bluuebunny/crossref_metadata_2025_split huggingface dataset:
A-82 Neurocognitive Improvement after Intra-Arterial Bevacizumab for Steroid-Refractory Radiation Necrosis of the Brain
Authors: Folley Bradley S , Kadner Robert J , Sheehan Jason P , Han Dong Y , Kryscio Richard J , Carter Mary B , Shields Lisa B E , Plato Brian M , La Rocca Renato V , Spalding Aaron C , Yao Tom L , Fraser Justin F , Dashti Shervin R 
Published: August 2021

Abstract

Objective
Evaluate neurocognitive change after single low-dose targeted intra-arterial (IA) bevacizumab in patients with brain radiation necrosis.

Methods
Phase II, single-arm, prospective trial. 10 adults underwent targeted 2.5 mg/kg IA bevacizumab. Neurocognitive indices (Neuropsychological Assessment Battery® and Wechsler Test of Adult Reading) were measured at baseline and 12-months to document performance in 5 domains: Attention, Language, Learning and Memory, Visuospatial, and Executive Function. Clinical indices also quantified. Data (mean ± SD, 95% confidence interval [CI], Cohen’s d) were analyzed using paired t tests. Null hypothesis rejected for p &lt; 0.05.

Results
At baseline, Numbers-&-Letters Speed T-score (38.2 ± 10.7) indicated decreased processing speed consistent with sub-cortical pattern of illness. All other baseline neurocognitive indices were within normalized means (image). 12-months post-treatment, Numbers-&-Letters Errors T-score increased by 6.0 ± 4.9 [95%CI 1.9,10.1] (t = 3.464, d = 1.225, p = 0.010). List-Learning List-Long-Delayed-Recall T-score increased by 9.0 ± 5.6 [95% CI 4.3,13.7] (t = 4.520, d = 1.598, p = 0.003) and Design-Construction T-score increased by 3.5 ± 4.1 [95%CI 0.04,7.0] (t = 2.391, d = 0.845, p = 0.048). Volume of radiation necrosis decreased by 74.4 ± 14.7% (t = −3.308, d = 1.169, p = 0.013). Headache decreased by 84.4 ± 18.2% (t = −3.495, d = 1.236, p = 0.010). 0/10 died or exhibited AEs attributed to bevacizumab. 2/10 patients experienced radiation necrosis recurrence at months 10 and 11, respectively.

Conclusions
Single low-dose intra-arterial targeted bevacizumab led to durable neuropsychological performance increase in memory retrieval and visuospatial ability consistent with improvement in sub-cortical function. To our knowledge this is the first prospective report of this novel approach in adults. Clinical improvements mirrored neuropsychologic improvements. Randomized trials are needed comparing targeted low-dose IA bevacizumab to multi-cycle IV bevacizumab at higher doses to determine which is best alternative in brain radiation necrosis.
A-84 Interdisciplinary Collaboration: Neuropsychology’s Role in Elucidating Neurocognitive Symptoms in a Patient with Arachnoid Cyst
Authors: Yunes Katelyn , Posada Carolina 
Published: August 2021

Abstract

Objective
Arachnoid cysts (ACs) are typically cerebrospinal fluid-filled abnormalities that occur within the central nervous system. ACs are uncommon (prevalence rate of 1.2%), and typically occur within the left hemisphere middle cranial fossa or posterior fossa. Symptoms vary depending on location and size but often include headaches, weakness, cognitive changes, and hydrocephalus. We present an unusual case of a 68-year-old right-handed woman with 13 years of education who was admitted to the hospital following overdose. During a previous admission, Patient was found to have a large arachnoid cystic lesion and right-sided weakness, but was determined not to require acute intervention. Neuropsychology was consulted to assess current cognitive functioning.

Method
Patient was initially diagnosed with a severe major depressive episode with new-onset psychotic features following an overdose of baclofen and Tylenol. Suicide attempt was denied. Magnetic Resonance Imaging (MRI) confirmed previously identified arachnoid cystic lesion (Figure 1) causing mass effect. Patient’s MRI also revealed pituitary macroadenoma (Figure 2) that caused subtle distortion along the optic chiasm.

Results
The results (Table 1) suggested an abnormal cognitive profile characterized by deficits on measures of language, visuoperception, memory, and abstract reasoning in the context of relatively intact auditory attention and working memory.

