bluuebunny/crossref_metadata_2025_split huggingface dataset:
A - 40 Assessment of Dementia with Lewy Bodies in a Patient with both Characteristic and Atypical Features
Authors: Banerjee Nikhil , Hicks Cullen , Acosta Lealani 
Published: October 2023

Abstract

Objective
Dementia with Lewy Bodies (DLB) is the second most common neurodegenerative dementia after Alzheimer disease (ad). Its heterogeneous presentation and overlapping features with other dementias result in frequent misdiagnosis, which can delay optimal management. The present case illustrates complex symptomology, comprehensive assessment, and diagnostic challenges in a patient with DLB.

Method
A 64-year-old female presented to an academic medical center neurology clinic with rapid cognitive deterioration over the past 1.5 years accompanied by visual disturbances, psychiatric and behavioral changes, and mild motor symptoms. Initial differential included Creutzfeldt-Jakob disease, atypical parkinsonism, frontotemporal lobar degeneration (FTLD), encephalopathy, and ad. Work-up in included neuropsychological, neuroimaging, cerebral spinal fluid (CSF), electroencephalogram (EEG), and skin biopsy assessments.

Results
Neuropsychological interview revealed fluctuating attention/alertness, visual hallucinations, hyposmia, paranoid and repetitive behaviors, and subtle evidence for dream enactment. Her cognitive profile showed global impairment with pronounced visuospatial and executive deficits. Recognition memory, verbal reasoning, and naming were relatively well-preserved. Magnetic resonance imaging showed mild atrophy; fluorodeoxyglucose positron emission tomography (PET) showed hypometabolism in frontal and temporal regions whereas uptake was highest in the occipital lobes and basal ganglia; skin biopsy was positive for synucleinopathy; CSF and EEG were broadly unrevealing.

Conclusions
The preponderance of data was consistent with diagnostic criteria for probable DLB. Skin biopsy increased diagnostic confidence. Atypical features included relatively rapid cognitive decline, minimal parkinsonism, and PET imaging suggesting FTLD. The present case highlights the utility of a multidisciplinary approach (e.g., neurological exam, detailed symptom screening, neuropsychological testing, and advanced laboratory assessments) in a complex case of DLB.
A - 52 Self-Reports and Informant-Reports of Everyday Functioning as Predictors of Objective Cognition in Mild Cognitive Impairment and Dementia
Authors: Hickman Angela , Kozuki Jordan , Lent David , Wright Matthew , Woo Ellen 
Published: October 2023

Abstract

Objective
The objective of the current study was to investigate self- and informant-reports of everyday functioning and whether they predicted objective cognitive functioning.

Method
Participants included 65 persons with mild cognitive impairment (MCI), 18 individuals with dementia, and 58 healthy older controls. Self-reports and informant-reports were taken on the Everyday Cognition Scales (E-Cog), which included seven subscales: everyday language, memory, executive functioning (EF) planning, EF organization, EF divided attention, visual–spatial/perceptual abilities, and attention. Participants also completed a neuropsychological battery, and composite scores were calculated for each cognitive domain.

Results
Regression analyses revealed that in healthy older controls, self-reported EF organization significantly predicted objective executive functions. Additionally, informant-reported language significantly predicted objective language. In the MCI group, self- and informant-reports on the E-Cog did not predict objective cognition. For the dementia group, informant-reported EF planning, EF organization, and EF divided attention significantly predicted objective executive functions. Furthermore, informant-reported language significantly predicted objective language.

Conclusions
Overall, informant-reports of everyday language predicted objective language in healthy aging and dementia. Self-reports were only predictive of objective cognition in healthy older controls, with self-reported everyday executive functions predicting objective executive functions. Interestingly, in MCI, self- and informant-reports were not predictive of any domain of objective cognitive skill. These results indicate that when the cognitive impairment is more subtle than in dementia, objective neuropsychological assessment will be even more important, as self- and informant-reports are not associated with actual cognitive functioning.
A - 59 Regional Cerebral Metabolism Is Associated with Performance on the Visual Object and Space Perception Battery in those with Posterior Cortical Atrophy
Authors: Richert Mallory , DiRita Victor , Moceri Anthony , Iordan Alexandru , Crowley Samuel , Koeppe Robert , Hampstead Benjamin 
Published: October 2023

