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Ahmadnezhad P, Burns JM, Akinwuntan AE, Ranchet M, Kondyli A, Mahnken JD, Devos H. Driving Automation for Older Adults with Preclinical Alzheimer's Disease. Gerontology 2023; 69:1307-1314. [PMID: 37557082 PMCID: PMC10843675 DOI: 10.1159/000531263] [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: 12/25/2022] [Accepted: 05/12/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Older adults with preclinical Alzheimer's disease (AD) show changes in on-road driving performance. The impact of preclinical AD on using automated vehicle (AV) technology is unknown. The aim was to evaluate safety and cognitive workload while operating AV technology in drivers with preclinical AD. INTRODUCTION This cross-sectional study included 40 participants: 19 older adults (age 74.16 ± 4.78; MOCA scores 26.42 ± 2.52) with preclinical AD, evidenced by elevated cortical beta-amyloid; and 21 controls (age 73.81 ± 5.62; MOCA scores 28.24 ± 1.67). All participants completed two scenarios in a driving simulator. Scenario 1 included conditional automation with an emergency event that required a manual take-over maneuver. Scenario 2 was identical but with a cognitive distractor task. Emergency response time was the main safety outcome measure. Cognitive workload was calculated using moment-to-moment changes in pupillary size and converted into an Index of Cognitive Activity (ICA). Mann-Whitney U and independent t tests were used to compare group differences. RESULTS Emergency response times were similar between drivers with preclinical AD and controls in scenario 1 (20.85 s ± 1.08 vs. 20.52 s ± 3.18; p = 0.83) and scenario 2 (14.83 s ± 7.37 vs. 13.45 s ± 10.43; p = 0.92). Likewise, no differences were found in ICA between drivers with preclinical AD and controls in scenario 1 (0.34 ± 0.08 vs. 0.33 ± 0.17; p = 0.74) or scenario 2 (0.30 ± 0.07 vs. 0.29 ± 0.17; p = 0.93). CONCLUSIONS Older drivers with preclinical AD may safely operate AV technology, without increased response times or cognitive workload. Future on-road studies with AV technology should confirm these preliminary results in drivers with preclinical AD.
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Affiliation(s)
- Pedram Ahmadnezhad
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas, USA,
| | - Jeffrey M Burns
- University of Kansas Alzheimer's Disease Research Center, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Abiodun E Akinwuntan
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas, USA
- University of Kansas Center for Community Access, Rehabilitation Research, Education, and Service (KU-CARES), University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Maud Ranchet
- Université Gustave Eiffel, IFSTTAR, University Lyon, Lyon, France
| | - Alexandra Kondyli
- Department of Civil, Environmental, Architectural Engineering at University of Kansas, Kansas City, Kansas, USA
| | - Jonathan D Mahnken
- University of Kansas Alzheimer's Disease Research Center, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Hannes Devos
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas, USA
- University of Kansas Alzheimer's Disease Research Center, University of Kansas Medical Center, Kansas City, Kansas, USA
- University of Kansas Center for Community Access, Rehabilitation Research, Education, and Service (KU-CARES), University of Kansas Medical Center, Kansas City, Kansas, USA
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Różanowski K. New biomarkers for the assessment of fatigue evoked by long-term sleep deprivation based on pupillary light reflex using rheological models. Biocybern Biomed Eng 2022. [DOI: 10.1016/j.bbe.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Cortical Correlates of Increased Postural Task Difficulty in Young Adults: A Combined Pupillometry and EEG Study. SENSORS 2022; 22:s22155594. [PMID: 35898095 PMCID: PMC9330778 DOI: 10.3390/s22155594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 02/01/2023]
Abstract
The pupillary response reflects mental effort (or cognitive workload) during cognitive and/or motor tasks including standing postural control. EEG has been shown to be a non-invasive measure to assess the cortical involvement of postural control. The purpose of this study was to understand the effect of increasing postural task difficulty on the pupillary response and EEG outcomes and their relationship in young adults. Fifteen adults completed multiple trials of standing: eyes open, eyes open while performing a dual-task (auditory two-back), eyes occluded, and eyes occluded with a dual-task. Participants stood on a force plate and wore an eye tracker and 256-channel EEG cap during the conditions. The power spectrum was analyzed for absolute theta (4−7 Hz), alpha (8−13 Hz), and beta (13−30 Hz) frequency bands. Increased postural task difficulty was associated with greater pupillary response (p < 0.001) and increased posterior region alpha power (p = 0.001) and fronto-central region theta/beta power ratio (p = 0.01). Greater pupillary response correlated with lower posterior EEG alpha power during eyes-occluded standing with (r = −0.67, p = 0.01) and without (r = −0.69, p = 0.01) dual-task. A greater pupillary response was associated with lower CoP displacement in the anterior−posterior direction during dual-task eyes-occluded standing (r = −0.60, p = 0.04). The pupillary response and EEG alpha power appear to capture similar cortical processes that are increasingly utilized during progressively more challenging postural task conditions. As the pupillary response also correlated with task performance, this measurement may serve as a valuable stand-alone or adjunct tool to understand the underlying neurophysiological mechanisms of postural control.
