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73 Processing Speed in Migraine With and Without Aura: A Meta-Analysis
- Jasmin H Pizer, Stephen L Aita, Melissa A Myers, Nanako A Hawley, Vasilios C Ikonomou, Kyle M Brasil, Katherine A Hernandez, Erika C Pettway, Benjamin D Hill
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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. 67
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Objective:
Migraine refers to recurrent, unilateral headache attacks, lasting 4-72 hours, that have a pulsating quality and can occur with or without aura. Aura is a symptom, usually preceding the onset of a migraine, where there is an experience of gradually spreading focal neurological symptoms which typically last less than one hour. A meta-analysis was conducted which quantitatively synthesized literature documenting performance on clinical measures of processing speed (PS) in individuals with migraine with (MwA) and without aura (MwoA).
Participants and Methods:Data for this study came from a larger study that compared overall neuropsychological functioning in primary headache disorders (PHD) and healthy controls (HC). We searched OneSearch and PubMed using a uniform search-strategy to locate original research comparing cognition between PHD and HC. Analyses were modeled under random effects. Hedge’s g was used as a bias-corrected estimate of effect size. We assessed between-study heterogeneity using Cochran’s Q and I2. Egger’s regression test was used to assess publication bias (i.e., the association between standard error and effect size). High heterogeneity in effects was analyzed for possible moderating variables using metaregression and sub-group analyses.
Results:The initial search interval spanned inception-May 2021 and yielded 6692 results. Twelve studies met inclusion criteria, included clinical measures of PS, and included PHD subgroups with MwA and/or MwoA (MwA n = 279, MwoA n = 655, HC n = 2159). MwA demonstrated moderately worse performance in PS overall when compared to HC (k = 7, g = -0.41, p = 0.028). MwoA also demonstrated worse performance in PS overall when compared to HC but the effect size was small (k = 12, g = -0.21, p = 0.006). Heterogeneity of MwoA studies was low (Q = 15.12, I2 = 21.19) while heterogeneity of MwA studies was high (Q = 21.91, I2 = 72.61). Meta-regressions of MwA studies indicated clinical age and disease duration to be related to effect sizes such that studies with older clinical participants and longer disease durations yielded greater (negative) differences. Egger’s regression intercept noted a possible association effect size and standard error for MwA articles (t = 3.60, p = 0.02) and MwoA articles (t = 5.21, p < 0.005). Trim-and-fill procedure estimated 0 MwA studies to be missing due to publication bias (adjusted g = -0.41, p = 0.028) while 7 MwoA studies were estimated to be missing due to publication bias (adjusted g = -0.03, Q = 34.79).
Conclusions:Individuals with migraine demonstrated worse performances on tests of PS compared to controls. Effect sizes were generally moderate in strength for MwA while effect sizes were generally small in strength for MwoA. This quantitative summary confirmed that individuals with migraine experience slowed processing speed in general and this effect is magnified when aura is a presenting symptom.
23 The Wandering Mind: Variability in Mindfulness is Associated with Improved Aspects of Executive Functioning.
- Ivan A Campbell, Vasilios C Ikonomou, Melissa A Myers, Nanako A Hawley, Jasmin H Pizer, Bailey Wagaman, Benjamin D Hill
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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. 705-706
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Objective:
Research evaluating mindfulness and cognition has produced mixed results. However, variability in mindfulness has not been previously evaluated as a predictor of cognitive ability. This study evaluated the relation between intra-individual variability (IIV) in mindfulness and cognitive performance.
Participants and Methods:274 university participants (M=19 years old, SD=1.5; 72.6% female, 67.2% White, 25.6% African American, 3.3% Asian American, 1.1% Hispanic American) completed the Five Facet Mindfulness Questionnaire (FFMQ) and the CNS Vital Signs computerized test battery. IIV was computed from the FFMQ facet T-scores. Additionally, high and low cognitive performance groups were formed from the top and bottom 16% of the sample using the neurocognition index (NCI) score from CNS Vital Signs (N=52 high NCI performance and N=46 low NCI performance).
Results:Pearson r correlations were used to evaluate the relation between mindfulness IIV and CNS Vital Signs domains. Mindfulness IIV was negatively associated with performance on the domains of psychomotor speed [r=-.18; p=.003], composite memory [r=-.14; p=.023] and verbal memory [r=-.15; p=.015]. For the high NCI group, IIV mindfulness was positively associated with cognitive flexibility [r=.31; p=.024], executive functioning [r=.33; p=.016] and was negatively related to visual memory [r=-.28; p=.043]. For the low NCI group, IIV mindfulness was negatively related to psychomotor speed [r=-.49; p<.001], composite memory [r=-.32; p=.033] and verbal memory [r=-.31; p=.038]. There was no relation found for individual FFMQ facet scores and CNS Vital Sign domains.
Conclusions:Increased consistency in self-reported mindfulness (lower IIV) was associated with greater processing speed and memory performance in the overall sample. However, the relation been mindfulness IIV and cognitive performance changed greatly in high NCI performers compared to low NCI performers. The low NCI group may be a proxy for poor effort which would explain why more variable self-reported mindfulness was associated with worse performance for processing speed and memory and this could be driving the results for the overall sample. However, our findings for the high NCI performance group are unique and suggest an association between increased variability in mindfulness facets and improved cognitive flexibility and executive functioning. Further study of mindfulness variability and aspects of executive functioning is warranted.
