Search

Background: Understanding the sequential progression of cognitive impairments in Parkinson's disease (PD) is crucial for elucidating neuropathological underpinnings, refining the assessment of PD-related cognitive decline stages and enhancing early identification for targeted interventions. The first aim of this study was to use an innovative event-based modeling (EBM) analytic approach to estimate the sequence of cognitive declines in PD. The second aim was to validate the EBM by examining associations with EBM-derived individual-specific estimates of cognitive decline severity and performance on independent cognitive screening measures., Methods: This cross-sectional observational study included 99 people with PD who completed a neuropsychological battery. Individuals were classified as meeting the criteria for mild cognitive impairment (PD-MCI) or subtle cognitive decline by consensus. An EBM was constructed to compare cognitively healthy individuals with those with PD-MCI or subtle cognitive disturbances. Multivariable linear regression estimated associations between the EBM-derived stage of cognitive decline and performance on two independent cognitive screening tests., Results: The EBM estimated that tests assessing executive function and visuospatial ability become abnormal early in the sequence of PD-related cognitive decline. Each higher estimated stage of cognitive decline was associated with approximately 0.24 worse performance on the Dementia Rating Scale (p<0.001) and 0.26 worse performance on the Montreal Cognitive Assessment (p<0.001) adjusting for demographic and clinical variables., Conclusion: Findings from this study will have important clinical implications for practitioners, on specific cognitive tests to prioritise, when conducting neuropsychological evaluations with people with PD. Results also highlight the importance of frontal-subcortical system disruption impacting executive and visuospatial abilities., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Cerebral amyloid angiopathy (CAA) is a main cause of cognitive dysfunction in the elderly. We investigated specific cognitive profiles, cognitive function in the stage before intracerebral hemorrhage (ICH), and the association between magnetic resonance imaging (MRI) based cerebral small vessel disease (cSVD) burden in CAA because data on these topics are limited., Methods: We included Dutch-type hereditary CAA (D-CAA) mutation carriers with and without ICH, patients with sporadic CAA (sCAA), and age-matched controls. Cognition was measured with a standardized test battery. Linear regression was performed to assess the association between MRI-cSVD burden and cognition., Results: D-CAA ICH- mutation carriers exhibited poorer global cognition and executive function compared to age-matched controls. Patients with sCAA performed worse across all cognitive domains compared to D-CAA ICH+ mutation carriers and age-matched controls. MRI-cSVD burden is associated with decreased processing speed., Discussion: CAA is associated with dysfunction in multiple cognitive domains, even before ICH, with increased MRI-cSVD burden being associated with slower processing speed., Highlights: Cognitive dysfunction is present in early disease stages of cerebral amyloid angiopathy (CAA) before the occurrence of symptomatic intracerebral hemorrhage (sICH). Presymptomatic Dutch-type CAA (D-CAA) mutation carriers show worse cognition than age-matched controls. More early awareness of cognitive dysfunction in CAA before first sICH is needed. Increased cerebral small vessel disease CAA-burden on magnetic resonance imaging is linked to a decrease in processing speed., (© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Introduction: The apnea-hypopnea index (AHI) is the current diagnostic parameter for diagnosing and estimating the severity of obstructive sleep apnea (OSA). It is, however, poorly associated with the main clinical symptom of OSA, excessive daytime sleepiness, and with the often-seen cognitive decline among OSA patients. To better evaluate OSA severity, novel hypoxic load parameters have been introduced that consider the duration and depth of oxygen saturation drops associated with apneas or hypopneas. The aim of this paper was to compare novel hypoxic load parameters and traditional OSA parameters to verbal memory and executive function in OSA patients., Method: A total of 207 adults completed a one-night polysomnography at sleep laboratory and two neuropsychological assessments, the Rey Auditory Verbal Learning Test and Stroop test., Results: Simple linear regression analyses were used to evaluate independent associations between each OSA parameter and cognitive performance. Associations were found between immediate recall and arousal index, hypoxia <90 %, average SpO 2 during sleep, and DesSev100+RevSev100. Total recall was associated with all OSA parameters, and no associations were found with the Stroop test. Subsequently, sex, age, and education were included as covariates in multiple linear regression analyses for each OSA parameter and cognitive performance. The main findings of the study were that average SpO 2 during sleep was a significant predictor of total recall (p < .007, β = -.188) with the regression model explaining 21.2 % of performance variation. Average SpO 2 during sleep was also a significant predictor of immediate recall (p < .022, β = -.171) with the regression model explaining 11.4 % of performance variation. Neither traditional OSA parameters nor novel hypoxic load parameters predicted cognitive performance after adjustment for sex, age, and education., Conclusion: The findings validate that the AHI is not an effective indicator of cognitive performance in OSA and suggest that average oxygen saturation during sleep may be the strongest PSG predictor of cognitive decline seen in OSA. The results also underline the importance of considering age when choosing neurocognitive tests, the importance of including more than one test for each cognitive domain as most tests are not pure measures of a single cognitive factor, and the importance of including tests that cover all cognitive domains as OSA is likely to have diffuse cognitive effects., Competing Interests: Declaration of competing interest KTH: no conflict of interest. HH: no conflict of interest. TK: no conflict of interest. SN: no conflict of interest. TD: no conflict of interest. IHN: no conflict of interest. TL: no conflict of interest. ESA: honoraria from Nox Medical, Philips, ResMed, Jazz Pharmaceuticals, Linde Healthcare, Alcoa – Fjardaral, WinkSleep, ApniMed and Vistor. She is also a member of the Philips Sleep Medicine & Innovation Medical Advisory Board. MKJ: no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Purpose: An observational study of children with severe traumatic brain injury (TBI) (Approaches and Decisions in Acute Pediatric TBI [ADAPT] Trial) demonstrated the benefits of inpatient rehabilitation on functional outcomes for those with more severely impaired consciousness when medically stable. We conducted a secondary analysis to assess whether using an inpatient rehabilitation or skilled nursing facility after acute hospitalization was associated with better motor, neuropsychological, and behavioral outcomes compared to receiving only non-inpatient rehabilitation among children with severe TBI., Materials and Methods: We included 180 children who used an inpatient rehabilitation or skilled nursing facility and 74 children who only received non-inpatient rehabilitation from the ADAPT trial. At 12 months post-injury, children underwent tests of motor skills, intellectual functioning, verbal learning, memory, processing speed, and cognitive flexibility. Parents/guardians rated children's executive function and behaviors. We performed inverse probability weighting to adjust for potential confounders., Results: No significant differences were found in any motor, neuropsychological, or behavioral measures between children receiving inpatient rehabilitation and children receiving only non-inpatient rehabilitation., Conclusions: Analyses of comprehensive outcomes did not show differences between children receiving inpatient rehabilitation and children receiving only non-inpatient rehabilitation, suggesting a need for more research on specific components of the rehabilitation process.

A clinically useful characterization of the cognitive aging process requires the development of valid and robust behavioral tests, with an emphasis on explaining and understanding typical inter-individual variability in cognition. Here, using a dataset that includes behavioral scores collected with the National Institute of Health Toolbox Cognition Battery (NIHTB-CB) and other auxiliary tests, we examined (1) the differences between young and old adults across different cognitive domains, (2) the strength of across-subject correlations in behavioral test scores, (3) the consistency of low-dimensional behavioral representations across age using factor analysis, and (4) the accuracy of behavioral scores in predicting participants' age. Our results revealed that (1) elderly females had better verbal episodic memory scores than elderly males, (2) across-subject correlations between behavioral tests varied with age group, (3) although a three-factor model explained the behavioral data in both age groups, some tasks loaded to different factors between the two groups, and (4) age-performance relationship (i.e. a regression model linking age to cognitive scores) in one group cannot be extrapolated to predict age in the other group, indicating an inconsistency in age-performance relationships across groups. These findings suggest that executive function tests might tap into different cognitive processes in different age groups, which might ultimately suggest that a statistically significant between-group difference in test performance might not always reflect differences in the same underlying cognitive processes. Overall, this study calls for more caution when interpreting age-related differences and similarities between age groups with different cognitive abilities even when the same tests are used., (© 2024. The Author(s).)

