Clinical Neuropsychologist最新文献

{"title":"Dispersion-based cognitive intra-individual variability in former American football players: Association with traumatic encephalopathy syndrome, repetitive head impacts, and biomarkers.","authors":"Caroline Altaras, Monica T Ly, Olivia Schultz, William B Barr, Sarah J Banks, Jennifer V Wethe, Yorghos Tripodis, Charles H Adler, Laura J Balcer, Charles Bernick, Henrik Zetterberg, Kaj Blennow, Nicholas Ashton, Elaine Peskind, Robert C Cantu, Michael J Coleman, Alexander P Lin, Inga K Koerte, Sylvain Bouix, Daniel Daneshvar, David W Dodick, Yonas E Geda, Douglas L Katz, Jason L Weller, Jesse Mez, Joseph N Palmisano, Brett Martin, Jeffrey L Cummings, Eric M Reiman, Martha E Shenton, Robert A Stern, Michael L Alosco","doi":"10.1080/13854046.2025.2453103","DOIUrl":"10.1080/13854046.2025.2453103","url":null,"abstract":"<p><p><b>Background:</b> Exposure to repetitive head impacts (RHI), such as those experienced in American football, is linked to cognitive dysfunction later in life. Traumatic encephalopathy syndrome (TES) is a proposed clinical syndrome thought to be linked to neuropath-ology of chronic traumatic encephalopathy (CTE), a condition associated with RHI from football. Cognitive intra-individual variability (d-CIIV) measures test-score dispersion, indicating cognitive dysfunction. This study examined d-CIIV in former football players and its associations with TES diagnosis, RHI exposure, and DTI and CSF biomarkers. <b>Methods:</b> Data included 237 males (45-74 years) from DIAGNOSE CTE Research Project, including former professional and college football players (COL) (<i>n</i> = 173) and asymptomatic men without RHI or TBI (<i>n</i> = 55). Participants completed neuropsychological tests. TES diagnosis was based on 2021 NINDS TES criteria. Years of football play and a cumulative head impact index (CHII) measured RHI exposure. Lumipulse technology was used for CSF assays. DTI fractional anisotropy assessed white matter integrity. Coefficient of variation (CoV) measured d-CIIV. ANCOVA compared d-CIIV among groups (football versus control; TES-status). Pearson correlations and linear regressions tested associations between d-CIIV, RHI exposure, and CSF and DTI biomarkers. <b>Results:</b> Former professional players had higher d-CIIV than controls (F(7, 194) = 2.87, <i>p</i> = .007). d-CIIV was associated with TES diagnosis (F(8, 146) = 9.063, <i>p</i> < .001), with highest d-CIIV in TES Possible/Probable-CTE. Higher d-CIIV correlated with higher CHII scores (<i>r</i> = 0.19), reduced CSF Aβ_1-42 (<i>β</i> = -0.302), increased p-tau₁₈₁ (<i>β<u> </u></i>= 0.374), and reduced DTI FA (<i>β</i> = -0.202). <b>Conclusion:</b> d-CIIV is linked to RHI exposure and TES diagnosis in former football players, with associated changes in CSF biomarkers and white matter integrity.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-29"},"PeriodicalIF":3.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Your clinical interview <i>is</i> data: The benefit of telehealth appointments to triage referrals made to pediatric neuropsychology.","authors":"Jonathan J Mietchen, Tayler M Cieminski, Alanna M Kessler-Jones","doi":"10.1080/13854046.2025.2456160","DOIUrl":"https://doi.org/10.1080/13854046.2025.2456160","url":null,"abstract":"<p><p><b>Objective</b>: We conducted a project to manage a high volume of referrals to pediatric neuropsychology. We aimed to manage referrals for children and adolescents without known medical risk factors. We proposed that a clinical neurodevelopmental interview conducted <i>via</i> telehealth would reduce the number of patients on the waitlist and identify those who do not need neuropsychological evaluation. <b>Method</b>: We conducted clinical neurodevelopmental interviews <i>via</i> telehealth to assess patients' need and urgency for neuropsychological testing. These patients had no or unclear risk factors and non-specific concerns with learning, attention, and/or behavior. We monitored our waitlist over a 2-year period to determine if this service could reduce our waitlist. We measured the time to initial consultation before and after this new service. We surveyed referring providers to assess their satisfaction of this