Anny Reyes

• Doctor of Philosophy
• Associate Staff Neuropsychologist at Cleveland Clinic

Objective Bilingual healthy adults have been shown to exhibit an advantage in executive functioning (EF) that is associated with microstructural changes in white matter (WM) networks. Patients with temporal lobe epilepsy (TLE) often show EF deficits that are associated with WM compromise. In this study, we investigate whether bilingualism can incre...

Objective: To identify distinct cognitive phenotypes in temporal lobe epilepsy (TLE) and evaluate patterns of white matter (WM) network alterations associated with each phenotype. Methods: Seventy patients with TLE were characterized into 4 distinct cognitive phenotypes based on patterns of impairment in language and verbal memory measures (lang...

Objective To identify cognitive phenotypes in temporal lobe epilepsy (TLE) and test their reproducibility in a large, multi‐site cohort of patients using both data‐driven and clinically driven approaches. Method Four‐hundred seven patients with TLE who underwent a comprehensive neuropsychological evaluation at one of four epilepsy centers were inc...

Objective: To characterize the nature and prevalence of cognitive disorders in older adults with temporal lobe epilepsy (TLE) and compare their cognitive profiles to non-epileptic patients with mild cognitive impairment (i.e., classic MCI; cMCI). Methods: Seventy-eight older patients with TLE, 77 cMCI, and 69 normal aging controls (NAC), all 55-80...

Cognitive and behavioural comorbidities are prevalent in childhood and adult epilepsies and impose a substantial human and economic burden. Over the past century, the classic approach to understanding the aetiology and course of these comorbidities has been through the prism of the medical taxonomy of epilepsy, including its causes, course, charact...

Background Older adults with epilepsy represent the largest and fastest‐growing segment of individuals with epilepsy and harbor risk factors for pathological aging, including cerebrovascular risk factors (CVRFs) and Alzheimer’s disease (AD)‐related pathology. In fact, several community‐based studies have reported up to a 3‐fold increased risk for d...

Despite the high prevalence of cognitive deficits in older people with epilepsy (PWE), their ability to judge and make decisions in daily life remains unexplored. In 61 older PWE (55–90 years) from the multicenter BRain Aging and Cognition in Epilepsy (BrACE) study, we examined everyday judgment, as measured by the Test of Practical Judgment (TOP‐J...

Background and objectives: Race and ethnicity are proxy measures of sociocultural factors that influence cognitive test performance. Our objective was to compare different regression-based cognitive normative models adjusting for demographics and different combinations of easily accessible/commonly used social determinants of health (SDoH) factors...

Objective The present study characterized heterogeneity in the cognitive profiles of monolingual and bilingual Latino older adults enrolled in the HABS-HD. Methods A total of 859 cognitively unimpaired older adults completed neuropsychological testing. Raw scores for cognitive tests were converted to z -scores adjusted for age, education, sex, and...

Background Patients with primary brain tumors demonstrate heterogeneous patterns of cognitive dysfunction, which we explore using latent profile analysis (LPA) to identify cognitive phenotypes and their trajectories in patients receiving radiotherapy (RT). Methods Ninety-six patients completed neuropsychological testing before and post-RT (3, 6, 1...

Background Patients with brain tumors demonstrate heterogeneous patterns of cognitive impairment, likely related to multifactorial etiologies and variable tumor-specific factors. Cognitive phenotyping offers a patient-centered approach to parsing heterogeneity by classifying individuals based on patterns of impairment. The aim of this study was to...

To present the background, rationale, details pertaining to use and essential computational steps, synopsis of findings to date, and future directions for the International Classification of Cognitive Disorders in Epilepsy (IC‐CoDE)—an initiative of the ILAE Neuropsychology Task Force. Examined are: (a) the 6 steps leading to the derivation of a co...

Objective Efforts to understand the global variability in cognitive profiles in patients with epilepsy have been stymied by the lack of a standardized diagnostic system. This study examined the cross‐cultural applicability of the International Classification of Cognitive Disorders in Epilepsy (IC‐CoDE) in a cohort of patients with temporal lobe epi...

Objective This study evaluated the diagnostic performance of a widely available cognitive screener, the Montreal cognitive assessment (MoCA), to detect cognitive impairment in older patients (age ≥ 55) with epilepsy residing in the US, using the International Classification of Cognitive Disorders in Epilepsy (IC‐CoDE) as the gold standard. Methods...

Background With expanding neurosurgical options in epilepsy, it is important to characterise each options’ risk for postoperative cognitive decline. Here, we characterise how patients’ preoperative white matter (WM) networks relates to postoperative memory changes following different epilepsy surgeries. Methods Eighty-nine patients with temporal l...

