Weschler Adult Intelligence Scale Research Articles

Recovery of Executive Functions in Alcohol Use Disorder: role of Neuropsychological Rehabilitation

Abstract Background Alcohol Use Disorder (AUD) is a growing public health concern with high incidence of executive functions (EFs) changes, affecting disease progression and treatment effectiveness. Inconsistencies persist in studies on the role of neuropsychological rehabilitation (NR) in EF recovery within AUD interventions. Our aim is to analyse the effect of NR on EFs in AUD interventions. Methods A prospective cohort study included 65 participants of both sexes, diagnosed with AUD, free of psychiatric comorbidities or severe neurological conditions. They underwent alcohol detoxification in hospital/home from 2021 to 2023, completing three evaluation moments (M1-Baseline, M2-3 months, M3-6 months). Patients receiving usual treatment (WTG-weekly therapeutic groups) - were compared to those with additional Neuropsychological Rehabilitation (NRG) regarding Sociodemographic and Severity of Alcohol Dependence Questionnaires, Hospital Anxiety and Depression Scale, Frontal Assessment Battery (FAB), Number and Letters Subscale of Weschler Adult Intelligence Scale (WAIS). Our main outcome was FAB-general executive functioning, and secondary outcome was WAIS-working memory. Friedman test compared assessments across the three points (alpha 5%). Results Statistically significant differences were found for FAB in both groups, (p < 0.001) between M1 and both M2 and M3, indicating improved executive functioning, particularly in NRG. Working memory also improved in both groups (WTG: p = 0.036; NRG: p < 0.001), with NRG showing better M2 performance. Conclusions There is evidence that neuropsychological rehabilitation facilitates the recovery of executive functions and may play a pivotal role in relapse prevention. It is crucial that the treatment of these situations incorporates public health, preventive and damage minimization measures. KeyWords: Executive Function; Neuropsychological Rehabilitation; Alcohol Use Disorder. Key messages • Recovery of executive functions is crucial from a Public Heath perspective in AUD populations, minimizing morbidity, permanent disabilities and contributing to more effective healthcare services. • Integrating Neuropsychological Rehabilitation into standard Alcohol Use Disorder treatments can enhance treatment effectiveness, reducing disease burden.

Brain activity associated with emotion regulation predicts individual differences in working memory ability.

Previous behavioral research has found that working memory is associated with emotion regulation efficacy. However, there has been mixed evidence as to whether the neural mechanisms between emotion regulation and working memory overlap. The present study tested the prediction that individual differences on the working memory subtest of the Weschler Adult Intelligence Scale (WAIS-IV) could be predicted from the pattern of brain activity produced during emotion regulation in regions typically associated with working memory, such as the dorsal lateral prefrontal cortex (dlPFC). A total of 101 participants completed an emotion regulation fMRI task in which they either viewed or reappraised negative images. Participants also completed working memory test outside the scanner. A whole brain covariate analysis contrasting the reappraise negative and view negative BOLD response found that activity in the right dlPFC positively related to working memory ability. Moreover, a multivoxel pattern analysis approach using tenfold cross-validated support vector regression in regions-of-interest associated with working memory, including bilateral dlPFC, demonstrated that we could predict individual differences in working memory ability from the pattern of activity associated with emotion regulation. These findings support the idea that emotion regulation shares underlying cognitive processes and neural mechanisms with working memory, particularly in the dlPFC.

B - 1 Cognitive Flexibility Moderates the Relationship between Trauma Symptoms and Cognitive Proficiency

Abstract Objective This study aims to lend additional empirical support for the relationship between cognitive proficiency and trauma. Importantly, the study seeks to advance our understanding of this relationship by investigating the possible moderating role of cognitive flexibility (CF). It was hypothesized that the relationship between trauma and cognitive proficiency would be stronger for individuals with less CF. Method Data were collected from 75 adult participants in a private practice. The sample was predominantly White and female, and all consented to a comprehensive neuropsychological assessment following referral for inattention and personal trauma. Relevant measures included the focused anxiety-trauma subscale of the Personality Assessment Inventory, the Cognitive Processing Index of the Weschler Adult Intelligence Scale, and Trails B to determine the correlation between trauma symptoms and cognitive proficiency and to evaluate whether CF moderated the relationship. Results Results indicated that greater trauma symptoms were associated with lower cognitive proficiency (B = −0.448, SE = 0.090, β = −0.554, p < 0.001). The interaction between trauma symptoms and CF was also significant (B = 0.007, SE = 0.002, β = 0.506, p < 0.001), suggesting the effect of trauma on cognitive proficiency depended upon the level of CF. Together, the variables accounted for approximately 30% of the variance in cognitive proficiency (R2 = 0.299, F(2, 73) = 15.574, p < 0.001). Conclusion This study supports the hypothesis that the impact of psychological trauma on cerebral efficiency is partially dependent on CF. These findings spotlight CF as a potential target for intervention to mitigate the cognitive effects of trauma.

