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Bhat A. Tele Neuropsychology: Is it a Viable Alternative to Conventional Face-to-Face Testing in the Indian Setting? Ann Indian Acad Neurol 2024; 27:309-310. [PMID: 38912542 PMCID: PMC11232840 DOI: 10.4103/aian.aian_718_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 06/25/2024] Open
Affiliation(s)
- Ashwani Bhat
- Department of Neurology, Himalayan Institute of Medical Sciences, Swami Ram Himalayan University, Dehradun, Uttarakhand, India
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Buhrs S, van Amelsvoort T, Strik J, Prudon S, Lousberg R. The Bivalent Shape Task in a Dutch primary school population: A pilot study for a first psychometric assessment. APPLIED NEUROPSYCHOLOGY. CHILD 2024; 13:126-136. [PMID: 36345054 DOI: 10.1080/21622965.2022.2140049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The Bivalent Shape Task (BST) tests the ability to suppress interfering information. The purpose of this study was to assess some psychometric properties of the BST in 5-11-year-old children, using multilevel analysis. METHODS The present study was initiated in a Dutch primary school in October 2019. The BST was administered as part of a larger neuropsychological assessment. The outbreak of Covid-19 and the subsequential lockdown in the Netherlands led to a premature termination of the study in March 2020. Data of 38 children were available. This dataset was analyzed and labeled as pilot. RESULTS Significant main effects of age, time components, levels, correct answer, and several interactions were found on the reaction time in the predicted direction. Random effects could also be modeled. A final statistical combination model is described. CONCLUSION Despite the small study sample, it seems to be justified to conclude that the BST is a potentially valuable instrument to test interference suppression in 5-11-year-old children. In the analysis of the BST, multilevel analysis has proven to be very rewarding. Since the present study only examined a small part of reliability and validity aspects, further psychometric research is desired.
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Affiliation(s)
- Susan Buhrs
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Jacqueline Strik
- Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sander Prudon
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Richel Lousberg
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
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Lähde N, Basnyat P, Raitanen J, Kämppi L, Lehtimäki K, Rosti-Otajärvi E, Peltola J. Complex executive functions assessed by the trail making test (TMT) part B improve more than those assessed by the TMT part A or digit span backward task during vagus nerve stimulation in patients with drug-resistant epilepsy. Front Psychiatry 2024; 15:1349201. [PMID: 38419904 PMCID: PMC10899669 DOI: 10.3389/fpsyt.2024.1349201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/05/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction There is a paucity of clinical studies examining the long-term effects of vagus nerve stimulation (VNS) on cognition, although a recent study of patients with drug-resistant epilepsy (DRE) treated with VNS therapy demonstrated significant improvement in executive functions as measured by the EpiTrack composite score. The present study aimed to investigate performance variability in three cognitive tests assessing executive functions and working memory in a cohort of DRE patients receiving VNS therapy during a follow-up duration of up to 5 years. Methods The study included 46 DRE patients who were assessed with the Trail Making Test (TMT) (Parts A and B) and Digit Span Backward (DB) task prior to VNS implantation, 6 months and 12 months after implantation, and yearly thereafter as a part of the clinical VNS protocol. A linear mixed-effects (LME) model was used to analyze changes in test z scores over time, accounting for variations in follow-up duration when predicting changes over 5 years. Additionally, we conducted descriptive analyses to illustrate individual changes. Results On average, TMT-A z scores improved by 0.024 units (95% confidence interval (CI): 0.006 to 0.042, p = 0.009), TMT-B z scores by 0.034 units (95% CI: 0.012 to 0.057, p = 0.003), and DB z scores by 0.019 units per month (95% CI: 0.011 to 0.028, p < 0.001). Patients with psychiatric comorbidities achieved the greatest improvements in TMT-B and DB z scores among all groups (0.0058 units/month, p = 0.036 and 0.028 units/month, p = 0.003, respectively). TMT-A z scores improved the most in patients taking 1-2 ASMs as well as in patients with psychiatric comorbidities (0.042 units/month, p = 0.002 and p = 0.003, respectively). Conclusion Performance in all three tests improved at the group level during the follow-up period, with the most robust improvement observed in TMT-B, which requires inhibition control and set-switching in addition to the visuoperceptual processing speed that is crucial in TMT-A and working-memory performance that is essential in DB. Moreover, the improvement in TMT-B was further enhanced if the patient had psychiatric comorbidities.