Conclusions
The extent and severity of Patient’s deficits are likely attributable to the cystic lesion, with recent onset of visual hallucinations likely caused by location of pituitary macroadenoma. This case highlights the importance of having access to a neuropsychological inpatient consultation service to assist with clarification of symptom etiology and facilitation of appropriate diagnosis and intervention.
A-92 Assessing Perceived Workload on the Brief Visual Memory Test in Traumatic Brain Injury Survivors
Authors: Smith Kristina E , Lopez-Hernandez Daniel W , Bueno Alexis , Rugh-Fraser Rachel A , Nordberg Bethany A , Budding Deborah , Hovda David A , McArthur David L , Plurad David , Fuster Joaquin M , Woo Ellen , Hardy David J , Wright Matthew J 
Published: August 2021

Abstract

Objective
We examined perceived workload as it is related to Brief Visual Memory Test-Revised (BVMT-R) short-delay and long-delay performance in traumatic brain injury (TBI) and healthy comparison (HC) participants.

Method
The sample consisted of 39 TBI participants and 54 HC participants. Demographically corrected BVMT-R scores were used to evaluate short-delay and long-delay performances. The perceived workload was measured using the NASA-TLX.

Results
ANOVA revealed that the HC group outperformed the TBI group on the BVMT-R short-delay and long-delay score, p &lt; 05, η p 2 = 0.05. ANCOVAs controlling for age were used to evaluate NASA-TLX group differences. In regards to the NASA-TLX, TBI participants reported higher levels of physical demand, effort, frustration and overall subjective workload on the BVMT-R short-delay compared to HC participants, p &lt; 05, η p 2 = 0.01–0.09. Furthermore, on the long-delay of the BVMT-R, the NASA-TLX revealed that the TBI group reported higher levels of temporal demand, effort, frustration and overall subjective workload compared to the HC group, p &lt; 0.05, η p 2 = 0.05–0.14.

Conclusions
Results revealed that TBI participants demonstrated worse BVMT-R performances than HC participants. However, TBI survivors reported higher perceived workload demands compared to the HC group in both short-delay and long-delay of the BVMT-R. Our findings suggest that TBI impacts non-verbal memory performance in both BVMT-R short-delay and long-delay. Also, brain injury may be impacting TBI survivors’ awareness of their non-verbal memory performance. Further work is required to determine what drives the impaired perception of non-verbal memory performance among TBI survivors.
A-12 Racial Differences in Performance Validity Test Failure Rates
Authors: Davis Jeremy , Rolin Summer , Hromas Gabrielle 
Published: August 2021

Abstract

Objective
Embedded performance validity tests (PVTs) may show increased false positive rates in racially diverse examinees. This study examined false positive rates by race in an older adult sample.

Method
The project involved secondary analysis of a deidentified dataset (N = 22,688) from the National Alzheimer’s Coordinating Center (NACC). Participants were included if their identified race was African American or white. Exclusion criteria included diagnosis of mild cognitive impairment (MCI; n = 5160) or dementia (n = 5550). The initial sample included 11,114 participants grouped as cognitively normal (89.9%) or impaired but not MCI of whom 16.4% identified as African American. Propensity score matching was conducted by diagnostic group to match African American and white participants on age, education, gender, and MMSE score. The final sample included 3024 and 482 participants in normal and impaired groups, respectively, with 50% of participants identifying as African American in each group. Failure rates on five embedded PVTs in the NACC cognitive test battery were examined by race and by diagnosis.

Results
Age, education, gender, and MMSE score were not significantly different by race in either diagnostic group. In the normal group, 4.7% of African American and 1.9% of white participants failed two or more PVTs (p &lt; 0.001). In the impaired group, 9.5% of African American and 5.8% of white participants failed two or more PVTs (n.s.).

Conclusions
PVT failure rates were significantly higher among African American participants in the normal group but not in the impaired group. Failure rates remained below a common false positive threshold of 10%.
A-113 Evaluation of a Recognition Trial for the Symbol Digit Modalities Test as a Performance Validity Measure in Monolingual and Bilingual Traumatic Brain Injury Survivors
Authors: Munoz Isabel , Lopez-Hernandez Daniel W , Rugh-Fraser Rachel A , Bichlmeier Amy , Baez Abril J , Nordberg Bethany A , Saravia Sarah , Litvin Pavel Y , Budding Deborah , Vespa Paul M , Hovda David A , Fuster Joaquin M , Woo Ellen , Hardy David J , Victor Tara L , Boone Kyle B , Wright Matthew J 
Published: August 2021

Abstract

Objective
Research shows that traumatic brain injury (TBI) patients perform worse than healthy comparisons (HC) on the Symbol Digit Modalities Test (SDMT). We evaluated cut-off scores for a newly developed recognition trial of the SDMT as a performance validity assessment in monolingual and bilingual TBI survivors and HC adults.

