Group-level Change Research Articles

Fairness matters for change: A multilevel study on organizational change fairness, proactive motivation, and change-oriented OCB.

The success of organizational change often hinges on the perception of fairness within a change unit. This group-level organizational change fairness is crucial for enhancing proactive motivation states and fostering positive change-oriented organizational citizenship behavior (OCB). Rooted in the proactive motivation model, this study establishes a comprehensive multilevel framework to investigate the influence of group-level organizational change fairness on employees' change-oriented OCB. It explores the mediating role of three proactive motivational states and the moderating impact of perceived change impact. Analyzing data collected from 597 employees within 107 teams across 43 Chinese companies, our findings indicate that group-level perceived organizational change fairness significantly predicts employees' change-oriented OCB through organizational change self-efficacy, involvement, and positive emotional experiences. Furthermore, the study reveals that group-level perceived change impact moderates the relationship between group-level fairness perception and both change self-efficacy and positive emotional experiences, with stronger associations observed under conditions of low perceived change impact. These insights notably advance our understanding of the cross-level determinants influencing change-oriented OCB through perceived fairness and proactive motivation. Managers should focus on developing fairness perceptions to stimulate OCB by fostering employees' proactive motivation states, particularly during low-impact organizational changes. Our findings provide valuable implications for organizational change management practices.

Brain volume loss after cranial irradiation: a controlled comparison study between photon vs proton radiotherapy for WHO grade 2-3 gliomas.

Radiation therapy (RT) is an integral treatment component in patients with glioma but associated with neurotoxicity. Proton RT (PRT), as compared with photon RT (XRT), reduces excess radiation to nontarget tissue. We used a retrospective method to evaluate brain imaging metrics of neurotoxicity after treatment with PRT and XRT for glioma. We analyzed brain volume change in thirty-four patients with WHO grade 2-3 gliomas treated with either PRT (n = 17) or XRT (n = 17). Both groups were carefully matched by demographic/clinical criteria and assessed longitudinally for two years post-radiotherapy. Brain volume change was measured as ventricular volume expansion in the tumor free hemisphere (contralateral to RT target) as a proxy indicator of brain volume loss. We further assessed the impact of volumetric changes on cognition in PRT patients, who completed neuropsychological testing as part of an outcome study. We found significant ventricular volume increases in the contralesional hemisphere in both groups at two years post-RT (F(1, 31) = 18.45, p < 0.000, partial η2 = 0.373), with greater volume change observed in XRT (26.55%) vs. PRT (12.03%) (M = 12.03%, SD = 16.26; F(1,31) = 4.26, p = 0.048, partial η2 = 0.121). Although, there was no group-level change on any cognitive test in PRT treated patients, individual changes on cognitive screening, working memory, processing speed and visual memory tasks correlated with contralesional brain volume loss. This study suggests progressive brain volume loss following cranial irradiation, with greater severity after XRT vs. PRT. Radiation-induced brain volume loss appears to be associated with measurable cognitive changes on an individual level. Prospective studies are warranted to validate these findings and their impacts on long-term cognitive function and quality of life. An improved understanding of the structural and functional consequences of cranial radiation is essential to develop neuroprotective strategies.

Measuring the association between the opening of a new multi-national restaurant with young people's eating behaviours

Out-of-home eating (takeaway, take-out and fast-foods) is associated with intakes of higher energy and fat, and lower intakes of micronutrients, and is associated with excess weight gain. In 2017, a unique opportunity arose to measure the association between the opening of a new multi-national fast-food restaurant (McDonald's) and consumption of fast-food on young people aged 11–16. This study uses a repeated cross-sectional design to explore group level change over time with respect to out-of-home eating behaviours of young people. Two secondary schools in Redcar and Cleveland agreed to participate and facilitated the completion of a questionnaire on their pupils eating behaviours at three timepoints a) prior to the new restaurant opening, b) three months post-opening and c) nine months post opening. Reported frequency of visits to McDonald's showed a statistically significant increase in visits between 3 and 9 months of the restaurant opening. This research asks and explores the question of whether the introduction of a new multi-national fast-food restaurant influences eating habits of young people attending schools near the new outlet.

Effects of Statistical Practices for Longitudinal Group Comparison of the Penetration-Aspiration Scale on Power and Effect Size Estimation: A Monte Carlo Simulation Study.

