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Atypical language organization in a Spanish-speaking adolescent with drug-resistant epilepsy: a multicultural case report. 一名讲西班牙语的青少年耐药性癫痫患者的非典型语言组织:一份多元文化病例报告。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-30 DOI: 10.1080/13854046.2024.2405086
Jenna A Chiang, Laura K Winstone-Weide, Dave F Clarke, Rosario C DeLeon

Objective: Epilepsy disproportionally affects children from Hispanic/Latino backgrounds, particularly among those born outside the U.S. Longstanding health-related disparities associated with ethnicity (e.g. language use) further contribute to gaps in care. Neuropsychologists are beginning to outline best practices when working with non-English speakers; however, the lack of appropriately normed/validated measures for pre-surgical language evaluation is a limiting factor. This report informs practices among neuropsychologists by discussing atypical language organization in a non-English speaker using a multicultural framework and collaborative therapeutic assessment process. Method: The current study presents a 16-year-old, right-handed, monolingual Spanish-speaking, Latina designated female with drug-resistant focal seizures with impaired awareness. Comprehensive presurgical epilepsy workup included: CBC, video EEG, brain MRI, functional MRI, PET, MEG, baseline neuropsychological evaluation by bilingual Spanish-English providers, and Wada testing. Results: Neuropsychological testing revealed the most pronounced deficits in language, working memory, and processing speed domains. Functional MRI showed bilateral language activation, which Wada testing confirmed along with bilateral memory representation. Conclusion: Diagnosis, treatment, surgical intervention, and post-operative status are discussed. The clinical course is examined through a multicultural lens, highlighting limitations in international health services, barriers accessing health care in the U.S., and patient-specific factors that were considered as a part of the clinical decision-making process. Targeted recommendations related to culturally-informed care are offered.

目的:癫痫对西班牙裔/拉丁美洲裔儿童的影响尤为严重,尤其是那些在美国境外出生的儿童。与种族(如语言使用)相关的长期健康相关差异进一步加剧了护理方面的差距。神经心理学家已开始概述与非英语人士合作时的最佳实践;然而,手术前语言评估缺乏适当的规范/验证措施是一个限制因素。本报告通过使用多元文化框架和合作治疗评估流程讨论非英语使用者的非典型语言组织,为神经心理学家的实践提供参考。方法:本研究介绍了一名 16 岁、右撇子、单语西班牙语的拉丁裔女性患者,她患有耐药性局灶性癫痫发作且意识受损。手术前的全面癫痫检查包括全血细胞计数、视频脑电图、脑核磁共振成像、功能性核磁共振成像、正电子发射计算机断层扫描、MEG、由西班牙语和英语双语医疗人员进行的基线神经心理评估以及 Wada 测试。结果:神经心理学测试表明,患者在语言、工作记忆和处理速度方面存在最明显的缺陷。功能磁共振成像显示双侧语言激活,Wada 测试证实了这一点以及双侧记忆表征。结论本文讨论了诊断、治疗、手术干预和术后状况。从多元文化的视角审视了临床过程,强调了国际医疗服务的局限性、在美国获得医疗服务的障碍以及临床决策过程中考虑的患者特定因素。此外,还提供了与文化知情护理相关的针对性建议。
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引用次数: 0
Disinhibition, rather than moderate-to-severe traumatic brain injury, moderates the impact of anger provocation on subjective emotional experience. 抑制作用,而非中度至重度脑外伤,可调节激怒对主观情绪体验的影响。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-24 DOI: 10.1080/13854046.2024.2406042
Michelle Mendez, Jodie Logan, Michaela Filipčíková, Skye McDonald, Travis Wearne

Objective: Altered reactivity to emotional stimuli is common after traumatic brain injury (TBI), which is suggested to reflect difficulties with emotion regulation. While disinhibition is common after moderate-to-severe TBI, limited research has investigated the link between disinhibition and emotional reactivity in this clinical group. The aim of this research, therefore, was to investigate the relationship between disinhibition and TBI to anger provocation.

Method: Thirty-five individuals with moderate-to-severe TBI and thirty-one controls completed an anger induction task. Participants rated their experience of emotions and subjective arousal before and after the induction. Heart rate, respiration and skin conductance were also measured. Disinhibition was measured using the Frontal Systems Behavior Scale.

