Journal of the International Neuropsychological Society最新文献

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.

Objective: The entorhinal cortex (EC) is the first cortical region affected by tau pathology in Alzheimer's disease (AD), but its functions remain unclear. The EC is thought to support memory binding, which can be tested using the Visual Short-Term Memory Binding Test (VSTMBT). We aimed to test whether VSTMBT performance can identify individuals with preclinical AD before noticeable episodic memory impairment and whether these performances are related to amyloid (Aβ) pathology and/or EC tau burden.

Methods: Ninety-four participants underwent the VSTMBT (including a shape-only condition (SOC) and a shape-color binding condition (SCBC)), standard neuropsychological assessment including the Preclinical Alzheimer Cognitive Composite (PACC5), an Aβ status examination, a 3D-T1 MRI and a [¹⁸F]-MK-6240 tau-PET scan. Participants were classified as follows: 54 Aβ-negative cognitively normal (Aβ - CN), 22 Aβ-positive CN (Aβ + CN, preclinical AD), and 18 Aβ + individuals with Mild Cognitive Impairment (Aβ + MCI, prodromal AD).

Results: Aβ + CN individuals performed worse than Aβ-CN participants in the SCBC while the SOC only distinguished Aβ - CN from MCI participants. The SCBC performance was predicted by tau burden in the EC after adjusting for Aβ, white matter hypointensities, inferior temporal cortex (ITC) tau burden, age, sex, and education. The SCBC was more sensitive than the PACC5 in identifying CN individuals with a positive tau-PET scan.

Conclusion: Impaired visual short-term memory binding performance was evident from the preclinical stage of sporadic AD and related to tau pathology in the EC, suggesting that SCBC performance could detect early tau pathology in the EC among CN individuals.

Objective: Significant gaps remain in our knowledge of cognitive aging in Hispanic adults, the largest and fastest-growing minority group in the United States (U.S.). Episodic autobiographical memory (EAM), which has well documented age-related differences, has not been directly examined in older U.S. Hispanic adults - a population that is commonly bilingual. This study aimed to examine the effects of Spanish-English bilingualism and aging on EAM among Hispanic adults.

Methods: In the present study 100 young and middle-aged/older Hispanic adults (50 English-Spanish bilingual Hispanic participants and 50 monolingual English-speaking Hispanic participants) narrated EAMs in a structured interview. We assessed these narratives for episodic and non-episodic details using an established scoring protocol.

Results: We replicated the commonly observed age-related decrease in episodic detail generation among Hispanic participants, with non-episodic detail not significantly differing between young and older Hispanic participants. Among young Hispanic participants, bilingualism was associated with higher episodic, but not non-episodic, detail generation. This bilingualism advantage for episodic detail, however, was not evident among older Hispanic participants.

Conclusions: These results underscore the complex interplay between bilingualism and age in autobiographical memory for events among Hispanic adults. Our study highlights the importance of including diverse racial/ethnic and linguistic samples in cognitive aging research to better understand how bilingualism and cultural factors influence memory across the lifespan.

Objective: The aim of this study was to investigate sensorimotor functions that require cerebellar processing, and visuospatial perception and visuospatial abilities in adult patients with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).

Method: We included patients with unmedicated ADHD (n = 52), medicated ADHD (n = 39), ASD (n = 33), the combination of unmedicated ADHD and ASD (n = 31) and controls (n = 78). A multimodal set of neurocognitive tests and motor tasks were administrated to evaluate cognitive and motor skills.

Results: All patient groups exhibited significantly worse performances than controls in sensorimotor functions, visuospatial perception, and visuospatial abilities. We observed significant associations between sensorimotor functions and visuospatial perception and visuospatial abilities. We conducted a regression analysis to evaluate the impact of potential confounders on neurocognitive outcomes. The results indicated that age, level of education, and insomnia, but not anxiety or depression, affected the performance on some tests.

Conclusions: Our results reveal deficits in sensorimotor functions, visuospatial perception, and visuospatial abilities in patients with neuropsychiatric disorders. Clear deficits emerged, despite the majority of patients showing a mild degree of severity index of ADHD/ASD across all groups (61-84%). The results are consistent with the idea that these disorders are linked to cerebellar deficits. Our results suggest that these objective tests have the potential to enhance clinical evaluations.

Background: Deficits in Executive Function (EF) and Theory of Mind (ToM) are common and significant in attention deficit hyperactivity disorder (ADHD), impacting self-regulation and social interaction. The nature of ToM deficits is believed to be partially associated with preexisting deficits in other core cognitive domains of ADHD, such as EF, which are essential for making mental inferences, especially complex ones. Evaluating these associations at a meta-analytic level is relevant.

Objective: To conduct a systematic literature review followed by a meta-analysis to identify potential associations between EF and ToM among individuals with ADHD and their healthy counterparts, considering different developmental stages.

Method: A systematic review was conducted in seven different databases. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale. The meta-analytic measurement was estimated with the correlation coefficient as the outcome. Due to the presence of heterogeneity, a random-effects model was adopted. Independent meta-analyses were conducted for different EF subdomains and ADHD and healthy control groups. Subgroup analyses were performed to examine the influence of age on the outcome of interest.

Results: Fifteen studies were analyzed. Moderate associations were found when comparing EF and ToM between individuals with ADHD (0.20-0.38) and healthy subjects (0.02-0.40). No significant differences were found between child and adult samples (p > 0.20).

Conclusion: The association between EF and ToM was significant, with a moderate effect size, although no significant differences were found according to age, the presence of ADHD, or EF subdomains. Future research is suggested to expand the age groups and overcome the methodological limitations indicated in this review.

