bluuebunny/crossref_metadata_2025 huggingface dataset:
A-099 Depression as a Factor in Neuropsychological Test Performance
Authors: C Gass , B Patten
Published: August 2020

Objective

Evaluate the relation between depression and performance on six widely used tests: the Boston Naming Test, Category Fluency Test, Controlled Oral Word Association Test, Corsi Block Tapping Test, Mazes and Trail Making Test (TMT), Parts Speed, A and B.

Method

Participants: 77 women and 33 men referred for a comprehensive neuropsychological examination in an outpatient memory disorders clinic as part of a broader neurodiagnostic workup for memory complaints and possible cognitive decline. Referral sources: neurologists (78%), primary care physicians (21%). Patients’ mean age: 59.3 (SD =12.1); education: 15.1 (SD = 2.7) years. They were screened from a larger sample (N = 175) for any known history of brain disorder or positive neurodiagnostic findings. They met performance and symptom validity criteria (Reliable Digit Span and scores on MMPI-2 validity scales). Diagnostically, 62% of the sample had mood disorders. Using their median score on the Depression scale of the MMPI-2 (T = 70), patients were classified into High and Low Depression groups (ns = 55). The two groups were no different on age, education, or predicted level of intelligence (Test of Premorbid Function).

Results

On all six of the neuropsychological tests (eight measures), scores were compared across the two groups. There was no main effect (MANOVA) for group, F(8,101) = 1.03, p = .427. Univariate comparisons revealed no intergroup differences across tests.

Conclusion

Results suggest that severity of depressive symptoms is not related to performance on these neuropsychological tests. In cooperative examinees, these tests are valid for assessing brain-based abilities independent of the examinees’ emotional status.
A-104 Meta-Analysis of Neuropsychological Intra-Individual Variability in Mild- and Moderate/Severe-Traumatic Brain Injury
Authors: S Aita , D Knapp , C Demming , B Hill
Published: August 2020

Objective

Intra-individual variability (IIV) applied to cognition refers to scatter of performances at the individual level. This study meta-analyzed research that examined consistency (i.e., within-task) IIV in mild-traumatic brain injury (mTBI) and moderate/severe-traumatic brain injury (msTBI) compared to normal controls.

Method

Using PRISMA-guided search parameters, eight databases within the EBSCO network as well as ProQuest Dissertations & Theses were searched for studies comparing cognitive IIV between TBI and control samples. Random-effects modeling was used for all analyses. Hedge’s g was used as the index of combined effect size, and Q and I2 were evaluated for heterogeneity analyses.

Results

This study was a part of a broader meta-analysis looking at IIV across all clinical samples. The initial search strategy yielded 2,962 results, which were reduced to 87 studies for final inclusion. This meta-analysis included 12 studies (mTBI: k = 9, 64 effect sizes; msTBI: k = 5, 10 effect sizes). Meta-analysis resulted in a significant combined effect size across all TBI studies (g = 0.45, Q = 23.49, I2 = 53.17). When stratifying for TBI severity, msTBI samples yielded a greater combined effect size (g = 0.66, Q = 10.70, I2 = 62.61) than mTBI (g = 0.39, Q = 10.49, I2 = 23.74). Highest degree of between-study heterogeneity was noted in the msTBI studies.

Conclussions

Broad TBI as well as mTBI and msTBI studies yielded significant combined effect sizes, consistently showing elevated cognitive IIV in TBI samples compared to healthy controls. The combined effect size approximately doubled from mTBI to msTBI. This provides evidence that consistency-based IIV is sensitive and possibly specific to neurologic/pathologic burden. This supports prior literature framing IIV as an index of neurological health.
A-106 Analysis of Switching and Clustering Performance in Anglo-Americans and Hispanic Traumatic Brain Injury Survivors and Healthy Comparison Adults
Authors: S Fatoorechi , D Lopez-Hernandez , S Mangassarian , P Litvin , J Knight , A Bichlmeier , R Rugh-Fraser , D Hardy , D Budding , R Cervantes , N Graub , P Vespa , D Hovda , D McArthur , D Plurad , J Fuster , E Woo , K Boone , M Wright
Published: August 2020

Objective

Research shows traumatic brain injury (TBI) survivors underperform compared to healthy comparison participants (HC) on verbal fluency tasks. Verbal fluency is typically comprised of two tasks: letter fluency and semantic fluency. During verbal fluency trials, participants often cluster responses and switch between clusters, which can serve as measures of executive control and organization. Also, research shows that Anglo-Americans (AA) outperformed ethnic minorities on various aspects of cognitive functioning. We examined the relationship between TBI and ethnic diversity on letter fluency, semantic fluency, switching, and clustering.

Method

The sample included 45 HC adults (21 Hispanics; 24 AA), 33 acute TBI adults (ATBI; 11 Hispanics; 22 AA), and 26 chronic TBI adults (CTBI; 9 Hispanics; 17 AA).

Results

The groups were well matched, with the exception of gender. ANCOVAs, controlling for gender, revealed HC outperformed ATBI participants on letter fluency, p = .007, ηp2 = .10, letter switching, p = .006, ηp2 = .10, and semantic switching, p = .018, ηp2 = .08. We also found HC outperformed both TBI groups in sematic fluency performances, p = .000, ηp2 = .15. Next, we found Hispanics outperformed AA on letter clustering, p = .003, ηp2 = .09 and semantic clustering, p = .010, ηp2 = .07. Finally, an interaction emerged in letter clustering, p = .044, ηp2 = .06, with the Hispanic ATBI outperforming the AA ATBI group.