Cognitive functioning predicts learning and performance of syncopated rhythms in healthy aging adults

AbstractBackgroundRhythmic music making may be beneficial for maintenance of healthy executive functioning and processing speed throughout the aging process. However, little is known about how engagement with rhythmic music making associates with healthy executive functioning and processing speed. This study aimed to determine the predictive potential of learning and performance of rhythms upon performance in executive functioning and processing speed tasks.MethodThis study involved a cross‐sectional, non‐randomized within subjects design, defined by a rhythmic musical activity (RMA), and executive functioning (EF) and processing speed (PS) tasks. The RMA involved thirty progressively syncopated rhythms, operationalized via three learning trials and a performance trial. The EF and PS tasks included multiple subtests of the Weschler Adult Intelligence Scale (WAIS) Working Memory and Processing Speed Indices (WMI & PSI), and Trail Making Parts A&B.ResultHealthy younger (ages 18‐35) and elderly (ages 55‐89) individuals provided informed consent and participated (N = 60; 46 female; 78.3% Caucasian). Learning and performance of syncopated rhythms between age groups significantly predicted scores on the WAIS PSI (t = 2.227/2.101, p = 0.030/0.040) and Trails A&B (t = ‐3.431/‐4.155, p = 0.003/<0.001; t = ‐3.636/‐4.256, p = <0.001/<0.001). Only rhythm learning predicted scores on WAIS WMI (t = 2.821, p = 0.007), with a trend shown for rhythm performance (t = 1.934, p = 0.059).ConclusionThis study is one of few to show relationships between rhythm perception and executive functioning in healthy aging. The results suggest the potential value of rhythmic music making upon maintenance of healthy executive functioning and processing speed throughout the aging process. A longitudinal study involving a control group and a larger sample size may enhance the findings of this study. Additionally, application to the Alzheimer’s disease and related dementias populations may provide comparative evidence to the healthy aging population.

Base rates of low neuropsychological test scores in older adults with subjective cognitive impairment: Findings from a tertiary memory clinic

Base rates of low scores are typically determined from normative samples, which differ from clinical samples. We examined base rates of spuriously low scores for 93 older adults with subjective cognitive impairment presenting to a memory clinic. Crawford’s Monte Carlo simulation algorithm was used to estimate multivariate base rates by calculating the percentage of cognitively intact memory clinic patients who produced normed scores at or below the 5th percentile. Neuropsychological tests included: Weschler Adult Intelligence Scale block design, digit span backwards, coding, Weschler Memory Scale logical memory immediate/delayed; California Verbal Learning Test immediate/delayed memory; Brief Visuospatial Memory Test immediate/delayed; and Delis-Kaplan Executive Functioning category switching, letter number sequencing, and inhibition/switching. An estimated 33.58% of the cognitively intact memory clinic population would have one or more low scores, 14.7% two or more, 6.55% three or more, 2.94% four or more, and 1.31% 5 or more due to chance. Base rates were then applied to a subset of clinical data: all with dementia and most with MCI had low scores that exceeded the base rates. Determining base rates of spuriously low scores on a neuropsychological battery in clinical samples could reduce false positives by using empirical adjustments for expected low scores.

