bluuebunny/crossref_metadata_2025_split huggingface dataset:
A - 49 Neuropsychological and Clinical Features of Ataxia Due to CACNA1A (P.1661H) Mutation: a Case Study
Authors: Hagy Hannah , Hill Gianna , Lacy Maureen 
Published: October 2023

Abstract

Objective
Mutations in CACNA1A gene can cause rare neurodegenerative conditions [spinocerebellar ataxia type 6 (SCA6); episodic ataxia type 2 (EA2)] which are caused by autosomal dominant mutations located on chromosome 19p13. Research suggests triplet repeat mutations in the CACNA1A gene are associated with SCA6 characterized by late onset, slowly progressive cerebellar ataxia. On the other hand, CACNA1A mutation with specific protein variant R1661H involvement is associated with EA2, characterized by early onset ataxia, which may be accompanied by vertigo, diplopia, dysarthria, and generalized weakness. We present a patient with genetically confirmed mutation in CACNA1A (p.1661H), not fitting the phenotype of EA2 despite associated variant.

Method
A retrospective review of the patient’s medical record along with review of neuropsychological and neuroimaging reports.

Results
Neuropsychological testing revealed a 79-year-old female who demonstrated executive, memory retrieval, construction and fine motor dexterity slowing along with dysfluency and anomia. Neurologic exam documented bilateral blepharospasm, with mild ataxia and speech disturbance (SARA total = 12). Neuroimaging revealed moderate cortical atrophy and chronic small vessel ischemia disease. Behavioral observations were notable for gait ataxia and dysarthria, as well as perseverative responding and anosognosia. She endorsed symptoms indicative of clinical levels of depression, apathy, anxiety and disinhibition. Her partner endorsed more notable executive dysfunction symptoms and functional impairment.

Conclusion
While the motor sequela is well documented, the neuropsychological impact is infrequently discussed in existing literature regarding CACNA1A (p.1661H) mutations. This case expands our understanding of the unique and varied phenotype associated with this unique CACNA1A gene variant.
A - 54 Interdisciplinary Assessment in the Differential Diagnosis of the Phenocopy Syndrome of Behavioral Variant Frontotemporal Dementia: a Case Study
Authors: Kdeiss Bianca , McCuddy William Travis 
Published: October 2023

Abstract

Objective
Phenocopy syndrome of behavioral variant frontotemporal dementia (phFTD) is a clinical syndrome in which the neuropsychiatric criteria of behavioral variant frontotemporal dementia (bvFTD) are fulfilled without demonstration of classic bvFTD neuroimaging abnormalities or clinical progression. We present a case of an individual with atypical bvFTD that was initially characterized as phFTD and discuss clinical considerations for complicated differential diagnosis in a phenocopy syndrome that is still not fully understood.

Method
A 77-year-old male presented to a neurology clinic for a third opinion due to behavior changes, with progressive course, reported by family since 2019. Magnetic resonance imaging (MRI) scan indicated nonspecific volume loss and mild chronic white matter ischemic changes. Fluorodeoxyglucose positron emission tomography (FDG-PET) scan indicated bilateral temporoparietal hypometabolism. Cerebrospinal fluid (CSF) biomarker study was not consistent with pathological changes of Alzheimer’s disease. C9orf72 and other FTD-associated gene mutations were negative.

Results
Neuropsychological test results were grossly normal across two separate evaluations between 2021–2022. A third evaluation in 2023 showed significant executive deficits, including below average to exceptionally low divided attention and set shifting, novel problem solving, and phonemic fluency.

Conclusion
This case underscores the complexity of differentiating between phFTD and bvFTD and highlights the need for interdisciplinary evaluation, including serial neuropsychological assessment. Additionally, it suggests that, in some cases, phFTD may represent prodromal bvFTD. Further research is needed to better understand the underlying mechanisms of phFTD and its relationship to FTD, as well as to develop more effective diagnostic tools and treatments for this challenging clinical syndrome.
A - 56 Examining the Impact of Cognition and Training on Successful Usage of an Assistive Smartphone Application for Older Adults Experiencing Cognitive Decline
Authors: Mckniff Moira E , Hackett Katherine , Pinsky Emma , Lehman Sarah , Tan Chiu , Giovannetti Tania 
Published: October 2023

Abstract

Objective
The SmartPrompt is an assistive smartphone application designed to prompt older adults to remember to do daily tasks and then log task completion in a photo log for later review. Here we examine whether and how cognitive status and performance during training with the SmartPrompt influenced usage of the app over a two-week testing period at Temple University.

