Archives Of Clinical Neuropsychology[JOURNAL]
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200 papers
The Utilization of Clinical Neuropsychological Services within a Forensic Psychiatric Hospital Setting: Treatment Outcomes, Stakeholder Perspectives, and Future Directions.
Hunter S, Kinney DI
Arch Clin Neuropsychol · 2026 Feb · PMID 41686535 · Publisher ↗
OBJECTIVE: Research is needed to demonstrate how neuropsychological services influence clinical outcomes. The current study examined the use and perceived utility of clinical neuropsychological evaluations within a foren...
OBJECTIVE: Research is needed to demonstrate how neuropsychological services influence clinical outcomes. The current study examined the use and perceived utility of clinical neuropsychological evaluations within a forensic psychiatric hospital with a high prevalence of schizophrenia spectrum disorders (SSD). METHOD: This cross-sectional observational study used a multi-method design, integrating survey data from multidisciplinary staff (n = 99) with archival review of hospital records for patients who received neuropsychological evaluations in 2022 (n = 62). The survey assessed staff perceptions of the clinical utility of neuropsychological evaluations, and archival data captured how often evaluation findings were documented in treatment plans, discharge summaries, and forensic evaluation reports. RESULTS: Staff reported high satisfaction with neuropsychological evaluations as a component of clinical care and endorsed their incremental value in informing diagnostic, treatment, and forensic decisions. Neuropsychological evaluation findings were documented in 48% of discharge summaries and 58% of forensic evaluation reports overall. Documentation occurred significantly more frequently for incompetent to stand trial (IST) patients than for non-IST patients in both discharge summaries (64% vs. 11%, respectively, p = .016) and forensic evaluation reports (80% vs. 39%, p = .012; Fisher's exact tests). CONCLUSIONS: Findings support the clinical utility of neuropsychological evaluations within forensic psychiatric settings, particularly for patients hospitalized as IST receiving competence restoration. Implications for clinical practice and policy are discussed, along with recommendations to enhance neuropsychological service utilization for individuals with SSD.
Neurocognitive Profile of Late Life Hoarding Disorder Using the NIH Toolbox Cognition Battery as an In-Home Assessment.
Schaff B, Williams J, Nix CA … +2 more , Porter B, Dozier ME
Arch Clin Neuropsychol · 2026 Feb · PMID 41686534 · Publisher ↗
OBJECTIVE: Adults with hoarding disorder report high levels of subjective cognitive impairment which have largely gone undetected in formal testing in laboratory settings; this discrepancy may be due to the testing envir...
OBJECTIVE: Adults with hoarding disorder report high levels of subjective cognitive impairment which have largely gone undetected in formal testing in laboratory settings; this discrepancy may be due to the testing environment. METHOD: This study examined associations between cognitive performance and hoarding severity in a sample of older adults diagnosed with hoarding disorder (N = 52) using the NIH Toolbox Cognition Battery administered in participants' homes. RESULTS: Participants demonstrated a cognitive profile that included weaknesses in attention, executive function, and processing speed. Conversely, the sample demonstrated strengths in delayed memory. CONCLUSIONS: Together, results suggest that adults with hoarding disorder, particularly older adults, may experience impaired cognitive functioning in the context of their household but demonstrate intact cognitive functioning in clinical settings. These findings demonstrate the utility of using the NIH Toolbox to assess for cognitive functioning related to late-life hoarding and underline the importance of in-home assessment for hoarding disorder.
An Exploratory Analysis and Comparison of Post-Concussion Symptom Networks in Young Adults with and without a Remote History of Concussion.
Ingram EO, Carmo M, Rast P … +2 more , Manderino L, Karr JE
Arch Clin Neuropsychol · 2026 Feb · PMID 41642234 · Publisher ↗
OBJECTIVE: Explore the utility of characterizing symptom presentations using a novel statistical approach that estimates intrapersonal concussion-like symptom networks and parameters. METHOD: Participants were N = 353 yo...
OBJECTIVE: Explore the utility of characterizing symptom presentations using a novel statistical approach that estimates intrapersonal concussion-like symptom networks and parameters. METHOD: Participants were N = 353 young adults ages 18-35 (84.7% female; 77.1% White; 25.8% with a lifetime concussion) who completed the Post-Concussion Symptom Scale thrice daily for 30 days. Network parameters (i.e., edge weights and bridge strength) were compiled per participant for within-person analyses, and in aggregate for between-person analyses, comparing groups with and without a lifetime concussion history. Example graphical networks were generated for within- and between-person results, although network analysis is an emerging area of research with limited guidelines for interpreting effect size and significance. RESULTS: Within-person analyses highlighted the substantial variability in concussion-like symptom presentations, with no single central symptom or edge weight emerging as especially common. The symptoms Irritability and Nervousness were among the most frequently central symptoms in both groups, though the concussion history group had a greater representation of sleep-related impairments being central symptoms. In between-person analyses, symptoms related to sleep and affect were the most common network parameters in the concussion history group versus predominantly physical symptoms in the control group. CONCLUSIONS: The variability in symptom presentations demonstrates the utility of within-person network models to match individuals to rehabilitation plans that best reflect their ongoing symptom experience over time. Future research should replicate this statistical approach in acutely injured, treatment-seeking individuals following concussion to determine if patterns of sleep impairments are truly specific to post-concussion presentations.
