bluuebunny/crossref_metadata_2025_split huggingface dataset:
43 Symptoms of Apathy in Older Adults with Multiple Sclerosis
Authors: Cote Sarah E. , Holtzer Roee 
Published: December 2023

Objective:Multiple sclerosis (MS) is a chronic neurodegenerative autoimmune disease of the central nervous system. Apathy is significantly higher in adults with MS compared to healthy populations. Apathy is a lack of motivation that can cause dysfunctions in each step of goal-directed behaviors. Apathy is associated with diminished ability to perform activities of daily living, tasks requiring normal executive function, and quality of life. Across various neurodegenerative disorders, apathy has been regarded as a predictor of poor cognition and functional outcomes. However, the severity of apathy and its association with cognitive function in older adults with MS have not been reported. This study's objective was to address this gap of knowledge. Hence, we evaluated: 1) the severity of apathy symptoms in older adults with MS compared to healthy older adults and, 2) the association of apathy symptoms and global cognitive functioning in older adults with MS compared to controls.Participants and Methods:Participants were community-residing older adults (age >60ys) enrolled in a cohort study, “Brain Predictors of Mobility and Falls in Older Adults with Multiple Sclerosis.” Healthy controls (n=59; mean age=66.25± 3.37; %female=47.5) and persons with MS (n=69; mean age=64.58± 3.88; %female=62.3) were included in the analysis. Using McDonald criteria, MS diagnosis was physician-confirmed by medical record review, apathy symptoms were assessed through 4 apathy symptom questions on the 30-item Geriatric Depression Scale (GDS), and global cognitive functioning was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Covariates included age, gender, years of education, global health score (GHS), and depression (GDS w/out apathy questions). For the first objective, a linear regression model was used with a bi-level group status variable (MS vs controls) serving as a predictor of apathy symptoms. For the second objective, two linear regression models stratified by group status were run with apathy symptoms as a predictor of global cognitive functioning.Results:The presence of MS was significantly associated with worse apathy (β=.34, p < .001) and it remained significant after adjusting for covariates (β=.19, p=.03). Additionally, apathy was negatively associated with global cognition in persons with MS (β=-.32, p =.01) and this association remained significant after adjusting for covariates (β=-.33, p =.01) except depression (β=-.27, p =.08). The association of apathy and global cognitive functioning was not significant in healthy controls (β=.01, p=.95).Conclusions:This study is the first to report worse apathy symptoms in older persons with MS compared to healthy controls. Additionally, worse apathy symptoms were associated lower global cognitive functioning in older adults with MS but not in healthy controls.
47 Evolution of Brain Morphology and Cognitive Performance in Parkinson’s Disease with Impulse Control Disorder
Authors: Patru Adina Lorena , Ronat Lucas , Hanganu Alexandru 
Published: December 2023

Objective:Parkinson’s disease (PD) affects the person’s quality of life, but the comorbidity of PD and impulsive control disorder (ICD), which has an average prevalence of 23%, can enhance the disruption of quality of life for the patients and their caregivers. The effects of ICD in PD on brain morphology and cognition have been little studied. Thus, this study proposes to investigate the differences in the evolution of cognitive performance and brain structures between PD patients with ICD (PD-ICD) vs. without ICD (PD-no-ICD).Participants and Methods:Parkinson’s Progression Markers Initiative (PPMI) data of 58 patients with idiopathic PD, including their MRI data at baseline and three years later, were analyzed. The MRIs were processed with FreeSurfer (7.1.1) to extract cortical volumes, areas, thicknesses, curvatures and folding index as well as volumes of subcortical segmentations. All participants underwent cognitive evaluations. The Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease was used to differentiate those with at least one ICD from those without any ICD. 12 of the 58 patients had an ICD at their first visit and 19 had an ICD at their visit three years later. There was no significant difference between PD-ICD and PD-no-ICD with respect to sex, use of overall medication, age, age of onset, age at diagnosis, years of education and the Montreal cognitive assessment score. Two-way mixed ANOVAs were performed for each neuropsychological test and brain structure extracted from MRIs with the time of the visit as the repeated independent variable (within participants) and the presence or absence of an ICD as the other independent variable (between participants).Results:The mixed ANOVA revealed that PD-ICD had their performance decline after three years, for the Hopkins Verbal Learning Test delayed recall and the Symbol Digit Modalities Test while PD-no-ICD saw their performance increase. A whole brain analysis showed that PD-ICD had a significant decrease after three years of the right cortex area total brain volume in comparison to PD-no-ICD. Specific brain structures also underwent significant changes over three years. Cortical changes in PD-ICD were: (1) increased surface area in the left temporal parahippocampus and (2) decreased surface areas of the right insula, right middle and superior temporal regions, left occipital lingual as well as left cingulate isthmus. Furthermore, in the subcortical nuclei, PD-ICD showed (1) increased volumes of the paratenial thalamic nucleus and whole right amygdala and (2) decreased volumes of the right amygdalian basal nucleus and thalamic ventromedial nucleus.Conclusions:This study suggests that PD patients who also have ICD might be prone to develop over three years: (1) significant changes in cognitive performance (memory, attention), (2) morphological changes in the amygdala and thalamic nuclei and (3) significant atrophy and area shrinkage in the temporal and insula regions.
