Patterns of psychopathology and cognition in sex chromosome aneuploidy

Background Sex chromosome aneuploidies (SCAs) are a collectively common family of genetic disorders that increase the risk for neuropsychiatric and cognitive impairment. Beyond being important medical disorders in their own right, SCAs also offer a unique naturally occurring model for studying X- and Y-chromosome influences on the human brain. However, it remains unclear if (i) different SCAs are associated with different profiles of psychopathology and (ii) the notable interindividual variation in psychopathology is related to co-occurring variation in cognitive ability. Methods We examined scores for 11 dimensions of psychopathology [Child/Adult Behavior Checklist (CBCL)] and general cognitive ability [full-scale IQ (FSIQ) from Wechsler tests] in 110 youth with varying SCAs (XXY = 41, XYY = 22, XXX = 27, XXYY = 20) and 131 typically developing controls (XX = 59, XY = 72). Results All SCAs were associated with elevated CBCL scores across several dimensions of psychopathology (two-sample t tests comparing the euploidic and aneuploidic groups [all |T| > 9, and p < 0.001]). Social and attentional functioning were particularly sensitive to the carriage of a supernumerary Y-chromosome. In particular, the XYY group evidenced significantly more social problems than both extra-X groups (Cohen’s d effect size > 0.5, Bonferroni corrected p < .05). There was marked variability in CBCL scores within each SCA group, which generally correlated negatively with IQ, but most strongly so for social and attentional difficulties (standardized β, − 0.3). These correlations showed subtle differences as a function of the SCA group and CBCL scale. Conclusions There is domain-specific variation in psychopathology across SCA groups and domain-specific correlation between psychopathology and IQ within SCAs. These findings (i) help to tailor clinical assessment of this common and impactful family of genetic disorders and (ii) suggest that dosage abnormalities of X- and Y-linked genes impart somewhat distinct profiles of neuropsychiatric risk.

Stimulating Music Supports Attention in Listeners with Attentional Difficulties

Background music is widely used to sustain attention, but little is known about what musical properties aid attention. This may be due to inter-individual variability in neural responses to music. We test the hypothesis that music can sustain attention by affecting oscillations via acoustic amplitude modulation, differentially for those with varying levels of attentional difficulty. We first show that heavily-modulated music improves sustained attention for participants with more ADHD symptoms. FMRI showed this music elicited greater activity in attentional networks in this group only, and EEG showed greater stimulus-brain coupling for this group in response to the heavily-modulated music. Finally, we parametrically manipulated the depth and rate of amplitude modulations inserted in otherwise-identical music, and found that beta-range modulations helped more than other frequency ranges for participants with more ADHD symptoms. Results suggest the possibility of an oscillation-based neural mechanism for targeted music to support improved cognitive performance.

Stimulating music supports attention in listeners with attentional difficulties

Background music is widely used to sustain attention, but little is known about what musical properties aid attention. This may be due to inter-individual variability in neural responses to music. We test the hypothesis that music can sustain attention by affecting oscillations via acoustic amplitude modulation, differentially for those with varying levels of attentional difficulty. We first show that heavily-modulated music improves sustained attention for participants with more ADHD symptoms. FMRI showed this music elicited greater activity in attentional networks in this group only, and EEG showed greater stimulus-brain coupling for this group in response to the heavily-modulated music. Finally, we parametrically manipulated the depth and rate of amplitude modulations inserted in otherwise-identical music, and found that beta-range modulations helped more than other frequency ranges for participants with more ADHD symptoms. Results suggest the possibility of an oscillation-based neural mechanism for targeted music to support improved cognitive performance.

A-139 Relationship between Obstructive Sleep Apnea and Neurocognitive Performance in a Veteran Population with Post-Traumatic Stress Disorder Symptomatology

