Clinical Neuropsychologist最新文献

Objective: The values of a field are reflected in the science it publishes. The goal of this study was to present a historical analysis of the extent to which the field of clinical neuropsychology publishes journals with titles that address culture in the context of brain function and behavior between 2010 and 2020.

Methods: Titles from articles published in 13 neuropsychology journals from 2010-2020 were collected and coded with regard to culture and multicultural content. The aims of the study were to (1) determine how often cultural or multicultural topics were represented in journal titles, (2) determine if cultural or multicultural content in neuropsychology journal publication titles increased over time, and (3) to explore other neuropsychological content that was most and least likely to appear in publications pertaining to culture or multicultural issues.

Results: Results indicated that titles for publications in clinical neuropsychology journals with content relevant to cultural or multicultural neuropsychology represented 1.1% to 13.4% of titles across the 13 journals. The number of cultural/multicultural titles increased over time. The number of cultural/multicultural titles per journal was not significantly correlated with the journal impact factor. Normative data were addressed significantly more often in cultural/multicultural titles versus non-cultural/multicultural titles, whereas psychiatric issues were addressed significantly less often.

Conclusions: There are many actions that clinical neuropsychologists can take to increase the field's attention to the effects of culture on brain function and behavior. It is vital to update our data from 2021 to the present, given the substantial increase in awareness of social justice issues that occurred since 2020.

Objective: Stroke represents a primary cause of morbidity and mortality in pregnant and postpartum people. While pregnancy-related stroke has drawn increased attention in certain domains of health research (e.g. obstetrics, neurology), neuropsychology has yet to contribute to this literature. Given neuropsychologists' crucial role in stroke evaluation and rehabilitation efforts, our field is poised to offer insights into this important topic. Method: This review presents facts about pregnancy-related stroke most relevant for neuropsychologists, including epidemiology, risk factors, and mechanisms, alongside clinical considerations and open areas of inquiry. Structured in the format of a traditional neuropsychological evaluation, we walk readers through factors to consider in record review, the clinical interview, and providing feedback and recommendations. Conclusions: Pregnancy-related stroke can be associated with marked functional disability and decreased quality of life, and it is notable that prevalence rates are increasing. Presenting at a time when people are experiencing adjustment to a new phase of life, and most commonly affecting women of color and other vulnerable populations, pregnancy-related stroke is a unique condition warranting special attention within the broader stroke discourse. This review aims to serve as a starting point for neuropsychologists to better understand the unique attributes of pregnancy-related stroke through a neuropsychology lens. Beyond that, it aims to promote broader meaningful discussion of neuropsychology's role in women's health.

Objective: Cognitive, mood, and behavioral changes are common among persons with epilepsy (PWE), resulting in a complex neuropsychological presentation. Women with epilepsy (WWE) represent a distinct cohort within the broader epilepsy population due to sex and gender-specific factors impacting epilepsy semiology and treatment. However, unique neuropsychological profiles among WWE have not been established. This narrative review aims to further define neuropsychological correlates in WWE and promote meaningful discussion related to enhancing the provision of neuropsychological care within this clinical population. Method: Current literature in PWE examining differences in cognitive function, mental health, and quality of life (QoL) between women and men was critically reviewed, emphasizing considerations for neuropsychological practice. Results: WWE demonstrate a preservation of verbal learning and memory compared to men both pre- and post-surgically, with sex-based, neurobiological mechanisms likely contributing to this association. WWE also have elevated risk for affective disorder psychopathology, suicidality, and traumatic experiences. Epidemiology related to psychotic and bipolar spectrum disorders is less clear, and findings are mixed regarding sex-specific behavioral side effects of antiseizure and psychotropic medication. Finally, hormonal and obstetric factors are highlighted as important contributors to neuropsychological symptoms in WWE, with elevated risk for low QoL and increased stigma associated with greater medical and psychiatric comorbidities compared to men. Conclusions: While emerging literature has begun to characterize the neuropsychological presentation of WWE, future research is needed to define sex and gender differences in neuropsychological sequalae among PWE to ensure consistency and quality of care for WWE.

