Clinical Neuropsychologist最新文献

Objective: This study examined the performance validity test (PVT) pass/fail rate in a sample of presurgical epilepsy candidates; assessed whether performance validity was associated with reduced performance across cognitive domains; investigated the relationship between performance validity and self-report mood questionnaires; and assessed whether PVT performance was associated with demographic or clinical factors (i.e. sex, race/ethnicity, age, years of education, reported history of special education, seizure longevity, and number of anti-seizure medications). Methods: One hundred and eighty-three presurgical epilepsy candidates were examined. Each patient's assessment battery included a stand-alone performance validity measure and two embedded validity measures. Results: PVT failure rate in this sample (10%) was associated with reduced performance on all neurocognitive measures: Full Scale IQ (FSIQ; r = -0.26), CVLT-II Total Learning (r = -0.36) and Long Delay Free Recall (LDFR; r = -0.38), BVMT-R Delayed Recall (r = -0.28), and Wisconsin Card Sorting Test (Categories Completed; r = -0.32). In addition, PVT failure rate was associated with elevated scores on the Beck Anxiety Inventory (r = .22) but not on the Beck Depression Inventory (BDI-II; r = .14). Correlations that were significant at the α = 0.05 level maintained significance following post hoc Bonferroni correction. The valid and invalid groups did not differ significantly in sex, race/ethnicity, age, years of education, reported history of special education, seizure longevity, and number of anti-seizure medications. Conclusions: Results from this study suggest that PVT performance was not impacted by demographic or clinical factors and therefore may be a reliable indicator of performance validity in a presurgical epilepsy sample.

Background: Knowledge is still lacking regarding the preferred method for evaluation of learning in the Rey Auditory Verbal Learning Test (RAVLT). Validity of different methods was examined by the effect size in differentiating diagnostic stages in memory clinic patients versus healthy adults and the strength of association between RAVLT performance and brain atrophy. Method: The study included individuals with dementia (n = 247), Mild Cognitive Impairment (MCI, n = 709), Subjective Cognitive Impairment (SCI, n = 175) and cognitively unimpaired adults serving as healthy controls (HC, n = 102). All patients went through a comprehensive clinical examination and neuropsychological assessment of cognition including episodic memory gauged with RAVLT and brain imaging of medial temporal atrophy, cortical atrophy, and white matter hyperintensity. Results: The standard method for evaluation of learning in RAVLT (summed score over five trials) together with the late learning method (mean of trials 4 and 5) were the two most powerful methods according to group differentiation (discriminant validity). Both methods also showed considerable association with medial temporal atrophy (construct validity). The initial RAVLT performance represented by results on trial 1 and the constant in regression analysis with the power function provided information regarding attention that was important for the separation of SCI and HC. Conclusions: The most favorable clinical utility was indicated by discriminant and construct validity by total learning (standard method) including both attention- and learning-related parts and late learning of RAVLT performance, while theoretical understanding of mental processes involved in RAVLT performance was provided by the distinction between initial versus the subsequent learning performance.

Objective: In patients with epilepsy, the insula has been increasingly recognized as a common site of seizures. There is growing interest in understanding the cognitive and psychological consequences of insular epilepsy to help provide clinical recommendations to support patient's cognitive and psychosocial functioning, and to help identify candidates for epilepsy resective surgery. The aim of this scoping review was to describe the cognitive and behavioural characteristics associated with insular epilepsy in children and adults. Method: A systematic search was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis -Extension for Scoping Reviews guidelines. Eligible studies reported on a neuropsychological or behavioural outcome, using standardized or research-based psychological measures, in individuals with insular epilepsy, (i.e. the seizure focus and/or surgical resection included the insula), and a comparison group. After duplicates were removed, 2,423 citations were identified from the search, and 39 studies were included in the scoping review. Results: Across the included studies, intellectual/global cognitive functioning and language were most often evaluated. Lower functioning was found across multiple cognitive and behavioural processes in pediatric and adult patients with insular epilepsy. Following resective surgery involving the insula, behavioural and cognitive outcomes are general stable. Conclusions: The results of this scoping review further neuropsychologists' knowledge of the cognitive and behavioural outcomes of insular seizures prior to and following surgical treatment. These results can aid in counselling patients of the potential cognitive dysfunctions, and aid with treatment planning.

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: 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: 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.