bluuebunny/crossref_metadata_2025_split huggingface dataset:
A-064 Executive Functioning in an Acute Pediatric Neurocritical Care Population Recently Discharged from the PICU: Exploring the Associations among Parent Report and Individual Performance Measures
Authors: E Holding , K Bradbury , S Leonard , E Turner , C Williams , T Hall 
Published: August 2020

Abstract

Objective
An emerging literature has identified that PICU survivors face a host of long-term physical, cognitive, emotional, and psychosocial difficulties that stem from the underlying concern and side effects of critical care intervention. Research shows that executive functioning (EF) is particularly vulnerable to sequelae. This study sought to understand associations between parent-report of daily life EF and performance-based measures following neurocritical care.

Method
Twenty-three children ages 8–16 (M = 12.66 years; 39% male) were screened as part of an integrated (neuropsychology and pediatric critical care) acute phase (3–6-week post-discharge) follow-up clinic. Injuries included children with traumatic brain injury (n = 19), or acquired brain injury (i.e., anoxic brain injury, AVM, acute cerebellitis, hemorrhagic stroke; n = 4). EF outcomes were assessed using the Behavior Rating Inventory of Executive Functioning, Second Edition (BRIEF-2), Delis-Kaplan Executive Function System (D-KEFS) Trail Making Test and Verbal Fluency Test, Children’s Memory Scale Digits Backwards, and Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V) Coding and Symbol Search subtests. Bivariate correlations were used to examine associations among parent-report of EF and performance-based measures of EF in our neurocritical care population.

Results
Analyses demonstrated significant (□ = .05) correlations between the WISC-V Coding subtest and the BRIEF-2 Shift scale (r = −.44) and Global Executive Composite (GEC; r = −.59). Correlations between D-KEFS Category Fluency and BRIEF-2 Initiate (r = −.51), Working Memory (r = −.44), and GEC (r = −.55) were significant. Inverse correlations demonstrate agreement.

Conclusion
In the acute recovery phase following neurocritical care, parent-report and specific performance-based measures are only moderately associated, demonstrating the importance of multi-method assessment to detect potential acquired deficits to inform rehabilitation.
A-068 Case Study: Neurodevelopment of Late Identification and Treatment of Nonsyndromic Multisutural Craniosynostosis
Authors: R Fleischer , V Chang , V Culotta 
Published: August 2020

Abstract

Objective
Craniosynostosis, the premature closure of cranial sutures, is frequently associated with intracranial hypertension, neurocognitive deficits, and neuromotor deficits. Younger age at treatment is associated with improved outcomes. This case study will expand upon the existing literature by characterizing the neurodevelopment of an individual whose nonsyndromic multisutural craniosynostosis was identified and treated late, when the patient was nearly three years old.

Method
A 7-year, 1-month old male with a history of bicoronal and sagittal craniosynostosis was seen for neuropsychological assessment. Diagnosis and cranial vault reconstruction occurred just before his third birthday. Evidence of increased intracranial pressure was found on presurgical CT scan, and by the appearance of his dura at surgery. His development after reconstruction was notable for articulation disorder, expressive language disorder, executive dysfunction, and adaptive skills deficits.

Results
Assessment revealed average non-verbal cognitive skills and low average verbal cognitive skills. Receptive language was below average. Exceptionally low scores were found on tasks of oromotor sequencing, verbal list learning, and immediate visual memory. Teacher ratings of executive functioning suggest below average skills. Measures of attention and impulsivity suggest mild weaknesses. Academically, he earned below average and exceptionally low scores on measures of reading and writing, with low average to average mathematics scores.

Conclusions
The neurodevelopment of children with late diagnosis/treatment of craniosynostosis is not well characterized and may confer increased risks. Late diagnosis is presumed to lead to more significant neurocognitive impairments due to the impact of prolonged intracranial pressure. Neuropsychological assessment and follow-up is critical for monitoring and intervention planning.
A-094 Isocitrate Dehydrogenase Status and Cognition in Glioma Patients
Authors: S Park , A Giles , M Liberatore , K Morgan , C Debruhl , C Cramer , R Strowd , M Chan , G Lesser , A Laxton , S Tatter , T Cummings 
Published: August 2020

Abstract

Objective
In gliomas, isocitrate dehydrogenase-wildtype (IDH-wt) is associated with poorer prognosis and is correlated with lower brain connectivity, implicating cognitive impairment. Little is known about the impact of IDH-wt on cognition. This study aimed to explore the relationship between IDH-wt and cognition.

