Verbal Memory Test Research Articles

Evaluation of the Oxford cognitive screen Indonesian version (OCS-Ina) for assessing cognitive function disorders: validation and reliability study

Background and objectives. The Oxford Cognitive Screen (OCS) is a valuable tool for assessing cognitive function, particularly in the context of aphasia and neglect. This study aims to assess the validity and reliability of the Indonesian version of OCS (OCS-INA), which has been adapted and translated following WHO guidelines. Materials and methods. The adaptation and translation process of OCS, in accordance with WHO guidelines, preceded the validity and reliability testing of OCS-INA. The study included participants aged 18 years and above with normal cognitive function, as assessed by the Moca-INA. Data collection took place in social institutions and healthcare facilities that met the specified inclusion criteria. Results. Among the 104 participants meeting the inclusion criteria, a majority were male (51.92%), with ages ranging from 20 to 87 years, and the highest age group being above 60 years (60%). Most participants had a high school education level (35.58%) and were not employed (62.5%). Validity testing, using the Spearman correlation coefficient formula, revealed that the majority of domains had calculated correlation coefficients (r values) exceeding the table values (0.1927). In terms of reliability, the kappa p statistic indicated very good agreement for six examination tasks: semantic (0.874), orientation (0.842), verbal memory (0.822), episodic memory (0.870), and visual field test (1.000). Good agreement scores were obtained for the picture naming test (0.774), sentence reading (0.726), and calculation (0.774). Conclusions. In conclusion, OCS-INA demonstrates both validity and reliability as a screening tool for cognitive impairment. It serves as a valuable complement to existing instruments used for similar purposes.

Sensitivity of the African neuropsychology battery memory subtests and learning slopes in discriminating APOE 4 and amyloid pathology in adult individuals in the Democratic Republic of Congo.

The current study examined the sensitivity of two memory subtests and their corresponding learning slope metrics derived from the African Neuropsychology Battery (ANB) to detect amyloid pathology and APOEε4 status in adults from Kinshasa, the Democratic Republic of the Congo. 85 participants were classified for the presence of β-amyloid pathology and based on allelic presence of APOEε4 using Simoa. All participants were screened using CSID and AQ, underwent verbal and visuospatial memory testing from ANB, and provided blood samples for plasma Aβ42, Aβ40, and APOE proteotype. Pearson correlation, linear and logistic regression were conducted to compare amyloid pathology and APOEε4 status with derived learning scores, including initial learning, raw learning score, learning over trials, and learning ratio. Our sample included 35 amyloid positive and 44 amyloid negative individuals as well as 42 without and 39 with APOEε4. All ROC AUC ranges for the prediction of amyloid pathology based on learning scores were low, ranging between 0.56-0.70 (95% CI ranging from 0.44-0.82). The sensitivity of all the scores ranged between 54.3-88.6, with some learning metrics demonstrating good sensitivity. Regarding APOEε4 prediction, all AUC values ranged between 0.60-0.69, with all sensitivity measures ranging between 53.8-89.7. There were minimal differences in the AUC values across learning slope metrics, largely due to the lack of ceiling effects in this sample. This study demonstrates that some ANB memory subtests and learning slope metrics can discriminate those that are normal from those with amyloid pathology and those with and without APOEε4, consistent with findings reported in Western populations.

Lower Dorsal Putamen D2/3 Receptor Availability and Amphetamine-Induced Dopamine Release are Related to Poorer Cognitive Function in Recently Abstinent People Who Smoke and Healthy Controls.

In the dopamine system, the mesolimbic pathway, including the dorsal striatum, underlies the reinforcing properties of tobacco smoking, and the mesocortical pathway, including the dorsolateral prefrontal cortex (dlPFC), is critical for cognitive functioning. Dysregulated dopamine signaling has been linked to drug-seeking behaviors and cognitive deficits. The dorsal striatum and dlPFC are structurally and functionally connected and are key regions for cognitive functioning. We recently showed that people who smoke have lower dlPFC dopamine (D2/3R) receptor availability than people who do not, which is related to poorer cognitive function. The goal of this study was to examine the same brain-behavior relationship in the dorsal striatum. Twenty-nine (18 males) recently abstinent people who smoke and 29 sex-matched healthy controls participated in 2 same-day [11C]-(+)-PHNO positron emission tomography scans before and after amphetamine administration to provoke dopamine release. D2/3R availability (binding potential; BPND) and amphetamine-induced dopamine release (%ΔBPND) were calculated. Cognition (verbal learning and memory) was assessed with the CogState computerized battery. There were no group differences in baseline BPND. People who smoke have a smaller magnitude %ΔBPND in dorsal putamen than healthy controls (p = .022). People who smoke perform worse on immediate (p = .035) and delayed (p = .011) recall than healthy controls. In all people, lower dorsal putamen BPND was associated with worse immediate (p = .006) and delayed recall (p = .049), and lower %ΔBPND was related to worse delayed recall (p = .022). Lower dorsal putamen D2/3R availability and function are associated with disruptions in cognitive function that may underlie difficulty with resisting smoking. This study directly relates dopamine imaging outcomes in the dorsal striatum to cognitive function in recently abstinent people who smoke cigarettes and healthy controls. The current work included a well-characterized subject sample in terms of demographics, smoking characteristics, and a validated neurocognitive test of verbal learning and memory. The findings of this study extend previous literature relating dopamine imaging outcomes to cognition in recently abstinent people who smoke and people who do not smoke, expanding our understanding of brain-behavior relationships.

