bluuebunny/crossref_metadata_2025_split huggingface dataset:
A - 156 History of Mild Traumatic Brain Injury Is Not Associated with worse Neuropsychological Functioning in Amnestic Mild Cognitive Impairment
Authors: Neaves Stephanie , Helphrey Jessica , Cabrera Hannah , Lacritz Laura , Schaffert Jeff , Smernoff Eric , Logan Rebecca , Nguyen Trung , Khera Alka , Hart John , Cullum C Munro , LoBue Christian 
Published: October 2023

Abstract

Objective
The mechanisms for traumatic brain injury (TBI) being a risk factor for Alzheimer’s disease is unclear, and whether mild TBI (mTBI) may relate to decreased neural circuit functioning in the prodromal phase is unknown. This study examined whether a history of mTBI was associated with lower functioning of neural circuits, measured with neuropsychological tasks, in amnestic Mild Cognitive Impairment (aMCI).

Method
Twenty older adults (MAge = 71 years; 70% Male; 90% White) with aMCI were recruited to complete a detailed TBI interview and were classified based on the presence (mTBI+ n = 13) or absence (mTBI- n = 7) of past mTBI. Most mTBI+ participants (n = 11) had multiple mTBIs, and on average were 32 years from last injury. A comprehensive neuropsychological assessment was administered, and composite T-scores were calculated for the domains of attention, executive functioning, memory, and language. One-tailed T-tests were conducted to compare the means between groups.

Results
No statistically significant differences (p’s = 0.06–0.09) were found between the groups in memory (mTBI+ M = 38.11; mTBI- M = 33.19), executive function (mTBI+ M = 48.79; mTBI- M = 43.09), language (mTBI+ M = 48.12; mTBI- M = 43.09), or attention (mTBI+ M = 40.54; mTBI- M = 35.57). Nonetheless, medium effect sizes were seen for the mTBI+ group performing better than the mTBI- group on all composite scores (Cohen’s d = 0.45–0.66).

Conclusions
A history of mTBI was not associated with poorer neuropsychological performance in aMCI, often a prodromal stage of Alzheimer’s disease. While concerns about later-in-life effects from multiple mTBIs is prevalent, repetitive mTBI may not be related to lower neural circuit functioning in aMCI, though further evaluation with larger samples is needed.
A - 157 Neurobehavioral Symptoms in Veterans with Deployment-Related TBI: Examining the Additional Impact of Pre- and Post-Deployment Tbis
Authors: Ozturk Erin , Yim Jaelynn , Chanfreau-Coffinier Catherine , Merritt Victoria 
Published: October 2023

Abstract

Objective
We utilized a large sample of Veterans who had sustained a traumatic brain injury (TBI) during deployment to evaluate the additional impact of pre- and post-deployment TBI’s on neurobehavioral symptoms.

Method
Participants included 9934 Veterans (90.9% male; age: M = 34.5) diagnosed with TBI during the Veterans Health Administration’s Comprehensive Traumatic Brain Injury Evaluation (CTBIE), a clinician-administered interview that includes an assessment of pre-, during-, and post-deployment TBI. The Neurobehavioral Symptom Inventory (NSI) is administered as part of the CTBIE, from which five subscale scores were evaluated: vestibular, somatic/sensory, cognitive, affective symptoms, and symptom interference. Chi-square tests evaluated the relationship between TBI group (“TBI during deployment only” [n = 6886]; “pre-deployment TBI” [n = 1835]; “post-deployment TBI” [n = 775]; “both pre/post-deployment TBI” [n = 438]) and NSI subscale scores (dichotomized into high vs. low symptoms).

Results
There was a significant association between TBI status and all five symptom scores (p’s ≤ 0.001; V = 0.04–0.06). The “post-deployment TBI” group endorsed the highest rates of symptoms across all NSI scores except vestibular. Pairwise comparisons showed that the “post-deployment TBI” and “both pre/post-deployment TBI” groups endorsed comparable rates of symptoms, while both groups generally endorsed higher rates of symptoms compared to the “pre-deployment TBI” and “TBI during deployment only” groups. Finally, rates of symptoms among these latter groups (pre-deployment and during deployment) did not differ from each other.

