Estimation Of Premorbid Intelligence Research Articles

Exploring Subfactors of Adult Cognitive Disengagement Syndrome and Impact on Neuropsychological Performance

Objective: This study investigated subfactors of cognitive disengagement syndrome (CDS; previously referred as sluggish cognitive tempo) among adults referred for neuropsychological evaluation of attentiondeficit/hyperactivity disorder (ADHD). Method: Retrospective analyses of data from 164 outpatient neuropsychological evaluations examined associations between CDS subfactors and self-reported psychological symptoms and cognitive performance. Results: Factor analysis produced two distinct but positively correlated constructs: “Cognitive Complaints’’ and “Lethargy.” Both correlated positively with symptom reports (rs = 0.26–0.57). Cognitive Complaints correlated negatively with working memory, processing speed, and executive functioning performance (rs = −0.21 to −0.37), whereas Lethargy correlated negatively only with processing speed and executive functioning performance (rs = −0.26 to −0.42). Both predicted depression symptoms, but only Cognitive Complaints predicted inattention symptoms. Both subfactors demonstrated modest to nonsignificant associations with cognitive performance after accounting for estimated premorbid intelligence and inattention. Conclusion: Findings indicate a bidimensional conceptualization of CDS, with differential associations between its constituent subfactors, reported symptoms, and cognitive performance.

SAT143 Domains Of Cognitive Dysfunction In Patients With Post-Bariatric Hypoglycemia

Abstract Disclosure: A.M. Puleio: None. A.L. Sheehan: None. G.J. Musen: None. M. Patti: Consulting Fee; Self; AstraZeneca, Fractyl Laboratories. Other; Self; Eiger Pharmaceuticals - Consulting, MBX Biosceinces - Consulting, Hanmi Pharmaceutical - Consulting, Recordati - Consulting. Objective: Bariatric surgery is a highly effective treatment for obesity and associated comorbidities. Studies suggest bariatric surgery may result in improved cognitive function and brain volume in parallel with improved cardiometabolic function. However, some post-bariatric individuals develop post-bariatric hypoglycemia (PBH), which can be frequent and severe. Whether repeated episodes of hypoglycemia can impact cognitive function in PBH is unknown. The objective of this pilot study was to determine whether individuals with PBH display reduced cognitive function compared to surgical non-hypoglycemic counterparts. Inclusion/Exclusion Criteria: Adults aged 18-70 years, with a history of Roux-en-Y gastric bypass (RYGB), without a current diagnosis of diabetes, were recruited and enrolled into two groups: individuals with PBH (PBH+), and asymptomatic individuals with history of prior RYGB without hypoglycemia (RYGB non-hypo). Individuals with a history of traumatic brain injury or cerebrovascular accident, active treatment with any medications for diabetes (other than acarbose), active alcohol/substance abuse, known neuroendocrine tumor, or active depression (score >4 for Patient Health Questionnaire-2 (PHQ-2)) were excluded. Methods: Fourteen adults (PBH+, n=7; RYGB non-hypo, n=7) completed assessments of executive function (Delis Kaplan Executive Function System), working memory and attention (Wechsler Memory Scale Third Edition), as well as psychomotor speed (grooved pegboard). Premorbid intelligence was estimated using the National Adult Reading Test. Results: Individuals with PBH+ displayed significantly decreased performance on tests of category fluency (p <0.01), category switching (p <0.01), and category switching accuracy (p <0.01), compared to those in the RYGB non-hypo group. Performance in other verbal fluency measures, including the first (p =0.03) and third interval (p = 0.045), were significantly lower in PBH+ vs. RYGB non-hypo. All other assessments did not differ, including the estimation of premorbid intelligence (p=0.14). Conclusion: PBH+ individuals may be at greater risk for cognitive impairment compared to RYGB non-hypo individuals, as suggested by the impaired semantic processing and cognitive flexibility, as well as greater difficulty initiating and sustaining word retrieval in PBH+. Groups did not differ in cognitive assessments of psychomotor speed, memory, attention, and executive function. Clinicians should be alert for symptoms of cognitive dysfunction in PBH+ patients and consider neurocognitive testing in parallel with assessment of glycemic control, as well as other potential cognitive risk factors. Larger, longitudinal trials are necessary to further elucidate the impact of hypoglycemia on cognition and risk of dementia in patients with PBH. Presentation: Saturday, June 17, 2023

Cognitive Reserve Moderates the Effects of Fatigue and Depressive Symptoms in Multiple Sclerosis.

