Neurocognitive Function Research Articles

Serum Mature and Precursor Brain-Derived Neurotrophic Factors and Their Association with Neurocognitive Function in ART-Naïve Adults Living with HIV in Sub-Saharan Africa.

This study investigates the association between serum mature brain-derived neurotrophic factor (mBDNF), its precursor proBDNF, and neurocognitive function in ART-naïve adults with HIV in sub-Saharan Africa, exploring the distinct roles of these neurotrophic factors in cognitive health. This cross-sectional analysis utilized stored baseline serum samples and neuropsychological test data from participants in the AIDS Clinical Trials Group (ACTG) A5199 study in the Johannesburg and Harare sites. Serum concentrations of mBDNF and proBDNF were quantified using ELISA. Neurocognitive function was assessed via standardized tests, with results adjusted for site-specific demographics. Linear and quantile regression models examined the relationship of mBDNF and proBDNF with a composite cognitive score (NPZ-6), and structural equation modeling (SEM) explored their association with individual cognitive test outcomes. The analysis involved 157 ART-naïve adults with HIV. Increased serum mBDNF levels showed a significant positive association with cognitive performance (β = 1.30, p = 0.02), while elevated proBDNF levels were linked to poorer outcomes, particularly affecting fine motor skills and speed (β = - 0.29 to - 0.38, p ≤ 0.01). Quantile regression analysis highlighted mBDNF's stronger positive impact at higher cognitive performance percentiles (β = 1.04 (0.01, 2.06) at the 75th percentile), while proBDNF showed significant negative association at the 75th percentile (β = - 0.26 (- 0.47, - 0.06)). The study highlights the positive association of mature BDNF and the negative association of proBDNF with cognitive function in HIV. These findings emphasize the need for longitudinal research to understand the temporal dynamics of neurotrophic factors during ART initiation and their potential as targets for neurocognitive interventions in HIV.

Investigating the efficacy of ergothioneine to delay cognitive decline in mild cognitively impaired subjects: A pilot study.

Dementia, particularly Alzheimer's disease, is a major healthcare challenge in ageing societies. This study aimed to investigate the efficacy and safety of a dietary compound, ergothioneine, in delaying cognitive decline in older individuals. Nineteen subjects aged 60 or above with mild cognitive impairment were recruited for this double-blinded, randomized, and placebo-controlled study (ClinicalTrials.gov identifier: NCT03641404, registration date: 19/08/2018). Subjects received either ergothioneine (25 mg per capsule) or a placebo, taken 3 times a week for one year. The whole blood profile, markers of renal and liver functions, neurocognitive performance, plasma levels of ergothioneine and its metabolites, and plasma biomarkers related to neurodegeneration were measured across the study. Ergothioneine intake did not alter clinical safety markers (blood counts, kidney and liver function) throughout the study, further validating its safety for human consumption. Subjects receiving ergothioneine demonstrated improved performance in assessment of learning ability and stabilized plasma levels of neurofilament light chain, compared with the placebo group, which saw no improvement in cognitive assessments and a significant increase in neurofilament light chain levels. Prolonged intake of ergothioneine showed no toxicity in elderly people. Enhanced Rey Auditory Verbal Learning Test performance and stabilized neurofilament light chain levels suggest improvements in memory and learning abilities and a deceleration of neuronal damage, respectively. Our results add to existing data that ergothioneine is safe for extended consumption and may hold the potential to delay cognitive decline in elderly adults.

Impact of Nutritional Minerals Biomarkers on Cognitive Performance Among Bangladeshi Rural Adolescents—A Pilot Study

