bluuebunny/crossref_metadata_2025_split huggingface dataset:
A - 98 Physical Activity and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in Older Adults with Dementia with Lewy Bodies (DLB) and Alzheimer’s Disease (ad)
Authors: Orr Victoria L , Brown Karl , Dean Pamela , Hu Shu-Ching , McRae Sharon , Payne Sarah , Seto Edmund , Shutes-David Andrew , Wilson Katherine , Tsuang Debby 
Published: September 2024

Abstract

Objective
Past studies have suggested an association between physical activity and neuropsychological scores in cognitively healthy older adults, but similar studies in adults with dementia have been inconsistent. This pilot study is one of the first to consider dementia subtypes and the relationship between daily physical activity and cognitive performance on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).

Methods
We administered the RBANS to participants with DLB (n = 11) and ad (n = 8) and then measured physical activity using triaxial wGT3X-BT actigraphy devices for two weeks. Two-sample t-tests were performed comparing participants with DLB and ad on physical activity, RBANS domains, and UPDRS scores (see Table 1). Linear mixed models with a random intercept were used to assess the association between activity counts and RBANS scores, adjusting for dementia subtype.

Results
Compared to participants with DLB, ad participants were significantly more active (p = 0.035) and had lower UPDRS Part III scores (p &lt; 0.001). We found no significant association between daily activity counts and total RBANS scores (Beta = −2.77, 95% CI -6.0, −0.47, p = 0.091).

Conclusions
To our knowledge, this is the first study to compare differences between physical activity and RBANS scores, accounting for dementia subtypes. Participants with DLB were less physically active than participants with ad; this is unsurprising given that parkinsonian signs and symptoms are a core DLB feature. We found no significant associations between daily activity and cognitive performance, but we lacked the sample size to account for potential contributory variables. Larger explorations of physical activity, RBANS domain score, and dementia subtype are necessary.
A - 99 Examining the Relationship between Adverse Childhood Experiences, Neuropsychological Functioning, and Neurocognitive Status among Older Adults
Authors: Jones Mackenze , Newkirk Bailey O , Rubright Colin , Jennette Kyle J , Soble Jason R , Phillips Matthew S 
Published: September 2024

Abstract

Objective
Adverse childhood experiences (ACEs) are associated with poorer cognitive and mental health outcomes in adulthood. However, there is limited research elucidating the relationship between ACE severity and specific neuropsychological outcomes among examinees with cognitive impairment. This study assessed the relationship between ACE exposure and cognitive and psychiatric outcomes among older adults with and without cognitive impairment.

Method
This cross-sectional study included 75 patients (64% female; MAge = 67, SD = 8.6; MEducation = 12.8, SD = 3.2) undergoing neuropsychological evaluation at an academic medical center. Analyses of variance (ANOVAs) compared high versus low ACE groups on specific tests of verbal fluency, processing speed, working memory, executive functions, and on depression and anxiety measures. Groups were formed based on neurocognitive status (i.e., no diagnosis, mild cognitive impairment, dementia) and ANOVAs were re-run for each diagnosis.

Results
No significant differences were detected on neurocognitive measures among the overall group or when groups were subdivided by diagnosis. Among the overall sample, significant group differences were detected for depression and anxiety symptoms, F(1,73) = 16.696, p &lt; 0.001 and F(1,73) = 12.268, p = 0.001 respectively, such that higher ACE groups endorsed significantly more psychiatric symptoms. Among the no-diagnosis group, depressive symptoms were bordering insignificance, p = 0.048, and no differences were detected for anxiety. By contrast, higher ACEs were associated with greater anxiety among the mild cognitive impairment group and greater depression among the dementia group.

Conclusions
Findings reinforce the impact of ACEs on psychiatric symptoms among older adults. Although there were no significant cognitive differences, further research is necessary to better understand the relationship between ACEs, neurocognitive impairment, and psychiatric functioning.
A - 112 Complex Attention and Frontotemporal Dementia Severity: the Role of Age and Gender in Trails a Performance
Authors: Brett Jonathan , Carrano Samantha , Bennett Ryan , Dabbagh Dania 
Published: September 2024

Abstract

Objective
To investigate frontotemporal dementia (FTD) impact on attention using Trails A test.

