Other Psychiatry and Psychology Commons^™

Introducing A Physical Therapist-Led Acceptance And Commitment Therapy Training For Pain: A Clinical Perspective, Joseph Tatta

Internet Journal of Allied Health Sciences and Practice

Purpose: Mounting evidence supports the use of cognitive and behavioral techniques as part of physical therapist practice. These methods are used within a physical therapist’s multimodal treatment approach for the management of pain and to facilitate health behavior change. There is a multitude of evidence-based cognitive behavioral techniques to choose from including newer approaches based on Acceptance and Commitment Therapy. Yet few studies have examined physical therapists’ perceptions to learning and implementing ACT into clinical practice. The purpose of this manuscript is to present a clinical perspective of physical therapists learning about and incorporating Acceptance and Commitment Therapy in clinical …

Explicit And Implicit Emotion Processing In The Cerebellum: A Meta‑Analysis And Systematic Review, Jordan E. Pierce, Marine Thomasson, Philippe Voruz, Garance Selosse, Julie Péron

Center for Brain, Biology, and Behavior: Faculty Publications

The cerebellum’s role in affective processing is increasingly recognized in the literature, but remains poorly understood, despite abundant clinical evidence for affective disruptions following cerebellar damage. To improve the characterization of emotion processing and investigate how attention allocation impacts this processing, we conducted a meta-analysis on task activation foci using GingerALE software. Eighty human neuroimaging studies of emotion including 2761 participants identified through Web of Science and ProQuest databases were analyzed collectively and then divided into two categories based on the focus of attention during the task: explicit or implicit emotion processing. The results examining the explicit emotion tasks identified …

The Role Of Reported Affective Symptoms And Anxiety In Recovery Trajectories After Sport-Related Concussion, Bernadette A. D'Alonzo, Abigail C. Bretzin, Douglas J. Wiebe, Ivy League–Big Ten Epidemiology Of Concussion Study Investigators, Arthur C. Maerlender, Cary R. Savage

Center for Brain, Biology, and Behavior: Faculty Publications

Background: There is growing awareness and clinical interest in athletes with affective symptoms after sport-related concussion (SRC), as these symptoms may contribute to overall symptoms and represent a modifiable risk factor of longer recovery. However, evidence of their effects on the entire return-to-play (RTP) trajectory, particularly among women and men, is limited.

Purpose/Hypothesis: To examine the relationship between affective symptom reporting and RTP progression after SRC among a cohort of Division 1 student-athletes. We hypothesized that those endorsing affective symptoms, specifically nervous-anxious symptoms, spend more time in RTP progression and recovery.

Study Design: Cohort study; Level of evidence, 3.

Methods: …

Age-Dependent White Matter Disruptions After Military Traumatic Brain Injury: Multivariate Analysis Results From Enigma Brain Injury, Heather C. Bouchard, Delin Sun, Emily L. Dennis, Mary R. Newsome, Seth G. Disner, Jeremy Elman, Annelise Silva, Carmen Velez, Andrei Irimia, Nicholas D. Davenport, Scott R. Sponheim, Carol E. Franz, William S. Kremen, Michael J. Coleman, M. Wright Williams, Elbert Geuze, Inga K. Koerte, Martha E. Shenton, Maheen M. Adamson, Raul Coimbra, Gerald Grant, Lori Shutter, Mark S. George, Ross D. Zafonte, Thomas W. Mcallister, Murray B. Stein, Paul M. Thompson, Elisabeth A. Wilde, David F. Tate, Aristeidis Sotiras, Rajendra A. Morey

Center for Brain, Biology, and Behavior: Faculty Publications

Mild Traumatic brain injury (mTBI) is a signature wound in military personnel, and repetitive mTBI has been linked to age-related neurogenerative disorders that affect white matter (WM) in the brain. However, findings of injury to specific WM tracts have been variable and inconsistent. This may be due to the heterogeneity of mechanisms, etiology, and comorbid disorders related to mTBI. Non-negative matrix factorization (NMF) is a data-driven approach that detects covarying patterns (components) within high-dimensional data. We applied NMF to diffusion imaging data from military Veterans with and without a self-reported TBI history. NMF identified 12 independent components derived from fractional …

