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Fernandez A, Askenazy F, Zeghari R, Auby P, Robert P, Thümmler S, Gindt M. Somatic and Posttraumatic Stress Symptoms in Children and Adolescents in France. JAMA Netw Open 2024; 7:e247193. [PMID: 38635269 DOI: 10.1001/jamanetworkopen.2024.7193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Importance Somatic symptoms are a major concern among the pediatric population because of frequency and burden. The association between adverse childhood experiences and somatic symptoms in adults is well established but less is known concerning somatic symptoms in young people. Objective To explore the frequency and intensity of somatic symptoms in children and adolescents exposed to traumatic events. Design, Setting, and Participants This cross-sectional study was conducted from January 1 to December 31, 2021, at the Nice Pediatric Psychotrauma Referral Center in Nice, France. Participants included pediatric outpatients, aged 7 to 17 years, who were referred to the center. Statistical analysis was performed in January 2022. Exposure All participants experienced at least 1 traumatic event during life. Main Outcome and Measure Somatic and posttraumatic stress symptoms were assessed using the Patient Health Questionnaire-13 (PHQ-13) and Child PTSD Checklist (CPC). Posttraumatic stress disorder (PTSD) and non-PTSD groups were defined based on CPC symptoms severity score. In the hypothesized association between somatic symptoms and posttraumatic stress symptoms (PTSS), PTSD and non-PTSD groups were compared, correlations between PTSS and severity of CPC were analyzed, and a regression model was performed. Results There were 363 participants included (mean [SD] age, 13.58 [0.25] years; 174 [47.9%] female, 189 [52.1%] male). Compared with the non-PTSD group, the PTSD group presented with a higher mean (SD) number of somatic symptoms (7.0 [2.5] vs 4.0 [2.5] symptoms; t360 = 11.7; P < .001), and higher mean (SD) intensity (10.4 [4.6] vs 4.8 [3.7] points; t360 = 12.6; P < .001). Most of the explored somatic symptoms positively correlated with the intensity of PTSS and their functional alterations (eg, PTSS intensity correlated with stomach pain symptoms [r = .30; P < .001]; and with headaches symptoms [r = .44; P < .001]). In the regression model, the combination of migraines, palpitation, nausea, tiredness, and sleep disorders explained 6.5% of the variance in the PTSD group. (F1,341 = 22.651; P < .001). Conclusions and Relevance In this cross-sectional study, somatic symptoms were positively correlated with PTSS both in frequency and intensity among youths. These results suggest that the systematic screening for somatic symptoms in youths with traumatic exposure should be a routine evaluation procedure.
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Affiliation(s)
- Arnaud Fernandez
- Nice Pediatric Psychotrauma Center, University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
- Centre Régional du Psychotraumatisme PACA, Nice, France
| | - Florence Askenazy
- Nice Pediatric Psychotrauma Center, University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
- Centre Régional du Psychotraumatisme PACA, Nice, France
| | - Radia Zeghari
- Nice Pediatric Psychotrauma Center, University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
| | - Philippe Auby
- Nice Pediatric Psychotrauma Center, University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
| | - Philippe Robert
- Nice Pediatric Psychotrauma Center, University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
| | - Susanne Thümmler
- Nice Pediatric Psychotrauma Center, University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
| | - Morgane Gindt
- Nice Pediatric Psychotrauma Center, University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
- CoBTek, Université Côte d'Azur, Nice, France
- Centre Régional du Psychotraumatisme PACA, Nice, France
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Manera V, Partos C, Beauchet O, Benoit M, Dupetit B, Elbaum J, Fabre R, Gindt M, Gros A, Guerchouche R, Klöppel S, König A, Martin A, Mouton A, Pancrazi MP, Politis A, Robert G, Sacco G, Sacconi S, Sawchuk K, Solari F, Thiebot L, Trimarchi PD, Zeghari R, Robert P. Teleconsultations for mental health: Recommendations from a Delphi panel. Internet Interv 2023; 34:100660. [PMID: 37655117 PMCID: PMC10465930 DOI: 10.1016/j.invent.2023.100660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 07/14/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction The use of teleconsultations for mental health has drastically increased since 2020 due to the Covid19 pandemic. In the present paper, we aimed to analyze the advantages and disadvantages of teleconsultations for mental health compared to face-to-face consultations, and to provide recommendations in this domain. Methods The recommendations were gathered using a Delphi methodology. The expert panel (N = 21) included professionals from the health and ICT domains. They answered questions via two rounds of web surveys, and then discussed the results in a plenary meeting. Some of the questions were also shared with non-experts (N = 104). Results Both the experts and the non-experts with teleconsultation experience reported a general satisfaction concerning teleconsultations. A SWOT analysis revealed several strengths and opportunities of teleconsultations for mental health, but also several weaknesses and threats. The experts provided a set of practical recommendations for the preparation and organization of teleconsultations for mental health. Discussion Teleconsultations for mental health have the potential to allow access to care for patients in remote and isolated areas. Thus, their use will unlikely be discontinued after the end of the pandemic. In this context, we suggest that the collaboration among clinicians, researchers, and interface designers is crucial to improve usability and user experience for both clinicians and patients. The importance of teaching teleconsultation skills and informing the public on the features of teleconsultations (e.g., data privacy/security) is also highlighted.
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Affiliation(s)
- Valeria Manera
- CobTeK laboratory, Université Côte d'Azur, Nice, France
- Association Innovation Alzheimer, Nice, France
- Department of Speech Therapy (Departement d'Orthophonie, DON), Université Côte d'Azur, Nice, France
| | - Claudia Partos
- Budapest University of Technology and Economics, Budapest, Hungary
| | - Olivier Beauchet
- Departments of Medicine and geriatrics, University of Montreal, Montreal, Quebec, Canada
- Research Centre of the Geriatric University Institute of Montreal, Montreal, Quebec, Canada
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Michel Benoit
- CobTeK laboratory, Université Côte d'Azur, Nice, France
- Université Cote d'Azur, Adult Psychiatry Department, Nice University Hospital, Nice, France
| | | | - Julia Elbaum
- CobTeK laboratory, Université Côte d'Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service clinique gériatrique de soins ambulatoires, Centre Mémoire Ressources et Recherche, Université Côte d'Azur, Nice, France
| | - Roxane Fabre
- Côte d'Azur University, Nice University Hospital, Public Health Department, Nice, France
| | - Morgane Gindt
- CobTeK laboratory, Université Côte d'Azur, Nice, France
- Nice Pediatric Psychotrauma Center (NPPC), Child And Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, Nice, France
| | - Auriane Gros
- CobTeK laboratory, Université Côte d'Azur, Nice, France
- Association Innovation Alzheimer, Nice, France
- Department of Speech Therapy (Departement d'Orthophonie, DON), Université Côte d'Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service clinique gériatrique de soins ambulatoires, Centre Mémoire Ressources et Recherche, Université Côte d'Azur, Nice, France
| | - Rachid Guerchouche
- CobTeK laboratory, Université Côte d'Azur, Nice, France
- Association Innovation Alzheimer, Nice, France
- ki:elements GmbH, Saarbrücken, Germany
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland
| | - Alexandra König
- CobTeK laboratory, Université Côte d'Azur, Nice, France
- Association Innovation Alzheimer, Nice, France
- ki:elements GmbH, Saarbrücken, Germany
| | | | - Aurélie Mouton
- CobTeK laboratory, Université Côte d'Azur, Nice, France
- Association Innovation Alzheimer, Nice, France
- Centre Hospitalier Universitaire de Nice, Service clinique gériatrique de soins ambulatoires, Centre Mémoire Ressources et Recherche, Université Côte d'Azur, Nice, France
| | | | - Antonios Politis
- Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Gabriel Robert
- Academic Psychiatry Department, Guillaume Régnier Hospital, Rennes, France
- Empenn Inserm U1228, IRISA UMR 6074, Rennes University Hospital, France
| | - Guillaume Sacco
- CobTeK laboratory, Université Côte d'Azur, Nice, France
- Association Innovation Alzheimer, Nice, France
- Centre Hospitalier Universitaire de Nice, Service clinique gériatrique de soins ambulatoires, Centre Mémoire Ressources et Recherche, Université Côte d'Azur, Nice, France
| | - Sabrina Sacconi
- Université Cote d'Azur, Peripheral Nervous System and Muscle Department, Nice University Hospital, Nice, France
| | - Kim Sawchuk
- Department of Communication Studies, Concordia University, Montreal, QC, Canada
| | - Fabio Solari
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Italy
| | | | | | - Radia Zeghari
- CobTeK laboratory, Université Côte d'Azur, Nice, France
- Nice Pediatric Psychotrauma Center (NPPC), Child And Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, Nice, France
| | - Philippe Robert
- CobTeK laboratory, Université Côte d'Azur, Nice, France
- Association Innovation Alzheimer, Nice, France
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Zeghari R, Gindt M, Guivarch J, Auby P, Robert P, Rolling J, Schröder C, Valo P, Askenazy F, Fernandez A. July 14th 2016 Nice Terrorist Attack Court Trial: A Protocol on Sleep Quality and Somatic Symptoms as Markers of Risk for Traumatic Reactivation in Adolescents Exposed to This Attack. Healthcare (Basel) 2023; 11:2953. [PMID: 37998445 PMCID: PMC10671086 DOI: 10.3390/healthcare11222953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
The court trial of the 14th of July 2016 terrorist attack in Nice (France) opened in September 2022 and ended in December 2022. Engaging in court proceedings, whether as a victim or a witness, can lead to a significant risk of traumatic reactivation (i.e., the re-emergence of post-traumatic stress symptoms). The present protocol aimed to improve knowledge of the pathophysiology of traumatic reactivation due to the media coverage of the trial by assessing sleep disturbances and somatic symptoms that could reappear if there is a traumatic reactivation. Method and Analysis: This is a monocentric longitudinal study, with recruitment solely planned at the Nice Pediatric Psychotrauma Center (NPPC). We intended to include 100 adolescents aged 12 to 17 years who were directly or indirectly exposed to the attack and included in the "14-7" program). Assessments began one month before the trial, in August 2022, and were scheduled once a month until the end of the trial. A smartwatch recorded sleep activity. Somatic and PTSD symptoms and sleep were assessed through validated questionnaires. The main analyses comprised the variance and regression analyses of predictors of clinical evolution over time. Ethics and Dissemination: The National Ethics Committee "NORD OUEST III" approved the "14-7" program protocol (number 2017-A02212-51). The specific amendment for this research was approved in April 2022 by the same national ethical committee. Inclusions started in August 2022.
