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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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Frigeni M, Petilli MA, Gobbo S, Di Giusto V, Zorzi CF, Rabuffetti M, Spinelli F, Gower V, Daini R, Cavallini A. Tablet-based Rey-Osterrieth Complex Figure copy task: a novel application to assess spatial, procedural, and kinematic aspects of drawing in children. Sci Rep 2024; 14:16787. [PMID: 39039095 PMCID: PMC11263365 DOI: 10.1038/s41598-024-67076-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 07/08/2024] [Indexed: 07/24/2024] Open
Abstract
The paper-and-pencil Rey-Osterrieth Complex Figure (ROCF) copy task has been extensively used to assess visuo-constructional skills in children and adults. The scoring systems utilized in clinical practice provide an integrated evaluation of the drawing process, without differentiating between its visuo-constructional, organizational, and motor components. Here, a tablet-based ROCF copy task capable of providing a quantitative assessment of the drawing process, differentiating between visuo-constructional, organizational, and motor skills, is trialed in 94 healthy children, between 7 and 11 years of age. Through previously validated algorithms, 12 indices of performance in the ROCF copy task were obtained for each child. Principal component analysis of the 12 indices identified spatial, procedural, and kinematic components as distinct dimensions of the drawing process. A composite score for each dimension was determined, and correlation analysis between composite scores and conventional paper-and-pencil measures of visuo-constructional, procedural, and motor skills performed. The results obtained confirmed that the constructional, organizational, and motor dimensions underlie complex figure drawing in children; and that each dimension can be measured by a unique composite score. In addition, the composite scores here obtained from children were compared with previsions results from adults, offering a novel insight into how the interplay between the three dimensions of drawing evolves with age.
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Affiliation(s)
- Marta Frigeni
- Fondazione Don Carlo Gnocchi IRCCS S. Maria Nascente, Milan, Italy.
- Division of Medical Genetics, Department of Pediatrics, Northwell Health, Great Neck, NY, USA.
| | - Marco A Petilli
- Department of Psychology, Università Degli Studi Di Milano-Bicocca, Milan, Italy
| | - Silvia Gobbo
- Department of Psychology, Università Degli Studi Di Milano-Bicocca, Milan, Italy
| | | | - Carla F Zorzi
- Fondazione Don Carlo Gnocchi IRCCS S. Maria Nascente, Milan, Italy
| | - Marco Rabuffetti
- Fondazione Don Carlo Gnocchi IRCCS S. Maria Nascente, Milan, Italy
| | | | - Valerio Gower
- Fondazione Don Carlo Gnocchi IRCCS S. Maria Nascente, Milan, Italy
| | - Roberta Daini
- Fondazione Don Carlo Gnocchi IRCCS S. Maria Nascente, Milan, Italy
- Department of Psychology, Università Degli Studi Di Milano-Bicocca, Milan, Italy
| | - Anna Cavallini
- Fondazione Don Carlo Gnocchi IRCCS S. Maria Nascente, Milan, Italy
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Baruzzo E, Terruzzi S, Feder B, Papagno C, Smirni D. Verbal and non-verbal recognition memory assessment: validation of a computerized version of the Recognition Memory Test. Neurol Sci 2024; 45:1979-1988. [PMID: 38129589 PMCID: PMC11021307 DOI: 10.1007/s10072-023-07171-3] [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: 03/21/2023] [Accepted: 10/30/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The use of computerized devices for neuropsychological assessment (CNADs) as an effective alternative to the traditional pencil-and-paper modality has recently increased exponentially, both in clinical practice and research, especially due to the pandemic. However, several authors underline that the computerized modality requires the same psychometric validity as "in-presence" tests. The current study aimed at building and validating a computerized version of the verbal and non-verbal recognition memory test (RMT) for words, unknown faces and buildings. METHODS Seventy-two healthy Italian participants, with medium-high education and ability to proficiently use computerized systems, were enrolled. The sample was subdivided into six groups, one for each age decade. Twelve neurological patients with mixed aetiology, age and educational level were also recruited. Both the computerized and the paper-and-pencil versions of the RMT were administered in two separate sessions. RESULTS In healthy participants, the computerized and the paper-and-pencil versions of the RMT showed statistical equivalence for words, unknown faces and buildings. In the neurological patients, no statistical difference was found between the performance at the two versions of the RMT. A moderate-to-good inter-rater reliability between the two versions was also found in both samples. Finally, the computerized version of the RMT was perceived as acceptable by both healthy participants and neurological patients at System Usability Scale (SUS). CONCLUSION The computerized version of the RMT can be used as a reliable alternative to the traditional version.
