INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #43 Independent Phonemic/Semantic Fluency Deficits in a PTLD Clinic Population Marianne Gorlyn, Columbia University/NYSPI, New York, United States Ellen Brown, Columbia University/NYSPI, New York, United States Ana Camacho, Columbia University/NYSPI, New York, United States John Keilp, Columbia University/NYSPI, New York, United States Brian Fallon, Columbia University/NYSPI, New York, United States Category: Medical/Neurological Disorders/Other (Adult) Keyword 1: language Keyword 2: lyme disease Keyword 3: infectious disease Objective: Post-Treatment Lyme disease (PTLD) is a constellation of symptoms that reemerge and persist after antibiotic treatment. Neuropsychological deficits are common in PTLD, typically affecting processing speed and memory. However, patients with PTLD also complain of word finding and language difficulties. In a research sample, we previously demonstrated verbal fluency deficits in PTLD that were independent of both general verbal ability and Lyme-related problems in processing speed and memory (Gorlyn et al., 2022). The goal of this analysis was to determine if this could be replicated in a clinic sample. Participants and Methods: Patients presenting for a Lyme disease diagnostic evaluation at New York Presbyterian Medical Center were included if they completed both medical and neuropsychological assessments and met established criteria for probable or definite PTLD (118 of 262 total patients). Of these, 63 were excluded from analysis because they had (a) never received adequate antibiotic treatment in the past, (b) other significant medical or neurological illnesses affecting cognition (c) other comorbid tick borne diseases, or (d) were not native English speakers. This final sample of 55 PTLD patients was compared to a sample of healthy volunteers (HV, n=57) archived from other studies. Neuropsychological assessment included Phonemic (F-A-S) and Semantic (Animals) Fluency tasks; abbreviated WAIS-IV that allowed computation of the Verbal Comprehension Index (VCI); Trail Making and WAIS-IV Coding to assess processing speed; and Buschke Selective Reminding Test (BSRT) and WMS-IV Logical Memory to measure verbal memory. Data analysis employed the covariance analysis conducted in our previous paper: PTLD and HV groups were compared on fluency performance (Phonemic, Semantic, and composite score) covarying for general verbal ability (VCI), processing speed (averaged z-scores of Trails and Coding), and verbal memory (averaged z-scores for BSRT and Logical Memory), to determine if these cognitive skills accounted for group differences in fluency performance. Results: PTLD and HV groups were similar in age, sex distribution, education level, and NAART reading score (High Average for both groups). After covariance adjustments, PTLD patients were significantly poorer on the composite fluency measure (p=.037) and on Phonemic (p=.006) but not on Semantic (p=.551) Fluency. All fluency measures covaried significantly with the VCI (p<.001, p<.001, and p=.006, respectively) and the processing speed composite score (p<.001, p=.002, p=.019, respectively). Conclusions: Data here replicate our prior report that language fluency is an independent cognitive deficit in PTLD, but also reinforce the superiority of the Phonemic Fluency task for characterizing this deficit. The differential sensitivity of the two fluency tasks may be useful in identifying the cerebral pathology underlying language impairment in PTLD, as phonemic fluency has been shown to utilize a broad frontoparietal white matter network and phonemic fluency deficits linked to disruption of inferior prefrontal and supplementary motor control regions of the cortex. Further exploration of language impairment in PTLD is needed.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #43

Independent Phonemic/Semantic Fluency Deficits in a PTLD Clinic Population

Marianne Gorlyn, Columbia University/NYSPI, New York, United States
Ellen Brown, Columbia University/NYSPI, New York, United States
Ana Camacho, Columbia University/NYSPI, New York, United States
John Keilp, Columbia University/NYSPI, New York, United States
Brian Fallon, Columbia University/NYSPI, New York, United States

Category: Medical/Neurological Disorders/Other (Adult)

Keyword 1: language
Keyword 2: lyme disease
Keyword 3: infectious disease

Objective:

Post-Treatment Lyme disease (PTLD) is a constellation of symptoms that reemerge and persist after antibiotic treatment. Neuropsychological deficits are common in PTLD, typically affecting processing speed and memory. However, patients with PTLD also complain of word finding and language difficulties. In a research sample, we previously demonstrated verbal fluency deficits in PTLD that were independent of both general verbal ability and Lyme-related problems in processing speed and memory (Gorlyn et al., 2022). The goal of this analysis was to determine if this could be replicated in a clinic sample.

Participants and Methods:

Patients presenting for a Lyme disease diagnostic evaluation at New York Presbyterian Medical Center were included if they completed both medical and neuropsychological assessments and met established criteria for probable or definite PTLD (118 of 262 total patients). Of these, 63 were excluded from analysis because they had (a) never received adequate antibiotic treatment in the past, (b) other significant medical or neurological illnesses affecting cognition (c) other comorbid tick borne diseases, or (d) were not native English speakers. This final sample of 55 PTLD patients was compared to a sample of healthy volunteers (HV, n=57) archived from other studies. Neuropsychological assessment included Phonemic (F-A-S) and Semantic (Animals) Fluency tasks; abbreviated WAIS-IV that allowed computation of the Verbal Comprehension Index (VCI); Trail Making and WAIS-IV Coding to assess processing speed; and Buschke Selective Reminding Test (BSRT) and WMS-IV Logical Memory to measure verbal memory. Data analysis employed the covariance analysis conducted in our previous paper: PTLD and HV groups were compared on fluency performance (Phonemic, Semantic, and composite score) covarying for general verbal ability (VCI), processing speed (averaged z-scores of Trails and Coding), and verbal memory (averaged z-scores for BSRT and Logical Memory), to determine if these cognitive skills accounted for group differences in fluency performance.

Results:

PTLD and HV groups were similar in age, sex distribution, education level, and NAART reading score (High Average for both groups). After covariance adjustments, PTLD patients were significantly poorer on the composite fluency measure (p=.037) and on Phonemic (p=.006) but not on Semantic (p=.551) Fluency. All fluency measures covaried significantly with the VCI (p<.001, p<.001, and p=.006, respectively) and the processing speed composite score (p<.001, p=.002, p=.019, respectively).

Conclusions:

Data here replicate our prior report that language fluency is an independent cognitive deficit in PTLD, but also reinforce the superiority of the Phonemic Fluency task for characterizing this deficit. The differential sensitivity of the two fluency tasks may be useful in identifying the cerebral pathology underlying language impairment in PTLD, as phonemic fluency has been shown to utilize a broad frontoparietal white matter network and phonemic fluency deficits linked to disruption of inferior prefrontal and supplementary motor control regions of the cortex. Further exploration of language impairment in PTLD is needed.