Neuropsychological Measures Research Articles

Results from a randomized controlled trial of zonisamide in the treatment of alcohol use disorder

There is preliminary evidence that the anticonvulsant medication Zonisamide (ZON) may be an effective, well-tolerated treatment for alcohol use disorder (AUD). However, further evaluation of its efficacy for treating patients with AUD is needed, and much remains unknown about ZON’s therapeutic mechanisms. The present study aimed to evaluate the efficacy and tolerability of ZON in a double-blind, placebo-controlled, randomized trial. Eighty-one adults (ages 21-65) diagnosed with AUD were randomly assigned to receive either ZON (at a target dose of 400 mg/d) or a pill placebo over 12 weeks, followed by a two-week taper. All participants also received a computerized alcohol reduction program, Take Control (TC). Primary drinking outcomes were average daily drinks, percentage drinking days, and percentage heavy drinking days. Further, we evaluated changes in AUD clinical severity and performance on neuropsychological measures. For both groups, drinking outcomes generally decreased, as did AUD clinical severity, though group differences were not statistically significant. Neuropsychological testing performance was similar for both groups at baseline; however, at post-treatment, participants in the ZON group demonstrated poorer working memory and lower performance on verbal fluency tests compared to the placebo group, and these differences were statistically significant with moderate-large effect sizes. One serious adverse event was reported among individuals receiving ZON. Study findings indicate that ZON combined with TC does not demonstrate superior effectiveness for reducing average daily drinks in this clinical sample with principal AUD compared to placebo and TC, and treatment with ZON may be associated with reduced neurocognitive performance over time.

The spectrum effect: Convergence of clinical and neuropsychological characteristics in adults referred for autism assessment

Clinical and neuropsychological profiles of adults referred for autism assessment are not thoroughly understood, and information derived from studies comparing autistic adults to neurotypical controls might not be accurate to infer on individuals in a real-world, clinical setting. 263 adults (aged 18–65 years, 70 % males) referred to our clinic with a suspected diagnosis of autism were clinically explored and administered neuropsychological investigations. The suspected diagnosis was either confirmed or rejected. We conducted multivariate and post-hoc univariate analyses of covariance (MANCOVA; ANCOVA), controlling for possible confounders, to evaluate differences between autistic and non-autistic participants and further associations. Effect sizes (partial η²) were calculated for significant results. There were no significant differences in age means and sex ratios. Both groups showed high Autism Questionnaire (AQ) scores, high schizoid, avoidant, and obsessive-compulsive scores, and mild depressive symptoms, without significant difference between groups. The effect sizes of differences ranged from negligible to small for measures of nonsocial cognition, but were large for a measure of social cognition, the emotion recognition 40 (ER40). Autistic and non-autistic participants present converging features across multiple measures. In this diagnostic setting, psychiatric and neuropsychological measures are helpful in identifying individual difficulties and strengths. However, most of them, including the AQ, are poor indicators of autism. Our results mostly aligned with previous research and showed that information derived from comparisons to neurotypical controls cannot be directly transferred to a real-world setting. Detected impairments in emotion recognition were fairly specific to autism, expanding on previous findings.

Retelling of Stories with Common Phrasal Expressions by High-Proficiency Learners: Implications for Learning and High-Stakes Testing

The goal of this research was to investigate how well L2 English speakers of different proficiency levels were able to perform on a test of auditory memory like that used in the Wechsler Memory Scale (WMS). In this test, participants must retell heard stories. While the validity of elicited imitation tests is well established in second-language acquisition research, the effectiveness of using retelling as a neuropsychological measurement when a language other than the test taker’s L1 is used is unclear. Further, due to their importance in memory function, this study also analyzed the role of common phrasal expressions in how well participants retold stories in three groups of different proficiency. The results indicated that the increase in scores in the retelling of stories aligned with the proficiency level of the non-native participants. Higher-proficiency NNSs were also able to use more of the commonly used spoken phrases in their retelling. Further, there was no difference in this measure between the higher-proficiency Second-Language English and First-Language English participants. While the effectiveness of this test method as a neuropsychological tool when a language other than the test taker’s L1 is used is unclear, these results indicate significant progress by the higher-proficiency participants. Nevertheless, given that this test is often used in this context with immigrants and minority language patients, doubts remain about its suitability for less proficient individuals.

