A-186 Preliminary Development of an Embedded Measure of Effort on the Memory Module of the Neuropsychological Assessment Battery (NAB)

Objective The Neuropsychological Assessment Battery (NAB) is an integrated neuropsychological battery for assessing cognitive skills in adults. The current study utilizes performance validity tests (PVTs) to interpret poor effort for scores on the NAB. Method Sample consisted of 306 adult civil litigants referred for a neuropsychological evaluation aged 18 to 85 years with a mean age of 43 years. Education ranged from 8 to 20 years with a mean of 14 years of education. Poor effort was denoted by “failing” 2 or more PVTs versus individuals who did not fail any PVTs (“pass”). Results Independent-samples t-tests were run to determine if there were differences in NAB Memory Module scores between the “pass” and “fail” groups. Multiple scores on NAB Memory Module yielded statistically significant differences. Scores were then used in subsequent ROC curve analyses to determine appropriate cutoff scores with an intent to maximally balance sensitivity and specificity. ROC curve analyses were favorable (i.e., AUC > 0.70) and yielded cut scores for List Learning A Immediate Recall (≤ 18), List Learning A Short Delayed Recall (≤ 6), List Learning A Long Delayed Recall (≤ 4), Shape Learning Immediate Recognition (≤ 15), Daily Living Memory Immediate Recall (≤ 39), Daily Living Memory Delayed Recall (≤ 11), List Learning A Discriminability (≤ 7), and Name/Address/Phone Delayed Recall (≤ 4) with sensitivity values ranging from 0.70 to 0.78 and specificity values ranging from 0.70 to 0.84. Conclusion Results provide preliminary evidence of suggested cutoffs to identify suspected poor effort for various scores in the NAB Memory Module.

A-192 Preliminary Evidence to Support Use of Personal Protective Equipment (PPE) during Administration of the Neuropsychological Assessment Battery (NAB)

Objective In June 2020, the American Psychological Association acknowledged that use of personal protective equipment (PPE) was key to psychologists safely resuming in-person services. However, there is no empirical evidence on the impact of PPE in delivering the provision of essential mental health services. Of particular concern is the unprecedented use of PPE during psychological assessment, which inherently breaches standardized test administration procedures. The current study provides preliminary evidence to support use of PPE during administration of the Neuropsychological Assessment Battery (NAB). Method This is a paired-case control study in which participants were administered the NAB using PPE. These individuals were matched based on age, sex, and education with participants from the same setting who were administered the NAB using standardized test administration procedures. Results Independent samples t-tests were run to determine if there were differences in index scores between the PPE and non-PPE groups. There were no significant differences in the standard scores for the NAB Total Index and all NAB Index scores with the exception of Language. Among the subtests that comprise the Language Index, only T-scores on the Oral Production subtest difference significantly between the PPE and non-PPE groups. Conclusions With the exception of the Language Index, index standard scores for both groups were found to be generally statistically equivalent. Given the sample size and setting limitations, no clear conclusions can be drawn about why performance varied between groups on the Language Index. Nevertheless, these data provide preliminary support for the use of PPE during administration of selected modules of the NAB.

Executive Functions Influence on Memory Process in Patients with Paranoid Schizophrenia and Bipolar Disorders with and without Psychotic Symptoms. A Pilot Study

The objective of the present study was to evaluate whether declarative memory deficits are related to executive function deficits (EF), since they could be a consequence of a poor organization of the material to memorize. This interaction between both cognitive processes can be studied simultaneously in a single task such as the Test of Memory Strategies (TSM). 23 patients with paranoid schizophrenic disorder, 11 with bipolar disorder with psychotic symptoms, 13 with bipolar disorder without psychotic symptoms and 15 healthy subjects were evaluated with the TSM; with the memory test Texts A and B (subtest of the Barcelona neuropsychological assessment battery), which assesses short-term and immediate recall without the influence of EF; and with the Trail Making Test (TMT): Part A (sustained attention) and Part B (executive control). The patients groups and the control group showed an improvement in memory performance across each of the TSM conditions. However, this facilitating effect of the strategies differed among the groups (the patients with higher EF deficits showed less improvement). Regarding these results, we conclude that this cognitive process cannot be independent of EF. However, due to the pilot nature of this study, it would be recommended to replicate these findings in new studies.

The neuropsychological assessment battery (NAB) is a valuable tool for evaluating neuropsychological outcome after aneurysmatic subarachnoid hemorrhage

Background Detecting and treating neuropsychological deficits after aneurysmatic subarachnoid hemorrhage (aSAH) play a key role in regaining independence; however, detecting deficits relevant to social and professional reintegration has been difficult and optimal timing of assessments remains unclear. Therefore, we evaluated the feasibility of administering the Neuropsychological Assessment Battery screening module (NAB-S) to patients with aSAH, assessed its value in predicting the ability to return to work and characterized clinical as well as neuropsychological recovery over the period of 24 months. Methods A total of 104 consecutive patients treated for aSAH were recruited. After acute treatment, follow up visits were conducted at 3, 12 and 24 months after the hemorrhage. NAB-S, Montreal Cognitive Assessment (MoCA) and physical examination were performed at each follow up visit. Results The NAB-S could be administered to 64.9, 75.9 and 88.9% of the patients at 3, 12 and 24 months, respectively. Moderate impairment of two or more neuropsychological domains (e.g speech, executive function, etc.) significantly correlated with inability to return to work at 12 and 24 months as well as poor outcome assessed by the extended Glasgow Outcome Scale (GOSE) at 3, 12 and 24 months. The number of patients with favorable outcomes significantly increased from 25.5% at discharge to 56.5 and 57.1% at 3 and 12 months, respectively, and further increased to 74.1% after 24 months. Conclusion The NAB-S can be administered to the majority of patients with aSAH and can effectively detect clinically relevant neuropsychological deficits. Clinical recovery after aSAH continues for at least 24 months after the hemorrhage which should be considered in the design of future clinical trials.