service. <b>Results</b>: Using this new triage consultation service, we found that 1 in 4 children did not require a neuropsychological evaluation. This reduced our waitlist by about 5 months, even while we had an increase in referrals during the same period. After implementation, patients were seen for consultation within a month of the referral. Referring providers were generally satisfied with this service. <b>Conclusions</b>: Implementing telehealth clinical interviews was effective in triaging healthy children with non-specific learning, attention, and/or behavior concerns. This new service effectively reduced our waitlist and offered quick access to neuropsychological consultation and recommendations. Referring providers appreciated efforts to increase access to pediatric neuropsychology services for those who were anticipated to benefit the most from such services.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-20"},"PeriodicalIF":3.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic traumatic encephalopathy: State-of-the-science update and narrative review.","authors":"Breton M Asken, Benjamin L Brett, William B Barr, Sarah Banks, Jennifer V Wethe, Kristen Dams-O'Connor, Robert A Stern, Michael L Alosco","doi":"10.1080/13854046.2025.2454047","DOIUrl":"10.1080/13854046.2025.2454047","url":null,"abstract":"<p><strong>Objective: </strong>The long-recognized association of brain injury with increased risk of dementia has undergone significant refinement and more detailed study in recent decades. Chronic traumatic encephalopathy (CTE) is a specific neurodegenerative tauopathy related to prior exposure to repetitive head impacts (RHI). We aim to contextualize CTE within a historical perspective and among emerging data which highlights the scientific and conceptual evolution of CTE-related research in parallel with the broader field of neurodegenerative disease and dementia.</p><p><strong>Methods: </strong>We provide a narrative state-of-the-science update on CTE neuropathology, clinical manifestations, biomarkers, different types and patterns of head impact exposure relevant for CTE, and the complicated influence of neurodegenerative co-pathology on symptoms.</p><p><strong>Conclusions: </strong>Now almost 20 years since the initial case report of CTE in a former American football player, the field of CTE continues evolving with increasing clarity but also several ongoing controversies. Our understanding of CTE neuropathology outpaces that of disease-specific clinical correlates or the development of in-vivo biomarkers. Diagnostic criteria for symptoms attributable to CTE are still being validated, but leveraging increasingly available biomarkers for other conditions like Alzheimer's disease may be helpful for informing the CTE differential diagnosis. As diagnostic refinement efforts advance, clinicians should provide care and/or referrals to providers best suited to treat an individual patient's clinical symptoms, many of which have evidence-based behavioral treatment options that are etiologically agnostic. Several ongoing research initiatives and the gradual accrual of gold standard clinico-pathological data will pay dividends for advancing the many existing gaps in the field of CTE.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-25"},"PeriodicalIF":3.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single- versus two-test criteria for cognitive impairment: associations with CSF and imaging markers in former American football players.","authors":"Monica T Ly, Caroline Altaras, Yorghos Tripodis, Charles H Adler, Laura J Balcer, Charles Bernick, Henrik Zetterberg, Kaj Blennow, Elaine R Peskind, Sarah J Banks, William B Barr, Jennifer V Wethe, Steve Lenio, Mark W Bondi, Lisa M Delano-Wood, Robert C Cantu, Michael J Coleman, David W Dodick, Jesse Mez, Daniel H Daneshvar, Joseph N Palmisano, Brett Martin, Alexander P Lin, Inga K Koerte, Sylvain Bouix, Jeffrey L Cummings, Eric M Reiman, Martha E Shenton, Robert A Stern, Michael L Alosco","doi":"10.1080/13854046.2025.2451828","DOIUrl":"10.1080/13854046.2025.2451828","url":null,"abstract":"<p><p><b>Objective:</b> Cognitive impairment is a core feature of traumatic encephalopathy syndrome (TES), the putative clinical syndrome of