Journal of the International Neuropsychological Society最新文献

Objective: Diagnosing HIV-Associated Neurocognitive Disorders (HAND) requires attributing neurocognitive impairment and functional decline at least partly to HIV-related brain effects. Depressive symptom severity, whether attributable to HIV or not, may influence self-reported functioning. We examined longitudinal relationships among objective global cognition, depressive symptom severity, and self-reported everyday functioning in people with HIV (PWH).

Methods: Longitudinal data from 894 PWH were collected at a university-based research center (2002-2016). Participants completed self-report measures of everyday functioning to assess both dependence in instrumental activities of daily living (IADL) and subjective cognitive difficulties at each visit, along with depressive symptom severity (BDI-II). Multilevel modeling examined within- and between-person predictors of self-reported everyday functioning outcomes.

Results: Participants averaged 6 visits over 5 years. Multilevel regression showed a significant interaction between visit-specific global cognitive performance and mean depression symptom severity on likelihood of dependence in IADL (p = 0.04), such that within-person association between worse cognition and greater likelihood of IADL dependence was strongest among individuals with lower mean depressive symptom severity. In contrast, participants with higher mean depressive symptom severity had higher likelihoods of IADL dependence regardless of cognition. Multilevel modelling of subjective cognitive difficulties showed no significant interaction between global cognition and mean depressive symptom severity (p > 0.05).

Conclusions: The findings indicate a link between cognitive abilities and IADL dependence in PWH with low to moderate depressive symptoms. However, those with higher depressive symptoms severity report IADL dependence regardless of cognitive status. This is clinically significant because everyday functioning is measured through self-report rather than performance-based assessments.

Objective: The cognitive trajectory of aging individuals with childhood-onset epilepsy is poorly understood. Our aim was to examine cognitive change over a 7-year period in aging individuals with epilepsy, originally recruited for prospective follow up in the early 1960's.

Method: 36 participants with childhood-onset epilepsy from a prospective population-based cohort and 39 controls participated in the 50-year and 57-year follow-up data collections. Eight participants had active epilepsy, 28 were in remission. Eleven neuropsychological tests were used to measure language/semantic function, episodic memory and learning, executive function, visuomotor function, and working memory. Regression-based standardized change scores were used to control for sources of error in test-retest assessments.

Results: Participants with epilepsy lacked a test-retest effect in language functions. A significant decline was found in participants with active epilepsy in episodic memory functions overall, and in those with remitted epilepsy in learning, immediate recall and set-shifting. The risk of clinically significant general cognitive decline was higher in participants with active epilepsy (OR 61.25, 95% CI 5.92-633.81, p = .0006). Among those with remitted epilepsy the risk was lower and non-significant (OR 2.19, 95% CI 0.58-8.23, p = .24).

Conclusions: Our results demonstrate poorer cognitive trajectories in participants with childhood-onset epilepsy compared to controls, particularly in those with active epilepsy. The risk of general cognitive decline was lower in participants with remitted epilepsy, but a decline in episodic memory functions was observed. Our findings likely reflect faster brain aging in childhood-onset epilepsy, even in individuals with early remission.

Objective: To examine the relationship between children's adaptive functioning and neighborhood resources - such as school quality, access to healthy food, green spaces, and housing quality - using a large, diverse clinical outpatient sample.

Method: Pediatric outpatients (N = 6,942; age M = 10.44 years; 67.0% male; 50.3% White; 33.9% Medicaid), aged 1-18, who underwent neuropsychological or psychological evaluation were included if their caregiver completed the Adaptive Behavior Assessment System, 3rd Edition (ABAS-3) and had a nationally normed Child Opportunity Index (COI) score, a composite measure of 29 geo-coded neighborhood characteristics.

Results: Children from higher-opportunity neighborhoods demonstrated significantly stronger adaptive functioning across conceptual, social, and practical domains. Those in the top 40% of neighborhood advantage exhibited stronger adaptive skills than those in the bottom 60%. Neighborhood resources and family financial resources were associated with greater adaptive skills beyond child age, sex, and racial/ethnic background.

Conclusion: Neighborhood resources are linked to children's adaptive functioning, possibly due to increased opportunities to practice these skills in safer, more supportive environments. These findings emphasize the importance of considering environmental factors in assessing adaptive skills and highlight the need for public health investments and legislation related to community resources.