Multiple bolus trials are administered during clinical and research swallowing assessments to comprehensively capture an individual's swallowing function. Despite valuable information obtained from these boluses, it remains common practice to use a single bolus (e.g., the worst score) to describe the degree of dysfunction. Researchers also often collapse continuous or ordinal swallowing measures into categories, potentially exacerbating information loss. These practices may adversely affect statistical power to detect and estimate smaller, yet potentially meaningful, treatment effects. This study sought to examine the impact of aggregating and categorizing penetration-aspiration scale (PAS) scores on statistical power and effect size estimates. We used a Monte Carlo approach to simulate three hypothetical within-subject treatment studies in Parkinson's disease and head and neck cancer across a range of data characteristics (e.g., sample size, number of bolus trials, variability). Different statistical models (aggregated or multilevel) as well as various PAS reduction approaches (i.e., types of categorizations) were performed to examine their impact on power and the accuracy of effect size estimates. Across all scenarios, multilevel models demonstrated higher statistical power to detect group-level longitudinal change and more accurate estimates compared to aggregated (worst score) models. Categorizing PAS scores also reduced power and biased effect size estimates compared to an ordinal approach, though this depended on the type of categorization and baseline PAS distribution. Multilevel models should be considered as a more robust approach for the statistical analysis of multiple boluses administered in standardized swallowing protocols due to its high sensitivity and accuracy to compare group-level changes in swallowing function. Importantly, this finding appears to be consistent across patient populations with distinct pathophysiology (i.e., PD and HNC) and patterns of airway invasion. The decision to categorize a continuous or ordinal outcome should be grounded in the clinical or research question with recognition that scale reduction may negatively affect the quality of statistical inferences in certain scenarios.

N of 1: Optimizing Methodology for the Detection of Individual Response Variation in Resistance Training.

Most resistance training research focuses on inference from average intervention effects from observed group-level change scores (i.e., mean change of group A vs group B). However, many practitioners are more interested in training responses (i.e., causal effects of an intervention) on the individual level (i.e., causal effect of intervention A vs intervention B for individual X). To properly examine individual response variation, multiple confounding sources of variation (e.g., random sampling variability, measurement error, biological variability) must be addressed. Novel study designs where participants complete both interventions and at least one intervention twice can be leveraged to account for these sources of variation (i.e., n of 1 trials). Specifically, the appropriate statistical methods can separate variability into the signal (i.e., participant-by-training interaction) versus the noise (i.e., within-participant variance). This distinction can allow researchers to detect evidence of individual response variation. If evidence of individual response variation exists, researchers can explore predictors of the more favorable intervention, potentially improving exercise prescription. This review outlines the methodology necessary to explore individual response variation to resistance training, predict favorable interventions, and the limitations thereof.

Predictors of Change in Wellbeing and Mental Health of Parents of Autistic Pre-Schoolers.

Parenting is a rewarding experience but is not without its challenges. Parents of Autistic children face additional challenges, and as a result can experience lower levels of wellbeing and more mental health problems (i.e., depression, anxiety, stress). Previous studies have identified concurrent correlates of wellbeing and mental health. However, few have investigated predictors of subsequent wellbeing and mental health, or of change over time, among parents of pre-school aged autistic children. We examined child-, parent-, and family/sociodemographic factors associated with change in parents' mental health and wellbeing across three timepoints (spanning approximately one year) among 53 parents of Autistic pre-schoolers (M = 35.48, SD = 6.36months. At each timepoint, parents reported lower wellbeing and greater mental health difficulties compared to normative data. There was no significant group-level change over time in parent outcomes. However, individual variability in short-term (~ 5months) wellbeing and mental health change was predicted by a combination of child- and parent-related factors, while variability in medium-term (~ 10months) change was predicted by parent factors alone. Parents' description of their child and their relationship predicted change in both wellbeing and mental health. Furthermore, participating in a parent-mediated intervention (available to a subgroup) was a significant predictor of change in wellbeing. Our findings highlight potentially modifiable factors (e.g., learning healthier coping strategies) that may positively impact both short- and medium-term change in parental outcomes.

Clinical meaningfulness and psychometric robustness of the MG Symptoms PRO scales in clinical trials in adults with myasthenia gravis.

