Neuropsychological Factors Research Articles

Prefrontal event-related potential markers in association with mild cognitive impairment.

Alzheimer's disease (AD) is among the leading contributors of dementia globally with approximately 60-70% of its cases. Current research is focused on the mild cognitive impairment (MCI), which is associated with cognitive decline but does not disrupt routine activities. Event-related potential (ERP) research is essential in screening patients with MCI. Low-density channel electroencephalography (EEG) is frequently used due to its convenience, portability, and affordability, making it suitable for resource-constrained environments. Despite extensive research on neural biomarkers for cognitive impairment, there is a considerable gap in understanding the effects on early stages of cognitive processes, particularly when combining physiological and cognitive markers using portable devices. The present study aimed to examine cognitive shortfalls and behavioral changes in patients with MCI using prefrontal selective attention ERP recorded from a prefrontal two-channel EEG device. We assessed cognitive decline using the Mini-Mental State Examination (MMSE) and the Seoul Neuropsychological Screening Battery (SNSB). We administered auditory selective attention tasks to 598 elderly participants, including those with MCI (160) and cognitively normal (CN) individuals (407). We conducted statistical analyses such as independent t-tests, Pearson's correlations, and univariate and multiple logistic regression analyses to assess group differences and associations between neuropsychological tests, ERP measures, behavioral measures, and MCI prevalence. Our findings revealed that patients with MCI demonstrated slower information-processing abilities, and exhibited poorer task execution, characterized by reduced accuracy, increased errors, and higher variability in response time, compared to CN adults. Multiple logistic regression analyses confirmed the association between some ERP and behavioral measures with MCI prevalence, independent of demographic and neuropsychological factors. A relationship was observed between neuropsychological scores, ERP, and behavioral measures. The slower information processing abilities, and poor task execution in the MCI group compared to the CN individuals suggests flawed neurological changes and reduced attentional maintenance during cognitive processing, respectively. Hence, the utilization of portable EEG devices to capture prefrontal selective attention ERPs, in combination with behavioral assessments, holds promise for the identification of mild cognitive deficits and neural alterations in individuals with MCI. This approach could potentially augment the traditional neuropsychological tests during clinical screening for MCI.

AGR - 2 Colloid Cyst: Underrecognized Neuropsychological Sequalae of a Neurosurgical Diagnosis.

Colloid cysts are a benign, fluid-filled collection often found in the rostral third ventricle at/near the foramen of Monro, accounting for 0.5-2% of all brain tumors. Modifying factors of neurocognition include: resultant hydrocephalus, mass effect, as well as size, location and laterality of cyst. The modality of neurosurgical intervention/approach also impacts the risk of post-operative neurocognitive morbidity. This grand rounds presentation reviews relevant literature - anchored by our own research - highlighting neuropsychological assessment considerations and possible interventional strategies in order to enhance outcomes in patients with colloid cyst. Neuropsychological test data evaluating 20 patients who underwent neuropsychological assessment pre- and post-endoscopic removal of a colloid cyst are discussed. Comprehensive testing included gold-standard metrics of attention, executive functioning, learning, memory, visuospatial abilities, language, motor, and mood. Neuroimaging data, surgical parameters and pre and post-neurosurgical neuropsychological test data are also presented on all patients. Additionally, a small subset of patients were evaluated post-computerized cognitive remediation to establish treatment efficacy. For each variable, a paired t-test was performed between the pre- and post-operative z-score. Only one sub-score evinced a statistically significant change post-operatively (p = 0.037), with Stroop Color-Word score improving from pre-surgical baseline. No other metric or analyzed sub-score reached statistical significance. Though obtained findings argue against post-operative declines, a variety of neuroanatomical, neurosurgical, neuropsychological, and behavioral factors underscore the need for a coordinated, multi-disciplinary approach to continuity of care in this patient population, as well as others with non-cancerous brain tumors and/or cysts.

Phenotyping Pain in Patients With Fibrous Dysplasia/McCune-Albright Syndrome.