Results: In the full sample, the mood induction led to increased skin conductance, respiration, and self-reported anger, tension, arousal and negative mood. There were no differences between those with TBI and controls. Disinhibition interacted with the impact of anger provocation on subjective, but not objective, outcomes such that those elevated in disinhibition reported increased feelings of anger and tension in response to the mood induction. Disinhibition did not interact with TBI across any subjective and objective emotional measures examined in response to mood induction.

Conclusions: While anger causes emotional changes for all individuals, these changes are particularly pronounced among those who are disinhibited, irrespective of whether an individual has sustained a TBI. This is an important consideration when examining emotional regulation post-TBI as the degree of disinhibition appears to alter subjective interpretations of emotional events, which could lead to emotion dysregulation.

目的:创伤性脑损伤(TBI)后对情绪刺激的反应性改变很常见,这被认为反映了情绪调节方面的困难。虽然中度至重度创伤性脑损伤后普遍存在抑制作用减弱的现象,但对这一临床群体抑制作用减弱与情绪反应之间关系的研究却十分有限。因此,本研究旨在调查抑制能力丧失与创伤性脑损伤激怒之间的关系:方法:35 名中重度创伤性脑损伤患者和 31 名对照组患者完成了一项愤怒诱发任务。参与者在诱导前后对自己的情绪体验和主观唤醒程度进行评分。同时还测量了心率、呼吸和皮肤电导。抑制行为采用额叶系统行为量表进行测量:结果:在所有样本中,情绪诱导导致皮肤传导、呼吸、自我报告的愤怒、紧张、唤醒和消极情绪增加。创伤性脑损伤患者与对照组之间没有差异。抑制与激怒对主观结果(而非客观结果)的影响相互影响,因此抑制水平较高的受试者在情绪诱导下的愤怒和紧张情绪有所增加。在对情绪诱导进行的主观和客观情绪测量中,抑制与创伤性脑损伤没有相互作用:结论:虽然愤怒会导致所有人的情绪变化,但这些变化在抑制失调者中尤为明显,与是否受过创伤性脑损伤无关。在研究创伤后的情绪调节时,这是一个重要的考虑因素,因为抑制的程度似乎会改变对情绪事件的主观解释,从而导致情绪失调。
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引用次数: 0
Cognitive reserve in the recovery and rehabilitation of stroke and traumatic brain injury: A systematic review. 中风和脑外伤康复过程中的认知储备:系统综述。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-22 DOI: 10.1080/13854046.2024.2405226
Giulia Oliva, Fabio Masina, Nazanin Hosseinkhani, Sonia Montemurro, Giorgio Arcara

Objective: Cognitive reserve (CR) is the brain's ability to cope with changes related to aging and/or disease. Originally introduced to explain individual differences in the clinical manifestations of dementia, CR has recently emerged as a relevant construct in stroke and traumatic brain injury (TBI). This systematic review aims to investigate whether CR could predict post-stroke and TBI clinical recovery and rehabilitation outcomes, and how different variables used to estimate CR (i.e., proxies) are related to the prognosis and effectiveness of rehabilitation in these clinical populations. Method: A search was made in Pubmed, Embase, and PsycInfo for articles published until 12 January 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocol guidelines. Results: 31 studies were included after completing all screening stages. Overall, results show that a higher CR was associated with a better prognosis and a more effective rehabilitation in most of the clinical aspects considered: cognitive functioning, functional, occupational, and socio-emotional abilities, as well as psychiatric and neurological scales. Conclusions: A higher CR seems to be associated with a more favorable prognosis and a better rehabilitation outcome after stroke and TBI. Results suggest that CR should be taken into account in clinical practice to make more accurate predictions about recovery and effectiveness of rehabilitation. However, some inconsistencies suggest the need for further investigations, possibly using multiple proxies for CR.

