Objective: To examine the efficacy of a one-time neuropsychological consultation as an intervention for youth with persistent postconcussive symptoms following mild traumatic brain injury.
Study Design: Using a prospective interrupted time series design, we enrolled 80 patients aged 8-17 years referred consecutively for clinical neuropsychological consultation. Patients needed to have sustained injury between 2 and 12 months prior to enrollment. Parent and child postconcussive symptom ratings were used as the primary outcome measures and were collected at 6 time points, 3 before the neuropsychological consultation and 3 after. Repeated measure ANOVA was used to estimate the magnitude of change in symptom ratings before and after the neuropsychological intervention.
Results: The decrease in symptoms for the week prior to consultation was nonsignificant by both child (P = .63) and parent (P = .19) report. In contrast, for both reporters, the decrease in symptoms at 1 week and 3 months postconsultation was significant (P < .0001). The difference in reported change was also significant when comparing the week before the intervention to the 3 months after (child: P < .0001; parent: P = .0009).
Conclusions: Postconcussive symptoms decreased significantly following the neuropsychological consultation. The primary limitation of the study is that it lacked randomization and a control group. The results warrant further research into the benefits of neuropsychological consultation after mild traumatic brain injury and provide justification for clinical providers to consider referring to neuropsychologists in the face of persistent postconcussive symptoms.
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http://dx.doi.org/10.1016/j.jpeds.2015.10.014 | DOI Listing |
J Alzheimers Dis
January 2025
Department of Neurology and the Franke Barrow Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix, AZ, USA.
Background: The aim of this study was to examine the potential added value of including neuropsychiatric symptoms (NPS) in machine learning (ML) models, along with demographic features and Alzheimer's disease (AD) biomarkers, to predict decline or non-decline in global and domain-specific cognitive scores among community-dwelling older adults.
Objective: To evaluate the impact of adding NPS to AD biomarkers on ML model accuracy in predicting cognitive decline among older adults.
Methods: The study was conducted in the setting of the Mayo Clinic Study of Aging, including participants aged ≥ 50 years with information on demographics (i.
Alzheimers Dement
December 2024
Hospital Italiano de Buenos Aires, Buenos aires, Argentina.
Background: It is common for individuals under the age of 65 to consult neurologists for cognitive complaints ranging from subjective cognitive issues to mood disorders that affect cognitive function. The challenge is rule out attention deficit hyperactivity disorders, other psychiatric causes, and cognitive impairment. In 2020, the Lancet Commission released a report analyzing 12 modifiable risk factors (MRFs) by age group.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Background: Stiffening of the large elastic arteries is an emerging age-related risk factor for Alzheimer's disease (AD) and related dementia (ADRD). Arterial stiffness is associated with pathological changes underlying AD/ADRD, and total arterial stiffness (T-PWV) can be subdivided into two main mechanisms. Structural stiffening (S-PWV) is due to intrinsic remodeling of the artery wall, and load-dependent stiffening (LD-PWV) is due to increased blood pressure without intrinsic changes to the artery wall.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, New York, NY, USA.
Background: Vocal biomarkers are emerging as potentially meaningful health indicators in multiple domains, including cognition. Because voice-enabled devices are widespread, automated vocal analysis could become a useful modality for early detection and monitoring of cognitive impairment. To assess the efficacy of vocal biomarkers in identifying cognitive impairment we evaluated prosodic speech features on vocal tasks in a research cohort from Kerala, India, and a referral cohort from the Montefiore-Einstein Center for the Aging Brain in the Bronx, NY.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Alpert Medical School of Brown University, Providence, RI, USA.
Background: Routine cognitive screening for older adults in primary care could improve AD early detection and streamline referrals for treatment or clinical trials. Digital assessments, especially when self-administered online, can overcome time barriers to cognitive screening in primary care settings and are conducive to repeat testing for disease monitoring and the evaluation of treatment outcomes. We report preliminary data on the feasibility and acceptability of three digital screening approaches for older adults completing annual follow-up visits with a primary care provider (PCP) METHODS: Cognitive screening approaches included: 1) remote online screening with the Boston Online Cognitive Assessment (BOCA) 1-4 weeks prior to the PCP appointment, 2) self-administered BOCA in the waiting room before or after the appointment, and 3) provider-administered screening during the appointment using the Digital Clock and Recall (Linus Health DCR).
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