Archives of Clinical Neuropsychology

Strong, Roger W; Grashow, Rachel; Roberts, Andrea L; Passell, Eliza; Scheuer, Luke; Terry, Douglas P; Cohan, Sarah; Pascual-Leone, Alvaro; Weisskopf, Marc G; Zafonte, Ross D; Germine, Laura T

2023 Archives of Clinical Neuropsychology

doi: 10.1093/arclin/acad008pmid: 36861317

ObjectiveSustaining concussions has been linked to health issues later in life, yet evidence for associations between contact sports exposure and long-term cognitive performance is mixed. This cross-sectional study of former professional American-style football players tested the association of several measures of football exposure with later life cognitive performance, while also comparing the cognitive performance of former players to nonplayers.MethodsIn total, 353 former professional football players (Mage = 54.3) completed both (1) an online cognitive test battery measuring objective cognitive performance and (2) a survey querying demographic information, current health conditions, and measures of past football exposure, including recollected concussion symptoms playing professional football, diagnosed concussions, years of professional play, and age of first football exposure. Testing occurred an average of 29 years after former players’ final season of professional play. In addition, a comparison sample of 5,086 male participants (nonplayers) completed one or more cognitive tests.ResultsFormer players’ cognitive performance was associated with retrospectively reported football concussion symptoms (rp = −0.19, 95% CI −0.09 to −0.29; p < 0.001), but not with diagnosed concussions, years of professional play, or age of first football exposure. This association could be due to differences in pre-concussion cognitive functioning, however, which could not be estimated based on available data.ConclusionsFuture investigations of the long-term outcomes of contact sports exposure should include measures of sports-related concussion symptoms, which were more sensitive to objective cognitive performance than other football exposure measures, including self-reported diagnosed concussions.

Lin, Hung-Yu; Chiu, En-Chi; Hsieh, Hsieh-Chun; Wang, Pei-Jung

2023 Archives of Clinical Neuropsychology

doi: 10.1093/arclin/acad019pmid: 36796801

ObjectiveDespite the relatively high prevalence of attention deficit hyperactivity disorder (ADHD), the impairment of ADHD in women is underestimated due to the different ways the phenomenon manifests compared to traditional male symptoms. In order to close the gender gap in diagnosis and treatment, this study aims to explore the impact of gender on auditory and visual attention in children with and without ADHD.MethodA total of 220 children with and without ADHD participated in this study. Their auditory and visual attention performances were analyzed by comparative computerized auditory and visual subtests.ResultsAuditory and visual attention performance in children with and without ADHD did affect by gender, including typically developing (TD) boys are better than TD girls at distinguishing visual targets from non-target stimuli. When performing attention tasks, TD girls generally maintained a cautious response, which was different from TD boys, who generally adopted positive response methods. ADHD girls suffered from more serious auditory inattention problems than ADHD boys; however, ADHD boys suffered from more auditory and visual impulsive problems than ADHD girls. The internal attention problems of female ADHD children were broader than that of their male ADHD peers and were also more severe, especially in problems of auditory omission and auditory response acuity.ConclusionsADHD children had a significant gap in auditory and visual attention performance compared to TD children. The research results support the impact of gender on the performance of auditory and visual attention in children with and without ADHD.

Voruz, Philippe; Haegelen, Claire; Assal, Frédéric; Drapier, Sophie; Drapier, Dominique; Sauleau, Paul; Vérin, Marc; Péron, Julie A

