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Munsell EGS, Bui Q, Kaufman KJ, Tomazin SE, Regan BA, Lenze EJ, Lee JM, Mohr DC, Fong MWM, Metts CL, Pham V, Wong AWK. Intraindividual variability in post-stroke cognition and its relationship with activities of daily living and social functioning: an ecological momentary assessment approach. Top Stroke Rehabil 2024; 31:564-575. [PMID: 38278142 DOI: 10.1080/10749357.2024.2307203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/12/2024] [Indexed: 01/28/2024]
Abstract
INTRODUCTION Ecological momentary assessment (EMA) is a methodological approach to studying intraindividual variation over time. This study aimed to use EMA to determine the variability of cognition in individuals with chronic stroke, identify the latent classes of cognitive variability, and examine any differences in daily activities, social functioning, and neuropsychological performance between these latent classes. METHODS Participants (N = 202) with mild-to-moderate stroke and over 3-month post-stroke completed a study protocol, including smartphone-based EMA and two lab visits. Participants responded to five EMA surveys daily for 14 days to assess cognition. They completed patient-reported measures and neuropsychological assessments during lab visits. Using latent class analysis, we derived four indicators to quantify cognitive variability and identified latent classes among participants. We used ANOVA and Chi-square to test differences between these latent classes in daily activities, social functioning, and neuropsychological performance. RESULTS The latent class analysis converged on a three-class model. The moderate and high variability classes demonstrated significantly greater problems in daily activities and social functioning than the low class. They had significantly higher proportions of participants with problems in daily activities and social functioning than the low class. Neuropsychological performance was not statistically different between the three classes, although a trend approaching statistically significant difference was observed in working memory and executive function domains. DISCUSSION EMA could capture intraindividual cognitive variability in stroke survivors. It offers a new approach to understanding the impact and mechanism of post-stroke cognitive problems in daily life and identifying individuals benefiting from self-regulation interventions.
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Affiliation(s)
- Elizabeth G S Munsell
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Quoc Bui
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Katherine J Kaufman
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Stephanie E Tomazin
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Bridget A Regan
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Eric J Lenze
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Jin-Moo Lee
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - David C Mohr
- Center for Behavioral Intervention Technologies and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Christopher L Metts
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Vy Pham
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Alex W K Wong
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation and Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Callaghan T, Colasante T, Muhammad S, Corbit J, Yavuz-Muren M, Raffaele C, Akter R, Al Janaideh R, Duan TY, Didkowsky N, Beuze JN, Homer B, Cameron CA, Malti T. Fostering Prosociality in Refugee Children: An Intervention With Rohingya Children. Monogr Soc Res Child Dev 2024; 89:7-109. [PMID: 39148465 DOI: 10.1111/mono.12477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 05/27/2024] [Accepted: 06/01/2024] [Indexed: 08/17/2024]
Abstract
Prosocial behavior is a distinguishing characteristic of human nature. Although prosocial behaviors emerge early in development, contextual factors play an important role in how these behaviors are manifested over development. A large body of research focuses on the trajectory of prosocial development across diverse cultures and investigating contexts that foster it. Against this backdrop of developmental research endeavoring to understand and enhance the cooperative side of humanity, is the catastrophic impact of profoundly negative forces on social-emotional development for children forced to flee from violent conflict. Close to half a million Rohingya children, whose families were forced to flee genocide in Myanmar, now live in the largest refugee camp in the world. To examine the resilience of human prosociality in the face of extreme adversity, we documented initial levels of prosociality in Rohingya refugee children living in a mega-camp (Cox's Bazar, Bangladesh) and the extent to which those levels were improved following a multifaceted intervention designed to foster prosociality. The research was a partnership between Rohingya community members with lived experience, humanitarian practitioners, and developmental researchers. A sample of 152 Rohingya children (5-12 years) participated in pre- and postintervention assessments of prosocial behaviors and related cognitive-affective processes. The 10-day collaboration-based intervention was implemented between November 2021 and January 2022 by Rohingya researchers. Birthplace was used as a proxy measure of trauma level. Children born in Myanmar (N = 88) directly experienced relatively higher levels of trauma (genocide, forced migration) than children who were born in the camp after their families fled from Myanmar (N = 64). Children were individually tested pre- and postintervention with a task battery, including a helping (Origami) and two sharing tasks (Dictator Game [DG], Forced Choice sharing) measuring prosocial behavior. Assessments of related cognitive-affective processes included measures of empathic responding and emotion perspective-taking in story tasks (Imagine, Judgment) and executive function (EF) skills (Younger: Hearts & Flowers; Older: Dimensional Change Card Sorting). Small group intervention sessions conducted over 10 days targeted these prosocial behaviors and cognitive-affective processes and were based on collaborative activities, emotion perspective taking and EF skills training with the same partner throughout the intervention phase. We used latent change modeling to examine initial levels (preintervention) and intervention-related changes in these measures from pre- to postintervention. Prosocial responding was found across all measures (preintervention) and improvements (pre- to postintervention change) were apparent across most measures. Age and birthplace variables were significant predictors of initial levels and intervention-related change. Initial levels: Regarding age, older children (9-12 years) showed higher levels than younger children (5-8 years) of sharing in the Forced Choice task but lower levels in the DG. Older children also showed higher levels of empathic responding when asked to report how they would feel and respond to another person's misfortune in the Imagine task. Regarding birthplace, prior to the intervention camp-born children showed higher levels than Myanmar-born children of helping in the Origami task and reported more behavioral responses indicating how they would respond to misfortune in the Imagine task. In contrast, Myanmar-born children had higher levels of sharing in the DG and consistently chose equality over inequality in the Forced Choice sharing task, even when their partner would receive more, indicating a pattern of generosity in these children. Myanmar-born children had lower levels than camp-born children on EF measures. Intervention-related change: Regarding age, older but not younger children were more likely to increase choices for equality over inequality on the Forced Choice sharing task following the intervention. Regarding birthplace and helping, camp-born children increased behaviors that helped their partner make origami shapes themselves ("how-to" helping), whereas Myanmar-born children increased behavior that took over folding for their partner ("do-for" helping). For sharing tasks, Myanmar-born but not camp-born children increased sharing in the DG and showed an increased pattern of generosity in Forced Choice sharing task. In the Imagine story task, children born in Myanmar were more likely than those born in camp to increase empathic responding (i.e., imagining how they would feel). Children born in Myanmar showed less improvement on EF measures than children born in the camp. Taken together, these findings provide evidence that in a context of extreme adversity, Rohingya children exhibited prosociality and benefitted from a multifaceted intervention. Our research adds credence to the view that human prosociality is a fundamental characteristic of humanity that not only survives but can be enhanced in even the most adverse of childhood environments. Our multifaceted intervention, which was implemented within a collaborative social context and targeted prosocial behaviors and related cognitive-affective processes, was designed to be easily implemented within existing psychosocial support programs in refugee contexts. As the numbers of children affected by violent conflict and forced migration rise alarmingly worldwide, there is a critical need to expand research partnerships that aim to improve developmental outcomes for these millions of children.
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Affiliation(s)
- Tara Callaghan
- Psychology Department, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | | | | | - John Corbit
- Psychology Department, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | | | - Charles Raffaele
- Educational Communication and Technology Program, Steinhardt, New York University, New York, New York, USA
| | - Rozina Akter
- Psychology Department, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Redab Al Janaideh
- Centre for Leadership and Learning, York Regional District School Board, Aurora, Ontario, Canada
| | - Tz-Yu Duan
- Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Nora Didkowsky
- Psychology Department, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | | | - Bruce Homer
- Program in Educational Psychology, The Graduate Center, City University of New York, New York, New York, USA
| | - Catherine Ann Cameron
- Psychology Department, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tina Malti
- Psychology Department, University of Toronto, Alexander von Humbolt Professor, Leipzig University, Leipzig, Germany
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Mather MA, Ho EH, Bedjeti K, Karpouzian-Rogers T, Rogalski EJ, Gershon R, Weintraub S. Measuring Multidimensional Aspects of Health in the Oldest Old Using the NIH Toolbox: Results From the ARMADA Study. Arch Clin Neuropsychol 2024; 39:535-546. [PMID: 38216151 PMCID: PMC11269891 DOI: 10.1093/arclin/acad105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/27/2023] [Accepted: 11/20/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE The percentage of older adults living into their 80s and beyond is expanding rapidly. Characterization of typical cognitive performance in this population is complicated by a dearth of normative data for the oldest old. Additionally, little attention has been paid to other aspects of health, such as motor, sensory, and emotional functioning, that may interact with cognitive changes to predict quality of life and well-being. The current study used the NIH Toolbox (NIHTB) to determine age group differences between persons aged 65-84 and 85+ with normal cognition. METHOD Participants were recruited in two age bands (i.e., 65-84 and 85+). All participants completed the NIHTB Cognition, Motor, Sensation, and Emotion modules. Independent-samples t-tests determined age group differences with post-hoc adjustments using Bonferroni corrections. All subtest and composite scores were then regressed on age and other demographic covariates. RESULTS The 65-84 group obtained significantly higher scores than the 85+ group across all cognitive measures except oral reading, all motor measures except gait speed, and all sensation measures except pain interference. Age remained a significant predictor after controlling for covariates. Age was not significantly associated with differences in emotion scores. CONCLUSIONS Results support the use of the NIHTB in persons over 85 with normal cognition. As expected, fluid reasoning abilities and certain motor and sensory functions decreased with age in the oldest old. Inclusion of motor and sensation batteries is warranted when studying trajectories of aging in the oldest old to allow for multidimensional characterization of health.
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Affiliation(s)
- Molly A Mather
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emily H Ho
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Katy Bedjeti
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Tatiana Karpouzian-Rogers
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Emily J Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Richard Gershon
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Novack MA, Young SR, Dworak EM, Kaat AJ, Slotkin J, Nowinski C, Yao L, Adam H, Stoeger J, Hosseinian Z, Amagai S, Pila S, Varela Diaz M, Almonte Correa A, Alperin K, Carlson S, Kellen M, Omberg L, Camacho MR, Landavazo B, Nosheny RL, Weiner MW, Gershon RC. Mobile toolbox (MTB) remote measures of executive function and processing speed: development and validation. J Int Neuropsychol Soc 2024:1-9. [PMID: 38989719 DOI: 10.1017/s1355617724000225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
OBJECTIVE The ability to remotely monitor cognitive skills is increasing with the ubiquity of smartphones. The Mobile Toolbox (MTB) is a new measurement system that includes measures assessing Executive Functioning (EF) and Processing Speed (PS): Arrow Matching, Shape-Color Sorting, and Number-Symbol Match. The purpose of this study was to assess their psychometric properties. METHOD MTB measures were developed for smartphone administration based on constructs measured in the NIH Toolbox® (NIHTB). Psychometric properties of the resulting measures were evaluated in three studies with participants ages 18 to 90. In Study 1 (N = 92), participants completed MTB measures in the lab and were administered both equivalent NIH TB measures and other external measures of similar cognitive constructs. In Study 2 (N = 1,021), participants completed the equivalent NIHTB measures in the lab and then took the MTB measures on their own, remotely. In Study 3 (N = 168), participants completed MTB measures twice remotely, two weeks apart. RESULTS All three measures exhibited very high internal consistency and strong test-retest reliability, as well as moderately high correlations with comparable NIHTB tests and moderate correlations with external measures of similar constructs. Phone operating system (iOS vs. Android) had a significant impact on performance for Arrow Matching and Shape-Color Sorting, but no impact on either validity or reliability. CONCLUSIONS Results support the reliability and convergent validity of MTB EF and PS measures for use across the adult lifespan in remote, self-administered designs.
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Affiliation(s)
- Miriam A Novack
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Stephanie Ruth Young
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Elizabeth M Dworak
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Aaron J Kaat
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jerry Slotkin
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, USA
| | - Cindy Nowinski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lihua Yao
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hubert Adam
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jordan Stoeger
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Zahra Hosseinian
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Saki Amagai
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sarah Pila
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Maria Varela Diaz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anyelo Almonte Correa
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | | | | - Monica R Camacho
- University of California, San Francisco, NCIRE, San Francisco, CA, USA
- Northern California Institute for Research and Education, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Bernard Landavazo
- University of California, San Francisco, NCIRE, San Francisco, CA, USA
- Northern California Institute for Research and Education, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Rachel L Nosheny
- University of California, San Francisco, NCIRE, San Francisco, CA, USA
- Northern California Institute for Research and Education, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Michael W Weiner
- University of California, San Francisco, NCIRE, San Francisco, CA, USA
- Northern California Institute for Research and Education, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Richard C Gershon
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Kuhn LJ, Camerota M, Willoughby MT, Blair C. A Comparison of Three Executive Function Batteries in a Preschool-Aged Sample. CHILDREN (BASEL, SWITZERLAND) 2024; 11:811. [PMID: 39062260 PMCID: PMC11275069 DOI: 10.3390/children11070811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/13/2024] [Accepted: 06/27/2024] [Indexed: 07/28/2024]
Abstract
There is great interest in the development of executive function (EF) in the preschool period. Accordingly, multiple performance-based measures of EF have been developed for this age group, yet little is known about how they compare to one another. This study used a large and diverse sample of 3-to-5-year-old children (N = 846), who completed subtests of the National Institutes of Health's Toolbox Cognition Battery (NTCB), the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV), and the EF Touch battery. Scores across the three batteries were compared and associations with age, income, and race/ethnicity were examined. Results revealed that (1) the three tasks were moderately correlated (r = 0.44-0.51, all p < 0.001), but children had higher mean accuracy scores on EF Touch than on the NTCB or the WPPSI-IV. (2) Mean accuracy scores on all batteries were linearly associated with child age (all F > 32.68, all p < 0.0001). (3) Comparisons by income and race/ethnicity showed lower accuracy for low-income children on the WPPSI-IV and lower accuracy for White children on the NTCB. Across all batteries, there was consistently lower accuracy for Hispanic children. In conclusion, the three batteries we examined performed similarly across several metrics. EF Touch may be more appropriate for younger children, while the NTCB performed well with older children.
