Poorer Executive Function Research Articles

Evaluation of Neurovascular Coupling in Early-Onset and Late-Onset Epilepsy of Unknown Etiology.

Previous studies have shown neurovascular coupling (NVC) dysfunction in epilepsy, suggesting its role in the pathological mechanisms. However, it remains unclear whether NVC abnormalities exist in epilepsy of unknown etiology (EU). To integrate multiparametric MRI to assess NVC and its relationship with cognition in early-onset and late-onset EU patients. Prospective. Ninety-six EU patients (46 early-onset, M/F = 20/26; 50 late-onset, M/F = 29/21) and 60 healthy controls (HCs, M/F = 25/35). 3.0 T, resting-state gradient echo-planar imaging, pseudo-continuous arterial spin labeling (pc-ASL), and T1-weighted brain volume sequence. Functional MRI data were analyzed to assess intrinsic brain activity including amplitude of low-frequency fluctuations (ALFF), fractional ALFF (fALFF), regional homogeneity (ReHo), and functional connectivity strength (FCS), while pc-ASL provided cerebral blood flow (CBF) measurements. Coupling correlation coefficients and ratios of CBF to neural activity were calculated to evaluate global and regional NVC. Two-sample t-test, Analysis of Variance, Kruskal-Wallis test, Chi-square test, Analysis of Covariance, family-wise error/Bonferroni correction, partial correlation analyses. Statistical significance was defined as P < 0.05. Whole-brain analysis revealed increased ALFF values in both patient groups' left precentral and postcentral gyri. Both patient groups had lower global NVC coefficients than HCs, with reduced CBF-ALFF (0.28 vs. 0.30), CBF-fALFF (0.43 vs. 0.45), and CBF-ReHo (0.40 vs. 0.41) in early-onset patients, and lower CBF-fALFF (0.38 vs. 0.45) and CBF-ReHo (0.32 vs. 0.41) in late-onset patients. Regional analysis showed significantly decreased CBF/ALFF ratios in the left precentral and postcentral gyri (T = 3.85 to 5.33). Reduced global NVC in early-onset patients was significantly associated with poorer executive function (r = 0.323), while global coupling in late-onset patients was negatively correlated with disease duration (r = -0.348 to -0.426). This study showed abnormal global and regional NVC in both early-onset and late-onset EU patients, emphasizing the potential role of NVC in the pathophysiological mechanisms of EU. 1 TECHNICAL EFFICACY: Stage 1.

Iowa Gambling Task performance in individuals with schizophrenia: the role of general versus specific cognitive abilities

ObjectiveWe aimed to explore how specific cognitive processes, such as attention and executive functions, account for variance in decision-making measured by Iowa Gambling Task (IGT) performance among individuals with schizophrenia spectrum disorders.MethodsAdults (N = 65, Mage = 25.4) with schizophrenia spectrum disorders participating in a clinical trial (registered at clinicaltrials.gov NCT03048695) completed the IGT, neuropsychological tests of attention, response inhibition, mental flexibility, working memory, and planning, as well as subtests from the Wechsler tests of intelligence to estimate IQ. Associations between performance on specific tasks, a composite score of executive function and attention, and IGT performance measured in two ways, one using the total net score, decks (C+D) – (A+B) and the other as preference for decks with more frequent gains than losses, decks (B+D) – (A+C), were analyzed with correlational and hierarchical regression analysis controlling for estimated IQ and psychotic symptoms, measured by the Positive and Negative Syndrome Scale.ResultsIn the regression analyses, the strongest predictor of IGT performance measured as the total net score was estimated IQ (b = 1.43, p &amp;lt;.001). Neither specific cognitive tasks nor the composite score of executive functioning significantly contributed to explaining variance in IGT total net score beyond IQ and symptoms of psychosis. However, IQ and symptoms of psychosis did not predict tendency towards selecting decks with different gain-to-loss frequency, whereas poorer composite executive functioning predicted a pattern of selecting decks A and C with more frequent losses, (b = 8.30, p &amp;lt;.05).DiscussionThe results suggest that both IQ and executive functions contribute to IGT performance, but in distinct ways. Whereas lower IQ may contribute to overall more disadvantageous decision-making, poorer executive functioning may contribute to a more risk-aversive decision-making style. A clinical implication may be that individuals with schizophrenia and lower IQ or poorer executive functioning will have a higher need for support and interventions targeting decision-making.