The objective of this research was to generate psychometric evidence supporting the myasthenia gravis (MG) symptoms patient-reported outcome (PRO) scales as a fit-for-purpose measure of severity of core symptoms of MG and provide information allowing their meaningful interpretation using data from a phase 3 study in MG. Data from the MycarinG study, a phase 3 study of rozanolixizumab in patients with generalized MG who experience moderate to severe symptoms (ClinicalTrials.gov Identifier: NCT03971422) were analyzed with both classical test theory (CTT) and Rasch measurement theory (RMT). Meaningful within-individual change and group-level meaningful change were estimated for three MG Symptoms PRO scales using anchor- and distribution-based methods. Anchor-based methods used patient global impression of severity (PGIS) and change (PGIC) in MG symptoms as anchors. Good measurement properties of the MG Symptoms PRO scales were shown in the sample of 200 participants: good to excellent reliability (test-retest and internal consistency reliability) and validity (associations between items and scores within the MG Symptoms PRO scales and between the MG Symptoms PRO scores and other clinical outcomes-MG ADL, QMG score, MGC score, and MGFA classes-were as expected); and the items showed good coverage of the continuum and fit to the Rasch model. Triangulation of the anchor- and distribution-based method results led to the definition of clinically meaningful within-patient improvement in scores for Muscle Weakness Fatigability (-16.67), Physical Fatigue (-20.00), and Bulbar Muscle Weakness (-20.00), with associated ranges. Benchmarks are also proposed for the interpretation of group-level results. The strong psychometric performance of the MG Symptoms PRO scales and the information generated to guide its interpretation supports its use in clinical trials for demonstrating the clinical benefits of new treatments targeting core symptoms of MG (muscle weakness fatigability, physical fatigue, bulbar muscle weakness, respiratory muscle weakness, and ocular muscle weakness).

Minimally important differences for interpreting EORTC QLQ-C30 change scores over time: A synthesis across 21 clinical trials involving nine different cancer types

IntroductionEarly guidelines for minimally important differences (MIDs) for the EORTC QLQ-C30 proposed ≥10 points change as clinically meaningful for all scales. Increasing evidence that MIDs can vary by scale, direction of change, cancer type and estimation method has raised doubt about a single global standard. This paper identifies MID patterns for interpreting group-level change in EORTC QLQ-C30 scores across nine cancer types. MethodsData were obtained from 21 published EORTC Phase III trials that enroled 13,015 patients across nine cancer types (brain, colorectal, advanced breast, head/neck, lung, mesothelioma, melanoma, ovarian, and prostate). Anchor-based MIDs for within-group change and between-group differences in change over time were obtained via mean change method and linear regression, respectively. Separate MIDs were estimated for improvements and deteriorations. Distribution-based estimates were derived and compared with anchor-based MIDs. ResultsAnchor-based MIDs mostly ranged from 5 to 10 points. Differences in MIDs for improvement vs deterioration, for both within-group and between-group, were mostly within a 2-points range. Larger differences between within-group and between-group MIDs were observed for several scales in ovarian, lung and head/neck cancer. Most anchor-based MIDs ranged between 0.3 SD and 0.5 SD distribution-based estimates. ConclusionsOur results reinforce recent claims that no single MID can be applied to all EORTC QLQ-C30 scales and disease settings. MIDs varied by scale, improvement/deterioration, within/between comparisons and by cancer type. Researchers applying commonly used rules of thumb must be aware of the risk of dismissing changes that are clinically meaningful or underpowering analyses when smaller MIDs apply.

Using Digital Measurement-Based Care to Address Symptoms of Inattention, Hyperactivity, and Opposition in Youth: Retrospective Analysis of Bend Health.

