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3 Are we Up-Front About Switching or are we Side-Stepping the Issue: Localization of Cognitive Switching Measures with Cortical Thickness
- Jessica Rodrigues, Shehroo B. Pudumjee, Jessica Z.K. Caldwell, Christina G. Wong, Justin B. Miller
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, p. 608
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Objective:
Set-shifting/switching tasks, among other measures of executive functioning, are typically thought to represent frontal lobe functioning. However, the neuroanatomical correlates of these tests are not fully established. The aim of this study was to examine associations between individual measures of set-shifting/switching and cortical thickness. We hypothesized that performance on each switching measure would strongly correlate with aggregated cortical thickness within the frontal lobe.
Participants and Methods:Measures of interest included set-shifting subtests of the Delis-Kaplan Executive Function System (DKEFS): Color-Word Inhibition Switching, Category Switching, and Trail Making Test Number-Letter Switching. Archival data from an outpatient memory disorders clinic were reviewed to identify individuals whose neuropsychological evaluations included the measures of interest and had quality-assessed, volumetric MRI data available (n=243; 53.1% male, 81.9% Caucasian, Mage=72.4, SDage=6.7). Cortical thickness values were generated by FreeSurfer and averages were calculated for both frontal and temporal lobes, separately. Using partial correlations, controlling for age, we explored associations between each switching trial separately with right and left, frontal and temporal cortical thickness. The strength of associations within each lobe were then compared using Fisher's r-to-z transformations.
Results:Category Switching was significantly correlated with left and right hemisphere temporal thickness (r=0.38 and 0.31, respectively), but was not significantly correlated with left or right frontal lobe cortical thickness (r=.12 and .07, respectively). Fisher's r-to-z transformations revealed significantly stronger relationships between Category Switching and temporal thickness, rather than frontal thicknesses. Trails Switching was also significantly correlated with left and right temporal cortical thickness (r=-0.28, and =-0.23, respectively) and bore weaker associations with frontal cortical thickness (r=-.13 and r = -.14 for left and right hemispheres, respectively). In contrast, Color-Word Inhibition-Switching did not show a significant relationship with frontal or temporal cortical thickness.
Conclusions:Contrary to our hypothesis, stronger associations were observed with temporal lobe cortical thickness for Category Switching. Category Switching involves a language production component which could explain the strong association with temporal cortical thickness compared to frontal cortical thickness. Additionally, the pattern of associations between Trails Switching and frontal and temporal thickness was non-specific. Perhaps most striking is the lack of association between each switching measure and frontal cortical thickness, which was unexpected, given that these measures are used to assess executive functioning, broadly localized to the frontal lobe. Future directions involve examining the associations of these measure with subcortical structures and replicating these findings in larger datasets.
53 Are Boys (names) Really Just Like Animals? Comparing Multi-Category Fluency Trials from the D-KEFS in Predicting Temporal Cortical Thickness in an Outpatient Memory Disorders Population
- Shehroo B. Pudumjee, Jessica Rodrigues, Jessica Z.K. Caldwell, Christina G. Wong, Justin B. Miller
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 731-732
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Objective:
Semantic fluency measures comprise a differing number of trials depending on the test battery and/or normative data used. Using semantic fluency trials from the Delis Kaplan Executive Function System (D-KEFS; Animals and Boys’ names), we sought to examine whether: 1) there was incremental benefit of multiple trials in associations with aggregated temporal cortical thickness and 2) patterns of neuroanatomical associations with specific temporal lobe structures differed between Animals and Boys’ names trials.
Participants and Methods:Archival records of adults who completed a neuropsychological evaluation which included the semantic fluency measures of interest and had undergone structural MRI were identified (n=243, Mage=72.35 years, SDage=6.74, Female=46.9%). Cortical thickness values were obtained using FreeSurfer and averaged across sub-regions, separately for the left and right temporal lobe, per recommendations from the FreeSurfer group. Multiple linear regression models were fit to examine separate and incremental contribution of both Animals and Boys’ names, on temporal lobe thickness, including age, sex, and education in the models. Zero order correlations with each of the temporal cortical thickness areas (inferior, middle, and superior temporal; banks of the superior temporal sulcus, fusiform, transverse temporal, entorhinal, temporal pole, and parahippocampal cortices) were also computed to identify more focal neuroanatomical correlates.
