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Wang M, Shen C, Liu X, Feng Z, Wang H, Han F, Xiao F. Executive function performance in children and adolescent patients with narcolepsy type 1. Sleep Med 2024; 119:342-351. [PMID: 38754344 DOI: 10.1016/j.sleep.2024.05.021] [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: 01/17/2024] [Revised: 04/25/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE The executive function profile in patients with narcolepsy type 1 (NT1) has been mentioned; however, limited research exists on children and adolescent patients with NT1.This study aims to assess executive function in children and adolescent patients with NT1 in China, examine potential influencing factors and evaluate the short-term treatment effect on executive function. METHODS 53 NT1 patients (36 males, age 12.2 ± 3.4 years) and 37 healthy controls (23 males, age 12.2 ± 2.5 years) underwent self-reported measures assessing subjective sleepiness, depression, anxiety and sleep quality. A comprehensive neuropsychological test was administered to assess executive function domains, including processing speed, inhibitory control, cognitive flexibility and working memory. These assessments were repeated in NT1 patients after three-day regular drug treatment. RESULTS NT1 patients exhibited higher levels of excessive daytime sleepiness, depression, anxiety, and poor sleep quality compared to healthy controls. Patients showed impaired processing speed, inhibitory control and cognitive flexibility (p < 0.05), whereas working memory was unaffected (p > 0.05). Regression analysis revealed that parameters from sleep monitoring, such as sleep efficiency and sleep latency, were correlated with executive function performance after controlling for age, gender, and education years. The short-term treatment led to improvements in inhibitory control, cognitive flexibility, and working memory. CONCLUSION The findings showed that executive function was impaired among children and adolescent patients with NT1, which was associated with objective sleep parameters. Furthermore, this study emphasizes the necessity of neuropsychological assessments and early interventions among children and adolescent NT1 patients.
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Affiliation(s)
- Mengmeng Wang
- School of Nursing, Peking University, Beijing, China; Division of Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Chaoran Shen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Xinran Liu
- School of Nursing, Peking University, Beijing, China; Division of Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Zhaoyan Feng
- Division of Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Huanhuan Wang
- School of Nursing, Peking University, Beijing, China; Division of Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Fang Han
- Division of Sleep Medicine, Peking University People's Hospital, Beijing, China.
| | - Fulong Xiao
- Division of Sleep Medicine, Peking University People's Hospital, Beijing, China.
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Kwak S, Kim H, Kim KY, Oh DY, Lee D, Nam G, Lee JY. Neuroanatomical and neurocognitive correlates of delusion in Alzheimer's disease and mild cognitive impairment. BMC Neurol 2024; 24:89. [PMID: 38448803 PMCID: PMC10916051 DOI: 10.1186/s12883-024-03568-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/12/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Neuropsychiatric symptoms and delusions are highly prevalent among people with dementia. However, multiple roots of neurobiological bases and shared neural basis of delusion and cognitive function remain to be characterized. By utilizing a fine-grained multivariable approach, we investigated distinct neuroanatomical correlates of delusion symptoms across a large population of dementing illnesses. METHODS In this study, 750 older adults with mild cognitive impairment and Alzheimer's disease completed brain structural imaging and neuropsychological assessment. We utilized principal component analysis followed by varimax rotation to identify the distinct multivariate correlates of cortical thinning patterns. Five of the cognitive domains were assessed whether the general cognitive abilities mediate the association between cortical thickness and delusion. RESULTS The result showed that distributed thickness patterns of temporal and ventral insular cortex (component 2), inferior and lateral prefrontal cortex (component 1), and somatosensory-visual cortex (component 5) showed negative correlations with delusions. Subsequent mediation analysis showed that component 1 and 2, which comprises inferior frontal, anterior insula, and superior temporal regional thickness accounted for delusion largely through lower cognitive functions. Specifically, executive control function assessed with the Trail Making Test mediated the relationship between two cortical thickness patterns and delusions. DISCUSSION Our findings suggest that multiple distinct subsets of brain regions underlie the delusions among older adults with cognitive impairment. Moreover, a neural loss may affect the occurrence of delusion in dementia largely due to impaired general cognitive abilities.
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Affiliation(s)
- Seyul Kwak
- Department of Psychology, Pusan National University, Busan, Republic of Korea
| | - Hairin Kim
- Department of Psychiatry, Seoul National University College of Medicine & SMG-SNU Boramae Medical Center, Seoul, 07061, Republic of Korea
| | - Keun You Kim
- Department of Psychiatry, Seoul National University College of Medicine & SMG-SNU Boramae Medical Center, Seoul, 07061, Republic of Korea
| | - Da Young Oh
- Department of Psychiatry, Seoul National University College of Medicine & SMG-SNU Boramae Medical Center, Seoul, 07061, Republic of Korea
| | - Dasom Lee
- Department of Psychiatry, Seoul National University College of Medicine & SMG-SNU Boramae Medical Center, Seoul, 07061, Republic of Korea
| | - Gieun Nam
- Department of Psychiatry, Seoul National University College of Medicine & SMG-SNU Boramae Medical Center, Seoul, 07061, Republic of Korea
| | - Jun-Young Lee
- Department of Psychiatry, Seoul National University College of Medicine & SMG-SNU Boramae Medical Center, Seoul, 07061, Republic of Korea.
- Department of Medical Device Development, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Kho SK, Leong BQZ, Keeble DRT, Wong HK, Estudillo AJ. A new Asian version of the CFMT: The Cambridge Face Memory Test - Chinese Malaysian (CFMT-MY). Behav Res Methods 2024; 56:1192-1206. [PMID: 36971958 DOI: 10.3758/s13428-023-02085-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 03/29/2023]
Abstract
The Cambridge Face Memory Test (CFMT) is one of the most important measures of individual differences in face recognition and for the diagnosis of prosopagnosia. Having two different CFMT versions using a different set of faces seems to improve the reliability of the evaluation. However, at the present time, there is only one Asian version of the test. In this study, we present the Cambridge Face Memory Test - Chinese Malaysian (CFMT-MY), a novel Asian CFMT using Chinese Malaysian faces. In Experiment 1, Chinese Malaysian participants (N = 134) completed two versions of the Asian CFMT and one object recognition test. The CFMT-MY showed a normal distribution, high internal reliability, high consistency and presented convergent and divergent validity. Additionally, in contrast to the original Asian CFMT, the CFMT-MY showed an increasing level of difficulties across stages. In Experiment 2, Caucasian participants (N = 135) completed the two versions of the Asian CFMT and the original Caucasian CFMT. Results showed that the CFMT-MY exhibited the other-race effect. Overall, the CFMT-MY seems to be suitable for the diagnosis of face recognition difficulties and could be used as a measure of face recognition ability by researchers who wish to examine face-related research questions such as individual differences or the other-race effect.
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Affiliation(s)
- Siew Kei Kho
- School of Psychology, University of Nottingham Malaysia, Jalan Broga, 43500, Semenyih, Selangor, Malaysia.
| | - Bryan Qi Zheng Leong
- School of Psychology, University of Nottingham Malaysia, Jalan Broga, 43500, Semenyih, Selangor, Malaysia
| | - David R T Keeble
- School of Psychology, University of Nottingham Malaysia, Jalan Broga, 43500, Semenyih, Selangor, Malaysia
| | - Hoo Keat Wong
- School of Psychology, University of Nottingham Malaysia, Jalan Broga, 43500, Semenyih, Selangor, Malaysia
| | - Alejandro J Estudillo
- School of Psychology, University of Nottingham Malaysia, Jalan Broga, 43500, Semenyih, Selangor, Malaysia.
- Department of Psychology, Bournemouth University, Poole House Talbot Campus, BH12, Bournemouth, UK.
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Fırat Z, Er F, Noyan H, Ekinci G, Üçok A, Uluğ AM, Aktekin B. Discriminant analysis using MRI asymmetry indices and cognitive scores of women with temporal lobe epilepsy or schizophrenia. Neuroradiology 2024:10.1007/s00234-024-03317-y. [PMID: 38416211 DOI: 10.1007/s00234-024-03317-y] [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: 08/16/2023] [Accepted: 02/20/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE This study aims to assess the diagnostic power of brain asymmetry indices and neuropsychological tests for differentiating mesial temporal lobe epilepsy (MTLE) and schizophrenia (SCZ). METHODS We studied a total of 39 women including 13 MTLE, 13 SCZ, and 13 healthy individuals (HC). A neuropsychological test battery (NPT) was administered and scored by an experienced neuropsychologist, and NeuroQuant (CorTechs Labs Inc., San Diego, California) software was used to calculate brain asymmetry indices (ASI) for 71 different anatomical regions of all participants based on their 3D T1 MR imaging scans. RESULTS Asymmetry indices measured from 10 regions showed statistically significant differences between the three groups. In this study, a multi-class linear discriminant analysis (LDA) model was built based on a total of fifteen variables composed of the most five significantly informative NPT scores and ten significant asymmetry indices, and the model achieved an accuracy of 87.2%. In pairwise classification, the accuracy for distinguishing MTLE from either SCZ or HC was 94.8%, while the accuracy for distinguishing SCZ from either MTLE or HC was 92.3%. CONCLUSION The ability to differentiate MTLE from SCZ using neuroradiological and neuropsychological biomarkers, even within a limited patient cohort, could make a substantial contribution to research in larger patient groups using different machine learning techniques.
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Affiliation(s)
- Zeynep Fırat
- Department of Radiology, Yeditepe University Hospitals, Kosuyolu, 34718, Istanbul, Turkey.
| | - Füsun Er
- Department of Information Systems Engineering, Piri Reis University, Istanbul, Turkey
| | - Handan Noyan
- Faculty of Social Sciences, Department of Psychology, Beykoz University, 34810, Istanbul, Turkey
| | - Gazanfer Ekinci
- Department of Radiology, Yeditepe University Hospitals, Kosuyolu, 34718, Istanbul, Turkey
| | - Alp Üçok
- Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul University, 34134, Istanbul, Turkey
| | - Aziz M Uluğ
- Institute of Biomedical Engineering, Boğaziçi University, Istanbul, Turkey
- CorTechs Labs Inc, San Diego, CA, USA
| | - Berrin Aktekin
- Department of Neurology, Yeditepe University Hospitals, Kosuyolu, 34718, Istanbul, Turkey
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Zhang P, Gan D, Chi X, Mao D, Gao Y, Li Y, Zhou D, Li Q, Zhang M, Lu B, Li F, Xue J, Wang X, Du H, Li X, Liang Y, Ye Y. Regression-based Chinese norms of number connection test A and digit symbol test for diagnosing minimal hepatic encephalopathy. Sci Rep 2024; 14:4005. [PMID: 38369632 PMCID: PMC10874952 DOI: 10.1038/s41598-024-54696-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 02/15/2024] [Indexed: 02/20/2024] Open
Abstract
Number connection test A (NCT-A) and digit symbol test (DST), the preferential neuropsychological tests to detect minimal hepatic encephalopathy (MHE) in China, haven't been standardized in Chinese population. We aimed to establish the norms based on a multi-center cross-sectional study and to detect MHE in cirrhotic patients. NCT-A and DST were administered to 648 healthy controls and 1665 cirrhotic patients. The regression-based procedure was applied to develop demographically adjusted norms for NCT-A and DST based on healthy controls. Age, gender, education, and age by education interaction were all predictors of DST, while age, gender, and education by gender interaction were predictors of log10 NCT-A. The predictive equations for expected scores of NCT-A and DST were established, and Z-scores were calculated. The norm for NCT-A was set as Z ≤ 1.64, while the norm for DST was set as Z ≥ - 1.64. Cirrhotic patients with concurrent abnormal NCT-A and DST results were diagnosed with MHE. The prevalence of MHE was 8.89% in cirrhotic patients, and only worse Child-Pugh classification (P = 0.002, OR = 2.389) was demonstrated to be the risk factor for MHE. The regression-based normative data of NCT-A and DST have been developed to detect MHE in China. A significant proportion of Chinese cirrhotic patients suffered from MHE, especially those with worse Child-Pugh classification.
