Neuropsychological Battery Research Articles

B - 96 Relationships between Self-Reported Cognitive Dysfunction, Functional Activities, and Intraindividual Cognitive Variability in Persons with Multiple Sclerosis (Pwms)

Abstract Objective To examine the relationships between intraindividual cognitive variability (IIV) and self-reported cognitive and functional difficulties in persons with multiple sclerosis (pwMS). We hypothesized higher perceived cognitive and functional difficulties would be associated with higher IIV. Method Participants (n = 35) were pwMS from a prospective memory intervention study. During the baseline evaluation, participants completed an objective neuropsychological test battery and a self-report measure of cognitive functioning (Perceived Deficits Questionnaire; PDQ Total). Participants were asked if they had problems in eight different functional areas due to their memory, with the number of endorsed problems summed. Two measures of IIV, an intraindividual standard deviation (ISD) score and maximum discrepancy score (MDS), were created from 11 indices. The relationship between the IIV and PDQ were assessed with individual linear regressions, controlling for demographics and disease-related characteristics, while Spearman correlations examined the associations with the number of reported functional memory problems. Results The PDQ was not significantly associated with either the ISD (b = −0.03, 95% CI: −0.15, 0.10, p = 0.672) or MDS (b = −0.01, 95% CI: −0.51, 0.32, p = 0.645). The overall number of functional memory problems was correlated with both the PDQ (ρ = 0.40, p = 0.018) and ISD (ρ = −0.35, p = 0.039), but not MSD (ρ = −0.22, p = 0.201). Conclusion(s) Perceived cognitive dysfunction was not associated with IIV. However, self-reported functional problems with memory were associated with perceived cognition, as well as one metric of IIV. ISD may better reflect moment to moment fluctuations that lead to difficulties with daily functioning, as opposed to MDS which may reflect underlying variation (e.g., base rates of impairment) in cognitive performance.

B - 10 Performance Validity Test Failure Base Rates among Presurgical Epilepsy Referrals

Abstract Objective Patients with epilepsy undergoing presurgical workup are generally considered a population without clear incentive to perform invalidly during neuropsychological evaluation. This study investigated the base rates of performance validity test (PVT) failure among a sample of presurgical epilepsy patients. Participants and. Methods Data were collected from 68 consecutive patients with epilepsy undergoing outpatient neuropsychological evaluation for surgical candidacy. The sample included 33 males/35 females, had a mean age of 36.29 (SD = 12.07), mean education of 12.51 (SD = 2.23), and was racially and ethnically diverse. All patients were administered a number of freestanding (Test of Memory Malingering [TOMM], Dot Counting Test [DCT], Coin-in-Hand [CIH]) and embedded (Rey Auditory Verbal Learning Test-Forced Choice [RAVLT-FC], Wechsler Memory Scale–3rd Edition Digit Span Reliable Digit Span [WMS-III DS RDS]) PVTs within a comprehensive neuropsychological assessment battery. Results Overall, 9% of the sample failed ≥2 PVTs, suggesting invalidity. An additional 22% failed 1 PVT. However, a large portion of the sample (69%) passed all freestanding and embedded PVTs. Among the freestanding PVTs, the failure rates were TOMM: 4%, DCT: 21%, and CIH: 3%. Failure rates on embedded PVTs were RAVLT-FC: 15% and WMS-III DS RDS: 3%. Conclusions Although there is not an expected incentive for suboptimal neuropsychological performance among presurgical epilepsy patients, results show a critical need for objective validity assessment to guard against inaccurate surgical prognostication from invalid test data for patients undergoing high-stakes presurgical evaluations. Given the high invalidity rate on some individual PVTs, further research is necessary to cross-validate established PVT cut-scores in epilepsy-specific populations.

B - 127 Equivalence of In-Person and Remotely Administered Performance Validity Tests: Evidence from a Forensic Sample

