Archives of Clinical Neuropsychology最新文献

Objective: Efficient and early detection of cognitive impairment may be facilitated using the NIH Toolbox (NIHTB), a computerized suite of assessments measuring multiple aspects of neurological functioning.

Methods: The Advancing Reliable Measurement in Alzheimer's Disease and cognitive Aging study validated the NIHTB across a geographically diverse cognitive aging sample. Participants aged >64 with normal cognition (NC), mild cognitive impairment (MCI), and dementia of the Alzheimer type (DAT) across nine research sites completed the NIHTB. One-way ANOVAs captured differences in performance on the Cognition Battery and effect sizes were calculated.

Results: Groups differed substantially across all cognition measures, with large differences in Total and Fluid Cognition, after demographic adjustment. The largest differentiators were in fluid measures, particularly for working and episodic memory.

Conclusions: NIHTB-CB differentiates NC, MCI, and DAT groups. Future studies will examine longitudinal differences and performance in enriched samples (African American participants, Spanish NIHTB, 85+ years old).

Introduction: Deficits in inhibition have been associated with various clinical conditions, including neurodegenerative diseases. The Hayling Sentence Completion Test (HSCT) is an assessment tool commonly used in clinical settings to measure verbal initiation and prepotent verbal response inhibition. Although it is used by numerous clinical and research groups in Quebec, normative data for the HSCT are not yet available for French-Quebec speakers.

Objectives: The aims of this study were to provide error scoring guidelines and normative data in the adult population of French Quebec for the HSCT-QC (Study 1) and to determine its known-group discriminant validity (Study 2).

Results: The results of Study 1, based on a sample of 214 healthy individuals aged 50 to 89, indicated that age significantly affected test performance, while educational level and sex did not. As no transformations were able to normalize the score distribution, percentile ranks for HSCT-QC performance were calculated solely based on age. Results from Study 2 demonstrated that the HSCT-QC effectively distinguishes the performance of healthy participants from those with mild cognitive impairment or Alzheimer's disease.

Conclusion: Norms and psychometric data for the HSCT-QC will be highly beneficial for assessing inhibitory control in French-speaking adults in Quebec, Canada.

Background: Single-item depression screening has shown utility in young adult samples with limited work focused on individuals 50 and older. We examined single-item depression screening in adults 50 and older with a history of TBI one year post-injury.

Method: This project involved secondary analysis of deidentified TRACK-TBI data. The sample (N = 508) included 61 control participants and 447 cases grouped by TBI severity. Outcome measures included the Brief Symptom Inventory-18 depression scale (BSI-D) and Patient Health Questionnaire-9 (PHQ-9). Depression was determined psychometrically by BSI-D (≥63 T) and PHQ-9 (≥10) if either score was above the cutoff. The Rivermead Postconcussion Symptoms Questionnaire depression item (RPQ-D) was used in logistic regression (LR) and receiver operating characteristic (ROC) analyses to predict depression.

Results: Depression was observed in 16.1% of cases and 6.6% of control participants (p = .05) with non-significant variability across TBI severity (12.9-18.3%; p = .17). The LR model with age, education, TBI severity, and RPQ-D as predictors was significant with age and RPQ-D as significant predictors. The model classified 87.9% of participants correctly. The area under the ROC curve was 0.86. The optimal cutoff was RPQ-D ≥ 2.

Conclusion: Single-item screening for depression is a suitable approach in adults 50 and older with a history of TBI.

Objective: The current study sought to gain a clearer understanding of the impact of child and parent linguistic factors, ethnic identity salience, and acculturation to both mainstream United States of America (USA) culture and their heritage culture on executive functioning task performance among Latin American youth living in the USA.

Method: Nine hundred eleven youth (Mage = 9.5, 51% female, 93% born in the USA) from the Adolescent Brain Cognitive Development repository completed the Flanker Inhibitory Control and Attention Test and the Dimensional Change Card Sort Test (DCCS). Youth and parent completed demographic questionnaires and ethnic identity salience and acculturation measures.

Results: Hierarchical linear regression analyses revealed that greater parent acculturation to heritage culture and lower youth acculturation to USA culture predicted better performance on the Flanker task, and greater parent ethnic identity salience predicted better performance on the DCCS test after controlling for demographic variables (parent educational attainment and full-time employment, immigration status household) and linguistic variables (parent's preferred language, primary language spoken at home).