Method
Participants (N = 3265) from a deidentified FTD database were stratified by Clinical Dementia Rating scores for severity: Normal (n = 1689, Mage = 47.15, Medu = 15.87, 59.8% female), Very Mild (n = 947, Mage = 63.54, Medu = 15.98, 44.7% female), Mild (n = 528, Mage = 64.9, Medu = 16.12, 38.1% female), Moderate–Severe (n = 101, Mage = 66.35, Medu = 16.59, 41.6% female). Stepwise regression analyzed Trails A scores’ predictive power for symptom severity.

Results
Stepwise regression indicated significant predictive relationship in Trails A and CDR category, accounting for 30.6% of the variance in CDR severity (R2 = 0.306, F(1, 3263) = 1441.094, p &lt; 0.001). Including age as a predictive variable in the second model resulted in increased explained variance to 41.2% (R2 = 0.412, F(2, 3262) = 1142.653, p &lt; 0.001). The inclusion of gender into the model resulted in minimal increase in variance explained to 41.8% (R2 = 0.418, F(3, 3261) = 781.027, p &lt; 0.001). In the final model, the Trails A Z-score had a coefficient of −0.157 (SE = 0.006, p &lt; 0.001), age had a coefficient of 0.020 (SE = 0.001, p &lt; 0.001), and gender had a coefficient of −0.134 (SE = 0.023, p &lt; 0.001).

Conclusion
Trails A, age, and gender predict FTD severity. Diminished Trails A performance indicates higher dementia severity, with age as a critical factor and gender showing nuanced differences in severity presentation. This supports personalized treatment approaches, emphasizing early cognitive assessments like Trails A for diagnosing and monitoring FTD-related declines in complex attention.
A - 113 Assessing the Feasibility of Machine Learning to Predict Frontotemporal Dementia Severity from Neuropsychological Assessments
Authors: Brett Jonathan , Bennett Ryan , Carrano Samantha , Dabbagh Dania 
Published: September 2024

Abstract

Objective
To assess the feasibility of utilizing machine learning (ML) of neuropsychological assessment data in determining the severity of frontotemporal dementia (FTD) as classified by the Clinical Dementia Rating (CDR).

Method
A Random Forest classification model was employed using a deidentified FTD dataset. Participants’ (N = 3023) were stratified based on CDR scores for severity: Normal (n = 1646, Mage = 46.95, 59.66% female), Mild (n = 855, Mage = 63.06, 57.08% female), Moderate–Severe (n = 522, Mage = 64.57, 62.45% female). Participants were than randomly stratified into a training set (80%) and a testing set (20%) for model evaluation. The model was then trained on the training set using participant data including age, gender, verbal fluency, digit span forward, digit span backward, trails A, trails B, and the MOCA total score. The model was then evaluated on the testing set.

Results
The model achieved an accuracy of 74.55% on the testing set. Detailed performance metrics revealed a precision of 86%, recall of 91%, and F1-score of 89% for the normal category, 56% precision, 56% recall, and 56% F1-score for mild, and 65% precision, 52% recall, and 58% F1-score for moderate–severe. The most salient features were verbal fluency and age, with assigned importance scores of 0.174 and 0.150, respectively.

Conclusions
Although the Random Forest model demonstrated potential in predicting FTD severity from neuropsychological data, its moderate performance for mild and severe categories indicates it’s not yet clinically viable. This study offers a foundational framework, suggesting further model refinement and larger datasets are necessary to enhance accuracy and clinical utility. Future research should focus on including diverse variables and populations.
A - 123 Word List Task Outperforms Cognitive Screener in Neurocognitive Disorder Detection
Authors: Griffin Rebekah A , Zamora Joel A , DiGiovanna Ben J , Motley John E , Gamino Denise , Arreola Langarica Ashley L , Carter Ericka , Barnett Michael D 
Published: September 2024

Abstract

Objective
The California Verbal Learning Test II (CVLT II) demonstrated utility in characterizing neurocognitive disorders (Webber et al., 2018). The Mini-Mental State Examination (MMSE) is considered the most widely used assessment tool in screening for possible neurocognitive disorders (Tsoi et al., 2015). The purpose of this study was to establish which cognitive assessment tool, MMSE or CVLT II, better-identified individuals at risk for neurocognitive impairment.

