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BACKGROUND: Pathologic perivascular spaces (PVS), the fluid-filled compartments surrounding brain vasculature, may underlie cognitive decline in Parkinsons disease (PD). However, whether this impacts specific cognitive domains has not been investigated. OBJECTIVES: This study examined the relationship of PVS volume at baseline with domain-specific and global cognitive change over 2 years in PD individuals. METHODS: A total of 39 individuals with PD underwent 3T T1w magnetic resonance imaging to determine PVS volume fraction (PVS volume normalized to total regional volume) within (i) centrum semiovale, (ii) prefrontal white matter (medial orbitofrontal, rostral middle frontal, and superior frontal), and (iii) basal ganglia. A neuropsychological battery included assessment of cognitive domains and global cognitive function at baseline and after 2 years. RESULTS: Higher basal ganglia PVS at baseline was associated with greater decline in attention, executive function, and global cognition scores. CONCLUSIONS: While previous reports have associated elevated PVS volume in the basal ganglia with decline in global cognition in PD, our findings show such decline may affect the attention and executive function domains.

This Dissertation investigated the interplay between executive function, creative thinking, and examples. Over 200 participants completed this experiment consisting of a battery of five creative thinking tasks and a battery of seven executive function tasks. All participants completed two different versions of each of the creative thinking tasks, one version with the help of examples to get them started on idea generation and one version without the help of examples. Data were analyzed both as latent and observed variables. Key results indicated that: (1) participants generated ideas that were rated as more creative when they had the help of examples than when they did not have examples; (2) executive function (particularly inhibition) was positively related to creativity in both conditions; (3) the role of executive function was not observed to depend on whether examples were involved in the idea generation process; and (4) conformity to examples was not observed to mediate the relation between executive function and creativity.

Executive function encompasses effortful cognitive processes that are particularly susceptible to aging. Functional brain networks supporting executive function-such as the frontoparietal control network and the multiple demand system-have been extensively investigated. However, it remains unclear how structural networks facilitate and constrain the dynamics of functional networks to contribute to aging-related executive function declines. We examined whether changes in structural network modal controllability-a network's ability to facilitate effortful brain state transitions that support cognitive functions-are associated with changes in executive function cross-sectionally and longitudinally. Diffusion-weighted imaging and neuropsychological testing were conducted at two time points (Time 1: ages 56 to 66, N = 172; Time 2: ages 61 to 70, N = 267) in community-dwelling men from the Vietnam Era Twin Study of Aging. An executive function factor score was computed from six neuropsychological tasks. Structural networks constructed from white matter connectivity were used to estimate modal controllability in control network and multiple demand system. We showed that higher modal controllability in control network and multiple demand system was associated with better executive function at Time 2, after controlling for age, young adult general cognitive ability, and physical health status. Moreover, changes in executive function over a period of 5 to 6 years (Time 1-Time 2, N = 105) were associated with changes in modal controllability of the multiple demand system and weakly in the control network over the same time period. These findings suggest that changes in the ability of structural brain networks in facilitating effortful brain state transitions may be a key neural mechanism underlying aging-related executive function declines and cognitive aging.

ObjectiveAlzheimer's disease (AD) is highly heritable, and AD polygenic risk scores (AD-PRSs) have been derived from genome-wide association studies. However, the nature of genetic influences very early in the disease process is still not well known. Here we tested the hypothesis that an AD-PRSs would be associated with changes in episodic memory and executive function across late midlife in men who were cognitively unimpaired at their baseline midlife assessment..MethodWe examined 1168 men in the Vietnam Era Twin Study of Aging (VETSA) who were cognitively normal (CN) at their first of up to three assessments across 12 years (mean ages 56, 62, and 68). Latent growth models of episodic memory and executive function were based on 6-7 tests/subtests. AD-PRSs were based on Kunkle et al. (Nature Genetics, 51, 414-430, 2019), p < 5×10-8 threshold.ResultsAD-PRSs were correlated with linear slopes of change for both cognitive abilities. Men with higher AD-PRSs had steeper declines in both memory (r = -.19, 95% CI [-.35, -.03]) and executive functioning (r = -.27, 95% CI [-.49, -.05]). Associations appeared driven by a combination of APOE and non-APOE genetic influences.ConclusionsMemory is most characteristically impaired in AD, but executive functions are one of the first cognitive abilities to decline in midlife in normal aging. This study is among the first to demonstrate that this early decline also relates to AD genetic influences, even in men CN at baseline.

BackgroundStudies have investigated white matter microstructure in relation to late-life cognitive impairments, with fractional anisotropy (FA) and mean diffusivity (MD) measures thought to capture demyelination and axonal degradation. However, new post-processing methods allow isolation of free water (FW), which captures extracellular fluid contributions such as atrophy and neuroinflammation, from tissue components. FW also appears to be highly relevant to late-life cognitive impairment. Here, we evaluated whether executive functions are associated with FW, and FA and MD corrected for FW (FAFWcorr and MDFWcorr).MethodWe examined 489 non-demented men in the Vietnam Era Twin Study of Aging (VETSA) at mean age 68. Two latent factors capturing 'common executive function' and 'working-memory specific' processes were estimated based on 6 tasks. Analyses focused on 11 cortical white matter tracts across three metrics: FW, FAFWcorr, and MDFWcorr.ResultsBetter 'common executive function' was associated with lower FW across 9 of the 11 tracts. There were no significant associations with intracellular metrics after false discovery rate correction. Effects also appeared driven by individuals with MCI (13.7% of the sample). Working memory-specific tasks showed some associations with FAFWcorr, including the triangularis portion of the inferior frontal gyrus. There was no evidence that cognitive reserve (i.e., general cognitive ability assessed in early adulthood) moderated these associations between executive function and FW or FA.DiscussionExecutive function abilities in early old age are associated primarily with extracellular fluid (FW) as opposed to white matter (FAFWcorr or MDFWcorr). Moderation analyses suggested cognitive reserve does not play a strong role in these associations, at least in this sample of non-demented men.

Performance on lab assessments of executive functions predicts academic achievement and other positive life outcomes. A primary goal of research on executive functions has been to design interventions that improve outcomes like academic achievement by improving executive functions. These interventions typically involve extensive practice on abstract lab-based tasks and lead to improvements on these practiced tasks. However, interventions rarely improve performance on non-practiced tasks and rarely benefit outcomes like academic achievement. Contemporary frameworks of executive function development suggest that executive functions develop and are engaged within personal, social, historical, and cultural contexts. Abstract lab-based tasks do not well-capture the real-world contexts that require executive functions and should not be expected to provide generalized benefits outside of the lab. We propose a perspective for understanding individual differences in performance on executive function assessments that focuses on contextual influences on executive functions. We extend this contextual approach to training executive function engagement, rather than training executive functions directly. First, interventions should incorporate task content that is contextually relevant to the targeted outcome. Second, interventions should encourage engaging executive functions through reinforcement and contextual relevance, which may better translate to real-world outcomes than training executive functions directly. While such individualized executive functions interventions do not address systemic factors that greatly impact outcomes like academic achievement, given the extensive resources devoted to improving executive functions, we hypothesize that interventions designed to encourage children's engagement of executive functions hold more promise for impacting real-world outcomes than interventions designed to improve executive function capacities.