Method
Thirty-eight patients (Age M = 48.73 ± 14.98; 50% female) diagnosed with a glioma (29% grade II, 16% grade III, 21% grade IV; Karnofsky Performance Status score (KPS) M = 88.75 ± 14.24) were selected from a retrospective data cohort. 34.2% of patients had left hemisphere tumors, 34.2% of tumors were in the frontal lobes, and 15.8% were temporal lobe tumors. Patients were assessed via abbreviated neuropsychological battery following surgical resection prior to radiation and/or chemotherapy.

Results
The overall cognitive composite was not statistically significant via independent samples t-test (IDH-wt+: M = 42.37; IDH-wt-: M = 39.29; p = 0.897). Subdomains for attention/executive functioning (p = 0.625), memory (p = 0.923), and language (p = 0.501) were not significantly different. Logistic regression was conducted to investigate how IDH status predicts cognitive status. The coefficient has a Wald statistic equal to 0.042 which is not significant (critical value of 0.837) [df = 1]. Of those with IDH-wt+, 57% were impaired and 43% remained intact.

Conclusion
We did not find a significant association between IDH status and cognition though sample size is a significant limitation of the present study. More investigations are needed given it is possible that cognitive performance is related to IDH status and knowledge in this area could improve patient care/patient education.
A-100 Neuropsychological Findings in a Case Involving a Rare Genetic Anomaly (de novo 6q24.2-q25.2 deletion on paternal chromosome 6) Associated with Intrauterine Growth Restriction (IUGR), Autism, OCD and Schizoaffective Disorder
Authors: L Bakry-Becker , E Goldberg 
Published: August 2020

Abstract

Objective
Individuals with deletions of the long arm of chromosome 6 have been known since 1975 with just over 100 cases reported as of 2015. Individuals with deletions involving band 6q25 have a high incidence of intrauterine growth retardation, intellectual disability, dysmorphic features, growth failure, and medical complications (Stagi et al, 2015). Findings will add to the literature base on this genetic anomaly.

Methods
A 21-year-old male was assessed to differentiate between obsessive vs. psychotic thinking. His history was notable for being born weighing 2300 grams at term, and having feeding, learning and social/emotional difficulties which progressed to OCD in later childhood. At age 15, he was determined to have a de novo 3.7 Mb microdeletion at 6q24.3.

Results
Neuropsychological assessment of attention, motor and executive functions reveal a variable profile with pockets of strengths relative to his own performance as well as significant normative impairment. Findings represented a significant decline from prior testing at age 10. His verbal memory was below average and his overall attention capacity was impaired. JT’s executive functioning, visual-motor integration, motor speed, and his verbal abstract reasoning were all below average. His non-verbal abstract reasoning and visual perception were intact. On results of objective, projective and neurocognitive testing, JT met criteria for diagnoses of Autism, Obsessive Compulsive Disorder, and Schizoaffective Disorder.

Conclusions
JT’s developmental history and symptom presentation are complex, revealing significant comorbidity; this case study describes the progression of JT’s difficulties over his lifespan, beginning with feeding difficulties, diagnoses of autism and OCD and progressing to a psychotic disorder.
A-101 PTSD and Personality Traits Influence the Relationship Between Memory Complaints and Memory Performance
Authors: P Armistead-Jehle , E Mattson , N Nelson , S Disner 
Published: August 2020

Abstract

Objective
Previous research has shown that post-traumatic stress disorder (PTSD) symptomatology may mediate the association between subjective cognitive complaints and objective cognitive performance, however, the precise nature of this mediation is not well understood. The present study aims to expand on these findings by focusing on memory processes and exploring the influence that personality variables may have on the mediational role of PTSD symptoms.

Methods
In a sample of 196 U.S. military service members and veterans, we administered the PTSD checklist (PCL), Personality Assessment Inventory (PAI), Memory Complaints Inventory (MCI), and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).

