane , Chu Zoey , Glisky Martha , Caughie Cali , Wee Janelle Y
Published: October 2023

Objective

The Beck Anxiety Inventory-II (BAI) is a widely used screening instrument for anxiety symptoms in clinical and medical populations. The factor structure of the BAI remains unknown for people with mild traumatic brain injury (mTBI), despite common anxiety symptoms in this group. This study compared one, two, and four-factor models of the BAI in an mTBI sample.

Data Selection

A sample of 141 individuals diagnosed with an mTBI were evaluated. All subjects were administered the BAI screening measure during a comprehensive neuropsychological evaluation in a private practice setting. Confirmatory factor analysis was used to test whether items loaded on a single anxiety factor, a two-factor structure with a somatic-affective and cognitive component of anxiety (based on original BAI), or a four-factor structure derived from studies in other populations with cognitive impairments.

Data Synthesis

The sample was predominantly female (63%), with a mean age of 46.93 (SD = 13.28) and a mean education level of 15.08 (SD = 2.65). Consistent with prior literature, 69% of our sample reported at least mild symptoms of anxiety (BAI > 8). Confirmatory factor analysis (CFA) results indicated the best fit was the model with four factors consisting of cognitive, autonomic, neuromotor, and panic symptoms, CFI = 0.92; RMSEA = 0.067, 90% CI (0.053,0.081).

Conclusion

These results suggest that instead of the two-factor model posited by original creators of the BAI, clinicians and researchers should attend to four clusters of anxiety symptoms in mTBI populations. Anxiety symptoms following mTBI can be evaluated based on cognitive, autonomic, neuromotor, and panic components.
A - 150 Emotional Awareness in Individuals with Traumatic Brain Injury
Authors: Lengenfelder Jeannie , Leddy Jacqueline , Pek Nicholas , Chiaravalloti Nancy
Published: October 2023

Objective

To examine emotional awareness in individuals with traumatic brain injury (TBI) utilizing the Levels of Emotional Awareness Scale (LEAS).

Methods

Thirty-nine individuals with moderate–severe TBI received the Levels of Emotional Awareness Scale (LEAS) consisting of 10 scenarios. Each scenario contains two components: a self-component, where participants are required to describe how they would feel, and another component, where they describe how the other person in the scenario would feel. Individuals also received Empathy Scale (ES) and Empathy Quotient (EQ) to evaluate empathy as well as measures of quality of life (Quality of Life After Brain Injury QOLIBRI), satisfaction with life (SWL), and mood (Beck Depression Inventory-II BDI-II; State Trait Anxiety Inventory- STAI).

Results

Individuals with TBI had a mean age of 46.08 (12.67), education of 14.28 (1.90) years and were on the average 113.25 (104.63) months since injury. Results indicate that the LEAS is associated with empathy on both the ES r(39) =0.34, p = 0.034 and EQ r(39) =0.37, p = 0.019. The LEAS was not associated with QOLIBRI r(39) =0.09, p = 0.572, SWL r(39) = −0.18, p = 0.286, BDI-II r(39) =0.12, p = 0.453 or STAI r(39) =0.05, p = 0.758.

Conclusions

Our data suggests individuals with TBI emotional awareness is associated with empathy, specifically lower emotional awareness is associated with lower empathy. Emotional awareness is not associated with quality of life, satisfaction with life or mood. Understanding the relationship between these two constructs may aide in where to target interventions to improve social outcomes for individuals with TBI.
A - 152 Won’t Get Fooled Again: Factors in Persistent Complaints Following Youth Concussion
Authors: Marschall Kelsea P , O'Reilly Molly , Barros Kathleen , Hammond Jared , Lichtenstein Jonathan
Published: October 2023

Objective

While symptoms following youth concussion typically resolve within one month of injury, some patients report persistent post-concussive symptoms (PPCS). The current project aims to characterize a sample of sports neuropsychology patients, examine clinical outcomes, and determine relevant factors.