BackgroundAlthough it is known that plant-based foods are important for physical health, little is known about the relationship between plant-based foods and cognitive health. Emerging evidence suggests that some macronutrients may influence cognition, but it is unclear which domains of cognition are involved; more importantly, it is unknown how a plant-based diet relates to cognition.ObjectiveTo examine associations between a plant-based dietary pattern and cognitive functioning.MethodsParticipants were 3,039 older adults who participated in the 2011-2014 waves of the National Health and Nutrition Examination Survey (NHANES). The present cross-sectional study used data on macronutrient intake from 24-hour dietary interviews, as well as performance on tests of long-term memory and executive function (i.e., delayed word recall, digit symbol substitution test, and animal fluency). Principal component analysis was used to extract a dietary pattern consistent with a plant-based diet.ResultsGreater adherence to a dietary pattern consistent with a plant-based diet was related to better performance on all cognitive tasks. Secondary analyses indicated that the associations between a plant-based dietary pattern and executive function accounted for the association between a plant-based dietary pattern and memory. Furthermore, this same plant-based dietary pattern was associated with reduced baseline inflammation in a separate dataset.ConclusionsExperimental manipulations are needed to determine the potential causal relations of these associations, but these results suggest that a plant-based diet relates to better cognition, especially through improved executive control. Future work should also attempt to extend these results by examining potential mechanisms underlying these associations, such as reduced inflammation.

INTRODUCTION: Executive functions (EFs) are linked to positive outcomes across the lifespan. Yet, methodological challenges have prevented precise understanding of the developmental trajectory of their organization. METHODS: We introduce novel methods to address challenges for both measuring and modeling EFs using an accelerated longitudinal design with a large, diverse sample of students in middle childhood (N = 1,286; ages 8 to 14). We used eight adaptive assessments hypothesized to measure three EFs, working memory, context monitoring, and interference resolution. We deployed adaptive assessments to equate EF challenge across ages and a data-driven, network analytic approach to reveal the evolving diversity of EFs while simultaneously accounting for their unity. RESULTS AND DISCUSSION: Using this methodological paradigm shift brought new precision and clarity to the development of these EFs, showing these eight tasks are organized into three stable components by age 10, but refinement of composition of these components continues through at least age 14.

Children with Down syndrome (DS) are at risk for challenges with aspects of executive function (EF). The current study explores whether heterogeneity in EF profiles can be detected within a sample of children with DS. Participants were 69 children with DS, ages 3-10 years (M = 6.23, SD = 1.91). T-scores from a caregiver-report measure of executive function were modeled using latent profile analysis, and auxiliary analyses examined the association between demographic and biomedical factors and probability of profile membership. The two-profile solution was the best fit for the sample, with a profile that involved elevated scores in working memory only ("Working Memory Only" profile; 43% of sample) and a "Multi-Domain" profile that involved elevated scores in planning, inhibition, and working memory (57%). The presence of congenital heart defects was associated with a higher probability of assignment to the Multi-Domain profile. Findings from this study contribute to the characterization of heterogeneous outcomes associated with DS.

Executive function (EF) underlies self-control deficits in alcohol use disorder (AUD) and traumatic brain injury (TBI). Cognitive training is a promising adjunctive treatment targeting TBI- and AUD- related cognitive dysfunction. However, major limitations related to compliance and generalizability in the field of cognitive training exist. Physical activity is associated with enhanced cognitive performance across several executive functions and may enhance the benefits of cognitive training. Virtual reality provides multisensory embodied experiences which are likely to engage brain networks more efficiently than standard cognitive training systems, ultimately resulting in greater near- and far-transfer effects. This pilot study aimed to obtain feasibility data and a preliminary assessment of an enriched virtual reality (VR) EF training (EFT) intervention combined with exercise (NCT03786276). Using an 8-week randomized adaptive design study, 30 AUD treatment seeking U.S. Veterans completed nine sessions of exercise-only (n = 15) or gameplay control (n = 15) over 3 weeks, followed by a week-4 repeat assessment in Phase 1. Twenty-three participants completed and moved onto Phase II, where they completed up to nine sessions of VR-EFT plus exercise and completed a week-8 end-of-study assessment. Primary outcomes included feasibility to retain participants, usability, and satisfaction of using VR-EFT. Secondary and exploratory outcomes included within group assessment of change in cognitive function, alcohol use, alcohol craving, and post-concussive symptoms among the three treatment conditions.VR-EFT was feasible with moderate usability and high acceptability ratings.The most common VR-related adverse effect was motion sickness (n = 2/16, 12.5%). The VR-EFT condition was associated with significant improvement in inhibition-switching and visual scanning (both p < 0.05) during Phase II. Exercise-only was associated with significant improvements in cognitive inhibition

IntroductionIn adolescents, the relationship between alcohol-related blackouts (ARBs) and distinct cognitive changes lasting beyond intoxication is unclear. We examined ARBs as a predictor of persistent changes in the development of learning, memory, and executive function in participants from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study.MethodsDescriptive analyses of the NCANDA sample (N = 831, 50.9% female, 12-21 years at baseline) identified ARB patterns within participants with an ARB history (n = 106). Latent growth curve modeling evaluated ARB-related performance changes on four neuropsychological measures across five years, excluding baseline data to reduce the magnitude of practice effects over time (n = 790). Measures included the Penn Conditional Exclusion Test (PCET), Penn Letter N-back Test (PLBT), Penn Facial Memory Test immediate (PFMTi), and delayed (PFMTd) recognition trials, and the Rey Complex Figure Test copy (RCFTc), immediate recall (RCFTi), and delayed recall (RCFTd) trials. Multivariate models were fit for raw accuracy scores from each measure, with ARB history (i.e., presence of past-year ARBs) as the main independent variable. Age, sex, race, socioeconomic status, assessment site, and alcohol use (i.e., past-year frequency) were included as covariates. Interaction effects between ARB history and alcohol use frequency were tested.ResultsBy year five, 16% of participants had experienced at least one ARB (59% of whom reported > 1 ARB and 57% of whom had an ARB lasting > 1 h). After controlling for demographics and alcohol use, ARB history predicted attenuated PFMTd performance growth at year one. Interaction effects between ARB history and alcohol use frequency predicted attenuated PFMTd performance growth at years one and two. ARB history predicted attenuated RCFTi and RCFTd performance growth by year four, but not PCET or PLBT performance over time. By contrast, greater past-year alcohol use pred