Attention-deficit/hyperactivity disorder (ADHD) and associated behavioral disorders are highly prevalent in children and adolescents, yet many of them do not receive the care they need. Digital mental health interventions (DMHIs) may address this need by providing accessible and high-quality care. Given the necessity for high levels of caregiver and primary care practitioner involvement in addressing ADHD symptoms and behavioral problems, collaborative care interventions that adopt a whole-family approach may be particularly well suited to reduce symptoms of inattention, hyperactivity, and opposition in children and adolescents. The purpose of this study is to use member (ie, child and adolescent) data from Bend Health, Inc, a collaborative care DMHI that uses a whole-family approach to address child and adolescent mental health concerns, to (1) determine the effects of a collaborative care DMHI on inattention, hyperactivity, and oppositional symptoms in children and adolescents and (2) assess whether the effects of a collaborative care DMHI vary across ADHD subtypes and demographic factors. Caregivers of children and adolescents with elevated symptoms of inattention, hyperactivity, or opposition assessed their children's symptom severity approximately every 30 days while participating in Bend Health, Inc. Data from 107 children and adolescents aged 6-17 years who exhibited clinically elevated symptoms at baseline were used to assess symptom severity across monthly assessments (inattention symptom group: n=91, 85.0%; hyperactivity symptom group: n=48, 44.9%; oppositional symptom group: n=70, 65.4%). The majority of the sample exhibited elevated symptoms of at least 2 symptom types at baseline (n=67, 62.6%). Members received care for up to 5.52 months and attended between 0 and 10 coaching, therapy, or psychiatry sessions through Bend Health, Inc. For those with at least 2 assessments, 71.0% (n=22) showed improvements in inattention symptoms, 60.0% (n=9) showed improvements in hyperactivity symptoms, and 60.0% (n=12) showed improvements in oppositional symptoms. When considering group-level change over time, symptom severity decreased over the course of treatment with Bend Health, Inc, for inattention (average decrease=3.51 points, P=.001) and hyperactivity (average decrease=3.07 points, P=.049) but not for oppositional symptoms (average decrease=0.70 points, P=.26). There was a main effect of the duration of care on symptom severity (P<.001) such that each additional month of care was associated with lower symptom scores. This study offers promising early evidence that collaborative care DHMIs may facilitate improvements in ADHD symptoms among children and adolescents, addressing the growing need for accessible and high-quality care for behavioral health problems in the United States. However, additional follow-up studies bolstered by larger samples and control groups are necessary to further establish the robustness of these findings.

Advancements of phonetics in the 21st century: Theoretical issues in sociophonetics

Variation in speech has always been important to phonetic theory, but takes centerstage in the growing area of sociophonetics, which places the role of the social at the heart of the theoretical and methodological enterprise. This paper provides a comprehensive survey of key advances and theoretical issues in sociophonetic research, in both production and perception. It reviews the foundations of sociophonetics in phonetics and sociolinguistics, and articulates several major theoretical questions that run through sociophonetic work, as well as the nature of evidence and methods in sociophonetics. It explores the many factors that underpin variation and change within individuals, such as speech accommodation and speech style, and major factors that organize group-level variation and change, including regional affiliation, social class, sex, gender, and sexuality, race and ethnicity, and age. By connecting sociophonetic research to a wide range of areas, from cognition to indexicality, the paper synthesizes cross-cutting themes from prior research, and highlights current and future directions for the field.

Investigating the intra-session reliability of short and long latency afferent inhibition

ObjectiveTo establish the intrasession relative and absolute reliability of Short (SAI) and Long-Latency Afferent Inhibition (LAI). These findings will allow us to guide future explorations of changes to these measures. Methods31 healthy individuals (21.06 ± 2.85 years) had SAI and LAI obtained thrice at 30-minute intervals in one session. To identify the minimum number of trials required to reliably elicit SAI and LAI, relative reliability was assessed at running intervals of 5 trials. ResultsSAI had moderate–high, and LAI had high-excellent relative reliability. Both SAI and LAI had high amounts of measurement error. LAI had high relative reliability when only 5 frames of data were included, whereas SAI required ∼20–30 frames of data for the same. For both SAI and LAI, individual smallest detectable change was large but was reduced at the group level. ConclusionsSAI and LAI can be used for both diagnostic purposes and to assess group level change but have limited utility in assessing within-individual changes. SignificanceThese results can be used to inform future work regarding the utility of SAI and LAI, particularly in terms of their ability to identify particularly high or low values of afferent inhibition.

Toward Bridging Unmet Medical Need in Early Alzheimer's Disease: An Evaluation of Beta-Amyloid (Aβ) Plaque Burden as a Potential Drug Development Tool.

Toward Bridging Unmet Medical Need in Early Alzheimer's Disease: An Evaluation of Beta-Amyloid (Aβ) Plaque Burden as a Potential Drug Development Tool.

Feasibility evaluation of a dual-mode ankle exoskeleton to assist and restore community ambulation in older adults.