Differential Associations Of Conduct Disorder, Callous‑Unemotional Traits And Irritability With Outcome Expectations And Values Regarding The Consequences Of Aggression, J. Elowsky, S. Bajaj, J. Bashford‑Largo, R. Zhang, A. Mathur, A. Schwartz, M. Dobbertin, K. S. Blair, E. Leibenluft, D. Pardini, R. J.R. Blair

Center for Brain, Biology, and Behavior: Faculty Publications

Background: Previous work has examined the association of aggression levels and callous-unemotional traits with outcome expectations and values regarding the consequences of aggression. Less work has examined the outcome expectations and values regarding the consequences of aggression of adolescents with Conduct Disorder (CD). Also, no studies have examined links between irritability (a second socio-affective trait associated with CD) and these social cognitive processes despite the core function of anger in retaliatory aggression and establishing dominance.

Method: The current study, investigating these issues, involved 193 adolescents (typically developing [TD; N = 106], 87 cases with CD [N = 87]). Participants completed …

Progression Through Return-To-Sport And Return-To-Academics Guidelines For Concussion Management And Recovery In Collegiate Student Athletes: Findings From The Ivy League–Big Ten Epidemiology Of Concussion Study, Douglas J. Wiebe, Abigail C. Bretzin, Bernadette A. D'Alonzo, Ivy League–Big Ten Epidemiology Of Concussion Study Investigators, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

Objective To examine the progression of collegiate student athletes through five stages of a return-to- activity protocol following sport-related concussion (SRC).

Methods In a multisite prospective cohort study, we identified the frequency of initial 24–48 hours physical and cognitive rest, and the sequence of (1) symptom resolution and return to (2) exertion activity, (3) limited sport, (4) full sport and (5) full academics. In resulting profiles we estimated the likelihood of return to full sport ≤14 days or prolonged >28 days and tested for variability based on timing of the stages.

Results Among 1715 athletes with SRC (31.6% females), 67.9% …

Head Impact Exposure In Youth And Collegiate American Football, Grace B. Choi, Eric P. Smith, Stefan M. Duma, Steven Rowson, Eamon Campolettano, Mireille E. Kelley, Derek A. Jones, Joel D. Stitzel, Jillian E. Urban, Amaris Genemaras, Jonathan G. Beckwith, Richard M. Greenwald, Arthur C. Maerlender, Joseph J. Crisco

Center for Brain, Biology, and Behavior: Faculty Publications

The relationship between head impact and subsequent brain injury for American football players is not well defined, especially for youth. The objective of this study is to quantify and assess Head Impact Exposure (HIE) metrics among youth and collegiate football players. This multiseason study enrolled 639 unique athletes (354 collegiate; 285 youth, ages 9–14), recording 476,209 head impacts (367,337 collegiate; 108,872 youth) over 971 sessions (480 collegiate; 491 youth). Youth players experienced 43 and 65% fewer impacts per competition and practice, respectively, and lower impact magnitudes compared to collegiate players (95th percentile peak linear acceleration (PLA, g) competition: 45.6 vs …

Constructing Neural Network Models From Brain Data Reveals Representational Transformations Linked To Adaptive Behavior, Takuya Ito, Guangyu Robert Yang, Patryk Laurent, Douglas H. Schultz, Michael W. Cole

Center for Brain, Biology, and Behavior: Faculty Publications

The human ability to adaptively implement a wide variety of tasks is thought to emerge from the dynamic transformation of cognitive information. We hypothesized that these transformations are implemented via conjunctive activations in “conjunction hubs”—brain regions that selectively integrate sensory, cognitive, and motor activations. We used recent advances in using functional connectivity to map the flow of activity between brain regions to construct a task-performing neural network model from fMRI data during a cognitive control task. We verified the importance of conjunction hubs in cognitive computations by simulating neural activity flow over this empirically-estimated functional connectivity model. These empiricallyspecified simulations …

Affective Flexibility As A Developmental Building Block Of Cognitive Reappraisal: An Fmri Study, Jordan E. Pierce, Eisha Haque, Maital Neta

Center for Brain, Biology, and Behavior: Faculty Publications

Cognitive reappraisal is a form of emotion regulation that involves reinterpreting the meaning of a stimulus, often to downregulate one’s negative affect. Reappraisal typically recruits distributed regions of prefrontal and parietal cortex to generate new appraisals and downregulate the emotional response in the amygdala. In the current study, we compared reappraisal ability in an fMRI task with affective flexibility in a sample of children and adolescents (ages 6–17, N = 76). Affective flexibility was defined as variability in valence interpretations of ambiguous (surprised) facial expressions from a second behavioral task. Results demonstrated that age and affective flexibility predicted reappraisal ability, …