Conclusion

The HC group outperformed both TBI groups only on semantic fluency, but they outperformed the ATBI survivors on letter fluency, letter switching, and semantic switching. Hispanics outperformed AA on letter clustering and semantic clustering, suggesting the use of clustering over switching strategies to provide verbal fluency responses in this group.
A-107 Historyt of Remote Mild TBI Predicts Poor Health-Related Quality of Life Outcomes in Military Veterans
Authors: M Sakamoto , L Delano-Wood , D Schiehser , V Merritt
Published: August 2020

Objective

We examined health-related quality of life (QOL) in military Veterans with and without a history of mild traumatic brain injury (mTBI). Additionally, we investigated how mTBI injury characteristics modify health-related QOL.

Method

Veterans with a history of remote mTBI (n = 81) and military controls (MCs) without a history of mTBI (n = 62) completed self-report questionnaires measuring combat exposure, posttraumatic stress disorder (PTSD) and neurobehavioral symptoms, and health-related QOL. Primary outcomes included the eight subscales of the 36-Item Short-Form Survey (SF-36).

Results

ANCOVAs adjusting for combat exposure and PTSD symptoms found that the mTBI group demonstrated significantly more health-related QOL symptoms when compared to MCs across the following SF-36 subscales: General Health, Vitality, Bodily Pain, Physical Role Functioning, and Social Functioning (p = .001–.045, ηp2 = 0.03–0.07). Within the mTBI sample, repetitive mTBI, combat exposure, and PTSD and neurobehavioral symptoms collectively significantly predicted all five QOL subscales (all p’s < .001), accounting for roughly 33–53% of the total variance. Greater neurobehavioral symptoms were associated with lower Physical Role Functioning, Vitality, and Social Functioning scores; repetitive TBI was associated with higher Bodily Pain scores; greater PTSD symptoms were associated with lower Social Functioning scores; and greater combat exposure was associated with lower General Health scores.

Conclusions

Results suggest that, over and above PTSD and combat exposure, mTBI status independently contributes to health-related QOL. Moreover, specific dimensions of health-related QOL are influenced by different factors, with affective and vestibular-related neurobehavioral symptoms showing the strongest negative associations with health-related QOL. Findings highlight the need for comprehensive assessment and multimodal treatment within this vulnerable population.
A-108 Differential Change in Eye Movement Performance Among Male Collegiate Athletes With Variable Exposure to Head Impacts
Authors: V Gallagher , P Murthy , J Stocks , T Karpouzian Rogers , B Vesci , J Mjaanes , Y Chen , H Breiter , C Labella , A Herrold , J Reilly
Published: August 2020

Objective

The primary aim of this study was to evaluate the use of eye movement testing to detect change in cognitive and sensorimotor processing among male club collegiate athletes following a season of participation in collision sports of variable exposure. We predicted that collision sport athletes (COLL) exposed to subconcussive head trauma would demonstrate longer reaction times (latency) on saccadic eye movement tasks with executive demands (antisaccade and memory-guided saccade [MGS] tasks), greater antisaccade inhibitory errors, and poorer MGS accuracy, a measure of spatial working memory, from pre-season to post-season, whereas non-collision sport athletes (NON-COLL) would demonstrate stability overtime. We predicted that longitudinal change in eye movement performance would be greater than change observed on ImPACT (Immediate Post-Concussion Assessment and Cognitive Test).

Method

Collegiate club athletes with variable exposure to contact sports participation [COLL-High Dose, n = 8; COLL-Low Dose, n = 9; NON-COLL, n = 17] completed eye movement and ImPACT assessments pre-season and post-season.

Results

NON-COLL demonstrated shorter post-season versus pre-season antisaccade and MGS latencies, whereas COLL groups showed stable, longer, or more attenuated (relative to NON-COLL) shorter latencies (ps ≤ .001). NON-COLL demonstrated improved MGS spatial accuracy over the season, whereas COLL groups showed poorer or stable accuracy (ps < .05). No differential change was observed in pre-season to post-season ImPACT performance among groups.

Conclusions

This pilot study provides preliminary evidence for the use of eye movement testing as a sensitive marker of subtle changes in attentional control and working memory resulting from participation in collision sports.
A-115 Predictors of Depressive Symptoms in Adolescent Patients Following Concussion
Authors: A Feder , A Kissinger-Knox , S Eagle , B Gillie , A Kontos
Published: August 2020

Objective

The present study sought to examine specific predictors and factors associated with depressive symptoms at initial(V1) and subsequent(V2) visits following concussion in adolescents.

Methods

This study enrolled adolescents aged 10–18 (14.5 ± 2.2 years) within 30 days of a diagnosed concussion. Patients completed Mood and Feelings Questionnaire-Short-Child Report (MFQC), Postconcussion Symptom Scale (PCSS), neurocognitive testing(ImPACT), and Vestibular-Ocular Motor Screening. Logistic regression (LR) analyses evaluated risk factors and clinical presentation as predictors of post-injury MFQP scores above a cutpoint of 8.

Results

Participants included 113 adolescents (50.4% male; 77% sport-related) who presented for V1 8.9 ± 6.2 days post-injury and V2 18.43 ± 11.9 days after V1. Overall, 5.3% reported pre-injury depression and 15.8% reported post-injury depressive symptoms above clinical cutoff on the MFQC. The LR model predicting increased depressive symptoms at V1 was significant (R2 = 45.0%, p = .007), supporting post-traumatic amnesia(PTA; OR = 3.15, 1.01–9.88) as a predictor. The LR model predicting depressive symptoms at V2 was significant (R2 = 62.2%, p = .021), supporting history of depression(OR = 25.5, 3.86–168.2) as the only significant predictor. Those scoring above 8 on the MFQC at V1 were more likely to have a prolonged recovery(over 30 days; OR = 10.4, 1.29–83.6).