Method
Older adults (n = 113; age 60–90, M = 73.53, SD = 7.16) from the general community received a comprehensive neuropsychological evaluation. We performed ROC curve analysis using SPSS to assess the predictive performance of two test variables, MMSE (M = 26.37; SD = 3.68) and CVLT LDFR (M = −0.14; SD = 1.45), in predicting whether the participant has a neurocognitive disorder.

Results
ROC curve analysis demonstrated that both variables, MMSE and CVLT LDFR, significantly predicted the presence of a neurocognitive disorder, with AUC values of 0.84 and 0.89, respectively. The variable CVLT LDFR shows a higher AUC value, indicating slightly better discriminatory power to the variable MMSE.

Conclusions
CVLT II’s long-delay free recall trial directly assesses verbal memory retention and recall. Memory impairment, particularly delayed recall deficits, is a hallmark feature of many neurocognitive disorders. This specificity aligns with the involvement of the hippocampus, a brain region crucial for memory consolidation, which is often dysfunctional in neurocognitive disorders. Therefore, a test targeting this aspect of memory function may offer greater sensitivity and specificity in detecting neurocognitive impairments compared to more general cognitive screening tools like the MMSE.
A - 133 The Clinical Utility of Large Language Models in Diagnosing Neurocognitive Disorders among NACC Participants
Authors: Su Charlie , Rafiuddin Hanan , Dimmick Allan A , Cicero David 
Published: September 2024

Abstract

Objective
Our study aimed to investigate ChatGPT’s ability to diagnose neurocognitive disorders in older adults based on neuropsychological interviews and test results and compare its accuracy with neuropsychologist consensus diagnosis.

Methods
We prompted ChatGPT-4 to provide provisional diagnoses (normal changes, mild cognitive impairment, or dementia) for each case. We also asked ChatGPT to diagnose the underlying etiology. We evaluated interrater reliability (IRR) with Cohen’s kappa and a chi-square test. Receiver operating characteristic (ROC) curves and area-under-the-curve (AUC) values were computed to explore measures predicting diagnostic agreement.

Results
Participants were 15,048 older adults (Mage = 69.13, 56.7% female) assessed in Alzheimer’s Disease Core Centers across the United States. For cognitive diagnoses, Cohen’s kappa demonstrated fair agreement (κ = 0.42; p &lt; 0.001). The chi-square test [χ2 (6) = 7896.51, p &lt; 0.001] revealed a significant and strong association (Cramer’s V = 0.51, p &lt; 0.001) between ChatGPT and clinicians’ diagnoses. For the underlying etiology, Cohen’s kappa demonstrated fair agreement on specific diagnoses (κ = 0.38; p &lt; 0.001). The chi-square test [χ2 (24) = 5353.04, p &lt; 0.001] revealed a significant and strong association (Cramer’s V = 0.30, p &lt; 0.001) between ChatGPT and clinicians’ diagnoses. ROC curves demonstrate that no variables predicted diagnostic agreement at above chance.

Conclusion
Our findings demonstrate the potential clinical utility of integrating LLMs into neuropsychology. While significant IRR was found between ChatGPT and the neuropsychologist diagnosis, further research is needed prior to the adoption of LLMs into clinical practice, given ongoing developments of artificial intelligence in the field of medicine.
A - 135 A Case Study of a Multilingual Individual with Primary Progressive Aphasia: Diagnostic Considerations and Implications for Language Reorganization
Authors: Kelly Brianna , Schulze Evan , Shehab Al Amira Safa 
Published: September 2024

Abstract

Objective
This study reports a case of primary progressive aphasia (PPA) in a multilingual Haitian-American individual. Earlier literature has suggested that cases of PPA in multilingual individuals are relatively rare. Several factors complicate the assessment of language dysfunction and diagnosis of PPA in multilingualism, including age of language acquisition, degree of proficiency, language reorganization in the bilingual brain, and limited availability/validity of tests/norms for bilinguals.