Enhanced neurobiological biomarker differentiation for attention-deficit/hyperactivity disorder through a risk-informed design.

Translation of biomarkers to clinical practice is hindered by the significant overlap in neurobiological measures between ADHD cases and controls. A risk-informed design can enhance the utility and validation of ADHD biomarkers by highlighting differences between individuals with ADHD and those without at differential risk. Participants were 2511 children and adolescents (aged 6 to 14 years) from the Brazilian High Risk Cohort for Mental Conditions. We calculated risk for ADHD among unaffected individuals using a multivariable clinical and sociodemographic risk model. We compared measures of three proposed ADHD biomarkers (polygenic scores, subcortical volumes, and executive function) between participants with vs. without ADHD, and ADHD vs. without ADHD with a high- vs. low-risk loading for ADHD. Compared to the unaffected group, children and adolescents with ADHD had higher ADHD polygenic scores (cohen's d = 0.17), smaller subcortical volumes (d = - 0.25), and poorer executive function (d = - 0.22). Separating the unaffected group into low- and high-risk subgroups revealed more pronounced differences (Cohen's d = 0.20 to 0.60) and nearly doubled the overlap-free area for these three neurobiological measures between the low-risk group and the other two groups. Upon adjustment for the number of ADHD symptoms, simple ADHD vs. without ADHD differences vanished, while the risk-informed analyses remained significant. Here, we demonstrate that a risk-based design increases effect sizes when comparing candidate biomarkers for ADHD. Our study provides a model that may hold promise for evaluating similar contrasts in other mental disorders and samples.

A173: An Experimental Study of the Effects of Exercise Intervention on Executive Function in Obese Adolescents

Background: Executive function (EF) is an important component of cognitive function, referring to a higher-level cognitive process that coordinates and controls various basic cognitive processes when completing complex cognitive tasks. It includes three sub-functions: inhibition, working memory, and cognitive flexibility. Globally, high rates of overweight and obesity remain a public health issue. Previous studies have shown that, compared to adolescents with healthy weight, adolescents with obesity have poorer inhibitory function in EF. In addition, the effectiveness of the exercise intervention is seen in the normal adolescent population as well as in special adolescents with poor EF. However, there have been few studies on exercise interventions for EF in adolescents with obesity, and the characteristics of time-course changes are unclear. Methods: 28 junior high school students with obesity were screened as the experimental group and 24 junior high school students with normal weight were randomly selected as the control group. The experimental group used a 14-week aerobic combined with resistance training exercise intervention, and the control group carried out the regular classroom exercise content. The three sub-functions of inhibition, refreshing, and switching of the obese and normal junior high school students were measured before the intervention, 12 weeks after the intervention, and 14 weeks after the intervention. Results: The results showed that: 1) Junior high school students with obesity had lower levels of inhibition (t (50) = 3.069, p = 0.003, Cohen's d = 0.848) and cognitive flexibility (t (50) = 2.600, p = 0.013, Cohen's d = 0.292) than healthy weight junior high school students. 2) The aerobic exercise combined with resistance training exercise intervention had positive benefits on EF in junior high school students with obesity. The inhibition (p &lt; 0.01, p = 0.003) and cognitive flexibility (p = 0.001, p &lt; 0.01) at 14 and 12 weeks of intervention were significantly better than the pretest, and the working memory (p = 0.004) at 14 weeks of intervention was significantly better than that at pretest. There were no significant differences between the time points (p &gt; 0.05) of EF in healthy weight junior high school students. Conclusion: The study concluded that adolescents with obesity have lower levels of inhibition and cognitive flexibility than healthy weight adolescents, and the time-course effects of the improvement effects of inhibition, updating of working memory, and cognitive flexibility vary with the intervention time in adolescents with obesity.