Results
Overall MCI score (reflecting subjective memory complaints) was associated with both RBANS immediate (β= −0.15, SE = 0.06, p = 0.01) and delayed memory performance (β= −0.13, SE = 0.06, p = 0.02), but PTSD severity mediated both of these relationships (95% CI -0.14, −0.01; 95% CI -0.14, −0.02, respectively). Trait depression moderated the mediation path between subjective memory complaints and PTSD severity (β= −0.02, SE = 0.004, p &lt; .001), but not the path between PTSD and either immediate or delayed memory performance (all p &gt; .05).

Conclusion
Results suggest that targeting PTSD and depressive symptoms may be a promising treatment for those with subjective memory complaints.
A-113 A Case Study: Utilization of C3 Logix in Serial Evaluation of Concussion in a Multidisciplinary Medical Setting
Authors: R Zill , H Dean-Hill , M Alcala , E Snell , G Getz 
Published: August 2020

Abstract

Objective
C3 Logix is a concussion assessment and management system addressing patient care, return to play standards, and rehabilitation or understanding of concussion. This case study demonstrates the utility of the C3 Logix screening measure with a concussion patient in a multidisciplinary medical setting. Repeat C3 Logix screening data was compared to reported symptoms on the Post-Concussion Symptom Scale (PCSS) and interpreted by a physician in medical setting. This case highlights the comparison of C3 Logix findings and a neuropsychological profile in a young adult with history of traumatic closed head injury.

Method
25-year old, right-handed, Caucasian man with no significant medical history prior to sustaining a parenchymal hemorrhage along the left anterior inferior frontal lobe and left temporal lobe, as well as a left anterior frontal subdural hematoma in 2019. The patient reported a premorbid history of generalized anxiety with panic, and elevated emotionality post-injury.

Results
Estimated premorbid verbal functioning was average, consistent with his score as predicted by demographic variables. The patient exhibited decreased concussion symptom severity and improved cognitive performance across repeat C3 Logix administrations. On comprehensive neuropsychological evaluation, he demonstrated intact performance across cognitive domains, with relative weakness consistent with localization of injury, sustained eye injury, and expected recovery duration.

Conclusions
Repeat cognitive screenings were generally consistent with comprehensive neuropsychological evaluation results. This case study highlights that the C3 Logix tool should be further considered as a brief cognitive screening measure to inform treatment of traumatic head injuries within a multidisciplinary medical setting.
A-114 Predicting Long-Term Cognitive Outcomes From Acute Orientation Performance After Traumatic Brain Injury
Authors: C Diblasio , R Kennedy , E Cook , A Fahey , T Novack 
Published: August 2020

Abstract

Objective
To evaluate how initial orientation, rate of change in orientation, and duration of post-traumatic amnesia (PTA) during inpatient rehabilitation predict cognitive functioning (overall cognition, episodic verbal memory, and executive function) 1 year and 2 years after sustaining a moderate-to-severe traumatic brain injury (TBI).

Methods
Participants were 101 adults aged 18–81 years (M age = 39 years; 67% male) receiving inpatient rehabilitation following new-onset moderate–severe TBI at a level I trauma center, acute inpatient hospital. Orientation data (initial orientation, rate of change in orientation, and duration of PTA) were collected during inpatient rehabilitation where each participant received serial assessments of their orientation with the Orientation Log (O-Log) during bedside rounds. The Brief Test of Adult Cognition by Telephone (BTACT) was administered to participants over the telephone at 1 year and 2 years post-injury to assess cognitive outcomes.

Results
Initial orientation during acute inpatient rehabilitation was significantly associated with overall cognition (p &lt; .01), episodic verbal memory (p &lt; .01), and executive function abilities (p &lt; .01) at 1 year post-injury. Duration of PTA and rate of change in orientation were not significant predictors, and none of the orientation factors predicted cognition at 2 years post-injury.

Conclusion
Initial level of orientation is important to consider in the prediction of cognitive impairments one year following moderate–severe TBI. This supports the need to assess orientation early in the recovery process, particularly upon admission to acute rehabilitation.
A-121 Verbal Learning in Veterans with Mild Traumatic Brain Injury, Posttraumatic Stress Disorder, and Co-occurring Conditions
Authors: V Jessie , T Bender-Pape 
Published: August 2020

Abstract

Objective
The study examined how veterans with PTSD only, mTBI only, and co-occurring mTBI and PTSD acquire, encode, and consolidate verbal information at least three months post mTBI.

