INS NYC 2024 Program

Poster	Poster Session 03 Program Schedule 02/15/2024 09:30 am - 10:40 am Room: Majestic Complex (Posters 61-120) Poster Session 03: Neurotrauma \| Neurovascular Final Abstract #77 Cognitive Correlates of Functional Assessment Tool in Expanded Sample of Veterans with Mild Traumatic Brain Injury Jillian Tessier, PhD, San Francisco VA, San Francisco, United States Maria Kryza-Lacombe, PhD, San Francisco VA, San Francisco, United States Rachel Santiago, PhD, San Francisco VA, San Francisco, United States Gary Abrams, MD, San Francisco VA, San Francisco, United States Tatjana Novakovic-Agopian, PhD, San Francisco VA, San Francisco, United States Category: Assessment/Psychometrics/Methods (Adult) Keyword 1: ecological validity Keyword 2: traumatic brain injury Keyword 3: executive functions Objective: Ecologically valid assessments offer several benefits when compared to traditional neuropsychological measures, including measuring multiple cognitive domains simultaneously in a setting that approximates the real world. Our group has developed one such tool, the Goal Processing Scale (GPS), and examined its cognitive correlates in multiple brain injury samples. In a previously presented analysis of Veterans with mild traumatic brain injury (mTBI), 7 of 8 GPS subdomains were related to at least one aspect of executive functioning (EF), with the majority related to mental flexibility. Since that time, a larger sample was collected. Thus, the objective of this analysis was to expand previous work examining cognitive correlates of GPS performance. Participants and Methods: Sample included 69 Veterans with chronic mTBI (age = 44.5 ± 14.3; 87% male). The GPS involves planning and executing a complex task following specified rules under a time constraint. Performance is rated by trained evaluators on a 0 (not able) to 10 (absolutely not a problem) scale in 8 domains: 1) Planning, 2) Initiation, 3) Self-Monitoring, 4) Maintenance of Attention, 5) Sequencing and Switching of Attention, 6) Flexible Problem Solving, 7) Task Execution, and 8) Learning and Memory. GPS Overall Performance is the average of 8 domain scores. Neuropsychological assessments were normed and transformed into z-scores. Scores were averaged into 2 domains: 1) Overall Attention/Executive Function (4 subdomains: Working Memory [Auditory Consonant Trigrams, WAIS-III Letter-Number Sequencing], Sustained Attention [Digit Vigilance Test], Inhibition [D-KEFS Stroop Inhibition], Mental Flexibility [Trail Making Test B, D-KEFS Stroop Inhibition Switching, Design Fluency Switching, Verbal Fluency Switching]) and 2) Overall Memory (2 subdomains: Total Recall [HVLT-R, BVMT-R], and Delayed Recall [HVLT-R, BVMT-R]). Correlations (Pearson’s r, Kendall’s Tau) were used to examine relations between GPS and neuropsychological measures, with p<.01 to adjust for multiple comparisons. Results: GPS Overall Performance was significantly related to Overall Attention/Executive Functioning and Overall Memory. There were also many significant subdomain relations. GPS Planning was related to Working Memory and Inhibition. GPS Self-Monitoring was related to Working Memory, Mental Flexibility, and Inhibition. GPS Maintenance of Attention was related to Working Memory, Mental Flexibility, Inhibition, and Total Recall. GPS Attentional Switching was related to Working Memory, Mental Flexibility, Inhibition, Total and Delayed Recall. GPS Flexible Problem Solving was related to Total and Delayed Recall. GPS Execution and Learning and Memory were related to Working Memory, Sustained Attention, Mental Flexibility, and Inhibition. Conclusions: Current findings extend previously published and presented work establishing validity of the GPS in brain injury samples (Novakovic-Agopian et al., 2012; Tessier et al., 2023). Similar to previous findings, mental flexibility, working memory, and inhibition emerged as strongly related to the majority of aspects of GPS performance. Research suggests that prefronto-thalamic connectivity that supports EF may be disrupted after mTBI. Our findings converge with this literature base, suggesting that mental flexibility, inhibition, and working memory relate to application of self-monitoring, maintenance and switching of attention, and task execution on a real-world task in an mTBI sample. Findings lend additional support for the GPS as a useful tool to measure multiple aspects of EF simultaneously.