Measuring episodic verbal learning ability in alcohol-related cognitive disorders in relation to everyday functioning

Adequate and timely assessment of learning abilities in individuals with alcohol-related cognitive disorders is highly relevant to optimize addiction care. Learning curves of episodic verbal memory tests have been used to assess learning ability in various neurocognitive disorders, but studies in alcohol-related cognitive disorders are lacking. Therefore, this study investigated California Verbal Learning Test (CVLT) learning curves in individuals with alcohol-use disorder (AUD) with and without cognitive impairments and examined associations between learning curves and changes in everyday functioning following a multicomponent care program. We fitted learning curves over the five immediate recall trials of the Dutch version of the CVLT of patients with Korsakoff's syndrome (KS; N = 117), alcohol-related cognitive impairment no KS (ARCI; N = 147), and uncomplicated AUD (N = 43) using a generalized non-linear mixed regression. This model was based on three different parameters: initial memory performance (attention), maximum number of correctly recalled words (maximum learning), and the increase of correctly recalled words over the trials (learning rate). Next, we related these learning curves with ratings of everyday activities using the Patient Competency Rating Scale (PCRS) before and after a care program following admission. Modelled learning curves differed across groups, with significant differences in Attention (KS<ARCI<AUD, p < 0.001), Maximum Learning (KS<ARCI<AUD, p<0.001), and Learning Rate (KS<ARCI=AUD, p < 0.001). However, modelled learning curves were not related to reliable improvement in PCRS scores (p>0.05). Although modelled learning curves may be used to differentiate diagnostic groups in alcohol-related cognitive disorders, future studies are needed to establish the criterion validity of learning curves in this population.

Cognitive training and brain stimulation in patients with cognitive impairment: a randomized controlled trial

BackgroundRepeated sessions of training and non-invasive brain stimulation have the potential to enhance cognition in patients with cognitive impairment. We hypothesized that combining cognitive training with anodal transcranial direct current stimulation (tDCS) will lead to performance improvement in the trained task and yield transfer to non-trained tasks.MethodsIn our randomized, sham-controlled, double-blind study, 46 patients with cognitive impairment (60–80 years) were randomly assigned to one of two interventional groups. We administered a 9-session cognitive training (consisting of a letter updating and a Markov decision-making task) over 3 weeks with concurrent 1-mA anodal tDCS over the left dorsolateral prefrontal cortex (20 min in tDCS, 30 s in sham group). Primary outcome was trained task performance (letter updating task) immediately after training. Secondary outcomes included performance in tasks testing working memory (N-back task), decision-making (Wiener Matrices test) and verbal memory (verbal learning and memory test), and resting-state functional connectivity (FC). Tasks were administered at baseline, at post-assessment, and at 1- and 7-month follow-ups (FU). MRI was conducted at baseline and 7-month FU. Thirty-nine participants (85%) successfully completed the intervention. Data analyses are reported on the intention-to-treat (ITT) and the per-protocol (PP) sample.ResultsFor the primary outcome, no difference was observed in the ITT (β = 0.1, 95%-CI [− 1.2, 1.3, p = 0.93] or PP sample (β = − 0.2, 95%-CI [− 1.6, 1.2], p = 0.77). However, secondary analyses in the N-back working memory task showed that, only in the PP sample, the tDCS outperformed the sham group (PP: % correct, β = 5.0, 95%-CI [− 0.1, 10.2], p = 0.06, d-prime β = 0.2, 95%-CI [0.0, 0.4], p = 0.02; ITT: % correct, β = 3.0, 95%-CI [− 3.9, 9.9], p = 0.39, d-prime β = 0.1, 95%-CI [− 0.1, 0.3], p = 0.5). Frontoparietal network FC was increased from baseline to 7-month FU in the tDCS compared to the sham group (pFDR < 0.05). Exploratory analyses showed a correlation between individual memory improvements and higher electric field magnitudes induced by tDCS (ρtDCS = 0.59, p = 0.02). Adverse events did not differ between groups, questionnaires indicated successful blinding (incidence rate ratio, 1.1, 95%-CI [0.5, 2.2]).ConclusionsIn sum, cognitive training with concurrent brain stimulation, compared to cognitive training with sham stimulation, did not lead to superior performance enhancements in patients with cognitive impairment. However, we observed transferred working memory benefits in patients who underwent the full 3-week intervention. MRI data pointed toward a potential intervention-induced modulation of neural network dynamics. A link between individual performance gains and electric fields suggested dosage-dependent effects of brain stimulation. Together, our findings do not support the immediate benefit of the combined intervention on the trained function, but provide exploratory evidence for transfer effects on working memory in patients with cognitive impairment. Future research needs to explore whether individualized protocols for both training and stimulation parameters might further enhance treatment gains.Trial registrationThe study is registered on ClinicalTrials.gov (NCT04265378). Registered on 7 February 2020. Retrospectively registered.

