scholarly journals A-09 The Relationship Between Subjective Cognitive Complaints, Depression, and Executive Functioning in mTBI Veterans

2020 ◽  
Vol 35 (6) ◽  
pp. 782-782
Author(s):  
T Scott ◽  
J Spellman ◽  
N Walker ◽  
J Rivera ◽  
D Waltzman ◽  
...  

Abstract Objective Among individuals with mild traumatic brain injury (mTBI), those with depression report greater subjective cognitive complaints than those without depression. In mTBI patients with general cognitive complaints, depression may account for poor performance on objective neuropsychological measures. This study seeks to expand this research by examining depression, subjective executive functioning (EF) complaints, and objective EF performance in Veterans with mTBI. Method Fifty-seven Veterans with deployment-related mTBI (12% female; age M = 42.0, SD = 13.6; years education M = 15.0, SD = 1.8) with (n = 29) or without (n = 28) a chart diagnosis of depression. Participants were administered the Behavioral Rating Inventory of Executive Functioning (BRIEF) and objective neuropsychological measures of working memory (i.e., Weschler Adult Intelligence Scale-IV Working Memory Index) and aspects of EF (i.e., Trail Making Test B and Delis-Kaplan Executive Functioning System (D-KEFS) subtests). Results Principal component analysis identified similar domains of EF to the BRIEF, including: task monitoring (Trail Making Test B, D-KEFS Letter Fluency, and D-KEFS Tower Test, eigenvalue = 1.93) and shifting (D-KEFS: Color-Word Interference Conditions 3 and 4, and Category Switching, eigenvalue = 1.24). Individuals with depression had greater subjective EF complaints in each BRIEF domain than non-depressed individuals (p’s ≤ .01). However, subjective complaints in these domains were not related to objective performance (r’s = −0.17,-0.19, p’s > .05). Moreover, depressed and non-depressed individuals performed similarly on all EF measures (p’s > .05). Conclusions mTBI Veterans with depression report more subjective EF complaints than those without depression. The lack of association between subjective complaints and objective EF performance suggests it is important to treat depression in mTBI patients to remedy perceived cognitive deficits.

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S50-S50
Author(s):  
Silvia Amoretti ◽  
Gerard Anmella ◽  
Ana Meseguer ◽  
Cristina Saiz ◽  
Sonia Canals ◽  
...  

Abstract Background The cognitive reserve (CR) refers to the brain’s capacity to cope with pathology in order to minimize the symptoms. In the field of first episode psychosis (FEP), the CR was able to predict functional and neurocognitive performance. Nevertheless, CR has been estimated using heterogeneous methods, which, in term, difficult to compare studies. Therefore, there is a need to create a specific scale for the assessment of this relevant construct. The Cognitive Reserve Assessment Scale in Health (CRASH) is the first measure developed specifically for patients with severe mental illness with optimal psychometric properties, facilitating reliable and valid measurement of CR. The study of the internal structure of the CRASH determined a four-factor structure (Education, Occupation, Leisure activities and Sociability) that can be analyzed separately to know what kind of relationship they might have with other variables. The aim of this study was to analyze the effects of CR measured with CRASH scale on functioning and neurocognitive performance and to explore the relationship of each factor with the outcome in an adult sample of subjects with FEP. Methods The sample of this study came from a multicentre, naturalistic and longitudinal research project financed by a catalan grant (“Pla Estratègic de Recerca i Innovació en Salut” - PERIS 2016–2018). Expedient Nº: SLT006/17/00345; entitled “Identificación y caracterización del valor predictivo de la reserva cognitiva en el curso evolutivo y respuesta en terapéutica en personas con un primer episodio psicótico”. 23 FEP patients and 72 healthy control (HC) were enrolled. The premorbid IQ was estimated with the Wechsler Adult Intelligence Scale (WAIS-IV) vocabulary subtest. To assess processing speed, Trail Making Test-part A was used. Sustained attention was tested with the Continuous Performance Test–II. The working memory was assessed with the Letters and Numbers Subtest of the WAIS-IV. Finally, the executive functions tested set shifting, planning and cognitive flexibility using the Tower of London task and the Trail Making Test (TMT) part B. Results Significant differences between the total CRASH score of patients and HC groups have been found. The patient group obtained lower scores compared to the HC group (36.66±16.01 vs 49.83±11.08, p<0.001). After performing a logistic regression to assess the predictive power of CRASH for each group, the model correctly classified 83.2% of the cases (B=0.091; p<0.001; Exp(B)=1.095). In FEP patients, the CRASH score was associated with premorbid IQ (p<0.001), processing speed (p=0.005), executive function (TMT-B, p=0.005; London Tower task, p=0.039) and attention (CPT Hit SE ISI change, p=0.004). Specifically, the Education factor was associated with premorbid IQ, processing speed, working memory and executive function. The Occupation was only associated with executive function. Leisure activities factor was correlated with premorbid IQ and functioning. Finally, Sociability was correlated with psychosocial functioning and duration of untreated psychosis. In HC, CRASH was associated with premorbid IQ (p<0.001) and attention (p=0.015). Education and Occupation factors were associated with premorbid IQ and attention; Leisure activities with processing speed; and sociability with attention. Discussion FEP patients were shown to have lower CR than HC, and CRASH correctly classified 83.2% of the sample. Each CRASH factor was associated with different outcome, which is why it can be interesting to analyze the total CRASH score and each factor separately. Patients with higher CR showed a better cognitive performance. Therefore, enhancing each factor involved in cognitive reserve may improve outcomes in FEP.