Background: Nutritional metals (NM) are essential for neurodevelopment and cognitive performance during growth. Nevertheless, epidemiological evidence regarding the associations between NM and brain function remains understudied, particularly among adolescents. Therefore, the objective of this pilot study was to examine the effects of NM biomarkers such as iron (Fe), selenium (Se), zinc (Zn), magnesium (Mg), and copper (Cu) on neurobehavioral functions among a group of rural Bangladeshi adolescents. Methodology: We conducted a cross-sectional study involving 105 adolescents aged 13–17 from Araihazar, Bangladesh. Cognitive function was assessed using the computer-based Behavioral Assessment and Research System (BARS), focusing attention, memory, and executive function, and blood NM levels (Fe, Se, Zn, Mg, and Cu) were measured. Associations between individual minerals, NM composite scores, and cognition were analyzed using multiple linear regressions. Results: This study included 47 boys and 58 girls with an average age of 15 years. Fe levels were correlated with Continuous Performance Test (CPT) latency (r = −0.42, p < 0.05) and Se levels correlated with Match-to-Sample (MTS) correct count (r = 0.32, p < 0.01). Linear regressions showed that Se was associated with MTS correct count (b = 0.02, 95%CI: 0.01, −0.04), reflecting visual memory, and Fe was associated with CPT latency (b = −0.68, 95%CI: −1.11, −0.26), reflecting improved attention. The same BARS measures were also significantly associated with the 3-NM composite score. Conclusions: Our findings suggest that NM, particularly Fe, Se, and NM mixtures, could play a crucial role in brain development and neurocognitive function during adolescence. Further studies will help design national public health policies and strategies to address and mitigate brain health deficiencies among adolescents.

NCOG-24. CHARACTERIZING NEUROTOXICITY ASSOCIATED WITH SYSTEMIC CHEMOTHERAPY IN PATIENTS WITH BREAST CANCER USING DOMAIN-SPECIFIC INTRA-INDIVIDUAL NEUROCOGNITIVE VARIABILITY

Abstract BACKGROUND Systemic chemotherapy is associated with neurotoxicity and neurocognitive functioning (NCF) changes. Intra-individual neurocognitive variability (IIV) is an index of NCF spread/dispersion across neuropsychological tests and can be elevated in patients with breast cancer (BC) after systemic chemotherapy. This study investigated longitudinal IIV changes within NCF domains after chemotherapy to determine whether: (1) IIV for NCF domains are more sensitive to changes than traditional mean-based metrics, and (2) whether changes in domain-specific IIV are associated with changes in mood disturbance or quality of life (QOL). METHODS Prior to and during/shortly after chemotherapy, 37 women with BC were administered a standardized NCF battery including tests within domains of attention/speed of information processing (A/SoP), learning/memory (L/M), and executive functions (EF). Within each domain, the coefficient of variation (CoV) was computed using the standard deviation of normatively-adjusted T-scores while adjusting for intra-individual mean. Patients were assessed for QOL using Functional Assessment of Cancer Therapy-Breast and mood using the STAI and BDI. RESULTS Paired samples t-tests revealed that mean NCF performances declined for L/M (t[36])=-4.44,p<.001,Hedge’s g=.70) and improved for A/SoP (t[36]=3.21,p=.003,g=.29), while CoV increased/worsened for L/M (t[36]=3.82,p<.001,g=.76) but did not change for A/SoP (t[36]=-0.05,p=.959,g=.01). There was no change in EF mean or CoV (ps >.10). No domain mean or IIV change was associated with mood changes (ps>.10). Mean NCF changes were not associated with QOL (ps >.10). Increased/worsened L/M CoV was associated with improved FACT-Breast scale QOL (ρ=.40,p=.020). CONCLUSIONS Both mean- and IIV-based NCF worsened for learning/memory. Discrepancies between mean and IIV change for attention/speed of information processing may be due to differential susceptibility to practice effects. Unexpected associations between learning/memory IIV changes and QOL require further investigation. Future studies are needed to examine NCF dispersion changes across treatment status and in other cancer populations.

Current investigation of neurocognitive functioning in preschool children with cancer: A cross-sectional study from western China.