91 Personality Traits Account for Variability in Self-Reported Executive Functioning but not Objective Executive Performance.
- Vasilios C. Ikonomou, Melissa A. Myers, Nanako A. Hawley, Jasmin H. Pizer, Ivan A. Campbell, Bailey Wagaman, Benjamin D. Hill
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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. 291
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Objective:
This study evaluated the relation between five-factor model (FFM) personality traits and intra-individual variability (IIV) in executive functioning (EF) using both subjective self-report and objectives measures of EF.
Participants and Methods:165 university participants (M=19 years old, SD=1.3; 55.2% White, 35.2% African American, 72.7% female) completed the Barkley Deficits in Executive Functioning Scale-Long Form (BDEFS), IPIP-NEO Personality Inventory, Trail-Making Test (TMT) Parts A and B, and the Neuropsychological Assessment Battery (NAB) EF module. A participant’s IIV was calculated as the standard deviation around their own mean performance. Objective EF IIV was computed from T-scores for performance on Trails A, Trails B, and the NAB EF module. Subjective EF IIV was computed from T-scores for performance across BDEFS domains.
Results:Pearson r correlations were used to evaluate the relation between subjective and objective IIV and FFM traits of personality. Subjective EF IIV was positively correlated with FFM neuroticism [r=.48; p<.001] and negatively correlated with FFM conscientiousness [r=-.43; p<.001], extraversion [r=-.18; p=.023] and agreeableness [r=-.22; p=.004]. There were no significant associations between FFM traits and objective EF IIV performance. There was additionally no significant relation between subjective EF IIV performance and objective EF IIV.
Conclusions:Personality traits were associated with individual variability on a self-reported measure of EF but not on performance-based EF measures. These results suggest that IIV for the BDEFS was influenced by personality traits, particularly neuroticism and conscientiousness, and may reflect method variance. It was notable that IIV was not correlated between subjective and objective EF measures.
75 Neuropsychological performance in vestibular migraine: Preliminary findings from a meta-analysis
- Nanako A Hawley, Jasmin H Pizer, Stephen L Aita, Melissa A Myers, Vasilios C Ikonomou, Kyle B Brasil, Katherine A Hernandez, Erika C Pettway, Benjamin D Hill
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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. 68-69
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Objective:
Primary headache disorder is characterized by recurrent headaches which lack underlying causative pathology or trauma. Primary headache disorder is common and encompasses several subtypes including migraine. Vestibular migraine (VM) is a subtype of migraine that causes vestibular symptoms such as vertigo, difficulties with balance, nausea, and vomiting. Literature indicates subjective and performance-based cognitive problems (executive dysfunction) among migraineurs. This study compared the magnitude of the total effect size across neuropsychological domains to determine if there is a reliable difference in effect sizes between individuals with VM and healthy controls (HC). An additional aim was to meta-analyze neuropsychological outcomes in migraine subtypes (other than VM) in reference to healthy controls.
Participants and Methods:This study was a part of a larger study examining neuropsychological functioning and impairment in individuals with primary headache disorder and HCs. Standardized search terms were applied in OneSearch and PubMed. The search interval covered articles published from 1986 to May 2021. Analyses were random-effects models. Hedge’s g was used as a bias-corrected estimate of effect size. Between-study heterogeneity was assessed using Cochran’s Q and I2. Publication bias was assessed with Duval and Tweedie’s Trim-and-Fill method to identify evidence of missing studies.
Results:The initial omnibus literature search yielded 6692 studies. Three studies (n=151 VM and 150 HC) met our inclusion criteria of having a VM group and reported neuropsychological performance. VM demonstrated significantly worse performance overall when compared to HCs (k=3, g=-0.99, p<0.001; Q=4.41, I2=54.66) with a large effect size. Within-domain effects of VM were: Executive Functioning=-0.99 (Q=0.62, I2=0), Screener=-1.15 (Q=3.29, I2=69.59), and Visuospatial/Construction=-1.47 (Q=0.001, I2=0.00). Compared to chronic migraine (k=3, g=-0.59, p<0.001; Q=0.68, I2=0.00) and migraine without aura (k=23, g=-0.39, p<0.001; Q=109.70, I2=79.95), VM was the only migraine subgroup to display a large effect size. Trim-and-fill procedure estimated zero VM studies to be missing due to publication bias (adjusted g=-0.99, Q=4.41).
Conclusions:This initial attempt at a meta-analysis of cognitive deficits in VM was hampered by a lack of studies in this area. Based on our initial findings, individuals with VM demonstrated overall worse performances on neuropsychological tests compared to HCs with the greatest level of impairment seen in visuospatial/construction. Additionally, VM resulted in a large effect size while other migraine subtypes yielded small to moderate effect sizes. Despite the small sample of studies, the overall effect across neuropsychological performance was generally stable (i.e., low between-study heterogeneity). Given than VM accounts for 7% of patients seen in vertigo clinics and 9% of all migraine patients, our results suggest that neuropsychological impairment in VM deserves significantly more study.