Methods

Sports neuropsychology evaluated 38 consecutively referred patients at a rural academic medical center. The sample was 50% female, mostly White (91.9%), and ranged from 7–22 years of age (M = 16.45, SD = 2.92). Most had pre-existing conditions (medical/psychiatric; 78.9%), and 63% had at least one previous concussion. Months-from-injury varied (median = 4; range = 1–29). FSIQ was average (M = 107, SD = 15.45). We analyzed relationships between factors and outcomes using correlations (Spearman’s rho or Pearson’s r) and stepwise linear regression to determine prediction.

Results

Only nine patients’ persistent complaints were due to concussion, while medical or psychiatric etiologies explained PPCS in the majority of the sample (76.3%). Outcomes were uncorrelated with gender, age, race, IQ, or months-since-injury. Pre-existing depression (rs(37) = −0.40, p = 0.01) and migraines (rs(37) = −0.35, p = 0.02) both showed significant moderate correlations with outcome. Stepwise regression indicated that only pre-existing depression (β = −0.360, p = 0.01) significantly predicted the non-concussion clinical outcome.

Conclusions

In our sample, the etiology of PPCS was something other than concussion in over 76% of youth seen by sports neuropsychology. Pre-existing depression and migraines were significantly correlated with this outcome, and depression was a significant predictor. These results add to the literature on PPCS in children. Neuropsychologist involvement earlier in concussion care may help prevent PPCS by rapidly connecting patients to the proper interventions, thereby reducing families’ economic burden and improving patients’ quality of life.
A - 153 Differing Impacts of Divided Auditory and Visual Attention on Abstract Reasoning among Patients with Mild Traumatic Brain Injury
Authors: Mateer Elizabeth , Wee Janelle Y , Caughie Cali , Chu Zoey , Glisky Martha
Published: October 2023

Objective

Although not all mild traumatic brain injuries (mTBIs) lead to long-term effects, they can still have significant cognitive and emotional impacts. One of the common lasting symptoms of mTBI is attentional deficit, with divided attention being specifically negatively impacted by mTBIs. This study investigated the impacts of divided auditory attention and divided visual attention on executive functioning among patients with mTBI.

Method

Participants were 98 mTBI patients. Ethnicity was self-identified as 77.5% White, 6.3%, Asian, 2.7% Hispanic, and 13.5% Mixed/Other, gender was 68% women. Tests included the Neuropsychological Assessment Battery (NAB) Numbers & Letters Test to assess divided visual attention, Paced Auditory Serial Addition Task (PASAT) for divided auditory attention, and the Halstead Category Test (HCT) to assess the abstract reasoning domain of executive functioning as part of a full neuropsychological evaluation at a private outpatient clinic. Multiple linear regression was used to analyze the data.

Results

The overall model was statistically significant (F(3,94) = 3.23, p = 0.03, R2 = 0.09). Results indicated a significant positive relationship between abstract reasoning and auditory divided attention (β = 2.42, p = 0.03), but no significant relationship between abstract reasoning and visual divided attention (β = 1.5, p = 0.2).

Conclusions

The findings of this study suggest that divided auditory and visual attention may impact the abstract reasoning and problem-solving domain of executive functioning differently among those who have sustained mild traumatic brain injury. Specifically, divided auditory attention may play a more significant role in abstract reasoning abilities than visual divided attention.
A - 163 Investigating the Relationship between the Brief Resilience Scale (BRS) and Screening Measures of Anxiety, Depression, and Emotional Symptoms in Adolescents with Concussion
Authors: Shurtz Logan , Bunt Stephen C , Chowdhury Sebastian K , Didehbani Nyaz , Stokes Matthew , Miller Shane M , Bell Kathleen R , Cullum C Munro
Published: October 2023

Objective

Resilience has been found to be a factor in concussion recovery, and the Brief Resilience Scale (BRS) has been validated as a measure of resilience in adults. Investigation of the BRS in adolescents with concussion and its relationship with current measures of anxiety, depression, and emotional symptoms may prove beneficial in further understanding emotional response to concussions in adolescents.

