Neurobehavioral Battery Research Articles

Diagnostic utility of culture/language‐specific normative data on the Version 3 of the Uniform Data Set Neuropsychological Battery for differentiating stages of cognitive impairment among Latinos in the United States

AbstractBackgroundAccurate detection of neurocognitive disorders of aging among Latinos in the United States (U.S.) is an important step towards addressing disparities in Alzheimer’s disease and related dementias (ADRDs) and promoting health equity in this group. Federally‐funded Alzheimer’s Disease Research Centers (ADRCs) in the U.S. have utilized the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set Version 3 Neurobehavioral Battery (UDS3‐NB) since 2015. Normative data on this battery adjusted for age, education and sex were published for English‐speakers in 2018 (Weintraub et al., 2018) and expanded to consider differences among non‐Hispanics White and Black people in 2020 (Sachs et al., 2020). We aimed to determine whether the use of newly developed culture/language‐specific neuropsychological normative data for Spanish‐ and English‐speaking Latinos in the U.S. improved diagnostic accuracy of the UDS3‐NB in this group.MethodParticipants included 1,018 Latino adults age 50+ enrolled in ADRCs. Table 1 presents participant demographics by global Clinical Dementia Rating (CDR) score, as indicative of stage of neurocognitive impairment (0 = normal, 0.5 = questionable impairment, 1 = mild impairment, 2‐3 = moderate‐to‐severe impairment). Individual test raw scores were converted to demographically‐adjusted z scores utilizing normative data on the UDS3‐NB developed for Latinos and for other culture/language groups. Individual tests z scores were converted to deficit scores and averaged to compute global deficit scores and determine global neurocognitive impairment (NCI). Rates of NCI based on culture/language specific normative data were compared across the four CDR groups via Chi‐Square tests. Sensitivity and specificity were computed for differentiating participants with CDR = 0 (normal) and CDR = 1 (mild impairment) based on different sets of normative data.ResultsUtilizing culture/language‐specific normative data significantly differentiated CDR groups (p<.001; Figure 1). These culture/language specific normative data performed better in differentiating between CDR = 0 and 1, than utilizing normative data developed for non‐Hispanic English speakers (Table 2).ConclusionCulture/language‐specific normative data improve diagnostic accuracy for neurocognitive impairment among Latinos in the U.S. relative to existing normative data developed for other groups. These culture/language‐specific norms can be used in research and clinical practice to enhance ADRD diagnosis among Latinos and represent an important step towards addressing ADRD disparities in this group.

Association between maternal labour epidural analgesia and autistic traits in offspring

Study objectiveStudies investigating associations between maternal epidural analgesia (MEA) and autism spectrum disorder (ASD) in the offspring are conflicting and lack prospective neurobehavioral follow-up assessments for autistic traits. We aim to prospectively investigate associations between MEA and autistic traits in the offspring. DesignProspective neurobehavioral observational cohort study. SettingSingaporean tertiary healthcare institutions. PatientsParticipants recruited were singleton non-IVF children, >36 weeks gestation, delivered via normal vaginal delivery by mothers >18 years of age, delivered in Singapore from June 2009–September 2010 and followed up over 7 years. InterventionsExposure to maternal epidural analgesia during delivery. MeasurementsThe primary outcome is an abnormal Social Responsiveness Scale (SRS) T score at 7 years (≥60 points). Secondary outcomes include the diagnosis of ASD and abnormal scores for autistic traits assessed via a neurobehavioral battery comprising: CBCL (child behavioural checklist), Q-CHAT (Quantitative Checklist for Autism in Toddlers), and Bayley-III. Multivariable analyses adjusting for maternal and offspring characteristics were performed. Main results704 out of 769 mother-child dyads recruited fulfilled the criteria for analysis. 365/704 mothers received MEA.The incidence of an abnormal SRS score at 7 years in offspring exposed to MEA was 19.9%, and 26.1% in non-exposed offspring (p = 0.154). Multivariable analysis did not demonstrate a significant association between MEA and abnormal SRS scores at 7 years (O.R.0.726, 95% C·I. 0.394–1.34, p = 0.305). After adjustment for maternal and fetal demographics, exposure to MEA was not significantly associated with an abnormal screen in all other tests for autistic traits.The clinical incidence of ASD was 1.76% in children without exposure to MEA, and 2.32% in children with MEA exposure (p = 0.506). ConclusionsMEA is not significantly associated with the development of ASD and autistic traits in offspring, assessed over 7 years. Results should be taken into perspective given our wide confidence intervals and small cohort size.