2009 ◽  
Vol 15 (3) ◽  
pp. 438-450 ◽  
Author(s):  
I. SÁNCHEZ-CUBILLO ◽  
J.A. PERIÁÑEZ ◽  
D. ADROVER-ROIG ◽  
J.M. RODRÍGUEZ-SÁNCHEZ ◽  
M. RÍOS-LAGO ◽  
...  

AbstractThe aim of this study was to clarify which cognitive mechanisms underlie Trail Making Test (TMT) direct and derived scores. A comprehensive review of the literature on the topic was carried out to clarify which cognitive factors had been related to TMT performance. Following the review, we explored the relative contribution from working memory, inhibition/interference control, task-switching ability, and visuomotor speed to TMT performance. Forty-one healthy old subjects participated in the study and performed a battery of neuropsychological tests including the TMT, the Digit Symbol subtest [Wechsler Adult Intelligence Scale (Third Version) (WAIS-III)], a Finger Tapping Test, the Digits Forward and Backward subtests (WAIS-III), Stroop Test, and a task-switching paradigm inspired in the Wisconsin Card Sorting Test. Correlation and regression analyses were used in order to clarify the joint and unique contributions from different cognitive factors to the prediction of TMT scores. The results suggest that TMT-A requires mainly visuoperceptual abilities, TMT-B reflects primarily working memory and secondarily task-switching ability, while B-A minimizes visuoperceptual and working memory demands, providing a relatively pure indicator of executive control abilities. (JINS, 2009, 15, 438–450.)


2006 ◽  
Vol 37 (S 1) ◽  
Author(s):  
N Kokubo ◽  
Y Inoue ◽  
A Gunji ◽  
M Inagaki ◽  
M Kaga ◽  
...  

2012 ◽  
Vol 34 (10) ◽  
pp. 799-805 ◽  
Author(s):  
Naomi Kokubo ◽  
Masumi Inagaki ◽  
Atsuko Gunji ◽  
Tomoka Kobayashi ◽  
Hidenobu Ohta ◽  
...  