Conclussions

The primary findings indicated that PTA was associated with increased depressive symptoms earlier, whereas a history of depression was associated with increase depressive symptoms later following concussion. Patients scoring higher on depressive symptoms were 10 times more likely to have a prolonged recovery. Together, these findings highlight the importance of evaluating depressive symptoms and factors that are associated with these symptoms to inform prognosis and earlier treatment for depressive symptoms following concussion.
A-120 Practice Effects on Repeat Neuropsychological Assessment of Adults with Chronic Severe TBI
Authors: D Stepien , D Huber , M Samples , S West
Published: August 2020

Objective

This study examined whether practice effects caused by repeated exposure to test materials during serial assessment significantly impacts the performance of adults with chronic severe traumatic brain injury (sTBI), given the severe memory impairment typical of this population. This study sought to describe the pattern of practice effects on repeat neuropsychological testing for this population. It was hypothesized that practice effects would be diminished for individuals with chronic sTBI.

Method

This study utilized longitudinal archival data collected as part of an annual neuropsychological assessment battery administered to 43 individuals receiving post-acute rehabilitation services at a structured multisite day treatment program. Each participant was tested at two time points which differed by an average of 13 months. The battery consisted of the Texas Functional Living Scale (TFLS), Trail Making Test (TMT), Brief Mood Survey, Neuropsychological Assessment Battery (NAB) Screening Module (NAB-SN), and Judgment subtest from the NAB Executive Functions Module (NAB Judgment).

Results

Practice effects were determined based on reliable improvement (p < .05) in scores across test administrations. A Reliable Change Index (RCI) was calculated for each test based on the method proposed by Jacobson and Truax (1991). Results revealed reliable improvements in performance for the NAB-SN Attention domain (RCI = 3.69), NAB Judgment subtest (RCI = 10.14), and TFLS Total Score (RCI = 4.38).

Conclusion

This study indicates that adults with chronic sTBI demonstrate significant practice effects primarily on measures associated with functional living skills. These findings suggest that repeat testing in this population may be less susceptible to the influence of practice effects.
A-122 Intra-Individual Variability in Traumatic Brain Injury and Questionable Performance Validity
Authors: J Davis , C Mullen , N Kurniadi , K Kitchen Andren , S Rolin
Published: August 2020

Objective

Intra-individual variability (IIV) has been associated with cognitive dysfunction and traumatic brain injury (TBI) severity. This study examined IIV in physical medicine and rehabilitation patients grouped by TBI severity and performance validity.

Method

Participants (N = 213) were 32% female and 90% white with average age and education of 42 (SD = 13) and 14 (SD = 2) years, respectively. Participants completed an outpatient evaluation using a flexible battery of up to 33 common neuropsychological measures. Participants were grouped by TBI severity and validity: mild (32%), moderate (14%), severe (32%), and questionable performance validity (QPV; 22%). QPV was determined on the basis of embedded and freestanding validity measures. Test battery scores were converted to T scores. Cases with four or more scores below 36 T were identified as impaired. Measures of IIV were calculated including overall test battery mean (OTBM), test battery standard deviation (SD), kurtosis, skew, range, and unbiased coefficient of variation (UCV). IIV measures were compared across groups.

Results

Groups were significantly different in OTBM (p < .001), kurtosis (p < .03), and UCV (p < .001). In valid cases, TBI severity was associated with OTBM (rho = −.31), SD (.19), kurtosis (−.16), and UCV (.33). Impaired and unimpaired cases were significantly different in OTBM (p < .001), SD (p < .001), range (p < .01), and UCV (p < .001). QPV cases were similar to impaired cases on measures of IIV.

Conclusions

IIV measures have potential clinical utility in characterizing cognitive deficits in TBI and warrant further study.
A-131 Clinical Utility of the Child & Adolescent Memory Profile in Children with TBI
Authors: J Donders , K Wilson , S Lesica
Published: August 2020

Objective

To evaluate the sensitivity of The Child and Adolescent Memory Profile (ChAMP), a relatively new test of learning and memory, to traumatic brain injury (TBI).

Method

The ChAMP was administered to 61 6–16 year-old children with TBI within 1–12 months post injury. The sample was 64% male and 75% Caucasian, with a median parental level of education of 13 years. Twenty-nine children had uncomplicated mild TBI whereas 32 children had either intracranial lesions on neuroimaging or coma of at least 24 hrs, or both. The findings from the complete TBI group were compared to those from a demographically matched control group, obtained from the ChAMP standardization sample.

Results

Within the TBI group, the Visual Memory, Immediate Memory, Total Memory and Screening Index scores all demonstrated statistically significant correlations with length of coma. After applying a Benjamini-Hochberg adjustment to correct for the effect of multiple comparisons, the performance of the matched control group was still statistically significantly better than that of the children with TBI on all of the ChAMP Index scores. Effect sizes ranged from small to medium. At the subtest level, Places and Places Delayed showed the greatest group differences.