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Affiliation(s)
- Peng Zhang
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Beijing University of Chinese Medicine Affiliated Dongfang Hospital, Beijing, China
| | - Danan Gan
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Xiaoling Chi
- Department of Hepatology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Dewen Mao
- Department of Hepatology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi Province, China
| | - Yueqiu Gao
- Department of Hepatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yong Li
- Department of Hepatology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Daqiao Zhou
- Department of Hepatology, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong Province, China
| | - Qin Li
- The Fourth Ward, Fuzhou Infectious Disease Hospital, Fuzhou, Fujian Province, China
| | - Mingxiang Zhang
- Department of Integrated Traditional and Western Medicine on Liver Diseases, Shenyang Infectious Disease Hospital, Shenyang, Liaoning Province, China
| | - Bingjiu Lu
- Department of Hepatology, The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, China
| | - Fengyi Li
- Treatment and Research Center of Infectious Disease, The Fifth Medical Center of the General Hospital of the People's Liberation Army, Beijing, China
| | - Jingdong Xue
- Department of Hepatology, Shanxi Hospital of Traditional Chinese Medicine, Xi'an, Shanxi Province, China
| | - Xianbo Wang
- Department of Hepatology, Beijing Ditan Hospital, Beijing, China
| | - Hongbo Du
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Xiaoke Li
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Yijun Liang
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
| | - Yongan Ye
- Institute of Liver Disease, Beijing University of Chinese Medicine, Beijing, China.
- Department of Gastroenterology and Hepatology, Institute of Liver Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China.
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Zhan Y, Cai DC, Liu Y, Song F, Shan F, Song P, Chen G, Zhang Y, Wang H, Shi Y. Altered metabolism in right basal ganglia associated with asymptomatic neurocognitive impairment in HIV-infected individuals. Heliyon 2024; 10:e23342. [PMID: 38169709 PMCID: PMC10758793 DOI: 10.1016/j.heliyon.2023.e23342] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 06/02/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024] Open
Abstract
Background Only few studies have focused on the metabolite differences between asymptomatic neurocognitive impairment (ANI) and cognitively normal people living with HIV (PLWH). The current study aims to examine whether brain metabolisms in basal ganglia (BG) by magnetic resonance spectroscopy (MRS) were potential to discriminate ANI from cognitively normal PLWH. Methods According to neuropsychological (NP) test, 80 PLWH (37.4 ± 10.2 years) were divided into ANI group (HIV-ANI, n = 31) and NP normal group (HIV-normal, n = 49). Brain metabolisms by MRS from right BG were compared between groups, including N-acetylaspartate and N-acetyl aspartylglutamate (tNAA), creatine and phosphocreatine (tCr), and choline-containing compounds (tCho). A total value of three metabolites were introduced. All brain metabolisms were evaluated as its percentage of total. Furthermore, correlations between MRS and NP and clinical measures were evaluated. A logistic regression model was applied, and the AUC values for the model and the continuous factors were compared using receiver operating curve (ROC) analysis. Results Compared to HIV-normal group, tNAA/total was lower and tCr/total was higher in the HIV-ANI group (P < 0.05). Both tNAA/total and tCr/total values were correlated with NP score (P < 0.05), especially in verbal fluency, speed of information processing, learning, and recall (P < 0.05). The logistic model included BG-tCr/total, current CD4 and infection years of PLWH. The AUC value for the BG-tCr/total was 0.696 and was not significantly lower than that for logistic model (P < 0.01). Conclusion The altered brain metabolites in the right BG were found in the ANI group compared to PLWH with normal cognition, and further associated with NP deficits. The current findings indicated that brain metabolites assessed by MRS has the potential to discriminate ANI from cognitively normal PLWH.
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Affiliation(s)
- Yi Zhan
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Dan-Chao Cai
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Ying Liu
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Fengxiang Song
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Fei Shan
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Pengrui Song
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Guochao Chen
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yijun Zhang
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - He Wang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Human Phenome Institute, Fudan University, Shanghai, China
| | - Yuxin Shi
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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Finsterer J. Before blaming unilateral upper-limb trauma for cognitive dysfunction, alternative causes must be ruled out. Hand Surg Rehabil 2023; 42:558-559. [PMID: 37482274 DOI: 10.1016/j.hansur.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 06/27/2023] [Indexed: 07/25/2023]
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Jung SO, Kim JEE, Kim HJ. Assessing objective cognitive impairments in cancer survivors: Features and validity of measures for research and clinical applications. Asia Pac J Oncol Nurs 2023; 10:100309. [PMID: 37928414 PMCID: PMC10622612 DOI: 10.1016/j.apjon.2023.100309] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/11/2023] [Indexed: 11/07/2023] Open
Abstract
Objective This narrative review aims to (1) identify neuropsychological tests for assessing cognitive function impairment in patients with cancer, specifically in the domains of attention and memory, (2) summarize the characteristics of these tests, including cognitive function domains, test content, readability, and psychometric quality, and (3) evaluate the feasibility of each test in cancer care. Methods Data sources include published test manuals, documents from official web pages, and published journal articles. Results Our study identified eight neuropsychological tests that are most frequently used to assess the attention and memory domains of objective cognitive function in patients with breast cancer. These tests include the California Verbal Learning Test, Hopkins Verbal Learning Test, Rey Auditory Verbal Learning Test, Rey-Osterrieth Complex Figure, CNS Vital Signs, Wechsler Adult Intelligence Scale, Wechsler Memory Scale, and Trail Making Test. They demonstrate acceptable evidence of psychometric quality and varying degrees of feasibility. Test feasibility is influenced by factors such as short testing time, brevity and comprehensiveness, clear cognitive domain distinctions, availability of normative data, minimal practice effects, ease of administration, and limited attention-span requirements. These attributes determine a test's feasibility for use in cancer care. Among the evaluated measures, the California Verbal Learning Test for memory, the Trail Making Test for attention, and the CNS Vital Signs for comprehensive assessment emerge as the most practical choices for cancer care. Conclusions The assessment and management of cognitive function impairment are crucial for enhancing the quality of life in cancer survivors. Nurses should possess knowledge of assessment tools for early detection and the ongoing monitoring of this symptom's progression.
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Affiliation(s)
- Sun Ok Jung
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | | | - Hee-Ju Kim
- College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
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Sáez-Atxukarro O, Del Pino R, Peña J, Schretlen DJ, Ibarretxe-Bilbao N, Ojeda N. UD Interference Test: creation and validation of a new instrument of resistance to interference. Normalisation and standardisation for Spanish population. Neurologia 2023; 38:566-576. [PMID: 37437656 DOI: 10.1016/j.nrleng.2023.07.004] [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: 11/26/2020] [Accepted: 01/14/2021] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION The UD Interference Test measures processing speed and attention, and is based on the concept of interference of the Stroop Color and Word Test. The main purpose of the study is to provide an alternative version of the Stroop Color and Word Test that overcomes some of the limitations of previous versions in assessing individuals with daltonism or age-related reading difficulties, and to obtain normative and standardised data for the Spanish population. METHODS This study is part of the Normacog project. We evaluated 905 individuals (age range, 18-93 years) to analyse the test's reliability and concurrent and construct validity. We evaluated the effect of age, sex, and level of education on UD Interference Test performance and calculated percentiles and age- and education-adjusted scaled scores. RESULTS The test has good reliability (α = 0.875) and concurrent (r = 0.443-0.725; P < .001) and construct validity (r = 0.472-0.737; P < .001). We observed age and educational level to have a significant effect on UD Interference Test scores, explaining 12% to 40% of variance. Sex only had a significant effect on the resistance to interference index. CONCLUSIONS We present an alternative version of the Stroop Color and Word Test with some advantages over previous versions. We provide standardised and normalised data for the Spanish population to correct the test according to the subject's age and level of education.
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Affiliation(s)
- O Sáez-Atxukarro
- Departamento de Métodos y Fundamentos de la Psicología; Universidad de Deusto, Bilbao, Spain
| | - R Del Pino
- Grupo de Enfermedades Neurodegenerativas, Instituto de Investigación Sanitaria Biocruces Bizkaia, Barakaldo, Spain
| | - J Peña
- Departamento de Métodos y Fundamentos de la Psicología; Universidad de Deusto, Bilbao, Spain
| | - D J Schretlen
- Departamento de Psiquiatría y Ciencias del Comportamiento; Facultad de Medicina; Johns Hopkins University, Baltimore, MD, USA; Departamento Russell H. Morgan de Radiología y Ciencias Radiológicas; Facultad de Medicina; Johns Hopkins University, Baltimore, MD, USA
| | - N Ibarretxe-Bilbao
- Departamento de Métodos y Fundamentos de la Psicología; Universidad de Deusto, Bilbao, Spain
| | - N Ojeda
- Departamento de Métodos y Fundamentos de la Psicología; Universidad de Deusto, Bilbao, Spain.
