Age group and sex differences in performance on a computerized neurocognitive battery in children age 8-21

Genetic risk for schizophrenia and brain activation during the Penn Conditional Exclusion Test: A multiplex extended pedigree study

Individuals with schizophrenia have poorer performance and often differing patterns of brain activation compared to controls on a variety of cognitive tasks, including those that require inhibition of responses and shifting to new responses. This study sought to examine the degree to which performance on a task developed to measure cognitive flexibility, the Penn Conditional Exclusion Test (PCET), and its related brain activation, as assessed on functional magnetic resonance imaging, may reflect schizophrenia genetic risk using an extended pedigree design. A total of 455 participants (27 schizophrenia probands, 170 of their first- to fourth-degree relatives, and 258 unrelated controls) completed similar versions of the PCET, both outside and inside a magnetic resonance imaging scanner. To examine brain activation that may underlie performance, ten regions of interest were identified where activation was significantly correlated with performance. To examine diagnostic specificity, we also investigated genetic correlations between diagnosed major depression and PCET performance and brain activation. Performance was significantly genetically correlated with schizophrenia both out of (Rg = -0.49, p < .001) and in the scanner (Rg = -0.59, p < .001) after false discovery rate correction. In contrast, none of the genetic correlations between schizophrenia and brain activation in the identified regions of interest were significant after false discovery rate correction. Neither behavioral performance nor brain activation measures were significantly genetically correlated with depression. These results suggest that behavioral performance on the PCET is more sensitive (and also specific compared with depression) to schizophrenia genetic risk than is functional magnetic resonance imaging activation that is correlated with performance. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Gender and Accuracy in Decoding Affect Cues: A Meta-Analysis

Gender differences in understanding the meanings of affect cues, often labeled emotion recognition, have been studied for over a century. Past reviews of the literature have concluded that girls and women score higher than boys and men on tests of accuracy in decoding affect cues, which are most often tested in the cue modalities of face, body, and content-free voice. The present meta-analysis updates knowledge on this topic by including many more studies (1188 effect sizes in 1011 studies; total N = 837,637) and examining a wide range of moderators such as health status of sample, international location, cue channels of the test, and other sample and test characteristics. Indeed, the gender difference favoring girls and women still exists, and evidence for publication bias was weak. The difference is not large (r = 0.12, d = 0.24), but it is extremely consistent across many moderators, which, even when significant, show minor differences. Health status was the only moderator to produce groups without a significant gender difference.

Measuring Cognitive Impairments Associated With Schizophrenia in Clinical Practice: Overview of Current Challenges and Future Opportunities

BACKGROUND

Cognitive impairment associated with schizophrenia (CIAS) negatively impacts daily functioning, quality of life, and recovery, yet effective pharmacotherapies and practical assessments for clinical practice are lacking. Despite the pivotal progress made with establishment of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) for clinical research, implementation of the full MCCB is too time-consuming and cost-ineffective for most clinicians in clinical practice.

STUDY DESIGN

Here we discuss current assessments in relation to delivery format (interview-based and performance-based), validity, ease of use for clinicians and patients, reliability/reproducibility, cost-effectiveness, and suitability for clinical implementation. Key challenges and future opportunities for improving cognitive assessments are also presented.

STUDY RESULTS

Current assessments that require 30 min to complete would have value in clinical settings, but the associated staff training and time required might preclude their application in most clinical settings. Initial profiling of cognitive deficits may require about 30 min to assist in the selection of evidence-based treatments; follow-up monitoring with brief assessments (10-15 min in duration) to detect treatment-related effects on global cognition may complement this approach. Guidance on validated brief cognitive tests for the strategic monitoring of treatment effects on CIAS is necessary.

CONCLUSIONS

With increased advancements in technology-based and remote assessments, development of validated formats of remote and in-person assessment, and the necessary training models and infrastructure required for implementation, are likely to be of increasing clinical relevance for future clinical practice.

Harmonizing cross-cultural and transdiagnostic assessment of social cognition by expert panel consensus

Social cognition, the perception and processing of social information, is adversely affected in multiple psychiatric, neurological, and neurodevelopmental disorders, and these impairments negatively impact quality of life for individuals across the globe. Despite the clear importance of social cognition, efforts to advance research via harmonization of data across cultures and diagnoses has been stymied by the lack of uniformly used and suitable assessments. To address this issue, the current study conducted an expert survey and consensus process to identify social cognitive assessments that are best suited for cross-cultural and transdiagnostic use among adults. A large group of experts in social cognition were surveyed to gather nominations for cross-culturally and transdiagnostically appropriate measures. These measures were then critically evaluated by a smaller group of experts using a Delphi consensus process to identify the best existing tasks for each use. Ninety-eight experts, representing 25 countries, responded to the initial survey and nominated a total of 81 tasks. Initial rounds of the Delphi process identified 50 tasks with adequate psychometric properties that were then subdivided into social cognition domains. For each domain, members ranked the five best tasks, once for cross-cultural use and once for transdiagnostic use, and rated the suitability of those tasks for the intended use. No tasks were identified as ideally suited for either use; however, within each domain, 4-5 tasks emerged as the most consistently selected, and all were ranked as having "good" or better suitability for use. While there is still a critical need for social cognitive assessments that are specifically designed for cross-cultural and transdiagnostic use, there does appear to be a handful of existing tasks that are currently available and likely informative. Caution is warranted however, as these still require comprehensive evaluation in cross-cultural and transdiagnostic studies.

Cluster analysis of physical activity and physical fitness and their associations with components of school skills in children aged 8-9 years

This study aimed to cluster physical activity (PA), physical fitness, visual-motor coordination, household duties, and their associations with school skills in 170 primary school children (88 girls and 82 boys) aged 8-9 years. Conducted as a cross-sectional design, the study analysed moderate-to-vigorous physical activity (MVPA) and household duties, which were assessed via questionnaires. Academic skills were evaluated using methods designed to diagnose school failure in students aged 7-9 years. Physical fitness was measured using the Eurofit test battery, and visual-motor coordination was assessed using a Piórkowski apparatus. Cluster analysis and general linear and non-linear regression analyses were used to determine associations with academic skills. Three clusters emerged: Cluster 1 (C1) was characterised by fast visual-motor coordination, high flexibility, and more time on household duties; Cluster 2 (C2) included children with the highest levels of PA and better performance in physical fitness items; Cluster 3 (C3) consisted of children with the lowest levels of PA, fitness, and low time on household duties. A regression analysis demonstrated a significant positive impact of cluster C1 on visual-auditory integration (total), with significantly better results for children in C1 compared to those in C3 (b = -2.69; p = 0.003). These results suggest that better visual-motor coordination, higher flexibility, and more time on housework are associated with better visual-auditory integration. Further research is needed to explore the physical and mental benefits of PA.

Utility of caregiver signaling questions to detect neurocognitive impairment in children with sickle cell disease

ABSTRACT

The American Society of Hematology cerebrovascular guidelines for sickle cell disease (SCD) recommend surveillance using signaling questions to screen for neurocognitive difficulties, although the clinical utility of these signaling questions has yet to be established. This study aimed to determine the clinical utility of caregiver signaling questions for detecting significant neurocognitive impairment (defined as >1.5 standard deviation [SD] below the normative mean on ≥2 measures) and domain-specific impairment (defined as >1.5 SD below the normative mean) in children and adolescents with SCD. A total of 421 caregivers of children with SCD aged 8 to 17 years (62% hemoglobin SS (HbSS) or hemoglobin S-beta zero (HbSβ0) thalassemia) were asked 7 signaling questions. Children completed performance-based neurocognitive and academic measures. Children who were reported to have repeated a grade, did not obtain primarily A/B grades in school, had a history of learning difficulties, or whose caregiver reported concern for their learning were more likely to have significant neurocognitive impairment and obtained lower scores across all measures (all q < 0.05). History of learning difficulties emerged as the most sensitive and specific signaling question for detecting significant neurocognitive impairment (sensitivity, 0.64; specificity, 0.77) and domain-specific impairment (sensitivity range, 0.56-0.77; specificity range, 0.63-0.72). Cumulative caregiver report improved prediction of neurocognitive impairment beyond demographic/clinical factors alone. Although performance-based screening for all patients with SCD is the most effective means to identify those with neurocognitive or academic impairment, use of caregiver signaling questions represents a brief and low-cost method to improve the detection of patients with SCD in need of support.