Prenatal chronic inflammation and children’s executive function development

ABSTRACT Fetal inflammation, typically measured indirectly through prenatal maternal cytokine markers, has been shown to impact early childhood executive functions (EFs), which are central to later cognitive and life outcomes. Here, we assessed the impact of prenatal inflammation on EF developmental trajectories using direct placenta histopathology measures in 131 mothers who predominantly self-identified as Black (90.8% Black; 0.8% Asian American, 1.5% biracial, 0.8% Latinx, 3.1% White, 3.1% Missing). We found that placental measures of inflammation were associated with limited gain in EF development from 3 to 5 years old. In follow up analyses, we addressed whether screening questionnaires in infancy might aid in classification of infants as higher risk for subsequent EF problems. We found that parent responses to the Ages & Stages Questionnaire and the Infant/Toddler Sensory Profile at 12 months predict the development of EF abilities in children exposed to chronic inflammation. These findings open promising opportunities for early screening of children at risk for poor executive functioning in children exposed to prenatal inflammation.

Severe traumatic brain injury temporally affects cerebral blood flow, endothelial cell phenotype, and cilia.

Previous clinical work suggested that altered cerebral blood flow (CBF) in severe traumatic brain injury (sTBI) correlates with poor executive function and clinical outcome. However, the molecular consequences of altered CBF on endothelial cells (ECs) and their blood flow-sensor organelle called cilia are not known. We performed laser speckle contrast imaging, single cell isolation, and single cell RNA sequencing (scRNAseq) after sTBI in a closed skull, linear impact mouse model. Validation of select ciliary target protein changes was performed using flow cytometry. Additionally, in vitro experiments modeled the post-injury hypoxic environment to evaluate the effect on cilia protein ARL13B in human brain microvascular ECs. We detected immediate reductions in CBF that were sustained for at least 100 minutes in both impacted and non-impacted sides of the brain. Our scRNAseq data detected heterogeneity in the brain cortex-derived EC cluster and demonstrated that two of five unique EC sub-clusters changed their relative proportions post-sTBI. Consistent with flow changes, we identified multiple genes associated with the fluid shear stress pathway that were significantly differentially expressed in brain ECs post-injury. Also, ECs displayed activation of ischemic pathway as early as day 1 post-injury, and enrichment of hypoxia pathway at day 7 and 28 post- injury. Arl13b ciliary gene expression was lost on day 1 in ECs cluster and remained lost for the entire course of the injury. We validated the loss of cilia protein ARL13B specifically from brain ECs as early as day 1 post-injury and detected the protein in the peripheral blood of the injured mice. We also determined that hypoxia could induce loss of ARL13B protein from cultured ECs. In severe TBI, blood flow is disrupted in both impacted and non-impacted regions of the brain, creating a hypoxic environment that may influence ciliary gene and protein expression on ECs.

Affect and executive function dynamics in primary school classrooms: an intensive longitudinal study

ABSTRACT This study investigates the temporal dynamics and affective associations related to executive function (EF) performance in primary school classrooms using an intensive longitudinal design. Data were collected from 35 students aged 8.9 to 11.4 years. Participants reported their affective experiences and completed EF measures three times daily following a fixed sampling schedule. The data collection spanned two consecutive school weeks across three primary school classrooms. Utilising Dynamic Structural Equation Modeling (DSEM), we examined 505 measurements of EF tasks and self-reported affective states over two weeks. The findings reveal significant within-person variability in EF, accounting for 52% of the observed variance, with performance declining later in the day and week. At the within-person level, positive affect was associated with improved EF performance, while negative affect was associated with poorer EF. No significant between-person relationships were found. These results underscore the importance of considering within-person processes and affective experiences in educational settings and highlight the need for further research employing intensive longitudinal methods to better understand the nuanced dynamics of affect and EF in real-world classroom environments.