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Affiliation(s)
- Niina Lähde
- Department of Neurology, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Pabitra Basnyat
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jani Raitanen
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Leena Kämppi
- Epilepsia Helsinki, Member of EpiCARE ERN, Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kai Lehtimäki
- Department of Neurosurgery, Tampere University Hospital, Tampere, Finland
| | - Eija Rosti-Otajärvi
- Department of Neurology, Tampere University Hospital, Tampere, Finland
- Department of Rehabilitation and Psychosocial Support, Tampere University Hospital, Tampere, Finland
| | - Jukka Peltola
- Department of Neurology, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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Chagas MHN, Nery AGS, Bomfim AJDL, Aggio NM. Development and validation of a brief digital cognitive test based on the paradigm of stimulus equivalence in a sample of older adults. Dement Neuropsychol 2023; 17:e20220050. [PMID: 38053644 PMCID: PMC10695439 DOI: 10.1590/1980-5764-dn-2022-0050] [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: 01/31/2023] [Revised: 07/18/2023] [Accepted: 07/30/2023] [Indexed: 12/07/2023] Open
Abstract
With the technological advancement and democratization of electronic devices, computerized cognitive tests have been increasingly used in the clinical context to evaluate cognitive performance in individuals. Objective This study aimed to propose a brief digital cognitive test based on the paradigm of stimulus equivalence and assess its convergent validity by comparing it with traditionally applied tests. Methods The study was carried out with a non-probabilistic sample of 50 older adults selected from a public call through the communication media, health units, and day centers of a city in the countryside of São Paulo. Participants were assessed by the brief digital cognitive test, Mini-Mental State Examination, Brief Cognitive Screening Battery, and the Five Digit Test. Results Participants had a mean age of 71.23 years (standard deviation [SD]: ±9.36) and a mean of 7.15 years of schooling (SD: ±5.34). The mean time to answer the test was 5.33 minutes (SD: ±1.92). There were statistically significant correlations between traditional and digital tests in most domains evaluated. In addition, considering the total score of the digital test, the test could discriminate participants with and without cognitive impairment: area under the ROC curve=0.765; 95%CI 0.630-0.901. Conclusion The brief digital cognitive test, using the stimulus equivalence paradigm, is an easy-to-apply and valid instrument for the investigation of cognitive impairment in older adults.
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Affiliation(s)
- Marcos Hortes Nisihara Chagas
- Universidade Federal de São Carlos, Grupo de Pesquisas em Saúde Mental, Cognição e Envelhecimento, São Carlos SP, Brazil
- Universidade de São Paulo, Programa de Pós-Graduação em Saúde Mental, Ribeirão Preto SP, Brazil
| | - Andreza Gomes Spiller Nery
- Universidade Federal de São Carlos, Grupo de Pesquisas em Saúde Mental, Cognição e Envelhecimento, São Carlos SP, Brazil
| | - Ana Julia de Lima Bomfim
- Universidade Federal de São Carlos, Grupo de Pesquisas em Saúde Mental, Cognição e Envelhecimento, São Carlos SP, Brazil
- Universidade de São Paulo, Programa de Pós-Graduação em Saúde Mental, Ribeirão Preto SP, Brazil
| | - Natalia Mario Aggio
- Universidade de Brasília, Departamento de Processos Psicológicos Básicos, Brasília DF, Brazil
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Wu TY, Hsieh YT, Wang YH, Chiou JM, Chen TF, Lai LC, Chen JH, Chen YC. The association between retinal vascular fractal dimension and cognitive function in the community-dwelling older adults cohort TIGER. J Formos Med Assoc 2023; 122:1050-1060. [PMID: 37085387 DOI: 10.1016/j.jfma.2023.04.001] [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: 09/17/2022] [Revised: 03/12/2023] [Accepted: 04/06/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND/PURPOSE The small retinal vessels reflect cerebral microcirculation and its fractal dimension (Df), representing the complexity of the retinal microcirculation. However, the connection between retinal circulation and cognitive function lacked consistent and longitudinal evidence. This study aimed to explore the association between retinal vascular complexity and cognitive impairment over time in non-demented community-dwelling older adults. METHODS This four-year prospective cohort study (2015-2019) is part of the ongoing Taiwan Initiative for Geriatric Epidemiological Research (TIGER, 2011 to present). Of the 434 older adults (age >65) recruited, 207 participants were included for analysis. The retinal vascular Df was assessed by baseline images from fundus photography (2015-2017). Global (Montreal Cognitive Assessment-Taiwanese version, MoCA-T) and domain-specific cognition were assessed at the baseline and 2-year follow-up (2017-2019). The multivariable linear regression models and generalized linear mixed models were used to evaluate the association of Df with cognitive decline/impairment over time. RESULTS Decreased left retinal vascular complexity was associated with poor attention performance (β = -0.40). As follow-up time increased, decreased vascular complexity was associated with poor memory performance (right: β = -0.25; left: β = -0.19), and decreased right vascular complexity was associated with poor attention performance (β = -0.18). CONCLUSION Low retinal vascular complexity of the right or left eye may be differentially associated with cognitive domains in community-dwelling older adults over two years. The retinal vascular Df of either eye may be served as a screening tool for detecting cognitive impairment in the preclinical phase of dementia.