Impact of Incidental Synucleinopathy in Mild Cognitive Impairment due to Alzheimer’s Disease (P7-6.003)

<h3>Objective:</h3> We sought to determine whether incidental LB pathology in patients with MCI due to AD is associated with faster rate of cognitive decline in the pre-clinical phase compared to MCI controls without mixed pathology. <h3>Background:</h3> The hallmark neuropathologies of Alzheimer’s disease include amyloid plaques and tau neurofibrillary tangles. Recent evidence suggests that incidental co-occurrence of Lewy Bodies (LB), correlates with accelerated disease progression in AD patients. It is unclear whether this effect is also exerted in the pre-dementia phase of AD, in patients with mild cognitive impairment (MCI). <h3>Design/Methods:</h3> 6654 subjects were identified from the National Alzheimer’s Coordinating Center (NACC) database with autopsy-confirmed AD pathology who remained in the MCI, (Albert 2011 criteria), throughout their ADRC annual assessments. 89 subjects had co-incident Lewy Bodies while the remaining 6565 controls lacked any mixed pathology. We utilized a repeated measures longitudinal analysis of multiple cognitive performance markers to determine whether decline in scores occurred at a greater rate in the synucleinopathy subjects. <h3>Results:</h3> For MCI-LB, mean age and education was (72.2± 8.9 and 15.7± 5.8). For MCI+LB subjects mean age and education was (77..9± 7.8 and 16.6± 6.8). 44 MCI +LB subjects and 2555 MCI -LB had complete data for MMSE scores and were included in the corresponding analysis and a subset had complete data for the Weschler Adult Intelligence Scale (WAIS) Digit Symbols test. The rate of decline in overall MMSE scores and WAIS-R Digit Symbols test did not differ between the two groups. <h3>Conclusions:</h3> While mixed LB pathology correlates with a greater rate of cognitive decline in patients with AD, our results do not suggest that co-incident LB accelerates decline in subjects remaining in MCI. To further characterize the effect of mixed pathology on AD disease course, next steps may include investigating whether co-occurrent LB pathology hastens progression to meeting criteria for AD diagnosis. <b>Disclosure:</b> Ms. Shriram has nothing to disclose. Michael Malek-Ahmadi has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Signant Health. Dr. Sabbagh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eisai. Dr. Sabbagh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genetech=Roche. Dr. Sabbagh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novo Nordisk. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Sabbagh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Synaptogenix. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Signant Health. Dr. Sabbagh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for T3D. Dr. Sabbagh has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for EIP Pharma. Dr. Sabbagh has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Quince-Cortexyme. Dr. Sabbagh has stock in Neurotau. Dr. Sabbagh has stock in Seq Biomarque. Dr. Sabbagh has stock in uMethod Health. Dr. Sabbagh has stock in Athira. Dr. Sabbagh has stock in Lighthouse Pharmaceuticals. Dr. Sabbagh has stock in Alzheom. The institution of Dr. Sabbagh has received research support from NIH. The institution of Dr. Sabbagh has received research support from ADDF. Dr. Sabbagh has received publishing royalties from a publication relating to health care.

Cognitive Behavior Therapy pada Individu yang Mengalami Phobia Sosial

Social phobia is something that happens a lot today and needs special attention. In overcoming social phobia, it can be done with Cognitive Behavior Therapy therapy. The purpose of Cognitive Behavior Therapy (CBT) therapy is to see how the Cognitive Behavior Therapy (CBT) method can help change the behavior and cognition of individuals who experience social phobia. This research was conducted for approximately 1 month. The subjects in this study were adult individuals aged 23 years who experienced social phobia. The method of collecting data by researchers is through observation, interviews, and psychological tests. Psychological tests were given to the subjects in the form of cognitive tests, namely the Weschler Adult Intelligence Scale (WAIS), personality tests, namely the Graphic and Wartegg tests, as well as the Sack's Sentence Comletion Test (SSCT) inventory test and the Depression, Anxiety, and Stress Scale (DASS) tests. This study uses a quantitative approach with an experimental method using a single case pre-test post-test design. Researchers use Cognitive Behavior Therapy (CBT) techniques to change negative thoughts and behaviors into more positive thoughts and behaviors when in social situations, in order to reduce the symptoms of social phobia they have. The intervention was given to the subject in 3 sessions. The results of the intervention showed that there was a change in behavior before and after the intervention. Before being given the CBT intervention, the subject had an anxiety level from 0 to 100, which was rated at 80, but after the intervention the subject had a rating of 60. In addition, based on the comparison of the DASS test scores between pre-test and post-test, it also decreased. It was found that the anxiety score in the subject decreased from very severe to severe and although the decrease in score had not reached the normal stage, the score obtained had decreased.

A comprehensive assessment of neurocognitive and psychological functioning in adults with early-treated phenylketonuria.