Method

Participants aged 12–17 who sustained a concussion (n = 1168) were evaluated within 30 days of injury at a North Texas Concussion Registry (ConTex) clinic. Participants completed the Brief Resilience Scale (BRS), the General Anxiety Disorder 7 scale (GAD-7), the Patient Health Questionnaire depression scale (PHQ-8), and the emotional cluster (feeling irritable, sad, nervous, and more emotional) of the Sport Concussion Assessment Tool 5th Edition Symptom Evaluation (SCAT5) at initial visit. Pearson’s correlation coefficient (r) was used to determine the relationship between scores on these four measures.

Results

Pearson correlations between BRS scores and scores from the other measures were modest but statistically significant: GAD-7 (r = −0.392, p < 0.001), PHQ-8 (r = −0.321, p < 0.001), and the emotional cluster of the SCAT5 (r = −0.301, p < 0.001).

Conclusions

Comparison of BRS score with GAD-7, PHQ-8, and the emotional cluster of the SCAT5 indicates that resilience may exhibit a modest inverse correlation with screening measures of anxiety, depression, and emotional symptoms, and thus a discrete factor for use in evaluating initial emotional response to concussion in adolescents.
A - 173 Symbol Match Validity at the Montefiore Memory Disorder Centers
Authors: Carmona Gabriela , Nsubayi Celeste , Stimmel Marnina , Ayers Emmeline , Verghese Joe , Weiss Erica F
Published: October 2023

Objective

To demonstrate the validity of the Symbol Match in a diverse clinical setting.

Background

To improve detection of cognitive impairment in older primary care patients, our team developed the 5-Cog, a 5-minute cognitive assessment and decision tree paradigm that can be administered by non-clinicians. The Symbol Match is a new 90-second oral symbol and digit substitution task that is one of the three tests in the 5-Cog that assesses processing speed and executive function.

Methods

50 participants (66% female; 44% Hispanic, 38% Non-Hispanic Black; 36% evaluated in Spanish) with a mean age of 77.84 ± 7.3, and 12 ± 4.7 mean years of education. Participants were recruited following clinical evaluations at the Montefiore Memory Disorder Centers and had confirmed clinical diagnoses of dementia, mild cognitive impairment (MCI), or subjective cognitive concerns (SCC).

Results

Symbol Match scores were significantly different (p < 0.001) between participants with SCC (N = 5, M = 48 ± 9.7), MCI (N = 14, M = 31.7 ± 14.3), and dementia (N = 28, M = 9.6 ± 11.5). Age (p = 0.004) and education (p < 0.001) were correlated with Symbol Match score in the overall sample. Symbol Match scores were significantly different between the 3 disease states (p < 0.001) even when controlling for age and education. The Symbol Match was highly correlated (r = 0.843, p < 0.001) with the Symbol Digit Modalities Test (SDMT), an established neuropsychological measure of processing speed and executive function.

Conclusion

This study provides initial validation of the Symbol Match and its utility in a clinical population. Further research on psychometric properties and construct validity of this new tool is needed.
A - 175 EEG Phase Can be Predicted with Similar Accuracy across Cognitive States after Accounting for Power and SNR
Authors: Kim Brian , Erickson Brian A , Fernandez-Nuñez Guadalupe , Medaglia John D , Mentzelopoulos Georgios , Rich Ryan R , Vitale Flavia
Published: October 2023

Objective

Electroencephalogram (EEG) phase can capture neural oscillation dynamics. Accordingly, EEG phase is a potential target for neurofeedback and brain-computer interfaces (BCIs). However, rigorous tests of the generalizability of real-time EEG phase are needed, requiring accurate phase estimates. We examined how cognitive states affect EEG phase prediction accuracy in the parieto-occipital alpha band.

Data Selection

We identified datasets through public repositories. After preprocessing, we used the Educated Temporal Prediction Algorithm (ETP) to predict future peaks. We compared these predictions to the original signal, and defined accuracy from 0 to 100%. Our independent variable was cognitive state (eyes-open rest, eyes-closed rest, task), dependent variable was accuracy, and covariates were EEG instantaneous power and signal-to-noise ratio (SNR). We used a linear mixed-effects model, with random effects for dataset and individual.