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D'Silva L, Chalise P, Rippee M, Devos H. Challenging the Vestibular System Affects Gait Speed and Cognitive Workload in Chronic Mild Traumatic Brain Injury and Healthy Adults. Front Neurol 2022; 13:819169. [PMID: 35812099 PMCID: PMC9259866 DOI: 10.3389/fneur.2022.819169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
People with persistent symptoms after mild traumatic brain injury (mTBI) report imbalance during walking with head movements. The purpose of this study was (1) to compare usual walk gait speed to walking with head turns (HT) between people with mTBI and controls, (2) to compare the cognitive workload from usual walk to HT walk between groups, and (3) to examine if gaze stability deficits and mTBI symptoms influence gait speed. Twenty-three individuals (mean age 55.7 ± 9.3 years) with persistent symptoms after mTBI (between 3 months to 2 years post-injury) were compared with 23 age and sex-matched controls. Participants walked a 12-inch wide, 60-foot walkway when looking ahead and when walking with HT to identify letters and their colors. Gait speed during usual walk and HT walk were calculated. Pupillary responses during both walks were converted to the Index of Cognitive Activity (ICA) as a measure of cognitive workload. Gaze stability was examined by the dynamic visual acuity (DVA) test in the yaw plane. The post-concussion symptom scale (PCSS) was used to collect symptom severity. Within group analysis showed that gait speed was lower during HT walk compared to usual walk in the people with mTBI (p < 0.001) as well as in controls (p < 0.001). ICA was higher with HT compared to usual walk in the mTBI group in the right eye (p = 0.01) and left eye (p = 0.001), and in controls in the right eye (p = 0.01) and left eye (p = 0.01). Participants in the mTBI group had slower usual (p < 0.001), and HT gait speed (p < 0.001) compared to controls. No differences were noted in ICA in the right or left eye during usual walk and HT walk between groups (p > 0.05). DVA loss in the yaw plane to the right and left was not different between groups (p > 0.05) and were not correlated with gait speed. PCSS scores were correlated with usual walk (r = −0.50, p < 0.001) and HT gait speed (r = −0.44, p = 0.002). Slower gait speed, poorer stability, and higher cognitive workload during walking with head turns may reduce community participation in people with mTBI and persistent symptoms.
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Affiliation(s)
- Linda D'Silva
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, MO, United States
- *Correspondence: Linda D'Silva
| | - Prabhakar Chalise
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, MO, United States
| | - Michael Rippee
- Department of Neurology, University of Kansas Medical Center, Kansas City, MO, United States
| | - Hannes Devos
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, MO, United States
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Sadeghi Talarposhti M, Ahmadi-Pajouh MA, Towhidkhah F. A Neuro-Computational Model for Discrete-Continuous Dual-Task Process. Front Comput Neurosci 2022; 16:829807. [PMID: 35422694 PMCID: PMC9003617 DOI: 10.3389/fncom.2022.829807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/28/2022] [Indexed: 12/03/2022] Open
Abstract
Studies on dual-task (DT) procedures in human behavior are important, as they can offer great insight into the cognitive control system. Accordingly, a discrete-continuous auditory-tracking DT experiment was conducted in this study with different difficulty conditions, including a continuous mouse-tracking task concurrent with a discrete auditory task (AT). Behavioral results of 25 participants were investigated via different factors, such as response time (RT), errors, and hesitations (pauses in tracking tasks). In DT, synchronization of different target neuron units was observed in corresponding brain regions; consequently, a computational model of the stimulus process was proposed to investigate the DT interference procedure during the stimulus process. This generally relates to the bottom-up attention system that a neural resource allocates for various ongoing stimuli. We proposed a black-box model based on interactions and mesoscopic behaviors of neural units. Model structure was implemented based on neurological studies and oscillator units to represent neural activities. Each unit represents one stimulus feature of task concept. Comparing the model's output behavior with the experiment results (RT) validates the model. Evaluation of the proposed model and data on RT implies that the stimulus of the AT affects the DT procedure in the model output (84% correlation). However, the continuous task is not significantly changed (26% correlation). The continuous task simulation results were inconsistent with the experiment, suggesting that continuous interference occurs in higher cognitive processing regions and is controlled by the top-down attentional system. However, this is consistent with the psychological research finding of DT interference occurring in response preparation rather than the stimulus process stage. Furthermore, we developed the proposed model by adding qualitative interpretation and saving the model's generality to address various types of discrete continuous DT procedures. The model predicts a justification method for brain rhythm interactions by synchronization, and manipulating parameters would produce different behaviors. The decrement of coupling parameter and strength factor would predict a similar pattern as in Parkinson's disease and ADHD disorder, respectively. Also, by increasing the similarity factor among the features, the model's result shows automatic task performance in each task.
