Wernicke’s encephalopathy (WE) is an acute neurological condition caused by thiamine deficiency. The typical presentation is characterized by a triad of oculomotor abnormalities, gait ataxia, and altered mental status, though patients rarely present with all three symptoms. WE is a serious medical condition that is associated with high rates of morbidity and mortality if left untreated. It is most commonly seen in patients with severe alcohol use disorder; however, it has also been found in patients with thiamine deficiency due to other causes of malnutrition such as prolonged starvation, hyperemesis, dialysis, cancer, and geriatric surgery. Despite growing research demonstrating WE in non-alcoholic populations, it is frequently misdiagnosed in patients without an extensive alcohol-use history, particularly when they do not present with the typical clinical triad of symptoms. Thus, more knowledge about non-alcoholic WE is needed to improve diagnostic accuracy.

We present a case of a 26-year-old male with an unremarkable alcohol use history, who was diagnosed with WE following a 6-week period of excessive nausea and vomiting of unclear etiology. He presented to the ED three times prior to his diagnosis, and was treated with intravenous hydration, Zofran, and Pepcid. He presented to the ED for the fourth time with altered mental status and gait ataxia and was diagnosed with WE based on MRI findings. He was admitted and treated with high doses of IV thiamine and folate. His clinical course was tracked over time via outpatient neurology examinations, and his cognitive functioning was assessed with an outpatient neuropsychological evaluation approximately six months post-discharge. Record review, including clinical notes, lab tests, and imaging results supplement his outpatient neuropsychological evaluation performance.

Data from a comprehensive outpatient neuropsychological evaluation approximately six months after WE diagnosis is presented. His cognitive profile was characterized by impaired performance on measures of verbal fluency and memory, including encoding and retention of verbal and visual information (with minimal benefit from cueing). Given these impairments and continued functional declines related to cognitive deficits, he met criteria for a Major Neurocognitive Disorder. These results demonstrate persistent cognitive deficits beyond the acute WE period.

WE is a serious neurological condition that can have lasting cognitive effects if left untreated. This case demonstrates persistent cognitive impairments six months after WE diagnosis in a young patient with an unremarkable alcohol history. These findings highlight the necessity of increased diagnostic efficiency of WE in non-alcoholic patients, as immediate thiamine treatment is essential to the recovery process. Neuropsychological functioning at a longer interval will be useful in further elucidating cognitive prognosis as well as providing quality of life recommendations.

Primary progressive aphasia (PPA) is a dementia syndrome characterized by initial development of progressive language deficits in the absence of impairment in other cognitive domains. It has historically been difficult to assess the presence or nature of true memory deficits in this population due to interference from language disturbance on task performance. The Three Words Three Shapes test (3W3S) is a relatively easy memory task that evaluates both verbal and nonverbal memory within the same modality and assesses different aspects of memory, including incidental encoding, effortful encoding, delayed recall, and recognition. Persons with PPA show a material-specific dissociation in performance on 3W3S; specifically, deficits in incidental encoding and recall are limited to verbal, not nonverbal material, in PPA, with preserved recognition of both types of information. However, it is unknown whether this pattern persists over time as the disease progresses.

Participants were 73 participants enrolled in an observational PPA research study at the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease (Mage = 66.75 years, SD = 6.77; Meducation = 16.11 years, SD = 2.38; 51% female). Participants were subtyped as semantic (n = 15), logopenic (n = 27), or agrammatic PPA (n = 31) based on Gorno-Tempini et al., 2011, using 3W3S and other neuropsychological measures as described previously. Participants were followed at 2-year intervals and tests were administered longitudinally. All participants in the current study had 3W3S scores from at least two research visits collected between September 2012 and September 2022.

There were no significant baseline group differences on 3W3S performance, except for better incidental encoding in the logopenic than the semantic group for shapes (p = .040) and words (p = .043). We then conducted a mixed measures ANOVAs to determine baseline within-person comparisons between words vs shapes. Within individuals, performance on incidental encoding, effortful encoding, and recognition was worse for words than shapes (ps < .01). There was an interaction between material and group for delayed recall (p < .001) such that there was a significantly larger discrepancy between word and shape recall in the semantic (Mdiff = -9.14) compared to logopenic (Mdiff = -3.07) and agrammatic groups (Mdiff = -2.13). Repeated measures ANOVAs determined changes in scores over time collapsed across PPA subtypes. Incidental encoding (ps = <.01), effortful encoding (ps < .05), and delayed recall (ps < .01) declined for both words and shapes over time. Copy and recognition of words (ps < .05), but not shapes declined over time.