2021 ◽  
Vol 36 (6) ◽  
pp. 1051-1051
Author(s):  
Kendra L Pizzonia ◽  
Andrew M Bryant ◽  
Leatha A Clark ◽  
Brian C Clark ◽  
Julie A Suhr

Abstract Objective ApoE is a well-known gene carrying risk for Alzheimer’s disease and is associated with memory performance while the COMT gene is associated with executive functioning but is understudied. The present study investigated these gene interactions across cognitive domains. Method A larger study on gait and aging recruited 89 healthy community-dwelling adults over the age of 60. The primary analyses included 82 participants (67% female, mean age = 74.61, SD = 6.71). The analyses on executive functioning included 72 participants (65% female, mean age = 73.02, SD = 4.99) who completed all measures of interest. ApoE status was defined as presence/absence of Ɛ4. The rs4680 gene on the COMT allele was classified into Val/Met, Val/Val, and Met/Met genotypes. Biological sex was included as a binary term (i.e., male/female). Index variables and age corrected standard scores on the Repeatable Battery for the Assessment of Neuropsychological Status, verbal fluency, and Trail Making Test were included. Results Gene–gene interactions were found for overall cognitive functioning, immediate memory, and semantic fluency. There were main effects of sex for overall cognitive functioning, immediate memory, delayed memory, and semantic fluency. There were main effects for COMT for delayed memory and a main effect for both COMT and ApoE for visuospatial functioning, coding, and verbal fluency (all p’s < 0.05). There were no ApoE x COMT x Sex interactions and Trail Making Test B was not related to either gene or sex. Conclusion(s) Our findings suggest that both COMT and ApoE (and their interaction) influence cognition. Future research should investigate gene–gene interactions in larger samples with more comprehensive cognitive batteries.


2021 ◽  
Vol 36 (6) ◽  
pp. 1252-1252
Author(s):  
Saranya Patel ◽  
Jeffrey Schaffert ◽  
Anne Carlew ◽  
Michael Conley ◽  
Heidi Rossetti ◽  
...  

Abstract Objective Various methods are used to derive normative data for neuropsychological assessment measures. The National Alzheimer’s Coordinating Center (NACC) regression norms (2011) are frequently used within Alzheimer’s Disease Research Centers, yet little research exists comparing these norms to similar regression/non-regression-based norms. Normative data for the widely-used Trail Making Test (TMTA&B) was compared between two regression-based normative data methods (Mitrushina and NACC) and traditional normative methods (i.e., Mayo’s Older Americans Normative Studies [MOANS]). Method TMTA&B data were obtained from 14,873 cognitively normal NACC participants (ages: 50–89; education: M = 15.81, SD = 2.90). T-scores for TMTA&B scores based on Mitrushina, NACC, and MOANS norms were computed. T-scores for regression norms were bounded from 20 to 80. Cohen’s d effect sizes were used to compare differences in scores. Results MOANS and Mitrushina norms produced similar normative scores in the overall sample (TMTA T-score difference = 1.06, d = 0.112, TMTB T-score difference = 1.4, d = 0.144). NACC-derived scores were ~ 0.5 SD below MOANS (TMTA T-score difference = −5.3, d = 0.553, TMTB T-score difference = −4.1, d = 0.427) and Mitrushina scores (TMTA T-score difference = −6.3, d = 0.736, TMTB T-score difference = −5.6, d = 0.615). NACC data produced the lowest average TMTA&B T-scores across all 5-year age band groups. Conclusions Significantly lower TMT scores were obtained using NACC’s regression-based norms compared to both MOANS norms and Mitrushina regression norms. These results underscore that the choice of norms may under and/or overestimate cognitive functioning, and comparison norms must be chosen carefully when making decisions about patients’ cognitive status. Future research applying NACC’s regression-based norms to other commonly used neuropsychological measures is warranted.