Manifestation of Psychosis and Impairments of Executive Functions Emphasize the Interaction of Psychological and Neurological Dysfunctions in People Who Use Methamphetamine

Aim: Cumulative evidence has demonstrated the neurotoxic effect of methamphetamine (Meth) on the central nervous system. Meth can induce psychotic symptoms and impairments of cognitive abilities, including executive function (EF). Method: In this study, we hypothesized the interaction of the neurotoxic effects of Meth on psychotic symptoms and EF performances. The Stroop test evaluated the EF performances, Go/No-Go task, one-back test (OBT), and Wisconsin Card Sorting Test (WCST) in people who use Meth with psychosis (MWP) and without psychosis (MWOP) compared with healthy control participants. Result: The results showed that MWOP and MWP exhibited EF deficits in attention, working memory, and initial conceptualization. Moreover, a deficit in inhibition was observed in MWOP, while poorer processing speed and cognitive flexibility were found in MWP. Conclusion: The correlation between psychotic symptoms and poor EF performances was observed in MWP. These findings underline the interaction of the mechanistic neurotoxic effect of Meth to induce psychological and neurological dysfunctions in people who use Meth.

Self-confidence as a mediator in the relationship between executive functioning and depression among ICU survivors: a latent variable analysis

BackgroundExecutive dysfunction and depression are common among ICU survivors, yet the mechanisms linking these two factors remain poorly understood. Self-confidence has been implicated as a key mediator in the relationship between cognitive impairments and mental health outcomes. This study aimed to explore the mediating role of self-confidence in the association between executive functioning and depression in ICU survivors.MethodA provisional questionnaire was used in a cross-sectional study to assess quality of life in 395 adult ICU survivors, each with a minimum 72-h stay at one of three ICUs at a Swedish university hospital, six months to three years post-discharge. Responses to questions on executive function, self-confidence, and depression were analysed. Structural equation modelling and confirmatory factor analysis were employed to examine the mediating effect of self-confidence on the relationship between executive function and depression. Model fit was evaluated using established indicators. Reliability of the measures was assessed using McDonald’s Omega and Cronbach’s Alpha.ResultsA significant positive correlation was found between depressive symptoms and both diminished self-confidence (r = 0.80, p < 0.001) and poorer executive function (r = 0.55, p < 0.001). Additionally, a correlation was observed between reduced self-confidence and compromised executive function (r = 0.62, p < 0.001). Age was negatively associated with depression, self-confidence, and executive function, while male gender was positively correlated with higher self-confidence.Mediation analysis revealed that the effect of impaired executive function on depressive symptoms was fully mediated by diminished self-confidence (B = 0.45; 95% CI 0.34–0.59). The direct effect of executive function on depression became non-significant when self-confidence was included in the model (B = 0.07, p = 0.18), suggesting complete mediation. The overall model fit was satisfactory (CFI = 0.962; RMSEA = 0.075), highlighting the robustness of the mediation pathway.ConclusionsSelf-confidence mediates the relationship between executive function and depression among ICU survivors. Interventions aimed at enhancing self-confidence could mitigate depressive symptoms in the ICU survivor population. Longitudinal studies are needed to confirm these findings and further explore the causal pathways involved.Trial registration ClinicalTrials.gov Ref# NCT02767180; Registered 28 April 2016.

Post-stroke fatigue severity is associated with executive dysfunction in chronic stroke

ABSTRACT Following stroke, fatigue is highly prevalent and managing fatigue is consistently rated a key unmet need by stroke survivors and professionals. Domain-specific cognitive impairments have been associated with greater fatigue severity in earlier stages of stroke recovery, but it is unclear whether these associations hold in chronic (>2 years) stroke. The present cross-sectional observational study evaluates the relationship between domain-specific cognitive functioning and the severity of self-reported fatigue among chronic stroke survivors. Participants (N = 105; mean age = 72.92, 41.90% female; mean years post-stroke = 4.57) were assessed in domains of attention (Hearts Cancellation test), language (Boston Naming Test), episodic memory (Logical Memory Test), working memory (Digit Span Backwards task), and executive functioning (set-shifting: Trail Making Test, Part B), as part of the OX-CHRONIC study, a longitudinal stroke cohort. Fatigue was assessed using the Fatigue Severity Scale. In a multiple linear regression analysis inclusive of above cognitive domains, only poorer executive functioning was associated with increased fatigue severity. This provides insight into the cognitive impairment profile of post-stroke fatigue long-term after stroke, with executive functioning deficits as the key hallmark.

