bluuebunny/crossref_metadata_2025_split huggingface dataset:
B-04 Combining tDCS and Cognitive Training for People with Severe Mental Illness: Preliminary Feasibility and Acceptability Findings
Authors: Burton C , Tso I , Hampstead B , Taylor S 
Published: August 2019

Abstract

Objective
Technological advances in neuromodulation and cognitive remediation provide opportunities to develop novel interventions, though a critical first determination is whether such treatments are feasible and acceptable to participants. This study evaluated a combined transcranial direct current stimulation (tDCS) and computerized cognitive training intervention for individuals with severe mental illness; we examined participant recruitment, retention, and adherence to the interventions, along with qualitative feedback.

Method
Participants included adults with schizophrenia-spectrum or bipolar disorder and impaired working memory (performance ≤1 standard deviation below average of healthy individuals on a spatial span or letter-number span test). In this randomized crossover study, all participants received the combined intervention (ten tDCS sessions in the clinic concurrent with cognitive training), and ten hours of at-home training, and completed neuropsychological and clinical assessments at three time points.

Results
To date, thirteen participants provided informed consent. Seven participants were screened out; five exceeded the cognitive cutoff and one did not meet the diagnostic criterion. No remaining participants have withdrawn prior to study completion. Four participants completed all tDCS sessions, and one completed 80%. No tDCS session has been discontinued. At-home training has proven more challenging; only one participant completed all ten hours, and three did not complete any at all. Participant feedback has been positive; all expressed satisfaction with both treatments though some said symptoms or busy schedules interfered with at-home training.

Conclusions
Combining tDCS with computerized cognitive training appears feasible and acceptable. Strategic recruitment efforts to capture those with cognitive impairment appears necessary, as well as troubleshooting barriers to at-home training.
B-08 Cerebral Blood Flow Differences at Baseline Between Cortical Regions in Tic Disorders Population
Authors: McDonald B , Lopez A , Lopez-Palacios D , Golden C , Amen D , Willeumier K , Taylor D 
Published: August 2019

Abstract

Objective
To identify CBF differences between individuals with Tic Disorder and healthy controls.

Methods
The data for this study was acquired from a de-identified archival Single-Photon Emission Computed Tomography (SPECT) database. The sample included a healthy control group (n = 83,age M = 42.02,54.22% female) and a second group included individuals diagnosed with Tic Disorder (n = 177,age M = 33.54,83.05% male). Significant differences were found for gender [χ(2) = 41.16,p < .001] between groups. As a result, ANCOVAs were conducted to measure CBF differences across the brain using SPECT scans between the two groups while controlling for gender.

Results
Results showed significant differences between the two groups and perfusion in 4 brain regions. Hypo-perfusion in the Tic Disorder group was observed in the right basal ganglia [F(1,260) = 30.959,p < .001] and left [F(1,260) = 32.16,p < .001]. Hyper-perfusion was found in the right cerebellum [F(1,260) = 16.63,p < .001], and left [F(1,260) = 22.17,p < .001] in the same group.

Conclusion
Results indicate that individuals with tic disorders have diminished CBF than healthy controls in both sides of the basal ganglia. This contrasts previous studies, which have shown that individuals with tic disorders have more CBF in the basal ganglia. Further research is needed to understand this inconsistency; a possible explanation is that there is an inhibiting effect on the basal ganglia. Increased CBF in both sides of the cerebellum supports previous research as this cortical area has been shown to have connections with the basal ganglia, activating the pathway that trigger the motor tics. Tic disorders are usually associated with other comorbidities therefore the sample may have other diagnoses that affect blood flow. Future research should control for potential comorbidities.
B-12 Cognitive Resilience in MS: Associations with Lesion Volume, Pain, and Smoking Status
Authors: Randolph J , Randolph J , Wishart H 
Published: August 2019

Abstract

Objective
Cognitive dysfunction is common in people with MS (pwMS), but relatively little is known about those with no objective or subjective impairment. We sought to further examine a previously characterized cognitively resilient group of pwMS (MS-RES)—individuals without cognitive impairment, without subjective cognitive complaints, and without informant-reported cognitive difficulties—and considered neuroimaging, pain-related, and smoking correlates in this group.