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Affiliation(s)
- Radia Zeghari
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Morgane Gindt
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Jokthan Guivarch
- Department of Child Psychiatry, APHM, 13009 Marseille, France;
- CANOP Institut de Neurosciences de la Timone, UMR 7289, CNRS, Aix Marseille University, 13005 Marseille, France
- Faculty of Medicine, Aix-Marseille University, 13005 Marseille, France
| | - Philippe Auby
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Philippe Robert
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Julie Rolling
- Regional Center for Psychotraumatism Great East, Strasbourg University Hospital, 67000 Strasbourg, France
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, 67000 Strasbourg, France
- CNRS UPR3212-Research Team “Light, Circadian Rhythms, Sleep Homeostasis and Neuropsychiatry”, Institute of Cellular and Integrative Neurosciences, 67000 Strasbourg, France
- Excellence Centre for Autism and Neurodevelopmental Disorders STRAS&ND, 67091 Strasbourg, France
- Sleep Disorders Centre & International Research Centre for ChronoSomnology (Circsom), University Hospitals Strasbourg, 67091 Strasbourg, France
| | - Carmen Schröder
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, 67000 Strasbourg, France
- CNRS UPR3212-Research Team “Light, Circadian Rhythms, Sleep Homeostasis and Neuropsychiatry”, Institute of Cellular and Integrative Neurosciences, 67000 Strasbourg, France
- Excellence Centre for Autism and Neurodevelopmental Disorders STRAS&ND, 67091 Strasbourg, France
- Sleep Disorders Centre & International Research Centre for ChronoSomnology (Circsom), University Hospitals Strasbourg, 67091 Strasbourg, France
- Expert Centre for High-Functioning Autism, Fondation FondaMental, 67000 Strasbourg, France
| | - Petri Valo
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Florence Askenazy
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Arnaud Fernandez
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
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Corveleyn X, Corbel C, Fabre R, Zeghari R, Dujardin K, Robert P, Manera V. Validation study of the apathy motivation index in French adults. Front Psychol 2023; 14:1252965. [PMID: 37928593 PMCID: PMC10624122 DOI: 10.3389/fpsyg.2023.1252965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/25/2023] [Indexed: 11/07/2023] Open
Abstract
Objective Apathy is present in many brain disorders, but it is also prevalent to varying degrees in healthy people. While many tools have been developed to assess levels of apathy in pathology, no standardized measure of apathy in healthy people exists. Method Therefore, this study aimed to validate the French version of the Apathy Motivation Index (f-AMI). The results of 729 participants were analyzed using an exploratory factorial analysis. Results Preliminary analyses suggested that the three domains of apathy extracted in the original AMI scale-behavioral activation (BA), social motivation (SM), and emotional sensitivity (ES)-could be found also in the f-AMI. A further exploratory analysis showed that a higher number of factors could be extracted, particularly for women. Specifically, both social and emotional factors could be divided into two sub-factors: (1) social motivation toward strangers or toward an acquaintance and (2) self-directed emotional sensitivity directed toward others. Regarding construct validity, the scores of f-AMI were correlated with the French Dimensional Apathy Scale results. Concerning the divergent validity, emotional sensitivity in apathy is different from depression, anhedonia, and fatigue levels. Conclusion These results suggest that the f-AMI can be used to assess levels of apathy in healthy adults.
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Affiliation(s)
- Xavier Corveleyn
- LAPCOS, Université Côte d'Azur, Nice, France
- MSHS Sud-Est, Maison des Sciences de l'Homme et de la Société Sud-Est, Nice, France
| | - Camille Corbel
- LAPCOS, Université Côte d'Azur, Nice, France
- MSHS Sud-Est, Maison des Sciences de l'Homme et de la Société Sud-Est, Nice, France
| | - Roxane Fabre
- CoBTeK Lab, Université Côte d'Azur, Nice, France
- Département de Santé Publique, Centre Hospitalier Universitaire de Nice (Public Health Department University Hospital of Nice), Nice, France
| | | | - Kathy Dujardin
- CHU Lille, Lille Neurosciences and Cognition, INSERM, Université Lille, Lille, France
| | - Philippe Robert
- CoBTeK Lab, Université Côte d'Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Centre mémoire CMRR, Nice, France
- Association Innovation Alzheimer, Nice, France
| | - Valeria Manera
- CoBTeK Lab, Université Côte d'Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Centre mémoire CMRR, Nice, France
- Association Innovation Alzheimer, Nice, France
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Mancioppi G, Rovini E, Fiorini L, Zeghari R, Gros A, Manera V, Robert P, Cavallo F. Mild cognitive impairment identification based on motor and cognitive dual-task pooled indices. PLoS One 2023; 18:e0287380. [PMID: 37531347 PMCID: PMC10395992 DOI: 10.1371/journal.pone.0287380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 06/05/2023] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVE This study investigates the possibility of adopting motor and cognitive dual-task (MCDT) approaches to identify subjects with mild cognitive impairment (MCI) and subjective cognitive impairment (SCI). METHODS The upper and lower motor performances of 44 older adults were assessed using the SensHand and SensFoot wearable system during three MCDTs: forefinger tapping (FTAP), toe-tapping heel pin (TTHP), and walking 10 m (GAIT). We developed five pooled indices (PIs) based on these MCDTs, and we included them, along with demographic data (age) and clinical scores (Frontal Assessment Battery (FAB) scores), in five logistic regression models. RESULTS Models which consider cognitively normal adult (CNA) vs MCI subjects have accuracies that range from 67% to 78%. The addition of clinical scores stabilised the accuracies, which ranged from 85% to 89%. For models which consider CNA vs SCI vs MCI subjects, there are great benefits to considering all three regressors (age, FAB score, and PIs); the overall accuracies of the three-class models range between 50% and 59% when just PIs and age are considered, whereas the overall accuracy increases by 18% when all three regressors are utilised. CONCLUSION Logistic regression models that consider MCDT PIs and age have been effective in distinguishing between CNA and MCI subjects. The inclusion of clinical scores increased the models' accuracy. Particularly high performances in distinguishing among CNA, SCI, and MCI subjects were obtained by the TTHP PI. This study suggests that a broader framework for MCDTs, which should encompass a greater selection of motor tasks, could provide clinicians with new appropriate tools.