目的:认知储备(CR认知储备(CR)是大脑应对与衰老和/或疾病相关的变化的能力。认知储备最初用于解释痴呆症临床表现的个体差异,最近已成为中风和创伤性脑损伤(TBI)的相关概念。本系统综述旨在研究 CR 是否可以预测中风和创伤性脑损伤后的临床恢复和康复效果,以及用于估算 CR 的不同变量(即替代变量)与这些临床人群的预后和康复效果之间的关系。研究方法:在Pubmed、Embase和PsycInfo上搜索截至2023年1月12日发表的文章,并遵循系统综述和元分析首选报告项目(PRISMA)协议指南。结果在完成所有筛选阶段后,共纳入 31 项研究。总体而言,研究结果表明,在认知功能、功能、职业和社会情感能力以及精神和神经量表等大多数临床方面,CR 越高,预后越好,康复效果越好。结论较高的 CR 似乎与中风和创伤性脑损伤后更有利的预后和更好的康复效果相关。结果表明,临床实践中应考虑 CR,以便更准确地预测康复情况和康复效果。然而,一些不一致的结果表明有必要进行进一步的研究,可能需要使用多种 CR 代用指标。
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引用次数: 0
Comparing in-home telehealth and in-person administration of neuropsychological measures in an outpatient pediatric sample during the COVID-19 pandemic. 比较在 COVID-19 大流行期间对门诊儿科样本进行的居家远程保健和面对面神经心理测量。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-19 DOI: 10.1080/13854046.2024.2403734
Madeline C Manning, Pieter J Vuijk, Eline Laurent, Emmaline Cook, Ellen B Braaten, Alysa E Doyle, Mary K Colvin

Objective: Research establishing the validity of neuropsychological assessment using telehealth (teleNP) is much needed in pediatric populations. Method: Current analyses compared performances on twelve common neuropsychological measures completed at home via teleNP or in-person during the COVID-19 pandemic in 476 youth (ages 6 to 17, Mage 11.4 ± 3.0). Results: No differences were found on nine measures. In-person performances on three verbal tests were ∼1 scaled score point lower (all padjusted <.05). Post-hoc analyses showed that the in-person pandemic performances were comparable to an in-person pre-pandemic cohort (unmasked). Conclusions: Overall, teleNP was comparable to in-person assessment. Results indicate that teleNP administration does not result in substantially different performance in pediatric patients undergoing clinical evaluations.

目的:儿科人群亟需通过远程医疗(teleNP)进行神经心理评估的有效性研究。研究方法在 COVID-19 大流行期间,对 476 名青少年(6 至 17 岁,Mage 11.4 ± 3.0)在家中通过远程 NP 或面对面完成的 12 项常见神经心理评估进行了分析比较。结果显示九项测试结果无差异。在三项言语测试中,面对面测试的成绩比远程测试低 1 分(均为调整后的结论):总体而言,远程 NP 与面对面评估结果相当。结果表明,对接受临床评估的儿科患者进行远程 NP 不会导致其表现出现重大差异。
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引用次数: 0
Large-scale evidence for the validity of remote MoCA administration among people with cerebellar ataxia. 小脑共济失调患者远程MoCA管理有效性的大规模证据。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-05 DOI: 10.1080/13854046.2024.2397835
Yael De Picciotto, Avigail Lithwick Algon, Inbal Amit, Eli Vakil, William Saban

Objective: For over half a century, studies of rare diseases using in-person cognitive tools have faced challenges, such as long study periods and small sample sizes (e.g. n = 10). The Montreal Cognitive Assessment (MoCA) was widely employed to assess mild cognitive impairment (MCI). We aimed to validate a modified online version of the MoCA in a large sample of a rare disease (population prevalence < .01%). Method: First, we analyzed 20 previous findings (n = 1,377), comparing the MoCA scores between large groups of neurotypically healthy (NH; n = 837) and cerebellar ataxia (CA; n = 540), where studies were conducted in-person. Second, we administered the MoCA in-person to a group of NH (n = 41) and a large group of CA (n = 103). Third, we administered a video conferencing version of the MoCA to NH (n = 38) and a large group of CA (n = 83). Results: We observed no performance differences between online and in-person MoCA administration in the NH and CA groups (p > .05, η2 = 0.001), supporting reliability. Additionally, our online CA group had lower MoCA scores than the NH group (p < .001, Hedges' g = 0.68). This result is consistent with previous studies, as demonstrated by our forest plot across 20 previous in-person findings, supporting construct validity. Conclusion: The results indicate that an online screening tool is valid in a large sample of individuals with CA. Online testing is not only time and cost-effective, but facilitates disease management and monitoring, ultimately enabling early detection of MCI.