Texas Card Sorting Test: a Brief Test of Executive Functioning with Age-Adjusted Norms and External Validation.
Lacritz LH, Kaser AN, Argueta-Ortiz F … +2 more , Hynan LS, Cullum CM
Arch Clin Neuropsychol · 2026 Feb · PMID 41642233 · Publisher ↗
OBJECTIVE: The Texas Card Sorting Test (TCST) is a brief test of executive functioning that involves sorting cards into groups based on like dimensions. The TCST is shorter than most available executive function measures...
OBJECTIVE: The Texas Card Sorting Test (TCST) is a brief test of executive functioning that involves sorting cards into groups based on like dimensions. The TCST is shorter than most available executive function measures, requires minimal language demands, and excludes negative feedback. This study generated age-adjusted normative data for the TCST in a healthy aging, normal control (NC) sample, examined its sensitivity and specificity, assessed convergent validity, and compared NC performance to an Alzheimer's disease clinical syndrome (ADCS) sample. METHOD: TCST data from 164 NC [Mage = 69.60 (SD = 8.6); Meducation = 15.46 years (SD = 2.83)] and 92 ADCS participants [Mage = 77.73 (SD = 7.55); Meducation = 13.65 years (SD = 3.53)] were obtained as part of a larger neuropsychological battery at Texas Alzheimer's Research and Care Consortium (TARCC) sites from which age-adjusted normative data were derived and sensitivity, specificity, diagnostic accuracy, and validity were examined. RESULTS: TCST Logical Sorts (LS), or correct card sorts, were significantly correlated with age, education, and other executive function measures. Lower but significant correlations were seen with attention and memory measures. TCST performance (LS and total errors) significantly differed between groups [F (1,249) = 142, p < .001 and F(1,248) = 26.5, p < .001]. Receiver operating characteristics analysis yielded an AUC of 0.912, sensitivity of 75%, specificity of 73%, and classification accuracy of 84% for NC versus ADCS. Optimal T score cut-offs, regression-based norms, and a T score calculator are provided. CONCLUSIONS: These findings support the TCST's validity and feasibility as a brief measure of executive functioning that can accurately discriminate between normal aging and dementia. Normative data provided will enhance interpretation of this measure.
Childhood Opportunity Index 2.0 and Cognition via the NIH Toolbox.
Harris JC, Cardenas-Iniguez C, Watts AL … +4 more , Moore HR, Malames BA, Nelson CA, Lisdahl KM
Arch Clin Neuropsychol · 2026 Feb · PMID 41642232 · Publisher ↗
BACKGROUND: This study relied on previously established factor scores of environmental, education, and socioeconomic-related variables in the Adolescent Brain Cognitive Development Study (ABCD) and their associations wit...
BACKGROUND: This study relied on previously established factor scores of environmental, education, and socioeconomic-related variables in the Adolescent Brain Cognitive Development Study (ABCD) and their associations with cognitive functioning in youth. METHOD: We used the ABCD Study (n = 9543) linked external data, cognitive task performance, and self-reported data from youth (ages 9-10) and their caregivers. We investigated the links between four previously established factor scores of the Child Opportunity Index 2.0 (COI) (Socioeconomic Attainment, Poverty, Neighborhood Enrichment, and Child Education) and cognitive functioning via the NIH Toolbox subscales. We estimated 36 models that examined all possible relationships between the (a) four COI factors and (b) cognitive functioning indices. RESULTS: Socioeconomic Attainment and Child Education factor scores were significantly positively associated with cognitive performance across all cognitive tasks subscales and composite scores (i.e., crystallized and fluid intelligence). Poverty factor scores were significantly negatively associated with cognitive performance across all subscales and composite scores. Finally, Neighborhood Enrichment factor scores were significantly positively associated with increased Oral Reading Recognition Task scores only, and no other cognitive task. DISCUSSION: Distinct dimensions of neighborhood opportunity were differentially associated with aspects of cognition, which may have a unique impact on brain development and neural outcomes as youth age into adolescence. The present study can help to inform future public health efforts and policy on improving built and natural environmental structures that may aid in supporting childhood cognitive development.