Pain is a poorly managed aspect in fibrous dysplasia/McCune-Albright syndrome (FD/MAS) because of uncertainties regarding the clinical, behavioral, and neurobiological underpinnings that contribute to pain in these patients. Identify neuropsychological and neurobiological factors associated with pain severity in FD/MAS. Prospective, single-site study. Twenty patients with FD/MAS and 16 age-sex matched healthy controls. Assessments of pain severity, neuropathic pain, pain catastrophizing (pain rumination, magnification, and helplessness), emotional health, and pain sensitivity with thermal quantitative sensory testing. Central nervous system (CNS) properties were measured with diffusion tensor imaging, structural magnetic resonance imaging, and functional magnetic resonance imaging. Questionnaire responses, detection thresholds and tolerances to thermal stimuli, and structural and functional CNS properties. Pain severity in patients with FD/MAS was associated with more neuropathic pain quality, higher levels of pain catastrophizing, and depression. Quantitative sensory testing revealed normal detection of nonnoxious stimuli in patients. Individuals with FD/MAS had higher pain tolerances relative to healthy controls. From neuroimaging studies, greater pain severity, neuropathic pain quality, and psychological status of the patient were associated with reduced structural integrity of white matter pathways (superior thalamic radiation and uncinate fasciculus), reduced gray matter thickness (pre-/paracentral gyri), and heightened responses to pain (precentral, temporal, and frontal gyri). Thus, properties of CNS circuits involved in processing sensorimotor and emotional aspects of pain were altered in FD/MAS. These results offer insights into pain mechanisms in FD/MAS, while providing a basis for implementation of comprehensive pain management treatment approaches that addresses neuropsychological aspects of pain.

THU220 Legal Degree Of Disability In Childhood-Craniopharyngioma Survivors After Follow-up - Results Of The Hit-Endo Study

Abstract Disclosure: S. Boekhoff: None. M. Eveslage: None. J. Beckhaus: None. C. Friedrich: None. H.L. Muller: None. Craniopharyngiomas are rare low-grade embryonic malformational tumors of the sellar/parasellar area. After a diagnosis during childhood and adolescence, endocrine and hypothalamic long-term sequalae affect the prognosis. Financial resources for psychological rehabilitation and involvement of craniopharyngioma survivors are made available by a legal status of the degree of disability (GdB), according to the German Social Code Book V. This study analyzed the relationship between clinical/psychosocial traits and quality of life (QoL) measures and the resulting GdB. The HIT-Endo study included pediatric craniopharyngioma patients (%lt;18 years of age at the time of diagnosis) and diagnosed before the year 2000. The GdB was evaluated in a cohort of 108 patients following a median follow-up time of 16 years. The GdB at follow-up was evaluated in relation to endocrine, ophthalmological, neuropsychological, and psychosocial factors. 44 patients (41%) did not receive a GdB, three patients (3%) received a GdB of 30-40, 43 patients (40%) a GdB of 50-90 and 18 patients (17%) the maximal GdB of 100. Higher GdB was associated with lower levels education, higher body mass index (BMI SDS), more severe visual impairment, and hypothalamic involvement of the tumor. Patients with a GdB of 100 reported impairments in social and occupational settings, as well as loss of physical and cognitive function, fatigue, dyspnea, and pain problems. In addition, they performed worse on the German Daily Life Ability Scale (FMH) than individuals with lower GdBs. The GdB reflects the long-term effects of craniopharyngioma during childhood and adolescence and is linked to physical and psychosocial problems. A low functional capacity, as measured by FMH scale, may indicate the eligibility for a higher GdB of craniopharyngioma survivors. Presentation: Thursday, June 15, 2023

Abstract PO-038: Metabolic-inflammatory investigation of head and neck cancer patient reported neuropsychological factors via multiomics integration of the plasma metabolome, lipidome, and circulating inflammation cytokines