目的:半个多世纪以来,使用现场认知工具对罕见疾病进行的研究一直面临着研究周期长、样本量小(如 n = 10)等挑战。蒙特利尔认知评估(MoCA)被广泛用于评估轻度认知障碍(MCI)。我们的目的是在一种罕见疾病的大样本中(人群患病率小于 0.01%)验证经过修改的在线版 MoCA。方法:首先,我们分析了之前的20项研究结果(n = 1,377),比较了神经健康(NH;n = 837)和小脑共济失调(CA;n = 540)两大群体的MoCA得分,这些研究都是亲自进行的。其次,我们对一组神经健康者(n = 41)和一大组小脑共济失调者(n = 103)亲自进行了 MoCA 测试。第三,我们对 NH(n = 38)和一大群 CA(n = 83)进行了视频会议版的 MoCA 测试。测试结果我们观察到,在线和面对面进行 MoCA 测验时,NH 组和 CA 组的表现没有差异(P > .05, η2 = 0.001),这证明了其可靠性。此外,在线 CA 组的 MoCA 分数低于 NH 组(p < .001,Hedges' g = 0.68)。这一结果与之前的研究结果一致,我们的森林图显示了之前 20 项面对面研究的结果,支持建构有效性。结论研究结果表明,在线筛查工具在大样本 CA 患者中是有效的。在线测试不仅省时省力,而且有利于疾病管理和监测,最终实现 MCI 的早期检测。
{"title":"Large-scale evidence for the validity of remote MoCA administration among people with cerebellar ataxia.","authors":"Yael De Picciotto, Avigail Lithwick Algon, Inbal Amit, Eli Vakil, William Saban","doi":"10.1080/13854046.2024.2397835","DOIUrl":"https://doi.org/10.1080/13854046.2024.2397835","url":null,"abstract":"<p><p><b>Objective</b>: For over half a century, studies of rare diseases using in-person cognitive tools have faced challenges, such as long study periods and small sample sizes (e.g. <i>n</i> = 10). The Montreal Cognitive Assessment (MoCA) was widely employed to assess mild cognitive impairment (MCI). We aimed to validate a modified online version of the MoCA in a large sample of a rare disease (population prevalence < .01%). <b>Method</b>: First, we analyzed 20 previous findings (<i>n</i> = 1,377), comparing the MoCA scores between large groups of neurotypically healthy (NH; <i>n</i> = 837) and cerebellar ataxia (CA; <i>n</i> = 540), where studies were conducted in-person. Second, we administered the MoCA in-person to a group of NH (<i>n</i> = 41) and a large group of CA (<i>n</i> = 103). Third, we administered a video conferencing version of the MoCA to NH (<i>n</i> = 38) and a large group of CA (<i>n</i> = 83). <b>Results</b>: We observed no performance differences between online and in-person MoCA administration in the NH and CA groups (<i>p</i> > .05, <i>η</i><sup>2</sup> = 0.001), supporting reliability. Additionally, our online CA group had lower MoCA scores than the NH group (<i>p</i> < .001, Hedges' <i>g</i> = 0.68). This result is consistent with previous studies, as demonstrated by our forest plot across 20 previous in-person findings, supporting construct validity. <b>Conclusion</b>: The results indicate that an online screening tool is valid in a large sample of individuals with CA. Online testing is not only time and cost-effective, but facilitates disease management and monitoring, ultimately enabling early detection of MCI.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-17"},"PeriodicalIF":3.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A clinical evaluation program to monitor neurocognitive risk in children and adolescents with sickle cell disease. 监测镰状细胞病儿童和青少年神经认知风险的临床评估计划。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-04 DOI: 10.1080/13854046.2024.2399861
Jennifer N Longoria, Jane E Schreiber, Brian Potter, Darcy Raches, Erin MacArthur, Diana Cohen, Marshetta Brazley-Rodgers, Jane S Hankins, Andrew M Heitzer