To investigate cognitive reserve as a possible moderator in the relationship between fatigue and depressive symptoms in persons with multiple sclerosis (PwMS). Fifty-three PwMS (37 female; mean age, 52.66; mean education, 14.81) completed comprehensive neuropsychological testing and psychosocial questionnaires assessing the perceived effects of fatigue (Fatigue Impact Scale) and depressive symptoms (Beck Depression Inventory-Fast Screen). Cognitive reserve (CR) was operationalized as Fixed CR and Malleable CR. Fixed CR was quantified as the standardized mean of years of education and a vocabulary-based estimate of premorbid intelligence. Malleable CR was quantified as the standardized mean of cognitive exertion, exercise, and socializing items from the Cognitive Health Questionnaire. Regressions on depressive symptoms examining fatigue, both conceptualizations of CR, and their interactions were explored. A Bonferroni correction was used; results were considered significant at an alpha level of p < .01. The interactions between fatigue and both conceptualizations of CR were significant, p = .005 (Fixed CR); p = .004 (Malleable CR). Simple effects tests revealed that fatigue only predicted depressive symptoms in PwMS with low Fixed CR or low Malleable CR (p's < .001), and not in those with high Fixed or high Malleable CR (p > .01). Cognitive reserve moderated the relationship between fatigue and depressive symptoms in PwMS. Specifically, fatigue does not appear to influence depression in PwMS with high cognitive reserve. Having higher cognitive reserve (either Fixed or Malleable) may reduce the likelihood that fatigue will lead to depressive symptoms in MS.

On the use of pseudoword reading as estimate of premorbid intelligence in brain injured, psychopathological, or cognitively impaired patients.

OPINION article Front. Psychol., 04 January 2023Sec. Cognition Volume 13 - 2022 | https://doi.org/10.3389/fpsyg.2022.1048237

Cognitive and Physiologic Reserve Independently Relate to Superior Neurocognitive Abilities in Adults Aging With HIV.

To investigate joint contributions of cognitive and physiologic reserve to neurocognitive SuperAging in older persons with HIV (PWH). Participants included 396 older PWH (age range: 50-69 years) who completed cross-sectional neuropsychological and neuromedical evaluations. Using published criteria, participants exhibiting global neurocognition within normative expectations of healthy 25-year-olds were classified as SuperAgers (SA; n = 57). Cognitively normal (CN; n = 172) and impaired (n = 167) participants were classified with chronological age-based norms. Cognitive reserve was operationalized with an estimate of premorbid verbal intelligence, and physiologic reserve was operationalized with a cumulative index of 39 general and HIV-specific health variables. Analysis of variance with confirmatory multinomial logistic regression examined linear and quadratic effects of cognitive and physiologic reserve on SA status, adjusting for chronological age, depression, and race/ethnicity. Univariably, SA exhibited significantly higher cognitive and physiologic reserve compared with CN and cognitively impaired ( d s ≥ 0.38, p s < 0.05). Both reserve factors independently predicted SA status in multinomial logistic regression; higher physiologic reserve predicted linear increases in odds of SA, and higher cognitive reserve predicted a quadratic "J-shaped" change in odds of SA compared with CN (ie, odds of SA > CN only above 35th percentile of cognitive reserve). Each reserve factor uniquely related to SA status, which supports the construct validity of our SA criteria and suggests cognitive and physiologic reserve reflect nonoverlapping pathways of neuroprotection in HIV. Incorporation of proxy markers of reserve in clinical practice may improve characterization of age-related cognitive risk and resilience among older PWH, even among PWH without overt neurocognitive impairment.

Estimation of premorbid intelligence: Demographical and current neurocognitive functioning based algorithms.