55 Tracking Cognitive Change in Huntington’s Disease with the Mini Mental State Exam and the Montreal Cognitive Assessment
Authors: Churchill Emma G , Culbert Braden , Smirnova Anna , Hughes Shelby , Snell Chase , Hall Andrew , Bohall Lauren , Ashraf Easha , Wright Brenton A. , Gilbert Paul , Corey-Bloom Jody 
Published: December 2023

Objective:To assess the utility of the Mini Mental State Exam (MMSE) and Montreal Cognitive Assessment (MoCA) for tracking cognitive changes Huntington’s Disease.Participants and Methods:Currently, the most frequently used brief assessment of global cognitive functioning is the MMSE. Although the MMSE is helpful for distinguishing individuals without significant cognitive impairment from those with dementia, it is not particularly sensitive to more subtle cognitive deficits. The MoCA is another brief cognitive screening tool that has been shown to be more sensitive to mild impairment and may have greater usefulness in subcortical dementias because of its more extensive assessment of executive function. Although the MoCA appears to have high sensitivity and specificity in a variety of neurological populations, there is currently little known about its efficacy in tracking cognitive decline in individuals with HD. We used a mixed effects model to analyze MMSE and MoCA scores collected prospectively during 5 years of follow-up for 163 patients with HD seen at one academic HDSA Center of Excellence. Baseline mean age for the HD cohort was 51.35 years, mean education 14.46 years, and a mean CAG repeat length 43.95. Mean follow-up time was 3.33 years.Results:Mean MMSE and MoCA scores at baseline were 25.13 (SD=1.66) and 22.76 (SD=3.70) respectively. At baseline, age and gender were not associated with MMSE and MoCA scores, while years of education were. Neither age nor gender predicted rate of decline for the MoCA while years of education predicted rate of decline for the MMSE. For the MMSE, each year of education predicted on average 0.51 points higher score at enrollment; for the MoCA, each year of education predicted on average 0.79 points higher score at enrollment. The mean rates of decline on the MMSE was 0.48 points per year (p<.001) while that on the MoCA was only 0.31 points annually (p<.001) in the first five years of observation.Conclusions:The MMSE and MoCA decline significantly over time in an unselected HD population. The smaller rate of decline in the MoCA may be due, in part, to the greater variability in baseline, MoCA (SD=3.70) vs MMSE (SD=1.66) scores in our HD cohort. Unlike cortical dementias, such as Alzheimer’s disease (AD), where declines of 2-3 points per year have been described for the MMSE and MoCA, much lower annual rates of decline have been reported in subcortical dementias such as Parkinson’s disease. To our knowledge, this is the first report of rate of cognitive decline on the MMSE and MoCA in HD: such information is vital for adequately preparing patients and families for future needs, in addition to planning for interventional/treatment trials in HD.