Objective: Sickle cell disease (SCD) is an inherited hematologic disorder that impacts approximately 100,000 Americans. This disease is associated with progressive organ damage, cerebral vascular accident, and neurocognitive deficits. Recent guidelines from the American Society of Hematology (ASH) recommend cognitive screening with a psychologist to help manage cerebrovascular risk and cognitive impairment in this population. SCD patients benefit from neuropsychology services and several institutions already have programs in place to monitor cognitive risk. Program Description: We describe a longitudinal neurocognitive evaluation program at our institution that serves all patients with SCD, regardless of disease severity or referral question. The Sickle Cell Assessment of Neurocognitive Skills (SCANS) program was established in 2012. We outline the program's theoretical framework, timepoints for evaluation, test battery, logistics, patient demographics, integration with research programming, and multidisciplinary collaboration to support optimal outcomes. Program Outcomes: Our program has provided 716 targeted neuropsychological evaluations for patients over the last decade. Nearly 26% of patients in the program have been followed longitudinally. The most common diagnoses generated across cross-sectional and longitudinal evaluations include cognitive disorder (n = 191), attention-deficit/hyperactivity disorder (n = 75), and specific learning disorder (n = 75). Approximately 87% of patients who participated in SCANS during late adolescence successfully transitioned from pediatric to adult care. Conclusion: We discuss considerations for developing programming to meet the needs of this population, including tiered assessment models, timing of evaluations, scope, and reimbursement. Program models that utilize prevention-based tiered models or targeted evaluations can assist with serving large volumes of patients.

目的:镰状细胞病(SCD)是一种遗传性血液病,影响着约 10 万美国人。这种疾病与渐进性器官损伤、脑血管意外和神经认知缺陷有关。美国血液学会(ASH)最近发布的指南建议由心理学家进行认知筛查,以帮助管理该人群的脑血管风险和认知障碍。SCD 患者从神经心理学服务中获益匪浅,一些机构已经制定了监控认知风险的计划。项目简介:我们介绍了本机构的一项纵向神经认知评估项目,该项目为所有 SCD 患者提供服务,无论疾病严重程度或转诊问题如何。镰状细胞神经认知能力评估(SCANS)项目成立于 2012 年。我们概述了该计划的理论框架、评估时间点、测试电池、后勤保障、患者人口统计学、与研究计划的整合以及多学科合作以支持最佳结果。项目成果:在过去十年中,我们的项目已为患者提供了 716 次有针对性的神经心理评估。该项目对近 26% 的患者进行了纵向随访。横向和纵向评估中最常见的诊断包括认知障碍(191 例)、注意力缺陷/多动障碍(75 例)和特殊学习障碍(75 例)。在青春期晚期参加 SCANS 的患者中,约有 87% 成功地从儿科转为成人护理。结论:我们讨论了制定方案以满足该人群需求的注意事项,包括分层评估模型、评估时机、范围和报销。利用以预防为基础的分层模式或针对性评估的计划模式可以帮助为大量患者提供服务。
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引用次数: 0
Neuropsychology practice guidance for the neuropsychiatric aspects of Long COVID. Long COVID 神经心理学实践指南。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-23 DOI: 10.1080/13854046.2024.2392943
Christine H Koterba, Ciaran M Considine, Jacqueline H Becker, Kristen R Hoskinson, Rowena Ng, Gray Vargas, Michael R Basso, Antonio Enrique Puente, Sara M Lippa, Douglas M Whiteside

Objective: The coronavirus disease-2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has had a profound global impact on individual health and well-being in adults and children. While most fully recover from COVID-19, a relatively large subgroup continues to experience persistent physical, cognitive, and emotional/behavioral symptoms beyond the initial infection period. The World Health Organization has termed this phenomenon "Post-COVID-19 Condition" (PCC), better known as "Long COVID." Due to the cognitive and psychosocial symptoms, neuropsychologists often assess and recommend treatment for individuals with Long COVID. However, guidance for neuropsychologists' involvement in clinical care, policy-making, and research has not yet been developed. The authors of this manuscript convened to address this critical gap and develop guidance for clinical neuropsychologists working with patients presenting with Long COVID. Method: Authors include pediatric and adult neuropsychologists with expertise in Long COVID and behavioral health. All authors have been engaged in clinical and research efforts examining the impact of COVID-19. Authors summarized the literature-to-date pertinent to the neuropsychiatric sequelae of Long COVID and developed guidance for neuropsychologists working with individuals with Long COVID. Conclusions: Research findings regarding neuropsychiatric symptoms associated with Long COVID are mixed and limited by methodological differences. As they practice and conduct research, neuropsychologists should remain mindful of the evolving and tenuous nature of the literature.