The current results are consistent with prior findings of relative preservation of memory for nonverbal compared to verbal material in PPA as measured by 3W3S, especially in the semantic subtype. Learning and recall of words and shapes declined over time in all groups, whereas there was selective decline in copy and recognition of words compared to shapes. These results provide evidence of differential patterns of decline in certain aspects of memory over time in PPA and highlight the relative preservation of memory in this language-focused dementia even over time.

Research shows intrusions in memory tests can predict cognitive impairment in abnormal aging. However, there still is a need for additional research regarding the association of intrusions in verbal fluency tasks and clinical diagnosis of mild cognitive impairment, and dementia. The aim of this research is to determine if there is an association between intrusion totals in verbal fluency tasks and diagnosis, longitudinally (across 3 years), if there are significant differences between category and phonemic fluency tasks in intrusion total scores, and if progression from cognitively normal (CN) to mild cognitive impairment (MCI) or dementia and from MCI to dementia can be indicated through differences in intrusion scores.

Participants were recruited from the Memory Disorders Center at Wien Center for Alzheimer’s Disease and Memory Disorders at Mount Sinai Medical Center in Miami, Florida to take part in the ongoing 1Florida Alzheimer’s Disease Research Center (ADRC) project. At baseline, participants had an average of 15 years of education (M = 15.00, SD = 3.65), were an average of 72.24 years old (M = 72.24, SD = 7.99), and were 62.93% female. At baseline (Visit/ year 1), there were 88 CN, 229 MCI, and 58 dementia participants. Participants were asked to complete Categorical and Phonemic verbal fluency tasks in which correct words said and intrusions were collected. Intrusion totals were quantified as the sum of intrusions within each subsection of the tasks (i.e., fruits, vegetables, and animals for the category; F, L, A, S for phonemic). Intrusion totals and correct words were analyzed across diagnostic groups and progressor vs. non-progressor groups.

Results indicated that intrusions are significantly associated with diagnosis in Phonemic fluency tasks, however, this was not the case for Category fluency tasks. Higher phonemic fluency task intrusions were associated with more severe cognitive decline. In progressor versus non-progressor groups there were no significant differences in intrusion totals. Lower correct scores for category and phonemic fluency tasks were found to be significantly associated with increased severity of diagnosis. Lower correct scores also significantly predicted progressor classification.

These findings suggest possible association of higher intrusion errors in verbal fluency tasks with more severe cognitive decline. Although these indications were significant, further research exploring intrusions and cognitive diagnosis are still needed.

To examine the feasibility of implementing a cardiorespiratory exercise stimulus during functional Magnetic Resonance Imaging (fMRI).

12 young adults (age: 18-22 years) completed progressive maximal exercise testing and a brain MRI scan. During scanning, participants completed three runs of functional MRI (volumes = 619; TR = 800 ms; multiband = 4; voxel size = 3 mm3). During each 8 minute fMRI run, participants completed an exercise challenge consisting of alternating blocks of exercise and rest. Exercise was implemented with a cardiostepper, an MRI-compatible device (similar to a Stairmaster) capable of generating a cardiorespiratory exercise stimulus. During exercise blocks, participants stepped at a rate of 60 Hz with pedal resistance determined by participants' fitness level. Heart rate and respiration data were collected during MRI. fMRI data were processed and analyzed using FMRIB Software Library (FSL). The ARtifact Detection Toolbox (ART) software was also used to identify volumes with significant artifact, and ICA-AROMA was used to remove motion-related BOLD signal components.

During exercise blocks, heart rate increased (mean = 131 beats per minute) compared to rest (mean = 87 beats per minute; t(34) = 4.3; p < .001). The mean heart rate during exercise blocks corresponds to an exercise intensity in the light to moderate intensity range for this age group. Motion (median framewise displacement) was significantly higher during exercise (mean = .53 mm) than rest (mean = .36 mm). Across all blocks, ART classified 19.8% of brain volumes as artifact-containing outliers, with 69% of the outliers occurring during exercise blocks. Although greater head motion was observed during exercise, the use of ICA-AROMA reduced the impact of motion considerably, recovering an additional 25% of the task-related signal, relative to noise. Comparison of fMRI activity during exercise versus rest revealed significant associations with primary and supplementary motor cortices, hippocampus, and the insula, among other regions.