Establishing a premorbid level of intellectual functioning is crucial for determining the severity level of impairment and prognosis for patients in clinical setting. Therefore, the study aimed to develop a method to estimate premorbid IQ of Hindi speaking Indian population. A Hindi vocabulary test was developed (N=60) and standardized (N=100). The regression algorithm has been developed using VAIS, WAPIS, RPMT, and a newly developed Vocabulary test, and validated on 100 normal individuals and on 39 brain injury patients. The estimated premorbid Verbal IQ and performance IQ equation was developed by using demographic variables combine with Hindi vocabulary scores and Matrix Reasoning raw scores respectively. Both the estimated premorbid verbal and performance IQ were found to be significant and valid in estimating verbal and performance IQ in normal and brain injury population. These equations for estimating verbal and performance IQ were found significantly accurate in predicting verbal and performance IQ.

When is it appropriate to infer cognitive impairment on the basis of premorbid IQ estimates? A simulation study.

Whether an individual meets psychometric criteria for cognitive impairment is dictated by the comparison criterion, which is typically either a normative mean or a known or estimated previous level of ability. This study investigated the conditions under which adjusting normative expectations based on estimated premorbid intelligence would be appropriate. A simulated data set was derived and several parameters were systematically varied: the correlation between premorbid intelligence and the cognitive test score, the cutoff used to classify a score as "normal" or "abnormal", and the population base rate of cognitive impairment. Simulation results demonstrated that the correlation between premorbid intelligence and the cognitive score was the only parameter to substantially influence the trade-off between the two normative approaches, with correlations above ρ = .35 signifying greater advantage to adjusting normative expectations by premorbid intelligence. These findings inform common neuropsychological practices regarding the application of premorbid intelligence estimates to the detection of cognitive impairment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Estimation of premorbid intelligence and executive cognitive functions with lexical reading tasks.

Estimation of premorbid intelligence and executive cognitive functions with lexical reading tasks.

Estimation of Cognitive Performance Based on Premorbid Intelligence in Parkinson's Disease.

Background:The estimation of premorbid intelligence (PI) is needed for an accurate diagnosis.Objective:This study aimed to estimate the cognitive performance taking into account the PI in Parkinson’s disease (PD) compared to healthy controls (HC); and to analyze the discrepancies between the current and the predicted cognitive performance based on the PI.Method:Semantic fluency, verbal and visual memory, and executive functions were assessed in 39 PD and 162 HC. A linear regression model was used to analyze the discrepancies between the predicted cognitive performance and the current raw scores through PI variables (Word Accentuation Test (WAT), Pseudo-Words (PW) Reading subtest from PROLEC-R, age, and years of education). ROC analyses were performed to assess their diagnostic properties.Results:Significant differences were found in the raw cognitive scores between patients and HC [semantic fluency (t = 6.07; p < 0.001), verbal memory (t = 6.63; p < 0.001), and executive functions (t = 2.57; p = 0.013), and in visual memory (t = 1.97; p = 0.055 marginally significant)]. Compared to HC, PD patients presented higher discrepancies between the predicted cognitive performance and the raw scores in semantic fluency, verbal memory, visual memory, executive functions (AUC = 0.78, 0.78; 0.64, 0.61, respectively).Conclusion:The magnitude of the discrepancies scores between the current and the predicted cognitive performance based on PI indicates the presence of cognitive decline in the specific cognitive domain in PD patients. This study underlines the usefulness of premorbid measures and variables, such as WAT, PW, age, and years of education, to more accurately estimate the cognitive performance in PD.

A brief report: The National Adult Reading Test (NART) is a stable assessment of premorbid intelligence across disease severity in obstructive sleep apnea (OSA).

Obstructive sleep apnea (OSA) is a widely prevalent disorder that can affect cognitive function. The relationship between cognitive function and OSA is known to be affected by an individual's premorbid cognitive ability. Tools to measure premorbid intelligence across OSA disease severity have not been validated. This brief report aims to establish if the National Adult Reading Test (NART) provides a stable estimate of premorbid intelligence across levels of OSA disease severity. We examined if NART scores varied systematically across levels of untreated OSA severity (defined according to the apnea-hypopnea index [AHI]) and mean oxygen saturation in sleep clinic (n=121) and community samples (n=398) using regression analysis. Simple linear regression was used to predict NART scores based on the AHI. NART-estimated premorbid IQ scores without demographics did not vary systematically with AHI (F<1; β=0.01) or mean SpO2 (F<1; β=0.12). NART-estimated premorbid IQ scores with added demographic information also did not vary systematically with AHI (F<1; β=-0.01) or mean SpO2 (F<1; β=0.15). This preliminary examination shows that the NART provides a stable estimate of premorbid intelligence across untreated OSA disease severity, as demarcated by AHI or mean nocturnal SpO2 .

