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Wang J, Huang B, Zhou L, Tang S, Feng H, Chan JWY, Chau SWH, Zhang J, Li SX, Mok V, Wing YK, Liu Y. Visuospatial dysfunction predicts dementia-first phenoconversion in isolated REM sleep behaviour disorder. J Neurol Neurosurg Psychiatry 2024:jnnp-2024-333865. [PMID: 38925912 DOI: 10.1136/jnnp-2024-333865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE While isolated rapid eye movement sleep behaviour disorder (iRBD) is known as a prodrome of α-synucleinopathies, the prediction for its future phenoconversion to parkinsonism-first or dementia-first subtype remains a challenge. This study aimed to investigate whether visuospatial dysfunction predicts dementia-first phenoconversion in iRBD. METHODS Patients with iRBD and control subjects were enrolled in this prospective cohort study. Baseline neuropsychological assessment included the Unified Parkinson's Disease Rating Scale part III, Montreal Cognitive Assessment (MoCA), Rey-Osterrieth complex figure (ROCF), Colour Trails test (CTT), Farnsworth-Munsell 100-hue test and Digit Span test. The anterior and posterior subscores of MoCA as well as their modified versions were explored. A composite score derived from ROCF and CTT was also explored. Regular follow-up was conducted to determine the phenoconversion status of iRBD patients. RESULTS The study included 175 iRBD patients and 98 controls. During a mean follow-up of 5.1 years, 25.7% of patients experienced phenoconversion. Most of the neuropsychological tests could differentiate dementia-first but not parkinsonism-first convertors from non-convertors. The modified posterior subscore of MoCA, by integrating the Alternating Trail Making and Clock Drawing components into original the posterior subscore, which mainly reflects visuospatial function, was the strongest predictor for dementia-first phenoconversion (adjusted HR 5.48, 95% CI 1.67 to 17.98). CONCLUSION Visuospatial dysfunction, as reflected mainly by the modified posterior subscore of MoCA, is a predictive factor for dementia-first phenoconversion in iRBD, suggesting its potential for being a biomarker for clinical prognostic prediction and potential neuroprotective trials aiming to delay or prevent dementia.
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Affiliation(s)
- Jing Wang
- Center for Sleep and Circadian Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Bei Huang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Li Zhou
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Shi Tang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Hongliang Feng
- Center for Sleep and Circadian Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Joey W Y Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Steven W H Chau
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shirley X Li
- Department of Psychology and the State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Vincent Mok
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Margaret K.L. Cheung Research Centre for Management of Parkinsonism, Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
| | - Yaping Liu
- Center for Sleep and Circadian Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education, Guangzhou Medical University, Guangzhou, Guangdong, China
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Card MR, Ryals AJ. Toward Development of a Novel Proprioceptive Trail-Making Test: Comparing Healthy Dancers and Non-Dancers. Percept Mot Skills 2024; 131:660-686. [PMID: 38537176 DOI: 10.1177/00315125241240891] [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] [Indexed: 05/25/2024]
Abstract
There is a pressing need for ecologically valid versions of traditional neuropsychological tests indexing executive function (EF), such as the Trail-Making Task (TMT), that incorporate movement and bodily awareness in healthy participants with varying abilities. We designed a proprioceptive version of the TMT (pTMT) that involved coordinated gross motor movement and proprioceptive awareness to investigate whether this measure of visual attention, task switching, and working memory positively correlated with a computerized version of the TMT (the dTMT). We aimed to establish the initial validity of our proprioceptive TMT (pTMT) by comparing performances on the dTMT and pTMT among a cohort of 36 healthy participants (18 dancers, 18 non-dancers; M age = 22, SD = 5.27; 64% female) anticipating that dancers would express higher intrinsic bodily awareness than non-dancers. Results revealed a mild to moderate but statistically significant positive correlation between dTMT and pTMT completion times [part A: r (36) = .33, p = .04; part B: r (36) = .37, p = .03] and numbers of errors [part B: r (36) = .41, p = .01] across both participant groups. These data suggest partial measurement convergence between these two TMT versions. Relative to non-dancers, dancers exhibited a higher level of performance (likely due to their better proprioceptive ability) through their faster completion times on dTMT-B [t (34) = 3.81, p = .006, d = 1.27] and pTMT-B [t (34) = 2.97, p = .005, d = .99], and their fewer errors on dTMT-B [t (34) = 2.93, p = .006, d = 1.0]. By identifying cognitive differences between these different groups of healthy individuals, our data contribute to both a theoretical understanding and the initial development of gross motor movement-based cognitive assessments, providing a path toward the further refinement of an ecologically valid full-body TMT.
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Affiliation(s)
- Madison R Card
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Anthony J Ryals
- Department of Psychology, University of North Texas, Denton, TX, USA
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Harris C, Tang Y, Birnbaum E, Cherian C, Mendhe D, Chen MH. Digital Neuropsychology beyond Computerized Cognitive Assessment: Applications of Novel Digital Technologies. Arch Clin Neuropsychol 2024; 39:290-304. [PMID: 38520381 DOI: 10.1093/arclin/acae016] [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: 02/05/2024] [Accepted: 02/16/2024] [Indexed: 03/25/2024] Open
Abstract
Compared with other health disciplines, there is a stagnation in technological innovation in the field of clinical neuropsychology. Traditional paper-and-pencil tests have a number of shortcomings, such as low-frequency data collection and limitations in ecological validity. While computerized cognitive assessment may help overcome some of these issues, current computerized paradigms do not address the majority of these limitations. In this paper, we review recent literature on the applications of novel digital health approaches, including ecological momentary assessment, smartphone-based assessment and sensors, wearable devices, passive driving sensors, smart homes, voice biomarkers, and electronic health record mining, in neurological populations. We describe how each digital tool may be applied to neurologic care and overcome limitations of traditional neuropsychological assessment. Ethical considerations, limitations of current research, as well as our proposed future of neuropsychological practice are also discussed.
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Affiliation(s)
- Che Harris
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
- Department of Neurology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - Yingfei Tang
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
- Department of Neurology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - Eliana Birnbaum
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
| | - Christine Cherian
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
| | - Dinesh Mendhe
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
| | - Michelle H Chen
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
- Department of Neurology, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
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Tikkanen V, Krüger J, Heikkinen AL, Hänninen T, Hublin C, Koivisto AM, Virkkala J, Saari TT, Remes AM, Paajanen TI. A Novel Computerized Flexible Attention Test in Detecting Executive Dysfunction of Patients with Early-Onset Cognitive Impairment and Dementia. Arch Clin Neuropsychol 2024:acae026. [PMID: 38581151 DOI: 10.1093/arclin/acae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/06/2024] [Accepted: 03/18/2024] [Indexed: 04/08/2024] Open
Abstract
OBJECTIVE The number of computer-based cognitive tests has increased in recent years, but there is a need for tests focusing on the assessment of executive function (EF), as it can be crucial for the identification of early-onset neurodegenerative disorders. This study aims to examine the ability of the Flexible Attention Test (FAT), a new computer-based test battery for detecting executive dysfunction of early-onset cognitive impairment and dementia patients. METHOD We analyzed the FAT subtask results in memory clinic patients with cognitive symptom onset at ≤65 years. The patients were divided into four groups: early onset dementia (EOD, n = 48), mild cognitive impairment due to neurological causes (MCI-n, n = 34), MCI due to other causes (MCI-o, n = 99), and subjective cognitive decline (SCD, n = 14). The test accuracy to distinguish EOD patients from other groups was examined, as well as correlations with pen-and-paper EF tests. We also reported the 12-months follow-up results. RESULTS The EOD and MCI-n patients performed significantly poorer (p ≤ .002) than those in the MCI-o and SCD groups in most of the FAT subtasks. The accuracies of the FAT subtasks to detect EOD from other causes were mainly moderate (0.34 ≤ area under the curve < 0.74). The FAT subtasks correlated logically with corresponding pen-and-paper EF tests (.15 ≤ r ≤ .75). No systematic learning effects were detected in the FAT performance at follow-up. CONCLUSIONS The FAT appears to be a promising method for the precise evaluation of EF and applicable distinguishing early-onset neurodegenerative disorders from patients with other causes of cognitive problems.
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Affiliation(s)
- Veera Tikkanen
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
| | - Johanna Krüger
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
| | - Anna-Leena Heikkinen
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
- Work Ability and Working Careers Unit, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Tuomo Hänninen
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Christer Hublin
- Work Ability and Working Careers Unit, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Anne M Koivisto
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
- Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Geriatrics, Helsinki University Hospital, Helsinki, Finland
- Clinical Neurosciences, University of Helsinki, Helsinki, Finland
| | - Jussi Virkkala
- Work Ability and Working Careers Unit, Finnish Institute of Occupational Health, Helsinki, Finland
- Clinical Neurophysiology and Clinical Neurosciences, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Toni T Saari
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
- Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Anne M Remes
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
- Clinical Neurosciences, University of Helsinki, Helsinki, Finland
| | - Teemu I Paajanen
- Work Ability and Working Careers Unit, Finnish Institute of Occupational Health, Helsinki, Finland
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Libon DJ, Swenson R, Tobyne S, Jannati A, Schulman D, Price CC, Lamar M, Pascual-Leone A. Dysexecutive difficulty and subtle everyday functional disabilities: the digital Trail Making Test. Front Neurol 2024; 15:1354647. [PMID: 38633534 PMCID: PMC11021769 DOI: 10.3389/fneur.2024.1354647] [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: 12/12/2023] [Accepted: 02/19/2024] [Indexed: 04/19/2024] Open
Abstract
Background Digital neuropsychological tests reliably capture real-time, process-based behavior that traditional paper/pencil tests cannot detect, enabling earlier detection of neurodegenerative illness. We assessed relations between informant-based subtle and mild functional decline and process-based features extracted from the digital Trail Making Test-Part B (dTMT-B). Methods A total of 321 community-dwelling participants (56.0% female) were assessed with the Functional Activities Questionnaire (FAQ) and the dTMT-B. Three FAQ groups were constructed: FAQ = 0 (unimpaired); FAQ = 1-4 (subtle impairment); FAQ = 5-8 (mild impairment). Results Compared to the FAQ-unimpaired group, other groups required longer pauses inside target circles (p < 0.050) and produced more total pen strokes to complete the test (p < 0.016). FAQ-subtle participants required more time to complete the entire test (p < 0.002) and drew individual lines connecting successive target circles slower (p < 0.001) than FAQ-unimpaired participants. Lines connecting successive circle targets were less straight among FAQ-mild, compared to FAQ-unimpaired participants (p < 0.044). Using stepwise nominal regression (reference group = FAQ-unimpaired), pauses inside target circles classified other participants into their respective groups (p < 0.015, respectively). Factor analysis using six dTMT-B variables (oblique rotation) yielded a two-factor solution related to impaired motor/cognitive operations (48.96% variance explained) and faster more efficient motor/cognitive operations (28.88% variance explained). Conclusion Digital assessment technology elegantly quantifies occult, nuanced behavior not previously appreciated, operationally defines critical underlying neurocognitive constructs related to functional abilities, and yields selected process-based scores that outperform traditional paper/pencil test scores for participant classification. When brought to scale, the dTMT-B test could be a sensitive tool to detect subtle-to-mild functional deficits in emergent neurodegenerative illnesses.
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Affiliation(s)
- David J. Libon
- Department of Geriatrics and Gerontology, New Institute for Successful Aging, Rowan University-School of Osteopathic Medicine, Stratford, NJ, United States
- Department of Psychology, Rowan University, Glassboro, NJ, United States
| | - Rod Swenson
- University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, United States
| | | | - Ali Jannati
- Linus Health, Boston, MA, United States
- Department of Neurology, Harvard Medical School, Boston, MA, United States
| | | | - Catherine C. Price
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Melissa Lamar
- Rush Alzheimer’s Disease Center and the Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Alvaro Pascual-Leone
- Linus Health, Boston, MA, United States
- Department of Neurology, Harvard Medical School, Boston, MA, United States
- Hinda and Arthur Marcus Institute for Aging Research and Deanna Sidney Wolk Center for Memory Health, and Eleanor and Herbert Bearak Memory Wellness for Life Program, Hebrew Senior Life, Boston, MA, United States
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Saalfield J, Piersol KL, Esopenko C, Bates ME, Weismiller SA, Brostrand K, Todaro SM, Conway FN, Wilde EA, Buckman JF. Digital neuropsychological test performance in a large sample of uninjured collegiate athletes. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:155-161. [PMID: 34822256 PMCID: PMC10199655 DOI: 10.1080/23279095.2021.2003365] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Digital neuropsychological test batteries are popular in college athletics; however, well-validated digital tests that are short and portable are needed to expand the feasibility of performing cognitive testing quickly, reliably, and outside standard clinical settings. This study assessed performance on digital versions of Trail Making Test (dTMT) and a modified Symbol Digit Modalities Test (dSDMT) in uninjured collegiate athletes (n = 537; 47% female) using the C3Logix baseline assessment module. Time to complete (dTMT) and the number of correct responses (dSDMT) were computed, transformed into z scores, and compared to age-matched normative data from analogous paper-and-pencil tests. Overall sample performance was compared to normative sample performance using Cohen's d. Sample averages on the dTMT, Part A, and dSDMT were similar to published norms; 97 and 92% of z scores fell within 2 standard deviations of normative means, respectively. The sample averaged faster completion times on dTMT, Part B than published norms, although 98% of z scores were within 2 standard deviations of the normative means. Brief, digitized tests may be useful in populations and testing environments when longer cognitive test batteries are impractical. Future studies should assess the ability of these tests to detect clinically relevant changes following a suspected head injury.