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Duricy E, Durisko C, Dickey MW, Fiez JA. Comparing the Reliability of Virtual and In-Person Post-Stroke Neuropsychological Assessment with Language Tasks. Arch Clin Neuropsychol 2023; 38:557-569. [PMID: 36537281 PMCID: PMC10202548 DOI: 10.1093/arclin/acac100] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE Neuropsychological testing is essential for both clinical and basic stroke research; however, the in-person nature of this testing is a limitation. Virtual testing overcomes the hurdles of geographic location, mobility issues and permits social distancing, yet its validity has received relatively little investigation, particularly in comparison with in-person testing. METHOD We expand on our prior findings of virtual testing feasibility by assessing virtual versus in-person administration of language and communication tasks with 48 left-hemisphere stroke patients (21 F, 27 M; mean age = 63.4 ± 12; mean years of education = 15.3 ± 3.5) in a quasi-test-retest paradigm. Each participant completed two testing sessions: one in their home and one in the research lab. Participants were assigned to one of the eight groups, with the testing condition (fully in-person, partially virtual), order of home session (first, second) and technology (iPad, Windows tablet) varied across groups. RESULTS Across six speech-language tasks that utilized varying response modalities and interfaces, we found no significant difference in performance between virtual and in-person testing. However, our results reveal key considerations for successful virtual administration of neuropsychological tests, including technology complications and disparities in internet access. CONCLUSIONS Virtual administration of neuropsychological assessments demonstrates comparable reliability with in-person data collection involving stroke survivors, though technology issues must be taken into account.
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Affiliation(s)
- Erin Duricy
- Learning Research and Development Center, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA 15213, USA
| | - Corrine Durisko
- Learning Research and Development Center, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Michael Walsh Dickey
- Center for the Neural Basis of Cognition, Pittsburgh, PA 15213, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Geriatric Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA
| | - Julie A Fiez
- Learning Research and Development Center, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA 15213, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA 15260, USA
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Ariza M, Cano N, Segura B, Adan A, Bargalló N, Caldú X, Campabadal A, Jurado MA, Mataró M, Pueyo R, Sala-Llonch R, Barrué C, Bejar J, Cortés CU, Garolera M, Junqué C. COVID-19 severity is related to poor executive function in people with post-COVID conditions. J Neurol 2023; 270:2392-2408. [PMID: 36939932 PMCID: PMC10026205 DOI: 10.1007/s00415-023-11587-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 03/21/2023]
Abstract
Patients with post-coronavirus disease 2019 (COVID-19) conditions typically experience cognitive problems. Some studies have linked COVID-19 severity with long-term cognitive damage, while others did not observe such associations. This discrepancy can be attributed to methodological and sample variations. We aimed to clarify the relationship between COVID-19 severity and long-term cognitive outcomes and determine whether the initial symptomatology can predict long-term cognitive problems. Cognitive evaluations were performed on 109 healthy controls and 319 post-COVID individuals categorized into three groups according to the WHO clinical progression scale: severe-critical (n = 77), moderate-hospitalized (n = 73), and outpatients (n = 169). Principal component analysis was used to identify factors associated with symptoms in the acute-phase and cognitive domains. Analyses of variance and regression linear models were used to study intergroup differences and the relationship between initial symptomatology and long-term cognitive problems. The severe-critical group performed significantly worse than the control group in general cognition (Montreal Cognitive Assessment), executive function (Digit symbol, Trail Making Test B, phonetic fluency), and social cognition (Reading the Mind in the Eyes test). Five components of symptoms emerged from the principal component analysis: the "Neurologic/Pain/Dermatologic" "Digestive/Headache", "Respiratory/Fever/Fatigue/Psychiatric" and "Smell/ Taste" components were predictors of Montreal Cognitive Assessment scores; the "Neurologic/Pain/Dermatologic" component predicted attention and working memory; the "Neurologic/Pain/Dermatologic" and "Respiratory/Fever/Fatigue/Psychiatric" components predicted verbal memory, and the "Respiratory/Fever/Fatigue/Psychiatric," "Neurologic/Pain/Dermatologic," and "Digestive/Headache" components predicted executive function. Patients with severe COVID-19 exhibited persistent deficits in executive function. Several initial symptoms were predictors of long-term sequelae, indicating the role of systemic inflammation and neuroinflammation in the acute-phase symptoms of COVID-19." Study Registration: www.ClinicalTrials.gov , identifier NCT05307549 and NCT05307575.
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Affiliation(s)
- Mar Ariza
- grid.5841.80000 0004 1937 0247Unitat de Psicologia Mèdica, Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
- grid.5841.80000 0004 1937 0247Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- grid.476208.f0000 0000 9840 9189Grup de Recerca en Cervell, Cognició I Conducta, Consorci Sanitari de Terrassa (CST), Terrassa, Spain
| | - Neus Cano
- grid.5841.80000 0004 1937 0247Unitat de Psicologia Mèdica, Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
- grid.476208.f0000 0000 9840 9189Grup de Recerca en Cervell, Cognició I Conducta, Consorci Sanitari de Terrassa (CST), Terrassa, Spain
- grid.410675.10000 0001 2325 3084Departament de Ciències Bàsiques, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Bàrbara Segura
- grid.5841.80000 0004 1937 0247Unitat de Psicologia Mèdica, Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
- grid.5841.80000 0004 1937 0247Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- grid.10403.360000000091771775Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Ana Adan
- grid.5841.80000 0004 1937 0247Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- grid.5841.80000 0004 1937 0247Departament de Psicologia Clínica I Psicobiologia, Universitat de Barcelona, Barcelona, Spain
| | - Núria Bargalló
- grid.10403.360000000091771775Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- grid.5841.80000 0004 1937 0247Diagnostic Imaging Centre, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
- grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Xavier Caldú
- grid.5841.80000 0004 1937 0247Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- grid.5841.80000 0004 1937 0247Departament de Psicologia Clínica I Psicobiologia, Universitat de Barcelona, Barcelona, Spain
- grid.411160.30000 0001 0663 8628Institut de Recerca de Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Barcelona, Spain
| | - Anna Campabadal
- grid.5841.80000 0004 1937 0247Unitat de Psicologia Mèdica, Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
- grid.5841.80000 0004 1937 0247Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- grid.10403.360000000091771775Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Maria Angeles Jurado
- grid.5841.80000 0004 1937 0247Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- grid.5841.80000 0004 1937 0247Departament de Psicologia Clínica I Psicobiologia, Universitat de Barcelona, Barcelona, Spain
- grid.411160.30000 0001 0663 8628Institut de Recerca de Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Barcelona, Spain
| | - Maria Mataró
- grid.5841.80000 0004 1937 0247Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- grid.5841.80000 0004 1937 0247Departament de Psicologia Clínica I Psicobiologia, Universitat de Barcelona, Barcelona, Spain
- grid.411160.30000 0001 0663 8628Institut de Recerca de Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Barcelona, Spain
| | - Roser Pueyo
- grid.5841.80000 0004 1937 0247Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- grid.5841.80000 0004 1937 0247Departament de Psicologia Clínica I Psicobiologia, Universitat de Barcelona, Barcelona, Spain
- grid.411160.30000 0001 0663 8628Institut de Recerca de Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Barcelona, Spain
| | - Roser Sala-Llonch
- grid.5841.80000 0004 1937 0247Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- grid.10403.360000000091771775Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- grid.5841.80000 0004 1937 0247Departament de Biomedicina, Universitat de Barcelona, Barcelona, Spain
- grid.429738.30000 0004 1763 291XCentro de Investigación Biomédica en Red en Bioingeniería, Biomateriales Y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | | | - Javier Bejar
- grid.5841.80000 0004 1937 0247Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Claudio Ulises Cortés
- grid.6835.80000 0004 1937 028XDepartament de Ciències de La Computació, Universitat Politècnica de Catalunya-BarcelonaTech, Barcelona, Spain
| | | | - Maite Garolera
- grid.476208.f0000 0000 9840 9189Grup de Recerca en Cervell, Cognició I Conducta, Consorci Sanitari de Terrassa (CST), Terrassa, Spain
- grid.476208.f0000 0000 9840 9189Neuropsychology Unit, Consorci Sanitari de Terrassa (CST), Terrassa, Spain
| | - Carme Junqué
- grid.5841.80000 0004 1937 0247Unitat de Psicologia Mèdica, Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
- grid.5841.80000 0004 1937 0247Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- grid.10403.360000000091771775Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
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12
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Worm MS, Miskowiak KW, Purdon SE, Flachs EM, Thomsen JF, Eller NH, Jensen JH. Do objective and subjective measures of cognitive impairment predict occupational status in patients with work-related stress? A clinical follow-up study. Int Arch Occup Environ Health 2023; 96:121-130. [PMID: 35896841 DOI: 10.1007/s00420-022-01909-w] [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: 04/13/2022] [Accepted: 07/05/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Cognitive impairment is a common complaint in prolonged work-related stress and may contribute to work disability. The objective was to evaluate the longitudinal impacts of objectively and subjectively measured cognitive impairment on occupational status and to evaluate the measurement's predictive properties regarding occupational prognosis in patients with work-related stress. METHODS Patients with work-related stress (n = 82) were assessed with Danish versions of the Screen for Cognitive Impairment in Psychiatry (SCIP-D) and the Cognitive Failure Questionnaire (CFQ), as screeners of objective and subjective cognitive impairments, respectively. Patients were contacted via telephone at 6-month follow-up providing data on occupational status (employment vs. non-employment). Impacts of cognitive impairment on occupational status were evaluated using logistic regression analyses adjusting for other explanatory covariates (sociodemographic factors, comorbidities etc.). The predictive performance of SCIP-D and CFQ were evaluated using non-adjusted logistic regression analysis and receiver-operating-characteristics curves. RESULTS There was a strong association between objective cognitive impairment measured with SCIP-D and non-employment when adjusting for other explanatory factors (OR adjusted 3.25, 95% CI 1.09-9.69). The association was attenuated but remained robust in the non-adjusted analysis (OR non-adjusted 1.74, 95% CI 1.08-2.81). Yet, a cut-score of SCIP-D performed inadequate as a sole predictor of occupational status. Subjective cognitive impairment was unrelated to subsequent occupational status. CONCLUSIONS Objective-but not subjective-cognitive impairment was associated with subsequent non-employment. Our results suggest a predictive potential in objective measurements of cognitive impairment with significant implications for clinical assessment of patients with work-related stress.
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Affiliation(s)
- Maja Søndergård Worm
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | - Kamilla Woznica Miskowiak
- Psychiatric Centre Copenhagen, Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Scot E Purdon
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Department of Neuropsychology, Alberta Hospital Edmonton, Edmonton, AB, Canada
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jane Frølund Thomsen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Nanna Hurwitz Eller
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Stress Research Center, Copenhagen, Denmark
| | - Johan Høy Jensen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark. .,Copenhagen Stress Research Center, Copenhagen, Denmark.