Cancer and its treatments may cause neurocognitive impairments in preschool children, but there is limited research on the neurocognitive outcomes of this population. This study, which assessed the neurocognitive function of preschool children with cancer and analyzed various influencing factors of neurocognitive functioning, is of significant importance. We aimed to investigate neurocognitive function and related risk factors in preschool children with cancer to inform preventive and intervention strategies. From September 2023 to May 2024, we recruited 100 preschool children with cancer. The Chinese version of the Ages & Stages Questionnaires, the Spence Preschool Anxiety Scale Chinese Version, and the Sleep Disturbance Scale for Children were used to collected data. Binary logistic stepwise regression analysis was used to explore the influencing factors of neurocognitive function in preschool children with cancer. 49% of the preschool children with cancer had abnormalities in at least one neurocognitive dimension. The majority of children had abnormalities in gross motor dimension, accounting for 30%, which was related to age and frequency of participation in neurocognitive activities. Communication dimension was related to father's education level, dietary habit, and frequency of participation in activities. Fine motor dimension was associated with age, sex, and father's education level. Problem-solving dimension was associated with age and dietary habit. Personal-social dimension was related to age and radiotherapy. Nearly half of preschool children with cancer experienced neurocognitive impairment. The Chinese version of the Ages & Stages Questionnaires is a simple and effective tool for screening children with possible neurocognitive impairment. It was found that children's neurocognitive function was significantly influenced by family environment, dietary habit, cognitive activities, and cancer treatment. Therefore, it is recommended to strengthen family and social support, and to formulate personalized intervention such as cognitive therapy and dietary adjustment based on children's age and family background, which are important for promoting neurocognitive recovery.

QOL-26. GLIOMA PATIENTS’ COGNITION AND THEIR CAREGIVERS: THE GOOD, THE BAD, AND THE BURDEN

Abstract BACKGROUND Cognitive decline, common in patients with gliomas, can contribute to reduced independence in daily functioning. Patients with gliomas often rely on informal caregivers for functional support, evidenced to cause distress in other caregiver populations (e.g., Alzheimer’s, terminal cancer, dementia). Few studies have investigated this relationship in neuro-oncology; thus, we explored whether patients’ neurocognitive function was associated with aspects of caregiver burden. METHODS Patients with glioma underwent neurocognitive testing including Auditory Verbal Learning Test-Delayed Recall (AVLT), Trail Making Test-Part B (TMT-B), Stroop Color-Word Interference (CWI), Controlled Oral Word Association Test (COWA), and the Grooved Pegboard (GPB). Caregiver burden was assessed using the schedule burden and self-esteem subscales of the Caregiver Reaction Assessment (CRA). Hierarchical regressions and independent samples t-tests evaluated whether neurocognitive performance predicted caregiver burden and differences in caregiver burden between patients with intact versus impaired (AVLT; ≥ -1.5 SD) memory. RESULTS Seventy-eight dyads were included for analyses (Patient: Mage=53.4, 65.4% male, 97.4% Non-Hispanic/White; Caregiver: Mage =52.5, 71.8% female, 96.2% Non-Hispanic/White). AVLT performance was significantly related to both caregiver schedule burden (β = -.63, p =.003) and self-esteem (β =.26, p =.046). Performance on TMT-B, COWA, GPB, and CWI and patient age were not related to caregiver burden in any model (ps>.05). There was a significant difference in caregiver schedule burden between those with (M=15.17, SD=5.84) and without memory impairment (M=18.50, SD=5.60) [t(72)=-2.44, p=.017] but not for self-esteem (p>.05). CONCLUSIONS Patient performance on verbal memory was sensitive to the changes that may contribute to increased caregiver burden. An amnestic profile may be the most salient cognitive predictor of strain on neuro-oncology caregivers. Our findings speak to the interdependence of patient outcomes and caregiver quality of life. Supporting patients’ neurocognitive capabilities, such as implementing individualized cognitive rehabilitation programs, may improve caregiver burden.

NCOG-31. NEUROCOGNITIVE OUTCOME FOLLOWING AWAKE CRANIOTOMY FOR INSULAR GLIOMA RESECTION: IMPACT OF SURGICAL APPROACH AND TUMOR CLASSIFICATION