61 Factors Affecting Executive Functioning in Patients with Parkinson’s Disease
Authors: Focht Kristen N , Lyon Abigail C 
Published: December 2023

Objective:Parkinson’s disease (PD) is one of the most prevalent neurodegenerative conditions that leads to progressive degeneration in areas of the brain that control movement. As the disease progresses, cognition is also frequently affected, primarily executive functioning. Multiple factors may be involved in the relationship between PD and cognitive dysfunction. This study seeks to determine the association between disease duration (i.e., years since PD diagnosis), vascular comorbidities, and cognitive reserve (CR) and their relationship with executive functioning, in a clinic-referred PD population.Participants and Methods:Participants included English-speaking subjects with a diagnosis of PD made by the patient’s treating neurologist (i.e., movement disorders specialist) who received their neurological care and had undergone a comprehensive neuropsychological evaluation at Thomas Jefferson University Hospital in Philadelphia, PA over the past five years. The sample consists of 67 patients. Comprehensive medical and psychiatric histories were obtained, and individuals with severe psychopathology (e.g., bipolar disorder or schizophrenia), medical or other neurological disorders (e.g., seizure disorder, stroke, documented head injury that was more severe than a mild TBI or intracranial bleeding) that could account entirely for cognitive impairment were excluded. An overall domain score of executive functioning was calculated by averaging each participant’s T-scores for the individual neuropsychological tests. Regression analysis was utilized to explore the relationship between number of vascular comorbidities, disease duration, and CR, as measured by a composite of formal education and literacy level, with executive functioning performance on neuropsychological testing for this sample.Results:The model explains 12.1% of the variance of executive functioning performance (F (3, 66) = 2.883, p = 0.043). A significant positive relationship was found between CR and executive functioning (b = .335, p = 0.008). No significant relationships were found between vascular comorbidities or disease duration with executive functioning. The relationship between CR and each neuropsychological measure was explored independently using Pearson correlation (2-tailed). Significant positive correlations were found between CR and WAIS-IV or WASI-II Similarities (r = .49, p < .001), CR and WAIS-IV or WASI-II Matrix Reasoning (r = .46, p = .001), and CR and FAS (r = .26, p = .037). No significant relationships were found between CR and TMT-B (r = .07, p = .565) or CR and Stroop Color and Word Interference (r = .17, p = .240).Conclusions:Results suggest that CR may be a better predictor of executive functioning in patients with PD than number of vascular comorbidities or disease duration. Stronger premorbid cognitive functioning and better cognitive efficiency may be neuroprotective and stave off cognitive decline in Parkinson’s disease.
71 Sleep Quality and Measures of Attention and Learning in Middle-Aged Adults
Authors: Thompson Jennifer L , Kneissler Casey J , Tucker Jacob D , Ahmed Fayeza S 
Published: December 2023

Objective:Sleep has been shown to directly impact cognitive function throughout the lifespan; good quality sleep benefits and improves cognitive function, including processing speed and attention, while poor quality sleep can contribute to negative cognitive outcomes1. In particular, attention, learning, and memory have been demonstrated to be sensitive to sleeping changes, including fragmentation and restriction2. Subjective sleeping scales are utilized in both research and clinical practice, allowing sleep to be measured via self-report on various domains, including duration and factors that can contribute to sleep disruption and disturbances3. This study aims to examine the possible relation between subjective sleep quality and cognitive function among middle-aged adults to inform future research for early interventions of modifiable behaviors that can contribute to abnormal cognitive decline.Participants and Methods:Data for this analysis is part of the preliminary results of an ongoing pilot study. 29 middle-aged (40-65 years, inclusive), cognitively unimpaired individuals were recruited from the community. Subjective sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Attention and memory were measured using the California Verbal Learning Test, Third Edition (CVLT-III).Results:Multiple hierarchical regression analyses were conducted to evaluate if aspects of sleep quality were significantly correlated to complex attention and learning performance in this sample. First, correlation amylases showed significant relationships between PSQI Component 6 (Use of Sleeping Medication) and Trials 1 to 2 Learning Slope (R2 = -0.56, p =0.002) and CVLT-III Trials 1 through 5 Recall Discriminability (R2 = -0.42, p = 0.02), each with significant regression analyses outcomes (b =0.42, p = 0.04 and b = -0.46, p = 0.04, respectively). There were other variables that were found to be significantly correlated; however, after adjusting for relevant demographic variables (age, education, sex), the hierarchical regression analyses revealed no association between the aforementioned variables.Conclusions:While multiple aspects of sleep quality were expected to influence measures of attention and learning, only PSQI Component 6 was found to be statistically significantly associated with only two learning variables. Limitations of this study included a small sample size which was limited to cognitive and relatively physically healthy middle-aged adults. Further, sleep quality was measured with one subjective measure and no objective data was collected to support the hypotheses. Future analysis is needed to continue to explore the relation between subjective sleep quality and cognitive outcomes. As this is an ongoing study, we look forward to exploring this research question in more detail as the study progresses.
