Assessment Of Executive Functions Research Articles

Neutrophil-to-lymphocyte ratio and longitudinal cognitive performance in Parkinson's disease.

Previous studies have suggested a link between peripheral inflammation and cognitive outcomes in the general population and individuals with Parkinson's disease (PD). We sought to test the association between peripheral inflammation, measured by the neutrophil-to-lymphocyte ratio (NLR), cognitive performance, and mild cognitive impairment (MCI) status in individuals with PD. A retrospective, longitudinal analysis was carried out using data from the Parkinson's Progression Markers Initiative (PPMI), including 422 participants with PD followed over 5 years. Cognitive performance was assessed using a neuropsychological battery including the Montreal Cognitive Assessment (MoCA) and tests of verbal learning, visuospatial function, processing speed, and executive function. Mixed-effect regression models were used to analyze the association between NLR, cognitive performance, and MCI status, controlling for age, sex, education, APOE genotype, and motor severity. There was a negative association between NLR and MoCA, even after adjusting for covariates (b = -0.12, p = 0.033). MoCA scores for individuals in the high NLR category exhibited a more rapid decline over time compared to the low NLR group (b = -0.16, p = 0.012). Increased NLR was associated with decreased performance across all cognitive domains. However, NLR was not associated with MCI status over 5 years of follow-up. This study demonstrates a link between elevated NLR and cognitive performance in PD, but not with MCI status over 5 years. This suggests that NLR is more strongly associated with day-to-day cognitive performance than with incident MCI, but this requires further study in more heterogeneous cohorts.

Relationship between frailty and executive function by age and sex in the Canadian Longitudinal Study on Aging.

Frailty reflects age-related damage to multiple physiological systems. Executive dysfunction is often a presenting symptom of diseases characterized by cognitive impairment. A decline in cardiovascular health is associated with worse executive function. We tested the hypothesis that higher frailty would be associated with executive dysfunction and that cardiovascular health would mediate this relationship. Middle- and older-aged adults at baseline (n = 29,591 [51% female]) and 3-year follow-up (n = 25,488 [49% females]) from the Canadian Longitudinal Study on Aging (comprehensive cohort) were included. Frailty was determined at baseline from a 61-item index, a cumulative cardiovascular health score was calculated from 30 variables at baseline, and participants completed a word-color Stroop task as an assessment of executive function. Multiple linear regressions and mediation analyses of cardiovascular health were conducted between frailty, Stroop interference-condition reaction time, and cardiovascular health in groups stratified by both age and sex (middle-aged males [MM], middle-aged females [MF], older-aged males [OM], older-aged females [OF]). Frailty (MM, 0.15 ± 0.05; MF, 0.16 ± 0.06; OM, 0.21 ± 0.06; OF, 0.23 ± 0.06) was negatively associated with cardiovascular health (MM, 0.12 ± 0.08; MF, 0.11 ± 0.07; OM, 0.20 ± 0.10; OF, 0.18 ± 0.09; β > 0.037, p < 0.001), as well as the Stroop reaction time at 3-year follow-up (MM, 23.7 ± 7.9; MF, 23.1 ± 7.3; OM, 32.9 ± 13.1; OF, 30.9 ± 12.0; β > 2.57, p < 0.001) across all groups when adjusted for covariates. Cardiovascular health was a partial (~ 10%) mediator between frailty and reaction time, aside from MFs. In conclusion, higher frailty levels are associated with executive dysfunction, which was partially mediated by cardiovascular health. Strategies to improve frailty and better cardiovascular health may be useful for combatting the age-related decline in executive function.