Neurocognitive Intraindividual Variability in Veterans with Mild Traumatic Brain Injury History and Posttraumatic Stress Disorder.

Veterans with a history of blast-related mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) may be at risk for greater cognitive concerns and worse functional outcomes compared to those with either condition in isolation. However, traditional neuropsychological assessment approaches have yielded equivocal results in these populations. The present study examined an alternative method for detecting subtle cognitive inefficiencies: neurocognitive intraindividual variability (IIV), a measure of within-person performance consistency. Participants were 79 male Veterans with a history of blast-related mTBI and current PTSD (mTBI/PTSD group; n = 54) or neither diagnosis (controls; n = 25). Mean T-scores and IIV scores were calculated from neuropsychological measures of attention and speed of information processing (A/SoP) as well as executive functioning (EF). Global IIV was significantly higher in the mTBI/PTSD group compared to controls (p = .047, Cohen's d = 0.49). At the domain level, larger effect sizes were observed for EF IIV (Cohen's d = 0.46) compared to A/SoP IIV (d = 0.32), although neither were statistically significant. Within the mTBI/PTSD group, higher Global IIV was associated with worse self-reported executive dysfunction, psychological quality of life, and cognitive post-concussive symptoms; at the domain level, these clinical outcomes were generally associated with greater A/SoP IIV (but not EF IIV). Findings extend previous investigations of neurocognitive IIV in individuals with a history of mTBI across PTSD status. Among Veterans with a history of mTBI and comorbid PTSD, neurocognitive variability may be a better indicator of self-reported cognitive inefficiencies and Veteran experience of daily cognitive functioning than mean neuropsychological performances.

Psychometrics of drift-diffusion model parameters derived from the Eriksen flanker task: Reliability and validity in two independent samples.

The flanker task is a widely used measure of cognitive control abilities. Drift-diffusion modeling of flanker task behavior can yield separable parameters of cognitive control-related subprocesses, but the parameters' psychometrics are not well-established. We examined the reliability and validity of four behavioral measures: (1) raw accuracy, (2) reaction time (RT) interference, (3) NIH Toolbox flanker score, and (4) two drift-diffusion model (DDM) parameters-drift rate and boundary separation-capturing evidence accumulation efficiency and speed-accuracy trade-off, respectively. Participants from two independent studies - one cross-sectional (N = 381) and one with three timepoints (N = 83) - completed the flanker task while electroencephalography data were collected. Across both studies, drift rate and boundary separation demonstrated comparable split-half and test-retest reliability to accuracy, RT interference, and NIH Toolbox flanker score, but better incremental convergent validity with psychophysiological measures (i.e., the error-related negativity; ERN) and neuropsychological measures of cognitive control than the other behavioral indices. Greater drift rate (i.e., faster and more accurate responses) to congruent and incongruent stimuli, and smaller boundary separation to incongruent stimuli were related to 1) larger ERN amplitudes (in both studies) and 2) faster and more accurate inhibition and set-shifting over and above raw accuracy, reaction time, and NIH Toolbox flanker scores (in Study 1). Computational models, such as DDM, can parse behavioral performance into subprocesses that exhibit comparable reliability to other scoring approaches, but more meaningful relationships with other measures of cognitive control. The application of these computational models may be applied to existing data and enhance the identification of cognitive control deficits in psychiatric disorders.