The current study demonstrates the feasibility of eliciting light to moderate intensity cardiorespiratory exercise (using a lower body stepping exercise) during functional MRI. Although increased head motion was observed during exercise compared to rest, the degree of head motion was roughly approximate to the values published in previous fMRI studies and post image acquisition processing improved task-related signal. During exercise, increased brain activation was observed in regions associated with the central command network, which regulates autonomic nervous system and musculoskeletal function during exercise.

As the global population of older adults increases, it is crucial to study the healthy aging brain. Despite representing approximately 50% of brain tissue, investigations of changes in white matter (WM) have been limited. Given that women outlive men in most populations worldwide, evaluating factors such as sex and gender in the normal aging trajectory are particularly important. However, past research has been limited by varying definitions of these terms and methodological challenges. Further, limited studies have employed longitudinal designs. The objective of the present study was to 1) compare sex similarities and differences in WM microstructure, and 2) investigate longitudinal changes in WM in healthy older adults. The Parkinson’s Progression Markers Initiative (PPMI) is an ongoing observational longitudinal study designed to investigate biomarkers related to Parkinson’s disease. For up-to-date information, please see: https://www.ppmi-info.org/. The PPMI study presents a convenient opportunity to investigate the expected aging trajectory among healthy older adults by using data from its healthy control cohort.

Participants (N=40) included 16 females (mean age = 60.50 + 5.99) and 24 males (mean age = 65.50 + 7.53) from the healthy control cohort of the PPMI. Diffusion tensor imaging (DTI) data from two time points (baseline and approximately one year later) were analyzed using tract-based spatial statistics from the FMRIB Software Library (FSL). Diffusion weighted images were acquired with a Siemens 3T TIM Trio scanner with a 12 channel Matrix head coil. All images were acquired with a spin echo, echo planar imaging sequence with 64 gradient directions and a b-value of 1000s/mm2 with a voxel size of 2 mm3. Two analyses were conducted: 1) between-groups, comparing differences in WM microstructure between males and females at baseline while controlling for age and total brain volume (TBV), and 2) within-subject, examining longitudinal changes in WM from baseline to one year later. DTI metrics included fractional anisotropy (FA) and mean diffusivity (MD).

Males were significantly older than females and had significantly larger TBVs. Results of voxelwise comparisons revealed no statistically significant differences in FA or MD between males and females when controlling for age and TBV. Longitudinally over one year, decreases in MD (p<.05, corrected) were found in the right superior and inferior longitudinal fasciculus, the right corticospinal tract, and the right inferior fronto-occipital fasciculus. Stability in FA was observed over one year. There was also an average of a one-point decline on the Montreal Cognitive Assessment during the study period of one year.

No significant sex differences in WM microstructure were found, which agrees with a published review of the literature that men and women show very similar brain structure after accounting for brain size differences. Across the entire sample, longitudinal changes in WM were captured via neuroimaging across a one-year time frame. Follow-up exploration of these data suggests great intraindividual variability in trajectories over time, which may have affected the overall group trajectory. Continued research of factors that contribute to the identifying individual healthy aging trajectories is warranted.

The locus coeruleus (LC) plays a key role in cognitive processes such as attention, executive function, and memory. The LC has been identified as an early site of tau accumulation in Alzheimer’s disease (AD). LC neurons are thought to survive, albeit with limited functionality, until later stages of the disease, though how exactly this limited functionality impacts cognition through the course of AD is still poorly understood. We investigated the interactive effects of an imaging biomarker of the LC and AD-related cerebrospinal fluid (CSF) biomarkers on attention, executive function, and memory.