Development of a self-administered online battery for remote assessment of executive functions and verbal memory: equivalence with face-to-face administration, preliminary norms, and acceptance

ABSTRACT Objectives Interest in teleneuropsychology services increased considerably after the COVID-19 pandemic. However, the utility of unsupervised administration of computerized tests remains largely unexplored. In the present study, we developed a brief computerized battery that assesses self-reported cognitive abilities and performances on executive functioning and verbal memory. We investigated the equivalence of the self-administration online (SAO) procedure and the face-to-face (FTF) administration. Preliminary normative data were developed and the acceptance of the SAO procedure was explored. Methods A community sample of 169 Greek adults [94 women; mean age: 41.95 (SD = 13.40) years, mean years of education: 15.10 (SD = 2.65)] completed the SAO assessment. A subgroup of 40 participants was tested in a counterbalanced way both with SAO and FTF. Participants’ performances were compared with paired sample t-tests and the agreement between the two methods was estimated with intraclass correlation coefficients (ICCs). Multiple linear regression analyses were applied to investigate the effect of demographic characteristics on SAO measures. Results No difference between SAO and FTF scores was observed. ICCs indicated moderate to good agreement (.418–.848) for most measures. Age was positively associated with self-reported cognitive state and negatively with neuropsychological performances and the level of acceptance of the SAO procedure. Approximately 80% of participants reported satisfaction from the SAO assessment, 69% good compliance with the instructions, but less than 30% belief that the FTF assessment could be adequately replaced. Conclusion SAO testing is feasible and well accepted among Greek adults yielding equivalent results with FTF testing. Despite the wide satisfaction, though, notable reluctance was noted for the substitution of FTF with SAO procedures.

Development of a self-administered online battery for remote assessment of executive functions and verbal memory: equivalence with face-to-face administration, preliminary norms, and acceptance

ABSTRACT Objectives Interest in teleneuropsychology services increased considerably after the COVID-19 pandemic. However, the utility of unsupervised administration of computerized tests remains largely unexplored. In the present study, we developed a brief computerized battery that assesses self-reported cognitive abilities and performances on executive functioning and verbal memory. We investigated the equivalence of the self-administration online (SAO) procedure and the face-to-face (FTF) administration. Preliminary normative data were developed and the acceptance of the SAO procedure was explored. Methods A community sample of 169 Greek adults [94 women; mean age: 41.95 (SD = 13.40) years, mean years of education: 15.10 (SD = 2.65)] completed the SAO assessment. A subgroup of 40 participants was tested in a counterbalanced way both with SAO and FTF. Participants’ performances were compared with paired sample t-tests and the agreement between the two methods was estimated with intraclass correlation coefficients (ICCs). Multiple linear regression analyses were applied to investigate the effect of demographic characteristics on SAO measures. Results No difference between SAO and FTF scores was observed. ICCs indicated moderate to good agreement (.418–.848) for most measures. Age was positively associated with self-reported cognitive state and negatively with neuropsychological performances and the level of acceptance of the SAO procedure. Approximately 80% of participants reported satisfaction from the SAO assessment, 69% good compliance with the instructions, but less than 30% belief that the FTF assessment could be adequately replaced. Conclusion SAO testing is feasible and well accepted among Greek adults yielding equivalent results with FTF testing. Despite the wide satisfaction, though, notable reluctance was noted for the substitution of FTF with SAO procedures.

Association of Overweight and Obesity with Impaired Executive Functioning in Mexican Adolescents: The Importance of Inhibitory Control

Overweight and obesity are major public health issues worldwide, including in Mexico, particularly among adolescents. This study aimed to analyze the associations between nutritional status and impaired executive function (EF) in Mexican adolescents. A case–control study was conducted with 98 male and female adolescents, categorized into normal weight and overweight/obese groups based on body mass index. EF was assessed using the BANFE-2 test. The prevalence of overweight and obesity was 54.3%. The EF assessment revealed that 82.45% of the overweight/obese group exhibited mild-to-severe impairment, compared to only 36.58% in the normal weight group (X2 = 21.69, p &lt; 0.0001). In the inhibitory control assessment, adolescents with overweight and obesity performed worse than their normal-weight counterparts. Specifically, females with overweight/obesity scored lower than females with normal weight on the risk–benefit processing test. The risk of severe EF impairment significantly increased with the presence of overweight/obesity (OR = 7.8, p &lt; 0.0001). These findings indicate that EF, particularly inhibitory control and risk–benefit processing, is impaired in adolescents with overweight or obesity.