Method
This is a 69-year-old right-handed trilingual (French/English/Haitian Creole) Haitian-American female with 16 years of education. Difficulties with word finding and speech production emerged two years prior to evaluation. Language was assessed with select subtests of the Boston Diagnostic Aphasia Examination (BDAE-3), Boston Naming Test (BNT), and Verbal Fluency. PET-CT imaging displayed large areas of hypometabolism in the left and right frontal, temporal, and parietal lobes, left areas being more greatly impacted.

Results
Neuropsychological testing showed impairments in visual and auditory naming, verbal fluencies, sentence repetition and word reading. Reading comprehension and repetition of single words were relatively spared. There were deficits in learning/memory, visuospatial functioning and processing speed. Speech was notably dysfluent with occasional agrammatism and mild dysarthria.

Conclusion
Overlapping characteristics of both logopenic and non-fluent/agrammatic variants of PPA were evident. Patient’s neuroimaging findings and clinical presentation suggest an advanced PPA syndrome. Cognitive/brain reserve and language reorganization, theorized in bilingual individuals, could be considered as contributors to the trajectory of her deficits. This case study contributes to the growing literature on PPA in diverse populations and multilingual individuals.
A - 146 Psychiatric Drugs Can Precipitate Neuropsychological Predicates of Homicide
Authors: Singer Raymond 
Published: September 2024

Abstract

Objective
A man inexplicably killed his beloved wife. He had no history of violence, was a prominent member of the community, and gave no indications of the impending horrific act. He had been recently commenced treatment with psychiatric drugs, and his condition deteriorated, culminating in homicide. After his incarceration, he stopped taking psychiatric drugs and his mental health improved. Many practitioners are not aware that psychiatric drugs can create a risk for violence - or precursors of violence - such as anger, hostility, and agitation. This risk is often described on the product label.

Method
The subject was an intensive care nurse who became exhausted and despondent serving long hours during the Covid epidemic, when many of his patients were put on ventilators and died. He had suffered panic attacks from his difficulty breathing through the respiratory masks. He temporarily left employment and sought psychiatric assistance for his professional “burn-out” condition. After three doses of venlafaxine, he reported side effects including increased anxiety, blood pressure and heart rate. He was then prescribed escitalopram without tapering of the venlafaxine. As his anxiety progressed, he was prescribed escitalopram once daily and buspirone three times daily, yet he continued to deteriorate until the homicide.

Results
Expert genetic analysis found susceptibility to the psychiatric drugs prescribed. The neuropsychological evaluation, months post-homicide, found excellent neuropsychological function, although psychomotor and processing speed was deficit. Personality testing found no disorders, with a profile inconsistent with violent behavior.

Conclusions
Prescribers need to monitor patients carefully for potentially adverse and violent outcomes of treatment.
A - 147 Patient-Centric Considerations for Selecting the Language of Procedure Administration in Candidates for Epilepsy Surgery: Implications for Data Interpretation, Prognostication and Outcomes
Authors: Bender Heidi A , Beattey Robert A , Katsman Kseniya , Lokai Andrew , Sacks-Zimmerman Amanda , Spat-Lemus Jessica S 
Published: September 2024

Abstract

Objective
Selecting the language of pre-surgical neuropsychological testing (NPT), intracarotid amobarbital procedure, and intra/extra functional language mapping (ESM) in bi−/multi-lingual patients is a high-stakes neuropsychological decision point. Though a patient’s self-selection of language is an integral consideration, both patient and provider must fully understand the potential implications of language selection on a patient’s data interpretation and overall case conceptualization.

Method
A 26-year-old, right-handed, bilingual (L1 = Mandarin-, L2 = English-speaking) female received pre-operative NPT, Wada test, and ESM to guide resective surgery targeting medically-refractory epilepsy involving the right superior temporal gyrus (STG) and mesial (MTL) temporal lobe. All procedures were conducted in English at the patient’s request with alternate forms of verbally-mediated NPT administered in Mandarin.

