Pub Date : 2024-09-30DOI: 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.
{"title":"Atypical language organization in a Spanish-speaking adolescent with drug-resistant epilepsy: a multicultural case report.","authors":"Jenna A Chiang, Laura K Winstone-Weide, Dave F Clarke, Rosario C DeLeon","doi":"10.1080/13854046.2024.2405086","DOIUrl":"https://doi.org/10.1080/13854046.2024.2405086","url":null,"abstract":"<p><p><b>Objective</b>: 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. <b>Method</b>: 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. <b>Results</b>: 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. <b>Conclusion</b>: 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.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-20"},"PeriodicalIF":3.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332773","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}
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.
{"title":"Disinhibition, rather than moderate-to-severe traumatic brain injury, moderates the impact of anger provocation on subjective emotional experience.","authors":"Michelle Mendez, Jodie Logan, Michaela Filipčíková, Skye McDonald, Travis Wearne","doi":"10.1080/13854046.2024.2406042","DOIUrl":"https://doi.org/10.1080/13854046.2024.2406042","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-21"},"PeriodicalIF":3.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332774","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}
Pub Date : 2024-09-22DOI: 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.
{"title":"Cognitive reserve in the recovery and rehabilitation of stroke and traumatic brain injury: A systematic review.","authors":"Giulia Oliva, Fabio Masina, Nazanin Hosseinkhani, Sonia Montemurro, Giorgio Arcara","doi":"10.1080/13854046.2024.2405226","DOIUrl":"10.1080/13854046.2024.2405226","url":null,"abstract":"<p><p><b>Objective:</b> 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. <b>Method:</b> 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. <b>Results:</b> 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. <b>Conclusions:</b> 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.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-37"},"PeriodicalIF":3.0,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301441","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}
Pub Date : 2024-09-19DOI: 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.
{"title":"Comparing in-home telehealth and in-person administration of neuropsychological measures in an outpatient pediatric sample during the COVID-19 pandemic.","authors":"Madeline C Manning, Pieter J Vuijk, Eline Laurent, Emmaline Cook, Ellen B Braaten, Alysa E Doyle, Mary K Colvin","doi":"10.1080/13854046.2024.2403734","DOIUrl":"https://doi.org/10.1080/13854046.2024.2403734","url":null,"abstract":"<p><p><b>Objective:</b> Research establishing the validity of neuropsychological assessment using telehealth (teleNP) is much needed in pediatric populations. <b>Method:</b> Current analyses compared performances on twelve common neuropsychological measures completed at home <i>via</i> teleNP or in-person during the COVID-19 pandemic in 476 youth (ages 6 to 17, M<sub>age</sub> 11.4 ± 3.0). <b>Results:</b> No differences were found on nine measures. In-person performances on three verbal tests were ∼1 scaled score point lower (all p<sub>adjusted</sub> <.05). Post-hoc analyses showed that the in-person pandemic performances were comparable to an in-person pre-pandemic cohort (unmasked). <b>Conclusions:</b> 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.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-15"},"PeriodicalIF":3.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301442","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}
Pub Date : 2024-09-05DOI: 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.
{"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}
Pub Date : 2024-09-04DOI: 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.
{"title":"A clinical evaluation program to monitor neurocognitive risk in children and adolescents with sickle cell disease.","authors":"Jennifer N Longoria, Jane E Schreiber, Brian Potter, Darcy Raches, Erin MacArthur, Diana Cohen, Marshetta Brazley-Rodgers, Jane S Hankins, Andrew M Heitzer","doi":"10.1080/13854046.2024.2399861","DOIUrl":"https://doi.org/10.1080/13854046.2024.2399861","url":null,"abstract":"<p><p><b>Objective:</b> 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. <b>Program Description:</b> 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. <b>Program Outcomes:</b> 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 (<i>n</i> = 191), attention-deficit/hyperactivity disorder (<i>n</i> = 75), and specific learning disorder (<i>n</i> = 75). Approximately 87% of patients who participated in SCANS during late adolescence successfully transitioned from pediatric to adult care. <b>Conclusion:</b> 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.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-21"},"PeriodicalIF":3.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134551","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}
Pub Date : 2024-08-23DOI: 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。
{"title":"Neuropsychology practice guidance for the neuropsychiatric aspects of Long COVID.","authors":"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","doi":"10.1080/13854046.2024.2392943","DOIUrl":"https://doi.org/10.1080/13854046.2024.2392943","url":null,"abstract":"<p><p><b>Objective:</b> 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. <b>Method:</b> 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. <b>Conclusions:</b> 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.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-29"},"PeriodicalIF":3.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037780","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}
Pub Date : 2024-08-23DOI: 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。
{"title":"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.","authors":"Loredana Frau, Erin Jonaitis, Rebecca E Langhough, Megan Zuelsdorff, Ozioma Okonkwo, Davide Bruno","doi":"10.1080/13854046.2024.2388904","DOIUrl":"https://doi.org/10.1080/13854046.2024.2388904","url":null,"abstract":"<p><p><b>Objective:</b> The current study examined the longitudinal relationship between cognitive reserve (CR), depression, and executive function (EF) in a cohort of older adults. <b>Methods</b>: 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. <b>Results</b>: 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. <b>Conclusions</b>: 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.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-23"},"PeriodicalIF":3.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047552","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}
Pub Date : 2024-08-19DOI: 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。
{"title":"Health insurance coverage moderates the relationship between metabolic syndrome and baseline memory outcomes in Latino older adults.","authors":"Jordana Breton, Janelle T Foret, Abbey M Hamlin, Nazareth Ortega, Alexandra L Clark","doi":"10.1080/13854046.2024.2392303","DOIUrl":"10.1080/13854046.2024.2392303","url":null,"abstract":"<p><p><b>Objective:</b> 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. <b>Methods:</b> 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. <b>Results:</b> Results revealed a significant MetS x HI interaction on memory (<i>F</i> = 4.33, <i>p</i> = 0.037, η<sub>p</sub><sup>2</sup> = .01); Latino adults with MetS and no HI coverage had worse memory performance than those with MetS who had HI coverage (<i>p</i> = 0.022, η<sub>p</sub><sup>2</sup> = .01), whereas there was no significant difference in memory between HI coverage groups in those without MetS (<i>p</i> > .05, η<sub>p</sub><sup>2</sup> = .002). No MetS x HI interaction was observed for the attention/executive functions composite (<i>F</i> = 0.29, <i>p</i> = 0.588, η<sub>p</sub><sup>2</sup> < .001). <b>Conclusion:</b> 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.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-16"},"PeriodicalIF":3.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001411","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}
Pub Date : 2024-08-18DOI: 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}