Neuropsychology最新文献

Objective: The Memory Binding Test (MBT) shows promise in detecting early cognitive changes associated with Alzheimer's disease (AD). This study assesses the psychometric properties (i.e., construct and criterion validity, test-retest reliability) of the MBT and its sensitivity to incipient disease and incident cognitive impairment.

Method: One hundred forty-nine cognitively unimpaired adults ages 45-85 completed the MBT and neuropsychological tests at baseline; 132 returned for 2-year follow-up. Based on neuroradiological ratings of amyloid positron emission tomography and MRI markers at baseline, they were categorized as healthy (n = 94) or having preclinical disease (n = 55, either on the AD continuum or having non-AD pathologic change). Construct validity was assessed by the associations between MBT scores, demographics, and neuropsychological scores within the healthy group. Criterion validity was assessed by testing how MBT scores correlate with AD biomarkers, differ and discriminate between groups at baseline, and predict incident cognitive impairment.

Results: MBT scores decreased with age and were strongly associated with memory and global cognition. MBT scores were largely not associated with amyloid, hippocampal volume, or AD signature cortical volume but related to white matter lesion volume in those with preclinical disease. The preclinical groups performed worse on MBT immediate free recall at baseline than the healthy group, but no scores predicted incident cognitive impairment at follow-up. Most scores demonstrated modest test-retest reliability.

Conclusions: This study demonstrates that the MBT has adequate construct validity in cognitively unimpaired adults, moderate sensitivity to preclinical disease cross-sectionally, and limited prognostic utility. Careful consideration of demographic influences on score interpretation remains necessary. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Children with attention-deficit/hyperactivity disorder (ADHD) exhibit difficulties with organizational skills such as task planning, managing materials, and organizing activities that have downstream consequences on academic functioning. At the same time, deficits in working memory have been linked with both the organizational skills difficulties and academic underachievement and underperformance observed in children with ADHD and have been hypothesized to account for the link between organizational and academic functioning. However, the extent to which working memory and organizational skills independently versus jointly contribute to ADHD-related academic difficulties remains unclear.

Method: The present study is the first to examine the unique and shared roles of working memory and organizational skills for explaining ADHD-related underachievement and underperformance in a clinically evaluated sample of 309 children with and without ADHD (M_age = 10.34, SD = 1.42; 123 girls; 69.6% White Not Hispanic or Latino).

Results: Bias-corrected, bootstrapped latent path analyses revealed that working memory and organizational skills together accounted for 100% of the academic achievement (d = -1.09) and 80.6% of the academic performance (d = -0.58) difficulties exhibited by children with ADHD. Working memory (d = -0.95 to -0.26), organizational skills (d = -0.30 to -0.11), and shared variance across working memory and organizational skills (d = -0.13 to -0.06) each independently predicted ADHD-related difficulties in both academic achievement and performance outcomes.

Conclusions: These findings are consistent with models suggesting that working memory has downstream consequences for functional impairments in ADHD, as well as evidence that organizational skills and working memory are each important predictors of ADHD-related academic functioning. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: We aimed to examine the association of childhood motor difficulties (MD) with cognitive impairment in midlife.

Method: We studied 357 participants from a cohort born in 1971-1975. At age 9, they had completed the Test of Motor Impairment, which classified them into three groups: childhood MD (cMD), borderline cMD (bcMD), or no cMD. Participants with attention-deficit/hyperactivity disorder were excluded. At age 40, participants comprised 18 (5.0%) with cMD, 43 (12.0%) with bcMD, and 296 (82.9%) with no cMD. They underwent neuropsychological assessment covering six domains: executive functions, processing speed, attention and working memory, learning and memory, verbal symbolic abilities, and visuoperceptual and visuospatial abilities. A participant was considered to have an impairment if their performance was in the 15th percentile of a normative group.

Results: Participants with cMD were more likely than those with no cMD to have an impairment in executive functions (OR = 6.73, p < .01), processing speed (OR = 3.85, p < .05), attention and working memory (OR = 4.79, p < .01), and a cross-domain impairment (OR = 3.62, p < .01). These differences remained significant after adjusting for parents' occupation, sex, and low birth weight and after multiple imputation. No consistent difference emerged between participants with bcMD and no cMD.

Conclusions: Childhood MD are associated with midlife cognitive impairment, which underscores their long-term implications. In the neuropsychological assessment of an adult patient, information on childhood motor development is of value. The assessment may help adapt the patient's physical or occupational therapy to the patient's cognitive profile. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Intra-Individual Cognitive Variability (IICV) is an emerging clinical tool that has shown promise in predicting cognitive decline and dementia incidence. The present study aims to assess the predictive validity of IICV in remote cognitive screening tests, using nationally representative data.