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Affiliation(s)
- Gianmaria Mancioppi
- The Department of Industrial Engineering, University of Florence, Florence, Italy
| | - Erika Rovini
- The Department of Industrial Engineering, University of Florence, Florence, Italy
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy
| | - Laura Fiorini
- The Department of Industrial Engineering, University of Florence, Florence, Italy
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy
| | - Radia Zeghari
- The CoBTeK, Université Côte d'Azur (UCA), Nice, France
- Nice University Hospital, Public Health Department, Côte d'Azur University, Nice, France
| | - Auriane Gros
- The CoBTeK, Université Côte d'Azur (UCA), Nice, France
- Association Innovation Alzheimer, Nice, France
- Department of Speech Therapy (Departement d'Orthophonie, DON), Université Côte d'Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Centre Mémoire Ressources et Recherche, Université Côte d'Azur, Nice, France
| | - Valeria Manera
- The CoBTeK, Université Côte d'Azur (UCA), Nice, France
- Association Innovation Alzheimer, Nice, France
- Department of Speech Therapy (Departement d'Orthophonie, DON), Université Côte d'Azur, Nice, France
| | - Philippe Robert
- The CoBTeK, Université Côte d'Azur (UCA), Nice, France
- Association Innovation Alzheimer, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Centre Mémoire Ressources et Recherche, Université Côte d'Azur, Nice, France
| | - Filippo Cavallo
- The Department of Industrial Engineering, University of Florence, Florence, Italy
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Pisa, Italy
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Zeghari R, Gindt M, König A, Nachon O, Lindsay H, Robert P, Fernandez A, Askenazy F. Study protocol: how does parental stress measured by clinical scales and voice acoustic stress markers predict children's response to PTSD trauma-focused therapies? BMJ Open 2023; 13:e068026. [PMID: 37160398 PMCID: PMC10173955 DOI: 10.1136/bmjopen-2022-068026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
INTRODUCTION Post-traumatic stress disorder (PTSD) symptoms in youth are influenced by parental anxiety and stress. When parents have high levels of stress or have developed PTSD themselves, children tend to show more anxiety symptoms. Parental stress can affect the severity of children's PTSD and lower the success of recovery. However, the influence of parental stress on the effectiveness of trauma-focused therapies (eye movement desensitisation and reprocessing and cognitive behavioural therapy) has not yet been investigated to our knowledge. Hence, we will measure parental stress (using both validated scales and vocal acoustic markers) and investigate how it influences children's PTSD recovery. METHOD AND ANALYSIS Sixty children between the ages of 7 and 15 years who experienced type 1 trauma will be recruited at the Nice Pediatric Psychotrauma Center in France. We plan to measure stress using two different approaches. We will ask parents to answer validated scales of stress and mood in general. Stress will also be measured using vocal acoustic markers. Parents will be recorded while narrating their child's trauma and during the narrative of a positive and neutral recall of events. Child participants will have to complete anxiety, PTSD and depression scales before the beginning of the trauma-focused therapy and after 3 months of treatment.Linear mixed effects models and differential statistics, such as significance testing corrected for multiple testing, will be used to determine the validity of speech features for the proposed hypotheses. Repeated measures analysis of variance will be performed on the clinical scales scores according to parental stress. Correlations will be performed between clinical scales of parents and children according to time of assessment. ETHICS AND DISSEMINATION This study was approved by the Committee for the Protection of Individuals of the University of Nice Sophia Antipolis (CERNI) on 21 February 2022, under the number CER2022-015.All participants will be informed that this is an observational study and their consent taken prior to the experiment. Participants will be informed that they can withdraw from the study at any time and that it would not affect the care provided. TRIAL REGISTRATION NUMBER CER AVIS n° 2022-015.
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Affiliation(s)
- Radia Zeghari
- Nice Pediatric Psychotrauma Center (NPPC), Child And Adolescent Psychiatry department, Hôpitaux Pédiatriques Universitaires Lenval, Nice, France
- Cobtek (Cognition-Behaviour-Technology), Université Côte d'Azur, Nice, France
| | - Morgane Gindt
- Nice Pediatric Psychotrauma Center (NPPC), Child And Adolescent Psychiatry department, Hôpitaux Pédiatriques Universitaires Lenval, Nice, France
- Cobtek (Cognition-Behaviour-Technology), Université Côte d'Azur, Nice, France
| | - Alexandra König
- Cobtek (Cognition-Behaviour-Technology), Université Côte d'Azur, Nice, France
- ki:elements GmbH, Saarbrucken, Germany
| | - Ophelie Nachon
- Nice Pediatric Psychotrauma Center (NPPC), Child And Adolescent Psychiatry department, Hôpitaux Pédiatriques Universitaires Lenval, Nice, France
- Cobtek (Cognition-Behaviour-Technology), Université Côte d'Azur, Nice, France
| | - Hali Lindsay
- Cognitive Assistants, Deutsches Forschungszentrum fur Kunstliche Intelligenz GmbH Standort Saarbrucken, Saarbrucken, Germany
| | - Philippe Robert
- Nice Pediatric Psychotrauma Center (NPPC), Child And Adolescent Psychiatry department, Hôpitaux Pédiatriques Universitaires Lenval, Nice, France
- Cobtek (Cognition-Behaviour-Technology), Université Côte d'Azur, Nice, France
| | - Arnaud Fernandez
- Nice Pediatric Psychotrauma Center (NPPC), Child And Adolescent Psychiatry department, Hôpitaux Pédiatriques Universitaires Lenval, Nice, France
- Cobtek (Cognition-Behaviour-Technology), Université Côte d'Azur, Nice, France
| | - Florence Askenazy
- Nice Pediatric Psychotrauma Center (NPPC), Child And Adolescent Psychiatry department, Hôpitaux Pédiatriques Universitaires Lenval, Nice, France
- Cobtek (Cognition-Behaviour-Technology), Université Côte d'Azur, Nice, France
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Manera V, Fabre R, Daumas L, Zeghari R, Derreumaux A, Payne M, Lemaire J, Sacco G, Gros A, Robert P. Cutoff scores for the "Interest game", an application for the assessment of diminished interest in neurocognitive disorders. Front Psychiatry 2023; 14:1126479. [PMID: 37020737 PMCID: PMC10067876 DOI: 10.3389/fpsyt.2023.1126479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 02/24/2023] [Indexed: 04/07/2023] Open
Abstract
Diminished interest is a core feature of apathy that shows high prevalence in people with Mild and Major Neurocognitive disorders (NCD). In the clinical setting, apathy is mainly assessed using clinical scales and questionnaires, but new technologies are starting to be employed to complement classical instruments. Here, we explored the performance of the "Interest game," a ludic application that assesses personal interests, in discriminating between persons with and without diminished interest based on the Apathy Diagnostic Criteria. Two hundred and twenty-seven elderly participants (56 healthy controls, 118 persons with mild-NCD, and 53 with major-NCD) completed the Interest game and were assessed by clinicians concerning the presence and the severity of apathy. Results showed that the application scores varied with the presence of apathy, the type of disorder, and the education level. Cutoff scores calculated for persons with Mild-NCD resulted in a sensitivity of 0.68 and a specificity of 0.65 for the main score index, suggesting the interest of employing this application in the clinical setting to complement the classical assessment.
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Affiliation(s)
- Valeria Manera
- Université Côte d’Azur, CobTeK, Nice, France
- Association Innovation Alzheimer, Nice, France
- Université Côte d’Azur, Department of Speech Therapy (Departement d’Orthophonie, DON), Nice, France
- *Correspondence: Valeria Manera,
| | - Roxane Fabre
- Université Côte d’Azur, CobTeK, Nice, France
- Université Cote d’Azur, Nice University Hospital (CHU), Public Health Department, Nice, France
| | - Lyne Daumas
- Université Côte d’Azur, CobTeK, Nice, France
- Université Côte d’Azur, LAMHESS, Nice, France
| | - Radia Zeghari
- Université Côte d’Azur, CobTeK, Nice, France
- Centre Hospitalier Universitaire-Lenval, Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, Hôpitaux Pédiatriques de Nice, Nice, France
| | - Alexandre Derreumaux
- Université Côte d’Azur, CobTeK, Nice, France
- Association Innovation Alzheimer, Nice, France
- Université Côte d’Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de Soins Ambulatoires, Centre Mémoire de Ressources et de Recherche, Nice, France
| | - Magali Payne
- Université Côte d’Azur, CobTeK, Nice, France
- Association Innovation Alzheimer, Nice, France
- Université Côte d’Azur, Department of Speech Therapy (Departement d’Orthophonie, DON), Nice, France
| | - Justine Lemaire
- Université Côte d’Azur, CobTeK, Nice, France
- Université Côte d’Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de Soins Ambulatoires, Centre Mémoire de Ressources et de Recherche, Nice, France
| | - Guillaume Sacco
- Université Côte d’Azur, CobTeK, Nice, France
- Association Innovation Alzheimer, Nice, France
- Université Côte d’Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de Soins Ambulatoires, Centre Mémoire de Ressources et de Recherche, Nice, France
| | - Auriane Gros
- Université Côte d’Azur, CobTeK, Nice, France
- Association Innovation Alzheimer, Nice, France
- Université Côte d’Azur, Department of Speech Therapy (Departement d’Orthophonie, DON), Nice, France
- Université Côte d’Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de Soins Ambulatoires, Centre Mémoire de Ressources et de Recherche, Nice, France
| | - Philippe Robert
- Université Côte d’Azur, CobTeK, Nice, France
- Association Innovation Alzheimer, Nice, France
- Université Côte d’Azur, Department of Speech Therapy (Departement d’Orthophonie, DON), Nice, France
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8
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Mancioppi G, Fiorini L, Rovini E, Zeghari R, Gros A, Manera V, Roberr P, Cavallo F. A New Motor and Cognitive Dual-Task Approach Based on Foot Tapping for The Identification of Mild Cognitive Impairment. Annu Int Conf IEEE Eng Med Biol Soc 2022; 2022:3231-3234. [PMID: 36086031 DOI: 10.1109/embc48229.2022.9871345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study investigates the adoption of innovative Motor and Cognitive Dual-Task (MCDT) based on the combination of increasing motor and cognitive tasks to discern between subjects with Mild Cognitive Impairment (MCI) and Cognitively Normal Adults (CNA). We aim to adopt new MCDT protocols and to compare their performance against the gold standard (a walking based MCDT, called GAIT). 27 older adults have been assessed through a customized wearable system during 4 MCDTs. We developed as many pooled indices (PIs), based on MCDTs perfomance, demographic data, and clinical scores. We use these parameters as regressors in 4 different logistic regression models. The regression models that encompassed features from innovative MCDT overcame the gold standard classification performance. In particular, models based on the heel tapping and the alternate heel-toe tapping reach the best outputs, namely +8% of accuracy if compared to the gold standard (a walking task). The use of logistic regression models based on MCDT PI have been effective in discerning between CNA vs MCI. Our results suggest that the gold standard MCDT may represents a too demanding exercise to highlight differences between CNA and MCI. It seems that MCDT based on an intermediate level of motor difficulty could represent the sweet spot for the identification of MCI against CNA. Clinical relevance- The combination of innovative digital devices and innovative approach on data analysis (PIs) opened a new scenarios to the early detection and prediction of dementia. Their use would standardize the assessment procedure, lightening the physician from the burden of cumbersome testing sessions. This study suggests that a broader framework for MCDT, which should encompass an ampler selection of motor tasks with different possibilities in terms of difficulties levels, could provide clinicians with a new appropriate set of tools for the early detection of dementia.