Cognitive Sex Differences: Evidence from Indian Young Adults

In the present study, we examined the effect of sex on cognitive abilities among young adults. Our total sample was comprised of 64 participants (33 females). Males and females were matched with respect to age and years of education. Each participant underwent a detailed neuropsychological assessment, including assessment of attention, executive functions, fluency, verbal and visuospatial memory. Results revealed that females exhibited superior performance in verbal domain such as learning, immediate memory, and fruit fluency. Additionally, a noteworthy trend was observed indicating females’ enhanced performance on verbal delayed recall, animal and vegetable fluency. Contrastingly, no discernible gender-based effects were identified in relation to executive functions, working memory, or visuospatial ability. It is pertinent to note that our findings did not conclusively support male superiority in the visuospatial or verbal domains. In conclusion, the present study provides valuable insights into sex-related differences in cognitive abilities among young adults. Nonetheless, further investigations employing larger sample sizes across diverse age groups are imperative to validate and extend these findings.

Neuropsychological tests associated with symptomatic HIV-associated neurocognitive disorder (HAND) in a cohort of older adults in Tanzania.

Human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) prevalence is expected to increase in East Africa as treatment coverage increases, survival improves, and this population ages. This study aimed to better understand the current cognitive phenotype of this newly emergent population of older combination antiretroviral therapy (cART)-treated people living with HIV (PLWH), in which current screening measures lack accuracy. This will facilitate the refinement of HAND cognitive screening tools for this setting. This is a secondary analysis of 253 PLWH aged ≥50 years receiving standard government HIV clinic follow-up in Kilimanjaro, Tanzania. They were evaluated with a detailed locally normed low-literacy neuropsychological battery annually on three occasions and a consensus panel diagnosis of HAND by Frascati criteria based on clinical evaluation and collateral history. Tests of verbal learning and memory, categorical verbal fluency, visual memory, and visuoconstruction had an area under the receiver operating characteristic curve >0.7 for symptomatic HAND (s-HAND) (0.70-0.72; p < 0.001 for all tests). Tests of visual memory, verbal learning with delayed recall and recognition memory, psychomotor speed, language comprehension, and categorical verbal fluency were independently associated with s-HAND in a logistic mixed effects model (p < 0.01 for all). Neuropsychological impairments varied by educational background. A broad range of cognitive domains are affected in older, well-controlled, East African PLWH, including those not captured in widely used screening measures. It is possible that educational background affects the observed cognitive impairments in this setting. Future screening measures for similar populations should consider assessment of visual memory, verbal learning, language comprehension, and executive and motor function.

Assessment of Executive Functions in Children with Sensorineural Hearing Loss and in Children with Specific Language Impairment: Preliminary Reports.

Executive functions (EFs) are related abilities, associated with the frontal lobes functions, that allow individuals to modify behavioral patterns when they become unsatisfactory. The aim of this study was to assess EFs in children with sensorineural hearing loss (SNHL) and in children with "specific language impairment" (SLI), compared with a control group of children with normal development, to identify specific skill deficits. Three groups of preschool children aged between 2 and 6 years were assessed: 19 children with normal hearing, cognitive, and language development, 10 children with SNHL, and 20 children with SLI. The FE-PS 2-6 Battery was used for the assessment of preschool EFs, supplemented with the Modified Bell Test for the analysis of selective attention. Statistically significant differences were found between the two experimental groups and the control one, regarding the investigated skills. Children with SNHL showed a clear deficit in flexibility, whereas children with SLI had greater problems in self-regulation and management of waiting for gratification. Selective attention was found to be deficient in all three groups, with no statistically significant differences. This study shows that the skills investigated were found to be deficient in both SNHL and SLI patients. It is essential to start targeted exercises based on specific deficient skills as part of the rehabilitation program. It is of great importance to understand the consequences of EF deficit in preschool children to achieve an accurate diagnosis and carry out customized rehabilitation programs.

