This retrospective study compared base rates of failure on a series of standalone and embedded performance validity tests (PVTs) in a sample of Spanish-speaking forensic litigants and explored the impact of demographic factors on PVT performance.

62 Spanish-speaking participants involved in litigation (primarily for work-related mTBI) underwent outpatient neuropsychological evaluation. Country of origin spanned South American (56.5%), Caribbean (22.5%), Central American (16.1%), North American (3.2%), and Spanish (1.6%) regions. Of this sample, 56 completed the Test of Memory Malingering (TOMM), 45 completed the Rey Fifteen Item Test (RFIT), and 49 completed the Dot Counting Test (DCT). Embedded validity measures, Reliable Digit Span (RDS) and the WHO-Auditory Verbal Learning Test (WHO-AVLT) were completed by 32 and 48 participants, respectively.

Effects of age (M=42.4, SD=11.72) and region of origin did not significantly impact overall performance on any measure. Mean scores across all standalone PVTs were below cutoffs, which have been previously suggested for use with Spanish-speaking populations (TOMM <40, RFIT total <21, DCT e-score >18). Overall base rates of failure were as follows: 52.5% TOMM (T1 M= 37.5, SD=10.7; T2 M=35.1, SD=10.6), 64.9% RFIT (M=17.8, SD=7.8) 57.6% DCT (M=18.3, SD=8.8), 51.1% RDS (M=6.1, SD=1.6), 29.4% WHO-AVLT (M=10.7, SD=3.9. Years of education (M=9.98, 3.96) was significantly correlated with RFIT total score (r(43) = .48, p<.01) and DCT e-score (r(47) = -.34, p<.05. When stratified by level of education (0-6, 7-11, and 12+), a large discrepancy in base rate of failure was observed on the RFIT, with failures in 92% of participants with less than six years of education, as compared to 52% and 59% failure in those with 7-11 and 12+ years, respectively. Variability in base rates of DCT failure across levels of education, although less extreme than on the RFIT, again demonstrated higher rates of failure in participants with less than six years of education (0-6: 71%, 7-11: 54%, 12+: 52%).

These findings add to the existing literature surrounding measurement of suboptimal effort in Spanish-speaking populations. Base rates of PVT failure on both standalone and embedded measures were generally much higher than those reported in prior studies of forensic or compensation-seeking groups, including some with Spanish speaking participants. These high rates of failure are likely attributable, at least in part, to sample characteristics, due to the high proportion of individuals engaged in litigation associated with workplace injuries on construction sites at the study location. Such findings illustrate the importance of a thorough effort assessment for this population. Finally, results demonstrating reduced specificity of the RFIT in Spanish-speaking participants with less than six years of education, suggesting caution is warranted for its use in neuropsychological evaluations with such individuals.

Prior research supports retirement may negatively impact cognitive functioning. The current study examined the relationship between retirement status and the level of cognitive dysfunction amongst individuals with Alzheimer’s disease (AD). For the purpose of this study, it was predicted that there would be significantly higher levels of cognitive dysfunction in retired participants after controlling for age.

Participants (ages 65 to 91) were drawn from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). The sample included 110 participants who were retired and 111 participants who were not retired. Cognitive dysfunction was assessed using the cognitive subscale of the modified Alzheimer’s Disease Assessment Scale (ADAS). A one-way ANCOVA analysis was conducted with cognitive dysfunction as the dependent variable and the age of the participants as a covariate.

The results of the one-way ANCOVA showed being retired was a significant predictor of greater cognitive dysfunction amongst individuals with AD after controlling for age (F(df=1, 218) = 231.143, p = < .001, p < .05) and accounted for 52% of the variance in the level of cognitive dysfunction.

Being retired is associated with higher levels of cognitive dysfunction in AD after accounting for the effects of age. As such, continued cognitive activity may slow the progression of cognitive declines amongst individuals with AD who are retired. There is a need for future longitudinal research to determine how late retirement may delay the progression of cognitive decline in AD by controlling for other moderator factors such as genetics and work-related stress.

The objective of the study was to examine longitudinal changes in the white matter tracts with diffusion tensor imaging (DTI), neuropsychological performance, and the associate between the two in adults with a mild traumatic brain injury (mTBI).

Sixteen adult patients (age = 38.5(12.8); 75% female) seeking medical care at an emergency department for their first mTBI and 15 healthy adults (age = 30.5(11.3); 33% female) from the community were recruited. DTI and the neuropsychological evaluation were performed at 7 days and 4-months post-injury. The neuropsychological evaluation consisted of the CNS Vital Signs computerized neurocognitive test battery and 2 trials of the Paced Auditory Serial-Addition Test.

Results showed a significant decrease in fractional anisotropy (FA) and an increase in radial diffusivity (RD) of the right uncinate fasciculus as well as a significant decrease in FA and axial diffusivity (AD) of the right inferior fronto-occipital fasciculus over the 4-month follow-up period in the mTBI group compared to the Control group.

The FA of multiple white matter tracts at baseline were positively associated with working memory, sustained attention, and complex attention at baseline in the mTBI group but not the Control group. The global mean cerebral diffusivity for FA at baseline was positively associated with working memory and sustained attention at 4-months post-injury.