Maintaining Physical Activity During Covid-19: The Influence Of Psychosocial Variables In Individuals With Back Pain, Heidi Stabbert

Student Scholar Symposium Abstracts and Posters

Stressor events, such as COVID-19, may trigger adaptive or maladaptive pain management strategies among individuals with persistent low back pain (LBP). Individuals with lower fear avoidance, depression and anxiety, and greater positive affect and quality of life may better maintain positive pain management strategies during stressor events. This study investigated psychosocial characteristics of individuals with LBP who demonstrated adaptive pain management strategies during COVID-19, indicated by maintenance of physical activity (PA). Individuals with persistent LBP (age 22.4 (3.4) years, n=25) from an existing longitudinal cohort participated. Participants completed a baseline survey prior to COVID-19 quantifying demographics, pain characteristics, the Physical …

In-Season Concussion Symptom Reporting In Male And Female Collegiate Rugby Athletes, Emily E. Kieffer,, P. Gunnar Brolinson, Arthur C. Maerlender, Eric Smith, Steven Rowson

Center for Brain, Biology, and Behavior: Faculty Publications

Symptom inventories are generally only collected after a suspected concussion, but regular in-season monitoring may allude to clinical symptoms associated with repetitive subconcussive impacts and potential undiagnosed concussions. Despite sex-specific differences in symptom presentation and outcome of concussion, no return-to-play protocol takes sex into account. The objective of this study was to monitor a cohort of contact-sport athletes and compare the frequency and severity of in-season concussion-like symptom reporting between sexes. Graded symptom checklists from 144 female and 104 male athlete-seasons were administered weekly to quantify the effect of subconcussive impacts on frequency and severity of in-season symptom reporting. In-season, …

Physical Therapy And Occupational Therapy Well-Being, Jenna Pilkington, Dara Musher-Eizenman, Cindi Baum, Elizabeth Emley

Honors Projects

There is a lack of research in the professions of physical therapy and occupational therapy. To be more specific, the areas of stress and burnout have been topics of research within the healthcare field for medical physicians and nurses, but currently there is little research looking at stress and burnout for physical therapists and occupational therapists. (Anderson 2015; Berry 2019). The current study aims to look at the emotional connections between patients and professions, along with the related emotional stress experienced by these professionals. A survey was administered to 59 physical therapists and occupational therapists for the purpose to give …

Music As A Gateway To Healing Speech Disorders And Mental Health Holistically In The Patient With Aphasia: A Literature Review, Susan Warren

Expressive Therapies Capstone Theses

People with some types of post-stroke aphasia often experience depression as well as loss of speech. Music therapy has unique properties that allow it to be used therapeutically to treat both speech impairment and depression yet it is rarely used to treat both disorders. This literature review seeks to examine the underlying causes for this discrepancy, review methods used by practitioners to treat both disorders and suggest future directions for additional research and implications for the treatment of patients with aphasia who have both language impairment and depression.

Making Room: Addressing The Counter-Therapeutic Nature Of Psychiatric Hospitalization Through Containment- Based Group Expressive Therapy, Max Sandor Copans

Expressive Therapies Capstone Theses

The process of hospitalization and the environment of a typical psychiatric hospital is often counter-therapeutic. To challenge this problem, clinicians may introduce the concept of psychological containment. To elaborate, being hospitalized anywhere can be disorienting, frightening and even traumatic. This problem is only further exacerbated in psychiatric hospitals where patients may be disorganized, manic, or struggling with psychosis. Furthermore, psychological containment is essentially the ability for psychiatric patients to prevent their intense emotions from effecting others negatively, and to act with resiliency when other patients are unable to contain their own disruptive behaviors. This paper utilizes both an initial literature …

Occupational Therapy In Youth Violence: An Occupation-Based Program For At-Risk Youth, Jasmine Shahin, Pam Kasyan-Howe, Kristin Domville