Peripheral inflammation is associated with impairments of inhibitory behavioral control and visual sensorimotor function in psychotic disorders.

Elevated markers of peripheral inflammation are common in psychosis spectrum disorders and have been associated with brain anatomy, pathology, and physiology as well as clinical outcomes. Preliminary evidence suggests a link between inflammatory cytokines and C-reactive protein (CRP) with generalized cognitive impairments in a subgroup of individuals with psychosis. Whether these patients with elevated peripheral inflammation demonstrate deficits in specific cognitive domains remains unclear. To examine this, seventeen neuropsychological and sensorimotor tasks and thirteen peripheral inflammatory and microvascular markers were quantified in a subset of B-SNIP consortium participants (129 psychosis, 55 healthy controls). Principal component analysis was conducted across the inflammatory markers, resulting in five inflammation factors. Three discrete latent cognitive domains (Visual Sensorimotor, General Cognitive Ability, and Inhibitory Behavioral Control) were characterized based on the neurobehavioral battery and examined in association with inflammation factors. Hierarchical clustering analysis identified cognition-sensitive high/low inflammation subgroups. Among persons with psychotic disorders but not healthy controls, higher inflammation scores had significant associations with impairments of Inhibitory Control (R2=0.100, p-value=2.69e-4, q-value=0.004) and suggestive associations with Visual Sensorimotor function (R2=0.039, p-value=0.024, q-value=0.180), but not with General Cognitive Ability (R2=0.015, p-value=0.162). Greater deficits in Inhibitory Control were observed in the high inflammation patient subgroup, which represented 30.2% of persons with psychotic disorders, as compared to the low inflammation psychosis subgroup. These findings indicate that inflammation dysregulation may differentially impact specific neurobehavioral domains across psychotic disorders, particularly performance on tasks requiring ongoing behavioral monitoring and control.

Neuropsychological Test Norms for the Assessment of HIV-Associated Neurocognitive Impairment Among South African Adults

Reliable and valid neurocognitive (NC) test batteries that assess multiple domains of cognitive functioning are vital tools in the early detection of HIV-associated NC impairment. The HIV Neurobehavioral Research Center’s International Neurobehavioral Battery (HNRC Battery) is one such diagnostic tool and has shown cultural validity in several international neuroHIV studies. However, no published norms are currently available for the full HNRC Battery in South Africa. To accurately interpret NC test results, appropriate reference norms are required. In light of this challenge, data were collected from 500 healthy, HIV-uninfected participants to develop demographically corrected South African norms. When demographically corrected United States of America (U.S.) norms were applied to the performance scores of our neurologically intact, HIV-negative sample, an impairment rate of 62.2% was observed compared to a 15.0% impairment rate when the newly generated South African norms were applied. These results reiterate the findings of other low- and middle-income countries, highlighting the need for localized, country-specific norms when interpreting NC performance.

Screening for HIV-associated neurocognitive impairment: Development and validation of an abbreviated neuropsychological test battery for use in South African clinical settings.

