The primary aim of this study was to evaluate whether military occupations with repetitive exposure to low-level blast (i.e., breachers and snipers) display poorer neurocognitive status compared to military controls without prior occupational engagement as breachers and/or snipers, and whether that effect is mediated by self-reported mental health symptoms.

With data collected from Canadian Armed Forces (CAF) breachers and snipers and sex- and age-matched CAF controls (n = 112), mental health was assessed using the PCL-5 (PTSD) and the Brief Symptoms Inventory, and neurocognitive function based on a set of computerized tasks (i.e., four-choice reaction time task, delayed matching-to-sample, n-back, Stroop). Directed Acyclic Graphs (DAGs) were created to establish a causal framework describing the potential effect of occupation on neurocognitive function while considering mental health. Factor analysis modeling was used to establish the latent construct of neurocognitive function, which was then incorporated into student-t models for effect estimation, following assumptions derived from causal inference principles.

Our results demonstrated that it is snipers specifically who displayed lower neurocognitive performance compared to breachers and controls. Critically, this effect was not mediated by mental health status. In fact, mental health was generally better in both breachers and snipers when compared to controls.

When the focus is on occupations with repetitive exposure to low-level blast, the snipers in particular are impacted most in terms of neurocognitive function. We speculate that this might be due to additional impact of recoil forces exacerbating the effect of blast overpressure on the nervous system.

Metabolic syndrome (MetS) is linked to later-life cognitive decline and brain aging, but early detection of vulnerability in midlife remains challenging. This study applied two methods to detect subtle changes in midlife adults with MetS: (1) latent profile analysis (LPA) to identify cognitive performance patterns and (2) an MRI-derived brain-predicted age metric to assess structural brain aging.

Participants were cognitively unimpaired, community-dwelling adults from prior studies on metabolic and brain health (N = 230; ages 40 – 65). MetS status was assigned using clinical criteria based on cardiovascular indicators and medical history. Cognitive test scores, adjusted for age, sex, and education, were analyzed using LPA, identifying four cognitive subgroups: High Memory, Low Executive, Global Average, and Low Memory. T1-weighted MRI scans were processed with brainageR to compute brain-predicted age difference (PAD). Analyses were conducted in R using chi-square tests, ANCOVA, regression, and nonparametric methods, with appropriate covariates and effect size estimates.

MetS prevalence differed across cognitive profiles (χ2 = 10.99, p = .012, V = 0.22), with higher rates in the Low Memory and Global Average groups than in the High Memory group. Individuals without MetS had younger brain ages than those with MetS (p = 0.003, η2 = 0.03). Only elevated triglycerides were associated with greater PAD (p = 0.012, η2 = 0.02). A Johnson–Neyman analysis showed the MetS–PAD association was significant between ages 40.0 and 54.6. PAD did not differ by cognitive profile.

Cognitive profiles and brain-predicted age metrics identify early vulnerability in midlife MetS, underscoring the importance of early intervention.

This study examined three neurocognitive patterns or “clinical pearls” historically viewed as evidence for executive dysfunction in Parkinson disease (PD): 1) letter < category fluency; 2) word list < story delayed recall; 3) word list delayed recall < recognition. The association between intraindividual magnitudes of each neuropsychological pattern and individual performance on traditional executive function tests was examined.

A clinical sample of 772 individuals with PD underwent neuropsychological testing including tests of verbal fluency, word list/story recall, recognition memory, and executive function. Raw scores were demographically normed (Heaton) and converted to z-scores for group-level analyses.

Letter fluency performance was worse than category fluency (d = −0.12), with 28% of participants showing a discrepancy of ≥ −1.0 SD. Delayed recall of a list was markedly poorer than story recall (d = −0.86), with 52% of the sample exhibiting ≥ −1.0 SD deficits. Lastly, delayed free recall was worse than recognition memory (d = −0.25), with 24% showing a discrepancy of ≥ −1.0 SD. These patterns did not consistently correlate with executive function scores. The word list < story recall pattern was more common in earlier than later PD stages and durations.

Among the three pearls, the most pronounced was stronger memory performance on story recall than word lists, observed in more than half the sample. Only ¼ the participants exhibited all three neurocognitive patterns simultaneously. The variability in patterns across individuals highlights the heterogeneity of cognitive impairment in PD and suggests that intra-individual comparisons may offer a more nuanced insight into cognitive functioning.