Executive function (EF) underlies self-control deficits in alcohol use disorder (AUD) and traumatic brain injury (TBI). Cognitive training is a promising adjunctive treatment targeting TBI- and AUD- related cognitive dysfunction. However, major limitations related to compliance and generalizability in the field of cognitive training exist. Physical activity is associated with enhanced cognitive performance across several executive functions and may enhance the benefits of cognitive training. Virtual reality provides multisensory embodied experiences which are likely to engage brain networks more efficiently than standard cognitive training systems, ultimately resulting in greater near- and far-transfer effects. This pilot study aimed to obtain feasibility data and a preliminary assessment of an enriched virtual reality (VR) EF training (EFT) intervention combined with exercise (NCT03786276). Using an 8-week randomized adaptive design study, 30 AUD treatment seeking U.S. Veterans completed nine sessions of exercise-only (n = 15) or gameplay control (n = 15) over 3 weeks, followed by a week-4 repeat assessment in Phase 1. Twenty-three participants completed and moved onto Phase II, where they completed up to nine sessions of VR-EFT plus exercise and completed a week-8 end-of-study assessment. Primary outcomes included feasibility to retain participants, usability, and satisfaction of using VR-EFT. Secondary and exploratory outcomes included within group assessment of change in cognitive function, alcohol use, alcohol craving, and post-concussive symptoms among the three treatment conditions.VR-EFT was feasible with moderate usability and high acceptability ratings.The most common VR-related adverse effect was motion sickness (n = 2/16, 12.5%). The VR-EFT condition was associated with significant improvement in inhibition-switching and visual scanning (both p < 0.05) during Phase II. Exercise-only was associated with significant improvements in cognitive inhibition

IntroductionIn adolescents, the relationship between alcohol-related blackouts (ARBs) and distinct cognitive changes lasting beyond intoxication is unclear. We examined ARBs as a predictor of persistent changes in the development of learning, memory, and executive function in participants from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study.MethodsDescriptive analyses of the NCANDA sample (N = 831, 50.9% female, 12-21 years at baseline) identified ARB patterns within participants with an ARB history (n = 106). Latent growth curve modeling evaluated ARB-related performance changes on four neuropsychological measures across five years, excluding baseline data to reduce the magnitude of practice effects over time (n = 790). Measures included the Penn Conditional Exclusion Test (PCET), Penn Letter N-back Test (PLBT), Penn Facial Memory Test immediate (PFMTi), and delayed (PFMTd) recognition trials, and the Rey Complex Figure Test copy (RCFTc), immediate recall (RCFTi), and delayed recall (RCFTd) trials. Multivariate models were fit for raw accuracy scores from each measure, with ARB history (i.e., presence of past-year ARBs) as the main independent variable. Age, sex, race, socioeconomic status, assessment site, and alcohol use (i.e., past-year frequency) were included as covariates. Interaction effects between ARB history and alcohol use frequency were tested.ResultsBy year five, 16% of participants had experienced at least one ARB (59% of whom reported > 1 ARB and 57% of whom had an ARB lasting > 1 h). After controlling for demographics and alcohol use, ARB history predicted attenuated PFMTd performance growth at year one. Interaction effects between ARB history and alcohol use frequency predicted attenuated PFMTd performance growth at years one and two. ARB history predicted attenuated RCFTi and RCFTd performance growth by year four, but not PCET or PLBT performance over time. By contrast, greater past-year alcohol use pred

The popular, award-winning game Zoombinis has been around since the 90s, with an updated version launched in 2015 for new devices. Since that relaunch, research has been conducted on the effectiveness of the game and related bridging activities for the teaching and learning of computational thinking (Asbell-Clarke et al, 2021; Rowe et al, 2021b; Almeda et al, 2019). Recently, efforts have been made to design and test executive function (EF) scaffolds that surround puzzles from the game, permitting learners who may have EF challenges, such as issues with working memory, attention, and metacognition, to demonstrate their skills with computational thinking (CT), a logical approach to problem solving which can be applied to any problem, task, or system. On this poster, we present the Zoombinis scaffolds, the intent of their design, and the results of their use with teachers and students, grades 3-8, as part of a larger CT-education project.

Early life exposure to per- and polyfluoroalkyl substances (PFAS) may adversely impact neurodevelopment, but epidemiological findings are inconsistent. In the Project Viva pre-birth cohort, we examined associations of prenatal and childhood PFAS plasma concentrations with parent and teacher assessments of childrens behavior problems [Strengths and Difficulties Questionnaire (SDQ)] and executive function abilities [Behavior Rating Inventory of Executive Function (BRIEF)] at age 6-10 years (sample sizes 485-933). PFAS concentrations in pregnant Project Viva mothers (in 1999-2002) and children at ages 6-10 (in 2007-10) were similar to concentrations at similar time points in women and children in the nationally representative U.S. National Health and Nutrition Examination Survey. We observed no consistent associations of prenatal PFAS concentrations with behavior or executive function. Childhood concentrations of perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), perfluorononanoate (PFNA) and perfluorodecanoate (PFDA) were associated with higher parent-rated SDQ Total Difficulties scores (mean = 6.7, standard deviation (SD) = 4.9), suggesting greater behavioral problems (top (Q4) versus bottom (Q1) quartile PFOA: 1.5, 95% confidence interval (CI): 0.3, 2.7; PFOS: 1.4, 95% CI: 0.3, 2.5; PFHxS: 1.2, 95% CI: 0.1, 2.3; PFNA: 1.2, 95% CI: 0.1, 2.2; PFDA: 1.1, 95% CI: 0.0, 1.1); teacher-rated SDQ scores did not show associations. Higher childhood PFOS was associated with higher (indicating more problems) parent-rated BRIEF General Executive Composite (GEC) scores (standardized to mean = 50, SD = 10) (Q4 vs. Q1: 2.4, 95% CI: 0.2, 4.6), while teacher BRIEF GEC scores indicated more problems among children with higher PFHxS (Q4 vs. Q1: 3.5, 95% CI: -0.8, 6.3). There were no consistent patterns of sexual dimorphism in associations. In a cohort of U.S. children, we observed cross-sectional associ

Obesity is associated with a multitude of negative health sequalae. Behavioral weight loss (BWL) is currently the recommended behavioral treatment for obesity; however, it is not effective for approximately half of the individuals who participate. BWL requires individuals to carry out many tasks requiring executive function (EF; i.e., higher order cognitive functions such as planning and problem solving) in order to be successful. Growing research supports that lower EF may be associated with attenuated weight loss following BWL, and targeting EF in treatment could improve outcomes. This paper aims to describe the rationale for the development of Novel Executive Function Training for Obesity (NEXT), which adapts Compensatory Cognitive Training to be delivered in conjunction with BWL. We summarize evidence relating EF to obesity and reduced weight loss following BWL, as well as the past success of cognitive training on EF. Then we describe the treatment model for NEXT followed by initial data suggesting that NEXT is feasible and acceptable and may impact EF and weight. Obesity treatments incorporating cognitive training, especially those that train compensatory strategies, may improve weight-loss outcomes and provide a more durable treatment than traditional interventions, but larger randomized control trials are necessary.