Data Synthesis

Across the 11 datasets, we had 543 participants and 1,641,074 predictions. There were no significant accuracy differences among the conditions (p < 1e-5), with a baseline accuracy of 59.07%. Power had an effect on accuracy, with a unit increase leading to a 13.1% increase in accuracy (p < 1e-5). SNR had an effect on accuracy, with an effect size of 0.46% (p < 1e-5), with a significant negative interaction with power with an effect size of −0.51% (p < 1e-5).

Conclusion

Our results indicated that we could predict EEG phase accurately across cognitive conditions and datasets, with higher accuracy for high instantaneous band-power and SNR. Accordingly, real-time EEG phase experiments, closed-loop technologies, and BCIs should minimize external unwanted noise while targeting periods of high power, as opposed to manipulating experimental and cognitive conditions.
A - 178 Development and Psychometric Properties of an Abbreviated Version of the Identi-Fi: a Test of Visual Organization and Recognition
Authors: Rodriguez Alexandra M , Iwanicki Sierra
Published: October 2023

Objective

There is a growing demand for efficient neuropsychological screening instruments to better triage referrals for more specialized evaluations. In particular, visuospatial problems tend to appear fairly early in Alzheimer’s dementia. The Identi-Fi: A Test of Visual Organization and Recognition is a reliable and valid measure of visual organization ability. Administration and scoring take 15 minutes, which precludes its use as a screening instrument. The current study aimed to create a brief version of the test for use in a standard screening battery.

Method

The normative sample participants (n = 901) and dementia clinical sample participants (n = 25) were administered the Identi-Fi.

Results

Item statistics were examined to develop short versions of the Visual Matching and Visual Recognition subtests with the goal of efficiently differentiating between the normative and dementia groups. Results yielded an 11-item VM (scores ranged from 0–11) and 11-item VR (scores ranged from 0–11) abbreviated subtest. 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 for both subtests (i.e., AUC ≥ 0.85), with cut scores at ≤7 for VM and ≤ 8 for VR. Sensitivity values ranged from 0.76 to 0.80 and specificity values ranged from.79 to.83 for the measure.

Conclusion

Results provide preliminary evidence of an abbreviated version of the Identi-Fi to assist in dementia screening.
A - 181 Test Fairness and True Peer Norms for English Learners: a Validation Study of the Ortiz Picture Vocabulary Acquisition Test
Authors: Wong Jane Y T
Published: October 2023

Objective

The Ortiz Picture Vocabulary Acquisition Test (Ortiz PVAT; Ortiz, 2018) incorporates English learners (ELs)’ lifetime exposure to English (LEE) in the assessment of ELs’ English receptive vocabulary. The current study aimed to examine the validity of the test and to provide support for the use of true peer norms that control for differences in LEE among ELs.

Method

An archival community-based dataset (N = 226; ages 2:7 and 18:11) drawn from the New York City metropolitan area was used to assess generalizability of Ortiz PVAT test scores, differences in standard scores obtained via traditional age norms vs. EL norms which account for LEE alongside age, and the predictive value of LEE.

Results

No significant differences in Ortiz PVAT performance was found based on gender or home language group membership, suggesting that the test measures receptive vocabulary in English in a fair manner across those demographic groups. Higher LEE was associated with better performance on the Ortiz PVAT. Significant differences in age-based standard scores with a medium effect size was found between monolingual English speakers and ELs with low or moderate LEE but not when LEE is accounted for using the EL norms. Lastly, an additional 18% of variance in Ortiz PVAT raw scores was accounted for by LEE above and beyond age, and LEE was found to exert more influence on test performance compared to age.

Conclusion

Results added to the existing fairness evidence for the Ortiz PVAT and supported the use of true peer norms to account for differences in LEE.
A - 184 Validity of the Infrequent Patterns of Performance Embedded Performance Validity Indicators in a Mixed Clinical Sample
Authors: Parks Adam , Reinhart Clare , Ecklund-Johnson Eric , Brunette Amanda , Spresser Carrie , Stroescu Ioan
Published: October 2023

Objective

Novel performance validity tests (PVTs) for the Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R), derived from infrequent patterns of performance (IPOP), were developed to examine invalid memory performance while reducing false positive misclassification. To examine their classification accuracy, these indicators were compared to several existing embedded PVTs in a mixed clinical sample.