Method
Nine community-dwelling older adults (M age = 77 ± 5.60, 67% male, 77% white) with mild cognitive impairment (MCI) or dementia underwent standardized training with the SmartPrompt app that included review and practice responding to SmartPrompt alarms and taking photos for the task log. Training was scored for time and performance accuracy. Following training, participants used the SmartPrompt to facilitate completion of two tasks of their choice every day for two weeks. The number of tasks completed (max =28), average time to respond to the SmartPrompt alarm, and a qualitative rating of the relevance of the photos in the log was scored.

Results
More time spent training was associated with more effective use of the SmartPrompt (task completion; rs = 0.715; p &lt; 0.05; acknowledgement time rs = −0.571). Training performance accuracy was related to the quality of SmartPrompt photos (rs = −0.485) but not to other SmartPrompt measures. Cognitive status (MMSE) was associated with training performance (rs = −0.824; p &lt; 0.01) and photo quality (rs = 0.737; p &lt; 0.05) during testing weeks.

Conclusions
Older adults show improved use of assistive smartphone applications when more time is spent on training and practice, regardless of their training performance accuracy or cognitive status.
A - 57 Virtual Group Dementia Caregiver Intervention for the Management of Neuropsychiatric Symptoms (NPS): 3-Month Follow-Up of a Pilot Study
Authors: O'Connor Maureen K , Shirk Steven , Moo Lauren , McLaren Jaye , Nguyen Andrew H , Pugh Kendra 
Published: October 2023

Abstract

Objective
Pilot test the feasibility and preliminary efficacy of a virtual group dementia caregiver intervention (TeleCARE) in improving depression, anxiety, and distress related to NPS.

Method
Twenty predominately female (80%), spouses (80%), ages 35–88 (M = 70.8), participated in TeleCARE. The CDR-Sum of Boxes for patient dementia severity reflected moderate dementia (M = 11.1, SD = 3.18). Caregiver data was collected at baseline, immediately following the intervention, and 3 months after completion.

Results
Following the intervention, 85% of caregivers understood NPS better, and 90% felt better able to care for the person with dementia (PWD) and manage caregiving. Immediately following the intervention, caregivers reported reductions in depression (BDI: M = 9.55, SD = 7.88 vs. M = 7.75, SD = 7.11), anxiety (BAI: M = 8.65, SD = 7.46 vs. M = 6.75, SD = 7.24), and distress related to NPS (M = 26.60, SD = 11.97 vs. M = 25.10, SD = 11.60). Decreases in depression and anxiety were not maintained at the 3-month follow-up (BDI: M = 8.60, SD = 7.82; BAI M = 8.95, SD = 10.90), but distress related to NPS declined further (M = 24.40, SD = 10.68).

Conclusion
TeleCARE improved the understanding of NPS and the ability to care for the PWD and manage caregiving demands. Reductions were seen in depression, anxiety, and distress related to NPS immediately following the intervention. Reductions in depression and anxiety were not maintained at 3-months, but caregivers showed further reductions in distress related to NPS, suggesting that the targeted NPS intervention had sustained targeted outcomes (distress related specifically to NPS), perhaps resulting from improved understanding of NPS and continued application of taught skills. Adding booster sessions may help sustain reductions in depression and anxiety.
A - 58 Verbal Fluency Word Generation Slope among Older Adults with MS
Authors: Pace Brigitte , Holtzer Roee 
Published: October 2023

Abstract

Objective
The decreasing rate of within-person word generation in verbal fluency (VF) tasks, here referred to as slope, is associated with mild cognitive impairment and with lower grey matter volume in select regions. While VF is sensitive to cognitive decline in Multiple Sclerosis (MS), VF slopes have yet to be assessed in older adults with MS. We, therefore, examined VF slopes in letter and category VF among dementia-free older adults with and without MS.