Cognitive Decline in Korean Patients with Neurocognitive Disorder due to Traumatic Brain Injury: A Control for Premorbid Intelligence.

ObjectivePrevious studies of cognitive decline in patients with neurocognitive disorder due to traumatic brain injury (NCD-TBI) have often failed to control for baseline factors such as premorbid intelligence. The purpose of the current study was to estimate and compare cognitive function among three groups (controls, complicated mild/moderate TBI, and severe TBI) after controlling for premorbid intelligence. MethodsSeverity of TBI was classified as complicated mild/moderate or severe based on duration of loss of consciousness and brain neuroimaging results. Premorbid intelligence quotients (IQs) were estimated with the Oklahoma Premorbid Intelligence Estimate. There were no differences in premorbid intelligence between the groups, which were also matched for age and education. Current cognitive function was evaluated with the Wechsler Adult Intelligence Scale-Fourth Edition. ResultsComparison of current cognitive function among the three groups indicated significant group differences for all indexes and subtest scores. Processing speed showed the highest effect size. However, only working memory differed significantly between the two NCD-TBI groups. ConclusionThe present findings suggest that mental memory manipulation processes seem to be more sensitive to TBI severity than are perceptual-motor processes. Specifically, both auditory rehearsal/discrimination and mental alertness/manipulation will be most strongly influenced by TBI severity.

Patterns of Cortical Structures and Cognition in Antipsychotic-Naïve Patients With First-Episode Schizophrenia: A Partial Least Squares Correlation Analysis

BackgroundSchizophrenia is associated with alterations in cortical structures and cognitive impairments, but antipsychotic medication may affect these measures. We investigated patterns of relationships between cortical structures and cognitive domains in antipsychotic-naïve patients with first-episode schizophrenia. MethodsT1-weighted 3T magnetic resonance imaging was performed in 105 patients and 136 healthy control subjects. Using FreeSurfer, we obtained measurements of cortical thickness, surface area, and mean curvature. Using an extensive neurocognitive battery including the Danish Adult Reading Test and subtests from the Cambridge Neuropsychological Test Automated Battery, we obtained estimates of premorbid intelligence, spatial working memory, spatial planning, intra-extradimensional set shifting, and reaction and movement times. With univariate analyses, we tested group differences between cortical structures and cognition. With partial least squares correlation analyses, we investigated patterns of associations between cortical structures and cognition. ResultsPatients had significantly higher mean curvature and were impaired on 7 of 11 cognitive parameters. The between-group partial least squares correlation analysis revealed two cortical thickness/cognition patterns that differentiated patients and healthy control subjects (omnibus test, p = .011). Most cortical regions contributed reliably to these patterns. In patients, spatial working memory, spatial planning, reaction and movement times, and premorbid intelligence contributed reliably to the pattern; in healthy control subjects, spatial planning and intra-extradimensional set shifting contributed reliably. ConclusionsAntipsychotic-naïve patients with first-episode schizophrenia displayed a higher mean curvature, but no significant difference in other gray matter indices was found. Nevertheless, the pattern of associations between global cortical thickness and cognitive functions was markedly different between groups. These multivariate analyses reveal a novel linkage between regional cortical brain structure and cognitive deficits at the earliest, never-medicated illness stage.

Development of the Korean Adult Reading Test (KART) to estimate premorbid intelligence in dementia patients.