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9
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Zeghari R, Guerchouche R, Tran-Duc M, Bremond F, Langel K, Ramakers I, Amiel N, Lemoine MP, Bultingaire V, Manera V, Robert P, König A. Feasibility Study of an Internet-Based Platform for Tele-Neuropsychological Assessment of Elderly in Remote Areas. Diagnostics (Basel) 2022; 12:diagnostics12040925. [PMID: 35453973 PMCID: PMC9031122 DOI: 10.3390/diagnostics12040925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 12/03/2022] Open
Abstract
Today, in rural isolated areas or so-called ‘medical deserts’, access to diagnosis and care is very limited. With the current pandemic crisis, now even more than ever, telemedicine platforms are gradually more employed for remote medical assessment. Only a few are tailored to comprehensive teleneuropsychological assessment of older adults. Hence, our study focuses on evaluating the feasibility of performing a remote neuropsychological assessment of older adults suffering from a cognitive complaint. 50 participants (aged 55 and older) were recruited at the local hospital of Digne-les-Bains, France. A brief neuropsychological assessment including a short clinical interview and several validated neuropsychological tests was administered in two conditions, once by Teleneuropsychology (TNP) and once by Face-to-Face (FTF) in a crossover design. Acceptability and user experience was assessed through questionnaires. Results show high agreement in most tests between the FTF and TNP conditions. The TNP was overall well accepted by the participants. However, differences in test performances were observed, which urges the need to validate TNP tests with broader samples with normative data.
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Affiliation(s)
- Radia Zeghari
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d’Azur, 06000 Nice, France; (R.G.); (F.B.); (V.M.); (P.R.); (A.K.)
- Correspondence:
| | - Rachid Guerchouche
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d’Azur, 06000 Nice, France; (R.G.); (F.B.); (V.M.); (P.R.); (A.K.)
- Institut National de Recherche en Informatique et en Automatique (INRIA), 06902 Valbonne, France;
| | - Minh Tran-Duc
- Institut National de Recherche en Informatique et en Automatique (INRIA), 06902 Valbonne, France;
| | - François Bremond
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d’Azur, 06000 Nice, France; (R.G.); (F.B.); (V.M.); (P.R.); (A.K.)
- Institut National de Recherche en Informatique et en Automatique (INRIA), 06902 Valbonne, France;
| | - Kai Langel
- Janssen Clinical Innovation (JCI), Janssen Research & Development, Division of Janssen Pharmaceutica NV, 2340 Beerse, Belgium;
| | - Inez Ramakers
- MHeNs School for Mental Health and Neuroscience, Maastricht University, 6211 LK Maastricht, The Netherlands;
| | - Nathalie Amiel
- Consultation Mémoire, Centre Hospitalier Digne-les-Bains, 04000 Digne-les-Bains, France; (N.A.); (M.P.L.); (V.B.)
| | - Maria Pascale Lemoine
- Consultation Mémoire, Centre Hospitalier Digne-les-Bains, 04000 Digne-les-Bains, France; (N.A.); (M.P.L.); (V.B.)
| | - Vincent Bultingaire
- Consultation Mémoire, Centre Hospitalier Digne-les-Bains, 04000 Digne-les-Bains, France; (N.A.); (M.P.L.); (V.B.)
| | - Valeria Manera
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d’Azur, 06000 Nice, France; (R.G.); (F.B.); (V.M.); (P.R.); (A.K.)
| | - Philippe Robert
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d’Azur, 06000 Nice, France; (R.G.); (F.B.); (V.M.); (P.R.); (A.K.)
| | - Alexandra König
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d’Azur, 06000 Nice, France; (R.G.); (F.B.); (V.M.); (P.R.); (A.K.)
- Institut National de Recherche en Informatique et en Automatique (INRIA), 06902 Valbonne, France;
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10
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König A, Zeghari R, Guerchouche R, Bremond F, Bultingaire V, Robert P, Linz N. Remote cognitive assessment of older adults in rural areas by telemedicine and automatic speech and video analysis. Alzheimers Dement 2022. [PMID: 34971222 DOI: 10.1002/alz.050302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Early detection of cognitive impairments is crucial for successful implementation of preventive strategies. However, in rural isolated areas or so-called 'medical deserts', access to diagnosis and care is very limited. With the current pandemic crisis, now even more than ever, remote solutions such as telemedicine platforms represent great potential and can help to overcome this barrier. Moreover, current advances made in voice and image analysis can help overcoming the barrier of the physical distance by providing additional information of a patients' emotional and cognitive state. Therefore, the aim of this study is to evaluate the feasibility and reliability of a videoconference system for remote cognitive testing empowered by automatic speech and video analysis. METHOD 60 participants (aged 55 and older) with and without cognitive impairment are recruited. A complete neuropsychological assessment including a short clinical interview are administered in two conditions, once by telemedicine and once by face-to-face. The administration procedure is randomized. Acceptability and user experience are assessed among participants and clinicians in qualitative and quantitative manner. Speech and video features will be extracted and analyzed to obtain additional information on mood and engagement levels. RESULT Similar results were obtained on the several cognitive test measures when comparing the remote to the face-to-face administration method. Word recall (r=0,928) and picture naming task (r=0,939) showed the strongest correlation. Acceptability of the tool was relatively high with preference even in the remote method for more convenience. CONCLUSION Results support the feasibility and reliability of remote cognitive testing through administration via a telemedicine tool. These systems can be used for remote disease monitoring, enabling patients to be assessed in their own homes and improve utilization of expert assessors allowing them to conduct neurocognitive testing remotely.
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Affiliation(s)
- Alexandra König
- CoBTeK (Cognition Behaviour Technology) Research Lab, University Côte d'azur, Nice, France.,National Institute for Research in Computer Science and Automation (INRIA), Sophia Antipolis, France
| | - Radia Zeghari
- Université Côte d'Azur, Cognition Behaviour Technology Lab (CoBTeK), Nice, France.,Association innovation Alzheimer, Nice, France
| | | | - Francois Bremond
- Institut de Recherche en Informatique et en Automatique, Sophia Antipolis, France
| | | | - Philippe Robert
- Université Côte d'Azur, Cognition Behaviour Technology Lab (CoBTeK), Nice, France.,Association innovation Alzheimer, Nice, France
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11
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Gindt M, Fernandez A, Zeghari R, Ménard ML, Nachon O, Richez A, Auby P, Battista M, Askenazy F. A 3-year retrospective study of 866 children and adolescent outpatients followed in the Nice Pediatric Psychotrauma Center created after the 2016 mass terror attack. Front Psychiatry 2022; 13:1010957. [PMID: 36569628 PMCID: PMC9772007 DOI: 10.3389/fpsyt.2022.1010957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The mass terrorist attack in Nice, France, in July 2016 caused deaths and injuries in a local population, including children and adolescents. The Nice Pediatric Psychotrauma Center (NPPC) was opened to provide mental health care to the pediatric population (0-18 years) who experienced traumatic events. OBJECTIVES This study describes the specificity of the care pathway for young trauma victims, with an explanation of how the NPPC works during the first three years. METHODS In this retrospective study, we conducted quantitative and qualitative data collection about new and follow-up consultations, primary and comorbid diagnoses, and the kind of trauma (terrorist attack versus other kinds of trauma). Ethics approval was obtained from the local Ethics committee. RESULTS 866 children and adolescents were followed in the NPPC. We found a high rate of Post-Traumatic Stress Disorder (PTSD; 71%) in this population with a high rate of comorbidities (67%), mainly sleep disorders (34.7%) and mood and anxiety disorders (16.2%). A high number of children and adolescents impacted by the terrorist attack required follow-up consultations after exposure to the mass terrorist attack, the first care-seeking requests continued to occur three years later, although at a slower rate than in the first and second years. New consultations for other kinds of trauma were observed over time. DISCUSSION This study supports previous findings on the significant impact of mass trauma in the pediatric population showing even a higher level of PTSD and a high rate of comorbidities. This may be explained by the brutality of the traumatic event, particularly for this age group. The findings of this study have implications for early interventions and long-term care for children and adolescents to prevent the development of chronic PTSD into adulthood.