Background: Obsessive-compulsive disorder (OCD) has been associated with neurocognitive impairments. The present study examined the effect of treatment on neurocognitive performance in OCD and the relationship between neurocognitive change and symptom change. The present study also examined polymorphisms influencing brain derived neurotrophic factor (BDNF) as predictors of neurocognitive change., Method: Treatment-seeking participants with OCD (N = 125) were assigned to cognitive behavioural therapy (CBT) alone, CBT combined with regular physical exercise, exercise alone, or a waitlist control group. Measures of OCD symptom severity and a neuropsychological battery were completed pre- and post-treatment. Blood or saliva samples were used to genotype the BDNF Val66Met polymorphism., Results: OCD symptom severity was not cross-sectionally associated with neurocognitive performance. Several neurocognitive measures improved over treatment. The BDNF Val66Met polymorphism was significantly associated with worse performance on the Stroop test but did not significantly predict change in neurocognitive performance over time., Limitations: Limitations include lack of a healthy control group., Conclusion: Improvement in neurocognitive performance corresponded to symptomatic improvement and was independent of the BDNF Val66Met genotype., Competing Interests: Declaration of competing interest This work was supported by the Canadian Institutes of Health Research., (Crown Copyright © 2024. Published by Elsevier B.V. All rights reserved.)

Aims: To (1) describe the prevalence of cognitive dysfunctions using performance-based and reported measures, and (2) explore the correlations between selected performance-based, patient-reported, and observer-reported neurocognitive outcome measures three months after hospital discharge in a population of out-of-hospital cardiac arrest (OHCA) survivors., Methods: Data from 193 OHCA survivors was derived from the Danish multicenter REVIVAL cohort study. At three months, four subtests of the performance-based Delis-Kaplan Executive Function System (D-KEFS) (Trail making, Color-word interference, Verbal fluency, and Figure design), the patient-reported Behavior Rating Inventory of Executive Function - Adult (BRIEF-A), and the observer-reported 16-item Short Form (SF) Informant Questionnaire on Cognitive Decline after Cardiac Arrest (SF-16 IQCODE-CA) were collected. Spearman's rank coefficient correlation analysis was performed to examine correlations between D-KEFS, BRIEF-A, and SF-16 IQCODE-CA., Results: Overall, 21% of survivors exhibited impairment in executive functioning using the D-KEFS subtest Color-word interference, while only 9% self-reported executive impairment (BRIEF-A) and 7% of relatives reported cognitive decline (SF-16 IQCODE-CA) in survivors at three months post-arrest. All correlations between D-KEFS, BRIEF-A and SF-16 IQCODE-CA were negligible to low., Conclusion: The results of this REVIVAL substudy suggest that although the performance-based and reported measures did not correlate, dual neurocognitive screening tools containing both a self-reported and an informant-reported version may have the potential to detect executive discrepancies in the return to everyday life and guide targeted neurorehabilitation after OHCA., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: People with bipolar disorder (BD) tend to show widespread cognitive impairment compared to healthy controls. Impairments in processing speed (PS), attention and executive function (EF) may represent 'core' impairments that have a role in wider cognitive dysfunction. Cognitive impairments appear to relate to structural brain abnormalities in BD, but whether core deficits are related to particular brain regions is unclear and much of the research on brain-cognition associations is limited by univariate analysis and small samples., Methods: Euthymic BD patients (n = 56) and matched healthy controls (n = 26) underwent T1-weighted MRI scans and completed neuropsychological tests of PS, attention and EF. We utilised public datasets to develop normative models of cortical thickness (n = 5977) to generate robust estimations of cortical abnormalities in patients. Canonical correlation analysis was used to assess multivariate brain-cognition associations in BD, controlling for age, sex and premorbid IQ., Results: BD showed impairments on tests of PS, attention and EF, and abnormal cortical thickness in several brain regions compared to healthy controls. Impairments in tests of PS and EF were most strongly associated with cortical thickness in the left inferior temporal, right entorhinal and right temporal pole areas., Conclusion: Impairments in PS, attention and EF can be observed in euthymic BD and may be related to abnormal cortical thickness in temporal regions. Future research should continue to leverage normative modelling and multivariate methods to examine complex brain-cognition associations in BD. Future research may benefit from exploring covariance between traditional brain structural morphological metrics such as cortical thickness, cortical volume and surface area., (© 2024 The Author(s). Bipolar Disorders published by John Wiley & Sons Ltd.)

Executive function (EF) is represented by a multidimensional set of measures. The central EFs considered are inhibitory control, working memory and cognitive flexibility (task shifting). Unlike other ability constructs, it has proven difficult to identify latent factors that underlie EF. Research has often taken a factor analytic approach for grouping executive functioning tasks. However, this approach has often proven unsuccessful. We aimed to compare factor analysis to a network analytic approach, as network analysis can summarize the pattern of relationships among elements without creating latent constructs. One hundred and thirteen undergraduate students completed a series of nine executive functioning tasks. In comparing exploratory factor analysis to network analysis, we found neither approach provided a compelling higher order grouping of EF measures., (© 2024 The British Psychological Society.)

Limited research has compared cognition of people with non-central nervous system metastatic cancer (NCM) vs. metastatic brain cancer (BM). This prospective cross-sectional study was comprised 37 healthy controls (HC), 40 NCM, and 61 BM completing 10 neuropsychological tests. The NCM performed below HCs on processing speed and executive functioning tasks, while the BM group demonstrated lower performance across tests. Tasks of processing speed, verbal fluency, and verbal memory differentiated the clinical groups (BM < NCM). Nearly 20% of the NCM group was impaired on at least three neuropsychological tests whereas approximately 40% of the BM group demonstrated the same level of impairment.

Objective: To identify which cognitive functions and specific neuropsychological assessments predict falls in older people living in the community., Methods: Five electronic databases were searched until 30/08/2022 for studies assessing the association between specific cognitive functions and faller status (prospective and retrospective), in community-dwelling older people. Risk of bias was assessed with the Newcastle-Ottawa Scale. Meta-analyses synthesised the evidence regarding the associations between different neurocognitive subdomains and faller status., Results: Thirty-eight studies (20 retrospective, 18 prospective) involving 37,101 participants were included. All but one study was rated high or medium quality. Meta-analyses were performed with data from 28 studies across 11 neurocognitive subdomains and four specific neuropsychological tests. Poor cognitive flexibility, processing speed, free recall, working memory and sustained attention were significantly associated with faller status, but poor verbal fluency, visual perception, recognition memory, visuo-constructional reasoning and language were not. The Trail Making Test B was found to have the strongest association with faller status., Conclusion: Poor performance in neurocognitive subdomains spanning processing speed, attention, executive function and aspects of memory are associated with falls in older people, albeit with small effect sizes. The Trail Making Test, a free-to-use, simple assessment of processing speed and mental flexibility, is recommended as the cognitive screening test for fall risk in older people., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Stephen Lord reports financial support was provided by National Health and Medical Research Council. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