Method
84 community-dwelling adults with MS (Mage = 64.7) and 86 without MS (Mage = 70.8) completed standard 60-sec letter (F, A, S) and category (fruits, vegetables, animals) VF tasks; responses were recorded in 20-sec intervals for each iteration of the task.

Results
Linear regressions showed that MS was associated with lower total word generation on category, but not letter, VF after accounting for age, sex, race, education, and health status (95% CI, [−2.27, −0.98], p &lt; 0.001). Linear mixed effects models showed that word generation declined during the course of both tasks (all p’s &lt; 0.001) in both groups; MS status did not moderate category or letter VF slopes.

Conclusion(s)
Extant literature on total letter and category VF word generation in MS is mixed. The current study indicates that in community-dwelling older adults MS was associated with lower total word scores in category but not letter VF. Negative word generation slopes were documented in category and letter VF irrespective of group status. These results suggest that time effects on word generation in VF tasks were generalizable to normal aging and MS.
A - 61 The Impact of Metacognition on Everyday Functioning in Mild Cognitive Impairment and Dementia
Authors: Hussein Jaidaa , Sidhu Jasman , Chapp Andrew , Lent David , Wright Matthew , Woo Ellen 
Published: October 2023

Abstract

Objective
The purpose of this study was to evaluate the role of metacognition on everyday functioning in mild cognitive impairment and dementia.

Method
Participants included 44 healthy older controls, 57 individuals with mild cognitive impairment (MCI), and 26 individuals with Alzheimer’s disease (ad). Participants were administered verbal and nonverbal memory tests and a visuospatial test. They made predictions about their performances before taking each test and then made postdictions about their performances after each test. Prediction and postdiction accuracy scores were calculated. Additionally, all participants took the Everyday Cognition (ECog) Scale.

Results
Regression analyses were conducted, separately for each diagnostic group, to determine the roles of prediction and postdiction accuracy on everyday functioning. For healthy older controls, prediction and postdiction accuracy on a visuospatial test significantly impacted overall everyday functioning. In MCI, prediction accuracy on a nonverbal memory test significantly impacted everyday functioning. Finally, in ad, postdiction accuracy on a nonverbal memory test significantly predicted everyday memory.

Conclusion(s)
Overall, metacognition predicts everyday functioning in healthy aging, MCI, and ad. For healthy aging and MCI, the ability to both accurately predict and retrospectively evaluate their own cognition impacts overall everyday functioning. With the increased cognitive impairment of ad, only the ability to retrospectively evaluate performances impacts everyday memory.
A - 62 Caregiver Relationship Type Significantly Moderates Association among NPI-Q Symptoms: a Moderated Network Analysis
Authors: Singsank Katie T , Goodwin Grace J , Juthapan Stacey Moeller , Salva Christine , John Samantha E 
Published: October 2023

Abstract

Objective
We investigated the influence of caregiver type (CT; ex. spouse, child, etc.) on the association among neuropsychiatric symptoms using the caregiver-endorsed Neuropsychiatric Inventory Questionnaire (NPI-Q) and a sample from the National Alzheimer’s Coordinating Center database.

Method
The selected sample (n = 12,337) includes those aged 50+ with complete baseline data for the NPI-Q and caregiver relationship. Included participants had ≥1 NPI-Q symptom(s) endorsed and a diagnosis of mild cognitive impairment or dementia with Alzheimer’s disease as the primary or contributing cause. A Moderated Network Model approach estimated whether associations among NPI-Q items depend on CT (moderator variable). Spouse was used as the reference group for all comparisons.

Results
CT significantly moderated the NPI-Q. Interaction effects were found between 3 moderated node pairs: agitation/aggression and disinhibition (edgeweight = 0.02), hallucinations and nighttime behaviors (edgeweight = 0.01), and depression/dysphoria and appetite/eating problems (edgeweight = 0.01). The edgeweights for these node pairs were reduced in the final model due to variance being accounted for by the addition of CT. The association between agitation/aggression and disinhibition was smaller for spouses than children, and larger for spouses than friends and paid caregivers. The association between hallucinations and nighttime behaviors was smaller for spouses than children, and larger for spouses than friends and paid caregivers. The association between depression/dysphoria and appetite/eating problems was smaller for spouses than siblings and friends.