Validation and Normative Data Study for the Turkish Version of the Movie for the Assessment of Social Cognition (MASC-TR).
Şandor S, Hıdıroğlu-Ongun C, Tanfer MC … +3 more , Gürkaş S, Bora E, Yıldırım E
Arch Clin Neuropsychol · 2026 Feb · PMID 41642231 · Publisher ↗
OBJECTIVE: This study aimed to adapt the Movie for the Assessment of Social Cognition (MASC) into Turkish (MASC-TR), examine its psychometric properties, and establish normative data. Additionally, the study investigated...
OBJECTIVE: This study aimed to adapt the Movie for the Assessment of Social Cognition (MASC) into Turkish (MASC-TR), examine its psychometric properties, and establish normative data. Additionally, the study investigated the discriminative validity of the MASC-TR in differentiating individuals with autism spectrum disorder (ASD) from healthy controls. METHODS: The sample comprised 228 healthy adults and 29 individuals with ASD aged 18-45 years. Participants completed the MASC-TR along with established measures of theory of mind (ToM)-the Reading the Mind in the Eyes Test (RMET) and the Faux Pas Recognition Test (FPRT)-as well as non-social cognitive tasks assessing attention, working memory, and executive functions. Reliability analyses included internal consistency and test-retest reliability. Construct validity was assessed via convergent and discriminant correlations. Group comparisons and receiver operating characteristic analyses were used to evaluate discriminative validity, while multifactorial analysis of variance and regression analyses examined demographic effects. RESULTS: The MASC-TR demonstrated acceptable internal consistency (α = 0.75) and excellent test-retest reliability (ICC = 0.98). Significant positive correlations with RMET and FPRT supported convergent validity. Education level emerged as the only significant demographic predictor of MASC-TR performance. The MASC-TR successfully differentiated individuals with ASD from controls (t = -3.87, p < .001), with an optimal cutoff of 23.5 yielding 97% sensitivity and 52% specificity (area under the curve = 0.72). CONCLUSIONS: The findings indicate that the MASC-TR is a valid and reliable measure of social cognition in Turkish adults. The availability of culturally adapted normative data enhances its clinical and research utility for assessing ToM functioning across populations.
Executive Function Performance in Bilingual and Monolingual Individuals with Attention Deficit Hyperactivity Disorder (ADHD): a Comparative Analysis of Cold (Inhibitory Control and Cognitive Flexibility) and Hot (Theory of Mind) Executive Functions.
Mehrafshan H, Purmohammad M
Arch Clin Neuropsychol · 2026 Feb · PMID 41642230 · Publisher ↗
OBJECTIVE: This research had three main objectives. The first objective was to compare the performance of individuals with ADHD and normal individuals in hot (theory of mind) and cold (cognitive flexibility and inhibitor...
OBJECTIVE: This research had three main objectives. The first objective was to compare the performance of individuals with ADHD and normal individuals in hot (theory of mind) and cold (cognitive flexibility and inhibitory control) executive functions. The second objective was to compare hot and cold executive functions in bilingual and monolingual individuals. The third objective of the study was to examine the interactive effect of bilingualism and ADHD on hot and cold executive functions. METHODS: To conduct the research, a variety of tools were employed, including the language experience and proficiency questionnaire, socio-economic status questionnaire (SES), Conners' Adult ADHD Rating Scale, Go/No-Go task, Wisconsin Card Sorting Task, Raven's Progressive Matrices, and The Reading the Mind in the Eyes Test. RESULTS: Individuals with ADHD showed deficits in both hot and cold executive functions. Another finding showed no significant difference between the bilingual and monolingual groups in cold executive functions, but there was a significant difference between the two groups in hot executive functions. Moreover, the results showed that bilingual and monolingual individuals with ADHD did not differ significantly in hot and cold executive functions. CONCLUSION: Individuals with ADHD exhibited impairments in both cold and hot executive functions, whereas bilingualism was associated with better theory-of-mind performance but not with cold executive functions. Critically, no significant interaction between bilingualism and ADHD was observed for any executive function domain, indicating that bilingualism neither mitigated nor exacerbated ADHD-related deficits.
Artificial Intelligence-Driven Adaptation of Pediatric Traumatic Brain Injury Case Descriptions for Family Communication.
García-Rudolph A, Berenguel MN, Opisso E … +3 more , Aparicio C, Rodriguez P, Enseñat A
Arch Clin Neuropsychol · 2026 Feb · PMID 41642229 · Publisher ↗
OBJECTIVE: We examined whether GPT-4o, a widely used large language model (LLM), could produce age- and education-appropriate versions of complex pediatric traumatic brain injury case descriptions, while preserving clini...