This study applied network analysis to executive function test performances to examine differences in network parameters between demographically matched children and adolescents with and without attention-deficit/hyperactivity disorder (ADHD) (n = 141 per group; M = 12.7 ± 2.9 years-old; 72.3% boys, 66.7% White, 65.2% ≥ 12 years maternal education). All participants completed the NIH Toolbox Cognition Battery, including the Flanker, measuring inhibition, Dimensional Change Card Sort, measuring shifting, and List Sorting test, measuring working memory. Children with and without ADHD had comparable mean test performances (d range: .05-0.11) but presented with differences in network parameters. Among participants with ADHD, shifting was less central, had a weaker relationship with inhibition, and did not mediate the relationship between inhibition and working memory. These network characteristics were consistent with the executive function network structure of younger ages in prior research and may reflect an immature executive function network among children and adolescents with ADHD, aligning with the delayed maturation hypothesis., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: In the current study, it was aimed to evaluate neurotrophic factor levels and their relationship with executive functions in high-risk children and adolescents (high-risk group) whose parents were diagnosed with bipolar disorder (BD) but not affected by any psychiatric disease,and in order to determine possible vulnerability factors related to the disease., Methods: The study sample consisted of 32 high-risk group and 34 healthy controls. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-Turkish Adaptation (KSADS-PL-T), Stroop Test, Serial Digit Learning Test (SDLT) and Cancellation Test to evaluate executive functions were administered to all participants by the clinician.Serum levels of neurotrophic factors were measured using commercial enzyme linked immunosorbent assay kits., Results: Serum BDNF, NT-3, NT-4 levels and SDLT scores were significantly lower in the high-risk group for BD compared to the healthy control group. A moderate negative correlation was found between BDNF levels and the Cancellation Test scores in the high-risk group. In addition to these results, the odds ratios of age, NT-4, SDLT scores for being in the risky group in terms of BD diagnosis were 1.26, 0.99 and 0.86 respectively., Limitations: This was a cross-sectional study. Causality between study results is therefore difficult to establish. The relatively small sample size of the study is another limitation., Conclusion: The results of the present study suggest that BDNF, NT-3, NT-4 may play a role in the physiopathology of BD and may be associated with impaired executive function areas such as attention and response inhibition in the high-risk group., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Financial disclosure Supported by Selcuk University Scientific Research Projects Coordination Office with the project number 21122019., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Cognitive difficulties are reported as lasting sequelae within post COVID-19 condition. However, the chronicity of these difficulties and related factors of fatigue, mood, and perceived health have yet to be fully determined. To address this, the current longitudinal study aimed to clarify the trends of cognitive test performance and cognitive domain impairment following COVID-19 onset, and whether hospitalization influences outcomes. 57 participants who reported subjective cognitive difficulties after confirmed COVID-19 infection were assessed at baseline (~6 months post COVID-19) and follow-up (~15 months later) visits. Assessments included measures across multiple cognitive domains and self-report questionnaires of fatigue, mood, and overall health. Analyses were conducted in three stages: at the test score level (raw and adjusted scores), at the cognitive domain level, and stratified by hospitalization status during infection. Results at the test-score level indicate that cognitive performance remains relatively stable across assessments at the group level, with no significant improvements in any adjusted test scores at follow-up. Cognitive domain analyses indicate significant reductions in attention and executive functioning impairment, while memory impairment is slower to resolve. On self-report measures, there was a significant improvement in overall health ratings at follow-up. Finally, those hospitalized during infection performed worse on timed cognitive measures across visits and accounted for a larger proportion of cases with short-term and working memory impairment at follow-up. Overall, our findings indicate that cognitive difficulties persist both at test score and cognitive domain levels in many cases of post COVID-19 condition, but evidence suggests some improvement in global measures of attention, executive functioning and overall self-rated health. Furthermore, an effect of hospitalization on cognitive symptoms post COVID-19 may be more discernible over time., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Grunden et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Assessment measures that quantify decision-making abilities in children and adolescents are limited. In the current study, a novel computerized Decision-Making Task (DMT), which identifies the process that is involved in decision-making, was developed based on an existing information-boards paradigm. The overall aim was to validate the DMT in a paediatric TBI population. This prospective study investigated the performance on the DMT for children post-TBI ( n  = 49; 7-15 years) compared to typically developing controls ( n  = 22; 7-15 years), and investigated the psychometric properties of the DMT by examining internal consistency-related reliability, convergent validity (measures of decision-making, working memory, functional outcomes, and behaviour), and divergent validity (vocabulary). Significant differences were detected for performance on the DMT between children post-TBI and the control group. Psychometric properties of the DMT were acceptable, with variable findings for convergent validity (working memory, functional outcomes, and behaviour). This is the first study to develop and investigate a novel computerised task to assess decision-making skills in a paediatric TBI population. Results cautiously suggest that the DMT is a valid and a reliable measure of decision-making in our clinical sample.

Objective: This study aims to investigate the relationships between four baseline oral conditions (periodontal status, dental caries, tooth wear, and dentition) and repeated global cognition or domain-specific cognition (memory, executive function, attention, and verbal fluency) in non-demented older adults over time., Methods: This prospective cohort study (2011-2019) enrolled 516 non-demented community-dwelling older adults (age ≥ 65) to explore the association between oral health and cognitive function. Global and domain-specific cognition were assessed biennially (four repeats) using a battery of neuropsychological tests. The baseline oral health conditions were examined, including periodontal status, dental caries, tooth wear, and dentition. The association of these oral conditions with cognition was evaluated by generalized linear mixed models. Stratified analyses were performed by important covariates., Results: Over time, dental caries was associated with poor memory in two different logical memory tests (β^= -0.06 and β^= -0.04). Incomplete dentition with less than 28 teeth was associated with poor performance in attention (β^= -0.05) and verbal fluency (β^= -0.03). These associations became more evident in those with an elevated inflammatory marker (IL-6, β^= -0.11 to -0.08). In contrast, tooth wear was associated with better memory in two different logical memory tests (β^= 0.33 and β^= 0.36) and better executive function (β^= 0.06) over time, and this association became more evident in those with the lowest inflammatory marker (IL-6, β^= 0.10)., Conclusions: Dental caries and incomplete dentition were associated with poor memory, attention, and verbal fluency performance. Conversely, tooth wear was associated with better memory performance and executive function., Clinical Significance: For early prevention of dementia, an evaluation of multiple dental and periodontal status in older adults helps predict the risk of dementia in the preclinical phase. Maintaining intact tooth structure without caries progression and eventually tooth loss may help prevent the worsening of memory, attention, and verbal fluency over time., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Executive function is a high-level set of cognitive processes related to goal-directed behaviors including two conceptual subtypes of hot (emotional) and cold (cognitive) executive function (to abbreviate EF). EF deficits in attention deficit hyperactivity disorder (ADHD) leads to significant social impairments in the home, school, and community. Today the type and the extent of executive function defects in ADHD are still debated in studies. We aimed to evaluate hot and cold executive function among medication-naive children with ADHD, with and without oppositional defiant disorder (ODD)., Methods: Forty-five children including suffering ADHD with ODD (n = 15), without ODD (n = 15), or typically developed (TD, n = 15) participated in this cross-sectional study (the age of children was between 7 and 12 years old). The Child Symptom Inventory-4 (CSI-4) was used to screen behavioral and emotional symptoms. Wechsler Adult Intelligence Scale-Revised-Digit Span Task (WAIS-R-DST), Corsi Block Task (CBT), and Wisconsin Card Sorting Test (WCST) were used for assessing cold executive function. Assessing hot executive function was done with Delay Discounting Task (DDT) and Iowa Gambling Task (IGT)., Results: Evaluating the cold executive function, total WAIS-R-DST score, Backward DST, total CBT score, and Backward CBT were significantly lower among ADHD than TD groups (p < 0.05). Assessing the hot executive function showed that the score of DDT and IGT was significantly lower among ADHD than TD groups (p < 0.05)., Conclusion: Both hot and cold executive functions are defective in children with ADHD, while the comorbid of ODD has no significant effect. We suggest the clinicians to consider cognitive rehabilitation interventions as a necessary treatment modality for ADHD patients., (© 2024 International Society for Developmental Neuroscience.)

The present study investigated the performance of children with neurofibromatosis type 1 on computerized assessments of attention and executive function. Relations to ADHD symptomatology were also examined. Participants included 37 children (20 male) with NF1 (9-13 years; M age  = 11.02). Participants completed the NIH Toolbox Dimensional Change Card Sort, List Sort Working Memory (LSWM), and Flanker tasks, as well as Cogstate Identification and One Back tests. ADHD symptomatology was assessed using the K-SADS. Average performance was significantly different from the normative mean on every measure, except LSWM. The NIH Toolbox Flanker and Cogstate Identification tasks detected the highest proportion of participants with at least mild difficulty, and the Cogstate Identification task detected the highest proportion of participants with severe difficulty. Analyses revealed significant relations with ADHD symptomatology for two NIH toolbox tasks. The various computerized measures of attention and executive function offer different information when working with school age children with NF1. The NIH Flanker may offer the most room for change and offers face validity, which may be beneficial for clinical trials research. However, the LSWM shows most support for relations with behavioral indicators of attention and executive challenges.

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.

Objective: This study evaluated the diagnostic performance of a widely available cognitive screener, the Montreal cognitive assessment (MoCA), to detect cognitive impairment in older patients (age ≥ 55) with epilepsy residing in the US, using the International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) as the gold standard., Methods: Fifty older adults with focal epilepsy completed the MoCA and neuropsychological measures of memory, language, executive function, and processing speed/attention. The IC-CoDE taxonomy divided participants into IC-CoDE Impaired and Intact groups. Sensitivity and specificity across several MoCA cutoffs were examined. Spearman correlations examined relationships between the MoCA total score and clinical and demographic variables and MoCA domain scores and individual neuropsychological tests., Results: IC-CoDE impaired patients demonstrated significantly lower scores on the MoCA total, visuospatial/executive, naming, language, delayed recall, and orientation domain scores (Cohen's d range: 0.336-2.77). The recommended MoCA cutoff score < 26 had an overall accuracy of 72%, 88.2% sensitivity, and 63.6% specificity. A MoCA cutoff score < 24 yielded optimal sensitivity (70.6%) and specificity (78.8%), with overall accuracy of 76%. Higher MoCA total scores were associated with greater years of education (p = 0.016) and fewer antiseizure medications (p = 0.049). The MoCA memory domain was associated with several standardized measures of memory, MoCA language domain with category fluency, and MoCA abstraction domain with letter fluency., Significance: This study provides initial validation of the MoCA as a useful screening tool for older adults with epilepsy that can be used to identify patients who may benefit from comprehensive neuropsychological testing. Further, we demonstrate that a lower cutoff (i.e., <24) better captures cognitive impairment in older adults with epilepsy than the generally recommended cutoff and provides evidence for construct overlap between MoCA domains and standard neuropsychological tests. Critically, similar efforts in other regions of the world are needed., Plain Language Summary: The Montreal cognitive assessment (MoCA) can be a helpful tool to screen for cognitive impairment in older adults with epilepsy. We recommend that adults 55 or older with epilepsy who score less than 24 on the MoCA are referred to a neuropsychologist for a comprehensive evaluation to assess any changes in cognitive abilities and mood., (© 2024 The Author(s). Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)