Conclusion

These findings supported the clinical utility of the ChAMP in the evaluation of learning and memory in children with TBI.
A-134 A Comparison Between English-Speaking and Mandarin-Speaking Adolescent Student Athletes on Baseline Preseason ImPACT® Neurocognitive Performances and Symptom Reporting
Authors: G Iverson , J Karr , Y Hong , C Yang , B Maxwell , P Berkner
Published: August 2020

Objective

Student athletes commonly complete baseline preseason assessments of neurocognitive performances and symptom reporting using ImPACT®. Some past researchers have examined differences in performances and symptoms based on language of administration and racial/ethnic identity. This study examines differences between Mandarin-speaking and English-speaking student athletes on ImPACT® at preseason assessments.

Method

Participants included 252 adolescent student athletes who completed preseason baseline ImPACT® testing in Mandarin and 252 participants who completed testing in English, matched on age, gender, and health and academic history. These groups were compared on neurocognitive composite scores and symptom ratings.

Results

Mandarin-speaking athletes performed modestly better on one of five neurocognitive composite scores (Visual Motor Speed, p < .001, d = .37). Language groups did not differ in total symptom severity, but Mandarin-speaking boys endorsed multiple physical symptoms at higher rates than English-speaking boys.

Conclusions

These results suggest that the current ImPACT® neurocognitive normative data are reasonably appropriate for use with Mandarin-speaking adolescents. When back translated, a few Mandarin-language symptoms were not semantically equivalent to their corresponding English-language symptoms, but no group differences were observed for these symptoms. Modest language group differences were observed in physical symptom reporting, more so in boys than girls. Individuals of Asian descent are more likely to express their mental health concerns in somatic terms, and greater physical symptoms in Mandarin-speaking boys could correspond to an expression of psychological distress. Clinicians should be mindful of psychological functioning at baseline testing and post-concussion evaluations because students who do not identify with the dominant culture of their sporting environment might experience acculturative stress.
A-136 Effect of Language Ability on Processing Speed in TBI
Authors: D Ream , P Fernandes , I Tourgeman
Published: August 2020

Objective

Traumatic brain injuries (TBIs) are not uniformly represented across monolinguals and bilinguals. Processing speed is often impacted as a result of a TBI. The objective of this study is to examine how processing speed is influenced by linguistic abilities after sustaining a TBI. Hypothesis: bilinguals will perform better than monolinguals on measures of processing speed.

Method

A total of 89 subjects, 36 monolinguals with a mean age of 37.83 (SD = 13.25) and 53 bilinguals with a mean age of 37.74 (SD = 13.53) were grouped based on language ability and performance was compared on the Trail Making Test, Part-A (TMT-A), Processing Speed Index (PSI) of the Wechsler Adult Intelligence Scale, 4th Edition (WAIS-IV), and the Symbol Search (SS) and Coding (CD) subtests of the PSI.

Results

An independent samples t-test revealed a significant different between bilinguals and monolinguals on TMT-A [t (87) = .154, p = .003], CD subtest [t (87) = −.823, p = .008], and PSI [t (87) = −2.10, p = .014]. There was not a significant difference observed on the SS subtest [t (87) = −2.71, p = .364].

Conclusion

This study revealed that bilinguals demonstrated better performance on measures that emphasize scanning, cognitive flexibility, sequencing abilities, and visual–spatial functioning. These data suggest that bilinguals perform at an average level while monolinguals perform on a low average level regarding processing speed after sustaining a TBI.
A-139 Knowledge of Concussion is Determined by Concussion Education but not Prior Concussion or Participation in Contact Sport
Authors: S Kinmond , K Sullivan , K Singaravelu Jaganathan
Published: August 2020

Objective

In order to prevent concussion and promote help-seeking behaviour, this study sought to establish baseline concussion knowledge scores in the general population and to better understand the factors that influence variations in these scores.

Data Selection

Participants were (N = 223) individuals over the age of 18 years (M = 35.21, SD = 14.31) recruited from the general population via an online questionnaire. Designed to measure knowledge of concussion, the questionnaire contained demographics, grouping variables (previous concussion education, n = 74; history of concussion, n = 72; and participation in contact sport, n = 36), and 37-items from the Concussion Knowledge Index (CKI) of the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS).

Results

Concussion knowledge was higher than expected with 79.12% of participants responding correctly to CKI items. Group comparisons found individuals with prior concussion education to be significantly higher than individuals without U = 4382.50, z = −2.526, p = .01 (two-tailed), the effect was small r = .21. There was no difference in knowledge scores for gender, participants with a history of concussion or those who participate in contact sport.

Conclusion

When compared to similar studies sampling contact sports players, concussion knowledge was higher than expected. High-risk groups within the study (history of concussion and contact sport) were similarly informed than the general population. Further research is needed to understand whether higher knowledge translates to increased injury reporting and safer behaviour.
A-141 An Inclusive Recruitment Strategy Can Help to Improve mTBI Research
Authors: K Singaravelu Jaganathan , K Sullivan , J Greenslade , A Lyrstedt , G Mitchell ,   Research Team t
Published: August 2020

Objective

Participant recruitment for mild traumatic brain injury (mTBI) research is challenging due to confounding factors and other documented selection biases. The strict application of typical inclusion and exclusion criteria has raised questions about the generalizability of mTBI research. This study explored the effect of applying commonly employed selection criteria on eligibility for mTBI research.

Method

Between July and October 2019, a trained research nurse performed a weekly review of a tertiary hospital emergency department treatment registry. Three hundred and eight cases coded as “minor head injury” were identified (Mage = 43.7, SDage = 25.6). The case records underwent formal data extraction. Extracted clinical and demographic data were mapped against commonly applied mTBI research selection parameters. The presence of persistent postconcussion symptoms (PPCS) was established via telephone administration of the Rivermead Postconcussion Symptom Questionnaire, 7–19 days post injury.