chronic traumatic encephalopathy-a neuropathological disease associated with repetitive head impacts (RHI). Careful operationalization of cognitive impairment is essential to improving the diagnostic specificity and accuracy of TES criteria. We compared single- versus two-test criteria for cognitive impairment in their associations with CSF and imaging biomarkers in male former American football players. <b>Method:</b> 169 participants from the DIAGNOSE CTE Research Project completed neuropsychological tests of memory and executive functioning. Cognitive impairment was identified by single-test criteria (<i>z</i>≤-1.5 on one test) and two-test criteria (<i>z</i><-1 on two tests within a domain). ANCOVAs adjusting for age, race, education, body mass index, word-reading score, and APOE ε4 status assessed whether single- or two-test criteria predicted CSF markers (Aβ_1-42, p-tau₁₈₁, p-tau₁₈₁/Aβ_1-42, total tau, neurofilament light [NfL], glial fibrillary acidic protein [GFAP]) and MRI markers (hippocampal volume, cortical thickness, white matter hyperintensities). <b>Results:</b> Ninety-nine participants met single-test criteria for cognitive impairment. Sixty-six met two-test criteria. Participants who met two-test criteria had greater exposure to RHI than those who did not (<i>p</i>=.04). Two-test criteria were -associated with higher CSF p-tau₁₈₁/Aβ_1-42 (<i>q</i>=.02) and CSF NfL (<i>q</i>=.02). The association between two-test criteria and CSF NfL remained after excluding amyloid-positive participants (<i>q</i>=.04). Single-test criteria were not associated with any biomarkers (<i>q</i>'s>.05). <b>Conclusions:</b> Two-test but not single-test criteria for cognitive impairment were associated with markers of neurodegeneration. Future clinical research in TES may benefit from applying two-test criteria to operationalize cognitive impairment.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-25"},"PeriodicalIF":3.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences and contributors to global cognitive performance in the underrepresented Latinx Parkinson's disease population.","authors":"Saar Anis, Henry Mauricio Chaparro-Solano, Thiago Peixoto Leal, Scott A Sperling, Claire Sonneborn, Camila Callegari Piccinin, Miguel Inca-Martinez, Mario Cornejo-Olivas, Maryenela Illanes-Manrique, Pedro Chana-Cuevas, Paula Safie Awad, Ana Jimena Hernández-Medrano, Amin Cervantes-Arriaga, Artur F S Schuh, Carlos R M Rieder, Pedro Braga-Neto, Antonio Andrei da Silva Sena, Bruno Lopes Santos-Lobato, Emilia M Gatto, Griselda J Alvarado, Cesar L Avila, Vitor Tumas, Maria Paula Foss, Vanderci Borges, Henrique Ballalai Ferraz, Jorge Luis Orozco Vélez, Beatriz Muñoz Ospina, Sonia Moreno, David Pineda, Julia Esther Rios Pinto, Patricio Olguín, Juan Cristobal Nuñez, Angel Viñuela, Alan O Espinal-Martinez, Nicanor Mori, Koni Mejía-Rojas, Angel Medina-Colque, Ana Lucia Zuma Rosso, Celmir Vilaça, Edward Ochoa-Valle, Iván Cornejo-Herrera, Paula Reyes-Perez, Alejandra Lázaro-Figueroa, Anna Letícia de Moraes Alves, Rubens Gisbert Cury, Hubert H Fernandez, Ignacio Mata","doi":"10.1080/13854046.2025.2450020","DOIUrl":"https://doi.org/10.1080/13854046.2025.2450020","url":null,"abstract":"<p><p><b>Objective:</b> Despite significant progress in understanding the factors influencing cognitive function in Parkinson's disease (PD), there is a notable gap in data representation for the Latinx population. This study aims to evaluate the contributors to and disparities in cognitive performance among Latinx patients with PD. <b>Methods:</b> A retrospective analysis was conducted based on cross-sectional data encompassing demographic, environmental, motor, and non-motor disease characteristics from the Latin American Research Consortium on the Genetics of PD (LARGE-PD) and the Parkinson's Progression Markers Initiative (PPMI) cohorts. Linear regression multivariable models were applied to identify variables affecting Montreal Cognitive Assessment (MoCA) scores, accounting for age, sex, and years of education. <b>Results:</b> The analysis comprised of 3,054 PD patients (2,041 from LARGE-PD and 1,013 from PPMI) and 1,303 Latinx-controls. Latinx-PD patients (mean age 63.0 ± 11.8, 56.8% male) exhibited a significantly lower