While early-life adverse experiences have been linked to late-life cognitive decline, few studies have explored war exposure. Paradoxically, one study even indicated a late-life cognitive advantage of early-childhood war exposure. In the present study, we explored these associations.

We examined older adults exposed to World War II (1940–1944; n = 1179) and the subsequent Civil war (1946–1949; n = 962) in Greece during early and middle childhood with a comprehensive neuropsychological assessment and for ApoE-ε allele status, including demographic information and medical history.

Higher cognitive performance in language tasks predicted middle childhood, relative to early childhood, WWII-exposure group membership (B = .316, p = .038, OR:1.372, 95%CI:1.018–1.849), primarily for men, while higher attention/speed (B = .818, p = .002, OR:2.265, 95%CI:1.337–3.838) and total cognitive score (B = .536, p = .040, OR:1.709, 95%CI:1.026–2.849) were predictors of belonging to the middle-childhood group, only in men. Individuals who did not meet criteria for Mild Cognitive Impairment (MCI)/dementia were more likely to belong to the middle-childhood war-exposure group. Similarly, for the Civil war, higher cognitive scores and reduced likelihood to meet criteria for MCI/dementia were predictors of middle, relative to early childhood war exposure group membership (visuospatial score: B = .544, p = .001, OR:1.723, 95%CI:1.246–2.381, MMSE: B = .134, p = .020, OR:1.143, 95%CI:1.021–1.297), primarily for women. Results remained consistent when adjusting for multimorbidity, sex, education, current age, depression, and anxiety.

The present findings suggest that better cognitive performance and lower likelihood of MCI or dementia were associated with being exposed to significant hardships, such as war, during middle childhood, regardless of potentially confounding factors. Further studies are needed to shed light on this relationship.

Network modeling of post-concussion symptoms following mild traumatic brain injury (mTBI) has emerged as a promising tool for understanding how cognitive, emotional, and somatic symptoms co-occur and interact. However, the generalizability of networks developed in individual studies remains unclear. This study aimed to develop the first-ever meta-analytic pooled between-persons network structure of post-concussion symptoms and systematically examine the between-study heterogeneity of these symptom networks.

Using the Meta-Analytic Gaussian Network Aggregation (MAGNA) framework, a single pooled network model was developed by aggregating data from 6 distinct samples, comprising a total of 5,776 participants. Additionally, this study quantitatively assessed the degree of heterogeneity across these studies.

Strong symptom clusters between cognitive, emotional, and somatic symptoms were identified. Concentration difficulty and slowed thinking were the most central symptoms in the pooled MAGNA network. Large between-study heterogeneity was observed.

Findings from this meta-analysis highlight cognitive symptoms as most important for defining the network structure after mTBI at a group level, potentially perpetuating and/or being perpetuated by symptoms in other domains. The large heterogeneity observed between studies underscores the need for an idiographic (person-specific) approach to studying post-concussion symptom networks to inform precision rehabilitation.

Mild cognitive impairment (MCI) involves measurable cognitive decline that does not yet significantly disrupt daily functioning but may signal increased risk of dementia. Reliable prediction of dementia conversion in MCI is essential for early intervention and optimized clinical trial design. This study aimed to evaluate the predictive performance of various machine learning (ML) classification algorithms using clinical and neuropsychological data.

Data were drawn from the Gothenburg MCI Study and included 347 patients from a memory clinic, of whom 84 (24%) converted to dementia within two to six years. We applied 11 ML classification algorithms (logistic regression, linear discriminant analysis, naïve Bayes, k-nearest neighbors, LASSO, ridge regression, elastic net, decision tree, random forest, gradient boosting, and support vector machine (SVM)) to predict dementia conversion based on 54 clinical predictors (e.g., cerebrospinal fluid biomarkers, neuropsychological test scores, comorbidities, and demographics). In a second step, we included delta scores reflecting change in neuropsychological test performance from baseline to follow-up.

