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Boccardi M, Monsch AU, Ferrari C, Altomare D, Berres M, Bos I, Buchmann A, Cerami C, Didic M, Festari C, Nicolosi V, Sacco L, Aerts L, Albanese E, Annoni JM, Ballhausen N, Chicherio C, Démonet JF, Descloux V, Diener S, Ferreira D, Georges J, Gietl A, Girtler N, Kilimann I, Klöppel S, Kustyniuk N, Mecocci P, Mella N, Pigliautile M, Seeher K, Shirk SD, Toraldo A, Brioschi-Guevara A, Chan KCG, Crane PK, Dodich A, Grazia A, Kochan NA, de Oliveira FF, Nobili F, Kukull W, Peters O, Ramakers I, Sachdev PS, Teipel S, Visser PJ, Wagner M, Weintraub S, Westman E, Froelich L, Brodaty H, Dubois B, Cappa SF, Salmon D, Winblad B, Frisoni GB, Kliegel M. Harmonizing neuropsychological assessment for mild neurocognitive disorders in Europe. Alzheimers Dement 2022; 18:29-42. [PMID: 33984176 PMCID: PMC9642857 DOI: 10.1002/alz.12365] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 03/11/2021] [Accepted: 04/05/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Harmonized neuropsychological assessment for neurocognitive disorders, an international priority for valid and reliable diagnostic procedures, has been achieved only in specific countries or research contexts. METHODS To harmonize the assessment of mild cognitive impairment in Europe, a workshop (Geneva, May 2018) convened stakeholders, methodologists, academic, and non-academic clinicians and experts from European, US, and Australian harmonization initiatives. RESULTS With formal presentations and thematic working-groups we defined a standard battery consistent with the U.S. Uniform DataSet, version 3, and homogeneous methodology to obtain consistent normative data across tests and languages. Adaptations consist of including two tests specific to typical Alzheimer's disease and behavioral variant frontotemporal dementia. The methodology for harmonized normative data includes consensus definition of cognitively normal controls, classification of confounding factors (age, sex, and education), and calculation of minimum sample sizes. DISCUSSION This expert consensus allows harmonizing the diagnosis of neurocognitive disorders across European countries and possibly beyond.
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Affiliation(s)
- Marina Boccardi
- DZNE - Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald site, Rostock, Germany
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland
| | - Andreas U Monsch
- Memory Clinic, University Department of Geriatric Medicine FELIX PLATTER, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Clarissa Ferrari
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Daniele Altomare
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland
- Memory Center, Geneva University Hospitals, Geneva, Switzerland
| | - Manfred Berres
- Department of Mathematics and Technology, University of Applied Sciences Koblenz, Koblenz, Germany
| | - Isabelle Bos
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Andreas Buchmann
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
| | - Chiara Cerami
- Institute for Advanced Studies (IUSS-Pavia), Pavia, Italy, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Mira Didic
- APHM, Timone, Service de Neurologie et Neuropsychologie, Hôpital Timone Adultes, Marseille, France
- Aix-Marseille Université, Inserm, INS, UMR_S 1106, 13005, Marseille, France
| | - Cristina Festari
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Valentina Nicolosi
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Leonardo Sacco
- Clinic of Neurology, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland
| | - Liesbeth Aerts
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | | | - Jean-Marie Annoni
- Department of Neuroscience and Movement Sciences, University of Geneva and Fribourg Hospital, Geneva, Switzerland
| | - Nicola Ballhausen
- Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands
| | | | - Jean-François Démonet
- Leenaards Memory Centre-CHUV, Clinical Neuroscience Department, Cité Hospitalière CHUV, Lausanne, Switzerland
| | - Virginie Descloux
- Department of Neuroscience and Movement Sciences, University of Geneva and Fribourg Hospital, Geneva, Switzerland
| | - Suzie Diener
- Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Anton Gietl
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
| | - Nicola Girtler
- Clinical Psychology and Psychotherapy, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Dept of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Ingo Kilimann
- DZNE - Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald site, Rostock, Germany
| | - Stefan Klöppel
- Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Nicole Kustyniuk
- Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Patrizia Mecocci
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Nathalie Mella
- Cognitive Aging Lab, University of Geneva, Geneva, Switzerland
| | - Martina Pigliautile
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Katrin Seeher
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Steven D Shirk
- VISN 1 New England MIRECC and VISN 1 New England GRECC, Bedford VA Healthcare System, Bedford, Department of Psychiatry and Population and Quantitative Health Sciences, University of Massachusetts Medical School, Massachusetts, USA
| | - Alessio Toraldo
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy, Milan Center for Neuroscience, Milan, Italy
| | - Andrea Brioschi-Guevara
- Leenaards Memory Centre-CHUV, Clinical Neuroscience Department, Cité Hospitalière CHUV, Lausanne, Switzerland
| | - Kwun C G Chan
- National Alzheimer's Coordination Center (NACC), Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Alessandra Dodich
- Neuroimaging and Innovative Molecular Tracers Laboratory, and Division of Nuclear Medicine, Diagnostic Departement, University of Geneva, University Hospitals of Geneva, Geneva, Switzerland