The current findings of abnormal white matter suggest an oxidative stress reaction as a result of mTBI altering the diffusivity of some white matter tracts. Furthermore, the disruption of the white matter tracts at baseline may serve as a biomarker for identifying mTBI and those who may have prolonged cognitive difficulties in working memory and attention as a result of the mTBI.

Cannabis use in older adults is becoming increasingly common as cannabis becomes both more socially acceptable and legally permissible, whether for medical or recreational purposes. While previous research has found harmful effects of cannabis use on cognition in adolescents and younger adults, few studies have explored cognition and cannabis use in older adults. This study aimed to examine the relationship between lifetime cannabis use patterns and subjective cognitive performance in older adults.

The sample (N=51) consisted of adults ages 60 and older residing in the United States who endorsed cannabis use within the previous year. Participants completed online questionnaires on demographics, mental health [Geriatric Anxiety Scale (GAS) short form and Geriatric Depression Scale (GDS) short form], and measures of subjective cognitive function [Cognitive Failures Questionnaire (CFQ), the Cognitive Problems and Strategies Assessment (CPSA), and part IV of the Cognitive Self Efficacy Questionnaire (CSEQ)]. The Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQCU) and the Cannabis Use Disorder Identification Test (CUDIT) were used to assess cannabis use, and the Alcohol Use Disorders Identification Test Consumption items (AUD-C) were used to assess alcohol use. Partial Pearson’s correlations were used to examine relationships between scores of subjective cognitive functioning and cannabis use patterns while controlling for alcohol consumption.

Participants aged 60+ (M=68.06, SD=5.80, 49% women) had 15.39 (SD=2.21, range 12-18) years of education on average. Participants’ race/ethnicity was reported as 90.2% White (n=47), 5.9% Latinx or Hispanic (n=3), 2% Black or African American (n=1), and 1% Other (n=1). Most participants (59%) reported first using cannabis as a child or adolescent (range of ages 7-17 years), while 31% reported first using cannabis as an adult (ages 18-58 years), and only 8% endorsed initial use in older adulthood (62-84 years). On average, this sample reported using cannabis for 19.75 days (SD=11.14) in the last month with n=35 (69%) and having used cannabis for 20 or more years (range 1-60 years). The total CUDIT score was positively correlated with CFQ (rp=.47, p<.001), CPSA problems (rp=.46, p<.001), GAS (rp=.43, p=.002), and GDS (rp=.35, p=.014), and negatively correlated with the CSEQ (rp=-.33, p=.02), all while controlling for alcohol consumption. Days of use in the past month and total years of use were not significantly associated with subjective cognitive function.

Among older adult cannabis users, symptoms of Cannabis Use Disorder (CUD) were significantly associated with greater self-reported cognitive failures/problems and worse self-efficacy for cognitive ability, as well as symptoms of anxiety and depression, when controlling for alcohol use. Notably, there was no relationship between subjective cognition and frequency of recent use or lifetime use. For patients who use cannabis, neuropsychologists may find it helpful to focus their clinical interview on CUD symptoms when discussing cognitive complaints rather than other measures of cannabis use. Additional research is needed to examine objective measures of cognitive functioning in older adult cannabis users.

Health numeracy is the understanding and application of information conveyed with numbers, tables and graphs, and probabilities in order to effectively manage one's own healthcare. Health numeracy is a vital aspect of communicating with healthcare providers and participating in one's own medical decision making, which is especially important in aging populations. Current literature indicates that assessing and establishing one's health numeracy abilities is among the first steps in providing necessary resources and accommodating patients' individual needs. Additionally, older adults with diffuse cognitive impairment often have issues with facets of executive functioning; however, the extant literature does not discuss the role of executive functioning in relation to health numeracy in this population. The purpose of this study was to explore the relationship between performance on tasks of executive functioning and objectively-measured health numeracy abilities in older adult patients.

This study included a sample of 42 older adult patients referred for neuropsychological evaluation for memory complaints who were administered the Test of Premorbid Functioning (TOPF), Trail Making Test - Part B (TMT-B), and Stroop Color and Word Test (SCWT Color Word Interference [CWI]) as part of a larger standardized battery. Patients were also administered the Numerical Understand in Medicine Instrument - Short Form (NUMI-SF). All included patients had <2 performance validity test failures. The sample was racially diverse (47.6% Black, 35.7% White, 14.3% Hispanic, 2.4% Asian) and 54.8% female. Average age was 62.95 (SD= 8.6) and average education was 14.1 (SD=2.7). Diagnostically, 47.6% of the sample were cognitively normal, 33.3% had mild cognitive impairment, and 19.0% had dementia. Average NUMI-SF score was 4.79 (SD= 1.7). Two multiple regressions were conducted to evaluate the extent to which executive functioning, as measured by the TMT-B and SCWT CWI predicted NUMI-SF, and the additive predictive power of premorbid IQ and demographics via the TOPF on the relationship between executive functioning and NUMI-SF.

The first regression, which measured the relationship between the TMT-B and SCWT CWI upon NUMI-SF scores, was not significant (p=.616). The model was significant with the addition of the TOPF (ß=.595, p<.001) and TOPF alone predicted ∼60% of the variance in NUMI-SF score, while TMT-B and SCWT CWI remained non-significant.