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Affiliation(s)
- Jessica Saalfield
- Department of Kinesiology and Health, Rutgers University–New Brunswick
| | - Kelsey L. Piersol
- Department of Kinesiology and Health, Rutgers University–New Brunswick
| | - Carrie Esopenko
- Department of Rehabilitation & Movement Sciences, School of Health Professions, Rutgers Biomedical and Health Sciences
| | - Marsha E. Bates
- Department of Kinesiology and Health, Rutgers University–New Brunswick
- Center of Alcohol and Substance Use Studies, Rutgers University – New Brunswick
| | - Scott A. Weismiller
- Center of Alcohol and Substance Use Studies, Rutgers University – New Brunswick
| | - Kyle Brostrand
- Department of Athletics, Rutgers University–New Brunswick
| | - Sabrina M. Todaro
- Center of Alcohol and Substance Use Studies, Rutgers University – New Brunswick
| | - Fiona N. Conway
- Department of Kinesiology and Health, Rutgers University–New Brunswick
- Center of Alcohol and Substance Use Studies, Rutgers University – New Brunswick
| | - Elisabeth A. Wilde
- Department of Neurology, University of Utah School of Medicine and the George E. Wahlen Veterans Affairs Medical Center
| | - Jennifer F. Buckman
- Department of Kinesiology and Health, Rutgers University–New Brunswick
- Center of Alcohol and Substance Use Studies, Rutgers University – New Brunswick
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Bushnell J, Hammers DB, Aisen P, Dage JL, Eloyan A, Foroud T, Grinberg LT, Iaccarino L, Jack CR, Kirby K, Kramer J, Koeppe R, Kukull WA, La Joie R, Mundada NS, Murray ME, Nudelman K, Rumbaugh M, Soleimani-Meigooni DN, Toga A, Touroutoglou A, Vemuri P, Atri A, Day GS, Duara R, Graff-Radford NR, Honig LS, Jones DT, Masdeu J, Mendez M, Musiek E, Onyike CU, Riddle M, Rogalski E, Salloway S, Sha S, Turner RS, Wingo TS, Wolk DA, Carrillo MC, Dickerson BC, Rabinovici GD, Apostolova LG, Clark DG. Influence of amyloid and diagnostic syndrome on non-traditional memory scores in early-onset Alzheimer's disease. Alzheimers Dement 2023; 19 Suppl 9:S29-S41. [PMID: 37653686 PMCID: PMC10855009 DOI: 10.1002/alz.13434] [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: 04/14/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION The Rey Auditory Verbal Learning Test (RAVLT) is a useful neuropsychological test for describing episodic memory impairment in dementia. However, there is limited research on its utility in early-onset Alzheimer's disease (EOAD). We assess the influence of amyloid and diagnostic syndrome on several memory scores in EOAD. METHODS We transcribed RAVLT recordings from 303 subjects in the Longitudinal Early-Onset Alzheimer's Disease Study. Subjects were grouped by amyloid status and syndrome. Primacy, recency, J-curve, duration, stopping time, and speed score were calculated and entered into linear mixed effects models as dependent variables. RESULTS Compared with amyloid negative subjects, positive subjects exhibited effects on raw score, primacy, recency, and stopping time. Inter-syndromic differences were noted with raw score, primacy, recency, J-curve, and stopping time. DISCUSSION RAVLT measures are sensitive to the effects of amyloid and syndrome in EOAD. Future work is needed to quantify the predictive value of these scores. HIGHLIGHTS RAVLT patterns characterize various presentations of EOAD and EOnonAD Amyloid impacts raw score, primacy, recency, and stopping time Timing-based scores add value over traditional count-based scores.
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Affiliation(s)
- Justin Bushnell
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Dustin B. Hammers
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Paul Aisen
- Alzheimer’s Therapeutic Research Institute, University of Southern California, San Diego, California, USA
| | - Jeffrey L. Dage
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ani Eloyan
- Department of Biostatistics, Center for Statistical Sciences, Brown University, Providence, Rhode Island, USA
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Lea T. Grinberg
- Department of Pathology, University of California – San Francisco, San Francisco, California, USA
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | - Leonardo Iaccarino
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | | | - Kala Kirby
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Joel Kramer
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | - Robert Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Walter A. Kukull
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Renaud La Joie
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | - Nidhi S. Mundada
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | | | - Kelly Nudelman
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Malia Rumbaugh
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - Arthur Toga
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Alexandra Touroutoglou
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Alireza Atri
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Gregory S. Day
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | - Ranjan Duara
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami, Florida, USA
| | | | - Lawrence S. Honig
- Taub Institute and Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - David T. Jones
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joseph Masdeu
- Nantz National Alzheimer Center, Houston Methodist and Weill Cornell Medicine, Houston, Texas, USA
| | - Mario Mendez
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Erik Musiek
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Chiadi U. Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Meghan Riddle
- Department of Neurology, Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Emily Rogalski
- Department of Psychiatry and Behavioral Sciences, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Steven Salloway
- Department of Neurology, Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Sharon Sha
- Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, California, USA
| | - Raymond S. Turner
- Department of Neurology, Georgetown University, Washington D.C., USA
| | - Thomas S. Wingo
- Department of Neurology and Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - David A. Wolk
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Maria C. Carrillo
- Medical & Scientific Relations Division, Alzheimer’s Association, Chicago, Illinois, USA
| | - Bradford C. Dickerson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Gil D. Rabinovici
- Department of Neurology, University of California – San Francisco, San Francisco, California, USA
| | - Liana G. Apostolova
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - David G. Clark
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Słowiński P, White A, Lison S, Sullivan S, Emmens T, Self P, Wileman J, Karl A, Tsaneva-Atanasova K. The potential of digital behavioural tests as a diagnostic aid for psychosis. PLOS DIGITAL HEALTH 2023; 2:e0000339. [PMID: 37713385 PMCID: PMC10503702 DOI: 10.1371/journal.pdig.0000339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/29/2023] [Indexed: 09/17/2023]
Abstract
Timely interventions have a proven benefit for people experiencing psychotic illness. One bottleneck to accessing timely interventions is the referral process to the specialist team for early psychosis (STEP). Many general practitioners lack awareness or confidence in recognising psychotic symptoms or state. Additionally, referrals for people without apparent psychotic symptoms, although beneficial at a population level, lead to excessive workload for STEPs. There is a clear unmet need for accurate stratification of STEPs users and healthy cohorts. Here we propose a new approach to addressing this need via the application of digital behavioural tests. To demonstrate that digital behavioural tests can be used to discriminate between the STEPs users (SU; n = 32) and controls (n = 32, age and sex matched), we compared performance of five different classifiers applied to objective, quantitative and interpretable features derived from the 'mirror game' (MG) and trail making task (TMT). The MG is a movement coordination task shown to be a potential socio-motor biomarker of schizophrenia, while TMT is a neuropsychiatric test of cognitive function. All classifiers had AUC in the range of 0.84-0.92. The best of the five classifiers (linear discriminant classifier) achieved an outstanding performance, AUC = 0.92 (95%CI 0.75-1), Sensitivity = 0.75 (95%CI 0.5-1), Specificity = 1 (95%CI 0.75-1), evaluated on 25% hold-out and 1000 folds. Performance of all analysed classifiers is underpinned by the large effect sizes of the differences between the cohorts in terms of the features used for classification what ensures generalisability of the results. We also found that MG and TMT are unsuitable in isolation to successfully differentiate between SU with and without at-risk-mental-state or first episode psychosis with sufficient level of performance. Our findings show that standardised batteries of digital behavioural tests could benefit both clinical and research practice. Including digital behavioural tests into healthcare practice could allow precise phenotyping and stratification of the highly heterogenous population of people referred to STEPs resulting in quicker and more personalised diagnosis. Moreover, the high specificity of digital behavioural tests could facilitate the identification of more homogeneous clinical high-risk populations, benefiting research on prognostic instruments for psychosis. In summary, our study demonstrates that cheap off-the-shelf equipment (laptop computer and a leap motion sensor) can be used to record clinically relevant behavioural data that could be utilised in digital mental health applications.
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Affiliation(s)
- Piotr Słowiński
- Translational Research Exchange @ Exeter, Living Systems Institute, Department of Mathematics and Statistics, Faculty of Environment, Science and Economy, University of Exeter, United Kingdom
| | - Alexander White
- Department of Psychology, Faculty of Health and Life Sciences, University of Exeter, United Kingdom
| | - Sian Lison
- Research & Development Department, Devon Partnership NHS Trust, Exeter, United Kingdom
| | - Sarah Sullivan
- Faculty of Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - Tobit Emmens
- Research & Development Department, Devon Partnership NHS Trust, Exeter, United Kingdom
| | - Philip Self
- Research & Development Department, Devon Partnership NHS Trust, Exeter, United Kingdom
| | - Jane Wileman
- Specialist Team for Early Psychosis, Devon Partnership NHS Trust, Exeter, United Kingdom
| | - Anke Karl
- Department of Psychology, Faculty of Health and Life Sciences, University of Exeter, United Kingdom
| | - Krasimira Tsaneva-Atanasova
- Translational Research Exchange @ Exeter, Living Systems Institute, Department of Mathematics and Statistics, Faculty of Environment, Science and Economy, University of Exeter, United Kingdom
- EPSRC Hub for Quantitative Modelling in Healthcare University of Exeter, Exeter, United Kingdom
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9
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Chandrasekharan J, Joseph A, Ram A, Nollo G. ETMT: A Tool for Eye-Tracking-Based Trail-Making Test to Detect Cognitive Impairment. SENSORS (BASEL, SWITZERLAND) 2023; 23:6848. [PMID: 37571630 PMCID: PMC10422410 DOI: 10.3390/s23156848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023]
Abstract
The growing number of people with cognitive impairment will significantly increase healthcare demand. Screening tools are crucial for detecting cognitive impairment due to a shortage of mental health experts aiming to improve the quality of life for those living with this condition. Eye tracking is a powerful tool that can provide deeper insights into human behavior and inner cognitive processes. The proposed Eye-Tracking-Based Trail-Making Test, ETMT, is a screening tool for monitoring a person's cognitive function. The proposed system utilizes a fuzzy-inference system as an integral part of its framework to calculate comprehensive scores assessing visual search speed and focused attention. By employing an adaptive neuro-fuzzy-inference system, the tool provides an overall cognitive-impairment score, allowing psychologists to assess and quantify the extent of cognitive decline or impairment in their patients. The ETMT model offers a comprehensive understanding of cognitive abilities and identifies potential deficits in various domains. The results indicate that the ETMT model is a potential tool for evaluating cognitive impairment and can capture significant changes in eye movement behavior associated with cognitive impairment. It provides a convenient and affordable diagnosis, prioritizing healthcare resources for severe conditions while enhancing feedback to practitioners.