Method
We derived two groups of pwMS: cognitively resilient (MS-RES; N = 15) and other MS (N = 85). MS groups showed equivalent education, gender, symptom and diagnosis duration, MS subtype, EDSS rating, and reported hours of sleep, and endorsed no more than mild depression. Both MS groups were compared to age- and gender-matched healthy controls (N = 31) on appropriate variables, and MS groups were compared on lesion volume, pain, and smoking variables.

Results
Despite showing intact subjective and objective cognition, the MS-RES group had lesion volume comparable to other MS participants. The MS-RES group also reported less of an impact of pain on overall functioning, recreational activities, and life enjoyment compared to other MS participants (p < .05), and were comparable to healthy controls. There was a trend toward MS-RES participants being less likely to be current smokers than others with MS (p = .09), and MS-RES and healthy controls showed comparable smoking status.

Conclusions
We found that cognitively resilient pwMS have unique clinical features that differentiate them from others with MS despite similar lesion volumes. A more complete understanding of cognitively resilient pwMS may inform interventions that promote MS symptom management and general resilience.
Self-efficacy and Performance Validity Testing in Active Duty Service Members
Authors: Armistead-Jehle P , Grills C 
Published: August 2019

Abstract

Objective
The base rate of performance validity test (PVT) failure in the military has been relatively well established and averages approximately 33% in clinical and 50% in disability samples, respectively. Secondary gain is an omnipresent concern; however, frank malingering may not account for all cases of PVT failure. As a result, other psychological and social factors potentially associated with PVT failure have been suggested and include nocebo effect, diagnosis threat, perceived injustice, and loss aversion. Self-efficacy has been associated with a range of medical and psychological conditions and outcomes. It was hypothesized that self-efficacy would be among the psychosocial factors impacting PVT failure.

Method
A retrospective review of 263 US Service Members administered the MMPI-2-RF and the Medical Symptom Validity Test (MSVT) and/or the Non-Verbal MSVT (NV-MSVT) in the context of neuropsychological assessments was conducted.

Results
Correlations between the MMPI-2-RF Inefficacy sub-scale (NFC) and MSVT and NV-MSVT were not statistically significant (r = -0.10, p = .12 & r = -.04, p = .53, respectively). Moreover, the Inefficacy sub-scale did not significantly differ as a function of PVT performance (non-significant t-tests) and effect sizes were low (Cohen’s d of .22 [MSVT] and .11 [NV-MSVT]).

Conclusions
Contrary to initial expectations, the current data failed to demonstrate a reliable relationship between self-efficacy and PVT performances. While various psychosocial variables have been associated with performance validity testing, it appears that self-efficacy is not.
Digit Span Forward as a Performance Validity Test in Dementia Evaluations: Specificity in Mild Cognitive Impairment, Mild Dementia, and Moderate Dementia
Authors: Clark H , Martin P , Schroeder R 
Published: August 2019

Abstract

Objective
Traditional performance validity tests (PVTs) often yield high false positive rates in dementia evaluations. The current study examined the frequency of extremely low scores (≤ 2 percentile) on WAIS-IV Digit Span Forward (DSF) in older adults with Mild Cognitive Impairment (MCI) or dementia to evaluate its possible utility as a PVT in these populations.

Method
Archival data from outpatient neuropsychological evaluations were analyzed. Individuals who were not diagnosed with a neurocognitive disorder, had missing data, or were believed to be invalidly performing were excluded. Participants (n = 195; mean age = 72.8; mean education = 13.2 years) were classified according to their evaluation diagnosis of MCI (n = 72; mean RBANS Total Score = 86.8) or dementia. Dementia patients were further divided by MoCA score into groups of mild dementia (n = 90; MoCA≥15; mean RBANS Total Score = 71.0) or moderate dementia (n = 33; MoCA < 15; mean RBANS Total Score = 55.9). Frequencies of scaled scores were analyzed to calculate specificity values for each group.

Results
A WAIS-IV DSF scaled score of ≤4 (≤ 2 percentile) resulted in specificity values of 0.99 and 0.94 in MCI and mild dementia, respectively. Conversely, in moderate dementia, ≥0.90 specificity was achieved only when using a more conservative cutoff of ≤2.