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13
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Kouzuki M, Miyamoto M, Tanaka N, Urakami K. Validation of a novel computerized cognitive function test for the rapid detection of mild cognitive impairment. BMC Neurol 2022; 22:457. [PMID: 36476188 PMCID: PMC9727980 DOI: 10.1186/s12883-022-02997-4] [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] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In the present study, we examined the distinguishing ability of a mild cognitive impairment (MCI) assessment tool for rapid screening using a computer (MARC) for Alzheimer's disease dementia (ADD), MCI, and non-demented controls (NDC) with no cognitive impairment, as well as its validity and reliability, as part of a preliminary trial for the development of the tool. METHODS A total of 64 participants (23 in the ADD group, 17 in the MCI group, and 24 in the NDC group) were analyzed. The participants were administered MARC and a pre-existing computerized Alzheimer's dementia screening test (MSP), and 31 participants (14 in the MCI group, 17 in the NDC group) were readministered MARC within 4 months from the first test. RESULTS The median (interquartile range) test time for MARC was 401 (350-453) s. Total MARC scores were significantly worse in the MCI and ADD groups than in the NDC group (p < 0.05 and p < 0.01, respectively). In the receiver operating characteristic (ROC) analysis, the area under the ROC curve (AUC) when comparing the NDC and MCI groups was 0.866 (95% CI, 0.759-0.974), when comparing the NDC and AD groups was 0.989 (95% CI, 0.970-1.000), and when comparing the MCI and AD groups was 0.889 (95% CI, 0.790-0.988). Furthermore, there was a significant correlation with the results of the existing test, MSP (r = 0.839, p < 0.001). In addition, the intraclass correlation coefficient (ICC) (1,1) when the first and second MARC scores were compared was 0.740 (95% CI, 0.529-0.865; p < 0.001). CONCLUSIONS MARC is considered capable of distinguishing MCI with high accuracy. The tool has good validity and reliability, and it can be administered in a short period of time without the need for a specialist.
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Affiliation(s)
- Minoru Kouzuki
- grid.265107.70000 0001 0663 5064Department of Biological Regulation, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, 683-8503 Japan
| | - Madoka Miyamoto
- grid.265107.70000 0001 0663 5064Department of Dementia Prevention, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, 683-8503 Japan
| | - Nobuto Tanaka
- grid.265107.70000 0001 0663 5064Department of Dementia Prevention, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, 683-8503 Japan
| | - Katsuya Urakami
- grid.265107.70000 0001 0663 5064Department of Dementia Prevention, School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, 683-8503 Japan
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14
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Shin HY, Yim TB, Heo HM, Jahng GH, Kwon S, Cho SY, Park SU, Jung WS, Moon SK, Ko CN, Park JM. Effects of Kami Guibi-tang in patients with mild cognitive impairment: study protocol for a phase III, randomized, double-blind, and placebo-controlled trial. BMC Complement Med Ther 2022; 22:318. [PMID: 36461035 PMCID: PMC9717542 DOI: 10.1186/s12906-022-03805-9] [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] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/21/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Amnestic mild cognitive impairment (aMCI) is often considered a precursor to Alzheimer's disease (AD) and represents a key therapeutic target for early intervention of AD. However, no treatments have been approved for MCI at present. Our previous pilot study has shown that Kami Guibi-tang (KGT), a traditional herbal prescription widely used in Korean medicine for treating amnesia, might be beneficial for improving general cognitive function of aMCI patients. We will conduct a larger-scale clinical trial to validate the findings of our pilot study and further examine the efficacy and safety of KGT in aMCI. METHODS This trial is designed as a randomized, double-blind, placebo-controlled clinical trial. A total of 84 aMCI patients will be recruited and randomized into the treatment and control groups. Participants will be administered either KGT or placebo granules for 24 weeks, with a follow-up period of 12 weeks after the last treatment. Primary outcomes will include changes in cognitive performance assessed using a neuropsychological test battery, called the Seoul Neuropsychological Screening Battery, between the baseline, post-intervention visit, and follow-up visit (24th and 36th week, respectively). Secondary outcomes will involve the rate of progression to AD, changes in neuroimaging signals assessed using structural magnetic resonance imaging (MRI), resting-state functional MRI (rs-fMRI), and task-based fMRI, and changes in blood biomarkers measured by the ratio of plasma amyloid-β 42/40 levels (Aβ42/Aβ40) between the baseline and post-intervention visit (24th week). For safety assessments, blood chemistry tests and electrocardiograms (ECG) will also be performed. DISCUSSION This study aims to provide confirmatory evidence of the effect of the Korean herbal medicine, KGT, on improving cognitive function in patients with aMCI. We will identify the possible mechanisms underlying the effects of KGT using neuroimaging signals and blood biomarkers. TRIAL REGISTRATION Korean Clinical Trial Registry ( https://cris.nih.go.kr/cris/search/detailSearch.do/16918; Registration number: KCT0007039; Date of registration: February 24, 2022).
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Affiliation(s)
- Hee-Yeon Shin
- grid.410886.30000 0004 0647 3511Department of Internal Korean Medicine, Korean Medicine Center, CHA university Bundang Medical Center, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 13496 Republic of Korea ,grid.289247.20000 0001 2171 7818Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
| | - Tae-Bin Yim
- grid.289247.20000 0001 2171 7818Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea ,grid.496794.1Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278 Republic of Korea
| | - Hye-Min Heo
- grid.289247.20000 0001 2171 7818Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea ,grid.496794.1Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278 Republic of Korea
| | - Geon-Ho Jahng
- grid.289247.20000 0001 2171 7818Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278 Republic of Korea
| | - Seungwon Kwon
- grid.289247.20000 0001 2171 7818Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
| | - Seung-Yeon Cho
- grid.496794.1Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278 Republic of Korea ,grid.289247.20000 0001 2171 7818Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
| | - Seong-Uk Park
- grid.496794.1Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278 Republic of Korea ,grid.289247.20000 0001 2171 7818Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
| | - Woo-Sang Jung
- grid.289247.20000 0001 2171 7818Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
| | - Sang-Kwan Moon
- grid.289247.20000 0001 2171 7818Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
| | - Chang-Nam Ko
- grid.496794.1Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278 Republic of Korea ,grid.289247.20000 0001 2171 7818Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
| | - Jung-Mi Park
- grid.496794.1Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul, 05278 Republic of Korea ,grid.289247.20000 0001 2171 7818Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447 Republic of Korea
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15
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Hanai T, Nishimura K, Miwa T, Maeda T, Nakahata Y, Imai K, Suetsugu A, Takai K, Shimizu M. A shortened Stroop test to identify covert hepatic encephalopathy and predict overt hepatic encephalopathy in patients with cirrhosis. J Gastroenterol 2022; 57:981-989. [PMID: 36173512 DOI: 10.1007/s00535-022-01925-0] [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: 07/15/2022] [Accepted: 09/13/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Covert hepatic encephalopathy (CHE) adversely affects the clinical outcomes of patients with cirrhosis but remains largely undiagnosed and untreated. Although the Stroop test is a useful method for CHE detection, a faster, simpler, and more accurate test is required to diagnose CHE. This prospective study aimed to develop a new shortened Stroop test that can detect CHE and predict overt hepatic encephalopathy (OHE) in Japanese patients with cirrhosis. METHODS Patients who underwent neuropsychological tests (NPT) and the Stroop test between November 2018 and December 2021 were enrolled and followed until OHE occurrence or March 2022. The discriminative ability of various run combinations in the off and on states to detect CHE was evaluated using the area under the receiver-operating characteristic curve (AUC) and compared with that of the total Stroop test time. RESULTS Among the 227 eligible patients, the On1-2Time cutoff value of 44.4 s had a comparable discriminative ability with the total Stroop test time to detect CHE, with an AUC of 0.791, a sensitivity of 0.827, and a specificity of 0.685. During a median follow-up period of 16 months, 37 patients developed OHE. On1-2Time ≥ 44.4 s (hazard ratio [HR], 3.93; 95% confidence interval [CI] 1.36-11.36) and serum albumin levels (HR, 0.28; 95% CI 0.11-0.67) were independently associated with OHE occurrence. CONCLUSIONS The shortened Stroop test (On1-2Time) is equivalent to the total Stroop test not only for identifying CHE but also for estimating the risk of progression to OHE.
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Affiliation(s)
- Tatsunori Hanai
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Kayoko Nishimura
- Center for Nutrition Support and Infection Control, Gifu University Hospital, Gifu, Japan
| | - Takao Miwa
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Toshihide Maeda
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Yuki Nakahata
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Kenji Imai
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Atsushi Suetsugu
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Koji Takai
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Masahito Shimizu
- Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
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16
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Machaczka O, Skoloudik D, Janoutova J, Roubec M, Reiterova E, Kovalova M, Zatloukalova A, Ambroz P, Janout V. Neuropsychological tests and prediction of dementia in association with the degree of carotid stenosis. J Appl Biomed 2022; 20:115-123. [PMID: 36708716 DOI: 10.32725/jab.2022.018] [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: 05/10/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
This study constitutes a cross sectional analysis of the association between cognitive impairment defined by neuropsychological tests and carotid stenosis. The main objective was to compare the results of the Mini-Mental State Examination (MMSE) and Addenbrooke's Cognitive Examination-Revised (ACE-R) with regard to the degree of carotid stenosis. The sample comprised 744 patients who underwent a carotid duplex ultrasound and cognitive function testing (by ACE-R and MMSE). A multivariable analysis of potential confounding factors was completed. The significance of the different number of positive (MMSE ≤ 27, ACE-R ≤ 88) and negative (MMSE ≥ 28, ACE-R ≥ 89) results of the neuropsychological tests was analysed with regard to the degree of carotid stenosis (50-99%). Neuropsychological test results were also compared between carotid stenosis of 50-69%, 70-89%, and 90-99%. For both the MMSE and ACE-R, a difference was observed between positive and negative test results when higher degrees of stenosis were present. However, for the ACE-R only, more severe stenosis (80-89%, 90-99%) was predominantly associated with positive test results (p-value < 0.017). The same dependence for ACE-R (although not statistically significant) was observed in the group of patients without an ischemic stroke (confounding factor). In the case of the MMSE and more severe stenosis, negative results predominated, regardless of the confounding factor. There were no statistically significant differences in test results between carotid stenosis of 50-69%, 70-89%, and 90-99%. The results suggest that for assessing the early risk of cognitive impairment in patients with carotid atherosclerosis, the ACE-R appears more suitable than the MMSE.