Abstract Objective While neuropsychologists are increasingly recognizing the importance of tele-neuropsychology (teleNP), existing research has not comprehensively explored equivalency of commonly used performance validity tests (PVTs) and symptom validity tests (SVTs) across in-person and remote administration. This is despite the fact that such measures are a crucial component of any neuropsychological assessment battery and are, as such, considered medically necessary. Furthermore, the existing teleNP research base is primarily limited to clinical and other non-forensic samples, with limited applicability to forensic teleNP evaluations. The current study examined the equivalency of in-person and remote administration of widely used PVTs and SVTs in a forensic sample. Method Archival data between July 2021 and December 2023 were collected from a private practice setting in which board-certified neuropsychologists (ABPP/ABCN) conducted independent medical evaluations (IMEs) in controlled settings with utilization of an on-site proctor. Mean PVT and SVT scores across in-person and remote evaluations were compared. Results All included PVTs and SVTs (TOMM, DCT, WAIS-IV RDS, Word Choice, WMT, MENT, MSVT, IOP-29, SIMS, MMPI-2-RF scales) showed mean equivalency across in-person and remote administration (p > 0.05). Conclusions Findings provide preliminary support for the adaptation of both PVTs and SVTs for teleNP. Implications are present for forensic and clinical practice, although future research should continue to establish preliminary trends.

B - 43 Utility of the Activity Measure for Post-Acute Care (AM-PAC) as a Measure of Functional Recovery across the TBI Rehabilitation Continuum

Abstract Objective To evaluate the utility of the AM-PAC (Activity Measure for Post-Acute Care) for functional assessment of patients with Traumatic Brain Injury (TBI) across inpatient and outpatient rehabilitation settings. We evaluated (1) Longitudinal changes (1-year) in cognitive and physical recovery patterns across the rehabilitation continuum (2) Concurrent validity of AM-PAC as compared to traditional measures. Method A prospective repeated measures cohort study of adults with TBI (n = 186), where 87 participants received inpatient rehabilitation (IR), and 99 participants received outpatient cognitive rehabilitation (CR). Functional recovery was assessed at IR admission, discharge, 6 months and 1 year, and at admission/discharge from CR for post-acute participants. Functional measures included AM-PAC-Basic Mobility (BM), Daily Activities (DA), and Applied Cognitive (AC) domains, Neuropsychological Assessment Battery (NAB), Texas Functional Living Scale (TFLS), Functional Independence Measure (FIM), Participation Assessment with Recombined Tools-Objective (PART-O), and Mayo-Portland Adaptability Inventory (MPAI-4: self-awareness). Results The AMPAC was sensitive to changes throughout the care continuum, demonstrating medium effect sizes across all three functional domains. Notably, AMPAC scores showed greater change compared to traditional tools (90% and 68% confidence levels). Additionally, analysis of Minimum Detectable Change thresholds demonstrated significant improvements, across settings and within moderate/severe TBI (p < 0.05), followed by predictably smaller gains in the mild TBI population (p < 0.05), underscoring the clinical relevance of these findings. Conclusions Results demonstrate that the AM-PAC is a practical, valid and sensitive scale responsive to longitudinal ecological and functional change in TBI. Analysis confirms the effectiveness of functional assessments, particularly emphasizing strengths of the AMPAC.

B - 111 Community Resource Access and Neuropsychological Outcomes in a Post-SARS-CoV-2 Clinical Sample

Abstract Objective Lower access to resources, income, education, and housing quality has been linked with poorer neuropsychological outcomes. This study evaluated the relationship between community resource access and several cognitive and psychological outcomes among clinical patients with persisting cognitive concerns following SARS-CoV-2 infection. Method The sample consisted of 49 patients (30.6% male; 35.3% White; Mage = 45.3, SD = 12.1; Meducation = 15.5, SD = 3.0) referred for neuropsychological evaluation to assess for long-term cognitive changes following SARS-CoV-2 infection. All patients were administered a uniform neuropsychological test battery that included measures of working memory, processing speed, and verbal learning/memory, as well as measures of depression, anxiety, and perceived stress. Area deprivation index (ADI) was determined using the national decile of the 2021 Neighborhood Atlas. Linear regression models were conducted between ADI and each cognitive and psychological outcome. Results No significant associations were identified between ADI and cognitive (working memory [F = 3.16, p = 0.08]; processing speed [F = 0.89, p = 0.32]; total learning [F = 0.41, p = 0.52]; delayed recall [F = 0.08, p = 0.78]) nor psychological (depressive symptoms [F = 0.09, p = 0.77]; anxiety symptoms [F = 0.05, p = 0.82]; perceived stress [F = 0.49, p = 0.49]) variables. Conclusions In this preliminary study, community access to resources did not significantly predict long-term cognitive or psychological symptoms following SARS-CoV-2 infection. This unexpected result suggests that neighborhood deprivation may be one particular social determinant of health that is less impactful for post-SARS-CoV-2 neuropsychological outcomes in similar populations. Generalizability is limited by sample characteristics (highly educated; uncomplicated disease course) and small sample size. Thus, replication in a larger database and further research involving other social determinants is indicated.

