Differences In Neuropsychological Scores Research Articles

21 Toxic Wounds are Associated with Cognitive Decrements in Women Veterans of the 1991 Gulf War

Objective:Gulf War Illness (GWI) is a debilitating multi-symptom condition that affects nearly a third of 1990-91 Gulf War (GW) veterans. Symptoms include chronic pain, debilitating fatigue, gastrointestinal issues, and cognitive decrements. Prior studies have documented reduced cognitive functioning in this affected population, particularly in the areas of memory, attention and response inhibition. To date, research has focused on cognitive functioning in male and female veterans together. Very limited research has reported on GW women's cognitive functioning separately mostly due to scarcity of data on women veterans. In this study, we had the unique opportunity to utilize a newly combined neuropsychological test dataset from women GW veterans in the Boston, Biorepository and Integrative Network (BBRAIN) for GWI. The aim was to compare neuropsychological outcomes with toxicant exposures in women veterans with and without GWI.Participants and Methods:Cognitive data from the BBRAIN biorepository was used for this study. The sample consisted of 62 women veterans who were deployed to the Persian Gulf War from 1990-91. Neuropsychological test scores included the Conners Continuous Performance Test Third Edition (CPT3), Delis-Kaplan Executive Function System (D-KEFS) Color-Word Interference, and the California Verbal Learning Test Second Edition (CVLT-II). War-related exposure to chemical weapons, anti-nerve gas pills and pesticides were measured by a self-reported survey. For analysis, war-related exposure was classified into three groups: controls with 0-6 days of exposure; cases with 0-6 days of exposure and cases with 7 or more days of exposure. Multiple linear regression modeling was used to measure differences in neuropsychological scores across the three groups by each war-related exposure.Results:After adjusting for age, education and other exposures, an increase in duration of exposure to pesticides was significantly associated with worse CPT3 commission errors, fewer words correct in the CVLT-II trials 1-5, and an increase in self-corrected errors on DKEFS Color-Word Interference Test Trials 1, 2 and 4 (p<0.05). More days reported hearing chemical alarms and seeing smoke from oil well fires was significantly associated with fewer words correct on all CVLT-II trials, and more self-corrected errors on Color-Word Interference Trials 2 and 4 (p<0.05). An increase in exposure duration to pyridostigmine bromide anti-nerve gas pills was associated with fewer words correct on the CVLT-II learning Trials 1-5 and short delay recall and an increase in self-corrected errors on Color-Word Interference Trials 2, 3, and 4 (p<0.05). When associations were adjusted for PTSD, all significant associations stayed constant (p<0.05).Conclusions:In this study, women veterans with GWI who had higher levels of exposure to pesticides, oil well fires and who took more antinerve gas pills during the war are showing increased learning difficulties and more deficits in attention and response inhibition. Future research should examine if similar patterns of neuropsychological symptoms are also present in male GW veterans with higher war-time related toxicant exposures.

Neuropsychological Profiles of Older Adults with Superior versus Average Episodic Memory: The Northwestern "SuperAger" Cohort.

SuperAgers are adults over the age of 80 with superior episodic memory performance and at least average-for-age performance in non-episodic memory domains. This study further characterized the neuropsychological profile of SuperAgers compared to average-for-age episodic memory peers to determine potential cognitive mechanisms contributing to their superior episodic memory performance. Retrospective analysis of neuropsychological test data from 56 SuperAgers and 23 similar-age peers with average episodic memory was conducted. Independent sample t-tests evaluated between-group differences in neuropsychological scores. Multiple linear regression determined the influence of non-episodic memory function on episodic memory scores across participants. As a group, SuperAgers had better scores than their average memory peers on measures of attention, working memory, naming, and speeded set shifting. Scores on tests of processing speed, visuospatial function, verbal fluency, response inhibition, and abstract reasoning did not differ. On an individual level, there was variability among SuperAgers with regard to non-episodic memory performance, with some performing above average-for-age across cognitive domains while others performed in the average-for-age range on non-memory tests. Across all participants, attention and executive function scores explained 20.4% of the variance in episodic memory scores. As a group, SuperAgers outperformed their average memory peers in multiple cognitive domains, however, there was considerable intragroup variability suggesting that SuperAgers' episodic memory strength is not simply related to globally superior cognitive functioning. Attention and executive function performance explained approximately one-fifth of the variance in episodic memory and maybe areas to target with cognitive interventions.

In Vivo Evaluation of White Matter Abnormalities in Children with Duchenne Muscular Dystrophy Using DTI.