Age-related deficits in plantar flexor muscle function during the push-off phase of walking likely contribute to the decline in mobility that affects many older adults. Isolated strengthening of the plantar flexor muscles has failed to improve push-off power or walking economy in this population. New mobility aids and/or functional training interventions may help slow or prevent ambulatory decline in the elderly. The overarching objective of this study was to explore the feasibility of using an untethered, dual-mode ankle exoskeleton for treating walking disability in the elderly; testing the device in assistance mode as a mobility aid to reduce energy consumption, and as a resistive gait training tool to facilitate functional recruitment of the plantar flexor muscles. We recruited 6 older adults between the ages of 68 to 83 years to evaluate the feasibility of the dual-mode exoskeleton across two visits. On the first visit, we quantified acute metabolic and neuromuscular adaption to ankle exoskeleton assistance during walking in older adults, and subsequently determined if higher baseline energy cost was related to an individual's potential to benefit from untethered assistance. On the second visit, we validated the potential for push-off phase ankle resistance combined with plantar pressure biofeedback to facilitate functional utilization of the ankle plantar flexors during walking. We also conducted a twelve-session ankle resistance training protocol with one pilot participant to explore the effects of gait training with wearable ankle resistance on mobility and plantar flexor strength. Participants reached the lowest net metabolic power, soleus variance ratio, and soleus iEMG at 6.6 ± 1.6, 19.8 ± 1.6, and 5.8 ± 4.9 minutes, respectively, during the 30-minute exoskeleton assistance adaptation trial. Four of five participants exhibited a reduction (up to 19%) in metabolic power during walking with assistance relative to baseline, but there was no group-level change. Participants who had greater baseline metabolic power exhibited a greater reduction during walking with assistance. Walking with resistance increased stance-phase soleus iEMG by 18 - 186% and stance-phase average positive ankle power by 9 - 88% compared to baseline. Following ankle resistance gait training, the participant exhibited a 5% increase in self-selected walking speed, a 15% increase in fast walking speed, a 36% increase in 6-min-walk-test distance, and a 31% increase in plantar flexor strength compared to pre-intervention measurements. Our results suggest that dual-mode ankle exoskeletons appear highly applicable to treating plantar flexor dysfunction in the elderly, with assistance holding potential as a mobility aid and resistance holding potential as a functional gait training tool. We used an untethered design to maximize the relevance of this for informing the design of intervention studies that may take place at home and in the community to improve mobility and quality of life in older adults. Future studies with larger sample sizes are recommended to expand on the results of this feasibility investigation.

Minimally important differences for the EORTC QLQ-C30 in prostate cancer clinical trials

BackgroundThe aim of the study was to estimate the minimally important difference (MID) for interpreting group-level change over time, both within a group and between groups, for the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) scores in patients with prostate cancer.MethodsWe used data from two published EORTC trials. Clinical anchors were selected by strength of correlations with QLQ-C30 scales. In addition, clinicians’ input was obtained with regard to plausibility of the selected anchors. The mean change method was applied for interpreting change over time within a group of patients and linear regression models were fitted to estimate MIDs for between-group differences in change over time. Distribution-based estimates were also evaluated.ResultsTwo clinical anchors were eligible for MID estimation; performance status and the CTCAE diarrhoea domain. MIDs were developed for 7 scales (physical functioning, role functioning, social functioning, pain, fatigue, global quality of life, diarrhoea) and varied by scale and direction (improvement vs deterioration). Within-group MIDs ranged from 4 to 14 points for improvement and − 13 to − 5 points for deterioration and MIDs for between-group differences in change scores ranged from 3 to 13 for improvement and − 10 to − 5 for deterioration.ConclusionsOur findings aid the meaningful interpretation of changes on a set of EORTC QLQ-C30 scale scores over time, both within and between groups, and for performing more accurate sample size calculations for clinical trials in prostate cancer.

Cortical Engagement Metrics During Reactive Balance Are Associated With Distinct Aspects of Balance Behavior in Older Adults.