Machine learning reveals sex differences in distinguishing between conduct-disordered and neurotypical youth based on emotion processing dysfunction

BACKGROUND

Theoretical models of conduct disorder (CD) highlight that deficits in emotion recognition, learning, and regulation play a pivotal role in CD etiology. With CD being more prevalent in boys than girls, various theories aim to explain this sex difference. The "differential threshold" hypothesis suggests greater emotion dysfunction in conduct-disordered girls than boys, but previous research using conventional statistical analyses has failed to support this hypothesis. Here, we used novel analytic techniques such as machine learning (ML) to uncover potentially sex-specific differences in emotion dysfunction among girls and boys with CD compared to their neurotypical peers.

METHODS

Multi-site data from 542 youth with CD and 710 neurotypical controls (64% girls, 9-18 years) who completed emotion recognition, learning, and regulation tasks were analyzed using a multivariate ML classifier to distinguish between youth with CD and controls separately by sex.

RESULTS

Both female and male ML classifiers accurately predicted (above chance level) individual CD status based solely on the neurocognitive features of emotion dysfunction. Notably, the female classifier outperformed the male classifier in identifying individuals with CD. However, the classification and identification performance of both classifiers was below the clinically relevant 80% accuracy threshold (although they still provided relatively fair and realistic estimates of ~ 60% classification performance), probably due to the substantial neurocognitive heterogeneity within such a large and diverse, multi-site sample of youth with CD (and neurotypical controls).

CONCLUSIONS

These findings confirm the close association between emotion dysfunction and CD in both sexes, with a stronger association observed in affected girls, which aligns with the "differential threshold" hypothesis. However, the data also underscore the heterogeneity of CD, namely that only a subset of those affected are likely to have emotion dysfunction and that other neurocognitive domains (not tested here) probably also contribute to CD etiology.

CLINICAL TRIAL NUMBER

Not applicable.

Exploration of cognitive flexibility and emotion recognition in adolescents with eating disorders

OBJECTIVES

This study compared cognitive flexibility (CF) and emotion recognition (ER) in adolescents with eating disorders (ED) to a healthy group.

METHODS

Forty healthy individuals aged 12-18 years with no psychiatric diagnosis and 46 patients diagnosed with anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED) according to DSM-5 criteria participated. CF was assessed using the Cognitive Flexibility Scale (CFS), Stroop Test, and Berg Card Sorting Test (BCST), while ER was evaluated using the test of perception of affect via nonverbal cues.

RESULTS

CFS scores were lower in the ED group compared to the control group. Neuropsychological test results indicated similar BCST perseverative error percentages among ED patients and controls. However, while the BED group demonstrated greater difficulties with inhibitory control, as shown in the Stroop Test, the BN and AN groups performed similarly to the control group. ER performance was similar across groups, although the AN subgroup exhibited heightened recognition of negative emotions, particularly disgust and fear.

CONCLUSIONS

This study highlights unique and shared neurocognitive patterns related to CF and ER profiles of ED patients. Despite self-reports of greater cognitive rigidity among ED patients, objective tests did not consistently confirm it. Notably, BED patients exhibited inhibitory control challenges, aligning with impulsive tendencies. ER abilities were similar to controls; however, the AN subgroup showed heightened sensitivity to certain negative emotions, such as disgust. These findings underscore the need for further research with larger, more balanced samples to explore how CF and ER vary across developmental stages and subtypes.

Development and Validation of a Brief Age-Normed Screening Tool for Subthreshold Psychosis Symptoms in Youth

BACKGROUND AND HYPOTHESIS

Improvements in screening tools for early subthreshold psychosis symptoms are needed to facilitate early identification and intervention efforts, especially given the challenges of rapidly differentiating age-appropriate experiences from potential early signs of emerging psychosis. Tools can be lengthy and time-consuming, impacting their utility and accessibility across clinical settings, and age-normed data are limited. To address this gap, we sought to develop and validate a brief, empirically derived, age-normed, subthreshold psychosis screening tool, for public use.

STUDY DESIGN

Computerized adaptive test simulation was used to derive a 5-item short form with age norm equivalencies from a 12-item PRIME-Screen-Revised (PRIME-12) administered to 7053 youth (Mage = 15.8, SD = 2.7; 54% female; 33% Black). Concurrent validity was assessed (n = 758) using contemporaneous administration of the PRIME-5 and the Structured Interview for Prodromal Syndromes. Comparability of criterion-related validity of the PRIME-5, PRIME-12, and Scale of Prodromal Symptoms (SOPS) was assessed by relating scores to psychosis-risk-relevant criteria. Finally, self-report versus assessor-administered PRIME total scores were compared (n = 131) to assess their concurrent validity.

STUDY RESULTS

Correlations among PRIME-5, PRIME-12, and SOPS were comparable and moderate, supporting their convergent validity. The PRIME-5 also showed comparable criterion-related validity, demonstrating similar relationships with psychosis-risk indicators as the other tools. Self-reported and assessor-administered PRIME-5 were moderately correlated.

CONCLUSIONS

Public availability of a brief, age-normed, and validated screening tool-which can be assessor or self-administered-will expedite and improve early identification of youth (age 11 and older) at risk for psychosis.

Age- and sex-related differences in social competence and emotion labeling in pre-adolescence

Identification of facial expressions is important to navigate social interactions and associates with developmental outcomes. It is presumed that social competence, behavioral emotion labeling and neural emotional face processing are related, but this has rarely been studied. Here, we investigated these interrelations and their associations with age and sex, in the YOUth cohort (1055 children, 8-11 years old). Using a multistep linear modelling approach, we associated parent-reported social competence, basic emotion labeling skills based on pictures of facial expressions, and neural facial emotion processing during a passive-watching fMRI task with pictures of houses and emotional faces. Results showed better emotion labeling and higher social competence for girls compared to boys. Age was positively associated with emotion labeling skills and specific social competence subscales. These age- and sex-differences were not reflected in brain function. During fMRI, happy faces elicited more activity than neutral or fearful faces. However, we did not find evidence for the hypothesized links between social competence and behavioral emotion labeling, and with neural activity. To conclude, in pre-adolescents, social competence and emotion labeling varied with age and sex, while social competence, emotion labeling and neural processing of emotional faces were not associated with each other.

The Relationship of Creativity and Motor Creativity with Physical Activity and Motor Fitness in a Gender Perspective Among 8-9-Year-Old Children

BACKGROUND

In this study, we aimed to determine the presence of any potential gender differences and relationships in terms of creativity, physical activity (PA), motor fitness, and motor creativity in children aged 8-9 years.

METHODS

The study included 195 primary school children (92 girls and 103 boys) aged 8-9 years old from grade 2. To determine creativity, the Test for Creative Thinking-Drawing Production was used, while motor creativity was assessed using Torrance's 'Thinking Creatively in Action and Movement' test. Motor fitness was assessed with the selected items from the Eurofit battery and Piórkowski tests. The level of moderate-to-vigorous PA was determined with the Physical Activity Screening Measure. The Mann-Whitney U test was employed for in-between group comparison and Spearman's correlation to determine relationships between the variables.

RESULTS

The results of the research showed the presence of differences in motor fitness between boys and girls, but no differences in PA, creativity, as well as motor creativity between genders. Moreover, it was found there was no association between PA and motor fitness and creativity or motor creativity in either boys or girls at this age.

CONCLUSIONS

Thus, it can be assumed that to develop creativity through PA in children aged 8-9 years, it might be necessary to create an appropriate environment and strategy that will strengthen, inspire, and promote children's creativity through movement. Having established that there is no difference in creativity between genders at this age, it was pointed out that it is necessary to look for teaching methods that would effectively awaken this ability in a co-educational setting.

Neurocognitive functioning during adolescence: Spanish validation of the Penn Computerized Neurocognitive Battery

OBJECTIVES

The Penn Computerized Neurocognitive Battery - Child Version (PennCNB-cv) is presented as a brief tool that allows comprehensive and automated assessment of 5 factors (via 14 performance tasks): Executive Control, Episodic Memory, Complex Cognition, Social Cognition, and Sensorimotor Speed. The literature links (dys)functions in these areas with psycho(patho)logical constructs, but evidence is scarce among Spanish-speaking youth. Therefore, this study aims to validate the PennCNB-cv in a community sample of Spanish adolescents.

METHODS

After a process of (back)translation and adaptation by bilingual researchers, the PennCNB-cv was administered in 34 schools. The sample included 1506 students, ages 14-19, 44.28% were male. Preliminary treatment of the data included descriptive and correlational statistics. To provide evidence of structural validity, exploratory and confirmatory factor analyses were performed.