Spring 2021 Virtual OTD Capstone Symposium

Throughout the years, youth participating in violence has become an increased concern around the nation as there is an increase in media outlets displaying tragedies, such as mass school shootings caused by students. The at-risk youth population is a specific population disadvantaged in engaging in safe and health-promoting activities due to limited resources or opportunities. As a result, at-risk youth make decisions based on their disadvantaged environment (Farajzadegan et al., 2018; Gallagher et al., 2015a). Factors including socioeconomic status, social support from family or friends, and mental health impact an individual’s opinions, attitudes, and interests as well as their occupational …

Deep-Learning-Based Multivariate Pattern Analysis (Dmvpa): A Tutorial And A Toolbox, Karl M. Kuntzelman, Jacob M. Williams, Phui Cheng Lim, Ashtok Samal, Prahalada K. Rao, Matthew R. Johnson

Center for Brain, Biology, and Behavior: Faculty Publications

In recent years, multivariate pattern analysis (MVPA) has been hugely beneficial for cognitive neuroscience by making new experiment designs possible and by increasing the inferential power of functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and other neuroimaging methodologies. In a similar time frame, “deep learning” (a term for the use of artificial neural networks with convolutional, recurrent, or similarly sophisticated architectures) has produced a parallel revolution in the field of machine learning and has been employed across a wide variety of applications. Traditional MVPA also uses a form of machine learning, but most commonly with much simpler techniques based on …

Resting Cerebral Oxygen Metabolism Exhibits Archetypal Network Features, Nicholas A. Hubbard, Monroe P. Turner, Kevin R. Sitek, Kathryn L. West, Jakub R. Kaczmarzyk, Lyndahl Himes, Binu P. Thomas, Hanzhang Lu, Bart Rypma

Center for Brain, Biology, and Behavior: Faculty Publications

Standard magnetic resonance imaging approaches offer high-resolution but indirect measures of neural activity, limiting understanding of the physiological processes associated with imaging findings. Here, we used calibrated functional magnetic resonance imaging during the resting state to recover low-frequency fluctuations of the cerebral metabolic rate of oxygen (CMRO2). We tested whether functional connections derived from these fluctuations exhibited organization properties similar to those established by previous standard functional and anatomical connectivity studies. Seventeen participants underwent 20 min of resting imaging during dual-echo, pseudocontinuous arterial spin labeling, and blood-oxygen-level dependent (BOLD) signal acquisition. Participants also underwent a 10 min normocapnic and hypercapnic …

Somatosensory Dysfunction Is Masked By Variable Cognitive Deficits Across Patients On The Alzheimer’S Disease Spectrum, Alex I. Wiesman, Victoria M. Mundorf, Chloe C. Casagrande, Sara L. Wolfson, Craig M. Johnson, Pamela E. May, Daniel L. Murman, Tony W. Wilson

Center for Brain, Biology, and Behavior: Faculty Publications

Background: Alzheimer’s disease (AD) is generally thought to spare primary sensory function; however, such interpretations have drawn from a literature that has rarely taken into account the variable cognitive declines seen in patients with AD. As these cognitive domains are now known to modulate cortical somato-sensory processing, it remains possible that abnormalities in somatosensory function in patients with AD have been suppressed by neuropsychological variability in previous research. Methods: In this study, we combine magnetoencephalographic (MEG) brain imaging during a paired-pulse somatosensory gating task with an extensive battery of neuropsychological tests to investigate the influence of cognitive variability on estimated …

Interactive Sonification To Assist Children With Autism During Motor Therapeutic Interventions, Franceli L. Cibrian, Judith Ley-Flores, Joseph W. Newbold, Aneesha Singh, Nadia Bianchi-Berthouze, Monica Tentori

Engineering Faculty Articles and Research

Interactive sonification is an effective tool used to guide individuals when practicing movements. Little research has shown the use of interactive sonification in supporting motor therapeutic interventions for children with autism who exhibit motor impairments. The goal of this research is to study if children with autism understand the use of interactive sonification during motor therapeutic interventions, its potential impact of interactive sonification in the development of motor skills in children with autism, and the feasibility of using it in specialized schools for children with autism. We conducted two deployment studies in Mexico using Go-with-the-Flow, a framework to sonify movements …

Developing A Computer-Controlled Treat Dispenser For Canine Operant Conditioning, Walker Arce, Jeffrey R. Stevens