The HIV Neurobehavioral Research Center International Neurobehavioral Battery is a culturally valid battery sensitive to the neurocognitive (NC) effects of HIV-infection. However, its lengthy administration time makes the battery impractical in resource-limited settings, like South Africa, which are often faced with an overwhelming disease burden, a lack of neurological and neuropsychological (NP) expertise, and staff shortages. The present study therefore sought to develop an abbreviated version of the HNRC Battery and validate this battery in a sample of people with HIV (PWH) in South Africa. The present study therefore sought to develop an abbreviated version of the HNRC battery and validate this battery in a sample of people with HIV (PWH) in South Africa. Six measures were selected based on the NC test performances of 103 HIV-positive and 135 HIV-negative South African adults. For the validation, a subgroup of 103 PWH completed the full version of the battery, while the other subgroup of 52 PWH completed only the abbreviated version. Deficit scores of each participant were calculated. These scores were used as the gold standard against which the abbreviated battery was compared. There was a reduction of 81% in administration time when compared to the full version of the battery. The abbreviated battery demonstrated good sensitivity (75.0%) and excellent specificity (94.9%) when compared with the full version. The abbreviated battery showed good diagnostic accuracy in identifying NC impairment in an HIV-positive South African sample with a significant reduction in administration time, making it a more practical option in busy South African clinic settings. The results of this study may facilitate the growth of neuroAIDS research and aid initial identification of HIV-related NC impairment in resource-constrained settings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Development and validation of a postnatal risk score that identifies children with prenatal alcohol exposure.

This study aimed to develop an efficient and easily calculable risk score that can be used to identify an individual's risk of having been exposed to alcohol prenatally. Data for this study were collected as part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, Phases 2 and 3. Two cohorts (ages 5 to 17years) completed a comprehensive neurobehavioral battery and a standard dysmorphology exam: a development cohort (DC; n=325) and a comparative cohort (CC; n=523). Both cohorts included two groups: those with histories of heavy prenatal alcohol exposure (AE-DC, n=121; AE-CC, n=177) and a control group that included subjects with minimal or no prenatal alcohol exposure (CON-DC, n=204; CON-CC, n=346). Behavioral assessments and physical exam data were combined using regression techniques to derive a risk score indicating the likelihood of prenatal alcohol exposure. Subjects were then divided into two subgroups: (1) low risk and (2) high risk. Chi-square (χ2 ) determined classification accuracy and ROC curves were produced to assess the predictive accuracy. Correlations between risk scores and intelligence quotient and executive function scores were calculated. Subjects were accurately classified in the DC (χ2 =78.61, p<0.001) and CC (χ2 =86.63, p<0.001). The classification model also performed well in the DC (ROC=0.835 [SE=0.024, p<0.001]) and CC (ROC=0.786 [SE=0.021, p<0.001]). In the AE-CC and CON-CC, there were modest but significant associations between the risk score and executive function (AE-CC: r=-0.20, p=0.034; CON-CC: r=-0.28, p<0.001) and intelligence quotient (AE-CC: r=-0.20, p=0.034; CON-CC: r=-0.28, p<0.001). The risk score significantly distinguished alcohol-exposed from control subjects and correlated with important cognitive outcomes. It has significant clinical potential and could be easily deployed in clinical settings.

Relationship between Bullying Experiences, SelfEsteem and Depression among secondary school pupils

Main Objective We examined whether exposure to bullying would predict low selfesteem and depression among secondary school adolescents.&#x0D; Design: We used an adolescent study sample of 250 day secondary school learners in Livingstone, Zambia, who were recruited randomly from conveniently selected day secondary schools. The sample comprised an equal number of boys(N=125) and girls (N=125) of age range 13 to 17.&#x0D; Out comes: The study showed gender differences on bullying and depression among the grade nine learners with highest levels ofbullying experiences, low self-esteem and depression among girls. An association (p &lt; .05) was established between bullying anddepression. Also, we were able to establish an inverse (p= -16) correlation between bullying and self-esteem. Bullying experiences(physical, social and verbal) accounted for 14.6 % of variance on low self-esteem and 33.7% of variance on depression. Social bullying was the strongest predictor of low self-esteem (beta= - .491, sig = .000) and depression (beta =.332, sig = .000).&#x0D; Measures: The participants self-reported their experiences of bullying on Adolescent Peer relations victim scale B (Parada 2000). Selfesteem levels were measured using the Rosenberg Self-esteem scale (Rosenberg,: 1985).The Beck depression inventory (BD1-11)from the Zambia Neurobehavioral Battery was used to measure adolescents levels of depression. This was a quantitative correlational study.&#x0D; Results: The more bullied students were, the less self-esteem thy exhibited and the more depressed they became. Girls were more vulnerable to bullying with low self-esteem and high depression levels as compared to boys.&#x0D; Conclusions: Adolescents who frequently experience bullying manifest low self-esteem and higher levels of depression. Increased frequency of exposure to bullying is a consistent predictor of adolescent depression and low selfesteem.