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Affiliation(s)
- Laura J. Kuhn
- FPG Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Marie Camerota
- Center for Developmental Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
| | | | - Clancy Blair
- Department of Applied Psychology, New York University, New York, NY 10012, USA
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Barber KE, Pitts BX, Stiede JT, Espil FM, Woods DW, Specht MW, Bennett SM, Walkup JT, Ricketts EJ, McGuire JF, Peterson AL, Compton SN, Wilhelm S, Scahill L, Piacentini JC. Perceived Negative Effects of Tic Management Strategies in Adults With Tic Disorders. Behav Modif 2024; 48:449-470. [PMID: 38557310 PMCID: PMC11179959 DOI: 10.1177/01454455241236446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Behavior therapy is a well-established and empirically supported treatment for tic disorders (TDs). However, concerns have been expressed about the negative effects of behavioral interventions, such as tic worsening, tic substitution, and excessive effort. This study explored perceived negative effects of tic management strategies in adults with TDs and predictors of these experiences. Participants (N = 72) completed semi-structured interviews 11 years after receiving behavior therapy or supportive therapy in a randomized clinical trial. We examined responses to interview questions about managing tics and predictors of reported negative effects. Most participants did not experience tic worsening (84%) or tic substitution (75%) from tic management strategies. The majority felt they could manage tics while participating in their environment (87%) and did not report life interference from tic management (77%). About half (45%) felt less present when managing tics. Treatment non-responders in the original trial were more likely to report negative effects of tic management strategies. No differences in reported negative consequences were found between those who received behavior therapy versus supportive therapy, suggesting that behavior therapy specifically does not lead to such adverse effects. These findings could reduce misconceptions about behavior therapy for TDs and enhance its acceptability and utilization.
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Affiliation(s)
| | | | | | | | | | | | | | - John T Walkup
- Ann and Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | - Emily J Ricketts
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | | | - Alan L Peterson
- The University of Texas Health Science Center at San Antonio, San Antonio, USA
| | | | | | - Lawrence Scahill
- Emory University School of Medicine Marcus Center, Atlanta, GA, USA
| | - John C Piacentini
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
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Stager LM, Watson CS, Cook EW, Fobian AD. Effect of Sleep Restriction on Adolescent Cognition by Adiposity: A Randomized Crossover Trial. JAMA Neurol 2024; 81:712-721. [PMID: 38767872 PMCID: PMC11106714 DOI: 10.1001/jamaneurol.2024.1332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/22/2024] [Indexed: 05/22/2024]
Abstract
Importance Pediatric obesity is associated with impaired cognitive function; however, the mechanisms underlying this association demand assessment. Sleep may be a relevant moderator, as poor sleep predicts both increased adiposity and impaired cognitive function. Objective To determine the effects of adiposity and sleep on adolescent cognitive function. Design, Setting, and Participants This single-blind randomized crossover trial was conducted from September 2020 to October 2022. Parents or caregivers provided demographic information for adolescent participants. Body mass index percentile and bioelectrical impedance analysis assessed adiposity. Adolescents completed 2 actigraphy-confirmed sleep conditions, adequate and restricted, followed by in-person cognitive assessment. No additional follow-up was provided. Data collection for this population-based study took place in a behavioral medicine clinic in Birmingham, Alabama. A total of 323 participants were assessed for eligibility (ages 14-19 years and healthy). Of the 244 eligible adolescents, 157 declined participation. Eighty-seven were randomized and 26 dropped out postenrollment. The final sample included 61 adolescents, 31 with healthy weight and 30 with overweight or obesity. Data were analyzed from April to October 2023. Interventions Following a 2-day washout period of adequate sleep, adolescents completed 2 sleep conditions: adequate (mean [SD] duration, 8 hours, 54 minutes [58.0 minutes]) and restricted (mean [SD] duration, 4 hours, 12 minutes [50.7 minutes]). Main Outcomes and Measures The National Institutes of Health Cognitive Toolbox assessed global and fluid cognition, cognitive flexibility, working and episodic memory, attention, and processing speed. The Stroop Task assessed inhibition. Results The final sample included 61 adolescents (mean [SD] age, 16.3 [1.6] years; 35 [57.4%] female). Restricted sleep predicted poorer global cognition scores (restricted mean [SD], 98.0 [2.8]; adequate mean [SD], 103.2 [2.9]), fluid cognition scores (restricted mean [SD], 94.5 [3.2]; adequate mean [SD], 102.0 [3.6]), and cognitive flexibility scores (restricted mean [SD], 84.8 [3.0]; adequate mean [SD], 92.8 [3.0]) for adolescents with overweight or obesity. No differences emerged for adolescents with healthy weight. Adolescents with overweight or obesity also had poorer attention scores (mean [SD], 80.0 [2.3]) compared to adolescents with healthy weight (mean [SD], 88.4 [SD, 2.3]) following restricted sleep. No differences emerged following adequate sleep. Findings were similar for total body fat percentage (TBF%); however, for adolescents with TBF% above 42, restricted sleep also predicted poorer processing speed, and the association between sleep and attention did not vary based on TBF%. Conclusions and Relevance Adolescents with overweight or obesity may be more vulnerable to negative cognitive effects following sleep restriction. Improved sleep hygiene and duration in this group may positively impact their cognitive health. Trial Registration ClinicalTrials.gov Identifier: NCT04346433.
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Affiliation(s)
| | | | - Edwin W. Cook
- Department of Psychology, University of Alabama at Birmingham
| | - Aaron D. Fobian
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
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Hao Y, Hu L. Lower Childhood Socioeconomic Status Is Associated with Greater Neural Responses to Ambient Auditory Changes in Adulthood. J Cogn Neurosci 2024; 36:979-996. [PMID: 38579240 DOI: 10.1162/jocn_a_02151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
Humans' early life experience varies by socioeconomic status (SES), raising the question of how this difference is reflected in the adult brain. An important aspect of brain function is the ability to detect salient ambient changes while focusing on a task. Here, we ask whether subjective social status during childhood is reflected by the way young adults' brain detecting changes in irrelevant information. In two studies (total n = 58), we examine electrical brain responses in the frontocentral region to a series of auditory tones, consisting of standard stimuli (80%) and deviant stimuli (20%) interspersed randomly, while participants were engaged in various visual tasks. Both studies showed stronger automatic change detection indexed by MMN in lower SES individuals, regardless of the unattended sound's feature, attended emotional content, or study type. Moreover, we observed a larger MMN in lower-SES participants, although they did not show differences in brain and behavior responses to the attended task. Lower-SES people also did not involuntarily orient more attention to sound changes (i.e., deviant stimuli), as indexed by the P3a. The study indicates that individuals with lower subjective social status may have an increased ability to automatically detect changes in their environment, which may suggest their adaptation to their childhood environments.
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Affiliation(s)
- Yu Hao
- University of Pennsylvania
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9
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Karr JE, Rivera Mindt M, Iverson GL. Interpreting reliable change on the Spanish-language NIH toolbox cognition battery. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:229-237. [PMID: 34904490 PMCID: PMC9976799 DOI: 10.1080/23279095.2021.2011726] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This study applied a reliable change methodology to the test-retest data from the Spanish-language NIH Toolbox Cognition Battery (NIHTB-CB) normative sample. Participants included Spanish-speaking adults (n = 48; 54.2% women, 100% Latinx) evaluated twice within one to two weeks on the Spanish-language NIHTB-CB, consisting of two crystallized and five fluid cognitive tests. Test-retest means, standard deviations, and intraclass correlations were used to calculate upper and lower bounds of 70, 80, and 90% confidence intervals (CIs) around change scores, with these bounds used as cutoffs for inferring reliable change. Cutoffs were calculated for raw scores, age-adjusted standard scores (SS; M = 100, SD = 15), and demographic-adjusted T-scores (T; M = 50, SD = 10), adjusting for age, gender, and education. Test-retest change scores on the Spanish-language NIHTB-CB exceeding the following cutoffs indicate reliable change based on an 80% CI (i.e., values exceeding these cutoffs indicate greater decline or greater improvement than 90% of the sample): Dimensional Change Card Sort (SS ≥ 15/T ≥ 11), Flanker (SS ≥ 13/T ≥ 10), List Sorting (SS ≥ 13/T ≥ 9), Picture Sequence Memory (SS ≥ 14/T ≥ 9), Pattern Comparison (SS ≥ 14/T ≥ 10), Picture Vocabulary (SS ≥ 8/T ≥ 6), Oral Reading (SS ≥ 7/T ≥ 5), Fluid Cognition Composite (SS ≥ 12/T ≥ 9), Crystallized Cognition Composite (SS ≥ 6/T ≥ 5), and Total Cognition Composite (SS ≥ 8/T ≥ 7). These cutoffs are one of few resources to interpret cognitive change at retest among Spanish-speaking patients and participants.
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Affiliation(s)
- Justin E Karr
- Department of Psychology, University of Kentucky, Lexington, KY, USA
| | - Monica Rivera Mindt
- Department of Psychology and Latin American and Latino Studies Institute, Fordham University, Bronx, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, Bronx, NY, USA
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Spaulding Research Institute, and Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, USA
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Boa Sorte Silva NC, Ten Brinke LF, Bielak AAM, Handy TC, Liu-Ambrose T. Improved intraindividual variability in cognitive performance following cognitive and exercise training in older adults. J Int Neuropsychol Soc 2024; 30:328-338. [PMID: 37860873 DOI: 10.1017/s1355617723000577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
OBJECTIVE Increased intraindividual variability (IIV) of cognitive performance is a marker of cognitive decline in older adults. Whether computerized cognitive training (CCT) and aerobic exercise counteracts cognitive decline by reducing IIV is unknown. We investigated the effects of CCT with or without aerobic exercise on IIV in older adults. METHODS This was a secondary analysis of an 8-week randomized controlled trial. Older adults (aged 65-85 years) were randomized to CCT alone (n = 41), CCT with aerobic exercise (n = 41), or an active control group (n = 42). The CCT group trained using the Fit Brains® platform 3×/week for 1 hr (plus 3×/week of home-based training). The CCT with aerobic exercise group received 15 min of walking plus 45 min of Fit Brains® 3×/week (plus 3×/week of home-based training). The control group received sham exercise and cognitive training (3×/week for 1 hr). We computed reaction time IIV from the Dimensional Change Card Sort Test, Flanker Inhibitory Control and Attention Test (Flanker), and Pattern Comparison Processing Speed Test (PACPS). RESULTS Compared with the control group, IIV reduced in a processing speed task (PACPS) following CCT alone (mean difference [95% confidence interval]: -0.144 [-0.255 to -0.034], p < 0.01) and CCT with aerobic exercise (-0.113 [-0.225 to -0.001], p < 0.05). Attention (Flanker congruent) IIV was reduced only after CCT with aerobic exercise (-0.130 [-0.242 to -0.017], p < 0.05). CONCLUSIONS A CCT program promoted cognitive health via reductions in IIV of cognitive performance and combining it with aerobic exercise may result in broader benefits.
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Affiliation(s)
- Nárlon C Boa Sorte Silva
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Lisanne F Ten Brinke
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Allison A M Bielak
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - Todd C Handy
- Department of Psychology, Faculty of Arts, University of British Columbia, Vancouver, BC, Canada
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
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11
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Chaytor NS, Trapani VR, Braffett BH, Fonseca LM, Lorenzi GM, Gubitosi-Klug RA, Hitt S, Farrell K, Jacobson AM, Ryan CM. Utility of the NIH Toolbox Cognition Battery in middle to older aged adults with longstanding type 1 diabetes: The DCCT/EDIC study. Clin Neuropsychol 2024; 38:1007-1027. [PMID: 37814481 PMCID: PMC11001788 DOI: 10.1080/13854046.2023.2266876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/28/2023] [Indexed: 10/11/2023]
Abstract
Objective: Adults with type 1 diabetes (T1D) face an increased risk for cognitive decline and dementia. Diabetes-related and vascular risk factors have been linked to cognitive decline using detailed neuropsychological testing; however, it is unclear if cognitive screening batteries can detect cognitive changes associated with aging in T1D. Method: 1,049 participants with T1D (median age 59 years; range 43-74) from the Diabetes Control and Complications Trial (DCCT), and the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study, completed the NIH Toolbox Cognition Battery (NIHTB-C) and Montreal Cognitive Assessment (MoCA). Neuropsychological assessments, depression, glycated hemoglobin levels (HbA1c), severe hypoglycemia, T1D complications, and vascular risk factors were assessed repeatedly over 32 years to determine associations with current NIHTB-C performance. Available cognitive data was clinically adjudicated to determine cognitive impairment status. Results: NIHTB-C scores had moderate associations (r = 0.36-0.53) with concurrently administered neuropsychological tests. In multivariate models, prior severe hypoglycemic episodes, depression symptoms, nephropathy, lower BMI, and higher HbA1c and LDL cholesterol were associated with poorer NIHTB-C Fluid Cognition Composite scores. The NIHTB-C adequately detected adjudicated cognitive impairment (Area Under the Curve = 0.86; optimal cut score ≤90). The MoCA performed similarly (Area Under the Curve = 0.83; optimal cut score ≤25). Conclusions: The NIHTB-C is sensitive to the cognitive effects of diabetes-related and vascular risk factors, correlated with neuropsychological testing, and accurately detects adjudicated cognitive impairment. These data support its use as a screening test in middle to older aged adults with T1D to determine if referral for detailed neuropsychological assessment is needed.
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Affiliation(s)
- Naomi S Chaytor
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | | | | | - Luciana M Fonseca
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Gayle M Lorenzi
- Medicine, University of California San Diego, La Jolla, CA, USA
| | - Rose A Gubitosi-Klug
- Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Susan Hitt
- Ophthalmology, University of Missouri, Columbia, MO, USA
| | - Kaleigh Farrell
- Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Alan M Jacobson
- NYU Langone Long Island Hospital, NYU Long Island School of Medicine, Mineola, NY, USA
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12
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Nashiro K, Yoo HJ, Cho C, Kim AJ, Nasseri P, Min J, Dahl MJ, Mercer N, Choupan J, Choi P, Lee HRJ, Choi D, Alemu K, Herrera AY, Ng NF, Thayer JF, Mather M. Heart rate and breathing effects on attention and memory (HeartBEAM): study protocol for a randomized controlled trial in older adults. Trials 2024; 25:190. [PMID: 38491546 PMCID: PMC10941428 DOI: 10.1186/s13063-024-07943-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/18/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND In healthy people, the "fight-or-flight" sympathetic system is counterbalanced by the "rest-and-digest" parasympathetic system. As we grow older, the parasympathetic system declines as the sympathetic system becomes hyperactive. In our prior heart rate variability biofeedback and emotion regulation (HRV-ER) clinical trial, we found that increasing parasympathetic activity through daily practice of slow-paced breathing significantly decreased plasma amyloid-β (Aβ) in healthy younger and older adults. In healthy adults, higher plasma Aβ is associated with greater risk of Alzheimer's disease (AD). Our primary goal of this trial is to reproduce and extend our initial findings regarding effects of slow-paced breathing on Aβ. Our secondary objectives are to examine the effects of daily slow-paced breathing on brain structure and the rate of learning. METHODS Adults aged 50-70 have been randomized to practice one of two breathing protocols twice daily for 9 weeks: (1) "slow-paced breathing condition" involving daily cognitive training followed by slow-paced breathing designed to maximize heart rate oscillations or (2) "random-paced breathing condition" involving daily cognitive training followed by random-paced breathing to avoid increasing heart rate oscillations. The primary outcomes are plasma Aβ40 and Aβ42 levels and plasma Aβ42/40 ratio. The secondary outcomes are brain perivascular space volume, hippocampal volume, and learning rates measured by cognitive training performance. Other pre-registered outcomes include plasma pTau-181/tTau ratio and urine Aβ42. Recruitment began in January 2023. Interventions are ongoing and will be completed by the end of 2023. DISCUSSION Our HRV-ER trial was groundbreaking in demonstrating that a behavioral intervention can reduce plasma Aβ levels relative to a randomized control group. We aim to reproduce these findings while testing effects on brain clearance pathways and cognition. TRIAL REGISTRATION ClinicalTrials.gov NCT05602220. Registered on January 12, 2023.