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Affiliation(s)
- Morgane Gindt
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Arnaud Fernandez
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Radia Zeghari
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Marie-Line Ménard
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Ophelie Nachon
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Aurélien Richez
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Philippe Auby
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France
| | - Michele Battista
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Florence Askenazy
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
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12
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König A, Ramakers IH, Linz N, Zeghari R, Robert P. Automated speech analysis for detection of cognitive and emotional changes. Alzheimers Dement 2021. [DOI: 10.1002/alz.049766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Alexandra König
- CoBTeK (Cognition Behaviour Technology) Research Lab, University Côte d’azur Nice France
- National Institute for Research in Computer Science and Automation (INRIA) Sophia Antipolis France
| | - Inez H.G.B. Ramakers
- School for Mental Health & Neuroscience Maastricht Netherlands
- Maastricht University Maastricht Netherlands
| | | | - Radia Zeghari
- Université Côte d’Azur, Cognition Behaviour Technology Lab (CoBTeK) Nice France
- Association Innovation Alzheimer Nice France
| | - Philippe Robert
- Université Côte d’Azur, Cognition Behaviour Technology Lab (CoBTeK) Nice France
- Association Innovation Alzheimer Nice France
- Association IA Nice France
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13
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L'Yvonnet T, De Maria E, Robert P, Rigault J, Zeghari R, Manera V, Moisan S. Serious mini‐games for cognitive function assessment. Alzheimers Dement 2021. [DOI: 10.1002/alz.057775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Thibaud L'Yvonnet
- STARS team, INRIA Sophia Antipolis ‐ Méditerranée (CRISAM) Sophia Antipolis France
- Université Côte d’Azur, Cognition Behaviour Technology Lab (CoBTeK) Nice France
| | | | - Philippe Robert
- Université Côte d’Azur, Cognition Behaviour Technology Lab (CoBTeK) Nice France
- Centre Hospitalier Universitaire de Nice, CMRR Nice France
- Association Innovation Alzheimer Nice France
| | - Jean‐Paul Rigault
- STARS team, INRIA Sophia Antipolis ‐ Méditerranée (CRISAM) Sophia Antipolis France
| | - Radia Zeghari
- Université Côte d’Azur, Cognition Behaviour Technology Lab (CoBTeK) Nice France
- Association Innovation Alzheimer Nice France
| | - Valeria Manera
- Université Côte d’Azur, Cognition Behaviour Technology Lab (CoBTeK) Nice France
- Association Innovation Alzheimer Nice France
| | - Sabine Moisan
- STARS team, INRIA Sophia Antipolis ‐ Méditerranée (CRISAM) Sophia Antipolis France
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14
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Zeghari R, Lockwood PL, L'Yvonnet T, Jo C, Robert P, Manera V. TaPiscine: An effort‐based decision‐making task for apathy assessment in people with neurocognitive disorders. Alzheimers Dement 2021. [DOI: 10.1002/alz.057746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Radia Zeghari
- Association innovation Alzheimer Nice France
- Université Côte d’Azur, Cognition Behaviour Technology Lab (CoBTeK) Nice France
| | - Patricia L Lockwood
- Centre For Human Brain Health, School of Psychology, University of Birmingham Birmingham United Kingdom
| | - Thibaud L'Yvonnet
- Université Côte d’Azur, Cognition Behaviour Technology Lab (CoBTeK) Nice France
- STARS team, INRIA Sophia Antipolis ‐ Méditerranée (CRISAM) Sophia Antipolis France
| | - Cutler Jo
- Centre For Human Brain Health, School of Psychology, University of Birmingham Birmingham United Kingdom
| | - Philippe Robert
- Association innovation Alzheimer Nice France
- Université Côte d’Azur, Cognition Behaviour Technology Lab (CoBTeK) Nice France
- Centre Hospitalier Universitaire de Nice, CMRR Nice France
| | - Valeria Manera
- Association innovation Alzheimer Nice France
- Université Côte d’Azur, Cognition Behaviour Technology Lab (CoBTeK) Nice France
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15
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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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16
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König A, Zeghari R, Guerchouche R, Duc Tran M, Bremond F, Linz N, Lindsay H, Langel K, Ramakers I, Lemoine P, Bultingaire V, Robert P. Remote cognitive assessment of older adults in rural areas by telemedicine and automatic speech and video analysis: protocol for a cross-over feasibility study. BMJ Open 2021; 11:e047083. [PMID: 34475154 PMCID: PMC8413472 DOI: 10.1136/bmjopen-2020-047083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 07/27/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Early detection of cognitive impairments is crucial for the successful implementation of preventive strategies. However, in rural isolated areas or so-called 'medical deserts', access to diagnosis and care is very limited. With the current pandemic crisis, now even more than ever, remote solutions such as telemedicine platforms represent great potential and can help to overcome this barrier. Moreover, current advances made in voice and image analysis can help overcome the barrier of physical distance by providing additional information on a patients' emotional and cognitive state. Therefore, the aim of this study is to evaluate the feasibility and reliability of a videoconference system for remote cognitive testing empowered by automatic speech and video analysis. METHODS AND ANALYSIS 60 participants (aged 55 and older) with and without cognitive impairment will be recruited. A complete neuropsychological assessment including a short clinical interview will be administered in two conditions, once by telemedicine and once by face-to-face. The order of administration procedure will be counterbalanced so half of the sample starts with the videoconference condition and the other half with the face-to-face condition. Acceptability and user experience will be assessed among participants and clinicians in a qualitative and quantitative manner. Speech and video features will be extracted and analysed to obtain additional information on mood and engagement levels. In a subgroup, measurements of stress indicators such as heart rate and skin conductance will be compared. ETHICS AND DISSEMINATION The procedures are not invasive and there are no expected risks or burdens to participants. All participants will be informed that this is an observational study and their consent taken prior to the experiment. Demonstration of the effectiveness of such technology makes it possible to diffuse its use across all rural areas ('medical deserts') and thus, to improve the early diagnosis of neurodegenerative pathologies, while providing data crucial for basic research. Results from this study will be published in peer-reviewed journals.