Results

Analysis revealed that 23% of patients met the World Health Organization operational definition of an mTBI. The failure to meet this criterion was primarily due to missing or incomplete information for post-traumatic amnesia. The application of exclusion criteria left just 5.5% of the initial pool eligible for mTBI research. Of these participants, ongoing PPCS could not be established in any individuals.

Conclusion

Participant recruitment for mTBI research could be improved by establishing a dedicated patient management system that streamlines and augments the quality of vital clinical data. An inclusive recruitment strategy that handles patient heterogeneity using statistical methods as opposed to exclusion from research could enhance the generalisability of mTBI research.
A-142 Examining the Impact of the Recent New Dot Counting Test Cut-Off Score in Bilingualism and Traumatic Brain Injury Survivors
Authors: N Graub , D Lopez-Hernandez , P Litvin , R Rugh-Fraser , H Rad , S Saravia , A Bichlmeier , W Olmos , M Lee , S Fatoorechi , A Bueno , A Arzuyan , D Budding , P Vespa , D Hovda , D Mcarthur , D Plurad , J Fuster , E Woo , D Hardy , K Boone , M Wright
Published: August 2020

Objective

McCaul et al. (2018) recently revised the Dot Counting Test (DCT) cut-off score from ≥17 to 13.80; we evaluated the new cut-off in monolingual and bilingual traumatic brain injury survivors (TBIS) and healthy comparison participants (HCP).

Method

The sample consisted of 43 acute TBI [ATBI; 23 English monolinguals (EM); 11 English first language bilinguals (EFLB); and 9 English second language bilinguals (ESLB)]; 30 chronic TBI (CTBI; 13 EM; 9 EFLB; 8 ESLB), and 56 HCP (23 EM; 11 EFLB; 22 ESLB).

Results

An ANCOVA, controlling for age and education, revealed an interaction where ATBI-EFLB had higher E-scores than the other groups and the CTBI-EFLB had lower E-scores than the other groups. Both the conventional and proposed new cut-off (PNC) scores had different failure rates in ATBI (conventional cut-off: 9%; PNC: 28%), CTBI (conventional cut-off: 10%; PNC: 20%), and HCP (conventional cut-off: 11%; PNC: 13%). For language groups, EM (conventional cut-off: 14%; PNC: 22%), EFLB (conventional cut-off: 10%; PNC: 26%), and ESLB (conventional cut-off: 5%; PNC: 10%) demonstrated different failure rates across cut-off scores. Group differences were found with McCaul et al. (2018) cut-off, but not the conventional cut-off score. Also, chi-squared analysis revealed ATBI EFLB and EM had greater failure rates than ATBI ESLB.

Conclusion

Unfortunately, the new DCT cut-off score resulted in greater failure rates in TBIS. Furthermore, ATBI EM and EFLB were impacted more by the new cut offs than ATBI ESLB who learned English later in life, although the reason for this finding is unclear and requires additional study.
A-150 Motor Sequencing Training Improved Executive Abilities in a Boy with Rolandic Epilepsy
Authors: N Kiseleva , S Kiselev
Published: August 2020

Objective

It is known that children with epilepsy can have deficit in neurocognitive abilities. It is of great significance to receive the evidence for efficiency of different treatments that are aimed to help children with epilepsy. The goal of this study was to reveal the impact of 12 weeks of motor sequencing training on the executive abilities in a child with Rolandic epilepsy.

Methods

The child is 7 year old boy. The neuropsychological assessment of child has revealed the mild deficit in executive abilities. Child participated in 12 weeks of motor sequencing training. A total of 36 therapy sessions lasting 50 minutes were performed.This therapy trains the child to plan, sequence and process information more effectively through repetition of goal-directed movements. This programme is built on the conceptual framework derived from the work of Luria’s theory of restoration of neurocognitive functions (Luria, 1963, 1974).

Results

Neuropsychological assessment (NEPSY) of child after the intervention period has revealed apparent progress in performance of 4 subtests which are designed to assess executive abilities and attention (Tower, Auditory Attention and Response Set, Visual Attention, Statue).

Conclusion

According to result of this case report it can be assumed that motor sequencing training can be used as a prospective treatment approach for development of executive abilities in children with Rolandic epilepsy.
A-151 Boy with Hemorrhagic Stroke in the Right Fronto-Parieto-Temporal Area Benefited from Visuospatial Training
Authors: S Kiselev
Published: August 2020

Objective

It is known that stroke has a devastating power for the future of child. The aim of this study is to describe the visuospatial training findings of a child with hemorrhagic stroke in the right fronto-parieto-temporal area, showing the progress after 8 months of therapy initiated early after acquired neurological injury.

Method

Boy of 8 years suffered a sudden illness and was referred to the emergency hospital and diagnosed with hemorrhagic stroke in the right fronto-parieto-temporal area. Surgical procedures were performed. At the time of hospital discharge, there was guidance about the need for therapy care. Neuropsychological assessment revealed the severe deficit in visuospatial abilities in this child. A total of 62 visuospatial training sessions lasting 50 minutes were performed for 8 months. This therapy trains the child to do different visuospatial exercises both on motor and cognitive level. This training is built on the conceptual framework derived from the work of Luria’s theory of restoration of neurocognitive functions (Luria, 1963, 1974).