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Affiliation(s)
- Ondrej Machaczka
- Palacky University Olomouc, Faculty of Health Sciences, Science and Research Centre, Olomouc, Czech Republic.,Palacky University Olomouc, Faculty of Health Sciences, Department of Healthcare Management and Public Health, Olomouc, Czech Republic
| | - David Skoloudik
- Palacky University Olomouc, Faculty of Health Sciences, Science and Research Centre, Olomouc, Czech Republic.,University of Ostrava, Faculty of Medicine, Medical Research Center, Ostrava, Czech Republic
| | - Jana Janoutova
- Palacky University Olomouc, Faculty of Health Sciences, Science and Research Centre, Olomouc, Czech Republic.,Palacky University Olomouc, Faculty of Medicine and Dentistry, Department of Public Health, Olomouc, Czech Republic
| | - Martin Roubec
- Palacky University Olomouc, Faculty of Health Sciences, Science and Research Centre, Olomouc, Czech Republic.,University of Ostrava, Faculty of Medicine, Medical Research Center, Ostrava, Czech Republic.,University Hospital Ostrava, Department of Neurology, Ostrava, Czech Republic
| | - Eva Reiterova
- Palacky University Olomouc, Faculty of Health Sciences, Science and Research Centre, Olomouc, Czech Republic
| | - Martina Kovalova
- Palacky University Olomouc, Faculty of Health Sciences, Department of Healthcare Management and Public Health, Olomouc, Czech Republic
| | - Anna Zatloukalova
- Palacky University Olomouc, Faculty of Health Sciences, Science and Research Centre, Olomouc, Czech Republic.,Palacky University Olomouc, Faculty of Health Sciences, Department of Healthcare Management and Public Health, Olomouc, Czech Republic
| | - Petr Ambroz
- Palacky University Olomouc, Faculty of Health Sciences, Science and Research Centre, Olomouc, Czech Republic.,Palacky University Olomouc, Faculty of Health Sciences, Department of Healthcare Management and Public Health, Olomouc, Czech Republic
| | - Vladimir Janout
- Palacky University Olomouc, Faculty of Health Sciences, Science and Research Centre, Olomouc, Czech Republic
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Naito Y, Hiraoka A, Himeno M, Chikazawa G, Arimichi M, Yuguchi S, Yoshitaka H, Sakaguchi T. Clinically Optimal Neuropsychological Tests for Postoperative Cognitive Dysfunction in Heart Valve Surgeries. Circ J 2022; 86:1719-1724. [PMID: 36198576 DOI: 10.1253/circj.cj-22-0390] [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] [Indexed: 11/09/2022]
Abstract
BACKGROUND Postoperative cognitive dysfunction (POCD) is widely recognized and reported, but the lack of a uniform definition makes it difficult to evaluate its clinical impact. The aim of this study is to establish the optimal neuropsychological tests and definition of POCD relevant to clinical outcomes in heart valve surgeries.Methods and Results: Between June 2015 and December 2019, 315 patients undergoing elective heart valve surgeries (age ≥65 years) were enrolled. The Mini-Mental Status Examination, Montreal Cognitive Assessment (MoCA), and the Trail Making Test A and B were performed to evaluate cognitive function. Clinical endpoints were defined as readmission and death. The postoperative readmission and death rate were 17% and 3% (54/315 and 8/315; follow-up 266-1,889 days). By multivariable Cox hazard analysis, Short Physical Performance Battery (adjusted hazard ratio [HR]: 0.84, 95% confidence interval [CI]: 0.49-0.98, P=0.001), MoCA change rate (adjusted HR: 0.64, 95% CI: 0.01-1.22, P=0.024), and intensive care unit stay (adjusted HR: 0.55%, 95% CI: 0.99-1.12, P=0.054) were detected as independent risk factors for combined events. The cutoff value was -12% in the change rate of MoCA. CONCLUSIONS MoCA was the only neuropsychological test that predicted the clinical impact on complex events and has the potential to define POCD.
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Affiliation(s)
- Yoshitaka Naito
- Department of Rehabilitation, The Sakakibara Heart Institute of Okayama
| | - Arudo Hiraoka
- Department of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama
| | - Manami Himeno
- Department of Rehabilitation, The Sakakibara Heart Institute of Okayama
| | - Genta Chikazawa
- Department of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama
| | - Masahisa Arimichi
- Department of Clinical Engineering, The Sakakibara Heart Institute of Okayama
| | - Satoshi Yuguchi
- Department of Physical Therapy, School of Health Sciences, Japan University of Health Sciences
| | - Hidenori Yoshitaka
- Department of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama
| | - Taichi Sakaguchi
- Department of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama
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18
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Kwak S, Park SM, Jeon YJ, Ko H, Oh DJ, Lee JY. Multiple Cognitive and Behavioral Factors Link Association Between Brain Structure and Functional Impairment of Daily Instrumental Activities in Older Adults. J Int Neuropsychol Soc 2022; 28:673-86. [PMID: 34308821 DOI: 10.1017/S1355617721000916] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Functional impairment in daily activity is a cornerstone in distinguishing the clinical progression of dementia. Multiple indicators based on neuroimaging and neuropsychological instruments are used to assess the levels of impairment and disease severity; however, it remains unclear how multivariate patterns of predictors uniquely predict the functional ability and how the relative importance of various predictors differs. METHOD In this study, 881 older adults with subjective cognitive complaints, mild cognitive impairment (MCI), and dementia with Alzheimer's type completed brain structural magnetic resonance imaging (MRI), neuropsychological assessment, and a survey of instrumental activities of daily living (IADL). We utilized the partial least square (PLS) method to identify latent components that are predictive of IADL. RESULTS The result showed distinct brain components (gray matter density of cerebellar, medial temporal, subcortical, limbic, and default network regions) and cognitive-behavioral components (general cognitive abilities, processing speed, and executive function, episodic memory, and neuropsychiatric symptoms) were predictive of IADL. Subsequent path analysis showed that the effect of brain structural components on IADL was largely mediated by cognitive and behavioral components. When comparing hierarchical regression models, the brain structural measures minimally added the explanatory power of cognitive and behavioral measures on IADL. CONCLUSION Our finding suggests that cerebellar structure and orbitofrontal cortex, alongside with medial temporal lobe, play an important role in the maintenance of functional status in older adults with or without dementia. Moreover, the significance of brain structural volume affects real-life functional activities via disruptions in multiple cognitive and behavioral functions.
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19
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Ulbl J, Rakusa M. Validation of Slovenian version of ADAS-Cog for patients with mild cognitive impairment and Alzheimer's disease. Acta Neurol Belg 2022; 122:695-702. [PMID: 34424494 DOI: 10.1007/s13760-021-01780-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 08/16/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Alzheimer's disease (AD) is the most common cause of neurodegenerative dementia where the most prominent cognitive impairment is memory loss. Screening tests are valuable tools for detecting cognitive impairment. One such test is the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) which consists of 11 tasks. The main goal of our study was to validate the Slovenian version of the ADAS-Cog for detecting mild cognitive impairment (MCI) and AD patients. METHODS Our sample included 128 participants: 61 healthy controls, 32 people with MCI, and 35 with AD. All participants were evaluated with the Slovenian translation of ADAS-Cog. RESULTS The optimal cut-off for the ADAS-Cog for MCI was 10/11 points. The sensitivity was 88%, specificity 85% and likelihood ratio 6. The optimal cut-off for AD was 11/12 points. Sensitivity was 100%, specificity 95% and likelihood ratio 20. CONCLUSION The obtained cut-off values are comparable to the results from similar validation studies. We can conclude that the ADAS-Cog is a reliable and valid tool for identifying people with MCI and AD from among healthy controls in the Slovenian population.
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20
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Jeong HS, Kim OL, Koo BH, Kim KH, Kim GH, Bai DS, Kim JY, Chang MS, Kim HG. A Study on Verification of Equivalence and Effectiveness of Non-Pharmacologic Dementia Prevention and Early Detection Contents : Non-Randomly Equivalent Design. J Korean Neurosurg Soc 2022; 65:315-324. [PMID: 35168310 PMCID: PMC8918252 DOI: 10.3340/jkns.2021.0153] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/28/2021] [Indexed: 11/28/2022] Open
Abstract
Objective The aim of this study was to verify the equivalence and effectiveness of the tablet-administered Korean Repeatable Battery for the Assessment of Neuropsychological Status (K-RBANS) for the prevention and early detection of dementia.
Methods Data from 88 psychiatry and neurology patient samples were examined to evaluate the equivalence between tablet and paper administrations of the K-RBANS using a non-randomly equivalent group design. We calculated the prediction scores of the tablet-administered K-RBANS based on demographics and covariate-test scores for focal tests using norm samples and tested format effects. In addition, we compared the receiver operating characteristic curves to confirm the effectiveness of the K-RBANS for preventing and detecting dementia.
Results In the analysis of raw scores, line orientation showed a significant difference (t=-2.94, p<0.001), and subtests showed small to large effect sizes (0.04–0.86) between paper- and tablet-administered K-RBANS. To investigate the format effect, we compared the predicted scaled scores of the tablet sample to the scaled scores of the norm sample. Consequently, a small effect size (d≤0.20) was observed in most of the subtests, except word list and story recall, which showed a medium effect size (d=0.21), while picture naming and subtests of delayed memory showed significant differences in the one-sample t-test. In addition, the area under the curve of the total scale index (TSI) (0.827; 95% confidence interval, 0.738–0.916) was higher than that of the five indices, ranging from 0.688 to 0.820. The sensitivity and specificity of TSI were 80% and 76%, respectively.
Conclusion The overall results of this study suggest that the tablet-administered K-RBANS showed significant equivalence to the norm sample, although some subtests showed format effects, and it may be used as a valid tool for the brief screening of patients with neuropsychological disorders in Korea.
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Affiliation(s)
- Hyun-Seok Jeong
- Department of Psychology, College of Social Science, Kyungpook National University, Daegu, Korea
| | - Oh-Lyong Kim
- Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Korea
| | - Bon-Hoon Koo
- Department of Psychiatry, College of Medicine, Yeungnam University, Daegu, Korea
| | - Ki-Hyun Kim
- Corporate Research Institute of Clupea, Inc., Daegu, Korea
| | - Gi-Hwan Kim
- Corporate Research Institute of Clupea, Inc., Daegu, Korea
| | - Dai-Seg Bai
- Department of Psychiatry, College of Medicine, Yeungnam University, Daegu, Korea
| | - Ji-Yean Kim
- Department of Psychiatry, College of Medicine, Yeungnam University, Daegu, Korea
| | - Mun-Seon Chang
- Department of Psychology, College of Social Science, Kyungpook National University, Daegu, Korea
| | - Hye-Geum Kim
- Department of Psychiatry, College of Medicine, Yeungnam University, Daegu, Korea
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21
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Arrington M, Elbich D, Dai J, Duchaine B, Scherf KS. Introducing the female Cambridge face memory test - long form (F-CFMT+). Behav Res Methods 2022; 54:3071-84. [PMID: 35194750 DOI: 10.3758/s13428-022-01805-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 12/16/2022]
Abstract
The Cambridge Face Memory Test (CFMT) is one of the most used assessments of face recognition abilities in the science of face processing. The original task, using White male faces, has been empirically evaluated for psychometric properties (Duchaine & Nakayama, 2006), while the longer and more difficult version (CFMT+; Russell et al., 2009) has not. Critically, no version exists using female faces. Here, we present the Female Cambridge Face Memory Test - Long Form (F-CFMT+) and evaluate the psychometric properties of this task in comparison to the Male Cambridge Face Memory Test - Long Form (M-CFMT+). We tested typically developing emerging adults (18 to 25 years old) in both Cambridge face recognition tasks, an old-new face recognition task, and a car recognition task. Results indicate that the F-CFMT+ is a valid, internally consistent measure of unfamiliar face recognition that can be used alone or in tandem with the M-CFMT+ to assess recognition abilities for young adult White faces. When used together, performance on the F-CFMT+ and M-CFMT+ can be directly compared, adding to the ability to understand face recognition abilities for different kinds of faces. The two tasks have high convergent validity and relatively good divergent validity with car recognition in the same task paradigm. The F-CFMT+ will be useful to researchers interested in evaluating a broad range of questions about face recognition abilities in both typically developing individuals and those with atypical social information processing abilities.