Abstract

Objective
Posterior cortical atrophy (PCA) is a relatively rare clinical syndrome characterized by visuoperceptual/spatial dysfunction with relatively preserved memory, language, and insight in the early stages. Thus, PCA provides a unique population through which to evaluate structure–function relationships for commonly used neuropsychological tests. Here, we evaluated relationships between fluorodeoxyglucose (FDG) positron emission tomography (PET) and performance on the Visual Object and Space Perception (VOSP) Battery.

Method
Ten participants with an established diagnosis of PCA underwent baseline neuropsychological testing that included the VOSP, FDG-PET, and structural MRI. We used FreeSurfer to identify anatomical structures in the structural MRI scans, aligned the MRI and PET scans, and then extracted FDG signal from these same regions. Several brain regions relevant for PCA were a priori targeted. We evaluated relationships between the regional FDG values and VOSP performances using Spearman’s rank correlation.

Results
Silhouettes, Dot Counting, and Number Location showed strong relationships with the superior parietal lobule bilaterally. The right superior parietal lobule showed moderate to strong relationships with Incomplete Letters and Progressive Silhouettes, whereas the left superior parietal lobule showed a strong relationship with Object Decision. Incomplete letters showed a strong relationship with the right supramarginal gyrus. Silhouettes showed a strong relationship with the left fusiform gyrus.

Conclusions
These findings from a relatively rare and heterogeneous syndrome provide insight into the regional contributions to visuospatial functioning. Future work will evaluate network-level integrity with these tasks in order to further clarify structure–function relationships.
A - 64 The Neuropsychology of Lost Person Behavior: Case Studies of Lost Persons with Substance Intoxication, Dementia, and Intact Cognitive Status
Authors: Torsney Kathleen 
Published: October 2023

Abstract

Objective
The location of lost persons by Search and Rescue teams is often achieved through statistical analyses based on previous cases, however, the impact of neuropsychological functioning on the behavior of lost persons has not been explored. Information about how the neuropsychological profile of various lost persons can inform the behavior of those persons will substantially assist Search and Rescue efforts.

Method
This poster examines 3 case studies of lost persons: an individual with dementia lost in a small city, an intoxicated man in his 20s lost in the woods, and a cognitively intact middle-aged man lost at the top of a mountain. The author describes each case and how the neuropsychological profile of a person with dementia, an intoxicated individual, and a person without cognitive deficits can inform lost person behavior.

Results
The poster highlights key factors in identifying how neuropsychological functioning in various profiles will influence how the lost person behaves. The results of the lost person behavior and their executive functioning profiles are compared and contrasted.

Conclusion
The author provides information about how neuropsychological profile of individuals with dementia, intoxication, and intact functioning influence how these persons behave when lost. This information may be used to assist Search and Rescue teams in more quickly and efficiently finding lost persons.
A - 67 Does Cognitive Set-Shifting in Multilinguals Serve as a Protective Factor against Depressive Rumination?
Authors: Caviasco Annalise , Storbeck Justin 
Published: October 2023

Abstract

Objective
The purpose of this study is to assess whether multilinguals’ advantage in cognitive flexibility serves as a protective factor against ruminative tendencies common in depressed mood. We compared monolinguals and multilinguals in a backward inhibition task during negative and neutral moods. It was hypothesized that monolinguals compared with multilinguals would perform worse on inhibition trials compared to control when induced into a negative mood.

Method
96 undergraduates from Queens College, a population with high linguistic diversity, were recruited from Psychology 101 courses. Participants were monolingual (n = 47) or multilingual (2+ languages; n = 49). Participants responded to questions about their language and social background before undergoing mood induction to either neutral or negative (sad) affective states. They then completed a computerized cognitive set-shifting task measuring reaction time (RT) and accuracy.

