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73 Changes in Sleep Negatively Impacts Next Day Inhibition Performance Among College Females
- Laura M Nicholson, Diana Ohanian, Amy Egbert, Becky Silton, Amy Bohnert
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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. 582-583
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Objective:
Sleep is a restorative function that supports various aspects of well-being, including cognitive function. College students, especially females, report getting less sleep than recommended and report more irregular sleep patterns than their male counterparts. Inadequate and irregular sleep are associated with neuropsychological deficits including more impulsive responding in lab-based tasks. Although many lab-based experiments ask participants to report their sleep patterns, few studies have analyzed how potential changes in sleep affect their findings. Utilizing data from a previously collected study, this study aims to investigate relations between sleep (i.e., sleep duration and changes in sleep duration) and performance-based measures of inhibition among female college students.
Participants and Methods:Participants (n = 39) were majority first-year students (Mage =19.27) and Caucasian (51%). Participants were recruited to participate in a larger study exploring how food commercials affect inhibitory control. Participants were randomized to each study condition (watching a food or non-food commercial) over two visits to the lab (T1 and T2). During both visits, they completed questionnaires asking about their 1) sleep duration the night before and 2) their “typical” sleep duration to capture changes in sleep duration. They also completed a computer-based stop signal task (SST) which required them to correctly identify healthy food images (stop signal accuracy [SSA] healthy) and unhealthy food images (SSA unhealthy) while inhibiting their response during a stop signal delay (SSD) which became increasingly more difficult (or delayed) as they successfully progressed. Since the main aim of the study was to explore the impact of sleep, analyses controlled for study condition. Analyses involving changes in sleep also accounted for sleep duration the night before the study visit.
Results:On average, students reported being under slept the night before the lab visit, reporting that they got 38 minutes less sleep than their “typical” sleep (7 hrs 3 min). Hierarchical regression analyses demonstrated that sleep duration the night before the lab visit was not associated with inhibition (i.e., SSA unhealthy, SSA healthy, SSD). In contrast, a greater change in sleep, or getting less sleep than “typical,” was associated with worsened inhibition across inhibition variables (SSA healthy, SSA unhealthy, SSD) above and beyond sleep duration at T1. At T2, only one analysis remained significant, such that getting less sleep than “typical” was associated with lower accuracy of appropriately identifying unhealthy images (SSA unhealthy) whereas other analyses only approached statistical significance.
Conclusions:These findings suggest that changes in sleep, or getting less sleep than typical, may impact inhibition performance measured in a lab, even when accounting for how much sleep they got the night before. Specifically, getting less sleep than typical was associated with reduced accuracy in selecting unhealthy images, a finding that was consistent across two visits to the lab. These preliminary findings offer opportunities for lab-based experiments to investigate the role of sleep when measuring inhibition performance. Further, clinicians conducting neuropsychological assessments in clinical settings may benefit from assessing sleep the night before the appointment and determine if this represents a change from their typical sleep pattern.
32 Pediatric traumatic brain injury and the interruption of premorbid hallucinations: a case study
- Diana M Ohanian, Megan Snidarich, Kelly King
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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. 140-141
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Objective:
Research has shown that a small, yet significant minority of individuals with traumatic brain injuries (TBI) experience psychotic symptoms post-TBI. TBI has also been associated with earlier onset schizophrenia in individuals with a genetic risk for psychosis.
The current case presents a 15-year-old female with pre-existing psychotic symptoms (auditory and visual hallucinations [AVH] and delusions) who stopped experiencing AVH a few weeks post-injury. The, at least temporary, cessation of her hallucinations raises several important questions about the neuroanatomy of pediatric psychosis and the impact of TBI on a potentially divergently developing brain.
Participants and Methods:Patient is a 15-year-old female who identifies as Hispanic (adopted, of Central American origin). Prior to her injury her developmental history was notable probable neglect prior to adoption, and her psychiatric history was notable for major depressive disorder, anxiety, chronic insomnia, and AVH. AVH were religious in nature and involved command hallucinations. AVH had been attributed to her chronic insomnia, per medical records. Participant was in a motorcycle accident with her caregiver and sustained a severe traumatic brain injury (GCS=3-8). Medical workup, including MRI, indicated a right basal ganglia hemorrhage, right thalamic hemorrhage, as well as injury of the brain stem at the pons, resulting in left-sided hemiparesis. She was ultimately diagnosed with traumatic right-sided intracerebral hemorrhage, traumatic subdural hematoma, traumatic hemorrhage of basal ganglia, traumatic encephalopathy, and a left homonymous hemianopia (left visual field cut) from her right temporal parietal injury. She received a neuropsychological evaluation 10 months post-TBI. Testing included: subtests of the WISC-V, measures of sustained attention and executive functioning, tasks of orientation and memory, and questionnaire measures assessing social-emotional, executive, and adaptive functioning. Parent and adolescent clinical interviews were conducted.
Results:Results indicated appropriate orientation, broadly intact intelligence presumed consistent with premorbid functioning, average sustained attention, and deficits in aspects executive functioning, visual-motor processing speed, and fine motor skills. Although she performed well on objective measures of memory, she reported significant long term social memory loss (e.g., difficulties remembering friends and memories of emotional connectedness) during the clinical interview. Interview and questionnaire measures also indicated continued challenges with depression and anxiety, as well as post-traumatic personality changes, tics, and symptoms of trauma. Patient reported that her hallucinations, both visual and auditory, stopped early in her recovery post-TBI; patient’s premorbid delusions were still present post-TBI.
Conclusions:This case raises questions related to the impact of structural or axonal injury to regions or networks in the brain that may be associated with psychosis. It also adds to a minimal literature examining AVH in pediatric TBI. Using the current literature as a framework we will explore 1) the injury to this patient’s thalamus as it relates to both her emotional memory deficits as well as the interruption of her AVH hallucinations, and 2) the relationship between her visual field cut and the interruption of her visual hallucinations. Overall, this case study highlights the unique nature of the developing brain both in terms of the TBI and psychosis.