Method

A chart review was completed for 75 adult outpatients (Mean Age = 52, Range = 19–85) referred to an academic medical center outpatient clinic for neuropsychological evaluation. Twenty-eight percent of the sample failed the Medical Symptom Validity Test (MSVT), which was used as the criterion to indicate invalid performance. Several established embedded validity indicators were calculated from HVLT-R and BVMT-R scores, including the recognition discrimination index (RDI) and percent retention (PR), as well as the Reliable Digit Span (RDS) validity indicator. Classification statistics, including sensitivity, specific, likelihood ratios, predictive values, and overall accuracy, were calculated and compared.

Results

The HVLT-R IPOP had a higher overall classification accuracy (72%) compared to the RDI indicator (68%) while maintaining excellent specificity (97%). The BVMT-R IPOP had identical classification accuracy (75%) compared to the RDI and PR indicators with very high specificity (96%). Both indicators were more accurate than RDS (72%).

Conclusions

The HVLT-R and BVMT-R IPOP performance validity indicators produced adequate classification statistics when compared to existing embedded PVTs. Both indicators maintained excellent specificity, which is crucial in reducing false positive classification. Future research will focus on further examining the validity of these indicators in other clinical groups and known groups, including medico-legal populations.
A - 186 Performance Characteristics of the Structured Inventory of Malingered Symptomatology in a Diverse Community Sample of Social Security Disability Applicants
Authors: Meharg Stephen S , Greenwald Cassie , Calver James D
Published: October 2023

Objective

Analyze performance characteristics of the Structured Inventory of Malingered Symptomatology (SIMS) in a diverse community sample of SSDI applicants.

Method

532 adult SSDI applicants providing research consent were administered the SIMS in conjunction with standard psychodiagnostic, intellectual, and neuropsychological assessments performed in a private practice setting. A broad range of ages and referring diagnoses are represented. Mean age was 42 years (SD = 13), with 56% female and 44% male. Based on the nature of the examination, WAIS (n = 47), WMS (n = 60), and Trail Making Test (n = 50) data were obtained, along with performance validity tests (PVTs) including Reliable Digit Span (n = 182), Dot Counting Test (n = 18), and Test of Memory Malingering (n = 70).

Results

No meaningful age or gender differences emerged across SIMS scores. The mean SIMS Total Score within this population is 22.9 (SD = 10.1). This compares to a suggested manual cutting score of 14–16 for detection of likely noncredible symptom reporting. 69% of this population produced SIMS Total Scores at or above 16, with 45% of the sample scoring 21 or above.

Conclusions

Established studies indicate a roughly 46% base rate of symptom invalidity in SSDI applicants. Standard SIMS cutoff scores when used with this population are likely to overestimate invalidity. Upward adjustment to 21 may be indicated for the SIMS Total Score when attempting to capture a portion of the SSDI population more likely to demonstrate symptom invalidity. Individual subscale performances and correlations with concurrently administered Wechsler scales and PVTs are reported, along with data limitations and additional areas of suggested research.
B - 01 Children with ADHD Demonstrate Cortical Thinning in Multiple Regions Compared to TD Controls
Authors: Bandel Lauren , Kibby Michelle
Published: October 2023

Objective

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often demonstrate functional and volumetric differences compared to typically developing (TD) children. These regions are associated with the deficits commonly seen in ADHD. However, there is limited research on cortical thickness in ADHD, and what does exist is inconsistent in its findings. Thus, the objective of this study was to examine potential differences in cortical thickness between children with ADHD and TD controls.

Method

Participants included 73 children (aged 8–12 years; 50.7% boys, 87.7% White) with ADHD and typically developing controls. It was a community sample. The children completed an MRI scan and a neuropsychological battery as part of a larger, grant-funded project (R03HD048752, R15HD065627). Group differences in cortical thickness were determined using CAT12 software.

Results

A t-test model was used for voxel-wise comparisons of cortical thickness between children with ADHD and TD controls. After aligning the MRI scans, the CAT12 software provides clusters of regions in which cortical thickness differs significantly between groups. Compared with TD controls, children with ADHD demonstrated reduced cortical thickness in three clusters in the left hemisphere and one large cluster in the right hemisphere (p < 0.05; FWE corrected). The clusters included several frontal and parietal regions, along with occipital and temporal regions.