Conclusions
The pairwise dependency between neuropsychiatric symptoms differs as a function of CT. Future research is needed to identify factors that influence symptom reporting, including interpersonal dynamics, amount of time spent together, and overall burden of symptoms.
A - 63 Neuropsychiatric and Cognitive Correlates of Pareidolias in Dementia with Lewy Bodies
Authors: Smith Madeleine P , Wang Jiangxia , Leverenz James B , Heller Nathan H , Magsaman Susan H , Bakker Arnold , Zabetian Cyrus B , Tsuang Debbie W , Oguh Odinachi , Lippa Carol F , Lopez Oscar L , Berman Sarah B , Irwin David J , Galasko Douglas R , Litvan Irene , Fleisher Jori E , Galvin James E , Bozoki Andrea C , Sabbagh Marwan N , Wint Dylan , Cholerton Brenna A , Pantelyat Alexander Y , Kamath Vidyulata 
Published: October 2023

Abstract

Objective
Pareidolias represent visual illusions of meaningful objects in ambiguous stimuli. Prior research has demonstrated phenomenological similarities between pareidolias and visual hallucinations (VH) and the potential clinical utility of pareidolias in discriminating dementia with Lewy bodies (DLB) from Alzheimer’s dementia (ad). Though pareidolias have been linked with VH severity in DLB, the relationships between pareidolias and other neuropsychiatric symptoms have not been explored in large DLB samples.

Method
Individuals meeting 2017 McKeith criteria for probable DLB (n = 114) were enrolled in a multi-site systematic longitudinal study of the US DLB Consortium. Study assessments included an informant-rated psychiatric inventory (NPI), Montreal Cognitive Assessment (MoCA), and Noise Pareidolia Task (NPT). Ninety-five participants completed all clinical assessments. To examine baseline relationships between pareidolias responses (NPT) and the presence of 12 neuropsychiatric symptom dimensions (NPI), we used Poisson regression models with robust standard error estimates adjusted for age, education, disease duration, cognition (MoCA), and cholinesterase inhibitor use.

Results
Contrary to expectation, the presence of VH was not associated with pareidolias in DLB (Incidence Rate Ratio = 1.37, p = 0.275). The presence of both delusions (IRR = 2.11, p = 0.01) and depression (IRR = 1.79, p = 0.015) was associated with greater pareidolias. Additionally, overall cognitive dysfunction was associated with pareidolias (IRR = 0.90, p &lt; 0.001).

Conclusions
Our findings indicate that pareidolias are associated with poorer cognition and neuropsychiatric dimensions beyond VH, including depression and delusions. As pareidolias have been put forth as a surrogate marker of VH in DLB, future studies examining pareidolias in conjunction with comprehensive psychiatric/cognitive assessment and neuroimaging will further elucidate the clinical utility of pareidolia testing.
A - 65 Neuropsychological Sequela of Late-Onset Epilepsy in Older Adults: a Case Study
Authors: Turchmanovych-Hienkel Nataliya , Lacy Maureen 
Published: October 2023

Abstract

Objective
Late-onset epilepsy is increasingly recognized as playing a role in cognitive decline during aging. Late-onset epilepsy and Alzheimer’s disease (ad) appear to share pathological links mediated by vascular changes and tau pathology (Sen et al., 2020). Current literature has established a bi-directional association between ad and epilepsy with each being a risk factor of the other (Zhang et al., 2022). The present case illustrates the complexity of differential diagnosis in older adults presenting with progressive memory decline and late-onset epilepsy.

Method
Clinical interviews with the patient and his wife, a review of medical records including neuroimaging results, neuropsychological history questionnaire, and neuropsychological assessment.

Results
59-year-old male with a three-to-four-year history of focal seizures and slowly progressive memory decline. Medical history was void of vascular risk factors. Family history of memory disorders was denied. Brain MRI scans were read as unremarkable. However, video EEG revealed independent sharp waves from bilateral temporal areas. Neuropsychological assessment revealed deficits in verbal memory, confrontation naming, and semantic fluency but otherwise intact cognition. Per family, the patient displayed increased irritability, apathy, disinhibition, and executive dysfunction.