Relative to youth with early-treated phenylketonuria (ETPKU), much less is known regarding the cognitive profile of adults with ETPKU. The present study aimed to address this gap by providing a comprehensive assessment of neuropsychological functioning among adults with ETPKU. A sample of 40 adults with ETPKU (ages 18 - 36) and a demographically matched group of 32 healthy individuals without PKU participated. Participants completed a comprehensive neuropsychological battery including the NIH Toolbox, Wechsler Abbreviated Scale of Intelligence - Second Edition (WASI-II), Conners' Continuous Performance Test (CPT-3), select subtests from the Weschler Adult Intelligence Scale - Fourth Edition (WAIS-IV) as well as several self-report measures of cognitive and psychoemotional functioning. Scores from these tests were combined to create cognitive composites reflecting overall task performance in the areas of verbal ability, visuospatial skills, executive functioning, motor skills, and processing speed. No group differences were observed for full scale IQ or verbal ability. However, individuals with ETPKU demonstrated poorer performance on measures of executive functioning, processing speed, motor skills, and visuospatial skills as compared to the non-PKU group. Within the ETPKU group, recent blood phenylalanine levels (an indicator of metabolic control) were significantly correlated with performance across most cognitive domains and aspects of psychological functioning. Present findings suggest that the neuropsychological profile of adult ETPKU is characterized by circumscribed impairments in select cognitive domains. In addition, the results underscore the importance of maintaining metabolic control across the lifespan in individuals with ETPKU.

A-168 The Role of Executive Functioning, Processing Speed, and Working Memory on the TMT-B in ADHD Populations

Abstract Objective: Trail-Making Test B (TMT-B) is a measure of attention and processing speed (PS), with sensitivity to executive functioning (EF; Reimers, 2019). The impacts of these domains on TMT-B are not well-understood, especially in those with Attention-Deficit/Hyperactivity Disorder, who experience deficits in EF, PS, and attention (Kramer et al., 2020, Theiling &amp; Petermann, 2016). We examined the contributions of EF, PS, and attention on TMT-B performance. Method: This study included archival data of 64 adults diagnosed with ADHD at a midwestern multidisciplinary behavioral health clinic. Commonality analyses were used to identify the predictive capacity of performance on measures of EF, attention, and PS on TMT-B. EF was measured using perseverative errors of Wisconsin Card Sort Test (WCST). Weschler Adult Intelligence Scale (WAIS) index scores of working memory (WMI), and processing speed (PSI) were used to examine attention and PS. Results: Data was analyzed using a series of block-wise hierarchical regression analyses, with each predictor variable entered in alternating sequence. Results indicated that the processing speed domain accounted for 10.8% (R2 change = .108, F(1, 60) = 8.407, p &amp;lt; .01) of the variance in TMT-B performance after controlling for variability accounted for by other domains. EF was a significant predictor after accounting for variability in other domains, but accounted for only 5% (R2 change = .05, F(1, 60) = 4.179, p &amp;lt; .045) of the variance. WMI was not a significant predictor in this clinical sample. Conclusion: TMT-B is affected by both PS and EF. Implications and limitations of this study will be discussed.

Terapi rasional-emotif perilaku untuk menurunkan tingkat depresi pada wanita

The subject is a college student woman who has changes in functionality in everyday life. Subject has a bad view of herself and tend to like to compare herself with others, especially physical problems. As a result, subject tend to be easily sad, lose interest, often feel tired and sometimes bring up suicidal thoughts. The assessment methods used were clinical interview, observation, and psychological tests, namely the Weschler Adult Intelligence Scale, graphics, Thematic Apperception Test, the Beck Depression Inventory II scale and WHODAS. Subject was diagnosed with major depressive disorder with moderate level of functioning. The intervention used was rational-emotive behavior therapy which was composed of five sessions. This therapy is used with the aim of reducing depression levels through changing irrational beliefs to become more rational. The results of the intervention showed a decrease in the subject's level of depression as indicated by changes in the scores obtained before and after the intervention was given.