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Affiliation(s)
- Kaoru Nashiro
- University of Southern California, Los Angeles, USA.
| | - Hyun Joo Yoo
- University of Southern California, Los Angeles, USA
| | | | | | | | - Jungwon Min
- University of Southern California, Los Angeles, USA
| | - Martin J Dahl
- University of Southern California, Los Angeles, USA
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
| | - Noah Mercer
- University of Southern California, Los Angeles, USA
| | - Jeiran Choupan
- University of Southern California, Los Angeles, USA
- NeuroScope Inc., New York, USA
| | - Paul Choi
- University of Southern California, Los Angeles, USA
| | | | - David Choi
- University of Southern California, Los Angeles, USA
| | | | | | | | | | - Mara Mather
- University of Southern California, Los Angeles, USA
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13
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Rosa MJ, Armendáriz-Arnez C, Gudayol-Ferré E, Prehn M, Fuhrimann S, Eskenazi B, Lindh CH, Mora AM. Association of pesticide exposure with neurobehavioral outcomes among avocado farmworkers in Mexico. Int J Hyg Environ Health 2024; 256:114322. [PMID: 38219443 PMCID: PMC10956701 DOI: 10.1016/j.ijheh.2024.114322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/06/2023] [Accepted: 01/08/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND AND AIM To date, few studies have focused on the health effects of pesticide exposure among avocado farmworkers. We examined the association of exposure to insecticides, fungicides, and herbicides with cognitive and mental health outcomes among these avocado workers from Michoacan, Mexico. MATERIALS AND METHODS We conducted a cross-sectional study of 105 avocado farmworkers between May and August 2021. We collected data on self-reported pesticide use during the 12 months prior to the baseline survey and estimated annual exposure-intensity scores (EIS) using a semi-quantitative exposure algorithm. We calculated specific gravity adjusted average concentrations of 12 insecticide, fungicide, or herbicide metabolites measured in urine samples collected during two study visits (8-10 weeks apart). We assessed participants' cognitive function and psychological distress using the NIH Toolbox Cognition Battery and the Brief Symptom Inventory 18 (BSI-18), respectively. We examined individual associations of EIS and urinary pesticide metabolites with neurobehavioral outcomes using generalized linear regression models. We also implemented Bayesian Weighted Quantile Sum (BWQS) regression to evaluate the association between a pesticide metabolite mixture and neurobehavioral outcomes. RESULTS In individual models, after adjusting for multiple comparisons, higher concentrations of hydroxy-tebuconazole (OH-TEB, metabolite of fungicide tebuconazole) were associated with higher anxiety (IRR per two-fold increase in concentrations = 1.26, 95% CI:1.08, 1.48) and Global Severity Index (GSI) (IRR = 1.89, 95% CI:1.36, 2.75) scores, whereas higher concentrations of 3,5,6-trichloro-2-pyridinol (TCPy, metabolite of chlorpyrifos) were associated with lower GSI scores (IRR = 0.69, 95% CI: 0.56, 0.85). In BWQS analyses, we found evidence of a mixture association of urinary pesticide metabolites with higher anxiety (IRR = 1.72, 95% CrI: 1.12, 2.55), depression (IRR = 4.60, 95% CrI: 2.19, 9.43), and GSI (IRR = 1.99, 95% CrI: 1.39, 2.79) scores. OH-TEB and hydroxy-thiabendazole (metabolite of fungicide thiabendazole) combined contributed 54%, 40%, and 54% to the mixture effect in the anxiety symptoms, depression symptoms, and overall psychological distress models, respectively. CONCLUSIONS We found that exposure to tebuconazole and thiabendazole, fungicides whose effects have been rarely studied in humans, may be associated with increased psychological distress among avocado farmworkers. We also observed that exposure to chlorpyrifos may be associated with decreased psychological distress.
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Affiliation(s)
- Maria José Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - Cynthia Armendáriz-Arnez
- Escuela Nacional de Estudios Superiores (ENES) Unidad Morelia, Universidad Nacional Autónoma de México (UNAM), Morelia, Mexico
| | - Esteve Gudayol-Ferré
- Facultad de Psicología, Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Mexico
| | - Manuela Prehn
- Escuela Nacional de Estudios Superiores (ENES) Unidad Morelia, Universidad Nacional Autónoma de México (UNAM), Morelia, Mexico
| | - Samuel Fuhrimann
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
| | - Brenda Eskenazi
- Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, Berkeley, United States
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, Lund, Sweden
| | - Ana M Mora
- Center for Environmental Research and Community Health (CERCH), School of Public Health, University of California, Berkeley, Berkeley, United States
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14
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Willbrand EH, Jackson S, Chen S, Hathaway CB, Voorhies WI, Bunge SA, Weiner KS. Sulcal variability in anterior lateral prefrontal cortex contributes to variability in reasoning performance among young adults. Brain Struct Funct 2024; 229:387-402. [PMID: 38184493 DOI: 10.1007/s00429-023-02734-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/12/2023] [Indexed: 01/08/2024]
Abstract
Identifying structure-function correspondences is a major goal among biologists, cognitive neuroscientists, and brain mappers. Recent studies have identified relationships between performance on cognitive tasks and the presence or absence of small, shallow indentations, or sulci, of the human brain. Building on the previous finding that the presence of the ventral para-intermediate frontal sulcus (pimfs-v) in the left anterior lateral prefrontal cortex (aLPFC) was related to reasoning task performance in children and adolescents, we tested whether this relationship extended to a different sample, age group, and reasoning task. As predicted, the presence of this aLPFC sulcus was also associated with higher reasoning scores in young adults (ages 22-36). These findings have not only direct developmental, but also evolutionary relevance-as recent work shows that the pimfs-v is exceedingly rare in chimpanzees. Thus, the pimfs-v is a key developmental, cognitive, and evolutionarily relevant feature that should be considered in future studies examining how the complex relationships among multiscale anatomical and functional features of the brain give rise to abstract thought.
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Affiliation(s)
- Ethan H Willbrand
- Medical Scientist Training Program, School of Medicine and Public Health, University of WI-Madison, Madison, WI, USA
| | - Samantha Jackson
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA
| | - Szeshuen Chen
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | | | - Willa I Voorhies
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Silvia A Bunge
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA.
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA.
| | - Kevin S Weiner
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA.
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA.
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15
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Elias MN, Ahrens EA, Tsai CS, Liang Z, Munro CL. Inactivity May Identify Older Intensive Care Unit Survivors at Risk for Post-Intensive Care Syndrome. Am J Crit Care 2024; 33:95-104. [PMID: 38424021 PMCID: PMC11098449 DOI: 10.4037/ajcc2024785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND Older adults (≥age 65) admitted to an intensive care unit (ICU) are profoundly inactive during hospitalization. Older ICU survivors often experience life-changing symptoms, including cognitive dysfunction, physical impairment, and/or psychological distress, which are components of post-intensive care syndrome (PICS). OBJECTIVES To explore trends between inactivity and symptoms of PICS in older ICU survivors. METHODS This study was a secondary analysis of pooled data obtained from 2 primary, prospective, cross-sectional studies of older ICU survivors. After ICU discharge, 49 English- and Spanish-speaking participants who were functionally independent before admission and who had received mechanical ventilation while in the ICU were enrolled. Actigraphy was used to measure post-ICU hourly activity counts (12:00 AM to 11:59 PM). Selected instruments from the National Institutes of Health Toolbox and Patient-Reported Outcomes Measurement Information System were used to assess symptoms of PICS: cognitive dysfunction, physical impairment, and psychological distress. RESULTS Graphs illustrated trends between inactivity and greater symptom severity of PICS: participants who were less active tended to score worse than one standard deviation of the mean on each outcome. Greater daytime activity was concurrently observed with higher performances on cognitive and physical assessments and better scores on psychological measures. CONCLUSIONS Post-ICU inactivity may identify older ICU survivors who may be at risk for PICS and may guide future research interventions to mitigate symptom burden.
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Affiliation(s)
- Maya N Elias
- Maya N. Elias is an assistant professor, Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle
| | - Emily A Ahrens
- Emily A. Ahrens is a PhD in nursing science student, School of Nursing, University of Washington, Seattle
| | - Chi-Shan Tsai
- Chi-Shan Tsai is a PhD in nursing science student, School of Nursing, University of Washington, Seattle
| | - Zhan Liang
- Zhan Liang is an assistant professor, School of Nursing & Health Studies, University of Miami, Coral Gables, Florida
| | - Cindy L Munro
- Cindy L. Munro is a dean and professor, School of Nursing & Health Studies, University of Miami, Coral Gables, Florida
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16
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Amin RM, Phillips JJ, Humbert AT, Cholerton BA, Short VD, Smith MJ, Zabetian CP, Mata IF, Kelly VE. Associations between baseline cognitive status and motor outcomes after treadmill training in people with Parkinson's disease: a pilot study. Disabil Rehabil 2024; 46:1082-1091. [PMID: 37010072 PMCID: PMC10545807 DOI: 10.1080/09638288.2023.2189318] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/27/2023] [Accepted: 03/05/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE To determine the effect of baseline cognition on gait outcomes after a treadmill training program for people with Parkinson's disease (PD). METHODS This pilot clinical trial involved people with PD who were classified as having no cognitive impairment (PD-NCI) or mild cognitive impairment (PD-MCI). Baseline executive function and memory were assessed. The intervention was a 10-week gait training program (twice-weekly treadmill sessions), with structured speed and distance progression and verbal cues for gait quality. Response to intervention was assessed by gait speed measured after week 2 (short-term) and week 10 (long-term). RESULTS Participants (n = 19; 12 PD-NCI, 7 PD-MCI) had a mean (standard deviation) age of 66.5 (6.3) years, disease duration of 8.8 (6.3) years, and MDS-UPDRS III score of 21.3 (10.7). Gait speed increased at short-term and long-term assessments. The response did not differ between PD-NCI and PD-MCI groups; however, better baseline memory performance and milder PD motor severity were independently associated with greater improvements in gait speed in unadjusted and adjusted models. CONCLUSIONS These findings suggest that memory impairments and more severe motor involvement can influence the response to gait rehabilitation in PD and highlight the need for treatments optimized for people with greater cognitive and motor impairment.IMPLICATIONS FOR REHABILITATIONCognitive deficits in Parkinson's disease (PD) could impact motor learning and gait rehabilitation, yet little is known about the effects of cognitive impairments on the response to rehabilitation in people with PD.This study demonstrates that the response to gait rehabilitation did not differ between people with PD who had no cognitive impairment and those with mild cognitive impairment.Across all participants, better baseline memory was associated with greater improvements in gait speed.Rehabilitation professionals should be mindful of PD severity, as those with more substantial memory and motor impairments may require additional dosing or support to maximize gait training benefits.
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Affiliation(s)
- Raima M. Amin
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
| | | | - Andrew T. Humbert
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Brenna A. Cholerton
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Valerie D. Short
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Melissa J. Smith
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Cyrus P. Zabetian
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Ignacio F. Mata
- Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
- Lerner Research Institute, Genomic Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Valerie E. Kelly
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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17
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Young SR, Dworak EM, Kaat AJ, Adam H, Novack MA, Slotkin J, Stoeger J, Nowinski CJ, Hosseinian Z, Amagai S, Pila S, Diaz MV, Correa AA, Alperin K, Omberg L, Kellen M, Camacho MR, Landavazo B, Nosheny RL, Weiner MW, Gershon RM. Development and Validation of a Vocabulary Measure in the Mobile Toolbox. Arch Clin Neuropsychol 2024:acae010. [PMID: 38414411 DOI: 10.1093/arclin/acae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/24/2024] [Accepted: 01/27/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVE We describe the development of a new computer adaptive vocabulary test, Mobile Toolbox (MTB) Word Meaning, and validity evidence from 3 studies. METHOD Word Meaning was designed to be a multiple-choice synonym test optimized for self-administration on a personal smartphone. The items were first calibrated online in a sample of 7,525 participants to create the computer-adaptive test algorithm for the Word Meaning measure within the MTB app. In Study 1, 92 participants self-administered Word Meaning on study-provided smartphones in the lab and were administered external measures by trained examiners. In Study 2, 1,021 participants completed the external measures in the lab and Word Meaning was self-administered remotely on their personal smartphones. In Study 3, 141 participants self-administered Word Meaning remotely twice with a 2-week delay on personal iPhones. RESULTS The final bank included 1363 items. Internal consistency was adequate to good across samples (ρxx = 0.78 to 0.81, p < .001). Test-retest reliability was good (ICC = 0.65, p < .001), and the mean theta score was not significantly different upon the second administration. Correlations were moderate to large with measures of similar constructs (ρ = 0.67-0.75, p < .001) and non-significant with measures of dissimilar constructs. Scores demonstrated small to moderate correlations with age (ρ = 0.35 to 0.45, p < .001) and education (ρ = 0.26, p < .001). CONCLUSION The MTB Word Meaning measure demonstrated evidence of reliability and validity in three samples. Further validation studies in clinical samples are necessary.