Conclusions

Results are consistent with findings from prior research comparing children with ADHD and TD controls using other neuroimaging methods, which displayed involvement of frontal–parietal and/or frontal-temporal networks. Furthermore, these regions are associated with cognitive and behavioral deficits commonly seen in ADHD, including various aspects of executive dysfunction.
B - 09 Neuropsychological Impacts and Cognitive Effects of Pediatric Leukemia Treatment
Authors: Aronson Rebecca , Stafford Claire , Garcia-Lavin Barbara
Published: October 2023

Objective

The current study seeks to investigate the neuropsychological and cognitive late effects of pediatric Acute Lymphoblastic Leukemia (ALL) treatment.

Data Selection

A search for peer-reviewed articles was conducted. Google Scholar was searched using keywords including neuropsychology, neuro-cognitive, neuropsychological effects, neuropsychological battery, neuropsychological impacts, cognitive effects, cognitive impacts, pediatric, pediatric leukemia, acute lymphoblastic leukemia treatment, bone marrow transplant, whole brain radiation, whole-body radiation, chemotherapy, cranial radiotherapy, health psychology, and neuropsychological testing. Articles were included if they discussed neuropsychology and ALL. Articles with non-human subjects and case studies were excluded from the study. Fifty-nine studies were included in the study.

Data Synthesis

Treatments for ALL result in impairments in working memory, reduced processing speed, attention deficits, executive functioning deficits, visual–spatial and visuomotor weakness, fine motor weakness, deficits in delayed memory, an initial decline in performance IQ, and a delayed decline in verbal abilities such as attention and reading.

Conclusions

The initial decline in performance abilities following a late decline in verbal abilities seen in patients who have undergone CRT may be due to structural changes in the white and gray matter following CRT treatment. Healthcare providers should attend to patients’ cognitive complaints, particularly as they pertain to patients’ ability to adhere to treatment recommendations and subsequently to their ability to resume attending school or social roles. As patient and parent complaints of cognitive compromise are associated with psychological distress and functional decline, cognitive complaints could justify further in-depth neuropsychological assessment to mobilize comprehensive supportive care or rehabilitative services.
B - 10 The Effect of Gestational Age on Development of Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder
Authors: Devonshire Ashley , Tuinstra Kaitlin , Kuwabara Hana , Durham Peter
Published: October 2023

Objective

Studies show individuals with comorbid neurodevelopmental disorders of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have poorer emotional, behavioral, and cognitive outcomes. While preterm birth (< 37 weeks) is an identified risk factor for ASD and ADHD, it is important to consider gestational age (ga) as it relates to the development of comorbid ASD/ADHD (ASD/ADHD). The current study aims to understand the relationship between level of prematurity (LoP) and neurodevelopmental disorders.

Method

Participants included 10,711 children/adolescents (52.5% male) from the Environmental Influences on Child Health Outcomes (ECHO) Program. LoP was categorized as Extremely Preterm (36 weeks). Chi-square analysis was conducted to examine the relationship between LoP and neurodevelopmental disorder diagnoses as indicated in medical records. Logistic regression was also conducted to analyze the relationship between ga (weeks) and neurodevelopmental disorder diagnosis.

Results

1521 individuals were diagnosed with ASD (n = 537), ADHD (n = 778), or ASD/ADHD (n = 206); ga ranged from 22 to 43 weeks. Results indicated the relationship between LoP and diagnoses was significant, ꭓ2(9, 10,771) = 148.31, p < 0.001. Extremely Preterm individuals were more likely than Full-term individuals to have ASD, ADHD, or ASD/ADHD. It was found that the odds of having a neurodevelopmental disorder decreased by 5.8% per 1-week ga increase (95% CI[−0.069, −0.048]).

Conclusion

Results indicate gestational age is associated with greater risk of neurodevelopmental disorders, including comorbid ASD/ADHD. Improved understanding of the association between level of prematurity and comorbid ASD/ADHD diagnoses may help inform early intervention services enhancing children’s outcomes throughout the lifespan.