The Oxford Digital Multiple Errands Test (OxMET) is a brief computer-tablet based cognitive screen, intended as an ecologically valid assessment of executive dysfunction. We examined aspects of predictive validity in relation to functional outcomes. Participants (≤ 2 months post-stroke) were recruited from an English-speaking stroke rehabilitation in-patient setting. Participants completed OxMET. The Barthel Index, Therapy Outcome Measure (TOMS), and modified Rankin Scale (mRS) were collected from medical notes. Participants were followed up after 6-months and completed the Nottingham Extended Activities of Daily Living (NEADL) scale. 117 participants were recruited ( M  = 26.18 days post-stroke ( SD  = 25.16), mean 74.44yrs ( SD  = 12.88), median NIHSS 8.32 ( IQR  = 5-11)). Sixty-six completed a follow-up ( M  = 73.94yrs ( SD  = 12.68), median NIHSS 8 ( IQR  = 4-11)). Significant associations were found between TOMS and mRS. At 6-month follow up, we found a moderate predictive relationship between the OxMET accuracy and NEADL (R 2  = .29, p  < .001), and we did not find this prediction with MoCA taken at 6-months. The subacute OxMET associated with measures of functionality and disability in a rehabilitation context, and in activities of daily living. The OxMET is an assessment of executive function with good predictive validity on clinically relevant functional outcome measures that may be more predictive than other cognitive tests.

Purpose: To describe the sociodemographic and cognitive profile of participants enrolled in an adapted driving program for individuals with neurological conditions, to explore the association between cognitive functioning and driving program outcome, and to describe driving habits after program completion., Methods: This study combined retrospective chart review and cross-sectional data collection., Results: The sample included 71 participants with neurological disorders (aged 15-56 years, M  = 22.2 ± 8.6; 39% women). Driving program was either successful (47%), failed (7%), discontinued (34%), or ongoing (13%). Among 35 participants with complete neuropsychological and driving program outcome data, those who successfully completed the program showed better attention functioning, and better performance relative to global functioning for attention, executive functions, and working memory, compared to those who discontinued/failed the program. Among 21 participants who completed a telephone questionnaire on average 3.7 years after program enrollment, 67% obtained their driver's license and drove regularly. Participants reported high levels of satisfaction with the program., Conclusion: These results suggest that approximately half of the persons enrolled in a driver training program designed for learners with neurological conditions, obtain a driver's license; and that attention, and to a lesser extent executive functioning and working memory, are related to driving program success.IMPLICATIONS FOR REHABILITATIONIn individual with neurological conditions, learning how to drive can be challenging.An adapted driver training program, involving collaboration between driving instructors and healthcare professionals, simplification of theoretical learning, and increasing driving practice opportunities, can be effective, both in terms of licensing success and client satisfaction.Conducting a pre-driving program neuropsychological assessment, with identification of cognitive strengths and weaknesses, can provide valuable information for clinicians and driving instructors for optimizing training and predicting outcome.Better performance in attention, and better relative to global cognitive functioning in attention, executive functions, and working memory, are related to higher success rate of an adapted driving program.

Purpose: We describe the communication challenges of four patients with a neurodegenerative disorder consistent with behavioral variant frontotemporal dementia (bvFTD), characterized by early behavioral and personality changes. By describing their clinical profiles, we identify common barriers to functional communication in this population and provide recommendations for how speech-language pathologists (SLPs) might contribute to minimizing them., Method: Four patients with bvFTD were selected from a cohort of patients with progressive communication impairments. Three of them returned for at least one follow-up visit. Case histories are presented along with the results of comprehensive speech and language, neuropsychological, and neurological testing., Results: At the time of initial evaluation, patients were between the ages of 54 and 66 years and had been experiencing symptoms for 1.5-6 years. Consistent with their bvFTD diagnoses, all patients had prominent behavioral and personality changes that impacted communication. Patients 1 and 2 also had mild aphasia at enrollment, primarily characterized by anomia and loss of word meaning. Patients 3 and 4 both had apraxia of speech and moderate-to-severe aphasia at enrollment with prominent anomia and agrammatism. All four patients had impaired executive functioning and relative sparing of visuospatial skills; episodic memory was also impaired for Patients 2 and 4. Even though functional communication was progressively limited for all patients, none of them received regular support from an SLP., Conclusions: This case series adds to a scant, but growing, literature demonstrating that patients with bvFTD have communication impairments. SLPs are uniquely positioned to identify barriers to functional communication and to provide tailored strategy training to the patients and their care partners over the course of their disease. Systematic evaluation of the efficacy of treatment in this population would be valuable., Supplemental Material: https://doi.org/10.23641/asha.25933762.

Patients with bipolar disorder type I (BP-I) often present with impairments in cognitive function. Offspring unaffected by the disorder can also present with cognitive dysfunction. The objective of this study was to compare the cognitive function of BP-I patients, their unaffected offspring (UO) and healthy control subjects (HC)., Methods: Verbal memory, working memory index, processing speed, attention, verbal and phonological fluency and executive function were evaluated through the application of a neuropsychological battery to three groups made up of BP-I patients that attended the Bipolar Disorder Outpatient Clinic of Clínica San Juan de Dios de Manizales [San Juan de Dios de Manizales Clinic] (n=30), UO (n=32) and control group (n=31). The UO group and the control group were matched by gender, age and level of education., Results: Major differences between the three groups were found in the measures of cognitive functions (except in semantic fluency). The HC group showed better cognitive performance in all the functions. Post-hoc analysis showed similar results in the cognitive performance between BP-I and UO except in verbal learning and executive function tasks where the results were better in UO. A better performance in the control group was found, compared to the UO group, in executive function, attention, working memory, and semantic fluency and phonological areas., Conclusions: These results indicate that the offspring of patients with BP-I present with cognitive impairments without suffering from the disorder. This suggests that cognitive dysfunction presents without diagnosis and supports the hypothesis that it can correspond to a BP-I endophenotype., (Copyright © 2022 Asociación Colombiana de Psiquiatría. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Ambulatory assessment of executive function - particularly in the form working memory (WM) - is increasingly common. Few studies to date, however, have also incorporated ambulatory measures of inhibitory control. Critically, the extended within-person reliability of ambulatory tasks tapping each of these constructs has been largely overlooked., Method: Participants ( N  = 283, M age  = 23.74 years, SD  = 9.04) received notifications every 3 days (for 4 weeks) to undertake ambulatory assessment versions of the n -Back and Stop-Signal Tasks (SST) via the smartphone application CheckCog. Within-person reliability of these measures was explored., Results: Compliance ranged from 66% (for eight sessions) to 89% (for four sessions). Our results reveal significant changes in performance within the first two sessions for both the n -Back and SST, with performance remaining largely consistent across the remaining (two to eight) sessions. In terms of test-retest reliability, the ICC (C, 1) values ranged from .29 to .68 on the n -Back (with overall accuracy being .51) and .31-.73 on the SST (with stop-signal reaction time being .53)., Conclusion: The results of the current study contribute to the literature by demonstrating the reliability of brief measures of executive function - in the form of inhibitory control and WM - delivered using smartphones in participants' natural environments. Based on our findings, the CheckCog app reliability tracks baseline systematic changes in WM and response inhibition across multiple time points and for an extended period in healthy individuals.

The common requirement to set the time to "10 past 11" on the Clock Drawing Test is intended to elicit a stimulus bound response (SBR), in which the responder is "pulled" to the salient stimulus "10," resulting in hands set at "10 before 11." SBRs are considered markers of executive dysfunction, although this assumption has not yet been validated. We compared SBR and other time-setting errors on inhibitory control tests, hypothesizing that they represent related constructs. The role of semantic dysfunction in the formation of those errors was also investigated. We examined baseline test performance of participants with Mild Cognitive Impairment or a history of depression, and control participants, enrolled in a dementia prevention study. Among 258 participants, we identified clocks with SBRs ( n  = 16), other time errors ( n  = 22), or no errors at all ( n  = 42). Performance between the groups with SBRs and other time-setting errors did not differ on any of the executive tests, and both error groups performed significantly worse than the No Error group on the semantic tests. Control for covariates further supported semantic and executive components in time-setting errors. Both semantic and inhibitory control deficits may underlie time representation errors in general.