These results indicate that common measures of executive functioning are not reliable predictors of health literacy with or without the moderating of premorbid intellectual functioning taken into consideration. This suggests that health numeracy is likely to be minimally affected by deficits in executive functioning and rather may be better accounted for by premorbid intellectual functioning and/or other sociodemographic factors (e.g. socioeconomic status, education quality, occupation). Future studies will benefit from elucidating the contributions of other social determinant factors on predicting health numeracy.

Assessment of learning potential in patients with cognitive disorders in individuals with alcohol-related cognitive disorders (including Korsakoff’s syndrome; KS) is highly relevant, as this may help to tailor interventions, guide treatment planning and help to optimize care. However, studies on assessing learning potential or learning ability using neuropsychological assessment in relation to changes in everyday activities during the course of treatment are scarce. In this study we examined whether verbal and visuospatial learning curves could be used as an index of learning ability in relation to everyday activities before and after a treatment program.

We examined the episodic learning ability of patients with KS (N=137), other alcohol-related cognitive impairments (ARCI; N=164), and uncomplicated alcohol use disorder (AUD; N=49). For this, we calculated the learning curves for the California Verbal Learning Test (CVLT) and the Location Learning Test - Revised (LLT-R) and examined their association with ratings of everyday activities by the patient and his/her professional caregiver using the Patient Competency Rating Scale (PCRS) before and after a 10-12 week treatment program following admission to the Korsakoff Centre.

For both verbal and visuospatial memory, the AUD group had a steeper learning curve than the ARCI patients, who in turn had a steeper learning curve than the KS group (p<.01). While the VLGT total score was related to the PCRS in all patient groups (Pearson r>.38, p<.01), this was only the case for the KS group for the LLT-R total score (r>-.29, p<.01). However, the learning curve estimates of both tests were neither related to the PCRS absolute scores (for patients and caregivers, before and after treatment) nor to the APCRS scores during the course of the treatment program.

Episodic learning ability, as measured with the learning curves of the CVLT and LLT-R, were unrelated to the patients everyday activity level as measures by the patients themselves or their professional caregiver. The results will be discussed in relation to other tools for assessing the learning potential of cognitively impaired patients, such as dynamic testing.

Cognitive, motor and sensory deficits associated with aging, and with some neurological conditions such as acquired brain injury, may lead to severe driving performance impairment. While rehabilitation and driver assistance technologies may improve driving performance, the assessment of the actual fitness-to-drive of these people is challenging. Office-based neuropsychological/physical tests are considered insufficient to understand one’s ability to drive. The gold standard is the on-road assessment with dual control cars, superior in ecological validity, but expensive, stressful, and potentially unsafe. Valid, more cost-effective solutions for a safer, more accurate, standardized assessment of fitness-to-drive are currently needed. Modern and sensorized driving simulators offer key advantages, such as the possibility of exposing drivers to several relevant driving scenarios, including hazard situations, and of assessing their driving performance without being physically at risk. However, the extraction and direct interpretation of existing simulator-produced data may require specialized data processing skills or simulation expertise. To overcome this, we have developed an easy-to-use, pencil-and-paper observational instrument. The Sim-DOS is an adaptation of the widely used instrument to assess “natural driving”, the Driving Observation Schedule (DOS; Vlahodimitrakou et al., 2013).

Via expert consensus, DOS targeted behaviors were adapted to a simulated-based environment (signaling, observation of environment, speed regulation, slow or unsafe reaction, distance interpretation, vehicle/lane positioning), and the Sim-DOS scores calculation (based on errors while doing such behaviors) was adapted from DOS to include hazard situations (HS, 0-100) and free driving (FD, 0-°°) scores. The instrument was then piloted with a sample of 35 older adults, along with the collection of simulator-produced data on number of harsh events and driving speed. Participants drove two consecutive 20-minutes long scenarios, with low and high traffic density (LTD, HTD). In each scenario, there were periods with and without potentially hazard situations.

Assessments were performed by two independent trained observers, producing substantial inter-rater reliability (intra-class correlation coefficients above 0.94). Participants (70.7±4.1 years old, 60% male, 46.1±6.7 years of driving experience) were mostly regular drivers (74%). However, psychomotor skills of the majority were compromised, with only one participant being above the 80th percentile in the reaction times test of the national mandatory driving assessment. When exposed to hazard situations, most of the participants (94.1%) did not perform well, independently of traffic density, with average Sim-DOS-HS scores of 87.1±9.7 (out of 100, t-values>7.3, p-values<.05).

Compared to LTD scenarios, in HTD scenarios participants drove less smoothly (HTD:0.97±1.24 vs. LTD:0.33±0.58 of harsh events, Z=3.1, p<.05). However, they also drove slower (HTD:82.41±27.43 vs. LTD:103.55±14.61 km/h, t=5.2, p<.05), improving their ability to manage hazard situations, and therefore producing higher than expected Sim-DOS scores (HTD:87.05±10.28). During free driving, participants performed worse under LTD conditions (Sim-DOS-FD scores: HTD:11.68±6.20 vs. LTD:14.40±9.58, t=2.15, p<.05) as they drove at higher speed (HTD:85.01±24.28 vs. LTD:104.70±11.94 km/h, t=5.8, p<.05), although they did it more smoothly (HTD:1.94±3.74 vs. LTD:0.45±0.74 harsh events, Z=2.65, p<.05).