Midlife blood pressure is associated with structural brain changes, cognitive decline, and dementia in late life. However, the relationship between early adulthood blood pressure exposure, brain structure and function, and cognitive performance in midlife is not known. A better understanding of these relationships in the preclinical stage may advance our mechanistic understanding of vascular contributions to late-life cognitive decline and dementia and may provide early therapeutic targets. To identify resting-state functional connectivity of executive control networks (ECNs), a group independent components analysis was performed of functional MRI scans of 600 individuals from the Coronary Artery Risk Development in Young Adults longitudinal cohort study, with cumulative systolic blood pressure (cSBP) measured at nine visits over the preceding 30 y. Dual regression analysis investigated performance-related connectivity of ECNs in 578 individuals (mean age 55.5 ± 3.6 y, 323 female, 243 Black) with data from the Stroop color-word task of executive function. Greater connectivity of a left ECN to the bilateral anterior gyrus rectus, right posterior orbitofrontal cortex, and nucleus accumbens was associated with better executive control performance on the Stroop. Mediation analyses showed that while the relationship between cSBP and Stroop performance was mediated by white matter hyperintensities (WMH), resting-state connectivity of the ECN mediated the relationship between WMH and executive function. Increased connectivity of the left ECN to regions involved in reward processing appears to compensate for the deleterious effects of WMH on executive function in individuals across the burden of cumulative systolic blood pressure exposure in midlife.

ObjectivesGeriatric depression often presents with memory and cognitive complaints that are associated with increased risk for Alzheimer's disease (AD). In a parent clinical trial of escitalopram combined with memantine or placebo for geriatric depression and subjective memory complaints, we found that memantine improved executive function and delayed recall performance at 12 months (NCT01902004). In this report, we used positron emission tomography (PET) to assess the relationship between in-vivo amyloid and tau brain biomarkers and clinical and cognitive treatment response.DesignIn a randomized double-blind placebo-controlled trial, we measured 2-(1-{6-[(2-[F18]fluoroethyl)(methyl)amino]-2-naphthyl}ethylidene) malononitrile ([18F]FDDNP) binding at baseline and assessed mood and cognitive performance at baseline, posttreatment (6 months), and naturalistic follow-up (12 months).ParticipantsTwenty-two older adults with major depressive disorder and subjective memory complaints completed PET scans and were included in this report.ResultsAcross both treatment groups, higher frontal lobe [18F]FDDNP binding at baseline was associated with improvement in executive function at 6 months (corrected p = .045). This effect was no longer significant at 12 months (corrected p = .12). There was no association of regional [18F]FDDNP binding with change in mood symptoms (corrected p = .2).Conclusions[18F]FDDNP binding may predict cognitive response to antidepressant treatment. Larger trials are required to further test the value of [18F]FDDNP binding as a biomarker for cognitive improvement with antidepressant treatment in geriatric depression.

This study aimed to explore cross-sectional associations between executive function (EF), and community and household factors (household SES, caregiver education, home learning environment, caregiver/child interaction, caregiver wellbeing, and exposure to community violence) in a sample of children from very low-SES settings in Cape Town, South Africa. Results revealed that children exposed to higher levels of violence perform worse on inhibition tasks. No other associations were significant, highlighting the need to reassess how researchers can better understand these settings and the effects on EF development.

Attention is widely considered a core process of Executive Function (EF), but it is not clear if it is a separable or integral component of EF in preschool children. Preschool children (n=137) completed a battery of tasks which included EF (i.e., response inhibition, working memory) and attentional control (AC) processes (i.e., sustained attention, selective attention). Confirmatory Factor Analyses (CFA) indicated that a two-factor model with EF and AC as separate factors fit the data better than a unitary one-factor model. These findings are consistent with the view that EF and AC are developing at different rates during the preschool years, and thus are not yet fully integrated in the processing of information. The implications of how EF and AC should be conceptualized in early childhood are discussed.

A considerable number of studies have investigated whether speaking two languages improves executive function. Results, while controversial, have highlighted the influence of second language proficiency on the emergence of these cognitive advantages. To date, few studies have investigated whether other related linguistic experiences, such as dialect use, confer similar advantages. The diverse range of dialects found across the People’s Republic of China provide ideal conditions under which to explore this question. Using a heterogeneous sample of Mandarin-English bilingual, bidialectal young adults (n = 73), the present study investigated whether differences in self-reported dialect proficiency impacted on Simon Task performance. While results showed reduced Simon effects associated with higher reported dialect proficiency, it was a consequence of slower performance on congruent trials, not improved performance on incongruent trials. The observed reduction in facilitation from congruent trials associated with higher reported dialect proficiency suggests a cognitive disadvantage, but merits further investigation.

This study aimed to explore cross-sectional associations between executive function (EF), and community and household factors (household SES, caregiver education, home learning environment, caregiver/child interaction, caregiver wellbeing, and exposure to community violence) in a sample of children from very low-SES settings in Cape Town, South Africa. Results revealed that children exposed to higher levels of violence perform worse on inhibition tasks. No other associations were significant, highlighting the need to reassess how researchers can better understand these settings and the effects on EF development.

Attention is widely considered a core process of Executive Function (EF), but it is not clear if it is a separable or integral component of EF in preschool children. Preschool children (n=137) completed a battery of tasks which included EF (i.e., response inhibition, working memory) and attentional control (AC) processes (i.e., sustained attention, selective attention). Confirmatory Factor Analyses (CFA) indicated that a two-factor model with EF and AC as separate factors fit the data better than a unitary one-factor model. These findings are consistent with the view that EF and AC are developing at different rates during the preschool years, and thus are not yet fully integrated in the processing of information. The implications of how EF and AC should be conceptualized in early childhood are discussed.

A considerable number of studies have investigated whether speaking two languages improves executive function. Results, while controversial, have highlighted the influence of second language proficiency on the emergence of these cognitive advantages. To date, few studies have investigated whether other related linguistic experiences, such as dialect use, confer similar advantages. The diverse range of dialects found across the People’s Republic of China provide ideal conditions under which to explore this question. Using a heterogeneous sample of Mandarin-English bilingual, bidialectal young adults (n = 73), the present study investigated whether differences in self-reported dialect proficiency impacted on Simon Task performance. While results showed reduced Simon effects associated with higher reported dialect proficiency, it was a consequence of slower performance on congruent trials, not improved performance on incongruent trials. The observed reduction in facilitation from congruent trials associated with higher reported dialect proficiency suggests a cognitive disadvantage, but merits further investigation.