average MoCA score (<i>p</i> < .001) compared to white Non-Hispanic PD patients from PPMI (mean age 67.5 ± 9.9, 61.7% male). This difference persisted when comparing the Latinx-PD to the Latinx-controls (mean age 58.7 ± 9.3, 33.2% male; <i>p</i> < .001). Factors significantly associated with better MoCA scores in Latinx-PD included unilateral symptom onset (<i>p</i> = .009), and higher educational attainment (<i>p</i> < .001). Conversely, those associated with worse scores included the use of dopamine agonists (<i>p</i> = .01), previous tobacco use (<i>p</i> = .01), older age (<i>p</i> < .001), and a higher Hoehn and Yahr scale score (<i>p</i> < .001). <b>Conclusions:</b> Latinx-PD patients demonstrated significantly lower cognitive scores compared to their white non-Hispanic PD counterparts and Latinx-controls. These results highlight the importance of interpreting MoCA scores in a nuanced manner within diverse populations.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-21"},"PeriodicalIF":3.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstructive sleep apnea and polysomnographic predictors of neuropsychological performance two years after injury in a prospective cohort of adults with traumatic brain injury.","authors":"Marc A Silva, Michelle A Babicz-Boston, Benjamin A Sudolcan, Jessica M Ketchum, Karel Calero, Kristen Dams O'Connor, Risa Nakase-Richardson","doi":"10.1080/13854046.2025.2451321","DOIUrl":"https://doi.org/10.1080/13854046.2025.2451321","url":null,"abstract":"<p><p><b>Objective:</b> Obstructive sleep apnea (OSA) has been associated with structural and functional brain changes and cognitive impairment in sleep clinic samples. Persons with traumatic brain injury (TBI) are at increased risk of OSA compared to community samples, and many experience chronic cognitive disability. However, the impact of OSA on cognitive outcome after TBI is unknown. The purpose of this study was to examine the relationship between polysomnographic sleep parameters on neuropsychological performance 2 years following TBI. We hypothesized that oxygen desaturation, sleep fragmentation, and sleep depth would predict neuropsychological performance. <b>Method:</b> Participants (<i>N</i> = 123) were persons with moderate-to-severe TBI who underwent Type 1 Polysomnography during acute neurorehabilitation. At 2 years post-TBI, participants completed telephone-based neuropsychological testing (the Brief Test of Adult Cognition by Telephone). General linear models were fit to investigate the relationship between sleep parameters and neuropsychological performance, controlling for demographics and posttraumatic amnesia. <b>Results:</b> When controlling for demographics, injury characteristics, and other sleep parameters, greater percent of Stage 1 sleep time predicted poorer cognitive performance (Overall BTACT composite, <i>p</i> = 0.0078, η_p2 = 6.6%; Verbal Memory composite, <i>p</i> = 0.0407, η_p2 = 3.9%; Executive Function composite, <i>p</i> = 0.0215, η_p2 = 4.9%). Oxygen desaturation, cortical arousals, Stage 3 sleep, and the obstructive apnea-hypopnea index were not significantly associated with cognitive outcome. <b>Conclusions:</b> Reduced sleep depth was associated with cognitive outcome in persons with TBI; these findings require replication. Future research should examine whether improving sleep (e.g. increasing deep sleep) during acute recovery can improve cognitive recovery following TBI.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-19"},"PeriodicalIF":3.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of direct-to-home teleneuropsychological assessment: a within-subject design study.","authors":"Elif Yildirim, Ezgi Soncu Buyukiscan, Şükriye Akça Kalem, Hakan Gürvit","doi":"10.1080/13854046.2025.2451247","DOIUrl":"https://doi.org/10.1080/13854046.2025.2451247","url":null,"abstract":"<p><p><b>Objective:</b> During the COVID-19 pandemic, the need to continue diagnosis and treatment processes, in addition to scientific research, led to a rapid shift towards direct-to-home tele-neuropsychology administrations, the reliability and validity of which had not been clearly established then. This study, therefore, aimed to examine the reliability of direct-to-home tele-neuropsychological