Without delta scores, LASSO, ridge, elastic net, random forest, and SVM performed best, achieving accuracy ≥0.87, kappa = 0.64, and AUC-ROC ≥0.90. These models demonstrated high specificity (0.94) but moderate sensitivity (0.68). Including delta scores improved performance, with ridge and elastic net achieving accuracy = 0.90, kappa = 0.73 and 0.72, AUC-ROC = 0.94, specificity = 0.96, and sensitivity = 0.73. The elastic net model yielded a positive predictive value of 0.85 and a negative predictive value of 0.92.

ML models incorporating clinical and cognitive change data can accurately predict dementia conversion in MCI, supporting their utility in clinical decision-making.

This study investigated functional connectivity in the default mode, central executive, dorsal attention, and salience networks (SN) and its relation to executive function in youth with traumatic brain injury.

Twenty-three youth with traumatic brain injury (11 with moderate-to-severe injury (6 male, mage = 11.78 ± 2.68 years, mtimesinceinjury = 3.71 ± 2.43 years) and 12 with complicated-mild injury (9 male, mage = 12.59 ± 1.99 years, mtimesinceinjury = 4.55 ± 1.59 years) and 17 youth with orthopedic injury (11 male, mage = 11.75 ± 2.12 years, mtimesinceinjury = 3.95 ± 1.79 years)) completed resting-state functional magnetic resonance imaging and a parent rated their child’s executive function.

We found group differences in the strength of connectivity among four regions in the default mode network (DMN) and two regions of the SN, ps < .05, Eta2 = .151–.229. The orthopedic injury group demonstrated significant negative between-network connectivity, while brain injury groups had negligible negative or, in some cases, positive between-network associations. Groups did not differ on parent ratings of executive function, as all groups fell above the normative mean, reflecting poorer than expected everyday executive behavior. Attenuation of typical negative between-network association between the posterior cingulate in the DMN and two regions of the salience network was associated with worse parent-rated executive behavior (rs = .291–.317, ps < .05).

Findings illustrate the implications of disrupted downregulation of the default mode network by the SN following pediatric brain injury. They also demonstrate how disruption in functional connectivity may underlie poor executive function after childhood traumatic brain injury.

Evaluating pauses in natural speech is a promising strategy for improving reliability, validity, and efficiency in assessing cognitive functions in people with mild cognitive impairment (MCI) and Alzheimer’s dementia (AD).

We conducted a quantitative meta-analysis of studies employing automated pause analysis. We included measures of speaking rate for comparison.

We identified 13 studies evaluating pause measures and 8 studies of speaking rate in people with MCI (n’s = 276 & 109, respectively) and AD (n’s = 170 & 81, respectively) and healthy aged controls (n’s = 492 & 231, respectively). Studies evaluated speech across various tasks, including standard neuropsychological, reading, and free/conversational tasks. People with AD and MCI showed longer pauses than controls at approximately 1.20 and 0.62 standard deviations, respectively, though there was substantial heterogeneity across studies. A more modest effect, of 0.66 and 0.27 SDs, was observed between these groups in speech rate. The largest effects were observed for standardized memory tasks.

Of the many ways that speech can be objectified, pauses appear particularly important for understanding cognition in AD. Pause analysis has the benefit of being face valid, interpretable in ratio format as a reaction time, tied to known socio-cognitive functions, and relatively easy to measure, compute, and interpret. Automation of speech analysis can greatly expand the assessment of AD and potentially improve early identification of one of the most devastating and costly diseases affecting humans.

Subjective cognitive complaints (SCC) can precede cognitive decline and are associated with demographic, exposure, lifestyle, and psychological factors. Prevalences of SCC and their correlates in individuals with repetitive head impacts (RHI) are poorly understood. This study characterized SCC in former elite American football players by frequency, mood and behavioral correlates, concordance with informant reports, and associations with neuropsychological test performance, cerebrospinal fluid (CSF), and magnetic resonance imaging (MRI) markers of neurodegeneration.

Former American football players (n = 180) completed measures of global and domain-specific SCC, neuropsychiatric symptom questionnaires, neuropsychological testing, lumbar puncture, and MRI. Elastic net regression evaluated the relative importance of potential SCC correlates. Intraclass correlation coefficients measured concordance between self and informant reports. Multiple linear regressions tested associations between SCC and verbal memory and executive functioning scores. CSF Aβ1-42, p-tau181, t-tau, neurofilament light (NfL), hippocampal volume, and regional cortical thickness were examined for their potential associations with SCC.