A - 83 Concordance between Informant Measures, Executive Functioning, and Functional Ability in an Older Adult Population

Abstract Objective Informant-report measures often do not correlate with neuropsychological tests measuring the same cognitive construct, yet they may offer insight into everyday difficulties not captured by objective tests. Performance-based measures of functional ability, developed to capture real-world skills, may better align with informant-report measures. Clarifying the relationship between subjective and objective assessment tools in older adults could enhance precision in selecting the most appropriate measures. Method As part of a comprehensive neuropsychological battery, community-dwelling older adults who were cognitively unimpaired or who presented with subjective cognitive decline or mild cognitive impairment completed tests of executive functioning (EF), (D-KEFS Trail Making Test 4, Letter Fluency, WCST, WAIS-Comprehension) and financial capacity, Financial Capacity Instrument (FCI-SF). Informants responded to measures of functional ability, Amsterdam Instrumental Activities of Daily Living Questionnaire Short Version (A-IADL-Q-SV) and Assessment of Functional Capacity Interview (AFCI) and items capturing EF on the Brief Informant Form of Neurobehavioral Symptomatology (BINS). Results Participants’ (N = 97, Mage = 74.64 ± 7.42 years; Meducation = 15.76 ± 2.42 years; 74.2% female) FCI-SF performance significantly correlated with higher A-IADL-Q-SV (r = 0.403, p < 0.01) and AFCI (r = −0.294, p < 0.01) scores, whereas there was no significant correlation between a composite Z-score for traditional neuropsychological tests and select EF items from the BINS, (r = −0.119, p = 0.252). Conclusion We found greater alignment between objective and subjective measures of functional ability than EF, possibly due to the observable nature of functional tasks. Objective and informant measures of EF do not align, potentially targeting different aspects of cognition in non-demented older adults. This should be considered when selecting instruments measuring specific constructs of interest.

B - 51 Are my Constructs Bass-Ackwards? A Hierarchical Approach to Neuropsychological Factors in Traumatic Brain Injury

Abstract Objective This study examined neuropsychological measures within a hierarchical framework in a traumatic brain injury (TBI) sample. Methods 270 individuals (M = 32 years old, SD = 14.8; 70% male, 94% white) with mixed TBI severity (73.7% mild TBI) completed the Meyers Neuropsychological Battery (MNB). Principal Components Analyses (PCAs) were conducted using Goldberg’s (2006) “bass-ackwards” hierarchical approach commonly used to evaluate “stratum” in personality and psychopathology. This involves an iterative top-down approach extracting a single general factor, then using the same data to extract two factors, then three factors, and continues as long as theoretically feasible. Extracted factors are saved as factor scores and correlated to reveal pathways between stratum. Results Iterative PCAs revealed a 4-stratum model. The first unrotated principal component (FUPC) was defined by loadings for Arithmetic, AVLT, RCFT, and Block Design. The second stratum factors were defined by AVLT and BNT (factor 1) and RCFT and Block Design (factor 2). The third stratum was defined by RCFT, Block Design, and Finger Localization nondominant (factor 1); Information and BNT (factor 2); and AVLT, Coding, and Finger Tapping dominant (factor 3). Stratum 4 was RCFT and Block Design (factor 1); AVLT (factor 2); Sentence Repetition, Similarities, and Information (factor 3); and Finger Tapping bilateral, Coding, and Trails Making Test (factor 4). Correlational pathways between factors ranged from 0.50 to 0.98. Conclusion Factors at lower stratum generally aligned with functions for cortical lobes. For example, Stratum 4 can be conceptualized as right temporoparietal (factor 1), left temporal (factor 2), left frontotemporal (factor 3), and bilateral frontal (factor 4).