Objective Given the lack of comprehensive neuropsychological tools and neuropsychological services in Sub-Saharan Africa (SSA), cognitive screeners for dementia can be useful tools to screen for suspected dementia at the population level. However, most available screeners have not been developed or validated in SSA populations. The Community Screen...

Objective Late-life depression is a complex condition impacted by both mental and physical health outcomes and psychosocial factors. Psychosocial predictors of depression are reliant on cultural factors including socioeconomic variables, stigmas, and cultural values. Most research on late-life depression and its effect on cognitive functioning has...

Objective The International Classification of Cognitive Disorder in Epilepsy (IC-CoDE) is a new consensus-based taxonomy that classifies patients into one of four cognitive phenotypes (i.e., cognitively intact, single-domain impairment, bi-domain impairment, generalized impairment). The IC-CoDE has been effectively applied to patients with temporal...

Objective To apply the new IC-CoDE cognitive diagnostic taxonomy (Norman et al., 2020) to a large cohort of people with temporal lobe epilepsy (TLE) in India. The IC-CoDE taxonomy of cognitive diagnoses for 1,409 Englishspeaking adults with TLE from seven epilepsy centres in the U.S. has been published (McDonald et al., 2022). Initial results sugge...

Objective Older adults represent the fastest-growing population of individuals with epilepsy with an incidence that peaks after age 65. Patients with late-onset epilepsy (LOE) have a multitude of risk factors for accelerated cognitive and brain aging, including vascular and metabolic risk factors. Despite this, there are few studies investigating t...

Beyond the hippocampus, there are no evidence-based dose constraints for eloquent brain structures which subserve cognitive domains. We performed a multivariate NTCP analysis of post-RT neurocognitive decline, examining dosimetric predictors of eloquent brain regions in a prospective longitudinal clinical trial. 83 patients with primary brain tumor...

Objective Patients with temporal lobe epilepsy (TLE) are often at a high risk for cognitive and psychiatric comorbidities. Several cognitive phenotypes have been identified in TLE, but it is unclear how phenotypes relate to psychiatric comorbidities, such as anxiety and depression. This observational study investigated the relationship between cogn...

This scientific commentary refers to ‘Identification of different MRI atrophy progression trajectories in epilepsy by subtype and stage inference’ by Xiao et al. (https://doi.org/10.1093/brain/awad284).

Introduction Predicting caregiver burden in individuals with suspected dementia – is critical due to the debilitating nature of these disorders and need for caregiver support. While some examination of the factors affecting burden has been undertaken in Sub‐Saharan Africa, each country presents with its own unique challenges and obstacles. This pil...

Introduction Cognitive phenotyping is a widely used approach to characterize the heterogeneity of deficits in patients with a range of neurological disorders but has only recently been applied to patients with epilepsy. In this study, we identify cognitive phenotypes in older adults with late-onset epilepsy (LOE) and examine their demographic, clin...

Beyond the hippocampus, there are no evidence-based dose constraints for eloquent structures which subserve memory and attention/processing speed. We performed a multivariate normal tissue complication probability analysis of post-RT neurocognitive decline, examining dosimetric predictors of eloquent brain regions in a prospective longitudinal clin...

Background: We analyzed post-radiation (RT) neurocognitive outcomes in an ethnically diverse pediatric brain tumor population undergoing photon radiotherapy (XRT) and proton radiotherapy (PRT). Procedure: Post-RT neurocognitive outcomes from 49 pediatric patients (37% Hispanic/Latino) with primary brain tumors were analyzed. Tests included cogni...

Background: The cerebellum's role in post-treatment neurocognitive decline is unexplored. We investigated associations between cerebellar microstructural integrity using quantitative neuroimaging biomarkers and neurocognition among primary brain tumor patients receiving partial-brain radiotherapy (RT). Materials and methods: On a prospective tri...

Purpose: Brain radiotherapy can impair fine motor skills (FMS). FMS are essential for activities of daily living, enabling hand-eye coordination for manipulative movements. We developed normal tissue complication probability (NTCP) models for decline in FMS after fractionated brain RT. Methods: On a prospective trial, 44 primary brain tumor pati...

Background: Amygdalae, bilateral almond-shaped structures located anterior to the hippocampi, are critical to limbic system functions of emotional processing and memory consolidation. The amygdalae are heterogeneous, composed of multiple nuclei with distinct structural and functional properties. We prospectively assessed associations between longi...

