Embargo
Test of memory malingering 2nd edition: normative data from cognitively intact adults living in Spain
(Routledge, 2024-11-05) Arango Lasprilla, Juan Carlos; Ayearst, Lindsay E.; Rivera, Diego; Dini, Mia E.; Olabarrieta Landa, Laiene; Ramos Usuga, Daniela; Perrin, Paul B.; McCaffrey, Robert; Ciencias de la Salud; Osasun Zientziak
This study evaluated the universality of the TOMM 2 and provided a reference sample of cognitively intact adults living in Spain whose native language was Spanish. A total of 203 adults completed the TOMM 2 from June 2019 to January 2020. When using the original TOMM cutoff scores derived from English speakers, all participants scored in a range that would suggest that they passed the TOMM. When using a cut score less than 40 on Trial 1, only one participant in this study would be mistakenly classified as providing an invalid performance. Spanish-speaking adults in Spain from this study achieved a perfect score on Trial 1 at a rate more than double that of English-speaking individuals on the original TOMM. At the item level, all but one item met the minimum standard for performance validity; this item fell only marginally below the standard at 89%. This study found a very low failure rate for the TOMM 2, suggesting that the second edition has at least as high specificity as the original in Spanish adults.
Open Access
Methodology for the generation of normative data for the U.S. adult Spanish-speaking population: a Bayesian approach
(SAGE, 2024-09-20) Rivera, Diego; Forte, Anabel; Olabarrieta Landa, Laiene; Perrin, Paul B.; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
Objective: To present the methodology for a study generating normative neuropsychological test data for healthy Spanish-speaking adults (18-80 years old) living in the U.S. using Bayesian inference as a novel approach. Method: The study sample consisted of 253 healthy adults from eight U.S. regions (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin), with individuals originating from a diverse array of Latin American countries. To participate in the study, individuals must have met the following criteria: were between 18 and 80 years of age, had lived in the U.S. for at least 1 year (12 continuous months), self-identified Spanish as their dominant language, had at least one year of formal education, were able to read and write in Spanish at the time of evaluation, scored ¿23 on the Mini-Mental State Examination, scored <10 on the Patient Health Questionnaire¿9, and scored <10 on the Generalized Anxiety Disorder scale. Participants completed 12 neuropsychological tests. Reliability statistics and norms were calculated for all tests. Conclusions: This was the first normative study for Spanish-speaking adults in the U.S. to implement demographic, acculturation, and bilingual dominance measures as possible controls. Additionally, it was the first study to use Bayesian linear or generalized linear regression models for generating normative data in neuropsychology.
Open Access
Normative data for tests of visuo-spatial, visuo-constructional skills, and visual memory for Spanish-speaking adults in the United States
(SAGE, 2024-09-17) Morel Valdés, Gloria M.; Rivera, Diego; Olabarrieta Landa, Laiene; Carrión, Carmen I.; Lequerica, Anthony H.; Maltez, Fatima Iyarit; Rodríguez, Miriam J.; Dini, Mia E.; Munoz, Geovani; Ramos Usuga, Daniela; Drago, Christin I.; García, Patricia; Rivera, Patricia M.; Perrin, Paul B.; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
Background: The Rey-Osterrieth Complex Figure Test (ROCFT) and the Clock Drawing Test (CDT) are commonly used in clinical practice. The ROCFT measures constructional praxis, visual perception, and visuospatial learning and memory and the CDT assesses for visuospatial, constructional, and executive difficulties. Several neurological disorders are associated with visuospatial and visuoconstructional impairments, yet reliable normative data accounting for sociodemographic aspects of identity and acculturative variables are scarce for Hispanics living in the U.S. Objective: To generate normative data for the ROCF and CDT in a Spanish-speaking adult population living in the U.S. Methods: The sample consisted of 245 participants' cognitively normal adults, recruited from several states in the U.S. Each participant was administered the ROCFT and CDT as part of a larger cognitive battery. The ROCFT and CDT were normed using a Bayesian approach. Age, age, education, sex, acculturation, and language competence, were included as predictors in the analyses. Results: ROCFT was associated with education and age, particularly as they interact with Spanish language competency, and time spent in the U.S. Education was significantly associated with recall abilities and a lower memory recall on the ROCFT. Age was found to vary depending on a person¿s bilingual abilities. Sex did not emerge as a predictor of performance, and it was not moderated by other variables. Conclusions: This is the first study to include acculturation and language proficiency variables in the creation of norms for the assessment of visuoconstruction abilities. This study will have a large impact on the practice of neuropsychology in the U.S.