Duchenne muscular dystrophy is an X-linked disorder characterized by progressive muscle weakness and prominent nonmotor manifestations, such as a low intelligence quotient and neuropsychiatric disturbance. We investigated WM integrity in patients with Duchenne muscular dystrophy using DTI. Fractional anisotropy and mean, axial, and radial diffusivity (DTI measures) were used to assess WM microstructural integrity along with neuropsychological evaluation in patients with Duchenne muscular dystrophy (n = 60) and controls (n = 40). Exon deletions in the DMD gene were confirmed using multiplex ligation-dependent probe amplification. Patients were classified into proximal (DMD Dp140+) and distal (DMD Dp140-) subgroups based on the location of the exon deletion and expression of short dystrophin Dp140 isoform. WM integrity was examined using whole-brain Tract-Based Spatial Statistics and atlas-based analysis of DTI data. The Pearson correlation was performed to investigate the possible relationship between neuropsychological scores and DTI metrics. The mean ages of Duchenne muscular dystrophy and control participants were 8.0 ± 1.2 years and 8.2 ± 1.4 years, respectively. The mean age at disease onset was 4.1 ± 1.8 years, and mean illness duration was 40.8 ± 25.2 months. Significant differences in neuropsychological scores were observed between the proximal and distal gene-deletion subgroups, with more severe impairment in the distal-deletion subgroup (P < .05). Localized fractional anisotropy changes were seen in the corpus callosum, parietal WM, and fornices in the patient subgroup with Dp140+, while widespread changes were noted in the Dp140- subgroup. The Dp140+ subgroup showed increased axial diffusivity in multiple WM regions relative to the Dp140- subgroup. No significant correlation was observed between clinical and neuropsychological scores and diffusion metrics. Widespread WM differences are evident in patients with Duchenne muscular dystrophy relative to healthy controls. Distal mutations in particular are associated with extensive WM abnormalities and poor neuropsychological profiles.

Vascular Depression and Cognition in Mexican Americans

Background: Mexican Americans are at increased risk of developing mild cognitive impairment (MCI) and Alzheimer’s disease compared to non-Hispanic whites. This study sought to examine the relationship between vascular risk, depression, and cognition in Mexican American elders. Methods: Data from 470 (390 normal controls, 80 MCI patients) Mexican Americans enrolled in the Health and Aging Brain among Latino Elders (HABLE) study were used. The cardiovascular risk was assessed by the Framingham Risk Score. Cognition was assessed with a neuropsychological battery, and depression was assessed based on scores from the Geriatric Depression Scale (GDS). ANOVAs were utilized to determine the differences in neuropsychological scores of normal controls with and without depression and CVD risk (low vs. high). Follow-up logistic regression was conducted to determine MCI risk. Results: The results of this study indicated that comorbid depression and a high CVD risk were associated with poorer cognitive performance in Mexican Americans. Depressed women with high CVD risk were more likely to have executive dysfunction, language deficits, and poorer global cognition than nondepressed women with a high CVD risk. In Mexican American men, those with a high vascular risk and depression were more likely to have executive dysfunction and poorer immediate memory than the nondepressed high-risk group. Higher GDS scores (OR = 1.10; 95% CI 1.02–1.10, p = 0.001) and higher vascular risk scores (OR = 1.05; 95% CI 1.02–1.10, p = 0.001) significantly predicted MCI status in Mexican Americans. Conclusion: The results of this study indicated that comorbid depression and a high CVD risk were associated with poorer cognitive performance and increased risk of MCI in Mexican Americans.

Early Cognitive, Structural, and Microstructural Changes in Presymptomatic C9orf72 Carriers Younger Than 40 Years

Presymptomatic carriers of chromosome 9 open reading frame 72 (C9orf72) mutation, the most frequent genetic cause of frontotemporal lobar degeneration and amyotrophic lateral sclerosis, represent the optimal target population for the development of disease-modifying drugs. Preclinical biomarkers are needed to monitor the effect of therapeutic interventions in this population. To assess the occurrence of cognitive, structural, and microstructural changes in presymptomatic C9orf72 carriers. The PREV-DEMALS study is a prospective, multicenter, observational study of first-degree relatives of individuals carrying the C9orf72 mutation. Eighty-four participants entered the study between October 2015 and April 2017; 80 (95%) were included in cross-sectional analyses of baseline data. All participants underwent neuropsychological testing and magnetic resonance imaging; 63 (79%) underwent diffusion tensor magnetic resonance imaging. Gray matter volumes and diffusion tensor imaging metrics were calculated within regions of interest. Anatomical and microstructural differences between individuals who carried the C9orf72 mutation (C9+) and those who did not carry the C9orf72 mutation (C9-) were assessed using linear mixed-effects models. Data were analyzed from October 2015 to April 2017. Differences in neuropsychological scores, gray matter volume, and white matter integrity between C9+ and C9- individuals. Of the 80 included participants, there were 41 C9+ individuals (24 [59%] female; mean [SD] age, 39.8 [11.1] years) and 39 C9- individuals (24 [62%] female; mean [SD] age, 45.2 [13.9] years). Compared with C9- individuals, C9+ individuals had lower mean (SD) praxis scores (163.4 [6.1] vs 165.3 [5.9]; P = .01) and intransitive gesture scores (34.9 [1.6] vs 35.7 [1.5]; P = .004), atrophy in 8 cortical regions of interest and in the right thalamus, and white matter alterations in 8 tracts. When restricting the analyses to participants younger than 40 years, compared with C9- individuals, C9+ individuals had lower praxis scores and intransitive gesture scores, atrophy in 4 cortical regions of interest and in the right thalamus, and white matter alterations in 2 tracts. Cognitive, structural, and microstructural alterations are detectable in young C9+ individuals. Early and subtle praxis alterations, underpinned by focal atrophy of the left supramarginal gyrus, may represent an early and nonevolving phenotype related to neurodevelopmental effects of C9orf72 mutation. White matter alterations reflect the future phenotype of frontotemporal lobar degeneration/amyotrophic lateral sclerosis, while atrophy appears more diffuse. Our results contribute to a better understanding of the preclinical phase of C9orf72 disease and of the respective contribution of magnetic resonance biomarkers. clinicaltrials.gov Identifier: NCT02590276.