Background: The prevalence of dementia in Sub-Saharan Africa, particularly in French-speaking countries, has received limited attention. This study investigates the prevalence and risk factors of suspected dementia in elderly adults in Kinshasa, Democratic Republic of the Congo (DRC). Methods: A community-based sample of 355 individuals over 65...

Background and objectives: There is growing evidence that bilingualism can induce neuroplasticity and modulate neural efficiency, resulting in greater resistance to neurological disease. However, whether bilingualism is beneficial to neural health in the presence of epilepsy is unknown. We tested whether bilingual individuals with temporal lobe ep...

Objective This study was undertaken to evaluate the cross‐cultural application of the International Classification of Cognitive Disorders in Epilepsy (IC‐CoDE) to a cohort of Spanish‐speaking patients with temporal lobe epilepsy (TLE) living in the United States. Methods Eighty‐four Spanish‐speaking patients with TLE completed neuropsychological m...

PURPOSE We investigated associations between imaging biomarkers of cerebellar injury and neurocognitive function among primary brain tumor patients receiving partial brain radiotherapy (RT). METHODS On a prospective trial, 65 patients underwent volumetric brain MRI, diffusion tensor imaging, and memory, executive function, language, attention, and...

In efforts to understand the cognitive heterogeneity within and across epilepsy syndromes, cognitive phenotyping has been proposed as a new taxonomy aimed at developing a harmonized approach to cognitive classification in epilepsy. Data- and clinically driven approaches have been previously used with variability in the phenotypes derived across stu...

Purpose/Objective(s) The amygdala, a deep gray matter structure comprised of several nuclei with different functional connectivity, plays a key role in emotional processing and memory. We analyzed volume change of the amygdala and respective nuclei after brain RT using quantitative brain MRI, and association with mood and memory outcomes. Material...

Purpose/Objective(s) Growing evidence suggests that the thalamus plays a central role in neurocognition. The thalamus is comprised of several nuclei, each with different anatomic connectivity and functional properties. We sought to understand the impact of microstructural injury to the thalamus and thalamic nuclei on neurocognition following RT in...

Purpose/Objective(s) Memory deficits after brain RT are common. Critical white matter tracts including the fornix, cingulum, and parahippocampal cingulum (PHC) connect with the hippocampus, comprising the memory network. We analyzed quantitative neuroimaging biomarkers of microstructural injury to these white matter regions of interest (ROI) and hi...

Purpose Brain radiotherapy can impair fine motor skills (FMS). FMS are essential for activities of daily living, enabling hand-eye coordination for manipulative movements. We developed normal tissue complication probability (NTCP) models for decline in FMS after fractionated brain RT. Methods On a prospective trial, 44 primary brain tumor patients...

Objective: Given the lack of comprehensive neuropsychological tools in Sub-Saharan Africa, there is a need to examine the clinical utility of dementia cognitive screeners in this setting. We examined the contribution of sociodemographic factors to performance on the Community Screening Instrument for Dementia (CSID) in Congolese older adults. Metho...

Objective Neuropsychological profiles are heterogeneous both across and within epilepsy syndromes, but especially in frontal lobe epilepsy (FLE), which has complex semiology and epileptogenicity. This study aimed to characterize the cognitive heterogeneity within FLE by identifying cognitive phenotypes and determining their demographic and clinical...

Individuals with left temporal lobe epilepsy (TLE) have a higher rate of atypical (i.e., bilateral or right hemisphere) language lateralization compared to healthy controls. In addition, bilinguals have been observed to have a less left-lateralized pattern of language representation. We examined the combined influence of bilingual language experien...

Objective: To describe the development and application of a consensus-based, empirically driven approach to cognitive diagnostics in epilepsy research—The International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) and to assess the ability of the IC-CoDE to produce definable and stable cognitive phenotypes in a large, multi-center te...

Background and Objectives Risk for memory decline is a substantial concern in patients with temporal lobe epilepsy (TLE) undergoing anterior temporal lobectomy (ATL). Although prior studies have identified associations between memory and integrity of white matter (WM) networks within the medial temporal lobe (MTL) pre -operatively, we contribute a...

Purpose/Objective(s) Impairment in fine motor skills (FMS), including motor speed and coordination, can occur after brain radiotherapy. FMS are essential for activities of daily living including writing, typing, and eating. Using a normal tissue complication probability (NTCP) framework, we sought to determine dosimetric predictors of FMS decline i...

Purpose/Objective(s) The entorhinal cortex in the medial temporal lobe is a critical part of the hippocampal memory system, crucial for memory formation and consolidation. Studies show the entorhinal cortex is particularly vulnerable to dose-dependent atrophy. We examined the association between entorhinal cortical volume and longitudinal verbal an...

