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Soffer M, Butters MA, Herrmann N, Black SE, Kumar S, Pugh B, Rajji TK, Tartaglia MC, Tang-Wai DF, Freedman M. About time: neurocognitive correlates of stimulus-bound and other time setting errors in the Clock Drawing Test. J Int Neuropsychol Soc 2024; 30:471-478. [PMID: 38088261 DOI: 10.1017/s1355617723011396] [Citation(s) in RCA: 1] [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] [Indexed: 05/09/2024]
Abstract
OBJECTIVE Previous findings suggest that time setting errors (TSEs) in the Clock Drawing Test (CDT) may be related mainly to impairments in semantic and executive function. Recent attempts to dissociate the classic stimulus-bound error (setting the time to "10 to 11" instead of "10 past 11") from other TSEs, did not support hypotheses regarding this error being primarily executive in nature or different from other time setting errors in terms of neurocognitive correlates. This study aimed to further investigate the cognitive correlates of stimulus-bound errors and other TSEs, in order to trace possible underlying cognitive deficits. METHODS We examined cognitive test performance of participants with preliminary diagnoses associated with mild cognitive impairment. Among 490 participants, we identified clocks with stimulus-bound errors (n = 78), other TSEs (n = 41), other errors not related to time settings (n = 176), or errorless clocks (n = 195). RESULTS No differences were found on any dependent measure between the stimulus-bound and the other TSErs groups. Group comparisons suggested TSEs in general, to be associated with lower performance on various cognitive measures, especially on semantic and working memory measures. Regression analysis further highlighted semantic and verbal working memory difficulties as being the most prominent deficits associated with these errors. CONCLUSION TSEs in the CDT may indicate underlying deficits in semantic function and working memory. In addition, results support previous findings related to the diagnostic value of TSEs in detecting cognitive impairment.
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Affiliation(s)
- Matan Soffer
- Centre for Addiction and Mental Health, Toronto, Canada
| | - Meryl A Butters
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nathan Herrmann
- Toronto Dementia Research Alliance, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Sandra E Black
- Toronto Dementia Research Alliance, Toronto, Canada
- Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Medicine (Neurology), Unviversity of Toronto, Toronto, Canada
| | - Sanjeev Kumar
- Centre for Addiction and Mental Health, Toronto, Canada
- Toronto Dementia Research Alliance, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Bradley Pugh
- Toronto Dementia Research Alliance, Toronto, Canada
- Rotman Research Institute, Baycrest Health Sciences Centre, Toronto, ON, Canada
| | - Tarek K Rajji
- Centre for Addiction and Mental Health, Toronto, Canada
- Toronto Dementia Research Alliance, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Maria Carmela Tartaglia
- Toronto Dementia Research Alliance, Toronto, Canada
- Department of Medicine (Neurology), Unviversity of Toronto, Toronto, Canada
- University Health Network Memory Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - David F Tang-Wai
- Toronto Dementia Research Alliance, Toronto, Canada
- Department of Medicine (Neurology), Unviversity of Toronto, Toronto, Canada
- University Health Network Memory Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - Morris Freedman
- Toronto Dementia Research Alliance, Toronto, Canada
- Department of Medicine (Neurology), Unviversity of Toronto, Toronto, Canada
- Rotman Research Institute, Baycrest Health Sciences Centre, Toronto, ON, Canada
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Park J, Jeong E, Seomun G. The clock drawing test: A systematic review and meta‐analysis of diagnostic accuracy. J Adv Nurs 2018; 74:2742-2754. [DOI: 10.1111/jan.13810] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 05/21/2018] [Accepted: 06/05/2018] [Indexed: 11/30/2022]
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Duro D, Tábuas-Pereira M, Freitas S, Santiago B, Botelho MA, Santana I. Validity and Clinical Utility of Different Clock Drawing Test Scoring Systems in Multiple Forms of Dementia. J Geriatr Psychiatry Neurol 2018; 31:114-122. [PMID: 29742972 DOI: 10.1177/0891988718774432] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Clock Drawing Test (CDT) has a known potential for the detection of cognitive impairment in populations with dementia, especially Alzheimer disease (AD). Our aim was to compare the clinical utility of 3 CDT scoring systems (Rouleau, Cahn, and Babins) in several pathologies with cognitive compromise from a tertiary center memory clinic. We selected patients with a clinical diagnosis of mild stage AD, behavioral variant frontotemporal dementia (FTD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and Parkinson disease with dementia (PDD). The results showed significant differences between the several diagnoses with the following pattern of results: AD, DLB < FTD, VaD, PDD. Qualitative analysis of clock drawing errors confirmed the stimulus-bound response as a hallmark of AD, while conceptual deficit was significantly more prevalent in patients with AD and DLB. Our results supported the CDT potential as a cognitive screening measure for mild dementia, particularly sensitive to AD and DLB, especially when we used the Cahn scoring system and its analysis of qualitative errors.
