The relationship between frontotemporal dementias (FTDs) and amyotrophic lateral sclerosis (ALS) is well established and is believed to be more pronounced in those with bulbar onset ALS (B-ALS). This study compared cognitive and behavioral symptoms among persons with B-ALS to those of individuals with nonbulbar phenotypes (NB-ALS).

Outpatient clinic data collected during an initial neuropsychology consultation at an ALS interdisciplinary clinic in an academic medical center was retroactively analyzed. All individuals were diagnosed with ALS by neurologists specializing in movement and neuromuscular disorders based on results of neurological/motor examination, electromyographies, and (when available) genotypic data. Total scores on the short form of the Montreal Cognitive Assessment (MoCA-SF) and scores on the ALS Cognitive Behavioral Screen (ALS-CBS) and ALS CBS Caregiver questionnaire were of focus. 22 B-ALS and 44 NB-ALS individuals were compared on said measures using univariate analyses while controlling for ALS symptoms duration.

B-ALS individuals scored significantly lower on the MoCA-SF (F(2)=3.15, p=0.05, n2=0.13) and the tracking subscale of the ALS-CBS (F(2)=3.50, p=0.04, n2=0.17). The groups were not significantly different on other ALS-CBS measures, including caregiver-rated behavior questionnaire.

Consistent with previous research, this study found lower total scores on a brief screener of global cognition and tasks of tracking requiring cognitive control in those with B-ALS relative to NB-ALS individuals. Interestingly, despite behavioral variant being the most prevalent FTD phenotype, the groups did not differ significantly in terms of caregiver-rated behavioral changes. It is hypothesized that the absence of these differences could reflect effects of gradual loss of speech and functionality that secondarily limit caregivers' abilities to observe behavioral changes concerning for possible behavioral variant FTD. That said this could reflect limitations of the sample and/or study design, and further exploration is therefore needed. Recommendations for future studies of neuropsychological/behavioral variables in B-ALS as well as development of more targeted instruments for use in this population are discussed.

Rapid automatized naming (RAN) assesses pre-literacy and could be useful for assessing the effects of HIV infection on the development of literacy. Many children with HIV live in sub-Saharan Africa, but the RAN has not been well-studied there. Cultural differences in when children learn color names and in how they prioritize between accuracy and speed can affect RAN results. Typically, RAN and other cognitive functions (e.g., general intelligence, processing speed, working memory, attention) are strongly related. Our goal is to examine how RAN performance relates to neurocognitive function in sub-Saharan Africa and whether RAN performance could reveal the effect of HIV on pre-literacy. The current study examines the relationship between RAN performance and cognitive variables in both children living with HIV (CLWH) and healthy controls in Tanzania.

486 children (ages 3-8) were administered RAN Color and Object tasks as part of a larger longitudinal study in Dar es Salaam, Tanzania. All participants were also administered the Leiter International Performance Scale - 3rd Edition (Leiter-3), a test of nonverbal intelligence and general cognitive function. Binomial logistic regression examined the likelihood of completing a RAN task and included age, Leiter-3 composite standard scores, and HIV status. Multiple linear regression using the same predictors assessed factors associated with RAN completion time in children who completed the tests. SES and education were not included in the model specifications because they were not correlated with any RAN measures.

Only 40% of children could complete the RAN Color task, while 88% completed the Object task. Logistic regression models showed that age (p<0.001), Leiter-3 Nonverbal IQ (p<0.01), and Processing Speed (p<0.001) composite scores were all unique predictors of whether children would complete the RAN Color task. Age (p <0.001) and Nonverbal IQ (p<0.001) were predictors of completing of the RAN Object task. Of those who could complete the RAN Color task, multiple linear regression demonstrated that age (p<0.01), Leiter-3 Nonverbal IQ (p=0.01) and Processing Speed (p=0.001) composites predicted completion time, with the model accounting for 25% of the variance. For the RAN Object task, multiple linear regression indicated age (p<0.001), Leiter-3 Processing Speed (p=0.01) and Nonverbal Memory (p=0.01) composites, and living with HIV (p=0.01), predicted completion time, with the model accounting for 42% of the variance.

Completion rates for RAN Color and Object tasks were low but improved with age. Consistent with brain maturation, increasing age and processing speed improved completion time, regardless of the RAN task. General cognitive ability predicted RAN Color performance, and Nonverbal Memory (encompassing attention, working memory, and retrieval) and HIV status additionally predicted RAN Object performance. Results extend research indicating RAN is distinct yet multifactorial, relying on various neurocognitive functions working together. Additionally, the relationship of HIV to RAN Object performance implies an overlap between the neurocognitive functions inherent in RAN and the neurocognitive weaknesses often reported in CLWH. These findings suggest cognitive vulnerabilities in CLWH may extend to literacy skills in sub-Saharan Africa, which requires further study.

Mobile, valid, and engaging cognitive assessments are essential for detecting and tracking change in research participants and patients at risk for Alzheimer’s Disease and Related Dementias (ADRDs). The mobile cognitive app performance platform (mCAPP) includes memory and executive functioning tasks to remotely detect cognitive changes associated with aging and preclinical Alzheimer’s disease. This study assesses participants’ comfort and subjective experiences with mCAPP as the potential utility and advantage of mobile app-based assessments for remote monitoring among older adults will depend upon usability and adoptability of such technology.

The mCAPP includes three gamified tasks: (1) a memory task involving learning and matching hidden card pairs (“Concentration”) (2) a stroop-like task (“Brick Drop”), and (3) a digit-symbol coding-like task (“Space Imposters”). Participants included 37 older adults (60% female; age=72±4.4; years of education=17±2.5; 67% White) with normal cognition enrolled in the Penn ADRC cohort. Participants completed one baseline session of mCAPP in-person, followed by two weeks of at-home use with eight scheduled sessions. Information on prior experience with mobile technology and games was collected, and usability of mCAPP was measured at baseline and after 2-weeks of use with the IBM Computer Usability Satisfaction Questionnaire and the mHeath App Usability Questionnaire (MAUQ) respectively. Feedback on perceived difficulty, enjoyment, and likelihood to play mCAPP games again on their own was collected.