Fetal Alcohol Spectrum Disorders in a Southeastern County of the United States: Child Characteristics and Maternal Risk Traits

To detail the characteristic traits of children with fetal alcohol spectrum disorders (FASDs) and maternal risk factors in a southeastern U.S. County. Independent samples were drawn from 2 different cohorts of first-grade students. All consented children (49.8%) were measured for height, weight, and head circumference, and those≤25th centile entered the study along with a random sample drawn from all enrolled students. Study children were examined for physical growth, dysmorphology, and neurobehavior, and their mothers were interviewed. Total dysmorphology scores discriminated well the physical traits of children across the FASD continuum: fetal alcohol syndrome (FAS)=15.8, partial FAS (PFAS)=10.8, alcohol-related neurobehavioral disorder (ARND)=5.2, and typically developing controls=4.4. Additionally, a neurobehavioral battery distinguished children with each FASD diagnosis from controls. Behavioral problems qualified more children for FASD diagnoses than cognitive traits. Significant proximal maternal risk variables were as follows: reports of prepregnancy drinking, drinking in any trimester, and comorbid use of other drugs in lifetime and during pregnancy, especially alcohol and marijuana (14.9% among mothers of children with FASD vs. 0.4% for controls). Distal maternal risks included reports of other health problems (e.g., depression), living unmarried with a partner during pregnancy, and a lower level of spirituality. Controlling for other drug use during pregnancy, having a child diagnosed with a FASD was 17.5 times greater for women who reported usual consumption of 3 drinks per drinking day prior to pregnancy than for nondrinking mothers (p<0.001, 95% CI=5.1 to 59.9). There was no significant difference in the prevalence of FASD by race, Hispanic ethnicity, or socioeconomic status. The prevalence of FASD was not lower than 17.3 per 1,000, and weighted estimated prevalence was 49.0 per 1,000 or 4.9%. This site had the second lowest rate in the CoFASP study, yet children with FASD are prevalent.

C-25 Neurocognitive Correlates of Chronological and Subjective Age Differences in Persons Living with HIV compared to those without HIV

Abstract Objective Investigate the discrepancy between subjective and chronologic age by HIV-serostatus, and the association of this discrepancy with subjective neurocognitive functioning (NCF) and objective NCF. Methods One hundred nineteen persons living with HIV (PWLH) and 98 HIV-uninfected (HIV-) adults (Mage = 50.9; SDage = 7.9) completed a comprehensive neurobehavioral battery. Subjective age was assessed using a single-item question (i.e., “how old do you feel?”). The difference between chronologic and subjective age resulted in subjective age discrepancy scores (SADS). Subjective NCF was measured using the Patient’s Assessment of Own Functioning Inventory; objective NCF was measured using global demographically-corrected T-scores. Linear regressions examined the association between subjective and objective NCF with SADS, covarying for significant PLWH and HIV- group differences (i.e., education, sex, ethnicity, and lifetime Major Depressive Disorder). Results PLWH reported lower SADS (indicating closer correspondence between chronologic and subjective age) than their HIV- counterparts, who reported feeling much younger (p = .05; 95% CI: -5.4, .001). Among PLWH, better subjective NCF was significantly related to greater SADS (p = .0002; 95% CI: -.48, -.16). Objective NCF was not associated with SADS among persons with and without HIV. Conclusions Adults without HIV reported feeling younger than their chronologic age, whereas PLWH felt significantly closer to their chronologic age. SADS were negatively associated with only subjective NCF, among only PLWH. This suggests perceived cognitive functioning has a greater impact on psychological well-being among this group. Future research is warranted to delineate the relationship between HIV, subjective neurocognition, and psychosocial factors related to daily functioning to improve successful aging outcomes among this vulnerable population.