- Centre for Mind/Brain Sciences, University of Trento, Rovereto, Italy
| | - Alice Grazia
- DZNE - Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald site, Rostock, Germany
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | | | - Flavio Nobili
- Neurology Clinic, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Dept of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Walter Kukull
- National Alzheimer's Coordination Center (NACC), Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin, Berlin, Germany, ZNE, German Center for Neurodegenerative Diseases, Berlin, Germany
| | - Inez Ramakers
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Stefan Teipel
- DZNE - Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald site, Rostock, Germany
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Michael Wagner
- DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern Feinberg School of Medicine, Chicago, Illinois
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lutz Froelich
- University of Heidelberg, Heidelberg, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Bruno Dubois
- Hôpital Pitié-Salpêtrière, AP-HP, Alzheimer Research Institute (IM2A), and Institut du cerveau et la moelle (ICM), Sorbonne Université, Paris, France
| | - Stefano F Cappa
- Institute for Advanced Studies (IUSS-Pavia), Pavia, Italy, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - David Salmon
- Department of Neurosciences, University of California San Diego School of Medicine, San Diego, USA
| | - Bengt Winblad
- Dept NVS, Center for Alzheimer Research, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Giovanni B Frisoni
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland
- Memory Center, Geneva University Hospitals, Geneva, Switzerland
| | - Matthias Kliegel
- Cognitive Aging Lab, Department of Psychology, University of Geneva, Geneva, Switzerland
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Abstract
BACKGROUND Certain neuropsychiatric symptoms (NPS), namely apathy, depression, and anxiety demonstrated great value in predicting dementia progression, representing eventually an opportunity window for timely diagnosis and treatment. However, sensitive and objective markers of these symptoms are still missing. Therefore, the present study aims to investigate the association between automatically extracted speech features and NPS in patients with mild neurocognitive disorders. METHODS Speech of 141 patients aged 65 or older with neurocognitive disorder was recorded while performing two short narrative speech tasks. NPS were assessed by the neuropsychiatric inventory. Paralinguistic markers relating to prosodic, formant, source, and temporal qualities of speech were automatically extracted, correlated with NPS. Machine learning experiments were carried out to validate the diagnostic power of extracted markers. RESULTS Different speech variables are associated with specific NPS; apathy correlates with temporal aspects, and anxiety with voice quality-and this was mostly consistent between male and female after correction for cognitive impairment. Machine learning regressors are able to extract information from speech features and perform above baseline in predicting anxiety, apathy, and depression scores. CONCLUSIONS Different NPS seem to be characterized by distinct speech features, which are easily extractable automatically from short vocal tasks. These findings support the use of speech analysis for detecting subtypes of NPS in patients with cognitive impairment. This could have great implications for the design of future clinical trials as this cost-effective method could allow more continuous and even remote monitoring of symptoms.
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Affiliation(s)
- Alexandra König
- Stars Team, Sophia Antipolis, Institut National de Recherche en Informatique et en Automatique (INRIA), Valbonne, France.,Clinical Research, ki:elements, Saarbrücken, Germany.,CoBTeK (Cognition-Behaviour-Technology) Lab, FRIS-University Côte d'Azur, Nice, France
| | - Elisa Mallick
- Stars Team, Sophia Antipolis, Institut National de Recherche en Informatique et en Automatique (INRIA), Valbonne, France.,Clinical Research, ki:elements, Saarbrücken, Germany.,CoBTeK (Cognition-Behaviour-Technology) Lab, FRIS-University Côte d'Azur, Nice, France
| | - Johannes Tröger
- Stars Team, Sophia Antipolis, Institut National de Recherche en Informatique et en Automatique (INRIA), Valbonne, France.,Clinical Research, ki:elements, Saarbrücken, Germany.,CoBTeK (Cognition-Behaviour-Technology) Lab, FRIS-University Côte d'Azur, Nice, France
| | - Nicklas Linz
- Stars Team, Sophia Antipolis, Institut National de Recherche en Informatique et en Automatique (INRIA), Valbonne, France.,Clinical Research, ki:elements, Saarbrücken, Germany.,CoBTeK (Cognition-Behaviour-Technology) Lab, FRIS-University Côte d'Azur, Nice, France
| | - Radia Zeghari
- Stars Team, Sophia Antipolis, Institut National de Recherche en Informatique et en Automatique (INRIA), Valbonne, France.,Clinical Research, ki:elements, Saarbrücken, Germany.,CoBTeK (Cognition-Behaviour-Technology) Lab, FRIS-University Côte d'Azur, Nice, France
| | - Valeria Manera
- Stars Team, Sophia Antipolis, Institut National de Recherche en Informatique et en Automatique (INRIA), Valbonne, France.,Clinical Research, ki:elements, Saarbrücken, Germany.,CoBTeK (Cognition-Behaviour-Technology) Lab, FRIS-University Côte d'Azur, Nice, France
| | - Philippe Robert
- Stars Team, Sophia Antipolis, Institut National de Recherche en Informatique et en Automatique (INRIA), Valbonne, France.,Clinical Research, ki:elements, Saarbrücken, Germany.,CoBTeK (Cognition-Behaviour-Technology) Lab, FRIS-University Côte d'Azur, Nice, France
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