Participants completed on average 11±4.9 sessions over 2 weeks, with each session lasting 11.5±2.5 minutes. 59% of participants reported using their mobile device to play games (“mobile game players”). Performance on mCAPP tasks was slower at baseline for non-players, with trend-level differences on higher-load blocks of Space Imposters (p=.057 and .059). No differences in game performance were seen between groups after playing 8 sessions at-home. There were no differences in usability of mCAPP between groups, with average usability 8.2±1.5 (IBM, 0-9 scale) at T1 and 6.2±0.8 (MAUQ, 1-7 scale) after completion of two weeks of at-home use (TLast). Reported enjoyment was moderate to high for both groups at baseline and increased over time. Likelihood to play Concentration and Brick Drop again trended lower among nonplayers at T1 (p=.061 and .054), but not at TLast. Further, change in likelihood to play mCAPP from T1 to TLast was positive among non-players, with change for Concentration significantly higher for non-players than for players (p=.037).

Participants were willing and able to complete at-home cognitive testing and most completed more than the assigned sessions. While participants who do not play games on their own mobile device were slower on some tasks at baseline, these differences dissipated with further play at-home. Usability and enjoyment of mCAPP games were high regardless of mobile game-playing status, and non-players demonstrated increased willingness to play mCAPP games again at the end of participation compared to baseline. This pilot study shows preliminary feasibility and adoptability of mobile app-based assessment regardless of prior experience with mobile games.

Reading is an important skill, and becomes even more so beyond elementary years, when the focus shifts to comprehension as a means of learning and understanding academic material across subjects (Kamil et al., 2008; Shanahan et al., 2010; Snow, 2002). One construct receiving much recent interest in research, especially that related to academic achievement, is mind wandering (MW). MW has been defined as "a shift away from a primary task toward internal information" (Smallwood & Schooler, 2006). Though it is known to be ubiquitous among people (McVay & Kane, 2012), there are numerous theories about why MW occurs, in different contexts, and in relation to various other factors, and no one theory is currently dominant. MW and other factors such as working memory (WM) and decoding are all known to influence functional outcomes such as reading comprehension (RC), but there is little information on how all of these factors interact with one another with regard to RC. Most prior work focuses on adults and thus generalization to children is still needed. Therefore, the goals of this project were to examine the roles of WM, MW, decoding, and their interactions in relation to RC. It was hypothesized that each would demonstrate a significant relationship with the outcome of RC and that they would interact with one another beyond their individual main effects.

The sample included 214 6th and 7th grade students with a larger proportion of struggling readers. Participants were each administered the Kaufman Test of Educational Achievement -Third Edition (KTEA-3; Kaufman & Kaufman, 2014) Letter Word Recognition subtest (decoding), the Weschler Intelligence Scale for Children - Fifth Edition (WISC-5; Wechsler, 2014) Digit Span and Picture Span subtests(WM), and the Gates-MacGinitie Reading Tests - Fourth Edition (GMRT-4; MacGinitie, 1978) Comprehension subtest (RC). Four measures of MW were administered: the trait-based Mind Wandering Questionnaire (MWQ; Mrazek et al., 2013); two task-based (or state-dependent) retrospective reporting (TBRR) questionnaires (Matthews et al., 2002), and a researcher-generated single-item task-based retrospective report administered after four tasks. Correlations and regression were utilized to evaluate the relationships among predictor variables, and with regard to RC, including how predictors moderate one another.

All three key predictors demonstrated a significant relationship with RC both via zero-order correlations and main effects in the context of interactive relationships. WM and decoding demonstrated positive relationships with RC and MW demonstrated a negative relationship with RC, though only when one (MWQ) measure of MW was used, rather than the TBRR measure. There was a significant interaction of decoding and MW as measured by the TBRR questionnaires on the outcome of RC. Other interactions were not significant.

These results clarify the interactive relationships of these three key predictors on the important academic achievement outcome of RC, ultimately suggesting that intervention strategies for achievement problems in areas such as RC should consider MW in conjunction with decoding abilities in order to implement effective strategies that capitalize on individual children's strengths and build on their particular weaknesses.

Social cognition refers to processing, analyzing and understanding information about emotions and social situations. Many studies indicate a frequent deficit of these functions in people with tumors of the cerebellum. Visual search is an important attention process prior to information processing. It also mediates the relationship between cognitive function (attention) and social cognition. There are numerous data showing that disorders of various aspects of attention are fairly common in patients with tumors of the cerebellum. The question arises whether there is any relationship between these functions. The purpose of this study was to find out if there is a relationship between visual search performance and the ability to recognize emotions.

The study included 19 patients with the cerebello-pontine angle (CPA) tumors (mean age = 38.84, SD = 14.27; 10 women and 9 men) and 19 healthy controls (mean age 38.26, SD = 10.40; 10 women and 9 men). The research group consisted of patients from the Department of Neurosurgery, UCK Medical University of Warsaw, the control group was healthy. The groups did not differ demographically. At the beginning, the respondents completed a questionnaire in which they were asked about demographic data and health status. Then, a series of 40 boards presenting the letters T in two colors, blue and orange, scattered in different planes was presented. The letters were right or upside down. The test person’s task was to find and click the correctly positioned orange T letter as quickly as possible. Then, a series of 56 photos of faces representing seven different emotions was presented (happiness, anger, sadness, surprise, disgust, fear and a neutral face). The test person’s task was to decide which of the emotions mentioned under the photo were presented by the presented face.

The results indicated that patients with tumors in the CPA area had a longer mean reaction time and lower accuracy when performing visual searches than subjects from the control group. Likewise, there were longer times and lower accuracy in the emotional recognition task. Moreover, in the group of patients with CPA tumor, the response time during visual search was negatively associated with the correctness of the response in visual search (p = -0.57, p <0.05). There were also negative correlations between the reaction time and the correctness of recognizing particular emotional states: anger (p = -0.48, p <0.05), disgust (p = -0.62, p <0.01) and neutral (p = -0.64, p <0.01). The correctness of answers in visual search correlated positively with the accuracy of emotion recognition (p = 0.72, p <0.01). None of the above-mentioned relationships were found in the control group.

The obtained results indicate a relationship between the quality of visual attention and the ability to recognize emotions in people with cerebellar lesions. In order to better understand this phenomenon, it is necessary to continue research in this field.