Rates of SCC ranged from 43 to 77% depending on the domain. Symptoms of depression, impulsivity, and anxiety were strongly associated with SCC. Self- and informant-reported SCC showed moderate inter-rater agreement. Adjusting for age, race, education, APOE ϵ4 carrier status, and depressive symptoms, SCC were associated with lower objective verbal memory and executive functioning performance. SCC were associated with lower parahippocampal cortical thickness but not with hippocampal volume or any of the measured CSF tests.

SCC are strongly associated with neuropsychiatric factors in former American football players. SCC may also be a marker of cognitive decline and neurodegeneration.

Increasing survival probabilities among children and young adults with acute lymphoblastic leukemia (ALL) have led to a growing population at risk for long-term neurocognitive sequelae. This study investigated cognitive functioning among individuals treated for ALL under the Nordic Society of Paediatric Haematology and Oncology ALL2008 protocol in Eastern Denmark, including performance across multiple domains and associations with age at diagnosis, sex, time since end of treatment, hematopoietic stem cell transplantation (HSCT), and neurotoxic events during treatment.

Eighty-three survivors of ALL diagnosed before age 25 underwent neurocognitive testing at a median of 7.24 years post-treatment (interquartile range: 4.20–8.78). Performance was measured as age-standardized Z scores derived from normative data. Impairment was defined as Z ≤ −1.3 and severe impairment as Z ≤ −2.0. Multiple linear regression was used to investigate associations between cognitive outcomes and clinical risk factors.

Average performance was generally comparable to norms, but at least 38.6% of participants showed severe impairment in one or more domains, and at least 12% in two or more. Younger age at diagnosis was associated with poorer processing speed, executive functions, and non-verbal reasoning, while HSCT was associated with poorer processing speed and non-verbal reasoning.

Although average performance of the participants was generally comparable to norms, a notable proportion exhibited multi-domain, severe cognitive impairment. Associations with age at diagnosis and HSCT indicate potential for risk-stratified cognitive monitoring and targeted interventions.

Spatial neglect is a heterogeneous post-stroke disorder with subtypes differing in reference frames, processing stages, and spatial domains. While egocentric peri-personal neglect recovery has been studied, recovery trajectories of allocentric peri-personal visuospatial and personal neglect remain unclear. This study investigated recovery time courses of egocentric and allocentric peri-personal visuospatial and personal neglect during the first 12 weeks post-stroke; whether initial severity predicts recovery and defines distinct patient clusters; and how subtypes interrelate over time.

Forty-one first-ever stroke patients were evaluated at weeks 3, 5, 8, and 12 post-stroke using the Broken Hearts Test, Line Bisection Test, Visuospatial Search Time Test, and Fluff Test. Recovery was analyzed using linear mixed models, clustering with Gaussian finite mixture models, and interrelationships using Spearman correlations.

Significant improvements occurred in egocentric and allocentric peri-personal visuospatial and personal neglect, primarily between weeks 3 and 5, followed by a plateau. The Line Bisection Test detected no changes. Higher initial severity predicted greater residual impairment. Cluster analysis identified near-normal, mild, and moderate-to-severe baseline subgroups with distinct recovery trajectories. Moderate-to-good correlations (ρ = 0.33 – 0.55) emerged between egocentric and allocentric neglect at week 3 and when timepoints were pooled.

Neglect improved mainly between weeks 3 and 5 after which recovery plateaued, mirroring motor and language recovery and suggesting a shared time-limited window. Initial severity was a determinant of recovery, highlighting the value of early severity stratification to monitor and support recovery potential after stroke. As subtypes are distinctive, assessment should include multiple neglect tests.

This study aimed to explore the correlates of zero, one, and multiple performance validity test (PVT) failures on cognitive test performance in patients with various degrees of severity of traumatic brain injury.