Purpose/Objective(s) SRS for brain metastases is associated with a high rate (52%-64%) of cognitive deterioration. We performed a phase II clinical trial of critical white matter and hippocampal sparing brain SRS in patients with limited brain metastases, to improve cognitive preservation. We present feasibility of this approach and interim results...

Purpose/Objective(s) Attention and processing speed, an important neurocognitive function, is subserved in the brain by critical white matter (WM): the corpus callosum (CC) and intra-hemispheric white matter tracts (IHWM). We sought to characterize the dose-response relationship of these structures with decline in attention/processing speed at 6 mo...

Objective A core mission of the Society for Black Neuropsychology (SBN) is to increase the representation of neuropsychologists, students, and scholars from diverse backgrounds. As such, SBN developed a 12-month mentoring program for trainees at all levels. The SBN Mentorship Program includes four components: mentoring where mentees are paired with...

Objective Episodic memory impairment and hippocampal pathology are hallmark features of both temporal lobe epilepsy (TLE) and amnestic mild cognitive impairment (aMCI). Pattern separation (PS), which enables the distinction between similar but unique experiences, is thought to contribute to successful encoding and retrieval of episodic memories. Im...

Background We conducted the first prospective longitudinal study examining the independent association between patient-reported hrQoL (physical, social/family, emotional, functional, and brain cancer-specific) and neurocognitive function (NCF), while controlling for mood symptoms in primary brain tumor patients. Methods Primary brain tumor patient...

Objective To develop and externally validate models to predict the probability of postoperative verbal memory decline in adults following temporal lobe resection (TLR) for epilepsy using easily-accessible preoperative clinical predictors. Methods Multivariable models were developed to predict delayed verbal memory outcome on three commonly used me...

Objective On March 11, 2020, the World Health Organization declared an outbreak of a new viral entity, coronavirus 2019 (COVID-19), to be a worldwide pandemic. The characteristics of this virus, as well as its short- and long-term implications, are not yet well understood. The objective of the current paper was to provide a critical review of the e...

Background: We explored fine motor skills (FMS) before and after brain radiotherapy (RT), analyzing associations between longitudinal FMS and imaging biomarkers of cortical and white matter (WM) integrity in motor regions of interest (ROIs). Methods: On a prospective trial, 52 primary brain tumor patients receiving fractionated brain RT underwen...

Objective To develop a model to predict the probability of mood decline in adults following temporal lobe resection for the treatment of pharmacoresistant epilepsy. Methods Variable selection was performed on 492 patients from the Cleveland Clinic using best subsets regression. After completing variable selection, a subset of variables was request...

Background The corpus callosum (CC) and intra-hemispheric white matter tracts (IHWM) subserve critical aspects of attention and processing speed. We analyzed imaging biomarkers of microstructural injury within these regions and association with attention/processing speed decline post-radiotherapy in primary brain tumor patients. Methods On a prosp...

Epilepsy incidence and prevalence peaks in older adults yet systematic studies of brain ageing and cognition in older adults with epilepsy remain limited. Here, we characterize patterns of cortical atrophy and cognitive impairment in 73 older adults with temporal lobe epilepsy (>55 years) and compare these patterns to those observed in 70 healthy c...

Objective To characterize the nature and prevalence of cognitive disorders in older adults with temporal lobe epilepsy (TLE) and compare their cognitive profiles to patients with amnestic mild cognitive impairment (ie, aMCI). Methods Seventy‐one older patients with TLE, 77 aMCI, and 69 normal aging controls (NACs), all 55‐80 years of age, complete...

Epilepsy incidence and prevalence peaks in older adults, yet systematic studies of brain aging and epilepsy remain limited. We investigated topological network disruption in older adults with temporal lobe epilepsy (TLE; age > 55 years). Additionally, we examined the potential network disruption overlap between TLE and amnestic mild cognitive impai...

Background Primary brain tumor patients are vulnerable to depression and anxiety symptoms, which may affect their neurocognitive functioning. We performed a prospective longitudinal analysis to examine the association between depression and anxiety symptoms and domain-specific neurocognitive functioning in primary brain tumor patients receiving rad...

This study explored the taxonomy of cognitive impairment within temporal lobe epilepsy and characterized the sociodemographic, clinical and neurobiological correlates of identified cognitive phenotypes. 111 temporal lobe epilepsy patients and 83 controls (mean ages 33 and 39, 57% and 61% female, respectively) from the Epilepsy Connectome Project un...

Purpose To investigate the association between imaging biomarkers of radiation-induced white matter (WM) injury within perisylvian regions and longitudinal language decline in brain tumor patients. Methods and Materials Primary brain tumor patients (n=44) on a prospective trial underwent brain MRI, diffusion-weighted imaging, and language assessme...