OBJECTIVE: We examined whether GPT-4o, a widely used large language model (LLM), could produce age- and education-appropriate versions of complex pediatric traumatic brain injury case descriptions, while preserving clinical accuracy and emotional tone. METHODS: Five cases were adapted into four audience scenarios. Text complexity was assessed via Flesch-Kincaid (FKS), Gunning Fog, and SMOG indices. Clinical human experts rated text fidelity and emotional appropriateness on a 3-point scale. RESULTS: Original texts showed very high complexity (FKS 18.2-20.5), equivalent to 18-20 years of education. Adaptations for parents with high school education were often over-simplified (FKS 4.75-7.1), while versions for 12-year-olds were well-matched (FKS ~5-6). Texts for 8-year-olds had FKS scores of 4.0-6.8 (above grade 2-3 targets) and reduced fidelity (scores 1-2). Emotional tone was consistently rated appropriate across all audiences. CONCLUSION: Clinicians may use LLMs to draft explanations, but must carefully review and tailor them.
Unfamiliar Odor Recognition Ability in Subjective Cognitive Decline.
Cheng YH, Yang CC, Chiu MJ … +3 more , Chen TF, Chang YL, Hua MS
Arch Clin Neuropsychol · 2026 Feb · PMID 41642228 · Publisher ↗
OBJECTIVE: This cross-sectional study aimed to explore the relationship between olfactory memory function and the early detection of dementia of Alzheimer's type (DAT), minimizing the confounding effects of previous expe...
OBJECTIVE: This cross-sectional study aimed to explore the relationship between olfactory memory function and the early detection of dementia of Alzheimer's type (DAT), minimizing the confounding effects of previous experiences and verbal memory by employing unfamiliar stimuli. Additionally, the study developed and evaluated the Olfactory Recognition Test with Unfamiliar Stimuli (ORT-US) to assess its discriminative power for identifying individuals with DAT. METHODS: Participants were recruited and classified to healthy control (HC, n = 30), subjective cognitive decline (SCD, n = 35), mild cognitive impairment (MCI, n = 18), and very mild DAT (n = 7) groups. ORT-US scores were compared across groups using analysis of variance, while discriminative power was examined via receiver operator characteristic (ROC) analysis. RESULTS: Significant differences in ORT-US scores were found only between the scores of HC and very mild DAT groups. The false-alarm scores (i.e., misrecognizing non-target odors as the targets) were significantly different, while those of the hit score (i.e., correctly recognize the target odors) were insignificant. No significant interaction between participant age and total scores, supporting their irrelevancy. Unsatisfactory area under the curve was found, indicating that odor recognition with unfamiliar stimuli cannot effectively detect individuals with DAT. CONCLUSIONS: While olfactory memory function presents relationships with the early detection of DAT, odor recognition using unfamiliar stimuli reveals limited efficacy as a clinical marker. Further studies are needed to validate these findings.
The State of Published Science in Clinical Neuropsychology's Lifespan Journals: A Mixed Methods Examination of Scope, Approaches, and Content.
Woods SP, Van Patten R, Block C … +7 more , Briceño EM, Calamia M, Clark AL, Fonseca LM, Jones JD, Kunicki ZJ, Farias ST
Arch Clin Neuropsychol · 2026 Jan · PMID 41615397 · Publisher ↗
OBJECTIVE: Clinical neuropsychology is an evidence-based discipline that draws heavily from the field's peer-reviewed journal articles. However, our scientific understanding of the methods and content that comprise the a...
OBJECTIVE: Clinical neuropsychology is an evidence-based discipline that draws heavily from the field's peer-reviewed journal articles. However, our scientific understanding of the methods and content that comprise the articles published in clinical neuropsychology journals is quite limited. METHOD: A mixed methods approach was used to describe the aims, methods, and content of clinical neuropsychology's major lifespan journals. Six-hundred articles were randomly sampled from the 2020-2024 volumes of six lifespan clinical neuropsychology journals. All articles were coded across 42 dimensions, including article type, population, design, methods, ability domains, and miscellaneous topics (e.g., brain health). The aims/scope sections of the journals were subjected to qualitative analyses, to identify relevant themes. RESULTS: The most common article content was observed in the areas of empirical/data-driven studies, cross-sectional and observational designs, older and neurological participants, cognitive testing of higher-order abilities, and psychometrics/methods. Results showed significant between-journal differences for some of these content areas at broadly medium effect sizes (e.g., experimental design, brain health topics). Qualitative analyses yielded five shared themes, suggesting that the lifespan clinical neuropsychology journals are interested in submissions on brain-behavior relationships, clinical applications, both clinical and healthy/typical populations, professional/guild matters, and multidisciplinary investigations. CONCLUSIONS: The scientific content published within clinical neuropsychology's six primary lifespan journals varies in some dimensions, but largely focuses on cross-sectional, observational studies of psychometrics and higher-order cognition. The implications of these findings for future research in clinical neuropsychology are contextualized for authors, reviewers, and readers.