2023 Archives of Clinical Neuropsychology

doi: 10.1093/arclin/acad013pmid: 36796803

IntroductionRisk factors (e.g., motor symptom asymmetry) for short- and long-term cognitive and neuropsychiatric symptoms following deep brain stimulation (DBS) of the subthalamic nucleus (STN) in patients with Parkinson’s disease have yet to be fully identified. The objectives of the present study were to determine whether motor symptom asymmetry in Parkinson’s disease is one such risk factor and to identify predictors of subnormal cognitive decline.MethodsA total of 26 patients receiving STN-DBS (13 with left-sided motor symptoms and 13 with right-sided ones) underwent follow-up neuropsychological, depression and apathy assessments over a 5-year period. Nonparametric intergroup comparisons were performed on raw scores, as well as Cox regression analyses on standardized Mattis Dementia Rating Scale scores.ResultsCompared with patients who had predominantly left-sided symptoms, right-sided patients scored higher on both apathy (at 3 months and 36 months) and depressive symptoms (at 6 months and 12 months) and scored lower on global cognitive efficiency (at 36 months and 60 months). Survival analyses revealed that only right-sided patients had subnormal standardized dementia scores, which were negatively associated with the number of perseverations in the Wisconsin Card Scoring Test.ConclusionRight-sided motor symptoms are a risk factor for more severe short- and long-term cognitive and neuropsychiatric symptoms following STN-DBS, confirming literature findings on left hemispheric vulnerability.

Petrovic, Sanja Andric; Kaurin, Nina; Knezevic, Jelena; Maric, Nadja P

2023 Archives of Clinical Neuropsychology

doi: 10.1093/arclin/acad007pmid: 36715310

ObjectiveDespite an increased interest in research of theory of mind (ToM) in recent years — both related to psychopathology (depression and anxiety spectrum disorders) and within the typical adults, the existing literature is scarce and presents some conflicting results. Present study aimed to explore sex differences in ToM, alongside its associations with current anxiety and depression symptoms, in a large sample of typical adults collected online.MethodParticipants completed the 15-minutes survey obtaining socio-demographic data, current self-reported depression and anxiety symptom severity, and ToM ability (the Reading the Mind in the Eyes Task). The sample comprised 605 participants —mostly younger adults, women, and high school graduate/student population.ResultsThe majority of participants reported minimal/mild depressive and anxiety symptoms that were significantly more severe in women. Women also displayed significantly better overall ToM ability than men. Significant negative correlation between the severity of current depressive and anxiety symptoms and ToM ability was also observed, but only in individuals expressing the symptoms requiring clinical attention (such association was absent in those exhibiting minimal/mild symptoms).ConclusionsPresent research adds to the existing knowledge on the association between ToM ability, anxiety, and depressive symptoms in typical adults as well as on the sex-differences in this important social cognitive domain. Exploring the factors representing indicators of vulnerability for depression–anxiety spectrum disorders is important for their timely detection and treatment.

Moran, Ryan N; Guin, J Russell; Gardner, James; Simer, Josh

2023 Archives of Clinical Neuropsychology

doi: 10.1093/arclin/acad015pmid: 36759181

ObjectiveNeurocognitive testing and oculomotor assessment have been an integral component to provide objective measures for sport-related concussion (SRC) detection and management. Hormonal contraceptive (HC) use is common among collegiate female athletes and may modify baseline SRC performance. The purpose was to examine the effects of HC use on baseline computerized neurocognitive testing (CNT) and oculomotor testing in college-aged individuals.MethodA total of 63 participants (22 HC using females, 22 non-HC using females, 19 males) completed a baseline SRC battery consisting of CNT, near point of convergence (NPC), and the King-Devick (KD) test. CNT measures were composite scores of verbal and visual memory, visual motor processing speed and reaction time, impulse control, and cognitive efficiency index (CEI). NPC was measured as the average convergence distance across three trials. KD time was recorded as total time for each of the two trials and best trial marked as baseline.ResultsThere were no group differences between HC, non-HC, and male control groups on all baseline CNT composite scores (p = .13–.98), impulse control (p = .47), and CEI (p = .49). NPC distance was similar between groups (p = .41), as well as KD time by trial (Trial 1 p = .65; 2 p = .48) and best time (p = .49).ConclusionsHC use does not appear to influence baseline SRC measures of neurocognition and oculomotor assessment. Clinicians should continue to consider the effects of modifying factors at baseline and post-concussion. Additional research is needed to better understand sex hormone levels and SRC performance measures.

