Neuropsychological Effects Research Articles

Effects of Animal-Assisted Therapy (AAT) in Alzheimer's Disease: A Case Study.

Alzheimer’s disease (AD) is a neurodegenerative disorder, characterized by cortical dementia and irreversibly progressive developments leading to a vegetative state and, finally, to death. Although many aspects of its etiology, diagnosis and treatment still remain obscure and the current approach to the disease mostly suffers from limited and low-efficiency therapeutic means, nevertheless, recent interventions have aimed at improving patients’ quality of life through nonpharmacological approaches, including animal-assisted therapy (AAT), arousing growing interest. In order to assess the physiological and neuropsychological effects of AAT on AD, 24 residents of a rest house in northern Italy were enrolled. The intervention consisted of one 45-minute AAT session per week over ten weeks. Twelve residents (six AD and six non-AD) received AAT and twelve (six AD and six non-AD) were controls. In order to evaluate the physiological and clinical effect of AAT on AD residents, three cardiac parameters, including the systolic and diastolic blood pressure and heart rate, were measured. Moreover, the neurocognitive and depressive states were assessed by the Mini Mental State Examination and the Geriatric Depression Scale, respectively. Analyses were performed by a four-way ANOVA model (including two ways for repeated measures) considering each main effect and interaction possible in the design. Our findings, despite the small sample size, suggest that AAT has a positive significant effect on physiological parameters and neurocognitive impairment, while no effect was observed on the depression level.

Antiseizure medication use and medical resource utilization after resective epilepsy surgery in children in the United States: A contemporary nationwide cross-sectional cohort analysis.

Antiseizure drug (ASD) therapy can significantly impact quality of life for pediatric patients whose epilepsy remains refractory to medications and who experience neuropsychological side effects manifested by impaired cognitive and social development. Contemporary patterns of ASD reduction after pediatric epilepsy surgery across practice settings in the United States are sparsely reported outside of small series. We assessed timing and durability of ASD reduction after pediatric epilepsy surgery and associated effects on health care utilization. We performed a retrospective analysis of 376 pediatric patients who underwent resective epilepsy surgery between 2007 and 2016 in the United States using the Truven MarketScan database. Filled ASD prescriptions during the pre- and postoperative periods were compared. Univariate and multivariate analyses identified factors associated with achieving a stable discontinuation of or reduction in number of ASDs. Health care utilization and costs were systematically compared. One hundred seventy-one patients (45.5%) achieved a >90-day ASD-free period after surgery, and 84 (22.3%) additional patients achieved a stable reduction in number of ASDs. Achieving ASD freedom was more common in patients undergoing total hemispherectomy (n=21, p=.002), and less common in patients with tuberous sclerosis (p=.003). A higher number of preoperative ASDs was associated with a greater likelihood of achieving ASD reduction postoperatively (hazard ratio [HR]: 1.85, 95% confidence interval [CI]: 1.50-2.28), but was not associated with a significant difference in the likelihood of achieving ASD freedom (0.83, 95% CI: 0.49-1.39). Achieving an ASD-free period was associated with fewer hospital readmissions within the first year after surgery. Patterns of ASD use and discontinuation after pediatric epilepsy surgery provide an unbiased surgical outcome endpoint extractable from administrative databases, where changes in seizure frequency are not captured. This quantitative measure can augment traditional surgical outcome scales, incorporating a significant clinical parameter associated with improved quality of life.

Neuropsychological effects in children exposed to anticonvulsant monotherapy during gestation: Phenobarbital, carbamazepine, and phenytoin