Method: Two waves of cognitive and diagnostic data from the Health and Retirement Study (collected in 2010 and 2012) were utilized to investigate whether baseline IICV can predict cognitive decline and dementia pathology. Middle-aged and older adults who were cognitively intact and completed all cognitive tests at both baseline and follow-up were recruited in the study, resulting in a sample of 6,050 participants. With the coefficient of variation method, the IICV-dispersion was calculated based on cognitive screeners to predict follow-up mean cognitive performance, global cognition, suspected cognitive impairment, and self-reported dementia diagnosis.

Results: After accounting for demographics, depressive symptoms, and baseline cognitive performance, the results provide support for the predictive validity of IICV. Specifically, the study demonstrated that IICV-dispersion significantly predicted cognitive and diagnostic outcomes in a concave pattern where the prediction was more sensitive toward the higher end of IICV. IICV explained about 0.2%-2.3% of the variance of outcomes variables.

Conclusions: IICV retrieved from cognitive screening tests in telemedicine settings offers insight into future cognitive functioning and neurocognitive diagnostic status, which can be cost-effective and reduce the burden on both patients and health care providers, especially benefitting individuals with low socioeconomic status and rural residents. Potential avenues for future research were also discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Posttraumatic stress disorder (PTSD) has been linked to deficits in executive functioning, but the literature suggests these associations are inconsistent. Results vary depending on the task used, test modality, and the specific subdomain being measured, such as inhibitory control (interference resolution, response inhibition) or set shifting (task switching, rule switching). Notably, deficits are more consistently observed in computerized tasks that measure precise reaction times (RTs) than in classic paper-and-pencil measures, but few studies have parsed specific executive functioning deficits in PTSD using detailed analyses of RT data.

Method: The present study used a cued-switching Stroop Task to examine both interference resolution and task switching in 28 veterans with PTSD and 28 age-matched controls. Each trial required attending to a randomly presented cue and responding to the specified target while ignoring irrelevant or opposing information. Analyses of RT distributions estimated both Gaussian (normal) and ex-Gaussian (exponential) parameters.

Results: Veterans with PTSD had slower and more variable RTs than the controls on trials that required ignoring conflicting information (interference resolution, d' = .68). These effects were confined to the normal distribution, not to excessively slow responses (as estimated by ex-Gaussian parameters). Veterans with PTSD also showed modestly slower RTs on trials that required switching between cues, but Bayesian evidence for this was weak, and measures by ex-Gaussian parameters were not significant.

Conclusions: These results highlight the importance of examining executive functioning in PTSD with a more nuanced approach, as clarity around these deficits may have important implications for future intervention and rehabilitation strategies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Temporal lobe epilepsy can disturb eloquent areas, affecting language. We applied a visually-mediated task to measure lateralization of language recognition in drug-resistant temporal lobe epilepsy.

Method: Patients with left (n = 26), right (n = 28) temporal lobe epilepsy and controls (n = 30) were administered the translingual lexical decision task. We performed repeated measures analyses of variance, with the visual half-field as an intrasubject factor and the group as an intersubject factor.

Results: A main effect of visual half-field was found, showing the right visual field (left hemisphere) advantage for both accuracy and response time. A main effect of the group was found in accuracy, showing that both epilepsy groups performed less accurately than controls, and left temporal lobe epilepsy performed less accurately than right temporal lobe epilepsy. Also, the group-by-visual half-field interaction was significant. Post hoc t tests indicated the controls and right temporal lobe epilepsy performed better in the right visual field than in the left visual field, whereas no visual half-field effect was found in left temporal lobe epilepsy. For response times, the interaction was also significant. Post hoc t tests showed a significant right visual-field advantage for controls (two-tailed) and for the right temporal lobe epilepsy (one-tailed). Right visual-field advantage was absent in left temporal lobe epilepsy.

Conclusions: The translingual lexical decision task can efficiently distinguish between left and right temporal lobe epilepsy. Compared to right temporal lobe epilepsy and controls, language lateralization is diminished in left temporal lobe epilepsy. The potential use of the translingual lexical decision task as an effective noninvasive presurgical language lateralization screening tool is highlighted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Women with a fragile X premutation (PM) self-report higher rates of attention difficulties than women without a PM; however, results of studies using objective measures of attention are inconsistent. The present study assessed whether intrasubject variability during a sustained attention task better predicted functional outcomes in women with a PM than the previously published standard reaction time and accuracy variables.

Method: We analyzed continuous performance test, a computerized measure of sustained attention, and the Conners' Adult Attention-Deficit/Hyperactivity Disorder Rating Scale Report (CAARS) data from 273 women with a PM and 175 women without a PM aged 18-50 years. Separate analyses using Pearson correlations and independent t tests were performed on the full range of coefficient of variation (CV) of reaction time scores and the subset of scores that showed higher variability.