Computerized assessment of executive functioning: Validation of the CNS Vital Signs executive functioning scores in a sample of community-dwelling older adults

Objective: Computerized assessment of cognitive functioning has gained significant popularity over recent years, yet options for clinical assessment of executive functioning (EF) are lacking. One computerized testing platform, CNS Vital Signs (CNS-VS), offers tests designed to measure EF but requires further validation. The goal of the present study was to validate CNS-VS executive scores against standard clinical measures of EF. We also sought to determine whether a modified CNS-VS composite score that included variables purported to measure inhibition, switching, and working memory would outperform the currently available CNS-VS Executive Function Index. Method: A sample of 73 cognitively healthy older adults completed four tests from the Delis-Kaplan Executive Function System, the Digit Span subtest from the Wechsler Adult Intelligence Scale-fourth edition, and three CNS-VS tasks purported to measure inhibition, switching, and working memory. Results: Performances on the CNS-VS tests were predicted by performances on standard paper-and-pencil measures. Although the currently available CNS-VS Executive Function Index predicted unique variance in a well-validated paper-and-pencil EF composite score, our Modified CNS-VS EF composite accounted for unique variance above and beyond the original CNS-VS Executive Function Index, while the reverse was not true. Conclusions: The present results support the construct validity of CNS-VS EF tests but also suggest that modifications to their current composite scores would improve the prediction of EF performance.

The relationship between objective and subjective executive function in Parkinson’s disease

ABSTRACT Introduction Difficulties in executive functioning (EF) are common in PD; however, the relationship between subjective and objective EF is unclear. Understanding this relationship could help guide clinical EF assessment. This study examined the relationship between subjective self-reported EF (SEF) and objective EF (OEF) and predictors of SEF-OEF discrepancies in PD. Method One-hundred and sixteen non-demented PD participants completed measures of OEF (i.e. problem-solving, cognitive flexibility, inhibition, and working memory) and SEF (Frontal Systems Behavior Scale-Self Executive Dysfunction Subscale). Pearson bivariate correlations and linear regressions were performed to examine the relationship between SEF and OEF and the non-motor symptoms (e.g. mood, fatigue), demographic, and PD characteristic (e.g. MCI status) predictors of discrepancies between OEF and SEF (|OEF minus SEF scores|). Correlates of under-, over-, and accurate-reporting were also explored. Results Greater SEF complaints and worse OEF were significantly associated (β =.200, p = .009) and 64% of participants accurately identified their level of OEF abilities. Fewer years of education and greater symptoms of depression, anxiety, and fatigue significantly correlated with greater discrepancies between OEF and SEF. Fatigue was the best predictor of EF discrepancy in the overall sample (β = .281, p = .022). Exploratory analyses revealed apathy and fatigue associated with greater under-reporting, while anxiety associated with greater over-reporting. Conclusions SEF and OEF are significantly related in PD. Approximately 64% of non-demented persons with PD accurately reported their EF skill level, while 28% under-reported and 8% over-reported. SEF-OEF discrepancies were predicted by fatigue in the overall sample. Preliminary evidence suggests reduced apathy and fatigue symptoms relate to more under-reporting, while anxiety relates to greater over-reporting. Given the prevalence of these non-motor symptoms in PD, it is important to carefully consider them when assessing EF in PD.

Incorporating Evidence-Based Gamification and Machine Learning to Assess Preschool Executive Function: A Feasibility Study.