RESULTS

Results from the exploratory and confirmatory factor analysis showed a four-factor model (Complex Cognition, Executive Control, Episodic Memory, and Social Cognition) as the most appropriate. These findings provide compelling evidence in favor of the a priori theory that underpinned the development​ of the CNB.

CONCLUSIONS

The study of the psychometric properties showed that the Spanish version of the PennCNB-cv, seems to be an adequate tool for assessing neurocognitive functioning during adolescence.

Could be better: adolescent access to health information and care

Many adolescents must overcome a broad range of barriers to access health information and care and are consequently reluctant to pursue assistance for their health concerns. In this review, we examine from whom and how adolescents seek help (for example, by consulting with friends and family members and by searching for health information using online platforms) and how adolescents treat symptoms without consulting with a clinician by engaging in self-medication. Next, we suggest ways to help adolescents receive accurate health information and access to healthcare through school-based health education programs and health centers. We also discuss how to improve the experience of care for adolescents by collaboratively engaging young patients with their physicians and caregivers using shared decision-making. Finally, we propose developing and posting accurate and engaging multilingual materials on popular online platforms to improve adolescent access to accurate health information and knowledge of how to engage with the healthcare system.

CONCLUSION

The purpose of this review is to examine how adolescents seek, and propose ways to help adolescents access, health information and care despite the many barriers they face.

WHAT IS KNOWN

• Adolescents encounter a broad range of barriers to access health information and care and turn to family members and friends, and search online, for health information. In addition, adolescents benefit from school-based health education programs and health centers that reduce barriers to healthcare access.

WHAT IS NEW

• Adolescents engage in self-medication, including with cannabis use, to treat self-diagnosed illness or symptoms in a potentially harmful manner. • While many adolescents distrust health information shared on social media, recent evidence suggests adolescents are receptive to, and will change some beliefs, in response to health information posted on social media platforms.

Gender, age, and longitudinal measurement invariance of child and adolescent depression scales: A systematic review

Understanding developmental trajectories and gender differences in depressive symptoms is clinically relevant. Discerning true differences across gender, age groups, and time is based on the often-neglected premise of measurement invariance (MI) of child and adolescent depression scales. In this systematic review, we assessed available evidence for MI across gender, age groups, and time for depression scales validated in children and adolescents, in studies with at least one assessment under age 18. A literature search using Medline, PsychInfo, Scopus, Web of Science, and Google Scholar databases identified 42 studies that examined MI. MI of eleven scales was tested in 1-9 studies per scale. Conclusions are hampered by different factor solutions tested within some scales. All included questionnaires showed preliminary evidence for MI across gender. Across some studies, crying had higher factor loadings in females compared to males, indicating that crying may be differently related to depression across gender. MI evidence was preliminary in just four scales across time, mostly confined to ages 13-17. One study showed developmental conclusions differed when non-invariance is not accounted for in observed scores. Overall, evidence for MI in child and adolescent depression scales is currently limited.

Cognitive performance from childhood to old age and intergenerational correlations in the multigenerational Young Finns Study

BACKGROUND

Cognitive performance changes during the lifespan, but the information is gathered from studies on separate age cohorts. Computerized neurocognitive testing enables efficient and similar assessments for all ages. We investigated (i) the effect of age at different stages of life and (ii) intergenerational correlations across cognitive domains in the multigenerational Young Finns Study.

METHODS

Participants in three familiarly related generations (n = 6486, aged 7-92 years) performed the Cambridge Neuropsychological Test Automated Battery (CANTAB). Overall cognitive performance and domains representing learning and memory, working memory, information processing, and reaction time were extracted by common principal component analysis from the cognitive data with several age groups. Linear models were used to study the association of age, sex, and education with overall cognitive performance and in the cognitive domains. Age-adjusted intergenerational correlations were calculated.

RESULTS

Learning and memory peaked earlier during the lifespan compared to working memory and information processing, and the rate of decline toward old age differed by domain. Weak intergenerational correlations existed between two consecutive generations but were nonsignificant between grandparents and grandchildren. There was no systematic sex-specific transmission in any cognitive domain.

CONCLUSION

This study describes the natural course of cognitive performance across the lifespan and proves that cognitive performance changes differently across cognitive domains with weak intergenerational transmission.

A longitudinal study of the relationship between alcohol-related blackouts and attenuated structural brain development

PURPOSE

Alcohol-related blackouts (ARBs) are common in adolescents and emerging adults. ARBs may also be indicative of persistent, alcohol-related neurocognitive changes. This study explored ARBs as a predictor of altered structural brain development and associated cognitive correlates.

METHODS

Longitudinal growth curve modeling estimated trajectories of brain volume across 6 years in participants from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study (n = 800, 213 with lifetime ARB history). While controlling for demographics and overall alcohol use, ARB history was analyzed as a predictor of brain volume growth in regions associated with alcohol-related cognitive change. Post hoc analyses examined whether ARBs moderated relationships between brain morphology and cognition.

RESULTS

ARBs significantly predicted attenuated development of fusiform gyrus and hippocampal volume at unique timepoints compared to overall alcohol use. Alcohol use without ARBs significantly predicted attenuated fusiform and hippocampal growth at earlier and later timepoints, respectively. Despite altered development in regions associated with memory, ARBs did not significantly moderate relationships between brain volume and cognitive performance.

CONCLUSION

ARBs and overall alcohol use predicted altered brain development in the fusiform gyrus and hippocampus at different timepoints, suggesting ARBs represent a unique marker of neurocognitive risk in younger drinkers.

Sex-related variability of white matter tracts in the whole HCP cohort

Behavioral differences between men and women have been studied extensively, as have differences in brain anatomy. However, most studies have focused on differences in gray matter, while white matter has been much less studied. We conducted a comprehensive study of 77 deep white matter tracts to analyze their volumetric and microstructural variability between men and women in the full Human Connectome Project (HCP) cohort of 1065 healthy individuals aged 22-35 years. We found a significant difference in total brain volume between men and women (+ 12.6% in men), consistent with the literature. 16 tracts showed significant volumetric differences between men and women, one of which stood out due to a larger effect size: the corpus callosum genu, which was larger in women (+ 7.3% in women, p = 5.76 × 10-19). In addition, we found several differences in microstructural parameters between men and women, both using standard Diffusion Tensor Imaging (DTI) parameters and more complex microstructural parameters from the Neurite Orientation Dispersion and Density Imaging (NODDI) model, with the tracts showing the greatest differences belonging to motor (cortico-spinal tracts, cortico-cerebellar tracts) or limbic (cingulum, fornix, thalamo-temporal radiations) systems. These microstructural differences may be related to known behavioral differences between the sexes in timed motor performance, aggressiveness/impulsivity, and social cognition.

Cross-Sectional Study on the Effect of Bilingualism, Age, Gender, and Family Income on Executive Function Development in a Sample of Lebanese School-Aged Children

This study investigates executive functions (EFs) and selected developmental factors in 120 children aged 6-11 years. By examining inhibition, working memory, and cognitive flexibility, the research evaluates the potential influences of age, gender, bilingualism, and family income on these EF skills. Tests adapted to Lebanese Arabic were used to assess EFs. Results indicate a linear development of inhibition, working memory, and flexibility with age. Gender differences were observed, affecting verbal and visuospatial working memory as well as flexibility. Bilingualism positively impacts EFs, with early bilinguals outperforming late bilinguals. Family income, however, shows no significant effect on EFs.

Sex differences in large-scale brain network connectivity for mental rotation performance

Mental rotation has emerged as an important predictor for success in science, technology, engineering, and math fields. Previous studies have shown that males and females perform mental rotation tasks differently. However, how the brain functions to support this difference remains poorly understood. Recent advancements in neuroimaging techniques have enabled the identification of sex differences in large-scale brain network connectivity. Using a classic mental rotation task with functional magnetic resonance imaging, the present study investigated whether there are any sex differences in large-scale brain network connectivity for mental rotation performance. Our results revealed that, relative to females, males exhibited less cross-network interaction (i.e. lower inter-network connectivity and participation coefficient) of the visual network but more intra-network integration (i.e. higher intra-network connectivity and local efficiency) and cross-network interaction (i.e. higher inter-network connectivity and participation coefficient) of the salience network. Across all participants, mental rotation performance was negatively correlated with cross-network interaction (i.e. participation coefficient) of the visual network, was positively correlated with cross-network interaction (i.e. inter-network connectivity) of the salience network, and was positively correlated with intra-network integration (i.e. local efficiency) of the somato-motor network. Interestingly, the cross-network integration indexes of both the visual and salience networks significantly mediated sex difference in mental rotation performance. The present findings suggest that large-scale brain network connectivity may constitute an essential neural basis for sex difference in mental rotation, and highlight the importance of considering sex as a research variable in investigating the complex network underpinnings of spatial cognition.