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Affiliation(s)
- Stephanie Ruth Young
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Elizabeth M Dworak
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Aaron J Kaat
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hubert Adam
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Miriam A Novack
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jerry Slotkin
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, USA
| | | | - Cindy J Nowinski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Zahra Hosseinian
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Saki Amagai
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sarah Pila
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Maria Varela Diaz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anyelo Almonte Correa
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | | - Monica R Camacho
- University of California San Francisco, San Francisco CA, USA
- Northern California Institute for Research and Education, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Bernard Landavazo
- University of California San Francisco, San Francisco CA, USA
- Northern California Institute for Research and Education, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Rachel L Nosheny
- University of California San Francisco, San Francisco CA, USA
- Northern California Institute for Research and Education, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Michael W Weiner
- University of California San Francisco, San Francisco CA, USA
- Northern California Institute for Research and Education, San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Richard M Gershon
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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18
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Karr JE, Ingram EO, Pinheiro CN, Ali S, Iverson GL. Test-Retest Reliability and Reliable Change on the NIH Toolbox Cognition Battery. Arch Clin Neuropsychol 2024:acae011. [PMID: 38402512 DOI: 10.1093/arclin/acae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/22/2023] [Accepted: 01/25/2024] [Indexed: 02/26/2024] Open
Abstract
OBJECTIVE Researchers and practitioners can detect cognitive improvement or decline within a single examinee by applying a reliable change methodology. This study examined reliable change through test-retest data from the English-language National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) normative sample. METHOD Participants included adults (n = 138; age: M ± SD = 54.8 ± 20.0, range: 18-85; 51.4% men; 68.1% White) who completed test-retest assessments about a week apart on five fluid cognition tests, providing raw scores, age-adjusted standard scores (SS), and demographic-adjusted T-scores (T). RESULTS The Fluid Cognition Composite (SS: ICC = 0.87; T-score: ICC = 0.84) and the five fluid cognition tests had good test-retest reliability (SS: ICC range = 0.66-0.85; T-score: ICC range = 0.64-0.86). The lower and upper bounds of 70%, 80%, and 90% confidence intervals (CIs) were calculated around change scores, which serve as cutoffs for determining reliable change. Using T-scores, 90% CI, and adjustment for practice effects, 32.3% declined on one or more tests, 9.7% declined on two or more tests, 36.6% improved on one or more tests, and 5.4% improved on two or more tests. CONCLUSIONS It was common for participants to show reliable change on at least one test score, but not two or more test scores. Per an 80% CI, test-retest difference scores beyond these cutoffs would indicate reliable change: Dimensional Change Card Sort (SS ≥ 14/T ≥ 10), Flanker (SS ≥ 12/T ≥ 8), List Sorting (SS ≥ 14/T ≥ 10), Picture Sequence Memory (SS ≥ 19/T ≥ 13), Pattern Comparison (SS ≥ 11/T ≥ 8), and Fluid Cognition Composite (SS ≥ 10/T ≥ 7). The reliable change cutoffs could be applied in research or practice to detect within-person change in fluid cognition at the individual level.
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Affiliation(s)
- Justin E Karr
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, KY, USA
| | - Eric O Ingram
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, KY, USA
| | - Cristina N Pinheiro
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, KY, USA
| | - Sheliza Ali
- Department of Neurology, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
- Department of Physical Medicine and Rehabilitation, Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, MA, USA
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, USA
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Karr JE, Pinheiro CN, Harp JP. Performance Validity Testing on the NIH Toolbox Cognition Battery: Base Rates of Failed Embedded Validity Indicators in the Adult Normative Sample. Arch Clin Neuropsychol 2024; 39:204-213. [PMID: 37718664 PMCID: PMC10879920 DOI: 10.1093/arclin/acad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVE The goal of this study was to determine the base rates of failing proposed embedded validity indicators (EVIs) for the National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) in the normative sample. METHOD Participants included adults in the NIHTB-CB normative sample with data to calculate age-adjusted standard scores (n = 855; ages: M(SD) = 46.9(17.3), range: 18-85; 65.0% women; education: M(SD) = 14.1(2.5) years) or demographically adjusted T-scores (n = 803; ages: M(SD) = 47.3(17.3), range: 18-85; 65.3% women; education: M(SD) = 14.2(2.5) years) for all tests. The NIHTB-CB includes two tests of crystallized cognition and five tests of fluid cognition. Individual norm-referenced test performances were categorized as falling above or below liberal and conservative cutoffs based on proposed univariate EVIs. The number of univariate EVI failures was summed to compute multivariable EVIs. EVI failure rates above 10% were considered high false-positive rates, indicating specificity < .90. Using chi-square analyses, the frequencies of EVI failures were compared based on gender, race/ethnicity, education, and crystallized composite. RESULTS The multivariable EVIs had predominantly low false-positive rates in the normative sample. EVI failure rates were most common among participants with low crystallized composites. Using age-adjusted standard scores, EVI failure rates varied by education, race/ethnicity, and estimated premorbid intelligence. These differences were mostly eliminated when using demographically adjusted T-scores. CONCLUSIONS Multivariable EVIs requiring ≥ 4 failures using liberal cutoffs or ≥ 3 failures using conservative cutoffs had acceptable false-positive rates (i.e., < 10%) using both age-adjusted standard scores and demographically adjusted T-scores. These multivariable EVIs could be applied to large data sets with NIHTB-CB data to screen for potentially invalid test performances.
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Affiliation(s)
- Justin E Karr
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, KY, USA
| | - Cristina N Pinheiro
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, KY, USA
| | - Jordan P Harp
- Department of Neurology, College of Medicine, University of Kentucky, Lexington, KY, USA
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20
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Vermeent S, Young ES, DeJoseph ML, Schubert AL, Frankenhuis WE. Cognitive deficits and enhancements in youth from adverse conditions: An integrative assessment using Drift Diffusion Modeling in the ABCD study. Dev Sci 2024:e13478. [PMID: 38321588 DOI: 10.1111/desc.13478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 12/20/2023] [Accepted: 01/09/2024] [Indexed: 02/08/2024]
Abstract
Childhood adversity can lead to cognitive deficits or enhancements, depending on many factors. Though progress has been made, two challenges prevent us from integrating and better understanding these patterns. First, studies commonly use and interpret raw performance differences, such as response times, which conflate different stages of cognitive processing. Second, most studies either isolate or aggregate abilities, obscuring the degree to which individual differences reflect task-general (shared) or task-specific (unique) processes. We addressed these challenges using Drift Diffusion Modeling (DDM) and structural equation modeling (SEM). Leveraging a large, representative sample of 9-10 year-olds from the Adolescent Brain Cognitive Development (ABCD) study, we examined how two forms of adversity-material deprivation and household threat-were associated with performance on tasks measuring processing speed, inhibition, attention shifting, and mental rotation. Using DDM, we decomposed performance on each task into three distinct stages of processing: speed of information uptake, response caution, and stimulus encoding/response execution. Using SEM, we isolated task-general and task-specific variances in each processing stage and estimated their associations with the two forms of adversity. Youth with more exposure to household threat (but not material deprivation) showed slower task-general processing speed, but showed intact task-specific abilities. In addition, youth with more exposure to household threat tended to respond more cautiously in general. These findings suggest that traditional assessments might overestimate the extent to which childhood adversity reduces specific abilities. By combining DDM and SEM approaches, we can develop a more nuanced understanding of how adversity affects different aspects of youth's cognitive performance. RESEARCH HIGHLIGHT: To understand how childhood adversity shapes cognitive abilities, the field needs analytical approaches that can jointly document and explain patterns of lowered and enhanced performance. Using Drift Diffusion Modeling and Structural Equation Modeling, we analyzed associations between adversity and processing speed, inhibition, attention shifting, and mental rotation. Household threat, but not material deprivation, was mostly associated with slower task-general processing speed and more response caution. In contrast, task-specific abilities were largely intact. Researchers might overestimate the impact of childhood adversity on specific abilities and underestimate the impact on general processing speed and response caution using traditional measures.
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Affiliation(s)
- Stefan Vermeent
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
- Max Planck Institute for the Study of Crime, Security, and Law, Freiburg, Germany
| | - Ethan S Young
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | - Meriah L DeJoseph
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, USA
- Graduate School of Education, Stanford University, Stanford, California, USA
| | | | - Willem E Frankenhuis
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
- Max Planck Institute for the Study of Crime, Security, and Law, Freiburg, Germany
- Evolutionary and Population Biology, Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Utrecht, Amsterdam, The Netherlands
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21
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Ho BD, Gullett JM, Anton S, Franchetti MK, Bharadwaj PK, Raichlen DA, Alexander GE, Rundek T, Levin B, Visscher K, Woods AJ, Cohen RA. Associations between physical exercise type, fluid intelligence, executive function, and processing speed in the oldest-old (85 +). GeroScience 2024; 46:491-503. [PMID: 37523033 PMCID: PMC10828155 DOI: 10.1007/s11357-023-00885-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND While much is known about the effects of physical exercise in adult humans, literature on the oldest-old (≥ 85 years old) is sparse. The present study explored the relationship between self-reported engagement in physical exercise and cognition in the oldest-old. METHODS The sample included 184 cognitively healthy participants (98 females, MoCA mean score = 24.81) aged 85 to 99 years old (mean = 88.49 years). Participants completed the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire and a cognitive battery including NIH-TB, Coding, Symbol Search, Letter Fluency, and Stroop task. Three groups of participants - sedentary (n = 58; MoCA mean score = 24; 36 females; mean age = 89.03), cardio (n = 60; MoCA mean score = 25.08; 29 females; mean age = 88.62), and cardio + strength training (n = 66; MoCA mean score = 25.28; 33 females; mean age = 87.91) - were derived from responses on CHAMPS. RESULTS Analyses controlled for years of education, NIH-TB Crystallized Composite, and metabolic equivalent of tasks. The cardio + strength training group had the highest cognitive performances overall and scored significantly better on Coding (p < 0.001) and Symbol Search (p < 0.05) compared to the sedentary group. The cardio + strength training group scored significantly better on Symbol Search, Letter Fluency, and Stroop Color-Word compared to the cardio group (p < 0.05). CONCLUSIONS Our findings suggest self-reported exercise in the oldest-old is linked to better performance on cognitive measures of processing speed and executive functioning, and that there may be a synergistic effect of combining aerobic and resistance training on cognition.
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Affiliation(s)
- Brian Duy Ho
- Center for Cognitive Aging and Memory Clinical Translational Research, Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
| | - Joseph M Gullett
- Center for Cognitive Aging and Memory Clinical Translational Research, Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Stephen Anton
- Institute On Aging, University of Florida, Gainesville, FL, USA
| | | | | | - David A Raichlen
- Department of Biological Sciences, University of Southern California, Los Angeles, CA, USA
| | - Gene E Alexander
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Tatjana Rundek
- Evelyn F. McKnight Brain Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Bonnie Levin
- Evelyn F. McKnight Brain Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Kristina Visscher
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory Clinical Translational Research, Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Ronald A Cohen
- Center for Cognitive Aging and Memory Clinical Translational Research, Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
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de Chiusole D, Spinoso M, Anselmi P, Bacherini A, Balboni G, Mazzoni N, Brancaccio A, Epifania OM, Orsoni M, Giovagnoli S, Garofalo S, Benassi M, Robusto E, Stefanutti L, Pierluigi I. PsycAssist: A Web-Based Artificial Intelligence System Designed for Adaptive Neuropsychological Assessment and Training. Brain Sci 2024; 14:122. [PMID: 38391697 PMCID: PMC10886469 DOI: 10.3390/brainsci14020122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/15/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
Assessing executive functions in individuals with disorders or clinical conditions can be challenging, as they may lack the abilities needed for conventional test formats. The use of more personalized test versions, such as adaptive assessments, might be helpful in evaluating individuals with specific needs. This paper introduces PsycAssist, a web-based artificial intelligence system designed for neuropsychological adaptive assessment and training. PsycAssist is a highly flexible and scalable system based on procedural knowledge space theory and may be used potentially with many types of tests. We present the architecture and adaptive assessment engine of PsycAssist and the two currently available tests: Adap-ToL, an adaptive version of the Tower of London-like test to assess planning skills, and MatriKS, a Raven-like test to evaluate fluid intelligence. Finally, we describe the results of an investigation of the usability of Adap-ToL and MatriKS: the evaluators perceived these tools as appropriate and well-suited for their intended purposes, and the test-takers perceived the assessment as a positive experience. To sum up, PsycAssist represents an innovative and promising tool to tailor evaluation and training to the specific characteristics of the individual, useful for clinical practice.
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Affiliation(s)
- Debora de Chiusole
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Via Venezia 14, 35131 Padova, Italy
| | - Matilde Spinoso
- Department of Psychology "Renzo Canestrari", University of Bologna, Piazza Aldo Moro 90, 47521 Cesena, Italy
| | - Pasquale Anselmi
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Via Venezia 14, 35131 Padova, Italy
| | - Alice Bacherini
- Department of Philosophy, Social Sciences and Education, University of Perugia, Piazza G. Ermini 1, 06123 Perugia, Italy
| | - Giulia Balboni
- Department of Philosophy, Social Sciences and Education, University of Perugia, Piazza G. Ermini 1, 06123 Perugia, Italy
| | - Noemi Mazzoni
- Department of Psychology "Renzo Canestrari", University of Bologna, Piazza Aldo Moro 90, 47521 Cesena, Italy
| | - Andrea Brancaccio
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Via Venezia 14, 35131 Padova, Italy
| | - Ottavia M Epifania
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Via Venezia 14, 35131 Padova, Italy
| | - Matteo Orsoni
- Department of Psychology "Renzo Canestrari", University of Bologna, Piazza Aldo Moro 90, 47521 Cesena, Italy
| | - Sara Giovagnoli
- Department of Psychology "Renzo Canestrari", University of Bologna, Piazza Aldo Moro 90, 47521 Cesena, Italy
| | - Sara Garofalo
- Department of Psychology "Renzo Canestrari", University of Bologna, Piazza Aldo Moro 90, 47521 Cesena, Italy
| | - Mariagrazia Benassi
- Department of Psychology "Renzo Canestrari", University of Bologna, Piazza Aldo Moro 90, 47521 Cesena, Italy
| | - Egidio Robusto
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Via Venezia 14, 35131 Padova, Italy
| | - Luca Stefanutti
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Via Venezia 14, 35131 Padova, Italy
| | - Irene Pierluigi
- Department of Philosophy, Social Sciences and Education, University of Perugia, Piazza G. Ermini 1, 06123 Perugia, Italy
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Lee SH, Pitt MA. Implementation of an online spacing flanker task and evaluation of its test-retest reliability using measures of inhibitory control and the distribution of spatial attention. Behav Res Methods 2024:10.3758/s13428-023-02327-7. [PMID: 38228815 DOI: 10.3758/s13428-023-02327-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 01/18/2024]
Abstract
The flanker task (Eriksen & Eriksen, Perception & Psychophysics, 16(1), 143-149, 1974) has been highly influential and widely used in studies of visual attention. Its simplicity has made it popular to include it in experimental software packages and online platforms. The spacing flanker task (SFT), in which the distance between the target and flankers varies, is useful for studying the distribution of attention across space as well as inhibitory control. Use of the SFT requires that the viewing environment (e.g., stimulus size and viewing distance) be controlled, which is a challenge for online delivery. We implement and evaluate an online version of the SFT that includes two calibration pretests to provide the necessary control. Test-retest and split-half reliability of the online version was compared with a laboratory version on measures of inhibitory control and measures of the distribution of attention across space. Analyses show that the online SFT is comparable to laboratory testing on all measures. Results also identify two measures with good test-retest reliability that hold promise for studying performance in the SFT: the mean flanker effect (ICC = 0.745) and RTs on incongruent trials across distances (ICC = 0.65-0.71).