Objective: The National Institutes of Health (NIH) Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (EXAMINER) is a validated laptop-based battery of executive functioning tests. A modified tablet version of the EXAMINER was developed on the UCSF Tablet-based Cognitive Assessment Tool (TabCAT-EXAMINER). Here we describe the battery and investigate the reliability and validity of a composite score.

Methods: A diagnostically heterogeneous sample of 2135 individuals (mean age = 65.58, SD = 16.07), including controls and participants with a variety of neurodegenerative syndromes, completed the TabCAT-EXAMINER. A composite score was developed using confirmatory factor analysis and item response theory. Validity was evaluated via linear regressions that tested associations with neuropsychological tests, demographics, clinical diagnosis, and disease severity. Replicability of cross-sectional results was tested in a separate sample of participants (n = 342) recruited from a frontotemporal dementia study. As this separate sample also collected longitudinal TabCAT-EXAMINER measures, we additionally assessed test-retest reliability and associations between baseline disease severity and changes in TabCAT-EXAMINER scores.

Results: The TabCAT-EXAMINER score was normally distributed, demonstrated high test-retest reliability, and was associated in the expected directions with independent tests of executive functioning, demographics, disease severity, and diagnosis. Greater baseline disease severity was associated with more rapid longitudinal TabCAT-EXAMINER decline.

Conclusions: The TabCAT-EXAMINER is a tablet-based executive functioning battery developed for observational research and clinical trials. Performance can be summarized as a single composite score, and results of this study support its reliability and validity in cognitive aging and neurodegenerative disease cohorts.

Objective: To document the evolution of subjective cognitive functioning over four years in adults hospitalized after traumatic brain injury (TBI), comparing mild and moderate-severe TBI, and accounting for sociodemographic and clinical factors.

Method: This secondary analysis of a longitudinal observational cohort study includes 222 adult participants hospitalized following a TBI (mean age = 41 ± 15 years; 29% women; 65% mild, 35% moderate-severe TBI). Data were collected via in-person/telephone interview and self-report questionnaires administered 4, 8, 12, 24, 36, and 48 months post-TBI. The primary outcome measure for subjective cognitive functioning was the Medical Outcomes Study Cognitive Functioning Scale (MOS-COG).

Results: Mixed model analyses revealed a significant Time effect, with post hoc tests showing a better perceived cognitive functioning on the MOS-COG at 4 months than at 24 and 36 months after TBI. The TBI severity effect and TBI severity*Time interaction were not significant. Secondary effects revealed that poorer subjective cognitive functioning was associated with higher levels of symptoms of depression, anxiety, insomnia, and fatigue, and lower quality of life. Overall, the MOS-Cog score was about one standard deviation below the normative mean, suggesting greater cognitive complaints than in the general population, regardless of injury severity.

Conclusions: The results suggest that subjective cognitive functioning is poorer than normative values and fairly stable over four years after TBI, with a slight decrease between 4 and 24-36 months, and is similar between mild and moderate-severe TBI.

Objective: Familiarity, the sense of knowing without recalling specific details, plays a critical role in memory processing and is mediated by the perirhinal cortex (PRC), a brain region that is critical for differentiating objects with high feature overlap, and is affected first by amnestic mild cognitive impairment (aMCI). Investigating familiarity in aMCI is crucial for insights into early diagnostic markers of cognitive impairment.

Method: We conducted two studies probing familiarity in aMCI. The first study employed a response deadline procedure (RDP) where participants were presented with pictures of objects and then completed an item recognition test under two deadlines: a long deadline of 5000 ms, indexing recollection, and a short deadline of 1200ms, indexing familiarity. The second study utilized a frequency judgment (FJ) task in which participants saw pictures of highly similar objects a variable number of times, and then were asked how many times each object was presented. Their frequency judgments were correlated with the actual presentation frequencies as a measure of familiarity.

Results: In the RDP, individuals with aMCI had significantly lower recognition accuracy than healthy counterparts, in the long and short deadline, indicating impaired recollection and familiarity. In the FJ task, individuals with aMCI had significantly lower frequency judgment correlations, indicating impaired familiarity.

Discussion: These results highlight the importance of minimizing the role of recollection when aiming to understand familiarity deficits and underscore the potential of familiarity as an early diagnostic marker of cognitive decline.

Objective: To examine the association of posttraumatic headache (PTH) type with postconcussive symptoms (PCS), pain intensity, and fluid cognitive function across recovery after pediatric concussion.

Methods: This prospective, longitudinal study recruited children (aged 8-16.99 years) within 24 hours of sustaining a concussion or mild orthopedic injury (OI) from two pediatric hospital emergency departments. Based on parent-proxy ratings of pre- and postinjury headache, children were classified as concussion with no PTH (n = 18), new PTH (n = 43), worse PTH (n = 58), or non-worsening chronic PTH (n = 19), and children with OI with no PTH (n = 58). Children and parents rated PCS and children rated pain intensity weekly up to 6 months. Children completed computerized testing of fluid cognition 10 days, 3 months, and 6- months postinjury. Mixed effects models compared groups across time on PCS, pain intensity, and cognition, controlling for preinjury scores and covariates.

Results: Group differences in PCS decreased over time. Cognitive and somatic PCS were higher in new, chronic, and worse PTH relative to no PTH (up to 8 weeks postinjury; d = 0.34 to 0.87 when significant) and OI (up to 5 weeks postinjury; d = 0.30 to 1.28 when significant). Pain intensity did not differ by group but declined with time postinjury. Fluid cognition was lower across time in chronic PTH versus no PTH (d = -0.76) and OI (d = -0.61) and in new PTH versus no PTH (d = -0.51).

Conclusions: Onset of PTH was associated with worse PCS up to 8 weeks after pediatric concussion. Chronic PTH and new PTH were associated with moderately poorer fluid cognitive functioning up to 6 months postinjury. Pain declined over time regardless of PTH type.