306 participants completed the Trail Making Test as part of a neuropsychological evaluation within 1–36 months post-injury. They were assigned to zero, one, or ≥ two fail groups on the basis of at least two independent PVTs. Group differences in Trail Making Test performance were analyzed with analysis of variance, with post hoc contrasts with the Bonferroni correction for multiple comparisons. Groups were also compared on various background characteristics.

Participants who passed all PVTs had statistically significantly better performance on both parts of the Trail Making Test as compared to those who failed either one or multiple PVTs, with the latter two groups not differing statistically significantly from each other. PVT failure was relatively more common in participants who were female, had an uncomplicated mild TBI, were involved in financial compensation-seeking, and were seen at a longer time point since injury.

Failure of even only one PVT is associated with lower neuropsychological test performance in patients with traumatic brain injury, especially when empirically validated criteria are used that are stratified by injury severity. Such failure does not always reflect malingering but must be interpreted and addressed in the context of patient background characteristics.

Switching is one of three primary executive functions alongside inhibitory control and updating but remains relatively understudied in childhood attention-deficit/hyperactivity disorder (ADHD) compared to investigations into working memory and inhibitory control deficits. Where extant literature in adults suggests that switch costs are due to a combination of task set inertia and task set reconfiguration costs, it is not clear which of these is most relevant to explaining ADHD-related atypicalities in performance.

Children with (N = 34) and without ADHD (N = 28) aged 8–12 (average age = 9.45) completed a 192-trial computerized cued switching paradigm. Diffusion model decomposition of the data was performed to identify cognitive subprocesses responsible for the switch.

Consistent with the switching literature in adults, switch costs for children were due to a combination of both task set inertia (reduced drift rate) as well as slower task set reconfiguration (Ter) on switch versus repeat trials. Children with ADHD were less accurate than non-ADHD controls, but the ADHD × Switch interactions were not significant for any variable, indicating that the deficit was general and not switch-specific. Lower accuracy was in turn attributed to slower general drift rate among children with ADHD.

This study contributes to a growing literature finding that the performance deficits in children with ADHD across executive and non-executive function tasks are related to lower-level perceptual decision-making weaknesses that have downstream effects on higher-order processing.

The Rey–Osterrieth complex figure (ROCF) test is widely used to assess constructional praxis. Qualitative scoring methods, such as the Boston Qualitative Scoring System (BQSS), enable the detection of alterations in spatial organization, planning, and executive control during copying performance. While alterations in constructional abilities have been previously reported in Parkinson’s disease (PD), the possible presence of subtle qualitative modifications in PD patients without cognitive impairment (PD-CU) and their relationship with the cognitive functioning is still to be elucidated. This study evaluates differences in copying strategies and error patterns in PD patients with (PD-MCI) or without (PD-CU) mild cognitive impairment, assessing the link with the cognitive profile.

Seventy PD patients and 56 healthy controls (HC) were recruited. All participants underwent a neuropsychological assessment, including the ROCF. Their performance was assessed by standard quantitative scoring and qualitative rating scales (BQSS). Statistical analyses compared BQSS performance between groups and examined associations between qualitative visuo-constructional features and other cognitive domains.

Both PD-MCI and PD-CU groups showed qualitative alterations compared to HC, associated with executive dysfunctions. Qualitatively, PD-CU patients showed lower scores in neatness and planning measures compared to HC, the latter particularly associated with executive alterations. Notably, patients reporting a left or right asymmetric copy were characterized by different cognitive profiles.

The here-presented results support the importance of qualitative assessment in identifying early cognitive impairments in PD patients and suggest that BQSS parameters (i.e., planning) may offer complementary insights to standard quantitative assessments in detecting subthreshold executive impairments not yet captured by conventional tests.

Sensory burden, a momentary experience of being bothered by sensory stimuli, is a frequent challenge following acquired brain injury (ABI). This study quantitatively tested a theoretical model conceptualizing sensory burden as a dynamic interaction between situational triggers and an individual’s biopsychosocial resources using an experience sampling method.