Exercise, memory, and the hippocampus: Uncovering modifiable lifestyle reserve factors in refractory epilepsy

Physical exercise is an emerging target for improving cognition in aging and neurological disease. Due to the beneficial impact of exercise on hippocampal health and the vulnerability of the hippocampus in medication-resistant temporal lobe epilepsy (TLE), exercise could present a promising intervention in TLE. We investigated whether exercise engagement is associated with verbal memory function and hippocampal integrity in 29 young to middle-aged adults with refractory TLE and 21 demographically matched controls. Participants completed a self-reported questionnaire of weekly exercise, three tests of verbal memory, and a subset (n = 44) underwent structural MRI. Individuals with TLE self-reported lower exercise scores than controls across all levels of exercise intensity (p < 0.001). In TLE, greater exercise engagement was associated with better verbal memory (word-list recall and associative learning; rho = 0.46–0.47; ps FDR < 0.05), and with larger contralateral hippocampal volumes (rho = 0.61; p < 0.01). These effects remained significant when controlling for epilepsy-related and demographic factors. Within the limitations of a cross-sectional observational study, these findings suggest that exercise may be a cognitive reserve factor in TLE, potentially mitigating memory decline by enhancing contralateral hippocampal integrity. With future replication and longitudinal studies to clarify the causal pathways of these relationships, exercise holds promise as a low-cost, accessible, and modifiable lifestyle target for improving cognitive health in individuals with refractory TLE.

Investigation of the Relationships Between Digital Games and Neuropsychological Test Scores and Cognitive Functions

This study aimed to examine the relationships between digital games and neuropsychological test scores (card sorting, verbal memory and digit span tests). The study was designed using the descriptive cross-sectional research method. Data were collected from a total of 117 volunteering university students at a state university. Of all the participants, 66.9% of them were women, and 33.1% were men. The mean age of the participants was calculated as 21.3 years. In the study, demographic variables were determined, and data on games were collected from the participants. In addition within the scope of neuropsychological tests, Wisconsin Card Sorting Test, Öktem Verbal Memory Processes Test and Digit Span Test were used. The results of the study revealed that the neuropsychological test scores did not show a significant difference in terms of digital game players/non-players and game types.

Verbal and non-verbal recognition memory assessment: validation of a computerized version of the Recognition Memory Test.

The use of computerized devices for neuropsychological assessment (CNADs) as an effective alternative to the traditional pencil-and-paper modality has recently increased exponentially, both in clinical practice and research, especially due to the pandemic. However, several authors underline that the computerized modality requires the same psychometric validity as "in-presence" tests. The current study aimed at building and validating a computerized version of the verbal and non-verbal recognition memory test (RMT) for words, unknown faces and buildings. Seventy-two healthy Italian participants, with medium-high education and ability to proficiently use computerized systems, were enrolled. The sample was subdivided into six groups, one for each age decade. Twelve neurological patients with mixed aetiology, age and educational level were also recruited. Both the computerized and the paper-and-pencil versions of the RMT were administered in two separate sessions. In healthy participants, the computerized and the paper-and-pencil versions of the RMT showed statistical equivalence for words, unknown faces and buildings. In the neurological patients, no statistical difference was found between the performance at the two versions of the RMT. A moderate-to-good inter-rater reliability between the two versions was also found in both samples. Finally, the computerized version of the RMT was perceived as acceptable by both healthy participants and neurological patients at System Usability Scale (SUS). The computerized version of the RMT can be used as a reliable alternative to the traditional version.

Does cannabis affect cognitive functioning in patients with schizophrenia?

IntroductionCannabis use impairs cognitive performance in healthy subjects; several studies have shown improved cognitive outcomes in schizophrenic patients using cannabis. The aim of this study was to evaluate the effects of cannabis use on cognitive function in Moroccan patients with schizophrenia who were cannabis users. MethodTwo groups were recruited in a Moroccan University Psychiatric Centre. Fifty patients diagnosed with schizophrenia according to the DSM-V who were cannabis users (SZ CANN +) and forty-nine patients diagnosed with schizophrenia according to DSM-V who do not use cannabis (SZ CANN-). Cognitive functioning was assessed using the CogState neuropsychological battery. ResultsThe results of the study suggest that SZ CANN- patients performed better in the test of psychomotor function, attention and verbal memory. While SZ CANN+ patients performed better in the test of working memory, visual memory and emotional recognition. We found no relationship between SZ CANN+ patients and SZ CANN- patients concerning executive function. ConclusionsOur results suggest that cannabis use may have different effects on neurocognitive functioning. It is associated with disorders of psychomotor function, attention and verbal memory. So, it is associated with an improvement in working memory, visual memory and emotion recognition.