Abstract Background: Neuropsychological factors (NPF) (i.e., fatigue, pain, cognitive dysfunction, depression, stress, and sleep disturbance) are common in head and neck cancer (HNC) and often cluster together. They can impair a patient’s functional status and quality of life and are an obstacle to effective treatment and a full recovery. Metabolism and inflammation may be underlying mechanisms but may work differently across HPV-related and unrelated HNC. We explored the joint interaction of metabolism, inflammation, and NPF via a stratified multiomics network analysis of the pretreatment plasma metabolome, lipidome, and inflammation cytokines across HPV-related and unrelated HNC. Methods: HNC patients completed validated symptom questionnaires (e.g., Multidimensional Fatigue Inventory, Patient Health Questionnaire-8, Perceived Stress Scale, Pittsburg Sleep Quality Index) and donated blood for untargeted (metabolome) and targeted (lipids and cytokines) assays prior to chemoradiotherapy. Metabolites and lipids were measured by liquid-chromatography high resolution mass spectrometry and the cytokines were measured via multiplex assays. A multiomics network analysis algorithm (xMWAS) plotted network graphs for HPV-related and unrelated HNC separately, by estimating pair-wise partial least squares correlations between the metabolites, lipids, cytokines, and NPF variables. To interpret each network, a multilevel community detection algorithm identified highly correlated clusters of variables, representing possible biological relatedness. Metabolic pathway analysis provided functional interpretation of the metabolite-lipid-cytokine-NPF clusters. Results: There were 82 subjects (59 years mean age, 72% male, 81% white, 48% HPV-related) in which, 186 metabolites, 78 lipids, 7 cytokines (C-reactive protein, Tumor necrosis factor-α, interleukin-1β, IL6, IL10, IL1 receptor antagonist, and TNF receptor-1) and 6 NPF were analyzed. We required a minimum correlation of 0.3 and P-value <0.05 to be included in the network. xMWAS modeled 525 correlations in HPV-related HNC compared to 419 correlations in HPV-unrelated. Three clusters were identified for HPV-related HNC: all 6 NPF were contained in a single cluster with 51 metabolites, 10 lipids, but 0 cytokines. Pathway analysis found enriched levels of aminoacyl-tRNA biosynthesis (P<.001), valine, leucine, and isoleucine biosynthesis (P<.001), and glycine, serine and threonine metabolism (P=0.003). Comparatively, five clusters were identified for HPV-unrelated HNC: the 6 NPF were dispersed between two closely linked clusters along with 23 metabolites, 4 lipids, and 4 cytokines (CRP, IL1β, IL10, IL1ra). Enriched pathways included aminoacyl-tRNA biosynthesis (P<.0001), glycine, serine, and threonine metabolism (P<.0001), cysteine and methionine metabolism (P<.0001). Conclusions: In both HPV-related and unrelated HNC, NPF were closely linked via metabolites enriched in amino acid metabolic pathways, suggesting that NPF may have an amino acid metabolic foundation. Cytokines may play a larger role in HPV unrelated HNC. Citation Format: Ronald C. Eldridge, Yufen Lin, Nabil F. Saba, Andrew Miller, Evanthia C. Wommack, Jennifer Felger, Deborah W. Bruner, Canhua Xiao. Metabolic-inflammatory investigation of head and neck cancer patient reported neuropsychological factors via multiomics integration of the plasma metabolome, lipidome, and circulating inflammation cytokines [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Innovating through Basic, Clinical, and Translational Research; 2023 Jul 7-8; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2023;29(18_Suppl):Abstract nr PO-038.

Sleep, eating and psychopathologies: Which one(s) may be associated with the development of metabolic syndrome in psoriasis patients through psoriasis quality of life?

Background: Psoriasis (PS) has many comorbidities including metabolic-syndrome (MetS) sleep and eating disorders and psychopathologies. Objectives: Investigating the relationship between the presence of MetS and sleep, eating and psychological pathologies in PS-patients through psoriasis quality of life (PSQoL). Methods: In this cross-sectional and descriptive correlation study, besides demographics, MetS-parameters and comorbidities, PS-severity, PS related quality of life (PSQoL), sleep-quality (SQ), depression, anxiety, body image-related QoL (BIQoL), perceived stress, flourishing, social appearance anxiety and eating attitudes of subjects were examined with related scales. Data analyzed using SPSS software, according to two PS groups with and without MetS. Results: Of 107 PS-patients, 68 were diagnosed with MetS. Mean-age and PS-duration were significantly higher in MetS (+) group. PS- severity was correlated with poor PSQoL, anxiety, depression, impairing flourishing, poor overall SQ and impairing in two sleep-subcomponents in MetS (+) group, whereas it was correlated with only poor PSQoL and poor overal SQ in MetS (-) group. Poor PSQoL was correlated with anxiety, depression, poor BIQoL, poor overal SQ and impairing in three sleep-subcomponents in MetS (+) group, whereas no correlation was found between these parameters and PSQoL in MetS(-) group. Conclusions: MetS is seen at high-rate in patients with long-term PS. PS-severity is especially correlated with anxiety, impaired-flourishing, and impaired-SQ in PS-patients with Mets (+). PSQoL appear to be correlated with depression, anxiety, distorted-BI and impaired SQ in these patients. It should be kept in mind that neuropsychological factors may facilitate the development of dysmetabolic events in PS-patients, by impairing PSQoL.