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Affiliation(s)
- Sang Ho Lee
- Department of Psychology, Seoul National University, Seoul, Korea.
- Department of Psychology, The Ohio State University, Columbus, OH, USA.
| | - Mark A Pitt
- Department of Psychology, The Ohio State University, Columbus, OH, USA
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24
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Elias MN, Ahrens EA, Schumacher FA, Liang Z, Munro CL. Associations Between Inactivity and Cognitive Function in Older Intensive Care Unit Survivors. Dimens Crit Care Nurs 2024; 43:13-20. [PMID: 38059708 PMCID: PMC11108648 DOI: 10.1097/dcc.0000000000000613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND/INTRODUCTION Critically ill older adults are profoundly inactive while in the intensive care unit (ICU), and this inactivity persists after discharge from the ICU. Older ICU survivors who were mechanically ventilated are at high risk for post-ICU cognitive impairment. OBJECTIVES/AIMS The present study examined the relationship between the ratio of daytime to nighttime activity and executive function in older ICU survivors. METHODS This was a secondary analysis of pooled data from 2 primary studies of older adults who were functionally independent prior to hospitalization, mechanically ventilated while in ICU, and within 24 to 48 hours post-ICU discharge. Actigraphy recorded daytime activity (mean activity counts per minute, 6 am to 9:59 pm) and nighttime activity (mean activity counts per minute, 10 pm to 5:59 am). A daytime-to-nighttime activity ratio was calculated by dividing daytime activity by nighttime activity. The NIH Toolbox Dimensional Change Card Sort Test assessed cognitive flexibility (DCCST: fully corrected T score). Multivariate regression examined the association between the daytime-to-nighttime activity ratio and DCCST scores, adjusting for 2 covariates (age in years and NIH Toolbox Grip Strength fully corrected T score). RESULTS The mean daytime-to-nighttime activity ratio was 2.10 ± 1.17 (interquartile range, 1.42). Ratios for 6 participants (13.6%) were less than 1, revealing higher activity during nighttime hours rather than daytime hours. Higher daytime-to-nighttime ratios were associated with better DCCST scores (β = .364, P = .005). CONCLUSIONS The proportion of daytime activity versus nighttime activity was considerably low, indicating severe alterations in the rest/activity cycle. Higher daytime-to-nighttime activity ratios were associated with better executive function scores, suggesting that assessment of daytime activity could identify at-risk older ICU survivors during the early post-ICU transition period. Promotion of daytime activity and nighttime sleep may accelerate recovery and improve cognitive function.
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Peterson M, Braga RM, Floris DL, Nielsen JA. Evidence for a Compensatory Relationship between Left- and Right-Lateralized Brain Networks. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.08.570817. [PMID: 38106130 PMCID: PMC10723397 DOI: 10.1101/2023.12.08.570817] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
The two hemispheres of the human brain are functionally asymmetric. At the network level, the language network exhibits left-hemisphere lateralization. While this asymmetry is widely replicated, the extent to which other functional networks demonstrate lateralization remains a subject of Investigation. Additionally, it is unknown how the lateralization of one functional network may affect the lateralization of other networks within individuals. We quantified lateralization for each of 17 networks by computing the relative surface area on the left and right cerebral hemispheres. After examining the ecological, convergent, and external validity and test-retest reliability of this surface area-based measure of lateralization, we addressed two hypotheses across multiple datasets (Human Connectome Project = 553, Human Connectome Project-Development = 343, Natural Scenes Dataset = 8). First, we hypothesized that networks associated with language, visuospatial attention, and executive control would show the greatest lateralization. Second, we hypothesized that relationships between lateralized networks would follow a dependent relationship such that greater left-lateralization of a network would be associated with greater right-lateralization of a different network within individuals, and that this pattern would be systematic across individuals. A language network was among the three networks identified as being significantly left-lateralized, and attention and executive control networks were among the five networks identified as being significantly right-lateralized. Next, correlation matrices, an exploratory factor analysis, and confirmatory factor analyses were used to test the second hypothesis and examine the organization of lateralized networks. We found general support for a dependent relationship between highly left- and right-lateralized networks, meaning that across subjects, greater left lateralization of a given network (such as a language network) was linked to greater right lateralization of another network (such as a ventral attention/salience network) and vice versa. These results further our understanding of brain organization at the macro-scale network level in individuals, carrying specific relevance for neurodevelopmental conditions characterized by disruptions in lateralization such as autism and schizophrenia.
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Affiliation(s)
- Madeline Peterson
- Department of Psychology, Brigham Young University, Provo, UT, 84602, USA
| | - Rodrigo M. Braga
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Dorothea L. Floris
- Methods of Plasticity Research, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Jared A. Nielsen
- Department of Psychology, Brigham Young University, Provo, UT, 84602, USA
- Neuroscience Center, Brigham Young University, Provo, UT, 84604, USA
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Stephens JA, Hernandez-Sarabia JA, Sharp JL, Leach HJ, Bell C, Thomas ML, Buryznska AZ, Weaver JA, Schmid AA. Adaptive yoga versus low-impact exercise for adults with chronic acquired brain injury: a pilot randomized control trial protocol. Front Hum Neurosci 2023; 17:1291094. [PMID: 38077184 PMCID: PMC10701427 DOI: 10.3389/fnhum.2023.1291094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/27/2023] [Indexed: 02/12/2024] Open
Abstract
Background Each year, millions of Americans sustain acquired brain injuries (ABI) which result in functional impairments, such as poor balance and autonomic nervous system (ANS) dysfunction. Although significant time and energy are dedicated to reducing functional impairment in acute phase of ABI, many individuals with chronic ABI have residual impairments that increase fall risk, decrease quality of life, and increase mortality. In previous work, we have found that yoga can improve balance in adults with chronic (i.e., ≥6 months post-injury) ABI. Moreover, yoga has been shown to improve ANS and brain function in healthy adults. Thus, adults with chronic ABI may show similar outcomes. This protocol details the methods used to examine the effects of a group yoga program, as compared to a group low-impact exercise, on primary and secondary outcomes in adults with chronic ABI. Methods This study is a single-blind randomized controlled trial comparing group yoga to group low-impact exercise. Participants must be ≥18 years old with chronic ABI and moderate balance impairments. Group yoga and group exercise sessions occur twice a week for 1 h for 8 weeks. Sessions are led by trained adaptive exercise specialists. Primary outcomes are balance and ANS function. Secondary outcomes are brain function and structure, cognition, quality of life, and qualitative experiences. Data analysis for primary and most secondary outcomes will be completed with mixed effect statistical methods to evaluate the within-subject factor of time (i.e., pre vs. post intervention), the between-subject factor of group (yoga vs. low-impact exercise), and interaction effects. Deductive and inductive techniques will be used to analyze qualitative data. Discussion Due to its accessibility and holistic nature, yoga has significant potential for improving balance and ANS function, along with other capacities, in adults with chronic ABI. Because there are also known benefits of exercise and group interaction, this study compares yoga to a similar, group exercise intervention to explore if yoga has a unique benefit for adults with chronic ABI.Clinical trial registration:ClinicalTrials.gov, NCT05793827. Registered on March 31, 2023.
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Affiliation(s)
- Jaclyn A. Stephens
- Department of Occupational Therapy, Colorado State University, Fort Collins, CO, United States
- Molecular Cellular and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO, United States
- Sharp Analytics, LCC, Fort Collins, CO, United States
| | | | - Julia L. Sharp
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
| | | | | | - Michael L. Thomas
- Molecular Cellular and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO, United States
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
| | - Agnieszka Z. Buryznska
- Molecular Cellular and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO, United States
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Jennifer A. Weaver
- Department of Occupational Therapy, Colorado State University, Fort Collins, CO, United States
| | - Arlene A. Schmid
- Department of Occupational Therapy, Colorado State University, Fort Collins, CO, United States
- Center for Healthy Aging, Fort Collins, CO, United States
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Singh A, Cole RC, Espinoza AI, Wessel JR, Cavanagh JF, Narayanan NS. Evoked mid-frontal activity predicts cognitive dysfunction in Parkinson's disease. J Neurol Neurosurg Psychiatry 2023; 94:945-953. [PMID: 37263767 PMCID: PMC10592174 DOI: 10.1136/jnnp-2022-330154] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 05/11/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Cognitive dysfunction is a major feature of Parkinson's disease (PD), but the pathophysiology remains unknown. One potential mechanism is abnormal low-frequency cortical rhythms which engage cognitive functions and are deficient in PD. We tested the hypothesis that mid-frontal delta/theta rhythms predict cognitive dysfunction in PD. METHOD We recruited 100 patients with PD and 49 demographically similar control participants who completed a series of cognitive control tasks, including the Simon, oddball and interval-timing tasks. We focused on cue-evoked delta (1-4 Hz) and theta (4-7 Hz) rhythms from a single mid-frontal EEG electrode (cranial vertex (Cz)) in patients with PD who were either cognitively normal, with mild-cognitive impairments (Parkinson's disease with mild-cognitive impairment) or had dementia (Parkinson's disease dementia). RESULTS We found that PD-related cognitive dysfunction was associated with increased response latencies and decreased mid-frontal delta power across all tasks. Within patients with PD, the first principal component of evoked electroencephalography features from a single electrode (Cz) strongly correlated with clinical metrics such as the Montreal Cognitive Assessment score (r=0.34) and with National Institutes of Health Toolbox Executive Function score (r=0.46). CONCLUSIONS These data demonstrate that cue-evoked mid-frontal delta/theta rhythms directly relate to cognition in PD. Our results provide insight into the nature of low-frequency frontal rhythms and suggest that PD-related cognitive dysfunction results from decreased delta/theta activity. These findings could facilitate the development of new biomarkers and targeted therapies for cognitive symptoms of PD.
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Affiliation(s)
- Arun Singh
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota
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Serper M, Chafale A, Burdzy A, Kim M, Asrani SK, Yoshino Benavente J, Gershon R, Reese PP, Schaubel DE, Boike JR, Blanco MC, Wolf MS. Cognitive function, self-management, and outcomes among liver transplant recipients: LivCog, a multicenter, prospective study. Hepatol Commun 2023; 7:e0259. [PMID: 37916863 PMCID: PMC10545399 DOI: 10.1097/hc9.0000000000000259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/13/2023] [Indexed: 11/03/2023] Open
Abstract
Liver transplantation is a life-saving option for decompensated cirrhosis. Liver transplant recipients require advanced self-management skills, intact cognitive skills, and care partner support to improve long-term outcomes. Gaps remain in understanding post-liver transplant cognitive and health trajectories, and patient factors such as self-management skills, care partner support, and sleep. Our aims are to (1) assess pre-liver transplant to post-liver transplant cognitive trajectories and identify risk factors for persistent cognitive impairment; (2) evaluate associations between cognitive function and self-management skills, health behaviors, functional health status, and post-transplant outcomes; and (3) investigate potential mediators and moderators of associations between cognitive function and post-liver transplant outcomes. LivCog is a longitudinal, prospective observational study that will enroll 450 adult liver transplant recipients and their caregivers/care partners. The duration of the study is 5 years with 24 additional months of patient follow-up. Data will be collected from participants at 1, 3, 12, and 24 months post-transplant. Limited pre-liver transplant data will also be collected from waitlisted candidates. Data collection methods include interviews, surveys, cognitive assessments, and actigraphy/sleep diary measures. Patient measurements include sociodemographic characteristics, pretransplant health status, cognitive function, physical function, perioperative measures, medical history, transplant history, self-management skills, patient-reported outcomes, health behaviors, and clinical outcomes. Caregiver measures assess sociodemographic variables, health literacy, health care navigation skills, self-efficacy, care partner preparedness, nature and intensity of care, care partner burden, and community participation. By elucidating various health trajectories from pre-liver transplant to 2 years post-liver transplant, LivCog will be able to better characterize recipients at higher risk of cognitive impairment and compromised self-management. Findings will inform interventions targeting health behaviors, self-management, and caregiver supports to optimize outcomes.
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Affiliation(s)
- Marina Serper
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Adwait Chafale
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alex Burdzy
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Minjee Kim
- Department of Neurology, Division of Neurocritical Care, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Surgery, Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Sumeet K. Asrani
- Department of Medicine, Baylor University Medical Center, Baylor Scott and White, Dallas, Texas, USA
| | - Julia Yoshino Benavente
- Department of Medicine, Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Richard Gershon
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Peter P. Reese
- Department of Medicine, Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Douglas E. Schaubel
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Justin R. Boike
- Department of Medicine, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
| | - Maria C. Blanco
- Clinical Research Computing Unit (CRCU), The Center for Clinical Epidemiology and Biostatistics (CCEB), Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Michael S. Wolf
- Department of Medicine, Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Sarabin E, Harkness K, Murias K. The Relationship Between Cortical Thickness and Executive Function Measures in Children With and Without ADHD. J Atten Disord 2023; 27:1263-1271. [PMID: 37183911 PMCID: PMC10466945 DOI: 10.1177/10870547231174036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inattention, hyperactivity, and impulsivity; however, other executive function dysregulation is common, including inhibition and working memory. This study aims to identify CT differences based on executive function performance in individuals with and without ADHD. METHODS Data for this study was acquired from the Adolescent Brain and Cognitive Development (ABCD) database (61 ADHD, and 61 age and sex matched controls). General linear models were used to assess relationships between measures, CT, and diagnosis. RESULTS We found a significant relation between CT and working memory scores in the right precentral area. Additionally, we found significant interactions between CT, diagnosis, and measure outcome in the Flanker assessment (in the left fusiform area) and the attention score of the CBCL (in the right precentral region). CONCLUSION This suggests that there may be different relationships that exist between CT and executive function in children with ADHD.