Open Access
A deep learning approach for automated scoring of the Rey-Osterrieth complex figure
(eLife Sciences Publications, 2024-11-28) Langer, Nicolas; Weber, Maurice; Hebling Vieira, Bruno; Strzelczyk, Dawid; Wolf, Lukas; Pedroni, Andreas; Heitz, Jonathan; Müller, Stephan; Schultheiss, Christoph; Troendle, Marius; Arango Lasprilla, Juan Carlos; Rivera, Diego; Scarpina, Federica; Zhao, Qianhua; Leuthold, Rico; Wehrle, Flavia; Jenni, Oskar; Brugger, Peter; Zaehle, Tino; Lorenz, Romy ; Zhang, Ce; Ciencias de la Salud; Osasun Zientziak
Memory deficits are a hallmark of many different neurological and psychiatric conditions. The Rey-Osterrieth complex figure (ROCF) is the state-of-the-art assessment tool for neuropsychologists across the globe to assess the degree of non-verbal visual memory deterioration. To obtain a score, a trained clinician inspects a patient's ROCF drawing and quantifies deviations from the original figure. This manual procedure is time-consuming, slow and scores vary depending on the clinician's experience, motivation, and tiredness. Here, we leverage novel deep learning architectures to automatize the rating of memory deficits. For this, we collected more than 20k hand-drawn ROCF drawings from patients with various neurological and psychiatric disorders as well as healthy participants. Unbiased ground truth ROCF scores were obtained from crowdsourced human intelligence. This dataset was used to train and evaluate a multihead convolutional neural network. The model performs highly unbiased as it yielded predictions very close to the ground truth and the error was similarly distributed around zero. The neural network outperforms both online raters and clinicians. The scoring system can reliably identify and accurately score individual figure elements in previously unseen ROCF drawings, which facilitates explainability of the AI-scoring system. To ensure generalizability and clinical utility, the model performance was successfully replicated in a large independent prospective validation study that was pre-registered prior to data collection. Our AI-powered scoring system provides healthcare institutions worldwide with a digital tool to assess objectively, reliably, and time-efficiently the performance in the ROCF test from hand-drawn images.
Open Access
Normative data for verbal fluency and naming tests in Spanish-speaking adults in the United States
(SAGE, 2024-08-22) Olabarrieta Landa, Laiene; Rivera, Diego; Xia, Bridget; Moreno, Oswaldo; Ramos Usuga, Daniela; Morel Valdés, Gloria M.; López, Enrique; Rodríguez, Miriam J.; Carrión, Carmen I.; Lequerica, Anthony H.; Drago, Christin I.; García, Patricia; Rivera, Patricia M.; Perrin, Paul B.; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
Background: The Rey-Osterrieth Complex Figure Test (ROCFT) and the Clock Drawing Test (CDT) are commonly used in clinical practice. The ROCFT measures constructional praxis, visual perception, and visuospatial learning and memory and the CDT assesses for visuospatial, constructional, and executive difficulties. Several neurological disorders are associated with visuospatial and visuoconstructional impairments, yet reliable normative data accounting for sociodemographic aspects of identity and acculturative variables are scarce for Hispanics living in the U.S. Objective: To generate normative data for the ROCF and CDT in a Spanish-speaking adult population living in the U.S. Methods: The sample consisted of 245 participants¿ cognitively normal adults, recruited from several states in the U.S. Each participant was administered the ROCFT and CDT as part of a larger cognitive battery. The ROCFT and CDT were normed using a Bayesian approach. Age, age2, education, sex, acculturation, and language competence, were included as predictors in the analyses. Results: ROCFT was associated with education and age, particularly as they interact with Spanish language competency, and time spent in the U.S. Education was significantly associated with recall abilities and a lower memory recall on the ROCFT. Age was found to vary depending on a person¿s bilingual abilities. Sex did not emerge as a predictor of performance, and it was not moderated by other variables. Conclusions: This is the first study to include acculturation and language proficiency variables in the creation of norms for the assessment of visuoconstruction abilities. This study will have a large impact on the practice of neuropsychology in the U.S.