ObjectiveUsage during pregnancy of the antiseizure medication (ASM), phenobarbital (PB), carbamazepine (CBZ), and phenytoin (PHT), has been associated with adverse pregnancy outcomes. While morphological effects on offspring are well-documented, inconsistent findings have been reported on neuropsychological development, possibly due to differences in attention to maternal demographics, and other design characteristics. Herein, we report the results of a carefully designed protocol used to examine the effects of gestational monotherapy with PB, CBZ, or PHT upon children’s general mental abilities, when compared to age- and gender- matched children born to unexposed women of similar age, education, and socioeconomic status. MethodsFor each ASM, we selected qualifying cases from children born to PB, CBZ, or PHT monotherapy-exposed and unexposed women. Following the application of inclusion, exclusion, and matching criteria, our sample included 34 PB-exposed, 40 PHT-exposed, and 41 CBZ-exposed children along with matched unexposed children for each drug group. Criteria were applied through examination of maternal medical and educational histories, parental socioeconomic characteristics, and child’s age and gender. Each child’s physical and neuropsychological characteristics were examined, using standardized protocols. We report on the cognitive performance of the children as assessed by the Wechsler Intelligence Scale for Children – III (WISC-III), the leading measure of mental ability in the U.S. ResultsAn overall mixed model ANOVA of the adjusted performance of the children across all groups controlling for maternal IQ revealed significant effects on verbal IQ, but not full-scale IQ or performance IQ. In the individual drug and unexposed group comparisons, only reduced verbal and full-scale IQ scores in PB-exposed versus matched unexposed children were found. Comparisons between drug groups revealed a significant reduction in verbal IQ and full-scale IQ in PB-exposed versus PHT-exposed children, but not in other drug–drug comparisons. SignificanceThese results demonstrate effects on children’s mental ability due to prenatal PB exposure, such that analyses adjusted for maternal IQ scores, revealed reduced verbal mental abilities and reduced full-scale IQ scores when scores in exposed children were compared to scores from children of the same age and sex born to demographically similar, healthy unexposed women. When comparisons were made between drug groups, children exposed prenatally to PB performed significantly worse than prenatally PHT-exposed children, but CBZ-exposed children’s scores were not significantly different from those of PB or PHT-exposed groups. In light of shared effects on structural teratogenicity, these findings suggest that use of PB monotherapy for the management of seizures during pregnancy may be associated with increased risk in comparison to PHT when neurobehavioral functioning is considered, and that only PB-exposed children have reduced performance compared to matched controls. Attention to these effects is critical in the developing world where use of these older medications remains predominant, and prudent choices can be made to reduce impact on cognitive development.

Default mode network connectivity and attention-deficit/hyperactivity disorder in adolescence: Associations with delay aversion and temporal discounting, but not mind wandering

BackgroundAttention-deficit/hyperactivity disorder (ADHD) has been associated with reduced resting state connectivity in the core subsystem of the default mode network (DMN; medial prefrontal cortex – posterior cingulate cortex). However, the neuropsychological consequences of this hypoconnectivity remain to be determined. Building on recent theoretical models of DMN function, we tested the association between DMN hypo-connectivity and three neuropsychological processes previously implicated in ADHD: (i) excessive task-unrelated spontaneous thought (i.e., mind-wandering); (ii) sub-optimal decision-making due to exaggerated temporal discounting; and (iii) delay aversion – a heightened emotional response to the imposition or experience of delay. MethodsTwenty male adolescents with a clinical diagnosis of ADHD and 18 typically developing adolescents (all aged 11–16 years) underwent a resting-state fMRI scan to assess DMN connectivity. An experimental paradigm was used to assess temporal discounting and self-report questionnaires were used to measure mind wandering and delay aversion. ResultsADHD was significantly associated with DMN hypo-connectivity specifically in the core subsystem, elevated levels of mind-wandering, delay aversion, and temporal discounting. Mediation analysis suggested that DMN hypoconnectivity mediated the link between ADHD and delay aversion. ConclusionThe results provide initial evidence that disturbances in the DMN may impair ability to regulate delay-related negative affect in adolescents with ADHD.

Neuropsychological Effects and Cognitive Deficits Associated with Exposure to Mercury and Arsenic in Children and Adolescents of the Mojana Region, Colombia

Neuropsychological Effects and Cognitive Deficits Associated with Exposure to Mercury and Arsenic in Children and Adolescents of the Mojana Region, Colombia

Early Life Quality on Instrumental, Daily and Neuropsychological Activities of Lewy Body Disease about 70 Patients in the Geriatric Department at the Pitié Salpêtrière Hospital of Paris, France