Oxidative stress and neurobehavioural changes in rats following copper exposure and their response to MiADMSA andd-penicillamine

An increase in copper concentration in body may lead to hepatolenticular degeneration which is considered as one clinical feature of Wilson’s disease. Chelation therapy using d-penicillamine is the preferred medical treatment for reducing the toxic effects of copper. However, a few shortcomings associated with d-penicillamine led us to search of an alternative antidote for copper toxicity. Monoisoamyl-2, 3-dimercaptosuccinic acid (MiADMSA), a potent arsenic chelator under clinical trial, has been reported to reduce system copper level. Thus, the present study was envisaged to explore the ameliorative effect of MiADMSA against copper toxicity. Copper pre-exposed animals (CuSO4.5H2O; 100 mg/kg; p.o., for 6 weeks) were segregated in different groups and were administered equimolar dose (0.3 mEq/kg/day; p.o.) of d-penicillamine and MiADMSA for 5 days. The effect of different treatments on spontaneous locomotor activity, muscle coordination, depression like behaviour and contextual fear memory was analysed using neurobehavioural battery test. Biochemical variables related to oxidative stress, zinc and copper concentration were determined in liver, kidney and brain. The results suggested that copper exposure led to oxidative stress in liver, kidney and blood, along with moderate effects in brain. Treatment with d-penicillamine and MiADMSA reduced liver copper load. MiADMSA produced more pronounced beneficial effect compared to d-penicillamine by increasing brain GPx activity. Our study suggests that MiADMSA might be equally effective as d-penicillamine in depleting body copper load. More detailed studies using different doses are required to suggest whether MiADMSA could be an alternative for d-penicillamine in reducing oxidative injury, neurobehavioural changes and depleting body copper burden.

Impaired Neurobehavioural Performance in Untreated Obstructive Sleep Apnea Patients Using a Novel Standardised Test Battery

Objective/BackgroundAlthough polysomnography (PSG) is the gold-standard measure for assessing disease severity in obstructive sleep apnea (OSA), it has limited value in identifying individuals experiencing significant neurobehavioural dysfunction. This study used a brief and novel computerised test battery to examine neurobehavioural function in adults with and without OSA.Patients/Methods204 patients with untreated OSA [age 49.3 (12.5) years; body mass index, [BMI] 33.6 (8.0) kg/m2; Epworth sleepiness scale 12 (4.9)/24; apnea hypopnea index 33.6 (25.8)/h] and 50 non-OSA participants [age 39.2 (14.0) years; BMI 25.8 (4.2) kg/m2, ESS 3.6 (2.3)/24]. All participants completed a computerised neurobehavioural battery during the daytime in the sleep clinic. The OSA group subsequently underwent an overnight PSG. The 30 min test battery assessed cognitive domains of visual spatial scanning and selective attention (Letter Cancellation Test), executive function (Stroop task) and working memory (2- and 3-Back tasks), and a validated sustained attention task (psychomotor vigilance task, PVT). Group differences in performance were compared. Associations between disease severity and performance were examined in the OSA group.ResultsAfter controlling for age, gender and education, OSA patients demonstrated impaired performance on the Stroop-Text, 2 and 3-Back tasks, and the PVT compared with the non-OSA group. OSA patients had worse performance on the LCT with fewer average hits albeit with better accuracy. Some OSA polysomnographic disease severity measures were weakly correlated with performance.ConclusionsThis brief test battery may provide a sensitive, standardised method of assessing daytime dysfunction in OSA.