Heightened reliance on the cerebral cortex for postural stability with aging is well-known, yet the cortical mechanisms for balance control, particularly in relation to balance function, remain unclear. Here we aimed to investigate motor cortical activity in relation to the level of balance challenge presented during reactive balance recovery and identify circuit-specific interactions between motor cortex and prefrontal or somatosensory regions in relation to metrics of balance function that predict fall risk. Using electroencephalography, we assessed motor cortical beta power, and beta coherence during balance reactions to perturbations in older adults. We found that individuals with greater motor cortical beta power evoked following standing balance perturbations demonstrated lower general clinical balance function. Individual older adults demonstrated a wide range of cortical responses during balance reactions at the same perturbation magnitude, showing no group-level change in prefrontal- or somatosensory-motor coherence in response to perturbations. However, older adults with the highest prefrontal-motor coherence during the post-perturbation, but not pre-perturbation, period showed greater cognitive dual-task interference (DTI) and elicited stepping reactions at lower perturbation magnitudes. Our results support motor cortical beta activity as a potential biomarker for individual level of balance challenge and implicate prefrontal-motor cortical networks in distinct aspects of balance control involving response inhibition of reactive stepping in older adults. Cortical network activity during balance may provide a neural target for precision-medicine efforts aimed at fall prevention with aging.

Effect of Aerobic Exercise on White Matter Tract Microstructure in Young and Middle-Aged Healthy Adults

Recent evidence suggests that being physically active can mitigate age-related white matter (WM) changes. In a randomized clinical trial, the effect of 6-month aerobic exercise (AE) or stretching/toning interventions on measures of WM microstructure (WMM) was assessed in a sample of 74 adults aged 20–67 years. Major WM pathways were reconstructed. No significant group-level change in WM tract microstructure following an AE training was observed. Without adjustment for multiple comparisons, an increase in fractional anisotropy (FA) and a decrease in mean diffusivity (MD) of the uncinate fasciculus were observed post-intervention in the AE group in comparison with the stretching group. In the AE group, a significant increase in cardiorespiratory fitness was measured but did not correlate with FA and MD change. The present results of this study are in accordance with similar studies in healthy adults that did not show significant benefit on WMM after participating in an AE program.Clinical Trial Registration: Clinicaltrials.gov identifier, NCT01179958.

Exploring directional and fluctuating asymmetry in the human palate during growth.

ObjectivesPalate morphology is constantly changing throughout an individual's lifespan, yet its asymmetry during growth is still little understood. In this research, we focus on the study of palate morphology by using 3D geometric morphometric approaches to observe changes at different stages of life, and to quantify the impact of directional and fluctuating asymmetry on different areas at different growth stages.Materials and MethodsThe sample consists of 183 individuals (1–72 years) from two identified human skeletal collections of 19th and early 20th Century Italian contexts. A 3D‐template of 41 (semi)landmarks was applied on digital palate models to observe morphological variation during growth.ResultsAsymmetrical components of the morphological structure appears multidirectional on the entire palate surface in individuals <2 years old and become oriented (opposite bilateral direction) between 2 and 6 years of age. Specifically, directional asymmetry differentially impacts palate morphology at different stages of growth. Both the anterior and posterior palate are affected by mild alterations in the first year of life, while between 2 and 6 years asymmetry is segregated in the anterior area, and moderate asymmetry affects the entire palatal surface up to 12 years of age. Our results show that stability of the masticatory system seems to be reached around 13–35 years first by females and then males. From 36 years on both sexes show similar asymmetry on the anterior area. Regarding fluctuating asymmetry, inter‐individual variability is mostly visible up to 12 years of age, after which only directional trends can be clearly observed at a group level.DiscussionMorphological structure appears instable during the first year of life and acquires an opposite asymmetric bilateral direction between 2 and 6 years of age. This condition has been also documented in adults; when paired with vertical alteration, anterior/posterior asymmetry seems to characterize palate morphology, which is probably due to mechanical factors during the lifespan. Fluctuating asymmetry is predominant in the first period of life due to a plausible relationship with the strength of morphological instability of the masticatory system. Directional asymmetry, on the other hand, shows that the patterning of group‐level morphological change might be explained as a functional response to differential inputs (physiological forces, nutritive and non‐nutritive habits, para‐masticatory activity as well as the development of speech) in different growth stages. This research has implications with respect to medical and evolutionary fields. In medicine, palate morphology should be considered when planning orthodontic and surgical procedures as it could affect the outcome. As far as an evolutionary perspective is concerned the dominance of directional asymmetries in the masticatory system could provide information on dietary and cultural habits as well as pathological conditions in our ancestors.

Long-term relapse rates after cognitive behaviour therapy for anxiety and depressive disorders among older adults: A follow-up study during COVID-19.