Abstract BACKGROUND Insular glioma resection harbors similar risk of neurocognitive function (NCF) decline as other tumor locations. However, differences in outcomes according to transsylvian versus transcortical surgical approach and tumor classification remain unknown. METHODS 53 patients with newly diagnosed insular glioma (47% high-grade; 23% GBM; 75% left hemisphere) underwent awake craniotomy for resection (transsylvian, 64%; transcortical, 36%). Patients completed neuropsychological testing preoperatively and <2 months postoperatively (M interval=23.7 days). Tumor location was described with Berger-Sinai zones collapsed into anterior (I and/or IV), posterior (II and/or III), superior (I and/or II), and inferior (III and/or IV) groups. Tumor extension was characterized with the Pitskhelauri system into insula only, insula with extension (lobar or medial), and predominantly (>50%) extra-insular groups. Result: Decline (z-score change<-1.0) on at least 1 test occurred in 85% of patients with largest effect (partial η2) in memory (.29–.44) and verbal fluency (.39). There was no interaction with approach on any NCF change score, though transcortical was associated with more frequent fluency decline (61% vs. 26%, p=.014). Left hemisphere tumor was associated with poorer outcome on 6/12 tests (all p<.01). Predominantly extra-insular tumors showed greater reductions in fluency (M=-1.21, SD=0.90) than insula only tumors (M=-0.10, SD=0.76; p=0.024). Number of Berger-Sanai quadrants involved was inversely associated with change in executive functioning (r=-0.34, p=.018). Poorer executive function outcome was also found in anterior (M=-0.61, SD=1.41) versus posterior tumors (M=0.86, SD=1.51; p=.014), and recognition memory outcome worse for inferior (M=-2.44, SD=1.81) than superior lesions (M=-0.31, SD=1.47; p=.021). CONCLUSIONS NCF decline is common in the early term following resection of insular glioma. While risk of verbal fluency decline may be greater for transcortical surgeries, outcomes were largely similar across approaches. In addition to hemisphere, tumor extension and insular zone localization may inform domain-specific risk of NCF decline following resection.

CTIM-31. PRELIMINARY RESULTS OF A PHASE II STUDY OF STEREOTACTIC RADIOSURGERY IN CONJUNCTION WITH THE PD-1 INHIBITOR PEMBROLIZUMAB FOR THE TREATMENT OF RECURRENT HIGH-GRADE MENINGIOMA

Abstract Recurrence of higher-grade meningioma after initial resection and radiotherapy is frequent and associated with high rates of morbidity and mortality. Salvage therapies have limited efficacy and average survival after recurrence is approximately 5-10 years. We report here preliminary data from a phase 2 study combining immunotherapy with checkpoint inhibition with stereotactic radiosurgery for treatment of recurrent high-grade meningioma (NCT04659811). Adult patients with either grade 2 or 3 meningioma who have recurred despite treatment with surgery and radiation and who meet eligibility criteria received stereotactic radiosurgery, in 1 to 5 fractions, in conjunction with pembrolizumab 200mg on the first day of radiation and then every 3 weeks until progression, unacceptable toxicity or for 2 years. Primary objective is PFS12, and secondary objectives include safety of the combined treatment in recurrent meningioma, mOS, mPFS, and neurocognitive function and QOL metrics. To date we have enrolled 18 of planned 37 patients, 33% female, 39% grade 2 and 61% grade 3. Safety lead in was completed without any dose limiting toxicity. There have been 4 SAEs, only one of which was related to study treatment (cerebral edema). 29% of patients had at least one AE, the most common were GI disorders (23%), skin disorders (23%) and headache (17%). Preliminary data from 12 patients shows PFS12 to be 50%, which suggests that the combination of stereotactic radiosurgery may be more beneficial than treatment of Pembrolizumab alone (mPFS 7.6 months). One patient was found to have a homozygous focal deletion of the MLH1 gene and had a dramatic reduction in size of her meningioma with a durable response for over one year. These preliminary data suggest that the combination of stereotactic radiosurgery and pembrolizumab is safe, well tolerated and may be beneficial to patients with recurrent higher-grade meningioma.