Prognosis of Early-Onset vs. Late-Onset Mild Cognitive Impairment: Comparison of Conversion Rates and Its Predictors.

Background: Despite having the same histopathological characteristics, early-onset and late-onset Alzheimer’s disease (AD) patients show some distinct clinical and neuropsychological profiles. Early Onset Mild Cognitive Impairment (EOMCI) is a less characterized group. The aim of this study is to characterize MCI probably due to AD in terms of the clinical, genetic, Cerebrospinal fluid (CSF) biomarkers profile and conversion rate of EOMCI, compared to the late-onset form (LOMCI). Methods: 159 MCI patients were divided in two groups: 52 EOMCI (onset < 65 years) and 107 LOMCI (onset ≥ 65 years). We investigated differences in neuropsychological scores, clinical variables, ApoE genotype, CSF biomarkers (Aβ42, t-Tau and p-Tau) in both groups. Conversion was ascertained during follow-up. Results: EOMCI showed a longer duration of symptoms prior to the first evaluation (EOMCI = 4.57 vs. LOMCI = 3.31, p = 0.008) and scored higher on the subjective memory complaints scale (9.91 vs. 7.85, p = 0.008), but performed better in brief cognitive tests (27.81 vs. 26.51, p < 0.001 in Mini-Mental State Examination; 19.84 vs. 18.67, p = 0.005 in Montreal Cognitive Assessment) than LOMCI. ApoE genotype distribution and CSF biomarker profile were similar in both groups, as was the conversion risk. Lower Aβ42 (Hazard ratio (HR): 0.998, 95% Confidence Interval (CI) = [0.996–1.000], p = 0.042), higher t-Tau levels (HR: 1.003, 95%CI = [1.000–1.005], p = 0.039) and higher scores in the Alzheimer Disease Assessment Scale-Cognitive (HR: 1.186, 95%CI = [1.083–1.299], p = 0.002) increased the risk of conversion. Discussion: Despite differences in memory performance and memory complaints, EOMCI and LOMCI seem to represent indistinct biological groups that do not have a higher risk of conversion to AD or differ in risk factors for conversion.

Daily Carnosine and Anserine Supplementation Alters Verbal Episodic Memory and Resting State Network Connectivity in Healthy Elderly Adults.

Carnosine and anserine are strong antioxidants, previously demonstrated to reduce cognitive decline in animal studies. We aimed to investigate their cognitive and neurophysiological effects, using functional MRI, on humans. Thirty-one healthy participants (age 40–78, 10 male/21 female) were recruited to a double-blind placebo-controlled study. Participants were assigned to twice-daily doses of imidazole dipeptide formula (n = 14), containing 500 mg (carnosine/anserine, ratio 1/3) or an identical placebo (n = 17). Functional MRI and neuropsychological assessments were carried out at baseline and after 3 months of supplementation. We analyzed resting state functional connectivity with the FSL fMRI analysis package. There were no differences in neuropsychological scores between the groups at baseline. After 3 months of supplementation, the carnosine/anserine group had better verbal episodic memory performance and decreased connectivity in the default mode network, the posterior cingulate cortex and the right fronto parietal network, as compared with the placebo group. Furthermore, there was a correlation between the extents of cognitive and neuroimaging changes. These results suggest that daily carnosine/anserine supplementation can impact cognitive function and that network connectivity changes are associated with its effects.