Grit and Ambition are Associated with Better Neurocognitive and Everyday Functioning Among Adults Living with HIV.

Grit and ambition are psychological factors that may protect neurocognitive function among persons living with HIV (PLWH). We examined associations between grit, ambition, premorbid verbal intellectual function, and current neurocognitive and everyday functioning among PLWH and persons without HIV (HIV-). 120 PLWH and 94 HIV- adults completed the Grit Scale (includes total score and consistency of interests and perseverance of effort subscales), ambition scale, and a comprehensive neurobehavioral battery. PLWH had lower grit scores than HIV- adults. The two groups did not differ on ambition. No relationship was observed between grit and cognition among HIV- adults. Among PLWH, however, higher perseverance of effort and more ambition was related to better global neurocognitive functioning, and higher grit, but not ambition, was related to independence in daily functioning. Longitudinal studies are needed to elucidate these relationships over time and examine whether grit or ambition have protective effects on cognitive outcomes among PLWH.

596: Ethyl pyruvate: A novel approach to protect the fetus against antenatal inflammatory damage

In pregnancies complicated by inflammation, activation of RAGE signaling pathways may be responsible for poor fetal and neonatal outcomes including stillbirth and neonatal brain injury. Ethyl pyruvate (EP) improved survival in murine models of endotoxemia via RAGE inhibition, and was already shown to be safe in humans. We investigated the effect of maternal administration of EP on neonatal growth and neurodevelopmental outcome using a genetically engineered over-expressing RAGETg murine model of in-utero inflammation. Saline or endotoxin (LPS, 5 or 10 μg/dam) were given intra-peritoneal (i.p.) on day 15 (d0=sperm plug), in mice randomly assigned to the following groups: 1) RAGETg and 2) Wild-type (WT) (n=9-30 pups/group) as controls. EP (40 mg/kg) was administered i.p. 2 hours later. Doses were chosen based on prior experiments demonstrating live birth. Pups underwent post-natal daily behavioral testing (i.e. cliff aversion, forelimb grasp, negative geotaxis) from birth to day 14 of life. Using immunohistochemistry (IHC), we assessed cortical neuronal density in animals sacrificed on day 20 of life. 1) In-utero exposure to EP did not increase post-natal mortality rate; 2) Compared to control, weight gain was inhibited in WT receiving LPS5 (p=0.02), which was ameliorated by EP (p=0.0001); 3) WT and RAGETg mice exposed to LPS demonstrated delay in achieving behavioral milestones, an effect reversed by EP (p<0.001, Figure); 4) WT and RAGETg mice showed improved neurobehavioral battery with EP independent of fetal gender; 5) EP protected against LPS-induced cortical neuronal loss (p=0.001) by IHC. We report a novel neuroprotective effect of EP from perinatal inflammatory insult.

P102 – 2305: Long-term neurodevelopmental and behavioural outcomes of acute organophosphate poisoning in South African children

Objective Organophosphate poisoning (OPP) is a significant cause of mortality in resource-poor countries, especially in economies such as that of South Africa where agricultural activity remains an important contributor to the economy. Long-term neurobehavioural sequelae of OPP have been reported in adults, but little is known about the neurodevelopmental outcomes of children who survive acute organophosphate pesticide poisoning, including that from domestic exposure. This study aimed to determine the performance of South African children surviving acute episodes of OPP on a standardized neurobehavioural battery compared to a control group of children previously admitted to hospital with paraffin poisoning. Methods Children were included who were 3–12 years with a previous admission for OPP to the Red Cross Children's Hospital, Cape Town. The control group comprised children admitted for paraffin poisoning and were matched to the index group for age, gender, home language, admission date and illness severity. All children were assessed for neurodevelopmental function. Caregivers were administered a questionnaire-based behavior rating scale, Achenbach System of Empirically Based Assessment. The neurodevelopmental performance and behaviour of OPP children was compared to that of the controls. Results A total of 91 children were tested, 46 OPP and 45 control children. No between group differences were found on any measures. Conclusion Although there were no significant differences between the children with OPP and those with acute paraffin exposure on preliminary analysis, possible explanations for this include sample size too small to detect subtle differences, exclusion from the study of children who had severe neurodisability or who had died due to OPP. Between group effects of these children may also have been masked by high prevalence risk factors in South Africa for poor development such as low socio-economic status, HIV exposure, maternal alcohol and smoking during pregnancy and poor maternal mental health.