Cognitive function and brain structure in COVID-19 survivors: The role of persistent symptoms

Persistent COVID-19 symptoms post-acute state have been shown to have a significant negative impact on brain structure and function. In this study, we conducted magnetic resonance imaging (MRI) of the whole brain in 43 working-age adults (mean age: 44.79±10.80; range: 24–65 years) with a history of COVID-19 (731.17±312.41 days post-diagnosis), and also assessed their cognitive function (processing speed, attention, working memory, executive function, and recognition memory), mental health, and sleep quality. MRI data were processed using FSL to derive regional volumes for bilateral nucleus accumbens, caudate, pallidum, putamen, thalamus, amygdala, and hippocampus, and total grey matter, white matter, and cerebral spinal fluid volume, and analysed in relation to persistent COVID-19 symptom load, mental health, and sleep quality. Higher persistent COVID-19 symptom load was significantly associated with smaller putamen volume, lower response accuracy on working memory, executive function, and recognition memory tasks, as well as a longer time to complete the executive function task, and poorer mental health and sleep quality. Smaller putamen fully mediated the relationship between persistent COVID-19 symptom load and lower executive function. Further research is required to confirm whether reduced putamen volume and its association with poor executive function persists in COVID-19 survivors in the long term.

The cumulative impact of clinical risk on brain networks and associations with executive function impairments in adolescents with congenital heart disease.

Patients with congenital heart disease (CHD) demonstrate altered structural brain network connectivity. However, there is large variability between reported results and little information is available to identify those patients at highest risk for brain alterations. Thus, we aimed to investigate if network connectivity measures were associated with the individual patient's cumulative load of clinical risk factors and with family-environmental factors in a cohort of adolescents with CHD. Further, we investigated associations with executive function impairments. In 53 adolescents with CHD who underwent open-heart surgery during infancy, and 75 healthy controls, diffusion magnetic resonance imaging and neuropsychological assessment was conducted at a mean age of 13.2 ± 1.3 years. Structural connectomes were constructed using constrained spherical deconvolution tractography. Graph theory and network-based statistics were applied to investigate network connectivity measures. A cumulative clinical risk (CCR) score was built by summing up binary risk factors (neonatal, cardiac, neurologic) based on clinically relevant thresholds. The role of family-environmental factors (parental education, parental mental health, and family function) was investigated. An age-adjusted executive function summary score was built from nine neuropsychological tests. While network integration and segregation were preserved in adolescents with CHD, they showed lower edge strength in a dense subnetwork. A higher CCR score was associated with lower network segregation, edge strength, and executive function performance. Edge strength was particularly reduced in a subnetwork including inter-frontal and fronto-parietal-thalamic connections. There was no association with family-environmental factors. Poorer executive functioning was associated with lower network integration and segregation. We demonstrated evidence for alterations of network connectivity strength in adolescents with CHD - particularly in those patients who face a cumulative exposure to multiple clinical risk factors over time. Quantifying the cumulative load of risk early in life may help to better predict trajectories of brain development in order to identify and support the most vulnerable patients as early as possible.