Results

Neuropsychological assessment of child has revealed apparent progress in performance of 4 subtests which are designed to assess visuospatial abilities (copying of a table, mental rotation task, Head subtest, reconstruction of 3-dimensional designs).

Conclusion

According to result of this case report it can be assumed that visuospatial training can be used as a prospective treatment approach for children with stroke which case deficit in the visuospatial abilities.
A-152 Long-term Outcome Profiles of Survivors of Traumatic Brain Injury and Stroke After Holistic Milieu-Oriented Neurorehabilitation
Authors: S Johnson , R Perumparaichallai , P Klonoff
Published: August 2020

Objective

The present study examined the outcome profiles of survivors of traumatic brain injury (TBI) and stroke up to 30 years after completing holistic milieu-oriented neurorehabilitation.

Method

Participants included 99 individuals with acquired brain injury (TBI n = 70; stroke n = 29) who attended holistic milieu-oriented outpatient neurorehabilitation between 1986 and 2016. On average, time of discharge to follow-up was 9.3 years with a range of 0 to 29.3 years. Data are a part of a larger ongoing follow-up survey using the Mayo-Portland Adaptability Inventory-4 (MPAI-4) and a psychosocial outcome questionnaire developed for this study.

Results

Independent-samples t-tests revealed that the TBI group was significantly younger than the stroke group on factors of age at the time of injury and age at the time of follow-up. However, the groups did not differ on factors of duration between discharge and follow-up as well as between injury and treatment. Regarding functional outcomes, analysis of covariance (ANCOVA) revealed no significant differences between the two groups on the MPAI-4 (Total Score and Subscales) while controlling for age at injury and age at the time of the study. Furthermore, 90% of TBI and 88% of stroke participants were productive (i.e., working/school full-time, part-time, or volunteering); whereas, 10% of TBI and 12% of stroke survivors were unemployed.

Conclusion

Overall, the findings suggest that both groups’ long-term functional outcomes are similar and very positive. Specifically, both stroke and TBI participants were able to successfully maintain functional and productive activities even close to 30 years after discharge from holistic milieu-oriented neurorehabilitation.
A-156 SPECT Imaging Differences During Connors’ CPT Task in Adult Males Versus Females with ADHD Combined Type
Authors: L Stebbins , D Taylor , K Willeumier , B Trinidad , C Golden , D Amen
Published: August 2020

Objective

To examine whether ADHD-Combined-Type in males and females alters brain activity at concentration.

Method

Participants were selected by DSM-IV diagnoses from a de-identified, archival database. Sample(n = 154) included a male(n = 97, Mage = 33.29, 67% Cau.) and female group(n = 57, Mage = 34.54, 71.9% Cau.). Exclusion criteria were most comorbid mood and neurological disorders. Cerebral blood flow(CBF) was assessed using SPECT during a concentration task(Conners’CPT) in 17-brain areas. Independent samples t-tests were performed to determine significant differences between groups (p < .001).

Results

Analysis determined statistically significant CBF differences between the female and male groups at concentration. Chi-square showed no significant associations with age(0.349).The analysis yielded an increase CBF in female group compared to male group in the Bilateral Limbic-System(left area:t(152) = 4.418, p < .0001; right:t(152) = 4.113, p < .001), Bilateral Basal Ganglia(left:t(152) = 5.948, p < .0001; right:t(152) = 5.653, p < .001), Left Motor-Sensory area(t(152) = 4.838, p < .0001), and Vermis(t(152) = 4.414, p < .0001). Male group had increased CBF in the Bilateral Cerebellum (left:t(152) = 6.592, p < .0001; right:t(152) = 7.172, p < .001) and Right Occipital(t(152) = 4.895, p < .0001) and Temporal lobes(t(152) = 3.904, p < .0001).

Conclusions

The female group, showed increases in CBF in the limbic system suggesting cognitive deficits related to emotional disturbances. While in the male group, the emotional control and auditory processing of information deficits can be related to the increased CBF in temporal area. Increased CBF in basal ganglia, vermis, and motor-sensory areas in the female group suggests increased activity related to integration of motor movements. Likewise, the male group showed deficits in motor movements, but also included deficits in balance and analyzation of objects/movement (increased CBF in cerebellum and occipital). Treatment of ADHD-Combined-Type can target discrete brain systems related to these differences in cognitive activity.
A-162 Neurocognitive Functioning in Youth with Neurofibromatosis Type 1: Examining Relations between Executive Functions and Academic Achievement
Authors: C Friedhoff , A Oh , L Ventura
Published: August 2020

Objective

Neurofibromatosis Type 1 (NF1) is an autosomal dominant genetic disorder affecting approximately 100,000 people in the U.S. It is commonly associated with neurofibromas, café-au-lait spots, and optic gliomas. It has also been linked to neurocognitive deficits, including learning disabilities and ADHD. This study examined relationships among executive functions (EF) and academic achievement in children diagnosed with NF1.

Methods

Participants included 29 children (ages 2–21; M = 9.28, SD = 5.50) diagnosed with NF1 referred for neuropsychological evaluation as part of standard clinical care. A battery of tests was administered, including measures of intelligence (Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition; Wechsler Intelligence Scale for Children, Fifth Edition; Wechsler Adult Intelligence Scale, Fourth Edition), attention (Conners’ Continuous Performance Test II), EF (Delis-Kaplan Executive Function System), academic achievement in reading and math (Wechsler Individual Achievement Test, Third Edition), and parent rating scales examining EF in the home environment (Behavior Rating Inventory of Executive Function, Second Edition).