Migraine, Headaches, and Cognition

The possible effects of migraine on executive abilities remain controversial; hence, we studied inter-ictal cognitive performance of individuals with migraine and non migraine headaches (NMH) compared with headache free controls. In a cross-sectional observational study, taking place in primary care, adults aged 50 or above were evaluated by a neurobehavioral battery including several executive measures. Present history of headache was sought, and migraine was diagnosed by the ID-Migraine questionnaire. The effect of headache type on cognitive measures was analyzed with multiple regression with adjustment by diagnosis, age, gender, education, and depressive symptoms. Among 478 participants, 23.2% reported current headache, of whom 50 were NMH, and 61 were migraine headaches. No group differences were found in the majority of cognitive measures. Compared with controls, migraine subjects performed worse on a test of attention, while NMH participants presented more intrusions and worse discriminability in memory recognition plus a lower performance on semantic memory tests. The presence of headaches in late adulthood was related to a worse performance on few measures of executive functioning, suggesting that cognitive impact is not specific to migraine but might be associated to headache.

EXAMINING THE ASSOCIATION BETWEEN LEVELS OF ARSENIC, LEAD AND MERCURY ON NEUROBEHAVIORAL PERFORMANCE AMONG METAL, CHEMICAL AND MINING INDUSTRY WORKERS

Background: Diet and working in the chemical, mining and metal industries are important sources of exposure to metals such as lead, mercury and arsenic, which are recognized causes of neurological disorders, among other human diseases. Our objective was to explore the relationship between cumulative exposure of arsenic, lead and mercury and neurobehavioral performance (subclinical effect) in a group of workers exposed to metals, and a group of workers unexposed to metals. Methods: We obtained results of cumulated metal levels in toenails and neurobehavioral test in 56 chemical/metal industry workers and 38 service workers unexposed to metals. A neurobehavioral battery consisting of 14 tests was administered. Multielemental ICP-MS was used to quantify toenails levels of arsenic, lead and mercury. General linear models were used including age, gender, and worker exposure group as covariates, plus the metal levels variable (log transformed toenail levels for each metal separately) to predict each of 14 neurobehavioral outcome variables. Results: We found a suggestion of an association between increased toenails levels of arsenic with a worse performance of the “Tapping with Alternating Hands” test (measures “coordination”) (p=0.17), and of the “Symbol Digit” test (related with “mental function) (p=0.11). Also, a suggestion of worse performance was observed between lead and the “Symbol Digit” test (p=0.087), the “Tapping with the Preferred Hand” test (related to “coordination”) (p=0.17), and the “Digit Span Reverse” test (related with “attention”) (p=0.126). Mercury levels were associated with a worse performance of the “Simple Reaction Time Total Error” test (related with “response speed”) (p=0.04), and showed a suggestion of an association with a better performance of the “Continuous Performance False Alarm Latency” test (p=0.13). Conclusions: Our results suggest that cumulated exposure to mercury, and to a lesser extend arsenic and lead, are related with poorer neurobehavioral performance among exposed workers.

Association of Preoperative Symptom Profile With Psychiatric Symptoms Following Subthalamic Nucleus Stimulation in Patients With Parkinson's Disease

In order to evaluate the severity of behavioral complications after deep brain stimulation of the subthalamic nucleus (STN-DBS) for Parkinson's disease and to explore possible predictive factors, the authors evaluated 22 patients for pre- and postoperative symptoms using a neurobehavioral battery. Compared to the time before STN-DBS, several behavioral symptoms had worsened in terms of prevalence and severity and appeared de novo in other patients. Apathy, anxiety, and suicidal ideation increased significantly, while depressive symptoms appeared stable. Compared with patients who improved, patients who had deteriorated behaviorally had similar prevalence and severity of preoperative behavioral symptoms but significantly shorter disease duration.