Background: Emerging evidence suggests that opioid receptor antagonists, such as naltrexone, are effective pharmacotherapies for alcohol, opioid, and possibly stimulant use disorders. It is posited that naltrexone exerts its effects, in part, by increasing functional connectivity between neural reward circuitry and frontal systems implicated in executive function. Yet no studies had examined whether executive function moderates these effects. Objectives: This study examined whether a composite measure of executive function (EF) moderates the effect of naltrexone on craving for methamphetamine and subjective responses following infusion of the drug. Methods: Individuals with methamphetamine use disorder (N = 30; 27% female) completed baseline neurocognitive assessments of premorbid and executive function, and an executive function factor was computed. Participants then underwent a randomized, double-blind, cross-over study of titration with naltrexone and placebo. Participants then received a 30-mg intravenous methamphetamine infusion and completed subjective response questionnaires at 8 times in the 120 minutes post-infusion. Results: Multilevel mixed models indicated a significant EF × medication interaction, reflecting greater effects of naltrexone to decrease "desire to access the drug", "want more of the drug", "crave the drug", "feel drug effects" and "feel high" in participants with low EF compared to those with high EF (Bs = .36-1.29, SEs = .14-.17, ps<0.01). These effects remained significant after controlling for premorbid cognitive functioning, baseline responses to methamphetamine, severity of methamphetamine use, and methamphetamine-related functional problems. Conclusion: Naltrexone may be especially effective in methamphetamine-dependent individuals with low EF. Neuropsychological assessments may also provide predictive clinical utility not captured by traditional measures of substance use severity.

Background: Emerging evidence suggests that opioid receptor antagonists, such as naltrexone, are effective pharmacotherapies for alcohol, opioid, and possibly stimulant use disorders. It is posited that naltrexone exerts its effects, in part, by increasing functional connectivity between neural reward circuitry and frontal systems implicated in executive function. Yet no studies had examined whether executive function moderates these effects. Objectives: This study examined whether a composite measure of executive function (EF) moderates the effect of naltrexone on craving for methamphetamine and subjective responses following infusion of the drug. Methods: Individuals with methamphetamine use disorder (N = 30; 27% female) completed baseline neurocognitive assessments of premorbid and executive function, and an executive function factor was computed. Participants then underwent a randomized, double-blind, cross-over study of titration with naltrexone and placebo. Participants then received a 30-mg intravenous methamphetamine infusion and completed subjective response questionnaires at 8 times in the 120 minutes post-infusion. Results: Multilevel mixed models indicated a significant EF × medication interaction, reflecting greater effects of naltrexone to decrease "desire to access the drug", "want more of the drug", "crave the drug", "feel drug effects" and "feel high" in participants with low EF compared to those with high EF (Bs = .36-1.29, SEs = .14-.17, ps<0.01). These effects remained significant after controlling for premorbid cognitive functioning, baseline responses to methamphetamine, severity of methamphetamine use, and methamphetamine-related functional problems. Conclusion: Naltrexone may be especially effective in methamphetamine-dependent individuals with low EF. Neuropsychological assessments may also provide predictive clinical utility not captured by traditional measures of substance use severity.

Executive function (EF) is an umbrella term for a collection of important cognitive skills, including working memory, cognitive flexibility, and inhibitory control. These skills are important for both short-term and long-term outcomes such as peer relations, mental and physical health, and academic achievement. Numerous factors influence performance on each of these skills, one of which is experiencing stress. However, how different stressors impact EF across the life span, and how stress-induced impacts on EF are related to other outcomes, is not fully understood. For example, while there is a large body of literature examining the effects of acute stress on adult EF, the literature on this relation in childhood is sparse. The aim of the following studies was to examine how different stressors impact EF and how this process relates to other outcomes, such as academic achievement and mental health. First, longitudinal analyses of the mediating role of executive function in middle childhood (age 7-11) in the relation between early-life family income (age 0-5) and academic achievement in late adolescence (16-18) were examined. These analyses indicated that executive function serves as a mediator in this relation. Second, the effects of an acute experimental stressor on EF performance in 9-11-year-old children were examined, as well as the potential moderating roles of child characteristics such as physiological reactivity and emotional and behavioral problems. There was no overall effect of stress on EF performance but there was a moderating effect of parasympathetic nervous system reactivity in the relation between stress condition and inhibitory control performance. Lastly, the association between COVID-19-related economic stress and both EF and mental health in 9-17-year-old children and their parents was examined. There were no effects of either parental job loss or family financial stress on EF, but family financial stress did predict worse mental health in paren

The present study explored the associations between executive function skills and play ability in toddlers with Down Syndrome (DS). Participants included 79 children with DS (mean age= 38 months; 53% female). Executive function ability was measured via parent report (BRIEF-P) and three child tasks (Memory Tower Task, EF Search Task, and the Persistence Puzzle Task). Play ability was measured via the Structured Play Assessment. Higher diversity of play acts predicted higher working memory ability and planning ability, while higher play level predicted better planning/persistence. Results suggest that play level and diversity of play can predict some aspects of EF (memory, planning, persistence), but not others (inhibition/shift from the Search Task) in this sample of toddlers with Down syndrome. Future research would benefit from larger samples that may address generalizability of study findings. Improving school readiness, as well as social and academic outcomes, in children with DS are critical research targets for this population during this developmental period. The results of this study may inform and support the development of interventions to better target improving these proficiencies.

ObjectivesContingency management is a promising intervention for Methamphetamine Use Disorder (MUD).Impaired executive function may decrease adherence to such treatment, but there are few data on whether impairment in executive function predicts treatment outcomes. We therefore evaluated whether baseline performance on tests of executive function predicted treatment response in a trial of contingency management for MUD.MethodsThirty participants with MUD and 23 healthy controls performed the Connors Continuous Performance Task (CPT) and the Trail Making Task. MUD participants then entered an 8-week contingency management trial. Participants were categorized as responders (n=17; no methamphetamine-positive urine tests) or non-responders (n=13; >1 positive test). The Kruskal-Wallis test was used to compare scores in participants with MUD and healthy controls, and in responders versus non-responders.ResultsParticipants withMUD performed worse than controls on the CPT (d-prime) (p=0.012); non-responders performed worse than responders (p = 0.034). Performance of MUD participants did not differ significantly from controls on the Trail Making Task B (time to completion), but variation was high with non-responders performing worse than responders (p=0.013).ConclusionThese findings suggest that tests of executive function at baseline may be useful in predicting treatment response in MUD. Future work in larger samples may ultimately allow a more personalized treatment approach to methamphetamine use disorder.