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Affiliation(s)
- Jyotsna Chandrasekharan
- Department of Computer Science and Engineering, Amrita School of Computing, Amrita Vishwa Vidyapeetham, Bengaluru 560035, India;
- Department of Industrial Engineering, University of Trento, 38123 Trento, Italy;
| | - Amudha Joseph
- Department of Computer Science and Engineering, Amrita School of Computing, Amrita Vishwa Vidyapeetham, Bengaluru 560035, India;
| | | | - Giandomenico Nollo
- Department of Industrial Engineering, University of Trento, 38123 Trento, Italy;
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10
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Zhong J, Zhang X, Xu H, Zheng X, Wang L, Jiang J, Li Y. Unlocking the enigma: unraveling multiple cognitive dysfunction linked to glymphatic impairment in early Alzheimer's disease. Front Neurosci 2023; 17:1222857. [PMID: 37547134 PMCID: PMC10400773 DOI: 10.3389/fnins.2023.1222857] [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: 05/15/2023] [Accepted: 06/26/2023] [Indexed: 08/08/2023] Open
Abstract
Background Alzheimer's disease (AD) is one of the world's well-known neurodegenerative diseases, which is related to the balance mechanism of production and clearance of two proteins (amyloid-β and tau) regulated by the glymphatic system. Latest studies have found that AD patients exhibit impairments to their glymphatic system. However, the alterations in the AD disease continuum, especially in the early stages, remain unclear. Moreover, the relationship between the glymphatic system and cognitive dysfunction is still worth exploring. Methods A novel diffusion tensor image analysis method was applied to evaluate the activity of the glymphatic system by an index for diffusivity along the perivascular space (ALPS-index). Based on this method, the activity of the glymphatic system was noninvasively evaluated in 300 subjects, including 111 normal controls (NC), 120 subjects with mild cognitive impairment (MCI), and 69 subjects with AD. Partial correlation analysis was applied to explore the association between glymphatic system and cognitive impairment based on three domain-general scales and several domain-specific cognitive scales. Receiver operating characteristic curve analysis was used to evaluate the classification performance of ALPS-index along the AD continuum. Results ALPS-index was significantly different among NC, MCI and AD groups, and ALPS-index decreased with cognitive decline. In addition, ALPS-index was significantly correlated with the scores of the clinical scales (p<0.05, FDR corrected), especially in left hemisphere. Furthermore, combination of ALPS and fractional anisotropy (FA) values achieved better classification results (NC vs. MCI: AUC = 0.6610, NC vs. AD: AUC = 0.8214). Conclusion Here, we show that the glymphatic system is closely associated with multiple cognitive dysfunctions, and ALPS-index can be used as a biomarker for alterations along the AD continuum. This may provide new targets and strategies for the treatment of AD, and has the potential to assist clinical diagnosis.
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Affiliation(s)
- Jiayi Zhong
- School of Life Science, Shanghai University, Shanghai, China
| | - Xiaochen Zhang
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Huanyu Xu
- School of Communication and Information Engineering, Shanghai University, Shanghai, China
| | - Xiaoran Zheng
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Luyao Wang
- School of Life Science, Shanghai University, Shanghai, China
| | - Jiehui Jiang
- Institute of Biomedical Engineering, Shanghai University, Shanghai, China
| | - Yunxia Li
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
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11
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Pedersen MK, Díaz CMC, Wang QJ, Alba-Marrugo MA, Amidi A, Basaiawmoit RV, Bergenholtz C, Christiansen MH, Gajdacz M, Hertwig R, Ishkhanyan B, Klyver K, Ladegaard N, Mathiasen K, Parsons C, Rafner J, Villadsen AR, Wallentin M, Zana B, Sherson JF. Measuring Cognitive Abilities in the Wild: Validating a Population-Scale Game-Based Cognitive Assessment. Cogn Sci 2023; 47:e13308. [PMID: 37354036 DOI: 10.1111/cogs.13308] [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: 03/21/2022] [Revised: 04/26/2023] [Accepted: 06/05/2023] [Indexed: 06/26/2023]
Abstract
Rapid individual cognitive phenotyping holds the potential to revolutionize domains as wide-ranging as personalized learning, employment practices, and precision psychiatry. Going beyond limitations imposed by traditional lab-based experiments, new efforts have been underway toward greater ecological validity and participant diversity to capture the full range of individual differences in cognitive abilities and behaviors across the general population. Building on this, we developed Skill Lab, a novel game-based tool that simultaneously assesses a broad suite of cognitive abilities while providing an engaging narrative. Skill Lab consists of six mini-games as well as 14 established cognitive ability tasks. Using a popular citizen science platform (N = 10,725), we conducted a comprehensive validation in the wild of a game-based cognitive assessment suite. Based on the game and validation task data, we constructed reliable models to simultaneously predict eight cognitive abilities based on the users' in-game behavior. Follow-up validation tests revealed that the models can discriminate nuances contained within each separate cognitive ability as well as capture a shared main factor of generalized cognitive ability. Our game-based measures are five times faster to complete than the equivalent task-based measures and replicate previous findings on the decline of certain cognitive abilities with age in our large cross-sectional population sample (N = 6369). Taken together, our results demonstrate the feasibility of rapid in-the-wild systematic assessment of cognitive abilities as a promising first step toward population-scale benchmarking and individualized mental health diagnostics.
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Affiliation(s)
- Mads Kock Pedersen
- Center for Hybrid Intelligence, Department of Management, Aarhus University
- Department of Business Development and Technology, Aarhus University
| | | | - Qian Janice Wang
- Center for Hybrid Intelligence, Department of Management, Aarhus University
- Department of Food Science, Aarhus University
| | | | - Ali Amidi
- Department of Psychology and Behavioural Sciences, Aarhus University
| | | | | | - Morten H Christiansen
- Department of Psychology, Cornell University
- School of Communication and Culture, Aarhus University
- Interacting Minds Centre, Aarhus University
| | - Miroslav Gajdacz
- Center for Hybrid Intelligence, Department of Management, Aarhus University
| | - Ralph Hertwig
- Center for Adaptive Rationality, Max Planck Institute for Human Development
| | | | - Kim Klyver
- Department of Entrepreneurship & Relationship Management, University of Southern Denmark
- Entrepreneurship, Commercialization and Innovation Centre (ECIC), University of Adelaide
| | - Nicolai Ladegaard
- Department of Clinical Medicine - Department of Affective Disorders, Aarhus University Hospital
| | - Kim Mathiasen
- Department of Clinical Medicine - Department of Affective Disorders, Aarhus University Hospital
| | | | - Janet Rafner
- Center for Hybrid Intelligence, Department of Management, Aarhus University
| | | | - Mikkel Wallentin
- School of Communication and Culture, Aarhus University
- Interacting Minds Centre, Aarhus University
| | - Blanka Zana
- Center for Hybrid Intelligence, Department of Management, Aarhus University
| | - Jacob F Sherson
- Center for Hybrid Intelligence, Department of Management, Aarhus University
- School of Communication and Culture, Aarhus University
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12
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Ben Yair N, Wilf M, Bahat Y, Plotnik M. Studying cognitive-motor interactions using a tablet-based application of the Color Trails Test. Exp Brain Res 2023; 241:1065-1075. [PMID: 36853381 DOI: 10.1007/s00221-022-06531-3] [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: 08/14/2022] [Accepted: 12/01/2022] [Indexed: 03/01/2023]
Abstract
The Color Trails Test (CTT) is a pen and paper (P&P) test designed to measure cognitive function. The test consists of two parts that evaluate primarily sustained visual attention (Trails A) and divided attention (Trails B). Based on clinical interest in converting neuropsychological testing from P&P to computerized testing, we developed a digital version of the CTT ('Tablet-CTT'). Twenty-four young, healthy participants performed Trails A and B of both the original P&P and the Tablet-CTT. Hand kinematics were calculated using the continuous location of an electronic pen on the tablet touch screen. To compare motor control aspects, we differentiated for each test session the 'movement planning' and 'movement execution' times (accumulated across all single target-to-target trajectories). Concurrent validity was demonstrated by the high correlation between completion times of the P&P and Tablet-CTT, in both Trails A (r = 0.6; p < 0.005) and Trails B (r = 0.8; p < 0.001). Trails B yielded significantly longer completion times in both formats (p < 0.001). Examining hand kinematics in Tablet-CTT revealed that the difference in durations was mostly due to prolonged planning time, but also due to significantly lower execution velocity in Trails B (p < 0.001). Lastly, we found increased hand velocity during the planning phase in Trails B compared to Trails A (p < 0.001). This study demonstrates how transforming the CTT to a digital platform could be useful for studying cognitive-motor interactions in healthy individuals. Moreover, it could potentially serve as a diagnosis tool by introducing a more comprehensive testing method that incorporates online recordings of hand movements.
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Affiliation(s)
- Noa Ben Yair
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
- Department of Biomedical Engineering, Ben-Gurion University, Beer Sheva, Israel
| | - Meytal Wilf
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yotam Bahat
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
| | - Meir Plotnik
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel.
- Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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13
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Park SY, Schott N. Which motor-cognitive abilities underlie the digital Trail-Making Test? Decomposing various test scores to detect cognitive impairment in Parkinson's disease-Pilot study. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-15. [PMID: 36412487 DOI: 10.1080/23279095.2022.2147837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Since Parkinson's disease (PD) is a heterogeneous disorder with symptoms, such as tremors, gait and speech disturbances, or memory loss, individualized diagnostics are needed to optimize treatment. In their current form, the typical paper-pencil methods traditionally used to track disease progression are too coarse to capture the subtleties of clinical phenomena. For this reason, digital biomarkers that capture, for example, motor function, cognition, and behavior using apps, wearables, and tracking systems are becoming increasingly established. However, given the high prevalence of cognitive impairment in PD, digital cognitive biomarkers to predict mental progression are important in clinical practice. This pilot study aimed to identify those components of our digital version of the TMT (dTMT) that allow discrimination between PD patients with and without cognitive deficits. A total of 30 healthy control (age 66.3 ± 8.61) and 30 participants with PD (age 68.3 ± 9.66) performed the dTMT using a touch-sensitive tablet to capture enhanced performance metrics, such as the speed between and inside circles. The decomposition of cognitive abilities based on integrating additional variables in the dTMT revealed that the Parkinson's disease group was significantly more sensitive to parameters of inhibitory control. In contrast, the mild cognitive impairment group was sensitive to parameters of cognitive flexibility and working memory. The dTMT allows objective, ecologically valid, and long-term cognitive and fine-motor performance tracking, suggesting its potential as a digital biomarker in neurodegenerative disorders.
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Affiliation(s)
- Soo-Yong Park
- Department of Sport Psychology & Human Movement Performance, Institute of Sport and Exercise Science, University of Stuttgart, Stuttgart, Germany
| | - Nadja Schott
- Department of Sport Psychology & Human Movement Performance, Institute of Sport and Exercise Science, University of Stuttgart, Stuttgart, Germany
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14
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Yamada Y, Kobayashi M, Shinkawa K, Nemoto M, Ota M, Nemoto K, Arai T. Characteristics of Drawing Process Differentiate Alzheimer’s Disease and Dementia with Lewy Bodies. J Alzheimers Dis 2022; 90:693-704. [DOI: 10.3233/jad-220546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Early differential diagnosis of Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB) is important for treatment and disease management, but it remains challenging. Although computer-based drawing analysis may help differentiate AD and DLB, it has not been extensively studied. Objective: We aimed to identify the differences in features characterizing the drawing process between AD, DLB, and cognitively normal (CN) individuals, and to evaluate the validity of using these features to identify and differentiate AD and DLB. Methods: We collected drawing data with a digitizing tablet and pen from 123 community-dwelling older adults in three clinical diagnostic groups of mild cognitive impairment or dementia due to AD (n = 47) or Lewy body disease (LBD; n = 27), and CN (n = 49), matched for their age, sex, and years of education. We then investigated drawing features in terms of the drawing speed, pressure, and pauses. Results: Reduced speed and reduced smoothness in speed and pressure were observed particularly in the LBD group, while increased pauses and total durations were observed in both the AD and LBD groups. Machine-learning models using these features achieved an area under the receiver operating characteristic curve (AUC) of 0.80 for AD versus CN, 0.88 for LBD versus CN, and 0.77 for AD versus LBD. Conclusion: Our results indicate how different types of drawing features were particularly discriminative between the diagnostic groups, and how the combination of these features can facilitate the identification and differentiation of AD and DLB.
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Affiliation(s)
| | | | | | - Miyuki Nemoto
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Miho Ota
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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15
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Linari I, Juantorena GE, Ibáñez A, Petroni A, Kamienkowski JE. Unveiling Trail Making Test: visual and manual trajectories indexing multiple executive processes. Sci Rep 2022; 12:14265. [PMID: 35995786 PMCID: PMC9395513 DOI: 10.1038/s41598-022-16431-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 07/11/2022] [Indexed: 11/20/2022] Open
Abstract
The Trail Making Test (TMT) is one of the most popular neuropsychological tests for executive functions (EFs) assessment. It presents several strengths: it is sensitive to executive dysfunction, it is easy to understand, and has a short administration. However, it has important limitations. First, the underlying EFs articulated during the task are not well discriminated, which makes it a test with low specificity. Second, the pen-and-paper version presents one trial per condition which introduces high variability. Third, only the total time is quantified, which does not allow for a detailed analysis. Fourth, it has a fixed spatial configuration per condition. We designed a computerised version of the TMT to overcome its main limitations and evaluated it in a group of neurotypical adults. Eye and hand positions are measured with high resolution over several trials, and spatial configuration is controlled. Our results showed a very similar performance profile compared to the traditional TMT. Moreover, it revealed differences in eye movements between parts A and B. Most importantly, based on hand and eye movements, we found an internal working memory measure that showed an association to a validated working memory task. Additionally, we proposed another internal measure as a potential marker of inhibitory control. Our results showed that EFs can be studied in more detail using traditional tests combined with powerful digital setups. The cTMT showed potential use in older adult populations and patients with EFs disorders.