Method
This retrospective study examined 57 veterans (15 mTBI only, 6 PTSD only, 19 mTBI + PTSD, and 17 veteran controls) from a VA setting who were recruited through: polytrauma clinic referrals, introductory letters, and study flyers. The sample included male and female OIF/OEF veterans aged 18 to 70. Inclusion and exclusion criteria of participants were determined by the following measures: (a) Structured Interview for TBI Diagnosis, (b) Clinician-administered PTSD Scale, and (c) Letter Memory Test. One-way ANOVA evaluated group differences between the mTBI only, PTSD only, and mTBI + PTSD groups. A two-way ANOVA evaluated group differences between veterans with and without PTSD.

Results
The two-way ANOVA revealed that veterans with PTSD perform below the mTBI only and veteran control groups (F = 6.59, p = 0.01) on serial clustering forward strategy. The one-way ANOVA demonstrated that the mTBI + PTSD group performed below the mTBI only group on Trial 1 (F = 3.61, p = 0.04).

Conclusions
The mTBI + PTSD group performed worse than the mTBI only group on their ability to acquire verbal information. This result may suggest that the co-occurring effects of mTBI and PTSD negatively attribute to a veteran’s ability to focus and attend to new information. Veterans without PTSD were more likely to use a serial clustering strategy to recall information compared to Veterans with PTSD.
A-123 Effects of Ethnicity, Educational Attainment, and Severity of Traumatic Brain Injury on Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Index Scores
Authors: J Ryan , D Kreiner , A Myers-Fabian , S Gontkovsky 
Published: August 2020

Abstract

Objective
This study utilized a culturally diverse sample with traumatic brain injury (TBI) to examine effects of ethnicity on the Verbal Comprehension (VCI), Perceptual Reasoning (PRI), Working Memory (WMI), and Processing Speed (PSI) indices of the Wechsler Adult Intelligence Scale-Fourth Edition while controlling for education and injury severity. Hypotheses were that education and ethnicity would significantly influence all indices, the latter to a lesser extent, and injury severity would most strongly affect PSI scores.

Method
Participants were 43 trauma center admissions with documented head injury. Mean age and education were 32.16 and 13.88 years, respectively. There were 14 Euro-, 17 Hispanic-, and 12 African-Americans.

Results
ANCOVAs revealed significant effects for education across indices. Significant effects were found for ethnicity on the VCI and PRI and injury severity on the PSI. Post hoc comparisons indicated Euro- and Hispanic-Americans did not differ on VCI but performed significantly higher than African-Americans. Euro-Americans performed significantly better than African-Americans on the PRI, but comparable performance emerged between Euro- and Hispanic-Americans and between African- and Hispanic-Americans. Groups did not differ on the WMI or PSI.

Conclusions
Education and ethnicity accounted for most of the variance in VCI and PRI. Analysis of the WMI revealed education produced a significant effect, but ethnicity and injury severity did not. On the PSI, education and injury severity had significant effects. PSI was the only composite to which injury severity made a statistically significant contribution. Despite the small sample size, findings have important implications in the intellectual assessment of individuals with TBI.
A-129 An Effect of Pre-injury Factors on the Relationship between Severity of Acute Symptoms and Sleep Quality Among Recovered and Non-Recovered Adolescents following Concussion
Authors: H Fatima , T Caze , T Meredith-Duliba , N David , S Bunt , L Hynan , C Lobue , M Cullum 
Published: August 2020

Abstract

Objective
Sleep disturbance following concussion has been linked to more severe symptoms and longer recovery times. However, it is unclear whether this association may be affected by pre-injury and mood factors. This study examines whether acute symptom severity was associated with poorer sleep quality among recovered vs not-yet-recovered adolescents at 3-months following injury after adjusting for age, sex and anxiety.

Method
Adolescents aged 12–18 (N = 449) presenting □7 days to ConTex specialty concussion clinics were studied. Of these, 60 reported not being recovered at 3-month follow-up (Mage = 15.23, Nmales = 27, Nfemales = 33). Participants completed the Sport Concussion Assessment Tool-3rd Edition (SCAT-3) Symptom Checklist, Pittsburgh Sleep Quality Index (PSQI), and General Anxiety Disorder-7 (GAD-7). Hierarchical linear regressions assessed if initial symptoms as measured by the SCAT-3 total symptom score, predicted sleep quality at 3-month follow-up, controlling for initial data of age, sex, PSQI, and GAD-7.