Amyloid deposition and its association with depressive symptoms and cognitive functions in late-life depression: a longitudinal study using amyloid-β PET images and neuropsychological measurements

BackgroundAlthough depression is linked to an increased risk of dementia, the association between late-onset depression (LOD) and amyloid burden remains unclear. This study aimed to determine amyloid deposition in patients with LOD compared to healthy controls (HC) using amyloid-beta (Aβ) positron emission tomography (PET) images and neuropsychological assessments.MethodsForty patients first diagnosed with major depressive disorder after the age of 60 (LOD) and twenty-one healthy volunteers (HC) were enrolled. Depression and anxiety were evaluated using the 17-item Hamilton Depression Scale, Hamilton Anxiety Rating Scale, and Clinical Global Impression Scale. Cognitive function was assessed using the Korean versions of the Mini-Mental Status Examination, Montreal Cognitive Assessment, and Seoul Neuropsychological Screening Battery at baseline and 3-month follow-up. 18F-florbetapir PET images were co-registered with T1-weighted magnetic resonance images.ResultsThere was no significant difference in Aβ deposition between LOD and HC groups. No significant correlation between Aβ burden and depressive symptom severity was found in LOD patients. Higher somatic anxiety was correlated with lower Aβ burden in multiple brain regions, including the left inferior frontal lobe (p = 0.009), right anterior cingulate (p = 0.003), and right superior frontal lobe (p = 0.009). Despite cognitive recovery in areas such as attention (Digit Span Forward, p = 0.026), memory (Auditory Verbal Learning Test Recall Total, p = 0.010; Rey Complex Figure Test Delayed Recall, p = 0.039), and frontal executive function (Contrasting Program, p = 0.033) after three months of antidepressant treatment, cognitive improvement showed no association with amyloid deposition.ConclusionsThese findings suggest distinct mechanisms may underlie amyloid deposition in neurodegenerative changes associated with depression. While amyloid burden in specific brain regions negatively correlated with somatic anxiety, it showed no significant correlation with the severity of depression or overall cognitive function.

The Moderating Role of Genetics on the Effectiveness of the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) Program on Cognitive Impairment.

Genetics may influence symptoms experienced by breast cancer survivors (BCS) by moderating the effects of stress-reducing interventions, including the Mindfulness-Based Stress Reduction (MBSR(BC)) program, to reduce symptom severity. As part of a larger clinical trial, the aim of this study was to evaluate genetic variants as moderators of MBSR(BC) on improvements among BCS in cognitive functioning and symptoms. BCS (n = 128) were randomized to MBSR(BC) or the Breast Cancer Education Support Program. Objective neuropsychological and subjective measures of cognitive performance, and psychological and physical symptoms were collected at baseline, 6, 12, and 26 weeks. Linear mixed models were implemented to identify MBSR(BC)'s effects over time. A total of 22 single nucleotide polymorphisms (SNPs) from 20 genes known to be related to these symptoms were investigated using genomic DNA. These SNPs were tested as moderators of MBSR(BC) program effects. Results showed MBSR(BC) participants experienced significantly greater benefits in cognitive functioning, however, the level of benefit varied based on one's genetic profile. Effects sizes, consistency across similar measures were investigated. Among 22 candidate SNPs, rs4680 in COMT, rs1800497 in ANKK1, and rs6277 in DRD2 demonstrated the strongest, most consistent positive effects in moderating MBSR(BC)'s impact on cognitive outcomes. Although the effects were small, this translational research may potentially identify BCS with genotypes that would be most influenced by the MBSR(BC) program. These results may be used to develop personalized intervention programs tailored to the genetic profile of each breast cancer survivor who received chemotherapy or chemotherapy and radiation. ClinicalTrials.gov, https://www.ClinicalTrials.gov Registration Number: NCT02786797.

Assessing the Effectiveness of Audio-Visual vs. Visual Neurofeedback for Attention Enhancement: A Pilot Study with Neurological, Behavioural, and Neuropsychological Measures.