Conclusions: This is the first study to comprehensively examine the effects of linguistic factors, acculturation, and ethnic identity salience on executive functioning performance among Latin American youth living in the USA. Results show that parental acculturation can have a meaningful impact on their children's executive functioning, which has implications for those who work with this demographic in clinical or research settings. Culturally informed suggestions for qualitative and quantitative information gathering are provided to account for this variable when conducting neuropsychological evaluations in this population.

Objective: Intravascular large B-cell lymphoma (IVLBCL) is a rare and aggressive lymphoma that can have heterogeneous central nervous system involvement and cerebrovascular complications. The development of IVLBCL can be fatal. Although relatively rare, the development of specific clinical syndromes, such as IVLBCL, has been implicated following infection and vaccination. To our knowledge, this is the first comprehensive neuropsychological evaluation assessing neurocognitive and psychological status after IVLBCL diagnosis.

Methods: The current study presents a right-handed mid-60-year-old male with a university-level education, who was diagnosed with IVLBCL following viral vector SARS-CoV-2 vaccination. He presented with a complex medical history including antiphospholipid syndrome, deafness (prior to cochlear implant), and cardiovascular complications secondary to lymphoma. Brain magnetic resonance imaging showed parietal, frontal, and cerebellar infarcts; encephalomalacia; and periventricular deep chronic ischemic changes. A comprehensive neuropsychological evaluation was completed.

Results: In consideration of an individual with an estimated above-average baseline, his neurocognitive profile demonstrated impairments across multiple domains that were more lateralized to the non-dominant hemisphere including visual attention, visual processing speed, visuo-construction, memory, motor dexterity, and right-sided ataxia (e.g., dysmetria). Clinical elevations for depression, hopelessness, and anxiety were also found.

Conclusions: The current study highlights a novel cognitive profile of IVLBCL and comorbidities with the patient having more predominant nondominant hemispheric-related deficits. There was evidence of disruption to visual processing networks, largely consistent with neuroimaging lesions. The current case also describes the unique experience of an individual coping with a rare condition, especially when resulting in functional decline (e.g., loss of audition). Implications are discussed.

Objective: Compare the changes in neuropsychological test scores between remote and in-person follow-up assessment over a 1-year period using standardized regression-based (SRB) change indices.

Method: Participants were from the Wake Forest Alzheimer's Disease Research Center (ADRC; N = 230) [mean age: 68.6 (7.8) years; education: 16.3 (2.3) years; 71% female; 86% White] and cognitively normal (as defined by a CDR of 0) at baseline and follow-up [mean days: 420.03 (48.53)]. Follow-up testing with the Uniform Data Set v3 Cognitive Battery was completed in person (n = 121) or remotely (n = 109) via phone (n = 61) or video (n = 48). SRB change scores were calculated using published formulas. Chi-square analysis compared the frequency of scores falling outside of an SRB cut-point +/-1.645 for follow-up assessments and mean SRB change scores were compared.

Results: There were no significant differences in the frequency of SRB change scores for in-person versus remote follow-up assessments at the SRB cut-point. Similarly, one-way ANOVAs comparing mean SRB change scores revealed no significant differences between in-person, telephone, and video follow-up means for any of the tests.

Conclusions: Telephone and video cognitive assessments performed similarly to in-person assessment and offer a valuable tool for research and clinical applications.

Objective: In adults who have experienced homelessness, greater psychological resilience is related to better quality of life, community functioning, and social cognition. Domain-specific cognitive functioning is positively associated with resilience in housed populations; however, these relationships have yet to be explored among adults experiencing homelessness. The aim of this study is to examine the relationships between domain-specific cognitive function and psychological resilience among adults experiencing homelessness.

Method: One hundred and six adults who have experienced homelessness were recruited in Toronto, Canada, and 88 were included in analyses (51% female, mean age = 43 years). Study measures assessed psychological resilience as well as domain-specific cognition (vocabulary, oral reading, processing speed, episodic memory, and executive functioning) using the NIH Toolbox Cognition Battery. Additional covariates of interest included psychological distress, social network size, substance misuse, and major psychiatric disorders. Hierarchical regression modeling explored the contributions of each cognitive domain to resilience while accounting for established covariates.

Results: Oral reading was positively associated with higher resilience, explaining 12.45% of the variance in resilience while controlling for age, education, gender, substance misuse, psychological distress, and social network size. Performance on measures of executive functioning, processing speed, and visual memory were not found to be related to self-reported resilience.