Computerized assessments and digital games have become more prevalent in childhood, necessitating a systematic investigation of the effects of gamified executive function assessments on performance and engagement. This study examined the feasibility of incorporating gamification and a machine learning algorithm that adapts task difficulty to individual children's performance into a traditional executive function task (i.e., Flanker Task) with children ages 3-5. The results demonstrated that performance on a gamified version of the Flanker Task was associated with performance on the traditional version of the task and standardized academic achievement outcomes. Furthermore, gamification grounded in learning science and developmental psychology theories applied to a traditional executive function measure increased children's task enjoyment while preserving psychometric properties of the Flanker Task. Overall, this feasibility study indicates that gamification and adaptive machine learning algorithms can be successfully incorporated into executive function assessments with young children to increase enjoyment and reduce data loss with developmentally appropriate and intentional practices.

Effect of Meta-Cognitive Strategy-Based Activities on Executive Functioning, Social Networking, and Instrumental Activities of Daily Living Among Women.

Background Aging has an impact on women's quality of life and is closely correlated with deteriorating social support systems and cognitive abilities. This project intends to improve women's performance, independence, and quality of life by using meta-cognitive strategy-based activities to improve executive functioning and their capacity to maintain social networks. The ultimate objective is to keep older women's cognitive abilities from declining and to give them more independence in carrying out essential everyday tasks. By enhancing their executive functioning skills, women will be better equipped to navigate daily challenges and maintain their autonomy. Additionally, the project aims to provide a supportive environment for older women to engage in social activities and strengthen their social connections, ultimately leading to a more fulfilling and enriched quality of life. Aims and objectives The study aims to evaluate the impact of meta-cognitive strategy-based activities on executive functioning, social networking, and instrumental activities of daily living. This study is specifically for women. Materials and method This is aquasi-experimental designwith convenience sampling and selected samples(n=70), who were then splitinto two groups: an experimental group (n=35) and a control group (n=35) based on the inclusion and exclusion criteria. The experimental group received intervention based on meta-cognitive strategies through various activities, while the control group did not receive any specific intervention except health education. Pre- and post-tests were conducted to measure the changes. Executive functioning was assessed using the Brief Executive Function Assessment Tool (BEAT), social networking was assessed using the Lubben Social Networking Scale, and instrumental activities of daily living were assessed using the Lawton Brody Instrumental Activities of Daily Living Scale. The duration of the study was six months,three sessions per week, lasting 45 minutes to an hour each. The statistical analysis was done with significance at a 5% alpha level using IBM SPSS version 29.0 (Armonk, NY: IBM Corp). Results The pre-test and post-test data were analyzed using the Wilcoxon signed-rank test and the Mann-Whitney test.Since the p-value of the experimental group was 0.00 for the Lubben Social Networking Scale, the BEAT, and the Lawton Brody Instrumental Activities of Daily Living Scale, the alternate hypothesis was accepted. Thus, the results showed significant improvement in executive functioning, social networking, and instrumental daily living activities in the experimental group compared to the control group. Conclusion The clinically significant finding of this study was that the participants were enthusiastic and motivated to engage in meta-cognitive strategy-based activities; furthermore, there was a significant improvement in the experimental group when compared with the control group in executive functioning and social networking abilities. This will enhance functions like instrumental activities of daily living and occupational performance. Meta-cognitive strategy-based activities appeared beneficial for improving the cognitive functions and quality of life of women. Although the findings from the studies arepositive for therapeutic and health benefits, more clinical trials are needed in order to prove the effect of meta-cognitive strategy-based activities as a therapeutic approach.