Cognitive Performance in Middle-Aged Adults with Type 2 Diabetes: Normative Comparisons and Associations with Medical and Psychological Variables.
Sola T, Pimiä E, Kangaslampi S … +2 more , Lahtela J, Jehkonen M
Arch Clin Neuropsychol · 2026 Jan · PMID 41615396 · Publisher ↗
OBJECTIVE: This study examined whether middle-aged individuals with type 2 diabetes mellitus (T2DM) without major comorbidities perform comparably to normative samples on a comprehensive neuropsychological test battery....
OBJECTIVE: This study examined whether middle-aged individuals with type 2 diabetes mellitus (T2DM) without major comorbidities perform comparably to normative samples on a comprehensive neuropsychological test battery. The study also investigated which medical, psychological, or demographic factors are associated with cognitive performance in this population. METHOD: Forty-eight middle-aged Finnish adults with T2DM completed a fixed neuropsychological test battery covering core cognitive domains. Z-scores were calculated for each test and cognitive domain using published normative data. Global and domain-specific performance was compared to normative expectations. Bivariate correlations were computed to examine associations with medical, psychological, and background variables. RESULTS: The cognitive performance of patients was broadly consistent with normative expectations, and the proportion of individuals with below-average scores in each domain did not exceed proportions expected based on normative distributions. No consistent or strong associations were found between cognitive performance and any medical or demographic variable. Psychological symptoms, especially fatigue and anxiety symptoms, were significantly associated with the presence of subjective cognitive complaints but not with objective neuropsychological test scores. CONCLUSIONS: Cognitive performance in middle-aged individuals with T2DM and no severe complications appears comparable to normative samples. The absence of associations with metabolic risk factors may reflect a preclinical stage before measurable cognitive decline emerges. Limited statistical power and use of non-local normative data should be considered when interpreting the findings. Overall, the results highlight middle age as a potential window for preventive efforts.
Exploration of an Embedded Symptom Validity Overreporting Cutoff for the Perceived Stress Scale in a Diverse Adult Outpatient Neuropsychological Sample.
Fawcett MK, Alex C, Shoemaker BE … +7 more , Piszczor J, Yandamuri T, Galindo BN, Kent GW, Phillips MS, Soble JR, Cerny BM
Arch Clin Neuropsychol · 2026 Jan · PMID 41615395 · Publisher ↗
INTRODUCTION: Perceived stress is routinely assessed in clinical evaluations. Ensuring symptom validity is critical when interpreting symptom measures and embedded symptom validity cutoffs have recently been explored for...
INTRODUCTION: Perceived stress is routinely assessed in clinical evaluations. Ensuring symptom validity is critical when interpreting symptom measures and embedded symptom validity cutoffs have recently been explored for several widely used measures of psychological distress. This study explored potential embedded validity cutoff scores in the 10-item Perceived Stress Scale (PSS) for detecting psychological symptom overreporting. METHODS: The final sample included 503 patients referred for neuropsychological evaluation who were independently classified into valid, possibly overreporting, or definitely overreporting groups based on the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) or Minnesota Multiphasic Personality Inventory-3 (MMPI-3) overreporting scales. Receiver operator characteristic curve analyses determined the optimal PSS cutoff for detecting noncredible responding using both the total raw score and race-corrected z-scores. RESULTS: Classification accuracy ranged from unacceptable to excellent for PSS raw scores and z-scores, with greater classification accuracy corresponding to greater likelihood of overreporting. Among models with acceptable or excellent classification accuracy, a cutoff of ≥28 produced 37%-57% sensitivity and 88% specificity for PSS raw scores. For PSS z-scores, a cutoff of ≥2.15 yielded 46% sensitivity and 89% specificity for detecting ≥3 possible overreporting elevations and ≥2.08 yielded 61% sensitivity and 88% specificity for detecting ≥1 definite overreporting elevation. CONCLUSION: Present findings provide preliminary evidence for an embedded overreporting cutoff for the PSS. While these results are promising, there remains a need for further replication in other clinical populations before it can be routinely adopted in general evaluations.
Parent and Child Agreement of Brain Injury Perceptions Following Pediatric Concussion.
