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Kettlety SA, Finley JM, Leech KA. Visuospatial Skills Explain Differences in the Ability to Use Propulsion Biofeedback Post-stroke. J Neurol Phys Ther 2024; 48:207-216. [PMID: 38912856 PMCID: PMC11424264 DOI: 10.1097/npt.0000000000000487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
BACKGROUND AND PURPOSE Visual biofeedback can be used to help people post-stroke reduce biomechanical gait impairments. Using visual biofeedback engages an explicit, cognitively demanding motor learning process. Participants with better overall cognitive function are better able to use visual biofeedback to promote locomotor learning; however, which specific cognitive domains are responsible for this effect are unknown. We aimed to understand which cognitive domains were associated with performance during acquisition and immediate retention when using visual biofeedback to increase paretic propulsion in individuals post-stroke. METHODS Participants post-stroke completed cognitive testing, which provided scores for different cognitive domains, including executive function, immediate memory, visuospatial/constructional skills, language, attention, and delayed memory. Next, participants completed a single session of paretic propulsion biofeedback training, where we collected treadmill-walking data for 20 min with biofeedback and 2 min without biofeedback. We fit separate regression models to determine if cognitive domain scores, motor impairment (measured with the lower-extremity Fugl-Meyer), and gait speed could explain propulsion error and variability during biofeedback use and recall error during immediate retention. RESULTS Visuospatial/constructional skills and motor impairment best-explained propulsion error during biofeedback use (adjusted R 2 = 0.56, P = 0.0008), and attention best-explained performance variability (adjusted R 2 = 0.17, P = 0.048). Language skills best-explained recall error during immediate retention (adjusted R 2 = 0.37, P = 0.02). DISCUSSION AND CONCLUSIONS These results demonstrate that specific cognitive domain impairments explain variability in locomotor learning outcomes in individuals with chronic stroke. This suggests that with further investigation, specific cognitive impairment information may be useful to predict responsiveness to interventions and personalize training parameters to facilitate locomotor learning.
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Affiliation(s)
- Sarah A Kettlety
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California (S.A.K., J.M.F., K.A.L.); Neuroscience Graduate Program, University of Southern California, Los Angeles, California (J.M.F., K.A.L.); and Department of Biomedical Engineering, University of Southern California, Los Angeles, California (J.M.F.)
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Kim M, Lee J, Lee SY, Ha M, Park I, Jang J, Jang M, Park S, Kwon JS. Development of an eye-tracking system based on a deep learning model to assess executive function in patients with mental illnesses. Sci Rep 2024; 14:18186. [PMID: 39107349 PMCID: PMC11303748 DOI: 10.1038/s41598-024-68586-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 07/25/2024] [Indexed: 08/10/2024] Open
Abstract
Patients with mental illnesses, particularly psychosis and obsessive‒compulsive disorder (OCD), frequently exhibit deficits in executive function and visuospatial memory. Traditional assessments, such as the Rey‒Osterrieth Complex Figure Test (RCFT), performed in clinical settings require time and effort. This study aimed to develop a deep learning model using the RCFT and based on eye tracking to detect impaired executive function during visuospatial memory encoding in patients with mental illnesses. In 96 patients with first-episode psychosis, 49 with clinical high risk for psychosis, 104 with OCD, and 159 healthy controls, eye movements were recorded during a 3-min RCFT figure memorization task, and organization and immediate recall scores were obtained. These scores, along with the fixation points indicating eye-focused locations in the figure, were used to train a Long Short-Term Memory + Attention model for detecting impaired executive function and visuospatial memory. The model distinguished between normal and impaired executive function, with an F1 score of 83.5%, and identified visuospatial memory deficits, with an F1 score of 80.7%, regardless of psychiatric diagnosis. These findings suggest that this eye tracking-based deep learning model can directly and rapidly identify impaired executive function during visuospatial memory encoding, with potential applications in various psychiatric and neurological disorders.