Center for Brain, Biology, and Behavior: Faculty Publications

When performing canine operant conditioning studies, the delivery of the reward can be a limiting factor of the study. While there are a few commercially available options for automatically delivering rewards, they generally require manual input, such as using a remote control, in accordance with the experiment script. This means that human reaction times and transmission distances can cause interruptions to the flow of the experiment. The potential for development of non-supervised conditioning studies is limited by this same factor. To remedy this, we retrofitted an off-the-shelf treat dispenser with new electronics that allow it to be remotely controllable as …

Core Neuropsychological Measures For Obesity And Diabetes Trials: Initial Report, Kimberlee D'Ardenne, Cary R. Savage, Dana Small, Uku Vainik, Luke E. Stoeckel

Center for Brain, Biology, and Behavior: Faculty Publications

Obesity and diabetes are known to be related to cognitive abilities. The Core Neuropsychological Measures for Obesity and Diabetes Trials Project aimed to identify the key cognitive and perceptual domains in which performance can influence treatment outcomes, including predicting, mediating, and moderating treatment outcome and to generate neuropsychological batteries comprised of well-validated, easy-to-administer tests that best measure these key domains. The ultimate goal is to facilitate inclusion of neuropsychological measures in clinical studies and trials so that we can gather more information on potential mediators of obesity and diabetes treatment outcomes. We will present the rationale for the project and …

Supporting Coordination Of Children With Asd Using Neurological Music Therapy: A Pilot Randomized Control Trial Comparing An Elastic Touch-Display With Tambourines, Franceli L. Cibrian, Melisa Madrigal, Marina Avelais, Monica Tentori

Engineering Faculty Articles and Research

Aim

To evaluate the efficacy of Neurologic Music Therapy (NMT) using a traditional and a technological intervention (elastic touch-display) in improving the coordination of children with Autism Spectrum Disorder (ASD), as a primary outcome, and the timing and strength control of their movements as secondary outcomes.

Methods

Twenty-two children with ASD completed 8 NMT sessions, as a part of a 2-month intervention. Participants were randomly assigned to either use an elastic touch-display (experimental group) or tambourines (control group). We conducted pre- and post- assessment evaluations, including the Developmental Coordination Disorder Questionnaire (DCDQ) and motor assessments related to the control of …

Flexible Coordinator And Switcher Hubs For Adaptive Task Control, Carrisa V. Cocuzza, Takuya Ito, Douglas H. Schultz, Dabielle D. Bassett, Michael W. Cole

Center for Brain, Biology, and Behavior: Faculty Publications

Functional connectivity (FC) studies have identified at least two large-scale neural systems that constitute cognitive control networks, the frontoparietal network (FPN) and cingulo-opercular network (CON). Control networks are thought to support goal-directed cognition and behavior. It was previously shown that the FPN flexibly shifts its global connectivity pattern according to task goal, consistent with a “flexible hub” mechanism for cognitive control. Our aim was to build on this finding to develop a functional cartography (a multimetric profile) of control networks in terms of dynamic network properties. We quantified network properties in (male and female) humans using a high-control-demand cognitive paradigm …

Validating Tackle Mechanics In American Football: Improving Safety And Performance, Arthur C. Maerlender, Caitlin J. Masterson, Rex Norris, Adam Hinthorne

Center for Brain, Biology, and Behavior: Faculty Publications

Research has helped to understand the risks of injuries of tackling in American football and rugby; however, approaches to teaching and analysis are not well-documented. Shoulder-led tackling has been proposed as a safer approach to tackling even though data on the effectiveness for safety and defensive performance is limited. Additionally, some have argued that safety and effectiveness are incompatible. The purpose of the study was to validate a specific sequence of tackling actions as a tool for teaching safer and more effective tackling skills. Results suggested tackle scores help predict presence of head contact, and that higher tackle scores were …

The Occupation Of Training Service Dogs: A Therapeutic Intervention For Combat Veterans With Ptsd, Denae A. Padilla, Jessica De Brun

San Marcos, Summer 2020

There are few interventions that present opportunities to engage in meaningful occupation (Kashiwa et al., 2017) to help Veterans reintegrate into the civilian lifestyle that create a desire to participate and attend therapy (Goetteret al., 2015).