Domain-specific associations between psychopathology and neurocognitive functioning

BACKGROUND

Neurocognitive dysfunction is a transdiagnostic finding in psychopathology, but relationships among cognitive domains and general and specific psychopathology dimensions remain unclear. This study aimed to examine associations between cognition and psychopathology dimensions in a large youth cohort.

METHOD

The sample (N = 9350; age 8-21 years) was drawn from the Philadelphia Neurodevelopmental Cohort. Data from structured clinical interviews were modeled using bifactor confirmatory factor analysis (CFA), resulting in an overall psychopathology ('p') factor score and six orthogonal psychopathology dimensions: dysphoria/distress, obsessive-compulsive, behavioral/externalizing, attention-deficit/hyperactivity, phobias, and psychosis. Neurocognitive data were aggregated using correlated-traits CFA into five factors: executive functioning, memory, complex cognition, social cognition, and sensorimotor speed. We examined relationships among specific and general psychopathology dimensions and neurocognitive factors.

RESULTS

The final model showed both overall and specific associations between cognitive functioning and psychopathology, with acceptable fit (CFI = 0.91; TLI = 0.90; RMSEA = 0.024; SRMR = 0.054). Overall psychopathology and most psychopathology dimensions were negatively associated with neurocognitive functioning (phobias [p < 0.0005], behavioral/externalizing [p < 0.0005], attention-deficit/hyperactivity [p < 0.0005], psychosis [p < 0.0005 to p < 0.05]), except for dysphoria/distress and obsessive-compulsive symptoms, which were positively associated with complex cognition (p < 0.05 and p < 0.01, respectively).

CONCLUSION

By modeling a broad range of cognitive and psychopathology domains in a large, diverse sample of youth, we found aspects of neurocognitive functioning shared across clinical phenotypes, as well as domain-specific patterns. Findings support transdiagnostic examination of cognitive performance to parse variability in the link between neurocognitive functioning and clinical phenotypes.

Sex-related patterns of functional brain networks in children and adolescents with autism spectrum disorder

Although numerous studies have emphasized the male predominance in autism spectrum disorder (ASD), how sex differences are related to the topological organization of functional networks remains unclear. This study utilized imaging data from 86 ASD (43 females, aged 7-18 years) and 86 typically developing controls (TCs) (43 females, aged 7-18 years) obtained from Autism Brain Imaging Data Exchange databases, constructed individual whole-brain functional networks, used a graph theory analysis to compute topological metrics, and assessed sex-related differences in topological metrics using a 2 × 2 factorial design. At the global level, females with ASD exhibited significantly higher cluster coefficient and local efficiency than female TCs, while no significant difference was observed between males with ASD and male TCs. Meanwhile, the neurotypical sex differences in cluster coefficient and local efficiency observed in TCs were not present in ASD. At the nodal level, ASD exhibited abnormal nodal centrality in the left middle temporal gyrus.

Montreal Cognitive Assessment (MoCA) as a screening tool for cognitive impairment in early stages of psychosis

Background

Cognitive alterations have been reported in early stages of psychosis including people with First Episode Psychosis (FEP), Clinical High-Risk Mental State (CHR), and Psychotic-Like Experience (PLE). This study aimed to compare the cognitive function in early stages of psychosis using the Montreal Cognitive Assessment (MoCA), a low-cost and brief assessment tool of cognitive functions.

Methods

A total of 154 individuals, including 35 with FEP, 38 CHR, 44 PLE, and 37 healthy controls (HC), were evaluated with the MoCA in Santiago, Chile. We calculated the mean total score of the MoCA and the standard deviation of the mean. Groups were assessed for a trend to lower scores in a pre-determined sequence (HC > PLE > CHR > FEP) using the Jonckheere-Terpstra test (TJT).

Results

The mean total MoCA scores were 24.8 ± 3.3 in FEP, 26.4 ± 2.4 in CHR, 26.4 ± 2.3 in PLE, and 27.2 ± 1.8 in HC. The analyses revealed a significant trend (p < 0.05) toward lower MoCA individual domain scores and MoCA total scores in the following order: HC > PLE > CHR > FEP. The mean total scores of all groups were above the cut-off for cognitive impairment (22 points).

Conclusions

The MoCA describes lower scores in cognition across early stages of psychosis and may be a useful low-cost assessment instrument in early intervention centers of poorly resourced settings.

Environmental predictors of children's executive functioning development

Executive functioning (EF) abilities develop through childhood, but this development can be impacted by various psychosocial environmental influences. Using longitudinal data from the Health Outcome and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort study, we examined if psychosocial environmental factors were significant predictors of EF development. Study participants comprised 271 children and their primary caregivers (98.5% mothers) followed from birth to age 12. We identified four distinct EF developmental trajectory groups comprising a consistently impaired group (13.3%), a descending impairment group (27.7%), an ascending impairment group (9.95%), and a consistently not impaired group (49.1%). Higher levels of maternal ADHD and relational frustration appear to be risk factors for increased EF difficulty over time, while higher family income may serve as a protective factor delaying predisposed EF impairment. Important intervention targets might include teaching positive and effective parenting strategies to mothers whose children are at risk for EF dysfunction.

Cognitive and psychopathological features of neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease: A narrative review

Clinicians are becoming increasingly aware of the cognitive and psychopathological consequences of neurological diseases, which were once thought to manifest with motor and sensory impairments only. The cognitive profile of multiple sclerosis, in particular, is now well-characterised. Similar efforts are being made to better characterise the cognitive profile of other central nervous system inflammatory demyelinating autoimmune disorders. This review discusses the current understanding of the cognitive and psychological features of neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Detailed analysis of the cognitive sequelae of the above conditions can not only assist with understanding disease pathogenesis but also can guide appropriate management of the symptoms and consequently, improve the quality of life and long-term outcomes for these patients. This narrative review will also identify research gaps and provide recommendations for future directions in the field.

The importance of improving cognitive flexibility in adolescents with anorexia nervosa: The case for cognitive remediation therapy

OBJECTIVE

Inefficiencies in executive functioning (EF), more specifically cognitive flexibility and an overly detailed processing style, are frequently observed in individuals with Anorexia Nervosa (AN) and have been identified as potential targets in treatment. Cognitive Remediation Therapy (CRT) is an adjunctive treatment approach specifically designed to have a positive impact on EF. Mainly evaluated in adults, CRT has been criticized for its perceived ineffectiveness in promoting weight restoration or directly reducing eating disorder symptoms.

METHOD

We argue that we need to refocus our conceptual framework for using CRT as an adjunctive treatment and specifically explore its potential benefit in adolescents.

RESULTS

Adolescence is a critical window for EF development during which CRT has the potential to have the most impact. While it may not specifically ameliorate eating disorder symptoms and directly improve weight gain, CRT may mitigate the impact of malnutrition on adolescent brain development, reduce attrition rates in treatment, and improve cognitive flexibility and (indirectly) other maintaining factors, thereby improving global functioning.

DISCUSSION

More research needs to be done to understand the development of EF in adolescents with AN and how best to employ CRT as an adjunctive treatment to support development and target maintaining factors. The current article broadly reviews findings on executive functioning inefficiencies in adolescents with AN and discusses the purpose and role of CRT in treating AN. Finally, we highlight key critiques of using CRT and pose questions for future research.

PUBLIC SIGNIFICANCE

Treatments targeting executive functioning in adolescents with AN are limited. We need to better understand how CRT can benefit adolescents in treatment. Increasing treatment options, including adjunctive treatments, is necessary to reduce the long-term impact of AN.

The Role of Sleep for Age-Related Differences in Neurobehavioral Performance

This study investigated developmental changes from childhood to adulthood in neurobehavioral performance and sleep measures. While many studies have examined age-related changes between childhood and adolescence and from mid-to-late adulthood, young adulthood has been overlooked. The main aim of this study was to investigate the effects of sleep loss on developmental changes in neurobehavioral performance and sleepiness in a natural setting. A total of 119 children, adolescents, and young adults (38 children aged 6-9; 38 adolescents aged 13-19; and 43 young adults aged 20-27) wore an actigraph for a continuous five-weekday night. Subjective sleepiness (Karolinska Sleepiness Scale) and neurobehavioral performance (using the psychomotor vigilance test and the digit symbol substitution test) were measured on five school days. The results showed that adolescents and young adults outperformed children on both the digit symbol substitution test and the psychomotor vigilance test measures. However, adolescents committed more errors of commission on the psychomotor vigilance test and reported higher levels of subjective sleepiness. The results are discussed in relation to brain maturation in various cognitive functions.