Objective: The executive function profile in patients with narcolepsy type 1 (NT1) has been mentioned; however, limited research exists on children and adolescent patients with NT1.This study aims to assess executive function in children and adolescent patients with NT1 in China, examine potential influencing factors and evaluate the short-term treatment effect on executive function., Methods: 53 NT1 patients (36 males, age 12.2 ± 3.4 years) and 37 healthy controls (23 males, age 12.2 ± 2.5 years) underwent self-reported measures assessing subjective sleepiness, depression, anxiety and sleep quality. A comprehensive neuropsychological test was administered to assess executive function domains, including processing speed, inhibitory control, cognitive flexibility and working memory. These assessments were repeated in NT1 patients after three-day regular drug treatment., Results: NT1 patients exhibited higher levels of excessive daytime sleepiness, depression, anxiety, and poor sleep quality compared to healthy controls. Patients showed impaired processing speed, inhibitory control and cognitive flexibility (p < 0.05), whereas working memory was unaffected (p > 0.05). Regression analysis revealed that parameters from sleep monitoring, such as sleep efficiency and sleep latency, were correlated with executive function performance after controlling for age, gender, and education years. The short-term treatment led to improvements in inhibitory control, cognitive flexibility, and working memory., Conclusion: The findings showed that executive function was impaired among children and adolescent patients with NT1, which was associated with objective sleep parameters. Furthermore, this study emphasizes the necessity of neuropsychological assessments and early interventions among children and adolescent NT1 patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Objectives: To explore the trajectories and the change-points of global and five domain-specific cognitive functions before the onset of Alzheimer's disease (AD)., Methods: Data was retrieved from the Alzheimer's Disease Neuroimaging Initiative with follow-up from 2005 to 2022. Participants with mild cognitive impairment (MCI) at baseline and those who progressed to AD during follow-up were included. The time of AD onset was defined as the visit time when participant was first diagnosed as AD during follow-up. Global and five domain-specific cognitive functions (immediate memory, visuospatial ability, language, processing speed and executive function) were assessed by Mini-Mental State Examination, Immediate recalling trials of Rey Auditory Verbal Learning Test, Clock Drawing Test, Animal Fluency Test, Part A and B of Trail Making Test, respectively. Their trajectories and change-points before AD onset were explored by generalized additive mixed models and piecewise linear regression models, respectively., Results: 349 participants were diagnosed as MCI at baseline and converted to AD during follow-up, who were included in this study. They had been visited on an average of 4.6 times (SD = 2.1, range = 2.0-13.0), with a total of 1593 visits. Their mean baseline age and AD onset age were 74.4 (SD = 6.4, range = 60.0-88.4) and 77.0 (SD = 6.8, range = 60.5-94.7) years, respectively. Baseline age and educational year were significantly associated with global cognitive, immediate memory, language and executive function. Men presented better global cognitive function (β = 0.54, p < 0.05) but poorer immediate memory (β = -1.72, p < 0.05) than women. Immediate memory and visuospatial ability showed the earliest change-points at 4 years before the onset of AD (Note as T-4years), followed by language (T-3.5years), executive function (T-2.5 years), processing speed (T-2.0 years), and finally the global cognitive function (T-1.5years)., Conclusions: The trajectories of the six neuropsychological scores were non-linear and showed deterioration in functions over time. Immediate memory and visuospatial ability showed the earliest change-points prior to AD onset., Competing Interests: Declaration of competing interest All authors disclosed no relevant relationships., (Copyright © 2024. Published by Elsevier B.V.)

Purpose: Attentional and executive dysfunctions are the most frequent cognitive disorders in neurofibromatosis type 1 (NF1), with a high prevalence of attention deficit-hyperactivity disorder (ADHD). We (i) compared attentional profiles between NF1 children with and without ADHD and children with primary ADHD criteria and (ii) investigated the possible relationship between attentional disorders and "unidentified bright objects" (UBOs) in NF1., Methods: This retrospective study included 47 NF1 children, 25 with ADHD criteria (NF1+adhd group), matched for age, sex, and cognitive level with 47 children with primary ADHD (ADHD group). We collected computer task (sustained-attention, visuomotor-decision, inhibition, and cognitive-flexibility tasks) scores normalized for age and sex, and brain magnetic resonance imaging data., Results: (i) Working memory was impaired in all groups. (ii) Omissions (p < 0.002) and response-time variability (p < 0.05) in sustained-attention and visuomotor-decision tasks and errors (p < 0.02) in the cognitive-flexibility task were lower for the NFI+adhd and ADHD groups than for the NF1-no-adhd group. (iii) The NF1+adhd group had slower response times (p ≤ 0.02) for inhibition and visuomotor-decision tasks than the other groups. (iv) We found no relevant association between cognitive performance and UBOs., Conclusions: NF1 children with ADHD have an attentional and executive functions deficit profile similar to that of children with primary ADHD, but with a slower response-time, increasing learning difficulties. The atypical connectivity of fronto-striatal pathways, poorer dopamine homeostasis, and increased GABA inhibition observed in NF1 renders vulnerable the development of the widely distributed neural networks that support attentional, working-memory, and executive functions., (Copyright © 2024 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.)

Rationale & Objective: Kidney disease negatively affects cognition. We assessed the effect of kidney transplantation (KT) on different cognitive domains., Study Design: Prospective cohort study., Setting & Participants: We examined pre- versus post-KT cognition in patients waitlisted for KT at an academic center., Predictors: Transplant status. We measured cognitive function before KT (n=101), 3 months after KT (n=78), and 1 year after KT (n = 83)., Outcomes: Our primary outcome was change in cognitive function before versus after KT. We used standard neuropsychological tests to assess global cognition (Mini-Mental State Exam [MMSE]), episodic/declarative memory (Logical Memory), psychomotor speed/visuospatial function (Digit Symbol Substitution Test [DSST], Trail Making Test [TMT] A), working memory/attention (Digit Span), executive function (TMT B), and semantic memory/verbal fluency/language (Category Fluency)., Analytical Approach: Using linear mixed model analysis, we evaluated the changes in neuropsychological test scores adjusted for age, sex, race, education, and number of assessments., Results: Before KT, Logical Memory I and II, DSST, MMSE, Category Fluency (animal naming), and Digit Span backward scores were low compared with normative values from the National Alzheimer's Coordinating Center data. Logical Memory I and II scores improved after KT (pre- vs post-KT, estimated group difference [d]=3.3, P<0.001 for Logical Memory I; d=4.27, P<0.001 for Logical Memory II), such that post-KT scores were similar to normative values (post-KT vs normative values, d = -0.37, P=0.06 for Logical Memory I; d = -0.89, P=0.08 for Logical Memory II). Category Fluency (animal naming; d=2.4, P<0.001) and DSST (d=3.12, P=0.01) scores also improved with KT, but post-KT DSST scores remained lower than normative values (post-KT vs normative values, d = -5.17, P<0.001). MMSE, Digit Span, and TMT A and B scores did not change after KT., Limitations: Single-center study., Conclusions: Episodic and verbal declarative memory normalize after KT. Semantic memory, verbal fluency, language, psychomotor speed, and visuospatial function show partial improvement. Cognitive impairment in kidney disease is therefore at least partly reversible with KT., Plain-Language Summary: Cognitive impairment in kidney disease affects self-esteem, vocational abilities, quality of life, health care costs, and mortality. It is not clear whether kidney transplantation (KT) improves cognition and whether the improvement is uniform across cognitive domains. The distinction between reversible and irreversible cognitive impairment has important implications in the clinical care of patients before and after KT. We assessed cognition before KT and 3 months and 12 months after KT and discovered that episodic and verbal declarative memory normalized with KT. Semantic memory, verbal fluency, language, psychomotor speed, and visuospatial function also improved with KT but did not reach normal levels. Cognitive impairment in kidney disease is therefore at least partly reversible., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: It is important to learn more about the prevalence, severity and characteristics (i.e., which cognitive abilities are especially affected) of cognitive impairment in kidney transplant patients. Furthermore, the impact of living vs. deceased donor renal transplantation on cognitive outcome in this patient group needs further studies., Methods: Fifty-nine patients (43 men, age 55 ± 13 years) who received a deceased donor or living donor kidney transplant, completed a comprehensive neuropsychological test assessment. Neuropsychological tests explored the cognitive domains of verbal and visual memory, attention, and executive functions., Results: Fifteen percent  of the patients had mild, 25% moderate, and 15% severe cognitive impairment. The level of domain-specific cognitive deficit differed between verbal memory, attention, and executive functions (χ 2 (2) = 7.11, p = 0.029). On average, patients showed the highest deficit in executive functions, and the lowest deficit in verbal memory. Patients who received a kidney graft from a deceased donor were more likely to have a cognitive impairment than those who received a kidney graft from a living donor (OR = 3.03, 95% CI [0.99,9.32], Wald χ 2 (1)  = 3.74, p = 0.053). This effect was independent of time on dialysis as well as of creatinine levels, or creatinine clearance., Conclusions: Our results show that in kidney transplant patients with cognitive impairment, the cognitive domain of executive functions is the most affected one. This might be detrimental for quality of life. The fact that patients who received living donor kidneys seem to do better in terms of cognition than patients with deceased donor kidneys deserves more attention in future research., (© 2024. The Author(s).)