Conclusions
Low DSF scaled scores occurred infrequently in MCI and mild dementia, indicating strong specificity and potential utility as a PVT in these populations. However, in moderate dementia, low DSF scores were more common, requiring use of a more stringent cutoff. Future research should examine DSF sensitivity to invalid performance, as well as DSF specificity according to specific etiologies of MCI and dementia.
Does Trauma Influence Post-concussive Symptom Recovery in Youth?
Authors: Tarkenton T , Hynan L , Didehbani N , Silver C , Cullum M 
Published: August 2019

Abstract

Objective
Minimal research has focused on youth concussions acquired in traumatic events versus non-traumatic events, despite overlap between post-concussive and post-traumatic stress symptoms. Youth sustaining a concussion during a motor vehicle accident (MVA) may endorse greater emotional and cognitive symptoms than those with sports-related concussion (SRC). This study’s aim was to compare recovery from concussion due to MVA versus SRC to determine if recovery profiles differ.

Data Selection
Participants aged 7-25 who reported to clinic within 30 days of SRC (n = 329) or MVA-related concussion (n = 67) and endorsed persistent post-concussive symptomatology (>1 month) were selected from the North Texas Concussion Registry (ConTex). Data collected at initial visit and 3-month follow-up included a four-factor symptom checklist (physical, emotional, cognitive, sleep), GAD-7 for anxiety, and PHQ-8 for depression.

Data Synthesis
Repeated measures ANOVA compared longitudinal score differences. MVA and SRC groups significantly improved on all measures at follow up; however, the MVA group reported higher symptomatology on all measures at both visits (ps < .01). For all cognitive and emotional scores, a significant interaction was found (ps < .01), with the MVA group demonstrating greater improvement over 3 months (See Image Attachment).

Conclusions
Mechanism of injury influences post-concussion symptom recovery. Despite greater improvement in cognitive and emotional symptoms between visits, the MVA group endorsed significantly higher post-concussive symptomatology across the recovery period. Perhaps because of trauma related to mechanism of injury, specific differences in cognitive and emotional symptom presentation/recovery profiles were observed. Posttraumatic stress symptom assessment may be useful in examining the influence of potential trauma/reactions on post-concussive symptom recovery.
Subtle Cognitive Decline predicts progression to Mild Cognitive Impairment Above and Beyond Alzheimer’s Disease Risk Factors
Authors: Osuna J , Thomas K , Edmonds E , Bangen K , Weigand A , Wong C , Cooper S , Bondi M 
Published: August 2019

Abstract

Objective
Early identification of those at risk for mild cognitive impairment (MCI) and Alzheimer’s disease (AD) is critical for early intervention. Recent work shows that subtle cognitive decline (SCD), operationally-defined using sensitive neuropsychological scores, predicts progression to MCI/AD and is associated with AD biomarkers. We aimed to determine whether SCD adds unique value in predicting progression to MCI/AD above and beyond other AD risk factors.

Method
547 cognitively unimpaired participants from the Alzheimer’s Disease Neuroimaging Initiative (359 without SCD; 188 with SCD) underwent neuropsychological testing and lumbar puncture. Participants were classified as SCD if they performed >1 SD below the demographically-adjusted mean on 1) two neuropsychological total scores in different cognitive domains, or 2) two memory test process scores (e.g., intrusion errors), or 3) one total score and one process score. Cox regressions examined whether SCD status predicted progression to MCI and AD within 5 years after adjusting for age, education, sex, MMSE, depressive symptoms, ischemia risk, apolipoprotein E genotype, and AD biomarker “positivity” based on the cerebrospinal fluid phosphorylated tau-to-β-amyloid ratio.

Results
SCD status predicted progression to MCI (HR = 2.74, 95% CI = 2.07-3.63, p < .001) and AD (HR = 2.20, 95% CI = 1.04-4.65, p = .04) within 5 years, even after including known AD risk factors in the model.

Conclusion
SCD conveys a 2-3 fold increased risk of progression to MCI/AD and is a unique predictor above and beyond risk factors that are commonly used in preclinical AD research. These findings support our novel SCD criteria as a cost-effective and non-invasive method for identifying those at risk for future cognitive decline.
Effects of Multiple Mild TBIs on Neuropsychological Functioning, Psychiatric Symptoms, and Neurobehavioral/Health-Related Symptoms in Combat-Exposed Veterans
Authors: Merritt V , Jurick S , Crocker L , Hoffman S , Keller A , Jak A 
Published: August 2019

Abstract

Objective
The purpose of this study was to examine the influence of multiple mild traumatic brain injuries (mTBI) on objective neuropsychological functioning and subjective symptom reporting in a sample of combat-exposed Veterans.