Quiescent ulcerative colitis and Crohn’s disease have potential effect on cognitive function

BackgroundUlcerative colitis (UC) and Crohn’s disease (CD) imply chronic intestinal inflammation with both local and systemic manifestations. Cognition is a lifelong process of learning and memory processing, which has been identified to be affected by chronic systemic illnesses.AimTo evaluate the cognitive functions in inflammatory bowel disease (IBD) patients in remissionPatients and methodsInclusion criteria are as follows: 70 IBD patients in remission and a group of 50 healthy control. Mini-mental state examination (MMSE) was used for assessment of global cognitive function and Trail Making Test (TMT) for assessment of executive functions. TMT consists of part A which measures attention and performance speed and part B which measures mental flexibility. Both tests have been previously validated on Arabic-speaking populations.ResultsThe study included 70 patients (50 UC and 20 CD), who have been in remission for 21 ± 9 months. Of the included cases, about 51 were already on steroids ± azathioprine, and 19 patients were on biologics. Males represented 60% (n = 42) while females 40% (n = 28), and their mean age was 34 ± 8 years. Both cases and controls were matched for age and sex. The mean score of MMSE among IBD cases was significantly worse than controls (28.5 ± 3 versus 30, P < 0.001). Also, the duration of TMT parts A and B was significantly longer in cases than controls. The cases group scored 32 ± 19.5 s in TMT part A, versus 23 s by the controls. In TMT B, the recorded scores were 255 ± 48, versus 234 s in cases and control groups respectively (P < 0.001). In the cases group, 6 patients (8%) had below normal MMSE score of less than 24, with mild (3 patients, mean score was 21) to moderate cognitive impairment (3 patients, mean score was 15). The presence of extraintestinal manifestation was the only disease-related factor that was associated with cognitive impairment. Of the patient-related factor: older age, being divorced, and living in rural areas were associated with poorer cognitive functions.ConclusionIBD patients potentially suffer from cognitive impairment. In our study, factors as extraintestinal complications, older age, marital status, and residence in rural areas could be contributing factors to this impairment.

The latent structure of the Delis-Kaplan system for autism.

A core feature of autism is deficits in executive functioning (EF), including difficulty with planning, cognitive flexibility, and working memory. Despite a growing need for evidence-based assessments of EF for autism populations, statistical models of many commonly used measures of EF, including the Delis-Kaplan Executive Function System (D-KEFS), have not been investigated for a sample of autistic participants. The purpose of this study was to address a gap in the literature regarding the latent structure of the D-KEFS in a sample of autistic individuals. The D-KEFS is one of the most widely used clinical assessments of executive function, but its factor structure has not been examined in a sample of autistic participants. Reliability analyses were performed for sample subgroups based on participants' clinical and demographic characteristics, including IQ, autism severity, age, and race/ethnicity. Verbal Fluency (VF) was found to consistently decrease or not affect the overall reliability score. Additionally, one- and two-factor structure models were tested for the D-KEFS with a sample of autistic participants. The one-factor model was not found to be a good fit for the data. However, the two-factor model, with Cognitive Flexibility and Abstraction latent factors, was found to fit the data relatively well. This two-factor model was reexamined excluding the VF observed variable, resulting in a better overall model fit. Communication deficits are a common feature of autism, which explains why the VF task, that requires participants to produce novel words, may not be an adequate measure of executive function for autism populations.

Developmental and behavioral phenotypes of pediatric patients with PTEN hamartoma tumor syndrome.

Our study characterized the neurodevelopmental spectrum of individuals with PTEN Hamartoma Tumor Syndrome (PHTS), a syndrome that predisposes to both neurodevelopmental phenotypes and cancer risk. We aim to better understand life-impacting neurodevelopmental features of PHTS. Our study recruited 20 children/adolescents with PHTS, who were then administered assessments for autism spectrum disorder (ASD) and other neurocognitive measures, including assessment of IQ, executive and adaptive functioning, and health-related quality of life. Thirteen individuals (65%) were identified as having ASD, of which five were newly diagnosed during the study. Of those, ASD symptom severity was in the mild-moderate range for 77%. Overall, IQ was in the average range, with a mean of 92.61 (SD 24.45, p = 0.5), though there was a non-statistically significant trend toward individuals without ASD having a higher mean IQ (102.7 vs 82.3; p = 0.1). Subjects had significant impairment in processing speed (mean 75.38, SD 24.75, p < 0.05), decreased adaptive functioning skills across all domains, and a trend toward having more executive functioning problems. Individuals with PHTS are at increased risk of neurodevelopmental disorders, including ASD and impaired executive and adaptive functioning. Although clear guidelines exist for cancer surveillance for individuals with PHTS, additional guidelines and screening for neurodevelopmental disorders are warranted.