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Affiliation(s)
- Ignacio Linari
- Laboratorio de Inteligencia Artificial Aplicada, Instituto de Ciencias de la Computación, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires - CONICET, Buenos Aires, Argentina
| | - Gustavo E Juantorena
- Laboratorio de Inteligencia Artificial Aplicada, Instituto de Ciencias de la Computación, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires - CONICET, Buenos Aires, Argentina
| | - Agustín Ibáñez
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, and National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, USA.,Trinity College Dublin (TCD), Dublin, Ireland.,Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Agustín Petroni
- Laboratorio de Inteligencia Artificial Aplicada, Instituto de Ciencias de la Computación, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires - CONICET, Buenos Aires, Argentina.,University of Gothenburg, Gothenburg, Sweden
| | - Juan E Kamienkowski
- Laboratorio de Inteligencia Artificial Aplicada, Instituto de Ciencias de la Computación, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires - CONICET, Buenos Aires, Argentina. .,Maestría de Explotación de Datos y Descubrimiento del Conocimiento, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina. .,Departamento de Computación, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Pabellón 1, Ciudad Universitaria, (1428) Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
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16
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Bulten R, Bedard C, Graham JD, Cairney J. Effect of cognitively engaging physical activity on executive functions in children. Front Psychol 2022; 13:841192. [PMID: 36059731 PMCID: PMC9428577 DOI: 10.3389/fpsyg.2022.841192] [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: 12/22/2021] [Accepted: 07/06/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose Physical activity (PA) has been shown to enhance executive functions (EFs) in children, and PA involving a cognitive component may confer additional benefit. The purpose of this study was to investigate whether cognitively engaging PA impacts EF, and whether affect and fitness act as either mediators or moderators of this relationship. Methods A randomized controlled trial was utilized to assess changes in EFs between a 20-min Dual Task (intervention condition), a PA Task (control condition), and a Cognitive Task (control condition). Children were scheduled for two visits in the INfant and Child Health (INCH) Lab at the University of Toronto. Physical fitness was assessed using the 20 m shuttle run, standing long jump, and grip strength tests. EFs were assessed using the Stroop Task, Trail Making Task (TMT), and Forward Working Memory Task (FWMT). Results 38 children (Mage = 11.95 years, SD = 0.49, 61% female) participated. Repeated measures ANOVA showed main interactions between time on inhibition scores (p < 0.05, ηp2 = 0.489), and positive affect scores (p < 0.01, ηp2 = 0.284). Interaction effects between condition and time were not significant (p = 0.787, ηp2 = 0.014, p = .333, ηp2 = 0.061, p = 0.799, ηp2 = 0.013 for inhibition, switching, and passive working memory, respectively). Results showed no significant mediation effect of affect (95% CI = –0.5915, 2.147), or moderating effect between fitness and EF changes. Conclusion Possible explanations for these findings include inadequate cognitive engagement, lack of EF transfer, and statistical power. Results suggest any of these interventions may be beneficial for improving inhibition and positive affect in children.
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Affiliation(s)
- Rheanna Bulten
- Michael G. DeGroote Centre for Learning and Discovery, McMaster University, Hamilton, ON, Canada
| | - Chloe Bedard
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Jeffrey D. Graham
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - John Cairney
- School of Human Movement and Nutritional Sciences, The University of Queensland, Brisbane, QLD, Australia
- *Correspondence: John Cairney,
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17
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Libon DJ, Swenson R, Lamar M, Price CC, Baliga G, Pascual-Leone A, Au R, Cosentino S, Andersen SL. The Boston Process Approach and Digital Neuropsychological Assessment: Past Research and Future Directions. J Alzheimers Dis 2022; 87:1419-1432. [PMID: 35466941 DOI: 10.3233/jad-220096] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Neuropsychological assessment using the Boston Process Approach (BPA) suggests that an analysis of the strategy or the process by which tasks and neuropsychological tests are completed, and the errors made during test completion convey much information regarding underlying brain and cognition and are as important as overall summary scores. Research over the last several decades employing an analysis of process and errors has been able to dissociate between dementia patients diagnosed with Alzheimer's disease, vascular dementia associated with MRI-determined white matter alterations, and Parkinson's disease; and between mild cognitive impairment subtypes. Nonetheless, BPA methods can be labor intensive to deploy. However, the recent availability of digital platforms for neuropsychological test administration and scoring now enables reliable, rapid, and objective data collection. Further, digital technology can quantify highly nuanced data previously unobtainable to define neurocognitive constructs with high accuracy. In this paper, a brief review of the BPA is provided. Studies that demonstrate how digital technology translates BPA into specific neurocognitive constructs using the Clock Drawing Test, Backward Digit Span Test, and a Digital Pointing Span Test are described. Implications for using data driven artificial intelligence-supported analytic approaches enabling the creation of more sensitive and specific detection/diagnostic algorithms for putative neurodegenerative illness are also discussed.
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Affiliation(s)
- David J Libon
- New Jersey Institute for Successful Aging, Rowan University, School of Osteopathic Medicine, NJ, USA
| | - Rod Swenson
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
| | - Melissa Lamar
- Rush Alzheimer's Disease Center and the Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Catherine C Price
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Ganesh Baliga
- Department of Computer Science, Rowan University, Glassboro, NJ, USA
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew Senior Life, Boston, MA, USA.,Department of Neurology, Harvard Medical School, Boston, MA, USA.,Guttmann Brain Health Institute, Barcelona, Spain
| | - Rhoda Au
- Departments of Anatomy & Neurobiology and Neurology; Framingham Heart Study, Slone Epidemiology Center and Alzheimer's Disease Research Center, Boston University School of Medicine, Boston, MA, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Stephanie Cosentino
- Department of Neurology, Taub Institute and Sergievsky Center, Cognitive Neuroscience Division, Columbia University Medical Center, New York, NY, USA
| | - Stacy L Andersen
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
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18
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Kobayashi M, Yamada Y, Shinkawa K, Nemoto M, Nemoto K, Arai T. Automated Early Detection of Alzheimer's Disease by Capturing Impairments in Multiple Cognitive Domains with Multiple Drawing Tasks. J Alzheimers Dis 2022; 88:1075-1089. [PMID: 35723100 PMCID: PMC9484124 DOI: 10.3233/jad-215714] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Automatic analysis of the drawing process using a digital tablet and pen has been applied to successfully detect Alzheimer's disease (AD) and mild cognitive impairment (MCI). However, most studies focused on analyzing individual drawing tasks separately, and the question of how a combination of drawing tasks could improve the detection performance thus remains unexplored. OBJECTIVE We aimed to investigate whether analysis of the drawing process in multiple drawing tasks could capture different, complementary aspects of cognitive impairments, with a view toward combining multiple tasks to effectively improve the detection capability. METHODS We collected drawing data from 144 community-dwelling older adults (27 AD, 65 MCI, and 52 cognitively normal, or CN) who performed five drawing tasks. We then extracted motion- and pause-related drawing features for each task and investigated the statistical associations of the features with the participants' diagnostic statuses and cognitive measures. RESULTS The drawing features showed gradual changes from CN to MCI and then to AD, and the changes in the features for each task were statistically associated with cognitive impairments in different domains. For classification into the three diagnostic categories, a machine learning model using the features from all five tasks achieved a classification accuracy of 75.2%, an improvement by 7.8% over that of the best single-task model. CONCLUSION Our results demonstrate that a common set of drawing features from multiple drawing tasks can capture different, complementary aspects of cognitive impairments, which may lead to a scalable way to improve the automated detection of AD and MCI.
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19
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Gnambs T. The Web-Based Assessment of Mental Speed. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2022. [DOI: 10.1027/1015-5759/a000711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Although web-based cognitive assessments have gained increasing attention in recent decades, it is still debated whether unstandardized test settings allow for comparable measurements as compared to proctored testing, particularly for speeded cognitive tests. Therefore, two within-subject experiments ( N = 73 and N = 72) compared differences in means, criterion correlations with measures of intelligence, and subjective test quality perceptions of a trail-making test between a proctored paper-based, a proctored computerized, and an unproctored web-based administration mode. The results in both samples showed equivalent means between the two computerized modes, equivalent criterion correlations between the three modes, and no differential item functioning. However, the web-based tests were rated as having an inferior measurement quality as compared to the proctored assessments. Thus, web-based testing allows for comparable measurements of mental speed as compared to traditional computerized tests, although it is still regarded as a lower quality medium by test takers.
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Affiliation(s)
- Timo Gnambs
- Leibniz Institute for Educational Trajectories, Bamberg, Germany
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20
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Yamada Y, Shinkawa K, Kobayashi M, Badal VD, Glorioso D, Lee EE, Daly R, Nebeker C, Twamley EW, Depp C, Nemoto M, Nemoto K, Kim HC, Arai T, Jeste DV. Automated Analysis of Drawing Process to Estimate Global Cognition in Older Adults: Preliminary International Validation on the US and Japan Data Sets. JMIR Form Res 2022; 6:e37014. [PMID: 35511253 PMCID: PMC9121219 DOI: 10.2196/37014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/25/2022] [Accepted: 04/05/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND With the aging of populations worldwide, early detection of cognitive impairments has become a research and clinical priority, particularly to enable preventive intervention for dementia. Automated analysis of the drawing process has been studied as a promising means for lightweight, self-administered cognitive assessment. However, this approach has not been sufficiently tested for its applicability across populations. OBJECTIVE The aim of this study was to evaluate the applicability of automated analysis of the drawing process for estimating global cognition in community-dwelling older adults across populations in different nations. METHODS We collected drawing data with a digital tablet, along with Montreal Cognitive Assessment (MoCA) scores for assessment of global cognition, from 92 community-dwelling older adults in the United States and Japan. We automatically extracted 6 drawing features that characterize the drawing process in terms of the drawing speed, pauses between drawings, pen pressure, and pen inclinations. We then investigated the association between the drawing features and MoCA scores through correlation and machine learning-based regression analyses. RESULTS We found that, with low MoCA scores, there tended to be higher variability in the drawing speed, a higher pause:drawing duration ratio, and lower variability in the pen's horizontal inclination in both the US and Japan data sets. A machine learning model that used drawing features to estimate MoCA scores demonstrated its capability to generalize from the US dataset to the Japan dataset (R2=0.35; permutation test, P<.001). CONCLUSIONS This study presents initial empirical evidence of the capability of automated analysis of the drawing process as an estimator of global cognition that is applicable across populations. Our results suggest that such automated analysis may enable the development of a practical tool for international use in self-administered, automated cognitive assessment.
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Affiliation(s)
| | | | | | - Varsha D Badal
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States
| | - Danielle Glorioso
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States
| | - Ellen E Lee
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,VA San Diego Healthcare System, San Diego, CA, United States
| | - Rebecca Daly
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States
| | - Camille Nebeker
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States
| | - Elizabeth W Twamley
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,VA San Diego Healthcare System, San Diego, CA, United States
| | - Colin Depp
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States
| | - Miyuki Nemoto
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Ho-Cheol Kim
- AI and Cognitive Software, IBM Almaden Research Center, San Jose, CA, United States
| | - Tetsuaki Arai
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Dilip V Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States.,Department of Neurosciences, University of California San Diego, La Jolla, CA, United States
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21
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Harvie G, Braund TA, Kohn MR, Korgaonkar MS, Clarke S, Williams LM, Griffiths KR. Cognitive and Executive Contributions to Trail-Making Task Performance on Adolescents With and Without Attention Deficit Hyperactivity Disorder. J Atten Disord 2022; 26:881-892. [PMID: 34384270 DOI: 10.1177/10870547211036743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The trail making task is used to assess executive functioning in ADHD youth, yet has only been validated in adult populations. We compare the relative contributions of various cognitive measures to performance on a trail making task analog, the Switching of Attention (SoA) task, in typically-developing and ADHD adolescents. METHOD Participants were 160 adolescents with ADHD from the International Study to Predict Optimized Treatment-in ADHD, assessed at pretreatment baseline and 6-week medicated follow-up, and 160 matched typically-developing peers. Attention, processing speed, working memory, impulsivity, and motor speed were assessed using a cognitive battery. RESULTS Processing speed and working memory significantly contributed to SoA performance in ADHD, regardless of medication status. While medicated, motor speed also underpinned the prediction of most task measures. For typically-developing adolescents, sustained attention and working memory contributed to SoA performance. CONCLUSION Typically-developing, unmedicated and treated ADHD adolescents recruit different aspects of cognition during SoA completion.