The present study explored the associations between executive function skills and play ability in toddlers with Down Syndrome (DS). Participants included 79 children with DS (mean age= 38 months; 53% female). Executive function ability was measured via parent report (BRIEF-P) and three child tasks (Memory Tower Task, EF Search Task, and the Persistence Puzzle Task). Play ability was measured via the Structured Play Assessment. Higher diversity of play acts predicted higher working memory ability and planning ability, while higher play level predicted better planning/persistence. Results suggest that play level and diversity of play can predict some aspects of EF (memory, planning, persistence), but not others (inhibition/shift from the Search Task) in this sample of toddlers with Down syndrome. Future research would benefit from larger samples that may address generalizability of study findings. Improving school readiness, as well as social and academic outcomes, in children with DS are critical research targets for this population during this developmental period. The results of this study may inform and support the development of interventions to better target improving these proficiencies.

ObjectivesContingency management is a promising intervention for Methamphetamine Use Disorder (MUD).Impaired executive function may decrease adherence to such treatment, but there are few data on whether impairment in executive function predicts treatment outcomes. We therefore evaluated whether baseline performance on tests of executive function predicted treatment response in a trial of contingency management for MUD.MethodsThirty participants with MUD and 23 healthy controls performed the Connors Continuous Performance Task (CPT) and the Trail Making Task. MUD participants then entered an 8-week contingency management trial. Participants were categorized as responders (n=17; no methamphetamine-positive urine tests) or non-responders (n=13; >1 positive test). The Kruskal-Wallis test was used to compare scores in participants with MUD and healthy controls, and in responders versus non-responders.ResultsParticipants withMUD performed worse than controls on the CPT (d-prime) (p=0.012); non-responders performed worse than responders (p = 0.034). Performance of MUD participants did not differ significantly from controls on the Trail Making Task B (time to completion), but variation was high with non-responders performing worse than responders (p=0.013).ConclusionThese findings suggest that tests of executive function at baseline may be useful in predicting treatment response in MUD. Future work in larger samples may ultimately allow a more personalized treatment approach to methamphetamine use disorder.

Executive function (EF) is an umbrella term for a collection of important cognitive skills, including working memory, cognitive flexibility, and inhibitory control. These skills are important for both short-term and long-term outcomes such as peer relations, mental and physical health, and academic achievement. Numerous factors influence performance on each of these skills, one of which is experiencing stress. However, how different stressors impact EF across the life span, and how stress-induced impacts on EF are related to other outcomes, is not fully understood. For example, while there is a large body of literature examining the effects of acute stress on adult EF, the literature on this relation in childhood is sparse. The aim of the following studies was to examine how different stressors impact EF and how this process relates to other outcomes, such as academic achievement and mental health. First, longitudinal analyses of the mediating role of executive function in middle childhood (age 7-11) in the relation between early-life family income (age 0-5) and academic achievement in late adolescence (16-18) were examined. These analyses indicated that executive function serves as a mediator in this relation. Second, the effects of an acute experimental stressor on EF performance in 9-11-year-old children were examined, as well as the potential moderating roles of child characteristics such as physiological reactivity and emotional and behavioral problems. There was no overall effect of stress on EF performance but there was a moderating effect of parasympathetic nervous system reactivity in the relation between stress condition and inhibitory control performance. Lastly, the association between COVID-19-related economic stress and both EF and mental health in 9-17-year-old children and their parents was examined. There were no effects of either parental job loss or family financial stress on EF, but family financial stress did predict worse mental health in paren

ObjectiveThe goal was to conduct exploratory analysis to determine if executive functions (EFs) and food responsiveness/satiety responsiveness (appetitive behaviours that describe one's tendency to eat in the presence of food or food cues) interact to influence weight status among preschool children participating in a trial promoting self-regulation around energy-dense foods.MethodsAt baseline, parents completed the Behaviour Rating Inventory of Executive Function-Preschool and the Child Eating Behaviour Questionnaire. Children completed anthropometric measurements at the preschool. Spearman's correlation, linear regression, and tests of interaction were conducted. The relationship between weight status and EFs among those who were high vs low in food responsiveness and satiety responsiveness was examined.ResultsChildren (n = 92) had a mean age of 5.1 years and body mass index (BMI) percentile of 57.6; half (54%) were male. There were significant correlations between food responsiveness and several EFs (emotional control, inhibitory control, working memory, and plan/organize). In the stratified analysis, children with high food responsiveness or low satiety responsiveness had higher BMI percentiles as emotional control skills worsened. BMI percentiles were not elevated among children with low food responsiveness and poor emotional control.ConclusionThese results suggest that EFs may be more relevant to weight status if preschool children had high levels of food responsiveness or low levels of satiety responsiveness (ie, increased tendency to be influenced by environmental food cues). This analysis should be replicated with direct measures of executive function and appetitive behaviours in larger samples of young children to examine longitudinal impact on weight status.

Despite a 100-year-old history and the existence of schools in nearly every country in the world, Waldorf education is a little known and poorly understood educational model that was developed in Europe by Austrian philosopher Rudolph Steiner. For many years it existed in the United States in the form of private schools. Few of their teachers or administrators were interested in the opinions of others regarding the effectiveness of their pedagogy. As Waldorf-inspired charter schools have grown across the U.S., there is a greater need to understand the system. The Waldorf curriculum was created by Austrian philosopher Rudolf Steiner who was a contemporary of John Dewey and Maria Montessori, and who shared their belief in the advantages of active learning. Yet Steiner was unique among his contemporaries in his focus on an artistic approach to learning. Using interviews, observations, and student work, I identify the beliefs that Waldorf teachers hold around the idea of what it means to be a teacher and then describe the ways in which their beliefs influence the integration of the arts in the literacy curriculum. Interviews confirmed previous research asserting that the Waldorf pedagogy is understood by its teachers in a consistent way across wholly independent schools. All three teachers shared a common understanding of child development, as well as a wholistic view of teaching and learning. Their beliefs centered around three ideas: first, that each child develops at their own pace, second, that academic achievement is not superior to physical, social, or behavioral achievement, and third, that focusing on foundational skills in grades one through three was one of the most important ways they could affect academic achievement. The teachers saw it as their role to a) be a guide and authority who b) strove to “see” the students in front of them, and c) worked reflectively to improve themselves as teachers. Their beliefs in the wholistic nature of learning led them to a

Systems neuroscience approaches with a focus on large-scale brain organization and network analysis are advancing foundational knowledge of how cognitive control processes are implemented in the brain. Over the past decade, technological and computational innovations in the study of brain connectivity have led to advances in our understanding of how brain networks function, inspiring new conceptualizations of the role of prefrontal cortex (PFC) networks in the coordination of cognitive control. In this review, we describe six key PFC networks involved in cognitive control and elucidate key principles relevant for understanding how these networks implement cognitive control. Implementation of cognitive control in a constantly changing environment depends on the dynamic and flexible organization of PFC networks. In this context, we describe major empirical and theoretical models that have emerged in recent years and describe how their functional architecture and dynamic organization supports flexible cognitive control. We take an overarching view of advances made in the past few decades and consider fundamental issues regarding PFC network function, global brain dynamics, and cognition that still need to be resolved. We conclude by clarifying important future directions for research on cognitive control and their implications for advancing our understanding of PFC networks in brain disorders.