A Comparative Study of Alpha Frequency Analysis between Medical and Consumer-grade Electroencephalography Devices on the Measurement of Male Healthy Subjects

The relatively high cost of medical-grade electroencephalography (EEG) devices has pushed the production of low-cost wireless consumer-grade devices. Therefore, it is essential to assess the performance of wireless consumer devices to determine whether they are sufficient for medical purposes. This research assessed consumer-grade EEG (C-EEG) recording quality by quantitatively comparing the consumer-grade EEG with a medical-grade EEG device (M-EEG). Recording data from C-EEG and M-EEG were obtained from 20 male subjects in age 19-23 years old. Recording for both devices was done sequentially with similar methods of recording. Upon EEG recording, the subject is asked to sit in a chair facing the screen. EEG recording was performed when the subject was asked to open and close their eyes for 30 seconds each. Subsequently, subjects took a verbal memory test. This research compared the following parameters: power spectral density (PSD), full width at half max (FWHM) from PSD, and individual peak alpha frequency (IPAF) shift. P-value, standard error, mean absolute percentage error (MAPE) and mean squared error (MSE) were also obtained based on mentioned parameters. Based on the IPAF shift, it was concluded that C-EEG could read EEG signals against time well. Based on PSD and FWHM results, it was concluded that the C-EEG could not read EEG signal amplitudes well compared to the M-EEG device. The results of this research are important as a benchmark for carrying out further research using EEG, both medical and consumer-grade.

Sex/gender differences in subjective cognitive decline’s association to cognition and depression

AbstractBackgroundDespite the fact that women are more likely to develop Alzheimer’s disease (AD) than men, and develop pathological changes at an earlier age, women often receive diagnoses later. This disparity is possibly due to women’s verbal memory advantage, and the fact that verbal memory tests are often the gold‐standard for diagnostics. Further, a recent meta‐analysis found that female sex/gender was associated with greater depression which is often a differential diagnosis for dementia (Eikelboom 2022). Understanding sex/gender differences in Subjective Cognitive Decline (SCD) is critical to closing the care gap, as SCD is thought to be a preclinical stage of AD where intervention may be most effective. Integration of challenging cognitive testing, including non‐verbal memory tests, along with measurement of depression, is key for defining this preclinical stage. In this study, we compare SCD’s associations with non‐verbal and verbal list‐learning and depression as a function of sex/gender.Method97 cognitively unimpaired older adults were recruited for this study. Participants completed surveys regarding SCD and depression (Geriatric Depression Scale [GDS]) and cognitive testing. Non‐verbal memory was assessed with the Biber Figure Learning Test – Extended (BFLT‐E), a challenging non‐verbal figure‐learning test. Verbal memory was assessed with the Loewenstein‐Acevedo Scales for Semantic Interference and Learning (LASSI‐L). Both tests are associated with early AD changes. Linear regressions were conducted and stratified by sex/gender to assess the relationships of cognition and mood with SCD. Models of cognitive performance included age and education as covariates.ResultVerbal list‐learning (LASSI‐L) predicted SCD in men (R2= .416, β = ‐.390, p = .017), but not in women (R2 = .217, β = ‐.173, p = .167). Non‐verbal figure‐learning, as measured by the BFLT‐E, predicted SCD in women (R2 = .267, β = ‐.342, p = .006), but not in men (R2 = .175, β = ‐.334, p = .078). Similarly, depression predicted SCD in women (R2 = .109, β = .330, p = .007), but not in men (R2 = .003, β = .055, p = .763).ConclusionResults demonstrate that in AD risk states such as SCD, cognitive dysfunction may manifest differently for women than men. Clinical care settings should consider integration of non‐verbal memory tests such as BFLT‐E along with regular screening of depression in order to address the inequities in diagnostics for women.

Challenges in identification of HIV‐Associated Neurocognitive Disorders, a focus on low and middle income countries