assessment (TNP). <b>Method:</b> The sample included 105 cognitively healthy individuals aged between 50-83 years, and 47 patients diagnosed with neurocognitive disorders (mild cognitive impairment and early-stage Alzheimer's type dementia). All participants underwent both face-to-face and teleneuropsychological assessments in a counterbalanced order. <b>Results:</b> The results revealed that performances across measures of attention, working memory, verbal fluency, verbal and visual memory, and visual perception were comparable across assessment modalities. Intraclass correlation coefficients of the tests ranged from .54 to .92. <b>Conclusions:</b> The findings of the study provide support for direct-to-home teleneuropsychological assessment among patients with neurocognitive disorders. Neuropsychological tests relying on verbal administration and independent of motor performance may represent a reliable alternative for this patient group when administered in settings where external distractions or technological limitations are controlled. For cognitively healthy individuals, on the other hand, the reliability of the TNP application is more questionable for memory and some executive function tests and therefore needs further exploration.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-22"},"PeriodicalIF":3.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term neurobehavioral and neuroimaging outcomes in athletes with prior concussion(s) and head impact exposure.","authors":"Benjamin L Brett, Mikaela E Sullivan, Breton M Asken, Douglas P Terry, Timothy B Meier, Michael A McCrea","doi":"10.1080/13854046.2024.2442427","DOIUrl":"https://doi.org/10.1080/13854046.2024.2442427","url":null,"abstract":"<p><p><b>Objective:</b> The long-term health of former athletes with a history of multiple concussions and/or repetitive head impact (RHI) exposure has been of growing interest among the public. The true proportion of dementia cases attributable to neurotrauma and the neurobehavioral profile/sequelae of multiple concussion and RHI exposure among athletes has been difficult to determine. <b>Methods:</b> Across three exposure paradigms (i.e. group comparisons of athletes <i>vs</i>. controls, number of prior concussions, and level of RHI exposure), this review characterizes the prevalence of neurodegenerative/neurological disease, changes in cognitive and psychiatric function, and alterations on neuroimaging. We highlight sources of variability across studies and provide suggested directions for future investigations. <b>Results:</b> The most robust finding reported in the literature suggests a higher level of symptom endorsement (general, psychiatric, and cognitive) among those with a greater history of sport-related concussion from adolescence to older adulthood. Pathological processes (e.g. atrophy, tau deposition, and hypometabolism) may be more likely to occur within select regions (frontal and temporal cortices) and structures (thalamus and hippocampus). However, studies examining concussion(s) and RHI exposure with imaging outcomes have yet to identify consistent associations or evidence of a dose-response relationship or a threshold at which associations are observed. <b>Discussion:</b> Studies have not observed a simple dose-response relationship between multiple concussions and/or RHI exposure with cognitive, psychiatric, or <i>in vivo</i> neurobiological outcomes, particularly at lower levels of play. The relationship between prior concussion and RHI exposure with long-term outcomes in former athletes is complex and likely influenced by -several non-injury-related factors.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-29"},"PeriodicalIF":3.