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Affiliation(s)
- Elena Baruzzo
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy.
| | - Stefano Terruzzi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Beatrice Feder
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Costanza Papagno
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Daniela Smirni
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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Telesca A, Vergallito A, Consonni M, Mattavelli G, Ferrario A, Grazzi L, Usai S, Romero Lauro LJ. Social cognition abilities in patients with primary and secondary chronic pain. Front Psychol 2024; 15:1315682. [PMID: 38596340 PMCID: PMC11002902 DOI: 10.3389/fpsyg.2024.1315682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/06/2024] [Indexed: 04/11/2024] Open
Abstract
Previous evidence suggested that chronic pain is characterized by cognitive deficits, particularly in the social cognition domain. Recently, a new chronic pain classification has been proposed distinguishing chronic primary pain (CPP), in which pain is the primary cause of patients' disease, and chronic secondary pain (CSP), in which pain is secondary to an underlying illness. The present study aimed at investigating social cognition profiles in the two disorders. We included 38 CPP, 43 CSP patients, and 41 healthy controls (HC). Social cognition was assessed with the Ekman-60 faces test (Ekman-60F) and the Story-Based Empathy Task (SET), whereas global cognitive functioning was measured with the Montreal Cognitive Assessment (MoCA). Pain and mood symptoms, coping strategies, and alexithymia were also evaluated. Correlations among clinical pain-related measures, cognitive performance, and psychopathological features were investigated. Results suggested that CSP patients were impaired compared to CPP and HC in social cognition abilities, while CPP and HC performance was not statistically different. Pain intensity and illness duration did not correlate with cognitive performance or psychopathological measures. These findings confirmed the presence of social cognition deficits in chronic pain patients, suggesting for the first time that such impairment mainly affects CSP patients, but not CPP. We also highlighted the importance of measuring global cognitive functioning when targeting chronic pain disorders. Future research should further investigate the cognitive and psychopathological profile of CPP and CSP patients to clarify whether present findings can be generalized as disorder characteristics.
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Affiliation(s)
- Alessandra Telesca
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Neuroalgology Unit, Milan, Italy
| | | | - Monica Consonni
- Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Neuroalgology Unit, Milan, Italy
| | - Giulia Mattavelli
- ICoN Center, Scuola Universitaria Superiore IUSS, Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, Pavia, Italy
| | - Alessia Ferrario
- Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Neuroalgology Unit, Milan, Italy
| | - Licia Grazzi
- Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Neuroalgology Unit, Milan, Italy
| | - Susanna Usai
- Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Neuroalgology Unit, Milan, Italy
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Zhang X, Lv L, Shen J, Chen J, Zhang H, Li Y. A tablet-based multi-dimensional drawing system can effectively distinguish patients with amnestic MCI from healthy individuals. Sci Rep 2024; 14:982. [PMID: 38200020 PMCID: PMC10781783 DOI: 10.1038/s41598-023-46710-y] [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: 02/17/2023] [Accepted: 11/03/2023] [Indexed: 01/12/2024] Open
Abstract
The population with dementia is expected to rise to 152 million in 2050 due to the aging population worldwide. Therefore, it is significant to identify and intervene in the early stage of dementia. The Rey-Osterreth complex figure (ROCF) test is a visuospatial test scale. Its scoring methods are numerous, time-consuming, and inconsistent, which is unsuitable for wide application as required by the high number of people at risk. Therefore, there is an urgent need for a rapid, objective, and sensitive digital scoring method to detect cognitive dysfunction in the early stage accurately. This study aims to clarify the organizational strategy of aMCI patients to draw complex figures through a multi-dimensional digital evaluation system. At the same time, a rapid, objective, and sensitive digital scoring method is established to replace traditional scoring. The data of 64 subjects (38 aMCI patients and 26 NC individuals) were analyzed in this study. All subjects completed the tablet's Geriatric Complex Figure (GCF) test, including copying, 3-min recall, and 20-min delayed recall, and also underwent a standardized neuropsychological test battery and classic ROCF test. Digital GCF (dGCF) variables and conventional GCF (cGCF) scores were input into the forward stepwise logistic regression model to construct classification models. Finally, ROC curves were made to visualize the difference in the diagnostic value of dGCF variables vs. cGCF scores in categorizing the diagnostic groups. In 20-min delayed recall, aMCI patients' time in air and pause time were longer than NC individuals. Patients with aMCI had more short strokes and poorer ability of detail integration (all p < 0.05). The diagnostic sensitivity of dGCF variables for aMCI patients was 89.47%, slightly higher than cGCF scores (sensitivity: 84.21%). The diagnostic accuracy of both was comparable (dGCF: 70.3%; cGCF: 73.4%). Moreover, combining dGCF variables and cGCF scores could significantly improve the diagnostic accuracy and specificity (accuracy: 78.1%, specificity: 84.62%). At the same time, we construct the regression equations of the two models. Our study shows that dGCF equipment can quantitatively evaluate drawing performance, and its performance is comparable to the time-consuming cGCF score. The regression equation of the model we constructed can well identify patients with aMCI in clinical application. We believe this new technique can be a highly effective screening tool for patients with MCI.