Method
The sample consisted of 43 acute TBI (ATBI; 24 monolinguals; 19 bilinguals), 32 chronic TBI (CTBI; 13 monolinguals; 19 bilinguals), and 57 HC (24 monolinguals; 33 bilinguals) participants. All participants received standardized administration of the SDMT. None of the participants displayed motivation for feigning cognitive deficits.

Results
The HC group outperformed both TBI groups on the demographically adjusted SDMT scores, p = 0.000, ηp2 = 0.24. An interaction emerged in SDMT scores where monolingual ATBI outperformed bilingual ATBI and bilingual CTBI outperformed monolingual CTBI, p = 0.017, ηp2 = 0.06. No differences were found in the SDMT recognition trial. Both Bichlmeier and Boone’s suggested cut-off scores had different failure rates in ATBI (Bichlmeier: 77%; Boone: 37%), CTBI (Bichlmeier: 69%; Boone: 19%), and HC (Bichlmeier: 56%; Boone: 26%). For the monolingual group (Bichlmeier: 66%; Boone: 36%) and the bilingual group (Bichlmeier: 66%; Boone: 21%). Finally, chi-squared analysis revealed monolingual TBI had greater failure rates than the bilingual ATBI.

Conclusion
Bichlmeier’s proposed cut-off score resulted in greater failure rates in TBI survivors compared to Boone’s suggested cut-off score. Furthermore, monolingual ATBI were influenced more by Bichlmeier’s cut-off score than the bilingual ATBI group, although the reason for this finding is unclear and requires additional study with a larger sample size.
A-122 Verbal Fluency Switching and Clustering Performance in Retired Professional Football Players
Authors: Nordberg Bethany , Lopez-Hernandez Daniel W , Bueno Alexis , Victor Tara L , Saravia Sarah , Baez Abril J , Sidhu Jasman , Munoz Isabel , Cantu Robert C , Guskiewicz Kevin M , Kelly Daniel F , Swerdloff Ronald , Hardy David J , Woo Ellen , Litvin Pavel Y , Wright Matthew J 
Published: August 2021

Abstract

Introduction
Repeated sports-related concussion has been associated with cognitive deficits, like other forms of traumatic brain injury. Football speed players (FSP; e.g., quarterbacks) are at greater risk of cognitive impairment compared to football non-speed players (FNP). Verbal fluency is typically comprised of two tasks: letter fluency (LF) and semantic fluency (SF). Verbal clustering (production of continuous words belonging to the same category or subcategory) and switching (abandoning an exhausted semantic cluster to a new one in order to produce more words) reflect executive control and strategy use. We examined LF, SF, as well as LF and SF switching and clustering performance in retired FSP, FNP, and healthy comparison (HC) participants.

Methods
The sample consisted of 28 HC, 17 retired FSP, and 53 retired FNP. ANOVAs were conducted to determine group differences on LF, SF, switching, and clustering. FSP and FNP did not differ in concussion frequency.

Results
We found the HC group outperformed the FSP group in LF, p = 0.042, ηp2 = 0.07. For SF, the HC and FNP groups outperformed the FSP group, p = 0.013, ηp2 = 0.09. Furthermore, we found the HC group outperformed both football groups in SF switching, p = 0.000, ηp2 = 0.17.

Conclusion
As expected, the HC group outperformed the FSP group on LF and SF. Also, the FNP group outperformed the FSP group on SF. Interestingly, FSP displayed generally worse performances, supporting the notion that their experience of sub-concussive blows puts them at greater risk for cognitive impairment. Further investigation is needed with larger sample sizes to evaluate SF and other cognitive deficits in the FSP participants.
A-14 Mechanisms and Neuropsychological Correlates of Sleep Disruption in Concussed College Athletes
Authors: Riegler Kaitlin E , Guty Erin T , Thomas Garrett A , Bradson Megan , Arnett Peter A 
Published: August 2021

Abstract

Objective
First, to explore demographic/injury characteristics associated with increased sleep disruption post-concussion. Second, to examine the association between sleep disruption post-concussion and symptom reporting and cognitive variability.