Low Dose to White Matter Predicts Attention and Processing Speed Decline After Fractionated Brain RT

<h3>Purpose/Objective(s)</h3> Attention and processing speed, an important neurocognitive function, is subserved in the brain by critical white matter (WM): the corpus callosum (CC) and intra-hemispheric white matter tracts (IHWM). We sought to characterize the dose-response relationship of these structures with decline in attention/processing speed at 6 months post-RT in patients with primary brain tumors, with particular attention to low doses. <h3>Materials/Methods</h3> On a prospective trial, 52 primary brain tumor patients receiving fractionated brain RT underwent volumetric MRI, diffusion tensor imaging, and neurocognitive assessments (for processing speed: Delis-Kaplan Executive Function System Trail Making (D-KEFS-TM) Number Sequencing (TM-NS), D-KEFS-TM Letter Sequencing (TM-LS), and Weschler Adult Intelligence Scale (WAIS-IV) Coding; for attention: D-KEFS-TM Visual Scanning (TM-VS) test and WAIS-IV Digit Span Digits Forward (DF) test. Reliable change indices were calculated and adjusted for practice effects (RCI-PE), with decrease in RCI-PE scored as decline. Regions of interest (ROIs) were autosegmented using open source software and atlas-based tractography, including: CC, all WM w/wo CC, total IHWM without CC, and right/left IHWM without CC. Censoring masks excluded tumor, surgical cavity, scarring, and edema. Planning CTs were co-registered to MRIs to extract DVH parameters for each ROI, including V10 Gy and V20 Gy. Univariate logistic regressions were used to test for dosimetric predictors of decline. <h3>Results</h3> Median age was 47y. Most patients (61.5%) had gliomas. Median prescription RT dose was 59.4 Gy. At baseline and 6 months, 37-43 patients completed the neurocognitive assessments, with 61-78% showing decline. Several significant associations between increasing relative volumes exposed to low dose and decline were seen in all assessments except TM-NS (Table). Investigation of mean and maximum dose parameters yielded similar results. <h3>Conclusion</h3> While maximum dose is typically considered the most relevant dosimetric parameter for toxicity endpoints in the brain, we also detected several significant logistic relationships between V10 and V20 to more diffuse white matter networks (CC and IHWM) and decline in attention and processing speed post-RT. Minimization of low dose bath, whether by planning optimization or use of more conformal modalities like protons, may be clinically relevant for preservation of these critical neurocognitive functions.

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

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

Assessing the validity of the Wechsler Adult Intelligence Scale (WAIS-IV) in predicting completion in a long-term residential rehabilitation for substance use problems

Background We aimed to examine the predictive validity of the Weschler Adult Intelligence Scale (WAIS-IV) in predicting treatment completion, over and above educational status. Methods One hundred and ninety-six (N = 196) individuals from the Odyssey House Residential Rehabilitation Program, NSW, Australia between 2010 and 2016 were administered a structured interview including substance use disorders and the Verbal Comprehension (VCI), Perceptual Reasoning (PRI), Working Memory (WMI), and Processing Speed (PSI) domains of the WAIS-IV. Results There were significant differences between our clinical sample and the population norm with respect to the proportion below the mean for PSI (z = 12.27, p < .001), VCI (z = 2.33, p < .02) but not for WMI (z = 1.67, p < .10) or PRI (z = −1.76, p < .08). The WAIS-IV subscales did not significantly predict treatment completion (p’s > .16) over and above educational status (p < .01). Conclusions Our findings suggest that in clients in drug and alcohol rehabilitation settings a combination of skills may be impacted including Verbal Comprehension and Processing Speed. Moreover, our findings also suggest that WAIS-IV subscales do not predict treatment completion in a drug and alcohol residential setting, over and above a brief assessment of educational status.

Limited Shared Variance among Measures of Cognitive Performance Used in Nutrition Research: The Need to Prioritize Construct Validity and Biological Mechanisms in Choice of Measures