Background: Lewy body disease (LBD) is a neurodegenerative affection responsible for impaired quality of life. The objective was to share the data experience of 14 years concerning the functional, neuropsychological and behaviors effects on geriatrics patients. Methodology: Descriptive retrospective study over 14 years (2005 to 2019) in the geriatrics department of Pitié Salpétrière Hospital, using the instrumentals activity of daily living (IADL) sheets and the neuropsychological inventory (NPI) assessed at the moment diagnosis according to the diagnostic criteria of 2017 and 1996. Results: A total of 70 patients including 55 exploitable files had been listed with a mean age 82.6 years [70 - 91], a sex ratio 1.2 in men favor, a mean socio-cultural level 5.2 [1 - 7], a mean Cumulating Illness Scale (CIRS52) = 10 [1 - 22]. The mean IADL and NPI were respectively 9.3 [3 - 11] and 25.1 [0 - 79]. We found an early global impairment of IADL activities frequent in transport (65%), medication management (49%), and displacement (42%) for basic activities without significant statistical difference between the age and sex groups but statistically significant early involvement with polypathology after adjustment for displacement (45%) and transport (65%). The IADL impairment is significant as soon as the MMS-BREF decreases. Hoen Yahr (HY) scale increase could influences shopping (22%), displacement (27%) after adjustment. NPI disorders frequently found were apathy-depression (31.8% - 25%), anxiety (28%), irritability (25.6%) and sleep disturbance (22.9%) after 80 years old independently of gender and poly-pathology. Also, the best mental status was associated of less disturbance of NPI items. Conclusion: Polypathology, motor disorders and cognitive decline seem to influence IADL while with advanced age, cognitive decline appears to be worsened early in LBD.

The relationship of carotid artery disease with mental and neurocognitive disorders

Carotid stenosis constitutes a common vascular disease that significantly affects cerebral blood flow and thus is associated with patients' cognitive functions. Carotid revascularization techniques [carotid endarterectomy (CEA) and carotid artery stenting (CAS)] may benefit cognition, though there are opposing findings, reporting an apparent decrement in cognitive function, no effect, or an apparent improvement after revascularization. A great number of studies are trying to evaluate the effect of carotid revascularization (CEA, CAS) on patients' cognitive functions, as well as on their psychological condition and quality of life through a baseline and follow-up neuropsychological examination. Recent reviews refer only to the narrow limits of cognitive deficits that may be attributed to carotid stenosis, rather than elucidating the outfit of all aspects of mental and cognitive correlations. Most of those findings depict controversy in current literature as far as the neuropsychological effects of carotid revascularization techniques are concerned, while clinical entities of "vascular dementia" and "vascular depression", as well as intercurrent vascular risk factors are also addressed. This might be taken into consideration, when determining the optimal therapeutic strategy for tackling carotid artery occlusive disease, while best practice clinical decisions should be still focused on stroke prevention and symptoms alleviation, until further research on the field of neuroangiology presents undisputable conclusions regarding the underlying effects of revascularization on mood and cognition. Τhe neurovascular interface, as far as mental and neurocognitive impact of carotid stenosis is concerned, also, comprises, the conceptual pathophysiological entity of "atheroinflammation", underscoring the association of vascular lesions with cognitive impairment, major depressive disorder and bipolar disorder. Chronic recurrent ischemia and chronic low perfusion are also addressed from neurocognitive aspect, regarding therapeutic strategies that might be preferred so as to reduce the burden of chronic cerebrovascular disease in both symptomatic and asymptomatic patients, given the fact that inflammatory processes of vascular complexion underlie both neuroinflammation and atherosclerosis, affecting cerebral perfusion as well as cortical blood flow.

Impact of post-stroke cognitive dysfunction on driving ability

The paper aims to present the current views on the impact of post-stroke cognitive deficits on driving ability, and diagnostic assessment practices in this area. Firstly, the neuropsychological consequences of stroke are briefly presented. This part focuses specifically on visuospatial and executive dysfunctions. Among those dysfunctions, unilateral neglect, especially as it is frequently associated with anosognosia, may have the greatest impact on driving ability, leading to an increased accident risk. Then, different approaches to assessing fitness to drive after stroke are presented, including on-road testing, testing with the use of simulator, and clinical assessment focusing on cognition. The role of cognitive assessment in predicting fitness to drive is described in more detail. The Clock Drawing Test is the most appropriate screening measure in this context, as it engages both visuospatial and executive functions. The Trail Making Test is the most popular working memory test in the context of drivers’ assessment, as it requires visual search and psychomotor speed. The Rey Complex Figure Test is another commonly used test. It requires visuospatial and executive functions, and may also serve as a measure of visuospatial memory. Finally, the legal aspects of the assessments are discussed with reference to the practices used in Great Britain, Belgium, Sweden, and Germany. In Poland, there are no detailed standards for post-stroke fitness-to-drive assessment.