目的:由严重急性呼吸系统综合征冠状病毒-2(SARS-CoV-2)引起的冠状病毒病-2019(COVID-19)大流行对全球成人和儿童的个人健康和福祉产生了深远的影响。虽然大多数人从 COVID-19 中完全康复,但仍有相对较大的亚群在最初感染期后继续出现持续的身体、认知和情绪/行为症状。世界卫生组织将这种现象称为 "后 COVID-19 症状"(PCC),也就是我们常说的 "长 COVID"。由于存在认知和社会心理症状,神经心理学家通常会对 Long COVID 患者进行评估并提出治疗建议。然而,神经心理学家参与临床护理、政策制定和研究的指南尚未制定。本手稿的作者们召集了会议,以解决这一关键性空白,并为临床神经心理学家在治疗长COVID患者时提供指导。方法:作者包括儿科和成人神经心理学家,他们都具有 Long COVID 和行为健康方面的专业知识。所有作者都参与了研究 COVID-19 影响的临床和研究工作。作者总结了与 Long COVID 神经精神后遗症相关的最新文献,并为神经心理学家治疗 Long COVID 患者制定了指南。结论:与 Long COVID 相关的神经精神症状的研究结果参差不齐,并受到方法学差异的限制。神经心理学家在进行实践和研究时,应始终注意文献的不断发展和不稳定性。
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引用次数: 0
The role of cognitive reserve and depression on executive function in older adults: A 10-year study from the Wisconsin Registry for Alzheimer's Prevention. 认知储备和抑郁对老年人执行功能的影响:威斯康星州阿尔茨海默氏症预防登记处的一项为期 10 年的研究。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-23 DOI: 10.1080/13854046.2024.2388904
Loredana Frau, Erin Jonaitis, Rebecca E Langhough, Megan Zuelsdorff, Ozioma Okonkwo, Davide Bruno

Objective: The current study examined the longitudinal relationship between cognitive reserve (CR), depression, and executive function (EF) in a cohort of older adults. Methods: 416 participants were selected from the Wisconsin Registry for Alzheimer's Prevention. They were native English speakers, aged ≥50+, and cognitively unimpaired at baseline, with no history of neurological or other psychiatric disorders aside from depression. Depression was assessed with the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). A composite score, based on the premorbid IQ (WRAT-3 Reading subtest) and years of education was used to estimate CR. Another composite score from four cognitive tests was used to estimate EF. A moderation analysis was performed to evaluate the effects of CR and Depression on EF at follow-up after controlling for age, gender, and APOE risk score. Moreover, a multinomial logistic regression was used to predict conversion to Mild Cognitive Impairment (MCI) from the healthy baseline. Results: The negative relationship between depression and EF was stronger in individuals with higher CR levels, suggesting a possible floor effect at lower CR levels. In the multinomial regression, the interaction between CR and depression predicted conversion to MCI status, indicating that lower CR paired with more severe depression at baseline was associated with a higher risk of subsequent impairment. Conclusions: This study sheds light on the intricate relationship between depression and EF over time, suggesting that the association may be influenced by varying levels of CR. Further studies may replicate these findings in clinical populations.

研究目的本研究考察了一组老年人认知储备(CR)、抑郁和执行功能(EF)之间的纵向关系。方法:从威斯康星州阿尔茨海默氏症预防登记处选取了 416 名参与者。他们以英语为母语,年龄≥50 岁以上,基线认知能力无障碍,除抑郁症外,无神经或其他精神疾病史。抑郁症采用 20 项流行病学研究中心抑郁量表(CES-D)进行评估。根据病前智商(WRAT-3 阅读子测试)和受教育年限得出的综合得分用于估算 CR。另一项来自四项认知测试的综合得分用于估算EF。在控制年龄、性别和 APOE 风险评分后,进行了调节分析,以评估 CR 和抑郁对随访时 EF 的影响。此外,还使用多项式逻辑回归预测从健康基线转为轻度认知障碍(MCI)的情况。结果显示在 CR 水平较高的个体中,抑郁与 EF 之间的负相关更强,这表明在 CR 水平较低时可能存在底线效应。在多项式回归中,CR 与抑郁之间的交互作用预测了向 MCI 状态的转换,表明基线时较低的 CR 与较严重的抑郁配对与较高的后续损伤风险相关。结论:本研究揭示了抑郁与 EF 之间随时间变化的复杂关系,表明这种关系可能受到不同 CR 水平的影响。进一步的研究可能会在临床人群中复制这些发现。
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引用次数: 0
Health insurance coverage moderates the relationship between metabolic syndrome and baseline memory outcomes in Latino older adults. 医疗保险的覆盖面可调节拉丁裔老年人代谢综合征与基线记忆结果之间的关系。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-19 DOI: 10.1080/13854046.2024.2392303
Jordana Breton, Janelle T Foret, Abbey M Hamlin, Nazareth Ortega, Alexandra L Clark