Electroencephalogram (EEG) based Neurofeedback training has gained traction as a practical method for enhancing executive functions, particularly attention, among healthy individuals. The neurofeedback protocols based on EEG channel locations, frequency bands, or EEG features has been tested. However, the improvement in attention was not measured by comparing different feedback stimulus types. We believe that multisensory nature feedback even with few training sessions may induce strong effect. Therefore, this study compares the effect of audio-visual and visual feedback stimuli for attention enhancement utilizing neurophysiological, behavioural and neuropsychological measures. Total 21 subjects were recruited, undergoing six alternate days of neurofeedback training sessions to upregulate EEG beta power of frontocentral (FC5). Dwell time, fractional occupancy and transition probability were also estimated from the EEG beta power. Audiovisual group (G1) as compared to visual group (G2) demonstrate a significant increase of global EEG beta activity alongside improved dwell time (t = 2.76, p = 0.003), fractional occupancy (t = 1.73, p = 0.042) and transition probability (t = 2.46, p = 0.008) over the course of six neurofeedback training sessions. Similarly, the group (G1) shows higher scores (t = 2.13, p = 0.032) and faster reaction times (t = 2.22, p = 0.028) in Stroop task, along with increased score in Mindfulness Attention Awareness Scale (MAAS-15) questionnaire (t = 2.306, p = 0.012). Audiovisual neurofeedback may enhance training effectiveness, potentially achieving the same outcomes in fewer sessions compared to visual-only feedback. However, sufficient training days are essential for effect consolidation. This highlights the feasibility of completing neurofeedback training, a significant challenge in practice.

Association of Normative and Non-Normative Brain Networks With Cognitive Function in Patients With Temporal Lobe Epilepsy.

Despite their temporal lobe pathology, a significant subgroup of patients with temporal lobe epilepsy (TLE) is able to maintain normative cognitive functioning. In this study, we identify patients with TLE with intact vs impaired neurocognitive profiles and interrogate for the presence of both normative and highly individual intrinsic connectivity networks (ICNs)-all toward understanding the transition from impaired to intact neurocognitive status. This retrospective cross-sectional study included patients with TLE and matched healthy controls (HCs) from the Thomas Jefferson Comprehensive Epilepsy Center. Functional MRI data were decomposed using independent component analysis to obtain individualized ICNs. In this article, we calculated the degree of match between individualized ICNs and canonical ICNs (e.g., 17 resting-state networks by Yeo et al.) and divided each participant's ICNs into normative or non-normative status based on the degree of match. 100 patients with TLE (mean age 42.0 [SD: 13.7] years, 47 women) and 92 HCs were included in this study. We found that the individualized networks matched to the canonical networks less well in the cognitively impaired (n = 24) compared with the cognitively intact (n = 63) patients with TLE by 2-way mixed-measures analysis of variance (impaired vs intact mean difference [MD] -0.165 [-0.317, -0.013], p = 0.028). The cognitively impaired patients showed significant abnormalities in the profiles of both normative (impaired vs intact MD -0.537 [-0.998, -0.076], p = 0.017, intact vs HC MD -0.221 [-0.536, 0.924], p = 0.220, and impaired vs HC MD -0.759 [-1.200, -0.319], p < 0.001) and non-normative networks (impaired vs intact MD 0.484 [0.030, 0.937], p = 0.033, intact vs HC MD 0.369 [0.059, 0.678], p = 0.014, and impaired vs HC MD 0.853 [0.419, 1.286], p < 0.001) while the intact patients showed abnormalities only in non-normative networks. At the same time, we found that normative networks held a strong, positive association with the neuropsychological measures, with this association negative in non-normative networks. Our data demonstrated that significant cognitive deficits are associated with the status of both canonical and highly individual ICNs, making clear that the transition from intact to impaired cognitive status is not simply the result of disruption to normative brain networks.

Microangiopathy in temporal lobe epilepsy with diffusion MRI alterations and cognitive decline