Open Access
WHO-UCLA auditory verbal learning test: normative data for Spanish-speaking adults in the United States
(SAGE, 2024-09-18) Arango Lasprilla, Juan Carlos; Rivera, Diego; Rodríguez, Miriam J.; Christ, Bryan R.; Moreno, Oswaldo; Ramos Usuga, Daniela; Olabarrieta Landa, Laiene; Perrin, Paul B.; Carrión, Carmen I.; Morel Valdés, Gloria M.; Krch, Denise; Amaya, Ariana; Drago, Christin I.; García, Patricia; Rivera, Patricia M.; Ciencias de la Salud; Osasun Zientziak
Background: Hispanics are a significant demographic in the US, with diverse cultures and languages. Yet, assessing cognition in this group is complex as cultural and linguistic factors have been found to affect test performance. Objective: To generate normative data on the WHO-UCLA AVLT in a sample of Spanish speaking Hispanics residing in the U.S. Methods: The sample included 245 Spanish speaking individuals aged 18-80 from eight U.S. states (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin). Participants were administered the WHO-UCLA AVLT as part of a comprehensive neuropsychological battery. A Bayesian regression approach was used to estimate normative data, including covariates found to be important for predicting performances on measures of learning and memory. Results: Bayesian models showed a logarithmic link between education and all WHO-UCLA AVLT trials, except recognition. For delayed recall, increased Spanish proficiency benefited women's performance exclusively. Time in the U.S. was a significant predictor for Total Recall, indicating worse performance with longer resi-dency. Conclusions: Recognizing cultural factors like language proficiency and duration of U.S. residence is essential for accurately evaluating cognitive function among His-panics. This research emphasizes the significance of accounting for cultural nuances in developing norms for neuropsychological assessments, thereby improving their relevance and effectiveness in diverse communities.
Open Access
Normative data for executive function tests in an Ecuadorian Waranka minority population
(Taylor & Francis, 2024-07-01) Fierro Bósquez, María José; Olabarrieta Landa, Laiene; Christ, Bryan R.; Arjol, David; Perrin, Paul B.; Arango Lasprilla, Juan Carlos; Rivera, Diego; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Objective: To generate normative data (ND) for executive functions tests in the Waranka minority population of Ecuador. Method: Four-hundred participants aged 6–17 completed the Symbol-Digit Modalities Test (SDMT), Trail-Making Test (TMT), Modified-Wisconsin Card Sorting Test (M-WCST), and Test of Colors-Words (STROOP). Scores were normed using multiple linear regressions, including age, age2, natural logarithm of mean parent education (MPE), sex, bilingualism, and two-way interactions as predictors. Results: Age by MPE and Age2 by MPE interactions arose for SDMT, so that children with illiterate parents scored lower than those with literate parents. Girls scored higher in SDMT. All TMT and M-WCST scores were influenced by age2. Age by MPE interaction was found for TMT–A, so that children with higher MPE went faster; and age by bilingualism interaction for TMT–B, so that more bilingual children needed less time. Stroop-Word and Color were influenced by age2 by MPE interaction, so that children, while older, scored higher, especially those with higher MPE. Also, age2 by sex interaction arose, so that girls increased scores curvilinearly while boys linearly. Word-Color was influenced by age, while Stroop-interference by age2. Age by MPE interaction was found for MCST-Categories and Perseveration, so that perseverations decreased to then increased, especially in those with illiterate parents. M-WCST-Category scores increased to then decrease later on age in children with illiterate parents. Z-scores calculated through indigenous ND were significantly lower than generated through non-indigenous norms. Conclusions: ND for minority populations are critical since Waranka sample performed worse when using non-indigenous norms for z-score calculation.