Previous research suggests that patients with peripheral vestibular dysfunction (PVD) suffer from nonspatial cognitive problems, including executive impairments. However, previous studies that assessed executive functions are conflicting, limited to single executive components, and assessments are confounded by other cognitive functions. We compared performance in a comprehensive executive test battery in a large sample of 83 patients with several conditions of PVD (34 bilateral, 29 chronic unilateral, 20 acute unilateral) to healthy controls who were pairwise matched to patients regarding age, sex, and education. We assessed basic and complex executive functions with validated neuropsychological tests. Patients with bilateral PVD performed worse than controls in verbal initiation and working memory span, while other executive functions were preserved. Patients with chronic unilateral PVD had equal executive performance as controls. Patients with acute unilateral PVD performed worse than controls in the exact same tests as patients with bilateral PVD (verbal initiation, working memory span); however, this effect in patients with acute PVD diminished after correcting for multiple comparisons. Hearing loss and affective disorders did not influence our results. Vestibular related variables (disease duration, symptoms, dizziness handicap, deafferentation degree, and compensation) did not predict verbal initiation or working memory span in patients with bilateral PVD. The results suggest that bilateral PVD not only manifests in difficulties when solving spatial tasks but leads to more general neurocognitive deficits. This understanding is important for multidisciplinary workgroups (e.g., neurotologists, neurologists, audiologists) that are involved in diagnosing and treating patients with PVD. We recommend screening patients with PVD for executive impairments and if indicated providing them with cognitive training or psychoeducational support., (© 2024. The Author(s).)

Objective: Previous findings suggest that time setting errors (TSEs) in the Clock Drawing Test (CDT) may be related mainly to impairments in semantic and executive function. Recent attempts to dissociate the classic stimulus-bound error (setting the time to "10 to 11" instead of "10 past 11") from other TSEs, did not support hypotheses regarding this error being primarily executive in nature or different from other time setting errors in terms of neurocognitive correlates. This study aimed to further investigate the cognitive correlates of stimulus-bound errors and other TSEs, in order to trace possible underlying cognitive deficits., Methods: We examined cognitive test performance of participants with preliminary diagnoses associated with mild cognitive impairment. Among 490 participants, we identified clocks with stimulus-bound errors ( n = 78), other TSEs ( n = 41), other errors not related to time settings ( n = 176), or errorless clocks ( n = 195)., Results: No differences were found on any dependent measure between the stimulus-bound and the other TSErs groups. Group comparisons suggested TSEs in general, to be associated with lower performance on various cognitive measures, especially on semantic and working memory measures. Regression analysis further highlighted semantic and verbal working memory difficulties as being the most prominent deficits associated with these errors., Conclusion: TSEs in the CDT may indicate underlying deficits in semantic function and working memory. In addition, results support previous findings related to the diagnostic value of TSEs in detecting cognitive impairment.

Introduction: Cognitive impairment associated with borderline personality disorder (BPD) has been consistently demonstrated. However, a specific neuropsychological profile has not yet been established for this disorder, maybe due to the heterogeneity of BPD. The aim of this work is the search for distinct neuropsychological subtypes among patients with BPD and for the association of neuropsychological subgroups with specific clinical characteristics., Methodology: One hundred fifteen patients with BPD diagnosis received an extensive neuropsychological evaluation assessing attentional, memory and executive functions indexes. For subtyping strategies, a cluster analysis of neuropsychological BPD distribution was performed. Central clinical dimensions of BPD were measured and analysed in relation with the obtained neuropsychological clusters., Results: Two clusters were found: Cluster 1 showed a significantly lower score on the working memory index, and Cluster 2 had significantly worse overall executive performance, response inhibition and planning abilities. Patients in the neurocognitive Cluster 2 showed significantly higher clinical deficits of attention as measured with subscales of the CAARS attention deficit hyperactivity disorder (ADHD) index (F = 2.549, p < 0.005, d = 11.49)., Conclusions: Two neuropsychological clusters of patients were found in the BPD sample: Cluster 1 patients showed greater impairment in working memory, while Cluster 2 patients had greater deficits of executive functioning, particularly for response inhibition and planning. In addition, BPD patients with greater executive deficits presented greater levels of ADHD clinical features. These findings might also facilitate earlier diagnosis of severe BPD patient profiles and to establish more personalized treatment based on neurocognitive stimulation., (© 2024 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.)

Objectives: To investigate the relation between cognitive and motor performance in individuals with mild traumatic brain injury (mTBI) and examine differences in both cognitive and motor performance between adults after mTBI and healthy controls., Design: Multi-center, cross-sectional study., Setting: Three institutional sites (Courage Kenny Research Center, Minneapolis, MN, Oregon Health & Science University, Portland, OR, and University of Utah, Salt Lake City, UT)., Participants: Data were collected from 110 participants (N=110), including those with mTBI and healthy controls, who completed cognitive and physical performance assessments., Interventions: Not applicable., Outcome Measures: Cognitive assessments involved the Automated Neuropsychological Assessment Metrics to evaluate domains of attention, memory, reaction time, processing speed, and executive function. Physical performance was evaluated through clinical performance assessments, such as the 1-min walk test, the modified Illinois Agility Test, the Functional Gait Assessment Tool, the High-Level Mobility Assessment Tool, a complex turning course, and a 4-Item Hybrid Assessment of Mobility for mTBI. Participants also completed additional trials of the 1-min walk test, modified Illinois Agility Test, and complex turning course with a simultaneous cognitive task., Results: Individuals with mTBI performed worse on cognitive assessments, as well as several of the physical performance assessments compared with healthy controls. Complex tasks were more strongly related to cognitive assessments compared with simple walking tasks., Conclusions: Combining complex motor tasks with cognitive demands may better demonstrate functional performance in individuals recovering from mTBI. By understanding the relation between cognitive and physical performance in individuals recovering from mTBI, clinicians may be able to improve clinical care and assist in return to activity decision-making., (Copyright © 2023 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: This study examined the moderating effect of traumatic brain injury (TBI) history on subjective and objective cognition across multiple cognitive domains., Setting, Participants, and Design: Participants included 242 Vietnam-era veterans with a history of no TBI (n = 86), mild TBI (n = 74), or moderate-to-severe TBI (n = 82) from the observational Department of Defense-Alzheimer's Disease Neuroimaging Initiative (DoD-ADNI) study., Main Measures: Objective cognition was the outcome and was measured using neuropsychological measures in the domains of memory, attention/executive functioning, and language. Subjective cognition was measured using the memory, divided attention, and language subscales from the Everyday Cognition (ECog) measure. TBI severity status was the moderating variable., Results: Veterans with a history of moderate-to-severe TBI had a stronger negative association between subjective and objective attention relative to participants without a TBI ( P = .002). Although this association did not differ between mild TBI and no TBI history groups ( P = .100), the association between subjective and objective attention for the mild TBI group was intermediate to the no TBI and moderate-to-severe TBI history groups. TBI status did not moderate associations between subjective and objective memory or language., Conclusion: Results highlight the importance of assessing subjective and objective cognition in older veterans and the relevance of attention in the context of TBI history. More work is needed to better understand the intersection of TBI and aging and how these factors may be used to guide individualized assessment and treatment approaches for older veterans., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc.)