AbstractBackgroundHIV‐associated neurocognitive disorders (HAND) are highly prevalent amongst people living with HIV (PLWH), especially in Sub‐Saharan Africa (SSA) where the majority of PLWH live. Current HAND identification measures lack accuracy in older PLWH on treatment, with substantial heterogeneity observed in SSA prevalence meta‐analyses There is a need to better understand the current cognitive phenotype of this newly emergent population, to develop appropriate screening tools. We report two linked studies.Study 1 compared diagnostic accuracy of the International HIV dementia scale (IHDS), and Identification and Interventions for Dementia in Elderly Africans (IDEA) screen, for identification of HAND in older PLWH in TanzaniaStudy 2 aimed to identify cognitive domains significantly associated with symptomatic HAND (s‐HAND) in older PLWH in Tanzania, with potential utility in future screening measures.MethodA systematic sample of 253 PLWH aged ≥ 50 attending a Government clinic underwent comprehensive HAND evaluation by consensus American Academy of Neurology (AAN) criteria including locally‐normed low‐literacy clinical neuropsychological assessment. A diagnostic accuracy study of the IHDS and IDEA screen versus AAN criteria was completed with strict blinding. Participants were offered identical annual reassessment at Y1 Y2 and Y3 and the relationship of cognitive domains with s‐HAND in a logistic mixed effects modelResultHAND was highly prevalent (47%) at baseline, increasing to 57.9% at year 3.At baseline, both IHDS and IDEA had limited diagnostic accuracy for HAND (AUROC 0.639–0.667 IHDS, 0.647–0.713 IDEA). On secondary analysis of longitudinal data, tests of verbal learning and memory, categorical verbal fluency, visual memory and visuoconstruction had AUROC &gt; 0.7 for s‐HAND (0.70 ‐ 0.72; p&lt;0.001 for all). Tests of visual memory, verbal learning and memory (delayed recall and recognition memory), psychomotor speed, language comprehension and categorical verbal fluency were independently associated with s‐HAND (p&lt;0.01 for all). Neuropsychological impairment pattern varied by education.ConclusionCurrent HAND screening tests no longer perform well in the new population of older PLWH in Africa. Tests most associated with s‐HAND include broad cortical and subcortical domains, some not included in existing HAND screening tests and vary by educational background. This should be considered in future HAND screening measure development.

A Cognitive Screening Test for detecting Alzheimer’s Disease Dementia in the Deaf older adults in Austria, and Greece: the De‐Sign Erasmus+ project

AbstractBackgroundUntil now there is a lack of cognitive screening tests for Deaf older adults to detect Alzheimer’s Disease Dementia (ADD) across Europe, as well as limited access to the therapeutic methods imposed. Therefore, the Deaf population has little access to dementia services.MethodTo fill this gap, the current Erasmus+ project aims to adapt the first dementia screening test for Deaf people in Austria and Greece being initially available for the British Deaf older adults and therefore, provide a valid and reliable tool to detect cognitive deficits by means of ADD in this population.ResultFor the project’s purposes, a group of experts will translate and adapt the CST in Austrian (ÖGS) and Greek sign languages (GSL), and after piloting the new CST versions, they will be administered in approximately 100 Deaf older adults in each country. Additionally, the following tests will be also administered: the Montreal Cognitive Assessment (MoCA), the Verbal Learning and Memory Test, and the Digit Span (forwards and backwards). To assess the psychometric properties of the new versions of CST, internal reliability, test retest reliability, as well as concurrent validity will be calculated. Finally, a digital web‐based platform including tests’ administration guidelines along with the test per se will be developed. To disseminate the project’s results, detailed seminars on the test administration as well as the use of the platform will be implemented to experts from the fields of dementia and sign languages.ConclusionTo introduce dementia screening as well as ADD detection in the Deaf in Austria and Greece.

Cognitive reserve in figural and verbal memory in healthy older adults – preliminary results

AbstractBackgroundCognitive reserve plays an important role in individual trajectories of age‐related memory decline, with education and semantic fluency representing cognitive reserve proxies (CRPs). Higher CR may attenuate well‐known effects of ageing on the brain, such as decreases in grey matter volume (GMV). We hypothesised that the known associations between age‐related GMV and cognition would be (differentially) attenuated by CRPs.MethodWe analysed 3‐Tesla T1‐weighted Multi‐Echo MPRAGE and cognitive data (Verbal Learning and Memory Test (VLMT), Rey Complex Figure Test (RCFT), and Regensburg Verbal Fluency Test (RWT)) from 51 cognitively normal adults (73.2±7.62 years, 31 male) in our new cohort established within the CRC1436 (https://sfb1436.de/). MRI data were pre‐processed and analysed using CAT12. We performed a whole‐brain linear regression to first assess age‐related reductions in GMV (covariates: sex, total intracranial volume (TIV), education), extracting mean betas for significant regions of interest (ROIs). We investigated the relationship between GMV in age‐vulnerable regions and memory using linear regressions in R (covariates: age, sex, TIV), and assessed CRPs as moderators on this relationship. Finally, we tested whether CRPs explained variance in memory performance over and above that of GMV and age. We accounted for multiple testing via Benjamini‐Hochberg‐correction.ResultWhole brain analyses identified bilateral hippocampal GMV as negatively associated with age (Fig.1). Linear regression analyses yielded a significant positive association between bilateral hippocampal GMV and figural memory (Fig.2). However, we observed no significant moderation by CRPs on this relationship. Finally, we observed weak evidence for cognitive reserve when adjusting for GMV and age, with higher variance explained by CRPs (Table 1). Semantic fluency positively predicted a figural memory composite when adjusting for right (p = 0.006) as well as left hippocampal GMV (p = 0.014). Education positively predicted verbal memory when adjusting for right (p&lt;0.001) as well as left hippocampal GMV (p&lt;0.001).ConclusionConsistent with operational definitions, our results provide weak evidence for semantic fluency and for education as CRPs in figural and verbal memory, respectively. However, our findings are preliminary, given the future addition of more participants. Nevertheless, these results provide important first insights into cognitive reserve in this developing cohort.