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Affiliation(s)
- Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul, 03080, Republic of Korea
| | - Jungha Lee
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Soo Yong Lee
- Kim Jaechul Graduate School of Artificial Intelligence, KAIST, Daejeon, Republic of Korea
| | - Minji Ha
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Inkyung Park
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Jiseon Jang
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Moonyoung Jang
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul, 03080, Republic of Korea
| | - Sunghyun Park
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
- Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul, 03080, Republic of Korea.
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea.
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Lindell AK. Do Left-Handed Older Adults Have Superior Visual Memories? Percept Mot Skills 2023; 130:1819-1833. [PMID: 37345753 PMCID: PMC10552343 DOI: 10.1177/00315125231185166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
On demanding visual memory tasks like the Rey Complex Figure Test and Recognition Trial (RCFT), left-handers often outperform right-handers and participants with mixed handedness. Left-handers' apparent visual memory superiority develops during late childhood and early adolescence and is established by young adulthood. Though many studies have examined RCFT performance in older adults and found that visual memory deteriorates with age, investigations of the relationship between handedness and visual memory abilities in older adults have been scarce. In the present study I sought to determine whether a left-handed RCFT performance advantage would be evident among older adults. I examined RCFT and handedness data from 800 older adults (Females = 152, Males = 648; M age = 69.86, SD = 5.18 years; range 60-85 years), who took part in prior research (Whitehall II Phase 11 sub-study). Among these participants, handedness predicted both immediate and delayed RCFT recall, with left-handers outperforming both mixed- and right-handers and with performance unrelated to gender. The absence of a left-handed advantage for copy accuracy suggests that the effects observed for recall do not stem from differences in participants' perceptual abilities and/or motor control. Instead, these data suggest that left-handers' superior performances stem from their advantage for visual memory. As visual memory predicts both motor learning capacity and motor skill retention in older adults, these results have potentially important implications for rehabilitation efficacy.
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Affiliation(s)
- Annukka K. Lindell
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, VIC, Australia
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Malek-Ahmadi M, Duff K, Chen K, Su Y, King JB, Koppelmans V, Schaefer SY. Volumetric regional MRI and neuropsychological predictors of motor task variability in cognitively unimpaired, Mild Cognitive Impairment, and probable Alzheimer's disease older adults. Exp Gerontol 2023; 173:112087. [PMID: 36639062 PMCID: PMC9974847 DOI: 10.1016/j.exger.2023.112087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/24/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The mechanisms linking motor function to Alzheimer's disease (AD) progression have not been well studied, despite evidence of AD pathology within motor brain regions. Thus, there is a need for new motor measure that is sensitive and specific to AD. METHODS In a sample of 121 older adults (54 cognitive unimpaired [CU], 35 amnestic Mild Cognitive Impairment [aMCI], and 32 probable mild AD), intrasubject standard deviation (ISD) across six trials of a novel upper-extremity motor task was predicted with volumetric regional gray matter and neuropsychological scores using classification and regression tree (CART) analyses. RESULTS Both gray matter and neuropsychological CART models indicated that motor task ISD (our measure of motor learning) was related to cortical regions and cognitive test scores associated with memory, executive function, and visuospatial skills. CART models also accurately distinguished motor task ISD of MCI and probable mild AD from CU. DISCUSSION Variability in motor task performance across practice trials may be valuable for understanding preclinical and early-stage AD.
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Affiliation(s)
- Michael Malek-Ahmadi
- Banner Alzheimer's Institute, Phoenix, AZ 85006, United States of America; Department of Biomedical Informatics, University of Arizona College of Medicine-Phoenix, Phoenix, AZ 85006, United States of America
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging, & Research, University of Utah, Salt Lake City, UT 84108, United States of America
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ 85006, United States of America
| | - Yi Su
- Banner Alzheimer's Institute, Phoenix, AZ 85006, United States of America
| | - Jace B King
- Center for Alzheimer's Care, Imaging, & Research, University of Utah, Salt Lake City, UT 84108, United States of America
| | - Vincent Koppelmans
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, United States of America
| | - Sydney Y Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ 85287, United States of America.