Schmitt AJ, Khalaifa M, Franklin K … +6 more , Jones J, Zynda AJ, Albrecht T, Walzer K, Kontos AP, Beidler E
Arch Clin Neuropsychol · 2026 Jan · PMID 41615394 · Publisher ↗
OBJECTIVE: To determine the agreement of parent and child responses to the Brain Injury Perception Scale (BIPS), a modified version of the Illness Perceptions Questionnaire-Revised, following a pediatric concussion. METH...
OBJECTIVE: To determine the agreement of parent and child responses to the Brain Injury Perception Scale (BIPS), a modified version of the Illness Perceptions Questionnaire-Revised, following a pediatric concussion. METHOD: This was a cross-sectional study of 88 parent-child dyads who completed the BIPS at their initial visit to a specialty concussion clinic within 30 days following pediatric (11-18 years of age) concussion. Descriptive statistics were calculated, followed by Spearman's rho (ρ), which assessed parent-child item consistency. Cross-tab tables were used to understand the direction of item consistency. RESULTS: Only five (13.2%) out of 38 BIPS items demonstrated parent-child consistency (p < .05), with both disagreeing that the brain injury is permanent (ρ = .27), will have major consequences on their life (ρ = .25), makes them upset (ρ = .22), will strongly affect the way others see them (ρ = .29), and will be with them for the rest of their life (ρ = .22). CONCLUSIONS: Parent-child agreement regarding brain injury perceptions following a pediatric concussion was low (13%), reflecting the importance of assessing and then addressing parent and child perceptions individually in pediatric concussion management.
Quality of Life, Self-Reported Cognitive Difficulties, and Performance-Based Cognitive Problems in Multiple Sclerosis: What's Sleep Got to Do With It?
Riegler KE, Román CAF, Guty ET … +3 more , Thomas GA, Bradson ML, Arnett PA
Arch Clin Neuropsychol · 2026 Jan · PMID 41615393 · Full text
OBJECTIVE: Examine group differences between people with multiple sclerosis (PwMS) with poor and adequate sleep quality on cognition (performance-based and self-reported difficulties) and examine the contribution of slee...
OBJECTIVE: Examine group differences between people with multiple sclerosis (PwMS) with poor and adequate sleep quality on cognition (performance-based and self-reported difficulties) and examine the contribution of sleep quality on quality of life (QoL). METHOD: Cross-sectional study of 97 PwMS. Two groups were created from a sleep quality composite: poor (n = 22) and adequate (n = 72) sleep quality. Seven domains from the Functional Assessment of Multiple Sclerosis (FAMS) assessed quality of life. A dichotomous (yes/no) item on the Sleep Habits Questionnaire assessed self-reported cognitive difficulties. Performance-based cognition was measured with a composite of mean neuropsychological performance and 2 intraindividual variability (IIV) indices. Two mulitavariate analyses of variance examined group differences on cognition and QoL. A chi-square test compared the proportion of PwMS with poor versus adequate sleep quality who self-reported cognitive difficulties. Follow-up hierarchical linear regressions were conducted to account for disease progression, fatigue, and depression. RESULTS: PwMS with poor and adequate sleep quality did not significantly differ in terms of performance-based cognitive functioning. A significantly greater proportion of PwMS with poor sleep quality reported that sleep patterns affected their cognitive abilities (86.36%) compared to those with adequate sleep quality (40.28%), χ2(1, N = 94) = 14.32, p < .001, φ = -.39. After accounting for disease progression, depression, and fatigue, sleep quality significantly predicted Symptoms QoL, R2 =.04, ΔF(1,88) = 4.72, p = .03, and Fatigue QoL, R2 = .05, ΔF(1,89) = 5.64, p = .02. CONCLUSIONS: Poor sleep quality was not associated with performance-based cognitive functioning but was associated with greater self-reported cognitive difficulties. After accounting for disease progression, depression, and fatigue, poor sleep quality was significantly predictive of both Symptoms and Fatigue QoL.
Correlation of White Matter Lesions, Cerebral Blood Flow, and Cognitive Decline in Patients With Alzheimer's Disease and Vascular Dementia.
Ye M, Pan X
Arch Clin Neuropsychol · 2026 Jan · PMID 41615392 · Publisher ↗
OBJECTIVE: This study investigated the relationship between white matter lesions (WMLs), cerebral blood flow (CBF), and cognitive decline in a mixed cohort of patients diagnosed with Alzheimer's disease (AD) and vascular...