White matter microvascular alterations in temporal lobe epilepsy (TLE) may be relevant to acquired neurodegenerative processes and cognitive impairments associated with this condition. We quantified microvascular changes, myelin, axonal, glial and extracellular-matrix labelling in the gyral core and deep temporal lobe white matter regions in surgical resections from 44 TLE patients with or without hippocampal sclerosis. We compared this pathology data with in vivo pre-operative MRI diffusion measurements in co-registered regions and neuropsychological measures of cognitive impairment and decline. In resections, increased arteriolosclerosis was observed in TLE compared to non-epilepsy controls (greater sclerotic index, p < 0.001), independent of age. Microvascular changes included increased vascular densities in some regions but uniformly reduced mean vascular size (quantified with collagen-4, p < 0.05–0.0001), and increased pericyte coverage of small vessels and capillaries particularly in deep white matter (quantified with platelet-derived growth factor receptorβ and smooth muscle actin, p < 0.01) which was more marked the longer the duration of epilepsy (p < 0.05). We noted increased glial numbers (Olig2, Iba1) but reduced myelin (MAG, PLP) in TLE compared to controls, particularly prominent in deep white matter. Gene expression analysis showed a greater reduction of myelination genes in HS than non-HS cases and with age and correlation with diffusion MRI alterations. Glial densities and vascular size were increased with increased MRI diffusivity and vascular density with white matter abnormality quantified using fixel-based analysis. Increased perivascular space was associated with reduced fractional anisotropy as well as age-accelerated cognitive decline prior to surgery (p < 0.05). In summary, likely acquired microangiopathic changes in TLE, including vascular sclerosis, increased pericyte coverage and reduced small vessel size, may indicate a functional alteration in contractility of small vessels and haemodynamics that could impact on tissue perfusion. These morphological features correlate with white matter diffusion MRI alterations and might explain cognitive decline in TLE.

Executive function and cortical thickness in biomarker aMCI

Introduction Memory deficits are the primary symptom in amnestic Mild Cognitive Impairment (aMCI); however, executive function (EF) deficits are common. The current study examined EF in aMCI based upon amyloid status (A+/A−) and regional atrophy in signature areas of Alzheimer’s disease (AD). Method Participants included 110 individuals with aMCI (A+ = 66; A− = 44) and 33 cognitively healthy participants (HP). EF was assessed using four neuropsychological assessment measures. The cortical thickness of the AD signature areas was calculated using structural MRI data. Results A + had greater EF deficits and cortical atrophy relative to A − in the supramarginal gyrus and superior parietal lobule. A − had greater EF deficits relative to HP, but no difference in signature area cortical thickness. Discussion The current study found that the degree of EF deficits in aMCI are a function of amyloid status and cortical thinning in the parietal cortex.

Memory-related brain potentials for visual objects in early AD show impairment and compensatory mechanisms.

Impaired episodic memory is the primary feature of early Alzheimer's disease (AD), but not all memories are equally affected. Patients with AD and amnestic Mild Cognitive Impairment (aMCI) remember pictures better than words, to a greater extent than healthy elderly. We investigated neural mechanisms for visual object recognition in 30 patients (14AD, 16 aMCI) and 36 cognitively unimpaired healthy (19 in the "preclinical" stage of AD). Event-related brain potentials (ERPs) were recorded while participants performed a visual object recognition task. Hippocampal occupancy (integrity), amyloid (florbetapir) PET, and neuropsychological measures of verbal & visual memory, executive function were also collected. A right-frontal ERP recognition effect (500-700ms post-stimulus) was seen in cognitively unimpaired participants only, and significantly correlated with memory and executive function abilities. A later right-posterior negative ERP effect (700-900ms) correlated with visual memory abilities across participants with low verbal memory ability, and may reflect a compensatory mechanism. A correlation of this retrieval-related negativity with right hippocampal occupancy (r = 0.55), implicates the hippocampus in the engagement of compensatory perceptual retrieval mechanisms. Our results suggest that early AD patients are impaired in goal-directed retrieval processing, but may engage compensatory perceptual mechanisms which rely on hippocampal function.

Suspected Pseudobulbar Affect in Neurodegenerative Disease.