QOL-16. POSTOPERATIVE MOTOR FUNCTION AND PROCESSING SPEED PREDICT QUALITY OF LIFE IN PATIENTS WITH GLIOBLASTOMA AT CHRONIC-PHASE

Abstract The quality of life (QOL) in patients with glioblastoma (GBM) should be paid attention. The aim of this study is to identify brain functions that influence the QOL of patients with GBM by objectively assessing neurocognitive functions. Data from 40 patients with newly diagnosed GBMs were analyzed. All patients completed the assessment of various neurological and neurocognitive functions and QOL at 6 months postoperatively. QOL was assessed using the 36-Item Short Form Survey (SF-36). In the SF-36, the physical, mental, and role and social component summary (PCS, MCS, and RCS, respectively) scores were calculated. Multiple logistic regression analyses and chi-square tests were used to evaluate the association between SF-36 scores and brain functions. The MCS was maintained, whereas the PCS and RCS scores were significantly lower in patients with GBMs than in healthy controls (p=0.0081 and p<0.0001, respectively). Among a variety of brain functions, motor function and processing speed were significantly correlated with PCS and RCS scores, respectively (p=0.0048 and p=0.030, respectively). Patients whose PCS or RCS remained stable had a higher probability of motor function or processing speed preservation than those whose RCS or PCS decreased (p=0.0026). Taken together, motor function and processing speed may be predictors of QOL in patients with GBMs.

NCMP-19. IMPACT OF SUBVENTRICULAR ZONE INVASION ON PREOPERATIVE COGNITIVE DECLINE IN DIFFUSE GLIOMA PATIENTS

Abstract PURPOSE To determine the impact of subventricular zone (SVZ) invasion on neurocognitive dysfunction in diffuse glioma patients. MATERIALS AND METHODS We collected neuropsychological assessments of treatment-naïve WHO grade 2-4 diffuse glioma patients between 2017 to 2023. The Chi-square test determined the odds ratio (OR), and multiple linear regression identified factors related to cognitive deficits using Python 3.11.4. RESULTS Of the 129 patients, 64 exhibited SVZ invasion (SVZ+) while 65 were SVZ-. Groups were matched for WHO grading. SVZ+ was associated with more defective domains than SVZ- in both lower grade (WHO grade 2,3, 3.2 ± 2.1 vs. 2.1 ± 1.9, p=0.019) and high grade (WHO grade 4, 4.9 ± 1.6 vs. 3.6 ± 2.2, p=0.019) tumors. In lower grade gliomas, SVZ+ increased risks of language (OR 7.500, p<0.001) and visual learning impairments (OR 4.375, p=0.014). In high grade gliomas, SVZ+ rendered greater language (OR 8.556, p=0.003) and auditory learning vulnerability (OR 3.850, p=0.039). In right hemispheric tumors, SVZ+ lesions conferred worse executive (OR 6.667, p=0.006) and language function (OR 9.063, p=0.017); in left hemispheric tumors, SVZ+ lesions increased language (OR 3.125, p=0.012) and auditory learning (OR 2.889, p=0.024) impairment. Frontal horn of SVZ+ was related to working memory decline, and body part of SVZ+ was related to emotional deficits. Age and WHO grade 4 were associate with more defective domains in the SVZ+ group. In the SVZ- group, parietal lobe tumor was associate with more defective domains, while high education, temporal lobe, and WHO grade 2 were associate with fewer defective domains. CONCLUSION SVZ invasion impacts pre-operative neurocognitive function regardless of lesion laterality and WHO grade. Distinct SVZ sub-regions are linked to specific cognitive impairments. These findings highlight the need for precise tumor mapping involving the SVZ to evaluate neurocognitive outcomes and consider preventive or rehabilitative interventions.

Aberrant dynamic functional network connectivity in patients with diffuse axonal injury

Diffuse axonal injury (DAI) results in aberrant functional connectivity and is significantly linked to cognitive impairment. Nevertheless, the network mechanisms influencing neurocognitive function following DAI remain unclear. This study aimed to examine the characteristics of static and dynamic functional network connectivity (FNC) in patients with DAI. Resting-state functional magnetic resonance imaging data were collected from 26 patients with DAI and 27 healthy controls. Resting-state networks were extracted using independent component analysis. We evaluated the connectivity strength through spatial maps and static FNC, and then further dynamic properties were identified using a sliding time-window approach and k-means clustering, and investigated their associations with clinical variables. Patients with DAI showed stronger intra-network spatial maps in the default mode network and subcortical network than healthy controls, but static inter-network functional connectivity remained stable. Furthermore, three recurring states for dynamic connectivity were identified in all participants, and state 1 occurred most frequently in patients with DAI and exhibited higher fractional time, and as well as longer mean dwell time, which was positively associated with MMSE scores. Meanwhile, patients with DAI exhibited mostly increased functional connectivity strength of dynamic FNC in all states, particularly within the default mode network and visual network. These findings suggest that patients with DAI are characterized by altered dynamic FNC and temporal properties, which provide distinct complementary information different from static functional connectivity, and new insights into the neural pathophysiology of DAI associated with cognitive impairment.