Neuropsychological Differences Between Surgery Interns and Age-Matched Adults

The purpose of this study was to assess how neuropsychological factors differ between general surgery interns and normative data from age-matched adults in the general population. Participants completed a comprehensive neuropsychological assessment battery. Neuropsychological factors assessed included: executive function (Behavioral Rating Inventory of Executive Function, BRIEF), working memory (Wechsler Adult Intelligence Scale, or WAIS, digit span), psychomotor speed (WAIS coding, Trails A and B), selective attention (D2 Test of Attention), and problem solving (Tower of London, TOL). Data for all measures was compared to previously published normative data for age-matched, healthy adults in the general population using one-sample t-tests. This study was completed at Indiana University School of Medicine in Indianapolis, IN, which is a large academic healthcare training institution. Postgraduate year 1 general surgery residents (PGY1s) voluntarily participated in this study. Twenty-six general surgery PGY1s completed all measures. We found that PGY1s had significantly better behavioral inhibition, working memory, selective attention, problem solving, and psychomotor speed than their counterparts in the general population (Table 1). Conversely, we found that PGY1s had significantly lower cognitive flexibility (p = 0.02) and ability to monitor task progress (p = 0.006) than the general population. The results from this study indicate that there are several neuropsychological factors that may help explain the high achievement of general surgery PGY1s. Assessment of these factors could aid general surgery programs in the selection and training of high-caliber residents. However, there are indicators that PGY1s struggle from cognitive inflexibility and task monitoring compared to the general population. These skills are needed to manage the complex and dynamic nature of surgical performance, so educators should consider methods to enhance junior residents' development of these characteristics.

Impact of COVID-19 on employment: sociodemographic, medical, psychiatric and neuropsychological correlates.

Given the nature of the persistent physical and neuropsychiatric symptoms reported in the literature, among individuals after acute COVID illness; there is growing concern about the functional implications of the Post-Acute Sequelae of COVID-19 (PASC). We aim to evaluate associations of sociodemographic, medical, psychiatric and neuropsychological factors with employment status post COVID-19. 59 participants were administered a neuropsychiatric assessment and queried about employment status and occupational difficulties months after quarantine. Two levels of comparison were conducted: (1) Those who took time off work (TTO) to those with no time off (NTO); (2) Those who reported occupational performance suffered (PS) to those who did not (PDNS). TTO vs. NTO exhibited extensive differences across medical, psychiatric and neurocognitive domains. PS vs. PDNS differed on subjective measures of physical and cognitive symptoms, but not on objective testing. Individuals who took time off beyond COVID-19 quarantine experience persistent physical, psychiatric, subjective and objective neurocognitive burden. In contrast, occupational impairment appears to reflect subjective complaints, but not objective measures. Clinical implications are discussed.

Economic Deprivation as a Neuropsychological Aspect of the Formation of Frustration in Potential Migrants

The article shows the peculiarities of personal deprivation as a neuropsychological factor of emigration in the context of frustration. Persons participating in emigration focus on their future life, mainly on economic and social life. Individual thoughts about one's future life, a warning about the unknown, means about one's future work, well-being, etc. Such a volume of actions causes disappointment, as well as a neuropsychological impulse of anxiety for the future life of a person. The study is aimed at determining the impact of migration intentions on the psychological state of the individual, in particular, the determination of frustration and neuropsychological factors. The learning principle is that frustration is a neuropsychological marker of individuals facing new challenges, especially during migration. Researched military tests are studied in a study of economic commitment as a factor in the frustration of individuals who plan to migrate. The research course uses the method of abstraction, the descriptive-research method, the method of analysis and synthesis. The method of generalization and systematization was used to determine the research results. The results of the work are the basis for the formation of the structure that the factor of economic destruction in this case is personal frustration and not all aspects of the issue needing further research are exhausted.