Objective: Latino adults are at increased risk of metabolic syndrome (MetS) and have lower rates of health insurance (HI) coverage. Although inadequate HI coverage and MetS have been independently linked to poor cognition, their potential interactive effects have not yet been examined. The present study explored whether HI moderated the association between MetS and cognition. We hypothesized that Latinos with MetS that did not have HI would demonstrate poorer cognition than those with HI, whereas there would be minimal differences in cognition across HI status in those without MetS. Methods: Cross-sectional data from 805 Latino older adults enrolled in the Health and Aging Brain Study-Health Disparities was utilized. Analysis of covariance adjusting for sociodemographics examined MetS x HI interactions on memory and attention/executive functions composites. Results: Results revealed a significant MetS x HI interaction on memory (F = 4.33, p = 0.037, ηp2 = .01); Latino adults with MetS and no HI coverage had worse memory performance than those with MetS who had HI coverage (p = 0.022, ηp2 = .01), whereas there was no significant difference in memory between HI coverage groups in those without MetS (p > .05, ηp2 = .002). No MetS x HI interaction was observed for the attention/executive functions composite (F = 0.29, p = 0.588, ηp2 < .001). Conclusion: Latino older adults with MetS that do not have HI coverage may be at risk for poorer memory outcomes. Increasing the accessibility of HI coverage may help reduce cognitive health disparities in Latino older adults with vascular health comorbidities.

目的:拉丁裔成年人患代谢综合征(MetS)的风险增加,而他们的医疗保险(HI)覆盖率较低。虽然医疗保险覆盖率不足和代谢综合征与认知能力差有独立联系,但尚未研究它们之间潜在的交互影响。本研究探讨了健康保险是否会调节 MetS 与认知能力之间的关系。我们假设,患有 MetS 但没有 HI 的拉美人的认知能力会比有 HI 的人差,而没有 MetS 的拉美人在不同 HI 状态下的认知能力差异很小。研究方法利用参加 "健康与老龄化大脑研究--健康差异 "的 805 名拉丁裔老年人的横截面数据。调整社会人口统计学因素后进行协方差分析,研究 MetS x HI 在记忆力和注意力/执行功能组合上的交互作用。结果显示结果表明,MetS x HI 在记忆力方面存在明显的交互作用(F = 4.33,p = 0.037,ηp2 = .01);患有 MetS 但没有 HI 保险的拉丁裔成年人的记忆力比患有 MetS 但有 HI 保险的成年人差(p = 0.022,ηp2 = .01),而在没有 MetS 的人群中,HI 保险组之间的记忆力没有明显差异(p > .05,ηp2 = .002)。在注意力/执行功能综合方面,未观察到 MetS x HI 的交互作用(F = 0.29,p = 0.588,ηp2 < .001)。结论患有 MetS 的拉丁裔老年人如果没有医疗保险,可能会面临记忆力较差的风险。提高医疗保险的可及性可能有助于减少患有血管健康合并症的拉美裔老年人在认知健康方面的差异。
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引用次数: 0
Hashimoto encephalopathy: a literature review and case report with comprehensive neuropsychological evaluation. 桥本脑病:文献综述和病例报告及综合神经心理学评估。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-08-18 DOI: 10.1080/13854046.2024.2388905
Lauren A-M Schenck, Halle T McCracken, Frank Andrasik, Brandon C Baughman