Principles for Adapting Assessments of Executive Function across Cultural Contexts.

Direct assessments of executive functions (EFs) are increasingly used in research and clinical settings, with a central assumption that they assess "universal" underlying skills. Their use is spreading globally, raising questions about the cultural appropriateness of assessments devised in Western industrialized countries. We selectively reviewed multidisciplinary evidence and theory to identify sets of cultural preferences that may be at odds with the implicit assumptions of EF assessments. These preferences relate to motivation and compliance; cultural expectations for interpersonal engagement; contextualized vs. academic thinking; cultural notions of speed and time; the willingness to be silly, be incorrect, or do the opposite; and subject-matter familiarity. In each case, we discuss how the cultural preference may be incompatible with the assumptions of assessments, and how future research and practice can address the issue. Many of the cultural preferences discussed differ between interdependent and independent cultures and between schooled and unschooled populations. Adapting testing protocols to these cultural preferences in different contexts will be important for expanding our scientific understanding of EF from the narrow slice of the human population that has participated in the research to date.

Intraoperative mapping and preservation of executive functions in awake craniotomy: a systematic review.

Awake craniotomy (AC) allows intraoperative brain mapping (ioBM) for maximum lesion resection while monitoring and preserving neurological function. Conventionally, language, visuospatial assessment, and motor functions are mapped, while the assessment of executive functions (EF) is uncommon. Impaired EF may lead to occupational, personal, and social limitations, thus, a compromised quality of life. A comprehensive literature search was conducted through Scopus, Medline, and Cochrane Library using a pre-defined search strategy. Articles were selected after duplicate removal, initial screening, and full-text assessment. The demographic details, ioBM techniques, intraoperative tasks, and their assessments, the extent of resection (EOR), post-op EF and neurocognitive status, and feasibility and potential adverse effects of the procedure were reviewed. The correlations of tumor locations with intraoperative EF deficits were also assessed. A total of 13 studies with intraoperative EF assessment of 351 patients were reviewed. Awake-asleep-awake protocol was most commonly used. Most studies performed ioBM using bipolar stimulation, with a frequency of 60Hz, pulse durations ranging 1-2ms, and intensity ranging 2-6mA. Cognitive function was monitored with the Stroop task, spatial-2-back test, line-bisection test, trail-making-task, and digit-span tests. All studies reported similar or better EOR in patients with ioBM for EF. When comparing the neuropsychological outcomes of patients with ioBM of EF to those without it, all studies reported significantly better EF preservation in ioBM groups. Most authors reported EF mapping as a feasible tool to obtain satisfactory outcomes. Adverse effects included intraoperative seizures which were easily controlled. AC with ioBM of EF is a safe, effective, and feasible technique that allows satisfactory EOR and improved neurocognitive outcomes with minimal adverse effects.

Abstract P170: Cognitive Function at Midlife by Sexual Orientation and Gender Identity in the CARDIA Cohort