Brain signal variability and executive functions across the life span

Neural variability is thought to facilitate survival through flexible adaptation to changing environmental demands. In humans, such capacity for flexible adaptation may manifest as fluid reasoning, inhibition of automatic responses, and mental set-switching-skills falling under the broad domain of executive functions that fluctuate over the life span. Neural variability can be quantified via the BOLD signal in resting-state fMRI. Variability of large-scale brain networks is posited to underpin complex cognitive activities requiring interactions between multiple brain regions. Few studies have examined the extent to which network-level brain signal variability across the life span maps onto high-level processes under the umbrella of executive functions. The present study leveraged a large publicly available neuroimaging dataset to investigate the relationship between signal variability and executive functions across the life span. Associations between brain signal variability and executive functions shifted as a function of age. Limbic-specific variability was consistently associated with greater performance across subcomponents of executive functions. Associations between executive function subcomponents and network-level variability of the default mode and central executive networks, as well as whole-brain variability, varied across the life span. Findings suggest that brain signal variability may help to explain to age-related differences in executive functions across the life span.

Adverse childhood experiences and cognition: A cross-sectional study in Xhosa people living with schizophrenia and matched medical controls

BACKGROUND

Adverse childhood experiences (ACEs) are associated with impaired cognitive function in adult life in the general population as well as in people living with schizophrenia (PLS). Research on cognitive function in PLS in low- and middle-income countries (LMIC) is, however, limited. The objectives of this study were to investigate the association between ACE types and various cognitive domains in a sample of PLS and matched medical controls, and to determine the moderating effect of group membership (PLS vs. medical controls) on these associations, in the South African setting.

METHODS

Participants (n PLS = 520; n medical controls = 832) completed the Childhood Trauma Questionnaire-Short Form, the Structured Clinical Interview for DSM-IV (SCID-I), and the University of Pennsylvania Computerized Neurocognitive Battery (PennCNB). An efficiency or speed score was used to assess performance across 9 cognitive domains. The association between exposure to different ACE types and 9 cognitive domains was examined using partial correlations and multiple linear regression models, adjusting for sex, age and education years. Finally, potential moderating effects of group membership (PLS vs. medical controls) on the association between ACEs and cognitive domains were tested.

RESULTS

In the entire sample, emotional and physical abuse predicted worse performance on sensorimotor and emotion identification domains. Also, emotional abuse was negatively associated with motor function, physical abuse was negatively associated with spatial processing, and physical neglect was negatively associated with face memory and emotion identification. In contrast, emotional neglect was related to better performance on abstraction and mental flexibility. No moderating effect of group membership was found on any of these associations.

CONCLUSION

Exposure to ACEs was associated with social and non-social cognition in adulthood, although the magnitude of these relationships was small and similar between PLS and matched medical controls. The nature of these associations differed across ACE subtype, suggesting the need for a nuanced approach to studying a range of mechanisms that may underlie different associations. However, a number of ACE subtypes were associated with worse performance on emotional identification, indicating that some underlying mechanisms may have more transversal impact. These findings contribute to the sparse body of literature on ACEs and cognition in PLS in LMIC.

Genome-wide association study identifies new loci associated with OCD

To date, four genome-wide association studies (GWAS) of obsessive-compulsive disorder (OCD) have been published, reporting a high single-nucleotide polymorphism (SNP)-heritability of 28% but finding only one significant SNP. A substantial increase in sample size will likely lead to further identification of SNPs, genes, and biological pathways mediating the susceptibility to OCD. We conducted a GWAS meta-analysis with a 2-3-fold increase in case sample size (OCD cases: N = 37,015, controls: N = 948,616) compared to the last OCD GWAS, including six previously published cohorts (OCGAS, IOCDF-GC, IOCDF-GC-trio, NORDiC-nor, NORDiC-swe, and iPSYCH) and unpublished self-report data from 23andMe Inc. We explored the genetic architecture of OCD by conducting gene-based tests, tissue and celltype enrichment analyses, and estimating heritability and genetic correlations with 74 phenotypes. To examine a potential heterogeneity in our data, we conducted multivariable GWASs with MTAG. We found support for 15 independent genome-wide significant loci (14 new) and 79 protein-coding genes. Tissue enrichment analyses implicate multiple cortical regions, the amygdala, and hypothalamus, while cell type analyses yielded 12 cell types linked to OCD (all neurons). The SNP-based heritability of OCD was estimated to be 0.08. Using MTAG we found evidence for specific genetic underpinnings characteristic of different cohort-ascertainment and identified additional significant SNPs. OCD was genetically correlated with 40 disorders or traits-positively with all psychiatric disorders and negatively with BMI, age at first birth and multiple autoimmune diseases. The GWAS meta-analysis identified several biologically informative genes as important contributors to the aetiology of OCD. Overall, we have begun laying the groundwork through which the biology of OCD will be understood and described.

Exploring sex differences: insights into gene expression, neuroanatomy, neurochemistry, cognition, and pathology

Increased knowledge about sex differences is important for development of individualized treatments against many diseases as well as understanding behavioral and pathological differences. This review summarizes sex chromosome effects on gene expression, epigenetics, and hormones in relation to the brain. We explore neuroanatomy, neurochemistry, cognition, and brain pathology aiming to explain the current state of the art. While some domains exhibit strong differences, others reveal subtle differences whose overall significance warrants clarification. We hope that the current review increases awareness and serves as a basis for the planning of future studies that consider both sexes equally regarding similarities and differences.

Regression and Alignment for Functional Data and Network Topology

In the brain, functional connections form a network whose topological organization can be described by graph-theoretic network diagnostics. These include characterizations of the community structure, such as modularity and participation coefficient, which have been shown to change over the course of childhood and adolescence. To investigate if such changes in the functional network are associated with changes in cognitive performance during development, network studies often rely on an arbitrary choice of pre-processing parameters, in particular the proportional threshold of network edges. Because the choice of parameter can impact the value of the network diagnostic, and therefore downstream conclusions, we propose to circumvent that choice by conceptualizing the network diagnostic as a function of the parameter. As opposed to a single value, a network diagnostic curve describes the connectome topology at multiple scales-from the sparsest group of the strongest edges to the entire edge set. To relate these curves to executive function and other covariates, we use scalar-on-function regression, which is more flexible than previous functional data-based models used in network neuroscience. We then consider how systematic differences between networks can manifest in misalignment of diagnostic curves, and consequently propose a supervised curve alignment method that incorporates auxiliary information from other variables. Our algorithm performs both functional regression and alignment via an iterative, penalized, and nonlinear likelihood optimization. The illustrated method has the potential to improve the interpretability and generalizability of neuroscience studies where the goal is to study heterogeneity among a mixture of function- and scalar-valued measures.

Validation of the cognitive section of the Penn computerized adaptive test for neurocognitive and clinical psychopathology assessment (CAT-CCNB)

BACKGROUND

The Penn Computerized Neurocognitive Battery is an efficient tool for assessing brain-behavior domains, and its efficiency was augmented via computerized adaptive testing (CAT). This battery requires validation in a separate sample to establish psychometric properties.

METHODS

In a mixed community/clinical sample of N = 307 18-to-35-year-olds, we tested the relationships of the CAT tests with the full-form tests. We compared discriminability among recruitment groups (psychosis, mood, control) and examined how their scores relate to demographics. CAT-Full relationships were evaluated based on a minimum inter-test correlation of 0.70 or an inter-test correlation within at least 0.10 of the full-form correlation with a previous administration of the full battery. Differences in criterion relationships were tested via mixed models.

RESULTS

Most tests (15/17) met the minimum criteria for replacing the full-form with the updated CAT version (mean r = 0.67; range = 0.53-0.80) when compared to relationships of the full-forms with previous administrations of the full-forms (mean r = 0.68; range = 0.50-0.85). Most (16/17) CAT-based relationships with diagnostics and other validity criteria were indistinguishable (interaction p > 0.05) from their full-form counterparts.