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22
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Barvas E, Mattavelli G, Meli C, Guttmann S, Papagno C. Standardization and normative data for a new test of visual long-term recognition memory. Neurol Sci 2021; 43:2491-2497. [PMID: 34611785 DOI: 10.1007/s10072-021-05642-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/16/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
The assessment of recognition memory is useful in several neurological conditions, but normative data for visual recognition memory of complex figures are still missing for the Italian population. The aim of this study is to present a new short test of visual recognition memory that consists in a supplementary task to be administered after the free delayed recall trial of the Modified Taylor Complex Figure (MTCF). The MTCF-Recognition Trial (MTCF-RT) includes 10 tables, each with a sub-component of the MTCF coupled with two interfering stimuli. Participants are asked to point, for each triplet, the item that was part of the original picture. Normative data were collected from a sample of 280 healthy Italian native speakers ranging in age from 18 to 89 years. The mean recognition score on the MTCF-RT was 9.125 ± 0.996. Results from multiple regression analyses showed that age and education (but not gender) were significant predictors of performance. Therefore, we provided correction grids to adjust raw scores for age and education and computed equivalent scores for the use of the MTCF-RT in the clinical assessment of recognition memory.
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Affiliation(s)
- Edoardo Barvas
- CeRiN, Centro Di Riabilitazione Neurocognitiva, CIMeC, Università Di Trento, Via Matteo del Ben 5/b, 38068, Rovereto, TN, Italy. .,Unità Operativa Di Neurologia, Ospedale di Stato della Repubblica di San Marino, Via Scialoja 20, 47893, Cailungo, Republic of San Marino.
| | - Giulia Mattavelli
- ICoN Center, Scuola Universitaria Superiore IUSS, Piazza della Vittoria 15, 27100, Pavia, Italy
| | - Claudia Meli
- CeRiN, Centro Di Riabilitazione Neurocognitiva, CIMeC, Università Di Trento, Via Matteo del Ben 5/b, 38068, Rovereto, TN, Italy
| | - Susanna Guttmann
- Unità Operativa Di Neurologia, Ospedale di Stato della Repubblica di San Marino, Via Scialoja 20, 47893, Cailungo, Republic of San Marino
| | - Costanza Papagno
- CeRiN, Centro Di Riabilitazione Neurocognitiva, CIMeC, Università Di Trento, Via Matteo del Ben 5/b, 38068, Rovereto, TN, Italy.,Dipartimento Di Psicologia, Università Degli Studi Di Milano-Bicocca, Piazza dell'Ateneo 1, 02100, Milan, Italy
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Howlett CA, Wewege MA, Berryman C, Oldach A, Jennings E, Moore E, Karran EL, Szeto K, Pronk L, Miles S, Moseley GL. Same room - different windows? A systematic review and meta-analysis of the relationship between self-report and neuropsychological tests of cognitive flexibility in healthy adults. Clin Psychol Rev 2021; 88:102061. [PMID: 34332263 DOI: 10.1016/j.cpr.2021.102061] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 06/01/2021] [Accepted: 06/17/2021] [Indexed: 01/14/2023]
Abstract
Cognitive flexibility can be thought of as the ability to effectively adapt one's cognitive and behavioural strategies in response to changing task or environmental demands. To substantiate the common inference that self-report and neuropsychological tests of cognitive flexibility provide 'different windows into the same room', we undertook a systematic review and meta-analysis to determine whether self-report and neuropsychological tests of cognitive flexibility are related in healthy adults. Ten databases and relevant grey literature were searched from inception. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were adhered to. Twenty-one articles satisfied our inclusion criteria. A multi-level random-effects meta-analysis revealed no relationship (0.05, 95% CI = -0.00 to 0.10). Random-effects meta-analyses raised the possibility that the Cognitive Flexibility Scale and the Trail Making Test - part B (time) may be related (0.19, 95% CI = 0.06 to 0.31). We conclude that the relationship between self-report and neuropsychological tests of cognitive flexibility is not large enough to be considered convincing evidence for the two assessment approaches sharing construct validity. These results have clear implications for assessing and interpreting cognitive flexibility research and clinical practice.
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Vrijsen J, van Erpecum CL, de Rooij SE, Niebuur J, Smidt N. The validity and reliability of a digital Ruff Figural Fluency Test (RFFT). BMC Psychol 2021; 9:65. [PMID: 33910642 PMCID: PMC8080381 DOI: 10.1186/s40359-021-00566-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Ruff Figural Fluency Test (RFFT) is a valid but time-consuming and labour-intensive cognitive paper-and-pencil test. A digital RFFT was developed that can be conducted independently using an iPad and Apple Pencil and RFFT scores are computed automatically. We investigated the validity and reliability of this digital RFFT. METHODS We randomly allocated participants to the digital or paper-and-pencil RFFT. After the first test, the other test was performed immediately (cross-over). Participants were invited for a second digital RFFT 1 week later. For the digital RFFT, an (automatic) algorithm and two independent raters (criterion standard) assessed the number of unique designs (UD) and perseverative errors (PE). These raters also assessed the paper-and-pencil RFFT. We used Intraclass correlation coefficients (ICC), sensitivity, specificity, %-agreement, Kappa, and Bland-Altman plots. RESULTS We included 94 participants (mean (SD) age 39.9 (14.8), 73.4% follow-up). Mean (SD) UD and median (IQR) PE of the digital RFFT were 84.2 (26.0) and 4 (2-7.3), respectively. Agreement between manual and automatic scoring of the digital RFFT was high for UD (ICC = 0.99, 95% CI 0.98, 0.99, sensitivity = 0.98; specificity = 0.96) and PE (ICC = 0.99, 95% CI 0.98, 0.99; sensitivity = 0.90, specificity = 1.00), indicating excellent criterion validity. Small but significant differences in UD were found between the automatic and manual scoring (mean difference: - 1.12, 95% CI - 1.92, - 0.33). Digital and paper-and-pencil RFFT had moderate agreement for UD (ICC = 0.73, 95% CI 0.34, 0.87) and poor agreement for PE (ICC = 0.47, 95% CI 0.30, 0.62). Participants had fewer UD on the digital than paper-and-pencil RFFT (mean difference: - 7.09, 95% CI - 11.80, - 2.38). The number of UD on the digital RFFT was associated with higher education (Spearman's r = 0.43, p < 0.001), and younger age (Pearson's r = - 0.36, p < 0.001), showing its ability to discriminate between different age categories and levels of education. Test-retest reliability was moderate (ICC = 0.74, 95% CI 0.61, 0.83). CONCLUSIONS The automatic scoring of the digital RFFT has good criterion and convergent validity. There was low agreement between the digital RFFT and paper-and-pencil RFFT and moderate test-retest reliability, which can be explained by learning effects. The digital RFFT is a valid and reliable instrument to measure executive cognitive function among the general population and is a feasible alternative to the paper-and-pencil RFFT in large-scale studies. However, its scores cannot be used interchangeably with the paper-and-pencil RFFT scores.
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Affiliation(s)
- J Vrijsen
- University Medical Centre Groningen, Department of Epidemiology, University of Groningen, Hanzeplein 1, FA40, P.O. Box 30 001, 9700 RB, Groningen, The Netherlands.
| | - C L van Erpecum
- University Medical Centre Groningen, Department of Epidemiology, University of Groningen, Hanzeplein 1, FA40, P.O. Box 30 001, 9700 RB, Groningen, The Netherlands
| | - S E de Rooij
- University Medical Center Groningen, Department of Internal Medicine, University of Groningen, Groningen, The Netherlands
| | - J Niebuur
- University Medical Centre Groningen, Department of Epidemiology, University of Groningen, Hanzeplein 1, FA40, P.O. Box 30 001, 9700 RB, Groningen, The Netherlands
| | - N Smidt
- University Medical Centre Groningen, Department of Epidemiology, University of Groningen, Hanzeplein 1, FA40, P.O. Box 30 001, 9700 RB, Groningen, The Netherlands
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25
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Kang SH, Park YH, Kim JP, Kim JS, Kim CH, Jang H, Kim HJ, Koh SB, Na DL, Chin J, Seo SW. Cortical neuroanatomical changes related to specific neuropsychological deficits in subcortical vascular cognitive impairment. Neuroimage Clin 2021; 30:102685. [PMID: 34215155 PMCID: PMC8102616 DOI: 10.1016/j.nicl.2021.102685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 04/06/2021] [Accepted: 04/18/2021] [Indexed: 11/30/2022]
Abstract
Poor performances in neuropsychological tests were associated with cortical atrophy. Neural substrates in Aβ (−) SVCI differed from those in ADCI. Neural substrate of episodic memory was frontal regions in Aβ (−) SVCI. Neural substrates of three neuropsychological tests showed laterality.
Objective Neuropsychological test-specific neural substrates in subcortical vascular cognitive impairment (SVCI) are expected to differ from those in Alzheimer’s disease-related cognitive impairment (ADCI) but the details are unclear. To determine neural substrates related to cerebral small vessel disease, we investigated the correlations between cognitive dysfunctions measured by standardized neuropsychological tests and cortical thickness in a large sample of participants with amyloid negative (Aβ (−)) SVCI. Methods One hundred ninety-eight participants with Aβ (−) SVCI were recruited from the memory clinic between November 2007 to August 2018. To acquire neural substrates, we performed linear regression using the scores of each neuropsychological test as a predictor, cortical thickness as an outcome, and age, sex, education years, intracranial volume and white matter hyperintensity (WMH) as confounders. Results Poor performances in each neuropsychological test were associated with cortical atrophy in certain brain regions regardless of WMH. Especially, not the medial temporal but the frontal and posterior cingulate regions with cortical atrophy were mainly associated with memory impairment. Poor performance in animal fluency was more likely to be associated with cortical atrophy in the left hemisphere, while poor performance in the visuospatial memory test was more likely to be associated with cortical atrophy in the right hemisphere. Conclusions Our findings suggested that cortical atrophy was an important factor of cognitive impairment in Aβ (−) SVCI regardless of WMH. Furthermore, our findings might give clinicians a better understanding of specific neural substrates of neuropsychological deficits in patients with SVCI.