Objective Obstructive Sleep Apnea (OSA) is associated with neuropsychological challenges, including attentional difficulties (Kim et al., 2017), and commonly comorbid with Posttraumatic Stress Disorder (PTSD) in veteran samples (Yesavage et al., 2014). We further explore the relationship between OSA and cognition in veterans with PTSD symptomatology. Method 58 veterans (6 females; mean age = 57.53 years, SD = 13.63) with OSA were screened as part of a larger outpatient study at Palo Alto VA Hospital, completing neuropsychological testing and Clinician Administered PTSD Scale for DSM-5 (CAPS-5) interview. Mean Apnea Hypopnea Index (AHI) was 23.95 (SD = 15.97). Positive Airway Pressure (PAP) therapy had not started at the time of screening. Domain-specific composite scores were created using z-score transformation of individual test scores and hierarchical regression used. Results Initial regression model was significant (F(1,57) = 4.99, p = 0.03, R2 = 0.081) with AHI significantly predicting executive function (EF; β = −0.28, p = 0.03). Attention was then entered into the model (F(2,56) = 22.31, p &lt; 0.01, R2 = 0.44) and significantly predicted EF (β = 0.63, p &lt; 0.01), but AHI was no longer significant. Lastly, CAPS-5 score (last month) was entered as a covariate to control for PTSD symptom severity (F(3,55) = 14.94, p &lt; 0.01, R2 = 0.45); however, attention remained the only significant predictor of EF (β = 0.63, p &lt; 0.01). Conclusions Findings suggest that EF concerns related to OSA may be driven by decreased attention performance, suggesting areas to highlight when formulating recommendations and treatment planning. Further implications and directions to be discussed. Funding Acknowledgements Supported by the Research Service of the Department of Veterans Affairs (Grant Number 1I01RX001799-01A2), VAPAHCS, and Sierra-Pacific MIRECC.

A-143 Sorry, I Wasn’t Paying Attention. The Moderating Role of Auditory Attention on the Relationship between Age and Verbal Learning

Objective Attentional difficulties are known to negatively impact learning (Hervey et al., 2004; Alderson et al., 2013). This study builds upon previous work examining the effect of sustained visual attention as a moderator of age and learning (Thomas et al., 2019) by examining performance on an auditory attention measure as a moderator of the relationship between age and performance on a verbal list-learning task. Method Archival data from 424 adults (Mage = 36.01, SD = 15.13) were collected at an outpatient clinic. Auditory attention was assessed via the Brief Test of Attention (BTA) raw score. Learning was assessed via the California Verbal Learning Test (CVLT-II) total T-Score (Trials 1–5). Results Results of a hierarchical linear regression indicated a significant effect between BTA and learning, (β = 0.287, F(1, 422) = 17.993, p &lt; 0.001, ΔR2 = 0.078). There was no significant effect between age and learning, (β = 0.022, F(1, 422) = 0.204, p = 0.652, ΔR2 = 0.000). Additional results from a simple moderated regression analysis indicated a significant overall model between age, learning and BTA (F(3, 420) = 15.749, p &lt; 0.001, ΔR2 = 0.1011) with BTA having a significant positive interaction effect on the relation between age and learning (β = 0.816, F(1, 420) = 10.436, p = &lt; 0.001, ΔR2 = 0.022). Conclusion Sustained attention has been shown to be an important consideration when assessing verbal learning and memory performance. Present results demonstrate that when accounting for age, auditory attention is a significant positive predictor of performance on measures of verbal learning. Additionally, confirming prior research, performances on auditory attention and verbal learning measures are positively correlated.

Poor concentration

Children with ADHD often have difficulty giving close attention to details. However, it is wrong to believe that children with ADHD cannot concentrate at all. Their mechanisms for concentrating are inefficient and unreliable, not absent. Difficulties with concentration result in children with ADHD often being confused and unable to understand instructions, and attentional difficulties may give children with ADHD an unfocused appearance. Often, children with ADHD have difficulty in adjusting their level of attention to suit the situation. This chapter discusses poor concentration in children with ADHD. It includes the attentional processes (internal and external) in the brain, and difficult tasks for attentional mechanisms.

The Effects of Choice on the Reading Comprehension and Enjoyment of Children with Severe Inattention and no Attentional Difficulties

It has been proposed that enhancing motivation supports the learning of children with Attention Deficit Hyperactivity Disorder (ADHD). Less is known if inattentive children with no ADHD diagnosis may similarly benefit, when being motivated to engage in an academic task. Using a repeated-measures design, this study investigated the effects of text choice as an intrinsic motivator on the reading comprehension and enjoyment of Year 4 children attending mainstream primary schools (N = 92; aged 8–9 years; 48 boys); comparing those with no attentional difficulties and severe inattention. We hypothesized that 1) choice would increase reading comprehension and enjoyment 2) choice would increase the reading comprehension and enjoyment of children both with severe inattention and no attentional difficulties 3) choice effects would be significantly greater for children with severe inattention than those with no attentional difficulties. Children participated in a reading intervention that included a Choice (experimental) and a No Choice (control) condition. Child inattention was measured via a Virtual Reality Continuous Performance Task (Omission errors, Reaction Time Variability) and Teacher Ratings. Choice significantly increased reading comprehension, but not enjoyment compared with no choice. Choice improved the reading comprehension of children with both severe inattention and no attentional difficulties. Choice did not benefit the reading of severely inattentive children more than that of children with no attentional difficulties. These findings underline the educational benefits of choice for young readers both with severe inattention and no attentional difficulties, which are further discussed drawing on existing theory and research.