CONCLUSIONS

The updated CNB shows psychometric properties acceptable for research. The full-forms of some tests should be retained due to insufficient time savings to justify the loss in precision.

The aging trajectories of brain functional hierarchy and its impact on cognition across the adult lifespan

Introduction

The hierarchical network architecture of the human brain, pivotal to cognition and behavior, can be explored via gradient analysis using restingstate functional MRI data. Although it has been employed to understand brain development and disorders, the impact of aging on this hierarchical architecture and its link to cognitive decline remains elusive.

Methods

This study utilized resting-state functional MRI data from 350 healthy adults (aged 20-85) to investigate the functional hierarchical network using connectome gradient analysis with a cross-age sliding window approach. Gradient-related metrics were estimated and correlated with age to evaluate trajectory of gradient changes across lifespan.

Results

The principal gradient (unimodal-to-transmodal) demonstrated a significant non-linear relationship with age, whereas the secondary gradient (visual-to-somatomotor) showed a simple linear decreasing pattern. Among the principal gradient, significant age-related changes were observed in the somatomotor, dorsal attention, limbic and default mode networks. The changes in the gradient scores of both the somatomotor and frontal-parietal networks were associated with greater working memory and visuospatial ability. Gender differences were found in global gradient metrics and gradient scores of somatomotor and default mode networks in the principal gradient, with no interaction with age effect.

Discussion

Our study delves into the aging trajectories of functional connectome gradient and its cognitive impact across the adult lifespan, providing insights for future research into the biological underpinnings of brain function and pathological models of atypical aging processes.

A preclinical model of THC edibles that produces high-dose cannabimimetic responses

No preclinical experimental approach enables the study of voluntary oral consumption of high-concentration Δ9-tetrahydrocannabinol (THC) and its intoxicating effects, mainly owing to the aversive response of rodents to THC that limits intake. Here, we developed a palatable THC formulation and an optimized access paradigm in mice to drive voluntary consumption. THC was formulated in chocolate gelatin (THC-E-gel). Adult male and female mice were allowed ad libitum access for 1 and 2 hr. Cannabimimetic responses (hypolocomotion, analgesia, and hypothermia) were measured following access. Levels of THC and its metabolites were measured in blood and brain tissue. Acute acoustic startle responses were measured to investigate THC-induced psychotomimetic behavior. When allowed access for 2 hr to THC-E-gel on the second day of a 3-day exposure paradigm, adult mice consumed up to ≈30 mg/kg over 2 hr, which resulted in robust cannabimimetic behavioral responses (hypolocomotion, analgesia, and hypothermia). Consumption of the same gelatin decreased on the following third day of exposure. Pharmacokinetic analysis shows that THC-E-gel consumption led to parallel accumulation of THC and its psychoactive metabolite, 11-OH-THC, in the brain, a profile that contrasts with the known rapid decline in brain 11-OH-THC levels following THC intraperitoneal (i.p.) injections. THC-E-gel consumption increased the acoustic startle response in males but not in females, demonstrating a sex-dependent effect of consumption. Thus, while voluntary consumption of THC-E-gel triggered equivalent cannabimimetic responses in male and female mice, it potentiated acoustic startle responses preferentially in males. We built a dose-prediction model that included cannabimimetic behavioral responses elicited by i.p. versus THC-E-gel to test the accuracy and generalizability of this experimental approach and found that it closely predicted the measured acoustic startle results in males and females. In summary, THC-E-gel offers a robust preclinical experimental approach to study cannabimimetic responses triggered by voluntary consumption in mice, including sex-dependent psychotomimetic responses.

Development of white matter fiber covariance networks supports executive function in youth

During adolescence, the brain undergoes extensive changes in white matter structure that support cognition. Data-driven approaches applied to cortical surface properties have led the field to understand brain development as a spatially and temporally coordinated mechanism that follows hierarchically organized gradients of change. Although white matter development also appears asynchronous, previous studies have relied largely on anatomical tract-based atlases, precluding a direct assessment of how white matter structure is spatially and temporally coordinated. Harnessing advances in diffusion modeling and machine learning, we identified 14 data-driven patterns of covarying white matter structure in a large sample of youth. Fiber covariance networks aligned with known major tracts, while also capturing distinct patterns of spatial covariance across distributed white matter locations. Most networks showed age-related increases in fiber network properties, which were also related to developmental changes in executive function. This study delineates data-driven patterns of white matter development that support cognition.

CoCoA: conditional correlation models with association size

Many scientific questions can be formulated as hypotheses about conditional correlations. For instance, in tests of cognitive and physical performance, the trade-off between speed and accuracy motivates study of the two variables together. A natural question is whether speed-accuracy coupling depends on other variables, such as sustained attention. Classical regression techniques, which posit models in terms of covariates and outcomes, are insufficient to investigate the effect of a third variable on the symmetric relationship between speed and accuracy. In response, we propose a conditional correlation model with association size, a likelihood-based statistical framework to estimate the conditional correlation between speed and accuracy as a function of additional variables. We propose novel measures of the association size, which are analogous to effect sizes on the correlation scale while adjusting for confound variables. In simulation studies, we compare likelihood-based estimators of conditional correlation to semiparametric estimators adapted from genomic studies and find that the former achieves lower bias and variance under both ideal settings and model assumption misspecification. Using neurocognitive data from the Philadelphia Neurodevelopmental Cohort, we demonstrate that greater sustained attention is associated with stronger speed-accuracy coupling in a complex reasoning task while controlling for age. By highlighting conditional correlations as the outcome of interest, our model provides complementary insights to traditional regression modeling and partitioned correlation analyses.

EEG microstates in early-to-middle childhood show associations with age, biological sex, and alpha power

Electroencephalographic (EEG) microstates can provide a unique window into the temporal dynamics of large-scale brain networks across brief (millisecond) timescales. Here, we analysed fundamental temporal features of microstates extracted from the broadband EEG signal in a large (N = 139) cohort of children spanning early-to-middle childhood (4-12 years of age). Linear regression models were used to examine if participants' age and biological sex could predict the temporal parameters GEV, duration, coverage, and occurrence, for five microstate classes (A-E) across both eyes-closed and eyes-open resting-state recordings. We further explored associations between these microstate parameters and posterior alpha power after removal of the 1/f-like aperiodic signal. The microstates obtained from our neurodevelopmental EEG recordings broadly replicated the four canonical microstate classes (A to D) frequently reported in adults, with the addition of the more recently established microstate class E. Biological sex served as a significant predictor in the regression models for four of the five microstate classes (A, C, D, and E). In addition, duration and occurrence for microstate E were both found to be positively associated with age for the eyes-open recordings, while the temporal parameters of microstates C and E both exhibited associations with alpha band spectral power. Together, these findings highlight the influence of age and sex on large-scale functional brain networks during early-to-middle childhood, extending understanding of neural dynamics across this important period for brain development.

Distinct neurocognitive profiles and clinical phenotypes associated with copy number variation at the 22q11.2 locus

Rare genetic variants that confer large effects on neurodevelopment and behavioral phenotypes can reveal novel gene-brain-behavior relationships relevant to autism. Copy number variation at the 22q11.2 locus offer one compelling example, as both the 22q11.2 deletion (22qDel) and duplication (22qDup) confer increased likelihood of autism spectrum disorders (ASD) and cognitive deficits, but only 22qDel confers increased psychosis risk. Here, we used the Penn Computerized Neurocognitive Battery (Penn-CNB) to characterized neurocognitive profiles of 126 individuals: 55 22qDel carriers (MAge  = 19.2 years, 49.1% male), 30 22qDup carriers (MAge  = 17.3 years, 53.3% male), and 41 typically developing (TD) subjects (MAge  = 17.3 years, 39.0% male). We performed linear mixed models to assess group differences in overall neurocognitive profiles, domain scores, and individual test scores. We found all three groups exhibited distinct overall neurocognitive profiles. 22qDel and 22qDup carriers showed significant accuracy deficits across all domains relative to controls (episodic memory, executive function, complex cognition, social cognition, and sensorimotor speed), with 22qDel carriers exhibiting more severe accuracy deficits, particularly in episodic memory. However, 22qDup carriers generally showed greater slowing than 22qDel carriers. Notably, slower social cognition speed was uniquely associated with increased global psychopathology and poorer psychosocial functioning in 22qDup. Compared to TD, 22q11.2 copy number variants (CNV) carriers failed to show age-associated improvements in multiple cognitive domains. Exploratory analyses revealed 22q11.2 CNV carriers with ASD exhibited differential neurocognitive profiles, based on 22q11.2 copy number. These results suggest that there are distinct neurocognitive profiles associated with either a loss or gain of genomic material at the 22q11.2 locus.