The influence of depression on the outcome of treatment in occupational dermatoses workers

Background: Contact dermatitis accounts for approximately 50% of occupational illnesses and is responsible for an estimated 25% of all lost work days. Objective: To evaluate the usefulness of using psycho-behavioural assessment in identifying the influence of depression on the treatment of occupational dermatoses. Methods: The study was conducted on 250 furnace workers exposed to arsenic in Helwan district, Cairo, Egypt. A complete history including occupational history and medical assessment were done followed by undergoing a neurobehavioural battery. The battery included the Beck Depression Inventory, personality tests, and cognitive tests. Patients received a class 1 topical corticosteroid, potassium permanganate soaks, and oral antihistamine for 6 months and after a change of work they were re-examined. Results: After 6 months, patients were divided into two groups according to response to therapy: group A (responders) and group B (non-responders). The psycho-behavioural battery was compared between both groups and showed a significant difference, suggesting the influence of depression on the outcome of treatment among group B patients. Conclusion: Psycho-behavioural analysis of occupational dermatitis patients before starting treatment is recommended. All occupational dermatitis patients showing a bad psycho-behavioural test should be psychologically treated with psychotherapy or antidepressants.

Inhalation Toxicity of Methylglutaronitrile in Rats

Methylglutaronitrile (MGN) is a high-boiling (263°C) solvent/intermediate used in the fiber industry. Twenty male rats per group were exposed nose-only to condensation aerosol/vapor concentrations of approximately either 5, 25, or 200 mg/m3 of MGN for 6 h/day, 5 days/week over a 4-week period. Ten rats/group were sacrificed one day after the final exposure and the remaining rats after a four-week recovery period. No effects were observed in clinical observations during the exposure period, but body-weight depression was observed in the 200 mg/m3 group. The 200 mg/m3 group showed minimal decreases in red blood cell count, hemoglobin, and hematocrit values accompanied by increases in reticulocytes. There were no other effects observed in clinical or pathologic evaluations in the study. A neurobehavioral battery of tests (including grip strength, functional observational battery, and motor activity tests) given at the end of the exposure and recovery periods showed no MGN effects. During the 4-week recovery, body weights in the 200 mg/m3 group returned to normal and the hematologic findings in all groups were normal. Based on the above findings of body weight depression at 200 mg/m3, the no-observed-adverse-effect level (NOAEL) for this study was considered to be 25 mg/m3.

Development of a Neurobehavioral Battery for Children Exposed to Neurotoxic Chemicals

In recent years there has been heightened concern over the potential impact of environmental exposures on neurological function in children. Children are thought to be especially vulnerable to neurotoxic effects due to a number of factors including play behavior, differences in metabolism, and the development state of the brain. Performance tests from the computerized Behavioral Assessment and Research System (BARS) and other non-computerized tests have been combined to develop a brief battery that assesses multiple neurobehavioral functions in preschool children aged 4–6. Tests were selected to assess a variety of cognitive functions including attention, memory, motor speed and coordination and other executive functions. The battery has also been translated into Spanish and developed for use with Latino populations. Four to six-year-old children are particularly challenging because of the shorter attention span and lower motivation to complete an extended test session. When testing this group it is important to maintain the motivation of the child throughout the entire session in order to obtain accurate performance measures. A series of sequential pilot studies were used to select and develop appropriate methods and parameters for the tests in the battery. Although English-speaking children were able to complete the initial battery with minimal difficulties, several difficulties were encountered when the tests were administered to a Latino population. Cultural differences made some material inappropriate for testing due to unfamiliarity with the material, and in some cases items in a test had more than one correct translation which made administration difficult.