Journal of the International Neuropsychological Society最新文献

Objective: Remote videoconference neuropsychological assessments offer opportunities that remain under-exploited. We aimed to evaluate teleneuropsychology (TeleNP)-suitable oral and digital versions of the Symbol Digit Modalities Task (SDMT) and Trail Making Test (TMT) - widely used measures of speed and attention - by comparing them to their written counterparts.

Methods: Three-hundred and twenty-one Australian Epilepsy Project (AEP) adult participants with seizure disorders completed the written SDMT and TMT in-person. One-hundred and forty-four of these participants also completed the oral SDMT and TMT during a remote videoconference-based assessment while 177 completed a novel, examiner-administered digital SDMT analogous measure named Symbol Decoding and a novel digital TMT remotely via custom videoconference-based software.

Results: Oral SDMT and digital Symbol Decoding strongly correlated with in-person written SDMT (r (133) = .77, p < .001 and r (126) = .76, p < .001, respectively). Oral TMT-B was only moderately associated (r (126) = .52, p < .001) with written TMT-B and, less strongly related to measures of sustained attention and spatial working memory than its written counterpart. Digital TMT better reproduced the written test's properties with improved association with written TMT-B (r (154) = .71, p < .001).

Conclusions: Oral SDMT and digital Symbol Decoding are strongly correlated with in-person written SDMT. The digital TMT better captures the cognitive demands and performance characteristics of the in-person written form than does oral TMT. Videoconference-integrated digital tasks offer increased standardization and automation in administration and scoring and the potential for rich metadata, making them an attractive area for further development.

Objective: We evaluated performance-based differences in neuropsychological functioning in older adults (age 65+) across the dementia continuum (cognitively intact, mild cognitive impairment, and dementia) according to recent cannabis use (past six months).

Method: A sample of 540 older adults from a well-characterized observational cohort was included for analysis. Participants completed a standardized questionnaire assessing cannabis use in the six months prior to the study visit and completed a comprehensive neuropsychological assessment. We used traditional cross-sectional analyses (multivariate, univariate) alongside causal inference techniques (propensity score matching [PSM]) to evaluate group differences according to recent cannabis use status. We also examined whether cannabis-related problem severity, a risk factor for cannabis use disorder (CUD), was associated with cognitive outcomes among those reporting recent cannabis use.

Results: Approximately 11% of participants reported using cannabis in the prior six months, with the median user consuming cannabis two to four times per month. Participants with recent cannabis use performed similarly across all five domains of neuropsychological functioning compared to those with no cannabis use. Among older adults reporting recent cannabis use, those with elevated risk for CUD demonstrated lower memory performance.

Conclusions: These preliminary results are broadly consistent with other findings indicating that low-frequency cannabis use among older adults, including those along the dementia continuum, is generally well tolerated from a cognitive perspective. However, among older adults who used cannabis, elevated symptoms of CUD may negatively impact memory performance. Future research should explore how variations in cannabis use patterns, individual characteristics, and clinical phenotypes influence cognitive outcomes.

Objective: Executive dysfunction is prevalent in early stroke and can predict long-term outcomes. Impairments can be subtle and undetected in cognitive stroke screens. To better assess executive functions, this study introduced a novel sentence completion test, which assesses multiple executive processes in <5 minutes (Brief Executive Language Screen - Sentence Completion; BELS-SC). The aim was to determine construct, convergent and divergent validity, sensitivity and specificity of the BELS-SC, and to explore differences between left and right hemisphere stroke patients (LHS and RHS, respectively) on the BELS-SC and standard executive function tests.

Method: Eighty-eight acute/early sub-acute stroke patients and 116 age-matched healthy controls were included.

Results: Principal Component Analysis (PCA) suggested four to five factors of the BELS-SC: Initiation, Selection, Inhibition (with strategy loading on Inhibition), Inhibition Response Time, and Semantic Retrieval Response Time. The BELS-SC had good sensitivity (.84) but poorer specificity (.66) differentiating controls and stroke, and good sensitivity (.83) and specificity (.80) differentiating executive function impaired versus executive function intact groups. BELS-SC Initiation and Inhibition subtests demonstrated convergent and divergent validity with corresponding Hayling subtests. LHS and RHS showed impairment across initiation, selection, inhibition and strategy; however, greatest deficits were shown by RHS on Inhibition items requiring suppression of one dominant response. More patients were impaired on BELS-SC than other executive function tests.

Conclusions: The BELS-SC demonstrated convergent, divergent, and construct validity, good sensitivity and specificity, taps multiple executive processes, and provides insight into strategy. Use in early stroke may aid in targeted and timely cognitive rehabilitation.