Conclusions
Results suggest that post-deployment TBI’s have a greater impact on symptom endorsement than pre-deployment TBI’s. Findings highlight the importance of evaluating both number and timing of TBI’s and the value of providing psychoeducation around brain health to this population.
A - 158 The Effects of Migraine and Traumatic Brain Injury on Subjective Cognitive Functioning in Veterans in the Million Veteran Program
Authors: Ozturk Erin , Merritt Victoria , Afari Niloofar , Gasperi Marianna 
Published: October 2023

Abstract

Objective
The relationship between migraine and cognitive symptoms in Veterans is a complex issue, made more challenging by the high prevalence of traumatic brain injury (TBI) in this population. This study examined the relationship between migraine, TBI, and subjective cognitive function.

Method
Participants included 338,217 Veterans enrolled in the Million Veteran Program who completed the Medical Outcomes Study Cognitive Functioning Scale Revised (MOS-Cog-R), a self-report measure of cognitive functioning. Veterans were categorized into the following groups: (1) both migraine and TBI history (n = 7828), (2) migraine-only (n = 22,252), (3) TBI-only (n = 24,078), and (4) no history of migraine or TBI (n = 284,059). MOS-Cog-R scales were compared across groups using the Kruskal-Wallis Test for omnibus differences and Dunn’s test and Cliff’s Delta for effect size calculations of differences between groups.

Results
The migraine/TBI group reported the highest prevalence of cognitive symptoms across all domains (range: 76.1% for confusion to 90.5% for forgetfulness). In contrast, the no migraine/TBI group had the lowest prevalence of cognitive problems (range: 32.0% for confusion to 63.7% for forgetfulness). All omnibus group differences were statistically significant (p &lt; 0.001), and nearly all pairwise comparisons were significant, except for some of the migraine-only vs. TBI-only group comparisons.

Conclusion
Results showed a “dose–response” relationship between diagnostic group and subjective cognitive symptoms, such that the migraine/TBI group fared the worst, followed by the TBI-only and migraine-only groups, and finally the no migraine/TBI group. Findings set the stage for follow-up work to be conducted within MVP that will address the neurobiological underpinnings of cognitive distress in this population.
A - 159 The Influence of Sleep Duration on Reported Post-Concussion Symptoms Following Cognitive Exertion
Authors: Peart Zachary , Brett Jonathan , Arias Brittny , Bennett Ryan 
Published: October 2023

Abstract

Objective
To investigate the influence of self-reported sleep disturbance on post-concussion symptom clusters after completing the ImPACT concussion screening tool in collegiate athletes.

Method
Participants (N&#3f215) were selected from a deidentified sports medicine ImPACT database. Participants were stratified into groups based on self-reported sleep disturbance: intact sleep duration (n = 150, Mage = 19.2, Medu = 11.8,64.7% female) and hyposomnia (n = 65, Mage = 22.5, Medu = 13.8,72.3% female). Data were included from the first post-injury follow-up session. Groups did not differ in gender, age, or years of education. ANCOVAs were used to test for differences in cognitive, physical, and neuropsychiatric symptom clusters post-ImPACT while controlling for pre-ImPACT symptoms and previous concussions.

Results
ANCOVA indicated a significant effect of sleep duration on cognitive (F(1,192) = 13.01,p &lt; 0.001,ηp2 = 0.063), physical (F(1,154) = 7.29,p = 0.008,ηp2 = 0.045), and neuropsychiatric (F(1,192) = 6.24,p = 0.013,ηp2 = 0.031) symptoms reported after completing the ImPACT screening assessment. Mean comparisons revealed that the hyposomnia group reported symptom scores 1.5 points greater on cognitive (SE = 0.42), 1.4 points greater on physical (SE = 0.52), and 0.78 points greater on neuropsychiatric (SE = 0.31) symptom clusters.