A - 111 Neuropsychological Functioning in those with Chronic Traumatic Encephalopathy

Abstract Objective To differentiate neurocognitive performance between those with chronic traumatic encephalopathy neuropathologic change (CTE-NC) and matched CTE-negative individuals. Methods Data were obtained from the National Alzheimer’s Coordinating Center (NACC). Participants with mild cognitive impairment (MCI) or dementia and CTE-NC (n = 22) were matched approximately 1:3 to those with MCI/dementia but without CTE-NC (n = 64) on demographics (age of initial cognitive diagnosis, education, sex) and postmortem Alzheimer’s and Lewy body neuropathology. ANCOVAs (covarying for symptom duration and cognitive diagnosis) compared neurocognitive measures between groups (MMSE and neuropsychological battery composites of Attention, Executive Function, and Speed [AEFS], Memory, and Language). Results Participants were all male, 89.3% White, and averaged 16.3 years of education. They were, on average, 74.8 years of age (SD = 7.3) when diagnosed with MCI/dementia and had 4.2 years (SD = 4.2) of cognitive symptoms prior to MCI/dementia diagnosis. Rates of comorbid moderate/severe Alzheimer’s or Lewy body pathology were high (n = 13, 54%) in the CTE-NC group. At time of cognitive diagnosis, individuals with CTE-NC performed slightly better on the MMSE (F = 4.510, p = 0.037, CTE-NC+ M = 26.03 [1.05] vs. CTE-NC- M = 23.44 [0.58]). No differences in AEFS [F = 0.280, p = 0.599], Memory [F = 2.265, p = 0.137], or Language [F = 3.424, p = 0.069] were observed between groups. Conclusions Those with CTE-NC did not greatly differ in neuropsychological domains, but had relatively higher MMSE scores compared to those without CTE-NC. This is the largest clinicopathological investigation utilizing in-vivo neurocognitive data, though NACC lacks CTE-NC severity/distribution data for sensitivity analyses. Nonetheless, results have implications for CTE clinical criteria frameworks and larger clinicopathological studies are needed to determine if CTE-NC has distinct neurocognitive features.

A - 70 Contextualizing Racial/Ethnic Differences in Baseline Assessment among Collegiate Athletes

Abstract Objective Compared to other factors that influence neuropsychological test performance, few studies have examined the relationship between racial/ethnic identity and baseline assessment performance in collegiate athletes, and even fewer have contextualized results using structural factors linked to test performance (e.g., premorbid cognitive ability). This study examined racial/ethnic differences in baseline assessment performance before and after controlling for premorbid functioning. We hypothesized that there would be racial/ethnic differences in performance but that controlling for premorbid functioning would reduce these differences. Method Participants included 875 collegiate athletes who were grouped based on racial/ethnic identity (White = 661, Black = 165, Another Race = 49) and underwent a comprehensive neuropsychological battery. Cognitive composite scores and intraindividual variability (IIV) were calculated for two neurocognitive domains: attention/processing speed and memory. Premorbid functioning was assessed with the Wechsler Test of Adult Reading (WTAR). ANCOVAs were used to examine racial/ethnic differences in these four cognitive domains before and after controlling for WTAR scores. Results Before controlling for WTAR scores, there were significant racial/ethnic differences in the attention/processing speed and memory composite scores and in attention/processing speed IIV, p’s < 0.001, ηp2 = 0.02–0.03. However, there were no significant racial/ethnic differences in memory IIV, p = 0.97. After controlling for WTAR scores, there were no significant racial/ethnic differences in the attention/processing (p = 0.530, ηp2 = 0.001) or memory (p = 0.183, ηp2 = 0.004) composite scores, and the relationship between racial/ethnic identity and attention/processing speed IIV became less significant (p = 0.014, ηp2 = 0.01). Conclusions Results suggest that racial/ethnic differences at baseline assessment can be largely accounted for by premorbid functioning, which underscores the importance of considering sociocultural context when assessing racially/ethnically diverse athletes.

A - 35 Effects of Childhood Trauma Exposure on Psychological Symptom Endorsement among Adult ADHD Referrals