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Affiliation(s)
- Grace Harvie
- The Westmead Institute for Medical Research, NSW, Australia
| | | | - Michael R Kohn
- Westmead Hospital, NSW, Australia.,Westmead Hospital and The Sydney Children's Hospital Network, NSW, Australia
| | | | - Simon Clarke
- Westmead Hospital, NSW, Australia.,Westmead Hospital and The Sydney Children's Hospital Network, NSW, Australia
| | - Leanne M Williams
- Stanford University, CA, USA.,VA Palo Alto Health Care System, CA, USA
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22
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Du M, Andersen SL, Cosentino S, Boudreau RM, Perls TT, Sebastiani P. Digitally generated Trail Making Test data: Analysis using hidden Markov modeling. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12292. [PMID: 35280964 PMCID: PMC8902814 DOI: 10.1002/dad2.12292] [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: 10/02/2021] [Revised: 01/04/2022] [Accepted: 01/16/2022] [Indexed: 06/14/2023]
Abstract
The Trail Making Test (TMT) is a neuropsychological test used to assess cognitive dysfunction. The TMT consists of two parts: TMT-A requires connecting numbers 1 to 25 sequentially; TMT-B requires connecting numbers 1 to 12 and letters A to L sequentially, alternating between numbers and letters. We propose using a digitally recorded version of TMT to capture cognitive or physical functions underlying test performance. We analyzed digital versions of TMT-A and -B to derive time metrics and used Bayesian hidden Markov models to extract additional metrics. We correlated these derived metrics with cognitive and physical function scores using regression. On both TMT-A and -B, digital metrics associated with graphomotor processing test scores and gait speed. Digital metrics on TMT-B were additionally associated with episodic memory test scores and grip strength. These metrics provide additional information of cognitive state and can differentiate cognitive and physical factors affecting test performance.
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Affiliation(s)
- Mengtian Du
- Department of BiostatisticsBoston UniversityBostonMassachusettsUSA
- Analysis Group111 Huntington Ave. 14th floorBostonMA02119USA
| | - Stacy L. Andersen
- Department of MedicineBoston University School of MedicineBostonMassachusettsUSA
| | - Stephanie Cosentino
- Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging BrainColumbia UniversityNew YorkNew YorkUSA
- Gertrude H. Sergievsky CenterColumbia UniversityNew YorkNew YorkUSA
| | - Robert M. Boudreau
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Thomas T. Perls
- Department of MedicineBoston University School of MedicineBostonMassachusettsUSA
| | - Paola Sebastiani
- Institute for Clinical Research and Health Policy StudiesTufts Medical CenterBostonMassachusettsUSA
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23
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Abstract
Internet-connected devices, including personal computers, smartphones, smartwatches, and voice assistants, have evolved into powerful multisensor technologies that billions of people interact with daily to connect with friends and colleagues, access and share information, purchase goods, play games, and navigate their environment. Digital phenotyping taps into the data streams captured by these devices to characterize and understand health and disease. The purpose of this article is to summarize opportunities for digital phenotyping in neurology, review studies using everyday technologies to obtain motor and cognitive information, and provide a perspective on how neurologists can embrace and accelerate progress in this emerging field.
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Affiliation(s)
- Anoopum S. Gupta
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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24
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Genome-wide association study identified INSC gene associated with Trail Making Test Part A and Alzheimer's disease related cognitive phenotypes. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110393. [PMID: 34224794 DOI: 10.1016/j.pnpbp.2021.110393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 06/14/2021] [Accepted: 06/29/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND The Trail Making Test (TMT) Part A (TMT-A) is a good measure of performance on cognitive processing speed. This study aimed to perform a genome-wide association study of TMT-A in Alzheimer's disease (AD). METHODS A total of 757 individuals with TMT-A phenotypes and 620,901 single nucleotide polymorphisms (SNPs) were extracted from the Alzheimer's Disease Neuroimaging Initiative 1 (ADNI-1) cohort. AD related cognitive phenotypes include TMT-A, TMT-B, Functional Activities Questionnaire (FAQ), Clinical Dementia Rating Sum of Boxes (CDR-SB), and Alzheimer's Disease Assessment Scale-Cognitive Subscale 13 (ADAS13). Multivariable linear regression analysis of TMT-A was conducted using PLINK software. The most TMT-A associated gene was tested with Color Trails Test 1 Form A (CTTA), a culturally fair analog of the TMT-A. Functional annotation of SNPs was performed using the RegulomeDB and Genotype-Tissue Expression (GTEx) databases. RESULTS The best signal with TMT-A was rs1108010 (p = 4.34 × 10-8) at 11p15.2 within INSC gene, which was also associated with TMT-B, FAQ, CDR-SB, and ADAS13 (p = 2.47 × 10-4, 8.56 × 10-3, 0.0127 and 0.0188, respectively). Furthermore, suggestive loci were identified such as FOXD2 and CLTA with TMT-A, GBP1/GBP3 with TMT-B, GRIK2 with FAQ, BAALC and CCDC146 with CDR-SB, BAALC and NKAIN2 with ADAS13. Additionally, the best SNP within INSC associated with CTTA was rs7931705 (p = 6.15 × 10-5). Several SNPs had significant eQTLs using GTEx. CONCLUSIONS We identified several genes/loci associated with TMT-A and AD related phenotypes. These findings offer the potential for new insights into the pathogenesis of cognitive function and Alzheimer's disease.
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25
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Baykara E, Kuhn C, Linz N, Tröger J, Karbach J. Validation of a digital, tablet-based version of the Trail-Making-Test in the ∆elta platform. Eur J Neurosci 2021; 55:461-467. [PMID: 34811827 DOI: 10.1111/ejn.15541] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/01/2021] [Accepted: 11/15/2021] [Indexed: 11/26/2022]
Abstract
Using digital technology for neuropsychological assessment is gaining popularity in both clinical and research settings. Digital neuropsychology offers many benefits over the traditional paper-pencil assessments; however, their comparability requires further validation. The aim of this study was to compare a digital, tablet-based Trail Making Test to the standard paper version. In a within-subject design, 108 healthy adults completed both digital and paper Trail Making Test in a counterbalanced order. Each participant also performed other tasks measuring core executive abilities (inhibition, working memory, flexibility) on the tablet. Our findings indicated that the Trail Making Test performance on the two different modalities correlated significantly. Furthermore, correlations of Trail Making Test performance with other cognitive tasks revealed that digital Trail Making Test is comparable to the paper version. However, the modality had a significant effect on Trail Making Test performance, i.e. participants were generally faster on the digital platform. Taken together, our findings suggest that with new normative data, traditional Trail Making Test can be adapted successfully to a digital platform.
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Affiliation(s)
- Ebru Baykara
- Department of Psychology, University of Koblenz-, Landau, Germany
| | - Caroline Kuhn
- Clinical Neuropsychology & Neuropsychological Outpatient Unit, Saarland University, Germany
| | | | - Johannes Tröger
- ki elements UG, Saarland, Germany.,German Research Center for Artificial Intelligence GmbH, Saarland, Germany
| | - Julia Karbach
- Department of Psychology, University of Koblenz-, Landau, Germany
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26
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Wang T, Thielen H, De Preter E, Vangkilde S, Gillebert CR. Encouraging Digital Technology in Neuropsychology: The Theory of Visual Attention on Tablet Devices. Arch Clin Neuropsychol 2021; 36:1450–1464. [PMID: 33621327 DOI: 10.1093/arclin/acab007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Visual attention helps us to selectively process relevant information and is crucial in our everyday interactions with the environment. Not surprisingly, it is one of the cognitive domains that is most frequently affected by acquired brain injury. Reliable assessment of attention deficits is pivotal to neuropsychological examination and helps to optimize individual rehabilitation plans. Compared with conventional pen-and-paper tests, computerized tasks borrowed from the field of experimental psychology bring many benefits, but lab-based experimental setups cannot be easily incorporated in clinical practice. Light-weight and portable mobile tablet devices may facilitate the translation of computerized tasks to clinical settings. One such task is based on the Theory of Visual Attention (TVA), a mathematical model of visual attention. TVA-based paradigms have been widely used to investigate several aspects of visual attention in both fundamental and clinical research, and include measures for general processing capacity as well as stimulus-specific attentional parameters. METHODS This article discusses the benefits of TVA-based assessments compared with frequently used neuropsychological tests of visual attention, and examines the reliability of a tablet-based TVA-based assessment in 59 neurologically healthy participants. RESULTS Pearson's correlations indicate that the tablet-based TVA assessment and the conventional lab-based TVA assessment have a comparable parallel-form (range: .67-.93), test-retest (range: .61-.78), and internal reliability (range: .56-.97). CONCLUSION Our results suggest that tablet-based TVA assessment may be a promising tool to acquire clinical measures of visual attention at low cost at the bedside of the patient.
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Affiliation(s)
- Tianlu Wang
- Department of Brain and Cognition, KU Leuven, Leuven, Belgium
| | - Hella Thielen
- Department of Brain and Cognition, KU Leuven, Leuven, Belgium
| | - Erik De Preter
- Department of Brain and Cognition, KU Leuven, Leuven, Belgium
| | - Signe Vangkilde
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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27
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Ross MK, Demos AP, Zulueta J, Piscitello A, Langenecker SA, McInnis M, Ajilore O, Nelson PC, Ryan KA, Leow A. Naturalistic smartphone keyboard typing reflects processing speed and executive function. Brain Behav 2021; 11:e2363. [PMID: 34612605 PMCID: PMC8613429 DOI: 10.1002/brb3.2363] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/11/2021] [Accepted: 08/31/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The increase in smartphone usage has enabled the possibility of more accessible ways to conduct neuropsychological evaluations. The objective of this study was to determine the feasibility of using smartphone typing dynamics with mood scores to supplement cognitive assessment through trail making tests. METHODS Using a custom-built keyboard, naturalistic keypress dynamics were unobtrusively recorded in individuals with bipolar disorder (n = 11) and nonbipolar controls (n = 8) on an Android smartphone. Keypresses were matched to digital trail making tests part B (dTMT-B) administered daily in two periods and weekly mood assessments. Following comparison of dTMT-Bs to the pencil-and-paper equivalent, longitudinal mixed-effects models were used to analyze daily dTMT-B performance as a function of typing and mood. RESULTS Comparison of the first dTMT-B to paper TMT-B showed adequate reliability (intraclass correlations = 0.74). In our model, we observed that participants who typed slower took longer to complete dTMT-B (b = 0.189, p < .001). This trend was also seen in individual fluctuations in typing speed and dTMT-B performance (b = 0.032, p = .004). Moreover, participants who were more depressed completed the dTMT-B slower than less depressed participants (b = 0.189, p < .001). A practice effect was observed for the dTMT-Bs. CONCLUSION Typing speed in combination with depression scores has the potential to infer aspects of cognition (visual attention, processing speed, and task switching) in people's natural environment to complement formal in-person neuropsychological assessments that commonly include the trail making test.
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Affiliation(s)
- Mindy K Ross
- University of Illinois at Chicago, Chicago, Illinois, USA
| | | | - John Zulueta
- University of Illinois at Chicago, Chicago, Illinois, USA
| | | | | | | | | | - Peter C Nelson
- University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kelly A Ryan
- University of Michigan, Ann Arbor, Michigan, USA
| | - Alex Leow
- University of Illinois at Chicago, Chicago, Illinois, USA
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28
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Spreij LA, Gosselt IK, Visser-Meily JMA, Hoogerbrugge AJ, Kootstra TM, Nijboer TCW. The journey is just as important as the destination-Digital neuropsychological assessment provides performance stability measures in patients with acquired brain injury. PLoS One 2021; 16:e0249886. [PMID: 34242235 PMCID: PMC8270450 DOI: 10.1371/journal.pone.0249886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 03/26/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cognitive performances on neuropsychological paper-and-pencil tests are generally evaluated quantitatively by examining a final score (e.g., total duration). Digital tests allow for a quantitative evaluation of "how" a patient attained a final score, which opens the possibility to assess more subtle cognitive impairment even when final scores are evaluated as normal. We assessed performance stability (i.e., the number of fluctuations in test performance) to investigate (1) differences in performance stability between patients with acquired brain injury (ABI) and healthy controls; (2) the added value of performance stability measures in patients with ABI; and (3) the relation between performance stability and cognitive complaints in daily life in patients with ABI. METHODS We administered three digital neuropsychological tests (Rey Auditory Verbal Learning Test, Trail Making Test, Stroop Colour and Word Test) and the Cognitive Complaints-Participation (CoCo-P) inventory in patients with ABI (n = 161) and healthy controls (n = 91). RESULTS Patients with ABI fluctuated more in their performance on all tests, when compared to healthy controls. Furthermore, 4-15% of patients who performed inside normal range on the conventional final scores were outside normal range on the performance stability measures. The performance stability measures, nor the conventional final scores, were associated with cognitive complaints in daily life. CONCLUSIONS Stability in test performance of patients was clearly dissociable from healthy controls, and may assess additional cognitive weaknesses which might not be observed or objectified with paper-and-pencil tests. More research is needed for developing measures better associated with cognitive complaints.
