| Poster | Poster Session 09 Program Schedule
02/16/2024
03:30 pm - 04:45 pm
Room: Majestic Complex (Posters 61-120)
Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease
Final Abstract #83
Failure on ACS Word Choice Test and its Association with Other Neuropsychological Measures in Adults with Epilepsy
Melissa Myers, Dartmouth Health, Lebanon, United States
Nahal Heydari, Dartmouth Health, Lebanon, United States
Jared Hammond, Dartmouth Health, Lebanon, United States
Grant Moncrief, Dartmouth Health, Lebanon, United States
Anna Graefe, Dartmouth Health, Lebanon, United States
Robert Roth, Dartmouth Health, Lebanon, United States
Category: Epilepsy/Seizures
Keyword 1: epilepsy / seizure disorders
Keyword 2: neuropsychological assessment
Keyword 3: performance validity
Objective:
The ACS Word Choice test (WCT) is a standalone performance validity test (PVT) that utilizes a dichotomous forced choice format. To our knowledge, the only published data on WCT performance in persons with epilepsy (PWE) is within the WCT manual and involves post-surgical patients. Therefore, we examined WCT performance and its association with performance on other neuropsychological tests in a sample of pre-surgical PWE.
Participants and Methods:
The sample consisted of 67 PWE, without history of neurosurgery, seen for clinical neuropsychological evaluation at a large Northeastern academic medical center (2021-2023). The sample had mean age of 40.88 years (SD = 12.93, range = 18-66), 13.49 years of education (SD = 2.33, range = 9-21), was 50.7% female, and predominantly White (98.5%). As part of a larger battery, patients completed the WCT, California Verbal Learning Test (CVLT-3), WMS-IV Logical Memory (LM), and WAIS-IV [(we restricted analyses to FSIQ, Digit Span (DS), and reliable digit span (RDS)]. As not all patients completed all tests, sample sizes varied for invalid vs. valid comparisons (25-67). Invalid WCT was operationalized as ≤ 45 for accuracy (WCT-A) and ≥ 171 seconds for completion time (WCT-T) (Tyson et al., 2023; Erdodi et al., 2016).
Results:
Mean WCT-A score was 48.40 (SD = 2.49). The subset of patients with invalid WCT-A (11.9%) had poorer CVLT-3 total trials 1-5 (p = .015), short- (p = .004) and long- (p = .006) delay free recall, and recognition hits (p <.001). In those also having WCT-T (N = 51), mean time was 123.92 seconds (SD = 69.55). Those with invalid WCT-T (13.4%) also had poorer CVLT-3 total trials 1-5 (p = .038), FSIQ (p = .048), and DS (p = .021). Only 4.5% were invalid for both WCT-A and WCT-T. CVLT-3 Forced Choice Recognition (FCR) was lower with either invalid WCT-A (p < .001) or WCT-T (p = .018), but RDS was only lower with invalid WCT-T (p = .040). Less than 1% of patients had an invalid WCT score and either invalid FCR or RDS. WCT scores were unrelated to age, education, WMS-IV LM, or number of antiepileptic drugs.
Conclusions:
The vast majority of PWE obtained valid WCT scores, and very few were invalid for both accuracy and time. WCT accuracy and time showed different patterns of association with other measures. Those with invalid WCT-A showed worse verbal learning and memory across several CVLT-3 scores, while invalid WCT-T was related only to worse CVLT-3 total trials 1-5, but also lower FSIQ and attention/working memory. Thus, both WCT-A and WCT-T should be considered when interpreting performance validity on the WCT. Few patients with invalid WCT were also invalid on embedded PVTs (CVLT-3 FCR or RDS), though this may be due to the limited subsample with invalid WCT performance. There is limited data on PVTs in PWE despite the importance of assessing suboptimal performance, especially in a population commonly referred for neuropsychological evaluation to inform treatment planning, including neurosurgical intervention. Further research in a larger sample, and with other reference PVTs, will be important.
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