Introduction: Sexual and gender minority (SGM) individuals have higher prevalence of dementia risk factors compared to non-SGM individuals. However, it is not known if differences in cognitive function appear during midlife, as prior studies lack comprehensive measures for sex, sexual orientation, and gender identity (SSOGI) or standardized cognitive assessments. We utilized Coronary Artery Risk Development in Young Adults (CARDIA) study data to assess midlife cognition by SSOGI. Hypothesis: We hypothesize that middle-aged sexual minority (SM) and transgender and non-binary (TGNB) participants demonstrate worse cognitive test scores compared to non-SM and non-TGNB participants, respectively. Methods: A total of 1,978 CARDIA participants completed cognitive assessments at Y25 and self-reported SSOGI measures at Y35. Participants with a history of brain cancer, kidney failure, or stroke prior to Y25 were excluded. Y25 examination included administration of standardized cognitive assessments of verbal memory (Rey Auditory Verbal Learning Test; RAVLT), processing speed (Digit Symbol Substitution Test; DSST), and executive function (Stroop Test). SSOGI variables are listed in Table 1 . Wilcoxon t-tests were used to compare cognitive test scores between analytic subgroups. Results: Mean age of the overall cohort at Y25 was 45 (SD = 3.6) years and 43% identified as Black. TGNB individuals performed significantly worse on a memory recall portion of the RAVLT ( p &lt;0.001) and DSST ( p &lt;0.05) compared to non-TGNB individuals. There was no significant difference in cognitive test scores between SM and non-SM and gay/lesbian and bisexual individuals. See Table 1 for statistical results. Conclusions: Preliminary findings suggest TGNB individuals may demonstrate lower midlife cognitive performance related to verbal memory and processing speed compared to non-TGNB individuals. Future studies will analyze associations of depression and chronic conditions with cognitive scores and expand to later CARDIA time points.

Subjective and objective assessments of executive functions are independently predictive of aggressive tendencies in patients with substance use disorder

Background and aimsImpairments in executive functions have been found to influence violent behavior. Executive functions are crucial in the treatment of patients with substance use disorders because substance use generally impairs cognitive processes and is therefore detrimental for executive functions thereby reducing control of behavior and thus of consumption impulses. We studied correlations between subjective, i.e. self-report, and objective, i.e. behavior-based, assessment of executive functions and the predictive validity of these measures for aggression in patients with substance use disorder. MethodsThe study included 64 patients with a diagnosed substance use disorder who were convicted according to the German Criminal Code for crimes they committed in the context of their disorder and were therefore in treatment in forensic psychiatric departments in Germany. Multiple self-report and behavior-based instruments were used to assess executive functions, appetitive and facilitative aggression as well as clinical and sociodemographic variables. ResultsParticipants showed impaired executive functions, and measures of executive functions predicted aggressive tendencies and violent offenses. Despite ecological validity of the findings, the subjective and objective assessments of executive functions did not correlate with each other, which corroborates studies in other clinical settings. ConclusionsWe discuss that this finding may be due to the conceptual differences between subjective and objective measures. Therefore, self-report and behavior-based measures should not be used as proxies of each other but as complementary measures that are useful for comprehensive diagnostics of cognitive impairments and assessment of risks for violent behavior.

Assessing the Contribution of Measures of Attention and Executive Function to Diagnosis of ADHD or Autism.

Attention and executive function (EF) dysregulation are common in a number of disorders including autism and attention-deficit/hyperactivity disorder (ADHD). Better understanding of the relationship between indirect and direct measures of attention and EF and common neurodevelopmental diagnoses may contribute to more efficient and effective diagnostic assessment in childhood. We obtained cognitive (NIH Toolbox, Little Man Task, Matrix Reasoning Task, and Rey Delayed Recall) and symptom (CBCL, and BPMT) assessment data from the Adolescent Brain and Cognitive Development (ABCD) database for three groups, autistic (N = 110), ADHD (N = 878), and control without autism or ADHD diagnoses (N = 9130) and used ridge regression to determine which attention and EF assessments were most strongly associated with autism or ADHD. More variance was accounted for in the model for the ADHD group (31%) compared to the autism group (2.7%). Finally, we ran odds ratios (using clinical cutoffs where available and 2 standard deviations below the mean when not) for each assessment measure, which generally demonstrated a greater significance within the indirect measures when compared to the direct measures. These results add to the growing literature of symptom variably across diagnostic groups allowing for better understanding of presentations in autism and ADHD and how best to assess diagnosis. It also highlights the increased difficulty in differentiating autism and controls when compared to ADHD and controls and the importance of indirect measures of attention and EF in this differentiation.