We aimed to develop a word-reading test for Korean-speaking adults using irregularly pronounced words that would be useful for estimation of premorbid intelligence. A linguist who specialized in Korean phonology selected 94 words that have irregular relationship between orthography and phonology. Sixty cognitively normal elderly (CN) and 31 patients with Alzheimer’s disease (AD) were asked to read out loud the words and were administered the Wechsler Adult Intelligence Scale, 4th edition, Korean version (K-WAIS-IV). Among the 94 words, 50 words that did not show a significant difference between the CN and the AD group were selected and constituted the KART. Using the 30 CN calculation group (CNc), a linear regression equation was obtained in which the observed full-scale IQ (FSIQ) was regressed on the reading errors of the KART, where education was included as an additional variable. When the regressed equation computed from the CNc was applied to 30 CN individuals of the validation group (CNv), the predicted FSIQ adequately fit the observed FSIQ (R2 = 0.63). In addition, independent sample t-test showed that the KART-predicted IQs were not significantly different between the CNv and AD groups, whereas the performance of the AD group was significantly worse in the observed IQs. In addition, an extended validation of the KART was performed with a separate sample consisted of 84 CN, 56 elderly with mild cognitive impairment (MCI), and 43 AD patients who were administered comprehensive neuropsychological assessments in addition to the KART. When the equation obtained from the CNc was applied to the extended validation sample, the KART-predicted IQs of the AD, MCI and the CN groups did not significantly differ, whereas their current global cognition scores significantly differed between the groups. In conclusion, the results support the validity of KART-predicted IQ as an index of premorbid IQ in individuals with AD.

P18.05 Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): Preliminary Data on Clinical Utility within the Brain Tumor Population

OBJECTIVE: The detrimental effects of brain tumors and related treatments on cognitive capacity are well documented. Since sustaining or improving quality of life is a goal of equal importance to prolonged survival rates, neurocognitive assessments have become integral to comprehensive neuro-oncology care. Existing screening tools are criticized because they are insensitive to cognitive changes caused by medical treatments. One measure that may offer unique utility is the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Research supports the clinical value and psychometric properties of the RBANS in various medical populations; however, there is minimal evidence for its use in the brain tumor population. The purpose of this study was to determine RBANS utility in a sample of brain tumor patients by assessing the incidence of cognitive impairment relative to normative data, as well as to an estimate of pre-morbid intelligence. Participants. Data was collected on 38 patients (53% male; mean age 51, range 27-81) with primary brain tumors, confirmed by histopathological diagnosis. Eighty-Two percent had received surgery as initial treatment, and 45% had undergone radiation, chemotherapy or both prior to assessment. METHODS: All patients were administered the RBANS and the Test of Premorbid Functioning (TOPF, an estimate of pre-morbid intelligence) according to standardized instructions. Composite and Index Standard Scores (SS) from the RBANS were compared to a normal distribution (SS ≤85 indicative of impairment) and TOPF (≥1 SD difference indicative of impairment) per patient. Correlations were completed to identify cognitive relationships within this cohort. RESULTS: Descriptive profiling of RBANS will be presented. Regarding demonstrated deficits, comparison with standardization norms (RBANS; 47% compositely impaired, 68% on at least one index, and 53% on multiple indexes) was strikingly similar compared to self (TOPF; 50%, 71%, 53%). However, patients had an increased likelihood of global impairment when compared to self (4 to 5 indexes impaired; 32% vs 8%). There was a positive correlation between quantity of deficits and TOPF (r = .636, p = .000), whereas there was a negative correlation when compared to RBANS normative distribution (r = -.351, p = .031). CONCLUSIONS: Accuracy and interpretation of neuropsychological assessment is crucial within the brain tumor population to correctly identify impairment, its influences on perception of illness, level of support, and recommendations for management. Our preliminary research demonstrates the utility of RBANS as an efficient tool to assess cognitive impairment in patients with primary brain tumors. Our data also supports the importance of comparison to self and estimated premorbid intelligence, rather than normative distribution, to ensure precision in estimation of impairment.

The relationship between premorbid IQ and neurocognitive functioning in individuals with cocaine use disorders.

