Demographically Calibrated Norms for Two Premorbid Intelligence Measures: The Word Accentuation Test and Pseudo-Words Reading Subtest

Clinical Neuropsychology of Bilingual Mexican American Adults: Effect of Language Proficiency and Dominance

OBJECTIVE

To assess the association between language proficiency and absolute dominance on language versus visual-perceptual formatted and executive versus delayed memory neuropsychological measures in bilingual adults.

METHODS

Data from 55 bilingual, conversationally fluent, neurologically intact, Mexican American, consecutive, adults tested in separate sessions in Spanish and English in a counterbalanced order were analyzed. Age, years of education, self-reported language proficiency, Woodcock-Muñoz Language Survey-Revised (WMLS-R) picture vocabulary measures of language proficiency, and dominance (absolute Spanish-English WMLS-R difference scores) were correlated with 11 measures from La Batería Neuropsicólogica en Español and its original English language tests.

RESULTS

Self-reported and WMLS-R measures of language proficiency were significantly correlated in each language. Absolute language dominance was not significantly associated with any Spanish or English neuropsychological raw score. The WMLS-R language proficiency, but not age or years of education, was significantly correlated with language-formatted neuropsychological measures of California Verbal Learning Test delayed free recall number of words (both languages), letter fluency (both languages), delayed story memory (in English), and Stroop interference (Spanish). Linear regression models using age, years of education, and WMLS-R picture vocabulary scores as predictors were significant for all these measures excepting the last. The WMLS-R language proficiency was not significantly associated with raw scores on any visual-perceptual formatted measure.

CONCLUSIONS

Monolingual neuropsychological test norms for language-formatted tests likely overestimate bilingual Mexican Americans' performance.

Postural instability in HIV infection: relation to central and peripheral nervous system markers

OBJECTIVES

Determine the independent contributions of central nervous system (CNS) and peripheral nervous system (PNS) metrics to balance instability in people with HIV (PWH) compared with people without HIV (PWoH).

METHODS

Volumetric MRI (CNS) and two-point pedal discrimination (PNS) were tested as substrates of stance instability measured with balance platform posturography.

DESIGN

125 PWH and 88 PWoH underwent balance testing and brain MRI.

RESULTS

The PWH exhibited stability deficits that were disproportionately greater with eyes closed than eyes open compared with PWoH. Further analyses revealed that greater postural imbalance measured as longer sway paths correlated with smaller cortical and cerebellar lobular brain volumes known to serve sensory integration; identified brain/sway path relations endured after accounting for contributions from physiological and disease factors as potential moderators; and multiple regression identified PNS and CNS metrics as independent predictors of postural instability in PWH that differed with the use of visual information to stabilize balance. With eyes closed, temporal volumes and two-point pedal discrimination were significant independent predictors of sway; with eyes open, occipital volume was an additional predictor of sway. These relations were selective to PWH and were not detected in PWoH.

CONCLUSION

CNS and PNS factors were independent contributors to postural instability in PWH. Recognizing that myriad inputs must be detected by peripheral systems and brain networks to integrate sensory and musculoskeletal information for maintenance of postural stability, age- or disease-related degradation of either or both nervous systems may contribute to imbalance and liability for falls.

Aging Accelerates Postural Instability in HIV Infection: Contributing Sensory Biomarkers

People living with HIV infection (PWH) who are adequately treated pharmacologically are now likely to have a near normal life span. Along with this benefit of the aging HIV population are potential physical problems attendant to aging, including postural stability. Whether aging with HIV accelerates age-related liability for postural instability and what sensory factors contribute to imbalance were examined in 227 PWH and 137 people living without HIV (PWoH), age 25 to 75 years. A mixed cross-sectional/longitudinal design revealed steeper aging trajectories of the PWH than PWoH in sway path length, measured as center-of-pressure micro-displacements with a force platform while a person attempted to stand still. Sway paths were disproportionately longer for PWH than PWoH when tested with eyes closed than open. Multiple regression identified objective measures of sensory perception as unique predictors of sway path length, whereas age, sway path length, and self-reports of falls were predictors of standing on one leg, a common measure of ataxia. Knowledge about sensory signs and symptoms of imbalance in postural stability with and without visual information may serve as modifiable risk factors for averting instability and liability for falls in the aging HIV population.

Eye movements and eating disorders: protocol for an exploratory experimental study examining the relationship in young-adult women with subclinical symptomatology

BACKGROUND

Recent research indicates that patients with anorexia (AN) show specific eye movement abnormalities such as shorter prosaccade latencies, more saccade inhibition errors, and increased rate of saccadic intrusions compared to participants without AN. However, it remains unknown whether these abnormal eye movement patterns, which may serve as potential biomarkers and endophenotypes for an early diagnosis and preventive clinical treatments, start to manifest also in people with subclinical eating disorders (ED) symptomatology. Therefore, we propose a protocol for an exploratory experimental study to investigate whether participants with subclinical ED symptomatology and control participants differ in their performance on several eye movement tasks.