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Affiliation(s)
- Lauriane A. Spreij
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Isabel K. Gosselt
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Johanna M. A. Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Alex J. Hoogerbrugge
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Timo M. Kootstra
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Tanja C. W. Nijboer
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
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29
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Le TP, Moscardini E, Cowan T, Elvevåg B, Holmlund TB, Foltz PW, Tucker RP, Schwartz EK, Cohen AS. Predicting self-injurious thoughts in daily life using ambulatory assessment of state cognition. J Psychiatr Res 2021; 138:335-341. [PMID: 33895607 DOI: 10.1016/j.jpsychires.2021.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 03/17/2021] [Accepted: 04/08/2021] [Indexed: 01/22/2023]
Abstract
Self-injurious thoughts (SITs) fluctuate considerably from moment to moment. As such, "static" and temporally stable predictors (e.g., demographic variables, prior history) are suboptimal in predicting imminent SITs. This concern is particularly true for "online" cognitive abilities, which are important for understanding SITs, but are typically measured using tests selected for temporal stability. Advances in ambulatory assessments (i.e., real-time assessment in a naturalistic environment) allow for measuring cognition with improved temporal resolution. The present study measured relationships between "state" cognitive performance, measured using an ambulatory-based Trail Making Test, and SITs. Self-reported state hope and social connectedness was also measured. Data were collected using a specially designed mobile application (administered 4x/week up to 28 days) in substance use inpatients (N = 99). Consistent with prior literature, state hope and social connectedness was significantly associated with state SITs. Importantly, poorer state cognitive performance also significantly predicted state SITs, independent of hallmark static and state self-report risk variables. These findings highlight the potential importance of "online" cognition to predict SITs. Ambulatory recording reflects an efficient, sensitive, and ecological valid methodology for evaluating subjective and objectives predictors of imminent SITs.
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Affiliation(s)
- Thanh P Le
- Department of Psychology, Louisiana State University, USA.
| | | | - Tovah Cowan
- Department of Psychology, Louisiana State University, USA
| | - Brita Elvevåg
- Department of Clinical Medicine, University of Tromsø - the Arctic University of Norway, Norway; The Norwegian Centre for eHealth Research, University Hospital of North Norway, Norway
| | - Terje B Holmlund
- Department of Clinical Medicine, University of Tromsø - the Arctic University of Norway, Norway
| | - Peter W Foltz
- Institue of Cognitive Science, University of Colorado Boulder, USA
| | | | | | - Alex S Cohen
- Department of Psychology, Louisiana State University, USA
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30
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Park SY, Reinl M, Schott N. Effects of acute exercise at different intensities on fine motor-cognitive dual-task performance while walking: A functional near-infrared spectroscopy study. Eur J Neurosci 2021; 54:8225-8248. [PMID: 33876859 DOI: 10.1111/ejn.15241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 11/26/2022]
Abstract
Studies on the effects of acute exercises on cognitive functions vary greatly and depend on the duration and intensity of exercise and the type of cognitive tasks. This study aimed to investigate the neural correlates that underpin the acute effects of high-intensity interval (HIIE) versus moderate-intensity continuous exercise (MCE) on fine motor-cognitive performance while walking (dual-task, DT) in healthy young adults. Twenty-nine healthy right-handers (mean age: 25.1 years ± 4.04; 7 female) performed the digital trail-making-test (dTMT) while walking (5 km/h) before and after acute exercise. During task performance, the hemodynamic activation of the frontopolar area (FPA), dorsolateral prefrontal (DLPFC), and motor cortex (M1) was recorded using functional near-infrared spectroscopy (fNIRS). Both HIIE and MCE resulted in improved dTMT performance, as reflected by an increase in the number of completed circles and a reduction in the time within and between circuits (reflecting improvements in working memory, inhibition, and decision making). Notably, HIIE evoked higher cortical activity on all brain areas measured in the present study than the MCE group. To our knowledge, these results provide the first empirical evidence using a mobile neuroimaging approach that both HIIE and MCE improve executive function during walking, likely mediated by increased activation of the task-related area of the prefrontal cortex and the ability to effectively use, among other things, high fitness levels as neural enrichment resources.
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Affiliation(s)
- Soo-Yong Park
- Department of Sport and Exercise Science, Institute of Sport Psychology and Human Movement Performance, University of Stuttgart, Stuttgart, Germany
| | - Maren Reinl
- Department of Sport and Exercise Science, Institute of Sport Psychology and Human Movement Performance, University of Stuttgart, Stuttgart, Germany
| | - Nadja Schott
- Department of Sport and Exercise Science, Institute of Sport Psychology and Human Movement Performance, University of Stuttgart, Stuttgart, Germany
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Málišová E, Dančík D, Heretik A, Abrahámová M, Krakovská S, Brandoburová P, Hajdúk M. Slovak version of the Trail Making Test: Normative data. APPLIED NEUROPSYCHOLOGY. ADULT 2021; 29:1-8. [PMID: 33761301 DOI: 10.1080/23279095.2021.1890596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The Trail Making Test (TMT) is a popular measure of cognitive functioning, especially processing speed and cognitive flexibility. This study aims to provide normative data for the Slovak adult population. The secondary aim is to test the convergent validity by examining relationships of direct and derived indices to other neuropsychological measures. A sample of 487 healthy adults undertook neuropsychological testing. The relationships of TMT scores to demographic variables and other neuropsychological measures were tested. Age was positively correlated with TMT-A (r = 0.444, p < .01), TMT-B (r = 0.426, p < .01), and the B-A index (r = 0.317, p < .01). Years of education were negatively correlated with TMT-B (r = -0.183, p < .01), B-A difference (r = -0.188, p < .01) and B/A ratio (r = -0.119, p < .01). There were no statistically significant differences in performance based on gender. The test scores were correlated with other measures of processing speed and executive functions. Presented normative data are stratified into 7 age categories. For more accurate interpretation, regression equations were calculated to take years of education into account. TMT-A and B performance, as well as B-A difference score, must be interpreted in relation to age, while education can provide additional information. The B/A ratio is independent from age but should be also corrected for educational level.
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Affiliation(s)
- Eva Málišová
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
| | - Daniel Dančík
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
- The Centre for Psychiatric Disorders Research, Science Park, Comenius University, Bratislava, Slovakia
| | - Anton Heretik
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
- The Centre for Psychiatric Disorders Research, Science Park, Comenius University, Bratislava, Slovakia
| | - Miroslava Abrahámová
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
| | - Simona Krakovská
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
- The Memory Centre, Bratislava, Slovakia
| | | | - Michal Hajdúk
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
- The Centre for Psychiatric Disorders Research, Science Park, Comenius University, Bratislava, Slovakia
- The Psychiatric Clinic, Faculty of Medicine, Comenius University, Bratislava, Slovakia
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Dobbs D, Sadeq NA, Peterson L, Sardina A, Tan SC, Brown-Hughes T, Andel R, Gamaldo A. Middle-aged and older Black adults' experiences completing a traditional paper-and-pencil cognitive battery and two contemporary computerized cognitive batteries. AGING NEUROPSYCHOLOGY AND COGNITION 2021; 28:600-615. [PMID: 33754964 DOI: 10.1080/13825585.2020.1802403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Traditional neuropsychological batteries may account for disparities in education and may produce testing anxiety, particularly for older Black adults. Computerized batteries may be more amenable to use. The current study used mixed-methods content analysis to explore the perceptions of middle-aged and older Black adults (N = 92) about the CogState Brief Battery (CSBB) and Joggle® computerized battery and a traditional paper-and-pencil neuropsychological battery. The data was analyzed using Atlas.ti. Themes were developed and qualitative responses were converted to quantitative counts to make comparisons to thematic differences based on demographics. Results: The majority of participants liked all three batteries. There were no differences based on demographics. Two prevalent themes across all three measures for what participants liked were 1) mental stimulation and memory, and 2) challenging. A disliked theme specific to the computerized batteries was personal competence. In summary, an array of accessible cognitive batteries is necessary to address individual preferences.
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Affiliation(s)
- Debra Dobbs
- School of Aging Studies, University of South Florida , Tampa, FL, USA
| | - Nasreen A Sadeq
- School of Aging Studies, University of South Florida , Tampa, FL, USA
| | - Lindsay Peterson
- School of Aging Studies, University of South Florida , Tampa, FL, USA
| | - Angela Sardina
- School of Health and Applied Human Sciences, University of North Carolina Wilmington , Wilmington, NC, USA
| | - Shyuan Ching Tan
- Human Development and Family Studies, The Pennsylvania State University , University Park, PA, USA
| | | | - Ross Andel
- School of Aging Studies, University of South Florida , Tampa, FL, USA
| | - Alyssa Gamaldo
- Human Development and Family Studies, The Pennsylvania State University , University Park, PA, USA
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Curtis A, Gooden JR, Cox CA, Harries T, Peterson V, Enticott PG, Sanfilippo PG, Miller PG, Lubman DI, Manning V. Neurocognitive functioning among people accessing an addiction neuropsychology clinic with and without a history of offending behaviour. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2021; 28:854-866. [PMID: 35694648 PMCID: PMC9176380 DOI: 10.1080/13218719.2021.1873204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Effectiveness of interventions for violent behaviour may be undermined by the presence of neurocognitive impairment, which is known to be common among alcohol and other drug (AOD) users and violent offenders. The current study aimed to examine whether the cognitive functioning of individuals with AOD histories presenting to a specialist addiction neuropsychology service differed according to their offending history (i.e. non-offending, non-violent offending and violent offending), using a retrospective case file audit design. Data were extracted from 190 clients. Tests assessed a breadth of cognitive domains. Violent offenders demonstrated the lowest premorbid IQ out of the three groups, and a significantly higher proportion of violent offenders presented with impaired divided attention and impaired cognitive inhibition compared to non-violent offenders. Rates of impairment across groups were well beyond those expected within the general population. Delivery of both AOD and violence interventions should be adapted to accommodate individuals' cognitive difficulties.
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Affiliation(s)
- Ashlee Curtis
- Centre for Drug Use, Addiction, and Anti-Social Behaviour Research, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - James R. Gooden
- Turning Point, Eastern Health, Richmond, VIC, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Box Hill, VIC, Australia
| | | | - Travis Harries
- Centre for Drug Use, Addiction, and Anti-Social Behaviour Research, School of Psychology, Deakin University, Geelong, VIC, Australia
| | | | | | - Paul G. Sanfilippo
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Peter G. Miller
- Centre for Drug Use, Addiction, and Anti-Social Behaviour Research, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Dan I. Lubman
- Turning Point, Eastern Health, Richmond, VIC, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Richmond, VIC, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
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Siquier A, Andrés P. Cognitive and Behavioral Inhibition Deficits in Parkinson's Disease: The Hayling Test as a Reliable Marker. Front Aging Neurosci 2021; 12:621603. [PMID: 33519424 PMCID: PMC7843521 DOI: 10.3389/fnagi.2020.621603] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/15/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The present study seeks to provide an overview of executive (inhibition and flexibility) deficits in Parkinson's disease (PD) by combining a cognitive and behavioral approach. METHODS Fifteen PD patients and 15 healthy controls underwent a neuropsychological and behavioral assessment including the Hayling and Trails Tests, the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP-RS), the Behavior Rating Inventory of Executive Function (BRIEF-A), and the Short Form-36 Health Survey (SF-36). The level of awareness of executive functioning was also analyzed. We finally explored how these neuropsychological and clinical outcomes could relate to each other. RESULTS PD patients performed significantly worse in both neuropsychological tasks designed to evaluate inhibition abilities. They also reported more inhibition difficulties in everyday life and poorer quality of life. Associations between neuropsychological measures and self-reports were found. Moreover, as indicated by the discrepancy score, PD patients were as accurate as their relatives in self-reporting their executive daily difficulties. CONCLUSION Inhibition and cognitive flexibility impairments assessed by the neuropsychological tests (Hayling and Trails tests) seem to capture daily life executive problems in PD. Furthermore, our study provides a deeper understanding of PD patients' and their relatives' experience of these executive dysfunctions.