Neuropsychological Profile in Pediatric Migraine without Aura: A Pilot Study.

Despite the high prevalence of headache in developmental age, current reports about its neuropsychological effects are still lacking. The aim of the present pilot study is to assess the neuropsychological skills among children affected by migraine without aura (MwoA). Fifteen children (7M/8F) (mean age 10.73 ± 2.13) with MwoA, consecutively referred to the Center for Childhood Headache at Università degli Studi della Campania “Luigi Vanvitelli”, underwent the Italian version of the NEPSY-2 after cognitive evaluation. Moreover, to assess the pain level and disability grade during daily activity, the VAS and PedMIDAS scales were used. MwoA children were comparable with the control group of 38 children with respect to age, gender, language, and education level. Written informed consent was obtained from all parents and from children directly, when appropriate. MwoA children differed from controls significantly among the NEPSY-2 subscales, with a relevant relationship between the frequency and intensity of the attacks. In conclusion, the results of the present pilot study may suggest that MwoA could impact significantly neuropsychological functioning in children.

Predictive factors of postoperative outcome in the elderly after resective epilepsy surgery

ObjectiveTo evaluate the efficiency of resective epilepsy surgery (RES) in patients over 50 years and determine prognostic factors. ResultsOver the 147 patients over 50 years (54.9±3.8 years [50–69]) coming from 8 specialized French centres for epilepsy surgery, 72.1%, patients were seizure-free and 91.2% had a good outcome 12 months after RES. Seizure freedom was not associated with the age at surgery or duration of epilepsy. In multivariate analysis, seizure freedom was associated with MRI and neuropathological hippocampal sclerosis (HS) (P=0.009 and P=0.028 respectively), PET hypometabolism (P=0.013), temporal epilepsy (P=0.01). On the contrary, the need for intracranial exploration was associated with a poorer prognosis (P=0.001). Postoperative number of antiepileptic drugs was significantly lower in the seizure-free group (P=0.001). Neurological adverse event rate after surgery was 21.1% and 11.7% of patients had neuropsychological adverse effects overall transient. ConclusionsRES is effective procedure in the elderly. Even safe it remains at higher risk of complication and population should be carefully selected. Nevertheless, age should not be considered as a limiting factor, especially when good prognostic factors are identified.

Abstract 13811: Cognitive and Psychological Outcomes of Patients 6 Months After Cardiac Arrest or Intensive Care Stay

Background: The neuropsychological and cognitive consequences of an ICU stay can cause a large burden on many patients. In this study, we assessed the outcomes of a group of patients attending a newly set up, multi-disciplinary outpatient clinic focused on assessing neuropsychological and cognitive outcomes following a significant (>72 hours) ICU stay, and compared patients whose ICU was post-OHCA (out of hospital cardiac arrest), and those non-OHCA. Methods: Between 2016 and 2019, 152 patients were assessed within the Care after REsuscitation (CARE) / ICU follow up clinic, 6 months following hospital discharge, using the SF-36, HADS, PTSS-14 and MoCA. The OHCA group were compared to other non-OHCA, ICU patients (>72 hour stay). Results: No significant differences (p<0.05) were found between the groups outcomes, however we found that 6 months post-discharge, the non-OHCA group experience significantly more pain, are older, and required a longer length of stay (p<0.05). However, we found compared to normative data of the SF-36, over half of the OHCA group (on 6 out of the 8 subscales) and the non-OHCA (on 7 out of the 8) were below population norms, especially Role-Physical (66.7% OHCA and 71.6% non-OHCA) and Energy/ fatigue (66.7% OHCA and 61.4% non-OHCA). Anxiety was observed in 33.3% of the OHCA group, and 35.2% of the non-OHCA group had an abnormal total HADS score. PTSD was seen in 12.7% of the OHCA group and 10.2% of the non-OHCA group. Cognitive impairment was observed in 61.9% of OHCA and 59.1% of non-OHCA patients. Age and hospital length of stay had no significant effect on outcomes on our OHCA population, however females had significantly worse health related quality of life (HRQoL) on 6 out of the 8 subscales (p<0.05). Conclusion: Despite the OHCA and non-OHCA groups having no significant difference between their outcomes, there is a great disease burden upon many individuals following ICU stay, with many experiencing poor HRQoL, mood disorders, PTSD and cognitive impairment. The factors contributing to poor outcome following both ICU related illness and cardiac arrest should be further studied. The creation and validation of new assessment tools is imperative to ensure we fully appreciate the extent of the morbidity in this group to improve care for all ICU patients.