Conclusion: The results suggest that verbal vocabulary, shaped by the accumulation of experiences across one's lifetime, may be an important contributor to psychological resilience. Better crystallized abilities may reflect more enriched early life experiences that are critical to better coping skills and well-being of adults experiencing homelessness.

Objective: Valid client performance is critical to effective psychological testing. The MMPI-2-RF includes the Response Bias Scale (RBS) as an effective over-reporting scale and was developed for such detection efforts. Emerging RBS research has evaluated modifications to improve the scale's reliability and validity, shortening it from 28 to 19-items. This study cross-validates RBS-19 in a large military sample using multiple Performance Validity Tests as outcome measures. It also examines the moderating effects of military rank.

Methods: Active-Duty Service members (n = 587) seen at Walter Reed National Medical Center. Archival data were collected during referral-based post-deployment screenings for reported cognitive impairments. Analytic plan includes PVT mean difference testing, RBS/RBS19 and PVT Pass All / Fail Any strengths of association, and moderation analyses.

Results: Results indicate a non-significant influence of rank at predicting PVT failure. RBS was generally equitable with RBS-19 but demonstrated some marginally better utility. Elevation frequency and differences in those rates (e.g., Chi Square and Phi Coefficient's) supported significant relationships between overall Pass All/Fail Any grouping.

Conclusions: Clinical implications suggest differences in PVT detection when assessing response invalidity. Important moderator findings suggest rank does not influence response style. Inconsistency with previous literature suggests importance of context dependent testing (e.g., post-deployment, fitness for duty vs forensic/outpatient settings). Recommendations for future use in Active-Duty populations are provided.

Objective: Research on the neuropsychological profile in individuals with Silver-Russell Syndrome (SRS), is scarce. The current study aims to enhance common clinical knowledge of SRS by exploring the syndrome related neuropsychological specificities previously described by literature and comparing those with neuropsychological findings in three adults with SRS.

Methods: Literature search on intelligence, cognition, and psychopathology in SRS was carried out. Included articles defined SRS adults with known genetic etiology and provided objective measures available within the investigated domains. Analyzes of the latter was conducted through available data from neuropsychological assessment in three persons with SRS; one male with maternal 11p duplication and two females with H19 hypomethylation.

Results: Analysis of the literature suggested specific cognitive profiles for individuals with different genetic variants. As to the presented cases, for the maternal 11p duplication, a higher variability of overall intellectual abilities and stronger verbal comprehension was found. Across all cases, overall intellectual abilities varied from mild intellectual disability to average level. No specific cognitive profile was found. Psychopathology presented itself either as externalizing or internalizing, and all cases reported negative life and/or learning experiences and self-esteem issues directly related to SRS.

Conclusion: Clinical cases' results were consistent with literature. Next to the prevailing focus on somatic aspects, current results support in-depth analysis of neuropsychological functioning as necessary to optimize care and reduce the risk of psychopathology during the life course in SRS. Further research and tailored selection of neuropsychological batteries is recommended to improve the understanding of the cognitive profile of SRS.

Objectives: Socioeconomic (SES) and health status (HS) are rarely considered when normative data are calculated. In the present study, normative data for the Trail Making Test (TMT) were developed from a large cohort and the association of sex, age and education, as well as HS and SES, with direct and derived TMT scores was explored.

Methods: Two thousand three hundred sixteen participants [1412 (61%) women; mean age: 47.11 (SD = 11.67) years; mean education: 14.82 (SD = 3.39) years] were drawn from the population-based Epirus Health Study. HS was rated on a self-reported scale and participants' medical conditions were recorded. SES was estimated from participants' after-tax income per month. The association of sex, age and education with TMT-A, TMT-B, TMT B-A and TMT B/A was explored with linear regression analyses. Hierarchical regression analyses were applied to control for HS and SES.

Results: Direct TMT scores were associated with sex, age and education (TMT-A: Bsex = 0.060, Bage = 0.322 and Beducation = -0.191; ΤΜΤ-Β: Bsex = 0.042, Bage = 0.330 and Beducation = -0.208). TMT B-A was associated with age (B = 0.176) and education (B = -0.130), whereas TMT B/A was not associated with any tested variable. SES, but not HS, was associated with TMT-A and TMT-B explaining the association of sex with TMT scores when included simultaneously in the model.

Conclusions: TMT performances are associated with age, education and sex. However, sex differences in direct TMT scores are attributed to underlying socioeconomic disparities in this large well-characterized cohort.