A non-negligeable proportion of individuals who have sustained a mild traumatic brain injury (TBI) are at risk of developing persistent symptoms. The impact of persistent post-mTBI symptoms can be profound, causing significant disruptions in well-being, functioning and quality of life (Agtarap, et al., 2021). Reduced social participation often extends beyond the acute recovery period and continues to be associated with lower quality of life for many months after mTBI (Voormolen et al., 2019). Coping was found to be essential in order to decrease physical symptoms, have better psychological health, as well as increase social participation (Vos et al., 2019). The variables of perceived stress and depression were also linked directly and indirectly to mild post-TBI adjustment in terms of their return-to-work status (Strom and Kosciulek, 2007). Furthermore, a greater percentage of individuals with mTBI report chronic pain as compared to individuals with more severe TBIs (Weyer Jamora, Schroeder & Ruff, 2013). Given these implications and the growing concern for mTBI as a potentially disabling and chronic medical condition, it is important to focus on identifying the processes that can lead to persistent symptoms and related preventive interventions that can be applied. This present study aimed to investigate the association between coping and social participation according to anxiety, depression, and pain symptomatology, before and after rehabilitation in a mild TBI population benefiting from an outpatient rehabilitation program.

A prospective longitudinal cohort study design was employed, with two-time points for outcome assessment (i.e., start and end of rehabilitation). This study included 70 adults aged between 18 and 78 who experienced a mTBI between February 2016 and January 2020 and received interdisciplinary outpatient rehabilitation services at a major rehabilitation centre in the Greater Montreal region.Measures administered pre and post rehabilitation included the Rehabilitation Survey of Problems and Coping (R-SOPAC), the Mayo-Portland Adaptability Inventory-4 (MPAI-4), the Depression Anxiety Stress Scales 21 (DASS-21), and the Brief Pain Inventory-Short Form (BPI-SF). Mediation analyses were carried out via PROCESS macro for SPSS, model 4 and 6 (Hayes, 2013).

Mediation analyses indicated a partial indirect link between coping, anxiety, and pain on the level of social participation at the pre-rehabilitation time point. Post-rehabilitation, a significant partial mediating relationship regarding the impact of pain on the link between coping and social participation, was found. In addition, a statistically significant mediation relationship was found, where anxiety mediated the relationship of coping and social participation. These relationships suggest that lower levels of coping appear to be linked to a higher self-reported level of psychological distress and pain, resulting in lower social participation.

This observational rehabilitation cohort study demonstrates how anxiety and pain are associated with coping and social participation outcome following mTBI. These results are quite pertinent for clinical purposes in that paying close attention to the level of anxiety and perceived impact of pain during rehabilitation, and applying targeted interventions at these levels, in particular to increase coping, may prove particularly beneficial to improve social participation outcome.

Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with impaired executive functioning and anxiety/depressive symptoms, which may contribute to reduced quality of life. We tested the hypotheses that (1) a childhood diagnosis of ADHD is related to reduced quality of life in emerging adulthood and that (2) this relationship is mediated by impaired executive functioning and anxiety/depressive symptoms.

We assessed 85 children and adolescents with ADHD and 50 typically developing peers at baseline (Mean age = 11.6 years, 58% males), two-year follow-up, and 10-year follow-up with neuropsychological tests of executive functioning, the Behavioral Rating Inventory of Executive Function (BRIEF), the Short Moods and Feelings Questionnaire (SMFQ), and the Revised Children’s Manifest Anxiety Scale, second edition (RCMAS-2), as well as the Perceived Quality of Life scale (PQoL) at the 10-year follow-up. Four neuropsychological tests of executive functioning, the Letter-Number Sequencing test (working memory), the Color-Word Interference test condition 3 (response inhibition), the Color-Word Interference test condition 4 (shifting), and the trail making test condition 4 (cognitive flexibility) were combined into a neuropsychological executive functioning composite score based on high factor loadings (> .73). the parent-reported BRIEF indexes, the behavioral regulation index, and the metacognition index were used as measures of everyday executive functioning. We conducted independent samples t-tests to compare the groups and simple and parallel mediation analyses with full information maximum likelihood estimation to examine whether the different executive functioning measures and anxiety/depressive symptoms at two-year follow-up mediated the relationship between baseline ADHD and self-reported quality of life at 10-year follow-up.

Baseline ADHD was associated with more difficulties with executive functioning on a composite measure of neuropsychological tests (p < .001, Hedges g = .79) and parent-reported everyday metacognitive (p < .001, Hedges g = 2.37) and behavioral regulation executive functioning (p < .001, Hedges g = 1.55), as well as self-reported anxiety (p < .001, Hedges g = 1.05) and depressive symptoms (p < .001, Hedges g = 1.00) at two-year follow-up. Baseline ADHD was associated with lower self-reported quality of life (p = .001, Hedges g = -.67) at 10-year follow-up. The mediation analysis showed that everyday metacognitive executive functioning (p = .011, ß = -.497) and an anxiety/depressive symptoms composite (p < .001, ß = -.404) parallelly mediated the relationship between ADHD and quality of life.

Impaired everyday executive functioning and anxiety/depressive symptoms may represent two distinct pathways to reduced quality of life in emerging adults with a childhood diagnosis of ADHD. These findings stress the importance of targeting both cognitive and emotional aspects in interventions for children and adolescents with ADHD to improve later quality of life.

Previous studies had shown that even with normal early development, preterm children at age six still have executive function deficits, including planning, cognitive flexibility, and nonverbal working memory. The present study aims to discuss further the correlation between IQ and EF of preterm children with different birthweight in order to clarify the potential influence of birthweight.