Advances in the Management of Lung Cancer Brain Metastases

Lung cancer, both non-small cell and small cell, harbors a high propensity for spreading to the central nervous system. Radiation therapy remains the backbone of the management of brain metastases. Recent advances in stereotactic radiosurgery have expanded its indications and ongoing studies seek to elucidate optimal fractionation and coordination with systemic therapies, especially targeted inhibitors with intracranial efficacy. Efforts in whole-brain radiotherapy aim to preserve neurocognition and to investigate the need for prophylactic cranial irradiation. As novel combinatorial strategies are tested and prognostic/predictive biomarkers are identified and tested, the management of brain metastases in lung cancer will become increasingly personalized to optimally balance intracranial efficacy with preserving neurocognitive function and patient values.

Neurocognitive functioning remained unchanged in adults with phenylketonuria: Report of a 15-year follow-up.

The long-term prognosis of treated phenylketonuria (PKU) is a controversial issue. A controlled long-term study was performed to assess the neuropsychological outcome in adult patients with early treated PKU. We investigated 27 patients aged 34-55 years (median age: 47 years) and 19 healthy controls, matched for age and socio-economic status. Patients and controls were assessed for their full-scale IQ (FSIQ), attention and information-processing abilities. Magnetic resonance imaging (MRI) of the brain was performed in all patients. Neuropsychological assessments and MRI were repeated at a 15-year follow-up. In the entire interval of 15 years, cognitive performance of patients and controls remained unchanged. Older adult patients showed poorer cognitive performance at all assessment times compared to young adult patients and controls. Cognitive performance showed no correlation to MRI results. FSIQ, however, was significantly correlated with blood phenylalanine levels in the adolescent years of adult patients older than 47 years. Cognitive performance in adult patients with early treated PKU does not seem to deteriorate in a 15 years interval. Neuropsychological assessment revealed constant modest neurocognitive impairment in patients older than 47 years. This seems to refer to an early relaxation of diet that was recommended when the older patients were adolescents.

The role of choline in the physiology of reproductivity

Choline is an essential nutrient, but intake among pregnant women is insufficient – only 7% of them consume adequate amounts of choline. The discrepancy between choline requirements and actual intake raises questions about the need for choline supplementation and its potential benefits for pregnant women. The diet of the expectant mother, rich in choline, in the preconception period ensures folliculogenesis and better quality of oocytes, changes the foetal epigenome, counteracting genomic defects during intrauterine development and reducing the susceptibility to metabolic changes in adulthood. Choline is a source of methyl groups and its consumption reduces the risk of NTDs by 7 times, so a promising trend in nutritional support of pregnancy and prevention of NTDs is the intake of folates and choline in combination with other micronutrients. Choline promotes the growth, proliferation and functioning of placental cells, transport of macronutrients, and has an anti-inflammatory effect. The risk of low foetal weight is reduced by 69% when choline is added to the mother’s regular diet. A significant connection has been shown between high levels of choline in the mother and a 2-fold reduction in the risk of preeclampsia, premature birth and a significant effect on the neurodevelopment and mental health of the child – improving neurocognitive functions and reducing the risk of autism and attention deficit hyperactivity disorder. A choline supplement at a dose of 130 mg/day as part of the vitamin-mineral complex Femibion 1 is sufficient to meet the needs for this nutrient during the preconception period and in the first trimester of pregnancy. The need for choline supplementation in the pregravid period and the first trimester of pregnancy is because on folliculogenesis and oocyte protection, epigenetic programming, the effectiveness of preventing congenital malformations of the foetus, participation in metabolic and physiological processes in the placenta, reducing the risk of placenta-associated complications, influence on the development of nervous tissue and brain of the foetus and newborn.