Most children recover from mild traumatic brain injury (mTBI), but some experience persistent neurocognitive effects. Understanding is limited due to methodological differences and a lack of pre-injury data. The study aimed to assess changes in neurocognitive outcomes in children following mTBI compared to orthopedic injury (OI) and non-injured (NI) controls, while accounting for pre-injury functioning.

Data were drawn from the Adolescent Brain and Cognitive Development (ABCD) study, a prospective longitudinal cohort. The sample included children with mTBI between the 1-year and 2-year follow-ups (n = 83), identified by parent report of head injury with memory loss or loss of consciousness, compared to children who experienced OI within the same period (n = 231) and an NI control group (n = 218). Changes in neurocognitive outcomes from baseline to the 2-year follow-up between groups (mTBI vs. OI; mTBI vs. NI) were estimated using linear mixed-effects models, accounting for demographic, behavioral, genetic, and white matter microstructural covariates.

At baseline prior to injury, the mTBI group demonstrated better performance on picture vocabulary and crystallized composite scores than the OI group. At post-injury, after adjusting for pre-injury baseline differences, children who sustained an mTBI were no different in any measure of neurocognitive outcomes compared to OI and NI controls.

The findings highlight the importance of accounting for pre-injury differences when evaluating neurocognitive outcomes following pediatric mTBI. Neurocognitive differences within a year post-injury may be more related to pre-existing individual factors rather than the injury itself, underscoring the need for a comprehensive approach in studying pediatric mTBI.

While psychiatric disorders (e.g., depression, anxiety) are well-established predictors of suicidal ideation (SI) in individuals with traumatic brain injury (TBI), the roles of other psychological and cognitive factors remain underexplored. This study examined associations between SI and emotion-processing difficulties, coping strategies, psychological resilience, and cognitive functioning after moderate–severe TBI.

This was a secondary analysis of data from 106 individuals with moderate–severe TBI. SI and emotional distress were assessed using the Inventory of Depression and Anxiety Symptoms and Hospital Anxiety and Depression Scale, respectively. Participants also completed measures of emotional lability and detachment (Comprehensive Assessment of Traits Relevant to Personality Disorders [CAT-PD]), coping (Coping Scale for Adults), psychological resilience (Connor–Davidson Resilience Scale), and cognitive functioning, including subjective (CAT-PD, Brief Rating of Executive Function) and objective measures (Brief Test of Adult Cognition by Telephone). Spearman’s correlations and path models were used to examine psychological and cognitive correlates of SI.

SI was positively associated with emotional lability, emotional detachment, non-productive coping, and self-reported cognitive problems, and negatively associated with resilience. Path models indicated that emotional distress accounted for 76–100% of these associations. Conversely, SI was not significantly associated with adaptive coping or objective cognitive performance.

Emotion-processing difficulties, non-productive coping strategies, low resilience, and self-reported cognitive problems are linked to SI in individuals with moderate–severe TBI, primarily through their associations with emotional distress. Findings underscore the importance of addressing emotional distress, including depression and anxiety, and its underlying contributors in suicide prevention for this population.

To investigate potential contributors to mental fatigue after aneurysmal subarachnoid hemorrhage (aSAH) and angiographically negative subarachnoid hemorrhage (anSAH), with a focus on information processing speed, attentional control, and psychological distress.

This observational study included 101 patients (70 aSAH, 31 anSAH) and 86 controls. Neuropsychological assessments and questionnaires were conducted five months post-SAH. Mental and physical fatigue were assessed with the Dutch Multifactor Fatigue Scale, information processing speed and attentional control with the Trail Making Test and Vienna Test System Reaction Time and Determination Test, and psychological distress with the Hospital Anxiety and Depression Scale.

Patients reported significantly higher mental and physical fatigue than controls (p < .001) and information processing speed and attentional control were significantly lower (p < .05), with no differences between aSAH and anSAH groups. Severe mental fatigue was present in 55.7% of patients with aSAH and 61.3% of patients with anSAH, significantly exceeding the prevalence of severe physical fatigue (p < .05). Higher mental fatigue correlated with worse attentional control in aSAH and with lower information processing speed in anSAH. Both mental and physical fatigue correlated with psychological distress, particularly after anSAH.

The factors related to mental fatigue appear to differ based on the type of SAH, potentially involving problems in information processing speed and attentional control, psychological distress, or both. This study emphasizes the need for individualized rehabilitation strategies addressing both cognitive and psychological factors in managing mental fatigue after SAH.