The preterm children were recruited from the Regional Cohort Network for premature infants who were admitted to neonatal intensive care units. Inclusion criteria were their scores of Bayley Scales of Infant and Toddler Development, second or third edition at 12 and 24 months, and Wechsler Preschool and Primary Scale of Intelligence, Revised Edition at 5 years old were higher than 70. Meanwhile, their FSIQ of Wechsler Intelligence Scale for Children, Fourth Edition were higher than 85 at age 6. Exclusion criteria were visual impairment, hearing impairment, and cerebral palsy. There was a total of 251 preterm children recruited in the present study. Preterm children were then divided into very low birthweight (VLBW) and extremely low birth weight (ELBW) groups. The VLBW group included 183 preterm children, whose birthweight is between 1000-1500g, and gestational age is less than 37 weeks. The ELBW group included 68 preterm children, whose birthweight is less than 1000g and gestational age is less than 37 weeks. Four types of executive function were assessed. Inhibition was assessed through Comprehensive Nonverbal Attention Test Battery (CNAT), cognitive flexibility was assessed through Wisconsin Card Sorting Test (WCST), verbal working memory was assessed through the Longest Digit Span Forward (LDSB) index of Digit Span Subtest of Wechsler Intelligence Scale for Children-IV (WISC-IV), and nonverbal working memory was assessed through Knox's Cube Test (KCT), and planning ability was assessed through Tower of London (ToL). Data were analyzed with independent T-test and Pearson Correlation.

In VLBW preterm group, results showed that there were significant correlations (p<.05) between FSIQ and EF indexes in five out of six indexes of WCST, LDSB of Digit Span of WISC-IV, Backward score of Knox's Cube Test, and three out of six indexes of ToL. As to the CNAT, there was no index of CNAT that was significantly correlated with FSIQ in the VLBW preterm group. In ELBW preterm group, results showed that there were significant correlations (p<.05) between FSIQ and EF indexes in one out of five indexes of CNAT, one out of six indexes of WCST, Backward score of Knox's Cube Test, and two out of six indexes of ToL. And the LDSB of Digit Span of WISC-IV was not significantly correlated with FSIQ in ELBW preterm group.

There were fewer EF indexes significantly correlated with FSIQ in ELBW preterm children with normal early development than VLBW preterm children with normal early development, suggesting that even with an IQ higher than 85, lower the birthweight, especially lower than 1000g, higher the EF performance should be concerned. Therefore, in the clinical setting, it is very important to assess the EF independently. And birthweight may be a crucial factor in preterm children's prefrontal cortex maturity.

The purpose of this investigation was to examine neuropsychological functioning after frontal (FL) or temporal lobectomy (ATL) in patients with localization related epilepsy. Few studies have compared cognitive changes following FL and ATL. Past research found improvement on measures of verbal and visual memory along with confrontation naming after FL (Busch et al., 2017). In contrast, a number of studies have reported verbal memory and naming decline in those undergoing left ATL. The current study examined post-operative cognitive changes in epilepsy patients who underwent either a left or right FL or ATL.

Subjects include 430 patients (204 men, 225 women, 1 gender not specified), who underwent surgical resection; Right FL = 25, Left FL = 26, Right ATL = 211, Left ATL = 168. Patients had a mean FSIQ = 90, ages ranging from 18 to 71 (mean age = 37 years), right (n=359), left (n=50), or mixed (n=18) handedness, and education ranging from 3 to 22 years (mean = 12.9 years of education). Change from pre- to post FL and ATL was examined in the following domains: learning and memory [Long Term Storage for Selective Reminding Tests (SRT), Wechsler’s Memory Scale (WMS): Logical Memory Delayed Recall (LM) and Visual Reproduction Delayed Recall (VR)], and language [Boston Naming Test (BNT)].

A one-way ANOVA was used to examine changes in language and memory. Our findings revealed statistically significant differences between resection groups for LM, SRT, and BNT. There were significant declines (p<.001) for left ATL when compared to right ATL for LM, SRT, and BNT. There were significant declines for left ATL, when compared to the gains in both left (p<.001; p=.002) and right (p=.018; p=.008) FL for LM and BNT. Left ATL also had significant declines when compared to gains in SRT (p<.001) for right FL. There were significant declines for left FL when compared to right ATL for SRT (p=.007). Lastly, there were significant gains for right FL when compared to left FL for SRT (p=.020).

The pre- to post-surgical neuropsychological change in learning, memory, and language is understudied in frontal lobe epilepsy (FLE); although several investigators reported some learning and memory impairments in FLE at either pre- or post-surgical time points (Johnson-Markve et al., 2011; Incisa Della Rocchetta et al., 1993). The current study suggests that resections of the frontal lobes are associated with better outcomes for naming and verbal memory (LM) when compared to left ATLs. Interestingly, verbal list learning declined more in left than right FL and right ATL patients suggesting a possible language based executive functioning component to this memory measure. As expected, our study further supports that left ATLs are associated with material specific memory declines. This pattern was not seen for those undergoing a right ATL (i.e., nonverbal memory did not decline in patients with right ATL).

Theory of mind (ToM) deficits have been reported in patients with multiple sclerosis (pwMS). However, most studies have used pictures or written scenarios as stimuli without distinguishing between cognitive and affective ToM, and no studies have investigated older pwMS. The aims of this study were to determine the impact of MS and age on cognitive and affective ToM using a more ecological video-based task. We also aimed to investigate the relationships between ToM, cognition and emotion reading to understand the nature of ToM deficits in pwMS.

We recruited 13 young healthy controls (HC), 14 young pwMS, 14 elderly HC and 15 elderly pwMS. ToM was measured using an adaptation of the Conversations and Insinuations task (Ouellet et al. 2010). In this task, participants watch four 2-minutes videos of social interactions, which are interrupted by multiple choice questions about either the emotional state (affective ToM; 14 questions) or the intention (cognitive ToM; 14 questions) of the characters. They also underwent a short neuropsychological battery including cognitive tasks (Montreal Cognitive Assessment (MoCA), DKEFS Color-Word Interference Test) and an experimental multimodal emotion recognition task.

We found significant effects of group (pwMS < HC), age (older < younger) and condition (cognitive ToM < affective ToM) on the ToM task. Although no interaction effect was found, the elderly pwMS group showed the largest discrepancy between their cognitive and affective ToM, the cognitive subtask being significantly more affected. ToM significantly correlated with general cognition (MoCA) in all participants, while cognitive inhibition (DKEFS Color-Word Interference Test) correlated with ToM only in elderly pwMS. No significant correlation was observed between ToM and emotion reading.

This study highlights both cognitive and affective ToM deficits in pwMS, and particularly in cognitive ToM in elderly pwMS. These impairments could be underlied by cognitive and executive difficulties, but not by core social cognitive impairments, as observed in the correlation analyses. Future studies should investigate the relationships between ToM impairments and impairments in real-life empathy and social behavior in pwMS.