Deficits in consummatory reward relate to severity of cocaine use

Background and aimsIdentifying modifiable neuropsychological factors associated with more severe CUD could improve CUD treatment. Impairments in processing of non-drug rewards may be one such factor. This study assessed the relationship between reward functioning and cocaine use severity using multi-modal measures of three distinct reward functions: consummatory reward (pleasure or “liking”); motivational reward (“wanting”) and reward learning. MethodsFifty-three adults with at least moderate CUD completed self-report and behavioral measures of consummatory reward, motivational reward and reward learning, and a composite cocaine use severity measure including quantity, frequency and life impacts of cocaine use. We conducted parallel Frequentist and Bayesian multiple regressions with measures of reward functioning as predictors of cocaine use severity. ResultsLess self-reported ability to experience pleasure, a hypothesized measure of consummatory reward, significantly predicted greater severity after adjustment for covariates and multiple hypothesis testing, β = 0.39, t(38) = 2.86, p = 0.007. Bayesian analyses confirmed a highly likely association between severity and ability to experience pleasure, and provided moderate evidence for associations with willingness to exert effort and reward learning. ConclusionsOur results suggest that less experience of subjective pleasure is related to greater cocaine use severity. This cross-sectional study cannot establish whether differences in consummatory reward are pre-existing, a result of CUD, or both. However, these results suggest interventions focused on increasing subjective pleasure, such as mindful “savoring”, should be investigated for CUD.

Pre-coronavirus disease 2019 brain structure might be associated with social anxiety alterations during the pandemic.

Pre-coronavirus disease 2019 brain structure might be associated with social anxiety alterations during the pandemic.

Developing a Curriculum for Functional Neurological Disorder in Neurology Training (P2-2.005)

<h3>Objective:</h3> To put forward a case for why a functional neurological disorder (FND) curriculum is needed and to provide guidance on curricular content and teaching methods. <h3>Background:</h3> FND is commonly encountered by neurologists, with a growing body of evidence-based treatments operationalized over the past two decades. There remains a large gap in neurology education regarding FND, with little to no formal teaching over the course of medical education, and many practicing neurologists do not feel as though they have good knowledge of FND. <h3>Design/Methods:</h3> We included multidisciplinary and interdisciplinary expert consensus from FND care providers across neurology, psychiatry, social work, physical therapy, and psychology to develop a framework for the development of an FND curriculum for neurology residents. <h3>Results:</h3> Key curricular content regarding FND should include: Medical knowledge regarding pathophysiology and neuropsychological etiological factors, diagnostic criteria, approach to adjunctive diagnostic testing, and principles underlying treatment modalities (rehabilitative and psychological therapies). Clinical skills including being able to perform a psychiatric and social history, specific exam maneuvers to determine rule-in diagnostic features, and formulation of a multidisciplinary treatment and longitudinal care plan. Communication and collaboration skills including effectively conveying an FND diagnosis, educating the patient/family around diagnosis and management including addressing diagnostic doubt, and a thorough understanding of all care team member roles and ability to work together towards care optimization. Methods for teaching this curricular content should include didactic sessions, clinical exposure, and access to supplementary content resources for self-guided learning. Methods for evaluation of curricular content should be linked to Accreditation Council for Graduate Medical Education milestones and include written evaluation, direct clinical observation, and standardized skill assessment through use of standardized or simulated patients. <h3>Conclusions:</h3> A dedicated FND curriculum to appropriately train residents is needed, and should aim to provide knowledge, clinical acumen, communication skills, and effective use of team-based collaboration. <b>Disclosure:</b> Dr. Finkelstein has received personal compensation in the range of $500-$4,999 for serving as a Speaker at Annual Fall Meeting with Massachusetts Neurologic Association. Dr. O’Neal has received personal compensation for serving as an employee of Best Doctors. Dr. O’Neal has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Crico malpractice company. Dr. O’Neal has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Crico malpractice company. Dr. O’Neal has received publishing royalties from a publication relating to health care. Dr. Baslet has received publishing royalties from a publication relating to health care. Dr. Dworetzky has received publishing royalties from a publication relating to health care. Ms. Godena has nothing to disclose. Mrs. Maggio has nothing to disclose. Dr. Millstein has nothing to disclose. Dr. Milligan has nothing to disclose. Dr. Perez has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley: Brain and Behavior. The institution of Dr. Perez has received research support from NIH. The institution of Dr. Perez has received research support from Sidney R. Baer Jr. Foundation. Dr. Perez has received publishing royalties from a publication relating to health care.

