A-77 Nonverbal Memory Dysfunction and Migraine-Related Disability Predict Subjective Cognitive Symptoms in Adults with Migraine

Objective This study investigated the relationship between subjective cognitive symptom reporting and objective cognitive functioning in adults with migraine. Method 88 participants (Mdn age = 46.0 [35.25–56.75]; Mdn years of education = 16.0 [13.0–19.0]; 88.6% female) completed neuropsychological testing and questionnaires assessing migraine disability (Migraine Disability Assessment Scale) and subjective cognition (Sickness Impact Profile-Alertness Behavior Subscale). Participants had primary headache disorder diagnosis of migraine. Bivariate correlations and hierarchical linear regression were performed. Results 83% of participants had episodic migraine (< 15 headache days/month) and 58% reported low or moderate disability (MIDAS ≤21). Subjective cognitive dysfunction was associated with lower education (ρ = −0.254; p = 0.018), higher disability (t(84) = −3.00, p = 0.004); and lower scores on coding (r = −0.224, p = 0.023) TMT-A (r = −0.238, p = 0.029), RCFT- Immediate Recall (r = −0.028, p = 0.010), RCFT- Delayed Recall (r = −0.38, p < 0.001), RCFT-recognition (r = −0.40, p < 0.001), and animal fluency (r = −0.27, p = 0.013). Migraine-related disability and RCFT- Delayed Recall (ß = −0.368, SE = 0.006).) accounted for 45.9% of variance in subjective cognitive symptom reporting. The addition of RCFT-recognition (ß = −0.050, SE = 0.025) increased explanation of variance by 4.1%. Conclusion Nonverbal memory dysfunction and higher disability may predict subjective cognitive complaints. This study contributes to the limited knowledge of objective and subjective cognitive functioning in adults with migraine.

A - 11 Are Self-Reported Cognitive Symptoms an Accurate Evaluation of Cognitive Functioning?

Objective The purpose of this study was to evaluate whether self-reports of cognitive symptoms were associated with cognitive test performances. Methods The sample included 112 Canadian Football League (CFL) athletes who were diagnosed using CFL concussion protocols. All participants underwent a cognitive assessment at baseline and prior to medical clearance. The battery included the immediate post-concussion assessment and cognitive testing (ImPACT) and The Post-Concussion Symptom Checklist. Results Self-reported cognitive symptoms and cognitive test performances were evaluated using Spearman’s rank correlations (rho; ρ). There were significant negative correlations between post-concussion verbal memory composite and the self-reported cognitive symptoms total (ρ = −0.22). Similar patterns were found for visual memory composite and the self-reported cognitive symptom total (ρ = −0.19). Paired-samples t-tests were used to assess differences between pre- and post-concussion scores. Cases were omitted if there were no pre- or post-test. If multiple concussions were sustained, the first assessment was used (n = 99). There was a significant difference between the pre- and post-test results between the subjective cognitive symptom total (t = −2.034, p > 0.05). Conclusions These outcomes suggest that CFL athletes report significantly higher cognitive symptoms following a concussion. Additionally, the pre-test subjective measures were not correlated to objective cognitive functioning. However, post-concussion subjective measures were negatively correlated with verbal and visual memory. This suggests that self-reports were more accurate at assessing their overall functioning following a concussion.

A Computational Study of Executive Dysfunction in Amyotrophic Lateral Sclerosis

Executive dysfunction is a well-documented, yet nonspecific corollary of various neurological diseases and psychiatric disorders. Here, we applied computational modeling of latent cognition for executive control in amyotrophic lateral sclerosis (ALS) patients. We utilized a parallel reinforcement learning model of trial-by-trial Wisconsin Card Sorting Test (WCST) behavior. Eighteen ALS patients and 21 matched healthy control participants were assessed on a computerized variant of the WCST (cWCST). ALS patients showed latent cognitive symptoms, which can be characterized as bradyphrenia and haphazard responding. A comparison with results from a recent computational Parkinson’s disease (PD) study (Steinke et al., 2020, J Clin Med) suggests that bradyphrenia represents a disease-nonspecific latent cognitive symptom of ALS and PD patients alike. Haphazard responding seems to be a disease-specific latent cognitive symptom of ALS, whereas impaired stimulus-response learning seems to be a disease-specific latent cognitive symptom of PD. These data were obtained from the careful modeling of trial-by-trial behavior on the cWCST, and they suggest that computational cognitive neuropsychology provides nosologically specific indicators of latent facets of executive dysfunction in ALS (and PD) patients, which remain undiscoverable for traditional behavioral cognitive neuropsychology. We discuss implications for neuropsychological assessment, and we discuss opportunities for confirmatory computational brain imaging studies.