Results

Relations between attention, EF, and academic achievement were examined using bivariate Pearson correlations. Lower scores on measures of EF (e.g., inhibition of prepotent responses) were linked to lower math achievement scores (r = .73, p < .05). Difficulties with sustained attention were associated with lower performance on measures of reading (r = −.60, p < .05) and math achievement (r = −.59, p < .05). Parent report of EF difficulties was correlated with lower reading scores (r = −.68, p < .05).

Conclusions

Results suggest that children with NF1 are at risk for deficits in EF and academic achievement. Problems in these two domains are likely to co-exist. Thus, interventions targeting these skills should be well integrated.
A-169 Sleep in Children with Fetal Alcohol Spectrum Disorders (FASD)
Authors: K Shada , R Tangen
Published: August 2020

Objective

Sleep problems in children with FASD have not been well characterized. This study predicts that children with FASD and sleep problems will have more attention [Conner’s Continuous Performance Test (CPT)] and executive functioning [Brief Rating Inventory of Executive Functioning (BRIEF)] difficulties.

Methods

Data from 46 children (ages 3–14) diagnosed with an Alcohol Related Neurobehavioral Disorder whose parents completed the Sleep Disturbance Scale for Children (SDSQ) were reviewed. The sample was divided into two groups: low-sleep (T-score < 64) and high-sleep (T-score > 65) using the SDSQ Disorders of Initiating and Maintaining Sleep subscale.

Results

The FASD clinical population showed more sleep problems than average, t(45) = 6.64, p < 001. Children with high levels of sleep problems showed significantly higher ratings of inhibition than children with low sleep problems on the BRIEF Inhibit Scale, t(35) = −2.095, p = .043). They also showed a higher Global Executive Composite t(35) = −2.033, p = .05, although this finding may be influenced by elevations on the Inhibit Scale.

Conclusion

In conclusion, although parents are reporting more inhibition in daily life, there are no differences on neuropsychological measures suggesting that sleep difficulties do not lead to additional impairment in attention and executive functioning. Findings suggest that children with FASD have difficulties with attention and executive functioning regardless of sleep problems.
A-173 Clinical Comparisons of Performance on the Wisconsin Card Sorting Task: Preliminary Findings for an Updated Adult Normative Data
Authors: K Eversole , C K Block , K C Hewitt , G Lee , E Dawson , C Nguyen
Published: August 2020

Objective

The Wisconsin Card Sorting Test (WCST) is a widely used neuropsychological measure of executive functioning. The purpose of this study is to present clinical comparisons of performance on the WCST among a group of adult patients referred for outpatient neuropsychological evaluation.

Method

Over two thousand and four hundred patients completed the WCST as part of a comprehensive test battery at an outpatient neuropsychology clinic (Mean age: 55.21 ± 15.39 years; Mean Education: 14.93 ± 2.76 years; 50.9% Female; and 90.2% White). Patients in the sample were referred for evaluations based on the following group classification: General Cognitive Concerns (n = 931); Dementia and Mild Cognitive Disorders (n = 182); Parkinson’s disease and other Movement Disorders (n = 608); Traumatic Brain Injuries/Concussion (n = 161); Primary Brain Tumors (n = 162); among others.

Results

Descriptive characteristics of raw scores for Total Errors, Perseverative Responses, Perseverative Errors, Nonperseverative Errors, Conceptual Level Responses, and Number of Categories Completed are presented based on clinical population. Group means and standard deviations for scores are presented. The sample are stratified into groups based on age, gender, and education. Base rate comparisons are presented.

Conclusions

Preliminary findings will contribute to efforts for an updated and demographically corrected normative data for the WCST. Implications are discussed.
A-179 The Relationship Between Self-Rated Everyday Memory and Cognitive Status Among Older Adults
Authors: M Vasquez , J Helphrey , A Sandlin , L Bennett-Leleux , R Donnell , T Glover , C Markey , J Moore , M Barnett
Published: August 2020

Objective

Neuropsychologists often supplement performance-based measures of cognition with self-report questionnaires. One questionnaire—the Measurement of Everyday Cognition (ECog)—has shown promise in differentiating between impaired and non-impaired populations; however, little research has been done specifically on the memory items from the shortened version: the ECog-12. The purpose of this study was to examine the extent to which the Ecog-12 Memory subscale can predict actual cognitive function as measured by a performance-based screening test.

Method

Older adults (ages 55–90; n = 74) completed the ECog-12 and were administered the Mini-Mental Status Exam—2nd Edition (MMSE-2), with scores dichotomized into normal function and impaired function.

Results

Binary logistic regression found that the ECog-12 Memory subscale items explained between 57% and 87% of variance in normal/impaired MMSE-2 scores and accurately classified 79.7% of cases.

Conclusion

Brief self-report measures of everyday memory functioning are sensitive to cognitive decline among older adults.
A-206 “Mittenberg-Type formula for Identifying Feigned ADHD Using WAIS-IV”
Authors: M Harrell , M Myers , S Aita , S Taylor , J Beach , M Calamia , B Hill
Published: August 2020

Objective

This study utilized logistic regression to determine whether performance patterns on the WAIS-IV subtests could differentiate between genuine-effort and simulated ADHD groups.

Method

Participants were 355 college students (55.3%% female; 65.7% Caucasian, 23.9% African American, 4.2% Asian; age range 17–51 years, Mage = 20.93 years, SD = 4.63; 76.4% no psychological diagnosis) who completed the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). Mean FSIQ for control group was 102.35 and 87.48 for the simulator group. Eighty participants (22.5%) simulated ADHD symptoms, while 276 participants (77.5%) provided genuine effort.