A-149 Boy with Rolandic Epilepsy Benefited from Visuospatial Training

Objective Children with epilepsy can have delay in the development of neurocognitive abilities. It is important to receive the evidence for efficiency of different treatments that are aimed to help children with epilepsy. The goal of this study was to assess the impact of 16 weeks of visuospatial training on the visuospatial abilities in 7 years of age child with Rolandic epilepsy. Methods The child is 7 year old boy with Rolandic epilepsy. The neuropsychological assessment of child has revealed the deficit in visuospatial abilities. Child participated in 16 weeks of visuospatial training. A total of 42 therapy sessions lasting 50 minutes were performed. This training trains the child to do different visuospatial exercises both on motor and cognitive level. This training is built on the conceptual framework derived from the work of Luria’s theory of restoration of neurocognitive functions (Luria, 1963, 1974). Results Neuropsychological assessment of child after the intervention period has revealed apparent progress in performance of 3 subtests from Luria’s neuropsychological assessment battery for children which designed to asses visuospatial functions (Head subtest, mental rotation, design copying). Conclusion According to result of this case report it can be assumed that visuospatial training can be used as a prospective approach for development of visuospatial functions in children with Rolandic epilepsy. However, we need to prove this result using visuospatial training for children with Rolandic epilepsy who suffer from deficit in visuospatial abilities.

A-120 Practice Effects on Repeat Neuropsychological Assessment of Adults with Chronic Severe TBI

Objective This study examined whether practice effects caused by repeated exposure to test materials during serial assessment significantly impacts the performance of adults with chronic severe traumatic brain injury (sTBI), given the severe memory impairment typical of this population. This study sought to describe the pattern of practice effects on repeat neuropsychological testing for this population. It was hypothesized that practice effects would be diminished for individuals with chronic sTBI. Method This study utilized longitudinal archival data collected as part of an annual neuropsychological assessment battery administered to 43 individuals receiving post-acute rehabilitation services at a structured multisite day treatment program. Each participant was tested at two time points which differed by an average of 13 months. The battery consisted of the Texas Functional Living Scale (TFLS), Trail Making Test (TMT), Brief Mood Survey, Neuropsychological Assessment Battery (NAB) Screening Module (NAB-SN), and Judgment subtest from the NAB Executive Functions Module (NAB Judgment). Results Practice effects were determined based on reliable improvement (p < .05) in scores across test administrations. A Reliable Change Index (RCI) was calculated for each test based on the method proposed by Jacobson and Truax (1991). Results revealed reliable improvements in performance for the NAB-SN Attention domain (RCI = 3.69), NAB Judgment subtest (RCI = 10.14), and TFLS Total Score (RCI = 4.38). Conclusion This study indicates that adults with chronic sTBI demonstrate significant practice effects primarily on measures associated with functional living skills. These findings suggest that repeat testing in this population may be less susceptible to the influence of practice effects.

Cognitive performance in patients with cerebral arteriovenous malformation

OBJECTIVEA cerebral arteriovenous malformation (cAVM) can change over time and cause symptoms, but clinical studies tend to define only the patients with ruptured cAVMs as symptomatic and do not consider neurocognitive aspects prior to neurosurgical intervention. The objective of this study was to describe the neurocognitive function of patients with ruptured and unruptured cAVMs according to the Spetzler-Martin (SM) grade, flow status, and anatomical topography.METHODSIn this blinded cross-sectional study, 70 patients of both sexes and ages 18–60 years were evaluated using the Brazilian Brief Neuropsychological Assessment Battery Neupsilin.RESULTSOf the 70 patients with cAVMs, 50 (71.4%) demonstrated deficits in at least one of the eight neurocognitive domains surveyed, although they did not exhibit neurological deficits. cAVMs in the temporal lobe were associated with memory deficits compared with the general population. The SM grade was not significantly associated with the results of patients with unruptured cAVMs. However, among patients with ruptured cAVMs, there were deficits in working memory in those with high-grade (SM grade) cAVMs and deficits in executive function (verbal fluency) in those with low-grade cAVMs (p < 0.001).CONCLUSIONSThis study indicates that patients with untreated cAVMs, either ruptured or unruptured, already exhibit neurocognitive deficits, even the patients without other neurological symptoms. However, the scales used to evaluate disability in the main clinical studies, such as A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA), do not assess neurocognitive alterations and therefore disregard any deficits that may affect quality of life. The authors’ finding raises an important question about the effects of interventional treatment because it reinforces the hypothesis that cognitive alterations may be preexisting and not determined by interventions.