Objective: Despite advances in antiretroviral treatment (ART), human immunodeficiency virus (HIV) can detrimentally affect everyday functioning. Neurocognitive impairment (NCI) and current depression are common in people with HIV (PWH) and can contribute to poor functional outcomes, but potential synergies between the two conditions are less understood. Thus, the present study aimed to compare the independent and combined effects of NCI and depression on everyday functioning in PWH. We predicted worse functional outcomes with comorbid NCI and depression than either condition alone.

Methods: PWH enrolled at the UCSD HIV Neurobehavioral Research Program were assessed for neuropsychological performance, depression severity (≤minimal, mild, moderate, or severe; Beck Depression Inventory-II), and self-reported everyday functioning.

Results: Participants were 1,973 PWH (79% male; 66% racial/ethnic minority; Age: M = 48.6; Education: M = 13.0, 66% AIDS; 82% on ART; 42% with NCI; 35% BDI>13). ANCOVA models found effects of NCI and depression symptom severity on all functional outcomes (ps < .0001). With NCI and depression severity included in the same model, both remained significant (ps < .0001), although the effects of each were attenuated, and yielded better model fit parameters (i.e., lower AIC values) than models with only NCI or only depression.

Conclusions: Consistent with prior literature, NCI and depression had independent effects on everyday functioning in PWH. There was also evidence for combined effects of NCI and depression, such that their comorbidity had a greater impact on functioning than either alone. Our results have implications for informing future interventions to target common, comorbid NCI and depressed mood in PWH and thus reduce HIV-related health disparities.

Objective: This study aims to investigate action language processing abilities in Parkinson's disease (PD) compared to healthy controls (HCs), specifically examining whether the involvement of motor systems is influenced by task context. By focusing on implicit versus explicit task demands, the study evaluates how semantic processing differs in PD and whether these differences align with a flexible embodied cognition framework.

Methods: The study analyzed the performance of participants on two tasks: an explicit task (semantic judgment task, SJ) and an implicit task (letter detection task, LD). PD outpatients (n = 31, mean age 64.58 years) referred to the Parkinson and Movement Disorders Unit of ICS Maugeri Hermitage were enrolled, along with a group of healthy controls (n = 31, mean age 64.19 years). Performance was measured through reaction times (RTs) and accuracy scores (Acc) during the processing of action verbs and abstract verbs.

Results: PD patients exhibited slower RTs and lower accuracy when processing action verbs compared to abstract verbs, but only during the SJ task. Slower RTs in the SJ task were predicted by language and executive functioning (semantic fluency) and disease progression (Hoehn and Yahr stages) for both action and abstract verbs. In the LD task, slower RTs were predicted by executive functioning for action verbs and attention (measured by Trail Making Test Part B and Stroop task) for abstract verbs.

Conclusions: The findings suggest a context-dependent involvement of the motor system in action language processing, supporting a flexible, embodied approach to conceptual semantic processing rather than an automatic one.

Objective: Interoception is crucial for emotional processing. It relies on the bidirectional connections between the insula, a crucial structure in interoception, and the frontal lobe, which is implicated in emotional experiences. Acquired frontal brain injury often leads to emotional disorders. Our goal was to explore the interoceptive profiles of patients with frontal lesions with or without insular involvement.

Method: Given the neuroanatomical links between interoception and emotions, we conducted a systematic Preferred Reporting Items for Systematic Reviews and Meta-analyses guided review of studies assessing at least one dimension of interoception in adults with acquired frontal injuries, with or without associated insular lesions.

Results: Seven articles were included. The review indicated that interoceptive accuracy declines after frontal injuries. The two studies that investigated interoceptive sensitivity found lower scores in patient groups. Finally, inconsistent results were found for interoceptive metacognition after frontal damage.

Conclusions: This review is the first to explore interoceptive disorders after acquired frontal brain injury. The findings reveal deficits in cardiac interoceptive accuracy and interoceptive sensitivity following frontal damage. Inconsistent results were observed for interoceptive metacognition. Further research is needed to confirm the presence of interoceptive deficits following a frontal lesion. Additionally, the relationship between interoceptive deficits and emotional disorders, often reported after frontal brain injury, should be investigated.