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Affiliation(s)
- Ting-Yu Wu
- Department of Ophthalmology, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yi-Ting Hsieh
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Hsin Wang
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Jeng-Min Chiou
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Liang-Chuan Lai
- Graduate Institute of Physiology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jen-Hau Chen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Yen-Ching Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
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Hasegawa N, Annaka H. Long-term effect associated with seizures and dynamic effect associated with treatment on cognitive dysfunction of adult patients with focal epilepsy as evaluated by the Trail Making Test. Epileptic Disord 2023; 25:731-738. [PMID: 37518899 DOI: 10.1002/epd2.20137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE This study was performed to clarify the utility of the Trail Making Test (TMT) in evaluating the effects of the course of epilepsy on cognitive function by evaluating the course of epileptic seizures and the results of the TMT over time. METHODS We performed the TMT twice at a 1-year interval for each patient with focal epilepsy. We performed multiple regression analyses with the first TMT scores as dependent variables and clinical features as independent variables. Next, we performed a multivariate analysis of covariance (MANCOVA) to evaluate the difference between the first and second TMT scores for patients in each seizure prognosis group. RESULTS We enrolled 132 adult patients in this study. Multiple regression analyses showed that longer active seizure periods were associated with worse first TMT-B performance (β = .318, p < .001) and B-A (β = .377, p < .001) and that the number of antiseizure medicines was associated with worse first TMT-A performance (β = .186, p = .025). In addition, topiramate and zonisamide adversely affected TMT performance. MANCOVA showed an interaction between the prognosis of TMT-B performance and the seizure prognosis [F(2, 120) = 3.68, p = .028]. Subeffect tests revealed that the second TMT-B performance improved only in the seizure improvement group [F(1, 10) = 10.07, p = .01]. SIGNIFICANCE Epileptic seizures were shown to be associated with both long-term and dynamic adverse effects on cognitive function evaluated with the TMT in adult patients with focal epilepsy. Seizure control is important for improving the cognitive function of patients with epilepsy; however, the potential adverse effects of polypharmacy and some antiseizure medicines such as zonisamide and topiramate on cognitive function should be considered.
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Affiliation(s)
- Naoya Hasegawa
- Department of Psychiatry, National Hospital Organization, Nishiniigata Chuo Hospital Epilepsy Center, Niigata, Japan
| | - Hiroki Annaka
- Department of Occupational Therapy, Faculty of Rehabilitation, Niigata University of Health and Welfare, Niigata, Japan
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Cioffi R, Lubetzky AV. BOXVR Versus Guided YouTube Boxing for Stress, Anxiety, and Cognitive Performance in Adolescents: A Pilot Randomized Controlled Trial. Games Health J 2023; 12:259-268. [PMID: 36745402 PMCID: PMC10254970 DOI: 10.1089/g4h.2022.0202] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: Adolescents frequently experience high levels of anxiety and stress, which can impede quality of life and academic performance. Boxing as a form of exercise has been shown to have mental health benefits in adults. Methods: This study investigated the impact of boxing exercise with a virtual reality (VR) game vs. with a guided video on anxiety, stress, and executive function in adolescents. Participants were randomly assigned to 1 of 3 cohorts: Oculus Rift BOXVR game (n = 14), boxing with a guided workout video (n = 14), or a non-intervention control (n = 14). The BOXVR and guided video groups participated in 10-minute exercise sessions, 5 times a week for 3 weeks. Results: The groups were comparable at baseline on all outcomes. Only BOXVR participants exhibited a significant (p < 0.001) reduction in stress and significant improvements on the Trail Making Test (TMT) B at weekly checkpoints and follow up. All cohorts showed improvements in executive function on the TMT A. At the end of the study, the BOXVR group reported significantly lower stress levels than the guided video group, and significantly better TMT A & B scores than the control group. Only the control group showed a significant reduction in anxiety but the groups were not significantly different in anxiety at the end of the study. The BOXVR group reported significantly greater enjoyment after each exercise session than the guided video group. Conclusion: BOXVR was shown to be effective in reducing adolescent stress and improving executive function over a three-week period. While larger studies with real-life functional outcomes are necessary, boxing with an immersive VR game represents a potential non-pharmaceutical mode to reduce stress in adolescents that is easy to implement in school settings.
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Affiliation(s)
- Rose Cioffi
- Ossining High School, Ossining, New York, USA
| | - Anat V. Lubetzky
- Physical Therapy Department, Steinhardt School of Culture Education and Human Development, New York University, New York City, New York, USA
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Stahl K, Adorjan K, Anderson-Schmidt H, Budde M, Comes AL, Gade K, Heilbronner M, Kalman JL, Klöhn-Saghatolislam F, Oraki Kohshour M, Papiol S, Reich-Erkelenz D, Schaupp SK, Schulte EC, Senner F, Vogl T, Wiltfang J, Reininghaus E, Falkai P, Schulze TG, Bickeböller H, Heilbronner U. Stability over time of scores on psychiatric rating scales, questionnaires and cognitive tests in healthy controls. BJPsych Open 2022; 8:e55. [PMID: 35232513 PMCID: PMC8935911 DOI: 10.1192/bjo.2022.17] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Case-only longitudinal studies are common in psychiatry. Further, it is assumed that psychiatric ratings and questionnaire results of healthy controls stay stable over foreseeable time ranges. For cognitive tests, improvements over time are expected, but data for more than two administrations are scarce. AIMS We comprehensively investigated the longitudinal course for trends over time in cognitive and symptom measurements for severe mental disorders. Assessments included the Trail Making Tests, verbal Digit Span tests, Global Assessment of Functioning, Inventory of Depressive Symptomatology, the Positive and Negative Syndrome Scale, and the Young Mania Rating Scale, among others. METHOD Using the data of control individuals (n = 326) from the PsyCourse study who had up to four assessments over 18 months, we modelled the course using linear mixed models or logistic regression. The slopes or odds ratios were estimated and adjusted for age and gender. We also assessed the robustness of these results using a longitudinal non-parametric test in a sensitivity analysis. RESULTS Small effects were detected for most cognitive tests, indicating a performance improvement over time (P < 0.05). However, for most of the symptom rating scales and questionnaires, no effects were detected, in line with our initial hypothesis. CONCLUSIONS The slightly but consistently improved performance in the cognitive tests speaks of a test-unspecific positive trend, while psychiatric ratings and questionnaire results remain stable over the observed period. These detectable improvements need to be considered when interpreting longitudinal courses. We therefore recommend recruiting control participants if cognitive tests are administered.