For patients with primary malignant brain tumors, cognitive decline is incredibly common and contributes to reduced independence in daily functioning. These patients often rely on informal caregivers (e.g., family, friends) for functional support, shown to increase caregiver distress in other neurologic populations. However, few studies have investigated this relationship in neuro-oncology; thus, we explored whether neuro-oncology patients’ neurocognitive function was associated with caregiver burden.

Neuro-oncology patients completed neuropsychological tests assessing commonly affected cognitive domains, and caregivers completed a validated measure of caregiver burden including impact on daily schedule, self-esteem, and availability of family support. Dyads were selected from a previous randomized-controlled trial (SmartCare) for distressed neuro-oncology caregivers. Independent samples t-tests and hierarchical regressions were used to evaluate the relationship between patients’ neurocognitive performance and caregiver burden.

Seventy-eight neuro-oncology dyads were included for analyses (Patients: Mage = 53.4, 65.4% male, Caregivers: Mage = 52.5, 71.8% female, 84.6% spouse). Caregiver schedule burden, but not self-esteem or family support, was significantly higher for caregivers of patients with deficits in verbal memory and divided attention (p < .05). After controlling for disease-specific characteristics and motor dexterity, only patient verbal memory performance remained a significant predictor of caregiver burden (p < .05). Inhibition and verbal fluency were not related to caregiver burden domains (ps > .05).

Patients’ verbal memory performance appears to be indicative of cognitive changes that contribute to increased caregiver demands on their daily schedule and time burden. Maximizing patients’ functioning through leveraging their continued cognitive strengths and implementing individualized cognitive rehabilitation programs may improve caregiver burden.

Body-focused repetitive behaviors (BFRBs) include activities like hair pulling and skin-picking that can lead to functional impairment. The neurocognitive underpinnings of BFRBs remain unclear, with inconsistent findings across domains.

This online study aimed to investigate the neuropsychological capacities of individuals with self-reported BFRBs. We administered the Go/No-Go test to assess inhibitory control and attention and the Verbal Learning and Memory Test to evaluate learning, recall, and memory confidence. From the 2,129 participants who entered the survey, 412 individuals with self-reported BFRBs and 412 matched controls from the general population were included. Drop-out was high.

Individuals with BFRBs showed no inhibitory deficits on the Go/No-Go test but made fewer hits on the Go trials compared to controls, indicating attentional lapses. Regarding memory, only immediate recall was worse in the BFRB sample. Controls were biased toward being more confident. When we divided the sample by impairment (>1 SD below the mean of controls), a minority of the BFRB group showed deficits in attention and immediate recall.

Our findings suggest that neurocognitive deficits are not prevalent in BFRB, affecting less than 20% of our sample. Yet, attentional problems in a subgroup of individuals with BFRB highlights the need to study heterogeneity within BFRBs. Potential moderators such as motivation, stress, and self-stigma remain to be explored. Our findings must be interpreted with caution given the study’s limited generalizability due to its online format, high drop-out rate, and absence of independent diagnostic confirmation.

Neuropsychological assessments commonly include word list learning tasks to assess verbal memory and learning. The California Verbal Learning Test (CVLT) provides multiple outcome measures and information regarding strategies used to enhance the coding and retrieval of information. Despite its popularity, the CVLT has not yet been formally translated into Hebrew and adapted to the Israeli population.

The CVLT-III was adapted to Hebrew (CVLT-IIIHebrew), and normative data of healthy Hebrew-speaking adults living in Israel (age range: 20 – 65, education range: 9 – 20) were collected (N = 235).

CVLT-IIIHebrew core scores were influenced by age, education level, and, to a lesser extent, sex. Normative data for the Hebrew-speaking Israeli population were generated using an overlapping interval strategy, and regression models were used to evaluate the necessity of adjusting core scale scores for sociodemographic variables. Internal reliability was very high. Clinicians can employ an easy-to-use calculator for adjusting CVLT-IIIHebrew core scores.

The adapted CVLT-IIIHebrew provides a valuable tool for evaluating the verbal memory of Hebrew speakers. Caution, however, is warranted when assessing individuals with lower education levels, as the normative sample was relatively highly educated. This highlights the importance of expanding the normative sample to include a broader spectrum of educational levels and ages. Moreover, the inclusion of Israeli minority groups, currently unrepresented in this normative sample, is of importance.

Post-stroke neurocognitive disorders are highly prevalent, yet screening tools that are fit for culturally diverse populations are scarce. This study evaluates the impact of cultural differences on the Oxford Cognitive Screen (OCS), a stroke-specific screening tool.