Open Access
Cognitive and brain connectivity trajectories in critically ill COVID-19 patients
(IOS Press, 2024) Ramos Usuga, Daniela; Jiménez-Marín, Antonio; Cabrera-Zubizarreta, Alberto; Benito Sánchez, Itziar; Rivera, Diego; Martínez-Gutiérrez, Endika; Panera, Elena; Boado, Victoria ; Labayen, Fermín; Cortés, Jesús M.; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
BACKGROUND: Multiple Organ failure (MOF) is one of the main causes of admission to the Intensive Care Unit (ICU) of patients infected with COVID-19 and can cause short- and long-term neurological deficits. OBJECTIVE: To compare the cognitive functioning and functional brain connectivity at 6-12 months after discharge in two groups of individuals with MOF, one due to COVID-19 and the other due to another cause (MOF-group), with a group of Healthy Controls (HC). METHODS: Thirty-six participants, 12 from each group, underwent a neuropsychological and neuroimaging assessment at both time-points. Functional connectivity of the resting state networks was compared between COVID-19 and HC while controlling for the effect of MOF. The association between functional connectivity and neuropsychological performance was also investigated. RESULTS: Compared to the HC, COVID-19 group demonstrated hypoconnectivity between the Default Mode Network and Salience Network. This pattern was associated with worse performance on tests of attention and information processing speed, at both time-points. CONCLUSION: The study of the association between cognitive function and brain functional connectivity in COVID-19 allows the understanding of the short- and long-term neurological alterations of this disease and promotes the development of intervention programs to improve the quality of life for this understudied population.
Open Access
A preliminary examination of the TOMM2 in a sample of Spanish speakers in the United States
(SAGE, 2024-09-02) Ramos Usuga, Daniela; Ayearst, Lindsay E.; Rivera, Diego; Krch, Denise; Perrin, Paul B.; Carrión, Carmen I.; Morel Valdés, Gloria M.; Loro, Delly; Rodríguez, Miriam J.; Munoz, Geovani; Drago, Christin I.; García, Patricia; Rivera, Patricia M.; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
BACKGROUND: The Test of Memory Malingering (TOMM) is a widely used performance validity measure that is available in both English and Spanish. The Spanish version, however, has historically lacked normative data from samples that are representative of the U.S. Hispanic/Spanish speaking population. OBJECTIVE: The aim of the current study was to collect normative data on the update TOMM 2 for Hispanic individuals residing in the U.S. METHODS: Normative data on the TOMM 2 was collected across 9 sites from different regions of the U.S. The total sample consisted of n=188 cognitively healthy adults aged 18 and over with no current or prior history of neurological or psychiatric disorder. Descriptive analyses were performed on total raw scores. RESULTS: Participants obtained a mean score of 48.15 (SD=2.81) on trial 1 of the TOMM 2, 49.86 (SD=0.487) on trial 2, and 49.84 (SD=0.509) on the recognition trial. Scores are provided for traditional cutoff scores as well as some popular cutoffs reported in the literature. Item level analyses were conducted as well as evaluation of performance based on a variety of demographics. CONCLUSION: When compared to the English-speaking normative sample used for the original TOMM, this sample demonstrated better performance on the TOMM 2 indicating better cultural appropriateness of the items. This is the first study conducted that provides culturally appropriate descriptive norms for use with Spanish speakers living in the U.S.
Open Access
Attention and processing speed tests: normative data for Spanish-speaking adults in the United States
(SAGE, 2024-09-26) Carrión, Carmen I.; Rivera, Diego; Forte, Anabel; Olabarrieta Landa, Laiene; Moreno, Oswaldo; Ramos Usuga, Daniela; Morel Valdés, Gloria M.; López, Melisa; Rodríguez, Miriam J.; Lequerica, Anthony H.; Drago, Christin I.; García, Patricia; Rivera, Patricia M.; Perrin, Paul B.; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
Background: Hispanics/Latinos are the largest Spanish-speaking subgroup in the U.S. and multiple sociodemographic, cultural, and linguistic factors have been found to impact their performances on cognitive testing. Despite this, few normative data are available for the heterogeneous Spanish-speaking population in the U.S. Objective: to generate normative data on the TMT, Bells Test, SDMT, and the BTA for Spanish speakers residing in the U.S. Methods: the sample included 245 Spanish speaking individuals aged 18-80 from eight states across the U.S. (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin). Participants were administered attention and processing speed measures as part of a comprehensive neuropsychological battery. We used a Bayesian regression approach to estimate normative data, including covariates found to be important for predicting performances on measures of attention and processing speed. Results: sociodemographic factors including education, time in the U.S., acculturation, age, and/or sex had differential effects on the TMT-A, TMT-B, SDMT, and the BTA whereas the Bells Test was not influenced by any of these sociodemographic factors. Conclusions: our findings indicate that while sex, age, and educational attainment are important factors to consider, language and acculturation can also influence attention and processing speed performances among Spanish speakers in the U.S.