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Affiliation(s)
- Alexandra König
- STARS Team, Institut National de Recherche en Informatique et en Automatique Centre de Recherche Sophia Antipolis Méditerranée, Sophia Antipolis, France
- Cobtek (Cognition-Behaviour-Technology) Lab, FRIS, Universite Cote d'Azur, Nice, France
| | - Radia Zeghari
- Cobtek (Cognition-Behaviour-Technology) Lab, FRIS, Universite Cote d'Azur, Nice, France
| | - Rachid Guerchouche
- STARS Team, Institut National de Recherche en Informatique et en Automatique Centre de Recherche Sophia Antipolis Méditerranée, Sophia Antipolis, France
- Cobtek (Cognition-Behaviour-Technology) Lab, FRIS, Universite Cote d'Azur, Nice, France
| | - Minh Duc Tran
- STARS Team, Institut National de Recherche en Informatique et en Automatique Centre de Recherche Sophia Antipolis Méditerranée, Sophia Antipolis, France
| | - François Bremond
- STARS Team, Institut National de Recherche en Informatique et en Automatique Centre de Recherche Sophia Antipolis Méditerranée, Sophia Antipolis, France
| | - Nicklas Linz
- German Research Centre for Artificial Intelligence Saarbrucken Branch, Saarbrucken, Germany
| | - Hali Lindsay
- Deutsches Forschungszentrum fur Kunstliche Intelligenz GmbH Standort Saarbrucken, Saarbrucken, Germany
| | - Kai Langel
- Janssen Healthcare Innovation, Beerse, Belgium
| | | | - Pascale Lemoine
- Centre Hospitalier de Digne-les-Bains, Digne-les-Bains, France
| | | | - Philippe Robert
- Cobtek (Cognition-Behaviour-Technology) Lab, FRIS, Universite Cote d'Azur, Nice, France
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Manera V, Galperti G, Rovini E, Zeghari R, Mancioppi G, Fiorini L, Gros A, Mouton A, Robert P, Cavallo F. Grasping Social Apathy: The Role of Reach-To-Grasp Action Kinematics for the Assessment of Social Apathy in Mild Neurocognitive Disorders. J Alzheimers Dis 2021; 81:569-582. [PMID: 33814424 DOI: 10.3233/jad-200966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Social apathy, a reduction in initiative in proposing or engaging in social activities or interactions, is common in mild neurocognitive disorders (MND). Current apathy assessment relies on self-reports or clinical scales, but growing attention is devoted to defining more objective, measurable and non-invasive apathy proxies. OBJECTIVE In the present study we investigated the interest of recording action kinematics in a social reach-to-grasp task for the assessment of social apathy. METHODS Thirty participants took part in the study: 11 healthy controls (HC; 6 females, mean age = 68.3±10.5 years) and 19 subjects with MND (13 females, mean age = 75.7±6.3 years). Based on the Diagnostic Criteria for Apathy, MND subjects were classified as socially apathetic (A-MND, N = 9) versus non-apathetic (NA-MND, N = 10). SensRing, a ring-shaped wearable sensor, was placed on their index finger, and subjects were asked to reach and grasp a can to place it into a cup (individual condition) and pass it to a partner (social condition). RESULTS In the reach-to-grasp phase of the action, HC and NA-MND showed different acceleration and velocity profiles in the social versus individual condition. No differences were found for A-MND. CONCLUSION Previous studies showed the interest of recording patients' level of weekly motor activity for apathy assessment. Here we showed that a 10-min reach-to-grasp task may provide information to differentiate socially apathetic and non-apathetic subjects with MND, thus providing a tool easily usable in the clinical practice. Future studies with a bigger sample are needed to better characterize these findings.
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Affiliation(s)
- Valeria Manera
- CoBTeK Laboratory, Université Cote d'Azur, Nice, France.,IA Association, Nice, France
| | - Guenda Galperti
- BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Erika Rovini
- BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Radia Zeghari
- CoBTeK Laboratory, Université Cote d'Azur, Nice, France.,IA Association, Nice, France
| | - Gianmaria Mancioppi
- BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Laura Fiorini
- Department of Industrial Engineering, University of Florence, Florence, Italy
| | - Auriane Gros
- CoBTeK Laboratory, Université Cote d'Azur, Nice, France.,IA Association, Nice, France.,Department of Speech Therapy,Université Cote d'Azur, Nice, France
| | - Aurélie Mouton
- CoBTeK Laboratory, Université Cote d'Azur, Nice, France.,IA Association, Nice, France.,Centre Mémoire de Ressources et de Recherche, Nice University Hospital, Nice, France
| | - Philippe Robert
- CoBTeK Laboratory, Université Cote d'Azur, Nice, France.,IA Association, Nice, France.,Centre Mémoire de Ressources et de Recherche, Nice University Hospital, Nice, France
| | - Filippo Cavallo
- Department of Industrial Engineering, University of Florence, Florence, Italy.,BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy.,Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
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18
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Zeghari R, König A, Guerchouche R, Sharma G, Joshi J, Fabre R, Robert P, Manera V. Correlations Between Facial Expressivity and Apathy in Elderly People With Neurocognitive Disorders: Exploratory Study. JMIR Form Res 2021; 5:e24727. [PMID: 33787499 PMCID: PMC8047819 DOI: 10.2196/24727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/23/2020] [Accepted: 01/18/2021] [Indexed: 01/20/2023] Open
Abstract
Background Neurocognitive disorders are often accompanied by behavioral symptoms such as anxiety, depression, and/or apathy. These symptoms can occur very early in the disease progression and are often difficult to detect and quantify in nonspecialized clinical settings. Objective We focus in this study on apathy, one of the most common and debilitating neuropsychiatric symptoms in neurocognitive disorders. Specifically, we investigated whether facial expressivity extracted through computer vision software correlates with the severity of apathy symptoms in elderly subjects with neurocognitive disorders. Methods A total of 63 subjects (38 females and 25 males) with neurocognitive disorder participated in the study. Apathy was assessed using the Apathy Inventory (AI), a scale comprising 3 domains of apathy: loss of interest, loss of initiation, and emotional blunting. The higher the scale score, the more severe the apathy symptoms. Participants were asked to recall a positive and a negative event of their life, while their voice and face were recorded using a tablet device. Action units (AUs), which are basic facial movements, were extracted using OpenFace 2.0. A total of 17 AUs (intensity and presence) for each frame of the video were extracted in both positive and negative storytelling. Average intensity and frequency of AU activation were calculated for each participant in each video. Partial correlations (controlling for the level of depression and cognitive impairment) were performed between these indexes and AI subscales. Results Results showed that AU intensity and frequency were negatively correlated with apathy scale scores, in particular with the emotional blunting component. The more severe the apathy symptoms, the less expressivity in specific emotional and nonemotional AUs was displayed from participants while recalling an emotional event. Different AUs showed significant correlations depending on the sex of the participant and the task’s valence (positive vs negative story), suggesting the importance of assessing male and female participants independently. Conclusions Our study suggests the interest of employing computer vision-based facial analysis to quantify facial expressivity and assess the severity of apathy symptoms in subjects with neurocognitive disorders. This may represent a useful tool for a preliminary apathy assessment in nonspecialized settings and could be used to complement classical clinical scales. Future studies including larger samples should confirm the clinical relevance of this kind of instrument.
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Affiliation(s)
- Radia Zeghari
- Cognition Behaviour Technology Research Unit, Memory Center, Université Côte d'Azur, Nice, France.,Association Innovation Alzheimer, Nice, France
| | - Alexandra König
- Cognition Behaviour Technology Research Unit, Memory Center, Université Côte d'Azur, Nice, France.,French Institute for Research in Computer Science and Automation, Valbonne, France
| | - Rachid Guerchouche
- French Institute for Research in Computer Science and Automation, Valbonne, France
| | | | | | - Roxane Fabre
- Cognition Behaviour Technology Research Unit, Memory Center, Université Côte d'Azur, Nice, France.,Centre Hospitalier Universitaire de Nice, Département de Santé Publique, Nice, France
| | - Philippe Robert
- Cognition Behaviour Technology Research Unit, Memory Center, Université Côte d'Azur, Nice, France.,Association Innovation Alzheimer, Nice, France
| | - Valeria Manera
- Cognition Behaviour Technology Research Unit, Memory Center, Université Côte d'Azur, Nice, France.,Association Innovation Alzheimer, Nice, France
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Mancioppi G, Fiorini L, Rovini E, Zeghari R, Gros A, Manera V, Mouton A, Philippe R, Cavallo F. How dominant hand dexterity could help in characterizing different grades of cognitive decline: A motor and cognitive dual‐task study. Alzheimers Dement 2020. [DOI: 10.1002/alz.042645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Laura Fiorini
- The BioRobotics Institute Scuola Superiore Sant’Anna Pontedera Italy
| | - Erika Rovini
- The BioRobotics Institute Scuola Superiore Sant’Anna Pontedera Italy
| | - Radia Zeghari
- Université Côte d’Azur Cognition Behaviour Technology Lab (CoBTeK) Nice France
| | - Auriane Gros
- Centre Mémoire de Ressources et de Recherche Nice University Hospital Nice France
| | - Valeria Manera
