bluuebunny/crossref_metadata_2025_split huggingface dataset:
B-57 Post-traumatic Stress Disorder is a Stronger Predictor of Long-term Neurobehavioral Outcome than Traumatic Brain Injury Severity in U.S. Military Service Members
Authors: Lange R , French L , Lippa S , Bailie J , Brickell T 
Published: August 2019

Abstract

Objective
The purpose of this study was to examine long-term neurobehavioral outcome in SMVs with versus without PTSD following TBI of all severities.

Methods
Participants were 536 SMVs recruited into three experimental groups (TBI, injured controls [IC], non-injured controls [NIC]). Participants completed the PTSD Checklist and the TBI-Quality of Life (TBI-QOL). Participants were divided into six subgroups based on the three experimental categories, two PTSD categories (i.e., present/absent), and two broad TBI severity categories (i.e., ‘unMTBI’ [includes uncomplicated mild TBI]; and ‘smcTBI’ [includes severe TBI, moderate TBI, and complicated mild TBI): (1) NIC/PTSD-Absent, (2) IC/PTSD-Absent, (3) unMTBI/PTSD-Absent, (4) unMTBI/PTSD-Present, (5) smcTBI/PTSD-Absent, and (6) smcTBI/PTSD-Present.

Results
There were significant main effects across the six groups for all TBI-QOL measures (p < .001). Select pairwise comparisons revealed significantly worse scores (p < .001) on all TBI-QOL measures in all PTSD-Present groups compared to the PTSD-Absent groups (i.e., Group 3v4 and 5v6; d = 0.90 to 2.11). In contrast, when controlling for PTSD, there were no significant differences between the TBI severity groups for all TBI-QOL measures (i.e., Group 3v5 and 4v6). In the TBI sample, a series of step-wise regression analyses revealed that PTSD, but not TBI severity, was consistently a strong predictor of all TBI-QOL scales (all p’s < .001), accounting for up to 64% of the variance.

Conclusions
These results provide support for the very strong influence of PTSD, but not TBI severity, on long-term neurobehavioral outcome following TBI. Concurrent PTSD and TBI of all severities should be considered a risk factor for poor long-term neurobehavioral outcome that requires ongoing monitoring.
B-62 Using Single-Item Reporting on the Neurobehavioral Symptom Inventory to Determine Minimum Thresholds of Clinical Anxiety in a Polytrauma Veteran Sample.
Authors: Palmer G , Falcone G , Arch A , Olson S 
Published: August 2019

Abstract

Objective
The Neurobehavioral Symptom Inventory (NSI) is a self-report measure used to evaluate physical and mental health symptoms secondary to traumatic brain injury (TBI) in the Department of Veterans Affairs health care system. There has been little research examining the relationship between anxiety reported on the NSI and other anxiety screening measures. The purpose of the study was to compare single-item response on item 19 (i.e., feeling anxious or tense) of the NSI to symptoms as reported on the Beck Anxiety Inventory (BAI).

Method
Retrospective data collected from veteran patients (N = 321) of a polytrauma outpatient clinic were used in the analyses. Veterans whose cutoff scores exceeded an embedded validity scale (i.e., NSI Validity-10) or had missing data were excluded. Receiver Operating Curve (ROC) analysis was conducted to determine which item score (i.e., score of 0-4) on the NSI best classified the presence of anxiety as measured by a BAI cut-off score greater than 7 (i.e., mild anxiety).

Results
There were 82 subjects who tested positive for anxiety based on a score of 3 on item 19 of the NSI. The ROC analysis was significant (AUC = .692, p < .001; 95% CI = .633 - .750). A score greater than 7 on the BAI yielded a sensitivity rate of .976 and a specificity rate of .711.

Conclusions
These results indicate that item 19 of the NSI is suggestive of a positive screen for mild anxiety in polytrauma samples with scores of 3 or greater indicating that further assessment of anxiety is recommended.
B-68 The Effect of Bilingualism on Stroop Performance in Traumatic Brain Injury Survivors and Healthy Adults
Authors: Knight J , Arzuyan A , Lopez-Hernandez W , Litvin P , Cervante R , Rugh-Fraser R , Torres E , Magassarian S , Fatoorechi S , Bichlmeier ABueno A , Hardy D , Vespa P , Plurad D , Hovda D , Woo E , Fuster J , Budding D , Wright M 
Published: August 2019

Abstract

Objective
Traumatic brain injury (TBI) affects neurocognition. Speaking multiple languages can also influence cognitive test performances. We examined the relationship between TBI and monolingualism/bilingualism on a task of attention and response inhibition (Stroop Color Word Test; SCWT).