Objective: Gulf War Illness (GWI) is a debilitating multisymptom condition that affects nearly a third of 1990-91 Gulf War (GW) veterans. Symptoms include pain, fatigue, gastrointestinal issues, and cognitive decrements. Our work has shown that GWI rates and potential causes for symptoms vary between men and women veterans. Studies have documented neuropsychological and neuroimaging findings mostly in men or combined sex datasets. Data are lacking for women veterans due to lack of power and repositories of women veteran samples. Methods: We characterized GW women veterans in terms of demographics, exposures, neuropsychological and neuroimaging outcomes from the newly collated Boston, Biorepository and Integrative Network (BBRAIN) for GWI. Results: BBRAIN women veterans are highly educated with an average age of 54 years. 81% met GWI criteria, 25% met criteria for current PTSD, 78% were white, and 81% served in the Army. Exposure to combined acetylcholinesterase inhibitors (AChEi) including skin pesticides, fogs/sprays and/or pyridostigmine bromide (PB) anti-nerve gas pill exposure resulted in slower processing speed on attentional tasks and a trend for executive impairment compared with non-exposed women. Brain imaging outcomes showed lower gray matter volumes and smaller caudate in exposed women. Conclusions: Although subtle and limited findings were present in this group of women veterans, it suggests that continued follow-up of GW women veterans is warranted. Future research should continue to evaluate differences between men and women in GW veteran samples. The BBRAIN women sub-repository is recruiting and these data are available to the research community for studies of women veterans.

Objectives: We aimed to describe the methods of smartphone-based cognitive ecological momentary assessment designs in clinical populations, with an intention to evaluate how the role of sex and/or gender has been considered in the design and analyses, particularly including female-specific physiology. Methods: This scoping review was conducted based on JBI scoping review methodology. On March 2nd, 2023, we searched for literature across four databases. Screening of the results and data extraction were conducted in duplicate according to the a priori methods in the pre-registered protocol. Results: 31 articles were included in this review. Participants ranged in age from 15-85 years old with various clinical disorders. Prompts were given between 1-7 times per day for 7-84 days. Executive function was the most frequently assessed cognitive domain. Over half the studies (n = 17, 55%) did not investigate the effects of sex and/or gender, and only one study considered the impact of hormonal therapy. Many studies (n = 14, 45%) used sex and gender interchangeably or incorrectly. Conclusions: Studies varied in design, with heterogeneity in the reporting of methodological information. The lack of attention to sex/gender on neuropsychological outcomes can lead to confusion and contradiction regarding its potential impact on cognition in clinical populations. This may hinder the identification of effective interventions for those assigned female at birth who have been overlooked or considered indistinguishable from their male counterparts. Given the well-documented impact of sex/gender on cognition, it is essential that future neuropsychological research, especially EMA-based studies, prioritize investigating sex/gender to ensure better outcomes for all.

Objective: To systematically review the literature on the neurocognitive effects of drug use to determine if there are significant gender differences. Methods: In April 2023, we conducted a broad search in MEDLINE (via PubMed), PsycINFO, and Embase for original research studies that used objective neuropsychological assessment to evaluate neurocognition in persons with drug use. Data extraction was performed in a masked, duplicate fashion. Results: Our initial search returned 22,430 records, of which 273 articles were included in our analysis. We found significant underrepresentation of women as participants in the studies. Twenty-one percent of studies had exclusively male participants; when women were included, they averaged only 23% of the sample. Only 49 studies sufficiently documented an analysis of their results by gender; due to the heterogeneity in study characteristics, no conclusions about cognitive differences between women and men could be made. Conclusions: Women are significantly underrepresented in the research on cognition in drug use. Increased efforts to include more women participants and consistent analysis and reporting of data for potential gender differences will be required to close this gap in knowledge, which may lead to improved substance abuse treatment approaches for women.

Objective: As programs expand globally, epilepsy surgery is becoming increasingly available as an effective treatment for some people with medically intractable seizures. Prospective candidates require careful neuropsychological evaluation and follow-up. The aim of this study was to examine the sex differences in neuropsychological function in presurgical presentation and postoperative outcomes in people with temporal lobe epilepsy referred for epilepsy surgery. Methods: Three hundred and seventy-two patients (202 Female; 170 Male) with a homogenous underlying pathology (hippocampal sclerosis) underwent a preoperative assessment on tests of intellectual, language, and memory function and were followed up one year after undergoing a unilateral temporal lobe resection; n = 169 Right (RTL), n = 203 Left (LTL). Results: There was no impact of sex or laterality of surgery on seizure outcome; 84% of males and 80% of females were seizure free at follow-up. Before surgery, sex effects were evident on tests of verbal memory with females performing better than males. Declines in verbal memory function following surgery were greater in females than males. Being female had a stronger association with postoperative decline on immediate prose recall (partial eta squared η² = 0.029), than side of surgery (η² = 0.018) albeit with a small effect size. Conclusions: There are subtle but significant sex differences in the neuropsychological profiles of people with temporal lobe epilepsy, before and following surgery. Whilst females generally perform better than males on tests of verbal memory function before surgery they demonstrate greater post-operative declines on these measures following surgery.