Method
124 athletes (M = 103, F = 21) completed neuropsychological testing within 14 days of concussion. Athletes were categorized as sleep-disrupted (n = 52) or not sleep-disrupted (n = 72). Athletes in the sleep-disrupted group endorsed one or more of the following from the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) Post-Concussion Symptom Scale (PCSS): trouble falling asleep, sleeping more than usual, and sleeping less than usual. Loss of consciousness (LOC) and concussion history were explored. Two neurocognitive variability measures were derived from the neuropsychological battery: intraindividual standard deviation (ISD) and maximum discrepancy score (MDS). Variability in memory and attention/processing speed (APS) composites were explored. Total PCSS symptom score, without sleep items, was calculated.

Results
A significantly greater proportion of sleep-disrupted athletes experienced LOC (30%) compared to not sleep-disrupted athletes (13%), χ2(1,N = 118) = 4.99, p &lt; 0.03, φ = 0.21. Sleep-disrupted athletes reported more symptoms, t(122) = −5.42, p &lt; 0.001, d = 0.98, and demonstrated more memory variability (memory ISD, t(122) = −2.22, p = 0.03, d = 0.40, and memory MDS, t(122) = −2.29, p = 0.02, d = 0.41) than not sleep-disrupted athletes. Groups did not differ in APS variability or concussion history.

Conclusions
Given the higher rate of LOC in sleep-disrupted athletes, it is possible that LOC is a mechanism leading to post-concussion sleep difficulties. Furthermore, sleep disruption following concussion results in more variable memory performance and higher symptom reporting. Symptom reporting and/or return to baseline cognitive functioning are often decision-making tools in concussion management. The difficulties experienced by sleep-disrupted athletes may complicate recovery.
A-165 Normative Data for the Rivermead Behavioral Memory Test (RBMT) in Collegiate Athletes
Authors: Thomas Garrett A , Guty Erin T , Riegler Kaitlin E , Bradson Megan L , Arnett Peter A 
Published: August 2021

Abstract

Objective
The Rivermead Behavioral Memory Test (RBMT) Story subtest has four alternate forms. While the use of different forms allows for greater test–retest reliability, it is unclear whether these forms are comparable in terms of difficulty and expected performance. Thus, this study aimed to evaluate performance on the different forms of the RBMT in college athletes.

Method
Our sample consisted of 602 (M = 450, F = 152) college athletes tested at baseline. We evaluated performance differences on the four different RBMT forms for immediate and delayed recall.

Results
Independent samples t-tests revealed significant differences between all forms at immediate recall, except when comparing Form A to Form B. There were also significant differences between all forms at delayed recall. Among males, there was a significant difference among most forms at immediate recall, with the exception of Form A compared to Form B. Additionally, among males, there was a significant difference among most forms at delayed recall, with the exception of Form A compared to Form D. Among females, findings indicate that Form A and Form B were comparable and not statistically different at immediate and delayed recall. Additionally, Form C and Form D were comparable and not significantly different at immediate and delayed recall among females.

Conclusions
The significant differences found between many of the RBMT forms at both immediate and delayed recall were further illuminated when accounting for sex differences. Therefore, we recommend using normative data that accounts for form and sex differences when using the RBMT, especially in cases where baseline testing is not available.
A-174 Diurnal Preference Relation to Need for Cognition and Cognitive Reflection
Authors: Pizer Jasmin H , Myers Melissa A , Hawley Nanako A , Harrell Murphy N , Hill Benjamin D 
Published: August 2021

Abstract

Objective
This study evaluated the effect of individual differences in diurnal preferences on a problem-solving test of intelligence and a measure of a personality trait of how much someone enjoys thinking.

Method
Archival data from 85 participants who had completed measures online were utilized in this study. The sample was 51.8% female, 71.8% Caucasian, and mean age was 19.5. Participants completed the Morningness-Eveningness Questionnaire (MEQ), Composite Morningness Questionnaire (CMQ), Cognitive Reflection Test (CRT), and Need for Cognition Scale-Short Form (NFC). Raw score totals were utilized. Diurnal preferences were later grouped for morning, evening, or in between based on published MEQ and CMQ cutoffs. Lower scores indicate evening types, and higher scores indicate morning types.

Results
Scores on measures of diurnal preference were significantly positively related to NFC (MEQ r = 0.28, p = 0.011; CMQ r = 0.36, p = 0.001) meaning that morning types tend to enjoy effortful mentation more. Diurnal preferences were not significantly related to CRT performance. One-way ANOVA was performed with diurnal preferences as the group factor and NFC and CRT as dependent variables. Significant main effects were not found for MEQ and NFC nor MEQ and CRT. Significant main effects were found for CMQ and NFC F(2,77) = 5.33, p = 0.007, but not for CMQ and CRT.