Our study provides a validated driving assessment tool for use in driving simulators that will allow a safer, more ecologic, holistic and informative evaluation of the fitness-to-drive of older adults and neurological patients.

Alzheimer’s disease (AD) pathophysiology, including β-amyloid (Aβ), can be appreciated with molecular PET imaging. Among older adults, the distribution of Aβ standard uptake value ratios (SUVR) is typically bimodal and a diagnostic cut is applied to define those who are amyloid ‘positive’ and ‘negative’. However, it is unclear whether the dynamic range of SUVRs in amyloid positive and negative individuals is meaningful and associated with cognition. Previous work by Insel and colleagues (2020) used screening data from the Anti-Amyloid Treatment in Asymptomatic Alzheimer’s (A4) trial to demonstrate subtle associations between a cortical summary SUVR and cognition, particularly on the Free and Cued Selective Reminding Test (FCSRT). We followed up this study to determine the extent to which regional SUVR is associated with performance on the FCSRT in amyloid positive and negative participants screened for participation in the A4 study.

We accessed regional Aβ SUVR, including anterior cingulate, posterior cingulate, parietal, precuneus, temporal, and medial/orbital frontal regions, along with FCSRT15 and demographic data from 4492 A4 participants at screening. Participants were coded as amyloid positive (n=1329; 30%) or amyloid negative (n=3169; 70%) based on a summary SUVR of greater than or equal to 1.15. We used separate general linear models to examine the association of total or regional SUVR, amyloid positivity status, and the interaction of SUVR and amyloid status with FCSRT scores. We compared model fits across regions with the Akaike Information Criterion (AIC). We ran post hoc correlational analyses examining the relationship between SUVR and FCSRT scores stratified by amyloid status in the case of significant interactions. Results were similar with and without demographic adjustment.

There was a significant interaction of summary and all regional SUVR with FCSRT scores in addition to main effects of amyloid positivity. In all models, there were small negative associations between SUVR and memory in amyloid positive individuals. For amyloid negative individuals, there was a significant and very small negative association between SUVR and FCSRT scores only in the parietal lobes and precuneus regions. Model fits were generally similar across the different analyses.

In this sample of individuals screened for a secondary prevention trial of AD, there were consistent associations between Aβ SUVR in all regions and memory for those considered amyloid positive. However, for individuals considered amyloid negative, there were only very small associations between SUVR and memory in parietal and precuneus regions. We conclude that the dynamic range of amyloid may be relevant among those with diagnostic evidence of amyloidosis, but that subtle Aβ accumulation in posterior regions may relate to declining memory in “subthreshold” states.

The study aimed to develop, validate and field test the cognitive screening tool for use in outpatient departments within health facilities in Uganda.

In the rural eastern region of Uganda, twenty-three (23) purposively selected health facilities and administered a scientifically derived cognitive screening tools to all eligible older persons. We conducted an inter-rater reliability in all the health facilities using three raters. Diagnosis of dementia (DSM IV) was classified as a major cognitive impairment and was quality checked by physiatrist who were blinded to results of the screening assessment.

The area under the receiver operating characterizes (AUROC) curve in health facilities was 0.912. The inter-rater reliability was good (Intra-class correlation coefficient of 0.692 to 0.734). the predictive accuracy of the tool to discriminate between dementia and other cognitive impairment was 0.892. In regression modal, the cognitive screening tool, didn’t appear to be biased by age.

The cognitive screening tool if performed well among the older persons, can be proved useful for screening dementia in other developing countries.

Cognitive impairment is often comorbid with depression and anxiety, and the cognitive status of older adult patients can drastically impact depression treatment outcomes. The cognitive status of these patients invariably changes psychological treatment approaches that otherwise are viable and feasible in older adults. For example, although cognitive behavioral therapy is effective in treating cognitively intact patients with depression, it often relies on executive function (such as flexible thinking and problem solving) and other cognitive abilities that are impaired in patients with comorbid cognitive impairment. Practically, this results in unstandardized modifications to psychotherapy that may impact the fidelity—and thus effectiveness—of treatment. It is important to assess and classify cognitive dysfunction in depression treatment-seeking older adults in trials. This can help generalize research findings and identify potential barriers in transferring psychotherapeutic approaches for older adults with depression from treatment trials to practical clinical use, particularly in hard-to-treat populations with comorbid cognitive impairment.

A systematic literature search was conducted in PubMed for the period 2000-2022. Study inclusion criteria was operationalised as follows: participants were identified as older adults (55 years and older), their primary psychiatric diagnosis was depression, and the study was a trial for depression treatment. Key search terms included: depression, treatment, psychotherapy, therapy, counseling, intervention, older adult, senior, late-life, elder, aged, clinical trial, and randomized controlled trial.

An initial search of the key terms returned 3,972 articles. 178 of these articles were subject to full text review. Of those, 45 articles met inclusion criteria. Overall study quality was acceptable. A portion of treatment trials did not assess for cognitive functioning. A majority of the articles excluded patients with cognitive impairment, with no further elaboration on the potential impact of cognitive functioning on treatment outcomes. A smaller portion of studies were more inclusive of the cognitive range of patient participants; however, they did not comment on the cognitive heterogeneity of their samples. Only three studies used a more extensive neuropsychological battery to examine cognitive profiles of patient participants. However, two of these studies also excluded individuals that fell below the cognitively intact range based on brief cognitive screening measures. Of the few studies that examined depression treatment in cognitively impaired and dementia patient populations, two trials examined cognitive functioning as a predictor or moderator of depression treatment outcome.