2 The Vietnamese Montreal Cognitive Assessment: An Evaluation of Construct Validity and Recommended Cut-off for Cognitive Impairment after TBI
Authors: Quang Halle , Nguyen Ashley , Do Cardinal , McDonald Skye , Nguyen Chris 
Published: December 2023

Objective:Cognitive screening tools such as the Montreal Cognitive Assessment (MoCA) play an essential role in the clinical evaluation of neuropsychological functions. Despite the extensive investigations of the MoCA in English speaking countries as well as emerging adaptation work in a few Asian cultures, evidence base for the utility of the Vietnamese MoCA (MoCA-V) is lacking. This has posed a huge challenge for current and future clinical practice in Vietnam, as the country continues to assume a large burden of brain-related disorders. This study examined the construct validity of the MoCA-V and identified a cut-off score for the determination of cognitive impairment in a prevalent neurological condition in Vietnam - traumatic brain injury (TBI).Participants and Methods:Participants included 129 neurologically healthy individuals and 80 patients with moderate-to-severe TBI. All participants completed the MoCA-V, along with other common neurocognitive measures such as the Trail Making Test (TMT) Parts A and B, Vietnamese Verbal Fluency Test, and Digit Span.Results:Pearson’s correlations revealed significant, moderate correlations between performance on the MoCA-V subdomains and more comprehensive cognitive measures. Performance on the MoCA-V Attention domain was correlated with both Digit Span Forward, r(110) = .453, p < .001] and Digit Span Backward, r(110) = .303, p = .001; performance on the MoCA Language domain was correlated with the Vietnamese Verbal Fluency Test, r(107) = .334, p < .001; and performance on the MoCA Executive Function domain was correlated with the TMT-B, r(108) = -.479, p = .022. Performance on the MoCA-V was also associated with age, r(127) = -.659, p < .001, and education, r(127) = .769, p < .001, consistent with the general effects of age and education in cognitive abilities. Finally, a cut-off score of 22.5 was identified for the detection of cognitive impairment in Vietnamese people with TBI (AUC = 0.811; 95% CI = .75-.87, p < .001).Conclusions:This study provides the first evidence for the construct validity and clinical utility of the MoCA-V. Future research is necessary to cross-validate study findings among other clinical populations. Lessons learned from neuropsychological test translation and adaptation process will be discussed, particularly in the development of the administration materials and test instructions (e.g., considerations for individuals with limited formal education, influences of colonialism in the development of test stimuli).