ObjectiveThis study assessed the long‐term symptom relapse rates among older adults previously treated with cognitive behaviour therapy (CBT) for anxiety and/or depression during COVID‐19.MethodsParticipants were 37 older adults (M = 75 years, SD = 5; 65% female) previously treated with CBT for anxiety and/or unipolar depression who were re‐assessed an average of 5.6 years later, during the first Australian COVID‐19 lockdown.ResultsOn average, there was no significant group‐level change in anxiety, depression or quality of life. When assessing change in symptoms based on clinical cut‐off points on self‐report measures, results suggest only 17%‐22% showed a relapse of symptoms by the COVID‐19 pandemic.ConclusionsFindings suggest that CBT may be protective in coping with life stressors many years after treatment ends. However, results warrant replication to attribute continued symptom improvement to CBT given the lack of control group.

Abstract P58: Motor Recovery After Chronic Stroke Correlates With Diffusion Tensor Measures of Ipsilesional Cerebral and Cerebellar White Matter Integrity

Introduction: We aimed to determine whether white matter (WM) tract integrity improved after a brain-computer interface (BCI) rehabilitation program for chronic stroke patients with upper extremity weakness. Mean diffusivity (MD) was calculated from diffusion tensor imaging (DTI) and is an indication of the integrity of axons and myelination in WM. MD is a biomarker in subacute stroke for post-stroke motor deficits and recovery. Methods: DTI scans were performed with 9 chronic hemiplegic stroke patients within 2 weeks of initiation and completion of a 12-week BCI rehabilitation program. All patients were a minimum of 6 months post-stroke. MD was then calculated using DSI-Studio for WM tracts in each patient at both pre- and post-therapy time points. Motor function was evaluated at these time points using the upper extremity portion of the Fugl-Meyer Assessment (UEFM). Voxelwise statistical analysis comparing pre- and post-intervention MD values was carried out using tract-based spatial statistics (TBSS). Relationships between MD measures in regions of interest and changes in motor function were estimated with Spearman correlations. Results: Voxelwise analysis using TBSS showed no significant group-level change in MD of WM tracts throughout the brain after completing BCI rehabilitation. However, the change in MD in ipsilesional cerebral WM was positively correlated with UEFM change (Spearman’s rho = 0.75, p = 0.02) as was the pre-BCI MD in the ipsilesional cerebellar WM (rho = 0.78, p = 0.01). The correlations between contralesional MD measures and UEFM change were not statistically significant. Conclusion: Correlation between changes in mean diffusivity of ipsilesional cerebral white matter and motor improvement in chronic stroke supports the literature that recovery may be mediated by axonal remyelination and regeneration. Furthermore, we find that pre-therapy, ipsilesional cerebellar white matter MD correlates with motor recovery and as such may serve as a predictive measure of the effectiveness of BCI therapy for patients.

Stereoelectroencephalographic language mapping of the basal temporal cortex predicts postoperative naming outcome.

In drug-resistant temporal lobe epilepsy (TLE) patients, the authors evaluated early and late outcomes for decline in visual object naming after dominant temporal lobe resection (TLR) according to the resection status of the basal temporal language area (BTLA) identified by cortical stimulation during stereoelectroencephalography (SEEG). Twenty patients who underwent SEEG for drug-resistant TLE met the inclusion criteria. During language mapping, a site was considered positive when stimulation of two contiguous contacts elicited at least one naming impairment during two remote sessions. After TLR ipsilateral to their BTLA, patients were classified as BTLA+ when at least one positive language site was resected and as BTLA- when all positive language sites were preserved. Outcomes in naming and verbal fluency tests were assessed using pre- and postoperative (means of 7 and 25 months after surgery) scores at the group level and reliable change indices (RCIs) for clinically meaningful changes at the individual level. BTLA+ patients (n = 7) had significantly worse naming scores than BTLA- patients (n = 13) within 1 year after surgery but not at the long-term evaluation. No difference in verbal fluency tests was observed. When RCIs were used, 5 of 18 patients (28%) had naming decline within 1 year postoperatively (corresponding to 57% of BTLA+ and 9% of BTLA- patients). A significant correlation was found between BTLA resection and naming decline. BTLA resection is associated with a specific and early naming decline. Even if this decline is transient, naming scores in BTLA+ patients tend to remain lower compared to their baseline. SEEG mapping helps to predict postoperative language outcome after dominant TLR.