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5
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Wang P, Lingo VanGilder J, Schweighofer N, Schaefer SY. Rey-Osterrieth complex figure recall scores and motor skill learning in older adults: A non-linear mixed effect model-based analysis. Hum Mov Sci 2022; 86:103004. [PMID: 36191575 PMCID: PMC11285843 DOI: 10.1016/j.humov.2022.103004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 08/18/2022] [Accepted: 09/24/2022] [Indexed: 11/04/2022]
Abstract
Age-related declines in motor learning are well documented. Visuospatial memory has been proposed as a key factor explaining age-related declines in sensorimotor adaptation, but most studies have not used standardized visuospatial memory tests nor controlled for age-related visuospatial memory declines. The present study explores the relationship between visuospatial memory and motor learning in older adults while also controlling for age and utilizing a standardized visuospatial memory test. Forty-nine nondemented older adults repetitively practiced a functional upper-extremity motor task and were re-assessed one week later. Training data were modeled with mixed-effect exponential decay functions, with parameters representing amount of performance change, rate of improvement, and final performance. Age and visuospatial memory were included as possible covariates for the parameter measuring rate of improvement (τ). After controlling for age, higher visuospatial memory scores were associated with faster rates of skill acquisition and better short-term retention one week later. These associations with visuospatial memory were dependent, however, on the level of initial skill. These findings suggest that the extent of re-learning motor skills in geriatric physical rehabilitation may depend on intact visuospatial memory.
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Affiliation(s)
- Peiyuan Wang
- School of Biological and Health Systems Engineering, Arizona State University, USA
| | | | | | - Sydney Y Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, USA.
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Lingo VanGilder J, Bergamino M, Hooyman A, Fitzhugh MC, Rogalsky C, Stewart JC, Beeman SC, Schaefer SY. Using whole-brain diffusion tensor analysis to evaluate white matter structural correlates of delayed visuospatial memory and one-week motor skill retention in nondemented older adults: A preliminary study. PLoS One 2022; 17:e0274955. [PMID: 36137126 PMCID: PMC9499308 DOI: 10.1371/journal.pone.0274955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 09/08/2022] [Indexed: 11/30/2022] Open
Abstract
Skill retention is important for motor rehabilitation outcomes. Recent work has demonstrated that delayed visuospatial memory performance may predict motor skill retention in older and neuropathological populations. White matter integrity between parietal and frontal cortices may explain variance in upper-extremity motor learning tasks and visuospatial processes. We performed a whole-brain analysis to determine the white matter correlates of delayed visuospatial memory and one-week motor skill retention in nondemented older adults. We hypothesized that better frontoparietal tract integrity would be positively related to better behavioral performance. Nineteen participants (age>58) completed diffusion-weighted imaging, then a clinical test of delayed visuospatial memory and 50 training trials of an upper-extremity motor task; participants were retested on the motor task one week later. Principal component analysis was used to create a composite score for each participant's behavioral data, i.e. shared variance between delayed visuospatial memory and motor skill retention, which was then entered into a voxel-based regression analysis. Behavioral results demonstrated that participants learned and retained their skill level after a week of no practice, and their delayed visuospatial memory score was positively related to the extent of skill retention. Consistent with previous work, neuroimaging results indicated that regions within bilateral anterior thalamic radiations, corticospinal tracts, and superior longitudinal fasciculi were related to better delayed visuospatial memory and skill retention. Results of this study suggest that the simple act of testing for specific cognitive impairments prior to therapy may identify older adults who will receive little to no benefit from the motor rehabilitation regimen, and that these neural regions may be potential targets for therapeutic intervention.