ABSTRACTBackgroundThe literature on correlates of nutrition has seen an increase in studies focused on functional consequences at the levels of neural, perceptual, and cognitive functioning. A range of measurement methodologies have been used in these studies, and investigators and funding agencies have raised the questions of how and if these various methodologies are at all comparable.ObjectiveThe aim was to determine the extent to which 3 different sets of cognitive measures provide comparable information across 2 subsamples that shared culture and language but differed in terms of socioeconomic status (SES) and academic preparation.MethodsA total of 216 participants were recruited at 2 US universities. Each participant completed 3 sets of cognitive measures: 1 custom-designed set based on well-understood laboratory measures of cognition [cognitive task battery (COGTASKS)] and 2 normed batteries [Cambridge Neuropsychological Test Automated Battery (CANTAB), Weschler Adult Intelligence Scale, fourth edition (WAIS-IV)] designed for assessing general cognitive function.ResultsThe 3 sets differed with respect to the extent to which SES and educational preparation affected the results, with COGTASKS showing no differences due to testing location and WAIS-IV showing substantial differences. There were, at best, weak correlations among tasks sharing the same name or claiming to measure the same construct.ConclusionsComparability of measures of cognition cannot be assumed, even if measures have the same name or claim to assess the same construct. In selecting and evaluating different measures, construct validity and underlying biological mechanisms need to be at least as important as population norms and the ability to connect with existing literatures.

Microstructural Injury to Corpus Callosum and Intrahemispheric White Matter Tracts Correlate With Attention and Processing Speed Decline After Brain Radiation

The corpus callosum (CC) and intrahemispheric white matter tracts (IHWM) subserve critical aspects of attention and processing speed. We analyzed imaging biomarkers of microstructural injury within these regions and association with attention and processing speed performance before and after radiation therapy in primary brain tumor patients. In a prospective clinical trial, 44 primary brain tumor patients underwent cognitive testing and magnetic resonance imaging/diffusion-weighted imaging at baseline (pre-radiation therapy) and 3-, 6-, and 12-months post-radiation therapy. CC (subregions, total) and IHWM tracts (left/right without CC, total) were autosegmented; tumor, tumor bed, and edema were censored. Biomarkers included volume changes (cm3), mean diffusivity ([MD]; higher values indicate white matter injury), fractional anisotropy ([FA]; lower values indicate white matter injury). Reliable-change indices measured changes in attention (Weschler Adult Intelligence Scale [WAIS-IV] digits-forward; Delis-Kaplan Executive Function System Trail Making [D-KEFS-TM] visual-scanning), and processing speed (WAIS-IV coding; D-KEFS-TM number-sequencing, letter-sequencing), accounting for practice effects. Linear mixed-effects models evaluated associations between mean radiation dose and biomarkers (volume, MD, FA) and imaging biomarkers and neurocognitive performance. Statistics were corrected for multiple comparisons. Processing speed declined at 6 months following radiation therapy (number sequencing, letter sequencing; P < .04). Seizures and antiepileptic drug therapy were associated with lower visual-scanning attention reliable-change indices at 6 months (P = .039). Higher radiation dose correlated with smaller midanterior CC volume (P = .023); lower FA in posterior CC, anterior CC, and total CC (all P < .03); and higher MD in anterior CC (P = .012). Smaller midanterior CC and left IHWM volume correlated with worse processing speed (coding, letter-sequencing, number-sequencing; all P < .03). Higher FA in right, left, and total IHWM correlated with better coding scores (all P < .01). Lower FA in total IHWM (P = .009) was associated with worse visual-scanning attention scores. Higher FA in midposterior CC (P = .029) correlated with better digits-forward attention scores. The CC demonstrated radiation dose-dependent atrophy and WM injury. Microstructural injury within the CC and IHWM was associated with attention and processing speed decline after radiation therapy. These areas represent possible avoidance regions for preservation of attention and processing speed.

APOE genotype, brain imaging, and neuropsychological testing markers of Alzheimer’s disease: Data from the Strong Heart Study