Results
Confrontation naming and verbal fluencies were impaired in both English and Mandarin. Wada testing administered in English revealed bilateral language and greater left hemisphere memory support. Following considerable psychoeducation regarding possible functional language loss in Mandarin post-operatively, the patient agreed to ESM in L1 with auditory and picture naming disruption after right STG stimulation.

Conclusion
Despite strong English-language fluency, assessment in Mandarin was of critical importance, as eloquent cortices essential for tonal language production may have been resected if mapping procedures were completed in English-only, as requested. Balancing factors informed by functional and structural neuroanatomy, patient worldview, and cross-cultural neuropsychology requires a tailored, patient-centric approach to case conceptualization.
B - 5 The Clinical Utility of Neuropsychological Assessment in Combatting Resource Misappropriation in the Social Media Era: a Case Series
Authors: Fisher Thomas L , Lewandowski Alan , Romano Lucie M , Keniston Alyssa , Cole Jolynn 
Published: September 2024

Abstract

Objective
Following the rise in popularity of social media applications such as TikTok, Instagram, and X, young adults are being exposed to more mental health-related content, particularly related to Autism Spectrum Disorder (ASD). Unfortunately, 30–84% of this content contains inaccurate or misleading information, which may be assimilated into personal accounts of psychological concerns reported to physicians (Borges do Nascimento et al., 2022; Bastiaens et al., 2024). This can contribute to misdiagnosis, resource misallocation, and inappropriate or contraindicated intervention. The present case series emphasizes the utility of neuropsychological assessment in assisting with proper diagnosis and subsequent treatment planning and intervention.

Method
This case series covers six patients ranging in age from 18 to 50, five of whom are female, who were referred for neuropsychological evaluation pursuant to self-suspected ASD based on symptom descriptions obtained via popular media. The comprehensive neuropsychological battery included both self-report measures of ASD symptomology (Social Responsiveness Scale) and the Autism Diagnostic Observation Schedule (ADOS-2).

Results
Neuropsychological testing reflects significant discrepancies between subjective and objective measures of ASD symptoms. These objective findings, combined with the patient’s history and objective measures of psychological functioning, support the accurate diagnosis of a variety of mental health disorders while ruling out ASD.

Conclusions
This case underscores the importance of neuropsychological assessment in providing meaningful and objective diagnostic data to combat a growing public health crisis of young adults overidentifying with ASD symptoms based on information presented online. Neuropsychological intervention is critical in aiding physicians in accurate differential diagnoses, providing psychoeducation and treatment recommendations, and conserving medical resources.
B - 7 Factor Structure of the Beck Depression Inventory-II in Epilepsy
Authors: Muller-Cohn Chantal , Brickell Emily , Boettcher Anneliese , Buckman Mark , Lee Bern G 
Published: September 2024

Abstract

Objective
This study aimed to explore the factor structure of the Beck Depression Inventory, Second Edition (BDI-II) in persons with epilepsy (PWE) and assess its correspondence with validated BDI-II cognitive and somatic-affective factors associated with depression in other populations.

Method
Retrospective data from 69 PWE (ages 18–72) who completed the BDI-II at a National Association of Epilepsy Centers level 4 epilepsy center were analyzed. Patients with diagnoses of bipolar disorder and schizophrenia spectrum disorders were excluded. An Exploratory Factor Analysis (EFA) using the psych package in R Studio was conducted, allowing factors to correlate with oblique factor rotation. The number of factors was determined using eigenvalues &gt;1 and scree plots.

Results
Statistical support is strongest for a one-factor solution with eigenvalue 7.91; however, a two-factor solution (Factor two eigenvalue = 1.16) also met criteria. These factors accounted for 30% and 10% of the variance, respectively. Due to the low eigenvalue, few item loadings (3), and low variance explained by the second factor, item-level considerations were implemented to determine whether a two-factor solution added clinically relevant information.

Conclusion
Although a one-factor solution was best supported by the data, a second factor including sadness, feeling of punishment, and suicidal thoughts may be clinically relevant given elevated suicide risk and qualitative research reporting punishment feelings among PWE.