We recruited 67 older adults from the San Diego community (mean age=74.52 years; 38 cognitively normal, 23 with mild cognitive impairment, and 6 with probable AD). Participants had LC-sensitive magnetic resonance imaging (MRI) used to obtain a measure of LC signal relative to surrounding tissue, with lower LC signal possibly indicating limited functionality. Participants also underwent a lumbar puncture to obtain CSF measurements of amyloid-beta 42 (Ab42) and phosphorylated tau (p-tau). We calculated the p-tau/Ab42 ratio, which is positively correlated with AD progression. Finally, participants were administered a comprehensive neuropsychological battery, and cognitive composites were created for attention (Digit Symbol, Digit Span Forward, Trails A), executive function (Digit Span Backward, Trails B, Color-Word Inhibition Switching), and two measures of verbal memory [learning (CVLT List A 1-5, Logical Memory Immediate Recall) and delay (CVLT Long Free Recall, Logical Memory Delayed Recall)]. Four multiple linear regressions modeled the relationship between each composite with age, gender, education, p-tau/Ab42, average LC contrast, and interactions between average LC contrast and p-tau/Ab42. For models that were statistically significant, additional regressions were assessed to determine which segment of the LC (caudal, middle, rostral) contributed to the relationship.

Our model predicted attention (p=.001, R2=.298) with main effects of average LC signal, p-tau/Ab42, and LC by p-tau/Ab42 interaction. Follow-up regressions revealed that each LC segment contributes to this relationship. Our model predicted executive function (p=.006, R2=.262) with a main effect of average LC signal and LC by p-tau/Ab42 interaction. Follow-up regressions revealed that this relationship was limited to the caudal and middle LC. Our models predicted both verbal learning (p<.001, R2=.512) and delayed memory (p<.001, R2=.364); both with main effects of gender and education. Follow-up regressions revealed that the rostral LC signal interacts with p-tau/Ab42 to predict both verbal learning and delayed memory. For all interactions, those with low p-tau/Ab42 exhibited a positive relationship between LC signal and cognition, whereas those with higher p-tau/Ab42 showed a negative relationship.

MR-assessed LC signal relates to attention, executive function, and verbal learning and memory in a manner that depends on CSF levels of p-tau and Ab42. The relationship between LC signal and cognition is positive at low levels and negative at higher levels of p-tau/Ab42. If lower LC signal indicates reduced integrity, these findings imply that MR-assessed LC signal may be a more meaningful marker of AD progression in earlier stages of the disease. Alternatively, this measure may capture a different underlying mechanism depending on tau and amyloid biomarker status.

Depression and borderline personality disorder (BPD) are frequently comorbid psychiatric disorders that reliably share deficits in executive functioning (EF). In addition to EF, meta-analytic evidence indicates that processing speed and verbal memory are also affected in depression and BPD, but the impact of BPD further spans the domains of attention, nonverbal memory, and visuospatial abilities. Suicidality is a notable phenotypic commonality in depression and BPD. Neuropsychologically, there are consistent discrepancies between individuals who have and have not thought about suicide in global cognitive functioning, as well as between those who have attempted suicide and those who have just thought about suicide in EF. This study aims to replicate the effect size differences between these groups and explore whether neuropsychological functioning relates to dimensional measures of psychopathology.

Right-handed women between the ages of 18 and 55 were recruited into one of three diagnostic groups: a) current major depressive episode (MDD; n=22); b) current major depressive episode with comorbid BPD (MDD+BPD; n=19); and c) absence of current major depressive episode and BPD (controls; n=20). Groups were also classified based on historical suicide attempt and on the presence or absence of historical suicidal ideation. Exclusions included bipolar disorder, neurodevelopmental disorder, moderate/severe brain injury, neurological illness, serious physical illness, eating disorder, and moderate/severe alcohol/substance use disorder. Participants were administered the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD), Beck Depression Inventory (BDI-II), Interpersonal Needs Questionnaire (INQ), UPPS-P Impulsive Behavior Scale, Everyday Memory Questionnaire, Brief Visuospatial Memory Test (BVMT), California Verbal Learning Test (CVLT), Delis-Kaplan Executive Function System (D-KEFS) Color-Word Interference Test, D-KEFS Trail Making Test, D-KEFS Verbal Fluency, Wechsler Adult Intelligence Scale-IV Coding and Digit Span subtests, Wechsler Memory Scale-IV Logical Memory, and Wechsler Test of Adult Reading.

