Archives of Clinical Neuropsychology

Alfano, Dennis P; Grummisch, Julia A; Gordon, Jennifer L; Hadjistavropoulos, Thomas

doi: 10.1093/arclin/acac026pmid: 35535668

ObjectiveA neuropsychological approach to the detection and classification of mild cognitive impairment (MCI) using “gold standard” clinical ratings (CRs) was examined in a sample of independently functioning community dwelling seniors. The relationship between CRs and life satisfaction, concurrent validity of cognitive screening measures, and agreement between CRs and existing criteria for MCI were also determined.MethodOne hundred and forty-two participants, aged 75 years and older, were administered a comprehensive battery of neuropsychological tests, along with self-report measures of psychological and psychosocial functioning, and functional independence. CRs were based on demographically corrected neuropsychological variables.ResultsThe prevalence of MCI identified using CRs in this sample was 26.1%. Single and multiple domain subtypes of MCI were readily identified with subtypes reflecting Amnestic and Executive Function impairment predominating. Executive Function was a significant predictor of Life Satisfaction. The MoCA and MMSE both showed weak performance in detecting MCI based on CRs. There was substantial agreement between CRs and the classification criteria for MCI defined by Petersen/Winblad and Jak/Bondi. A global deficit score had near perfect performance as a proxy for CRs in detecting MCI in this sample.ConclusionsThe results provide strong support for the utility of neuropsychological CRs as a “gold standard” operational definition in the detection and classification of MCI in older adults.

Miller, Jennifer R; Altaras, Caroline; Zemon, Vance; Barr, William B; Weinberger, Andrea H; Foley, Frederick W

doi: 10.1093/arclin/acac012pmid: 35284930

BackgroundMultiple sclerosis (MS) affects over 2.5 million individuals worldwide, yet much of the disease course is unknown. Hemispheric vulnerability in MS may elucidate part of this process but has not yet been studied. The current study assessed neuropsychological functioning as it relates to hemispheric vulnerability in MS.MethodsVerbal IQ, as measured by verbal comprehension index (VCI), nonverbal IQ, as measured by perceptual reasoning index (PRI) and memory acquisition were compared in right-handed (dextral) and non-right-handed (non-dextral) persons with MS (PwMS).ResultsLinear mixed-effects modeling indicated a significant main effect of handedness, F(1, 195.35) = 3.95, p = .048, for a composite measure of VCI, PRI, and memory acquisition, with better performance for dextral PwMS. In examining differences for specific neuropsychological measures, the largest effect size between dextral and non-dextral participants was seen in PRI (d = 0.643), F(1,341) = 12.163, p = .001. No significant interaction effect between handedness and IQ was found, F(3, 525.60) = 0.75, p = .523.ConclusionsDextral PwMS perform better than non-dextral PwMS when assessing neuropsychological performance for memory and IQ combined. Results are suggestive of increased vulnerability in the left brain to the pathological process of MS.

García, Maitane; Rouco-Axpe, Idoia; Amayra, Imanol; Rodríguez-Antigüedad, Alfredo; Catalli, Claudio; Cabrera-Zubizarreta, Alberto; Rodríguez, Alicia Aurora; Pérez, Manuel

doi: 10.1093/arclin/acac024pmid: 35484833

Hereditary ataxias are a heterogeneous group of disorders characterized by degeneration of the cerebellum and its connections. It is known that patients with ataxia can manifest a broad spectrum of motor symptoms; however, current research has emphasized the relevance of cognitive disturbances. The aim of this study is to analyze the presence of cognitive impairment in a heterogeneous cohort of patients with hereditary ataxia (HA). A group of 38 patients with HA of different etiologies and a matched group of 38 healthy controls were recruited and evaluated through a comprehensive battery of neuropsychological tests. The findings show a worse performance in ataxic patients on planning, visuospatial skills, naming, and Theory of Mind tasks, regardless their physical and psychological symptomatology. The influence of clinical status as well as functional ability-related variables on their performance were analyzed, showing that the level of disability and motor disturbances have a significant effect on verbal memory, verbal fluency, and working memory. These findings suggest that patients with HA can manifest cognitive and neuropsychiatric symptoms as part of their clinical features, which demands its inclusion for the diagnosis and management of the disease.