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Affiliation(s)
| | - Kelsey Harkness
- University of Calgary, Calgary, AB, Canada
- Alberta Children’s Hospital Research Institute, Calgary, AB, Canada
- Hotchkiss Brain Institute, Calgary, AB, Canada
| | - Kara Murias
- University of Calgary, Calgary, AB, Canada
- Alberta Children’s Hospital Research Institute, Calgary, AB, Canada
- Hotchkiss Brain Institute, Calgary, AB, Canada
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Curiel Cid RE, Zheng DD, Kitaigorodsky M, Adjouadi M, Crocco EA, Georgiou M, Gonzalez-Jimenez C, Ortega A, Goryawala M, Nagornaya N, Pattany P, Sfakianaki E, Visser U, Loewenstein DA. A Novel Computerized Cognitive Test for the Detection of Mild Cognitive Impairment and Its Association with Neurodegeneration in Alzheimer's Disease Prone Brain Regions. ADVANCES IN ALZHEIMER'S DISEASE 2023; 12:38-54. [PMID: 38873169 PMCID: PMC11170665 DOI: 10.4236/aad.2023.123004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
During the prodromal stage of Alzheimer's disease (AD), neurodegenerative changes can be identified by measuring volumetric loss in AD-prone brain regions on MRI. Cognitive assessments that are sensitive enough to measure the early brain-behavior manifestations of AD and that correlate with biomarkers of neurodegeneration are needed to identify and monitor individuals at risk for dementia. Weak sensitivity to early cognitive change has been a major limitation of traditional cognitive assessments. In this study, we focused on expanding our previous work by determining whether a digitized cognitive stress test, the Loewenstein-Acevedo Scales for Semantic Interference and Learning, Brief Computerized Version (LASSI-BC) could differentiate between Cognitively Unimpaired (CU) and amnestic Mild Cognitive Impairment (aMCI) groups. A second focus was to correlate LASSI-BC performance to volumetric reductions in AD-prone brain regions. Data was gathered from 111 older adults who were comprehensively evaluated and administered the LASSI-BC. Eighty-seven of these participants (51 CU; 36 aMCI) underwent MR imaging. The volumes of 12 AD-prone brain regions were related to LASSI-BC and other memory tests correcting for False Discovery Rate (FDR). Results indicated that, even after adjusting for initial learning ability, the failure to recover from proactive semantic interference (frPSI) on the LASSI-BC differentiated between CU and aMCI groups. An optimal combination of frPSI and initial learning strength on the LASSI-BC yielded an area under the ROC curve of 0.876 (76.1% sensitivity, 82.7% specificity). Further, frPSI on the LASSI-BC was associated with volumetric reductions in the hippocampus, amygdala, inferior temporal lobes, precuneus, and posterior cingulate.
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Affiliation(s)
- Rosie E. Curiel Cid
- Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - D. Diane Zheng
- Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Marcela Kitaigorodsky
- Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Malek Adjouadi
- Center for Advanced Technology and Education, Department of Electrical and Computer Engineering, College of Engineering and Computing, Florida International University, Miami, Florida, USA
| | - Elizabeth A. Crocco
- Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Mike Georgiou
- Department of Radiology and Nuclear Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Christian Gonzalez-Jimenez
- Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Alexandra Ortega
- Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Mohammed Goryawala
- Department of Radiology and Nuclear Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Natalya Nagornaya
- Department of Radiology and Nuclear Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Pradip Pattany
- Department of Radiology and Nuclear Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Efrosyni Sfakianaki
- Department of Radiology and Nuclear Medicine, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Ubbo Visser
- Department of Computer Science, University of Miami, Miami, Florida, USA
| | - David A. Loewenstein
- Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
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Wray C, Kowalski AJ, Mpondo F, Ochaeta L, Belleza D, DiGirolamo A, Waford R, Richter L, Lee N, Scerif G, Stein A, Stein AD. Contrasting speed and accuracy approaches to measure executive functions in three low-and middle-income countries. PLoS One 2023; 18:e0290238. [PMID: 37651434 PMCID: PMC10470922 DOI: 10.1371/journal.pone.0290238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/05/2023] [Indexed: 09/02/2023] Open
Abstract
Executive functions (EF) can be measured by tests assessing accuracy, reaction times and by computing scores which combine these two components. Interpretation issues can arise from the use of different scoring methods across studies. Given that EF measures and their scoring methods are predominantly developed and validated in high income countries, little is known about the generalisability of such methods cross- culturally. The current paper compares two different established scoring approaches for measures of inhibition and cognitive flexibility: difference scores (which utilise reaction time only) and computed scores (combining accuracy and reaction time). We utilised data collected in adulthood from three low- and middle-income birth cohorts (Guatemala, Philippines, South Africa). Non-normal distributions were observed for both scoring methods in all three samples; however, this was more pronounced for the difference score method. Differing distribution patterns were observed across the three cohorts, which was especially evident in the Guatemala cohort, highlighting potential issues with using these methods across diverse populations. The data suggest that the computed scores may be a reliable measure of EF. However, the different ways of scoring and interpreting EF instruments need to be considered carefully for each population before use.
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Affiliation(s)
- Charlotte Wray
- Department of Psychiatry, the University of Oxford, Oxford, United Kingdom
| | - Alysse J. Kowalski
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, United States of America
| | - Feziwe Mpondo
- DSI-NRF Centre of Excellence in Human Development at the University of the Witwatersrand, Johannesburg, South Africa
| | - Laura Ochaeta
- Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Delia Belleza
- Department of Psychology, School of Arts and Sciences, University of San Carlos, Cebu, Philippines
| | - Ann DiGirolamo
- Georgia Health Policy Center, Georgia State University, Atlanta, GA, United States of America
| | - Rachel Waford
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Linda Richter
- DSI-NRF Centre of Excellence in Human Development at the University of the Witwatersrand, Johannesburg, South Africa
| | - Nanette Lee
- USC-Office of Population Studies Foundation, Inc., University of San Carlos, Cebu, the Philippines
| | - Gaia Scerif
- Department of Experimental Psychology, the University of Oxford, Oxford, United Kingdom
| | - Alan Stein
- Department of Psychiatry, the University of Oxford, Oxford, United Kingdom
- African Health Research Institute, KwaZulu Natal, South Africa
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Aryeh D. Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
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Namaky N, Swearingen HR, Winter J, Bozzay M, Primack JM, Philip NS, Barredo J. Suicidal thoughts and behaviours among military veterans: protocol for a prospective, observational, neuroimaging study. BMJ Open 2023; 13:e070654. [PMID: 37586858 PMCID: PMC10432662 DOI: 10.1136/bmjopen-2022-070654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/01/2023] [Indexed: 08/18/2023] Open
Abstract
INTRODUCTION This study's overarching goal is to examine the relationship between brain circuits and suicidal thoughts and behaviours (STBs) in a transdiagnostic sample of US military veterans. Because STBs have been linked with maladaptive decision-making and disorders linked to impulsivity, this investigation focuses on valence and inhibitory control circuits. METHODS AND ANALYSIS In this prospective, observational study, we will collect functional MRI (fMRI), cognitive and clinical data from 136 veterans (target sample size) recruited from the Providence VA Health System (PVAHS): 68 with STBs and 68 matched controls. Behavioural data will be collected using standardised measures of STBs, psychiatric symptoms, cognition, functioning and medical history. Neuroimaging data will include structural, task and resting fMRI. We will conduct follow-up interviews and assessments at 6, 12 and 24 months post-enrolment. Primary analyses will compare data from veterans with and without STBs and will also evaluate whether activation and connectivity within circuits of valence and inhibition covary with historical and prospective patterns of suicidal ideation and behaviour. ETHICS AND DISSEMINATION The PVAHS Institutional Review Board approved this study (2018-051). Written informed consent will be obtained from all participants. Findings from this study will be published in peer-reviewed journals and presented at local, regional, national and international conferences.Nauder Namaky, Ph.D.* nauder_namaky@brown.edu.
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Affiliation(s)
- Nauder Namaky
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- VA RR&D Center for Neurorestoration and Neurotechnology, Providence, Rhode Island, USA
| | - Hannah R Swearingen
- VA RR&D Center for Neurorestoration and Neurotechnology, Providence, Rhode Island, USA
| | - Jake Winter
- VA RR&D Center for Neurorestoration and Neurotechnology, Providence, Rhode Island, USA
| | - Melanie Bozzay
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Jennifer M Primack
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- VA Long Term Services and Support Center of Innovation, Providence, Rhode Island, USA
| | - Noah S Philip
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- VA RR&D Center for Neurorestoration and Neurotechnology, Providence, Rhode Island, USA
| | - Jennifer Barredo
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- VA RR&D Center for Neurorestoration and Neurotechnology, Providence, Rhode Island, USA
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Zhang W, Liu H, Zhang T. Immediate and short-term effects of single-task and motor-cognitive dual-task on executive function. PLoS One 2023; 18:e0290171. [PMID: 37585447 PMCID: PMC10431647 DOI: 10.1371/journal.pone.0290171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 08/02/2023] [Indexed: 08/18/2023] Open
Abstract
OBJECTIVES Executive function plays an important role in our daily life and can be affected by both single task (acute aerobic exercise or cognitive training) and dual-task (acute motor-cognitive training) interventions. Here we explored the immediate and short-term effect on executive function to texted whether dual-task interventions are more effective at promoting executive function. METHODS Forty-six young men were recruited (mean age: 20.65 years) and assigned randomly to aerobic exercise (n = 15), cognitive training (n = 15), or dual-task (n = 16) groups. Executive functions were assessed before, immediately after, and 30 min after intervention using Go/No-go, 2-back, and More-Odd-Shifting tests. RESULTS Working memory function improved after all three interventions (significant Time effect, F(2,86) = 7.05, p = 0.001). Performance on the 2-back test was significantly better immediately after dual-task intervention (p = 0.038) and the response time was shorter (p = 0.023). Performance on the More-Odd-Shifting test improved over time (significant Time effect, F(2,86) = 30.698, p = 0.01), both immediately after the dual-task intervention (p = 0.015), and 30 min later (p = 0.001). Shifting-test performance was also better immediately after (p = 0.005) and 30 min after (p < 0.001) aerobic exercise. CONCLUSION Executive function was enhanced by single-task (acute aerobic exercise or cognitive training) and dual-task interventions. The effect continued for 30 min after both the single-task aerobic exercise and the dual-task intervention. For short-term intervention, the dual-task was not more effective than either of the single tasks.
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Affiliation(s)
- Weibin Zhang
- School of Sports Medicine and Rehabilitation, North Sichuan Medical College, Gaoping District, Nanchong, Sichuan Province, China
| | - Hua Liu
- School of Kinesiology and Health, Capital University of Physical Education and Sports, Haidian District, Beijing, China
| | - Tong Zhang
- Rehabilitation Teaching and Research Department, Zhoukou Vocational and Technical College, Zhoukou City, Henan Province, China
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Soltani A, Schworer EK, Altaye M, Fidler DJ, Beebe DW, Wiley S, Hoffman EK, Voth K, Esbensen AJ. Psychometric properties of inhibitory control measures among youth with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:753-769. [PMID: 37218393 PMCID: PMC10524385 DOI: 10.1111/jir.13043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Inhibitory control measures have been commonly used when assessing individuals with Down syndrome. However, minimal attention has been devoted to evaluating the appropriateness of specific assessments for use in this population, potentially leading to erroneous conclusions. This study aimed to examine the psychometric properties of measures of inhibitory control among youth with Down syndrome. We sought to examine the feasibility, presence of floor or practice effects, test-retest reliability, convergent validity and correlations with broader developmental domains of a set of inhibitory control tasks. METHODS A sample of 97 youth with Down syndrome aged 6 to 17 years old participated in verbal and visuospatial tasks of inhibitory control including the Cat/dog Stroop, Neuropsychological Assessment Second Edition (NEPSY-II) Statue, National Institutes of Health (NIH) Toolbox Cognition Battery (TCB) Flanker, Leiter-3 Attention Sustained, and the Test of Attentional Performance for Children (KiTAP) Go/No-go and Distractibility subtests. Youth also completed standardised assessments of cognition and language, and caregivers completed rating scales. Psychometric properties on the tasks of inhibitory control were evaluated against a priori criteria. RESULTS Apart from demonstrating negligible practice effects, adequate psychometric properties were not observed for any inhibitory control measure within the current sample's age range. One task with low working memory demands (NEPSY-II Statue) generally had better psychometric properties than the other tasks assessed. Subgroups of participants with an IQ greater than 30 and age more than 8 years were shown to be more likely to be able to complete the inhibition tasks. CONCLUSIONS Findings suggest better feasibility for analogue tasks rather than computerised assessments of inhibitory control. Given the weak psychometrics of several common measures, future studies are required to evaluate other inhibitory control measures, specifically those with reduced working memory demands for youth with Down syndrome. Recommendations for use of the inhibitory control tasks among youth with Down syndrome are provided.
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Affiliation(s)
- Amanallah Soltani
- Department of Educational Psychology, Kerman Branch, Islamic Azad University, Kerman, Iran
| | - Emily K. Schworer
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Mekibib Altaye
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital, Cincinnati, OH, USA
| | - Deborah J. Fidler
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - Dean W. Beebe
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Susan Wiley
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Emily K. Hoffman
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Kellie Voth
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Anna J. Esbensen
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Pará T, Vidal de Carvalho LA, Mattos P, Dantas S, Gravier S, Johnston-Wilder S. Can the Clobber game become a classroom-based tool for screening students' executive functions? PROGRESS IN BRAIN RESEARCH 2023; 279:81-97. [PMID: 37661164 DOI: 10.1016/bs.pbr.2023.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
The use of games for cognitive screening is not new and involves employing simple tasks as well as virtual reality. In this work, we introduce the use of the combinatorial game Clobber, created by the mathematicians Albert, Grossman, Nowakowski and Wolfe in 2001 in a classroom-based experiment and analyzed how it can assess cognitive functions. Specifically, this study tries to address how the use of the Clobber game can target executive functions (EFs) and why it may be a valuable game to assess EFs. Executive functions have an extremely complex nature and combine abilities which involve planning, decision-making, productive action, and self-regulation, among others. We performed a cross-sectional study with a sample of 111 participants aged 9-30 from three educational levels in which Clobber was applied in four different configurations varying in complexity. The findings identify two variables that can guide future experiments with Clobber: the game configuration and the time spent solving the game.
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Affiliation(s)
- Telma Pará
- Fundação de Apoio à Escola Técnica-FAETEC-RJ, Rio de Janeiro, Brazil.
| | | | - Paulo Mattos
- Fundação de Apoio à Escola Técnica-FAETEC-RJ, Rio de Janeiro, Brazil
| | - Simone Dantas
- Fundação de Apoio à Escola Técnica-FAETEC-RJ, Rio de Janeiro, Brazil
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Amadon GK, Goeckner BD, Brett BL, Meier TB. Comparison of Various Metrics of Repetitive Head Impact Exposure And Their Associations With Neurocognition in Collegiate-Aged Athletes. Arch Clin Neuropsychol 2023; 38:714-723. [PMID: 36617242 PMCID: PMC10369361 DOI: 10.1093/arclin/acac107] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Characterize the levels of various metrics of repetitive head impacts (RHI) in contact (CS) and non-contact (NCS) sport athletes and determine the extent to which they are associated with fluid cognition. METHODS Collegiate-aged athletes (n = 176) completed semi-structured interviews about participation in contact sport. RHI was operationalized based on current sport (CS/NCS), the cumulative number of years of participation, age at first exposure (AFE), and based on recently proposed traumatic encephalopathy syndrome (TES) categories. The NIH Toolbox Cognition Battery assessed fluid cognition. General linear models compared RHI metrics between CS and NCS athletes and tested associations of RHI measures with fluid cognition. RESULTS CS athletes had more years of RHI exposure, higher rates of "extensive" exposure based on TES criteria, and were more likely to have AFE before age 12 relative to NCS (ps < .001). A subset of NCS athletes, however, reported prior RHI at levels categorized as being "extensive" based on TES criteria (5%), while a larger minority had AFE before 12 (34%). No adverse associations of RHI and fluid cognition were observed (ps > .05). Across all RHI metrics, more or earlier RHI was associated with better episodic memory (ps ≤ .05). Secondary analyses showed this effect was driven by women. CONCLUSIONS Current results find no evidence that RHI in collegiate-aged athletes is associated with worse neurocognition. Although there was extensive overlap among RHI measures, results demonstrate that categorizing athletes based on their current sport undercounts the lifetime RHI exposure in many NCS athletes.