Sakamoto, McKenna S; Hanson, Karen L; Chanfreau-Coffinier, Catherine; Lai, Mark H C; Román, Cristina A F; Clark, Alexandra L; Marquine, María J; Delano-Wood, Lisa; Merritt, Victoria C; ,

2023 Archives of Clinical Neuropsychology

doi: 10.1093/arclin/acad005pmid: 36702773

ObjectiveThe purpose of this study was to explore racial/ethnic differences in neurobehavioral symptom reporting and symptom validity testing among military veterans with a history of traumatic brain injury (TBI).MethodParticipants of this observational cross-sectional study (N = 9,646) were post-deployed Iraq-/Afghanistan-era veterans enrolled in the VA’s Million Veteran Program with a clinician-confirmed history of TBI on the Comprehensive TBI Evaluation (CTBIE). Racial/ethnic groups included White, Black, Hispanic, Asian, Multiracial, Another Race, American Indian or Alaska Native, and Native Hawaiian or Other Pacific Islander. Dependent variables included neurobehavioral symptom domains and symptom validity assessed via the Neurobehavioral Symptom Inventory (NSI) and Validity-10, respectively.ResultsChi-square analyses showed significant racial/ethnic group differences for vestibular, somatic/sensory, and affective symptoms as well as for all Validity-10 cutoff scores examined (≥33, ≥27, ≥26, >22, ≥22, ≥13, and ≥7). Follow-up analyses compared all racial/ethnic groups to one another, adjusting for sociodemographic- and injury-related characteristics. These analyses revealed that the affective symptom domain and the Validity-10 cutoff of ≥13 revealed the greatest number of racial/ethnic differences.ConclusionsResults showed significant racial/ethnic group differences on neurobehavioral symptom domains and symptom validity testing among veterans who completed the CTBIE. An enhanced understanding of how symptoms vary by race/ethnicity is vital so that clinical care can be appropriately tailored to the unique needs of all veterans. Results highlight the importance of establishing measurement invariance of the NSI across race/ethnicity and underscore the need for ongoing research to determine the most appropriate Validity-10 cutoff score(s) to use across racially/ethnically diverse veterans.

DeGutis, Joseph; Agnoli, Sam; Bernstein, John P K; Jagger-Rickels, Audreyana; Evans, Travis C; Fortier, Catherine B; McGlinchey, Regina E; Milberg, William P; Esterman, Michael

2023 Archives of Clinical Neuropsychology

doi: 10.1093/arclin/acad012pmid: 36781401

ObjectivePost-9/11 Veterans endorse greater self-reported functional disability than 80% of the adult population. Previous studies of trauma-exposed populations have shown that increased post-traumatic stress disorder (PTSD) and depressive symptoms are consistently associated with greater disability. Additionally, poorer cognitive performance in the domain of executive functions, particularly inhibitory control, has been associated with disability, though it is unclear if this effect is independent of and/or interacts with PTSD and depression.MethodThree overlapping samples of n = 582, 297, and 183 combat-deployed post-9/11 Veterans completed comprehensive assessments of executive functions, PTSD and depressive symptoms, and self-reported World Health Organization Disability Assessment Schedule-II (WHODAS II).ResultsPoorer performance on measures of inhibitory control (Delis-Kaplan Executive Functioning System Color-Word Interference-CWI Test and gradual-onset Continuous Performance Test-gradCPT), but not other executive functions, were significantly associated with greater disability on the WHODAS II (ρ’s = −.13 and −.13, p = .002 and .026, respectively). CWI inhibitory control measures accounted for unique variance in disability after controlling for PTSD and depressive symptoms (R2 change = 0.02, p < .001). Further, CWI significantly moderated the effect of depressive symptoms on disability, such that better inhibitory control weakened the relationship between depression and disability.ConclusionsInhibitory control deficits are uniquely associated with increased disability in combat-deployed post-9/11 Veterans, and better inhibitory control abilities may serve as a protective factor for depressive symptoms leading to increased disability.Key PointsQuestionIn a trauma-exposed Veteran population, does inhibitory control predict functional disability above and beyond PTSD and depressive symptoms?FindingsAfter controlling for PTSD and depressive symptoms, inhibitory control explained unique variance in self-reported disability. Inhibitory control also showed a moderation effect on depression where greater inhibitory control on the color-word interference test reduced the association between depression and disability symptoms.ImportanceInhibitory control represents an important mechanism in understanding and improving daily life functioning in trauma-exposed Veteran populations.Next StepsFuture research should further characterize the different aspects of inhibitory control deficits in trauma-exposed populations and focus on enhancing inhibitory control paired with more standard psychological distress treatments.