Objective: While sex differences in autism spectrum disorder (ASD) have been identified in areas such as neurocognitive functioning, behavior patterns, and diagnostic criteria, less work has focused on differences within females referred for ASD evaluation, including those who did not go on to receive a diagnosis. This study examined psychological and behavioral characteristics and co-occurring and differential DSM-5 diagnoses between pediatric female participants who received an ASD diagnosis (ASD+) and those who did not (ASD-). Method: Data on cognitive functioning, adaptive functioning, internalizing symptoms, externalizing symptoms, and ADOS-2 scores were analyzed among 137 3- to 20-year-old patients. The sample was divided into two age groups (ages 3-8 and ages 9-20) for analyses of between-group differences (ASD+ vs. ASD-) and predictors of group membership. Results: Females in the ASD+ group were significantly younger, had lower cognitive scores, lower internalizing and externalizing symptoms, and had higher Autism Diagnostic Observation Schedule-2 (ADOS-2) scores than those in the ASD- group. ADOS-2 scores were also the only significant predictor of ASD group membership across age groups. The ASD+ group had a higher percentage of intellectual disability while the ASD- group had higher percentages of anxiety disorder, attention-deficit/hyperactivity disorder, and disruptive behavior disorders. Conclusions: Psychological and behavioral presentations among females referred for ASD evaluation varied with age and ASD diagnostic groups. These results highlight potential female differences in ASD referrals and identification of ASD and the need to improve care for females in consideration of demographic factors.

Objective: This study investigated influence of biological sex on postconcussive symptoms (PCS) following concussion using the Federal Interagency Traumatic Brain Injury Research (FITBIR) database. Method: All studies with publicly released data as of 4/7/21 that included both males and females, enough information to determine severity of injury consistent with concussion, a measure of PCS, and objective measures of neurocognitive functioning were used. This resulted in 6 studies with a total of 9890 participants (3206 females, 6684 males); 815 participants completed the Neurobehavioral Symptom Inventory (NSI), 471 completed the Rivermead Post-Concussion Symptoms Questionnaire (RPSQ), and 8604 completed the Sport Concussion Assessment Tool-3rd Edition (SCAT 3). Questionnaires were harmonized and the following symptom composite scores were computed: total score, somatic, cognitive, and affective. Data were analyzed using linear mixed-effects models. Results: Females endorsed higher total symptoms relative to males and that military personnel endorsed higher symptoms relative to civilians. Additionally, there was a small but significant interaction effect, such that female military personnel endorsed even higher symptoms than would be predicted by the main effects. Similar patterns were observed for somatic, cognitive, and affective symptom domains. Conclusions: Further understanding sex differences in PCS reporting is key to informing the most appropriate treatment options. Future work will need to examine whether sex differences in symptom reporting is due to sex differences in endorsement styles or genuine differences in symptom presentation, as well as the relationship between study population (e.g., military, civilian, sport) and sex on objective cognitive functioning and other functional outcomes.

ObjectiveThis study aimed to evaluate prevalence rates (PRs) of neurocognitive impairment and its potential moderators among patients with rheumatoid arthritis (RA). MethodA systematic review of the available literature and data extraction was undertaken on 6 August 2021, with the update by 14 September 2023, by two reviewers independently. Literature was screened for reported rates of prevalence of neurocognitive impairment in RA patients. The meta-analysis was performed using RStudio with the "meta" library. ResultsTwenty-two studies that fulfilled all selection criteria were carefully analyzed. The PR of neurocognitive impairment was 0.49 [0.38-0.61] across all studies included in the review; 0.75 [0.54-0.88] for the MoCA; 0.56 [0.40-0.72] for the MMSE; and 0.26 [0.16-0.38] for comprehensive batteries. The meta-regression results indicated that, depending on the measurement method, the percentage of subjects with positive rheumatoid factor, women ratio, mean age of participants, mean duration of RA, and percentage of domains that had to be impaired to diagnose neurocognitive impairment turned out to be statistically significant moderators. ConclusionsNeurocognitive impairment is a clinically relevant condition in many RA patients, and its prevalence is alarming high.