Results

A logistic regression analysis was performed with known group as the dependent variable and WAIS-IV subtest scaled scores as predictor variables. The final model of five predictor variables (Similarities, Information, Digit Span, Symbol Search, and Coding) significantly predicted group status (χ2 = 140.91, df = 5, N = 355, p < .001). The model accounted for 33% to 50% of the variance (Cox and Snell R2 = .33; Nagelkerke R2 = .50) in performance classification with overall 86% of individuals correctly predicted to their known group. At a cut value of .65 the sensitivity was 69.6% and the specificity was 90.6%. A cut value of.55 the sensitivity was 53.2% and the specificity was at 94.6%.

Conclusions

These findings are consistent with prior research suggesting discriminant function analysis derived from clinical measures (e.g., WAIS-IV) can be useful as embedded validity measures in distinguishing suspicious and genuine performance. Sensitivity, specificity, and predictive power of the WAIS-IV subtests were acceptable at 5% and 10% false positive rates.
A-212 The Relationships between PAI over-reporting SVTs and PVTs in a Military Sample
Authors: P Armistead-Jehle , P Ingram , N Morris
Published: August 2020

Objective

Recent research has worked to explore the relationships between symptom and performance validity testing. The current study sought to examine the association between PAI over-reporting SVTs and well validated stand-alone and embedded PVTs.

Methods

Retrospective review of 468 active duty Army cases referred for outpatient neuropsychological testing at a Military Health Center. Each subject was administered the PAI, MSVT, NV-MSVT, and RBANS Effort Index. Groups were defined in two ways, as valid (0 PVT failures) or invalid (1 or more PVT failures) and based on the number of failed PVTs (0, 1, 2, and 3).

Results

Partial results are summarized here for the valid/invalid analysis. The PAI Negative Impression Management (NIM), Multi-Feigning Index (MFI), and Malingering Index (MAL) differed significantly as a function of PVT performance (p < .05). Differences on Rogers Discriminant Function were not significant. AUC for NIM, MAL, and MFI were .69, .66, and .54 (respectively). AUC for RDF was unacceptable at .49. At a T-score of 64 the NIM scale had specificity of .91, sensitivity of .32 and at a T-score of 59 the MAL had specificity of .91 and sensitivity of .14.

Conclusions

There appears an association between PVTs and PAI over-reporting scales, such that elevations on the NIM, MAL, and MFI scales are related to PVT failure. However, the sensitives of these scales are limited in predicting PVT failure. To this end, the current data are in line with previous studies that indicate the need to administer both performance and symptom validity scales.
A-214 Multiple Assessments of Effort in Retired NFL Players Seeking Compensation
Authors: D Hadorn-Papke , D Gibson , C Golden
Published: August 2020

Objective

Determining the effort level allocated during a neuropsychological evaluation is essential, as effort has been shown to predict performance.

Method

One hundred and thirty-seven former NFL players were given the Test of Memory Malingering (TOMM) and Green’s Medical Symptoms Validity Test (MSVT) as part of a comprehensive neuropsychological evaluation.

Results

Based on established “cutoff” scores, 42 of the 137 individuals failed the TOMM (Trial 2, raw score < 45). Using the recommended “cutoff” scores, (Immediate recall, Delayed recall, Consistency <=85%, Paired Associated <=70%, Free recall<=50%), 74 individuals failed the MSVT. Together, the TOMM and the MSVT identified 81 individuals with sub-optimal effort and likely invalid neuropsychological test data, as both the TOMM and MSVT are passed by groups with known traumatic brain injury and other impairments.

Conclusions

We conclude that 59.1% of the Former NFL players put forth inadequate effort during testing. While the reasons for PVT failure are known only by the test-takers themselves, the validity of the results is highly questionable regardless and must be interpreted in this context.
A-216 The Relationship Between Cognitive Performance on a Sports-Concussion Assessment Battery and the Motivation Behaviors Checklist (MBC)
Authors: E Guty , K Riegler , G Thomas , P Arnett
Published: August 2020

Objective

The Motivation Behaviors Checklist (MBC) was designed as an observational rating scale to assess effort during baseline evaluations (Rabinowitz, Merritt, and Arnett, 2016). This study aims to explore the MBC in relation to a comprehensive battery of neuropsychological tests, including paper-and-pencil tests.

Method

Participants included 291 (M = 213, F = 78) student-athletes from a Division I University sports concussion program. Seventeen neuropsychological test indices were used to create a neurocognitive composite. The 18-item MBC was scored such that higher values indicate greater motivation/effort. Across test indices, the number of impaired scores (below the 80th percentile) was also calculated. Individuals were placed into impairment groups (Impaired ≥3 impaired scores) and motivation groups based on their MBC scores (High Motivation = score greater than the median of 49).

Results

Bivariate correlations demonstrated a significant relationship (ρ = .39, p < .001) between cognitive performance and the MBC total score. Chi-square analysis demonstrated that significantly more of the 81 individuals in the Impaired group were also in the Low Motivation group (n = 56, 69%), χ2 (1, N = 291) = 18.53, p < .001, Φ = −.25.

Conclusions

Higher motivation scores on the MBC are related to better cognitive performance. Compared with cognitively intact individuals, those who were cognitively impaired were significantly more likely to score below the cut off score of 49 on the MBC. Future work will explore different cutoff values that maximize sensitivity and specificity for test performance in order to provide guidelines for clinicians wishing to utilize the MBC.