Sleep‐mediated cognitive assessment and sleep architecture associations for real‐world diagnostic phenotyping of neurocognitive disorders

AbstractBackgroundSleep disorders precede cognitive deficits by an average of four years in Alzheimer’s disease, and disrupted sleep has been associated with worse cognitive performance. We examined the association of a novel sleep‐mediated cognitive assessment to sleep architecture in people with and without cognitive impairment, towards earlier diagnosis of cognitive impairment.MethodForty‐three participants from the Sleep &amp; Memory Center at the Neurological Institute of Athens cohort underwent a comprehensive evaluation that included polysomnography and pre‐ and post‐ sleep cognitive assessments of a novel short term verbal memory test as well as phonemic fluency testing. We examined the correlation of sleep‐mediated cognitive performance to sleep metrics of total sleep time, NREM/REM sleep, as well as respiratory metrics of Apnea‐Hypopnea Index and oxygen saturation during sleep.ResultSleep‐mediated spontaneous recall and phonemic fluency metrics were not associated to sleep architecture metrics. Instead, sleep‐mediated cued recall and recognition was positively associated to REM metrics of sleep time and relative REM/NREM ratio (R &gt; 0.39; p &lt; 0.039). On individual metrics, pre‐sleep verbal learning was positively associated to total sleep time (R &gt; 0.30; p&lt;0.05) as well as a larger REM/NREM ratio (R 0.52; p = 0.003). Finally, higher levels of oxygen during sleep, especially REM sleep, were associated with better pre‐sleep verbal learning (R &gt; 0.39; p &lt; 0.44).ConclusionOur results on people across a spectrum of cognitive abilities suggest that sleep‐mediated cognitive performance is significantly affected by shorter sleep times, and to a large extent these effects are dependent to the integrity of REM sleep. It is possible that both late evening learning abilities and sleep‐mediated memory reflects a person’s cholinergic capacity, as represented in subsequent REM sleep.

Sex differences in the pre and postoperative neuropsychological function of epilepsy surgery candidates

Objective: As programs expand globally, epilepsy surgery is becoming increasingly available as an effective treatment for some people with medically intractable seizures. Prospective candidates require careful neuropsychological evaluation and follow-up. The aim of this study was to examine the sex differences in neuropsychological function in presurgical presentation and postoperative outcomes in people with temporal lobe epilepsy referred for epilepsy surgery. Methods: Three hundred and seventy-two patients (202 Female; 170 Male) with a homogenous underlying pathology (hippocampal sclerosis) underwent a preoperative assessment on tests of intellectual, language, and memory function and were followed up one year after undergoing a unilateral temporal lobe resection; n = 169 Right (RTL), n = 203 Left (LTL). Results: There was no impact of sex or laterality of surgery on seizure outcome; 84% of males and 80% of females were seizure free at follow-up. Before surgery, sex effects were evident on tests of verbal memory with females performing better than males. Declines in verbal memory function following surgery were greater in females than males. Being female had a stronger association with postoperative decline on immediate prose recall (partial eta squared η 2 = 0.029), than side of surgery (η 2 = 0.018) albeit with a small effect size. Conclusions: There are subtle but significant sex differences in the neuropsychological profiles of people with temporal lobe epilepsy, before and following surgery. Whilst females generally perform better than males on tests of verbal memory function before surgery they demonstrate greater post-operative declines on these measures following surgery.

8 The Battery for Executive Functions in Addiction: Validation of a Novel Screening Tool

Objective:Executive functions (EF) are a primary mediator of both typical and atypical functioning, influencing the progression of psychopathology due to their role in supporting self-monitoring/regulation and top-down control of cognitive processes. According to recent models, EF impairments may contribute to the functional decline of patients with substance use disorder (SUD), exacerbating secondary affective and social symptoms. Despite these potential implications, the tools now commonly used to outline neurocognitive, and specifically EF, impairments in patients with addiction are not tailored to this clinical population, having been developed to assess cognitive or dysexecutive deficits in neurology or geriatric patients. Because of their different clinical focus, such tools are frequently unable to fully delineate the dysfunctional EF profile of addiction patients. We here present the development and validation of a novel specific screening battery for executive disorders in addiction: Battery for Executive Functions in Addiction (BFE-A).Participants and Methods:151 SUD patients and 55 control persons were recruited for the validation of the BFE-A battery. The battery consists of two computerized neurocognitive tasks (Stroop and Go/No-go tasks) and five digitalized neuropsychological tests (focus: short/long-term memory, working memory, focused attention, verbal/non-verbal cognitive flexibility). The tests are designed to assess executive control, inhibition mechanisms, and attention bias toward drugs of abuse.Results:In tests of verbal memory, focused attention, and cognitive flexibility, as well as in computerized tasks, inferential statistical analyses revealed lower performance in SUD patients compared to control participants, indicating a lack of inhibitory processes and dysfunctional management of cognitive resources. The investigation of Cohen’s d values has revealed that inhibitory control, verbal/nonverbal fluency, and short/long-term memory are the areas with the most significant impairments.Conclusions:While the evaluation of EF dysfunctions associated to addiction is a currently underrepresented component of the diagnostic procedure in drug assistance/treatment programs, is also is an essential step for both profiling of patients and design of rehabilitation protocols. Clinical interviews should be complemented by early assessment of cognitive weaknesses and preserved EF skills in order to establishing personalized therapy strategy and perhaps organizing a concurrent phase of cognitive rehabilitation.