Objective To determine the predictive power of white matter neuronal networks (i.e., structural connectomes [SCs]) in discriminating memory-impaired patients with temporal lobe epilepsy (TLE) from those with normal memory. Methods T1- and diffusion MRI (dMRI), clinical variables, and neuropsychological measures of verbal memory were available for...

Objective: The distributed white matter network underlying language leads to difficulties in extracting clinically meaningful summaries of neural alterations leading to language impairment. Here we determine the predictive ability of the structural connectome (SC), compared with global measures of white matter tract microstructure and clinical dat...

Available online xxxx Cerebrovascular risk factors (CVRFs) and comorbid cardiovascular and metabolic disease have been linked to accelerated cognitive aging and dementia in the general population; however, the contribution of these comorbid-ities to the risk of post anterior temporal lobectomy (ATL) memory decline has been unexamined. We explored t...

Objective To identify neuroimaging and clinical biomarkers associated with a language‐impaired phenotype in refractory temporal lobe epilepsy (TLE). Methods Eighty‐five patients with TLE were characterized as language‐impaired (TLE‐LI) or non–language‐impaired (TLE‐NLI) based on comprehensive neuropsychological testing. Structural magnetic resonan...

Objectives Temporal lobe epilepsy (TLE) is known to affect large‐scale gray and white matter networks, and these network changes likely contribute to the verbal memory impairments observed in many patients. In this study, we investigate multimodal imaging patterns of brain alterations in TLE and evaluate the sensitivity of different imaging measure...

Objective: Individuals with temporal lobe epilepsy (TLE) often experience diminished quality of life (QoL). Although comorbid depression is one of the most recognized predictors of poor QoL in TLE, impairments in verbal memory (VM) and executive functioning (EF), have also been identified as risk factors, independent of other biological and psycho...

Several methods for identifying suboptimal effort on Spanish neuropsychological assessment have been established. The purpose of this retrospective study was to determine whether recognition data from the WHO-AVLT could be employed for determination of malingering in a Spanish-speaking sample. Sixteen subjects in litigation, 25 neurological patient...

Blocked and event-related fMRI designs are both commonly used to localize language networks and determine hemispheric dominance in research and clinical settings. We compared activation profiles on a semantic monitoring task using one of the two designs in a total of 43 healthy individual to determine whether task design or subject-specific factors...

Objective: Executive dysfunction is observed in a sizable number of patients with refractory temporal lobe epilepsy (TLE). The frontostriatal network has been proposed to play a significant role in executive functioning, however, because of the complex architecture of these tracts, it is difficult to generate measures of fiber tract microstructure...

This study explored the relationships among multimodal imaging, clinical features, and language impairment in patients with left temporal lobe epilepsy (LTLE). Fourteen patients with LTLE and 26 controls underwent structural MRI, functional MRI, diffusion tensor imaging, and neuropsychological language tasks. Laterality indices were calculated for...

Objective: Patients with temporal lobe epilepsy (TLE) show reduced bilateral frontal lobe activity at rest, as assessed by the fractional amplitude of low-frequency fluctuations (fALFFs) in the resting-state fMRI BOLD signal. Bilateral cortical thinning has also been observed within the frontal lobe. We investigate whether reduced fALFF and cortica...

Significance Autism spectrum disorders (ASDs) comprise a heterogeneous set of neurodevelopmental disorders. Although hundreds of genes have now been identified to be associated with ASD, genetic factors cannot fully explain ASD’s incidence. The early environment is now known to be pivotal in ASD’s etiology too. In the face of this complexity, one a...

Objective. Language reorganization in patients with temporal lobe epilepsy (TLE) appears to result from a complex array of clinical and neurobiological factors. This study aimed to explore the relationship among multimodal brain imaging, clinical features, and language impairment in left TLE (LTLE). Method. Fourteen LTLE patients and 26 healthy co...

Objective: We assessed whether presurgical resting state functional magnetic resonance imaging (fMRI) provides information for distinguishing temporal lobe epilepsy (TLE) with mesial temporal sclerosis (TLE-MTS) from TLE without MTS (TLE-noMTS). Methods: Thirty-four patients with TLE and 34 sex-/age-matched controls consented to a research imagi...

Inter- and intra-species differences in social behavior and recognition-related hormones and receptors suggest that different distribution and/or expression patterns may relate to social recognition. We used qRT-PCR to investigate naturally occurring differences in expression of estrogen receptor-alpha (ERα), ER-beta (ERβ), progesterone receptor (P...