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Objective Value in evaluating error subtypes on visuospatial line orientation tests has been reported. Directional bias metrics for line orientation test errors represent easily quantifiable data that have not previously been studied. We evaluated whether patients with a clinical condition known to affect visuospatial functioning (Parkinson’s disease [PD]) exhibited unique directional error patterns on the RBANS Line Orientation test relative to other neuropsychology-referred patients. Method We compared overall directional bias in errors, directional bias by line location (left or right line and visual field), and absolute error rates (regardless of direction) by line location in a retrospective sample of patients with PD and a sample of neuropsychology-referred patients without PD. Groups were roughly matched on age, education, gender, and overall level of cognitive impairment. Results Patients with PD exhibited higher rates of leftward bias in errors, both overall and for the left stimulus line in each pair. Directional bias error scores better predicted PD versus non-PD group status than RBANS Line Orientation raw scores. Classification accuracy data for these variables were modest in the entire sample but stronger in a subsample of patients with mild levels of overall cognitive impairment. Conclusions Directional bias metrics for line orientation tests represent easily quantifiable data with potential theoretical and clinical value. In our sample, patients with PD made more left-biased line orientation errors than other neuropsychology-referred patients. By themselves, directional bias scores may have limited diagnostic potential, but they may be useful in diagnostic classification models and may have implications for clinical care.

Background Technological advances have allowed a variety of computerized cognitive training tools to be engineered in ways that are fun and entertaining yet challenging at a level that can maintain motivation and engagement. This revolution has created an opportunity for gerontological scientists to evaluate brain gaming approaches to improve cognitive and everyday function. The purpose of this scoping review is to provide a critical overview of the existing literature on nonimmersive, electronic brain gaming interventions in older adults with mild cognitive impairment or dementia. Research Design and Methods Systematic search was conducted using 7 electronic databases from inception through July 2017. A comprehensive 2-level eligibility process was used to identify studies for inclusion based on PRISMA guidelines. Results Seventeen studies met eligibility criteria. Majority of the studies were randomized controlled trials (n = 13) and incorporated an active control (n = 9). Intervention doses ranged from 4 to 24 weeks in duration with an average of 8.4 (±5.1 standard deviation [SD]) weeks. Session durations ranged from 30 to 100 min with an average of 54 (±25 SD) minutes. Nearly half of studies included a follow-up, ranging from 3 months to 5 years (n = 8). For most studies, brain gaming improved at least one cognitive outcome (n = 12); only one study reported improvement in activities of daily living. Discussion and Implications This scoping review conveys the breadth of an emerging research field, which will help guide future research to develop standards and recommendations for brain gaming interventions which are currently lacking.

Objective Veterans presenting to neuropsychology clinics with subjective cognitive complaints often attribute these complaints to history of mild Traumatic Brain Injury (mTBI). However, many of these Veterans also have co-occurring mood, sleep, and pain concerns – all of which negatively impact cognition, but are also modifiable. Here, we investigated the relative contributions of demographic factors, behavioral health and mood symptoms, and history of mTBI on neuropsychological test performance. Method Across three Veterans Affairs Polytrauma Network Sites, 250 Veterans who deployed to Iraq and/or Afghanistan conflicts and had not received treatment for concussion in the preceding 30 days were enrolled between 8/1/2010 and 9/30/2011. Separate multiple regression models were used to examine specified predictor variables (estimated pre-injury IQ, demographics, behavioral health ratings, insomnia, alcohol use, pain, positive mTBI history, anxiety, depression, presence of Posttraumatic Stress Disorder [PTSD]) and their impact on neuropsychological test performances. Results When predicting cognitive functioning, history of mTBI was not a significant predictor in any of the cognitive models. Rather, presence of PTSD was a significant predictor for both immediate (p Conclusion Modifiable factors may play a greater role in objective cognitive abilities (i.e., performance on neuropsychological tests) than mTBI history. These findings inform ongoing efforts to improve patient education regarding the expected recovery course from mTBI and the relationship between mood and health on daily cognitive efficiency.