P.083 Early and 30-day clinical and neuropsychological effects of iatrogenic brain infarcts in the ENACT randomized-controlled trial

Background: Small brain infarcts are often seen on diffusion-weighted MRI(DWI) following surgical/endovascular procedures. Little is known about their clinical effects. We examined the association of iatrogenic infarcts with outcomes in the ENACT(Evaluating Neuroprotection in Aneurysm Coiling Therapy) trial of nerinetide in endovascular aneurysm repair. Methods: In this post-hoc analysis, we used multi-variable models to evaluate the association of presence/number of DWI iatrogenic infarcts with NIHSS(National Institutes of Health Stroke Scale), mRS(modified Rankin Scale), and cognitive/neuropsychological scores(30-minute battery) at 1-4 and 30-days post-procedure. We also related infarct number to a Z-score-derived composite outcome score(quantile regression). Results: Among 185 patients(median age:56,IQR:50-64), 124(67.0%) had iatrogenic infarcts(median:4,IQR:2-10.5). Nerinetide resulted in fewer infarcts. Patients with infarcts had lower Mini-Mental State Exam(MMSE) scores at 2-4 days(median:28 vs 29, adjusted-coefficient[acoef] per additional infarct:-1.11,95%CI:-1.88 to -0.34,p=0.005). Infarct number was associated with worse day-1 NIHSS(aOR for NIHSS≥1:1.07,1.02-1.12,p=0.009), day 2-4 mRS(adjusted common odds-ratio[aOR]:1.05,1.01-1.09,p=0.005) and MMSE(acoef:-0.07,-0.13 to -0.003,p=0.040), 30-day mRS(aOR:1.04,1.01-1.07,p=0.016) and Hopkins Verbal Learning Test scores(acoef:-0.21,-0.39 to -0.03,p=0.020), as well as worse composite scores at 1-4 and 30-days(acoef:-0.09,-0.15 to -0.03,p=0.006). Conclusions: Iatrogenic infarcts were associated with subtle differences in post-procedural(1-4 days) and 30-day outcomes in this middle-aged cohort. Future studies should use batteries of similar/greater granularity to validate optimal measures for short- versus long-term manifestations.

Prospective Neurocognitive Functions of Patients Treated With Concurrent Nivolumab and Stereotactic Brain Radiosurgery for NSCLC and RCC Brain Metastases