Zuno Reyes, Angelica; Trejo, Salvador; Matute, Esmeralda

2023 Archives of Clinical Neuropsychology

doi: 10.1093/arclin/acad009pmid: 36747327

ObjectiveSince evidence of adults’ cognition decline is based on standardized testing, we developed regression-based continuous norms by linear regression (LR) and nonlinear quantile regression (NQR) with years of schooling (YoS), age, and sex as covariates on the Mexican adaptation of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD-MX) and complementary tasks.Methods392 healthy, Spanish-speaking Mexican adults (50.25% women) aged 18–59 completed the 15 CERAD-MX cognitive tasks and complementary tasks. We used raw scores and examined YoS-related effects considering sex and age as covariates. For the NQR, we used calibrated scores for sex and age. While LR represents one line across the performance, NQR differentiated several nonlinear performance bands by quantiles.ResultsLR showed positive relationships between YoS and cognitive performance with a funnel variance pattern. Therefore, this relationship is better represented with NQR than LR. A small, but significant, negative effect of age was found for this age range (18–59 years). The band with fewer years of schooling (1–6) showed greater variability in the cognitive measures than those with more years of schooling (16–22).ConclusionThis study shows that NQR is useful for accurately positioning participants’ performance relative to their peers. NQR accounts more than LR for the inconsistent variability of cognitive performance as a function of YoS by identifying the variability according to YoS (low, medium, high). Thus, NQR represents an appropriate way to construct norms for the cognitive performance of adults.

Nielsen, T Rune; Staios, Mathew

2023 Archives of Clinical Neuropsychology

doi: 10.1093/arclin/acad006pmid: 36702784

ObjectiveTo examine the clinical utility of Wechsler Adult Intelligence Scale-IV (WAIS-IV) Matrix Reasoning in limited educated recently arrived immigrants in Denmark.MethodParticipants were 64 limited educated (0–9 years’ education) independently living adult immigrants primarily from Middle Eastern and Sub-Saharan African countries who completed WAIS-IV Matrix Reasoning as well as demographic, and medical questionnaires.ResultsThirty-eight participants (59%) scored more than two standard deviations below the Scandinavian mean (scaled score < 4). Performances were significantly associated with years of education but not with occupational status, years of residence in Denmark, or Danish language skills. The most common error types were repetition errors (15.84%) and incomplete correlate errors (10.47%), with a strong trend for a higher proportion of repetition errors in participants with <5 years of education.ConclusionsThe findings indicate that WAIS-IV Matrix Reasoning underestimates cognitive functioning in limited educated recently arrived immigrants, thus calling its clinical utility into question.

Sutin, Angelina R; Stephan, Yannick; Luchetti, Martina; Aschwanden, Damaris; Sesker, Amanda A; Zhu, Xianghe; Terracciano, Antonio

2023 Archives of Clinical Neuropsychology

doi: 10.1093/arclin/acad014pmid: 36744681

ObjectiveA sense of purpose in life is associated with healthier cognitive outcomes, including lower risk of Alzheimer’s Disease (ad). The present research examines whether purpose is also associated with beliefs and knowledge of ad.MethodA random subsample (N = 1,187) of community-dwelling participants from the Health and Retirement Study completed a module on self-reported beliefs and knowledge of ad.ResultsPurpose in life was associated with lower perceived threat of ad and greater belief that modifiable factors (e.g., physical activity) decrease risk. Associations were not moderated by experience with ad or depressive symptoms. Purpose was unrelated to beliefs that genetics or stress increase risk or knowledge of ad.ConclusionsIndividuals with a sense of purpose are less concerned about risk of developing ad and believe modifiable factors reduce risk. These beliefs may support engagement in behaviors that reduce risk and be one psychological pathway through which purpose protects against ad.