With one exception, analyses of raw scores indicated there were no significant neuropsychological differences between groups based on diagnosis, historical suicidal ideation, and suicide attempt (p>.05). However, individuals with MDD+BPD, historical suicidal ideation, or suicide attempt endorsed more memory complaints than the other groups with large effect size differences. Differences in self-reported impulsivity indicated large effects between controls and MDD+BPD, moderate to large effects when comparing controls to MDD and MDD to MDD+BPD, and moderate effects among the suicidal ideation and suicide attempt groups. Impulsivity was rated highest in those with MDD+BPD, historical suicidal ideation, or suicide attempt. These analyses applied false-discovery rate correction and adjusted for age. Using ridge regressions to separately predict depressive symptoms, BPD symptoms, and suicide risk factors, neuropsychological indices were most associated with suicide risk factors and explained 22.8% of INQ variance. Conversely, these indices explained 9.6% of ZAN-BPD variance and 0.6% of BDI-II variance.

The neuropsychological literature on BPD describes moderate crosscutting neuropsychological dysfunction, and clarifying the distinct cognitive alterations associated with comorbid psychiatric disorders and suicide phenomena offers novel avenues of research for investigating their mechanisms. While neuropsychological functioning may not strongly relate to psychiatric symptomatology, it may contribute to meaningful algorithms of suicide risk in individuals with depression and BPD.

Schizophrenia is often disguised as a crisis of adolescence. We want to understand how schizophrenia manifests itself in speech. We expect the difference in the Word Fluency Association Task (WFAT) in Normality Index and Time Delay.

The analyses data was collected by the WFAT (authored by V.Kritskaya). WFAT actualize speech connections based on past experience. Stimuli - various syllables of 2-letters (20 pcs.), 3-letters (30 pcs.), varying in frequency of use (compiled on the basis of the Corpuses of the Russian language). Instruction: “Now I will tell you a syllable, your task is to complete the proposed syllable to words as quickly as possible, your words must be real”. For study purposes we subdivided the sample into two subgroups: 12-14 years, 15-17 years. For statistical analysis we used U-criterion, Mann-Whitney. Analyzed parameters:

Normality index (NI) - the ratio of productive nouns to the amount of the standard associations

Time delay (TD) - response delay of the subject (sec., millisec.)

Study involved 57 participants: 27 adolescents with schizophrenia (Cl_G) aged from 12 to 18 years, assessed in the hospital setting (DS: F20.xx, F21.xx) and 30 normotypal peers (Co_G) assessed in the school setting. Exclusion criteria: patients in the acute psychotic phase, left-handers.

NI grouped with the following rates: subgroup 1- Co_G 70,4, Cl_G 58,5, subgroup 2 - Co_G 65,2, Cl_G 56,1 There was no statistically significant difference between Cl_g Co_g in NI (P=0,000 and p=0,002 respectively). TD grouped with the following rates: subgroup 1-Co_G 2,42, Cl_G 22,63, subgroup 2 - Co_G 4,48, Cl_G 3,14 There was statistically significant difference between Cl_g Co_g in TD (P=0,432 and p=0,25 respectively).

Temporal indicators of cognitive activity differ in the clinical and control groups, which testifies to the significance of this indicator in the context of WFAT. There is no difference in terms of semantics. However, we expect to see it, because such difference has previously been shown in a group of adult patients with a severe type of schizophrenia. In the future, we would like to expand the group and select additional methods that evaluate the semantic component.

Long-term exposure to the psychoactive ingredient in cannabis, delta-9-tetrahydrocanabinol (THC), has been consistently raised as a notable risk factor for schizophrenia. Additionally, cannabis is frequently used as a coping mechanism for individuals diagnosed with schizophrenia. Cannabis use in schizophrenia has been associated with greater severity of psychotic symptoms, non-compliance with medication, and increased relapse rates. Neuropsychological changes have also been implicated in long-term cannabis use and the course of illness of schizophrenia. However, the impact of co-occurring cannabis use in individuals with schizophrenia on cognitive functioning is less thoroughly explored. The purpose of this meta-analysis was to examine whether neuropsychological test performance and symptoms in schizophrenia differ as a function of THC use status. A second aim of this study was to examine whether symptom severity moderates the relationship between THC use and cognitive test performance among people with schizophrenia.