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Affiliation(s)
- Katharina Stahl
- Department of Genetic Epidemiology, University Medical Center Göttingen, Germany
| | - Kristina Adorjan
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany
| | - Heike Anderson-Schmidt
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Germany
| | - Ashley L Comes
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Germany
| | - Katrin Gade
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany
| | - Maria Heilbronner
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Germany
| | - Janos L Kalman
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany; and International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | | | - Mojtaba Oraki Kohshour
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Germany; and Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany
| | - Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Germany
| | - Sabrina K Schaupp
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Germany
| | - Eva C Schulte
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany
| | - Fanny Senner
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany
| | - Thomas Vogl
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany; and German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany; and iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Austria
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Germany; Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA; and Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Heike Bickeböller
- Department of Genetic Epidemiology, University Medical Center Göttingen, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Germany
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LEMOS IS, CARVALHO JVSD, MENDES MTG, BRYS I. Mindfulness and relaxation: the effects of a program with university hospital workers. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2021. [DOI: 10.1590/1982-0275202138e190128] [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
Abstract Our study compared the effects of mindfulness and relaxation interventions on stress, quality of life, resilience, and mindfulness levels. A total of 29 workers, recruited at a university hospital in the northeastern region of Brazil and distributed in two groups: Mindfulness (89.5% female, age mean 37.5 ± 6.23 years old); and Relaxation (90.0% female, age mean 34.2 ± 8.66). After eight weeks of daily mindfulness or relaxation practices, both groups significantly reduced the perceived stress and stress at work, and increased their mindfulness and resilience levels, as well as the physical and psychological quality of life domains. Our results suggest that both interventions may be effective in the organizational environment, assisting in health promotion and increasing the ability of individuals to recover from an adversity (resilience).
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Affiliation(s)
| | | | | | - Ivani BRYS
- Universidade Federal do Vale do São Francisco, Brasil
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Hooper B, Faria LO, Fortes LDS, Wanner SP, Albuquerque MR. Development and reliability of a test for assessing executive functions during exercise. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:750-760. [PMID: 32854556 DOI: 10.1080/23279095.2020.1807984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Previous research suggests that performance on executive functions tests may be different at rest, versus when one is engaged in physical exercise. Therefore, the present study aimed to develop an integrated system that evaluates executive functions during exercise. We conducted two test-retest studies, with ten healthy male volunteers participating in each study. Participants visited the laboratory three (Study 1) or four (Study 2) times. During the first visit in both studies, questionnaires were administered, and a maximal cardiopulmonary exercise test (CPT) was performed. In Study 1, during the second and third visits, participants exercised on a cycle ergometer at a moderate intensity for 30 minutes before starting the Flanker/Reverse Flanker test while they were still cycling. In Study 2, during the second visit, participants performed three sets of the executive functions test while sitting on the bike, with a 5 min interval between each set. On visits 3 and 4, participants performed the same exercise protocol as the one described in Study 1. In summary, our results indicated that the Flanker/Reverse Flanker test that we developed and conducted in exercising individuals has similar elements to previous versions and can be considered a reliable test for executive functions assessment during exercise.