Conclusion
Results indicated that athletes who endorsed sleeping less during concussion recovery reported greater symptom scores after completing cognitive screening when controlling for pre-screening symptoms. These findings align with previous research suggesting that sleep dysfunction may negatively impact the recovery process. Our findings suggest that reduced sleep duration may lead to worsened symptoms following cognitive exertion, thereby exacerbating deficits and potentially lengthening the recovery trajectory. As a result, these athletes may benefit from interventions targeting sleep and a gradual return to sport.
A - 160 Cognition over Time in Chronic sTBI with Non-Neurologic Comorbidities in Residential NeuroRehab
Authors: Pigman Matthew C , West Sarah 
Published: October 2023

Abstract

Objective
Traumatic brain injury has been associated with increased risk of many comorbid neurologic and non-neurologic disorders (Masel & DeWitt, 2010). There is scant literature, however, to describe serial assessment of cognitive changes associated with comorbid non-neurologic disorders and sequelae in patients with chronic, severe traumatic brain injury (sTBI).

Method
A 60-year-old, right-handed, White male sustained an sTBI at age 15 secondary to a motor vehicle collision and subsequently developed behavioral and substance use problems, before being placed in a long-term residential neurorehabilitation program. He later developed kidney disease, believed to be the result of long-term use of anti-epileptic drugs (AEDs) that were prescribed to control seizures that developed following his brain injury. He continued to experience seizures, despite taking AEDs. Staff at his residential program reported concerns of declines in cognition and daily functioning over the past three years.

Results
Compared to results from two previous evaluations performed approximately four and six years prior, he demonstrated reductions in attention and working memory, processing speed, executive functioning, auditory and reading comprehension, and functional living skills. Expressive language, memory, and visuospatial skills were generally consistent with previous evaluations.

Conclusions
Due to significant reductions across multiple cognitive domains, and multiple potential contributing factors, including ongoing seizures, late-stage kidney disease, and a possible superimposed neurodegenerative disorder, it was recommended that the patient continue to undergo serial neurocognitive testing to monitor for further decline and provide etiological clarification. The results were used by his therapists, residential program staff, and neurology providers to inform his treatment planning and care.
A - 161 Acute Injury Characteristics and Cognitive Post-Concussion Symptom Reporting in Collegiate Athletes with Sports-Related Concussion
Authors: Sakamoto McKenna S , Thomas Garrett A , Bradson Megan L , Merritt Victoria C , Arnett Peter A 
Published: October 2023

Abstract

Objective
Surprisingly little is known about how acute injury characteristics (i.e., loss of consciousness [LOC], retrograde amnesia [RA], and anterograde amnesia [AA]) predict cognitive symptom reporting after sports-related concussion (SRC). This study examined this relationship in collegiate athletes who sustained an SRC. We predicted that athletes who endorsed LOC, RA, and AA would report more cognitive symptoms.

Method
141 collegiate athletes who recently sustained an SRC were grouped based on whether they experienced LOC, RA, or AA. Cognitive symptoms were assessed by the cognitive cluster of the Post Concussion Symptoms Scale (PCSS-Cog) both categorically (i.e., presence of symptoms) and continuously (i.e., total score). Chi-square tests investigated group differences on the presence of cognitive symptoms, and independent samples t-tests examined group differences on PCSS-Cog scores.

Results
Athletes who experienced RA were significantly more likely to report cognitive symptoms than those without RA (RA+/PCSS-Cog+ = 62.50%; RA-/PCSS-Cog+ = 40.17%), X2 (1, N = 141) = 4.03, p = 0.045. Similar results were observed for athletes who endorsed AA (AA+/PCSS-Cog+ = 58.82%; AA-/PCSS-Cog+ = 35.56%), X2 (1, N = 141) = 7.15, p = 0.007. There was not a significant relationship between cognitive symptom endorsement and LOC. Athletes who experienced AA had significantly higher PCSS-Cog scores (M = 3.27, SD = 4.60) than those without AA (M = 1.39, SD = 3.04), t(75.22) = 2.62, p = 0.011, 95% CI[0.45, 3.32]. However, there was not a significant relationship between PCSS-Cog scores and LOC or RA.