Method
The sample (N = 96) consisted of 37 healthy controls (19 bilingual; 18 monolingual), 32 acute TBI participants (12 bilingual; 20 monolingual), and 27 chronic TBI participants (16 bilingual; 11 monolingual). Acute TBI participants were tested 6 months post-injury and chronic TBI participants were tested 12 months or more post-injury. The SCWT included the word (SCWT-W), color (SCWT-C), and color-word interference (SCWT-I) conditions. All participants passed performance validity testing. 3X2 ANOVAs were conducted to examine the relationship between TBI and monolingualism/bilingualism on SCWT performances.

Results
Group effects (control and TBI groups) were found for all Stroop measures. We found main effects of TBI on SCWT-W, p = .013, ηp² = .09, SCWT-C, p = .001, ηp² = .14, and SCWT-I, p = .022, ηp² = .08, with the controls outperforming acute TBI survivors on SCWT-I, chronic TBI survivors on SCWT-W, and both TBI groups on SCWT-C. We also observed main effects of language for SCWT-C, p = .012, ηp² = .07, and SCWT-I, p = .003, ηp² = .09, with the monolinguals outperforming bilinguals on SCWT-C and SCWT-I. However, no significant interactions between TBI and language were found.

Conclusion
As expected, the control group outperformed TBI survivors on the SCWT. Monolinguals outperformed bilinguals on all Stroop measures except SCWT-W condition. Our findings seem to suggest that monolingual speakers may have better attention and response inhibition abilities that resulted in better SCWT performance.
B-76 Benefits of Solution Focused Therapy for Collegiate Athletes
Authors: Mara P , Shumway K , Andrews G 
Published: August 2019

Abstract

Objective
Collegiate athletes experience competition anxiety as their greatest impedance to optimal performance. Competition anxiety encompasses both somatic and cognitive symptoms (Smith, Smoll, Cumming, & Grossbard, 2006). Somatic symptoms are more likely to impact performance (Mabweazara, Leach, & Andrews, 2017). Solution-Focused Therapy is an effective intervention used to decrease competition anxiety (Bell, Skinner, & Halbrook, 2011). This study sought to discover if Solution-Focused Therapy decreases anxiety levels in team sports athletes compared to individual sports.

Method
The study consisted of college athletes (7 women, 10 men) who volunteered to participate. Anxiety was measured through self-report questionnaires (General Anxiety Disorder Scale and the Sports Anxiety Scale) measured both pre and posttest. Solution-Focused Therapy was administered through 5 hour-long sessions by Masters level clinicians-in-training. The independent variable was sport (team or individual). The dependent variables included level of anxiety, worry, and concentration disruption.

Results
A MANOVA was used to analyze the data. A main effect for time occurred for anxiety scores (p = .006, n2 = .422). A main effect for time was found for worry (p = .027, n2 = .302) and a significant interaction occurred between type of sport and time (p = .044, n2 = .260). Those in individual sports had larger decreases in worry. There were no significant differences in concentration difficulties (p = .770).

Conclusion
Participation in Solution-Focused Therapy decreased anxiety overall for athletes in both team and individual sports. Athletes in individual sports appear to benefit from Solution-Focused Therapy to decrease worry more than those in team sports. Solution-Focused therapy is beneficial for managing anxiety in collegiate athletes.
C-01 An Evaluative Study of a Cognitive Training Program on Cognitive Outcomes in Older Adults with Moderate to Severe Cognitive Impairment
Authors: Dye A , Gehling J , Buchanan J 
Published: August 2019

Abstract

Objective
Because medical interventions for persons with dementia have limited effectiveness, there is a need to evaluate non-pharmacological interventions designed to support individuals with cognitive impairment. Cognitive training is a non-pharmacological approach aimed at improving or maintaining cognitive functioning through practice. The current study evaluated the effects of a cognitive training program in older adults with moderate to severe cognitive impairment.

Method
Data were collected from seven females and one male with a mean age of 83.1 who met criteria for moderate to severe cognitive impairment as defined by a Modified Mini-Mental Status Exam score between 49-77 (M = 54.5). Participants were recruited from two organizations that provide housing and supportive services for older adults with cognitive impairments. Cognitive changes were measured using the Repeatable Battery for the Assessment of Neuropsychological Status-Update.