Results:Animals and Boys’ names trials individually accounted for a significant proportion of variance when predicting temporal cortical thickness over and above demographics, but Animals was a considerably stronger predictor for left temporal cortical thickness (Left: Animals AR2 =.127*, Boys’ names AR2 = .067*; Right: Animals AR2 =.074*, Boys’ names AR2 = .065*). The variance accounted for by Boys’ names incrementally over Animals was not significant (AR2 = .004 for left and .015 for right hemispheres, respectively). Similarly, though the composite Category fluency index accounted for a significant proportion of the variance independently, it did not add incrementally over and above Animals alone when predicting cortical thickness in either hemisphere. When examining simple correlations with specific temporal cortices, Animals consistently had correlations of a greater magnitude than Boys’ names within the left hemisphere (Animals r>.3 for superior, middle, inferior, and fusiform gyri; Boys’ names r< .3 for all cortical thickness regions). Greater variability was noted for associations with right temporal thickness but Animals continued to show associations of a greater magnitude of associations than Boys’ names for several sub-regions. * denotes significance at p < .01.
Conclusions:The additional Boys’ names trial does not confer significant benefit over Animals alone, when predicting cortical thickness in either temporal lobe. Additionally, overall category fluency provided little incremental utility over and above the Animals trial alone in predicting temporal thickness. Psychometrically, it is expected that composites derived from multiple trials are more robust. However, this study demonstrates that it is important to examine whether the administration of additional trials is truly beneficial, particularly in a climate where brevity of neuropsychological assessment is critically desired. Further, psychometric tests have historically been validated against other neuropsychological measures, but it is critical we also validate measures against neuroanatomical correlates.
46 Comparison of Anxiety Measures in a Memory Clinic Sample
- Raelynn Mae de la Cruz, Jessica Rodrigues, Rachel M. Butler-Pagnotti, Filippo Cieri, Shehroo B. Pudumjee, Sonakshi Arora, Kimberly L. Cobos, Jessica Z. K. Caldwell, Lucille Carriere, Christina G. Wong
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 725-726
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Objective:
As the presentation of anxiety may differ between younger and older adults, it is important to select measures that accurately capture anxiety symptoms for the intended population. The 21-item Beck Anxiety Inventory (BAI) is widely used; however, its high reliance on somatic symptoms may result in artificial inflation of anxiety ratings among older adults, particularly those with medical conditions. The 30-item Geriatric Anxiety Scale (GAS) was specifically developed for older adults and has shown strong psychometric properties in community-dwelling and long-term care samples. The reliability and validity of the GAS in a memory clinic setting is unknown. The present study aimed to compare the psychometric properties of the GAS and the BAI in a memory disorder clinic sample.
Participants and Methods:Participants included 35 older adults (age=73.3±5.0 years; edu=15.3±2.8 years; 42% female; 89% non-Hispanic white) referred for a neuropsychological evaluation in a memory disorders clinic. In addition to the GAS and BAI, the Geriatric Depression Scale (GDS) and Montreal Cognitive Assessment (MoCA) were included. Cutoffs for clinically significant anxiety were based on published data for each measure. A dichotomous anxiety rating (yes/no) was created to examine inter-measure agreement; minimal anxiety was classified as “no” and mild, moderate and severe anxiety were classified as “yes.” Internal scale reliability was examined using Cronbach’s alpha. Convergent and discriminant validity were examined using Spearman rank correlation coefficients. Frequency distributions determined the proportion of yes/no anxiety ratings, and a McNemar test compared the proportion of anxiety classifications between the two measures.
Results:Both measures had excellent internal consistency (BAI: a=.88; GAS: a=.94). The BAI and GAS were highly correlated with each other (r=.79, p<.001) and positively correlated with a depression measure (BAI-GDS: r=.51, p=.002; GAS-GDS: r=.53, p=.001). Discriminant validity was supported by lower correlations between the anxiety measures and cognition (BAI-MoCA: r=.38, p=.061; GAS-MoCA: r=.34, p=.098). The BAI classified 14 participants as having anxiety (40%) and 21 participants as not having anxiety (60%), whereas the GAS classified 21 participants as having anxiety (60%) and 14 participants as not having anxiety (40%). The proportion of anxiety classifications were significantly different between the two measures (p =.016). For 28 participants (80%), there was agreement between the anxiety ratings. Seven participants (20%) were classified as having anxiety by the GAS, but not by the BAI; GAS items related to worry about being judged or embarrassed may contribute to discrepancies, as they were frequently endorsed by these participants and are unique to the GAS.
Conclusions:Results support that both anxiety measures have adequate psychometric properties in a clinical sample of older adult patients with memory concerns. It was expected that the BAI would result in higher classification of anxiety due to reliance on somatic symptoms; however, the GAS rated more participants as having anxiety. The GAS may be more sensitive to detecting anxiety in our sample, but formal anxiety diagnoses were not available in the current dataset. Future research should examine the diagnostic accuracy of the GAS in this population. Overall, preliminary results support consideration of the GAS in memory disorder evaluations.