Peer-reviewed articles comparing schizophrenia with and without cannabis use disorder (SZ SUD+; SZ SUD-) were selected from three scholarly databases; Ovid, Google Scholar, and PubMed. The following search terms were applied to yield studies for inclusion: neuropsychology, cognition, cognitive, THC, cannabis, marijuana, and schizophrenia. 11 articles containing data on psychotic symptoms and neurocognition, with SZ SUD+ and SZ SUD- groups, were included in the final analyses. Six domains of neurocognition were identified across included articles (Processing Speed, Attention, Working Memory, Verbal Learning Memory, and Reasoning and Problem Solving). Positive and negative symptom data was derived from eligible studies consisting of the Positive and Negative Syndrome Scale (PANSS), the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), Self-Evaluation of Negative Symptoms (SNS), Brief Psychiatric Rating Scale (BPRS), and Structured Clinical Interview for DSM Disorders (SCID) scores. Meta analysis and meta-regression was conducted using R.

No statistically significant differences were observed between SZ SUD+ and SZ SUD-across the cognitive domains of Processing Speed, Attention, Working Memory, Verbal Learning Memory, and Reasoning and Problem Solving. Positive symptom severity was found to moderate the relationship between THC use and processing speed, but not negative symptoms. Positive and negative symptom severity did not significantly moderate the relationship between THC use and the other cognitive domains.

Positive symptoms moderated the relationship between cannabis use and processing speed among people with schizophrenia. The reasons for this are unclear, and require further exploration. Additional investigation is warranted to better understand the impact of THC use on other tests of neuropsychological performance and symptoms in schizophrenia.

Cognitive deficits in patients diagnosed with schizophrenia are a core feature of the disorder. There are currently no treatments for these cognitive deficits. Our aim was to examine and compare patterns of increased versus decreased activity in the central executive network (CEN), salience network (SN), and default mode network (DMN) between healthy controls (HCs) and patients diagnosed with schizophrenia (SZs) as well as to explore the influence of task load on these networks between HCs and SZs.

Analyses focused on a secondary dataset comprising Blood Oxygen-Level Dependent (BOLD) data collected from 25 HCs and 27 SZs who completed a working memory (WM) task (N-back) with 5 load conditions while undergoing functional magnetic resonance imaging (fMRI). Region of interest (ROI) data were analyzed using linear mixed-effects models.

Group activation differences were found in the posterior salience network (pSN), default mode network (DMN), dorsal default mode network (dDMN), and ventral default mode network (vDMN) showing greater activity for SZs. Specifically, pSN, DMN, dDMN, and vDMN all showed increased activity in SZs compared to HCs. The curve of brain activity was consistent between HCs and SZs with the exception of the vDMN, where HCs show greater activation at modest mental workload (quadratic curve) and SZs showed greater brain activation at lower mental workload (linear). In the CEN, there were no group differences, and the response curve was the same for both groups.

These group differences demonstrate network difference between HCs and SZs and could show value in treatments targeting cognitive deficits in SZs from a large-scale brain network connectivity perspective. Future studies are needed to confirm these results with larger sample size in order to examine potential subtleties of interactions between these networks.

Cognitive deficits in first-episode psychosis (FEP) are well documented, particularly aspects of cognitive control, which is one of the primary hypothesized functions of the frontoparietal network (FPN). The clinical features of psychotic disorders are known to differ between men and women, but little work has systematically studied neurobiological differences between the sexes, particularly in FEP. The current study aimed to examine sexual dimorphisms in structural integrity of the frontoparietal network (FPN) and its role in cognitive control in FEP.

A total of 111 FEP patients (68 male, 43 female) and 55 healthy control participants (35 male, 20 female) from the Human Connectome Project for Early Psychosis underwent T1-weighted magnetic resonance imaging and neuropsychological testing were included in the study. Regions of interest (ROIs) included: left and right superior frontal gyrus, left and right middle frontal gyrus, left inferior frontal gyrus, left and right inferior parietal gyrus, right caudate and left thalamus. Using high-dimensional brain mapping procedures, surface shape of the caudate and thalamus was characterized using Large Deformation Diffeomorphic Metric Mapping, and cortical thickness of frontal and parietal regions was estimated using the FreeSurfer toolkit. Cognitive control was assessed using the Fluid Cognition Composite score from the NIH Toolbox Cognition Battery. Multivariate ANOVA models tested group differences, separated by sex, in cortical thickness ROIs, in addition to a whole-brain vertex-wise analysis. Vertex-wise statistical surface t-maps evaluated differences in subcortical surface shape, and Pearson correlations tested relationships between brain regions and Fluid Cognition performance.