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Affiliation(s)
- Diana Duro
- 1 Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,2 Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Miguel Tábuas-Pereira
- 2 Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Sandra Freitas
- 1 Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Beatriz Santiago
- 2 Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | | | - Isabel Santana
- 1 Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,2 Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Amiri H, Saeidi K, Borhani P, Manafirad A, Ghavami M, Zerbi V. Alzheimer's disease: pathophysiology and applications of magnetic nanoparticles as MRI theranostic agents. ACS Chem Neurosci 2013; 4:1417-29. [PMID: 24024702 PMCID: PMC3837373 DOI: 10.1021/cn4001582] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 09/05/2013] [Indexed: 11/29/2022] Open
Abstract
Alzheimer's disease (AD) is the most common form of dementia. During the recent decade, nanotechnology has been widely considered, as a promising tool, for theranosis (diagnosis and therapy) of AD. Here we first discuss pathophysiology and characteristics of AD with a focus on the amyloid cascade hypothesis. Then magnetic nanoparticles (MNPs) and recent works on their applications in AD, focusing on the superparamagnetic iron oxide nanoparticles (SPIONs), are reviewed. Furthermore, the amyloid-nanoparticle interaction is highlighted, with the scope to be highly considered by the scientists aiming for diagnostics and/or treatment of AD employing nanoparticles. Furthermore, recent findings on the "ignored" parameters (e.g., effect of protein "corona" at the surface of nanoparticles on amyloid-β (Aβ) fibrillation process) are discussed.
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Affiliation(s)
- Houshang Amiri
- Department of Radiology and Department
of Anatomy, Donders Institute for Brain,
Cognition and Behaviour, Radboud University
Nijmegen Medical Centre, 6500HB Nijmegen, The Netherlands
| | - Kolsoum Saeidi
- Department of Medical Genetics and Department of Radiological
Sciences, Kerman University of Medical Sciences, 7618747653 Kerman, Iran
| | - Parvin Borhani
- Department of Medical Genetics and Department of Radiological
Sciences, Kerman University of Medical Sciences, 7618747653 Kerman, Iran
| | - Arash Manafirad
- National Cell Bank, Pasteur Institute of Iran, 13164 Tehran, Iran
| | - Mahdi Ghavami
- National Cell Bank, Pasteur Institute of Iran, 13164 Tehran, Iran
| | - Valerio Zerbi
- Department of Radiology and Department
of Anatomy, Donders Institute for Brain,
Cognition and Behaviour, Radboud University
Nijmegen Medical Centre, 6500HB Nijmegen, The Netherlands
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Teixeira-Arroyo C, Barbieri FA, Vitório R, Pereira MP, Lirani-Silva E, Gobbi LTB. Parâmetros na marcha na paralisia supranuclear progressiva: um estudo de caso. FISIOTERAPIA EM MOVIMENTO 2012. [DOI: 10.1590/s0103-51502012000400021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: Comprometimentos na marcha de pacientes com paralisia supranuclear progressiva (PSP) podem aumentar o risco de quedas durante o andar, especialmente em ambientes complexos. OBJETIVO: Descrever o comportamento locomotor de uma paciente com PSP, nas condições de marcha livre e marcha adaptativa. MATERIAIS E MÉTODOS: Estudo de caso de uma paciente com PSP (71 anos). Para análise cinemática, nas condições de marcha livre, com obstáculo baixo e alto, uma câmera digital registrou uma passada completa da paciente. RESULTADOS: Com o aumento da complexidade do ambiente (marcha livre, obstáculo baixo e alto, respectivamente), foi observada diminuição do comprimento do passo (0,37 ± 0,07; 0,30 ± 0,07; 0,26 ± 0,06 m), do comprimento da passada (0,71 ± 0,11; 0,58 ± 0,15; 0,47 ± 0,07 m) e da velocidade da passada (0,55 ± 0,14; 0,43 ± 0,11; 0,36 ± 0,11 m/s). Aumento progressivo ocorreu na duração do duplo suporte da passada livre (29,47%) para a passada antes do obstáculo alto (41,11%). Observou-se, ainda, ligeira diminuição na distância vertical pé/obstáculo alto (membro/abordagem: 7,18 ± 1,88; e membro/suporte: 8,84 ± 2,57 cm) em relação ao obstáculo baixo (membro de abordagem: 8,86 ± 1,88; e membro de suporte: 11,67 ± 2,09 cm). CONCLUSÃO: A PSP afetou de forma evidente a marcha da paciente. Inflexibilidade para a adaptação da marcha às demandas do ambiente foi observada durante a aproximação e a transposição dos obstáculos, o que pode aumentar o risco de tropeços e quedas.