This paper shares the results of an exploratory study that measured the change in Executive Function (EF) skills of At-Risk third-grade students with varying Adverse Childhood Experiences (ACEs) before and after an Arts-Integration (AI) program. Student EF skills were measured using the Minnesota Executive Function Scale (MEFS) and a statistically significant increase in EF skills was observed in the post-test. In addition, a regression analysis was conducted to determine if students with a high level of ACEs improved at a different rate than students with a low level of ACEs and it was found that the number of ACEs was a significant predictor of improvement on the MEFS.  The article describes why students with high ACEs would likely have EF skill deficiencies, why EF skills are important for success in school, and how using the arts in curricula can help develop EF skills in students.

This paper shares the results of an exploratory study that measured the change in Executive Function (EF) skills of At-Risk third-grade students with varying Adverse Childhood Experiences (ACEs) before and after an Arts-Integration (AI) program. Student EF skills were measured using the Minnesota Executive Function Scale (MEFS) and a statistically significant increase in EF skills was observed in the post-test. In addition, a regression analysis was conducted to determine if students with a high level of ACEs improved at a different rate than students with a low level of ACEs and it was found that the number of ACEs was a significant predictor of improvement on the MEFS.  The article describes why students with high ACEs would likely have EF skill deficiencies, why EF skills are important for success in school, and how using the arts in curricula can help develop EF skills in students.

BACKGROUND:Executive function (EF) is vital to human beings. It has been linked to many genes and family environmental factors in separate studies, but few studies have examined the potential interactions between gene(s) and environmental factor(s). The current study explored the whole genome to identify SNPs, genes, and pathways that interacted with parental warmth (PW) on EF. RESULTS:Nine EF tasks were used to measure its three components (common EF, updating, shifting) based on the model proposed by Miyake et al. (2000). We found that rs111605473, LAMP5, SLC4A7, and LRRK1 interacted significantly with PW to affect the updating component of EF, and the GSE43955 pathway interacted significantly with PW to affect the common EF component. CONCLUSIONS:The current study is the first to identify genes that interacted with PW to affect EF. Further studies are needed to reveal the underlying mechanism.

The Met-allele of the COMT Val158Met polymorphism slows metabolism and increases bioavailability of dopamine (DA) in the prefrontal cortex compared to the Val-allele. Healthy Met-carriers outperform Val-carriers on executive function (EF) tests, yet this 'advantage' disappears in methamphetamine (METH) dependence. Met-carriers may be disproportionately vulnerable to METH-related perturbations of DA, yet it is unknown whether COMT modulates METH effects on CSF DA biomarkers. Participants were 75 METH+ and 47 METH- men who underwent neurocognitive testing, COMT genotyping, and lumbar puncture. CSF was assayed for DA and its metabolite, homovanillic acid (HVA). Separate linear models regressed DA, HVA, and HVA/DA ratios on COMT, METH and their interaction. Pearson correlations examined associations between DA and EF. Significant interactions indicated that METH+ had lower DA and higher HVA/DA ratios among Met/Met, but not Val/Met-or Val/Val. Met/Met-exhibited the highest DA levels among METH-, whereas DA levels were comparable between Met/Met-and Val-carriers among METH+. Higher DA correlated with better EF in METH- Met/Met, but did not predict EF in the entire sample. DA was expectedly higher in METH- Met/Met, yet a discordant genotype-phenotype profile emerged in METH+ Met/Met, consistent with the notion that slow DA clearance exacerbates METH-associated DA dysregulation.

Executive function is a cognitive control system contributes uniquely to resilience (Greenberg, 2006; Obradovic, 2016).This study looked into resilience development during its controversial age period in cognitive perspective, aims to explorehow its components (i.e., cognitive flexibility, inhibitory control, and working memory) affect resilience in different agegroups. Data were collected in middle schools and universities (N=197). Participants were asked to join a series of labexperiments and questionnaires in a psychological lab. Results showed resilience as well as executive function in algorith-mic mind level develop from adolescence to emerging adulthood. Cognitive flexibility plays central role in functioningresilience with various cognitive mechanisms for different populations. With the identification of cognitive mechanismsunderlying the relation between cognitive flexibility subsets (i.e., reactive flexibility and spontaneous flexibility) and re-silience, this study contributes a cognitive perspective for better understanding of resilience before challenging eventshappen.

BACKGROUND:Executive function (EF) is vital to human beings. It has been linked to many genes and family environmental factors in separate studies, but few studies have examined the potential interactions between gene(s) and environmental factor(s). The current study explored the whole genome to identify SNPs, genes, and pathways that interacted with parental warmth (PW) on EF. RESULTS:Nine EF tasks were used to measure its three components (common EF, updating, shifting) based on the model proposed by Miyake et al. (2000). We found that rs111605473, LAMP5, SLC4A7, and LRRK1 interacted significantly with PW to affect the updating component of EF, and the GSE43955 pathway interacted significantly with PW to affect the common EF component. CONCLUSIONS:The current study is the first to identify genes that interacted with PW to affect EF. Further studies are needed to reveal the underlying mechanism.

OBJECTIVE: To examine feasibility, convergent validity and biases associated with a mobile color-word interference test (mCWIT) among older persons living with HIV (PLHIV). METHOD: Over a 14-day period, 58 PLHIV and 32 HIV-uninfected individuals (aged 50-74) completed the mCWIT on smartphones once per day in real-world settings. Participants also completed a comprehensive laboratory-based neuropsychological evaluation. RESULTS: A high rate of compliance was observed (86%) in the repeated administration of the mCWIT. A practice effect was observed in the overall sample concerning mCWIT subscores, and these learning effects were greater for PLHIV. Stabilization of performance was observed after 6 (HIV+) and 7 days (HIV-) for completion time and after 2 (HIV-) and 3 days (HIV+) for mCWIT errors. A minor fatigue effect was observed in the overall sample which was unassociated with group status. Moderate to strong correlations were found between mCWIT completion time and mCWIT errors with global neurocognition and with all of the individual neurocognitive domains. The strongest associations were with mCWIT completion time and laboratory-based global neurocognition, executive function, and working memory scores. CONCLUSIONS: Cognitive testing administered within the context of a persons daily life provides qualitatively different data than neuropsychological testing completed in clinical settings, and it may constitute a more ecologically valid indicator of cognitive performance than traditional methods. Mobile cognitive testing has potential to help characterize real-time cognitive performance and serve as a complementary assessment tool to traditional methods.