41 individuals with ABI (median age = 59 years, median time since injury = 6.3 years) provided real-time data at seven semi-random intervals per day over seven consecutive days. Multilevel regression modeling assessed the influence of situational triggers (setting, company, effort, activity dissatisfaction, and negative affect) and individual resources (processing speed, fatigue, and sleep quality) on sensory burden.

Momentary fluctuations in sensory burden varied in severity and variability across individuals. Sensory burden was associated with higher levels of negative affect (β = .58, p < .01), activity dissatisfaction (β = .07, p < .01), effort (β = .09, p < .01), and being in company (β = .39, p < .01). Moreover, sensory burden was related to slower processing speed (β = −0.04, p = .02) and higher fatigue (β = .19, p < .01). However, no interaction effects were found. Effort was the only positive, significant between-person predictor (β = .56, p < .01).

These findings underscore the dynamic and individualized nature of sensory burden after ABI, emphasizing the need for personalized interventions targeting sensory hypersensitivity. Future research should explore additional triggers, resources, and causal pathways to further elucidate the proposed mechanisms and inform treatment development.

The clock drawing test is widely used in clinical neurological and neuropsychological assessment. We hypothesized that younger adults would have greater problems with clock drawing than older adults, perhaps due to decreasing analog clock use.

Cross-sectional study analyzing clock drawing performance and cognitive function across four generations (Gen Z, Millennials, Gen X, Baby Boomers). Participants included 92 adults divided into two generations (63 younger [18–42 years old] and 29 older [43–77 years old]) assessed between October 2022 and December 2024. Participants were screened to exclude conditions affecting cognition. The primary outcome was performance errors in clock drawing (e.g., writing “11:10” instead of drawing an analog clock, or placing hands incorrectly), assessed using standardized criteria. Cognitive function was assessed using eight computerized tests (CogState) measuring processing speed, attention, executive function, visuospatial memory, and verbal memory. Confirmatory factor analysis (CFA) validated three cognitive domain composites: Speed/Attention, Executive/Spatial, and Verbal Memory.

Performance errors were significantly more prevalent among younger participants compared with older participants (p = .016; risk ratio, 4.45). The effect size was large (Cohen’s h = .63). The generation effect was stronger (OR = 28.66, p = .003) after controlling for CFA-validated cognitive domain composites. This provides strong evidence that generational differences are independent of cognitive abilities.

Younger adults demonstrate significantly higher rates of clock drawing errors compared with older adults, independent of cognitive performance. These findings suggest a need for generation-specific or age adjusted norms in clock drawing test interpretation.

To extend the current understanding of executive function (EF) deficits in youth with neurofibromatosis type 1 by investigating the impact of cognitive load on performance compared to typically developing children.

In this prospective multicenter study, 42 children with neurofibromatosis type 1 (NF1) (ages 7–18) completed neuropsychological assessments of intellect and executive functioning. Age- and sex-matched controls (n = 42) were drawn from the normative database for the tasks of executive control (TEC). Multivariate and supplementary univariate analyses examined group differences and task effects (inhibitory control and working memory demand). Associations between TEC performance and parent-reported executive dysfunction (BRIEF) were also explored.

Both groups showed reduced accuracy and speed with increased inhibitory demand and made fewer errors with increased working memory demand. However, children with NF1 were significantly less accurate and consistent across tasks, particularly under higher cognitive load, while controls improved or maintained performance. Significant group × cognitive load interactions were observed, and laboratory-based deficits in NF1 were associated with parent-reported executive dysfunction.

Children with NF1 experience unique and multidimensional decrements in EF performance in response to increased cognitive load, unlike typically developing peers. These deficits appear to be clinically relevant. Targeting working memory and inhibitory control may reduce susceptibility to cognitive overload and improve outcomes for children with NF1.

Neurocognitive assessment is an essential research instrument for autism spectrum disorder (ASD), as the clinical manifestations are rooted in diverse neurocognitive processes that cause variation in clinical presentation. Few instruments comprehensively capture relevant neurocognitive domains, and most require professional assessors. The Penn Computerized Neurocognitive Battery (CNB) is widely used in child and adolescent psychiatry research across cultures. This study adapted and validated the CNB for a clinical ASD cohort in Hong Kong.