Objective: Pediatric cancer survivors are at increased risk for neurocognitive challenges that can impact academic achievement and attainment. Educational supports via accommodations or special education can promote better outcomes for these youth; however, barriers often stand in the way of appropriate supports being implemented. Neuropsychological evaluation reports highlight a child's neurocognitive strengths and needs, but an additional tool to assist parents and educators in understanding the extent to which a child's neurocognitive needs are addressed by their educational supports may help ensure appropriate supports.

Method: The present study piloted a novel neurocognitive needs-to-educational supports alignment rubric in a referred sample of pediatric survivors of cancer, bone marrow transplant, and cancer predisposition syndromes (i.e., neurofibromatosis).

Results: Inter-rater reliability across disciplines was satisfactory. Among school-aged patients who were attending public school (n = 90), mean needs-to-supports alignment was 20.3%, indicating that on average, referred patients were receiving minimal classroom supports addressing identified neurocognitive needs. Among the 42.9% with a formal support plan, proportion of needs met by a support rose to only 47%, indicating that in spite of some recognition of patient needs, supports remain inadequate to the breadth of patient needs.

Conclusions: This alignment tool can assist parents and educators in better tailoring a child's educational supports to meet their needs, serve as a communication tool between healthcare and education teams, and provide a quantitative metric for evaluating educationally focused interventions (e.g., school liaison programming) in youth with a variety of chronic health conditions and developmental disabilities.

Objective: Because of the complexity of Alzheimer's Disease (AD) clinical presentations across bio-psycho-social domains of functioning, data-reduction approaches, such as latent profile analysis (LPA), can be useful for studying profiles rather than individual symptoms. Previous LPA research has resulted in more precise characterization and understanding of patients, better clarity regarding the probability and rate of disease progression, and an empirical approach to identifying those who might benefit most from early intervention. Whereas previous LPA research has revealed useful cognitive, neuropsychiatric, or functional subtypes of patients with AD, no study has identified patient profiles that span the domains of health and functioning and that also include motor and sensory functioning.

Methods: LPA was conducted with data from the Advancing Reliable Measurement in Alzheimer's Disease and cognitive Aging study. Participants were 209 older adults with amnestic mild cognitive impairment (aMCI) or mild dementia of the Alzheimer's type (DAT). LPA indicator variables were from the NIH Toolbox® and included cognitive, emotional, social, motor, and sensory domains of functioning.

Results: The data were best modeled with a 4-profile solution. The latent profiles were most differentiated by indices of social and emotional functioning and least differentiated by motor and sensory function.

Conclusions: These multi-domain patient profiles support and extend previous findings on single-domain profiles and highlight the importance of social and emotional factors for understanding patient experiences of aMCI/DAT. Future research should investigate these profiles further to better understand risk and resilience factors, the stability of these profiles over time, and responses to intervention.

Objective: Healthy sleep contributes to better cognitive functioning in children. This study sought to investigate the role of pre-injury sleep disturbance as a predictor or moderator of cognitive functioning across 6 months post-injury in children with mild traumatic brain injury (mTBI) or orthopedic injury (OI).

Method: Participants were 143 children with mTBI and 74 with OI, aged 8 - 16 years, prospectively recruited from the Emergency Departments of two children's hospitals in Ohio, USA. Parents rated their children's pre-injury sleep retrospectively using the Sleep Disorders Inventory for Students. Children completed the National Institutes of Health (NIH) Toolbox Cognition Battery at 10 days and 3 and 6 months post-injury.

Results: Group differences in both overall performance and reaction time on the Flanker Inhibitory Control and Attention Test varied significantly as a function of the level of pre-injury sleep disturbance as well as time since injury. At the 10 day visit, among children with worse pre-injury sleep, mTBI was associated with slower reaction times relative to OI. Among children with worse pre-injury sleep, those with mTBI improved over time while those with OI did not. Main effects of pre-injury sleep and time since injury were found for several other NIH Toolbox subtests, with poorer performance associated with worse pre-injury sleep and early vs. later timepoints.

Conclusions: These results suggest that pre-existing sleep disturbances and mTBI are jointly associated with poorer executive functioning post-injury. Interventions to improve sleep might help mitigate the effects of mTBI on children's cognitive functioning.

Objective: This systematic review and meta-analysis aimed to review existing measures of subjective cognition during menopause and to estimate the correlation between subjective and objective cognition in perimenopausal and postmenopausal women.

Method: Eligible studies reported scores for at least one subjective and objective measure of cognition for perimenopausal or postmenopausal women. EMBASE, Medline, and PsycINFO were searched for eligible studies on November 22^nd 2024. The risk of bias in individual studies was evaluated using a modified QUADAS-2 form. The results of the review were summarized in narrative form. Studies that reported correlations between subjective and objective cognition were synthesized using a multilevel meta-analysis.