Circulating IL-17A and Executive Function in Middle-Aged Adults with and without Type 2 Diabetes

Abstract Background Midlife cardiovascular risk factors, such as Type 2 Diabetes Mellitus (T2DM) and obesity, are associated with a greater risk of cognitive impairment and dementia in later life, with altered peripheral inflammation postulated as a crucial mechanistic link. Yet there is a significant gap in knowledge regarding when pathogenic alterations to these systemic inflammatory responses change during the early stages of cognitive dysfunction prior to overt disease development. To assess the earliest possible signs of this link, we recruited a cohort of middle-aged cognitively-unimpaired individuals with and without uncomplicated T2DM. Methods A comprehensive neuropsychological assessment was performed at baseline and at 4-year follow-up. A panel of ten serum chemokines and cytokines were measured at both time-points using high-sensitivity assays (Eotaxin, MCP-1, MIP-1β, CXCL-10, IL-6, IL-10, IL12p70, IL-17A, IFN-γ and TNF-α). Results Overall, 136 individuals were recruited including 90 with uncomplicated midlife T2DM (age 52.6 ± 8.3; 47% female) and 46 without (age 52.9 ± 8.03; 61% female). Cognitive trajectories were stable over time and did not differ by T2DM status. Yet on cross-sectional analyses, we observed consistent evidence across timepoints between greater circulating IL-17A and poorer performance on tests of executive function/attention (β: -0.21; -0.40, -0.02, p = 0.03 at baseline; β: -0.26; -0.46, -0.05, p = 0.02 at follow-up) as well as poorer reaction time (β: 0.34; 0.12, 0.56, p = 0.003 at follow-up). These persisted on covariate adjustment and did not differ by T2DM status. Conclusion We provide exploratory evidence that greater serum IL-17A levels are associated with poorer executive function in midlife. Long-term follow-up of this and other cohorts will further elucidate this relationship to provide further mechanistic insights and potentially identify individuals at greatest risk for later cognitive decline.

Executive Function and Adherence in Children and Adolescents Living with HIV: Evidence from the HIV-associated Neurocognitive Disorders in Zambia (HANDZ) Study.

Executive function (EF) may be impaired in people with human immunodeficiency virus (HIV) infection, and poor EF may affect medication adherence. However, there is little data on EF in children with HIV in sub-Saharan Africa. 208 children/adolescents with perinatally acquired HIV and 208 HIV-exposed uninfected controls were recruited in Zambia for this prospective cohort study. EF was measured using performance-based, self-report, and parental report measures. Adherence over one year of follow-up was assessed through questionnaires and viral load measurement. Children with HIV performed significantly worse on all three measures of EF. Lower parental rating of EF was associated with poorer antiretroviral therapy adherence (OR: 1.5, 95% CI = 1.02 - 2.2, p = 0.04). Children with HIV have EF impairments which may lead to consequences like poor medication adherence and treatment failure. Interventions to improve EF or compensate for impaired EF may be necessary in this population.

Executive Functions are Independently Associated with Cognitive Dispersion in HIV Disease.

People with HIV (PWH) can demonstrate elevated cognitive intraindividual variability (IIV-dispersion) that is associated with everyday functioning problems. Higher IIV-dispersion is theorized to reflect lapses in executive aspects of cognitive control, but few studies have directly evaluated this possibility. 72 PWH completed the Cogstate and clinical measures of executive functions, psychomotor speed, and episodic memory. IIV-dispersion was calculated with the coefficient of variation (CoV) from six age-adjusted Cogstate subtest scores. Multiple regression showed that the three domain-level cognitive predictors explained 8% of the variance in Cogstate CoV (p = .03). Within this model, poorer executive functions were moderately associated with higher Cogstate CoV (p = .01), but the psychomotor and episodic memory domains were not (ps > .05). Findings align with cognitive theory in demonstrating IIV-dispersion is uniquely associated with independent measures of executive functions among PWH. Future experimental and mechanistic studies are needed to determine the precise executive aspects of IIV-dispersion.