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Affiliation(s)
- Xiaonan Zhang
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, China
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, China
| | | | - Jiani Shen
- Department of First Clinical Medicine, Shanxi Medical University, Taiyuan, China
| | - Jinyu Chen
- Department of First Clinical Medicine, Shanxi Medical University, Taiyuan, China
| | - Hui Zhang
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, China.
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, China.
- Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, China.
| | - Yang Li
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China.
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Basagni B, Abbruzzese L, Damora A, Conforti J, Saviola D, De Tanti A, Podgorska A, Biagioni C, Bacci M, Gambarelli C, Strologo F, Maietti A, Mancuso M. Cognition in COVID-19 infected patients undergoing invasive ventilation: results from a multicenter retrospective study. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-10. [PMID: 36827188 DOI: 10.1080/23279095.2023.2181083] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
A growing number of scientific contributions suggest that COVID-19 infection can lead to impairment of cognition, mainly in executive functions and memory domains, even in the absence of frank neurological pathologies.The primary objective of this retrospective study is to evaluate the frequency and type of inefficiencies in a selection of cognitive tests administered to a sample of subjects who, following infection, required invasive assisted ventilation and were admitted to rehabilitation wards for the treatment of functional impairment.Fifty-seven subjects were enrolled. The recruited patients undergone an assessment of verbal and visuospatial memory and executive functions, upon entry into the rehabilitation department, after discharge from intensive care. The following tests were administered: Rey Auditory Verbal Learning Test (AVLT) (immediate and delayed recall), Rey-Osterrieth Complex Figure Test (ROCFT) (copy and delayed recall), Stroop Color-Word Test, and Trail Making Test (TMT, A and B).Deficient scores, in beyond 25% of subjects, were found in the copy of the ROCFT (32.1% of subjects), and in the delayed recall of ROCFT (27.2%). Between 10 and 20% of patients presented an abnormal result in delayed recall of AVLT (16.07%), and Stroop Test (time, 15.6%, error, 11.5%). Less than 10% of the sample had abnormal performances on TMT (A, 3.5%, and B, 9.4%), and in AVLT immediate recall (8.9%). Correlations of the performances with age, sex, and education were also found.This paper highlights the high incidence of abnormal cognitive performances in this specific subpopulation of patients with COVID-19 infection.
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Affiliation(s)
| | | | - Alessio Damora
- CRT Clinica Riabilitazione Toscana, Montevarchi (AR), Italy
| | | | | | | | - Aleksandra Podgorska
- UOC Recupero e Rieducazione Funzionale-Area Grossetana, USL Toscana Sud-Est, Grosseto (GR), Italy
| | - Clarissa Biagioni
- UOC Recupero e Rieducazione Funzionale-Area Grossetana, USL Toscana Sud-Est, Grosseto (GR), Italy
| | - Marco Bacci
- UOC Recupero e Rieducazione Funzionale-Area Grossetana, USL Toscana Sud-Est, Grosseto (GR), Italy
| | - Carmen Gambarelli
- Ospedale Civile di Baggiovara- Struttura Complessa di Medicina Riabilitativa, Baggiovara (MO), Italy
| | - Francesca Strologo
- Ospedale Civile di Baggiovara- Struttura Complessa di Medicina Riabilitativa, Baggiovara (MO), Italy
| | - Alessandra Maietti
- Fondazione Poliambulanza - UO Riabilitazione Specialistica, Brescia (BS), Italy
| | - Mauro Mancuso
- CRT Clinica Riabilitazione Toscana, Montevarchi (AR), Italy
- UOC Recupero e Rieducazione Funzionale-Area Grossetana, USL Toscana Sud-Est, Grosseto (GR), Italy
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