- Université Côte d’Azur Cognition Behaviour Technology Lab (CoBTek) Nice France
| | - Aurelie Mouton
- Centre Hospitalier Universitaire de Nice CMRR Nice France
| | | | - Filippo Cavallo
- The BioRobotics Institute Scuola Superiore Sant’Anna Pontedera Italy
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20
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Manera V, Galperti G, Rovini E, Zeghari R, Mancioppi G, Fiorini L, Plonka A, Mouton A, Zory R, Corveleyn X, Robert P, Cavallo F, Gros A. Developing non‐invasive, objective assessment tools for social apathy in neurocognitive disorders: The role of action kinematics. Alzheimers Dement 2020. [DOI: 10.1002/alz.047204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Valeria Manera
- Université Côte d’Azur Cognition Behaviour Technology Lab (CoBTeK) Nice France
- Association innovation Alzheimer Nice France
| | - Guenda Galperti
- The BioRobotics Institute Scuola Superiore Sant’Anna Pontedera Italy
| | - Erika Rovini
- The BioRobotics Institute Scuola Superiore Sant’Anna Pontedera Italy
| | - Radia Zeghari
- Université Côte d’Azur Cognition Behaviour Technology Lab (CoBTeK) Nice France
- Association innovation Alzheimer Nice France
| | | | - Laura Fiorini
- The BioRobotics Institute Scuola Superiore Sant’Anna Pontedera Italy
| | | | - Aurelie Mouton
- Université Côte d’Azur Cognition Behaviour Technology Lab (CoBTeK) Nice France
- Centre Hospitalier Universitaire de Nice, CMRR Nice France
| | | | | | - Philippe Robert
- Université Côte d’Azur Cognition Behaviour Technology Lab (CoBTeK) Nice France
- Association innovation Alzheimer Nice France
- Centre Hospitalier Universitaire de Nice, CMRR Nice France
| | - Filippo Cavallo
- The BioRobotics Institute Scuola Superiore Sant’Anna Pontedera Italy
| | - Auriane Gros
- Université Côte d’Azur Cognition Behaviour Technology Lab (CoBTeK) Nice France
- Université Cote d'Azur Department of Speech Therapy Nice France
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21
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König A, Zeghari R, Guerchouche R, Linz N, Ramakers IHGB, Lemoine P, Bultingaire V, Robert P. Validation of a telemedicine tool for patient monitoring in clinical dementia trials. Alzheimers Dement 2020. [DOI: 10.1002/alz.047345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Alexandra König
- CoBTeK (Cognition Behaviour Technology) Research Lab University Côte d’Azur Nice France
- National Institute for Research in Computer Science and Automation (INRIA) Sophia Antipolis France
| | - Radia Zeghari
- Université Côte d’Azur Cognition Behaviour Technology Lab (CoBTeK) Nice France
| | | | | | - Inez HGB Ramakers
- Alzheimer Center Limburg School for Mental Health and Neuroscience Maastricht University Maastricht Netherlands
| | - Pascale Lemoine
- Centre Hospitalier Dignes‐les‐Bains, France Dignes‐les‐Bains France
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22
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Mancioppi G, Fiorini L, Rovini E, Zeghari R, Gros A, Manera V, Robert P, Cavallo F. How Dominant Hand and Foot Dexterity May Reveal Dementia Onset: A Motor and Cognitive Dual-Task Study .. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:5619-5622. [PMID: 33019251 DOI: 10.1109/embc44109.2020.9175854] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The combined provision of an arising number of dementia cases, and the substantial absence of effective treatments, led the scientific community toward the identification of early phases of this condition. Such an effort aims at the recognition of therapeutic windows and the characterization of the disease's different grades. In the last years, Motor and Cognitive Dual-Tasks (MCDT) have been widely used to address the early diagnosis of several neurocognitive disorders, among which dementia. Here we present different protocols: the walking MCDT, the toe-tapping MCDT, and the forefinger-tapping MCDT. Moreover, each task has been performed under different cognitive conditions: no cognitive effort, counting backwards by 1, 3, and 7. In this work, we report the results obtained through the combination of different motor and cognitive tasks, and we present 2 brand-new MCDT protocols, attempting to identify a sweet-spot for early diagnosis of dementia.
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23
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Manera V, Abrahams S, Agüera-Ortiz L, Bremond F, David R, Fairchild K, Gros A, Hanon C, Husain M, König A, Lockwood PL, Pino M, Radakovic R, Robert G, Slachevsky A, Stella F, Tribouillard A, Trimarchi PD, Verhey F, Yesavage J, Zeghari R, Robert P. Recommendations for the Nonpharmacological Treatment of Apathy in Brain Disorders. Am J Geriatr Psychiatry 2020; 28:410-420. [PMID: 31495772 DOI: 10.1016/j.jagp.2019.07.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/26/2019] [Accepted: 07/26/2019] [Indexed: 11/18/2022]
Abstract
Apathy is a common neuropsychiatric syndrome observed across many neurocognitive and psychiatric disorders. Although there are currently no definitive standard therapies for the treatment of apathy, nonpharmacological treatment (NPT) is often considered to be at the forefront of clinical management. However, guidelines on how to select, prescribe, and administer NPT in clinical practice are lacking. Furthermore, although new Information and Communication Technologies (ICT) are beginning to be employed in NPT, their role is still unclear. The objective of the present work is to provide recommendations for the use of NPT for apathy, and to discuss the role of ICT in this domain, based on opinions gathered from experts in the field. The expert panel included 20 researchers and healthcare professionals working on brain disorders and apathy. Following a standard Delphi methodology, experts answered questions via several rounds of web-surveys, and then discussed the results in a plenary meeting. The experts suggested that NPT are useful to consider as therapy for people presenting with different neurocognitive and psychiatric diseases at all stages, with evidence of apathy across domains. The presence of a therapist and/or a caregiver is important in delivering NPT effectively, but parts of the treatment may be performed by the patient alone. NPT can be delivered both in clinical settings and at home. However, while remote treatment delivery may be cost and time-effective, it should be considered with caution, and tailored based on the patient's cognitive and physical profile and living conditions.
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Affiliation(s)
- Valeria Manera
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France; Association Innovation Alzheimer (VM, PR), Nice, France.
| | - Sharon Abrahams
- School of Philosophy, Psychology and Language Sciences (SA), University of Edinburgh, Edinburgh, United Kingdom; Euan MacDonald Centre for Motor Neurone Disease Research (SA, RR), University of Edinburgh, Edinburgh, United Kingdom
| | - Luis Agüera-Ortiz
- Department of Psychiatry (LA-O), Instituto de Investigación Sanitaria (imas12), Hospital Universitario 12 de Octubre & CIBERSAM, Madrid, Spain
| | - François Bremond
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France; INRIA (FB, AK), STARS Team, Sophia Antipolis, France
| | - Renaud David
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France; Centre Hospitalier Universitaire (CHU) de Nice (RD, PR), CMRR, Nice, France
| | - Kaci Fairchild
- Department of Veterans Affairs (KF, JY), VA Palo Alto Health Care System, CA; Department of Psychiatry and Behavioral Sciences (KF, JY), Stanford University School of Medicine, CA
| | - Auriane Gros
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France
| | - Cécile Hanon
- Psychiatric Department, Regional Resource Center of Old Age Psychiatry Corentin-Celton Hospital (CH), Academic Hospital West Paris, AP-HP, Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Masud Husain
- Nuffield Department of Clinical Neurosciences (MH, PL), John Radcliffe Hospital Oxford OX3 9DU, United Kingdom; Department of Experimental Psychology (MH, PL), University of Oxford, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging (MH, PL), University of Oxford, Oxford, United Kingdom
| | - Alexandra König
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France; INRIA (FB, AK), STARS Team, Sophia Antipolis, France
| | - Patricia L Lockwood
- Nuffield Department of Clinical Neurosciences (MH, PL), John Radcliffe Hospital Oxford OX3 9DU, United Kingdom; Department of Experimental Psychology (MH, PL), University of Oxford, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging (MH, PL), University of Oxford, Oxford, United Kingdom
| | - Maribel Pino
- Broca Living Lab (MP), AP-HP, Paris Descartes University, Sorbonne Paris Cite, Paris, France
| | - Ratko Radakovic
- Euan MacDonald Centre for Motor Neurone Disease Research (SA, RR), University of Edinburgh, Edinburgh, United Kingdom; Faculty of Medicine and Health Sciences (RR), University of East Anglia, Norwich, United Kingdom; Alzheimer Scotland Dementia Research Centre (RR), University of Edinburgh, Edinburgh, United Kingdom
| | - Gabriel Robert
- EA4712 "Comportement et Noyaux Gris Centraux" (GR), Université de Rennes1, France
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO) (AS), Faculty of Medicine, University of Chile, Santiago, Chile; Neuropsychology and Clinical Neuroscience Laboratory (LANNEC) (AS), Physiopathology Department - ICBM, Chile; Neuroscience and East Neuroscience Departments (AS), Faculty of Medicine, University of Chile, Chile; Memory and Neuropsychiatric Clinic (CMYN) Neurology Department (AS), Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile; Servicio de Neurología (AS), Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Florindo Stella
- Laboratório de Neurociências LIM27 (FS), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brasil; UNESP - Universidade Estadual Paulista (FS), Biosciences Institute, Campus of Rio Claro, Rio Claro, SP, Brazil