Impact of Adolescent Cannabis Use on Neurocognitive and Brain Development

Research examining associations between frequent cannabis use in adolescence and brain-behavior outcomes has increased substantially over the past 2 decades. This review attempts to synthesize the state of evidence in this area of research while acknowledging challenges in interpretation. Although there is converging evidence that ongoing, frequent cannabis use in adolescence is associated with small reductions in cognitive functioning, there is still significant debate regarding the persistence of reductions after a period of abstinence. Similarly, there is controversy regarding the replicability of structural and functional neuroimaging findings related to frequent cannabis use in adolescence. Larger studies with informative designs are needed.

Clustering and Switching in Semantic Verbal Fluency: Their Development and Relationship with Word Productivity in Typically Developing Greek-Speaking Children and Adolescents

Performance in semantic verbal fluency (SVF) tasks, mainly measured by the number of words of a particular semantic category produced within a limited time, is a widely accepted measure of cognitive functioning used in the neuropsychological assessment of children and adults. Two strategic processes, Clustering and Switching (C&S) have been proposed to underlie fluency processes and affect performance in the task. However, few studies have reported on the development of those cognitive strategies and their relationship with word productivity in typically developing children. Even fewer studies have covered a broad developmental period from preschool to adolescence or measured the effect of contextual factors in this relationship. Based on a sample of 472 typically developing Greek-speaking children aged 4;0 to 16;11 years, we investigated the development of SVF performance and reported on the degree to which it is affected by C&S strategies, children's sex, and level of parental education. Results revealed a large effect of age on word productivity and on the use of C&S strategies. Two switching factors (number of clusters and number of switches) and two clustering factors (mean cluster size and a novel measure, maximum cluster size), appeared to be significantly associated with word productivity, with the largest effect being attributed to the two switching factors. C&S factors, together with children's age and parental education, predicted 91.7% of the variance in the SVF score. Children's sex was not found to have a significant effect on either word productivity or C&S strategies. Results are discussed for their theoretical implications on the strategic processes underlying word production in typically developing children.

A canonical trajectory of executive function maturation from adolescence to adulthood

Theories of human neurobehavioral development suggest executive functions mature from childhood through adolescence, underlying adolescent risk-taking and the emergence of psychopathology. Investigations with relatively small datasets or narrow subsets of measures have identified general executive function development, but the specific maturational timing and independence of potential executive function subcomponents remain unknown. Integrating four independent datasets (N = 10,766; 8-35 years old) with twenty-three measures from seventeen tasks, we provide a precise charting, multi-assessment investigation, and replication of executive function development from adolescence to adulthood. Across assessments and datasets, executive functions follow a canonical non-linear trajectory, with rapid and statistically significant development in late childhood to mid-adolescence (10-15 years old), before stabilizing to adult-levels in late adolescence (18-20 years old). Age effects are well captured by domain-general processes that generate reproducible developmental templates across assessments and datasets. Results provide a canonical trajectory of executive function maturation that demarcates the boundaries of adolescence and can be integrated into future studies.

White matter functional gradients and their formation in adolescence

It is well known that functional magnetic resonance imaging (fMRI) is a widely used tool for studying brain activity. Recent research has shown that fluctuations in fMRI data can reflect functionally meaningful patterns of brain activity within the white matter. We leveraged resting-state fMRI from an adolescent population to characterize large-scale white matter functional gradients and their formation during adolescence. The white matter showed gray-matter-like unimodal-to-transmodal and sensorimotor-to-visual gradients with specific cognitive associations and a unique superficial-to-deep gradient with nonspecific cognitive associations. We propose two mechanisms for their formation in adolescence. One is a "function-molded" mechanism that may mediate the maturation of the transmodal white matter via the transmodal gray matter. The other is a "structure-root" mechanism that may support the mutual mediation roles of the unimodal and transmodal white matter maturation during adolescence. Thus, the spatial layout of the white matter functional gradients is in concert with the gray matter functional organization. The formation of the white matter functional gradients may be driven by brain anatomical wiring and functional needs.

Neurophysiological and gait outcomes during a dual-task gait assessment in concussed adolescents

BACKGROUND

Gait deficits are common after concussion in adolescents. However, the neurophysiological underpinnings of these gait deficiencies are currently unknown. Thus, the goal of this study was to compare spatiotemporal gait metrics, prefrontal cortical activation, and neural efficiency between concussed adolescents several weeks from injury and uninjured adolescents during a dual-task gait assessment.

METHODS

Fifteen concussed (mean age[SD]: 17.4[0.6], 13 female, days since injury: 26.3[9.9]) and 17 uninjured adolescents (18.0[0.7], 10 female) completed a gait assessment with three conditions repeated thrice: single-task walking, single-task subtraction, and dual-task, which involved walking while completing a subtraction task simultaneously. Gait metrics were measured using an inertial sensor system. Prefrontal cortical activation was captured via functional near-infrared spectroscopy. Neural efficiency was calculated by relating gait metrics to prefrontal cortical activity. Differences between groups and conditions were examined, with corrections for multiple comparisons.

FINDINGS

There were no significant differences in gait metrics between groups. Compared to uninjured adolescents, concussed adolescents displayed significantly greater prefrontal cortical activation during the single-task subtraction (P = 0.01) and dual-task (P = 0.01) conditions with lower neural efficiency based on cadence (P = 0.02), gait cycle duration (P = 0.03), step duration (P = 0.03), and gait speed (P = 0.04) during the dual-task condition.

INTERPRETATION

Our findings suggest that several weeks after injury concussed adolescents demonstrate lower neural efficiency and display a cost to gait performance when cognitive demand is high, e.g., while multitasking, suggesting that the concussed adolescent brain is less able to compensate when attention is divided between two concurrent tasks.

Development and application of novel performance validity metrics for computerized neurocognitive batteries

OBJECTIVES

Data from neurocognitive assessments may not be accurate in the context of factors impacting validity, such as disengagement, unmotivated responding, or intentional underperformance. Performance validity tests (PVTs) were developed to address these phenomena and assess underperformance on neurocognitive tests. However, PVTs can be burdensome, rely on cutoff scores that reduce information, do not examine potential variations in task engagement across a battery, and are typically not well-suited to acquisition of large cognitive datasets. Here we describe the development of novel performance validity measures that could address some of these limitations by leveraging psychometric concepts using data embedded within the Penn Computerized Neurocognitive Battery (PennCNB).

METHODS

We first developed these validity measures using simulations of invalid response patterns with parameters drawn from real data. Next, we examined their application in two large, independent samples: 1) children and adolescents from the Philadelphia Neurodevelopmental Cohort (n = 9498); and 2) adult servicemembers from the Marine Resiliency Study-II (n = 1444).

RESULTS

Our performance validity metrics detected patterns of invalid responding in simulated data, even at subtle levels. Furthermore, a combination of these metrics significantly predicted previously established validity rules for these tests in both developmental and adult datasets. Moreover, most clinical diagnostic groups did not show reduced validity estimates.

CONCLUSIONS

These results provide proof-of-concept evidence for multivariate, data-driven performance validity metrics. These metrics offer a novel method for determining the performance validity for individual neurocognitive tests that is scalable, applicable across different tests, less burdensome, and dimensional. However, more research is needed into their application.

Psychosis spectrum features, neurocognition and functioning in a longitudinal study of youth with 22q11.2 deletion syndrome

BACKGROUND

Neuropsychiatric disorders are common in 22q11.2 Deletion Syndrome (22q11DS) with about 25% of affected individuals developing schizophrenia spectrum disorders by young adulthood. Longitudinal evaluation of psychosis spectrum features and neurocognition can establish developmental trajectories and impact on functional outcome.

METHODS

157 youth with 22q11DS were assessed longitudinally for psychopathology focusing on psychosis spectrum symptoms, neurocognitive performance and global functioning. We contrasted the pattern of positive and negative psychosis spectrum symptoms and neurocognitive performance differentiating those with more prominent Psychosis Spectrum symptoms (PS+) to those without prominent psychosis symptoms (PS-).