Method
Participants included 80 combat-exposed Iraq/Afghanistan Veterans (91.3% male; age: M = 34.33, SD = 6.44) divided into three groups based on mTBI history: 0 mTBIs (n = 33), 1-2 mTBIs (n = 26), and 3+ mTBIs (n = 21). Veterans with mTBI were assessed, on average, 7.5 years following their most recent mTBI. Participants underwent comprehensive neuropsychological testing and completed self-report measures assessing psychiatric and neurobehavioral/health-related symptoms.

Results
ANCOVAs adjusting for level of combat exposure showed no group differences on the memory and attention/executive functioning composite scores (p’s>.05). Additionally, groups did not differ with respect to symptoms of posttraumatic stress and depression (p’s>.05). In contrast, there were significant group differences on all neurobehavioral/health-related symptoms, including post-concussive symptom clusters (p’s < .001-.005), sleep problems (p = .024), pain symptoms (p < .001), and pain catastrophizing (p = .049). In general, Veterans with 3+ mTBIs self-reported the most severe symptoms, followed by Veterans with 1-2 mTBIs and 0 mTBIs.

Conclusions
History of multiple, remote mTBIs is associated with elevated subjective neurobehavioral/health-related symptoms in a dose-dependent fashion, but is not associated with objective neuropsychological functioning or ratings of psychiatric distress in combat-exposed Veterans. These results advance understanding of the long-term consequences of multiple mTBIs in this population and suggest that Veterans with 3 or more mTBIs may especially benefit from (1) early treatments aimed at ameliorating sleep and pain symptoms and (2) therapies that provide tools to temper catastrophic thinking about these symptoms.
PGR - 1 A Pediatric Case Study of Autism Spectrum Disorder Associated with Germinal Matrix-Intraventricular Hemorrhage, Periventricular Leukomalacia, and Cerebral Palsy.
Authors: Smith A , Davis A 
Published: August 2019

Abstract

Objective
Germinal matrix-intraventricular hemorrhage (GMH-IVH) is a serious complication of prematurity that places infants at risk for damage to important white matter pathways which can result in periventricular leukomalacia (PVL) and ultimately cerebral palsy (CP). GMH-IVH also increases the risk of developmental and intellectual disabilities for preterm infants, highlighting the need for early detection and treatment.

Method
This case study presents on the neuropsychological profile of a 4-year-old boy who was born micropremature and had a history of multiple hemorrhages, extensive PVL, and CP in the context of significant developmental and social delays.

Results
Neuropsychological testing revealed severe impairments in intellectual functioning (Stanford Binet-5 FSIQ = 42, Nonverbal IQ = 43, Verbal IQ = 47; Leiter-3 Nonverbal IQ = 41), adaptive skills, language, social cognition, visuomotor abilities, spatial skills, pre-academic skills, and attention/executive functioning. He scored in the significant range on measures specific to Autism Spectrum Disorder (ADOS-2; CARS-2; SCQ) and behavioral-emotional functioning. Lastly, he exhibited intermittent staring behaviors that were concerning for possible seizure activity.

Conclusions
Recommendations were made to increase special education services for the child and to modify his academic goals. Recommendations were also given to aid in treatment planning for his referring neurologist and clinical interventions (e.g., ABA, social work, speech/language, occupational therapy, and physical therapy). This case study demonstrates the need for early neuropsychological detection and treatment for children with complications of prematurity during this important period of brain development, particularly as there are higher rates of autism in this population. Prompt detection leads to earlier treatment and better outcomes.
AGR - 1 The Use of Repeat Neuropsychological Assessment to Guide Treatment of Possible Normal Pressure Hydrocephalus in a Complex Case
Authors: Schneider S , Weiss E 
Published: August 2019

Abstract

Objective
Normal Pressure Hydrocephalus (NPH) is a condition that is characterized by the buildup of cerebrospinal fluid (CSF) in the brain that can cause urinary incontinence, gait disturbance, and cognitive impairment. NPH can be progressive but may be managed or reversed with shunt placement. External Lumbar Drainage (ELD) trials in determining if shunt placement is appropriate are common, but the role of repeat neuropsychological assessments during ELD procedures is not well documented in the literature. Repeat, pre, peri and post- ELD trial, assessment in a complex case of possible NPH is presented.