Abstract Objective Adults with attention-deficit/hyperactivity disorder (ADHD) are more likely to have childhood trauma exposure. Trauma exposure evaluations are not always standard practice for adult ADHD evaluations, but personality inventories like the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) are more commonly used to differentiate neurodevelopmental symptoms from psychiatric disorders. This study assessed the impact of childhood trauma exposure on MMPI-2-RF profiles among adults referred for ADHD evaluation. Method Cross-sectional data from 222 patients referred for neuropsychological evaluation for attention concerns and administered the Adverse Childhood Experiences (ACE) Checklist and MMPI-2RF were examined. Patients were racially diverse with a Mage 29.15 (SD = 7.63) and Meducation 16.15 years (SD = 2.13). Patients were divided into low (0–3 ACEs) and high (>3 ACEs) ACE groups. ACEs groups’ MMPI-2RF Restructured Clinical (RC) scale scores were compared via multivariate analyses of variance (MANOVAs) for the overall sample and subsample of those who ultimately received an ADHD diagnosis. Results The sample had 52% low ACEs/48% high ACEs, and 65% ADHD diagnosis/35% non-ADHD diagnosis. Overall, there was a significant multivariate effect (Wilks Λ =0.812; F(9,212) = 5.45, p < 0.001; np2 = 0.188); those with high ACE scores had significantly higher RC1, RC4, RC6, RC7, and RC8 scores. Significant MANOVA effects remained when the sample with subdivided. Across ADHD and non-ADHD subgroups, significantly higher RC4 and RC6 scores were consistent. Conclusions Exposure to childhood trauma had a significant impact on the MMPI-2-RF profile of adults being evaluated for ADHD. Screening for trauma exposure should be incorporated into standard neuropsychological batteries to inform the interpretation of personality inventories used to differentiate psychopathology.

B - 3 The Role of Artificial Intelligence: Utilization of the Meyers Battery for Diagnostically Differentiating a Complex Neuropsychological Case

Abstract Objectives As medical technology progresses, artificial intelligence (AI) is becoming a common method for providing diagnostic information to patients. In neuropsychology, the Meyers Neuropsychological Battery (MNB) provides impartial data through artificial intelligence. The following case illustrates how AI provided diagnostic clarity and aided in treatment planning. Method A 65-year-old female was referred by her neurosurgeon due to cognitive decline, delusions and hallucinations, and episodes of aggression toward her caretaker. A full, comprehensive neuropsychological examination was administered. Her medical history was remarkable for hypertension, hypercholesterolemia, thyroid cancer, two cerebrovascular accidents, traumatic brain injury, and multiple ischemic strokes. The patient’s most recent imaging was remarkable for chronic encephalomalacia involving the R basal ganglia, mild chronic small vessel ischemic changes, a ventricular shunt within the anterior horn of the R lateral ventricle, and post-coil embolization of a right supraclinoid artery. Results The patient was administered the MNB along with psychological measures. Results were consistent with diffuse and lateralized (RCH > LCH) neuropsychological impairment. Employing the MNB algorithms and AI, this patient’s data matched statistically with Multi-Infarct Dementia, Hydrocephalus, and Lewy Body Dementia. Conclusion These independent applications and AI enable neuropsychologists to respond beyond the “referral question” and provide an objective perspective unique to the patient’s neuropsychological profile. AI is not applied as the only diagnostic approach but rather provides the patient’s medical team with an alternative perspective regarding the entire neuropsychological picture. MNB’s AI not only aids in “matching” neurological conditions to the patient’s profile but also excludes proposed diagnoses in question and underscores a realistic treatment plan.

The relative associations of aortic and carotid artery stiffness with CeVD and cognition.

We examined the relative associations of aortic and carotid artery stiffness with cerebrovascular disease (CeVD), cognition, and dementia subtypes in a memory clinic cohort of 272 participants (mean age = 75.4, SD = 6.8). We hypothesized that carotid artery stiffness would have greater effects on outcomes, given its proximate relationship to the brain. Aortic and carotid artery stiffness were assessed with applanation tonometry and carotid ultrasonography, respectively. CeVD markers included white matter hyperintensities (WMH), lacunes, cerebral microbleeds, cortical infarcts, and intracranial stenosis. Cognition was assessed by the Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and a neuropsychological battery. Multivariable linear regression was conducted to determine associations of arterial stiffness with WMH and cognition, while logistic regression analysed associations with CeVD markers and dementia subtypes. Carotid artery stiffness z-score was associated with WMH, cortical infarcts, vascular cognitive impairment, and MMSE, independent of age, sex, education, vascular risk factors, and aortic stiffness z-score. Although aortic stiffness z-score was independently associated with cortical infarcts, this became non-significant after further adjusting for carotid artery stiffness z-score. We found that carotid artery stiffness had greater effects on CeVD, cognitive function and impairment in memory clinic patients compared to aortic stiffness.