Previous studies have suggested activity of anti-PD1 antibodies against brain metastases from non-small cell lung cancer (NSCLC) and renal cell cancer (RCC). Our investigator-initiated phase 2 trial examined the neuropsychological effect of combining nivolumab with radiosurgery (SRS) in the treatment of patients with brain metastases from NSCLC and RCC.This is a multicenter open-label trial (NCT02978404) in which patients diagnosed with NSCLC or RCC, having ≤ 10 cc of un-irradiated brain metastases, no prior whole brain radiotherapy and no prior immunotherapy were eligible. Study treatment commenced with a dose of nivolumab (240mg or 480mg IV), which was continued until progression for up to 2 years at bi-weekly or monthly intervals. SRS (15-21 Gy) to all visible un-irradiated brain lesions was administered within 14 days of the first dose of nivolumab (cycle 1). Patients were followed by brain MRI and CT scans of the chest, abdomen and pelvis. Neurocognitive assessment was performed using the Hopkins verbal learning test-revised (HVLT-R), the Trail Making Test (TMT) and the Controlled Oral Word Association Test (COWA) RESULTS: 26 study patients (22 NSCLC and 4 RCC) were enrolled between Aug 2017 and January 2020. Patients had a median of 2 (1-9) brain metastases treated with SRS. The median diagnosis-specific graded prognostic assessment (GPA) score was 2 (1-3). Forty-two percent of the patients had received prior cytotoxic chemotherapy, and 1 patient had received prior brain SRS. PD-L1 status was known for 21 of the 22 NSCLC patients (12 with ≥50% PD-L1 expression (DAKO 22C3)). Median icPFS was 5.0 months (6 intracranial progressions and 9 deaths without progression in the brain). Accounting for death as a competing risk, the 1-year cumulative incidence of intracranial relapse was 20%, whereas the rate of extracranial relapse was 48.3% at 1-year. Median overall survival was 14 months. Neuropsychological evaluation was completed in 16 and 9 patients at 3 and 6-month follow-up, respectively. Median age of the 16 patients was 63 (46-77). At 3 months follow up, there was no significant difference on the patient's mean performance in any of the neurocognitive assessments; a deterioration of ≥1 standard deviation in at least 1 assessment from baseline was observed in 8 (50%) patients. At 6 months, participants significantly improved on the TMT- Parts A (P = 0.04) and Parts B (P = 0.03).Neurocognitive assessments suggest that upfront SRS concurrent with nivolumab PD1 inhibition is safe. Patient neurocognitive function showed potential improvements in patients able to complete 6-month assessments. A potential synergy between nivolumab and SRS loco-regionally within the brain may be present, leading to high intracranial control. However, the high rate of extracranial progression does not suggest an abscopal effect triggered by SRS during nivolumab.G.L. Masucci: Research Grant; BMS.O. Boucher: None. F. Marie: None. M. Plourde: None. V. Panet-Raymond: None. M. Pavic: None. S. Owen: None. L. Masson-Cote: None. C. Menard: Research Grant; Siemens Healthcare, Philips, Progenics, Varian. B. Routy: None. M. Tehfe: None. N. Blais: consultant; BMS.D. Roberge: Independent Contractor; CHUM, CDL Proton Therapy. Research Grant; Elekta. Honoraria; BrainLab, Varian Medical Systems, Siemens Medical Systems, EMD Serono, recordati. In-kind Donation; Accuray. ownership stake; afx, croton healthcare. P. Wong: Research Grant; BMS, AstraZeneca, NexPlasmaGen. Advisory Board; BMS, AstraZeneca. Travel Expenses; BMS, AstraZeneca.

Brain Injury and Mental Health Among the Victims of Intimate Partner Violence: A Case-Series Exploratory Study.

Intimate partner violence (IPV) survivors frequently report face, head, and neck as their injury site. Many mild traumatic brain injuries (TBIs) are undiagnosed or underreported among IPV survivors while these injuries may be linked to changes in brain function or pathology. TBI sustained due to IPV often occurs over time and ranges in severity. The aim of this case-series study was to explore risk factors, symptoms, and brain changes unique to survivors of intimate partner violence with suspicion of TBI. This case-series exploratory study examines the potential relationships among IPV, mental health issues, and TBI. Participants of this study included six women: 3 women with a history of IPV without any experience of concussive blunt force to the head, and 3 women with a history of IPV with concussive head trauma. Participants completed 7T MRI of the brain, self-report psychological questionnaires regarding their mental health, relationships, and IPV, and the Structured Clinical Interview. MRI scans were analyzed for cerebral hemorrhage, white matter disturbance, and cortical thinning. Results indicated significant differences in resting-state connectivity among survivors of partner violence as well as differences in relationship dynamics and mental health symptoms. White matter hyperintensities are also observed among the survivors. Developing guidelines and recommendations for TBI-risk screening, referrals, and appropriate service provision is crucial for the effective treatment of TBI-associated IPV. Early and accurate characterization of TBI in survivors of IPV may relieve certain neuropsychological consequences.

Neuropsychological Functioning in Users of Serotonergic Psychedelics - A Systematic Review and Meta-Analysis.