To investigate the association between suspected pseudobulbar affect (PBA), clinical diagnosis, cognitive testing, and self-reported mood in older adults presenting for evaluation of dementia. Patients presenting to an outpatient memory disorders clinic (N=311). We used traditional and novel network modeling approaches to examine associations between neuropsychological (NP) tests, patient and clinician rating scales, and the Center for Neurological Study-Lability Scale (CNS-LS) among patients with suspected AD (n=133) and other neurocognitive diagnosis (n=178). We then examined differences in test performance between patients with and without suspected PBA (CNS-LS cut-off of ≥ 13), while accounting for demographic and psychiatric covariates with propensity score matching. Group differences were assessed with Bayesian models. Prevalence of suspected PBA in AD was slightly less than half (44.4%) and at a similar rate in other dementias (e.g., 46.9% in CVD and 45.5% in LBD). In network models, the CNS-LS was associated with higher anxiety and better word list recall. After accounting for covariates, AD patients with suspected PBA performed better on word list recall βM=0.40, 95% CI [0.15, 0.66], and committed fewer false positive errors on recognition βM=-1.51, 95% CI [-2.34, -0.59] than AD patients without suspected PBA. There were no differences in patients with any other diagnostic impression, nor group differences on other NP measures. Patients with suspected PBA and AD diagnosis had better memory recall and recognition than those without suspected PBA, suggesting that impaired emotional regulation may be an early sign of AD in patients with less prominent memory decline. Better understanding PBA in neurodegenerative diseases, including prevalence and comorbidity with psychiatric conditions, could help with early identification, education, and initiation of treatment.

Cognitive dispersion and its functional relevance in behavioral variant frontotemporal dementia and prodromal behavioral variant frontotemporal dementia.

Executive dysfunction is characteristic of behavioral variant frontotemporal dementia (bvFTD) but can be challenging to detect. Dispersion-based intraindividual variability (IIV-d) is hypothesized to reflect a sensitive index of executive dysfunction and has demonstrated relevance to functional decline but has not been evaluated in bvFTD. We report on 477 demographically matched participants (159 cognitively healthy [CH], 159 clinical Alzheimer's disease [AD], 159 clinical bvFTD/prodromal bvFTD) who completed the Uniform Data Set 3.0 Neuropsychological Battery. IIV-d was measured using the coefficient of variance (CoV; raw and demographically adjusted) across 12 Uniform Data Set 3.0 Neuropsychological Battery indicators and the informant-rated Functional Activities Questionnaire assessed daily functioning. Analysis of covariance showed that participants in the bvFTD/prodromal bvFTD group exhibited higher raw and demographically adjusted CoV compared to CH participants, at a very large effect size (d = 1.28-1.47). Demographically adjusted (but not raw) CoV was lower in the bvFTD/prodromal bvFTD group than the AD group, though the effect size was small (d = .38). Both CoV metrics accurately differentiated the bvFTD/prodromal bvFTD and CH groups (areas under the curve = .84), but not bvFTD/prodromal bvFTD and AD groups (areas under the curve = .59). Regression analyses in the bvFTD/prodromal bvFTD group indicated that higher IIV-d on both metrics was associated with greater daily functioning impairment, over and above covariates. Compared to healthy adults, individuals with bvFTD/prodromal bvFTD show greater levels of performance variability across a battery of neuropsychological measures, which interferes with everyday functioning. These data demonstrate the clinical utility and ecological validity of IIV-d in bvFTD/prodromal bvFTD, though these findings should be replicated in more diverse samples. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A scoping review of remote and unsupervised digital cognitive assessments in preclinical Alzheimer's disease.

Subtle cognitive changes in preclinical Alzheimer's disease (AD) are difficult to detect using traditional pen-and-paper neuropsychological assessments. Remote and unsupervised digital assessments can improve scalability, measurement reliability, and ecological validity, enabling the detection and monitoring of subtle cognitive change. Here, we evaluate such tools deployed in preclinical AD samples, defined as cognitively unimpaired individuals with abnormal levels of amyloid-β (Aβ), or Aβ and tau. In this scoping review, we screened 1,680 unique reports for studies using remote and unsupervised cognitive assessment tools in preclinical AD samples; 23 tools were found. We describe each tool's usability, validity, and reported metrics of reliability. Construct and criterion validity according to associations with established neuropsychological assessments and measures of Aβ and tau are reported. With this review, we aim to present a necessary update to a rapidly evolving field, following a previous review by Öhman and colleagues (2021; Alzheimers Dement. Diagn. Assess. Dis. Monit ) and addressing the open questions of feasibility and reliability of remote testing in the target population. We discuss future directions for using remote and unsupervised digital cognitive assessments in preclinical AD and how such tools may be used for longitudinal monitoring of cognitive function, scalable case finding, and individualized prognostics in both clinical trials and healthcare contexts.