Early High-Dose Erythropoietin and Cognitive Functions of School-Aged Children Born Very Preterm

Children born very preterm are at risk for long-term neurodevelopmental sequelae. Prophylactic high-dose recombinant human erythropoietin (rhEpo) shortly after birth has not been shown to improve cognitive, motor, and behavioral development at 2 and 5 years. To investigate whether early high-dose rhEpo is associated with better executive functions and processing speed-late-maturing cognitive functions-in school-aged children born very preterm. This single-center cohort study was a prospective, observational follow-up study of a multicenter neonatal clinical trial; 365 children born very preterm (mean gestational age, 29.3 weeks [range, 26.0-31.9 weeks]) who had been enrolled in the Swiss EPO Neuroprotection Trial at birth between 2005 and 2012, and who were included in the primary outcome analyses at 2 years, were eligible to be recruited for the EpoKids study between 2017 and 2021 when they were at school age. Term-born children were additionally recruited and included in a control group. Data were analyzed between May and September 2022. Administration of rhEpo (3000 IU/kg) or placebo (saline, 0.9%) intravenously 3 times within the first 2 days of life as part of the Swiss EPO Neuroprotection Trial. A comprehensive neuropsychological test battery assessed executive functions and processing speed, and parents reported on their child's executive functions in everyday life to test the hypothesis that early high-dose rhEpo administration is associated with better cognitive outcomes at school age. In the EpoKids study, 214 children born very preterm (58.6% of 365 children in eligible cohort) were assessed at a mean age of 10.4 years (range, 6.9-13.4 years); 117 (54.7%) were boys. There was no evidence that the 117 children who had received rhEpo differed from the 97 children who had received placebo in any of the 15 executive function and processing speed tests, nor in parent-rated executive functions (estimates ranged from -0.138 to 0.084, all 95% CIs included 0). Irrespective of rhEpo or placebo allocation, children born very preterm scored lower on 11 of 15 executive function and processing speed tests than term-born peers (estimates ranged from 0.112 to 0.255, 95% CIs did not include 0). This study found no evidence for a positive association between prophylactic early high-dose rhEpo administration and long-term neurodevelopmental outcomes after very preterm birth. These results suggest that a comprehensive approach, including pharmacological and nonpharmacological prevention and intervention strategies, is needed to support these children's neurodevelopmental outcome.

Risk Factors for Postoperative Delirium Severity After Deep Brain Stimulation Surgery in Parkinson's Disease.

Postoperative delirium (POD) is a serious complication following deep brain stimulation (DBS) but only received little attention. Its main risk factors are higher age and preoperative cognitive deficits. These are also main risk factors for long-term cognitive decline after DBS in Parkinson's disease (PD). To identify risk factors for POD severity after DBS surgery in PD. 57 patients underwent DBS (21 female; age 60.2±8.2; disease duration 10.5±5.9 years). Preoperatively, general, PD- and surgery-specific predictors were recorded. Montreal Cognitive Assessment and the neuropsychological test battery CANTAB ConnectTM were used to test domain-specific cognition. Volumes of the cholinergic basal forebrain were calculated with voxel-based morphometry. POD severity was recorded with the delirium scales Confusion Assessment Method for Intensive Care Unit (CAM-ICU) and Nursing Delirium Scale (NU-DESC). Spearman correlations were calculated for univariate analysis of predictors and POD severity and linear regression with elastic net regularization and leave-one-out cross-validation was performed to fit a multivariable model. 21 patients (36.8%) showed mainly mild courses of POD following DBS. Correlation between predicted and true POD severity was significant (spearman rho = 0.365, p = 0.001). Influential predictors were age (p < 0.001), deficits in attention and motor speed (p = 0.002), visual learning (p = 0.036) as well as working memory (p < 0.001), Nucleus basalis of Meynert volumes (p = 0.003) and burst suppression (p = 0.005). General but also PD- and surgery-specific factors were predictive of POD severity. These findings underline the multifaceted etiology of POD after DBS in PD. Valid predictive models must therefore consider general, PD- and surgery-specific factors.