OBJECTIVE: This study investigated the relationship between white matter lesions (WMLs), cerebral blood flow (CBF), and cognitive decline in a mixed cohort of patients diagnosed with Alzheimer's disease (AD) and vascular dementia (VaD). METHOD: This cross-sectional study included 100 patients with AD or VaD (ages 55-85) and 50 age- and education-matched healthy controls. Participants underwent neuroimaging and cognitive assessment. Volumetric WMLs were quantified using FLAIR MRI, and CBF was measured with arterial spin labeling MRI. Cognitive function was evaluated using the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog). Structural atrophy was also visually rated, and biochemical markers were analyzed. RESULTS: Compared to controls, the AD/VaD patient group had a significantly higher WML volume (p < .001), reduced global CBF (p < .001), greater brain atrophy, and worse ADAS-Cog scores (p < .001). A hierarchical multiple linear regression analysis in the patient group revealed that WML volume (β = 0.55, p < .001) and global CBF (β = -0.38, p < .001) were significant independent predictors of ADAS-Cog scores after controlling for age, education, and brain atrophy. Brain atrophy itself was also a significant predictor (β = 0.21, p = .005). The model explained 72% of the variance in cognitive scores. CONCLUSIONS: In a clinically mixed dementia cohort, the burden of WMLs and the magnitude of CBF reduction are strongly associated with the severity of cognitive impairment. These findings highlight the critical contribution of cerebrovascular pathology to cognitive dysfunction and underscore the value of quantitative imaging markers in understanding dementia's neurobiological substrates.
Apathy and Depression Impact on Cognitive Decline: Neuropsychological Specificities across Neurodegenerative Diseases.
Oliveri S, Gastaldo F, Maiorana NV … +5 more , Guidetti M, Bocci T, Rosci C, Marceglia S, Priori A
Arch Clin Neuropsychol · 2026 Jan · PMID 41615391 · Full text
OBJECTIVE: Apathy is a common symptom across neurodegenerative diseases with origins still debated. "Vascular apathy hypothesis" by Van der Mast suggests vascular pathologies precede apathy. Other evidence points to dysf...
OBJECTIVE: Apathy is a common symptom across neurodegenerative diseases with origins still debated. "Vascular apathy hypothesis" by Van der Mast suggests vascular pathologies precede apathy. Other evidence points to dysfunction in dopamine pathways, driving apathy by impairing goal-directed behaviour. The impact of apathy on cognitive decline and autonomy, particularly with coexisting depression, remains unclear. This cross-sectional study aimed to (1) characterize apathy in vascular dementia, Parkinson's disease (PD), and Mild Cognitive Impairment-Alzheimer Disease (MCI-AD) regarding incidence, severity, and cognitive specificity; (2) differentiate effects of apathy and depression on cognitive impairment and daily autonomy (Activities of Daily Living [ADL]). METHOD: Fifty-three patients underwent neuropsychological testing and completed the Geriatric Depression Scale, Starkstein's Apathy Scale, and ADL questionnaire at a clinical neuropsychology outpatient setting in Milan. RESULTS: 56% patients had cardiovascular pathologies, 20% had PD, and 22% had MCI-AD. Neither prevalence nor severity of apathy or depression differed significantly across diseases. Hierarchical regression showed apathy predicted language initiative controlling for depression (R2 = 0.249; F(2) = 4.144; p = .028), and inversely correlated with working memory, language and frontal functioning, while depression predicted autonomy controlling for apathy (R2 = 0.234; F (2) = 3.821; p = .036). CONCLUSIONS: Apathy is prevalent across different neurodegenerative diseases and exacerbates specific cognitive impairments. Distinguishing vascular apathy from other forms remains challenging.
Editorial.
Donders J
Arch Clin Neuropsychol · 2026 Jan · PMID 41467509 · Publisher ↗
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Differential Metacognitive Profiles in Relapsing-Remitting and Progressive Multiple Sclerosis: Associations with Fatigue, Cognition, and Perceived Disability.
Totuk O, Turkkol M, Gudek HC … +4 more , Dogan IG, Tezer DC, Sahin S, Demir S
Arch Clin Neuropsychol · 2026 Feb · PMID 41467506 · Publisher ↗
OBJECTIVE: This study examined metacognitive belief profiles in individuals with multiple sclerosis (MS) and their associations with cognitive, emotional, and functional outcomes. Specifically, we compared relapsing-remi...