1776 – Clinical and cognitive correlates of suicide attempts in bipolar disorder

Introduction Bipolar disorder (BD) is strongly associated with suicidal behaviors. Suicidal behavior is based on a stress/vulnerability model. Several factors have been identified, including clinical features (such as impulsivity) and cognitive deficits (such as impaired decision making or problem solving). Identifying specific factors in BD patients is needed to better prevent suicidal behaviors. Objectives 1) To identify clinical and cognitive characteristics associated with suicidal behaviors in euthymic BD patients. 2) To determine a correlation between neuropsychological variables and the number and characteristics of suicidal attempts. Methods 214 euthymic BD patients from the national network of “Centres Experts Bipolaires” were included and divided into two groups based on the personal history of suicide attempts. Socio-demographic and clinical variables were collected and neuropsychological functions were assessed (attention, memory and executive functions). Results We found an association between suicidal behavior and gender, employment status. Suicidal attempters had significantly more mixed episodes and hospitalizations. There was no difference between the two groups concerning neuropsychological measures. The number of suicide attempts and verbal fluency scores were negatively correlated. Conclusions The lack of significant differences in neuropsychological scores may be due to a common vulnerability between suicidal behaviors and BD. Further studies, especially prospective ones, are needed in order to characterize high risk BD patients in order to develop effective specific preventive strategies.

Characteristics of cognitive function in early and late stages of amnestic mild cognitive impairment

The detection of the early stages in amnesic mild cognitive impairment (aMCI) is considered important in diagnosing progression to Alzheimer's disease. The current study sought to investigate differences in cognitive function between control subjects with no memory loss (control), and subjects in the early stage of aMCI (EMCI) and late stage of aMCI (LMCI). A total of 100 community-dwelling older adults aged 65 years and over were recruited from 1543 potential subjects. Subjects were classified into three groups based on the degree of objective memory impairment; control (n=29), EMCI (n=34) and LMCI (n=37). Multiple neuropsychological tests were carried out to examine cognitive function. The EMCI individuals showed lower cognitive function relative to controls; not only in logical memory, but also in letter fluency (P<0.05). There were no significant differences in neuropsychological scores between the EMCI and LMCI groups, except for category fluency and logical memory. In addition, the EMCI subjects' logical memory score showed a significant relationship with letter fluency, category fluency and digit span backward test performance (P<0.05). These results suggest that the application of multiple neuropsychological tests might be useful in diagnosing older adults with EMCI and LMCI.

The Relationship Between Pain, Neuropsychological Performance, and Physical Function in Community-Dwelling Older Adults with Chronic Low Back Pain

Chronic pain and cognitive impairment are prevalent and disabling in older adults (OA), but their interrelationship has not been rigorously tested. We did so in OA with chronic low back pain (CLBP). A total of 323 OA (160 pain-free, 163 CLBP; mean age 73.5 years, 45% female) had neuropsychological (NP) testing with the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Test, and the Grooved Pegboard Test. Pain intensity was measured with the McGill Pain Questionnaire Short Form. Physical performance (gait speed, functional reach, chair rise, trunk rotation, and static/dynamic lifting), psychosocial disruption (Geriatric Depression Scale, the Short Form-36 Mental Health and Role Limitations-Emotional Composite scale), and self-reported disability (Functional Status Index, the Short From-36 Physical Functioning/Role-Physical Composite scale) were also measured. Outpatient research laboratory. There were no group differences in age, gender, or educational level, but significant differences in NP scores (P = 0.01) were found. Five scales accounted for the differences: immediate memory (P = 0.002), language (P = 0.004), delayed memory (P = 0.04), mental flexibility (Trails B [P = 0.02]), and Grooved Pegboard (P = 0.05). NP scores were significantly correlated with physical performance (R2= 0.30, P < 0.001), but not self-reported disability (R2= 0.04, P = 0.52) or psychosocial disruption (R2= 0.05, P = 0.46). NP function was correlated with pain intensity (R2= 0.17, P < 0.001), and NP function mediated the relationship between pain and physical performance. OA with CLBP demonstrated impaired NP performance as compared with pain-free OA. Further, pain severity was inversely correlated with NP performance, and NP performance mediated the relationship between pain and physical performance. Future research should examine whether cognitive function and impaired physical performance can be improved with pain reduction.

Behavioral effects of exposure to organic solvents in carpet layers

Carpet layers and age-matched controls were investigated both at the beginning of a working day and at the end with four subtests of a neuropsychological test battery (NES2). Exposure to toluene, cyclohexane, ethyl acetate, and heptane was measured with personal air sampling methods. One group of carpet layers used water-based adhesives (WBA) on the day the investigation took place and the other group used contact adhesives (CA) on that day. The WBA group was exposed primarily to toluene, and the CA group was exposed to other solvents as well. Initial (before work) differences in neuropsychological scores between all exposed workers and controls could be attributed to differences in education, the carpet layers being somewhat higher educated. No differences were found between the solvent-exposed and control groups that would suggest persistent effects of chronic solvent exposures. The improvement in test scores over the day was the same in both groups. However, evidence for exposure-related changes in test scores over the day were found within the exposed group.