INS NYC 2024 Program

Poster	Poster Session 04 Program Schedule 02/15/2024 12:00 pm - 01:15 pm Room: Shubert Complex (Posters 1-60) Poster Session 04: Neuroimaging \| Neurostimulation/Neuromodulation \| Teleneuropsychology/Technology Final Abstract #19 Mean Performance is the Greatest Predictor of Within-Person Variability on Repeated Smartphone-Based Ecological Momentary Cognitive Testing Laura Campbell, UC San Diego, San Diego, United States Emily Paolillo, UC San Francisco, San Francisco, United States Jessica Bomyea, UC San Diego and VA San Diego Healthcare System, San Diego, United States Colin Depp, UC San Diego and VA San Diego Healthcare System, San Diego, United States Phillip Harvey, University of Miami, Miami, United States Ashley Henneghan, The University of Texas at Austin, Austin, United States Elizabeth Twamley, UC San Diego and VA San Diego Healthcare System, San Diego, United States Raeanne Moore, UC San Diego, San Diego, United States Category: Teleneuropsychology/ Technology Keyword 1: computerized neuropsychological testing Keyword 2: test reliability Keyword 3: test development Objective: Integration of cognitive testing with ecological momentary assessment (EMA) using smartphones, known as ecological momentary cognitive testing (EMCT), is a valuable tool for understanding real-world cognitive functioning. Unlike traditional neuropsychological assessment, EMCT allows for examination of average and variability in performance across relatively short periods of time and contexts. Intraindividual cognitive variability is clinically relevant but has been challenging to measure with traditional neuropsychological testing. Therefore, we examined correlates of within-person variability on EMCTs over time within a 10-day assessment burst, including demographic factors, mood, smartphone type, and average performance. Participants and Methods: This analysis examined adults aged 20-79 (Mean age=45; 52% male; 71% non-Hispanic white; 100% English as a first language; 56% Android users and 44% iOS users) who participated in a normative study of the NeuroUX EMCT platform via their personal smartphones. Participants completed daily EMA surveys for ten consecutive days, on which they reported mood ratings, alcohol/cannabis use, and interruptions/distractions during EMCT. Over a 10-day period, participants completed eight EMCT tests five times. Tests assessed list-learning recognition memory (“Memory List” total correct), visual-span working memory (“Memory Matrix” score, “CopyCat” score), go/no-go response inhibition (“Quick Tap 2” reaction time), cognitive flexibility via an adapted Flanker paradigm (“Hand Swype” reaction time), and psychomotor processing speed (“Matching Pair” reaction time for matching shapes; “Quick Tap 1” reaction time for tapping the target image; “Odd One Out” reaction time for identifying an oddball stimulus). Instances in which participants reported alcohol or cannabis use earlier that day or being interrupted/distracted during testing were excluded. Within-person variability for each test was calculated via the root mean square of successive distances, which accounts for gradual shifts in mean (e.g., practice effects), across the five administrations. Separate multivariable linear regressions examining within-person variability for each test included demographics (age, sex, race/ethnicity, and education), mean depression rating, mean performance, and smartphone type. Bonferroni corrected significance level was 0.00625. Results: Mean performance had the strongest association with within-person variability. Better average performance was associated with less within-person variability for tests of memory (β=-0.382, p<0.001), inhibition (β=-0.466, p<0.001), cognitive flexibility (β=-0.384, p<0.001), and one test of processing speed (Quick Tap 1: β=-0.692, p<0.001). On tests of working memory, better average performance was associated with greater within-person variability (Memory Matrix: β=0.395, p<0.001; CopyCat: β=0.557, p<0.001). Demographic variables, mean depression rating, and smartphone type were not associated with within-person variability after Bonferroni correction. Conclusions: Participants who performed better on average exhibited greater consistency in their performance across most measures. However, the opposite pattern was observed in working memory tests, possibly due to the difficulty of these tasks at higher levels of performance. These findings support more research into the reliability and confidence intervals of single administration neuropsychological test scores across different levels of performance. This research underscores the advantages of EMCT to assess within-person variability and may be particularly useful to examine populations that may be vulnerable to cognitive fluctuations; future studies should examine clinical populations to understand differential correlates of within-person variability across populations.