In this Hong Kong version of the CNB (CNB-HK), thirteen cognitive tasks were translated and adapted, with one task for sensorimotor speed and twelve belonging to four specific domains (episodic memory, social cognition, complex cognition, and executive function). The CNB-HK was administered to 636 normal-IQ children with ASD (mean age: 8.4 years, 87.1% male) and 412 children without ASD (mean age: 8.6 years, 55.1% male). Factor structure was examined using factor analyses.

The CNB-HK had high feasibility for children with ASD, with <7% invalid data across all tasks. The original four-factor and bi-factor structures were replicated with good model fit, and partial scalar invariance was achieved between children with and without ASD. The factor scores correlated positively with estimated IQ in the ASD group. The ASD group had worse performance across all four cognitive domains and the g factor compared to the group without ASD.

The CNB-HK is a valid, multi-domain cognitive assessment tool for children with ASD in Hong Kong, offering a feasible and reliable approach for research and clinical settings.

The International Neuropsychological Society (INS) Justice and Equity Subcommittee initiated a survey of neuropsychological academic training programs, clinical practices, and research across Africa, examining respondents’ interest in collaboration and their views on resources needed to advance the field.

This quantitative, cross-sectional study employed chain-referral sampling at higher education institutions identified via uniRank. Of the 1,244 institutions screened, 241 offered psychology or psychiatry coursework. A multilingual cover letter and survey link (English, Swahili, Arabic, French, Portuguese, Spanish) were distributed, yielding 42 respondents from 17 of 54 countries (≈31.5% country response rate).

Most respondents were clinical psychologists or neuropsychologists and reported 1–5 neuropsychologists per country. Neuropsychologists’ roles included cognitive assessment, research, teaching, and assisting in neurological diagnoses, primarily using tests developed outside Africa. Current research centered on the neuropsychological effects of psychiatric disorders, infectious diseases (e.g., HIV, cerebral malaria), and neurodevelopmental disorders, with future focus areas identified as traumatic brain injury and epilepsy. Educational and training opportunities remain limited. Key barriers to program development included insufficient numbers of trained neuropsychologists, clinical training sites, and employment prospects. Despite this, there is strong interest in collaboration to accelerate the development of neuropsychology and neurosciences, given the heavy burden of neurological disease.

To foster growth, efforts must target the creation of academic and clinical training pathways and the adaptation, standardization, and norming of assessment tools tailored to African populations. There exist ample impactful avenues for individual and organizational collaboration or support to further the global development of neuropsychology.

Thai researchers developed a new self-report measure of executive functions for adolescents based on Diamond’s framework (the Behavioral Inventory Measure of Executive Functions [BIMEFs]). How it was developed, its psychometric properties, and norms by sex and age are reported here.

An independent panel of experts evaluated the content validity of BIMEFs. Reliability was checked using Cronbach’s alpha with a sample of 45 secondary students. 1,865 students, ages 12 – 18 years (65% female) from across Thailand participated in the normative study.

The BIMEFs consists of 42 items that assess inhibitory control (IC), working memory (WM), and cognitive flexibility (CF), including eight subcomponents. For all items, the index of item-objective congruence was >0.5 and Cronbach’s alpha was >0.7. Confirmatory factor analysis (CFA) showed the adjusted goodness of fit index to be 0.9. The strongest sex difference was for IC. Students of 13 years scored lower on EFs overall, IC, WM, CF, and all subcomponents than older students. Self-control, verbal working memory, and being able to change perspectives showed the most pronounced differences by age.

The BIMEFs, which is designed to be culturally-appropriate for Thailand and cross-culturally generally, is the first EF questionnaire based on Diamond’s framework. It shows good psychometric properties and sensitivity to age and sex differences. It indicates that IC development, at least in Thailand, plateaus earlier than WM and CF and that CF shows a more protracted development during adolescence than IC or WM.

Within resource-limited health care, it is important to demonstrate the value and impact of neuropsychological assessment (NPA) services. However, the most suitable methods for capturing these outcomes are yet to be established. We aimed to identify key potential outcomes of NPA, existing measures of these outcomes, and issues and challenges associated with outcome measurement.