Given that cognitive status can significantly impact depression treatment outcomes for older adults, there is a shocking dearth of inclusion of cognitively impaired patients in depression treatment clinical trials. Moreover, the limited studies that examined depression treatment in cognitively impaired populations, there is a lack of comprehensive cognitive assessment, and lack of exploration on how different types of cognitive dysfunction may contribute to variable depression treatment response. Future depression treatment trials in older adults should expand to include a variety of cognitive functioning ranges, as well as a more detailed assessment of how specific cognitive domains may impact treatment outcomes.

Executive functions have been shown to predict prospective memory (PM) performance (Martin, Kliegel, & McDaniel, 2003). PM performance has also been associated with retrospective memory and working memory (Smith, 2003; McDaniel & Einstein, 2000). We investigated the association between PM performance and cognitive domains (executive functions, episodic memory, working memory) in adults at 40 years.

The participants (n = 470, age 40) were part of a longitudinal study including a cohort with a history of a birth risk (eg. asphyxia, low birth weight, hyperbilirubinemia) prospectively followed since birth and controls without birth risks. PM performance was assessed using the new Finnish Proper Prospective Memory Test (PROPS) offering a score for laboratory tasks and naturalistic tasks separately, for event-based PM (EBPM) and time-based PM (TBPM) performance, and a total score. Composite scores of three cognitive domains - executive functions, episodic memory, working memory -were formed by converting raw scores of nine cognitive test (e.g. the Wechsler subtests, the Stroop test, the Trail Making Test) to z scores, summed up and averaged. We calculated Spearman’s correlation coefficient between the five PROPS scores and the composite scores of the cognitive domains.

The episodic memory domain score correlated significantly with the PROPS laboratory tasks (rs = .23, p = < .01), naturalistic tasks, (rs = .13, p = < .01), the total score (rs = .23, p = < .01), EBPM (rs = .25, p = < .01), and TBPM (rs = .15, p = < .01). The executive functions domain score correlated with the PROPS laboratory tasks (rs = .17, p = < .01), the total score (rs = .16, p = < .01) and EBPM (rs = .20, p = < .01). The associations between the working memory domain and the PROPS test varied, in the laboratory setting (rs = .14, p = < .01), in the total score (rs = .13, p = < .01) and in EBPM (rs = .21, p = < .01). Furthermore, the composite score of the combined episodic memory and executive functions domains correlated significantly with the PROPS test in the laboratory setting (rs = .25, p = < .01), in the total score (rs = .25, p = < .01) and in EBPM (rs = .28, p = < .01).

The combination of the episodic memory domain and the executive functions domain was most associated with PM performance measured with the new Finnish Prospective Memory test (PROPS). Only the episodic memory domain was linked with the PROPS tasks in the naturalistic setting. Although the episodic memory domain was more associated with PM performance, the results support the multidomain nature of PM functions.

Pediatric acquired demyelinating syndromes (PADS) include a heterogeneous group of diagnoses, including acute disseminated encephalomyelitis (ADEM), neuromyelitis optica spectrum disorders (NMOSD), optic neuritis (ON) and transverse myelitis (TM). Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is often associated with demyelinating conditions, but may also present with encephalopathy without demyelinating lesions. Approximately 30% of patients diagnosed with MOGAD experience a relapse. Neurocognitive outcomes in PADS have reduced performance on tasks related to attention, processing speed, visual motor, and fine motor functioning. Psychosocial problems include anxiety, depression, and fatigue. Neurocognitive and psychosocial impacts of MOGAD events for the pediatric population are sparse. The current study sought to characterize neurocognitive sequelae from MOGAD (MAGAD+) compared to patients diagnosed withPADS without MOGAD (MOGAD-).

Twenty children and adolescents (6–18 years) diagnosed with PADS were recruited using a clinic convenience sample of patients. Study participants completed a neurocognitive battery and parents completed questionnaires of behavioral and emotional functioning. Demographic and medical variables were collected via retrospective chart review. Chi square and t-test analyses were used to compare MOGAD+ and MOGAD- groups. Performance on neuropsychological and behavioral questionnaires were compared to established sex and age norms to assess the degree to which group means deviate from normative expectations.

MOGAD+ and MOGAD- groups did not significantly differ based on demographic, neurocognitive, or parent reported social and behavioral functioning. Neurocognitive testing documented mean scores that were in the average range between groups. Notable variability in performance was observed within both MOGAD+ and MOGAD- groups. Bilateral fine motor deficits, visual motor, visual perception attention, and executive functioning deficits were notable for the combined PADS group, with 30-50% performing >1.5 SD below the mean. The number of white matter lesions or hospital duration were not significantly associated with performance on neurocognitive measures. However, older age of onset of PADS was significantly correlated with lower performance on visual motor integration and visual perception tasks (r(18) = -.50 p = .026; r(18) = -.53 p = .016). Findings also revealed associations of shorter hospitalization stays with higher behavioral symptoms on a parent measure of social/behavioral functioning (r(18) = -.47 p = .037).