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Affiliation(s)
- Sung Hoon Kang
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea; Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Yu Hyun Park
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea; Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea
| | - Jun Pyo Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea
| | - Ji-Sun Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea
| | - Chi Hun Kim
- Department of Neurology, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Daegu, South Korea; Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Hyemin Jang
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea
| | - Hee Jin Kim
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Duk L Na
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea
| | - Juhee Chin
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea.
| | - Sang Won Seo
- Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; Neuroscience Center, Samsung Medical Center, Seoul 06351, South Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea; Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea; Samsung Alzheimer Research Center and Center for Clinical Epidemiology Medical Center, Seoul, South Korea.
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Sousa C, Rigueiro-Neves M, Passos AM, Ferreira A, Sá MJ. Assessment of cognitive functions in patients with multiple sclerosis applying the normative values of the Rao's brief repeatable battery in the Portuguese population. BMC Neurol 2021; 21:170. [PMID: 33882847 PMCID: PMC8059237 DOI: 10.1186/s12883-021-02193-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/19/2021] [Accepted: 03/23/2021] [Indexed: 11/18/2022] Open
Abstract
Background The Brief Repeatable Battery of Neuropsychological Tests (BRBN-T) is one of the most sensitive and used measures for detecting cognitive impairment in Multiple Sclerosis (MS). Objective The aim of this study was to adapt and validate this battery to the Portuguese population of MS patients. Methods The Portuguese version of the BRBN-T was applied to a stratified control national sample of 326 individuals considering sex, age, educational level and geographic location and also a clinical sample of 115 MS patients from several national hospitals. Through the exploration of its psychometrics properties, the Portuguese BRBN-T norms were produced. Results The normative data is presented as a regression-based formula to adjust test scores for gender, education and age, and the results reveal the BRBN-T has the ability to differentiate between MS patients and healthy participant’s cognitive performance. Conclusion This study demonstrated in our clinical population a good ability to detect cognitive impairment. Its clearly contributed to reinforcing the neuropsychological assessment in Portugal in patients with MS, by providing a new set of instruments, which can be used in the clinical practice, and in future studies. Moreover, it will allow a rigorous and precise support in relation to neuropsychological assessment for future longitudinal studies and clinical trials.
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Affiliation(s)
- Claudia Sousa
- MS Clinic, Department of Neurology, Centro Hospitalar Universitário São João Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal. .,Neuropsychological Unit, Department of Psychology, Centro Hospitalar Universitário São João Porto, Alameda Prof. Hernâni Monteiro, 4200 - 319, Porto, Portugal.
| | | | | | - Aristides Ferreira
- BRU-IUL, Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | - Maria José Sá
- MS Clinic, Department of Neurology, Centro Hospitalar Universitário São João Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal.,Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
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Sáez-Atxukarro O, Del Pino R, Peña J, Schretlen DJ, Ibarretxe-Bilbao N, Ojeda N. UD Interference Test: Creation and validation of a new instrument of resistance to interference. Normalization and standardization for Spanish population. Neurologia 2021; 38:S0213-4853(21)00031-1. [PMID: 33722456 DOI: 10.1016/j.nrl.2021.01.014] [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: 11/26/2020] [Revised: 01/14/2021] [Accepted: 01/14/2021] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION The UD Interference Test measures processing speed and attention, and is based on the concept of interference of the Stroop Test. The main purpose of the study is to provide an alternative version of the Stroop Test that overcomes some of the limitations of previous versions in assessing individuals with daltonism or age-related reading difficulties, and to obtain normative and standardised data for the Spanish population. METHODS This study is part of the Normacog project. We evaluated 905 individuals (age range, 18-93 years) to analyse the test's reliability and concurrent and construct validity. We evaluated the effect of age, sex, and level of education on UD Interference Test performance and calculated percentiles and age- and education-adjusted scaled scores. RESULTS The test has good reliability (α = 0.875) and concurrent (r = 0.443-0.725; p < .001) and construct validity (r = 0.472-0.737; p < .001). We observed age and educational level to have a significant effect on UD Interference Test scores, explaining 12-40% of variance. Sex only had a significant effect on the resistance to interference index. CONCLUSIONS We present an alternative version of the Stroop Color and Word Test with some advantages over previous versions. We provide standardised and normalised data for the Spanish population to correct the test according to the subject's age and level of education.
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Affiliation(s)
- O Sáez-Atxukarro
- Departamento de Métodos y Fundamentos de la Psicología; Universidad de Deusto, Bilbao, España
| | - R Del Pino
- Grupo de Enfermedades Neurodegenerativas, Instituto de Investigación Sanitaria Biocruces Bizkaia, Barakaldo, España
| | - J Peña
- Departamento de Métodos y Fundamentos de la Psicología; Universidad de Deusto, Bilbao, España
| | - D J Schretlen
- Departamento de Psiquiatría y Ciencias del Comportamiento; Facultad de Medicina; Johns Hopkins University, Baltimore, MD, EE. UU.; Departamento Russell H. Morgan de Radiología y Ciencias Radiológicas; Facultad de Medicina; Johns Hopkins University, Baltimore, MD, EE. UU
| | - N Ibarretxe-Bilbao
- Departamento de Métodos y Fundamentos de la Psicología; Universidad de Deusto, Bilbao, España
| | - N Ojeda
- Departamento de Métodos y Fundamentos de la Psicología; Universidad de Deusto, Bilbao, España.
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Sun Y, Feng H, Zou T, Hou M, Jin Y, Gu C, Wang Y, Li J, Liu M, Zhang M, Gao Y. Assessment of risk factors for postoperative cognitive dysfunction after coronary artery bypass surgery: a single-center retrospective cohort study. Biosci Rep 2021; 41:BSR20190719. [PMID: 33511391 DOI: 10.1042/BSR20190719] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 01/15/2021] [Accepted: 01/27/2021] [Indexed: 02/04/2023] Open
Abstract
Aim: To find out risk factors for postoperative cognitive dysfunction (POCD) after coronary artery bypass grafting (CABG), and to provide basis for clinical prevention of POCD. A total of 88 patients who underwent CABG were surveyed with Telephone Questionnaire (TICS-M) for their cognitive impairment after 3, 7, 21, 90, 180 days post-surgery. The occurrence of POCD was diagnosed by Neuropsychological Battery which included Vocabular Learning Test (VLT), Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT) and Symbol Digit Modalities Test (SDMT). The preoperative, intraoperative and postoperative risk factors were assessed by the χ2 or t test. Multivariate analysis was used to study the correlation between the risk factors and the occurrence of POCD. Age, aortic plaque, carotid artery stenosis, cerebrovascular disease, anesthesia time, the rate of decline in intraoperative hemoglobin concentration (ΔHb) and systemic inflammatory response syndrome (SIRS) score on postoperative day 2 had statistically significant (P<0.05) influence on the occurrence of POCD. Aortic plaque, carotid artery stenosis, anesthesia time and SIRS score (odds ratio (OR) value > 1, P<0.05) are the risk factors for POCD. The incidence of day-21 and -180 POCD was approximately 26.1 and 22.7%, respectively.
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Maerlender A, Smith E, Brolinson PG, Crisco J, Urban J, Ajamil A, Rowson S, Campolettano ET, Gellner RA, Bellamkonda S, Kieffer E, Kelley ME, Jones D, Powers A, Beckwith J, Stitzel J, Greenwald RM, Duma S. Neuropsychological Change After a Single Season of Head Impact Exposure in Youth Football. J Int Neuropsychol Soc 2021; 27:113-23. [PMID: 32762785 DOI: 10.1017/S1355617720000685] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Head impact exposure (HIE) in youth football is a public health concern. The objective of this study was to determine if one season of HIE in youth football was related to cognitive changes. METHOD Over 200 participants (ages 9-13) wore instrumented helmets for practices and games to measure the amount of HIE sustained over one season. Pre- and post-season neuropsychological tests were completed. Test score changes were calculated adjusting for practice effects and regression to the mean and used as the dependent variables. Regression models were calculated with HIE variables predicting neuropsychological test score changes. RESULTS For the full sample, a small effect was found with season average rotational values predicting changes in list-learning such that HIE was related to negative score change: standardized beta (β) = -.147, t(205) = -2.12, and p = .035. When analyzed by age clusters (9-10, 11-13) and adding participant weight to models, the R2 values increased. Splitting groups by weight (median split), found heavier members of the 9-10 cohort with significantly greater change than lighter members. Additionaly, significantly more participants had clinically meaningful negative changes: X2 = 10.343, p = .001. CONCLUSION These findings suggest that in the 9-10 age cluster, the average seasonal level of HIE had inverse, negative relationships with cognitive change over one season that was not found in the older group. The mediation effects of age and weight have not been explored previously and appear to contribute to the effects of HIE on cognition in youth football players.
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Toyoshima K, Kako Y, Toyomaki A, Shimizu Y, Tanaka T, Nakagawa S, Inoue T, Martinez-Aran A, Vieta E, Kusumi I. Associations between cognitive impairment and illness awareness in fully remitted bipolar outpatients. Psychiatry Res 2021; 296:113655. [PMID: 33373809 DOI: 10.1016/j.psychres.2020.113655] [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: 02/18/2019] [Accepted: 12/14/2020] [Indexed: 10/22/2022]
Abstract
The euthymic state of bipolar disorder is often characterized by impaired cognitive function. In this investigation, we hypothesized that subjective cognitive function is impaired and illness awareness is inadequate and we further explored the associations among cognitive complaints, objective cognitive functions, and current illness awareness in Japanese patients. Twenty-seven patients in remission and 27 healthy subjects were recruited in this study. The Japanese version of the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) and Scale to Assess Unawareness in Mental Disorders (Japanese, SUMD-J) were used to assess each patient. All patients underwent neuropsychological tests for the assessment of objective cognitive functions. Only SUMD2.C (current awareness of the effects of medication) was significantly correlated with COBRA, and the objective cognitive assessments, Word Fluency Test and Stroop Test Reaction Time, represented significant correlations with SUMD1.C (current awareness of mental illness). In remitted bipolar outpatients, both the objective and subjective cognitive functions were found to be associated with illness awareness. However, subjective and objective cognitive functions differed in the related illness awareness subscales in fully remitted bipolar outpatients.