Victims of electrical injury (EI) often experience injuries to the peripheral nervous system and neuromuscular damage that may diminish motor function, such as flexibility/dexterity. These difficulties may continue after rehabilitation due to the reorganization of muscle afferent projections during peripheral nerve regeneration. Therefore, understanding how patients with a history of thermal burn injuries perform on motoric measures is necessary to explain the impact neuromuscular damage has on both motor and non-motor tests of cognition. However, no studies have examined the impact of motor functioning on cognition in patients who experienced thermal and electrical injuries compared to an electrical shock injury. This study explored the impact of motor dysfunction and psychiatric distress measured by depression severity on psychomotor speed and executive test performances among EI patients with and without thermal burn injuries.

This cross-sectional study consisted of EI patients undergoing an outpatient neuropsychological evaluation, including tests of motor dexterity (Grooved Pegboard [GP]), psychomotor speed (Wechsler Adult Intelligence Scale-IV Coding, Trail Making Test [TMT] Part A), and executive functioning (Stroop Color and Word Test [SCWT] Color-Word trial, TMT Part B). The sample was 83% male and 17% female, 88% White, 3% Black, 5% Hispanic, and 2% other race/ethnicity, with a mean age of 43.9 years (SD=11.36), mean education of 12.9 years (SD=2.05), and mean depression severity of 20.05 (SD=12.59) on the Beck Depression Inventory-II (BDI-II). Exclusion criteria were: 1) injury history of moderate-to-severe head trauma, 2) >2 performance validity test failures, and 3) any amputation of the upper extremity. Regression analyses included GP T-Scores for dominant hand and BDI-II total score as independent variables and neuropsychological normative test data as dependent variables.

Among validly performing patients with EI (n=86), regression analyses revealed GP performance accounted for significant variance (R2 =.153-.169) on all neuropsychological measures. Among EI patients with burn injuries (n=50), regression analyses revealed GP performance accounted for significant variance (R2 =.197-.266) on all neuropsychological measures. Among EI patients without burn injuries (n=36), analyses revealed that neither GP performance nor BDI-II severity accounted for significant variance across the neurocognitive tests (R2=.056-.142). Furthermore, among EI patients with burn injuries and the total sample, regression analyses revealed depression severity negatively predicted GP performance (R2 =.099-.13), however, in patients without burn injuries, depression did not predict GP performance (R2 =.052).

Overall, results showed that GP performance is a significant predictor of neurocognitive performance on both motor and non-motor measures in EI patients with burn injuries. Therefore, among EI patients with burn injuries, GP performance may have potential utility as an early indicator of injury severity, considering that it predicts neuropsychological test performance on measures of psychomotor speed and executive functioning. Lastly, depression predicted GP performance within the burn injury sample illustrating that psychological distress may negatively impact motor functionality.

The National Institutes of Health-Toolbox cognition battery (NIH-TCB) is widely used in cognitive aging studies and includes measures in cognitive domains evaluated for dimensional structure and psychometric properties in prior research. The present study addresses a current literature gap by demonstrating how NIH-TCB integrates into a battery of traditional clinical neuropsychological measures. The dimensional structure of NIH-TCB measures along with conventional neuropsychological tests is assessed in healthy older adults.

Baseline cognitive data were obtained from 327 older adults. The following measures were collected: NIH-Toolbox cognitive battery, Controlled Oral Word Association (COWA) letter and animals tests, Wechsler Test of Adult Reading (WTAR), Stroop Color-Word Interference Test, Paced Auditory Serial Addition Test (PASAT), Brief Visuospatial Memory Test (BVMT), Letter-Number Sequencing (LNS), Hopkins Verbal Learning Test (HVLT), Trail Making Test A&B, Digit Span. Hmisc, psych, and GPARotation packages for R were used to conduct exploratory factor analyses (EFA). A 5-factor solution was conducted followed by a 6-factor solution. Promax rotation was used for both EFA models.

The 6-factor EFA solution is reported here. Results indicated the following 6 factors: working memory (Digit Span forward, backward, and sequencing, PASAT trials 1 and 2, NIH-Toolbox List Sorting, LNS), speed/executive function (Stroop color naming, word reading, and color-word interference, NIH-Toolbox Flanker, Dimensional Change, and Pattern Comparison, Trail Making Test A&B), verbal fluency (COWA letters F-A-S), crystallized intelligence (WTAR, NIH-Toolbox Oral Recognition and Picture Vocabulary), visual memory (BVMT immediate and delayed), and verbal memory (HVLT immediate and delayed. COWA animals and NIH-Toolbox Picture Sequencing did not adequately load onto any EFA factor and were excluded from the subsequent CFA.

Findings indicate that in a sample of healthy older adults, these collected measures and those obtained through the NIH-Toolbox battery represent 6 domains of cognitive function. Results suggest that in this sample, picture sequencing and COWA animals did not load adequately onto the factors created from the rest of the measures collected. These findings should assist in interpreting future research using combined NIH-TCB and neuropsychological batteries to assess cognition in healthy older adults.

Early detection of mild cognitive impairment (MCI) and dementia is crucial for initiation of treatment and access to appropriate care. While comprehensive neuropsychological assessment is often an intrinsic part of the diagnostic process, access to services may be limited and cannot be utilized effectively on a large scale. For these reasons, cognitive screening instruments are used as brief and cost-effective methods to identify individuals who require further evaluation. Novel technologies and automated software systems to screen for cognitive changes in older individuals are evolving as new avenues for early detection. The present study presents preliminary data on a new technology that uses automated linguistic analysis software to screen for MCI and dementia.

Data were collected from 148 Spanish-speaking individuals recruited in Spain (MAge=74.4, MEducation=12.93, 56.7% females) of whom 78 were diagnosed as cognitively normal [CN; Mmmse = 28.51 (1.39)], 49 as MCI [MMMSE = 25.65 (2.94)], and 21 as all-cause dementia [MMMSE = 22.52 (2.06)]. Participants were recorded performing various verbal tasks [Animal fluency, phonemic (F) fluency, Cookie Theft Description, and CERAD list learning task]. Recordings were processed via text-transcription and sound signal processing techniques to capture neuropsychological variables and audio characteristics. Features from each task were used in the development of an algorithm (for that task) to compute a score between 0 or 1 (healthy to more impairment), and a fifth algorithm was constructed using audio characteristics from all tasks. These five classifiers were combined algorithmically to provide the final algorithm. Receiver Operating Characteristic (ROC) analysis was conducted to determine sensitivity and specificity of predicted algorithm performance [CN vs. impaired (MCI or dementia)] against clinical diagnoses, and additional general linear modeling was used to test whether age, sex, education, and multilingualism significantly predicted logistically transformed weighted algorithm scores.