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Affiliation(s)
- Antònia Siquier
- Neuropsychology and Cognition Research Group, Department of Psychology, Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Palma, Spain
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain
| | - Pilar Andrés
- Neuropsychology and Cognition Research Group, Department of Psychology, Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Palma, Spain
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain
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Park SY, Schott N. The trail-making-test: Comparison between paper-and-pencil and computerized versions in young and healthy older adults. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1208-1220. [PMID: 33397159 DOI: 10.1080/23279095.2020.1864374] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
One of the key challenges in assessing cognitive performance is to detect not only apparent impairment but to also pick up on subtle differences. Computerized tests benefit especially from the acquisition of fine-grained outcome measures. However, the equivalency of paper-based and computerized tests cannot be assumed. The Trail-Making-Test is a paper-pencil cognitive assessment tool (ppTMT) that has been used in many research studies to evaluate visuomotor abilities and mental flexibility. A digital version of the extended TMT (including a condition measuring fine motor speed) called the dTMT has been developed. This study aims to test (1) reliability, (2) equivalence, and (3) agreement of the ppTMT and dTMT. A total of 53 healthy individuals aged 19 to 82 years of age (22 men, 31 women; mean age 42.2, SD = 22.8) completed three trials per ppTMT and dTMT condition. Part M involves following a predefined path, Part A links numbers randomly distributed in space, in ascending order, and Part B alternates between linking numbers and letters. dTMT scores were highly reproducible, correlated strongly with paper-pencil administered durations, and discriminated young from older adults. Measures of reliability, sensitivity, and clinical meaning for dTMT scores were favorable compared with ppTMT-based testing. Our findings support the comparability of TMT-indices in computerized assessments. While many digital biomarker efforts are in progress (e.g., neurodegenerative disorders), the dTMT sets itself apart through its high sensitivity, the alternate forms, and the additional component measures. In this light, it could serve as a starting point for an early diagnostic tool.
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Affiliation(s)
- Soo-Yong Park
- Institute of Sport and Movement Science, University of Stuttgart, Stuttgart, Germany
| | - Nadja Schott
- Institute of Sport and Movement Science, University of Stuttgart, Stuttgart, Germany
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Design of a Mobile-Based Neurological Assessment Tool for Aging Populations. LECTURE NOTES OF THE INSTITUTE FOR COMPUTER SCIENCES, SOCIAL INFORMATICS AND TELECOMMUNICATIONS ENGINEERING 2021. [DOI: 10.1007/978-3-030-70569-5_11] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Yamada Y, Shinkawa K, Kobayashi M, Caggiano V, Nemoto M, Nemoto K, Arai T. Combining Multimodal Behavioral Data of Gait, Speech, and Drawing for Classification of Alzheimer's Disease and Mild Cognitive Impairment. J Alzheimers Dis 2021; 84:315-327. [PMID: 34542076 PMCID: PMC8609704 DOI: 10.3233/jad-210684] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Gait, speech, and drawing behaviors have been shown to be sensitive to the diagnosis of Alzheimer's disease (AD) and mild cognitive impairment (MCI). However, previous studies focused on only analyzing individual behavioral modalities, although these studies suggested that each of these modalities may capture different profiles of cognitive impairments associated with AD. OBJECTIVE We aimed to investigate if combining behavioral data of gait, speech, and drawing can improve classification performance compared with the use of individual modality and if each of these behavioral data can be associated with different cognitive and clinical measures for the diagnosis of AD and MCI. METHODS Behavioral data of gait, speech, and drawing were acquired from 118 AD, MCI, and cognitively normal (CN) participants. RESULTS Combining all three behavioral modalities achieved 93.0% accuracy for classifying AD, MCI, and CN, and only 81.9% when using the best individual behavioral modality. Each of these behavioral modalities was statistically significantly associated with different cognitive and clinical measures for diagnosing AD and MCI. CONCLUSION Our findings indicate that these behaviors provide different and complementary information about cognitive impairments such that classification of AD and MCI is superior to using either in isolation.
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Affiliation(s)
| | | | | | - Vittorio Caggiano
- Healthcare and Life Sciences, IBM Research, Yorktown Heights, NY, USA
| | - Miyuki Nemoto
- Department of Psychiatry, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Bissig D, Kaye J, Erten‐Lyons D. Validation of SATURN, a free, electronic, self-administered cognitive screening test. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12116. [PMID: 33392382 PMCID: PMC7771179 DOI: 10.1002/trc2.12116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/19/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cognitive screening is limited by clinician time and variability in administration and scoring. We therefore developed Self-Administered Tasks Uncovering Risk of Neurodegeneration (SATURN), a free, public-domain, self-administered, and automatically scored cognitive screening test, and validated it on inexpensive (<$100) computer tablets. METHODS SATURN is a 30-point test including orientation, word recall, and math items adapted from the Saint Louis University Mental Status test, modified versions of the Stroop and Trails tasks, and other assessments of visuospatial function and memory. English-speaking neurology clinic patients and their partners 50 to 89 years of age were given SATURN, the Montreal Cognitive Assessment (MoCA), and a brief survey about test preferences. For patients recruited from dementia clinics (n = 23), clinical status was quantified with the Clinical Dementia Rating (CDR) scale. Care partners (n = 37) were assigned CDR = 0. RESULTS SATURN and MoCA scores were highly correlated (P < .00001; r = 0.90). CDR sum-of-boxes scores were well-correlated with both tests (P < .00001) (r = -0.83 and -0.86, respectively). Statistically, neither test was superior. Most participants (83%) reported that SATURN was easy to use, and most either preferred SATURN over the MoCA (47%) or had no preference (32%). DISCUSSION Performance on SATURN-a fully self-administered and freely available (https://doi.org/10.5061/dryad.02v6wwpzr) cognitive screening test-is well-correlated with MoCA and CDR scores.
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Affiliation(s)
- David Bissig
- Department of NeurologyUniversity of California–DavisSacramentoCaliforniaUSA
| | - Jeffrey Kaye
- Department of NeurologyOregon Health and Science UniversityPortlandOregonUSA
| | - Deniz Erten‐Lyons
- Department of NeurologyVeterans Affairs Medical CenterPortlandOregonUSA
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Bitar D, Walton LM, Schbley B, Mohamed ME, Adel M. Differences in dual task paradigms and executive function ability for recreational athletes in United Arab Emirates. J Phys Ther Sci 2020; 32:698-705. [PMID: 33281283 PMCID: PMC7708006 DOI: 10.1589/jpts.32.698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/04/2020] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study to measure four components of executive function:
(1) cognitive flexibility, (2) inhibition, (3) working memory and (4) processing speed,
along with the ability to dual task in recreational athletes. [Participants and Methods]
This was a cross-sectional study of (n=102) male and female participants, between the ages
of 18–40 years of age across different levels and types of sport related physical
activity. The International Physical Activity Questionnaire (IPAQ), short version, Dual
Task Abilities (DTA) were measured utilizing a quantitative, dual task, gait test and
Executive Function (EF) was measured through Stroop Color Word Test and Trail Making Test.
[Results] Differences in EF and Dual Task-Interference (DTI) in recreational athletes did
not show a significant difference between varying types of sport and level of sport
related activity, with reported values high across all groups. Males reported better dual
task interference abilities than females, though there were no significant differences in
executive function between males and females. Executive function performance was the
highest among the age group (18–24 years) population, but there were no significant
differences between those in the higher age groups (25–34 years) and (35–40 years).
[Conclusion] Overall, those participating in the study exhibited high prevalence of strong
EF ability, regardless of sport activity type or level. This may suggest that type and
level of sport activity may not be important when considering executive function
performance maintenance for recreational athletes.
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Affiliation(s)
- Deema Bitar
- Department of Physiotherapy, University of Sharjah: Sharjah, Non-US 00000, United Arab Emirates
| | - Lori Maria Walton
- Department of Physiotherapy, University of Sharjah: Sharjah, Non-US 00000, United Arab Emirates
| | | | | | | | - Maha Ehab Mohamed
- Department of Physiotherapy, University of Sharjah: Sharjah, Non-US 00000, United Arab Emirates
| | - Mennatallah Adel
- Department of Physiotherapy, University of Sharjah: Sharjah, Non-US 00000, United Arab Emirates
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Digitization of neuropsychological diagnostics: a pilot study to compare three paper-based and digitized cognitive assessments. Aging Clin Exp Res 2020; 33:1585-1597. [PMID: 33001402 PMCID: PMC8203506 DOI: 10.1007/s40520-020-01668-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 07/20/2020] [Indexed: 12/03/2022]
Abstract
Background and objective The number of people suffering from dementia is increasing worldwide and so is the need for reliable and economical diagnostic instruments. Therefore, the aim of this study was to compare the processing times of the neuropsychological tests Trail Making Tests A and B (TMT-A/B) and Color-Word Interference Test (CWIT), which were performed in both digital and paper versions. Methods The pilot study was conducted among 50 healthy participants (age 65–83 years) using a randomized crossover design. The correlations and differences in the individual processing times of the two test versions were statistically analyzed. Further research questions concerned the influence of the individual usage of technology and the technology commitment of participants as well as the influence of the assessed usability on participants’ performance. Results Between the two versions (paper-based vs. digital) statistically significant correlations were found in all tests, e.g., TMT-A r(48) = 0.63, p < 0.01; TMT-B rs(48) = 0.77, p < 0.001). The mean value comparison showed statistically significant differences, e.g., interference table (CWIT) t(49) = 11.24, p < 0.01). Correlations with medium effect were found between the differences in processing times and the individual usage of computer (e.g., rs(48) = − 0.31) and smartphone (rs(48) = − 0.29) and between the processing times of the TMT-B and the usability (rs(48) = 0.29). Conclusions The high correlations between the test procedures appear promising. However, the differences found in the processing times of the two test versions require validation and standardization of digitized test procedures before they can be used in practice.
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Lunardini F, Luperto M, Romeo M, Basilico N, Daniele K, Azzolino D, Damanti S, Abbate C, Mari D, Cesari M, Borghese NA, Ferrante S. Supervised Digital Neuropsychological Tests for Cognitive Decline in Older Adults: Usability and Clinical Validity Study. JMIR Mhealth Uhealth 2020; 8:e17963. [PMID: 32955442 PMCID: PMC7536607 DOI: 10.2196/17963] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/12/2020] [Accepted: 06/03/2020] [Indexed: 12/02/2022] Open
Abstract
Background Dementia is a major and growing health problem, and early diagnosis is key to its management. Objective With the ultimate goal of providing a monitoring tool that could be used to support the screening for cognitive decline, this study aims to develop a supervised, digitized version of 2 neuropsychological tests: Trail Making Test and Bells Test. The system consists of a web app that implements a tablet-based version of the tests and consists of an innovative vocal assistant that acts as the virtual supervisor for the execution of the test. A replay functionality is added to allow inspection of the user’s performance after test completion. Methods To deploy the system in a nonsupervised environment, extensive functional testing of the platform was conducted, together with a validation of the tablet-based tests. Such validation had the two-fold aim of evaluating system usability and acceptance and investigating the concurrent validity of computerized assessment compared with the corresponding paper-and-pencil counterparts. Results The results obtained from 83 older adults showed high system acceptance, despite the patients’ low familiarity with technology. The system software was successfully validated. A concurrent validation of the system reported good ability of the digitized tests to retain the same predictive power of the corresponding paper-based tests. Conclusions Altogether, the positive results pave the way for the deployment of the system to a nonsupervised environment, thus representing a potential efficacious and ecological solution to support clinicians in the identification of early signs of cognitive decline.
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Affiliation(s)
- Francesca Lunardini
- Nearlab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Matteo Luperto
- AISLab, Department of Computer Science, University of Milano, Milano, Italy
| | - Marta Romeo
- School of Computer Science, The University of Manchester, Manchester, United Kingdom
| | - Nicola Basilico
- AISLab, Department of Computer Science, University of Milano, Milano, Italy
| | - Katia Daniele
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Domenico Azzolino
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Nutritional Sciences, University of Milano, Milano, Italy
| | - Sarah Damanti
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Nutritional Sciences, University of Milano, Milano, Italy
| | - Carlo Abbate
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Daniela Mari
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Clinical and Community Sciences, University of Milano, Milano, Italy
| | | | - Simona Ferrante
- Nearlab, Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
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Lai FHY, Dawson D, Yan EWH, Ho ECW, Tsui JWM, Fan SHU, Lee ATK. The validity, reliability and clinical utility of a performance-based executive function assessment in people with mild to moderate dementia. Aging Ment Health 2020; 24:1496-1504. [PMID: 30990085 DOI: 10.1080/13607863.2019.1599818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Performance-based evaluation of executive function by using real-world daily living activities is an important area of study. This approach has been used extensively in evaluating patients after stroke or traumatic brain injury and patients with schizophrenia. Most important is the fact that until now, there has been no validated performance-based evaluation of executive function in people with dementia.Methods: To address that knowledge gap, this study recruited 80 patients diagnosed with dementia and 80 demographically matched healthy controls. The participants were administered tests for evaluating their performance-based executive function (Chinese Multiple Errands Test), their instrumental activities of daily living (Lawton Instrumental Activities of Daily Living Scale, Chinese Version), and their functional disability (Chinese Version of the Disability Assessment for Dementia), along with a cognitive screening test (Montreal Cognitive Assessment, Hong Kong Version) and a neuropsychological test of executive function (Trail-making Test).Results: The Chinese Multiple Errands Test demonstrated excellent inter-rater reliability, test-retest reliability and high internal consistency. Results revealed that the healthy controls out-performed the dementia patients in the performance-based executive function and cognitive screening, but not in the instrumental activities of daily living tests. Additionally, the performance efficiency scores of the older adults with dementia on the Chinese Multiple Errands Test correlated significantly with their performance results on the neuropsychological test of executive function and on the tests of functional disability and cognitive function.Conclusion: Our results indicated that the Chinese Multiple Errands Test is a reliable and valid instrument for assessing executive function in Chinese older people with dementia.