Focus groups of experienced Australian neuropsychologists discussed possible NPA outcomes, existing measures, and challenges of outcome measurement, analyzed using thematic analysis. The Delphi method of expert consensus was then used to identify the most important set of NPA outcomes, using iterative survey rounds with expert panelists. Panelists also rated the top three outcomes most likely to demonstrate the impact of NPA in trials.

There were 50 potential NPA outcomes generated by the focus groups, spanning proximal and distal patient, caregiver, health service, and societal domains. Numerous issues and challenges were identified associated with meaningfully measuring NPA outcomes. After three Delphi survey rounds (n = 46), a total of 16 outcomes achieved consensus agreement. Few existing validated measures were identified. The top three rated outcomes were 1) better patient and/or caregiver understanding of presenting problems, 2) better patient and/or caregiver understanding of how to manage and cope with cognitive symptoms, and 3) diagnostic clarification.

Psychoeducational benefits of NPA were considered by Australian experts as key outcomes relevant across contexts; however, there are no existing measures of these outcomes. Future research should develop valid outcome measures to be used in clinical trials evaluating NPA impacts.

To review the historical, conceptual, and ethical foundations of intelligence testing in neuropsychology and to consider whether alternative cognitive performance labels offer greater conceptual precision while reducing stigma.

We conducted a narrative review of early twentieth century cognitive assessments, tracing the evolution of intelligence testing and its intersections with eugenic ideology. Key examples include the Army Alpha and Beta tests administered during World War I and Ellis Island immigration assessments, which were frequently interpreted without consideration of cultural or educational influences. We examine how these practices informed early interpretations of neuropsychological performance, particularly in individuals with epilepsy, and shaped initial characterizations of neurologically based cognitive abilities.

Early intelligence testing was grounded in the belief that intelligence was a fixed and directly genetically determined trait. Test performance was interpreted as an index of biological superiority, lending scientific legitimacy to eugenic ideologies and reinforcing stigma toward individuals with epilepsy. Although modern frameworks emphasize multidimensional cognitive abilities, intelligence-based characterization persists and continues to be frequently reported as a primary outcome of neuropsychological testing.

In contexts that require a single summary indicator of cognitive performance, labels such as Total Cognitive Composite are recommended since they avoid implying a fixed or unitary capacity. Continued reliance on the construct of “intelligence” is inconsistent with contemporary models of cognition, reflects outdated theoretical assumptions, and carries enduring psychosocial stigma. Moreover, its circular and internally inconsistent definitions substantially limit its validity and appropriateness within contemporary adult clinical neuropsychological practice.

Language deficits are frequently described by patients with multiple sclerosis (MS); however, objective characterization remains somewhat limited due to its omission from standard MS cognitive evaluation and the inconsistent findings that arise from current language measures.

To establish alternative approaches to characterizing single-word level language in MS, this study (i) validates the Sydney Language Battery (SYDBAT) visual confrontation naming subtest and (ii) examines the insights provided by examining naming errors and latencies.

40 MS patients from Royal Melbourne Hospital’s Cognitive Neuroimmunology Clinic and 40 matched controls completed a series of neuropsychological tests, including the SYDBAT and ‘gold standard’ confrontation naming task, the Boston Naming Test (BNT). Error types and latencies on the SYDBAT were extracted from assessment audio recordings.

SYDBAT and BNT scores were highly correlated (r = 0.81, p < .001) and these tasks reported comparable receiver operating characteristic curves (p = .091). Latency analysis captured lexical retrieval difficulties, with patients displaying significantly longer mean latencies than controls on the SYDBAT (p = .012, β = 0.54).

These findings support the validity of the SYDBAT and value of the latency analysis in characterizing language impairment in MS. Use of the SYDBAT and latency considerations contribute to a broader assessment with a briefer administration time compared to gold-standard evaluation. The study thereby offers clinicians an enhanced toolkit to more effectively and appropriately evaluate language functioning and supplement standard cognitive evaluation in this population.