Executive function and metacognition are two core concepts in cognitive psychology, yet research linking EF and metacognition directly remains rare. It has been suggested that error monitoring can be used as a window to study the association between EF and metacognition (Roebers, 2018). Error monitoring is indexed by post-error slowing, a phenomenon describing a delayed response in actions after error commissions. The present study uses hierarchical multiple regression to investigate whether EF and metacognition can both predict PES. Individual constructs of EF are measured by four computerised-based tasks. Metacognition is assessed by a simplified version of the Self-Regulated Learning Questionnaire (Dowson & McInerney, 2004). A total of 456 participants (M age of 11.9, SD = 0.92) are included in the final analysis. Results indicate that two EF constructs: inhibition and planning, predict corresponding PES in inhibition and planning tasks. Only the regulation component of metacognition predicts PES in the planning task.

Executive function and metacognition are two core concepts in cognitive psychology, yet research linking EF and metacognition directly remains rare. It has been suggested that error monitoring can be used as a window to study the association between EF and metacognition (Roebers, 2018). Error monitoring is indexed by post-error slowing, a phenomenon describing a delayed response in actions after error commissions. The present study uses hierarchical multiple regression to investigate whether EF and metacognition can both predict PES. Individual constructs of EF are measured by four computerised-based tasks. Metacognition is assessed by a simplified version of the Self-Regulated Learning Questionnaire (Dowson & McInerney, 2004). A total of 456 participants (M age of 11.9, SD = 0.92) are included in the final analysis. Results indicate that two EF constructs: inhibition and planning, predict corresponding PES in inhibition and planning tasks. Only the regulation component of metacognition predicts PES in the planning task.

We examined developmental differences and sources of variability in trait reasoning. Four- to 10-year-olds and adults (N=198) rated how mean or nice "medium-mean" and "medium-nice" babies, kids, and teenagers were earlier in their lifetime and would be at older ages. Participants expected nice-labeled characters to be nice throughout their lives (participant age effects were null). In contrast, we documented age-related differences in judgments about meanness. With increasing participant age, individuals expected that meanness present in infancy, childhood, and adolescence would persist into adulthood. We discovered a curvilinear pattern in assessments of whether meanness originates during infancy: Four- to 5-year-olds and adults expected mean-labeled kids and teenagers to have been nicer as babies than did 6- to 10-year-olds. Controlling for age and working memory, participants with better inhibitory control more frequently expected mean-labeled individuals to remain mean across the lifespan, but inhibitory control was unrelated to judgments about nice-labeled individuals.

BackgroundChildhood trauma is known to impart risk for several adverse life outcomes. Yet, its impact during adolescent development is not well understood. We aimed to investigate the relationships among childhood trauma, functional brain connectivity, executive dysfunction (ED), and the development of high-risk drinking in adolescence.MethodsData from the National Consortium on Alcohol and Neurodevelopment in Adolescence (sample size = 392, 55% female) cohort were used. This included resting-state functional magnetic resonance imaging at baseline, childhood trauma and ED self-reports, and detailed interviews on alcohol and substance use collected at baseline and at 4 annual follow-ups. We used longitudinal regression analyses to confirm the relationship between childhood trauma and ED, identified the mediating functional brain network hubs, and used these linkages to predict future high-risk drinking in adolescence.ResultsChildhood trauma severity was significantly related to ED in all years. At baseline, distributed functional connectivity from hub regions in the bilateral dorsal anterior cingulate cortex, right anterior insula, right intraparietal sulcus, and bilateral pre- and postcentral gyri mediated the relationship between childhood trauma and ED. Furthermore, high-risk drinking in follow-up years 1-4 could be predicted with high accuracy from the trauma-affected functional brain networks that mediated ED at baseline, together with age, childhood trauma severity, and extent of ED.DiscussionFunctional brain networks, particularly from hub regions important for cognitive and sensorimotor control, explain the relationship between childhood trauma and ED and are important for predicting future high-risk drinking. These findings are relevant for the prognosis of alcohol use disorders.

ObjectiveHIV-associated neurocognitive impairment continues to be prevalent and clinically relevant. We examined the relationship between neurocognition and full plasma HIV RNA suppression among study participants over a 15-year period at a large research program.Design/methodsWe analyzed the combined prospective studies of the HIV Neurobehavioral Research Program at the University of California at San Diego. Participants were eligible for analysis if on three drug combination antiretroviral therapy with comprehensive neuropsychological testing results. Participants who reported recent nonadherence were excluded. The primary outcome was plasma HIV RNA of 50 copies/ml or less. Generalized estimating equation was used to assess for associations with full virologic suppression taking into account longitudinal visits.ResultsThere were 1943 participants at baseline, of whom 69.4% had plasma HIV RNA of 50 copies/ml or less. Participants with full suppression were slightly older, less likely to abuse cocaine, and had significantly better executive function. Multivariate analysis with incorporation of longitudinal visits (total = 5555) confirmed current cocaine abuse to be strongly associated with lack of virologic suppression (odds ratio = 0.45, 95% confidence interval = 0.31-0.63). In contrast, increasing age, increasing years of HIV infection, and increasing executive function (odds ratio = 1.18 for T score change of 10, 95% confidence interval = 1.07-1.30) were associated with full virologic suppression. Lack of virologic suppression at baseline was associated with a significant subsequent decline in executive function.ConclusionIn a 15-year research cohort of almost 2000 HIV-infected individuals on combination antiretroviral therapy, better executive function was associated with full virologic suppression, possibly as a result rather than a cause.

ObjectiveHIV-associated neurocognitive impairment continues to be prevalent and clinically relevant. We examined the relationship between neurocognition and full plasma HIV RNA suppression among study participants over a 15-year period at a large research program.Design/methodsWe analyzed the combined prospective studies of the HIV Neurobehavioral Research Program at the University of California at San Diego. Participants were eligible for analysis if on three drug combination antiretroviral therapy with comprehensive neuropsychological testing results. Participants who reported recent nonadherence were excluded. The primary outcome was plasma HIV RNA of 50 copies/ml or less. Generalized estimating equation was used to assess for associations with full virologic suppression taking into account longitudinal visits.ResultsThere were 1943 participants at baseline, of whom 69.4% had plasma HIV RNA of 50 copies/ml or less. Participants with full suppression were slightly older, less likely to abuse cocaine, and had significantly better executive function. Multivariate analysis with incorporation of longitudinal visits (total = 5555) confirmed current cocaine abuse to be strongly associated with lack of virologic suppression (odds ratio = 0.45, 95% confidence interval = 0.31-0.63). In contrast, increasing age, increasing years of HIV infection, and increasing executive function (odds ratio = 1.18 for T score change of 10, 95% confidence interval = 1.07-1.30) were associated with full virologic suppression. Lack of virologic suppression at baseline was associated with a significant subsequent decline in executive function.ConclusionIn a 15-year research cohort of almost 2000 HIV-infected individuals on combination antiretroviral therapy, better executive function was associated with full virologic suppression, possibly as a result rather than a cause.