Traditional Neuropsychological Testing Does Not Predict Motor-Cognitive Test Performance

Linear brain measurement: a new screening method for cognitive impairment in elderly patients with cerebral small vessel disease

Background

The old adults have high incidence of cognitive impairment, especially in patients with cerebral small vessel disease (CSVD). Cognitive impairment is not easy to be detected in such populations. We aimed to develop clinical prediction models for different degrees of cognitive impairments in elderly CSVD patients based on conventional imaging and clinical data to determine the better indicators for assessing cognitive function in the CSVD elderly.

Methods

210 CSVD patients were screened out by the evaluation of Magnetic Resonance Imaging (MRI). Then, participants were divided into the following three groups according to the cognitive assessment results: control, mild cognitive impairment (MCI), and dementia groups. Clinical data were collected from all patients, including demographic data, biochemical indicators, carotid ultrasound, transcranial Doppler (TCD) indicators, and linear measurement parameters based on MRI.

Results

Our results showed that the brain atrophy and vascular lesions developed progressive worsening with increased degree of cognitive impairment. Crouse score and Interuncal distance/Bitemporal distance (IUD/BTD) were independent risk factors for MCI in CSVD patients, and independent risk factors for dementia in CSVD were Crouse Score, the pulsatility index of the middle cerebral artery (MCAPI), IUD/BTD, and Sylvian fissure ratio (SFR). Overall, the parameters with high performance were the IUD/BTD (OR 2.28; 95% CI 1.26-4.10) and SFR (OR 3.28; 95% CI 1.54-6.91), and the AUC (area under the curve) in distinguishing between CSVD older adults with MCI and with dementia was 0.675 and 0.724, respectively. Linear brain measurement parameters had larger observed effect than other indexes to identify cognitive impairments in CSVD patients.

Conclusion

This study shows that IUD/BTD and SFR are good predictors of cognitive impairments in CSVD elderly. Linear brain measurement showed a good predictive power for identifying MCI and dementia in elderly subjects with CSVD. Linear brain measurement could be a more suitable and novel method for screening cognitive impairment in aged CSVD patients in primary healthcare facilities, and worth further promotion among the rural population.

Validity of the SKILLCOURT® technology for agility and cognitive performance assessment in healthy active adults

Background/Objectives

Agility and cognitive abilities are typically assessed separately by different motor and cognitive tests. While many agility tests lack a reactive decision-making component, cognitive assessments are still mainly based on computer-based or paper-pencil tests with low ecological validity. This study is the first to validate the novel SKILLCOURT technology as an integrated assessment tool for agility and cognitive-motor performance.

Methods

Thirty-two healthy adults performed agility (Star Run), reactive agility (Random Star Run) and cognitive-motor (executive function test, 1-back decision making) performance assessments on the SKILLCOURT. Cognitive-motor tests included lower limb responses in a standing position to increase the ecological validity when compared to computer-based tests. Test results were compared to established motor and agility tests (countermovement jump, 10 m linear sprint, T-agility tests) as well as computer-based cognitive assessments (choice-reaction, Go-NoGo, task switching, memory span). Correlation and multiple regression analyses quantified the relation between SKILLCOURT performance and motor and cognitive outcomes.

Results

Star Run and Random Star Run tests were best predicted by linear sprint (r = 0.68, p < 0.001) and T-agility performance (r = 0.77, p < 0.001), respectively. The executive function test performance was well explained by computer-based assessments on choice reaction speed and cognitive flexibility (r = 0.64, p < 0.001). The 1-back test on the SKILLCOURT revealed moderate but significant correlations with the computer-based assessments (r = 0.47, p = 0.007).

Conclusion

The results support the validity of the SKILLCOURT technology for agility and cognitive assessments in more ecologically valid cognitive-motor tasks. This technology provides a promising alternative to existing performance assessment tools.

Optimizing Reaction Time in Relation to Manual and Foot Laterality in Children Using the Fitlight Technological Systems

The purpose of the study was to design and implement, in the physical and sports education process and in the motor evaluation process, a program of exercises and specific tests to optimize reaction time by using the Fitlight technological systems in relation to the manual and foot laterality of the pupils and identification of gender differences regarding the development of reaction speed. The study included 231 pupils, between 10 and 11 years old, who were divided into two groups according to gender, as follows: the male sample included 109 (97.32%) subjects, and the female sample included 103 (94.45%) participants. All subjects were identified with right manual and foot laterality. Both samples performed a specific exercise program to optimize reaction time in relation to manual and foot laterality by using Fitlight technologies. In the study, four tests were applied in order to evaluate reaction times using Fitlight, two in relation to the manual laterality and two with foot laterality, and the results were statistically processed with IBM SPPS Statistic 24 (IBM Corp., Armonk, NY, USA). Through the comparative analysis of the samples and the progress aimed at optimizing the reaction time specific to our study, it was found that the female sample recorded greater progress at the level of manual laterality, both for the right hand and for the left one, while the sample of boys recorded significant progress in terms of improving reaction time at the level of right and left foot laterality. At the foot laterality level, the results for the executions with the right foot were better in the simple test with four Fitlight spotlights in a line, and for the complex test, with eight Fitlight spotlights in a square, the results were better in the executions with the left foot. This reveals the fact that the greater the execution complexity, the better the motor prevalence on the left side.