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Affiliation(s)
- Beatriz Hooper
- Sports Psychology Laboratory, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Larissa Oliveira Faria
- Sports Psychology Laboratory, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Leonardo de Sousa Fortes
- Associate Graduate Program of Physical Education of Federal University of Paraíba (UFPB), João Pessoa, Brazil
| | - Samuel Penna Wanner
- Sports Psychology Laboratory, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.,Exercise Physiology Laboratory, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Grant A, Metzger GJ, Van de Moortele PF, Adriany G, Olman C, Zhang L, Koopermeiners J, Eryaman Y, Koeritzer M, Adams ME, Henry TR, Uğurbil K. 10.5 T MRI static field effects on human cognitive, vestibular, and physiological function. Magn Reson Imaging 2020; 73:163-176. [PMID: 32822819 DOI: 10.1016/j.mri.2020.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/21/2020] [Accepted: 08/14/2020] [Indexed: 01/18/2023]
Abstract
PURPOSE To perform a pilot study to quantitatively assess cognitive, vestibular, and physiological function during and after exposure to a magnetic resonance imaging (MRI) system with a static field strength of 10.5 Tesla at multiple time scales. METHODS A total of 29 subjects were exposed to a 10.5 T MRI field and underwent vestibular, cognitive, and physiological testing before, during, and after exposure; for 26 subjects, testing and exposure were repeated within 2-4 weeks of the first visit. Subjects also reported sensory perceptions after each exposure. Comparisons were made between short and long term time points in the study with respect to the parameters measured in the study; short term comparison included pre-vs-isocenter and pre-vs-post (1-24 h), while long term compared pre-exposures 2-4 weeks apart. RESULTS Of the 79 comparisons, 73 parameters were unchanged or had small improvements after magnet exposure. The exceptions to this included lower scores on short term (i.e. same day) executive function testing, greater isocenter spontaneous eye movement during visit 1 (relative to pre-exposure), increased number of abnormalities on videonystagmography visit 2 versus visit 1 and a mix of small increases (short term visit 2) and decreases (short term visit 1) in blood pressure. In addition, more subjects reported metallic taste at 10.5 T in comparison to similar data obtained in previous studies at 7 T and 9.4 T. CONCLUSION Initial results of 10.5 T static field exposure indicate that 1) cognitive performance is not compromised at isocenter, 2) subjects experience increased eye movement at isocenter, and 3) subjects experience small changes in vital signs but no field-induced increase in blood pressure. While small but significant differences were found in some comparisons, none were identified as compromising subject safety. A modified testing protocol informed by these results was devised with the goal of permitting increased enrollment while providing continued monitoring to evaluate field effects.
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Affiliation(s)
- Andrea Grant
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States.
| | - Gregory J Metzger
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
| | | | - Gregor Adriany
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
| | - Cheryl Olman
- Department of Psychology, University of Minnesota, Minneapolis, MN, United States
| | - Lin Zhang
- School of Public Health Biostatistics, University of Minnesota, Minneapolis, MN, United States
| | - Joseph Koopermeiners
- School of Public Health Biostatistics, University of Minnesota, Minneapolis, MN, United States
| | - Yiğitcan Eryaman
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
| | - Margaret Koeritzer
- M Health Fairview, Department of Audiology, Minneapolis, MN, United States
| | - Meredith E Adams
- Department of Otolaryngology, Head and Neck Surgery, University of Minnesota, Minneapolis, MN, United States
| | - Thomas R Henry
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States; Department of Neurology, University of Minnesota, Minneapolis, MN, United States
| | - Kamil Uğurbil
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
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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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Vidot H, Cvejic E, Finegan LJ, Shores EA, Bowen DG, Strasser SI, McCaughan GW, Carey S, Allman-Farinelli M, Shackel NA. Supplementation with Synbiotics and/or Branched Chain Amino Acids in Hepatic Encephalopathy: A Pilot Randomised Placebo-Controlled Clinical Study. Nutrients 2019; 11:E1810. [PMID: 31390762 PMCID: PMC6723588 DOI: 10.3390/nu11081810] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Hepatic encephalopathy (HE) is common in patients with cirrhosis and is characterised by reduced hepatic ammonia clearance. This is accompanied by alterations in gut bacteria that may be ameliorated with synbiotics (pro- and prebiotics). Branched chain amino acids (BCAAs) are thought to have a role in the detoxification of ammonia. We investigated the effects of the administration of synbiotics and/or BCAAs in treating HE. METHODS Participants with overt HE were randomised in a blinded placebo-controlled study to receive synbiotics, BCAAs, or a combination of BCAAs and Synbiotics. Relevant biochemical and nutritional data and depression and anxiety scores (DASS-21) were collected at entry, 4 weeks, and on completion, at 8 weeks. The Trail Making Test (TMT) and Inhibitory Control Test (ICT) were used to assess cognitive function in patients withHE. Results were analysed using linear mixed effects regression analyses. RESULTS Sixty-one participants were enrolled and 49 who returned for at least 1 follow-up review were included in the intention to treat analysis. The mean age was 55.8 ± 6.1 years and 86% were males. Despite evidence of a placebo effect, there was significant improvement in TMT B and ICT weighted lures in participants who received combined synbiotics/BCAAs treatment compared to placebo at study completion (p ≤ 0.05). Cognitive improvement occurred without a significant change in ammonia levels. CONCLUSION To our knowledge, this is the first study reporting that combined synbiotics and BCAAs improve HE, and that may be beneficial in the management of HE. A larger study is needed to confirm these results.