Results
Effect sizes (Cohen’s d) were calculated to measure the magnitude of change from pre- to post-intervention. Results indicated no change in the domains of immediate memory (d = -0.08) and attention (d = -0.17). A medium effect size was found in delayed memory (d = 0.68), while large effect sizes were found in language (d = 1.70), visuospatial/constructional (d = 0.89), and the total scale index (d = 1.40).

Conclusion
The results provide tentative support for the effectiveness of cognitive training in maintaining or improving some cognitive abilities in older adults with moderate to severe cognitive impairment. Further research with larger samples sizes and control groups are necessary to verify these preliminary findings and to determine if benefits generalize to everyday life.
C-07 Global Precedence: Examining Contributing Effects of Age and Cognitive Functioning
Authors: Johnson M , Lai J , Corona M , Lupas G 
Published: August 2019

Abstract

Objective
Global precedence (GP) is an individual’s ability to readily identify global (gestalt) features when both global and local (internal) details are presented. Prior research shows that both age and neurodegenerative diseases, such as Alzheimer’s, affect GP. The goal of the current study is to examine differences in GP between individuals with early-onset Alzheimer’s disease (EOAD; before age 65) and healthy controls (HC).

Method
Fourteen EOAD patients and 6 HC’s recruited from Behavioral Neurology at an academic medical center were included in the current analysis. EOAD participants were diagnosed by clinical history, routine labs, neuroimaging, and neurological examination. Exclusion criteria included unstable medical conditions and history of severe head injury, psychotic disorder, or psychoactive substance use. All participants completed a Mini Mental Status Examination (MMSE) to assess overall cognitive functioning and a 4-item Navon's paradigm task (consisting of a larger letter whose shape is composed of smaller repeats of a different letter) to assess for GP.

Results
Linear regression analysis was performed, with the total score on Navon task as the dependent variable and age, MMSE score, and study group as predictor variables. Analysis yielded significant findings, suggesting a difference in GP performance between the two groups. However, coefficients suggested that while age did not contribute to the between-group difference, MMSE scores significantly accounted for our findings. In fact, when effects of MMSE scores were controlled, the between-group difference was no longer significant.

Conclusion
Findings suggest that individuals with EOAD perform worse on tasks of GP, which may be secondary to overall cognitive decline.
C-11 Neurocognitive Differences in Alzheimer’s Dementia Compared to Healthy Controls on the WAIS-IV
Authors: Burger C , Berger R , Marker C 
Published: August 2019

Abstract

Objective
The present study seeks to identify neurocognitive patterns of those diagnosed with Alzheimer’s dementia (AD) compared to those with no diagnosis (ND), potentially aiding in the diagnostic process. Previous research found visuospatial differences, but on previous versions of the WAIS.

Method
Participants (n = 580) were referred to a large assessment outpatient clinic with a variety of presenting problems, such as neurological diagnosis, personality functioning, and ADHD assessment. To measure cognitive functioning, participants were administered the WAIS-IV. Participants included individuals diagnosed with AD (n = 43) and those with ND (n = 40).

Results
Subtest scores for those diagnosed with AD were lower than participants with ND. We adjusted the mean level difference using vocabulary (VC). Using regression, variance associated with VC was pulled out, as it is not susceptible to cognitive decline. Both Matrix Reasoning (MR) (r-square = .04; p =.001) and Digit Span (DS) (r-square = .04; p = .001) were significantly different for the two groups even after controlling for VC. Block Design (BD) was not significantly different (p = 0.07).

Conclusions
While previous research indicates patterns of visuospatial difficulties in neurocognitive functioning among those with AD, the current findings suggest impairments in perceptual reasoning and working memory. Previous research also suggests that BD predicts AD. However, the current study indicates MR and DS predicts AD, whereas BD does not. While these results may be due to small sample size, this study did control for intellectual functioning. Additional research involving an extensive test battery is needed to further examine these findings.
C-21 Emotional Predictors of Self-Reported Frontal Behavior Disruption in Older Adults
Authors: Dorenkamp M , Irrgang M , Jacova C , Reohr P , Smith S , Vik P 
Published: August 2019

Abstract

Objective
Behavioral manifestations of executive dysfunction (e.g., apathy) include internal experiences subject to informant misinterpretation. Self-reports of these functions, however, may be influenced by subjective cognitive concerns (SCC). The purpose of this study was to assess emotional distress and SCC as predictors of self-reported frontal behavior disruption.