The purpose of this study is to explore the effectiveness of training service dogs as an occupation and means of social support for combat Veterans living with PTSD with the following objectives:

• explore an occupation basedintervention that addresses low retention rates in occupational therapy.
• teach coping mechanisms and provide social support as a by-product to training service dogs in order to assist in reintegration …

Circus In Motion: A Multimodal Exergame Supporting Vestibular Therapy For Children With Autism, Oscar Peña, Franceli L. Cibrian, Monica Tentori

Engineering Faculty Articles and Research

Exergames are serious games that involve physical exertion and are thought of as a form of exercise by using novel input models. Exergames are promising in improving the vestibular differences of children with autism but often lack of adaptation mechanisms that adjust the difficulty level of the exergame. In this paper, we present the design and development of Circus in Motion, a multimodal exergame supporting children with autism with the practice of non-locomotor movements. We describe how the data from a 3D depth camera enables the tracking of non-locomotor movements allowing children to naturally interact with the exergame . A …

Mental Associations And Music Therapy: Including The History Of Associationism And The Neurology Of Associations, Dianna Rose

Expressive Therapies Capstone Theses

Associations are formed in our minds based upon three elements: sensory experience, emotions, and memories. These associations, unique to each individual, dictate thoughts, beliefs, behaviors, and actions. Some are necessary and supportive, while others can be maladaptive. Established associations can be changed, and new associations can be formed, to align with a client’s goals. The literature presents a strong history of associationism, as well as a body of research that demonstrates the neurological processes of how mental associations are formed. There are also studies showing how music activates the brain. However, there is a lack of research which draws direct …

Language, Motor, And Cognitive Outcomes Of Toddlers Who Were Born Preterm, Diane Frome Loeb, Caitlin M. Imgrund, Jaehoon Lee, Steven Barlow

Center for Brain, Biology, and Behavior: Faculty Publications

Purpose: The purpose of this study was to examine the language, motor, and cognitive abilities of children born preterm in four categories: (a) healthy preterm infants, (b) infants of diabetic mothers, (c) infants with respiratory distress syndrome, and (d) infants with chronic lung disease when the children were 30 months, uncorrected age. Comorbidity of language, motor, and cognitive skills was examined, along with predictor variables.

Method: A total of 148 children who were born preterm participated and were assessed using bivariate tests and logistic regression on standardized assessment scores.

Results: Controlling for the children’s gestational age (GA), overall language ability …

Alexithymia Symptoms Are Not Associated With Childhood Trauma Or Crhr1 Rs110402 Genotype, Emily Wiatr, Grace Sullivan, Scott Stoltenberg

Center for Brain, Biology, and Behavior: Faculty Publications

Alexithymia is associated with difficulties in emotional self-regulation, and alexithymia is specifically associated with an absence of emotional experience and cognition of emotion. Past research has indicated a potential association between alexithymia and the CRHR1 gene . Situational factors may also impact the expression of the CRHR1 gene within an individual. Berenbaum (1996) found associations between PTSD/childhood trauma and alexithymia. This study examined these associations using the Online Alexithymia Questionnaire-G2 (OAQ-G2) as well as DNA samples gathered from 657 participants at the University of Nebraska-Lincoln (72% women; 78.6% white; mean age= 20.34; standard deviation of 2.6). It was hypothesized that …

Neuropsychological Change After A Single Season Of Head Impact Exposure In Youth Football, Arthur C. Maerlender, Eric Smith, P. Gunnar Brolinson, Joseph J. Crisco, Jillian Urban, Amaris Ajamil, Steven Rowson, Eamon T. Campolettano, Ryan A. Gellner, Srinidhi Bellamkonda, Emily Kieffer, Mireille E. Kelley, Derek Jones, Alex Powers, Jonathan Beckwith, Joel Stitzel, Richard M. Greenwald, Stefan Duma

Center for Brain, Biology, and Behavior: Faculty Publications

Objectives: Head impact exposure (HIE) in youth football is a public health concern. The objective of this study was to determine if one season of HIE in youth football was related to cognitive changes.

Method: Over 200 participants (ages 9–13) wore instrumented helmets for practices and games to measure the amount of HIE sustained over one season. Pre- and post-season neuropsychological tests were completed. Test score changes were calculated adjusting for practice effects and regression to the mean and used as the dependent variables. Regression models were calculated with HIE variables predicting neuropsychological test score changes.

Results: For the full …