Scores were transformed to logit scores, with significant differences in mean logit scores between all groups (p <.001). Logit-inverse transformation of mean logit scores (possible range 0 -1) resulted in values of 0.06 for CN, 0.90 for MCI, and 0.99 for all-cause dementia groups. ROC curve analyses revealed the algorithm obtained a total area under the curve of 0.92, with an overall accuracy of 86.8%, a sensitivity of 0.92, and specificity of 0.82. Age was identified as a significant predictor (beta = 0.22; p <0.01) of algorithm output, whereas years of education (beta = -0.04; p = 0.64), sex (beta = 0.38; p = 0.02, did not survive correction for type-1 error), and multilingualism (beta = -0.24; p = 0.22) were non-significant.

These findings provide initial support for the utility of an automated speech analysis algorithm to detect cognitive impairment quickly and efficiently in a Spanish-speaking population. Although sociodemographic variables were not included in the algorithm, age significantly predicted algorithm output, and should be further explored to determine if age-adjusted formulas would improve algorithm accuracy for younger versus older individuals. Additional research is needed to validate this novel methodology in other languages, as this may represent a promising cross-cultural screening method for MCI and dementia detection.

Cognitive tests requiring spoken responses, such as paragraph recall, are rich in cognitive-related information that is not captured using traditional scoring methods. This study aimed to determine if linguistic features embedded in spoken responses may differentiate between individuals who are and are not cognitively impaired.

Participants in the Long Life Family Study completed a neuropsychological assessment which included the WMS-R Logical Memory I paragraph recall. For a subset of participants (N=709), test responses were digitally recorded and manually transcribed. We used Linguistic Inquiry Word Count, a text analysis program, to quantify word counts, grammatical features (e.g, prepositions, verb tenses), and the use of content words related to specific semantic categories (e.g., work-related, numbers) for immediate (IR) and delayed recall (DR). We used regression models with Generalized Estimating Equations adjusted by age, sex, education, and within-family correlation to select features associated with cognitive status (normal cognition [NC] versus cognitive impairment [CI]; Bonferroni-corrected threshold p<0.001). Next, we developed a “polyfeature score” (PFS) for both immediate and delayed recall, each calculated as a weighted sum of the selected linguistic features. We then built a logistic regression model to evaluate the predictive value of each PFS for identifying cognitively impaired individuals. In secondary analyses, we used regression models as above to identify features associated with mild cognitive impairment subtype (amnestic [aMCI] versus nonamnestic [naMCI]; threshold p< .05).

The sample included 599 participants with NC and 110 with CI (mean age = 72.3 ± 11.0 years, 54% female). The regression identified 8 linguistic features for IR and 7 for DR that significantly predicted cognitive status. Decreased use of content words related to work (e.g., employed, school, police) and biological processes (e.g., cook, cafeteria, eat) and the use of negations (e.g., no, not, can’t) were predictive of cognitive impairment in both recall conditions. In contrast, the use of other content word categories were predictive of cognitive status in only one recall condition (IR: leisure, cognitive processes, space; DR: drives, number). The use of fewer prepositions in IR, more first-person pronouns in DR, and fewer words in the past tense in DR were each associated with cognitive impairment. Word count was not predictive of cognitive status. Both PFSs were highly associated with cognitive status (PFS_IR ß= 0.74, p< 0.001; PFS_DR ß= 0.86, p= 0.001) with high discriminative value (PFS_IR AUC= 0.93, sensitivity = 0.81, specificity= 0.91; PFS_DR AUC= 0.95, sensitivity= 0.77, specificity= 0.88). In the CI subset, linguistic features differed between those classified as aMCI (n= 24) and naMCI (n= 40). Two function word categories predicted aMCI in IR whereas decreased word count, two function word categories, and two content word categories predicted aMCI in DR (all p< .05)

Linguistic features from paragraph recall provide high predictive value for classifying cognitive status increasing its potential as a cognitive screener in clinical settings. Additionally, each recall condition identified unique linguistic features associated with cognitive impairment which may aid differentiation of cognitive impairment subtypes and elucidate processes underlying deficits in learning and recall.

Parkinson’s disease (PD) is one of the most prevalent neurodegenerative conditions that leads to progressive degeneration in areas of the brain that control movement. As the disease progresses, cognition is also frequently affected, primarily executive functioning. Multiple factors may be involved in the relationship between PD and cognitive dysfunction. This study seeks to determine the association between disease duration (i.e., years since PD diagnosis), vascular comorbidities, and cognitive reserve (CR) and their relationship with executive functioning, in a clinic-referred PD population.

Participants included English-speaking subjects with a diagnosis of PD made by the patient’s treating neurologist (i.e., movement disorders specialist) who received their neurological care and had undergone a comprehensive neuropsychological evaluation at Thomas Jefferson University Hospital in Philadelphia, PA over the past five years. The sample consists of 67 patients. Comprehensive medical and psychiatric histories were obtained, and individuals with severe psychopathology (e.g., bipolar disorder or schizophrenia), medical or other neurological disorders (e.g., seizure disorder, stroke, documented head injury that was more severe than a mild TBI or intracranial bleeding) that could account entirely for cognitive impairment were excluded. An overall domain score of executive functioning was calculated by averaging each participant’s T-scores for the individual neuropsychological tests. Regression analysis was utilized to explore the relationship between number of vascular comorbidities, disease duration, and CR, as measured by a composite of formal education and literacy level, with executive functioning performance on neuropsychological testing for this sample.