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Affiliation(s)
- Jennapher Lingo VanGilder
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, United States of America
| | - Maurizio Bergamino
- Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, Arizona, United States of America
| | - Andrew Hooyman
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, United States of America
| | - Megan C. Fitzhugh
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Corianne Rogalsky
- College of Health Solutions, Arizona State University, Tempe, Arizona, United States of America
| | - Jill C. Stewart
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States of America
| | - Scott C. Beeman
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, United States of America
| | - Sydney Y. Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, United States of America
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, United States of America
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Giofrè D, Allen K, Toffalini E, Caviola S. The Impasse on Gender Differences in Intelligence: a Meta-Analysis on WISC Batteries. EDUCATIONAL PSYCHOLOGY REVIEW 2022. [DOI: 10.1007/s10648-022-09705-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AbstractThis meta-analysis reviews 79 studies (N = 46,605) that examined the existence of gender difference on intelligence in school-aged children. To do so, we limited the literature search to works that assessed the construct of intelligence through the Wechsler Intelligence Scales for Children (WISC) batteries, evaluating eventual gender differences in indices and subtests. The theoretical framework we adopted is the cross-battery approach which locates cognitive abilities into different levels, also considering the possible mediating effect of the version of the WISC being used. As for broad abilities, a notable discrepancy emerged in favour of males for visual and crystallized intelligence, while female/male differences on fluid intelligence were negligible. Conversely, females’ performance on the processing speed factor was superior. Interesting results emerged at the subtest levels, albeit with less pronounced differences in performance. Results generally showed that older versions of WISC batteries displayed larger gender differences compared to the most recent ones.
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Hooyman A, VanGilder JL, Schaefer SY. Mediation Analysis of the Effect of Visuospatial Memory on Motor Skill Learning in Older Adults. J Mot Behav 2022; 55:68-77. [PMID: 35902117 PMCID: PMC9792432 DOI: 10.1080/00222895.2022.2105793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 06/10/2022] [Accepted: 07/20/2022] [Indexed: 02/02/2023]
Abstract
There is high inter-individual variability in motor skill learning among older adults. Identifying the nature of these individual differences remains challenging due to interactions between participant characteristics (e.g., age, cognition) and task-related factors (e.g., nature of task, level of skill pre-training), making it difficult to determine plausibly causal relationships. This study addresses these competing explanations by using mediation analysis to examine plausible causal inference between visuospatial memory and one-month retention of both gross and fine motor components of a functional upper-extremity task following training. Results suggest that better visuospatial memory results in more retention of fine but not gross motor skill, expanding on previous correlational studies in older adults and informing future interventions for maximizing motor learning in geriatric populations.
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Affiliation(s)
- Andrew Hooyman
- School of Biological and Health Systems Engineering,
Arizona State University, Tempe, AZ, USA
- The Arizona Alzheimer's Consortium, Phoenix, AZ,
USA
| | | | - Sydney Y. Schaefer
- School of Biological and Health Systems Engineering,
Arizona State University, Tempe, AZ, USA
- The Arizona Alzheimer's Consortium, Phoenix, AZ,
USA
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9
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Cardillo R, Lievore R, Mammarella IC. Do children with and without autism spectrum disorder use different visuospatial processing skills to perform the Rey-Osterrieth complex figure test? Autism Res 2022; 15:1311-1323. [PMID: 35384343 PMCID: PMC9325558 DOI: 10.1002/aur.2717] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/27/2022] [Accepted: 03/14/2022] [Indexed: 12/04/2022]
Abstract
Visuospatial organization abilities are closely related to other visuospatial processing skills, such as visuomotor coordination, perceptual abilities, mental rotation, and working memory (WM). One task that enables visuospatial organization abilities to be investigated is the Rey-Osterrieth complex figure test (ROCFT). When examining visuospatial functioning, individuals with autism spectrum disorder (ASD) have proved capable of operating both locally and globally, depending on the sub-domain embraced, with a preference for a locally-oriented processing of visuospatial information. The present research aimed to establish whether different underlying visuospatial skills might account for performance in the ROCFT in children and adolescents with ASD, compared with typically developing (TD), by considering the role of local/global visuospatial processing. The study involved 39 participants who have ASD without intellectual disability, and 57 TD aged 8-16 years. The participants were administered tasks assessing visuospatial organization abilities, manual dexterity, visual perception, mental rotation, spatial-sequential, spatial-simultaneous WM, and visuospatial processing. Our results suggest that manual dexterity and visuospatial processing similarly explain performance in both groups, while differences in visuospatial WM account for the two groups' visuospatial organization abilities. Spatial-simultaneous WM predicted performance in copy and recall conditions in the TD group but not in the ASD group, while spatial-sequential WM only did so in the latter group, reinforcing the tendency of children with ASD towards local bias in the visuospatial organization domain. The implications of these findings are discussed. LAY SUMMARY: The visuospatial organization abilities of children and adolescents with and without autism were compared, considering their underlying visuospatial skills. Visuospatial organization impairments emerged for children with autism, who differed from typically developing children in the underlying visuospatial skills involved. Given the crucial role of visuospatial organization abilities in everyday life, our results could inspire practitioners to develop training interventions that take into account the strengths and weaknesses of individuals with autism.