25 Longitudinal Decline in Memory in 1991 Gulf War Veterans: Where you Start Matters.

Objective:Memory complaints have been a concern of Gulf War (GW) veterans since their return from the war in 1991, and over time it has been reported that exposures to neurotoxicants during the war have been associated with memory decline from premorbid levels. However, many of the studies that have shown slight or no memory decrements only looked at one time point and have not followed participants to document trajectory of symptoms over time. Longitudinal design is an optimal way to document change in cognitive function over time and the Fort Devens cohort (FDC), the longest running cohort of GW veterans, is ideal for assessing such change. This prospectively designed non-treatment seeking cohort were assessed at multiple timepoints with neuropsychological assessments and surveys. Initial neuropsychological assessments from 1997 showed above average scores on tests of verbal memory (California Verbal Learning Test) and average nonverbal memory (Wechsler Memory Scale-R) performances. A follow-up study of neuropsychological testing was completed between 2019-2022. This study was designed to document change in cognitive status between the two time points.Participants and Methods:Participants (N=50) from the original 1991 cohort were again tested from 2019-2022. Neuropsychological tests included California Verbal Learning Test-Second edition (CVLT2) for verbal learning, and the visual reproduction subtest from the Wechsler Memory Scale-Revised (WMS-R) for nonverbal learning and memory. For both time points, the average scores of the participants were compared with age scaled scores for each neuropsychological test.Results:The mean age of our current participants was 58 years. 72% were men. Relative to standardized test norms at the first time point, the scores for total learning from trials 1 through 5 from the CVLT2 were in the above average range relative to age and gender-based norms. During the second time point, the participants average scores on the same scale had dropped to the average range, one full standard deviation below their prior performances. In addition, at the first time point, total learning from visual reproductions was in the average range and dropped to the low average range for the second time point. This value dropped by one-half a standard deviation.Conclusions:Results showed significant diminishment in verbal and visual memory relative to prior test performances. Whenever possible, documenting the trajectory of symptoms relative to where each participant started on neuropsychological functional outcomes is key to understanding the longitudinal impact of neurotoxicant and other war-related exposures in military veterans. Given this decline, further assessment of GW veterans’ cognitive trajectories is warranted.

5 The Association of Neighborhood Socioeconomic Deprivation with Neurocognition in a Diverse Cohort of Middle- and Older-Aged Persons Living with and Without HIV

Objective:Due to decades of structural and institutional racism, minoritized individuals in the US are more likely to live in low socioeconomic neighborhoods, which may underlie the observed greater risk for neurocognitive impairment as they age. However, these relationships have not been examined among people aging with HIV. To investigate neurocognitive disparities among middle- and older-aged Latino and non-Latino White people living with HIV (PWH), and whether neighborhood socioeconomic deprivation may partially mediate these relationships.Participants and Methods:Participants were 372 adults ages 40-85 living in southern California, including 186 Latinos (94 PWH, 92 without HIV) and 186 non-Latino (NL) Whites (94 PWH, 92 without HIV) age-matched to the Latino group (for the overall cohort: Age M=57.0, SD=9.1, Education: M=12.7, SD=3.9, 38% female; for the group of PWH: 66% AIDS, 88% on antiretroviral therapy [ART]; 98% undetectable plasma RNA [among those on ART]). Participants completed psychiatric and neuromedical evaluations and neuropsychological tests of verbal fluency, learning and memory in person or remotely. Neuropsychological results were converted to demographically-unadjusted global scaled scores for our primary outcome. A neighborhood socioeconomic deprivation variable (SESDep) was generated for census tracts in San Diego County using American Community Survey 2013-2017 data. Principal components analysis was used to create one measure using nine variables comprising educational (% with high school diploma), occupational (% unemployed), economic (rent to income ratio, % in poverty, (% female-headed households with dependent children, % with no car, % on public assistance), and housing (% rented housing, % crowded rooms) factors. Census tract SESDep values were averaged for a 1km radius buffer around participants’ home addresses.Results:Univariable analyses (independent samples t-tests and Chi-square tests) indicated Latinos were more likely to be female and had fewer years of formal education than NL-Whites (ps&lt;.05). Latino PWH had higher nadir CD4 than White PWH (p=.02). Separate multivariable regression models in the overall sample, controlling for demographics and HIV status, showed Latinos had significantly lower global scaled scores than Whites (b=-0.59; 95%CI-1.13, -0.06; p=.03) and lived in more deprived neighborhoods (b=0.62; 95%CI=0.36, 0.88; p&lt;.001). More SES deprivation was significant associated with worse global neurocognition in an unadjusted linear regression (b=-0.55; 95%CI=-0.82, -0.28; p&lt;.001), but similar analyses controlling for demographics and HIV status, showed SESDep was not significantly related to global scaled scores (b=-0.11; 95%CI= -0.36, 0.14; p=.40). Exploratory analyses examined primary language (i.e., English vs Spanish) as a marker of Hispanic heterogeneity and its association with neurocognition and SESDep. Controlling for demographics and HIV status, both English-speaking (b=0.33; 95%CI=0.01. 0.64; p=.04) and Spanish-speaking Latinos (b=0.88; 95%CI=0.58, 1.18; p&lt;.001) lived in significantly greater SESDep neighborhoods than Whites, with SESDep greater for Spanish-speakers than English-speakers (p&lt;.001). However, only English-speaking Latinos had significantly lower neurocognition than Whites (b=-0.91; 95%CI=0-1.57, -0.26; p&lt;.01; Spanish-speakers: b=-0.27; 95%CI=-0.93, 0.38; p=.41).Conclusions:Among our sample of diverse older adults living with and without HIV, English-speaking Latinos showed worse neurocognition than Whites. Though SES neighborhood deprivation was worse among Latinos (particularly Spanish-speakers) it was not associated with neurocognitive scores after adjusting for demographics. Further studies investigating other neighborhood characteristics and more nuanced markers of Hispanic heterogeneity (e.g., acculturation) are warranted to understand factors underlying aging and HIV-related neurocognitive disparities among diverse older adults.