The Development of Assertiveness of the Individual as a Subject of Communication

The problem of socialization of the younger generation in general and the development of assertiveness of the individual as a subject of communication, in particular, becomes especially relevant against the background of radical changes in social, political and economic life. The immaturity of the individual's ability to set and implement their own goals and aspirations leads to dissatisfaction with life, the emergence of social fear. Considering the development of assertiveness in neuropsychology, the emphasis is on working with the behavioral and motivational-value range of the individual, which indicates the difficulty of differentiating manifestations of self-confidence and aggressiveness. For the development of confident personality behavior, numerous psychological programs of active social psychological training offer trainings. The purpose is to theoretically identify and empirically investigate the neuropsychological features of the development of assertiveness of adolescents in a children's health institution and secondary school, diagnose neuropsychological factors and present the most pronounced individual psychological qualities of adolescents, which should be identified as psychological reasons that determine the development of assertiveness in adolescence. At different stages of the empirical study, a number of psychodiagnostic techniques were used: the questionnaire "Diagnosis of the assertiveness level"; methods of diagnostics of basic values; SOINT questionnaire; associative experiment with the following procedure of subjective scaling; colour test of relations, test-questionnaire "Emotional orientation"; level of subjective control; personal questionnaire of R. Kettell.

Body temperatures, thermal comfort, and neuropsychological responses to air temperatures ranging between 12°C and 39°C in people with Multiple Sclerosis

The negative effects of thermal stress on Multiple Sclerosis (MS)’ symptoms have long been known. However, the underlying mechanisms of MS heat and cold intolerance remain unclear. The aim of this study was to evaluate body temperatures, thermal comfort, and neuropsychological responses to air temperatures between 12 and 39 °C in people with MS compared to healthy controls (CTR). Twelve MS (5 males/7 females; age: 48.3 ± 10.8 years; EDSS range: 1–7) and 11 CTR participants (4 males /7 females; age: 47.5 ± 11.3 years) underwent two 50-min trials in a climatic chamber. Air temperature was ramped from 24 °C to either 39 °C (HEAT) or 12 °C (COLD) and we continuously monitored participants’ mean skin (Tsk) and rectal temperatures (Trec), heart rate and mean arterial pressure. We recorded participants’ self-reported thermal sensation and comfort, mental and physical fatigue, and we assessed their cognitive performance (information processing). Changes in mean Tsk and Trec did not differ between MS and CTR neither during HEAT nor COLD. However, at the end of the HEAT trial, 83% of MS participants and 36% of CTR participants reported being “uncomfortable”. Furthermore, self-reports of mental and physical fatigue increased significantly in MS but not CTR (p < 0.05), during both HEAT and COLD. Information processing was lower in MS vs. CTR (p < 0.05); yet this cognitive impairment was not exacerbated by HEAT nor COLD (p > 0.05). Our findings indicate that neuropsychological factors (i.e. discomfort and fatigue) could contribute to MS heat and cold intolerance in the absence of deficits in the control of body temperature.

Priming effects of a slot machine game and amphetamine on probabilistic risk-taking in people with gambling disorder and healthy controls