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Affiliation(s)
- Ramona Cardillo
- Department of Developmental and Social PsychologyUniversity of PadovaPadova
| | - Rachele Lievore
- Department of Developmental and Social PsychologyUniversity of PadovaPadova
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Rangarajan V, Schreiber JJ, Barragan B, Schaefer SY, Honeycutt CF. Delays in the Reticulospinal System Are Associated With a Reduced Capacity to Learn a Simulated Feeding Task in Older Adults. Front Neural Circuits 2022; 15:681706. [PMID: 35153677 PMCID: PMC8829385 DOI: 10.3389/fncir.2021.681706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022] Open
Abstract
Learning declines with age. Recent evidence indicates that the brainstem may play an important role in learning and motor skill acquisition. Our objective was to determine if delays in the reticular formation, measured via the startle reflex, correspond to age-related deficits in learning and retention. We hypothesized that delays in the startle reflex would be linearly correlated to learning and retention deficits in older adults. To determine if associations were unique to the reticulospinal system, we also evaluated corticospinal contributions with transcranial magnetic stimulation. Our results showed a linear relationship between startle onset latency and percent learning and retention but no relationship between active or passive motor-evoked potential onsets or peak-to-peak amplitude. These results lay the foundation for further study to evaluate if (1) the reticular formation is a subcortical facilitator of skill acquisition and (2) processing delays in the reticular formation contribute to age-related learning deficits.
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Schaefer SY, Malek-Ahmadi M, Hooyman A, King JB, Duff K. Association Between Motor Task Performance and Hippocampal Atrophy Across Cognitively Unimpaired, Amnestic Mild Cognitive Impairment, and Alzheimer's Disease Individuals. J Alzheimers Dis 2022; 85:1411-1417. [PMID: 34958015 DOI: 10.3233/jad-210665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Hippocampal atrophy is a widely used biomarker for Alzheimer's disease (AD), but the cost, time, and contraindications associated with magnetic resonance imaging (MRI) limit its use. Recent work has shown that a low-cost upper extremity motor task has potential in identifying AD risk. Fifty-four older adults (15 cognitively unimpaired, 24 amnestic mild cognitive impairment, and 15 AD) completed six motor task trials and a structural MRI. Several measures of motor task performance significantly predicted bilateral hippocampal volume, controlling for age, sex, education, and memory. Thus, this motor task may be an affordable, non-invasive screen for AD risk and progression.