To determine whether premorbid IQ mediates performance on neurocognitive tests in individuals diagnosed with cocaine use disorder (CUD). Recently abstinent cocaine users (N = 113) completed measures sensitive to the effects of cocaine on cognition: Conners' Continuous Performance Task-II (CPT-II), n-back working memory test, and Hopkins Verbal Learning Task-Revised (HVLT-R). Premorbid IQ was calculated using the Oklahoma Premorbid Intelligence Estimate, which integrates scores from the Wechsler Adult Intelligence Scale-III and demographic variables. Participants were grouped according to their premorbid IQ using commonly accepted classifications of ability level (above average [>110], average [90-109], and below average [<90]) and comparisons in neurocognitive performance were performed using one-way analysis of variance. Significant differences were detected between groups on the HVLT-R including Trial 1 (p = .002), total word recall across the 3 list-learning trials (p < .001), and recall following a delay (p < .001). Significant differences were also detected on the N-back, including auditory and visual accuracy (p = .022 and p < .001, respectively) and mean and maximum block length (p < .001). Although significant differences were observed between the above average and average groups (mean effect size = .418 [Cohen's d]), the magnitude of group differences was greatest between the average and below average groups (mean effect size = .716). These results raise questions as to whether the neurocognitive impairment observed in individuals diagnosed with CUD predated the onset of cocaine use or whether the impairments were caused by cocaine use. Because these impairments are potential risk factors for poor treatment outcomes, it is important to consider the need to modify treatment programs to account for lower premorbid IQ. (PsycINFO Database Record

Estimates of premorbid ability in a neurodegenerative disease clinic population: comparing the Test of Premorbid Functioning and the Wide Range Achievement Test, 4th Edition

Objective: Two frequently used measures to assess premorbid intellectual ability include the Wide Range Achievement Test, 4th Edition Reading Subtest (WRAT-4 READ) and the Test of Premorbid Functioning (TOPF). The present study compared estimates obtained from these measures in a neurodegenerative disease population. Method: Records from 85 referrals seen for neuropsychological evaluation in a neurodegenerative disorders clinic were reviewed. Evaluations included TOPF, WRAT-4 READ, and measures of memory, reasoning, language, and executive functioning. Pairwise correlations and concordance correlation coefficients (CCC) were calculated between raw scores and predicted intelligence estimates. Discrepancy scores were calculated between estimates and data were divided into three groups based on size of standardized discrepancy score: Equal, WRAT-4 READ > TOPF, and TOPF > WRAT-4 READ. analysis of variances compared groups on demographic characteristics and cognitive performance. Results: Despite strong Pearson correlation, CCC between predicted IQ estimates showed poor agreement between measures, with evidence of both fixed and proportional bias. Discrepancies ranged from −24.0 to 22.0 (M = 1.78, SD = 6.65), with TOPF generating higher estimates on average. Individuals performing better on WRAT-4 READ were significantly older (M age = 76.26, SD = 7.53) than those performing similarly on both measures and those performing better on TOPF (F (2, 82) = 7.31, p < .001). All other comparisons between groups on demographic variables and cognitive measures were non-significant. Conclusions: Estimates of premorbid intelligence obtained from the TOPF and WRAT-4 READ have a strong linear relationship, but systematically generate inconsistent estimates in a neurodegenerative disease clinical sample and should not be used interchangeably.

Estimation of K-WAIS-IV Premorbid Intelligence in South Korea: Development of the KPIE-IV

Objective: The accurate estimation of premorbid intellectual functioning in patients with known or suspected cognitive impairment is crucial for clinicians. However, there is no reliable method for estimating premorbid intelligence in South Korea. The purpose of this study was to develop the Korea Premorbid Intelligence Estimate (KPIE) as an estimate of the premorbid intellectual functioning. Method: Data from the Korean WAIS-IV standardization sample were used to generate several Full Scale Intelligence Quotient (FSIQ) estimation formulas using demographic variables and current WAIS-IV subtest performance. The standardization sample (N = 1216) was randomly divided into two groups: the first group was used to develop the formulas and the second group was used to validate the prediction equations. Age, education, gender, region of the country, and select subtest raw scores (Vocabulary, Information, Matrix Reasoning, and Visual Puzzle) were used as predictor variables. Results: Five KPIE-4 equations were generated. Estimated FSIQ derived from the KPIE-4 equation is highly correlated with K-WAIS-IV FSIQ. Conclusions: The resulting formulas for estimating premorbid FSIQ were highly significant and precise in predicting FSIQ scores of participants in the K-WAIS-IV normative sample. These equations provide a means for clinicians to estimate intellectual functioning in adults, and can be utilized as a method of estimating individuals premorbid functioning.

