Episode 68 | Obstructive Sleep Apnea and Neuropsychology – With Dr. Mark Aloia
Obstructive sleep apnea (OSA) is a disorder of breathing during sleep. It can lead to both sleep fragmentation and hypoxia, it has a negative impact on cardiovascular functioning, and it is associated with various neurobiological, cognitive, and emotional sequelae. OSA is underdiagnosed in the general population, and even following successful diagnosis the most popular treatment (positive airway pressure [PAP] devices) is not always well tolerated, leading to low treatment adherence. Given that OSA impacts the brain and behavior, that it is underdiagnosed, and that successful intervention requires a significant behavior change (e.g., PAP adherence), neuropsychologists have a significant role to play in this public health issue. In the current episode, John and Ryan speak with Dr. Mark Aloia about various aspects of OSA, including an in-depth discussion of cognitive/emotional effects of the condition, as well as motivational interviewing techniques to improve PAP adherence.
Episode 48 | Neuropsychology of Human Immunodeficiency Virus (HIV) – With Dr. April Thames
The U.S. has the largest annual incidence of new human immunodeficiency virus (HIV) diagnoses among high-income nations. This is relevant for neuropsychologists because many individuals with HIV develop a spectrum of cognitive, motor, and/or mood problems collectively known as HIV-Associated Neurocognitive Disorder (HAND). In this episode, we talk with April Thames, Ph.D., about cross-cultural considerations and age-related cognitive decline in HIV.
Episode 64 | Spina bifida and hydrocephalus, Christine Koterba
Approximately one in every 2,800 babies are born with spina bifida each year. Spina bifida is related to multiple physical and neurological symptoms including hydrocephalus, which differs from its presentation in older adults. Today, John and Ryan talk with Christine Koterba, Ph.D., ABPP-CN, about spina bifida, hydrocephalus, and how neuropsychologists can contribute to the care of children with these disorders.
Episode 50 | Non-CNS Cancer and Cognition – With Dr. Mike Parsons
The cognitive consequences of non-central nervous system (non-CNS) cancer and cancer-related treatments did not become the subject of scientific investigation until recently and is still a growing area of research. Contemporary studies have made it clear that neuropsychology is an integral part of the evaluation and care of individuals with cancer. Today we talk with Michael Parsons, Ph.D., ABPP-CN, about the evaluation of cognitive change due to cancer and cancer-related treatment, factors that influence cognitive decline in these patients, and how interdisciplinary work can benefit these patients.
Episode 52 | The Hierarchical Taxonomy of Psychopathology (HiTOP) – With Dr. Robert Latzman
Our current nosology of psychopathology relies on a categorical model that has notable limitations. For example, this medical model of classifying mental disorders does not account for the significant heterogeneity of symptom presentations across psychopathology. Today, we speak with Robert Latzman, Ph.D., to discuss the Hierarchical Taxonomy of Psychopathology (HiTOP), an alternative nosology that uses factor analysis to address the issues with our current diagnostic classification standard.
Episode 63 | COVID-19: The Role of Neuropsychology – With Dr. Chaya Fridman
Emerging research suggests that a sizeable portion of individuals hospitalized due to COVID-19 develop cognitive and psychological sequelae. In our conversation with Dr. Chaya Fridman, a board-certified neuropsychologist at Cornell, we discuss the ways that SARS-CoV-2 (the virus that causes COVID-19) may lead to neurocognitive impairment, including both direct effects of the virus and secondary factors (e.g., respiratory distress and treatments used in the Intensive Care Unit). We review how the virus gains access to the central nervous system and the potential underlying mechanisms by which it causes an increased risk of stroke and other neurological issues. We also examine the long-term effects of prior coronaviruses (SARS-CoV and MERS-CoV) to attempt to forecast the long-term effects of COVID-19, with a focus on how neuropsychological practice (both inpatient and outpatient) might be affected.
Episode 62 | Multiple Sclerosis: Cognitive and Emotional Sequelae – with Dr. Peter Arnett
About 50% of individuals with multiple sclerosis (MS) exhibit cognitive deficits in additional to physical symptoms. Depression and fatigue are also common in MS and can be debilitating. Therefore, it is not uncommon for an individual with MS to be referred for neuropsychological evaluation, making it important for neuropsychologists to familiarize themselves with the neurobiological underpinnings and signs and symptoms of MS. Today, John and Ryan talk with Dr. Peter Arnett about the cognitive and emotional symptoms of MS, and how neuropsychology can contribute to the care of patients with MS.
Episode 20 | The Interplay Between Cerebrovascular Disease and Alzheimer’s Disease – With Dr. Adam Brickman
Adam Brickman, Ph.D., returns to discuss the involvement of white matter disease in Alzheimer’s disease progression and clinical presentation. Dr. Brickman discusses his research on the presence of biomarkers of cerebrovascular disease (e.g., white matter hyperintensities), which are present in aging and Alzheimer’s disease. Although cerebrovascular disease is traditionally associated with its own unique cognitive profile, Dr. Brickman discusses evidence suggesting that the cognitive deficits and underlying etiologies often commingle and complicate our case conceptualization. Additionally, he proposes the integral role that cerebrovascular disease may play in predicting (and possibly initiating) disease progression and cognitive decline in Alzheimer’s disease.
Episode 19 | Redefining Alzheimer’s Disease: Does Cognition Matter? – With Dr. Adam Brickman
The estimated annual cost of healthcare for individuals living with Alzheimer’s disease (AD) or other dementias is almost $300 billion. In addition to this financial burden, the number of adults aged 65 or older is projected to double and it is expected an estimated 10 million of these individuals will develop AD by 2050. Despite global efforts to understand and ultimately assess, diagnose, and treat Alzheimer’s disease (AD) more effectively, a consensus definition of AD still does not exist. In 2018, the National Institute of Aging – Alzheimer’s Association (NIA-AA) Research Framework recommended that we should shift the definition of AD from a syndrome (i.e., the cognitive/behavioral symptoms that individuals present with) to a purely biological construct, specifically the presence of βamyloid deposition, pathologic tau, and neurodegeneration (the “A/T/N” model). In this episode, we talk with Dr. Adam Brickman about the NIA-AA Research Framework biological definition of AD, the role of vascular contributions, assumptions about the amyloid hypothesis, and implications of not including the clinical syndrome in the diagnosis of AD.
Episode 33 | Neuropsychology 3.0 – With Dr. Robert Bilder
Research has repeatedly demonstrated the benefits of neuropsychological evaluations to patients and their families. However, there is great potential for advancement and improvement in the field. For example, there is growing interest in improving the validity of neuropsychological tests in the assessment and prediction of complex medical conditions using biological, statistical, and informatic techniques. We discuss these issues with Robert “Bob” Bilder, Ph.D., ABPP-CN, a leader in the conceptual and technical evolution of the field. We also discuss the problem of inertia, ecological and physiological validity, item response theory, computerized neuropsychological testing, and the National Neuropsychology Network (NNN).