INS NYC 2024 Program

Poster	Poster Session 05 Program Schedule 02/15/2024 02:30 pm - 03:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 05: Neuropsychiatry \| Addiction/Dependence \| Stress/Coping \| Emotional/Social Processes Final Abstract #52 Executive Function Subcomponents and Processing Speed are Differentially Related to Functional Impairment and White Matter Hyperintensities in Covert Cerebral Small Vessel Disease Hanna Jokinen, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki; Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland Hanna Laakso, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland Anne Arola, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland Teemu Paajanen, Work Ability and Working Careers Unit, Finnish Institute of Occupational Health, Helsinki, Finland Jussi Virkkala, Work Ability and Working Careers Unit, Finnish Institute of Occupational Health, Helsinki, Finland Teppo Särkämö, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland Tommi Makkonen, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland Johanna Pitkänen, Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland Antti Korvenoja, Department of Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland Susanna Melkas, Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland Category: Stroke/Cerebrovascular Injury and Disease (Adult) Keyword 1: executive functions Keyword 2: attention Keyword 3: vascular cognitive impairment Objective: Cerebral small vessel disease (cSVD) is one of the major causes of progressive cognitive and functional impairment in older people. Currently, there is no consensus of assessment methods for the identification of cognitive impairment in cSVD and no single test has the ability to differentiate cSVD from other neurocognitive disorders. Executive functions and processing speed have shown relatively greater deficits in those with early cSVD as compared to healthy controls, but it remains unclear whether the different subcomponents of executive abilities are equally affected and whether some tests are more sensitive in detecting impairment than others. This study investigated the associations of specific executive abilities (cognitive flexibility, response inhibition, working memory) and processing speed with instrumental activities of daily living (IADL) and white matter hyperintensity (WMH) volume in subjects with covert cSVD. Participants and Methods: 152 participants from the Helsinki Small Vessel Disease Study (age 65-75 years) with varying degrees of WMH but no clinical stroke or dementia were evaluated with a comprehensive neuropsychological assessment and quantitative structural MRI analysis. The measures of executive functions and processing speed included the Wechsler adult intelligence scale (WAIS-IV) Coding subtest, Stroop test, Hayling sentence completion test, Brixton spatial anticipation test, verbal fluency test, Wechsler memory scale (WMS-III) Digit span and Number-letter sequencing subtasks. In addition, the computerized Flexible attention test (FAT), Simon task and Sustained attention to response task (SART) were used. IADL was evaluated with the Amsterdam IADL questionnaire. Results: As evaluated with linear regression analyses adjusted for age, sex and education, we found significant associations between WMH volume and measures within all evaluated subdomains, but there were marked differences between individual test results. The strongest associations with WMH were observed for the FAT Numbers and Number-letter task (computerized tests based on the Trail making test), FAT Visuospatial span, Simon task and semantic verbal fluency. IADL score had the strongest associations with FAT Numbers and the Simon task. Some of the widely used clinical tests such as the Stroop inhibition, phonemic fluency and Digit span failed to reach significance with either WMH volume or IADL score. Conclusions: Deficits in processing speed and executive function subcomponents of flexibility, initiation, inhibition and working memory are significantly related to functional impairment and severity of WMH in covert cSVD. However, the strength of associations within subdomains is highly dependent on the psychometric method. Computerized tests providing precise measures of reaction times and response accuracy seem to outperform many of the conventional paper-and-pencil tests. These results have implications for observational studies and intervention trials, where the selection of sensitive outcome measures is crucial.

Poster

02/15/2024
02:30 pm - 03:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 05: Neuropsychiatry | Addiction/Dependence | Stress/Coping | Emotional/Social Processes

Final Abstract #52

Executive Function Subcomponents and Processing Speed are Differentially Related to Functional Impairment and White Matter Hyperintensities in Covert Cerebral Small Vessel Disease

Hanna Jokinen, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki; Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Hanna Laakso, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Anne Arola, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Teemu Paajanen, Work Ability and Working Careers Unit, Finnish Institute of Occupational Health, Helsinki, Finland
Jussi Virkkala, Work Ability and Working Careers Unit, Finnish Institute of Occupational Health, Helsinki, Finland
Teppo Särkämö, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Tommi Makkonen, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Johanna Pitkänen, Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Antti Korvenoja, Department of Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Susanna Melkas, Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland

Category: Stroke/Cerebrovascular Injury and Disease (Adult)

Keyword 1: executive functions
Keyword 2: attention
Keyword 3: vascular cognitive impairment

Objective:

Cerebral small vessel disease (cSVD) is one of the major causes of progressive cognitive and functional impairment in older people. Currently, there is no consensus of assessment methods for the identification of cognitive impairment in cSVD and no single test has the ability to differentiate cSVD from other neurocognitive disorders. Executive functions and processing speed have shown relatively greater deficits in those with early cSVD as compared to healthy controls, but it remains unclear whether the different subcomponents of executive abilities are equally affected and whether some tests are more sensitive in detecting impairment than others. This study investigated the associations of specific executive abilities (cognitive flexibility, response inhibition, working memory) and processing speed with instrumental activities of daily living (IADL) and white matter hyperintensity (WMH) volume in subjects with covert cSVD.

Participants and Methods:

152 participants from the Helsinki Small Vessel Disease Study (age 65-75 years) with varying degrees of WMH but no clinical stroke or dementia were evaluated with a comprehensive neuropsychological assessment and quantitative structural MRI analysis. The measures of executive functions and processing speed included the Wechsler adult intelligence scale (WAIS-IV) Coding subtest, Stroop test, Hayling sentence completion test, Brixton spatial anticipation test, verbal fluency test, Wechsler memory scale (WMS-III) Digit span and Number-letter sequencing subtasks. In addition, the computerized Flexible attention test (FAT), Simon task and Sustained attention to response task (SART) were used. IADL was evaluated with the Amsterdam IADL questionnaire.

Results:

As evaluated with linear regression analyses adjusted for age, sex and education, we found significant associations between WMH volume and measures within all evaluated subdomains, but there were marked differences between individual test results. The strongest associations with WMH were observed for the FAT Numbers and Number-letter task (computerized tests based on the Trail making test), FAT Visuospatial span, Simon task and semantic verbal fluency. IADL score had the strongest associations with FAT Numbers and the Simon task. Some of the widely used clinical tests such as the Stroop inhibition, phonemic fluency and Digit span failed to reach significance with either WMH volume or IADL score.

Conclusions:

Deficits in processing speed and executive function subcomponents of flexibility, initiation, inhibition and working memory are significantly related to functional impairment and severity of WMH in covert cSVD. However, the strength of associations within subdomains is highly dependent on the psychometric method. Computerized tests providing precise measures of reaction times and response accuracy seem to outperform many of the conventional paper-and-pencil tests. These results have implications for observational studies and intervention trials, where the selection of sensitive outcome measures is crucial.