Results
A two-way ANOVA was conducted examining the effect of mood condition and mono/multilingualism status on RT and accuracy on the set-switching task for backward inhibition trials. There was a statistically significant interaction between the effects of mood condition and mono/multilingualism on RT, F(1, 92) =6.062, p = 0.002, such that multilinguals had a higher RT compared to monolinguals when induced into a negative mood. The main effects of mono/multilingualism and mood condition were not statistically significant. Difference in accuracy between groups was not statistically significant.

Conclusions
Contrary to our hypothesis, bilinguals took longer to respond than monolinguals in a sad mood, specifically for lag inhibition trials. Additional research is needed to determine how sociocultural factors may explain multilinguals’ slowed response in a negative mood.
A - 68 Brain Health Clinic’: a Neuropsychometric Screening & Triage Model
Authors: Hicks Cullun , Banerjee Nikhil , Pilote Kristen , Romano Raymond , Considine Ciaran 
Published: October 2023

Abstract

Objective
Cognitive symptoms are frequently not diagnostic for underlying brain damage or disease, but secondary to other treatable medical/psychiatric factors. Neuropsychological evaluation can inform the differential, but is limited by access issues and reduced diagnostic certitude in the setting of unmanaged secondary factors. Development and implementation of a neuropsychometric screening and triage model to address these issues has flexible application across different clinical settings.

Data Selection
Literature on cognitive/behavioral/somatic screening methods were reviewed. Measures and associated cut-offs were selected based on open-source availability, clinical domain/condition relevance, intended population, and time to administer/interpret. Consultation with first-line clinicians in general neurology and non-neurology clinics guided refinement. Consultation with Neurologists informed triage guidelines. Recent CPT/CMS guidance on e-consultation billing was reviewed and integrated.

Data Synthesis
A “Brain Health Clinic” model composed of neuropsychometric screening with empirically-derived cut-off scores, along with expert consensus first-line intervention and triage, was piloted with advanced practice providers in a Cognitive Neurology Clinic. E-consultation support was provided by Neuropsychology. Practice findings and refinements are discussed. Adaptations to the model designed for a post-COVID clinic, Concierge Medicine clinic, and Primary Care Practice with integrated Neuropsychologist are reviewed.

Conclusions
Upstream extension of neuropsychological expertise via screening and triage with appropriate remote involvement of the neuropsychologist has the potential to resolve cognitive complaints prior to referral, or, optimization of confounding medical/psychiatric factors in those patients eventually escalated for full evaluation. New CPT/CMS billing options make this a viable approach for neuropsychologists across different clinical settings. Empirically-based refinement and assessment of outcomes in the future is indicated.
A - 69 Examining Differences in Neuropsychological Test Performance Based on Deployment Era and Years Served in United States Veterans
Authors: Engel David , Smith Cassandra , Courtwright Kylie , Callahan Megan 
Published: October 2023

Abstract

Objective
To determine the influence of years of military service and deployment era on neurocognitive performance.

Method
Archival data included 316 veterans (89.6% male; 94.3% White) seen for neuropsychological evaluation at the Portland VA (M/SD: age = 55.54/14.39; education = 13.32/2.44). Participants were administered a comprehensive neuropsychological battery. Two-way between-subjects analyses of variance (ANOVAs) examined the effects of years of service and deployment era on test performance. Bonferroni post-hoc tests compared differences between groups when a significant main effect was observed.

Results
Significant main effects were found for deployment era on TOMM Retention trial (F(4, 20) = 4.39, p = 0.04), WAIS-IV Block Design (F(5, 244) = 2.45, p = 0.04), WMS-IV Logical Memory I (F(5, 230) = 3.79, p &lt; 0.01), Trail Making Test Part A (F(5, 242) = 3.54, p &lt; 0.01), Trail Making Test Part B (F(5, 227) = 3.38, p &lt; 0.01) and Grooved Pegboard for nondominant hand (F(4, 86) = 3.22, p &lt; 0.05). Significant main effects were also observed for years of service for Trail Making Test Part A (F(4, 242) = 2.81, p &lt; 0.05) and DKEFS Color-Word Trial 2 (F(4, 77) = 2.67, p &lt; 0.05). A significant interaction was found between deployment era and years served on the BVMT-R total recall score (F(15, 213) = 1.92, p &lt; 0.05). Post-hoc analyses did not reveal significant variance accounted for on neuropsychological tests.