Symptom Dimensions and Cognitive Impairments in Individuals at Clinical High Risk for Psychosis

BackgroundUnderstanding the intricate relationships between symptom dimensions, clusters, and cognitive impairments is crucial for early detection and intervention in individuals at clinical high risk for psychosis. This study delves into this complex interplay in a clinical high risk sample with the aim of predicting the conversion to psychosis. MethodsA comprehensive cognitive assessment was performed in 744 clinical high risk individuals. The study included a 3-year follow-up period to allow assessment of conversion to psychosis. Symptom profiles were determined using the Structured Interview for Prodromal Syndromes. By applying factor analysis, symptom dimensions were categorized as dominant negative symptoms (NSs), positive symptoms-stressful, and positive symptoms-odd. The factor scores were used to define 3 dominant symptom groups. Latent class analysis (LCA) and factor mixture model (FMM) were employed to identify discrete clusters based on symptom patterns. The 3-class solution was chosen for the LCA and FMM analysis. ResultsIndividuals in the dominant NS group exhibited significantly higher conversion rates to psychosis than those in the other groups. Specific cognitive variables, including performance on the Brief Visuospatial Memory Test–Revised (odds ratio = 0.702, p = .001) and Neuropsychological Assessment Battery Mazes Test (odds ratio = 0.776, p = .024), significantly predicted conversion to psychosis. Notably, cognitive impairments associated with NSs and positive symptoms-stressful affected different cognitive domains. LCA and FMM cluster 1, which was characterized by severe NSs and positive symptoms-odd, exhibited more impairments in cognitive domains than other clusters. No significant difference in the conversion rate was observed among the LCA and FMM clusters. ConclusionsThese findings highlight the importance of NSs in the development of psychosis and suggest specific cognitive domains that are affected by symptom dimensions.

Lack of Efficacy of JNJ-18038683 on Cognitive Impairment in Patients With Stable Bipolar Disorder.

The serotonin type 7 (5-HT7) receptor is one of 14 5-HT receptors. It has received attention for its possible role in mood disorders and cognition. The 5-HT7 receptor antagonist, JNJ-18038683, has been reported to be effective in rodent models of depression and REM sleep. Also, 5-HT7 receptor blockade has been postulated to be a key component of cognitive enhancement in a number of drugs. Bipolar disorder (BD) usually endures cognitive impairment (CI); however, no treatment for CI in BD has been approved. This study aimed to evaluate the efficacy of JNJ-18038683 to improve the CI of BD compared to a placebo. We conducted a placebo-controlled, 8-week trial of JNJ-18038683 in BD patients. Each patient's data were analyzed and reassessed blindly with a comprehensive neuropsychological battery, depression and hypomania ratings, and overall social and work function measures. Of 60 patients, 38 (63%) were female, 43 (72%) had BD type 1, and most patients were Caucasian and married. The overall time effect for the combined group shows statistically significant improvement from baseline to week 8 for most of the neurocognitive battery measures. This indicates a significant improvement in psychopathology and cognition during the study time in both JNJ-18038683 and placebo groups, but no difference between groups. This study showed no efficacy for the improvement of CIBD or mood symptoms with JNJ-18038683 compared to the placebo.

The impact of MIND diet consumption and physical activity on cognitive functioning in healthy aging older adults

Objective: Modifiable lifestyle factors evidence great promise in reducing cognitive decline in older adults. Greater consumption to the MIND diet (Morris et al.) and increased daily physical activity (Buchman et al.) are associated with higher cognitive functioning. The interactive effects of lifestyle factors on cognition in older adults has not been investigated extensively. The present study examined the interaction between MIND diet consumption and intensity of physical activity on cognition in community-dwelling older adults. Methods: The sample included 215 older adults (159 female, Mage=79.8; Medu =15.5) from the Memory and Aging Project (Bennet et al.). The measures included the food frequency questionnaire (FFQ, MIND diet consumption), a portable actigraph worn 24 h a day for ten days (activity intensity), and a neuropsychological battery (cognitive variables). Results: Controlling for age and education, multiple regression analyses revealed that MIND diet consumption significantly predicted global cognition (ps< .05). Physical activity significantly predicted global cognition (ps< .05), and processing speed (ps< .01). Interaction effects were significant in global cognition (ps< .05), and episodic memory (ps< .01) revealing a pattern that those with the lowest MIND diet consumption may experience greater cognitive benefits from physical activity in than those with higher diet consumption. Conclusions: Findings suggest that older adults who do not consume the MIND diet closely may experience greater benefit in cognitive functioning from exercise than individuals who more greatly consume the diet.

Neuropsychological performance in women at risk of postpartum depression and postpartum psychosis.