ABSTRACT Introduction The Game of Dice Task (GDT) captures probabilistic risk-taking, which is an important feature of addictions and integral to gambling disorder (GD). No research appears to have assessed effects of gambling-specific priming manipulations or the pharmacological basis of such effects on the GDT. Aims To investigate effects of slot machine gambling (Slots) and d-amphetamine (AMPH; 20 mg) on risk-taking in people with GD and healthy controls (HCs) (n = 30/group). The role of dopamine (DA) was assessed by pre-treating participants with the D2 receptor (D2R)-preferring antagonist, haloperidol (HAL; 3-mg) or mixed D1R-D2R antagonist, fluphenazine (FLU; 3-mg). Hypotheses Slots and AMPH will each increase risk-taking based on fewer (less probable) possible outcomes selected (POS) and poorer net monetary outcomes (NMO; gains minus losses) on the GDT, with stronger effects in Group GD. If DA mediates these effects, outcomes will vary with pre-treatment. Method Participants attended a pre-experimental baseline session and 4 test sessions. Antagonist Group (HAL, FLU) was manipulated between-participants. Pre-treatment (antagonist, placebo) was manipulated within-participants and counterbalanced over sessions for Slots and AMPH test phases. Moderator/mediator effects of trait and neuropsychological factors and GD severity (South Oaks Gambling Screen; SOGS) were explored via covariance. Results AMPH led to an escalation in risky POS over trial blocks in both groups, regardless of pre-treatment. Cognitive inflexibility (high perseveration-proneness) moderated this effect in Group HC. In Group GD, SOGS selectively predicted riskier POS on AMPH sessions. Group GD achieved poorer NMO vs. Group HC on the pre-experimental baseline and Placebo-Slots sessions. Group HC selectively displayed poorer NMO on the Antagonist-Slots session. Conclusions The GDT can detect behavioral and pharmacological priming effects. Cognitive inflexibility and symptom severity moderate AMPH-induced risk-taking in HC and GD participants, respectively. Sensitization-related “wanting” of risk may contribute to the latter effect in people with GD.

Factors Influencing Driving following DBS Surgery in Parkinson’s Disease: A Single UK Centre Experience and Review of the Literature

Parkinson's disease (PD) is a complex neurodegenerative disorder, leading to impairment of various neurological faculties, including motor, planning, cognitivity, and executive functions. Motor- and non-motor symptoms of the disease may intensify a patient's restrictions to performing usual tasks of daily living, including driving. Deep Brain Stimulation (DBS) associated with optimized clinical treatment has been shown to improve quality of life, motor, and non-motor symptoms in PD. In most countries, there are no specific guidelines concerning minimum safety requirements and the timing of return to driving following DBS, leaving to the medical staff of individual DBS centres the responsibility to draw recommendations individually regarding patients' ability to drive after surgery. The aim of this study was to evaluate factors that might influence the ability to drive following DBS in the management of PD. A total of 125 patients were included. Clinical, epidemiological, neuropsychological, and surgical factors were evaluated. The mean follow-up time was 129.9 months. DBS improved motor and non-motor symptoms of PD. However, in general, patients were 2.8-fold less likely to drive in the postoperative period than prior to surgery. Among the PD characteristics, patients with the akinetic subtype presented a higher risk to lose their driving licence postoperatively. Furthermore, the presence of an abnormal postoperative neuropsychological evaluation was also associated with driving restriction following surgery. Our data indicate that restriction to drive following surgery seems to be multifactorial rather than a direct consequence of DBS itself. Our study sheds light on the urgent need for a standardised multidisciplinary postoperative evaluation to assess patients' ability to drive following DBS.

Determinants of medication adherence in people with epilepsy: A multicenter, cross-sectional survey

ObjectivesPoor medication adherence in people with epilepsy (PwE) increases mortality, hospitalization, and poor quality of life, representing a critical challenge for clinicians. Several demographic, clinical, and neuropsychological factors were singularly found associated with medication adherence in several studies, but the literature lacks a comprehensive study simultaneously assessing all these variables. MethodsWe performed a multicenter and cross-sectional study using online questionnaires with the following clinical scales: Morisky Medication Adherence Scale (MMAS-8), Quality of Life in Epilepsy Inventory 31 (QoLIE-31), Beck Depression Inventory-II (BDI-II), Generalized Anxiety Disorder-7 (GAD-7) and 14-item Resilience scale (RES14) in a population of 200 PwE. We used the ANOVA test and Spearman’s correlation to evaluate the relationship between medication adherence and demographic, clinical (seizure frequency, number of anti-seizure medications), and neuropsychological characteristics. We trained separate machine learning models (logistic regression, random forest, support vector machine) to classify patients with medium–high adherence (MMAS-8 ≥ 6) and poor adherence (MMAS-8 < 6) and to identify the main features that influence adherence. ResultsWomen were more adherent to medication (p-value = 0.035). Morisky Medication Adherence Scale -8 showed a direct correlation with RES14 (p-value = 0.001) and age (p-value = 0.001), while was inversely correlated with BDI-II (p-value = 0.001) and GAD-7 (p-value = 0.001). In our model, the variables mostly predicting treatment adherence were QoLIE-31 subitems, followed by age, resilience, anxiety, years of school, and disease duration. ConclusionOur study confirms that gender, age, and neuropsychological traits are relevant factors in predicting medication adherence to PwE. Furthermore, our data provided the first evidence that machine learning on multidimensional self-report questionnaires could help to develop a decisional support system in outpatient epilepsy clinics.