Connectivity patterns of task-specific brain networks allow individual prediction of cognitive symptom dimension of schizophrenia and link to molecular architecture

BackgroundDespite the marked inter-individual variability in the clinical presentation of schizophrenia, it remains unclear the extent to which individual dimensions of psychopathology may be reflected in variability across the collective set of functional brain connections. Here, we address this question using network-based predictive modeling of individual psychopathology along four data-driven symptom dimensions. Follow-up analyses assess the molecular underpinnings of predictive networks by relating them to neurotransmitter-receptor distribution patterns.MethodsWe investigated resting-state fMRI data from 147 schizophrenia patients recruited at seven sites. Individual expression along negative, positive, affective, and cognitive symptom dimensions was predicted using relevance vector machine based on functional connectivity within 17 meta-analytic task-networks following a repeated 10-fold cross-validation and leave-one-site-out analyses. Results were validated in an independent sample. Networks robustly predicting individual symptom dimensions were spatially correlated with density maps of nine receptors/transporters from prior molecular imaging in healthy populations.ResultsTen-fold and leave-one-site-out analyses revealed five predictive network-symptom associations. Connectivity within theory-of-mind, cognitive reappraisal, and mirror neuron networks predicted negative, positive, and affective symptom dimensions, respectively. Cognitive dimension was predicted by theory-of-mind and socio-affective-default networks. Importantly, these predictions generalized to the independent sample. Intriguingly, these two networks were positively associated with D1 dopamine receptor and serotonin reuptake transporter densities as well as dopamine-synthesis-capacity.ConclusionsWe revealed a robust association between intrinsic functional connectivity within networks for socio-affective processes and the cognitive dimension of psychopathology. By investigating the molecular architecture, the present work links dopaminergic and serotonergic systems with the functional topography of brain networks underlying cognitive symptoms in schizophrenia.

PENGARUH EDUKASI MANAJEMEN DIRI TERHADAP DAN TEKANAN DARAH PASIEN HIPERTENSI DI RUANG RAWAT INAP RUMAH SANTA ELISABETH MEDAN

Introduction: The risk for cardiovascular disorder caused by hypertension can be forestalled and controlled by applying healthy behavior such as exercises, cognitive symptom management, healthy diet, and blood pressure monitoring. In this case, education plays an important role in increasing the control of blood pressure. The objective of the research was to identify the influence of self-management education on healthy behavior and blood pressure in hypertension patients in the Hospital Elisabeth Medan Method: The research used quasi experiment and nonequivalent control group pre-post test design. The samples for this study were 60 hypertension patients as the respondents divided into two group, 30 in the intervention group and 30 in the control group taken by consecutive sampling technique. The data were gathered by using modification instruments from Stanford University; they were exercise behavior scale, cognitive symptom scale, questionnaires on healthy diet, and digital Omron tensimeter for measuring blood pressure Result: The data were gathered by using modification instruments from Stanford University; they were exercise behavior scale, cognitive symptom scale, questionnaires on healthy diet, and digital Omron tensimeter for measuring blood pressure. Data were analyzed using descriptive statistics, Wilcoxon and Mann Whitney test. The result of the research showed that there was no influence of self-management education on exercise (p-value = 1.00 > 0.05), there was the influence of self-management education on cognitive symptom (p-value = 0.00 < 0.05), there was the influence of self-management education on healthy diet (p-value = 0.00 < 0.05), and there was the influence of self-management education on systolic and diastolic blood pressure (p-value = 0.00 < 0.05).. Discussion: The conclusion of the research was that education could increase the application of healthy behavior and controlling blood pressure in hypertension patients. The result of the research could be an input for health care to maintain and increase education in hypertension patients so that they could control their blood pressure and forestall hypertension complication.

The timing and impact of psychiatric, cognitive and motor abnormalities in Huntington's disease

Objective: To assess the prevalence, timing and functional impact of psychiatric, cognitive and motor abnormalities in Huntington's disease (HD), we analysed retrospective clinical data from individuals with manifest HD. Methods: Clinical features of HD patients were analysed for 6316 individuals in the European REGISTRY study from 161 sites across 17 countries. Data came from clinical history and the Clinical Characteristics Questionnaire that assessed eight symptoms: motor, cognitive, apathy, depression, perseverative/obsessive behavior, irritability, violent/aggressive behavior, and psychosis. Multiple logistic regression was used to analyse relationships between symptoms and functional outcomes. Results: The initial manifestation of HD is increasingly likely to be motor, and less likely to be psychiatric, as age at presentation increases. The nature of the first manifestation is not associated with pathogenic CAG repeat length. Symptom prevalence data from the patient-completed Clinical Characteristics Questionnaire correlate specifically with validated clinical measures. Using these data, we show that psychiatric and cognitive symptoms are common in HD, with earlier onsets associated with longer CAG repeats. 42.4% of HD patients reported at least one psychiatric or cognitive symptom before motor symptoms, with depression most common. Apathy and cognitive impairment tend to come later in the disease course. Each psychiatric or cognitive symptom was associated with significantly reduced total functional capacity scores. Conclusions: Psychiatric and cognitive symptoms occur before motor symptoms in many more HD patients than previously reported. They have a greater negative impact on daily life than involuntary movements and should be specifically targeted with clinical outcome measures and treatments.