Background: Serotonergic psychedelics (SPs) like LSD, psilocybin, DMT, and mescaline are a heterogeneous group of substances that share agonism at 5-HT2a receptors. Besides the ability of these substances to facilitate profoundly altered states of consciousness, persisting psychological effects have been reported after single administrations, which outlast the acute psychedelic effects. In this review and meta-analysis, we investigated if repeated SP use associates with a characteristic neuropsychological profile indicating persisting effects on neuropsychological function.Methods: We conducted a systematic review of studies investigating the neuropsychological performance in SP users, searching studies in Medline, Web of Science, embase, ClinicalTrials.gov, and EudraCT. Studies were included if they reported at least one neuropsychological measurement in users of SPs. Studies comparing SP users and non-users that reported mean scores and standard deviations were included in an exploratory meta-analysis.Results: 13 studies (N = 539) published between 1969 and 2020 were included in this systematic review. Overall, we found that only three SPs were specifically investigated: ayahuasca (6 studies, n = 343), LSD (5 studies, n = 135), and peyote (1 study, n = 61). However, heterogeneity of the methodological quality was high across studies, with matching problems representing the most important limitation. Across all SPs, no uniform pattern of neuropsychological impairment was identified. Rather, the individual SPs seemed to be associated with distinct neuropsychological profiles. For instance, one study (n = 42) found LSD users to perform worse in trials A and B of the Trail-Making task, whereas meta-analytic assessment (5 studies, n = 352) of eleven individual neuropsychological measures indicated a better performance of ayahuasca users in the Stroop incongruent task (p = 0.03) and no differences in the others (all p > 0.05).Conclusion: The majority of the included studies were not completely successful in controlling for confounders such as differences in non-psychedelic substance use between SP-users and non-users. Our analysis suggests that LSD, ayahuasca and peyote may have different neuropsychological consequences associated with their use. While LSD users showed reduced executive functioning and peyote users showed no differences across domains, there is some evidence that ayahuasca use is associated with increased executive functioning.

Effect of landscape design elements on promoting neuropsychological health of children

The environmental design of built spaces can have neuro-psychological effects on humans. The design of hospital environments, especially for children, is probably more important than the other spaces because children are mentally more vulnerable than other social groups. This research aimed to examine the children's and therapists' views and perceptions on the effect of a children's hospital's landscape design elements to improve their neuropsychological health during their treatment period. Sixty sick children and 60 hospital staff (therapists) evaluated landscape images and responded to a questionnaire. Both respondent groups believed in the positive effects of landscape elements on all children's neuropsychological indices, including the increased emotional index, increased cognitive index, and reduced non-symptoms index. Both respondent groups firstly preferred children's features and secondly, water features. These preferences positively affected many neuropsychological indices of sick children. However, children chose water features as their priority, which positively affected sick children's relaxation. However, this view was not consistent with their therapists' views. The children and their therapists were also not in agreement on the impact of other landscape elements (trees, flowers, ground cover plants, turfgrasses, and mulch) on many neuropsychological indices of sick children. Therefore, based on this research, children's therapists cannot be good representatives for their psychological perceptions about the hospital's landscape elements when a direct assessment of children's perceptions is almost impossible. This research has practical recommendations for landscape professionals around the world on the sustainable design of therapeutic landscapes.

A-153 Neuropsychological Effects Assessed Using WISC-IV and WISC-V

Abstract Objective This review explores The Weschler Intelligence Scale for Children – Fourth Edition (WISC-IV) and the Weschler Intelligence Scale for Children – Fifth Edition (WISC-V) administered to children with various medical histories including traumatic brain injury, vascular conditions, brain tumor, epilepsy, strokes, sickle cell disease, down syndrome, and neurotoxicity on neurodevelopment. This review aims to explore neuropsychological effects of these medical conditions derived from final scores and scale comparisons. Data Selection Peer-reviewed studies between 2000 and 2020 were gathered from EBSCO, Google Scholar, and Science Direct. Criteria was limited to neurological conditions present in children, who were required to be assessed using either WISC-IV or WISC-V. Children with other developmental or learning disabilities were excluded. Data on Weschler Adult Intelligence Scale (WAIS) were excluded along with any other assessment administered to children. Thirteen articles were included based on the criteria along with two articles that discuss the validity of WISC. Data Synthesis The components of the WISC-IV or WISC-V demonstrated low average or below average scores on many scales, especially overall FSIQ. The largest impairments were present in Processing Speed Index, Verbal Comprehension Index, Working Memory Index, Visual Spatial Index, and overall FSIQ. All children assessed with preexisting neurological conditions demonstrated deficits in neuropsychological domains. The severity of the neurological condition significantly impacted scores when compared to children with no conditions. Conclusions The administration of WISC-IV and WISC-V demonstrated neuropsychological and functioning impairments in children with preexisting neurological conditions. The assessment successfully identified deficit areas and earlier testing can encourage earlier treatments.

Psychological Distress in Intracranial Neoplasia: A Comparison of Patients With Benign and Malignant Brain Tumours.