Neuropsychological Technologies for Maintaining Occupational Health of an Individual

The article is devoted to the problem of theoretical consideration of the best neuropsychological technologies for maintaining, strengthening and developing the occupational health of a specialist, particularly from the risk group of occupational diseases, nervous exhaustion, stress, neurosis and emotional burnout. Important criteria of occupational (psychological) health are considered. The concept of occupational health in the neuropsychological context is clarified. The criteria of occupational health and scientific approaches to consideration of neuropsychological technologies of occupational health development by foreign and domestic researchers are generalized. Occupational well-being is identified as the main criterion of occupational health. The role of neuropsychological prevention of burnout is indicated. Neuropsychological recommendations have been developed to ensure and maintain occupational health of specialists in the process of their professional development, in particular in the professional system “human – human”. Neuropsychological factors of occupational health are specified. It is noted that the state of occupational health may be associated with functional asymmetry of the brain, which requires development and implementation of neuropsychological programs to restore occupational health of professionals from a risk group.

Exploring the sociodemographic, clinical and neuropsychological factors associated with relational memory in schizophrenia

ABSTRACT Introduction The Transverse Patterning (TP) task has been used to measure episodic relational memory (RM) deficits in clinical populations. Individuals with schizophrenia often fail to learn TP with standard, and sometimes extensive training. Identifying the differences between TP learners and non-learners can improve our understanding of successful TP performance and its underlying mechanisms, which may help improve interventions aimed at ameliorating RM performance. We investigated sociodemographic, clinical and neuropsychological factors associated with TP performance in schizophrenia. Methods Sixty-six participants with schizophrenia completed a semantically rich and a relational-binding dependent version of the TP task and reported on their task awareness and strategy use. Results Twenty-six participants failed to learn the task rules after extensive training. Learners had superior verbal, visual and working memory, executive functions and overall cognitive functioning compared to non-learners. Learners also had superior awareness of task rules and pairs relationships and used elaborated cognitive strategies more often. Conclusions Our results support previous findings that some individuals with schizophrenia show RM impairment even with extensive TP training. We shed light on neuropsychological and metacognitive factors associated with TP performance. This knowledge could enhance interventions targeted to improve relational memory in schizophrenia when extensive training fails.

Are Signals Regulating Energy Homeostasis Related to Neuropsychological and Clinical Features of Gambling Disorder? A Case-Control Study.

Gambling disorder (GD) is a modestly prevalent and severe condition for which neurobiology is not yet fully understood. Although alterations in signals involved in energy homeostasis have been studied in substance use disorders, they have yet to be examined in detail in GD. The aims of the present study were to compare different endocrine and neuropsychological factors between individuals with GD and healthy controls (HC) and to explore endocrine interactions with neuropsychological and clinical variables. A case−control design was performed in 297 individuals with GD and 41 individuals without (healthy controls; HCs), assessed through a semi-structured clinical interview and a psychometric battery. For the evaluation of endocrine and anthropometric variables, 38 HCs were added to the 41 HCs initially evaluated. Individuals with GD presented higher fasting plasma ghrelin (p < 0.001) and lower LEAP2 and adiponectin concentrations (p < 0.001) than HCs, after adjusting for body mass index (BMI). The GD group reported higher cognitive impairment regarding cognitive flexibility and decision-making strategies, a worse psychological state, higher impulsivity levels, and a more dysfunctional personality profile. Despite failing to find significant associations between endocrine factors and either neuropsychological or clinical aspects in the GD group, some impaired cognitive dimensions (i.e., WAIS Vocabulary test and WCST Perseverative errors) and lower LEAP2 concentrations statistically predicted GD presence. The findings from the present study suggest that distinctive neuropsychological and endocrine dysfunctions may operate in individuals with GD and predict GD presence. Further exploration of endophenotypic vulnerability pathways in GD appear warranted, especially with respect to etiological and therapeutic potentials.