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Affiliation(s)
- Helen Vidot
- Department of Nutrition and Dietetics, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
- Liver Injury and Cancer Centre, Centenary Research Institute, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Erin Cvejic
- School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Liam J Finegan
- School of Business, The University of Sydney, Sydney, NSW 2006, Australia
| | - E Arthur Shores
- Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia
| | - David G Bowen
- Liver Injury and Cancer Centre, Centenary Research Institute, The University of Sydney, Sydney, NSW 2006, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006 Australia
- A.W. Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Simone I Strasser
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006 Australia
- A.W. Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Geoffrey W McCaughan
- Liver Injury and Cancer Centre, Centenary Research Institute, The University of Sydney, Sydney, NSW 2006, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW 2006 Australia
- A.W. Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Sharon Carey
- Department of Nutrition and Dietetics, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Margaret Allman-Farinelli
- School of Life and Environmental Sciences Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Nicholas A Shackel
- Department of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
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14
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Abstract
The repeated administration of working memory capacity tests is common in clinical and research settings. For cognitive ability tests and different neuropsychological tests, meta-analyses have shown that they are prone to retest effects, which have to be accounted for when interpreting retest scores. Using a multilevel approach, this meta-analysis aims at showing the reproducibility of retest effects in working memory capacity tests for up to seven test administrations, and examines the impact of the length of the test-retest interval, test modality, equivalence of test forms and participant age on the size of retest effects. Furthermore, it is assessed whether the size of retest effects depends on the test paradigm. An extensive literature search revealed 234 effect sizes from 95 samples and 68 studies, in which healthy participants between 12 and 70 years repeatedly performed a working memory capacity test. Results yield a weighted average of g = 0.28 for retest effects from the first to the second test administration, and a significant increase in effect sizes was observed up to the fourth test administration. The length of the test-retest interval and publication year were found to moderate the size of retest effects. Retest effects differed between the paradigms of working memory capacity tests. These findings call for the development and use of appropriate experimental or statistical methods to address retest effects in working memory capacity tests.
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15
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Weng PH, Chen JH, Chiou JM, Tu YK, Chen TF, Chiu MJ, Tang SC, Yeh SJ, Chen YC. The effect of lifestyle on late-life cognitive change under different socioeconomic status. PLoS One 2018; 13:e0197676. [PMID: 29897986 PMCID: PMC5999076 DOI: 10.1371/journal.pone.0197676] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 05/07/2018] [Indexed: 12/20/2022] Open
Abstract
This study aimed to identify lifestyle factors associated with cognitive change and to explore whether the effect of lifestyle varies by socioeconomic status (SES). Participants aged 65 years and older were recruited from elderly health checkup programs from 2011 to 2013 in Taiwan. Neuropsychological tests, including tests of global cognition, logical memory, executive function, verbal fluency and attention, were administered at baseline (N = 603) and 2 years later (N = 509). After literature review, 9 lifestyle factors and 3 SES indicators were chosen and their effects on cognitive change were evaluated using linear regression adjusting for age, sex, education, APOE ε4 status, and baseline cognitive score. Five lifestyle factors (high vegetable and fish intake, regular exercise, not smoking, and light to moderate alcohol consumption) and 3 SES indicators [annual household income (> 33,333 USD vs. less), occupational complexity (high vs. low mental demanding job), and years of education (> 12 years vs. less)] were found to be protective against cognitive decline (P < 0.1 in any cognitive domains, ß ranging from 0.06 to 0.38). After further adjusting for all the lifestyle and SES factors, fish intake, higher income and occupational complexity remained protective. Significant interactions were found between a healthful lifestyle (defined as having ≥ 3 healthful lifestyle factors) and income on changes of global cognition and verbal fluency (Pinteraction = 0.02 and 0.04). The protective effect of a healthful lifestyle was observed only among participants with lower income in global cognition and logical memory [ß = 0.17, 95% confidence interval (CI) = 0.07–0.26; ß = 0.30, 95% CI = 0.14–0.46]. To the best of our knowledge, this study for the first time explored how the interactions of lifestyle and SES affect cognitive change. Our findings will aid in developing dementia prevention programs and reduce health inequalities.
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Affiliation(s)
- Pei-Hsuan Weng
- Department of Family Medicine, Taiwan Adventist Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jen-Hau Chen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jeng-Min Chiou
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Jang Chiu
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Sung-Chun Tang
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Shin-Joe Yeh
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Ching Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
- Research Center for Genes, Environment and Human Health, College of Public Health, National Taiwan University, Taipei, Taiwan
- * E-mail:
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16
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Völter C, Götze L, Dazert S, Falkenstein M, Thomas JP. Can cochlear implantation improve neurocognition in the aging population? Clin Interv Aging 2018; 13:701-712. [PMID: 29719382 PMCID: PMC5916259 DOI: 10.2147/cia.s160517] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Introduction The relationship between cognition and the ability to hear is well known. Due to changes in demographics, the number of people with sensorineural hearing loss and cognitive impairment is increasing. The aim of this study was to identify the impact of hearing rehabilitation via cochlear implantation on cognitive decline among the aging population. Patients and methods This prospective study included 60 subjects aged between 50 and 84 years (mean 65.8 years, SD=8.9) with a severe to profound bilateral hearing impairment. A computer-based evaluation of short- and long-term memory, processing speed, attention, working memory and inhibition was performed prior to surgery as well as 6 and 12 months after cochlear implantation. Additionally, speech perception at 65 and 80 dB (Freiburger monosyllabic speech test) as well as disease-related (Nijmegen Cochlear Implant Questionnaire) and general (WHOQOL-OLD) quality of life were assessed. Results Six months postimplantation, speech perception, quality of life and also neurocognitive abilities significantly increased. The most remarkable improvement after 6 months was detected in executive functions such as attention (p<0.001), inhibition (p=0.025) and working memory (n-back: p=0.002; operation span task: p=0.008), followed by delayed recall (p=0.03). In contrast, long-term memory showed a significant change of performance only after 12 months (p=0.021). After 6 months, most cognitive domains remained stable, except working memory assessed by the operation span task, which significantly improved between 6 and 12 months (p<0.001). No correlation was found between cognitive results and duration of deafness, speech perception or quality of life. Conclusion Cochlear implantation does not only lead to better speech perception and quality of life, but has also been shown to improve cognitive skills in hearing impaired adults aged 50 years or more. These effects seem to be independent of each other.
