Normative Reference Values, Reliability, and Item-Level Symptom Endorsement for the PROMIS® v2.0 Cognitive Function-Short Forms 4a, 6a and 8a.

OBJECTIVE: Reliable, valid, and precise measures of perceived cognitive functioning are useful in clinical practice and research. We present normative data, internal consistency statistics, item-level symptom endorsement, and the base rates of symptoms endorsed for the PROMIS® v2.0 Cognitive Function-Short Forms. METHOD: The four-, six -, and eight-item short form of the PROMIS® v2.0 Cognitive Function scale assess subjective cognitive functioning. We stratified the normative sample from the U.S. general population (n = 1,009; 51.1% women) by gender, education, health status, self-reported history of a depression or anxiety diagnosis, and recent mental health symptoms (i.e., feeling anxious or depressed in the past week) and examined cognitive symptom reporting. RESULTS: Internal consistency was measured using Cronbach's alpha and ranged from .85 to .95 for all three forms, across all groups. Mann-Whitney U test comparisons showed that individuals with past or present mental health difficulties scored significantly lower (i.e., worse perceived cognitive functioning) on the self-report questionnaires, particularly the eight-item form (history of depression, men: p < .001, Cohen's d = 1.07; women: p < .001, d = .99; history of anxiety, men: p < .001, d = 1.06; women: p < .001, d = .98; and current mental health symptoms, men: p < .001, d = 1.38; women: p < .001, d = 1.19). CONCLUSIONS: All three short forms of the PROMIS® v2.0 Cognitive Function scale had strong internal consistency reliability, supporting its use as a reliable measure of subjective cognitive functioning. The subgroup differences in perceived cognitive functioning supported the relationship between emotional and cognitive well-being. This study is the first to present normative values and base rates for several community-dwelling subgroups, allowing for precise interpretation of these measures in clinical practice and research.

Neuropsychological Assessment and Screening in Heart Failure: a Meta-Analysis and Systematic Review.

A variety of neuropsychological changes secondary to heart failure have been documented in the literature. However, what remains unclear are which neuropsychological abilities are the most impacted by heart failure and what tests have the sensitivity to measure that impact. Eight databases were searched for articles that examined the neuropsychological functioning of patients with heart failure. Some of the inclusion criteria were articles had to have a heart failure group with a demographically comparable control group and standardized neuropsychological testing. Exclusion criteria included articles with a heart failure group with any other type of major organ failure, or comparisons that were between different classes of heart failure rather than between a heart failure and non-heart failure group. A total of 33 articles met the inclusion criteria (total heart failure sample n = 8900) and provided effect size data for 20 neuropsychological domains. All observed domain-level differences between heart failure and non-heart failure groups were statistically significant, except for simple motor functioning and confrontation naming. The greatest differences in performance were in executive functioning, global cognition, complex psychomotor speed, and verbal memory. The highest effect sizes came from Trail-Making Test-Part B, CAMCOG, Symbol Digit Modality Test, and California Verbal Learning Test. The neuropsychological patterns of heart failure suggested diffuse cognitive involvement, with higher-level processes being most affected. It is important to track neurocognition in this clinical population since neuropsychological impairment is prevalent, and screening measures appear to be reliable. Such screening and further assessment would inform future medical treatment and may improve patient care management.

Examining Normative Reference Values and Item-Level Symptom Endorsement for the Quality of Life in Neurological Disorders (Neuro-QoL™) v2.0 Cognitive Function-Short Form.

OBJECTIVE: We examined the normative reference values, item-level symptom endorsement, internal consistency reliability, and the base rates of symptoms endorsed for the quality of life in neurological disorders (Neuro-QoL™) v2.0 Cognitive Function-Short Form. METHOD: The Neuro-QoL™ v2.0 Cognitive Function-Short Form measures subjective cognitive difficulties. The normative sample from the U.S. general population was stratified by gender, education, health status, self-reported diagnosis of depression or anxiety, and recent mental health symptoms (i.e., endorsed frequent anxiety or depression symptoms in the last week). RESULTS: A cohort of 1,009 adults completed this scale and their mean score was 32.60 (SD = 6.89). The base rates of those who reported zero cognitive symptoms were consistently higher among the healthy samples (healthy men = 79.2%; all men = 63.9%; healthy women = 90.2%; all women = 80.0%). Endorsing three or more cognitive symptoms was more common in the mental health subgroups for both men (full men's sample [n = 493] = 17.6%; depression subgroup [n = 70] = 30.0%; anxiety subgroup [n = 61] = 29.5%; mental subhealth group [n = 70] = 38.6%) and women (full women's sample [n = 516] = 7.4%; depression subgroup [n = 123] = 13.0%; anxiety subgroup [n = 103] = 12.6%; mental health subgroup [n = 101] = 14.9%). Internal consistency was measured using Cronbach's α and ranged from 0.87 to 0.94 across groups. CONCLUSIONS: The Neuro-QoL™ v2.0 Cognitive Function-Short Form is a brief, efficient, and reliable measure of perceived cognitive difficulties. As expected, individuals with a favorable overall health and quality of life reported less cognitive symptoms than the total sample, whereas individuals with mental health difficulties reported more. These normative values and base rates stratified by gender, overall health, and mental health status may be useful when interpreting this measure in clinical practice.