Results of deep brain region comparisons between schizophrenia males (SCZM) and schizophrenia females (SCZF) groups revealed significant outward deformation at the tail of the right caudate and significant inward deformation along the dorsal aspects of the right caudate. Additionally, significant inward deformation in multiple nuclei of the left thalamus were revealed. Significant negative relationships between Fluid Cognition and the left superior/middle frontal gyrus (r = -0.24, p = 0.05) in the male FEP group were observed. Additionally, significant positive relationships between Fluid Cognition and left inferior frontal gyrus (r = 0.35, p = 0.02) and left inferior parietal gyrus (r = 0.35, p = 0.02) in the female FEP group were found.

Overall, findings revealed significant brain differences of the FPN in deep-brain structures only, including abnormal caudal and thalamic shape, in male FEP compared to female FEP, providing evidence of the importance to examine sex differences in deep-brain regions at the first episode. Differential brain relationships with cognitive control also highlight sex-specific presentations that may aid in clinical management and further characterization of the illness in early stages.

Compared to older men, Alzheimer’s Disease (AD) is more common in older women, who present with higher levels of pathological tau and accelerated memory decline, although it is unclear why. Furthermore, sleep complaints increase with age, with older women reporting worse sleep quality than older men, and past studies have linked sleep disturbances to tau. Because of the life-long “verbal memory advantage” in women over men, nonverbal memory may more accurately reflect tau burden in women since sex differences are not as apparent. Here, in a sample of older women in the Women Inflammation Tau Study (WITS), we examined the associations between subjective sleep quality, tau in temporal regions, and memory, and whether tau would be more strongly related to nonverbal memory than verbal memory.

In WITS, women have elevated AD polygenic hazard scores and have mild cognitive impairment as indicated by the telephone Montreal Cognitive Assessment (range:13-20). This preliminary sample of 20 women (aged 72.0±3.7) completed the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality in 7 domains of sleep health over the past month. A global score (range:0-21) is calculated, with a score >5 indicative of being a poor sleeper. Participants also underwent positron emission tomography (PET) with the 18F-MK6240 tracer and T1-weighted magnetic resonance imagining (MRI) to determine tau deposition. Standardized uptake value ratio (SUVR) was calculated using the inferior cerebellum grey matter as the reference region, which was created from Automated Anatomic Labeling atlas in native T1 space. The region of interest (ROI) was a composite meta-temporal region. The Rey Auditory Verbal Learning Test (RAVLT) and Logical Memory (LM) Story A and B were administered to assess verbal memory. The Brief Visuospatial Memory Test-Revised (BVMT-R) was administered to assess nonverbal memory. Analysis focused on the delayed recall scores from the memory tests. Partial correlation was used to analyze the associations between PSQI global score, tau-PET SUVR in meta-temporal ROI, and memory delayed recall scores, while adjusting for age and education years.

8 women were poor sleepers indicated by the PSQI global score (mean:4.9±2). Worse subjective sleep quality was associated with greater tau in meta-temporal ROI (r=0.63, p=0.005) and lower BVMT-R delayed recall (r=-0.46, p=0.05). Sleep quality was not significantly related to either RAVLT or LM delayed recall (all p’s>0.40). Tau in meta-temporal ROI was not significantly associated with nonverbal (p=0.23) or verbal memory (all p’s>0.40) delayed recall.

In this preliminary analysis, subjective sleep quality was linked to temporal tau deposition and nonverbal memory delayed recall, which may suggest that poor sleep exacerbates pathogenesis of tau that leads to memory difficulties in older women at increased risk for AD. Although tau was not significantly related to any memory measures, we will explore whether tau will mediate or moderate the relationship between sleep quality and nonverbal memory once we are powered to do so. Continual evaluation and treatment of sleep may be imperative in mitigating AD risk, especially for older women, however, future longitudinal studies will be necessary to investigate this.

Probability bias—overestimation of the likelihood that feared social outcomes will occur—is a mechanism targeted for symptom reduction in cognitive behavioral therapy for social anxiety. Safety behaviors (i.e., the conscious and unconscious actions taken to reduce discomfort in feared social situations) are related to cognitive biases and can be manipulated to reduce probability bias. The purpose of this research was to test the hypothesis that scores from a newly developed computer task to measure probability bias, the Outcome Probability Task (OPT; Draheim & Anderson, 2022) would be associated with self-reported safety behaviors during a speech task.