Circulating Interleukin-17A is associated with executive function in middle aged adults with and without type 2 diabetes

Midlife cardiovascular risk factors such as Type 2 Diabetes (T2DM) and obesity are associated with the later development of cognitive impairment and dementia. Systemic inflammation is postulated as a crucial mechanism, yet there are few studies examining this at the earliest stages prior to overt cognitive impairment. To assess this, we recruited a cohort of middle-aged cognitively-unimpaired individuals with and without uncomplicated T2DM. Comprehensive neuropsychological assessment was performed at baseline and at 4-year follow-up. Ten serum chemokines and cytokines (Eotaxin, MCP-1, MIP-1β, CXCL10, IL-6, IL-10, IL12p70, IL-17A, IFN-γ and TNF-α) were measured at both baseline and follow-up using high-sensitivity assays. Overall, 136 participants were recruited including 90 with uncomplicated midlife T2DM (age 52.6 ± 8.3; 47% female) and 46 without (age 52.9 ± 8.03; 61% female). Cognitive trajectories were stable over time and did not differ with T2DM. Yet on cross-sectional analyses at both baseline and follow-up, greater circulating IL-17A was consistently associated with poorer performance on tests of executive function/attention (β: 0.21; −0.40, −0.02, p = 0.03 at baseline; β: 0.26; −0.46, −0.05, p = 0.02 at follow-up). Associations persisted on covariate adjustment and did not differ by T2DM status. In summary, we provide evidence that greater circulating IL-17A levels were associated with poorer executive function in midlife, independent of T2DM. Long-term follow-up of this and other cohorts will further elucidate the earliest stages in the relationship between systemic inflammation and cognitive decline to provide further mechanistic insights and potentially identify those at greatest risk for later cognitive decline.

Association between Reported Sleep Disorders and Behavioral Issues in Children with Myotonic Dystrophy Type 1-Results from a Retrospective Analysis in Italy.

Background: Sleep disorders have been poorly described in congenital (CDM) and childhood (ChDM) myotonic dystrophy despite being highly burdensome. The aims of this study were to explore sleep disorders in a cohort of Italian CDM and ChDM and to assess their association with motor and respiratory function and disease-specific cognitive and behavioral assessments. Methods: This was an observational multicenter study. Reported sleep quality was assessed using the Pediatric Daytime Sleepiness Scale (PDSS) and Pediatric Sleep Questionnaire (PSQ). Sleep quality was correlated to motor function (6 min walk test, 6MWT and grip strength; pulmonary function (predicted Forced Vital Capacity%, FVC% pred.); executive function assessed by BRIEF-2; autism traits assessed by Autism Spectrum Screening Questionnaire (ASSQ) and Repetitive Behavior Scale-revised (RBS-R); Quality of life (PedsQL) and disease burden (Congenital Childhood Myotonic Dystrophy Health Index, CCMDHI). Results: Forty-six patients were included, 33 CDM and 13 ChDM, at a median age of 10.4 and 15.1 years. Daytime sleepiness and disrupted sleep were reported by 30% children, in both subgroups of CDM and ChDM. Daytime sleepiness correlated with autism traits in CDM (p < 0.05). Disrupted sleep correlated with poorer executive function (p = 0.04) and higher disease burden (p = 0.03). Conclusions: Sleep issues are a feature of both CDM and ChDM. They correlate with behavioral issues and impact on disease burden.

B - 65 Adolescent Cortico-Limbic Connectivity Mediates Associations between Internalizing Symptomology and Subsequent Neurocognitive Performance