Neuropsychological functioning in opioid use disorder: A research synthesis and meta-analysis.

BACKGROUND: Research has demonstrated that patients with opioid use disorders (OUD; including both opioid abuse and/or dependence) have poorer neuropsychological functioning compared to healthy controls; however, the pattern and robustness of the findings remain unknown. OBJECTIVES: This study meta-analyzed the results from previous research examining the neuropsychological deficits associated with opioids across 14 neurocognitive domains. METHOD: Articles comparing patients with OUD to healthy controls were selected based on detailed inclusion/exclusion criteria and variables of interest were coded. In total, 61 studies were selected for the analyses. These consisted of 2580 patients with OUD and 2102 healthy control participants (15.9% female). Drug-related variables were analyzed as potential moderators. RESULTS: The largest effect size difference in neuropsychological performance was observed in complex psychomotor ability. With the exception of the motor and processing speed domains, which showed no group differences, small-to-medium effect sizes were associated with all neurocognitive domains examined. Meta-regression revealed that increases in the length of abstinence were associated with decreases in effect sizes of the complex psychomotor domain. Additionally, attentional ability predicted effect size differences in executive functioning as well as verbal memory ability. Although the majority of meta-analyzed studies demonstrated significant differences between patients with OUD and controls, the average raw scores for patients with OUD in these studies typically fell within the normal range. CONCLUSION: The pattern of neuropsychological performance among patients with OUD appears to reflect mild generalized cognitive dysfunction, with a large effect in complex psychomotor abilities.

Neuropsychological comparisons of cocaine versus methamphetamine users: A research synthesis and meta-analysis.

BACKGROUND: Previous meta-analytical research examining cocaine and methamphetamine separately suggests potentially different neuropsychological profiles associated with each drug. In addition, neuroimaging studies point to distinct structural changes that might underlie differences in neuropsychological functioning. OBJECTIVES: This meta-analysis compared the effect sizes identified in cocaine versus methamphetamine studies across 15 neuropsychological domains. METHOD: Investigators searched and coded the literature examining the neuropsychological deficits associated with a history of either cocaine or methamphetamine use. A total of 54 cocaine and 41 methamphetamine studies were selected, yielding sample sizes of 1,718 and 1,297, respectively. Moderator analyses were conducted to compare the two drugs across each cognitive domain. RESULTS: Data revealed significant differences between the two drugs. Specifically, studies of cocaine showed significantly larger effect-size estimates (i.e., poorer performance) in verbal working memory when compared to methamphetamine. Further, when compared to cocaine, methamphetamine studies demonstrated significantly larger effect sizes in delayed contextual verbal memory and delayed visual memory. CONCLUSION: Overall, cocaine and methamphetamine users share similar neuropsychological profiles. However, cocaine appears to be more associated with working memory impairments, which are typically frontally mediated, while methamphetamine appears to be more associated with memory impairments that are linked with temporal and parietal lobe dysfunction.

Gray matter abnormalities in opioid-dependent patients: A neuroimaging meta-analysis.

BACKGROUND: Prior research utilizing whole-brain neuroimaging techniques has identified structural differences in gray matter in opioid-dependent individuals. However, the results have been inconsistent. OBJECTIVES: The current study meta-analytically examines the neuroimaging findings of studies published before 2016 comparing opioid-dependent individuals to drug-naïve controls. METHOD: Exhaustive search of five databases yielded 12 studies that met inclusion criteria. Anisotropic Effect-Size Seed-Based d Mapping (AES-SDM) was used to analyze the data extracted by three independent researchers. Voxel-based AES-SDM distinguishes increases and decreases in brain matter significant at the whole-brain level. RESULTS: AES-SDM identified the fronto-temporal region, bilaterally, as being the primary site of gray matter deficits associated with opioid use. Moderator analysis revealed that length of opioid use was negatively associated with gray matter in the left cerebellar vermis and the right Rolandic operculum, including the insula. Meta-regression revealed no remaining significant areas of gray matter reductions, except in the precuneus, following longer abstinence from opioids. CONCLUSIONS: Opioid-dependent individuals had significantly less gray matter in several regions that play a key role in cognitive and affective processing. The findings provide evidence that opioid dependence may result in the breakdown of two distinct yet highly overlapping structural and functional systems. These are the fronto-cerebellar system that might be more responsible for impulsivity, compulsive behaviors, and affective disturbances and the fronto-insular system that might account more for the cognitive and decision-making impairments.