Consistent with the PADS literature, relative to control norms, lower performance on tasks related to attention, executive functioning, visual motor, and fine motor skills, irrespective of MOGAD status, are observed in the current study. The variability of functioning and heterogeneity observed across PADS diagnoses warrants further study to better understand the impact of clinical course, treatment outcomes, and neuropsychological sequelae over time in this population. Higher behavioral distress with shorter hospital stays may indicate a potential opportunity for patient and family education preparing for return to home/community. The current study was limited by small sample size, variable time since hospitalization, and heterogeneous diagnoses within PADS that make it difficult to generalize findings. Future studies could prospectively follow patients over time to better understand the trajectory of recovery, identify predictors for relapse, and those at greatest risk of neurocognitive and behavioral deficits.

Brain science demonstrates that people who stutter (PWS) exhibit insufficient activation in the auditory speech area of the left hemisphere (Kikuchi, et al. 2011 ; Garnett, et al. 2018). In this study, we reported the auditory brainstem response of PWS: in PWS with moderate and severe impairment, significantly longer interpeak latencies (IPLs) between waves I and V (IPL [I-V]) of the right ear than those of the left ear were observed. However, in PWS with mild impairment, the IPLs (I-V) of the left ear were significantly longer than those of the right ear (Anzaki et al., 2020). We considered that the differences in the IPLs (I-V) between the right and left ears cause monitoring disturbance in communication, which results in developmental stuttering. It has been reported that stuttering was improved by delayed auditory feedback (DAF) (Stromsta, 1956; Sakai, 2008). Thus, we improved the DAF system and developed an application that can be used by PWS to listen to their own voices with no differences in the IPLs (I-V) between their left and right ears. We verified the effectiveness of this application.

This study included five male adults with developmental stuttering (ADSs), with a mean age and handedness index of 36 years and 84, respectively. The application was adjusted so that the IPLs (I-V) of the left and right ears were the same. For example, one ADS showed that the IPL (I-V) of their right ear was 0.5 msec longer than that of their left. Subsequently, the application was adjusted so that the IPL (I-V) of his left ear would be delayed by 0.5 msec. We asked the participants to use the application for six months when free talking and reading aloud. Using the Japanese Standardized Test for Stuttering (JSTS) (Ozawa, et al. 2013), we compared their disfluencies with and without the application.

As per the JSTS, the stuttering severity in all participants improved. Case 1, who had severe impairment (level 5), showed a moderate improvement (level 4), Cases 2 and 3, who had moderate impairment (level 4), showed a mild improvement (level 3), and Cases 4 and 5, who had mild impairment (level 3), exhibited a normal level of improvement (level 1). We calculated the z-scores of the improvement rates of the JSTS based on the standard deviations according to the severity (Anzaki, 2019). The z-scores of Case 4 and 5 were 4.01 and 2.01, respectively, indicating a significant improvement.

In our report last year, although ADSs with moderate and severe impairment showed improvement by stimulation intervention on the left hemisphere through the right ear, those with mild impairment exhibited only a slight or no improvement as per the JSTS (Anzaki, et al. 2021). The application developed in this study was found to significantly improve the disfluencies of all the participants as per the JSTS, especially those with mild impairment. Therefore, we considered that stuttering disorders are layered; ADSs have auditory monitoring disorder in the base.

Studies on vulnerability to interference have shown promise in distinguishing between normal and pathological aging, such as the early stage of Alzheimer’s disease (AD) or amnestic Mild Cognitive Impairment (aMCI). However, these studies did not include a non-semantic condition essential in distinguishing between what is attributable specifically to semantic memory impairments and more generalized vulnerability to interference. The present study aimed to determine whether the increased vulnerability to semantic interference previously observed in individuals at increased risk of AD (aMCI) is specifically associated with the semantic nature of the material, or if it also affects other types of material, suggesting more generalized executive and inhibitory impairment.

Seventy-two participants (N = 72) divided into two groups (33 aMCI and 39 NC) matched for age and education were included in the study. They underwent a comprehensive neuropsychological examination, and took the adapted French version of the LASSI-L (semantic interference test), as well as a homologous experimental phonemic test, the TIP-A. Independent sample t-tests, mixed ANOVA and ANCOVA on memory and vulnerability to interference scores with the Group (NC, aMCI) as between-group factor and the Type of material (semantic, phonemic) as within-subject factor were conducted to compare memory and interference in both contexts for both groups.

For all memory scores, results revealed a significant main effect of group (NC > aMCI), a significant main effect of the type of material (semantic > phonemic) and a significant Group x Type interaction (disproportionately poorer performance in a semantic context for aMCI compared to NC). Word recognition was equivalent in both contexts for aMCI, whereas NC were better in a semantic context. aMCI also committed more phonemic false recognition errors, were disproportionately more vulnerable to retroactive semantic interference and showed a disproportionately higher percentage of intrusion errors associated with proactive semantic interference than NC.