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Affiliation(s)
- Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr University Bochum, St. Elisabeth-Hospital, Bochum, Germany
| | - Lisa Götze
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr University Bochum, St. Elisabeth-Hospital, Bochum, Germany
| | - Stefan Dazert
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr University Bochum, St. Elisabeth-Hospital, Bochum, Germany
| | - Michael Falkenstein
- Institute for Work, Learning and Ageing (ALA), Bochum, Germany.,Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Jan Peter Thomas
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr University Bochum, St. Elisabeth-Hospital, Bochum, Germany
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18
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Jonasson LS, Nyberg L, Kramer AF, Lundquist A, Riklund K, Boraxbekk CJ. Aerobic Exercise Intervention, Cognitive Performance, and Brain Structure: Results from the Physical Influences on Brain in Aging (PHIBRA) Study. Front Aging Neurosci 2017; 8:336. [PMID: 28149277 PMCID: PMC5241294 DOI: 10.3389/fnagi.2016.00336] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/23/2016] [Indexed: 11/13/2022] Open
Abstract
Studies have shown that aerobic exercise has the potential to improve cognition and reduce brain atrophy in older adults. However, the literature is equivocal with regards to the specificity or generality of these effects. To this end, we report results on cognitive function and brain structure from a 6-month training intervention with 60 sedentary adults (64-78 years) randomized to either aerobic training or stretching and toning control training. Cognitive functions were assessed with a neuropsychological test battery in which cognitive constructs were measured using several different tests. Freesurfer was used to estimate cortical thickness in frontal regions and hippocampus volume. Results showed that aerobic exercisers, compared to controls, exhibited a broad, rather than specific, improvement in cognition as indexed by a higher "Cognitive score," a composite including episodic memory, processing speed, updating, and executive function tasks (p = 0.01). There were no group differences in cortical thickness, but additional analyses revealed that aerobic fitness at baseline was specifically related to larger thickness in dorsolateral prefrontal cortex (dlPFC), and hippocampus volume was positively associated with increased aerobic fitness over time. Moreover, "Cognitive score" was related to dlPFC thickness at baseline, but changes in "Cognitive score" and dlPFC thickness were associated over time in the aerobic group only. However, aerobic fitness did not predict dlPFC change, despite the improvement in "Cognitive score" in aerobic exercisers. Our interpretation of these observations is that potential exercise-induced changes in thickness are slow, and may be undetectable within 6-months, in contrast to change in hippocampus volume which in fact was predicted by the change in aerobic fitness. To conclude, our results add to a growing literature suggesting that aerobic exercise has a broad influence on cognitive functioning, which may aid in explaining why studies focusing on a narrower range of functions have sometimes reported mixed results.