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Kahya M, Lyons KE, Pahwa R, Akinwuntan AE, He J, Devos H. Pupillary Response to Postural Demand in Parkinson's Disease. Front Bioeng Biotechnol 2021; 9:617028. [PMID: 33987171 PMCID: PMC8111006 DOI: 10.3389/fbioe.2021.617028] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/09/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Individuals with Parkinson’s disease (PD) may need to spend more mental and physical effort (i.e., cognitive workload) to maintain postural control. Pupillary response reflects cognitive workload during postural control tasks in healthy controls but has not been investigated as a measure of postural demand in PD. Objectives: To compare pupillary response during increased postural demand using vision occlusion and dual tasking between individuals with PD and healthy controls. Methods: Thirty-three individuals with PD and thirty-five healthy controls were recruited. The four conditions lasted 60 s and involved single balance task with eyes open; single balance task with eyes occluded; dual task with eyes open; dual task with eyes occluded. The dual task comprised the Auditory Stroop test. Pupillary response was recorded using an eye tracker. The balance was assessed by using a force plate. Two-way Repeated Measures ANOVA and LSD post-hoc tests were employed to compare pupillary response and Center of Pressure (CoP) displacement across the four conditions and between individuals with PD and healthy controls. Results: Pupillary response was higher in individuals with PD compared to healthy controls (p = 0.009) and increased with more challenging postural conditions in both groups (p < 0.001). The post-hoc analysis demonstrated increased pupillary response in the single balance eyes occluded (p < 0.001), dual task eyes open (p = 0.01), and dual task eyes occluded (p < 0.001) conditions compared to single task eyes open condition. Conclusion: Overall, the PD group had increased pupillary response with increased postural demand compared to the healthy controls. In the future, pupillary response can be a potential tool to understand the neurophysiological underpinnings of falls risk in the PD population.
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Affiliation(s)
- Melike Kahya
- Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, United States
| | - Kelly E Lyons
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Rajesh Pahwa
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Abiodun E Akinwuntan
- Office of the Dean, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States.,Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jianghua He
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, United States
| | - Hannes Devos
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
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Devos H, Gustafson K, Ahmadnezhad P, Liao K, Mahnken JD, Brooks WM, Burns JM. Psychometric Properties of NASA-TLX and Index of Cognitive Activity as Measures of Cognitive Workload in Older Adults. Brain Sci 2020; 10:E994. [PMID: 33339224 PMCID: PMC7766152 DOI: 10.3390/brainsci10120994] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/01/2020] [Accepted: 12/14/2020] [Indexed: 11/16/2022] Open
Abstract
Cognitive workload is increasingly recognized as an important determinant of performance in cognitive tests and daily life activities. Cognitive workload is a measure of physical and mental effort allocation to a task, which can be determined through self-report or physiological measures. However, the reliability and validity of these measures have not been established in older adults with a wide range of cognitive ability. The aim of this study was to establish the test-retest reliability of the National Aeronautics and Space Administration Task Load Index (NASA-TLX) and Index of Cognitive Activity (ICA), extracted from pupillary size. The convergent validity of these measures against event-related potentials (ERPs) was also investigated. A total of 38 individuals with scores on the Montreal Cognitive Assessment ranging between 17 and 30 completed a working memory test (n-back) with three levels of difficulty at baseline and at a two-week follow-up. The intraclass correlation coefficients (ICC) values of the NASA-TLX ranged between 0.71 and 0.81, demonstrating good to excellent reliability. The mean ICA scores showed fair to good reliability, with ICCs ranging between 0.56 and 0.73. The mean ICA and NASA-TLX scores showed significant and moderate correlations (Pearson's r ranging between 0.30 and 0.33) with the third positive peak of the ERP at the midline channels. We conclude that ICA and NASA-TLX are reliable measures of cognitive workload in older adults. Further research is needed in dissecting the subjective and objective constructs of cognitive workload.
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Affiliation(s)
- Hannes Devos
- Laboratory for Advanced Rehabilitation Research in Simulation, Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Kathleen Gustafson
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (K.G.); (W.M.B.); (J.M.B.)
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Pedram Ahmadnezhad
- Laboratory for Advanced Rehabilitation Research in Simulation, Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Ke Liao
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Jonathan D. Mahnken
- University of Kansas Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS 66160, USA;
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - William M. Brooks
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (K.G.); (W.M.B.); (J.M.B.)
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS 66160, USA;
- University of Kansas Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Jeffrey M. Burns
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (K.G.); (W.M.B.); (J.M.B.)
- University of Kansas Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, KS 66160, USA;
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