The model explains 12.1% of the variance of executive functioning performance (F (3, 66) = 2.883, p = 0.043). A significant positive relationship was found between CR and executive functioning (b = .335, p = 0.008). No significant relationships were found between vascular comorbidities or disease duration with executive functioning. The relationship between CR and each neuropsychological measure was explored independently using Pearson correlation (2-tailed). Significant positive correlations were found between CR and WAIS-IV or WASI-II Similarities (r = .49, p < .001), CR and WAIS-IV or WASI-II Matrix Reasoning (r = .46, p = .001), and CR and FAS (r = .26, p = .037). No significant relationships were found between CR and TMT-B (r = .07, p = .565) or CR and Stroop Color and Word Interference (r = .17, p = .240).

Results suggest that CR may be a better predictor of executive functioning in patients with PD than number of vascular comorbidities or disease duration. Stronger premorbid cognitive functioning and better cognitive efficiency may be neuroprotective and stave off cognitive decline in Parkinson’s disease.

Health providers frequently probe patients’ recall of current and/or remote news items to determine the extent of memory loss. Impaired memory for transient events (i.e., in the news for a circumscribed time) may provide information regarding the onset of cognitive impairment. We utilized the Transient News Events Test (TNET) to explore how memory changes over time in older adults with cognitive impairment (CI) and non-cognitively impaired (NCI) individuals. We hypothesized that CI individuals would demonstrate reduced memory for transient events. We investigated the role of semantic and episodic memory on TNET performance.

Participants completed the TNET as part a comprehensive neuropsychological evaluation. Analyses included t tests to evaluate group differences for TNET performance, and correlations between TNET and neuropsychological measures, including episodic and semantic memory tests.

NCI adults demonstrated better memory than CI participants for TNET items. The NCI and CI groups did not differ regarding memory for remote items; however, CI participants had worse memory for recent items. There was a significant association between TNET performance and capacity for episodic and semantic memory in people with CI. In the NCI group, the TNET was associated only with episodic memory.

Findings support the use of news events to assess remote memories in older adults. Novel remote memory measures broaden the scope of memory assessment far beyond what is feasible within traditional neuropsychological assessment and provide insight into the onset of memory changes. Results enhance understanding of memory decline in older adults with cognitive impairment.

Medulloblastoma is the most common pediatric malignant brain tumor. Approximately 29% of medulloblastoma patients experience postoperative posterior fossa syndrome (PFS) characterized by impairments in speech, motor, and mood. An interdisciplinary rehabilitation approach is associated with greater rehabilitation gains than a single discipline approach for brain injury patients with significant rehabilitation needs. However, literature regarding the feasibility and utility of this approach within a tertiary care pediatric hematology/oncology setting is lacking. The Acute Neurological Injury (ANI) service was developed to coordinate care for neurologically complex hematology/oncology patients receiving active cancer treatment, including those with PFS. ANI care coordination includes bimonthly interdisciplinary team meetings, interdisciplinary goal implementation for each patient, parent psychoeducation about applicable brain-behavior relationships (including PFS) at treatment initiation, neuropsychological assessment at transition times throughout treatment, cognitive remediation, and coordinated end of treatment transition planning. We gathered caregiver perspective on this approach within a tertiary care pediatric hematology/oncology setting.

Parents of children and young adults (ages 4-20) with PFS after medulloblastoma resection who received coordinated care as part of the ANI program (n=20) were interviewed at least 4 months following completion of cancer treatment. 75% experienced postoperative mutism while the remainder experienced significantly decreased speech without mutism. All received cranial-spinal irradiation and focal boosts to tumor sites followed by chemotherapy per multi-institutional treatment protocol. Caregivers were interviewed regarding perceived feasibility and utility of ANI program components including parent psychoeducation, neuropsychological assessment, cognitive remediation, and interdisciplinary team coordination/goal setting, as well as parental supports. Yes/no responses were gathered as well as responses regarding the perceived utility of aspects of the interdisciplinary ANI program approach via a five-point Likert scale.

Surveys were completed by 66% of families contacted. Mean age at first contact with neuropsychology as part of the ANI program was 9.45 years (SD=4.4 years). Mean time between end of treatment and parent interview was 3.20 years (SD=2.01 years). Most parents reported that initial psychoeducation about PFS helped to decrease their concerns (81%) and increased their understanding of their child’s functioning in the context of PFS (88%). They reported benefit from neuropsychological assessment reports prior to initiating adjuvant treatment (92%), at end of treatment (90%), and one year following initiation of cancer treatment (100%), though they perceived less benefit from assessments intended to inform provider interventions during treatment (81% and 66%). Reports were shared most often with schools (75%), behavioral therapists (50%), physicians (50%), and rehabilitation specialists (25%). Parents indicated that the interdisciplinary ANI program approach was helpful (94%) and the coordinated interdisciplinary goal was beneficial (92%). Most parents favored the weekly frequency of cognitive remediation sessions (83%). Much interest was voiced in establishing a formal mentoring program to offer peer support by parents whose children have previously experienced PFS to those acutely managing a new PFS diagnosis (95%). Of note, all participants indicated that they would be willing to serve in a peer mentor role (100%).

The interdisciplinary ANI program approach is feasible with perceived benefits to families managing new PFS and medulloblastoma diagnoses and receiving active cancer treatment.

We ask about the degree to which the association between (1) the quantity and quality of people’s education and (2) midlife self-reported concerns about cognition and daily function is mediated by occupational complexity. The overarching hypothesis is that amount and quality of education provides people with access to better jobs, including jobs that are more cognitively complex. Occupational complexity, in turn, may be protective against cognitive impairment. If true, this means that part of the poorly-understood connection between education and cognitive impairment can be attributed to occupational complexity.

We use data from a nationally representative sample of 13,525 people who participated in the 2021 wave of the High School & Beyond (HSB) cohort study. HSB began in 1980 with a nationally-representative sample of American 10th and 12th grade students; these students have been followed up on six occasions since 1980, yielding extraordinary and prospectively-collected life course data on all key measures for a large, multicultural sample.

In 2021, HSB sample members were evaluated with neuropsychological tests that evaluated list learning and memory, semantic and letter fluency, and working memory. They were also asked to self-report memory and functional decline using the AD8, using a cutoff of 2 or more items for significant concerns. Mild Cognitive Impairment will be identified using an algorithm validated in a similar sample of middle aged participants.

HSB surveys gathered information about sample members’ labor force activities in every survey between 1980 and 2021, including information sufficient to code verbatim reports of occupations to the standards of the 2010 Standard Occupational Classification. We have linked these codes for sample members’ 2013 and 2021 occupations to the O*Net database, which includes extensive information about the cognitive complexity (and other attributes) of every occupation.