Conclusions
Results suggest that athletes who experience amnesia during SRC are more likely to report cognitive symptoms post-concussion. Moreover, amnesia may be a risk factor for increased self-reported cognitive dysfunction, and athletes who experience RA and especially AA may require more careful SRC management.
A - 162 Comparing Bilingual and Monolingual Baseline Post-Concussion Symptom Scale Network Structures
Authors: Salva Christine E , Kuwabara Hana C , Goodwin Grace J , Goto Amber , Ross Staci , Kinsora Thomas , Allen Daniel N 
Published: October 2023

Abstract

Objective
Studies comparing Post-Concussion Symptom Scale (PCSS) ratings between bilingual Spanish/English- and monolingual English-speaking athletes have found increased symptom endorsements for bilingual individuals. Conducting network analysis on PCSS scores and comparing network structures between bilingual and monolingual individuals can help characterize possible differences in symptom interactions between these two groups. We conducted baseline PCSS network comparisons between bilingual and monolingual high school athletes to examine differences in symptom interactions.

Method
Bilingual (n = 5201) and monolingual (n = 5201) athletes completed the PCSS in English (matched by age, gender, and sport type). Network analysis was conducted on valid baseline PCSS scores, with nodes representing symptoms and edges representing partial correlations among symptoms. Each symptom’s importance was determined by calculating their expected influence. Network connectivity, structure, and symptoms’ expected influences were compared using Network Comparison Tests.

Results
Both networks had positive and negative edges. The strongest edges connected symptoms within similar domains (i.e., “feeling more emotional” and “sadness”). Node expected influence was stable in both networks. “Feeling more emotional”, “difficulty concentrating”, and “dizziness” were most influential in both networks. The networks did not differ in connectivity, structure, and expected influence.

Conclusions
PCSS network connectivity, structure, and symptom influence do not differ between bilingual and monolingual athletes, suggesting differences do not exist in symptom interactions between groups and likely do not underly observed differences in symptom ratings. Future work should examine whether administration language influences symptom networks.
A - 165 A Pilot Study of an Online Screening Assessment of Lifetime Exposure to Traumatic Brain Injury (TBI)
Authors: Sullivan Karen , Caltabiano Elysia 
Published: October 2023

Abstract

Objective
To conduct a pilot test of the feasibility and validity of administering an online screening measure of lifetime TBI exposure (LTE) and determine associations between LTE and health status.

Method
156 adults were recruited from the general community (Age = 18–65 years; 73% women) most of whom (~70%) were at-risk for TBI, primarily from playing contact-sport (62.2%). TBI exposure was assessed using the Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID) short form. Health status was assessed using the Rivermead Post-concussion Symptoms Questionnaire, the Depression, Anxiety and Stress Scales, and items from the 2014 Ohio Behavioral Risk Factor Surveillance Study. All measures were administered via cross-sectional survey.

Results
Online OSU TBI-ID feasibility was high (e.g., minimal missing data/attrition). With covariates controlled (e.g., TBI risk), there were positive associations between LTE [Worst TBI, Multiple TBIs] and health status (post-concussion symptoms; p’s &lt; 0.05.

Conclusion
Initial support was found for the feasibility and validity of the online OSU TBI-ID. The patterns of associations between online LTE measures and health status were consistent with those reported for non-online methods (e.g., interview). While validation of the online LTE record against clinical records would be ideal, this study suggests that a structured method of assessing LTE can be validly administered online.
A - 167 Neuropsychological Correlates of Challenging Behavior in Moderate to Severe ABI
Authors: West Sarah , McGrath Claire , Buckley Caitlin Ogram 
Published: October 2023

Abstract

Objective
Cognitive and behavioral changes, common after severe acquired brain injury (ABI), are important predictors of functional recovery, independence, and quality of life. The Overt Behavior Scale (OBS) is a standardized measure of challenging behaviors following ABI, and has been associated with pre-injury risk factors and psychosocial stressors. Information about the neuropsychological underpinnings of OBS scores is unknown, however. The current study is a preliminary analysis of relationships among OBS scores and neuropsychological data associated with behavioral dysregulation in adults with chronic moderate to severe ABI in a residential neurorehabilitation setting.

Method
Participants were 81 adults, ages 27–71 (SD = 10.46), 55 males, with average education of 12.6 years, and average time since injury of 26.34 (SD = 13.35). Participants were administered neuropsychological tests (including NAB Screening Module Memory, Executive Functioning, and Attention Index and subtests, NAB Judgment, and Trails B). The OBS was administered by the psychology provider with input from the treatment team.