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Affiliation(s)
- Sydney Y Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, USA
| | | | - Andrew Hooyman
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Jace B King
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging, & Research, University of Utah, Salt Lake City, UT, USA
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12
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Lingo VanGilder J, Lopez-Lennon C, Paul SS, Dibble LE, Duff K, Schaefer SY. Relating Global Cognition With Upper-Extremity Motor Skill Retention in Individuals With Mild-to-Moderate Parkinson's Disease. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:754118. [PMID: 36188810 PMCID: PMC9397847 DOI: 10.3389/fresc.2021.754118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/27/2021] [Indexed: 11/18/2022]
Abstract
Background and Purpose: Cognition has been linked to rehabilitation outcomes in stroke populations, but this remains unexplored in individuals with Parkinson's disease (PD). The purpose of this secondary data analysis from a recent clinical trial (NCT02600858) was to determine if global cognition was related to skill performance after motor training in individuals with PD. Methods: Twenty-three participants with idiopathic PD completed 3 days of training on an upper-extremity task. For the purposes of the original clinical trial, participants trained either "on" or "off" their dopamine replacement medication. Baseline, training, and 48-h retention data have been previously published. Global cognition was evaluated using the Montreal Cognitive Assessment (MoCA). Linear regression examined whether MoCA score predicted longer-term retention at nine-day follow-up; baseline motor task performance, age, PD severity, depressive symptoms, and group (medication "on"/"off") were included as covariates. Baseline and follow-up motor task performance were assessed for all participants while "on" their medication. Results: MoCA score was positively related to follow-up motor task performance, such that individuals with better cognition were faster than those with poorer cognition. Baseline task performance, age, PD severity, depressive symptoms, and medication status were unrelated to follow-up performance. Discussion and Conclusions: Results of this secondary analysis align with previous work that suggest cognitive impairment may interfere with motor learning in PD and support the premise that cognitive training prior to or concurrent with motor training may enhance rehabilitative outcomes for individuals with PD. Findings also suggest that assessing cognition in individuals with PD could provide prognostic information about their responsiveness to motor rehabilitation.
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Affiliation(s)
- Jennapher Lingo VanGilder
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
| | - Cielita Lopez-Lennon
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - Serene S. Paul
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Leland E. Dibble
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging and Research, University of Utah Health Sciences Center, Salt Lake City, UT, United States
- Department of Neurology, University of Utah Hospital, Salt Lake City, UT, United States
| | - Sydney Y. Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
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13
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Lingo VanGilder J, Hooyman A, Bosch PR, Schaefer SY. Generalizing the predictive relationship between 1-month motor skill retention and Rey-Osterrieth Delayed Recall scores from nondemented older adults to individuals with chronic stroke: a short report. J Neuroeng Rehabil 2021; 18:94. [PMID: 34082761 PMCID: PMC8173502 DOI: 10.1186/s12984-021-00886-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/25/2021] [Indexed: 11/24/2022] Open
Abstract
Motor learning is fundamental to motor rehabilitation outcomes. There is growing evidence from non-neurological populations supporting the role of visuospatial memory function in motor learning, but current predictive models of motor recovery of individuals with stroke generally exclude cognitive measures, thereby overlooking the potential link between motor learning and visuospatial memory. Recent work has demonstrated that a clinical test of visuospatial memory (Rey-Osterrieth Complex Figure Delayed Recall) may predict 1-month skill learning in older adults; however, whether this relationship persists in individuals with chronic stroke remains unknown. The purpose of this short report was to validate previous findings using Rey-Osterrieth Complex Figure Delayed Recall test scores to predict motor learning and determine if this relationship generalized to a set of individuals post-stroke. Two regression models (one including Delayed Recall scores and one without) were trained using data from non-stroke older adults. To determine the extent to which Delayed Recall test scores impacted prediction accuracy of 1-month skill learning in older adults, we used leave-one-out cross-validation to evaluate the prediction error between models. To test if this predictive relationship generalized to individuals with chronic ischemic stroke, we then tested each trained model on an independent stroke dataset. Results indicated that in both stroke and older adult datasets, inclusion of Delayed Recall scores explained significantly more variance of 1-month skill performance than models that included age, education, and baseline motor performance alone. This proof-of-concept suggests that the relationship between delayed visuospatial memory and 1-month motor skill performance generalizes to individuals with chronic stroke, and supports the idea that visuospatial testing may provide prognostic insight into clinical motor rehabilitation outcomes.
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Affiliation(s)
| | - Andrew Hooyman
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, USA
| | - Pamela R Bosch
- Department of Physical Therapy, Northern Arizona University, Phoenix Campus, Phoenix, USA
| | - Sydney Y Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, USA.
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, USA.
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