Conclusions
While there were significant differences between multiple measures, deployment era and years of service do not impact veteran’s cognitive performance.
A - 78 Characterization of Post-Stroke Cognitive and Mood Impairment within 1-Year Post-Stroke after Hospital Discharge
Authors: Saurman Jessica L , Nahab Fadi , Barrett A M , Belagaje Samir , Henriquez Laura , Starnes Danielle , Christopher Hannah , Blanke Debra , Loring David W 
Published: October 2023

Abstract

Objective
To demonstrate the feasibility of cognitive and psychological characterization after stroke during post-discharge neurology visit as part of standard care.

Method
From January 1, to April 29, 2023, 33 patients were evaluated using the MoCA and screening tests for aphasia, spatial neglect, depression, and anxiety during their neurology outpatient visit. Neuropsychological measures evaluating attention, processing speed, language, visuospatial, memory, and executive function abilities were also administered. Patients were aged 30–87 years (Mage = 64.8, SDage = 14.2). The sample included 37.1% women and was primarily Black/African American (37.1%) and White (54.3%). The average level of education was some college (Medu = 14.7, SDedu = 32.7). Time between stroke and testing ranged from 0–11 months (Melapsed = 2.8, SDelapsed = 3.1 and 88.6% of patients experienced ischemic stroke.

Results
Over 68% of patients examined demonstrated global cognitive impairment on the MoCA (MMoCA = 21.2, SDMoCA = 5.1). 5.7% of patients met criteria for spatial neglect and 5.7% met criteria for aphasia. A higher percentage demonstrated impairments within visuospatial or language domains (51.4% visuospatial and 34.3% language, respectively. Further, impairments were observed across all other domains assessed, including attention (22.9%), processing speed (31.4%), verbal memory (62.9%), visual memory (54.3%), and executive function (51.4%). Depression and anxiety were present in 42.9% and 37.1% of the sample, respectively. Elapsed time, type of stroke, lateralization of stroke, sex, or mood scores were not associated with lower performance on the MoCA.

Conclusions
Cognitive and behavioral deficits following stroke can be identified as part of standard neurologic care that may otherwise have been missed, providing an opportunity to intervene and maximize recovery in stroke patients.
A - 89 Cognitive Evaluation of Suspected Wernicke- Korsakoff’s Encephalopathy in a Woman with Complicated Hyperemesis Gravidarum
Authors: González Marela Firpi , Facchini Ronda , McGinley John , Bronshteyn Diana , Stimmel Marnina , Weiss Erica F 
Published: October 2023

Abstract

Objective
Wernicke-Korsakoff syndrome (WKS) is a neurological disorder caused by the lack of thiamine (vitamin B1) and includes Wernicke encephalopathy and the later stage of Korsakoff amnesic syndrome. WKS could be secondary to malnutrition, including Hyperemesis Gravidarum (HEG), which is characterized by severe vomiting during pregnancy. We present a case of HEG resulting in suspected WKS where neuropsychological evaluation clarified cognitive status with complex cultural, language, and educational factors.

Method
Repeat evaluations of a 29-year-old West-African* woman with mental status change, decreased verbal output, agitation, and inability to walk in the context of HEG. Initially referred for inpatient neuropsychological evaluation at 21 weeks gestation. MRI demonstrated mild diffuse cerebral atrophy and symmetric foci of T2 FLAIR hyperintensities in periaqueductal gray matter, hypothalamus, bilateral thalami, perirolandic cortex, and bilateral mammillary bodies.

Results
Initial inpatient testing with a face-to-face language congruent interpreter demonstrated notable multidomain impairment. Possible Intellectual Disability was considered by the referring team and test performances. Attempts at re-evaluation were limited by medical complications and prolonged hospitalization. Repeat inpatient evaluation 5 months later following birth of healthy child and initiation of stimulant medication, demonstrated profound memory impairment but otherwise improved cognitive capacity and engagement. Results aided in discharge planning including cognitive remediation with goal of improving functional independence.