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Affiliation(s)
- Grace K Amadon
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Bryna D Goeckner
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Benjamin L Brett
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
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Munn EE, Lang DM, Hynes J, Northcutt A, Patten BS, Wadsworth DD, Pangelinan MM. The Effects of Virtual Zumba ® on Functional Outcomes in Adults with Developmental Disabilities. Med Sci Sports Exerc 2023; 55:1151-1159. [PMID: 36878019 DOI: 10.1249/mss.0000000000003157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
INTRODUCTION Few studies have examined the comprehensive impact of adaptive exercise interventions across multiple functional domains (i.e., physical and cognitive health) in adults with developmental disabilities (DD). METHODS The present study examined the effects of a 10-wk (2 sessions per week, 1 h per session) adapted Zumba ® intervention on the Six-Minute Walk Test (6MWT), Timed Up and Go (TUG), Clinical Test of Sensory Interaction on Balance, body composition, and executive function in 44 adults with DD age 20.8-69.2 yr. In addition to examining overall differences between control and intervention conditions, the effects of different Zumba ® tempos (normal/low) were examined. A crossover design with a 3-month wash-out period was used such that participants in the intervention also served as controls. The participants were quasi-randomized into one of two Zumba ® conditions: low-tempo Zumba ® (0.75 normal speed; n = 23) and normal-tempo Zumba ® ( n = 21). RESULTS A significant condition-time interaction was observed for the 6MWT and TUG; participants in the low and normal-tempo Zumba ® conditions significantly increased the distance walked for the 6MWT and reduced the total time for the TUG. No improvement was observed during the control condition for these measures. There were no significant condition-time interactions for the other outcomes. CONCLUSIONS These findings have implications on the efficacy and implementation of virtual Zumba ® programs to increase abilities related to independent performance of activities of daily living in adults with disabilities.
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Affiliation(s)
| | - Danielle M Lang
- School of Kinesiology, College of Education, Auburn University, Auburn, AL
| | | | - Alice Northcutt
- School of Kinesiology, College of Education, Auburn University, Auburn, AL
| | - Betty S Patten
- Department of Special Education, Rehabilitation, and Counseling, College of Education, Auburn University, Auburn, AL
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Bukhari H, Su C, Dhamala E, Gu Z, Jamison K, Kuceyeski A. Graph-matching distance between individuals' functional connectomes varies with relatedness, age, and cognitive score. Hum Brain Mapp 2023; 44:3541-3554. [PMID: 37042411 PMCID: PMC10203814 DOI: 10.1002/hbm.26296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/10/2023] [Accepted: 03/20/2023] [Indexed: 04/13/2023] Open
Abstract
Functional connectomes (FCs), represented by networks or graphs that summarize coactivation patterns between pairs of brain regions, have been related at a population level to age, sex, cognitive/behavioral scores, life experience, genetics, and disease/disorders. However, quantifying FC differences between individuals also provides a rich source of information with which to map to differences in those individuals' biology, experience, genetics or behavior. In this study, graph matching is used to create a novel inter-individual FC metric, called swap distance, that quantifies the distance between pairs of individuals' partial FCs, with a smaller swap distance indicating the individuals have more similar FC. We apply graph matching to align FCs between individuals from the the Human Connectome ProjectN = 997 and find that swap distance (i) increases with increasing familial distance, (ii) increases with subjects' ages, (iii) is smaller for pairs of females compared to pairs of males, and (iv) is larger for females with lower cognitive scores compared to females with larger cognitive scores. Regions that contributed most to individuals' swap distances were in higher-order networks, that is, default-mode and fronto-parietal, that underlie executive function and memory. These higher-order networks' regions also had swap frequencies that varied monotonically with familial relatedness of the individuals in question. We posit that the proposed graph matching technique provides a novel way to study inter-subject differences in FC and enables quantification of how FC may vary with age, relatedness, sex, and behavior.
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Affiliation(s)
- Hussain Bukhari
- Department of NeuroscienceWeill Cornell MedicineNew YorkNew YorkUSA
| | - Chang Su
- Department of BiostatisticsYale UniversityNew HavenConnecticutUSA
| | - Elvisha Dhamala
- Department of PsychologyYale UniversityNew HavenConnecticutUSA
| | - Zijin Gu
- Department of Electrical and Computer EngineeringCornell UniversityIthacaNew YorkUSA
| | - Keith Jamison
- Department of RadiologyWeill Cornell MedicineNew YorkNew YorkUSA
| | - Amy Kuceyeski
- Department of RadiologyWeill Cornell MedicineNew YorkNew YorkUSA
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Pronk T, Hirst RJ, Wiers RW, Murre JMJ. Can we measure individual differences in cognitive measures reliably via smartphones? A comparison of the flanker effect across device types and samples. Behav Res Methods 2023; 55:1641-1652. [PMID: 35710865 PMCID: PMC10250264 DOI: 10.3758/s13428-022-01885-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 01/12/2023]
Abstract
Research deployed via the internet and administered via smartphones could have access to more diverse samples than lab-based research. Diverse samples could have relatively high variation in their traits and so yield relatively reliable measurements of individual differences in these traits. Several cognitive tasks that originated from the experimental research tradition have been reported to yield relatively low reliabilities (Hedge et al., 2018) in samples with restricted variance (students). This issue could potentially be addressed by smartphone-mediated administration in diverse samples. We formulate several criteria to determine whether a cognitive task is suitable for individual differences research on commodity smartphones: no very brief or precise stimulus timing, relative response times (RTs), a maximum of two response options, and a small number of graphical stimuli. The flanker task meets these criteria. We compared the reliability of individual differences in the flanker effect across samples and devices in a preregistered study. We found no evidence that a more diverse sample yields higher reliabilities. We also found no evidence that commodity smartphones yield lower reliabilities than commodity laptops. Hence, diverse samples might not improve reliability above student samples, but smartphones may well measure individual differences with cognitive tasks reliably. Exploratively, we examined different reliability coefficients, split-half reliabilities, and the development of reliability estimates as a function of task length.
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Affiliation(s)
- Thomas Pronk
- Department of Psychology, Faculty of Social and Behavioural Sciences, University of Amsterdam, P.O. Box: 15804, 1001 NH, Amsterdam, The Netherlands.
- Behavioural Science Lab, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands.
- Open Science Tools (PsychoPy) Lab, School of Psychology, University of Nottingham, Nottingham, UK.
| | - Rebecca J Hirst
- Open Science Tools (PsychoPy) Lab, School of Psychology, University of Nottingham, Nottingham, UK
| | - Reinout W Wiers
- Department of Psychology, Faculty of Social and Behavioural Sciences, University of Amsterdam, P.O. Box: 15804, 1001 NH, Amsterdam, The Netherlands
| | - Jaap M J Murre
- Department of Psychology, Faculty of Social and Behavioural Sciences, University of Amsterdam, P.O. Box: 15804, 1001 NH, Amsterdam, The Netherlands
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Zavaliangos-Petropulu A, McClintock SM, Khalil J, Joshi SH, Taraku B, Al-Sharif NB, Espinoza RT, Narr KL. Neurocognitive effects of subanesthetic serial ketamine infusions in treatment resistant depression. J Affect Disord 2023; 333:161-171. [PMID: 37060953 DOI: 10.1016/j.jad.2023.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 04/17/2023]
Abstract
INTRODUCTION Ketamine treatment prompts a rapid antidepressant response in treatment-resistant depression (TRD). We performed an exploratory investigation of how ketamine treatment in TRD affects different cognitive domains and relates to antidepressant response. METHODS Patients with TRD (N = 66; 30 M/35F; age = 39.5 ± 11.1 years) received four ketamine infusions (0.5 mg/kg). Neurocognitive function and depressive symptoms were assessed at baseline, 24 h after the first and fourth ketamine infusion, and 5 weeks following end of treatment. Mixed effect models tested for changes in seven neurocognitive domains and antidepressant response, with post-hoc pairwise comparisons between timepoints, including follow-up. Relationships between change in neurocognitive function and antidepressant response over the course of treatment were tested with Pearson's correlation and mediation analyses. Associations between baseline neurocognitive performance and antidepressant response were tested with Pearson's correlation. RESULTS Significant improvements in inhibition, working memory, processing speed, and overall fluid cognition were observed after the first and fourth ketamine infusion. Improvements in processing speed and overall fluid cognition persisted through follow-up. Significant improvements in depressive symptoms reverted towards baseline at follow-up. Baseline working memory and change in inhibition were moderately correlated with antidepressant response, however, improvements in neurocognitive performance were statistically independent from antidepressant response. CONCLUSION Antidepressant ketamine leads to improved neurocognitive function, which persist for at least 5 weeks. Neurocognitive improvements observed appear independent of antidepressant response, suggesting ketamine may target overlapping but distinct functional brain systems. Limitations Research investigating repeated serial ketamine treatments is important to determine cognitive safety. This study is a naturalistic design and does not include placebo.
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Affiliation(s)
- Artemis Zavaliangos-Petropulu
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA.
| | - Shawn M McClintock
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jacqueline Khalil
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Shantanu H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Brandon Taraku
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Noor B Al-Sharif
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Randall T Espinoza
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
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Peller A, Garib R, Garbe E, Komforti D, Joffe C, Magras A, Trapuzzano A, Stock MS, Dawson NT. Validity and reliability of the NIH Toolbox® Standing Balance Test As compared to the Biodex Balance System SD. Physiother Theory Pract 2023; 39:827-833. [PMID: 35068342 DOI: 10.1080/09593985.2022.2027584] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND/ PURPOSE The NIH Toolbox® was developed to assess functions among motor, sensory, emotional, and cognitive domains. The motor domain of the NIH Toolbox® includes an assessment for standing balance. Studies have validated early versions of the balance assessment for ages 3 through 85; however, no studies have examined the reliability and validity in its current version (using iPod Touch) against established balance measurements such as the Biodex SD modified clinical test of sensory integration of balance (m-CTSIB). SUBJECTS Ninety-three community dwelling older adults (38 males 55 females) ≥60 years old (SD 74 ± 6). METHODS One-day assessment using the NIH Toolbox® and the Biodex SD m-CTSIB. Intraclass correlation coefficients (ICC3,1) were used to measure the test-retest reliability, and Pearson's product correlation examined criterion validity. RESULTS The overall composite of the Biodex SD m-CTSIB and NIH Toolbox® showed moderate test-retest reliability (ICC3,1 = 0.71, MDC = 1.21) (ICC3,1 = 0.84, MDC = 0.65,) respectively. The NIH Toolbox® Theta Score and Biodex overall Sway Index (SI) shows acceptable reliability criterion validity (r = 0.52) indicating moderate overlap in constructs. CONCLUSIONS The NIH Toolbox®balance assessment demonstrates acceptable criterion validity compared to the Biodex SD m-CTSIB. The NIH Toolbox® is a valid, reliable, and accessible device; therefore, the NIH Toolbox® should be considered for use in clinical evaluations.
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Affiliation(s)
- Alexander Peller
- Division of Physical Therapy, School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA
| | - Rishi Garib
- Division of Physical Therapy, School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA
| | - Emily Garbe
- Division of Physical Therapy, School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA
| | - Daniel Komforti
- Division of Physical Therapy, School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA
| | - Chett Joffe
- Division of Physical Therapy, School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA
| | - Adonis Magras
- Division of Physical Therapy, School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA
| | - Ashleigh Trapuzzano
- Division of Physical Therapy, School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA
| | - Matt S Stock
- Division of Physical Therapy, School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA
| | - Nicole T Dawson
- Division of Physical Therapy, School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida, Orlando, FL, USA
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Jia L, Yuen WL, Ong Q, Theseira WE. Pitfalls of self-reported measures of self-control: Surprising insights from extreme debtors. J Pers 2023; 91:369-382. [PMID: 35556246 DOI: 10.1111/jopy.12733] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 04/04/2022] [Accepted: 05/05/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE We took a rare opportunity to examine whether extreme debtors have inflated assessment of their self-control capacity, potentially rendering self-reported measures ineffective as prediction tools for debt risks. METHOD The self-control profiles of extreme debtors (n = 1442), whose credit card debt amounted to more than 12 months of their income, were compared with samples of the general population (n = 505) and students from an elite university (n = 1011) on a self-reported measure, a behavioral intention measure, and an executive function measure. RESULTS Extreme debtors reported the highest self-control on the self-reported measure but scored the lowest on the behavioral intention measure and executive function. This pattern was robust across different subsections of demographics and diverse reasons of indebtedness. CONCLUSION Our findings suggest that self-reported measures may be more susceptible to psychological distortions than behavioral measures, a pitfall that past research has overlooked. Furthermore, we reveal a double whammy faced by extreme debtors: they have a low capacity to regulate their behavior but hold an illusory perception of high capacity, which may expose them to further debt accumulation. The insights from our study underscore the utility of examining extreme segments of the population for advancing psychological knowledge.