To evaluate cultural differences, we compared two populations with varying degrees of cultural diversity and Western, Educated, Industrialized, Rich and Democratic (WEIRD) characteristics. We adapted the Dutch OCS for Suriname through a multi-stage process. Using Bayesian hierarchical regression analysis, we compared 264 Surinamese participants, assessed with the adapted Dutch OCS, with 247 Belgian participants, assessed with the Dutch OCS, while controlling for age and education. We further investigated whether the associations of age and education with performance were comparable between the two populations.

Our findings revealed minimal differences in OCS performance between the Belgian and Surinamese populations. Both populations showed similar age-related decline and education-related improvement across all subtests, except for Picture naming, where the age-related decline was more pronounced in the Belgian population.

These findings suggest that with minimal adaptation, the OCS is a viable tool for screening post-stroke neurocognitive disorders in culturally diverse populations.

Instrumental activities of daily living (iADLs) are critical in aging and neurodegenerative research, both diagnostically (e.g., distinguishing dementia from mild cognitive impairment) and as endpoints for trials maintaining or improving functioning. However, measurement has not consistently kept pace with a changed world wherein the ability to navigate technology is pertinent to maintaining independent functioning. The current study used harmonization approaches to link traditional and technological iADLs measures using two samples.

262 individuals (53.4% women, 91.7% non-Hispanic White, Mage = 76.2, Meducation = 15.6) completed both measures: (1), the Functional Activities Questionnaire (FAQ), and (2), the new Expanded FAQ. Item response theory (IRT) analyses extracted item parameters to characterize measure psychometrics and accurately determine individual functional ability. Harmonization was done using both nonequivalent groups anchor test (NEAT) and equipercentile linking methods with supplementary traditional iADL parameter estimates from the National Alzheimer Coordinating Center (n = 48,605).

Correlations verified the measures were sufficiently related (rs = .79), and confirmatory factor analyses and reliability determined all items assessed a single construct. Items from both measures complemented each other to provide more information about milder and more severe functional change. NEAT models converged to provide IRT linking equations and equipercentile conversation tables.

This study provides critical information for harmonizing evolving technological iADLs with traditional iADLs that are assessed in longstanding cohorts. It further provides support for use of an expanded FAQ.

In ADHD a common obstacle of academic success is impaired reading comprehension. Impaired comprehension in ADHD is accompanied by altered eye movements during reading as well as more general eye movement deficits associated with non-verbal stimuli. This suggests that the reading deficits do not cause the eye movement impairment. Instead, eye movements might contribute to reading comprehension difficulties.

We tested whether minimizing the need for eye movements during reading aids comprehension. We measured reading comprehension in a sample of undergraduate students with and without ADHD. Students read short paragraphs using normal text reading with all words fully visible (FULL), PACED reading that preserved text layout with one word at a time appearing at its usual location in the text, and reading with minimal eye movements in which one word at a time appeared in the center of the screen in a rapid serial visual presentation (RSVP).

ADHD participants performed better in the RSVP condition relative to the other two reading conditions that required eye movements, and they benefited from the RSVP condition requiring minimal eye movements by almost 13% relative to neurotypical controls, who showed comprehension difficulties using the RSVP mode.

Minimizing eye movement boosted reading comprehension in the ADHD suggesting that eye movements are implicated in reading processes in ADHD, an interference that can be avoided in the RSVP reading condition. Future work should explore the possibility of RSVP as a reading aid in ADHD adults and potentially school-aged children.

Reading is a complex cognitive process requiring the integration of orthographic, phonological, and semantic information. The visual word form area, located in the ventral occipitotemporal cortex, is critically involved in orthographic decoding, and damage to this region is known to cause alexia. In contrast, the contributions of white matter pathways supporting reading are less well understood.

We present a unique neurosurgical case undergoing awake brain surgery for resection of a metastasis in the left occipitotemporal cortex. A tubular retractor was used to access the lesion and during the insertion of the retractor the patient underwent careful, continuous neuropsychological testing, including evaluation of reading. fMRI language mapping and diffusion MRI were performed preoperatively. Postoperative neuropsychological testing was completed two weeks after surgery to assess cognitive outcome.

The patient developed an alexia with letter-by-letter reading in real time during insertion of the tubular retractor. Stealth imaging enabled localization of the tubular retractor at the exact onset of the alexia and, by correlating this with tractography, showed that the tubular retractor was in the vertical occipital fasciculus (VOF).

We present the first detailed case report linking the VOF to the acute onset of alexia observed intraoperatively during awake brain surgery. We discuss the connectomics of reading and possible contributions of the VOF in reading.