Results
Initial total symptom scores did not predict higher PSQI scores at 3-months for either recovered or non-recovered subjects [F (1, 362, p = .550 and F (1,48), p = .307, respectively]. For recovered subjects, initial sleep ratings (p &lt; .001) predicted 3-month sleep quality, while there was a trend for age (p = .054). For non-recovered subjects, only sex was associated with lower sleep quality at 3-months (p = .034).

Conclusions
Sleep disturbance was not associated with severity of concussion symptoms when accounting for age, sex, and initial sleep quality. These findings do suggest, however, that females were more likely to report lower sleep quality when experiencing longer recovery.
A-143 Neurocognitive Effects of Comorbid Affective Disorders in College Athletes
Authors: G Thomas , K Riegler , E Guty , P Arnett 
Published: August 2020

Abstract

Objective
The objective of the current study is to examine the effects of depression, anxiety, and comorbid depression/anxiety on neurocognitive performance in college athletes. We hypothesized a priori that the mood disorder groups would perform worse than healthy controls, with the comorbid group performing worst overall.

Method
831 (M = 620, F = 211) collegiate athletes completed a comprehensive neuropsychological test battery at baseline which included self-report measures of anxiety and depression. Athletes were separated into 4 groups (Healthy Control (HC) (n = 578), Depression Only (n = 137), Anxiety Only (n = 54), Comorbid Depression/Anxiety (n = 62)) based on their anxiety and depression scores. Athletes’ neurocognitive functioning was analyzed via z-score composites of Attention/Processing Speed, Memory, and Global Functioning.

Results
A one-way ANOVA comparing the means of the four groups revealed that, compared to athletes in the HC group (e.g. those with no affective symptoms), those in the depression only and anxiety only groups were not significantly different from one another or the HC group on neurocognitive outcomes. However, the comorbid group performed significantly worse than the HC group on Attention/Processing Speed, t(827) = −2.28, p = 0.023, d = 0.30, and Global Functioning, t(827) = −2.32, p = 0.020, d = 0.30, but not on the Memory composite.

Conclusions
Athletes in the comorbid group performed significantly worse than HCs on composites of Attention/Processing Speed and Global Functioning. These results show that collegiate athletes tested at baseline who have comorbid depression and anxiety should be identified, as their poorer cognitive performance at baseline could skew future/post-concussion comparisons.
A-168 Do Family Members’ Subjective Perceptions of Decline in Executive Functioning Skills Reflect Objective Cognitive Dysfunction?
Authors: H Clark , R Schroeder , P Martin 
Published: August 2020

Abstract

Objective
On behavior rating scales completed by family members, executive functioning is often operationalized in terms of subdomain abilities (e.g., problem-solving, multitasking, and organizing). It is unclear, however, how well collateral assessments of these abilities reflect patients’ actual executive functioning. The current study investigated the relationship between family members’ reported perceptions of change in patients’ problem-solving, multitasking, and organizing abilities and objective neuropsychological test findings.

Method
Patients undergoing dementia evaluations (n = 56, mean age = 71.4, mean education = 13.0 years) minimally completed subtests from the Delis-Kaplan Executive Function System (D-KEFS; Trail Making, Verbal Fluency, Color-Word, Tower) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Information from family members was obtained via a questionnaire asking about degrees of change (no change, mild change, moderate change, or severe change) in problem-solving, multitasking, and organizing. Spearman correlations were calculated between family members’ perceptions of change and cognitive dysfunction, as measured by D-KEFS (subtests and combined averaged scaled score) and RBANS index scores.

Results
Perceived changes in problem-solving, multitasking, and organizing did not significantly correlate at p &lt; .05 with either D-KEFS subtest scores or the combined scaled score. Perceived changes significantly correlated with RBANS Immediate Memory (problem-solving: rs = −.338, p = .014; multitasking: rs = −.323, p = .017; organizing: rs = −.293, p = .028) and Language (problem-solving: rs = −.306, p = .027) indices.

Conclusions
Family members’ perceptions of change in problem-solving, multitasking, and organizing did not correspond with objective executive dysfunction observed on neuropsychological testing. Future research should attempt to cross-validate these findings. If cross-validated, results would suggest limited utility in using these terms to operationalize executive functioning on behavior rating scales.