To our knowledge, this is the first study to meticulously compare aMCI and elderly control vulnerability to inter-list interference and its impact on memory processes in two very similarly designed conditions using different types of material (semantic vs. phonemic). Indeed, many studies on interference focused solely on intra-list buildup of interference or on semantic material. Taken together, our results suggest that aMCI patients present generalized difficulties in source memory and inhibition, but that their inability to benefit normally from the depth of processing of semantic material results in even more semantic intrusion errors during proactive interference. This superficial semantic processing also significantly impacts the ability of aMCI to show good recall after being exposed to an interference list and the passage of time, resulting in a greater vulnerability to semantic retroactive interference than controls. In summary, our results suggest that impairment of semantic memory, and, more precisely, the loss of benefit from the depth of semantic processing, represents the cornerstone of their memory and vulnerability to interference patterns. The classical level of processing theory therefore constitutes an ideal, simple framework to predict aMCI patients’ performance when facing interference, a parallel too rarely addressed in the literature.

Rapid Onset Obesity with Hypoventilation, Hypothalamic Dysfunction, Autonomic Dysregulation (ROHHAD) is a rare and often progressive syndrome with unknown etiology and only 100 cases reported to date. The syndrome is characterized by generally normal development followed by rapid onset of pain, muscle weakness, personality changes, and developmental regression. Associated chronic pain and fatigue result in difficulty concentrating, slow information processing, and executive function challenges. Only one study has examined the neuropsychological profile of pediatric patients with this syndrome.

Our patient was a 10-year-old, right-handed male with a history of ROHHAD syndrome, focal epilepsy, mild neurocognitive disorder, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) who underwent two comprehensive neuropsychological evaluations at our medical center.

Findings across multiple evaluations showed solid verbal skills and difficulty processing visual-spatial and nonverbal information, as well as problems with attention, executive functioning, and adaptive skills, and psychosocial functioning consistent with his diagnoses of ADHD and ASD. He exhibited fine-and gross-motor challenges associated with hypotonia. Chronic fatigue contributed to his challenges with attention and information processing. These findings are generally consistent with previous research examining the neuropsychological profile associated with ROHHAD syndrome.

Results from our case study highlight the complexity and challenges associated with ROHHAD syndrome. Consistent with available information, etiology of our patients’ neuropsychological weakness and functional decline is unclear. Yearly neuropsychological evaluations are recommended for these patients to update interventions based on their variable abilities. More research is needed to firmly establish the neuropsychological profile in youth of varying ages afflicted with this syndrome.

Neuropsychological evaluations are used to examine a person’s current cognitive functioning. Performance validity tests (PVT) are included in neuropsychological test batteries to ensure that examinees are performing to the best of their abilities and identify non-credible performance. There are two types of PVTs: freestanding and embedded. A freestanding PVT is a cognitive test created to evaluate performance validity and do not measure any type of cognition directly. Meanwhile, an embedded PVT is a task design to evaluate some sort of cognition (e.g., memory) by using traditional neuropsychological tests (e.g., Trail Making Test) and performance validity. Research suggests that undergraduate college students are not always performing to the best of their abilities when completing a comprehensive neuropsychological battery. In fact, in one study where an undergraduate college sample was given three PVTs, it was reported that 56% of the participants failed at least one PVT in their first session and 31% in their second session. Research has also shown that speaking multiple languages can influence cognition. The purpose of this study was to identify in three credible language groups of college students what PVTs does bilingualism influence higher failure rates. It was predicted that bilingual college students would significantly demonstrate higher PVTs failure rates compared to monolingual college students.

The sample consisted of 70 English first language monolinguals (EFLM), 33 English first language bilinguals (EFLB), and 68 English second language bilinguals (ESLB) that were psychologically and neurologically healthy. All participants completed a comprehensive neuropsychological battery in English. The Rey-Osterrith complex figure copy test, Comalli Stroop part A, B, and C, Trail Making Test part A and B, Symbol Digit Modalities Test written and oral parts, Controlled Oral Word Association Test (COWAT) letter fluency, and Finger Tapping Test were the tasks used as embedded PVTs to evaluate failure rates in our sample. Moreover, all participants were credible (i.e., they did not fail two or more PVTs). PVT cutoff scores were selected for each embedded PVT from previous literature. Chi-square analysis were used to evaluate failure rates between language groups on each PVT.

We found no significant failure rate differences between language groups on any of the PVTs. However, while no significant group differences were found, on the COWAT letter fluency results revealed higher failure rates between the three language groups (i.e., 13% EFLM, 24% EFLB, and 22% ESLB) compared to other PVTs.

Our data suggested no significant failure rate differences between language groups. It has been suggested in previous studies that linguistic factors impact PVT performance and test interpretation. On the COWAT letter fluency task, it is possible that language is driving higher failure rates between bilingual speakers, even though we found no significant failure rates or performance differences between the three language groups. Future studies should examine language groups and other cultural variables (e.g., time perspective) to determine what may be driving high failure rates on the COWAT letter fluency task in credible participants.

The CCoSI is a brief screening instrument that is designed to detect cognitive impairment in children aged 5y0m-16y11m shortly after acquired brain injury (ABI) by evaluating language, fluency, attention, memory, and visuospatial domains. Each domain translates to a CCoSI index and is composed of a series of brief subtests. This study assessed the feasibility of modifying the Children’s Cognitive Screening Instrument (CCoSI) into an electronic version (eCCoSI) and administering it using video teleconferencing (VTC).