Madiouni, Clarisse; Broc, Guillaume; Cindy, Lebrun; Bayard, Sophie

doi: 10.1093/arclin/acac006pmid: 35175334

ObjectiveAdult attention-deficit/hyperactivity disorder (ADHD) is characterized by a dysexecutive syndrome reflected in cognitive, emotional, and behavioral areas. Independently of a formal diagnosis of ADHD, higher ADHD symptoms are associated with higher levels of insomnia and sleepiness symptoms in adult population-based samples. Insomnia and sleepiness are sleep disorders that are both associated with deficits in several aspects of executive functions which in turn are likely to mimic a range of ADHD symptoms. Our objective was to explore the interrelationships between ADHD, insomnia, and sleepiness symptoms and executive functioning in community-dwelling adults.MethodA total of 442 participants (18–89 years, 56% females) underwent a semistructured clinical interview and completed questionnaires for insomnia, sleepiness, and everyday behaviors in which executive functions are implicated. Mediation Models were applied.ResultsInsomnia and sleepiness symptoms did not play a mediating role between ADHD symptoms and executive functioning. Conversely, our results highlighted a mediating effect of daytime insomnia consequences and sleepiness on ADHD symptoms via behavioral regulation executive symptoms (respectively, β = −0.32, p < .001, 95% CI [−0.46, −0.20]; β = 0.09, p < .05, 95% CI [0.02, 0.16]) and metacognitive executive symptoms (respectively, β = −0.30, p < .001, 95% CI [−0.44, −0.18]; β = 0.12, p < .01, 95% CI [0.04, 0.22]).ConclusionsDaytime insomnia consequences and sleepiness symptoms could lead to ADHD-like symptoms through their associated executive symptoms expressed in daily life. When faced with symptoms suggestive of ADHD in adults, insomnia and sleepiness should be systematically screened with standardized instruments.

Maddaluno, Ottavia; Aiello, Edoardo Nicolò; Roncoroni, Camilla; Prunas, Antonio; Bolognini, Nadia

doi: 10.1093/arclin/acab100pmid: 35107132

ObjectiveSocial cognition and executive deficits are frequent in neurological and neuropsychiatric disorders. Yet, there is a paucity of standardized domain-specific psychometric tools for the assessment of complex decision-making, social cognition (i.e., Theory of Mind), and empathy. To this aim, this study intended at providing normative data in an Italian population sample for the Iowa Gambling Task, the Reading the Mind in the Eyes Test, and the Interpersonal Reactivity Index.MethodThe Iowa Gambling Task, the Reading the Mind in the Eyes Test, and the Interpersonal Reactivity Index were administered to 462 healthy Italian participants aged between 18 and 91 years, considering demographic factors. A confirmatory factor analysis was run to test for unidimensionality. Normative values were derived by means of the Equivalent Scores method.ResultsEducation predicted all tests’ scores, age influenced scores at the Interpersonal Reactivity Index and the Reading the Mind in the Eyes Test, gender predicted empathic abilities only. The three tests did not underpin a unidimensional structure.ConclusionsThe present work provides demographically adjusted Italian normative data for a set of tests assessing real-life decision-making, emotion recognition and empathy, filling a gap within II-level, domain-specific, neuropsychological testing. For the first time, the Interpersonal Reactivity Index is proposed as an adjuvant neuropsychological tool, while the standardization of the Iowa Gambling Task offers a new scoring system for advantageous/disadvantageous choices.

García-Herranz, Sara; Díaz-Mardomingo, M Carmen; Suárez-Falcón, Juan Carlos; Rodríguez-Fernández, Raquel; Peraita, Herminia; Venero, César

doi: 10.1093/arclin/acab094pmid: 34984432

ObjectiveThis study aimed to generate updated normative data for commonly used tests in neuropsychological assessment applied to older monolingual Spanish-speaking adults: Verbal fluency tests, the Trail Making Test (TMT), and the Rey–Osterrieth complex figure test (ROCF).MethodTo obtain normative data, 382 cognitively healthy 60- to 90-year-old Spanish monolingual participants from the Autonomous Community of Madrid (Spain) with 0–22 years education were assessed using an overlapping interval strategy that involved cell and midpoint techniques, and that assessed the influence of age, education, and sex.ResultsAge and education were associated with the scores in the verbal fluency tests, TMT, and ROCF, whereas sex only significantly affected the TMT results. Age-adjusted scaled scores (SSA) based on percentile ranks were also converted into age–education scaled scores (SSAE) using a linear regression model. In addition, tables with the relevant adjustments for sex are provided for TMT-A and TMT-B.ConclusionsThus, this study provides updated, uniform normative data for widely used neuropsychological tests on older Spanish adults. The normative procedure followed helps to make consistent comparisons when using these neuropsychological tests, which will improve the interpretation of the data obtained when these tools are employed, reducing the risk of misdiagnosing cognitive impairment in older adults.