Method
Twenty-one women and 18 men aged 55 to 83 (M = 66), completed measures of emotional functioning and SCC. The Frontal Systems Behavior Scale (FrSBe) measured frontal behavior concerns, which provided three subscales (Apathy, Disinhibition, Executive Function) and a total score. Emotional functioning was measured with the Patient Health Questionnaire, 9-item (PHQ-9), Generalized Anxiety Disorder, 7-item (GAD-7), and the Dementia Worry Scale (DWS). SCCs were measured using the Cognitive Function- Short-Form 6a (CFSF).

Results
FrSBe scores were regressed on PHQ-9, GAD-7, CFSF, and DWS. Apathy was predicted by PHQ (B = 1.02, CI: .49 to 1.55, sr2 = .151), CFSF (B = -.42, CI: -.75 to -.10, sr2 = .071), and DWS (B = .14, CI: .02 to .26, sr2 = .052). Disinhibition was predicted by CFSF (B = -.61, CI: -1.06 to -.15, sr2 = .134). Executive dysfunction was predicted by DWS (B = .22, CI: .02 to .41, sr2 = .080). Trends were found for PHQ and CFSF to predict Executive Dysfunction.

Conclusions
Depression, dementia worry, and SCC predicted aspects of perceived frontal behavior disruption, particularly apathy. Subjective cognitive concern predicted perceived apathy ad disinhibition; dementia worry predicted perceived apathy and executive dysfunction. Depression was only predictive of perceived apathy. These findings support the relationship between depression, dementia worry, SCC, and self-reported behavioral disruption emphasizing the importance of emotions and SCC in self-reported behavioral functioning.
C-33 Abnormal MoCA Scores in a Clinic-Referred Sample
Authors: Marceaux J , Bain K , Fullen C 
Published: August 2019

Abstract

Objective
To examine Montreal Cognitive Assessment (MoCA) performance and frequency of low scores among veterans with primary diagnoses of cognitive disorder, psychiatric disorder, or no disorder.

Method
A clinic-referred sample of veterans (n = 214; Mage = 66.1, SD = 15; Medu = 13.3, SD = 2.7) diagnosed with mild cognitive impairment (MCI; n = 97), dementia (n = 47), depression (n = 18), PTSD (n = 22), or no cognitive or psychiatric disorder (n = 30) were included. All participants were administered the MoCA as part of a larger battery of tests. Analysis of covariance (ANCOVA), controlling for age and education, was conducted (Bonferroni correction applied) to compare diagnostic groups on MoCA uncorrected total score.

Results
Across groups, mean MoCA scores were significantly different using ANCOVA, F(4, 207) = 31.5, p < .001. As expected, those with no diagnosis (M = 24.7, SD = 2.1) or psychiatric disorders (PTSD M = 24.4, SD = 4.1; Depression M = 23.9, SD = 3) scored higher than those with cognitive disorder (MCI M = 21.7, SD = 3.1; Dementia M = 17.4, SD = 4.1), p < .001. While both psychiatric groups scored higher than those with dementia (p < .001), the depression group did not significantly differ from those with MCI (p = .11). Examination of scores across all groups revealed a majority of participants scored below the recommended cutoff of < 26. Specifically, 100% of dementia cases, 89.7% of MCI cases, 63.3% of no diagnosis cases, 50% of PTSD cases, and 72.2% of depression cases scored < 26.

Conclusion
Abnormal MoCA scores are common, even in the absence of cognitive impairment. Individuals with PTSD or depression are likely to score below the publisher's recommend cutoff. While this may reflect cognitive symptoms of psychiatric conditions, it may also reflect normative limitations as identified in past studies.
C-35 Clinical Diagnosis of Behavioral Variant Frontotemporal Dementia with Underlying Primary Age-Related Tauopathy
Authors: Carlew A , Fields L , White C , Evers B , Lacritz L 
Published: August 2019

Abstract

Objective
Primary age-related tauopathy (PART) is a neuropathologic entity characterized by neurofibrillary tangles in medial temporal regions comparable to Alzheimer’s disease (AD), but with few or no amyloid plaques. A definitive clinical phenotype for PART has not been determined. Some studies report milder deficits and a longer course compared with AD. In the National Alzheimer’s Coordinating Center database, the most common clinical diagnosis of PART cases classified as dementia is AD, though primary progressive aphasia/behavioral-variant frontotemporal dementia (bvFTD) is also common. We describe 3 patients diagnosed with bvFTD later found to have PART to further describe possible PART phenotypes.

Method
Charts of 3 autopsy-proven PART cases clinically diagnosed as bvFTD by consensus conference were reviewed. All patients (A, B, C) were male and presented with behavioral changes. Only B was APOE4+. Neuroimaging was mostly unremarkable (ventriculomegaly in patient C).