Conclusion
Clinicians need to be increasingly aware of the growing incidence of late-onset epilepsy with aging and its symbiotic role in the risk for ad. Mechanistic evidence will be reviewed such as similar network hyperexcitability along with the accumulation of amyloid and hyperphosphorylated tau-protein.
A - 71 Cognitive Complaints and Neuropsychological Performance in Cancer: the Role of Affect
Authors: Lemos Raquel , Sousa Berta , Manica Isabel , Frasquilho Diana , Cardoso Fátima , Oliveira-Maia Albino J 
Published: October 2023

Abstract

Objective
To examine the impact of cancer treatments in affect and in cognition.

Method
The study evaluated 115 breast cancer patients before- and 6 months after-treatment, and a group of 90 cognitively healthy subjects paired for age and education at matched intervals. All participants performed a comprehensive assessment with measures of affect (HADS and PANAS), subjective complaints (FACT-Cog), and a battery of neuropsychological tests comprising memory, attention, and executive functioning domains. Comparisons were done between-groups pre-treatment, and within-groups between timepoints. Correlations between psychological and cognitive measures were made at 6 months.

Results
Before treatment, patients exhibited significant lower levels of positive affect (PANAS, p = 0.003), but no complaints or cognitive impairment, when compared to controls. Longitudinal analyses revealed an effect of time, towards improvement, in HADS anxiety (p = 0.0006) and PANAS negative (p &lt; 0.0001), in the clinical group, and a small but significant increase in subjective complaints for both groups (p &lt; 0.001). No objective cognitive decline was found in any group across time. A pattern of significant negative correlations between HADS measures and subjective cognitive assessment was found in the two groups, suggesting that higher affective symptoms are related to more cognitive complaints. No correlations were found between affect and neuropsychological performance, or between subjective and objective cognitive assessments, in any group.

Conclusion
Our data showed that there is a discrepancy between cognitive complaints and objective scores due to the presence of affective symptoms in breast cancer patients. Importantly, the similar pattern in matched controls assessed in the same timepoints shows that it is not attributable to cancer treatments.
A - 73 The Impact of Posttraumatic Stress Disorder on Cognitive Health in 9/11 Responders: the Role of Sleep Disturbances
Authors: Schultz Elaine , Heilbronner Robert , Hill Scot , Kotov Roman , Waszczuk Monika 
Published: October 2023

Abstract

Objective
PTSD is known to have a long-term impact on cognitive health, specifically executive dysfunction. However, most studies have not tested possible mechanisms underpinning this association. Sleep disturbances have emerged as a potential pathway between PTSD and cognitive functioning. This study aimed to investigate whether sleep disturbances account for the association between PTSD and executive dysfunction in trauma-exposed first responders.

Method
Participants consisted of 9/11 WTC responders (N = 452, mean age = 55.22, SD = 8.73, 89% male, 90% White). Data collection occurred across 3 time points, each 1 year apart. Measures included self-reported PTSD and insomnia symptoms, two weeks of Ecological Momentary Assessment of sleep duration and sleep quality, and the Trail Making Test part B. Due to high stability across 3 years, the present study focused on mean, trait-like variables. Analyses adjusted for demographics, BMI, and trauma exposure severity.

Result
PTSD was associated with Trail Making Test part B (r = 0.10, p = 0.03), as well as insomnia (r = 0.63, p &lt; 0.00) and sleep quality (r = −0.45, p &lt; 0.00), but not sleep duration. Mediation analyses revealed that sleep quality fully accounts for the significant association between PTSD and executive functioning (indirect effect β = 0.056, p = 0.041, 95% CI [0.009, 0.108]).

Conclusions
The current results highlight the important role that disturbances in sleep may have on cognitive health outcomes. Improving sleep, in the context of PTSD, could attenuate cognitive symptoms, and possibly protect against further decline. Future research conducted in the acute phase of trauma-exposure and PTSD is needed to clarify the directionality of these relationships, with longitudinal analyses that will allow form modeling cognitive decline.