| | - Anaïs Tribouillard
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France; ISTR (AT), Institute of Rehabilitation Sciences and Techniques, University of Lyon 1, Lyon, France; Specialised Alzheimer Team (AT), SSIAD Quimper, France
| | | | - Frans Verhey
- Department of Psychiatry and Neuropsychology (FV), Maastricht University, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht, the Netherlands
| | - Jerome Yesavage
- Department of Veterans Affairs (KF, JY), VA Palo Alto Health Care System, CA; Department of Psychiatry and Behavioral Sciences (KF, JY), Stanford University School of Medicine, CA
| | - Radia Zeghari
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France
| | - Philippe Robert
- Université Côte d'Azur, CoBTeK lab (VM, FB, RD, AG, AK,AT, RZ, PR), Nice, France; Association Innovation Alzheimer (VM, PR), Nice, France; Centre Hospitalier Universitaire (CHU) de Nice (RD, PR), CMRR, Nice, France
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Zeghari R, Manera V, Fabre R, Guerchouche R, König A, Phan Tran MK, Robert P. The “Interest Game”: A Ludic Application to Improve Apathy Assessment in Patients with Neurocognitive Disorders. J Alzheimers Dis 2020; 74:669-677. [DOI: 10.3233/jad-191282] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Radia Zeghari
- Université Côte d’Azur, CoBTeK Laboratory, Nice, France
- Association IA (Alzheimer-Affect-Autism), Nice, France
| | - Valeria Manera
- Université Côte d’Azur, CoBTeK Laboratory, Nice, France
- Association IA (Alzheimer-Affect-Autism), Nice, France
| | - Roxane Fabre
- Université Côte d’Azur, CoBTeK Laboratory, Nice, France
- Centre Hospitalier Universitaire de Nice, Département de Santé Publique, Nice, France
| | | | - Alexandra König
- Université Côte d’Azur, CoBTeK Laboratory, Nice, France
- Inria Sophia Antipolis, STARS team, Sophia Antipolis, France
| | - Minh Khue Phan Tran
- Université Côte d’Azur, CoBTeK Laboratory, Nice, France
- Inria Sophia Antipolis, STARS team, Sophia Antipolis, France
| | - Philippe Robert
- Université Côte d’Azur, CoBTeK Laboratory, Nice, France
- Association IA (Alzheimer-Affect-Autism), Nice, France
- Centre Hospitalier Universitaire de Nice, Resource & Research Memory Centre, Nice
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25
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Manera V, Fabre R, Stella F, Loureiro JC, Agüera-Ortiz L, López-Álvarez J, Hanon C, Hoertel N, Aalten P, Ramakers I, Zeghari R, Robert P. A survey on the prevalence of apathy in elderly people referred to specialized memory centers. Int J Geriatr Psychiatry 2019; 34:1369-1377. [PMID: 30993719 DOI: 10.1002/gps.5125] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 04/12/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND Apathy is a pervasive neuropsychiatric syndrome in people with neurocognitive and psychiatric disorders. The diagnostic criteria for apathy (DCA) have been revised in 2018. OBJECTIVES Employing the 2018 DCA, in the present study, we investigated in groups of elderly subjects suffering from different neuropsychiatric disorders (a) the apathy prevalence; (b) the most commonly affected apathy dimensions (behavior/cognition, emotion, and social interaction); (c) the sensitivity and specificity of those dimensions for apathy diagnosis; and (d) the concurrent validity of 2018 DCA compared with the 2009 DCA. METHODS This multicenter survey included 166 subjects. Each center checked the presence of apathy in subjects belonging to the following DSM-5 diagnoses: mild neurocognitive disorders (mild NCDs); major NCDs; affective disorders (Aff D); and subjective cognitive decline (SCD). RESULTS The frequency of apathy varied significantly based on the diagnostic groups (0% of subjects with apathy in the SCD group; 25% in the mild NCD group; 77% in the major NCD group; and 57% in the Aff. D group). All subjects with apathy fulfilled the criteria for the behavior/cognition dimension, 73.1% fulfilled the criteria for the emotion dimension, and 97.4% fulfilled the criteria for the social interaction dimension. Behavior/cognition showed the highest sensitivity, the copresence of emotion and social interaction the highest specificity. The concordance between the 2009 and the 2018 DCA indicated an almost perfect agreement. CONCLUSIONS These results are consistent with previous reports and confirm that the social interaction dimension added to the 2018 DCA is present in most of subjects with apathy referred to specialized memory centers.
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Affiliation(s)
- Valeria Manera
- Université Côte d'Azur, CoBTeK lab, Centre Hospitalier Universitaire de Nice, CMRR, Nice, France
| | - Roxane Fabre
- Université Côte d'Azur, CoBTeK lab, Centre Hospitalier Universitaire de Nice, CMRR, Nice, France
| | - Florindo Stella
- Laboratório de Neurociências LIM27, Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.,Biosciences Institute, UNESP-Universidade Estadual Paulista, Campus of Rio Claro, São Paulo, Brazil
| | - Júlia Cunha Loureiro
- Laboratório de Neurociências LIM27, Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.,Biosciences Institute, UNESP-Universidade Estadual Paulista, Campus of Rio Claro, São Paulo, Brazil
| | - Luis Agüera-Ortiz
- Department of Psychiatry, Instituto de Investigación Sanitaria (imas12), Hospital Universitario 12 de Octubre, CIBERSAM, Madrid, Spain
| | - Jorge López-Álvarez
- Department of Psychiatry, Instituto de Investigación Sanitaria (imas12), Hospital Universitario 12 de Octubre, CIBERSAM, Madrid, Spain
| | - Cécile Hanon
- Psychiatric Department, AP-HP, Regional Resource Center of Old Age Psychiatry Corentin-Celton Hospital, Academic Hospital West Paris, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Nicolas Hoertel
- Psychiatric Department, AP-HP, Regional Resource Center of Old Age Psychiatry Corentin-Celton Hospital, Academic Hospital West Paris, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Pauline Aalten
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht, The Netherlands
| | - Inez Ramakers
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience (MHeNs), Alzheimer Center Limburg, Maastricht, The Netherlands
| | - Radia Zeghari
- Université Côte d'Azur, CoBTeK lab, Centre Hospitalier Universitaire de Nice, CMRR, Nice, France
| | - Philippe Robert
- Université Côte d'Azur, CoBTeK lab, Centre Hospitalier Universitaire de Nice, CMRR, Nice, France
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König A, Guerchouche R, Manera V, Linz N, Philippe R, Zeghari R. P4‐700: REMOTE COGNITIVE TESTING AND MONITORING OF PATIENTS IN RURAL AREAS BY TELEMEDICINE AND AI ‐ EMPOWERED AUTOMATIC SPEECH AND IMAGE ANALYSIS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.09.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Alexandra König
- CoBTeK (Cognition Behaviour Technology) Research Lab University Côte d'Azur Nice France
- National Institute for Research in Computer Science and Automation (INRIA) Sophia Antipolis France
| | | | - Valeria Manera
- CoBTeK “Cognition Behaviour Technology”, Cote d'Azur University Nice France
| | - Nicklas Linz
- Deutsches Forschungszentrum fuer Kuenstliche Intelligenz Saarbrücken Germany
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27
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Affiliation(s)
- Radia Zeghari
- CobTEk Université Nice Sophia Antipolis; Nice France
| | | | - Valeria Manera
- CoBTeK “Cognition Behaviour Technology”; Cote d'Azur University; Nice France
| | | | - Alexandra König
- CoBTeK (Cognition Behaviour Technology) Research Lab; University Côte d'Azur; Nice France
- National Institute for Research in Computer Science and Automation (INRIA); Sophia Antipolis France
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28
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Manera V, Zeghari R, Antelmi L. P2-520: PREVALENCE OF LACK OF INTEREST AND ANHEDONIA IN THE GENERAL POPULATION OF THE UK BIOBANK. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.2928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Valeria Manera
- CoBTeK “Cognition Behaviour Technology ”; Cote d'Azur University; Nice France
| | - Radia Zeghari
- CobTEk Université Nice Sophia Antipolis; Nice France
| | - Luigi Antelmi
- Université Cote d'Azur; INRIA-Epione Team; Sophia Antipolis France
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29
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Robert P, Zeghari R, Manera V. TD‐P‐20: TIMES ARE CHANGING: ASSESSMENT OF APATHY USING NEW TECHNOLOGIES. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | | | - Valeria Manera
- CoBTeK “Cognition Behaviour Technology” Cote d'Azur University Nice France
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König A, Linz N, Zeghari R, Klinge X, Tröger J, Alexandersson J, Robert P. Detecting Apathy in Older Adults with Cognitive Disorders Using Automatic Speech Analysis. J Alzheimers Dis 2019; 69:1183-1193. [DOI: 10.3233/jad-181033] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Alexandra König
- CoBTeK (Cognition-Behaviour-Technology) Lab, Memory Center CHU, Université Côte d’Azur, Nice, France
- INRIA Stars Team, Sophia Antipolis, Valbonne, France
| | - Nicklas Linz
- German Research Center for Artificial Intelligence (DFKI), Saarbrücken, Germany
| | - Radia Zeghari
- CoBTeK (Cognition-Behaviour-Technology) Lab, Memory Center CHU, Université Côte d’Azur, Nice, France
| | - Xenia Klinge
- German Research Center for Artificial Intelligence (DFKI), Saarbrücken, Germany
| | - Johannes Tröger
- German Research Center for Artificial Intelligence (DFKI), Saarbrücken, Germany
| | - Jan Alexandersson
- German Research Center for Artificial Intelligence (DFKI), Saarbrücken, Germany
| | - Philippe Robert
- CoBTeK (Cognition-Behaviour-Technology) Lab, Memory Center CHU, Université Côte d’Azur, Nice, France
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