Abstract Objective During development, internalizing symptoms negatively impact broad neurocognitive functioning. Hypoconnectivity between the Cingulo-Opercular network (CON) and limbic regions has been implicated in various psychiatric disorders. Here we attempt to investigate whether CON-limbic connectivity longitudinally mediates associations between internalizing behaviors and cognitive outcomes during adolescence. Method Internalizing symptoms were measured in 2668 youth (47% female) enrolled in the Adolescent Brain Cognitive Development study using the Child Behavior Checklist. Zero-order correlations were tested between baseline (ages 9–11) internalizing symptoms (anxiety, depression, somatic complaints) and performance on NIH Toolbox® neurocognitive measures at 4-year follow-up (ages 13–15). Significantly predicted tasks were included in a structural equation model (SEM), which tested whether a latent factor representing 2-year follow-up resting-state fMRI connectivity between the CON and limbic regions (i.e., bilateral hippocampus and amygdala) mediated associations between baseline internalizing symptoms and 4-year cognitive outcomes. Results Four neurocognitive tasks (Flanker, Picture Sequence, List Sorting, Pattern Comparison) regressed significantly onto at least one internalizing symptom. An SEM which tested the mediatory effects of CON-limbic connectivity on these associations fit the data well (CFI = 0.997; SRMR = 0.007; RMSEA =0.015 [0,0.027]). Increased anxiety and somatic symptoms significantly predicted reduced CON-limbic connectivity, while depression did not. Associations between anxiety and somatic symptoms and List Sorting performance were suppressed, indicating full mediation by CON-limbic connectivity on working memory. Connectivity also partially mediated a negative association between anxiety and Flanker performance. Conclusions Our findings point to CON-limbic hypoconnectivity as a potential mechanism underlying associations between late childhood internalizing symptoms and poorer executive functioning (most notably working memory) during early adolescence.

A - 22 Effects of Gender on the Relationship between Coping Styles and Executive Functioning in Alcohol Use Disorders

Abstract Objective Executive functioning (EF) and coping styles are important factors likely to influence risk and resilience to relapse following Alcohol Use Disorder (AUD) treatment. This study aims to evaluate EF and coping as independent predictors of relapse and the interplay between these two constructs by treatment outcome group and gender differences. Methods 23 females and 59 males in AUD residential treatment programs completed self-report questionnaires, a neuropsychological battery, and were followed for six months to determine treatment outcome. A logistic regression analysis was performed to evaluate coping (Brief COPE Inventory) and EF (Delis-Kaplan Executive Function System, Color-Word Interference Test, CWIT; inhibition and switching conditions) variables as predictors of relapse status. Significant predictors were evaluated by group status and gender to understand the association between coping and EF using Pearson correlation within each group. Results Gender (B = 8.6, p = 0.032), two coping (self-distraction (B = 2.3, p = 0.051) and humor (B = 1.9, p = 0.051)) and two EF (CWIT inhibition (B = 0.5, p = 0.007) and CWIT switching (B = 1.9, p = 0.006)) variables resulted in 85.4% overall classification accuracy. Correlations between these coping and EF, when evaluated by treatment group and gender, revealed significant gender-specific associations only among the relapse groups: self-distraction and CWIT inhibition (r = 0.379) in females and humor and CWIT inhibition (r = 0.242) in males. Conclusion Overall, EF and coping styles have independent predictive value for determining relapse risk in individuals with AUD. Poor EF skills may inhibit an individual’s ability to engage in appropriate coping during times of emotional distress. Understanding gender differences in relation to these dynamic relationships is essential for creating supportive and effective psychosocial interventions.

Concurrent and longitudinal associations between touchscreen use and executive functions at preschool-age

IntroductionThe prevalence of touchscreen devices has recently risen amongst young children. Some evidence suggests that increased touchscreen use may be negatively related to preschool-age children's executive functions (EFs). However, it has been argued that actively interacting with touchscreen devices (e.g., via creative apps for drawing) could better support EF development compared to passive use (e.g., watching videos). There is a pressing need to understand whether the type of use can explain potential associations between touchscreen use and EF.MethodsBy following up longitudinally on an infant sample, now aged 42-months (N = 101), the current study investigates the relative contributions of passive and active touchscreen use, measured concurrently at 42-months and longitudinally from 10-to-42-months, on parent-reported EFs.ResultsA multivariate multiple regression found no significant negative associations between touchscreen use and preschool EF. There was a significant positive association between active touchscreen use at 42-months and the BRIEF-P Flexibility Index.DiscussionThe lack of significant negative associations found is consistent with an earlier study's findings in the same sample at infancy, suggesting that the moderate levels of early touchscreen use in this sample are not significantly associated with poorer EF, at least up to preschool-age.