Neurocognitive dysfunction in adolescents with recent onset major depressive disorder: a cross-sectional comparative study.

The aim of this study was to examine the neurocognitive deficits associated with the first episode of major depressive disorder (recent onset depression, ROD) in adolescents as compared to adult patients. Cross-sectional neurocognitive data from the baseline assessments of the PRONIA study with N = 650 (55.31% females) were analyzed. Based on a principal component analysis of eleven neurocognitive tests, we constructed an overall neurocognitive performance (NP) score. We examined mean score differences in NP between the groups of healthy controls (HC) and ROD and between adolescents (15-21years) and adults (22-40years) within a GLM approach. This accounts for unbalanced data with focus on interaction effects while controlling for effects of medication and educational years. Our results show lower NP for the ROD as compared to the HC group (d = -0.29, p = .046) and lower NP for the adolescent group as compared to the adult group (d = -0.29; p < .039). There was no interaction between these two group effects (F = 1.11; p = .29). Our findings suggest that the detrimental effect of ROD on neurocognitive functioning is comparable in adolescent and adult patients, since lower scores in adolescent patients are explained by effects of age and education. Neurocognitive impairment is an under addressed issue in clinical treatment guidelines for adolescent MDD. We suggest efficient monitoring in clinical practice by using an aggregate of the Digit Symbol Substitution Test and the Trail Making Test B, which highly correlated with the overall score of NP (r = 0.82).

Differential association between childhood trauma subtypes and neurocognitive performance in adults with major depression

BackgroundNeurocognitive impairment is one of the prominent manifestations of major depressive disorder (MDD). Childhood trauma enhances vulnerability to developing MDD and contributes to neurocognitive dysfunctions. However, the distinct impacts of different types of childhood trauma on neurocognitive processes in MDD remain unclear.MethodsThis study comprised 186 individuals diagnosed with MDD and 268 healthy controls. Childhood trauma was evaluated using the 28-item Childhood Trauma Questionnaire-Short Form. Neurocognitive abilities, encompassing sustained attention, vigilance, visual memory, and executive functioning, were measured by the Cambridge Neuropsychological Testing Automated Battery.ResultsMultivariable linear regressions revealed that childhood trauma and MDD diagnosis were independently associated with neurocognitive impairment. Physical neglect was associated with impaired visual memory and working memory. MDD diagnosis is associated with working memory and planning. Interactive analysis revealed that physical/sexual abuse was associated with a high level of vigilance and that emotional neglect was linked with better performance on cognitive flexibility in MDD patients. Furthermore, childhood emotional abuse, physical abuse, and emotional neglect were revealed to be risk factors for developing early-onset, chronic depressive episodes.ConclusionThus, specific associations between various childhood traumas and cognitive development in depression are complex phenomena that need further study.

From oxygen shortage to neurocognitive challenges: behavioral patterns and imaging insights

Environmental hypoxia, resulting from reduced oxygen supply, poses a significant risk of dysfunctioning and damaging the neurocognitive system, particularly in relation to anxiety and stress. Inadequate oxygenation can lead to acute and chronic brain damage. Scholars used behavioral, hemodynamic, and electromagnetic neurofunctional techniques to investigate the effects of normobaric and hypobaric hypoxia on neurocognitive systems. They found a correlation between hypoxia, altered psychomotor responses, and changes in EEG alpha, theta, beta, and gamma rhythms, which affect spatial attention and memory. Hypoxia affects event related potential (ERP) components differently depending on latency. Perceptual responses N1 and P2 remain largely unaffected, while the amplitudes of preattentive MMN, vMMN, and P3a are significantly altered. Late latency components related to attention, particularly P3b, are also altered. These changes illustrate the spectrum from sensory detection to more complex cognitive processing, highlighting the brain's efficiency in managing information. Interestingly, the amplitudes of P3b, ADAN and CNV can increase with increased cognitive demands in hypoxia. This suggests a compensatory response. Prolonged exposure exacerbates these effects, resulting in compensatory delayed behavioral responses and alterations in behavioral monitoring and conflict inhibitory control, as reflected by reduced amplitudes in some attention related ERP components, including N2, N2pc, and ERN. Thus, neurocognitive function and integrity are under stress. ERP sources and hemodynamic images reveal that vulnerable brain regions include the frontal prefrontal cortices, hippocampus, basal ganglia, and parietal and visual cortices, which are essential for attention related processes like decision making and spatial memory. The auditory system appears less affected.