Method
33-year-old Hispanic English-Speaking female with cognitive/memory complaints following intraventricular hemorrhage (IVH) secondary to vasculopathy was initially seen for post IVH outpatient neuropsychological evaluation. MRI showed enlarged ventricles/communicating hydrocephalus and workup for NPH was initiated. Repeat inpatient evaluations were completed during the ELD trial, with annual outpatient neuropsychological follow-up.

Results
Gait evaluation was inconclusive. Inpatient testing demonstrated minor improvement immediately following ELD opening, but performances were variable across the 4 days of re-evaluation. Shunt placement was rejected due to neuropsychological findings. Outpatient follow-up of patient over several years has demonstrated mild improvement and not evidence of cognitive decline since ELD trial.

Conclusions
Assessment of cognitive functioning in outpatient and inpatient settings before, during, and for several years following ELD testing was beneficial to ascertain the decision not to place a shunt. Repeat neuropsychological assessment in inpatient and outpatient settings provided crucial information for guiding treatment decisions.
AGR - 3 Socially Responsible Neuropsychology (SRN) in Action: Navigating Relevant Socio-Cultural and Educational Factors in Frontotemporal Dementia
Authors: Miranda A , Diaz-Santos M , Suarez P , Cagigas X 
Published: August 2019

Abstract

Objective
Socio-cultural factors obscure diagnostic specificity for neurodegenerative disorders, particularly among minority or foreign-born patients with limited access to education. Our objective with the following case presentation is to illustrate the utility of a Socially Responsible Neuropsychology (SRN) model in guiding clinical practice through the comprehensive incorporation of significant, yet common, socio-cultural factors throughout the neuropsychological assessment.

Method
The present case involved a 79-year-old Spanish-speaking Mexican woman with two years of education, who underwent two serial neuropsychological assessments, as well as, structural/functional neuroimaging to monitor acute onset of telegraphic speech following the kidnapping of her husband. The SRN model guided clinical decision-making in understanding the onset and progression of symptoms within the context of medical-psychiatric comorbidities intertwined with socio-cultural and educational factors.

Results
Mild vascular neurocognitive disorder and complicated grief were the initial diagnostic impressions as supported by structural neuroimaging. Neuropsychological assessment over time, however, revealed progressive global cognitive decline whereas psychiatric symptomatology remained stable. In the presence of equivocal converging evidence from available neuroimaging studies (PET vs MRI), strong suspicion for the language variant of frontotemporal neurocognitive disorder was considered given the onset and progressive decline of expressive/receptive language, executive and memory abilities, and qualitative evidence for progressive behavioral disihibition.

Conclusion
Telegraphic speech in an elderly Latina woman that initially appeared most consistent with vascular neurocognitive disorder in the context of complex trauma with possible conversion disorder, was deemed most consistent with a neurodegenerative process after careful consideration of the time course and evolution of the neurocognitive profile over time within an SRN model.
Hierarchically embedded interaction networks represent a missing link in the study of behavioral and community ecology
Authors: Montiglio P O , Gotanda K M , Kratochwil C F , Laskowski K L , Farine D R 
Published: August 2019

AbstractBecause genes and phenotypes are embedded within individuals, and individuals within populations, interactions within one level of biological organization are inherently linked to interactors at others. Here, we expand the network paradigm to consider that nodes can be embedded within other nodes, and connections (edges) between nodes at one level of organization form “bridges” for connections between nodes embedded within them. Such hierarchically embedded networks highlight two central properties of biological systems: 1) processes occurring across multiple levels of organization shape connections among biological units at any given level of organization and 2) ecological effects occurring at a given level of organization can propagate up or down to additional levels. Explicitly considering the embedded structure of evolutionary and ecological networks can capture otherwise hidden feedbacks and generate new insights into key biological phenomena, ultimately promoting a broader understanding of interactions in evolutionary theory.