Neuropsychological deficits in past suicide attempters with varying levels of depression severity.

Our previous work identified deficits in interference processing and learning/memory in past suicide attempters who were currently depressed and medication-free. In this study, we extend this work to an independent sample studied at various stages of illness and treatment (mild symptoms, on average) to determine if these deficits in past suicide attempters are evident during a less severe clinical state. A total of 80 individuals with a past history of major depression and suicide attempt were compared with 81 individuals with a history of major depression and no lifetime suicide attempts on a battery of neurocognitive measures assessing attention, memory, abstract/contingent learning, working memory, language fluency and impulse control. Past attempters performed more poorly in attention, memory and working memory domains, but also in an estimate of pre-morbid intelligence. After correction for this estimate, tests that had previously distinguished past attempters - a computerized Stroop task and the Buschke Selective Reminding Test - remained significantly worse in attempters. In a secondary analysis, similar differences were found among those with the lowest levels of depression (Hamilton Depression Rating Scale score <10), suggesting that these deficits may be trait markers independent of current symptomatology. Deficits in interference processing and learning/memory constitute an enduring defect in information processing that may contribute to poor adaptation, other higher-order cognitive impairments and risk for suicidal behavior.

Relationships between ophthalmic artery flow direction and cognitive performance in patients with unilateral carotid artery stenosis

BackgroundCerebral hypoperfusion is responsible for cognitive impairment in patients with severe carotid artery stenosis (CAS). The manifestation of reversed ophthalmic artery flow (ROAF) is not uncommon in patients with CAS, suggesting a state of intensified cerebral hypoperfusion. This study aimed to examine whether the presence of ROAF can exacerbate cognitive impairment in patients with severe unilateral CAS. MethodsOne-hundred-and-two patients with CAS and 37 age-matched volunteers participated in this case–control study. Depending on the side of CAS and occurrences of ROAF, the patients were allocated to four groups: left CAS groups with ROAF (n=28) or without ROAF (n=22), and right CAS groups with ROAF (n=26) or without ROAF (n=26). All subjects underwent a battery of neuropsychological tests. ResultsAll patients performed worse than the control group on most tests. No significant differences were observed between patient groups (ps>0.05), except for inferior performance on psychomotor speed and visuospatial tests in the right ROAF group (ps<0.03). Hierarchical regression analyses indicated strong contributions of estimated premorbid intelligence to performance on most tests (ps<0.05). The severity of left and right CAS was distinctively associated with different functions. To a lesser extent, the severity of infarcts was also associated with impairment of psychomotor speed and some executive functions (ps<0.05). The contributions of ROAF to performance on most tests were negligible. ConclusionPatients with unilateral CAS may present with specific cognitive impairment relevant to the ipsilateral hemispheric functions. However, the manifestation of ROAF does not necessarily imply more extensive or severe cognitive impairment.

Naming Test of the Neuropsychological Assessment Battery: Reliability and Validity in a Sample of Patients with Acquired Brain Injury

The current study assessed the internal consistency, alternate forms reliability, and convergent/divergent validity of the Naming Test of the Neuropsychological Assessment Battery (NAB) in patients with acquired brain injury. Fifty-nine patients were administered the NAB Naming Test (forms 1 and 2) and the Boston Naming Test (BNT), as well as other tests of neuropsychological functioning. Forms 1 and 2 of the NAB Naming Test demonstrated adequate internal consistency and alternate forms reliability. The NAB Naming Test was significantly associated with scores from the BNT, as well as scores from tests that assess visuospatial skills, semantic fluency, and verbal memory. The divergent validity of the NAB Naming Test was demonstrated by non-significant associations with tests of attention and processing speed. BNT scores correlated significantly with the educational level and estimated premorbid intelligence but not age, whereas the NAB Naming Test scores only correlated significantly with estimated premorbid intelligence. The current study provides independent validation supporting the utility of the NAB Naming Test for patients with acquired brain injury.