Results
Exploratory correlations examined the relationship between neuropsychological tests and OBS scores. Results found a significant relationship between the number of challenging behaviors on the OBS and NAB delayed story recall (p &lt; 0.040, r = −0.266). Other correlations between OBS and the NAB and Trails B were not significant.

Conclusions
The results raise the possibility that the OBS captures unique aspects of behavioral change that are not measured by traditional neuropsychological tests. Other possible explanations of the data include that the severity of cognitive impairment and physical limitations may be moderating factors, which will be examined in future studies.
A - 168 Self-Awareness in Survivors of Acquired Brain Injury and the Impact on Family Burden
Authors: Barcenas Caleb , Murthy Joseph , Schaffer Samuel , Klonoff Pamela 
Published: October 2023

Abstract

Objective
Caregiver burden is commonly experienced by family members of survivors of acquired brain injury (ABI). Research has demonstrated that self-awareness of survivors of ABI impacts family member burden (Rubin et al. 2020). This study utilized the discrepancy model of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) to measure self-awareness by calculating a discrepancy score from self and family member-rated MPAI-4 total score. We examined the relationship between family member burden, time since injury, and level of self-awareness of survivors of ABI at discharge following holistic neurorehabilitation.

Method
This retrospective study analyzed data on 28 individuals with heterogeneous ABI’s who participated in a holistic milieu-oriented outpatient neurorehabilitation program from 2020–2023. Demographic information (age, education, race/ethnicity), injury history (injury type, age at injury, chronicity), program variables (length of program participation), functionality (MPAI-4), and family burden (Zarit Burden Interview) at discharge were collected.

Results
A multiple linear regression analysis was run to predict family burden from self-awareness of survivors of ABI and time since injury. The multiple regression model statistically significantly predicted family burden, F(2, 24) = 6.698, p &lt; 0.005, adj. R2 = 0.305. Only self-awareness added statistically significantly to the prediction, p &lt; 0.002. Self-awareness accounted for 33.4% of the variance in family burden.

Conclusion
Among family members of survivors of ABI, self-awareness of the survivor is an important predictor of burden experienced by family. Self-awareness, as measured by utilizing the MPAI-4 discrepancy model, explained a significant proportion of the variance in family burden regardless of time since injury.
A - 169 Efficacy, Retention and Predictors of Response to Treatment of Group Based Remotely Delivered Goal Management Training for Acquired Brain Injury
Authors: Colella Brenda , Meusel Liesel-Ann , Jeffay Eliyas , Sharma Bhanu , Curran Orla , Green Robin 
Published: October 2023

Abstract

Objective
Given the gap in group-based, remotely delivered executive interventions, and the ubiquitousness of executive impairment in acquired brain injury (ABI), we examined: (1) pre-to-post-to-follow-up efficacy of remotely-delivered, group-based Goal Management Training (GMT; a metacognitive, executive intervention) in individuals with neurological disorders in the chronic stages of illness (2) predictors of response to treatment.

Methods
Participants and Protocol. N = 160 adults with ABI &gt;6 months post-diagnosis, participated in this single-group study at the Telerehab Centre for ABI @KITE, University Health Network, Toronto, Canada. GMT – which enhances self-awareness, task engagement and task follow-through - was delivered remotely and in group format to allow scalability, peer-to-peer support, cost-effectiveness, and geographical reach. Primary outcomes. Cognitive Failures Questionnaire (CFQ); Dysexecutive Questionnaire (DEX). Predictors of response to treatment. Demographics (age, education); time since injury; and symptom burden (i.e., cognitive, somatic, and emotional). Linear mixed effects models measured efficacy and predictors of change.

Results
Significant pre/post and pre/follow-up improvements on the CFQ total and “forget”, “false”, and “distract” subscales (95% CI; p = 0.000 all comparisons). Significant pre/post improvements observed for the DEX (95% CI; p = 0.000), but not significant retention. No effects of age, education or time since injury found, indicating generalizability. High symptom burden negatively associated with pre/post and pre/ follow-up improvements on CFQ.

Conclusions
Encouragingly, this group-based, remotely delivered GMT offers promise of efficacy and retention regardless of age, time since injury or educational attainment of patients, and can reach patients regardless of geographic location. Lower response with heavy symptom burden suggests collateral treatment of symptoms may improve treatment response.