A Comparison of Teleneuropsychological and Traditional Neuropsychological Battery Factor Structures

This study compared the factor structures of a traditional neuropsychological battery, administered in-person, and a teleneuropsychological battery, administered remotely. Participants were divided into two groups dependent on test condition (i.e., in- person or remote). Individuals in the in-person test condition group (n = 100) were selected from a sample of individuals who were assessed in-person in a previous archival study, and individuals in the remote testing condition group (n = 100) were assessed via teleneuropsychology in their home environment. Two Exploratory Factor Analyses (EFA) using Principal Component Analysis (PCA) method were conducted on the T-scores and scaled scores of each subtest to compare the internal factor structures of the two neuropsychological batteries. For hypothesis one, it was hypothesized an EFA using PCA method of the subtests from the in-person neuropsychological battery would reveal three primary factors: general intelligence, auditory memory, and verbal comprehension. The Parallel Analysis recommended a three-factor solution for the in-person neuropsychological battery, and the factors extracted were labeled as general intelligence, general memory, and processing speed. For hypothesis two, it was hypothesized an EFA using PCA method of the subtests from the teleneuropsychological battery would reveal three primary factors:general intelligence, attention/ working memory, and verbal comprehension. The Parallel Analysis also recommended a three-factor solution for the teleneuropsychological battery, and the factors extracted were labeled as general memory, attention, and verbal comprehension. Results of the two EFAs using PCA method revealed both similarities and differences between the two factor structures. Both batteries extracted a memory factor. However, although the teleneuropsychological battery was designed to measure the same cognitive constructs as a traditional neuropsychological battery, there were more differences than there were similarities. The in-person battery extracted general intelligence and processing speed factors, which were not captured in the teleneuropsychological battery. The teleneuropsychological battery extracted attention and verbal comprehension factors, which were not found to be primary factors in the in- person battery. Altogether, results of the two factor analyses do not indicate the batteries measured the same underlying cognitive skills. This suggests different cognitive skills are utilized when some measures, traditionally administered in person, are administered virtually. These findings have several implications on the use of teleneuropsychology. The interpretation of results obtained from testing using virtual platforms must be altered as it cannot be assumed that virtual assessments measure the same cognitive domains as tests administered in-person. It is essential for clinicians to be cognizant of the differences between virtual and in-person batteries and incorporate this knowledge while conceptualizing an individual’s performance. Clinicians should openly acknowledge this limitation and be cautious in their ability to form definitive conclusions from virtual testing. Results of the present study also illuminate the potential benefits of teleneuropsychological testing and extending neuropsychological services to patients in their home environment. Though the interpretation of results of remote testing must be altered and require further understanding, this study showed valuable information can still be acquired regarding an individual’s cognitive abilities through virtual testing. Implementing teleneuropsychological testing can help reduce numerous barriers for patients who would not otherwise have access to healthcare, particularly during a global pandemic which has limited the use of in-person neuropsychological testing

Effects of Diversity and Neuropsychological Performance in an NFL Cohort

Objective: The aim of this study was to examine the effect of ethnicity on neuropsychological test performance by comparing scores of white and black former NFL athletes on each subtest of the WMS. Participants and Methods: Data was derived from a de-identified database in South Florida consisting of 63 former NFL white (n=28, 44.4%) and black (n=35, 55.6%) athletes (Mage= 50.38; SD= 11.57). Participants completed the following subtests of the WMS: Logical Memory I and II, Verbal Paired Associates I and II, and Visual Reproduction I and II. Results: A One-Way ANOVA yielded significant effect between ethnicity and performance on several subtests from the WMS-IV. Black athletes had significantly lower scores compared to white athletes on Logical Memory II: F(1,61) = 4.667, p= .035, Verbal Paired Associates I: F(1,61) = 4.536, p = .037, Verbal Paired Associates: II F(1,61) = 4.677, p = .034, and Visual Reproduction I: F(1,61) = 6.562, p = .013. Conclusions: Results suggest significant differences exist between white and black athletes on neuropsychological test performance, necessitating the need for proper normative samples for each ethnic group. It is possible the differences found can be explained by the psychometric properties of the assessment and possibility of a non-representative sample for minorities, or simply individual differences. Previous literature has found white individuals to outperform African-Americans on verbal and non-verbal cognitive tasks after controlling for socioeconomic and other demographic variables (Manly & Jacobs, 2002). This highlights the need for future investigators to identify cultural factors and evaluate how ethnicity specifically plays a role on neuropsychological test performance. Notably, differences between ethnic groups can have significant implications when evaluating a sample of former athletes for cognitive impairment, as these results suggest retired NFL minorities may be more impaired compared to retired NFL white athletes

The Effect of Ethnicity on Neuropsychological Test Performance of Former NFL Athletes

Objective: To investigate the effect of ethnicity on neuropsychological test performance by specifically exploring differences between white and black former NFL athletes on subtests of the WAIS-IV. Participants and Methods: Data was derived from a de-identified database in Florida consisting of 63 former NFL athletes (Mage=50.38; SD=11.57); 28 white and 35 black. Participants completed the following subtests of the WAIS-IV: Block Design, Similarities, Digit Span, Matrix Reasoning, Arithmetic, Symbol Search, Visual Puzzles, Coding, and Cancellation. Results: One-Way ANOVA yielded a significant effect between ethnicity and performance on several subtests. Black athletes had significantly lower scaled scores than white athletes on Block Design F(1,61)=14.266, p\u3c.001, Similarities F(1,61)=5.904, p=.018, Digit Span F(1,61)=8.985, p=.004, Arithmetic F(1,61)=16.07, p\u3c.001 and Visual Puzzles F(1,61)=16.682, p\u3c .001. No effect of ethnicity was seen on performance of Matrix Reasoning F(1,61)=2.937, p=.092, Symbol Search F(1,61)=3.619, p=.062, Coding F(1,61)=3.032, p=.087 or Cancellation F(1,61)=2.289, p=.136. Conclusions: Results reveal significant differences between white and black athletes on all subtests of the WAIS-IV but those from the Processing Speed Scale and Matrix Reasoning. These findings align with previous literature that found white individuals to outperform African-Americans on verbal and non-verbal tasks after controlling for socioeconomic and demographic variables (Manly & Jacobs, 2002). These differences may also be a reflection of the WAIS-IV’s psychometric properties and it is significant to consider the normative sample used may not be appropriate for African-Americans. This study highlights the need for future research to identify how ethnicity specifically influences performance, sheds light on the importance of considering cultural factors when interpreting test results, and serves as a call to action to further understand how and why minorities may not be accurately represented in neuropsychological testing