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Affiliation(s)
- Frank Ho-Yin Lai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Deirdre Dawson
- Department of Occupational Science & Occupational Therapy, Rehabilitation Sciences Institute, University of Toronto, Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | | | - Eric Chun-Wui Ho
- Occupational Therapy Department, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | | | | | - Alice Tsz-Kiu Lee
- Occupational Therapy Department, TWGHs Jockey Club Rehabilitation Complex, Aberdeen, Hong Kong
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Thornton IM, Horowitz TS. Searching Through Alternating Sequences: Working Memory and Inhibitory Tagging Mechanisms Revealed Using the MILO Task. Iperception 2020; 11:2041669520958018. [PMID: 33149874 PMCID: PMC7580152 DOI: 10.1177/2041669520958018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/21/2020] [Indexed: 01/04/2023] Open
Abstract
We used the Multi-Item Localisation (MILO) task to examine search through two sequences. In Sequential blocks of trials, six letters and six digits were touched in order. In Mixed blocks, participants alternated between letters and digits. These conditions mimic the A and B variants of the Trail Making Test (TMT). In both block types, targets either vanished or remained visible after being touched. There were two key findings. First, in Mixed blocks, reaction times exhibited a saw-tooth pattern, suggesting search for successive pairs of targets. Second, reaction time patterns for vanish and remain conditions were identical in Sequential blocks-indicating that participants could ignore past targets-but diverged in Mixed blocks. This suggests a breakdown of inhibitory tagging. These findings may help explain the elevated completion times observed in TMT-B, relative to TMT-A.
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Affiliation(s)
- Ian M. Thornton
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Todd S. Horowitz
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Holowaychuk A, Parrott Y, Leung AWS. Exploring the Predictive Ability of the Motor-Free Visual Perception Test (MVPT) and Trail Making Test (TMT) for On-Road Driving Performance. Am J Occup Ther 2020; 74:7405205070p1-7405205070p8. [PMID: 32804625 DOI: 10.5014/ajot.119.040626] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Resuming driving after a change in functional ability is challenging for patients with a neurological condition. Although a combination of assessment tools has been suggested for use in driving evaluation, resources and availability of tools have been a problem. OBJECTIVE To examine the predictive ability of two commonly used tools, the Motor-Free Visual Perception Test (MVPT) and the Trail Making Test, Parts A and B (TMTA and TMTB), on on-road driving performance. DESIGN Retrospective chart review of 82 patient charts between 2015 and 2016. SETTING Local rehabilitation hospital. PARTICIPANTS Eighty-two patients with a primary neurological diagnosis (general neurological condition, n = 13; spinal cord injury, n = 11; stroke, n = 58). OUTCOMES AND MEASURES MVPT, TMTA, and TMTB. RESULTS Among the patients, 36 passed and 46 failed the on-road evaluation. The TMTA and TMTB scores were significantly different between those who passed or failed the on-road evaluation. Logistic regression analyses revealed that the TMTB completion time was the only significant predictor of on-road driving performance (for the all-patient model, 66% prediction accuracy, -2 log-likelihood [LL] = 93.47, exp β = 0.98; for the stroke-only model, 76% prediction accuracy, -2LL = 59.61, exp β = 0.97). CONCLUSIONS AND RELEVANCE Our findings suggest that the TMTB is a better predictor of on-road driving performance for patients with a neurological condition than the MVPT. The findings shed light on the importance of selecting proper tools when assessing driving performance. Future prospective studies with a wider array of predictive variables are recommended to support the present findings. WHAT THIS ARTICLE ADDS Occupational therapists should revisit the use of the MVPT in driving assessment and consider multiple assessment tools when evaluating and predicting driving performance.
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Affiliation(s)
- Ana Holowaychuk
- Ana Holowaychuk, MSc, OT(C), is Occupational Therapist, Department of Occupational Therapy, Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Alberta, Canada
| | - Yolan Parrott
- Yolan Parrott, MSc, OT(C), is Occupational Therapist, Department of Occupational Therapy, Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Alberta, Canada
| | - Ada W S Leung
- Ada W. S. Leung, PhD, OT(C), is Associate Professor, Department of Occupational Therapy, Faculty of Rehabilitation Medicine, and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada;
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Gamaldo AA, Tan SC, Sardina AL, Henzi C, Guest R, Ross LA, Willingham K, Zonderman AB, Andel RA. Older Black Adults' Satisfaction and Anxiety Levels After Completing Alternative Versus Traditional Cognitive Batteries. J Gerontol B Psychol Sci Soc Sci 2020; 75:1462-1474. [PMID: 30265365 PMCID: PMC7530491 DOI: 10.1093/geronb/gby095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The objective of this study was to examine satisfaction, test anxiety, and performance using computer-based cognitive batteries versus a paper-and-pencil neuropsychological battery among older Blacks. METHOD Self-identified Black adults (n = 87, age range: 55-86; mean education = 14) completed two computer-based tests (CogState and Joggle) and a paper-and-pencil neuropsychological battery. After each battery, participants reported their testing anxiety and satisfaction using the batteries. Descriptive, correlational, and regression analyses compared satisfaction, anxiety, and performance across the batteries. RESULTS Majority of the participants reported more satisfaction with the computer-based (Joggle: 66%; CogState: 77%) than the neuropsychological (52%) battery. Participants also reported less testing anxiety after completing the computer-based batteries than the neuropsychological battery, F(2, 172) = 22.96, p < .001. Older adults' familiarity and comfort level with the computer were not associated with their performance on the computer-based tests (p > .05). Although testing anxiety was not associated with performance across the batteries, age and education quality were uniquely associated with performance on the CogState and neuropsychological batteries. CONCLUSIONS Computer-based cognitive batteries appear to be less intimidating than the commonly used paper-and-pencil neuropsychological tests for Black adults. Thus, these cognitive batteries may be useful tools for monitoring older Blacks' cognitive status.
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Affiliation(s)
- Alyssa A Gamaldo
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
- School of Aging Studies, University of South Florida, Tampa, Florida
- Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, Maryland
| | - Shyuan Ching Tan
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
| | - Angie L Sardina
- School of Health and Applied Human Sciences, University of North Carolina Wilmington, Wilmington, North Carolina
| | - Carolyn Henzi
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
| | - Rosalyn Guest
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
| | - Lesley A Ross
- Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania
| | - Kurtis Willingham
- Aging Studies, School of Medicine, Tulane University, New Orleans, Louisiana
| | - Alan B Zonderman
- Behavioral Epidemiology Section, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, Maryland
| | - Ross A Andel
- School of Aging Studies, University of South Florida, Tampa, Florida
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Jyotsna C, Amudha J, Rao R, Nayar R. Intelligent gaze tracking approach for trail making test. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2020. [DOI: 10.3233/jifs-179711] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- C. Jyotsna
- Department of Computer Science & Engineering, Amrita School of Engineering, Bengaluru, Amrita Vishwa Vidyapeetham, India
| | - J. Amudha
- Department of Computer Science & Engineering, Amrita School of Engineering, Bengaluru, Amrita Vishwa Vidyapeetham, India
| | - Raghavendra Rao
- Health Care Global Enterprises Ltd (HCG) Hospitals, Bengaluru, India
| | - Ravi Nayar
- Health Care Global Enterprises Ltd (HCG) Hospitals, Bengaluru, India
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Thornton IM. MILO Mobile: An iPad App to Measure Search Performance in Multi-Target Sequences. Iperception 2020; 11:2041669520932587. [PMID: 32612800 PMCID: PMC7307404 DOI: 10.1177/2041669520932587] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/15/2020] [Indexed: 01/18/2023] Open
Abstract
This article introduces a mobile app version of the Multi-Item Localization (MILO) task. The MILO task was designed to explore the temporal context of search through a sequence and has proven useful in both basic and applied research settings. Here, we describe the basic features of the app and how it can be obtained, installed, and modified. We also provide example data files and present two new sets of empirical data to verify that previous findings concerning prospective planning and retrospective memory (i.e., inhibitory tagging) are reproducible with the app. We conclude by discussing ongoing studies and future modifications that illustrate the flexibility and potential of the MILO Mobile app.
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Affiliation(s)
- Ian M. Thornton
- Department of Cognitive Science,
Faculty of Media and Knowledge Sciences, University of
Malta
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Hannukkala MS, Mikkonen K, Laitinen E, Tuononen T. Staying on the digitalized trail. HEALTH AND TECHNOLOGY 2020. [DOI: 10.1007/s12553-020-00425-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Saarikivi KA, Huotilainen M, Tervaniemi M, Putkinen V. Selectively Enhanced Development of Working Memory in Musically Trained Children and Adolescents. Front Integr Neurosci 2019; 13:62. [PMID: 31780907 PMCID: PMC6851266 DOI: 10.3389/fnint.2019.00062] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 10/07/2019] [Indexed: 11/17/2022] Open
Abstract
In the current longitudinal study, we investigated the development of working memory in musically trained and nontrained children and adolescents, aged 9-20. We measured working memory with the Digit Span (DS) forwards and backwards tests (N = 106) and the Trail-Making A and B (TMT-A and B; N = 104) tests three times, in 2011, 2013, and 2016. We expected that musically trained participants would outperform peers with no musical training. Indeed, we found that the younger musically trained participants, in particular, outperformed their nontrained peers in the TMT-A, TMT-B and DS forwards tests. These tests all primarily require active maintenance of a rule in memory or immediate recall. In contrast, we found no group differences in the backwards test that requires manipulation and updating of information in working memory. These results suggest that musical training is more strongly associated with heightened working memory capacity and maintenance than enhanced working memory updating, especially in late childhood and early adolescence.
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Affiliation(s)
- Katri Annukka Saarikivi
- Cognitive Brain Research Unit, University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Minna Huotilainen
- Department of Psychology and Logopedics, Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
| | - Mari Tervaniemi
- Department of Psychology and Logopedics, Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- CICERO Learning, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
| | - Vesa Putkinen
- Department of Psychology and Logopedics, Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Turku PET Centre, Turku, Finland
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Björngrim S, van den Hurk W, Betancort M, Machado A, Lindau M. Comparing Traditional and Digitized Cognitive Tests Used in Standard Clinical Evaluation - A Study of the Digital Application Minnemera. Front Psychol 2019; 10:2327. [PMID: 31681117 PMCID: PMC6813236 DOI: 10.3389/fpsyg.2019.02327] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 09/30/2019] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to compare a new digitized cognitive test battery, Minnemera, with its correspondent traditional paper-based cognitive tests. Eighty-one healthy adults between the ages of 21 and 85 participated in the study. Participants performed the two different test versions (traditional paper-based and digitized) with an interval of four weeks between the tests. Test presentation (the order of the test versions presented) was counterbalanced in order to control for any possible test learning effects. The digitized tests were constructed so that there were only minor differences when compared to the traditional paper-based tests. Test results from the paper-based and digitized versions of the cognitive screening were compared within individuals by means of a correlation analysis and equivalence tests. The effects of demographic variables (age, gender and level of education) and test presentation were explored for each test measure and each test version through linear regression models. For each test measure, a significant correlation between traditional and digitized version was observed ranging between r = 0.34 and r = 0.67 with a median of r = 0.53 (corresponding to a large effect size). Score equivalence was observed for five out of six tests. In line with previous traditional cognitive studies, age was found to be the most prominent predictor of performance in all digitized tests, with younger participants performing better than older adults. Gender was the second strongest predictor, where women outperformed men in tests measuring verbal memory; men performed better than women in tests with a strong visual component. Finally, the educational level of the test subjects had an effect on executive functions, with a higher educational level linked to a better inhibition response and working memory span. This study suggests that the tests in the Minnemera cognitive screening battery are acceptably comparable to the traditional paper-based counterparts.
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Affiliation(s)
- Stina Björngrim
- Department of Psychology, University of Stockholm, Stockholm, Sweden
| | | | - Moises Betancort
- Department of Clinical Psychology, Psychobiology and Methodology, Faculty of Psychology, University of La Laguna, Tenerife, Spain
| | - Alejandra Machado
- Mindmore AB, Stockholm, Sweden.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Maria Lindau
- Department of Psychology, University of Stockholm, Stockholm, Sweden
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