Objective: Cognitive impairment is a common feature of multiple sclerosis (MS), and its severity may be influenced by several factors, such as biological sex and levels of cognitive reserve (CR). The relationship between sex, CR, and cognition has not yet been fully investigated. Therefore, the present study aimed to explore sex differences in CR building and the effect of sex and CR on cognitive performance in MS.

Method: 233 participants underwent the Brief Repeatable Battery of Neuropsychological Tests (BRB-N), the Stroop test, and the Cognitive Reserve Scale. The t-test was performed to compare sociodemographic variables, Italian adaptation of the Cognitive Reserve Scale, and cognitive test scores between sexes. To evaluate the effect of CR and sex and their interaction on cognitive performance several models of multivariate analyses of covariance were performed (dependent variables: all subtests of Brief Repeatable Battery of Neuropsychological Tests and Stroop scores; independent variables: sex and CR). Covariates included age, Expanded Disability Status Scale, and BDI-II scores.

Results: Women showed higher levels of CR, particularly in daily activities (t = -5.848, p<.001), hobbies (t = -2.591, p = .010), and social life (t = -2.362, p = .011). Sex differences were noted in verbal memory and fluency (with women outperforming men) and processing speed (with men performing better than women). Multivariate analyses revealed a nonsignificant interaction between CR and sex on cognition (Λ=.950, F_(10,260)=.813, p = .617, η_p² = .050).

Conclusions: CR and sex seemed to affect cognitive performance independently in pwMS. This highlights the importance of considering both factors in cognitive assessment, and that both sexes may benefit from specific psychoeducational training aimed at increasing CR levels.

Objective: Cognitive impairment is prevalent, disabling, and poorly managed in multiple sclerosis (MS). Physical activity, often expressed as steps/day, has been associated with cognitive function in this population. This brief report examined the possibility of a (1) steps/day threshold associated with absence of cognitive impairment or (2) dose-response relationship between steps/day and cognitive function in MS.

Method: The sample included 358 persons with MS who provided demographic (age, sex, race) and clinical (MS type, disease duration, disability status) information, and completed the Symbol Digit Modalities Test (SDMT) and California Verbal Learning Test-Second Edition (CVLT-II). Participants wore an ActiGraph GT3X+ accelerometer above the non-dominant hip during waking hours of the day over a 7-day period for measuring steps/day.

Results: The receiver operating characteristic (ROC) curve analysis did not identify a steps/day threshold associated with cognitive impairment on SDMT (area under the curve [AUC] ranged between 0.606 and 0.691). The ROC curve analysis further did not identify a threshold of steps/day associated with cognitive impairment based on CVLT-II (AUC range 0.606 to 0.691). The regression analysis indicated significant linear relationships between steps/day and SDMT (R² = .06; β=.251; p < .001) and CVLT-II (R² = .06; β=.247; p < .001) z-scores.

Conclusion: The observed linear relationship suggests that focusing on increasing steps/day across all levels of physical activity might have benefits for cognitive function in MS.

Objective: Post-traumatic stress disorder (PTSD) and hypertension are highly prevalent among Veterans. Cognitive dispersion, indicating within-person variability across neuropsychological measures at one time point, is associated with increased risk of dementia. We examined interactive effects of PTSD symptom severity and hypertension on cognitive dispersion among older Veterans.

Methods: We included 128 Vietnam-era Veterans from the Department of Defense-Alzheimer's Disease Neuroimaging Initiative (DoD-ADNI) with a history of PTSD. Regression models examined interactions between PTSD symptom severity and hypertension on cognitive dispersion (defined as the intraindividual standard deviation across eight cognitive measures) adjusting for demographics and comorbid vascular risk factors.

Results: There was an interaction between PTSD symptom severity and hypertension on cognitive dispersion (p = .026) but not on mean cognitive performance (p = .543). Greater PTSD symptom severity was associated with higher cognitive dispersion among those with hypertension (p = .002), but not among those without hypertension (p = .531). Results remained similar after adjusting for mean cognitive performance.

Conclusions: Findings suggest, among older Veterans with PTSD, those with both hypertension and more severe PTSD symptoms may be at greater risk for cognitive difficulties. Further, cognitive dispersion may be a useful marker of subtle cognitive difficulties. Future research should examine these associations longitudinally and in a diverse sample.