SUMMARY OBJECTIVES Temporal lobe epilepsy (TLE) patients experience significant deficits in category-related object recognition and naming following standard surgical approaches. These deficits may result from a decoupling of core processing modules (e.g., language, visual processing, semantic memory), due to “collateral damage” to temporal regions outside the hippocampus following open surgical approaches. We predicted stereotactic laser amygdalohippocampotomy (SLAH) would minimize such deficits because it preserves white matter pathways and neocortical regions critical for these cognitive processes. METHODS Tests of naming and recognition of common nouns (Boston Naming Test) and famous persons were compared with nonparametric analyses using exact tests between a group of nineteen patients with medically-intractable mesial TLE undergoing SLAH (10 dominant, 9 nondominant), and a comparable series of TLE patients undergoing standard surgical approaches (n=39) using a prospective, non-randomized, non-blinded, parallel group design. RESULTS Performance declines were significantly greater for the dominant TLE patients undergoing open resection versus SLAH for naming famous faces and common nouns (F=24.3, p<.0001, η2=.57, & F=11.2, p<.001, η2=.39, respectively), and for the nondominant TLE patients undergoing open resection versus SLAH for recognizing famous faces (F=3.9, p<.02, η2=.19). When examined on an individual subject basis, no SLAH patients experienced any performance declines on these measures. In contrast, 32 of the 39 undergoing standard surgical approaches declined on one or more measures for both object types (p<.001, Fisher’s exact test). Twenty-one of 22 left (dominant) TLE patients declined on one or both naming tasks after open resection, while 11 of 17 right (non-dominant) TLE patients declined on face recognition. SIGNIFICANCE Preliminary results suggest 1) naming and recognition functions can be spared in TLE patients undergoing SLAH, and 2) the hippocampus does not appear to be an essential component of neural networks underlying name retrieval or recognition of common objects or famous faces.

The Boston Qualitative Scoring System (BQSS) was used as a method to examine executive skills on the Rey-Osterrieth complex figure (ROCF). Young-adult survivors of childhood brain tumor (N = 31) and a demographically-matched comparison group (N = 33) completed the ROCF copy version and Grooved Pegboard, and informants were administered the Scales of Independent Behavior-Revised (SIB-R) and Behavior Rating Inventory of Executive Function (BRIEF). Survivors had significantly lower BQSS planning and SIB-R community living skills and greater perseveration. Mediation analyses found that BQSS planning skills mediate the relationship between group and community living skills. Convergent findings of the BRIEF Planning, and discriminant findings with the BQSS Fragmentation, BRIEF Emotional Control, and Grooved Pegboard support the planning construct as the specific mediator in this model. Together, these findings highlight the role of planning skills in adaptive functions of young-adult survivors of childhood brain tumor.

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Objective: To test the validity of a common measure of health-related quality of life (Short-Form-36 [SF-36]) in cognitively healthy older adults living in rural and urban Costa Rica. Method: Confirmatory factor analysis was applied to SF-36 data collected in 250 older adults from San Jose and Guanacaste, Costa Rica. Results: The best fitting model for the SF-36 was an eight first-order factor structure. A high correlation between the Mental Component Summary and Physical Component Summary scores was found. Region differences indicated that rural dwellers perceive a poorer health-related quality of life compared with the urban group. Discussion: Costa Rican older adults perceived health as a unidimensional construct. Age and urbanity of older adult Costa Ricans should be appreciated when trying to measure self-reported physical and mental health. Cultural context of the individuals should be considered when studying health-related quality of life.

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Objective Costa Rica has the highest percentage of older adults (65+) of the Central American and Latin American region. In fact, Costa Rica has the highest life expectancy within an advanced healthcare system and socioeconomic infrastructure that differentiates it from neighboring countries in Central America. Previous research has shown that older adults who engage in higher social engagement show overall better cognitive functioning (Chen et al., 2018); however, limited research has examined the impact of socialization on cognition across rural and urban regions and furthermore no research to date has examined these factors in Costa Rican older adults. This study examined the effects of community engagement on cognition in urban and rural older adults residing in Costa Rica. Participants and Method Participants were neurotypical older adults residing in San Jose (urban region, n = 156) and Guanacaste (rural region, n = 69). Those with a history of neurological conditions and major psychiatric disorders were excluded. Results Older adults residing in an urban area (M = 55.43, SD = 23.26) participate more in social engagement within the community compared to those residing in the rural region (M = 46.30, SD = 28.50), p = 0.019. Furthermore, in the urban sample, those with higher social engagement showed better performance on learning and encoding (r = 30), verbal memory (r = 0.26), and executive functioning (r = .20). In older adults residing in the rural region, higher social engagement was only associated with better visuospatial abilities (r = 0.27). Conclusions Findings suggest that social engagement in the community for older adults in Costa Rica may serve as a protective factor for their cognitive health. However, there are significant differences on what cognitive processes serve as a protective factor as a function of location (rural versus urban). This study highlights the importance of examining the quality of social engagement when evaluating the cognition of Costa Rican older adults. References Chen, Ya-Mei, Tu, Yu-Kang, Yu, Hsiao-Wei, Chiu, Tzu-Ying, Chiang, Tung-Liang, Chen, Duan-Rung, & Chang, Ray-E. (2018). Leisure time activities as mediating variables in functional disability progression: An application of parallel latent growth curve modeling. PLoS ONE, 13(10).

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