Objective: Decision-making is responsible for the best and worst of human nature. The field of decision science has done much to elucidate the psychological process of decision-making, variables that affect decision-making, and outcomes of disadvantageous decision-making. However, understanding any psychological process requires creation of reliable measures. Few studies focus on the test-retest reliability of behavioral decision-making tasks despite their utility in repeated assessment batteries., Method: The present study examined the extent to which common behavioral decision-making tasks are reliable across time. Across two samples and two time points, participants completed multiple decision-making assessments., Results: Results revealed moderate at best evidence of test-retest reliability across a 10-week interval in any of the tasks assessed., Conclusions: These findings raise large questions for the field of behavioral decision-making and the utility for tasks to track changes in decision-making across time in clinical populations., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)

Objective: The Test of Practical Judgment (TOP-J) is a stand-alone judgment measure that is considered to tap into aspects of executive functioning (EF) and inform clinical predictions of daily functioning in older adults. Past validation research is variable and has some limitations. The present study sought to examine the reliability and construct, criterion, and incremental validities of scores on TOP-J 9-item version (TOP-J/9)., Method: Participants were 95 community-dwelling older adults aged 60 to 85. Participants completed TOP-J/9, measures of EF and global cognition, and three different modalities of instrumental activities of daily living (IADLs) (self-report, performance-based tasks conducted in the laboratory, and performance-based tasks completed at home over 3 weeks)., Results: TOP-J/9 scores showed adequate internal consistency (α = 0.73) after correcting for the low number of items. TOP-J/9 was correlated with global cognition and EF, although EF did not survive correction for lower-order processes. Finally, although TOP-J/9 scores were associated with home-based IADL tasks (but not with self-report and laboratory-based IADLs), providing some evidence of criterion validity, they did not incrementally contribute to home-based IADL performance beyond other cognitive measures. However, when two items pertaining to social/ethical judgment were removed, this modified version of TOP-J did relate to EF beyond lower-order processes and contributed uniquely to prediction of home-based IADLs beyond other measures., Conclusion: Results suggest that TOP-J/9 taps into global cognitive status (but not necessarily EF) and predicts "real-world" functioning (but not above and beyond other cognitive measures). TOP-J psychometrics may be improved by removing two social/ethical items., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Central nervous system tumors produce adverse outcomes in daily life, although low-grade gliomas are rare in adults. In neurological clinics, the state of impairment of executive functions goes unnoticed in the examinations and interviews carried out. For this reason, the objective of this study was to describe the executive function of a 59-year-old adult neurocancer patient. This study is novel in integrating and demonstrating biological effects and outcomes in performance evaluated by a neuropsychological instrument and psychological interviews. For this purpose, pre- and post-evaluations were carried out of neurological and neuropsychological functioning through neuroimaging techniques (iRM, spectroscopy, electroencephalography), hospital medical history, psychological interviews, and the Wisconsin Card Classification Test (WCST). There was evidence of deterioration in executive performance, as evidenced by the increase in perseverative scores, failure to maintain one's attitude, and an inability to learn in relation to clinical samples. This information coincides with the evolution of neuroimaging over time. Our case shows that the presence of the tumor is associated with alterations in executive functions that are not very evident in clinical interviews or are explicit in neuropsychological evaluations. In this study, we quantified the degree of impairment of executive functions in a patient with low-grade glioma in a middle-income country where research is scarce.

The term "ecological validity" (EV) has traditionally referred to test scores' ability to predict real-world functioning. However, a test's similarity to real-world tasks is sometimes mistaken for evidence of its ability to predict daily life, sometimes bypassing rigorous validation research. The goal of this systematic review was to examine the type and quality of evidence used to support claims of EV of novel face-valid tests of executive functions (EF). MEDLINE and PsychINFO databases were searched using the following terms: ecologic* AND neuropsychol* AND (executive function* OR executive dysfunction OR executive abilit*). Thirty-two articles that explicitly stated that their results demonstrated EV of a novel face-valid test of EF were identified. Results showed that only 60% of studies based their claims about EV on test scores' ability to predict functional outcomes, with the remaining 40% relying on other evidence (e.g., correlations with other measures, participant feedback, group differences). Among the studies that did base their conclusions on test scores' ability to predict outcomes ( n = 19), an overwhelming majority relied on behavioral rating scales, utilized small sample sizes and participant-to-variable ratios, and failed to control for covariates and multiple comparisons. Poor scientific rigor was particularly pronounced in studies of "naturalistic" tests. The present systematic review reveals significant conceptual, methodological, and statistical flaws among an overwhelming majority of studies that claim to have found support for the EV of a novel face-valid test of EF. We call upon authors, reviewers, and editors to safeguard the scientific rigor of research in this area. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: Bipolar disorder (BD) is associated with cognitive abnormalities that may persist during euthymia and are linked to poor occupational performance. The cognitive differences between phases of BD are not well known. Therefore, a cross-sectional study with a relatively large population was conducted to evaluate the differences among BD phases in a wide range of neurocognitive parameters., Methods: Neuropsychological profile of 169 patients with a diagnosis of BD in manic, depressive, mixed, and euthymic phases between the ages of 18 and 70 years were compared to 45 healthy individuals' between ages of 24 and 69 years. The working memory (digit-span backward test), face recognition, executive functions (verbal fluency and Stroop test), face recognition, and visual and verbal memory (immediate and delayed recall) were evaluated. For BD subgroup analyses, we used the Kruskal-Wallis (KW) test. Then, for the comparison of BD versus healthy individuals, we used the Mann-Whitney U (MWU) test., Results: Analyses based on non-parametric tests showed impairments in BD for all tests. There were no significant differences between phases., Conclusion: Cognitive performance in patients with BD appears to be mostly unrelated to the phase of the disorder, implying that cognitive dysfunction in BD is present even during remission.

Objectives: Neuropsychological test batteries, which accurately and comprehensively assess cognitive functions, are a crucial approach in the early detection of and interventions for cognitive impairments. However, these tests have yet to gain wide clinical application in China owing to their complexity and time-consuming nature. This study aimed to develop the Computerized Neurocognitive Battery for Chinese-Speaking participants (CNBC), an autorun and autoscoring cognitive assessment tool to provide efficient and accurate cognitive evaluations for Chinese-Speaking individuals., Methods: The CNBC was developed through collaboration between clinical neurologists and software engineers. Qualified volunteers were recruited to complete CNBC and traditional neurocognitive batteries. The reliability and validity of the CNBC were evaluated by analyzing the correlations between the measurements obtained from the computerized and the paper-based assessment and those between software-based scoring and manual scoring., Results: The CNBC included 4 subtests and an autorun version. Eighty-six volunteers aged 51-82 years with 7-22 years of education were included. Significant correlations (0.256-0.666) were observed between paired measures associated with attention, executive function, and episodic memory from the CNBC and the traditional paper-based neurocognitive batteries. This suggests a strong construct validity of the CNBC in assessing these cognitive domains. Furthermore, the correlation coefficients between manual scoring and system scoring ranged from 0.904-1.0, indicating excellent inter-rater reliability for the CNBC., Interpretation: A novel CNBC equipped with automated testing and scoring features was developed in this study. The preliminary results confirm its strong reliability and validity, indicating its promising potential for clinical utilization., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: To study the features of executive functions in patients with alcohol use disorders and comorbid exogenous organic brain damage of non-alcoholic nature., Material and Methods: Sixty-five men, aged 24 to 55 years, with alcohol use disorders were examined. Thirty mentally healthy men were examined as a control group. To assess executive functioning, standard neuropsychological tests were used: the Go/No-Go task, the Corsi test and the Stroop Color Test., Results: Patients with alcohol use disorders and comorbid exogenous organic brain damage made significantly more errors in the Go/No-Go task (skipping the Go signal: p =0.004) and performed the Stroop Color test longer (task completion time: p =0.003). According to multivariate regression analysis, the presence of exogenous organic brain damage predicted the worst indicators of psychomotor reaction ( p =0.009) and cognitive flexibility ( p =0.021)., Conclusion: Comorbid exogenous organic brain damage in patients with alcohol use disorders leads to a significant deterioration of executive functions, including psychomotor reaction and cognitive flexibility, compared with patients suffering only from alcohol use disorders.

Objective: To establish specific features of executive functions (EF) impairment and attention in vascular cognitive impairment (VCI) and Alzheimer's disease (AD)., Material and Methods: Eighty people (over the age of 50) diagnosed with cerebrovascular disease (CVD) and AD, as well as 29 healthy volunteers (control group), were examined. The following neuropsychological methods were used to study the quantitative and qualitative characteristics of cognitive impairments: Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), EXIT-25, Frontal Assessment Battery (FAB), Clock Drawing Test, «12 Words» test, verbal associations (literal and categorical) method, Trail Making Test A and B, Symbol-Digit Modalities Test (SDMT), Stroop Test, and Benton Visual Retention Test. Mandatory inclusion criteria in the study included having a completed magnetic resonance imaging (MRI) of the brain (in T1, T2, FLAIR, DWI, SWI modes) within 1 year before enrollment in one of the groups., Results: No significant differences in age, sex, and level of education were found between the groups. Groups AD and CVD were also comparable in the severity of cognitive impairment overall. Attention and working memory deficits were observed in both CVD and AD, with slightly more pronounced deficits in the AD group. Qualitative analysis of individual components of working memory revealed that both CVD and AD groups had comparable cognitive control impairment compared to the control group, while AD was characterized by a more significant decrease in intellectual flexibility compared to CVD. Sustained attention was equally impaired among patients in the CVD and AD groups, with a significant difference from the control group ( p <0.05). In terms of memory, it was found that auditory-verbal memory and semantic memory were significantly more affected in AD, while visual memory was impaired in both conditions., Conclusion: Attention and EF impairments are not specific to the «subcortical» type of cognitive disorders. Already in the early stages, AD is characterized by a significant impairment of attention and EF, and such a component of EF as intellectual flexibility suffers at the onset of AD to a greater extent than in VCI. Memory impairments are not specific to AD; already at the onset of VCI, visual memory impairment comparable to AD is noted. The obtained data can be used for early neuropsychological diagnosis and differential diagnosis of dementing cerebral diseases.