Poster

02/15/2024
09:30 am - 10:40 am
Room: Majestic Complex (Posters 61-120)

Poster Session 03: Neurotrauma | Neurovascular

Final Abstract #77

Cognitive Correlates of Functional Assessment Tool in Expanded Sample of Veterans with Mild Traumatic Brain Injury

Jillian Tessier, PhD, San Francisco VA, San Francisco, United States
Maria Kryza-Lacombe, PhD, San Francisco VA, San Francisco, United States
Rachel Santiago, PhD, San Francisco VA, San Francisco, United States
Gary Abrams, MD, San Francisco VA, San Francisco, United States
Tatjana Novakovic-Agopian, PhD, San Francisco VA, San Francisco, United States

Category: Assessment/Psychometrics/Methods (Adult)

Keyword 1: ecological validity
Keyword 2: traumatic brain injury
Keyword 3: executive functions

Objective:

Ecologically valid assessments offer several benefits when compared to traditional neuropsychological measures, including measuring multiple cognitive domains simultaneously in a setting that approximates the real world. Our group has developed one such tool, the Goal Processing Scale (GPS), and examined its cognitive correlates in multiple brain injury samples. In a previously presented analysis of Veterans with mild traumatic brain injury (mTBI), 7 of 8 GPS subdomains were related to at least one aspect of executive functioning (EF), with the majority related to mental flexibility. Since that time, a larger sample was collected. Thus, the objective of this analysis was to expand previous work examining cognitive correlates of GPS performance.

Participants and Methods:

Sample included 69 Veterans with chronic mTBI (age = 44.5 ± 14.3; 87% male). The GPS involves planning and executing a complex task following specified rules under a time constraint. Performance is rated by trained evaluators on a 0 (not able) to 10 (absolutely not a problem) scale in 8 domains: 1) Planning, 2) Initiation, 3) Self-Monitoring, 4) Maintenance of Attention, 5) Sequencing and Switching of Attention, 6) Flexible Problem Solving, 7) Task Execution, and 8) Learning and Memory. GPS Overall Performance is the average of 8 domain scores. Neuropsychological assessments were normed and transformed into z-scores. Scores were averaged into 2 domains: 1) Overall Attention/Executive Function (4 subdomains: Working Memory [Auditory Consonant Trigrams, WAIS-III Letter-Number Sequencing], Sustained Attention [Digit Vigilance Test], Inhibition [D-KEFS Stroop Inhibition], Mental Flexibility [Trail Making Test B, D-KEFS Stroop Inhibition Switching, Design Fluency Switching, Verbal Fluency Switching]) and 2) Overall Memory (2 subdomains: Total Recall [HVLT-R, BVMT-R], and Delayed Recall [HVLT-R, BVMT-R]). Correlations (Pearson’s r, Kendall’s Tau) were used to examine relations between GPS and neuropsychological measures, with p<.01 to adjust for multiple comparisons.

Results:

GPS Overall Performance was significantly related to Overall Attention/Executive Functioning and Overall Memory. There were also many significant subdomain relations. GPS Planning was related to Working Memory and Inhibition. GPS Self-Monitoring was related to Working Memory, Mental Flexibility, and Inhibition. GPS Maintenance of Attention was related to Working Memory, Mental Flexibility, Inhibition, and Total Recall. GPS Attentional Switching was related to Working Memory, Mental Flexibility, Inhibition, Total and Delayed Recall. GPS Flexible Problem Solving was related to Total and Delayed Recall. GPS Execution and Learning and Memory were related to Working Memory, Sustained Attention, Mental Flexibility, and Inhibition.

Conclusions:

Current findings extend previously published and presented work establishing validity of the GPS in brain injury samples (Novakovic-Agopian et al., 2012; Tessier et al., 2023). Similar to previous findings, mental flexibility, working memory, and inhibition emerged as strongly related to the majority of aspects of GPS performance. Research suggests that prefronto-thalamic connectivity that supports EF may be disrupted after mTBI. Our findings converge with this literature base, suggesting that mental flexibility, inhibition, and working memory relate to application of self-monitoring, maintenance and switching of attention, and task execution on a real-world task in an mTBI sample. Findings lend additional support for the GPS as a useful tool to measure multiple aspects of EF simultaneously.