METHODS

The sample will be recruited through convenience sampling. The Eating Disorder Examination Questionnaire will be administered as a screening tool to split the sample into participants with subclinical ED symptomatology and control participants. A fixation task, prosaccade/antisaccade task, and memory-guided task will be administered to both groups. Additionally, we will measure anxiety and premorbid intelligence as confounding variables. Means comparison, exploratory Pearson's correlations and discriminant analysis will be performed.

DISCUSSION

This study will be the first to elucidate the presence of specific eye movement abnormalities in participants with subclinical ED symptomatology. The results may open opportunities for developing novel diagnostic tools/therapies being helpful to the EDs research community and allied fields.

Survey of Spanish Language Neuropsychological Test Use in the Assessment of Hispanic Americans/Latino/as/x

OBJECTIVE

To identify the Spanish language neuropsychological tests most frequently used in the evaluation of Hispanic Americans/Latino/as/x across eight neuropsychological domains. To compare these with previously surveyed most frequently used English language tests in the US/Canada. To describe the norms used with Spanish language tests.

METHOD

An anonymous, uncompensated, 12-min survey was emailed to 169 members of the American Academy of Clinical Neuropsychology, Hispanic Neuropsychological Society, and National Academy of Neuropsychology who self-identified as providing neuropsychological evaluations in Spanish via organizational websites.

RESULTS

The response rate was 36%. Respondents were all licensed U.S. psychologists with the majority fluent in Spanish, conducting less than half their evaluations in Spanish. There was an overlap between the versions of the three most frequently used Spanish versus English neuropsychological tests, but it varied by domain with 3/3 similar for visual-spatial/visuoconstructional skills and sensory/motor functioning domains and 2/3 similar for all other domains except memory (0/3). English language norm use predominated within the mood/personality and sensory/motor functioning domains. In all other domains, Spanish language norms collected in the continental US were preferred to those from foreign Spanish-speaking countries. The most frequently used foreign norms were from Mexico.

CONCLUSION

Except for the memory domain, there was a sizeable overlap between the three most frequently used Spanish and English language neuropsychological tests in the US. Spanish language tests are primarily interpreted with Spanish norms collected in the continental US except within the mood/personality and sensory/motor functioning domains where English language norms predominate.

Estimation of Cognitive Performance Based on Premorbid Intelligence in Parkinson's Disease

BACKGROUND

The estimation of premorbid intelligence (PI) is needed for an accurate diagnosis.

OBJECTIVE

This study aimed to estimate the cognitive performance taking into account the PI in Parkinson's disease (PD) compared to healthy controls (HC); and to analyze the discrepancies between the current and the predicted cognitive performance based on the PI.

METHOD

Semantic fluency, verbal and visual memory, and executive functions were assessed in 39 PD and 162 HC. A linear regression model was used to analyze the discrepancies between the predicted cognitive performance and the current raw scores through PI variables (Word Accentuation Test (WAT), Pseudo-Words (PW) Reading subtest from PROLEC-R, age, and years of education). ROC analyses were performed to assess their diagnostic properties.

RESULTS

Significant differences were found in the raw cognitive scores between patients and HC [semantic fluency (t = 6.07; p < 0.001), verbal memory (t = 6.63; p < 0.001), and executive functions (t = 2.57; p = 0.013), and in visual memory (t = 1.97; p = 0.055 marginally significant)]. Compared to HC, PD patients presented higher discrepancies between the predicted cognitive performance and the raw scores in semantic fluency, verbal memory, visual memory, executive functions (AUC = 0.78, 0.78; 0.64, 0.61, respectively).

CONCLUSION

The magnitude of the discrepancies scores between the current and the predicted cognitive performance based on PI indicates the presence of cognitive decline in the specific cognitive domain in PD patients. This study underlines the usefulness of premorbid measures and variables, such as WAT, PW, age, and years of education, to more accurately estimate the cognitive performance in PD.

Development of a word accentuation test for predicting cognitive performance in Portuguese-speaking populations

The Word Accentuation Test (WAT) has been used to predict premorbid intelligence and cognitive performance in Spanish-speaking populations. It requires participants to read a list of words without the accent marks that indicate the stressed syllable. Label="OBJECTIVE">As Portuguese pronunciation is also strongly based on accent marks, our aim was to develop a Brazilian version of the WAT. METHODS An initial pool of 60 items was constructed and a final version of 40 items (named WAT-Br) was derived by item response theory. A sample of 206 older adults underwent the WAT-Br and a standardized neuropsychological battery. Independent ratings were performed by two observers in 58 random participants. RESULTS The items showed moderate to high discrimination (α between 0.93 and 25.04) and spanned a wide range of difficulty (β between -2.07 and 1.40). The WAT-Br was shown to have an excellent internal consistency (Kuder-Richardson Formula 20 = 0.95) and inter-rater reliability (intraclass correlation coefficient = 0.92). It accounted for 61% of the variance in global cognitive performance. CONCLUSION A version of the WAT for Portuguese-speaking populations was developed and proved to be a valuable tool for estimating cognitive performance.