1 Network Efficiency as Structural Reserve: Pre- And Post-Operative Associations Between Network Organization and Memory in Temporal Lobe Epilepsy

Objective:Memory impairment is a common comorbidity in individuals with temporal lobe epilepsy (TLE). Further, in medication-resistant epilepsy the frontline option, neurosurgical epileptogenic zone destruction, places memory at significant risk. Research has highlighted that TLE causes whole-brain network efficiency disruption, but it is not established how this may explain pre- and post-surgical cognition. Here we examine whether white matter structural network organization predicts pre-operative memory function and/or risk for post-operative memory decline.Participants and Methods:Patients with drug-resistant TLE were recruited from two epilepsy centers in a prospective longitudinal study. The pre-operative sample included 51 individuals with left TLE (L-TLE), 52 with right TLE (R-TLE), and 57 healthy controls who underwent T1- and diffusion-weighted MRI (dMRI), and neuropsychological tests of verbal and visual memory. Forty-four patients (n=21 L-TLE) subsequently underwent temporal lobe surgery (36 anterior temporal lobectomy; 7 stereotactic laser amygdalohippocampectomy; 1 amygdalohippocampectomy) and completed post-operative memory testing. Whole-brain connectomes were generated via diffusion tractography and analyzed using graph theory, focusing on network integration (path length) and specialization (transitivity). In the preoperative dataset, first we compared TLE versus controls with analysis of covariance (ANCOVAs) controlling for age. Next, linear regressions examined the association between memory scores and network efficiency between L-TLE, R-TLE and controls. In the post-operative sample, bivariate correlations examined the association between pre- to post-operative memory change and 1) global network efficiency and 2) asymmetry of mesial temporal efficiency (i.e., local efficiency of the hippocampal, parahippocampal, and entorhinal nodes). Finally, efficiency metrics were entered into stepwise regressions along with established predictors of memory decline.Results:Compared to controls, TLE showed longer path length (p &lt; .05; ηp2 = .03) and lower transitivity (p = .01; ηp2 = .04). Pre-operatively, better verbal learning and memory were associated with both shorter path length (β = -0.23 to -0.32; psadjusted &lt; .05) and increased transitivity (β = 0.20 to 0.31; psadjusted &lt; .05). These associations were greater in L-TLE than R-TLE (i.e., a significant interaction; β = -0.29 to 0.25; psadjusted &lt;.05). Post-operatively, global metrics predicted decline on list learning for LTLEs (rs = -.57 to .58; ps &lt; .01), and were marginal on list recall (rs = -.42 to .40; ps &lt; .10). Leftward asymmetry of mesial temporal local efficiency predicted greater decline across most verbal memory measures for L-TLE (rs -.47 to -59; psadjusted &lt;.05), but not R-TLE. Asymmetry of mesial network efficiency uniquely explained at least 20 to 43% of the variance in list learning, recall, and story learning for L-TLE, outperforming hippocampal asymmetry and preoperative score (psadjusted &lt;.05).Conclusions:Our findings suggest that global white matter network abnormalities contribute to verbal memory impairment pre-operatively and vulnerability to decline post-operatively in L-TLE. Asymmetry of a predefined mesial temporal sub-network may help predict post-operative memory function following left temporal lobe surgery, such that greater efficiency in the to-beresected mesial temporal network may be an important risk factor for decline. Our findings extend the importance of network approaches in TLE to include the relationships between neurobiological networks and memory function.