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Affiliation(s)
| | | | - Rodrigo Vitório
- Universidade Estadual Paulista Júlio de Mesquita Filho, Brasil
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Zhao S, Liu G, Shen Y, Zhao Y. Reasonable neuropsychological battery to identify mild cognitive impairment. Med Hypotheses 2011; 76:50-3. [DOI: 10.1016/j.mehy.2010.08.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2010] [Revised: 08/03/2010] [Accepted: 08/09/2010] [Indexed: 10/19/2022]
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Longitudinal changes in clock drawing test (CDT) performance according to dementia subtypes and severity. Arch Gerontol Geriatr 2010; 53:e179-82. [PMID: 21035204 DOI: 10.1016/j.archger.2010.08.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2010] [Revised: 08/16/2010] [Accepted: 08/18/2010] [Indexed: 11/21/2022]
Abstract
UNLABELLED The CDT requires a patient to draw the face of a clock, insert all the numbers and set the hands for a specified time. This task engages a number of cognitive abilities including verbal understanding, memory, spatially coded knowledge, planning, concentration and visuoconstructive skills. Although CDT has been regarded as a simple and useful screening tool in dementia, little is known about the longitudinal changes in CDT performance and error types, according to dementia subtypes and their severity. MATERIALS AND METHODS Two hundred thirty-five consecutive patients with dementia (Alzheimer disease = AD, n=94, Parkinson's disease with dementia (PDD), n = 119, Vascular dementia = VaD, n = 22) were recruited from the memory clinic at Chungnam University hospital from January 2005 to July 2009. The Korean version of the mini-mental state examination (MMSE-K) and CDT were performed by all participants every 6 months. Scoring of the CDT performance was in accordance with the method of Mano and Wu. Error types of CDT were classified as follows: stimulus-bound response (SBR), conceptual deficit (CD), spatial and/or planning deficit (SPD) and perseveration error (PE). We divided patients into 3 groups by their initial MMSE-K score (severe, MMSE-K ≤ 17; moderate, 18 ≤ MMSE-K < 24; mild, 24 ≤ MMSE-K). Comparisons of CDT scores and error types in the three dementia subtypes and three cognitive groups were conducted. RESULTS Longitudinal changes on CDT and MMSE-K scores were not different between the three dementia subtypes. From the analysis of CDT error type, the most common error type was SPD in patients with mild to moderate dementia. In contrast, CD error was the most frequent in severe dementia group. The order of error frequency in all subjects from baseline to the last follow-up was as follows: SPD, CD, SBR and PE except CD was the most frequent error type in AD patients after 18 months from baseline. CONCLUSION Longitudinal analysis of error on CDT may reflect different characteristics of cognitive deterioration according to dementia subtypes and dementia stages.
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Eschweiler GW, Leyhe T, Klöppel S, Hüll M. New developments in the diagnosis of dementia. DEUTSCHES ARZTEBLATT INTERNATIONAL 2010; 107:677-83. [PMID: 20963198 DOI: 10.3238/arztebl.2010.0677] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Accepted: 12/08/2009] [Indexed: 11/27/2022]
Abstract
BACKGROUND The terms "dementia" and "Alzheimer's disease" are often wrongly used as if they were synonyms. Dementia is a clinical syndrome whose main element is memory impairment; it is due to Alzheimer's disease in more than 75% of cases. Alzheimer's disease, on the other hand, is a neuropathological entity that is characterized by a protracted preclinical phase followed by the onset of slowly progressive dementia. METHODS We here review relevant literature that we retrieved by a selective Medline search (2005-2009), paying special attention to the early diagnosis of Alzheimer's disease, its clinical manifestations, and its relevance in primary care. RESULTS The early clinical manifestations of a dementing illness can be detected in primary care through the use of simple screening tests such as the mini mental state examination, clock drawing tests, and DemTect. A diminished concentration of Abeta-peptide and an increase of (phospho-)tau in the cerebrospinal fluid can suggest the presence of Alzheimer's disease even before the onset of dementia: these substances are components of amyloid plaques and neurofibrillary tangles, which are the characteristic neuropathological lesions of Alzheimer's disease. New types of morphological magnetic resonsance imaging (MRI), and automated analysis of the images obtained, can improve the consistency of radiological assessment over the traditional visual method and thus enable more secure diagnosis. CONCLUSION The early, preclinical phase of Alzheimer's disease involves what has been termed mild cognitive impairment and may last as long as five years until the onset of dementia. With the aid of the new biomarkers described here, the likelihood of diagnosing Alzheimer's disease correctly in this phase can be raised above 80%. Early detection of Alzheimer's disease before the onset of dementia provides an opportunity to study potential approaches for secondary prevention, which are now an object of intense clinical research.
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Affiliation(s)
- Gerhard W Eschweiler
- Universitätsklinik für Psychiatrie und Psychotherapie Tübingen, Geriatrisches Zentrum am Universitätsklinikum Tübingen, Germany.
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CLOCK DRAWING INTERPRETATION SCALE (CDIS) AND NEURO-PSYCHOLOGICAL FUNCTIONS IN OLDER ADULTS WITH MILD AND MODERATE COGNITIVE IMPAIRMENTS. Arch Gerontol Geriatr 2009; 49 Suppl 1:39-48. [DOI: 10.1016/j.archger.2009.09.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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