37 Clinical utility of the BEARS as a sensitive screener for sleep problems in ADHD.
Authors: Kivisto Lynette R , Casey Joseph E 
Published: December 2023

Objective:Many children and adolescents do not achieve adequate sleep durations. The prevalence of sleep problems has been estimated at 7% for typically developing children (Corkum, Tannock, & Moldofsky, 1998) and as high as 45% for representative samples of children, including participants with various diagnoses in proportion to what would be expected in the population (Sher-Fen Gau, 2006). For children with ADHD, the prevalence of sleep problems has been estimated at between 25-50% (Corkum, Tannock, & Moldofsky, 1998). Given the important role that sleep plays in children with ADHD, a brief and effective screener is needed to aid clinicians in assessing for sleep problems, especially when the referral for a neuropsychological evaluation concerns ADHD or any other neurodevelopmental disorder for which presenting concerns involve symptoms that overlap with ADHD. While the developers of the BEARS have demonstrated its utility as a screening tool, there is currently no independent published research replicating this finding. The current study aimed to replicate the findings of the BEARS developers by demonstrating its utility as a sensitive screening tool for sleep problems. It was predicted that the BEARS would demonstrate high sensitivity in identifying children with sleep problems.Participants and Methods:Data from 54 school aged children (aged 6-147-13, Mage = 9.83) was analysed. Children were administered the BEARS, and caregivers completed the BEARS and Children's Sleep Habits Questionnaire (CSHQ), as part of a larger study.Results:Binomial logistic regression model was statistically significant, x2(2) = 20.508, p < .0005. The model explained 46.8% (Nagelkerke R2) of the variance and correctly classified 70.8% of cases. Sensitivity was 78.6%, specificity was 60.0%, positive predictive value was 73.3%, and negative predictive value was 66.7%. Both predictor variables, parent reported BEARS (p = .001) and child-reported BEARS (p = .049), were significant. Children with higher BEARS parent report scores had 3.27 times higher odds, and those with higher self-report scores had 2.88 times higher odds, of exceeding the CSHQ cut-off than those with lower scores. ROC curve analysis revealed that the BEARS parent and self-report scores had excellent diagnostic utility (Hosmer et al., 2013) for accurately classifying children who exceeded the cut-off on the CSHQ from those who did not (area under the curve [AUC] = 0.849, SE = 0.054, 95% CI = .742 to .956, p < .001).Conclusions:The results of the current study indicate that the BEARS has excellent diagnostic utility for accurately classifying sleep problems. Additionally, it is quick to administer making it a practical screening tool for clinicians to include as part of a comprehensive neuropsychological assessment.
4 Assessing Visuospatial Skills in Parkinson’s Disease Using the Identi-Fi
Authors: Teti AnneMarie , Thompson Ryan C. , Moncrief Grant G. , Roth Robert M. 
Published: December 2023

Objective:Patients with Parkinson’s disease (PD) commonly show deficits on tests of visuospatial functioning. The Identi-Fi is a new measure of visual organization and recognition composed of two components. The Visual Recognition (VR) subtest asks persons to identify an object that has been broken its pieces and rearranged, akin to the Hooper Visual Organization Test, but using updated and colorful pictures. The Visual Matching (VM) subtest involves showing the same stimuli, but the examinee must select the correct response from among five choices (1 correct and 4 foils), placing greater demand on visuospatial discrimination. Together, the two subtests comprise the Visual Organization Index (VOI), reflecting overall visual processing and organization ability. The present study examined performance on the Identi-Fi in patients with PD and its association with other aspects of cognition.Participants and Methods:Participants were 23 patients with PD (95% male; mean age = 69.7 years [SD = 7.8], range = 47-79) and 12 patients with cognitive concerns (CC) who were intact on neuropsychological testing (excluding consideration of Identi-Fi scores; 50% male, mean age = 71.08 [SD = 6.27], range = 60-78) seen for a neuropsychological evaluation at a large Northeastern medical center. As part of a larger battery, patients completed the Identi-Fi, Trail Making Test (TMT), Category Fluency, Test of Premorbid Functioning (TOPF), and Brief Visuospatial Memory Test, Revised (BVMT-R).Results:The PD group performed significantly worse than the CC group on VR and VM, as well as VOI, of the Identi-Fi (p < .001). Within the PD group, poorer VR, VM, and VOI performance was associated with lower scores on the TOPF (p < .05), BVMT-R learning (p < .05) and delayed recall (p < .05), as well as TMT Parts A and B (p < .05). VR was significantly correlated with Category Fluency (p < .05), while a trend was seen for the association between VOI and Category Fluency (p = .094).Conclusions:Identi-Fi performance was worse in the PD group than the CC group, which is consistent with prior research indicating that visuospatial processing is often abnormal in patients with PD. Furthermore, findings indicate that poorer performance on the Identi-Fi in the PD group is associated with poorer cognitive functioning in other domains (i.e., visuospatial learning and memory, processing speed, cognitive flexibility, and semantic fluency), as well as lower premorbid intellectual functioning. While these findings suggest that the Identi-Fi is useful in identifying visuospatial dysfunction in PD, findings should be interpreted with caution given the small sample sizes and uneven gender distribution