Cut-off point development for the Everyday Memory Questionnaire – Revised in perimenopausal women

Objective Subjective cognitive complaints have been reported in women during perimenopause and the Everyday Memory Questionnaire – Revised (EMQ-R) has been recently evaluated as a standardized instrument to measure subjective cognitive changes. The purpose of this study was to identify potential cut-off points for the EMQ-R retrieval subscale and attentional subscale, and to assess the validity of these cut-off points in detecting objective cognitive changes associated with reported subjective cognitive complaints. Method After screening, 232 perimenopausal women were included in the analyses. The supervised classification and regression tree was applied to identify optimal cut-off points. Its performance was evaluated by the value of the receiver operating characteristics curve, sensitivity and specificity. Results Findings revealed that the optimal cut-off point for the attentional subscale was 7, and for the retrieval subscale was 13. Both cut-off points presented acceptable discrimination performance. An independent t-test indicated that both cut-off points were associated with significant differences in scores on neuropsychological measures of retrieval (episodic memory and verbal fluency) as well as neuropsychological measures of higher-level attention (working memory). Conclusion The identified cut-off points may be helpful for women to track or quantify their subjective experiences of brain fog or cognitive symptoms during the menopause transition.

Cardiovascular Disease, Brain Glucose Metabolism, and Neurocognitive Decline in People With Human Immunodeficiency Virus.

Cardiovascular disease (CVD) and neuroinflammation are thought to exacerbate neurocognitive dysfunction in treated people with human immunodeficiency virus (PWH). Here, we longitudinally measured brain glucose metabolism as a measure of neuronal integrity in treated PWH using [18F]Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in correlation with atherosclerotic cardiovascular disease (ASCVD) scores, cerebrospinal fluid (CSF) neuroinflammatory markers, neurocognitive outcomes, and other clinical and laboratory variables (CLVs). Well-controlled PWH (n = 36) underwent baseline and follow-up FDG PET/CT obtained 3.5 years apart on average. Longitudinal changes in whole brain and regional relative FDG uptake, brain volumes, CLVs, CSF cytokines, and neuropsychological measures were measured. A variable selection model identified baseline variables related to future brain metabolic changes while multivariable models explored neuropsychological implications of brain metabolism and volumetrics. High ASCVD scores predicted future decreased thalamic uptake (slope = -0.0068, P = .027) and decreasing thalamic uptake correlated with worsening cognition (slope = 15.80, P = .020). Despite longitudinal greater than expected gray matter loss, whole brain FDG uptake did not change over the follow-up period. Most CSF cytokines decreased longitudinally but were not predictive of FDG changes. We found that high ASCVD scores in a group of treated PWH were related to thalamic hypometabolism, which in turn correlated with neurocognitive decline. Our findings support the contribution of CVD to neurocognitive dysfunction. More proactive CVD management may have a role in mitigating progression of cognitive impairment. Lack of change in global brain glucose metabolism despite documented accelerated gray matter volume loss over the same period suggests that FDG PET might underestimate neuronal injury in PWH compared to structural magnetic resonance imaging.

Anatomical and behavioural correlates of auditory perception in developmental dyslexia.