Patterns of Psychopathology and Cognition in Sex Chromosome Aneuploidy

Background Sex chromosome aneuploidies (SCAs) are a collectively common family of genetic disorders that increase risk for neuropsychiatric and cognitive impairment. Beyond being important medical disorders in their own right, SCAs also offer a unique naturally-occurring model for X- and Y-chromosome influences on the human brain. However, it remains unclear if (i) different SCAs are associated with different profiles of psychopathology, and (ii) the notable interindividual variation in psychopathology is related to co-occurring variation in cognitive ability. Methods We examined scores for 11 dimensions of psychopathology [Child/Adult Behavior Checklist (CBCL)] and general cognitive ability [full-scale IQ (FSIQ) from Wechsler tests] in 110 youth with varying SCAs (XXY = 41, XYY = 22, XXX = 27, XXYY = 20) and 131 typically developing controls (XX = 59, XY = 72). Results All SCAs were associated with elevated CBCL scores across several dimensions of psychopathology, but social and attentional functioning were particularly sensitive to carriage of a supernumerary Y-chromosome. There was marked variability in CBCL scores within each SCA group, which generally correlated negatively with IQ, but most strongly so for social and attentional difficulties. These correlations showed subtle differences as a function of SCA group and CBCL scale. Conclusions There is domain-specific variation in psychopathology across SCA groups, and domain-specific correlation between psychopathology and IQ within SCAs. These findings (i) help to tailor clinical assessment of this common and impactful family of genetic disorders, and (ii) suggest that dosage abnormalities of X- and Y-linked genes impart somewhat distinct profiles of neuropsychiatric risk.

Attentional shifting differences in autism: Domain general, domain specific or both?

Atypical attention is considered to have an important role in the development of autism. Yet, it remains unclear whether these attentional difficulties are specific to the social domain. This study aimed to examine attentional orienting in autistic and non-autistic adults from and to non-social and social stimuli. We utilised a modified gap–overlap task with schematic images (Experiment 1: autistic = 27 and non-autistic = 26) and photographs (Experiment 2: autistic = 18 and non-autistic = 17). Eye-tracking data (i.e. saccadic latencies) were then compared across condition and type of stimulus (social or non-social) using multilevel modelling. Autistic adults exhibited mostly typical gap and overlap effects, as well as a bias towards social stimuli. Yet, autistic participants benefitted from exogenous disengagement when orienting to social information more than non-autistic participants. Neither a domain general nor social domain–specific account for attentional atypicalities in autism was supported separately. Yet, subtle combined domain differences were revealed in the gap condition. Lay abstract Previous research has shown that autistic individuals look at other people less and orient to them more slowly than others. Yet, it is still unclear if this represents general visual differences (e.g. slower looking at any new information, social or not) or a uniquely social difference (e.g. only slower looking to humans but not objects). Here, we aimed to examine how quickly autistic and non-autistic adults look to and away from social (i.e. faces) and non-social information (i.e. squares and houses). We used an attentional shifting task with two images where sometimes the first image disappears before the new image appears (makes it easier to notice the new image) and other times it stays on the screen when the new image appears. In Experiment 1, we showed schematic faces and squares to 27 autistic and 26 non-autistic adults, and in Experiment 2, we showed photographs of faces and houses to 18 autistic and 17 non-autistic adults. In general, autistic adults looked at the new non-social or social images similarly to non-autistic adults. Yet, only autistic adults looked at new social information faster when the first image disappeared before the new image appeared. This shows that autistic individuals may find it easier to notice new social information if their attention is not already occupied.

Effect of the Brain Balance Program® on Cognitive Performance in Children and Adolescents with Developmental and Attentional Issues

We reviewed the cognitive task performance of children and adolescents with developmental and attentional issues, before and after participation in the Brain Balance® (BB) program. The program consisted of three 1-hour sessions/week (sensorimotor stimulation and academic activities) with other multimodal activities, for 3 months. Participants were compared to a control group that had the same underlying demographic and phenotypical features but did not yet complete the program (participated on average for 27 days). For all ages (4-6 and 7+ years), we found a significant main effect of group, such that BB groups improved overall more than controls (CTRLs). More specifically, BB groups improved on all cognitive tests (three tests for ages 4-6 years; 12 tests for ages 7+ years), whereas CTRLs only improved on one test. These data support the potential of multimodal training programs toward the overarching goal of improving cognitive performance in children with developmental and attentional difficulties.