Results: The sample included 5629 participants over 24 studies, including 295 perimenopausal women, 5086 postmenopausal women, and 248 women across mixed peri- and post-menopausal samples. Twelve measures of subjective cognition were used across studies. Six studies were included in the meta-analysis. A small significant correlation was observed between subjective cognition and objective measures of learning efficiency (r = .12; CI = .02 to .23). Correlations across other cognitive domains were non-significant.

Conclusions: Our findings suggest subjective cognition may be associated with performance on measures of learning efficiency, offering a starting point for further research on menopausal brain fog. The present findings highlight the need for a reliable measure of subjective cognitive symptoms associated with menopause. Additionally, a better characterization of the neuropsychological profile of menopausal brain fog is needed to progress research in this field and ultimately improve clinical support for women experiencing these symptoms.

Objective: Developmental Gerstmann's Syndrome (DGS) is a proposed neurological disorder characterized by finger agnosia, acalculia, right-left disorientation, agraphia, and in some cases, constructional dyspraxia. Case studies of DGS are limited, particularly those reporting on assessments in adults. The present case study demonstrates the presence of DGS symptoms in a young female adult with an autoimmune disorder but no clear history of neurological damage.

Method: This client sought academic accommodations for her undergraduate math classes. She was administered a comprehensive neuropsychological assessment, during which she demonstrated difficulties with mathematical concepts, right-left disorientation, inverted writing, mild finger agnosia, andimpairments in fine motor abilities and visual motor coordination.

Results: The client's symptoms were consistent with DGS, though variability in her performance on assessments suggests compensatory strategies she may have developed throughout her life.

Conclusion: Our client demonstrated similarities with previously reported accounts of DGS as assessed in adults. This case proposes further evidence for DGS as a syndrome and presents challenges to assessing DGS in high-functioning adults. The case highlights a need for a standardized testing battery to assess DGS.

Objective: Despite recent attention to the increased risk of cognitive impairment in older adults with essential tremor (ET), there are only limited data on the trajectories of cognitive change in ET or the demographic and motor predictors of such change.

Method: This study included 148 cognitively normal individuals with ET (mean age = 76.7 ± 9.7 years) at baseline and had at least one follow-up evaluation (mean years of observation = 5.2 ± 1.6). Generalized Estimating Equations examined rates of change in six composite cognitive outcomes as a function of time, as well as demographic (age, sex, and education) and motor predictors (tremor severity, age of tremor onset, presence of rest tremor, cranial tremor, intention tremor, tandem gait) of rates of change. Demographics, medication use, and mood symptoms at baseline were covariates for all models.

Results: Participants evidenced a decline in global cognition, executive function, and attention (p _range = <0.001-0.044) over time. Older age predicted faster decline in all cognitive outcomes except attention (p _range =<0.001-0.025). Tremor severity predicted faster decline in executive function (p = 0.011). Rest tremor predicted faster decline in executive function and attention (p = 0.033, 0.017). Tandem gait missteps predicted faster decline in memory and visuospatial ability (p = 0.026, 0.028).

Conclusions: Results point to a dissociation in the predictive value of different motor features for specific aspects of cognitive decline. These results shed light on the earliest manifestations of cognitive impairment in older adults with ET and implicate different pathways by which heterogeneous cognitive changes emerge.

Objective: The ability to efficiently complete everyday tasks was evaluated with a novel, performance-based test called the Virtual Kitchen Challenge (VKC) in college athletes. Analyses focused on the effect of practice and associations between the VKC and conventional measures of cognition.

Method: 81 college athletes with and without self-reported concussion completed conventional cognitive tests and the VKC, a nonimmersive virtual-reality task that requires manipulating virtual objects on a touch screen to prepare a breakfast and lunch under two conditions: 1) Training condition with feedback and 2) Test condition without feedback. VKC performance was scored for completion time, percent of time working on-screen, number of interactions with target and distractor objects. Paired t-tests compared VKC Training and Test conditions, correlations examined relations between VKC performance and cognitive tests.

Results: VKC performance was significantly better after practice, as noted by faster completion time, fewer screen interactions, and a higher proportion of time spent on-screen during Test vs. Training conditions. Interactions with distractors were too infrequent for analyses. Correlations showed VKC Training was associated with episodic memory abilities whereas VKC Test scores were associated with executive function. VKC scores did not differ between participants with versus without concussion.

Conclusions: The VKC is a promising portable performance-based measure of subtle functional difficulties for young, high-functioning participants. The VKC automated scoring makes it highly efficient for large studies and clinical settings.