Results: Performance variability of sustained attention measured by the continuous performance test was associated with functional outcomes measured by the CAARS in women with a PM but not women without a PM. Specifically, the CV in those with higher variability was correlated with two CAARS subscale scores (p = .006). Independent t tests showed significant differences in CV between CAARS scores dichotomized for the presence of subclinical symptoms for two subscales (p ≤ .001-.007). Correlation between the full range of CV scores and the CAARS Inattention/Memory Problems subscale approached significance (p = .012).

Conclusions: Findings highlight the importance of including intrasubject variability in analyzing attention in clinical populations as a more sensitive objective measure associated with reported symptoms and to assist in predicting functional outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Assessment of cognition in American Indians poses challenges, including barriers to healthcare, unvalidated clinical standards, and confounding social determinants of health. Alternative strategies for case identification include algorithmic methods, which can outperform clinical judgment in some circumstances.

Method: Algorithmic methods can be maximized using single-domain tests with multiple-serial trial tasks, such as the California Verbal Learning Test II-Short Form (CVLT-SF). We collected CVLT-SF and detailed clinical data, including dementia gold standard by consensus adjudication, in 818 American Indians aged 65-95 in 2010-2013 and repeated in 403 returning participants in 2017-2019 (mean follow-up 6.7 years, range: 4-9). Our algorithm categorized CVLT-SF scores into four memory deficit categories: none, encoding, storage, and retrieval.

Results: At Visit 1, 75.4% had no memory deficit, 15.6% encoding deficit, 3.5% storage deficit, and 5.5% retrieval deficit. At Visit 2, comparable percentages were 68.7%, 10.6%, 6.5%, and 14.2% (respectively). The majority with any deficit at Visit 1-especially encoding-were lost to follow-up by Visit 2. Most with deficits at Visit 2 were newly categorized from those previously intact. The performance of our memory algorithm, compared with adjudication for dementia, was moderately good: correct classification 69%, sensitivity 51%, and specificity 91%.

Conclusions: These descriptive findings encompass a novel contribution in defining memory impairment among American Indians from a single cognitive test. However, more work is needed to improve the sensitivity of this algorithm and maximize its utility for case identification over conventional methods. Altogether, these data provide an important step toward better cognitive characterization and dementia care for an understudied, underserved population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: This study describes trajectories of cognitive aging among American Indian/Alaskan Native (AI/AN) adults with and without HIV and the role of immunosenescence longitudinally.

Method: We characterized trajectories of cognitive aging in a sample of 333 AI/AN and 309 non-Hispanic White (NHW) adults who were followed longitudinally for up to 20 years by the HIV Neurobehavioral Research Program (HNRP) across six U.S. research sites. We used growth curve modeling with autoregressive Lag-1 structures and heterogeneous residual variances to assess the role of ethnoracial identity and HIV grouping upon decline in trajectories of cognitive aging.

Results: HIV- AI/AN adults demonstrated earlier and steeper decline in normative trajectories of cognitive aging on tasks of processing speed, timed tasks of attention/working memory, executive function, and psychomotor speed in comparison to HIV- NHW adults. Accentuated trajectories of cognitive aging were evident in both HIV+ and HIV+ immunosuppressed groups in comparison to HIV- peers and were primarily driven by the role of immunosenescence.

Conclusions: AI/AN disparities in trajectories of cognitive aging are evident and are likely explained by the interplay of biopsychosociocultural factors, including immunosenescence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Numerous nonpharmacological treatments (NPTs) have been developed for older adults with mild cognitive impairment (MCI). Two forms of cognition-focused NPTs, cognitive rehabilitation (CR) and cognitive training (CT), demonstrate cognitive benefit, but limitations remain regarding the contribution of cultural and demographic factors to study outcome heterogeneity, generalizability to diverse populations, and feasibility. This article aimed to review demographic and culturally informed NPTs and provides recommendations for culturally informed clinical practice and research.

Method: We conducted a PubMed review to identify CR and CT interventions that incorporated cultural adaptations. Results from the review, combined with the authors' clinical expertise, were used to identify methodological, demographic, social, cultural, and systemic variables relevant to NPTs.

Results: Existing CR and CT studies that included cultural adaptations adopted modifications to language, measures (cognition, function), and lifestyle factors (diet, physical activity) among others. In addition, provider, patient, and group-level factors were then raised to promote inclusivity and increase NPT generalizability. Nevertheless, there is a paucity of research considering cultural and demographic factors when delivering cognition-focused NPTs. Recommendations were generated that incorporated current literature as well as the authors' clinical and research experiences.

Conclusions: Culturally informed NPTs are understudied. Social, demographic, and cultural factors may contribute to the heterogeneity of outcomes, lack of generalizability of findings to diverse groups, and application of intervention to said groups. Several tools are available and can focus on broadening collection of information regarding patients' identities, social network, adapting to literacy level and linguistic diversity needs, and responding to social and structural determinants of health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).