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Affiliation(s)
- Lars S. Jonasson
- Department of Radiation Sciences, Diagnostic Radiology, Umeå UniversityUmeå, Sweden
- Umeå Center for Functional Brain Imaging, Umeå UniversityUmeå, Sweden
- Center for Demographic and Aging Research, Umeå UniversityUmeå, Sweden
| | - Lars Nyberg
- Department of Radiation Sciences, Diagnostic Radiology, Umeå UniversityUmeå, Sweden
- Umeå Center for Functional Brain Imaging, Umeå UniversityUmeå, Sweden
- Department of Integrative Medical Biology, Physiology, Umeå UniversityUmeå, Sweden
| | - Arthur F. Kramer
- Departments of Psychology and Mechanical and Industrial Engineering, Northeastern UniversityBoston, MA, USA
- Beckman Institute, University of Illinois at Urbana-ChampaignUrbana-Champaign, IL, USA
| | - Anders Lundquist
- Umeå Center for Functional Brain Imaging, Umeå UniversityUmeå, Sweden
- Department of Statistics, Umeå School of Business and Economics, Umeå UniversityUmeå, Sweden
| | - Katrine Riklund
- Department of Radiation Sciences, Diagnostic Radiology, Umeå UniversityUmeå, Sweden
- Umeå Center for Functional Brain Imaging, Umeå UniversityUmeå, Sweden
| | - Carl-Johan Boraxbekk
- Umeå Center for Functional Brain Imaging, Umeå UniversityUmeå, Sweden
- Center for Demographic and Aging Research, Umeå UniversityUmeå, Sweden
- Danish Research Centre for Magnetic Resonance, Copenhagen University HospitalHvidovre, Denmark
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Wiloth S, Lemke N, Werner C, Hauer K. Validation of a Computerized, Game-based Assessment Strategy to Measure Training Effects on Motor-Cognitive Functions in People With Dementia. JMIR Serious Games 2016; 4:e12. [PMID: 27432746 PMCID: PMC4969551 DOI: 10.2196/games.5696] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/26/2016] [Accepted: 07/04/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Exergames often used for training purpose can also be applied to create assessments based on quantitative data derived from the game. A number of studies relate to these use functionalities developing specific assessment tasks by using the game software and provided good data on psychometric properties. However, (1) assessments often include tasks other than the original game task used for training and therefore relate to similar but not to identical or integrated performances trained, (2) people with diagnosed dementia have insufficiently been addressed in validation studies, and (3) studies did commonly not present validation data such as sensitivity to change, although this is a paramount objective for validation to evaluate responsiveness in intervention studies. OBJECTIVE Specific assessment parameters have been developed using quantitative data directly derived from the data stream during the game task of a training device (Physiomat). The aim of this study was to present data on construct validity, test-retest reliability, sensitivity to change, and feasibility of this internal assessment approach, which allows the quantification of Physiomat training effects on motor-cognitive functions in 105 multimorbid patients with mild-to-moderate dementia (mean age 82.7±5.9). METHODS Physiomat assessment includes various tasks at different complexity levels demanding balance and cognitive abilities. For construct validity, motor-cognitive Physiomat assessment tasks were compared with established motor and cognitive tests using Spearman's rank correlations (rs). For test-retest reliability, we used intra-class correlations (ICC3,1) and focused on all Physiomat tasks. Sensitivity to change of trained Physiomat tasks was tested using Wilcoxon statistic and standardized response means (SRMs). Completion rate and time were calculated for feasibility. RESULTS Analyses have mostly shown moderate-to-high correlations between established motor as well as cognitive tests and simple (rs=-.22 to .68, P ≤.001-.03), moderate (rs=-.33 to .71, P ≤.001-.004), and complex motor-cognitive Physiomat tasks (rs=-.22 to .83, P ≤.001-.30) indicating a good construct validity. Moderate-to-high correlations between test and retest assessments were found for simple, moderate, and complex motor-cognitive tasks (ICC=.47-.83, P ≤.001) indicating good test-retest reliability. Sensitivity to change was good to excellent for Physiomat assessment as it reproduced significant improvements (P ≤.001) with mostly moderate-to-large effect sizes (SRM=0.5-2.0) regarding all trained tasks. Completion time averaged 25.8 minutes. Completion rate was high for initial Physiomat measures. No adverse events occurred during assessment. CONCLUSIONS Overall, Physiomat proved to have good psychometric qualities in people with mild-to-moderate dementia representing a reliable, valid, responsive, and feasible assessment strategy for multimorbid older adults with or without cognitive impairment, which relates to identical and integrated performances trained by using the game.
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Affiliation(s)
- Stefanie Wiloth
- AGAPLESION Bethanien Hospital, Geriatric Centre of the University of Heidelberg, Heidelberg, Germany.
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Gagnon MM, Laforce R. Computerized vs. Paper-Pencil Assessment of Cognitive Change following Acute Ischemic Stroke. ACTA ACUST UNITED AC 2016. [PMID: 28649579 PMCID: PMC5482710 DOI: 10.4172/2329-6895.1000317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Importance Cognitive impairment is common among patients with stroke and early recognition can optimize patient care. Objective To determine the validity of computerized cognitive testing in an adult population with acute ischemic stroke. Design Validation study comparing computerized vs paper-pencil assessments at two time points three months apart in a stroke unit. Main outcome Correlation analyses between computerized (using CogState Brief Battery) and paper-pencil testing (using the Montreal Cognitive Assessment) both at study entry and follow-up visits. Results We found moderate to strong significant correlations between the two instruments at study entry and follow-up sessions. Executive dysfunctions were the main cognitive changes. Test-retest correlations were strong. Conclusion and Relevance The CogState Brief Battery is a valid alternative for clinicians who wish to measure cognitive skills following acute ischemic stroke. Limitations of computerized testing are discussed.
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Affiliation(s)
- Maude-Marie Gagnon
- Département des Sciences Neurologiques, CHU de Québec-Université Laval, Québec, Canada.,Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec-Université Laval, Québec, Canada.,Faculty of Medicine, Laval University, Québec, Canada
| | - Robert Laforce
- Département des Sciences Neurologiques, CHU de Québec-Université Laval, Québec, Canada.,Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec-Université Laval, Québec, Canada.,Faculty of Medicine, Laval University, Québec, Canada
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