OBJECTIVE: This study examined metacognitive belief profiles in individuals with multiple sclerosis (MS) and their associations with cognitive, emotional, and functional outcomes. Specifically, we compared relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), and primary progressive MS (PPMS) to determine whether distinct metacognitive patterns characterize different disease phenotypes. METHOD: A total of 504 participants (75.6% RRMS, 9.9% SPMS, 14.5% PPMS) were recruited from a neurology clinic. Participants completed the Metacognitions Questionnaire-30 (MCQ-30), Montreal Cognitive Assessment (MoCA), Beck Depression Inventory (BDI), Modified Fatigue Impact Scale (MFIS), Expanded Disability Status Scale (EDSS), Short Form-12 (SF-12), and Occupational Self-Assessment (OSA). Group differences were examined using ANOVA, correlations via Pearson coefficients, and hierarchical and ordinal regression models. RESULTS: Progressive phenotypes, particularly PPMS, showed significantly higher maladaptive metacognitive beliefs than RRMS. RRMS individuals exhibited greater cognitive self-consciousness and need for control, whereas PPMS was associated with lower cognitive confidence and stronger negative beliefs about uncontrollability. No subtype differences emerged in positive beliefs. Maladaptive metacognition correlated with lower cognitive performance, greater fatigue, depressive symptoms, reduced quality of life, and lower self-efficacy. In regression models, depression was the strongest negative predictor of self-efficacy, while cognitive self-consciousness was a positive predictor. Clinical and psychological variables together explained 60% of the variance in self-efficacy. Metacognitive beliefs and fatigue also predicted higher neurological disability (EDSS). CONCLUSIONS: Metacognitive belief patterns differ across MS phenotypes and significantly impact both functional and neurological outcomes. These findings support incorporating metacognitive assessment into routine MS care and underscore the need for tailored psychological interventions addressing cognitive-emotional regulation.
Ambulatory Cognitive Function and Cognitive Dispersion among Individuals with Type I Diabetes: Examining Biobehavioral and Glycemic Correlates.
Smith PJ, Barker R, Hassenstab J … +1 more , Merwin RM
Arch Clin Neuropsychol · 2026 Feb · PMID 41420851 · Publisher ↗
AIMS: Diabetes mellitus (DM) is widely regarded as an important risk factor for Alzheimer's Disease and Related Dementias (ADRD), with higher blood glucose variability (BGV) associating with greater ADRD risk. Few studie...
AIMS: Diabetes mellitus (DM) is widely regarded as an important risk factor for Alzheimer's Disease and Related Dementias (ADRD), with higher blood glucose variability (BGV) associating with greater ADRD risk. Few studies have linked BGV with ambulatory cognitive functioning or cognitive dispersion measures in T1DM. MATERIALS AND METHODS: We conducted a pilot study in which 20 individuals with type-I DM (T1DM) wore a continuous glucose monitor and actigraphy monitor for one week while completing ambulatory measures of cognition. In addition to ambulatory measures, participants completed a 45-min neuropsychological battery consisting of eight standard measures of Executive Functioning, Memory and Learning, and premorbid intellectual functioning. Demographically corrected t-scores were obtained, as well as measures of cognitive dispersion. RESULTS: Cardiovascular risk factors and markers of metabolic function were associated with cognitive function and cognitive dispersion. Higher glucose levels, HbA1c, and body mass, as well as lower physical activity and sleep efficiency all associated with worse ambulatory cognition. CONCLUSIONS: Ambulatory cognitive measures demonstrated robust associations with clinical neuropsychological measures and dynamic associations with ambulatory metabolic function and health behaviors. Greater levels of cognitive dispersion associated with vascular risk factors, worse metabolic function, and worse ambulatory cognitive functioning.
Validation and Normative Data of a Modified Autobiographical Interview for Use in Taiwanese Patients with Temporal Lobe Epilepsy: A Preliminary Study.
Chen WY, Chen TC, Chiu PY … +3 more , Wang WH, Chen MK, Chang HT
Arch Clin Neuropsychol · 2026 Feb · PMID 41396690 · Publisher ↗
OBJECTIVE: Autobiographical memory (AM) refers to the recollection of events in an individual's life. AM deficits have been associated with brain disorders, such as temporal lobe epilepsy (TLE). Researchers have develope...
OBJECTIVE: Autobiographical memory (AM) refers to the recollection of events in an individual's life. AM deficits have been associated with brain disorders, such as temporal lobe epilepsy (TLE). Researchers have developed interview protocols to assess AM deficits. We aimed to validate a modified version of the Autobiographical Interview (mAI) among Taiwanese patients with TLE. METHODS: A normative reference sample of 100 healthy individuals was established to model age- and education-adjusted performance. From this group, 38 individuals were matched to TLE patients to validate discriminative ability. RESULTS: The mAI demonstrated high interrater reliability. Retrieval of episodic AM from childhood was associated with linguistic ability. Retrieval of episodic AM from adolescence involved both arbitrary and meaningful associations. Retrieval of episodic AM from recent life was not dependent on arbitrary associations. Age was negatively associated with episodic AM retrieval, whereas educational level was positively associated. CONCLUSIONS: TLE patients displayed deficits in episodic AM retrieval from adolescence while AM retrieval from childhood and recent life was preserved. These results support the validity of the mAI as a tool for assessing AM deficits in TLE patients.
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