Conclusions
Wernicke-Korsakoff syndrome due to Hyperemesis Gravidarum is an uncommon but known complication that can have profound acute and long-term consequences. This case demonstrates that repeat neuropsychological evaluations can clarify cognitive status in complex medical/cultural/language situations. *(country of origin and primary language not provided for patient privacy).
A - 99 Older Adult Male with Idiopathic Normal Pressure Hydrocephalus (iNPH): Neuropsychological Case Study
Authors: Kim Doyen , Kearns Kelly A 
Published: October 2023

Abstract

Objective
Idiopathic normal pressure hydrocephalous (iNPH) is a potentially reversible syndrome characterized by ventriculomegaly. Parkinsonism is an often-overlooked clinical feature of iNPH. Mostile et al. (2022) argued that the diagnostic iNPH “triad” should be reconsidered as a “tetrad” including parkinsonism. This case will discuss iNPH presenting with parkinsonism. Patient is an 81-year-old male with a history of iNPH with Hakim’s triad. His medical history includes hyperlipidemia, hypertension, deep vein thrombosis, benign prostatic hyperplasia, total knee replacement, and chronic depression. Presenting concerns were continued cognitive and gait impairments.

Method
Patient was referred from his physiatrist for evaluation of his cognitive functioning and assistance with discharge planning in an acute inpatient rehabilitation hospital. Patient was neuropsychologically evaluated to clarify the etiology of his cognitive presentation.

Results
Patient’s cognitive profile was impaired in areas of attention, executive functioning, processing speed, visuoperception, and displayed a subcortical memory profile. Patient had intact functioning in areas of oral reading, naming, and working memory. Motor examination was evident for apraxia, task-specific tremor, and micrographia.

Conclusions
This case report provides additive findings for common presentation of iNPH including parkinsonism presenting with comorbid psychiatric and medical confounders, highlighting the need for further research on neuropsychological profile of iNPH post shunt procedure. It also accentuates the need to accept parkinsonism as one of the common presentations of iNPH. Akinesia has been reported in nearly 70% of iNPH cases (Krauss et al, 1997), with bradykinesia and postural instability being the main parkinsonian features. Asymmetry and resting tremor were seen to be uncommon (Molde et al., 2017).
A - 114 Long Term Cognitive Sequela of Intracranial Radiation Therapy in a Pediatric Cerebellar Medulloblastoma Survivor
Authors: Strebler Pelin , Schmitt Andrew 
Published: October 2023

Abstract

Objective
Intracranial radiation therapy (IRT) for pediatric brain tumors is associated with late delayed brain injury due to cerebrovascular abnormality, white matter necrosis, demyelination, and gliosis which are irreversible. As a result, persistent cognitive deficits in adulthood emerge which are aggravated by younger age at diagnosis, higher radiation dose, whole brain radiation (WBR), and concurrent chemotherapy. The case is a childhood brain tumor survivor seen 18 years post treatment who displayed cognitive deficits reflecting the cognitive sequela of WBR that overlapped with the anatomical distribution of white matter damage sustained.

Method
23-year-old Black male with a history of childhood cerebellar medulloblastoma diagnosed at age 4, tumor resection, WBR, chemotherapy, more recent seizure disorder and medullary stroke, diabetes, and hypertension was seen for a neuropsychological evaluation due to memory complaints. His neuroimaging showed white matter hyperintensities in bilateral temporal and occipital lobes, bilateral cerebellar hemispheres, bilateral frontal lobes, medial posterior right cerebellar cyst, and 10 x 5 mm cyst in the left temporal lobe.

Results
Results showed FSIQ = 59 and deficits in language, processing speed, visuospatial abilities, executive functioning, and verbal memory. His auditory working memory and visual memory were preserved. Based on his numerous adaptive limitations, moderate intellectual development disorder diagnosis was given.

Conclusions
Deficits across several cognitive domains were consistent with multi-focal white matter lesions seen in patient’s neuroimaging which reflect radiographic findings related to long-term sequela of previous intracranial radiation. A unique finding was relatively preserved visual memory as findings related to asymmetrical memory dysfunction in childhood medulloblastoma survivors are scarce.