AbstractBackgroundCarrying an APOE ε4 allele increases risk for Alzheimer’s disease and related dementias. However, risk effects and prevalence of risk alleles are not consistent across races/ethnicities. Prevalence of cognitive impairment or dementia and attributable risk from APOE ε4 genotype are unknown in American Indians (AI). This project evaluated associations of APOE genotype with cranial imaging and cognitive testing markers of vascular and Alzheimer’s dementias in a large, prospective, population‐based cohort of AI.MethodThe Strong Heart Study recruited 4,549 AI aged 45‐75 from 13 tribal communities across 3 major geographic regions in 1989‐1991. In 2010‐2013, all eligible surviving participants, then aged 65‐95, underwent cognitive examination including 3MS, WAIS, COWA, and CVLT‐II long delay free recall and cranial magnetic resonance imaging (MRI). APOE was genotyped from blood using ABI PRISM Linkage Mapping and DNA sequencing.ResultMost participants carried either 3.3 (73%) or 4.3 genotypes (23%). Clinical risk factors for dementia were prevalent, including high body mass index (mean&gt;30), hypertension (80%), diabetes (48%), high LDL (39‐44%), chronic kidney disease (27%), and prior stroke (8‐9%). APOE ε4 carriers did not differ from non‐carriers in clinical factors, with the exception of serum LDL (103.9 mg/dL vs 96.7 mg/dL, P=0.015). Findings from MRI were also similar between genotypes, including presence of infarcts or hemorrhages, brain volume, and grade (0‐9) for white matter hyperintensities, sulcal widening, and ventricle enlargement. APOE ε4 carriers had marginally more WMH volume than non‐carriers. Cognitive examination scores were also similar, including Modified Mini Mental Status Examination (3MSE), Weschler Adult Intelligence Scale coding test (WAIS), Controlled Oral Word Association test (COWA), California Verbal Learning Test long delay free recall (CVLT).ConclusionDespite evidence for higher risk of Alzheimer’s and related dementias from presence of APOE ε4 allele among individuals from other populations, our study found little evidence of such an effect in elderly AIs. These findings raise intriguing questions about the presence of as‐yet‐unknown protective factors. Limitations of this study include cross‐sectional analyses and possibility of selective survival before the MRI examination. Future research should directly examine whether longitudinal changes in cognition and brain structure are associated with APOE genotype.

A-028 Utilizing Virtual Reality to Assess the Relationship between Prospective Memory and Processing Speed

Abstract Objective Processing speed may partially mediate age-related differences in prospective memory (PM) abilities (West &amp; Craik, 2001). The present preliminary study aimed to further investigate the relationships between prospective memory and processing speed by utilizing a novel virtual reality-based prospective memory measure. The task was designed to assess the impacts of a virtual environment would facilitate a deeper level of processing and enhance prospective memory performance. Method 49 older adults (M = 73.87, SD = 8.24) and 39 younger adults(M = 18.87, SD =1.61) completed the Coding subtest of the Weschler Adult Intelligence Scale (WAIS- IV) as well as a virtual-reality prospective memory measure that utilized both time-based and event-based cues. Results Coding was strongly correlated with PM time-based cues (r = .43, p &amp;#60; .01) and event-based cues (r = .53, p &amp;lt; .001). There were no correlations between processing speed and prospective memory in the young adult sample. Conclusion This study suggests that processing speed is strongly related to virtual-reality based PM and suggests that processing speed is a crucial component in prospective memory outcomes in older adults. This novel task virtual reality task may provide construct validity against other prospective memory measures.

A-198 Major Errors on BVRT Determine Specific Cognitive Deficit in a Veteran Sample

Abstract Objective The goal of the study is to examine the underlying conceptual factors that account for major performance errors of the Benton Visual Retention Test (BVRT) using indices of the Weschler Adult Intelligence Scale, 3rd Edition (WAIS-III) as gold-standard comparison variables. Method One hundred thirty participants with mixed cognitive and psychiatric diagnoses who were referred to the neuropsychological assessment clinic at the VA Palo Alto Health Care System and completed the BVRT and WAIS-III measures were included in the analysis of the data. Factor Analysis of BVRT major memory and copy errors (rotations, distortions, and perseverations) and WAIS-III indices were conducted using SPSS 25. Results BVRT major memory and copy errors factored onto WAIS-III index variables using Principal Components Analysis with Equamax rotation yielded a four-factor model explaining 79% of total variance. Major errors on the immediate recall trial of the BVRT were found to be specifically and inversely related to performance on the WAIS-III Perceptual Organization and Processing Speed Indices. Major errors on the copy trial of the BVRT showed an inverse relationship with performance on the WAIS-III Verbal Comprehension and Working Memory Indices. Conclusions BVRT recall errors are related to failures in visual perceptual processing. Conversely, copy errors on the BVRT are potentially attributable to deficits in auditory-verbal-attentional information processing. The results of the study provide evidence for the BVRT as a viable measurement tool to determine domain-specific cognitive impairment when considering error types on recall and copy trials.