Introduction: Neighborhood socioeconomic status (NSES) has been linked with overall health, and this study will evaluate whether NSES is cross-sectionally associated with cognition in non-Hispanic whites (NHWs) and Mexican Americans (MAs) from the Health and Aging Brain: Health Disparities Study (HABS-HD)., Methods: The HABS-HD is a longitudinal study conducted at the University of North Texas Health Science Center. The final sample analyzed (n = 1,312) were 50 years or older, with unimpaired cognition, and underwent an interview, neuropsychological examination, imaging, and blood draw. NSES was measured using the national area deprivation index (ADI) percentile ranking, which considered socioeconomic variables. Executive function and processing speed were assessed by the trail making tests (A and B) and the digit-symbol substitution test, respectively. Linear regression was used to assess the association of ADI and cognitive measures., Results: MAs were younger, more likely to be female, less educated, had higher ADI scores, performed worse on trails B (all p &lt; 0.05), and had lower prevalence of APOE4 + when compared to NHWs (p &lt; 0.0001). A higher percentage of MAs lived in the most deprived neighborhoods than NHWs. For NHWs, ADI did not predict trails B or DSS scores, after adjusting for demographic variables and APOE4. For MAs, ADI predicted trails A, trails B, and DSS after adjusting for demographic covariates and APOE4 status., Conclusion: Our study revealed that living in an area of higher deprivation was associated with lower cognitive function in MAs but not in NHWs, which is important to consider in future interventions to slow cognitive decline., (© 2024 S. Karger AG, Basel.)

Background: Executive dysfunction in mild cognitive impairment (MCI) has been associated with gray matter atrophy. Prior studies have yielded limited insight into associations between gray matter volume and executive function in early and late amnestic MCI (aMCI)., Objective: To examine the relative importance of predictors of executive function at 24 months and relationships between baseline regional gray matter volume and executive function performance at 24-month follow-up in non-demented older adults., Methods: 147 participants from the Alzheimer's Disease Neuroimaging Initiative (mean age = 70.6 years) completed brain magnetic resonance imaging and neuropsychological testing and were classified as cognitively normal (n = 49), early aMCI (n = 60), or late aMCI (n = 38). Analyses explored the importance of demographic, APOEɛ4, biomarker (p-tau/Aβ42, t-tau/Aβ42), and gray matter regions-of-interest (ROI) variables to 24-month executive function, whether ROIs predicted executive function, and whether relationships varied by baseline diagnostic status., Results: Across all participants, baseline anterior cingulate cortex and superior parietal lobule volumes were the strongest predictors of 24-month executive function performance. In early aMCI, anterior cingulate cortex volume was the strongest predictor and demonstrated a significant interaction such that lower volume related to worse 24-month executive function in early aMCI. Educational attainment and inferior frontal gyrus volume were the strongest predictors of 24-month executive function performance for cognitively normal and late aMCI groups, respectively., Conclusions: Baseline frontoparietal gray matter regions were significant predictors of executive function performance in the context of aMCI and may identify those at risk of Alzheimer's disease. Anterior cingulate cortex volume may predict executive function performance in early aMCI.

Introduction: Prediction of the dementia progression is important for patient management. We aimed to investigate the cognitive trajectories of Alzheimer's disease dementia (ADD) and dementia with Lewy bodies (DLB) according to the initial structural change measured by comprehensive visual rating scales (CVRS)., Methods: We retrospectively included the patients who initially visited the Dementia Clinic of Chonnam National University Hospital between 2010 and 2012. All patients underwent dementia workup including neuropsychological battery (Seoul Neuropsychological Screening Battery, SNSB). We recruited the participant who underwent SNSB annually for 3 years successively. A total of 136 patients of ADD and 63 patients of DLB were included for analysis. We analyzed the decline pattern of the cognitive profile according to the initial brain structural changes., Results: The general cognitive trajectories between ADD and DLB patients were not different. However, DLB patients showed more rapid decline of cognitive function in language and related function, visual memory function, and frontal executive function. The scores were lower in participants with DLB with the lesser atrophy group in attention, visuospatial function, and frontal executive function. In analysis of the cognitive trajectories, the visual memory domain declined rapidly in the DLB with lesser atrophy group compared with the ADD with lesser atrophy group., Conclusion: We founded that the differences in the visual cognitive profile in ADD and DLB patients in serial follow-up of neuropsychological tests. It is prominent in the mild structural change group of ADD and DLB., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Background: Insulin-like growth factor-I (IGF-I) regulates myelin, but little is known whether IGF-I associates with white matter functions in subjective and objective mild cognitive impairment (SCI/MCI) or Alzheimer's disease (AD)., Objective: To explore whether serum IGF-I is associated with magnetic resonance imaging - estimated brain white matter volumes or cognitive functions., Methods: In a prospective study of SCI/MCI (n = 106) and AD (n = 59), we evaluated the volumes of the total white matter, corpus callosum (CC), and white matter hyperintensities (WMHs) as well as Mini-Mental State Examination (MMSE), Trail Making Test A and B (TMT-A/B), and Stroop tests I-III at baseline, and after 2 years., Results: IGF-I was comparable in SCI/MCI and AD (113 versus 118 ng/mL, p = 0.44). In SCI/MCI patients, the correlations between higher baseline IGF-I and greater baseline and 2-year volumes of the total white matter and total CC lost statistical significance after adjustment for intracranial volume and other covariates. However, after adjustment for covariates, higher baseline IGF-I correlated with better baseline scores of MMSE and Stroop test II in SCI/MCI and with better baseline results of TMT-B and Stroop test I in AD. IGF-I did not correlate with WMH volumes or changes in any of the variables., Conclusions: Both in SCI/MCI and AD, higher IGF-I was associated with better attention/executive functions at baseline after adjustment for covariates. Furthermore, the baseline associations between IGF-I and neuropsychological test results in AD may argue against significant IGF-I resistance in the AD brain.

Background: This study extends long-term predictive research on ADHD by including both neuropsychological and symptom measures at baseline in adolescence as predictors of diagnostic persistence 25 years later., Methods: Nineteen males with ADHD and 26 healthy controls (HC; M/F = 13/13), were assessed in adolescence and 25 years later. Measurements at baseline included a comprehensive test battery measuring eight neuropsychological domains, an IQ estimate, the Child Behavior Checklist (CBCL), and the Global Assessment Scale of Symptoms. Differences between ADHD Retainers, Remitters, and HC were calculated with ANOVAs, and potential predictions of differences in the ADHD group by linear regression analyses., Results: Eleven (58%) participants retained their ADHD diagnoses at follow-up. Motor Coordination and Visual perception at baseline predicted diagnosis at follow-up. CBCL Attention problems at baseline in the ADHD group predicted variance in diagnostic status., Conclusion: Lower-order neuropsychological functions related to motor function and perception are important long-time predictors of persistence of ADHD.

Objectives: Age-related differences in cognition are typically assessed by comparing groups of older to younger participants, but little is known about the continuous trajectory of cognitive changes across age, or when a shift to older adulthood occurs. We examined the pattern of mean age differences and variability on episodic memory and executive function measures over the adult life span, in a more fine-grained way than past group or life-span comparisons., Method: We used a sample of over 40,000 people aged 18-90 who completed psychometrically validated online tests measuring episodic memory and executive functions (the Cogniciti Brain Health Assessment)., Results: Cognitive performance declined gradually over adulthood, and rapidly later in life on spatial working memory, processing speed, facilitation (but not interference), associative recognition, and set shifting. Both polynomial and segmented regression fit the data well, indicating a nonlinear pattern. Segmented regression revealed a shift from gradual to rapid decline that occurred in the early 60s. Variability between people (interindividual variability or diversity) and variability within a person across tasks (intraindividual variability or dispersion) also increased gradually until the 60s, and rapidly after. Confirmatory factor analysis revealed a single general factor (of variance shared between tasks) offered a good fit for performance across tasks., Discussion: Life-span cognitive performance shows a nonlinear pattern, with gradual decline over early and mid-adulthood, followed by a transition in the 60s to notably accelerated, but more variable, decline. Some people show less decline than others, and some cognitive abilities show less within-person decline than others., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America.)