2020 ◽  
Vol 35 (6) ◽  
pp. 960-960
Author(s):  
Lopez A ◽  
Lopez Palacios D ◽  
Quintana A ◽  
Gibson D ◽  
Arguelles-Borge S

Abstract Objective This study examined the role of apathy on performance of an executive functioning task. Method The data for this study was derived from the National Alzheimer’s Coordinating Center’s Uniform Data Set containing neuropsychological information for stroke patients (n = 317) who completed the Neuropsychiatric Inventory-Questionnaire (NPI-Q) and the Trail Making Test (Part B). The sample was divided into two groups. One which endorsed feelings of apathy in the last month (n = 102; mean age = 84,SD = 8.33) and a second group which denied feelings of apathy within the last month (n = 215; mean age = 86, SD = 8.02). Results After controlling for depression [as measured by the Geriatric Depression Scale (GDS)], age, gender, and motor impairment, the results of an ANCOVA showed that those who reported apathy performed significantly slower on the Trail Making Test—Part B than those who did not report it [F(1,312 = 6.01, p = .02]. Conclusions It has previously been found that cognitive performance can be impacted by depression on stroke patients. However, recently, it has been identified that apathy specifically, can have an effect on cognitive domains such as verbal learning, short-term, and long-term memory. The present study further supports that apathy may play a role in overall cognitive performance. Therefore, even if patients do not meet criteria for depression, the presence of apathy should still be taken into account. Future research should examine other possible contributing factors such as processing speed should be taken into account as they could be affecting the scores. Finally, researchers should utilize additional measures of executive functioning as only one was available for this study.


Author(s):  
Kim Charest ◽  
Alexandra Tremblay ◽  
Roxane Langlois ◽  
Élaine Roger ◽  
Pierre Duquette ◽  
...  

ABSTRACT:Background:Although cognitive deficits are frequent in multiple sclerosis (MS), screening for them with tools such as the Montreal Cognitive Assessment (MoCA) test is usually not performed unless there is a subjective complaint. The Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) is among the instruments most commonly used to assess self-reported subjective complaints in MS. Nonetheless, it does not always accurately reflect cognitive status; many patients with cognitive deficits thus fail to receive appropriate referral for detailed neuropsychological evaluation. The objective of this study was to examine the validity of the MoCA test to detect the presence of objective cognitive deficits among patients with MS without subjective complaints using the Minimal Assessment of Cognitive Function in MS (MACFIMS) as the gold standard.Methods:The sample included 98 patients who were recruited from a university hospital MS clinic. The MSNQ was used to select patients without subjective cognitive complaints who also completed the MACFIMS, MoCA test and MSQOL-54.Results:23.5% of patients without subjective cognitive complaints had evidence of objective cognitive impairment on the MACFIMS (z score < -1.5 on two or more tests). The MoCA had a sensitivity of 87% and a specificity of 68% for detecting objective cognitive impairment in this patient population using a cut-off score of 27.Conclusion:A significant proportion of patients without self-reported cognitive impairment do have evidence of cognitive deficits on more exhaustive cognitive assessment. The MoCA is a rapid screening test that could be used to target patients for whom a more detailed neuropsychological assessment would be recommended.


2002 ◽  
Vol 16 (3) ◽  
pp. 400-410 ◽  
Author(s):  
Chris Bassel ◽  
Sean B. Rourke ◽  
Mark H. Halman ◽  
Mary Lou Smith

2013 ◽  
Vol 18 (1) ◽  
pp. 79-89 ◽  
Author(s):  
MIRA GORAL ◽  
LUCA CAMPANELLI ◽  
AVRON SPIRO

This study aimed to examine the so-called bilingual advantage in older adults’ performance in three cognitive domains and to identify whether language use and bilingual type (dominant vs. balanced) predicted performance. The participants were 106 Spanish–English bilinguals ranging in age from 50 years to 84 years. Three cognitive domains were examined (each by a single test): inhibition (the Simon task), alternating attention (the Trail Making test), and working memory (Month Ordering). The data revealed that age was negatively correlated to performance in each domain. Bilingual type – balanced vs. dominant – predicted performance and interacted with age only on the inhibition measure (the Simon task). Balanced bilinguals showed age-related inhibition decline (i.e., greater Simon effect with increasing age); in contrast, dominant bilinguals showed little or no age-related change. The findings suggest that bilingualism may offer cognitive advantage in older age only for a subset of bilinguals.


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