Can neurocognitive performance account for dimensional paranoid ideation?

Paranoid ideation underlies numerous psychological disorders and has debilitating effects on daily life. Deficits in neurocognition are highlighted as a contributing factor to paranoid-related disorders, but the impact on the symptom-level experience of paranoid ideation is unclear. This study aimed to employ a dimensional approach to understand the association between neurocognition and the severity and presence of paranoid ideation. 400 participants, representative of the general population of the USA, completed an online questionnaire consisting of the Brief Symptom Inventory-53, and demographic and clinical questions. The participants then completed four computerised neurocognitive tasks measuring working memory, shifting, inhibition, and speed of processing. Speed of processing accounted for unique variance in the severity of paranoid ideation with a small effect size, after controlling for covariates. Working memory, shifting, and inhibition could not uniquely or collectively, account for paranoid ideation. Neurocognitive performance could not distinguish between individuals with and without paranoid ideation experiences. This research supports the body of literature that speed of information processing may be a key feature of paranoid ideation. Future research should employ non-linear dynamic methods to better understand the potential interactions between neurocognitive components and how this may relate to paranoid ideation.

Identifying Factors that Increase False-Positive Rates on Embedded Performance Validity Testing in ADHD Evaluations.

This study investigated why certain embedded performance validity indicators (EVIs) are prone to higher false-positive rates (FPRs) in attention-deficit/hyperactivity disorder (ADHD) evaluations. The first aim was to establish the relationship between FPRs and 15 EVIs derived from six cognitive tests when used independently and together among adults with ADHD who have valid test performance. The second aim was to determine which specific EVIs increase the FPRs in this population. Participants were 517 adult ADHD referrals with valid neurocognitive test performance as determined by multiple performance validity tests and established empirical criteria. FPRs were defined by the proportion of participants who scored below an empirically established EVI cutoff with ≥0.90 specificity. EVIs derived from two of the six tests exhibited unacceptably high FPRs (>10%) when used independently, but the total FPR decreased to 8.1% when the EVIs were aggregated. Several EVIs within a sustained attention test were associated with FPRs around 11%. EVIs that did not include demographically adjusted cutoffs, specifically for race, were associated with higher FPRs around 14%. Conversely, FPRs did not significantly differ based on whether EVIs included timed versus untimed, verbal versus nonverbal, or graphomotor versus non-graphomotor components, nor whether they had raw versus standardized cut scores. Findings suggest that practitioners should consider both the type of test from which an EVI is derived and the aggregate number of EVIs employed to minimize the FPRs in ADHD evaluations. Findings also indicate that more nuanced approaches to validity test selection and development are needed.

The effects of cognitive training on driving performance.

Driving is a complex task necessitating an intricate interplay of sensory, motor, and cognitive abilities. Extensive research has underscored the role of neurocognitive functions, including attention, memory, executive functions, and visuospatial skills, in driving safety and performance. Despite evidence suggesting cognitive training's potential in enhancing driving abilities, comprehensive cognitive training's impact on driving performance in young adult drivers remains unexplored. Our study aimed to fill this gap by implementing an intensive, 8-week, multidomain computerized cognitive training program and assessing its transfer effects on the driving performance of young adult drivers, using a high-fidelity simulator. The study employed a randomized controlled trial design, with passive control group. The mixed-design analysis of variance (ANOVA) revealed a notable interaction between the time of testing and the respective participant groups concerning driving performance. Post hoc analyses showed that, compared to the control group, participants undergoing cognitive training demonstrated significantly fewer traffic infractions in the post-training evaluation. These findings suggest that cognitive training could be a useful tool for enhancing driving safety and performance in young adult drivers. Further research should aim to address the limitations posed by the absence of an active control group.