While neuropsychological deficits are commonly observed in affective and psychotic disorders, this remains unexplored in these disorders when they occur during pregnancy and the postpartum period. A neuropsychological test battery was administered to women defined at risk of postpartum depression (PD, N = 53) because having either a current or past diagnosis of major depressive disorder, women at risk of postpartum psychosis (PP, N = 43) because of a diagnosis of bipolar disorder or schizoaffective disorder and/or a previous episode of PP and women not at risk (NR, N = 48) in the third trimester of pregnancy. Generalized and specific cognitive abilities were compared between groups. Women at risk of PP presented worse executive functions and processing speed compared to NR and worse performance compared to women at risk of PD across all cognitive domains. In addition, women at risk of PP who developed a psychiatric relapse in the first four weeks post-partum showed worse verbal learning and memory, visual memory, executive functions and processing speed in pregnancy compared to NR, whereas women at risk of PP who remained well presented neuropsychological performance that was intermediate between that of the women NR and those at risk of PP who developed symptoms. There were no differences in performance between women at risk of PD and the NR women, even if 31 women at risk of PD presented depressive symptoms at the time of cognitive assessment. Our findings in women at risk of PP align with neuropsychological findings in individuals with, or at risk of psychosis unrelated to pregnancy. In addition, initial evidence that women at risk of PP who develop a psychiatric relapse in the postpartum show a particularly poor neuropsychological performance in pregnancy suggests that this could be considered part of a phenotype for the disease and help guiding future preventive strategies in this clinical population. In women at risk of PD, the presence of depressive symptoms did not influence cognitive performance.

Forget me not: The effect of doxycycline on human declarative memory

Investigations into neuroprotective drugs are in high demand for the treatment of neurodegenerative diseases, such as multiple sclerosis or Alzheimer's disease, but also psychiatric disorders, such as depression, trauma, and substance use. One potential drug class being investigated are tetracyclines impacting on a variety of neuroprotective mechanisms. At the same time, tetracyclines like doxycycline have been suggested to affect human fear and spatial memory as well as reducing declarative memory retention. Based on the assumed necessity for synaptic consolidation in hippocampus-dependent learning, we hypothesised declarative memory may be similarly impaired by doxycycline as fear and spatial memory. Therefore, in this study we investigate the potential diminishing effects of doxycycline on consolidation of declarative memory in healthy humans. Additionally, to test for effect specificity we assessed motor memory, sustained attention, and processing speed. We administered a neuropsychological test battery in three independent randomized placebo-controlled double-blind trials (RCTs), in which healthy young volunteers (total N = 252) either received a single oral dose doxycycline (200 mg, n = 126) or placebo (n = 126) in a between-subject design. We found no evidence for a detrimental effect of doxycycline on declarative memory; instead, doxycycline improved declarative learning (p-value=0.022, Cohen's d=0.15) and memory consolidation (p=0.040, d=0.26). Contrarily, doxycycline slightly reduced motor learning (p=0.001, d=0.10) but subtly strengthened long-term motor memory (p=0.001, d=0.10). These results suggest that doxycycline can improve declarative learning and memory without having long term negative effects on other cognitive domains in healthy humans. Our results give hope to further investigate doxycycline in neuroprotective treatment applications.

Hyperhomocysteinemia and its effect on ageing and language functions – HEAL study

Hyperhomocysteinemia or high levels (> 15 µmol/L) of homocysteine (Hcy)in the blood has been suggested to affect the brain through vascular and neurodegenerative pathways and potentially impact cognition. The current study aims to explore the association of high homocysteine with cognition and brain volume changes in a cohort of middle and old agedr adults. The study recruited 1296 participants aged ≥ 45 years from Tata Longitudinal Study of Ageing (TLSA), an ongoing cohort study. The participants underwent detailed cognitive assessments using Addenbrooke’s Cognitive Examination-III (ACE-III) and Computerized Assessment of Adult Information Processing (COGNITO) neuropsychological battery and MR imaging using a 3T scanner. The participants were classified based on the median homocysteine level (16.89 µmol/L) into low Hcy (≤ median) and high Hcy (> median) groups. When adjusted for age, gender, years of education, vitamin B12, folate and dyslipidaemia, Generalised Linear Model (GLM) found a significant association of high Hcy with vocabulary task [β (95% CI) − 1.354 (− 2.655, − 0.052); p = 0.041]. Significant associations was also obtained between cerebral white matter volume and high Hcy [β (95% CI) − 5617.182 (− 11062.762, − 173.602); p = 0.043]. The results suggest that people with high Hcy levels performed poorer in cognitive tasks related to language domain and had lesser cerebral white matter volume. This indicates that homocysteine might have a profound impact on brain structure as well as function.