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABBA Letter Alternation: A telehealth inspired measure of executive functioning/inhibitory control.","authors":"David W Loring, Kelsey C Hewitt, Daniel L Drane, Liping Zhao, Han Xu, James J Lah, Felicia C Goldstein","doi":"10.1080/13854046.2024.2448872","DOIUrl":"https://doi.org/10.1080/13854046.2024.2448872","url":null,"abstract":"<p><p><b>Objective:</b> To introduce ABBA Letter Alternation (ABBA) as a computerized measure of response inhibition/response alternation developed for telehealth following restrictions of in-person testing due to COVID-19. ABBA consists of two PowerPoint-administered trials: Letter Reading of 25 capital As or Bs individually presented, and Letter Alternation with instructions to say the opposite letter to what is presented. <b>Method:</b> We obtained initial normative ABBA performance from 899 healthy research volunteers participating in the Emory Healthy Brain Study (EHBS) with Montreal Cognitive Assessment (MoCA) scores 24/30 and higher. Cutpoints derived from the EHBS sample were applied to a series of 32 Parkinson disease (PD) patients being evaluated for deep brain stimulation to provide preliminary clinical validation. Trail Making B (TMT B) was also examined in both groups. <b>Results:</b> 775 (86.2%) EHBS participants made 0-1 ABBA Letter Alternation errors, 58 (6.5%) EHBS participants had 2 ABBA alternation errors, and 66 (7.3%) made 3+ errors. Applying these thresholds to PD patients, 22 (68.8%) made 0-1 alternation errors, 3 PD (9.4%) patients made 2 errors, and 7 PD subjects (21.8%) made 3+ errors, which significantly differed in frequency from the EHBS group (<i>χ²</i>=9.8, <i>p</i>=.007). EHBS vs. PD differed on MoCA, a medium effect (<i>p</i><.00001; <i>η²=</i>.076), and on TMT B (<i>p</i><.00001; <i>η²=</i>.158), which is considered a large effect. <b>Conclusion:</b> These results provide initial support for ABBA Letter Alternation as a response inhibition/response alternation. Application in larger clinical samples, in both telehealth and face-to-face settings, will be needed to more fully establish ABBA's clinical utility.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-12"},"PeriodicalIF":3.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication adherence feedback with older adults with cognitive impairment: a mixed Methods study.","authors":"Kelli L Sullivan, Emily S Hallowell, Allyson Goldstein, Persis V Commissariat, Lori A Daiello, Jennifer D Davis, Seth A Margolis","doi":"10.1080/13854046.2024.2447094","DOIUrl":"https://doi.org/10.1080/13854046.2024.2447094","url":null,"abstract":"<p><p><b>Objective:</b> Older adults with cognitive impairment are at risk of medication-taking errors. This study assessed the impact of providing medication adherence feedback to cognitively impaired older adults. <b>Methods:</b> Forty participants with mild cognitive impairment or mild dementia had their medication adherence electronically monitored for 8 weeks. They were provided with verbal and visual feedback about their adherence results. Initial participant reactions were elicited using a Motivational Interviewing approach, and self-reported behavior changes were assessed during a follow-up interview. Quantitative analyses assessed relationships among electronically monitored and self-rated adherence, initial reactions to adherence feedback, and subsequently reported medication self-management changes. Thematic analysis determined facilitators and barriers to making self-management changes. <b>Results:</b> Although self-rated adherence was high, electronic monitoring revealed that 20% of the sample had suboptimal adherence (took the recommended dose on <80% of monitored days). Fifty-three percent of the sample reported feeling surprised by their adherence results, and 45% endorsed initial motivation to change self-management behaviors. Motivated participants demonstrated worse electronically monitored adherence than unmotivated peers, and those who were surprised by their medication-taking errors expressed greater initial motivation to change. At follow-up, 50% reported having made changes, and 82.4% of them indicated that this study played a role. Facilitators of making changes included awareness of medication-taking errors and cognitive impairment, whereas barriers included lack of perceived difficulty/need. <b>Conclusions:</b> Adherence monitoring with feedback is feasible and impactful in cognitively impaired older adults. Increasing awareness of medication-taking errors fosters motivation to improve medication self-management and results in participant-reported behavior change.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-21"},"PeriodicalIF":3.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}