RESULTS

We identified differences in the trajectories of psychosis symptoms and neurocognitive performance between the groups. The PS+ group showed age associated increase in symptom severity, especially negative symptoms and general nonspecific symptoms. Correspondingly, their level of functioning was worse and deteriorated more steeply than the PS- group. Neurocognitive performance was generally comparable in PS+ and PS- groups and demonstrated a similar age-related trajectory. However, worsening executive functioning distinguished the PS+ group from PS- counterparts. Notably, of the three executive function measures examined, only working memory showed a significant difference between the groups in rate of change. Finally, structural equation modeling showed that neurocognitive decline drove the clinical change.

CONCLUSIONS

Youth with 22q11DS and more prominent psychosis features show worsening of symptoms and functional decline driven by neurocognitive decline, most related to executive functions and specifically working memory. The results underscore the importance of working memory in the developmental progression of psychosis.

Brain tissue iron neurophysiology and its relationship with the cognitive effects of dopaminergic modulation in children with and without ADHD

Children with attention-deficit/hyperactivity disorder (ADHD) exhibit impairments in response inhibition. These impairments are ameliorated by modulating dopamine (DA) via the administration of rewards or stimulant medication like methylphenidate (MPH). It is currently unclear whether intrinsic DA availability impacts these effects of dopaminergic modulation on response inhibition. Thus, we estimated intrinsic DA availability using magnetic resonance-based assessments of basal ganglia and thalamic tissue iron in 36 medication-naïve children with ADHD and 29 typically developing (TD) children (8-12 y) who underwent fMRI scans and completed standard and rewarded go/no-go tasks. Children with ADHD additionally participated in a double-blind, randomized, placebo-controlled, crossover MPH challenge. Using linear regressions covarying for age and sex, we determined there were no group differences in brain tissue iron. We additionally found that higher putamen tissue iron was associated with worse response inhibition performance in all participants. Crucially, we observed that higher putamen and caudate tissue iron was associated with greater responsivity to MPH, as measured by improved task performance, in participants with ADHD. These results begin to clarify the role of subcortical brain tissue iron, a measure associated with intrinsic DA availability, in the cognitive effects of reward- and MPH-related dopaminergic modulation in children with ADHD and TD children.

Connectome-based predictive modeling of fluid intelligence: evidence for a global system of functionally integrated brain networks

Cognitive neuroscience continues to advance our understanding of the neural foundations of human intelligence, with significant progress elucidating the role of the frontoparietal network in cognitive control mechanisms for flexible, intelligent behavior. Recent evidence in network neuroscience further suggests that this finding may represent the tip of the iceberg and that fluid intelligence may depend on the collective interaction of multiple brain networks. However, the global brain mechanisms underlying fluid intelligence and the nature of multi-network interactions remain to be well established. We therefore conducted a large-scale Connectome-based Predictive Modeling study, administering resting-state fMRI to 159 healthy college students and examining the contributions of seven intrinsic connectivity networks to the prediction of fluid intelligence, as measured by a state-of-the-art cognitive task (the Bochum Matrices Test). Specifically, we aimed to: (i) identify whether fluid intelligence relies on a primary brain network or instead engages multiple brain networks; and (ii) elucidate the nature of brain network interactions by assessing network allegiance (within- versus between-network connections) and network topology (strong versus weak connections) in the prediction of fluid intelligence. Our results demonstrate that whole-brain predictive models account for a large and significant proportion of variance in fluid intelligence (18%) and illustrate that the contribution of individual networks is relatively modest by comparison. In addition, we provide novel evidence that the global architecture of fluid intelligence prioritizes between-network connections and flexibility through weak ties. Our findings support a network neuroscience approach to understanding the collective role of brain networks in fluid intelligence and elucidate the system-wide network mechanisms from which flexible, adaptive behavior is constructed.

Individual differences in delay discounting are associated with dorsal prefrontal cortex connectivity in children, adolescents, and adults

Delay discounting is a measure of impulsive choice relevant in adolescence as it predicts many real-life outcomes, including obesity and academic achievement. However, resting-state functional networks underlying individual differences in delay discounting during youth remain incompletely described. Here we investigate the association between multivariate patterns of functional connectivity and individual differences in impulsive choice in a large sample of children, adolescents, and adults. A total of 293 participants (9-23 years) completed a delay discounting task and underwent 3T resting-state fMRI. A connectome-wide analysis using multivariate distance-based matrix regression was used to examine whole-brain relationships between delay discounting and functional connectivity. These analyses revealed that individual differences in delay discounting were associated with patterns of connectivity emanating from the left dorsal prefrontal cortex, a default mode network hub. Greater delay discounting was associated with greater functional connectivity between the dorsal prefrontal cortex and other default mode network regions, but reduced connectivity with regions in the dorsal and ventral attention networks. These results suggest delay discounting in children, adolescents, and adults is associated with individual differences in relationships both within the default mode network and between the default mode and networks involved in attentional and cognitive control.

Deviation From Normative Whole Brain and Deep Gray Matter Growth in Children With MOGAD, MS, and Monophasic Seronegative Demyelination

BACKGROUND AND OBJECTIVES

Pediatric-acquired demyelination of the CNS associated with antibodies directed against myelin oligodendrocyte glycoprotein (MOG; MOG antibody-associated disease [MOGAD]) occurs as a monophasic or relapsing disease and with variable but often extensive T2 lesions in the brain. The impact of MOGAD on brain growth during maturation is unknown. We quantified the effect of pediatric MOGAD on brain growth trajectories and compared this with the growth trajectories of age-matched and sex-matched healthy children and children with multiple sclerosis (MS, a chronic relapsing disease known to lead to failure of normal brain growth and to loss of brain volume) and monophasic seronegative demyelination.

METHODS

We included children enrolled at incident attack in the prospective longitudinal Canadian Pediatric Demyelinating Disease Study who were recruited at the 3 largest enrollment sites, underwent research brain MRI scans, and were tested for serum MOG-IgG. Children seropositive for MOG-IgG were diagnosed with MOGAD. MS was diagnosed per the 2017 McDonald criteria. Monophasic seronegative demyelination was confirmed in children with no clinical or MRI evidence of recurrent demyelination and negative results for MOG-IgG and aquaporin-4-IgG. Whole and regional brain volumes were computed through symmetric nonlinear registration to templates. We computed age-normalized and sex-normalized z scores for brain volume using a normative dataset of 813 brain MRI scans obtained from typically developing children and used mixed-effect models to assess potential deviation from brain growth trajectories.

RESULTS

We assessed brain volumes of 46 children with MOGAD, 26 with MS, and 51 with monophasic seronegative demyelinating syndrome. Children with MOGAD exhibited delayed (p < 0.001) age-expected and sex-expected growth of thalamus, caudate, and globus pallidus, normalized for the whole brain volume. Divergence from expected growth was particularly pronounced in the first year postonset and was detected even in children with monophasic MOGAD. Thalamic volume abnormalities were less pronounced in children with MOGAD compared with those in children with MS.

DISCUSSION

The onset of MOGAD during childhood adversely affects the expected trajectory of growth of deep gray matter structures, with accelerated changes in the months after an acute attack. Further studies are required to better determine the relative impact of monophasic vs relapsing MOGAD and whether relapsing MOGAD with attacks isolated to the optic nerves or spinal cord affects brain volume over time.

Depression pathophysiology, risk prediction of recurrence and comorbid psychiatric disorders using genome-wide analyses

Depression is a common psychiatric disorder and a leading cause of disability worldwide. Here we conducted a genome-wide association study meta-analysis of six datasets, including >1.3 million individuals (371,184 with depression) and identified 243 risk loci. Overall, 64 loci were new, including genes encoding glutamate and GABA receptors, which are targets for antidepressant drugs. Intersection with functional genomics data prioritized likely causal genes and revealed new enrichment of prenatal GABAergic neurons, astrocytes and oligodendrocyte lineages. We found depression to be highly polygenic, with ~11,700 variants explaining 90% of the single-nucleotide polymorphism heritability, estimating that >95% of risk variants for other psychiatric disorders (anxiety, schizophrenia, bipolar disorder and attention deficit hyperactivity disorder) were influencing depression risk when both concordant and discordant variants were considered, and nearly all depression risk variants influenced educational attainment. Additionally, depression genetic risk was associated with impaired complex cognition domains. We dissected the genetic and clinical heterogeneity, revealing distinct polygenic architectures across subgroups of depression and demonstrating significantly increased absolute risks for recurrence and psychiatric comorbidity among cases of depression with the highest polygenic burden, with considerable sex differences. The risks were up to 5- and 32-fold higher than cases with the lowest polygenic burden and the background population, respectively. These results deepen the understanding of the biology underlying depression, its disease progression and inform precision medicine approaches to treatment.