Diffusion Imaging Biomarkers of Corpus Callosum Injury and Dose-Dependent Volumetric Changes Correlate with Attention and Processing Speed Changes after Brain Radiotherapy

Attention and processing speed are core cognitive functions subserved by the corpus callosum (CC), a critical white matter structure. We hypothesized that CC volume changes and diffusion weighted imaging (DWI) biomarkers of CC injury would correlate with changes in attention and processing speed function after brain radiotherapy (RT). We prospectively studied 29 patients with primary brain tumors who received fractionated RT. Patients underwent formal neuropsychological testing and high resolution volumetric MRI with DWI (b-values 0, 500, 1500 s/mm2 fit to single tensor) prior to and 6 months post RT. Auditory attention was measured with the Weschler Adult Intelligence Scale (WAIS-IV) Digit Span Forward test; processing speed was measured with the Delis-Kaplan Executive Function System Trail Making number sequencing (TM-NS) and letter sequencing (TM-LS) subtests. Reliable change indices accounting for practice effects (RCI-PE) were calculated to determine 0-6 month change on each measure. Image processing at each time point included auto-segmentation with volume calculations of regions of interest (ROIs): the entire CC and anterior, mid-anterior, central, mid-posterior, and posterior subdivisions. Tumor, tumor bed, edema, and segmentation errors were censored. DWI biomarkers including mean diffusivity (MD, increases with injury) and fractional anisotropy (FA, decreases with injury) were calculated. Mean dose to each ROI was determined. One sample t-tests (H0=0) were performed to determine significant group cognitive decline. Pearson correlation coefficients evaluated the relationship between RCI-PEs and clinical variables, dose, changes in volume, MD, and FA. Statistical significance was set at α=0.05. Processing speed (TM-LS) significantly declined 6-months post-RT (mean change -0.472, p = 0.003). Age and years of education did not influence attention or processing speed changes. Significant dose-dependent atrophy was seen in the mid-anterior (r = -0.432, p = 0.024), mid-posterior (r = -0.408, p = 0.031), and posterior CC (r = -0.600, p = 0.001). Smaller mid-anterior CC volume was associated with worse processing speed (TM-LS, r = 0.424, p = 0.031). Decreased FA in the anterior CC was associated with worse attention (digits forward, r = 0.401, p = 0.038) and decreased FA in the posterior CC was correlated with worse processing speed (TM-LS, r = 0.444, p = 0.02). Increased MD in the anterior CC (r = -0.386, p = 0.046) was correlated with worse attention (digits forward). In this prospective study, dose-dependent atrophy of CC subdivisions was seen after fractionated brain RT. Microstructural damage, including atrophy and white matter injury, within CC subdivisions was significantly associated with worse attention and processing speed. Damage to this critical structure is highly implicated in attention/processing speed changes after brain RT.

A path analysis of multiple neurotoxic chemicals and cognitive functioning in older US adults (NHANES 1999\u20132002)

BackgroundPolychlorinated biphenyls (PCBs) and metals (lead and cadmium) are neurotoxic and affect neurobehavioral performance. Yet little is known about the association between exposure to multiple neurotoxic compounds and cognitive functioning in older adults.MethodsUsing data from two consecutive cycles of the National Health and Nutrition and Examination Survey (1999–2002), path analysis was used to simultaneously evaluate the association between whole blood concentrations of 14 neurotoxic compounds and cognitive functioning measured by the Digit Symbol Coding Test of the Weschler Adult Intelligence Scale, 3rd Edition in participants 60–84 years of age (N = 498). Effect modification was assessed for age (above/below the mean) and sex.ResultsThe final path model fit 5 compounds (i.e. PCB 74, PCB 118, PCB 146, PCB 153, and lead). After controlling for co-exposures and confounders, PCB 146 (β = −0.16, 95% CI: −0.29, −0.02, p = 0.02) and lead (β = −0.10, 95% CI: −0.20, −0.006, p = 0.04) were negatively associated with DSC scores in 60–84 year olds. Whereas, PCB 153 was positively associated with DSC scores (β =0.20, 95% CI: 0.05, 0.35; p = 0.01).ConclusionsThis cross-sectional analysis which controlled for collinear exposure to several neurotoxic compounds demonstrated an association between non-dioxin like polychlorinated biphenyl exposure, specifically PCB 146, and lower cognitive functioning, in older adults. Lead exposure was also weakly associated with lower cognitive functioning. Additional studies are needed to determine the causality of the observed associations.