Measures of key confounders—including social and economic background; demographic characteristics; educational contexts, opportunities, and attainments that are associated with labor force outcomes; adolescent achievement test scores; and aspects of midlife occupations besides complexity (e.g., how well they pay)—were measured prospectively and in great detail in the surveys administered between the 1980s and 2021.

We estimate logistic regression models predicting significant cognitive and functional concerns as a function of educational contexts, opportunities, and outcomes; we also estimate models that account for the confounders listed above. Our main focus is on coefficients for education in models that do and do not include occupational complexity as a mediator. All models account for the clustered sampling design of HSB and use sampling weights to account for HSB’s complex sampling design and selective attrition from the panel.

Nearly one in five cohort members had significant cognitive and functional concerns; rates are lower for non-Latinx Whites and for better educated people. Associations between educational contexts, opportunities, and outcomes (including attainment) are robust, even after adjusting for confounders.

Between one quarter and one third of the conditional association between education and self-reported cognitive and functional concerns can be attributed to occupational complexity.

Occupational complexity is an important pathway through which more and better education protects people from concerns about cognitive and functional decline at about age 60.

Early cognitive signs of Alzheimer's disease are often subtle and go unnoticed until they become more prominent and debilitating. Thus, symptoms begin long before an actual Alzheimer's diagnosis is given. However, it is known that cognitively healthy older individuals with lower amyloid/tau ratios (PAT) are more likely to develop Alzheimer's disease than those with higher amyloid/tau ratios (NAT). Therefore, we explored whether this ratio can be used in conjunction with neuropsychological tests to isolate cognitive predictors of Alzheimer's disease amongst cognitively healthy older adults. We were interested in potential group differences on the California Verbal Learning Test, Second Edition (CVLT-II) Long Delay Free Recall scores and Cued Recall scores. We hypothesized that: (a) individuals in the PAT group would have weaker CVLT-II Long Delay Free Recall scores than individuals in the NAT group; and (b) individuals in the PAT group would recall fewer words on the CVLT-II Long Delay Cued Recall trial than individuals in the NAT group.

There were 115 older individuals recruited via Huntington Medical Research Institutes and the University of Southern California who had their cerebral spinal fluid extracted to measure amyloid/tau ratios. They completed the California Verbal Learning Test-II as part of a larger neuropsychological battery and were determined to be cognitively healthy. The mean age of these participants was 74.5 years (SD = 8.3), and there were 36 who met the threshold for the amyloid/tau ratio associated with Alzheimer's disease (PAT) while the other 79 did not (NAT). A hierarchical linear regression tested the hypotheses, with two blocks used for the analyses. Block 1 for both analyses contained variables to control for the potential effects of various factors in performance on the Long Delay tasks. Block 2 consisted of the amyloid groups (NAT vs. PAT).

After controlling for age, sex, education, body mass index, Montreal Cognitive Assessment scores, and depression, we found no significant difference between CVLT-II Long Delay Free Recall scores or Long Delay Cued Recall scores for the two groups.

While no significant difference was found on the long delay trials of the CVLT-II, it is important to note that it is unclear at what stage Alzheimer's related decline begins or can be detected using cognitive testing. Longitudinal studies would help to better understand if this lack of association holds true over time. Other aspects of the CVLT-II, such as intrusions and repetitions, would also help to better understand the different ways that symptoms of Alzheimer's disease can manifest early on.

Children with neurodevelopmental disorders (NDDs) commonly experience attentional and executive function (EF) difficulties that are negatively associated with academic success, psychosocial functioning, and quality of life. Access to early and consistent interventions is a critical protective factor and there are recommendations to deliver cognitive interventions in schools; however, current cognitive interventions are expensive and/or inaccessible, particularly for those with limited resources and/or in remote communities. The current study evaluated the school-based implementation of two game-based interventions in children with NDDs: 1) a novel neurocognitive attention/EF intervention (Dino Island; DI), and 2) a commercial educational intervention (Adventure Academy; AA). DI is a game-based attention/EF intervention specifically developed for children for delivery in community-based settings.

Thirty five children with NDDs (ages 5-13 years) and 17 EAs participated. EAs completed on-line training to deliver the interventions to assigned students at their respective schools (3x/week, 40-60 minutes/session, 8 weeks, 14 hours in total). We gathered baseline child and EA demographic data, completed pre-intervention EA interviews, and conducted regular fidelity checks throughout the interventions. Implementation data included paper-pencil tracking forms, computerized game analytic data, and online communications.

Using a mixed methods approach we evaluated the following implementation outcomes: fidelity, feasibility, acceptability, and barriers. Overall, no meaningful between-group differences were found in EA or child demographics, except for total number of years worked as an EA (M = 17.18 for AA and 9.15 for DI; t (22) = - 4.34, p < .01) and EA gender (χ2 (1) = 6.11, p < .05). For both groups, EA age was significantly associated with the number of sessions played [DI (r = .847, p < .01), AA (r = .986, p < .05)]. EAs who knew their student better completed longer sessions [DI (r = .646), AA (r = .973)], all ps < .05]. The number of years worked as an EA was negatively associated with the total intervention hours for both groups. Qualitative interview data indicated that most EAs found DI valuable and feasible to deliver in their classrooms, whereas more implementation challenges were identified with AA. Barriers common to both groups included technical difficulties (e.g., game access, internet firewalls), environmental barriers (e.g., distractions in surroundings, time of the year), child factors (e.g., lack of motivation, attentional difficulties, frustration), and game-specific factors (e.g., difficulty level progression). Barriers specific to DI included greater challenges in motivating children as a function of difficulty level progression. Furthermore, given the comprehensive nature of training required for delivery, EAs needed a longer time to complete the training for DI. Nevertheless, many EAs in the DI group found the training helpful, with a potential to generalize to other children in the classroom.

The availability of affordable, accessible, and effective cognitive intervention is important for children with NDDs. We found that delivery of a novel cognitive intervention by EAs was feasible and acceptable, with similarities and differences in implementation facilitators/barriers between the cognitive and commercialized academic intervention. Recommendations regarding strategies for successful school-based implementation of neurocognitive intervention will be elaborated on in the poster.