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Affiliation(s)
- Lile Jia
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Wei Lun Yuen
- Department of Marketing, National University of Singapore, Singapore, Singapore
| | - Qiyan Ong
- Social Service Research Centre, National University of Singapore, Singapore, Singapore.,Department of Economics, Radboud University, Nijmegen, The Netherlands
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Shah VA, Cruz-Almeida Y, Roy A, Cenko E, Downey RJ, Ferris DP, Hass CJ, Reuter-Lorenz PA, Clark DJ, Manini TM, Seidler RD. Uneven terrain versus dual-task walking: differential challenges imposed on walking behavior in older adults are predicted by cognitive and sensorimotor function. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.14.531779. [PMID: 36993462 PMCID: PMC10054936 DOI: 10.1101/2023.03.14.531779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Aging is associated with declines in walking function. To understand these mobility declines, many studies have obtained measurements while participants walk on flat surfaces in laboratory settings during concurrent cognitive task performance (dual-tasking). This may not adequately capture the real-world challenges of walking at home and around the community. Here, we hypothesized that uneven terrains in the walking path impose differential changes to walking speed compared to dual-task walking. We also hypothesized that changes in walking speed resulting from uneven terrains will be better predicted by sensorimotor function than cognitive function. Sixty-three community-dwelling older adults (65-93 yrs old) performed overground walking under varying walking conditions. Older adults were classified into two mobility function groups based on scores of the Short Physical Performance Battery. They performed uneven terrain walking across four surface conditions (Flat, Low, Medium, and High unevenness) and performed single and verbal dual-task walking on flat ground. Participants also underwent a battery of cognitive (cognitive flexibility, working memory, inhibition) and sensorimotor testing (grip strength, 2-pt discrimination, pressure pain threshold). Our results showed that walking speed decreased during both dual-task walking and across uneven terrain walking conditions compared to walking on flat terrain. Participants with lower mobility function had even greater decreases in uneven terrain walking speeds. The change in uneven terrain speed was associated with attention and inhibitory function. Changes in both dual-task and uneven terrain walking speeds were associated with 2-point tactile discrimination. This study further documents associations between mobility, executive functions, and somatosensation, highlights the differential costs to walking imposed by uneven terrains, and identifies that older adults with lower mobility function are more likely to experience these changes to walking function.
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Affiliation(s)
- Valay A Shah
- Dept. of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
- Dept. of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA
- Dept. of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Arkaprava Roy
- Dept. of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Erta Cenko
- Dept. of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
- Dept. of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Ryan J Downey
- Dept. of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Daniel P Ferris
- Dept. of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Chris J Hass
- Dept. of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | | | - David J Clark
- Dept of Physiology and Aging, University of Florida, Gainesville, FL, USA
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA
| | - Todd M Manini
- Dept. of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Rachael D Seidler
- Dept. of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
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Ford SH, Bruckner L, Thoyre S, Baker MJ, Bartlett TR, Hodges EA. Gut-Brain Axis Perspective on Negative Symptoms and Their Neighbors in Early Adolescence: Can We Move Care Upstream? J Psychosoc Nurs Ment Health Serv 2023:1-10. [PMID: 36853039 DOI: 10.3928/02793695-20230221-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The current study investigated symptom network patterns in adolescents from a gut-brain-axis (GBA) biopsychosocial perspective. Our secondary analysis of data from the Adolescent Brain Cognitive Development Study assessed symptom relationships using network analysis to provide information about multivariate structural dependencies among 41 signs and symptoms. Cross-sectional EBICglasso symptom networks were evaluated to assess patterns associated with anhedonia and depressed mood. Significant differences were identified between symptom neighbors of anhedonia compared with depressed mood based on stratification by age. The GBA perspective revealed several symptom neighbors that could expand clinical assessment, diagnosing criteria, education, and interventions for adolescents at risk for, or with, anhedonia or depressed mood. Results speak to the unique impact of symptoms on health that are not interchangeable with other symptoms and do not have equal effects. Mental health nurses should consider a holistic and proactive precision health approach to improving health and well-being through evidence-based assessment of symptom associations. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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Nashiro K, Yoo HJ, Cho C, Min J, Feng T, Nasseri P, Bachman SL, Lehrer P, Thayer JF, Mather M. Effects of a Randomised Trial of 5-Week Heart Rate Variability Biofeedback Intervention on Cognitive Function: Possible Benefits for Inhibitory Control. Appl Psychophysiol Biofeedback 2023; 48:35-48. [PMID: 36030457 PMCID: PMC9420180 DOI: 10.1007/s10484-022-09558-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 12/01/2022]
Abstract
Previous research suggests that higher heart rate variability (HRV) is associated with better cognitive function. However, since most previous findings on the relationship between HRV and cognitive function were correlational in nature, it is unclear whether individual differences in HRV play a causal role in cognitive performance. To investigate whether there are causal relationships, we used a simple breathing manipulation that increases HRV through a 5-week HRV biofeedback intervention and examined whether this manipulation improves cognitive performance in younger and older adults (N = 165). The 5-week HRV biofeedback intervention did not significantly improve inhibitory control, working memory and processing speed across age groups. However, improvement in the Flanker score (a measure of inhibition) was associated with the amplitude of heart rate oscillations during practice sessions in the younger and older intervention groups. Our results suggest that daily practice to increase heart rate oscillations may improve inhibitory control, but future studies using longer intervention periods are warranted to replicate the present finding.
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Affiliation(s)
- Kaoru Nashiro
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA.
| | - Hyun Joo Yoo
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Christine Cho
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Jungwon Min
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Tiantian Feng
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Padideh Nasseri
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | - Shelby L Bachman
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
| | | | | | - Mara Mather
- University of Southern California, 3715 McClintock Avenue, Los Angeles, CA, 90089, USA
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The Longitudinal Associations of Household Economic Pressure and Home Chaos with Children’s Executive Functioning, Word Reading, and School Readiness. CHILD & YOUTH CARE FORUM 2023. [DOI: 10.1007/s10566-023-09733-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Beckers L, Tromp N, Philips B, Mylanus E, Huinck W. Exploring neurocognitive factors and brain activation in adult cochlear implant recipients associated with speech perception outcomes-A scoping review. Front Neurosci 2023; 17:1046669. [PMID: 36816114 PMCID: PMC9932917 DOI: 10.3389/fnins.2023.1046669] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/05/2023] [Indexed: 02/05/2023] Open
Abstract
Background Cochlear implants (CIs) are considered an effective treatment for severe-to-profound sensorineural hearing loss. However, speech perception outcomes are highly variable among adult CI recipients. Top-down neurocognitive factors have been hypothesized to contribute to this variation that is currently only partly explained by biological and audiological factors. Studies investigating this, use varying methods and observe varying outcomes, and their relevance has yet to be evaluated in a review. Gathering and structuring this evidence in this scoping review provides a clear overview of where this research line currently stands, with the aim of guiding future research. Objective To understand to which extent different neurocognitive factors influence speech perception in adult CI users with a postlingual onset of hearing loss, by systematically reviewing the literature. Methods A systematic scoping review was performed according to the PRISMA guidelines. Studies investigating the influence of one or more neurocognitive factors on speech perception post-implantation were included. Word and sentence perception in quiet and noise were included as speech perception outcome metrics and six key neurocognitive domains, as defined by the DSM-5, were covered during the literature search (Protocol in open science registries: 10.17605/OSF.IO/Z3G7W of searches in June 2020, April 2022). Results From 5,668 retrieved articles, 54 articles were included and grouped into three categories using different measures to relate to speech perception outcomes: (1) Nineteen studies investigating brain activation, (2) Thirty-one investigating performance on cognitive tests, and (3) Eighteen investigating linguistic skills. Conclusion The use of cognitive functions, recruiting the frontal cortex, the use of visual cues, recruiting the occipital cortex, and the temporal cortex still available for language processing, are beneficial for adult CI users. Cognitive assessments indicate that performance on non-verbal intelligence tasks positively correlated with speech perception outcomes. Performance on auditory or visual working memory, learning, memory and vocabulary tasks were unrelated to speech perception outcomes and performance on the Stroop task not to word perception in quiet. However, there are still many uncertainties regarding the explanation of inconsistent results between papers and more comprehensive studies are needed e.g., including different assessment times, or combining neuroimaging and behavioral measures. Systematic review registration https://doi.org/10.17605/OSF.IO/Z3G7W.
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Affiliation(s)
- Loes Beckers
- Cochlear Ltd., Mechelen, Belgium,Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands,*Correspondence: Loes Beckers,
| | - Nikki Tromp
- Cochlear Ltd., Mechelen, Belgium,Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Emmanuel Mylanus
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Wendy Huinck
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
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Walker WC, O'Neil ME, Ou Z, Pogoda TK, Belanger HG, Scheibel RS, Presson AP, Miles SR, Wilde EA, Tate DF, Troyanskaya M, Pugh MJ, Jak A, Cifu DX. Can mild traumatic brain injury alter cognition chronically? A LIMBIC-CENC multicenter study. Neuropsychology 2023; 37:1-19. [PMID: 36174184 PMCID: PMC10117581 DOI: 10.1037/neu0000855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE While outcome from mild traumatic brain injury (mTBI) is generally favorable, concern remains over potential negative long-term effects, including impaired cognition. This study examined the link between cognitive performance and remote mTBIs within the Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) multicenter, observational study of Veterans and service members (SMs) with combat exposure. METHOD Baseline data of the participants passing all cognitive performance validity tests (n = 1,310) were used to conduct a cross-sectional analysis. Using multivariable regression models that adjusted for covariates, including age and estimated preexposure intellectual function, positive mTBI history groups, 1-2 lifetime mTBIs (nonrepetitive, n = 614), and 3 + lifetime mTBIs (repetitive; n = 440) were compared to TBI negative controls (n = 256) on each of the seven cognitive domains computed by averaging Z scores of prespecified component tests. Significance levels were adjusted for multiple comparisons. RESULTS Neither of the mTBI positive groups differed from the mTBI negative control group on any of the cognitive domains in multivariable analyses. Findings were also consistently negative across sensitivity analyses (e.g., mTBIs as a continuous variable, number of blast-related mTBIs, or years since the first and last mTBI). CONCLUSIONS Our findings demonstrate that the average veteran or SM who experienced one or more mTBIs does not have postacute objective cognitive deficits due to mTBIs alone. A holistic health care approach including comorbidity assessment is indicated for patients reporting chronic cognitive difficulties after mTBI(s), and strategies for addressing misattribution may be beneficial. Future study is recommended with longitudinal designs to assess within-subjects decline from potential neurodegeneration. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- William C Walker
- Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University
| | | | - Zhining Ou
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah
| | - Terri K Pogoda
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System
| | | | | | - Angela P Presson
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah
| | - Shannon R Miles
- Mental Health and Behavioral Sciences Service, James A Haley Veterans' Hospital
| | - Elisabeth A Wilde
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine
| | - David F Tate
- Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University
| | | | - Mary Jo Pugh
- George E. Wahlen Veterans Affairs Salt Lake City Healthcare System
| | - Amy Jak
- VA San Diego Healthcare System
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University
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Krebs C, Brill E, Minkova L, Federspiel A, Kellner-Weldon F, Wyss P, Teunissen CE, van Harten AC, Seydell-Greenwald A, Klink K, Züst MA, Brem AK, Klöppel S. Investigating Compensatory Brain Activity in Older Adults with Subjective Cognitive Decline. J Alzheimers Dis 2023; 93:107-124. [PMID: 36970895 DOI: 10.3233/jad-221001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Preclinical Alzheimer's disease (AD) is one possible cause of subjective cognitive decline (SCD). Normal task performance despite ongoing neurodegeneration is typically considered as neuronal compensation, which is reflected by greater neuronal activity. Compensatory brain activity has been observed in frontal as well as parietal regions in SCD, but data are scarce, especially outside the memory domain. OBJECTIVE To investigate potential compensatory activity in SCD. Such compensatory activity is particularly expected in participants where blood-based biomarkers indicated amyloid positivity as this implies preclinical AD. METHODS 52 participants with SCD (mean age: 71.00±5.70) underwent structural and functional neuroimaging (fMRI), targeting episodic memory and spatial abilities, and a neuropsychological assessment. The estimation of amyloid positivity was based on plasma amyloid-β and phosphorylated tau (pTau181) measures. RESULTS Our fMRI analyses of the spatial abilities task did not indicate compensation, with only three voxels exceeding an uncorrected threshold at p < 0.001. This finding was not replicated in a subset of 23 biomarker positive individuals. CONCLUSION Our results do not provide conclusive evidence for compensatory brain activity in SCD. It is possible that neuronal compensation does not manifest at such an early stage as SCD. Alternatively, it is possible that our sample size was too small or that compensatory activity may be too heterogeneous to be detected by group-level statistics. Interventions based on the individual fMRI signal should therefore be explored.
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Affiliation(s)
- Christine Krebs
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Esther Brill
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Lora Minkova
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Ber, Bern, Switzerland
| | - Frauke Kellner-Weldon
- Section Neuroradiology of the Department of Radiology, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Patric Wyss
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Vrije University, Amsterdam, the Netherlands
| | - Argonde C van Harten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | - Katharina Klink
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marc A Züst
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Anna-Katharine Brem
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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Boutelle KN, Rhee KE, Manzano MA, Bernard RS, Strong DR, Eichen DM, Anderson CCA, Marcus BH, Akshoomoff N, Crow SJ. Design of the FRESH-DOSE study: A randomized controlled noninferiority trial evaluating a guided self-help family-based treatment program for children with overweight or obesity. Contemp Clin Trials 2023; 124:106996. [PMID: 36343880 PMCID: PMC9968239 DOI: 10.1016/j.cct.2022.106996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
Overweight and obesity affect 45% of children and increases the risk for several negative health sequelae. Family-Based Behavioral Treatment (FBT) is the most efficacious treatment for child weight management and consists of nutrition and physical activity education, behavior change skills and parenting skills training. FBT is time and staff intensive and can include 20, 60-min separate groups for parents and children, as well as 20-min behavior coaching sessions to help problem solve barriers to implementing the skills learned and individualize the program. Guided self-help (GSH) therapies involve providing families a manual to review independently and brief coaching sessions by an interventionist to facilitate adherence. We developed a GSH version of FBT (gshFBT) which provides a manual to both parents and children and includes 14, 20-min coaching sessions over 6-months. The current study randomized 150 children (mean age = 10.1 years (SD = 1.38); mean BMI% = 97.3% (SD = 2.84); mean BMIz = 2.09 (SD = 0.40); 49% female; 43% Hispanic) and one of their parents (mean age = 41.8 years (SD = 6.52); mean BMI = 32.0 (SD = 7.24); 87.3% female; 43% Hispanic) to either a group-based FBT program or a gshFBT program. Assessments are conducted at baseline, post-treatment (6 months), 6-month follow-up (12 months) and 12-month follow-up (18 months). Primary outcomes are child weight change (BMIz) and cost effectiveness. Recruitment occurred between May 2017 and October 2021 and follow-up assessments are underway. Given the public health concern for children with obesity and the low level of access to FBT, gshFBT could prove extremely useful to provide intervention to a greater proportion of the population.
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Affiliation(s)
- Kerri N Boutelle
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Kyung E Rhee
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Michael A Manzano
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court Suite 102, San Diego, CA 92120, USA
| | - Rebecca S Bernard
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - David R Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Dawn M Eichen
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Cheryl C A Anderson
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Bess H Marcus
- Department of Behavioral and Social Sciences, Brown University, School of Public Health, 121 South Main Street, box G-S121-3, Providence, RI 02912-G, USA
| | - Natacha Akshoomoff
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Scott J Crow
- Department of Psychiatry, University of Minnesota, F282/2A West 2450 Riverside Ave, Minneapolis, MN 55454, USA
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