Objective: We aimed to assess psychological distress in patients with intracranial neoplasia, a group of patients who suffer from severe functional, neurocognitive and neuropsychological side effects, resulting in high emotional distress.Methods: We conducted a cross-sectional study, including inpatients with brain tumours. Eligible patients completed validated self-report questionnaires measuring depression, anxiety, distress, symptoms of posttraumatic stress disorder (PTSD), fear of progression and health-related quality of life. The questionnaire set was completed after brain surgery and receiving diagnosis and before discharge from hospital.Results: A total of n = 31 patients participated in this survey. Fourteen of them suffered from malignant (n = 3 metastatic neoplasia) and 17 from benign brain tumours. Mean values of the total sample regarding depression (M = 9.28, SD = 6.08) and anxiety (M = 6.00, SD = 4.98) remained below the cut-off ≥ 10. Mean psychosocial distress (M = 16.30, SD = 11.23, cut-off ≥ 14) and posttraumatic stress (M = 35.10, SD = 13.29, cut-off ≥ 32) exceeded the clinically relevant cut-off value in all the patients with intracranial tumours. Significantly, more patients with malignant (79%) than benign (29%) brain tumours reported PTSD symptoms (p = 0.006).Conclusion: Distress and clinically relevant PTSD symptoms in patients with intracranial neoplasia should be routinely screened and treated in psycho-oncological interventions immediately after diagnosis. Especially, neuro-oncological patients with malignant brain tumours or metastases need targeted support to reduce their emotional burden.

Neuropsychological effects of direct-acting antiviral treatment for Hepatitis C virus subjects: A systematic review.

Direct-acting antivirals (DAAs) have been approved in recent years to treat patients infected by the Hepatitis C virus (HCV). The DAAs treatment is well tolerated and increases sustained virological responses, but there is no consensus about the neuropsychological functioning related to the treatment. This systematic review aims to provide an overview of the recent findings exploring the cognitive effects of DAAs treatment in patients with HCV. After a systematic search on PubMed, Embase, Scopus and LILACS, studies that assessed neuropsychological data related to DAAs treatment were included. We found nine articles, considering the inclusion and exclusion criteria. Three other manuscripts were included after searching for the references listed in the previously mentioned articles. We observed methodological heterogeneity in terms of neuropsychological tests used, cognitive domain explored and the sample characteristic presented between the studies. Studies presented data from HCV subjects monoinfected with or without cirrhosis, advanced liver disease and post-transplant patients; and HCV subjects coinfected with human immunodeficiency virus (HIV). Most results from the 12studies that explored the effect of DAAs treatment in HCV subjects' neurocognitive functioning demonstrated cognitive improvement following treatment. In general, HCV and HCV/HIV subjects improved processing speed, verbal fluency and verbal/visual episodic memory. The DAAs treatment is effective for neurocognitive functioning in HCV monoinfected and coinfected subjects, with or without advanced liver disease, since neuropsychological scores increased after treatment. Further studies, however, are needed to confirm these findings.

Effects of Virtual Reality-Based Cognitive Training in the Elderly with and without Mild Cognitive Impairment.

ObjectiveThis study aimed to introduce a 4-week long fully immersive virtual reality-based cognitive training (VRCT) program that could be applied for both a cognitively normal elderly population and patients with mild cognitive impairment (MCI). In addition, we attempted to investigate the neuropsychological effects of the VRCT program in each group. MethodsA total of 56 participants, 31 in the MCI group and 25 in the cognitively normal elderly group, underwent eight sessions of VRCT for 4 weeks. In order to evaluate the effects of the VRCT, the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet was administered before and after the program. The program’ s safety was assessed using a simulator sickness questionnaire (SSQ), and availability was assessed using the presence questionnaire. ResultsAfter the eighth session of the VRCT program, cognitive improvement was observed in the ability to learn new information, visuospatial constructional ability, and frontal lobe function in both groups. At the baseline evaluation, based on the SSQ, the MCI group complained of disorientation and nausea significantly more than the cognitively normal elderly group did. However, both groups showed a reduction in discomfort as the VRCT program progressed. ConclusionWe conclude that our VRCT program helps improve cognition in both the MCI group and cognitively normal elderly group. Therefore, the VRCT is expected to help improve cognitive function in elderly populations with and without MCI.