Poster

02/15/2024
12:00 pm - 01:15 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 04: Neuroimaging | Neurostimulation/Neuromodulation | Teleneuropsychology/Technology

Final Abstract #19

Mean Performance is the Greatest Predictor of Within-Person Variability on Repeated Smartphone-Based Ecological Momentary Cognitive Testing

Laura Campbell, UC San Diego, San Diego, United States
Emily Paolillo, UC San Francisco, San Francisco, United States
Jessica Bomyea, UC San Diego and VA San Diego Healthcare System, San Diego, United States
Colin Depp, UC San Diego and VA San Diego Healthcare System, San Diego, United States
Phillip Harvey, University of Miami, Miami, United States
Ashley Henneghan, The University of Texas at Austin, Austin, United States
Elizabeth Twamley, UC San Diego and VA San Diego Healthcare System, San Diego, United States
Raeanne Moore, UC San Diego, San Diego, United States

Category: Teleneuropsychology/ Technology

Keyword 1: computerized neuropsychological testing
Keyword 2: test reliability
Keyword 3: test development

Objective:

Integration of cognitive testing with ecological momentary assessment (EMA) using smartphones, known as ecological momentary cognitive testing (EMCT), is a valuable tool for understanding real-world cognitive functioning. Unlike traditional neuropsychological assessment, EMCT allows for examination of average and variability in performance across relatively short periods of time and contexts. Intraindividual cognitive variability is clinically relevant but has been challenging to measure with traditional neuropsychological testing. Therefore, we examined correlates of within-person variability on EMCTs over time within a 10-day assessment burst, including demographic factors, mood, smartphone type, and average performance.

Participants and Methods:

This analysis examined adults aged 20-79 (Mean age=45; 52% male; 71% non-Hispanic white; 100% English as a first language; 56% Android users and 44% iOS users) who participated in a normative study of the NeuroUX EMCT platform via their personal smartphones. Participants completed daily EMA surveys for ten consecutive days, on which they reported mood ratings, alcohol/cannabis use, and interruptions/distractions during EMCT. Over a 10-day period, participants completed eight EMCT tests five times. Tests assessed list-learning recognition memory (“Memory List” total correct), visual-span working memory (“Memory Matrix” score, “CopyCat” score), go/no-go response inhibition (“Quick Tap 2” reaction time), cognitive flexibility via an adapted Flanker paradigm (“Hand Swype” reaction time), and psychomotor processing speed (“Matching Pair” reaction time for matching shapes; “Quick Tap 1” reaction time for tapping the target image; “Odd One Out” reaction time for identifying an oddball stimulus). Instances in which participants reported alcohol or cannabis use earlier that day or being interrupted/distracted during testing were excluded. Within-person variability for each test was calculated via the root mean square of successive distances, which accounts for gradual shifts in mean (e.g., practice effects), across the five administrations. Separate multivariable linear regressions examining within-person variability for each test included demographics (age, sex, race/ethnicity, and education), mean depression rating, mean performance, and smartphone type. Bonferroni corrected significance level was 0.00625.

Results:

Mean performance had the strongest association with within-person variability. Better average performance was associated with less within-person variability for tests of memory (β=-0.382, p<0.001), inhibition (β=-0.466, p<0.001), cognitive flexibility (β=-0.384, p<0.001), and one test of processing speed (Quick Tap 1: β=-0.692, p<0.001). On tests of working memory, better average performance was associated with greater within-person variability (Memory Matrix: β=0.395, p<0.001; CopyCat: β=0.557, p<0.001). Demographic variables, mean depression rating, and smartphone type were not associated with within-person variability after Bonferroni correction.

Conclusions:

Participants who performed better on average exhibited greater consistency in their performance across most measures. However, the opposite pattern was observed in working memory tests, possibly due to the difficulty of these tasks at higher levels of performance. These findings support more research into the reliability and confidence intervals of single administration neuropsychological test scores across different levels of performance. This research underscores the advantages of EMCT to assess within-person variability and may be particularly useful to examine populations that may be vulnerable to cognitive fluctuations; future studies should examine clinical populations to understand differential correlates of within-person variability across populations.