Developmental dyslexia is typically associated with difficulties in basic auditory processing and in manipulating speech sounds. However, the neuroanatomical correlates of auditory difficulties in developmental dyslexia (DD) and their contribution to individual clinical phenotypes are still unknown. Recent intracranial electrocorticography findings associated processing of sound amplitude rises and speech sounds with posterior and middle superior temporal gyrus (STG), respectively. We hypothesize that regional STG anatomy will relate to specific auditory abilities in DD, and that auditory processing abilities will relate to behavioral difficulties with speech and reading. One hundred and ten children (78 DD, 32 typically developing, age 7-15 years) completed amplitude rise time and speech in noise discrimination tasks. They also underwent a battery of cognitive tests. Anatomical MRI scans were used to identify regions in which local cortical gyrification complexity correlated with auditory behavior. Behaviorally, amplitude rise time but not speech in noise performance was impaired in DD. Neurally, amplitude rise time and speech in noise performance correlated with gyrification in posterior and middle STG, respectively. Furthermore, amplitude rise time significantly contributed to reading impairments in DD, while speech in noise only explained variance in phonological awareness. Finally, amplitude rise time and speech in noise performance were not correlated, and each task was correlated with distinct neuropsychological measures, emphasizing their unique contributions to DD. Overall, we provide a direct link between the neurodevelopment of the left STG and individual variability in auditory processing abilities in neurotypical and dyslexic populations.

Clinical utility of brief screening measures during neuropsychological consultation for pediatric onset multiple sclerosis.

Pediatric-onset multiple sclerosis (POMS) accounts for approximately 2 to 5% of all individuals with MS and is associated with an increased risk for cognitive impairment. In recent years, neuropsychological screening questionnaires have been increasingly utilized for pediatric populations in multidisciplinary settings. This study examines the clinical utility of the Colorado Learning Difficulties Questionnaire (CLDQ) and Pediatric Perceived Cognitive Functioning (Peds PCF) screening measures for identifying cognitive impairment in persons with POMS during a target neuropsychological evaluation. Retrospective data was gathered from electronic medical records at a single pediatric hospital. Forty-nine participants were included (69% female; 43% Hispanic/Latinx; mean age = 16.1 years old, range = 9.9 to 20.6 years old). Correlation analyses demonstrated strong interrelatedness between caregiver ratings on screening measures and performance on traditional neuropsychological measures. Effect sizes were medium across comparisons (CLDQ: Spearman's rho = -.321 to -.563; PedsPCF: Spearman's rho = .308 to .444). Exploratory cut-points using receiver operating characteristic analysis and Youden indices are also discussed. Comparison of scores across caregiver rating questionnaires and on a targeted neuropsychological battery suggests that the screening surveys alone may not be sensitive enough to identify children with cognitive impairments, but ratings may provide qualitatively meaningful information along with neuropsychological testing. This study illustrates how pediatric neuropsychologists can leverage screening tools to focus consultative interviews and effectively triage referrals for evaluation within an academic medical setting.

Neuropsychological application of the International Test Commission Guidelines for Translation and Adapting of Tests.

The number of test translations and adaptations has risen exponentially over the last two decades, and these processes are now becoming a common practice. The International Test Commission (ITC) Guidelines for Translating and Adapting Tests (Second Edition, 2017) offer principles and practices to ensure the quality of translated and adapted tests. However, they are not specific to the cognitive processes examined with clinical neuropsychological measures. The aim of this publication is to provide a specialized set of recommendations for guiding neuropsychological test translation and adaptation procedures. The International Neuropsychological Society's Cultural Neuropsychology Special Interest Group established a working group tasked with extending the ITC guidelines to offer specialized recommendations for translating/adapting neuropsychological tests. The neuropsychological application of the ITC guidelines was formulated by authors representing over ten nations, drawing upon literature concerning neuropsychological test translation, adaptation, and development, as well as their own expertise and consulting colleagues experienced in this field. A summary of neuropsychological-specific commentary regarding the ITC test translation and adaptation guidelines is presented. Additionally, examples of applying these recommendations across a broad range of criteria are provided to aid test developers in attaining valid and reliable outcomes. Establishing specific neuropsychological test translation and adaptation guidelines is critical to ensure that such processes produce reliable and valid psychometric measures. Given the rapid global growth experienced in neuropsychology over the last two decades, the recommendations may assist researchers and practitioners in carrying out such endeavors.