Participants (N=90) included diverse students from a university in a southern, metropolitan area. Individuals reported an average age of 20.74 (SD=3.57) and self-identified as 'Woman’ (69%), 'Man’ (30%), 'Transgender’ (1%), or 'Non-binary/Agender’ (1%), and 'African American or Black’ (52%), 'Asian or Asian American’ (19%), 'White’ (16%), 'Multi-racial’ (7%), 'Hispanic or Latine’ (5%), or 'Middle Eastern’ (1%). Participants viewed social images and imagined themselves in the scenarios, then rated the likelihood that they would be negatively evaluated on a 0-100% scale (higher ratings indicate greater probability bias), gave a speech, and completed a standardized self-report measure of safety behaviors to rate how often they engaged in avoidant safety behaviors during the speech.

Results from a linear regression indicated that OPT scores (ß=.43) were positively associated with self-reported safety behaviors during a speech task, R2 = .19, F(1, 88) = 20.02, p < .001, 95% CI [0.170, 0.443].

Negatively biased expectations about fear-relevant social situations—measured by a digital imagery task, the OPT—may contribute to increased engagement in avoidant safety behaviors during a speech task among a convenience sample. Outcome probability bias has previously only been measured through self-report, and the OPT is a promising new measure to multi-modally assess this aspect of social cognition. This task could be used along with imaging techniques to better understand the functional brain activity involved in outcome probability bias. Future studies could explore how activity in the orbitofrontal cortex, which is associated with the anticipation of negative outcomes, relates to responses on the OPT. If there is a connection, this brain region could be an indicator of improvement following intervention, such as cognitive behavioral therapy, for probability biases involved in social anxiety.

We aim to highlight a unique case that required adaptation of a neuropsychological battery used as part of a pre-surgical workup for medically refractory epilepsy, to meet the needs of a culturally and linguistically-diverse patient with visual impairment.

Comprehensive pre-surgical neuropsychological evaluation for a 34-year-old Spanish-speaking patient with a past medical history of epilepsy, hydrocephalus, and a subependymal giant cell astrocytoma resection, with subsequent complete blindness. EEG findings demonstrated abnormal left frontal dysfunction. A neuropsychological evaluation was conducted utilizing components from the Neuropsychological Screening Battery for Hispanics (NeSBHIS) as well as additional supplemental Spanish language assessments. Due to the patient’s visual impairment, visuospatial measures were unable to be utilized. Hand dynamometer was used in place of the Grooved Pegboard Test.

Results from the evaluation indicated a generally intact cognitive profile with a few observed deficits. Relative and normative weaknesses were identified on tasks of verbal learning. His initial learning of a list of orally presented words was in the Low Average range, where he demonstrated a positive though somewhat flat learning profile. His performances on short- and long-delay free recall tasks were in the Exceptionally Low range. With a recognition format, he performed within normal limits and made no false positive errors. Importantly, during the initial learning of the word list, the patient demonstrated a significant number of repetitions (13) and semantically related intrusions (6). These likely led to downstream difficulties encoding information; however, he displayed a minimal loss of information over a delay. Similarly, his immediate and delayed recall of an orally presented story fell in the Exceptionally Low range. Additional relative weaknesses were observed on tasks of working memory (Low Average range) and on a task of phonemic fluency (Below Average range). This performance was a notable contrast to his performance on tasks of semantic fluency, which ranged from the Low Average to Average range. On a task of motor functioning, grip strength performances were intact bimanually (Low Average to Average range) without a significant asymmetry between his left and right hands. Lastly, formal assessment of emotional functioning on self-report measures revealed minimal depression, minimal anxiety, and no significant quality of life concerns.

Taken together, the weaknesses observed in the domains of verbal learning, working memory, and phonemic fluency, in addition to the learning profile observed during the verbal encoding task, suggest that his overall profile is indicative of dominant frontal systems dysfunction. This finding was concordant with prior EEG and MRI studies. Notably, given the patient’s visual impairment, visuospatial measures were unable to be utilized, and lateralization was unable to be fully assessed given the abbreviated battery. The neuropsychological battery used for this evaluation was based on established guidelines, and while there were limitations in administration of the present battery, it is imperative to highlight the necessity and feasibility for adaptation of protocols to best capture data in culturally-underrepresented and visually impaired populations.