Hammers, Dustin B; Spencer, Robert J; Apostolova, Liana G; ,

doi: 10.1093/arclin/acac002pmid: 35175287

BackgroundThe learning ratio (LR) is a novel learning slope score that was developed to identify learning more accurately by considering the proportion of information learned after the first trial of a multi-trial learning task. Specifically, LR is the number of items learned after trial one divided by the number of items yet to be learned. Although research on LR has been promising, convergent validation, clinical characterization, and demographic norming of this LR metric are warranted to understand its clinical utility when derived from the Rey Auditory Verbal Learning Test (RAVLT).MethodData from 674 robustly cognitively intact older participants from the Alzheimer’s Disease Neuroimaging Initiative (aged 54– 89) were used to calculate the LR metric. Comparison of LR’s relationship with standard memory measures was undertaken relative to other traditional learning slope metrics. In addition, retest reliability at 6, 12, and 24 months was examined, and demographically adjusted normative comparisons were developed.ResultsLower LR scores were associated with poorer performances on memory measures, and LR scores outperformed traditional learning slope calculations across all analyses. Retest reliability exceeded acceptability thresholds across time, and demographically adjusted normative equations suggested better performance for cognitively intact participants than those with mild cognitive impairment.ConclusionsThese results suggest that this LR score possesses sound retest reliability and can better reflect learning capacity than traditional learning slope calculations. With the added development and validation of regression-based normative comparisons, these findings support the use of the RAVLT LR as a clinical tool to inform clinical decision-making and treatment.

Kumar, Rishika; Berry, Jamie; Koning, Ashley; Rossell, Steve; Jain, Harshali; Elkington, Selina; Nagaraj, Sagar; Batchelor, Jennifer

doi: 10.1093/arclin/acac010pmid: 35292809

Individuals with substance use disorder (SUD) often present with cognitive impairments, which may impede their ability to make decisions for themselves, including treatment-related decisions. It is therefore important to assess whether individuals with SUD have adequate decision-making capacity. Indeed, there have not been any capacity assessment tools tailored for use with SUD populations that demonstrate adequate psychometric properties or that have the strong ethical foundation that is required of capacity assessment tools. The Compulsory Assessment and Treatment–Capacity Assessment Tool (CAT–CAT) was designed to fill this gap in the literature. Therefore, the aim of this study was to establish the interrater and test–retest reliability, and discriminative validity of the CAT–CAT. The first of this two-part study recruited healthcare professionals in New Zealand and asked them to conduct a capacity assessment on two hypothetical clients. Generally, excellent interrater reliability (ρ = .998 overall) and test–retest reliability (ρ = .996 overall) was found. The CAT–CAT has exhibited reliability that was at least comparable to widely used capacity assessment tools for other pathologies. The second part of this study involved cognitively normal individuals undergoing capacity assessments to investigate the hypothesis that individuals that do not lack capacity will obtain scores significantly higher than 50% in each section of the CAT–CAT. This hypothesis was met with highly significant results. To conclude, preliminary data suggest that the CAT–CAT has excellent reliability and correctly classifies those with capacity.

Albrecht, T J; Mehmel, B M; Eagle, S R; Leonard, B T; Marchetti, G F; Zhang, M; Reecher, H M; Snyder, V; Holland, C L; Rossi, E A; Collins, M W; Kontos, A P

doi: 10.1093/arclin/acac32.01pmid:

Anderson, M N; Lynall, R C; O'Connor, P J; Schmidt, J D

doi: 10.1093/arclin/acac32.02pmid: N/A

Purpose: Individuals with a concussion history are more likely to sustain subsequent concussions and/or musculoskeletal injuries. Underlying mechanisms are unclear; reaction time (RT) deficits associated with anxiety may play an important role. The primary aim of this study was to determine if anxiety and recent concussion history predict functional RT (i.e., head protective, jump landing) under single and dual-task conditions. Methods: 40 participants (concussion:healthy = 20:20; time since concussion = 11.8 months) completed the State–Trait Anxiety Inventory, anxiety ratings before and after each task, and performed RT tasks. We used a virtual reality environment and motion capture laboratory to collect RTs for head protective and jump landing, respectively. Participants completed assessments under both single-task (i.e., “Focus solely on completing the task as quickly as possible”) and dual-task (i.e., “Subtract as quickly and accurately as possible as you await your visual stimulus”) conditions. Instructions gave equal weight to speed and accuracy. All RTs were calculated (ms) as the time from visual onset of stimuli to first movement ≥3 cm of hands (head protective) or sacral body (jump landing). A series of linear regression models determined if the independent variables predicted RTs. Results: Regression models did not explain a significant proportion of the variance in head protective (single- R2 = 0.05; p = 0.78; dual- R2 = 0.09; p = 0.49), or jump landing (single- R2 = 0.21; p = 0.08; dual- R2 = 0.12; p = 0.32) RTs. Conclusions: In a low anxiety sample, recent concussion history and anxiety do not predict clinical or functional reaction times at twelve-months post-concussion. If these differences exist, they are likely resolved by this time.