Objective: Hashimoto's encephalopathy (HE), a rare immune-mediated disorder, manifests as altered mental state, cognitive and psychological dysfunction, seizures, and myoclonus. Little is known, however, about the neuropsychological profiles of individuals with HE due to the sparse amount of research. This report overviews HE, summarizes findings from available published neuropsychological evaluations, and details neuropsychological examinations of a 57-year-old White woman with a confirmed HE diagnosis evidencing persistent neuropsychological impairment at two discrete timepoints. Method: An extensive literature search was conducted on PubMed and Google Scholar for studies including neuropsychological evaluations of HE cases. Our neuropsychological evaluation included chart review, diagnostic clinical interview, performance-based neurocognitive assessment, and measures of personality and psychopathology. Results: Our assessment revealed a largely subcortical pattern of neurocognitive impairment and impactful neuropsychiatric symptoms that, together, significantly impacted the patient's quality of life and functional status. The patient's performance improved during a six-month re-evaluation within the domains of cognition, psychological functioning, and functional independence. Conclusions: This article highlights the complexity and possible long-term sequela of HE. Complex medical history (including autoimmune disorders) and psychiatric presentation at onset may be factors related to longer-term cognitive dysfunction. Neuropsychology and psychology can serve important and unique roles in assessing long-term functioning and response to treatment in such cases.

目的:桥本脑病(HE)是一种罕见的免疫介导疾病,表现为精神状态改变、认知和心理功能障碍、癫痫发作和肌阵挛。然而,由于研究数量稀少,人们对 HE 患者的神经心理学特征知之甚少。本报告概述了高血压,总结了已发表的神经心理学评估结果,并详细介绍了对一名确诊为高血压的 57 岁白人女性进行的神经心理学检查,该患者在两个不连续的时间点上出现了持续性神经心理障碍。研究方法我们在 PubMed 和 Google Scholar 上进行了广泛的文献检索,以了解有关 HE 病例神经心理学评估的研究。我们的神经心理学评估包括病历审查、诊断性临床访谈、基于表现的神经认知评估以及人格和精神病理学测量。评估结果我们的评估结果显示,患者的神经认知功能障碍主要表现为皮层下模式,并伴有严重的神经精神症状,这些症状严重影响了患者的生活质量和功能状态。在为期 6 个月的重新评估中,患者在认知、心理功能和功能独立性方面的表现均有所改善。结论:本文强调了高血压的复杂性和可能出现的长期后遗症。复杂的病史(包括自身免疫性疾病)和发病时的精神表现可能是导致长期认知功能障碍的相关因素。神经心理学和心理学可在评估此类病例的长期功能和治疗反应方面发挥重要而独特的作用。
{"title":"Hashimoto encephalopathy: a literature review and case report with comprehensive neuropsychological evaluation.","authors":"Lauren A-M Schenck, Halle T McCracken, Frank Andrasik, Brandon C Baughman","doi":"10.1080/13854046.2024.2388905","DOIUrl":"https://doi.org/10.1080/13854046.2024.2388905","url":null,"abstract":"<p><p><b>Objective:</b> Hashimoto's encephalopathy (HE), a rare immune-mediated disorder, manifests as altered mental state, cognitive and psychological dysfunction, seizures, and myoclonus. Little is known, however, about the neuropsychological profiles of individuals with HE due to the sparse amount of research. This report overviews HE, summarizes findings from available published neuropsychological evaluations, and details neuropsychological examinations of a 57-year-old White woman with a confirmed HE diagnosis evidencing persistent neuropsychological impairment at two discrete timepoints. <b>Method:</b> An extensive literature search was conducted on PubMed and Google Scholar for studies including neuropsychological evaluations of HE cases. Our neuropsychological evaluation included chart review, diagnostic clinical interview, performance-based neurocognitive assessment, and measures of personality and psychopathology. <b>Results:</b> Our assessment revealed a largely subcortical pattern of neurocognitive impairment and impactful neuropsychiatric symptoms that, together, significantly impacted the patient's quality of life and functional status. The patient's performance improved during a six-month re-evaluation within the domains of cognition, psychological functioning, and functional independence. <b>Conclusions:</b> This article highlights the complexity and possible long-term sequela of HE. Complex medical history (including autoimmune disorders) and psychiatric presentation at onset may be factors related to longer-term cognitive dysfunction. Neuropsychology and psychology can serve important and unique roles in assessing long-term functioning and response to treatment in such cases.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-20"},"PeriodicalIF":3.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Clinical Neuropsychologist
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