Tasks and stimuli were modified for online administration. Typically developing children aged 5y0m-16y11 m were tested using the modified eCCoSI via VTC. The eCCoSI was administered using Skype for Business and Microsoft Teams. Participants attended one 25-minute video assessment session over either platform. Results of VTC-assessed healthy controls were compared to age-matched peers ([25] Female: [19] Male; mean age = [11.54], SD = [3.01], age range =5.00-15.75) who had been previously tested face-to-face (FTF) with the original CCoSI at the Bristol Royal Hospital for Children (BRHC).

Age-related trends in performance were also examined across FTF and VTC for comparability.

44 typically developing children were virtually assessed ([25] Female: [19] Male; mean age = [11.79], SD = [3.03], age range =5.05-16.92). Results from a 2x2 ANOVA with age-group and modality as independent factors showed no significant difference in performance between participants tested FTF and VTC over the CCoSI Attention, Fluency, Language, Memory, and Visuospatial indices. No significant result of interaction between age and modality was found; however, there was a significant result of age-group.

VTC assessment is a feasible alternative to FTF administration of the CCoSI within healthy controls. Results from the present study are promising for the use of the eCCoSI in clinical practice. Further research should attempt to replicate these results within clinical populations.

Bilingualism has shown to have significant implications for neuropsychological assessment, namely, the Digit Span task. Moreover, bilingual individuals have been shown to exhibit both advantages and disadvantages on Digit Span; however, the relationship between bilingualism and performance on this subtest is poorly understood. This research aims to better understand how Hispanic Spanish-English bilinguals perform on this commonly administered working memory subtest.

Participants included 82 Hispanic Spanish-English bilinguals [Age: M=29.11 (SD=6.369); Education: M=15.68 (SD=2.255); 53.7% female]. The participants completed the Language and Social Background Questionnaire (LSBQ; composite factor scores) and the Wechsler Adult Intelligence Scale -Fourth Edition (WAIS-IV) Digit Span (raw scores) subtest via Zoom, an online video conferencing platform. A hierarchical multiple regression analysis was utilized to predict participants’ Digit Span performance based on their LSBQ composite factor scores. Hierarchical multiple regression analyses were conducted using SPSS Version 27.

LSBQ composite factor scores significantly predicted Digit Span Forward, F (3, 78) = 1.835, p < 0.43 (R2 = .030) and Longest Digit Span Forward, F (1, 78) = 4.02, p < 0.48 (R2 = .041) scores. LSBQ composite factor scores did not significantly predict Digit Span Backward, F (3, 78) = .344, p = .941, Digit Span Sequencing, F (3, 78) = .598, p = .731, Digit Span Total, F (3, 78) = .440, p = 0.296, Longest Digit Span Backward, F (3, 78) = .510, p = .666, or Longest Digit Span sequencing F (3, 78) = .200, p = .751 scores.

Results suggest that Hispanic Spanish-English bilinguals perform worse on Digit Span Forward and Longest Digit Span Forward as their bilingual experiences increase. However, bilingual experiences did not significantly predict Digit Span Backward, Digit Span Sequencing, Digit Span Total, Longest Digit Span Backward, or Longest Digit Span Sequencing scores. The contrasts in Digit Span performance may be attributed to the different ways in which each condition of the subtest is cognitively processed. Therefore, clinicians and researchers should use caution when interpreting test data for Digit Span with Hispanic Spanish-English bilinguals.

Typical evaluations of adult ADHD consist of behavior self-report rating scales, cognitive or intellectual functioning measures, and specific measures designed to measure attention. Boone (2009) suggested monitoring continuous effort is essential throughout psychological assessments. However, very few research studies have contributed to malingering literature on the ADHD population. Many studies have reported the adequate use of symptom validity tests, which assess effortful performance in ADHD evaluations (Jasinski et al., 2011; Sollman et al., 2010; Schneider et al., 2014). Because of the length of ADHD assessments, individuals are likely to become weary and tired, thus impacting their performance. This study investigates the eye movement strategies used by a clinical ADHD population, non-ADHD subjects, and malingering simulators when playing a common simple visual search task.

A total of 153 college students participated in this study. To be placed in the ADHD group, a participant must endorse four or more symptoms on the ASRS (N = 37). To be placed in the non-ADHD, participants should have endorsed no ADHD symptoms (N = 43). Participants that did not meet the above criteria for ADHD and not-ADHD were placed in an Indeterminate group and were not included in the analysis. A total of 20 participants were instructed to fake symptoms related to ADHD during the session. A total of twelve Spot the Difference images were used as the visual picture stimuli. Sticky by Tobii Pro (2020) was used for the collection of eye-movement data was utilized. Sticky by Tobii Pro is an online self-service platform that combines online survey questions with an eye-tracking webcam, allowing participants to see images from their home computers.

Results indicated on the participants classified as Malingering had a significantly Visit Count (M = 17.16; SD= 4.99) compared to the ADHD(M = 12.53; SD= 43.92) and not-ADHD groups (M =11.51; SD=3.23). Results also indicated a statistically significant Area Under the Curve (AUC) = .784; SE = .067; p -.003; 95% CI = .652-.916. Optimal cutoffs suggest a Sensitivity of 50% with a False Positive Rate of 10%.

Results indicated that eye-tracking technology could help differentiate simulator malingerers from non-malingerers with ADHD. Eye-tracking research’ relates to a patchwork of fields more diverse than the study of perceptual systems. Due to their close relation to attentional mechanisms, the study’s results can provide an insight into cognitive processes related to malingering performance.