Conclusion
These findings indicate that diurnal preference was not associated with performance on the problem-solving intelligence test used in this study. However, morning types appear to be higher for personality traits related to motivation to engage in thinking and would be expected to do better on some cognitive tests that demand more test engagement.
A-176 Undercover Performance Validity Testing: Proposed Embedded Validity Indicators for Pediatric Neuropsychological Assessment
Authors: Kaswan Naomi R , Thompson Ryan C , Markiv Yelena , Deenen Aubrey , Pilavjian Haig V , Hirst Rayna B 
Published: August 2021

Abstract

Objective
Literature supports the use of the Delis-Kaplan Executive Function System Trail Making Test Conditions 4/2 ratio (TMT 4/2) and Stroop Color Word Test Word Reading (WR) as embedded validity indicators (EVIs) with adults (Erdodi et al., 2018; Guise et al., 2012) and the Wechsler Abbreviated Scale of Intelligence, 2nd Edition Matrix Reasoning (MR) as an EVI with children (Sussman et al., 2017). This study assessed the utility of these measures as EVIs in healthy children, compared to the Test of Memory Malingering Trial 1 (TOMM1 &lt; 45; Perna & Loughan, 2013) and Reliable Digit Span (RDS).

Method
Participants (n = 99, 68.7% male, Mage = 11.9) completed baseline neuropsychological evaluations for sport participation, including the aforementioned measures. Receiver operator characteristic curve analysis was used to determine whether TMT 4/2, MR, and WR accurately categorized valid performance.

Results
TMT 4/2 yielded adequate sensitivity (0.83–1.00) but poor specificity (0.07–0.09) when predicting TOMM1 and RDS pass/fail performances. MR yielded adequate sensitivity (1.00) and specificity (0.92) when predicting RDS pass/fail performance and adequate specificity (0.92) and poor sensitivity (0.18) when predicting TOMM1 pass/fail performance. The only EVI that produced better than chance accuracy was MR when predicting RDS pass/fail performance (area under the curve [AUC] = 0.98). All participants failed the WR cutoff, suggesting poor specificity.

Conclusion
Results suggest that MR was the only EVI that achieved minimally acceptable specificity (≥0.90) in children. MR performed adequately when detecting valid performances but variably when detecting invalid performances; therefore, MR may be used alongside well-established performance validity tests with children but not independently.
A-183 Base Rates of Performance and Symptom Validity Test Failures in Active Duty and Veteran Samples Referred for Attention-Deficit/Hyperactivity Disorder Evaluation
Authors: Shura Robert D , Armistead-Jehle Patrick , Cooper Douglas B 
Published: August 2021

Abstract

Objective
To evaluate base rates of abnormal MMPI-2-RF symptom validity test (SVT) and stand-alone performance validity test (PVT) scores in active duty (ad) service member and Veterans Affairs clinical samples referred for neuropsychological assessment of ADHD.

Method
MMPI-2-RF SVT scores and various PVTs were evaluated in two samples referred specifically for assessment of ADHD: service members (N = 82) and Veterans (N = 355). SVT and PVT outcomes were then compared to published data establishing invalid base rates in larger, more general samples.

Results
Elevated MMPI-2-RF overreport scales (F-r ≥ 79; FS, RBS, and FBS-r ≥ 80; & Fp-r ≥ 70) ranged from 14.6% (FBS-r) to 40.0% (RBS) in the ad sample and 12.0% (FBS-r) and 28.9% (RBS) in the veteran sample. MMPI-2-RF profiles that were invalidated due to overreport (e.g., F-r = 120, all others ≥100) were under 5% on the veteran sample and no greater than 6.1% in the ad sample. Elevations on underreport scales were higher in the veteran sample (L-r = 12.9%, K-r = 2.0%) than the ad sample (L-r = 3.7%, K-r = 1.2%). In the ad sample, 21.5% failed one PVT and 6.3% failed two. In the Veteran sample, 23.4% failed one PVT.

Conclusions
Elevated MMPI-2-RF overreport scales were relatively common on ad and Veterans referred for ADHD evaluations. However, frequencies of elevated and invalidated scales were diminished relative to overall base rates reported in national data. Regarding PVT failure, both samples were lower than national average invalid rates. Despite the incentive inherent in ADHD exams, invalidity in both samples were consistently lower for both SVTs and PVTs.