Results
All subjects presented with anosognosia, fatigue, and behavioral changes, 1 (A) with pronounced apathy and 2 (B, C) with disinhibition, impulsivity, and mood swings. Onset was early 70’s for A & C, and 50’s for B. Patients B & C had gradual onset/course (~20 years) with initial subtle executive (EF) dysfunction and intact memory. Patient A had a 6-year course and initial deficits in EF and memory.

Conclusion
This review underscores the varied presentation and clinical course of PART, including presence of early behavioral changes. Slower progression as previously reported was seen in 2 of 3 patients. Future research is warranted to better characterize the entire spectrum of clinical presentations in subjects with PART neuropathology.
C-36 Montreal Cognitive Assessment for Dementia Severity Rating in a Diagnostically Heterogeneous Clinical Cohort
Authors: Stewart P , Swartz J , Tapscott B , Davis B 
Published: August 2019

Abstract

Objective
The Mini Mental State Exam (MMSE) has enjoyed widespread use as a dementia severity staging instrument (Perneczky et al., 2006). More recently, the Montreal Cognitive Assessment (MoCA; Nasreddine, 2005) has been advanced as a potentially superior measure with enhanced sensitivity to Mild Cognitive Impairment (MCI). To the authors’ knowledge, there are no published guidelines for staging dementia severity with the MoCA. The aim of this study was to evaluate the utility of the MoCA for dementia severity staging.

Method
Participants (N = 162) were drawn from a diagnostically heterogeneous retrospective sample of referrals to a multidisciplinary memory clinic. Participants were categorized as MCI, mild dementia, or moderate dementia using the Quick Dementia Rating System (QDRS) sum of boxes score. Receiver operating characteristics of the MoCA were calculated using MATLAB and optimal cutpoints were determined using Youden’s Index.

Results
The MoCA demonstrated some utility in differentiating MCI from all severity dementia as defined by the QDRS, with an optimal cutpoint of 17 (AUC = .75). Cut points of 17 and 14 best separated MCI from mild dementia (AUC = .72) and mild from moderate dementia (AUC = .66), respectively. These cutpoints were associated with modest sensitivity (.50 - .53) and reasonable specificity (.76 - .87). Average diagnostic accuracy was 69.5%.

Conclusions
This study suggests that the MoCA has some utility for dementia severity staging. Future work should replicate these findings in other clinical cohorts. The use of the QDRS (an informant report measure) as the severity criterion is a significant limitation of the present study.
C-39 Utility of Addenbrooke's Cognitive Exam III (Singapore-Chinese Version) for Cognitive Screening and Correlation with Standardized Neuropsychological Tests
Authors: Koay W , Tay S , Ting S , Hameed S 
Published: August 2019

Abstract

Objective
Dementia is a public health priority worldwide. Early screening of cognitive impairment and locating of specific impaired areas are essential for timely intervention and prolonging independence. The commonly-used Mini Mental State Examination (MMSE) is inadequate. Alternatively, the Addenbrooke's Cognitive Exam III (ACE-III) that assesses five domains (attention, memory, verbal fluency, language and visuospatial abilities) is recommended.
Thus, we aim to examine the utility of Singapore-Chinese version (ACE-III-SG-C) for case finding of cognitive impairment, and its correlation with the respective standardized neuropsychological tests.

Methods
22 participants were referred by neurologists for comprehensive neuropsychological assessment at public healthcare institution. Participants were categorized into three groups (No Cognitive Impairment, NCI: 6; Mild Cognitive Impairment, MCI: 9; Dementia: 7). The ACE-III-SG-C and MMSE were administered. ACE-III-SG-C total and individual domain scores were computed.

Results
No significant difference in age and education across three groups. The MMSE scores (F(2,19) = 5.005, p = .018) and ACE-III-SG-C total scores (F(2,19) = 21.296, p < 0.001) were significantly different across three groups. Post hoc comparisons indicated that dementia (p < .001) and MCI (p = 0.046) groups had significantly lower ACE-III-SG-C total scores than NCI group. However, the MMSE scores of the MCI and NCI groups were comparable (p = 0.850). The Modified Boston Naming Test were significantly correlated with ACE-III-SG-C language domain scores (r = .605, p = .003), but not MMSE (r = .400, p = .065).

Conclusions
ACE-III-SG-C demonstrated its usefulness for early screening of MCI and dementia. Its correlation with language test suggested potential detection for disorders with language impairment. Further research is needed to unravel its utility of describing other specific impaired areas.