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Affiliation(s)
- Kuniyoshi Toyoshima
- Department of Psychiatry, Wakkanai City Hospital, Wakkanai, Japan; Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
| | - Yuki Kako
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Atsuhito Toyomaki
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yusuke Shimizu
- Department of Psychiatry, Iwamizawa Municipal General Hospital, Iwamizawa, Japan
| | - Teruaki Tanaka
- Department of Psychiatry, KKR Sapporo Medical Center, Sapporo, Japan
| | - Shin Nakagawa
- Division of Neuropsychiatry, Department of Neuroscience, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Anabel Martinez-Aran
- Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Villarroel 170, Barcelona, 08036 Catalonia, Spain
| | - Eduard Vieta
- Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Villarroel 170, Barcelona, 08036 Catalonia, Spain
| | - Ichiro Kusumi
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Byeon H. Best early-onset Parkinson dementia predictor using ensemble learning among Parkinson's symptoms, rapid eye movement sleep disorder, and neuropsychological profile. World J Psychiatry 2020; 10:245-259. [PMID: 33269221 PMCID: PMC7672787 DOI: 10.5498/wjp.v10.i11.245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/27/2020] [Accepted: 10/11/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Despite the frequent progression from Parkinson’s disease (PD) to Parkinson’s disease dementia (PDD), the basis to diagnose early-onset Parkinson dementia (EOPD) in the early stage is still insufficient.
AIM To explore the prediction accuracy of sociodemographic factors, Parkinson's motor symptoms, Parkinson’s non-motor symptoms, and rapid eye movement sleep disorder for diagnosing EOPD using PD multicenter registry data.
METHODS This study analyzed 342 Parkinson patients (66 EOPD patients and 276 PD patients with normal cognition), younger than 65 years. An EOPD prediction model was developed using a random forest algorithm and the accuracy of the developed model was compared with the naive Bayesian model and discriminant analysis.
RESULTS The overall accuracy of the random forest was 89.5%, and was higher than that of discriminant analysis (78.3%) and that of the naive Bayesian model (85.8%). In the random forest model, the Korean Mini Mental State Examination (K-MMSE) score, Korean Montreal Cognitive Assessment (K-MoCA), sum of boxes in Clinical Dementia Rating (CDR), global score of CDR, motor score of Untitled Parkinson’s Disease Rating (UPDRS), and Korean Instrumental Activities of Daily Living (K-IADL) score were confirmed as the major variables with high weight for EOPD prediction. Among them, the K-MMSE score was the most important factor in the final model.
CONCLUSION It was found that Parkinson-related motor symptoms (e.g., motor score of UPDRS) and instrumental daily performance (e.g., K-IADL score) in addition to cognitive screening indicators (e.g., K-MMSE score and K-MoCA score) were predictors with high accuracy in EOPD prediction.
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Affiliation(s)
- Haewon Byeon
- Department of Medical Big Data, College of AI Convergence, Inje University, Gimhae 50834, Gyeonsangnamdo, South Korea
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Byeon H. Development of a depression in Parkinson's disease prediction model using machine learning. World J Psychiatry 2020; 10:234-244. [PMID: 33134114 PMCID: PMC7582129 DOI: 10.5498/wjp.v10.i10.234] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 09/01/2020] [Accepted: 09/22/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND It is important to diagnose depression in Parkinson’s disease (DPD) as soon as possible and identify the predictors of depression to improve quality of life in Parkinson’s disease (PD) patients.
AIM To develop a model for predicting DPD based on the support vector machine, while considering sociodemographic factors, health habits, Parkinson's symptoms, sleep behavior disorders, and neuropsychiatric indicators as predictors and provide baseline data for identifying DPD.
METHODS This study analyzed 223 of 335 patients who were 60 years or older with PD. Depression was measured using the 30 items of the Geriatric Depression Scale, and the explanatory variables included PD-related motor signs, rapid eye movement sleep behavior disorders, and neuropsychological tests. The support vector machine was used to develop a DPD prediction model.
RESULTS When the effects of PD motor symptoms were compared using “functional weight”, late motor complications (occurrence of levodopa-induced dyskinesia) were the most influential risk factors for Parkinson's symptoms.
CONCLUSION It is necessary to develop customized screening tests that can detect DPD in the early stage and continuously monitor high-risk groups based on the factors related to DPD derived from this predictive model in order to maintain the emotional health of PD patients.
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Affiliation(s)
- Haewon Byeon
- Major in Medical Big Data, College of AI Convergence, Inje University, Gimhae 50834, Gyeonsangnamdo, South Korea
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Hurtado-Pomares M, Valera-Gran D, Sánchez-Pérez A, Peral-Gómez P, Navarrete-Muñoz EM, Terol-Cantero MC. Adaptation of the Spanish version of the Frontal Assessment Battery for detection of executive dysfunction. Med Clin (Barc) 2020; 156:229-232. [PMID: 32919777 DOI: 10.1016/j.medcli.2020.04.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/18/2020] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The Frontal Assessment Battery (FAB) evaluates executive dysfunctions; however, there is no culturally adapted version of this instrument for the Spanish population. The aim of this study was the translation and cross-cultural adaptation of the original version of the FAB into Spanish and to pilot test this version. METHODS The cross-cultural adaptation was conducted following standard procedures. The final Spanish version of the FAB (FAB-E) was pilot tested with 19 healthy Spanish individuals. Total and subtest FAB-E scores were analysed to verify that the test could be understood and that the items assessed what they were intended to assess. RESULTS The FAB-E revealed that items/instructions were culturally appropriate and written clearly. Pilot testing showed that most of the participants had scores ranging between 2 and 3 points in all the items. The mean of the total FAB-E was 15.8 (SD=1.3) and the values ranged from 13 to 18. Age and educational level seemed to indicate differences in FAB-E scores. CONCLUSION Our findings support that the FAB-E can be used to screen for executive dysfunctions in a Spanish-speaking population.
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Affiliation(s)
- Miriam Hurtado-Pomares
- Grupo de Investigación en Terapia Ocupacional (InTeO). Department of Pathology and Surgery, Miguel Hernandez University, Alicante, Spain
| | - Desirée Valera-Gran
- Grupo de Investigación en Terapia Ocupacional (InTeO). Department of Pathology and Surgery, Miguel Hernandez University, Alicante, Spain; Department of Health Psychology, Miguel Hernandez University, Alicante, Spain.
| | - Alicia Sánchez-Pérez
- Grupo de Investigación en Terapia Ocupacional (InTeO). Department of Pathology and Surgery, Miguel Hernandez University, Alicante, Spain
| | - Paula Peral-Gómez
- Grupo de Investigación en Terapia Ocupacional (InTeO). Department of Pathology and Surgery, Miguel Hernandez University, Alicante, Spain
| | - Eva-María Navarrete-Muñoz
- Grupo de Investigación en Terapia Ocupacional (InTeO). Department of Pathology and Surgery, Miguel Hernandez University, Alicante, Spain
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Medrano-Martinez P, Peraita-Adrados R. Neuropsychological Alterations in Narcolepsy with Cataplexy and the Expression of Cognitive Deficits. J Int Neuropsychol Soc 2020; 26:587-95. [PMID: 31826783 DOI: 10.1017/S1355617719001334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The objective of our study was to assess attention processes and executive function in patients with narcolepsy with cataplexy (NT1). To do so, we compared the results with those of a control group from the general population using an extensive neuropsychological test battery. METHODS We studied 28 patients with NT1 and 28 healthy control participants matched for age, gender, and educational level. They all completed questionnaires on sleepiness, anxiety, and depression symptoms. In addition, they underwent neuropsychological tests. The ability to maintain attention was assessed using three computer tasks with different levels of complexity. RESULTS Patients had significantly more daytime sleepiness than controls. A significant negative correlation between depression and disease duration was found in NT1 patients. The results of the anxiety questionnaire correlated with the presence of sleep paralysis. There were significant differences in information processing speed subtasks. Patients made significantly more omissions and generally reacted slower and more variably than controls in computerized tasks. As for executive function, patients performed worse in phonologic fluency tasks than controls. However, when the influence of processing speed on fluency tasks was statistically controlled, part of this significant difference disappeared. CONCLUSIONS Our results indicate that the negative correlation between depression and disease duration probably reflects progressive adaptation to the functional burden of the disease. Information processing speed plays a fundamental role in the expression of cognitive deficits. We emphasized the need to control the influence of processing speed and sustained attention in the neuropsychological assessment of NT1 patients.
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Reukers DFM, Aaronson J, van Loenhout JAF, Meyering B, van der Velden K, Hautvast JLA, van Jaarsveld CHM, Kessels RPC. Objective cognitive performance and subjective complaints in patients with chronic Q fever or Q fever fatigue syndrome. BMC Infect Dis 2020; 20:397. [PMID: 32503444 PMCID: PMC7275429 DOI: 10.1186/s12879-020-05118-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/30/2019] [Accepted: 05/26/2020] [Indexed: 02/02/2023] Open
Abstract
Background Primary aim of this study was to compare cognitive performance of patients with chronic Q fever or Q fever fatigue syndrome (QFS) to matched controls from the general population, while taking performance validity into account. Second, we investigated whether objective cognitive performance was related to subjective cognitive complaints or psychological wellbeing. Methods Cognitive functioning was assessed with a neuropsychological test battery measuring the domains of processing speed, episodic memory, working memory and executive functioning. Tests for performance validity and premorbid intelligence were also included. Validated questionnaires were administered to assess self-reported fatigue, depressive symptoms and cognitive complaints. Results In total, 30 patients with chronic Q fever, 32 with QFS and 35 controls were included. A high percentage of chronic Q fever patients showed poor performance validity (38%) compared to controls (14%, p = 0.066). After exclusion of participants showing poor performance validity, no significant differences between patients and controls were found in the cognitive domains. QFS patients reported a high level of cognitive complaints compared to controls (41.2 vs 30.4, p = 0.023). Cognitive complaints were not significantly related to cognitive performance in any of the domains for this patient group. Conclusions The high level of self-reported cognitive complaints in QFS patients does not indicate cognitive impairment. A large proportion of the chronic Q fever patients showed suboptimal mental effort during neuropsychological assessment. More research into the underlying explanations is needed. Our findings stress the importance of assessing cognitive functioning by neuropsychological examination including performance validity, rather than only measuring subjective cognitive complaints.
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Affiliation(s)
- Daphne F M Reukers
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Justine Aaronson
- Department of Medical Psychology, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Joris A F van Loenhout
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.,Centre for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Birte Meyering
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.,Department of Medical Psychology, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Koos van der Velden
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Jeannine L A Hautvast
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Cornelia H M van Jaarsveld
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Roy P C Kessels
- Department of Medical Psychology, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
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García-Pallero MA, Torres Díaz CV, Hernando CG, Plasencia PM, Manzanares R, García LE, Navas M, Pulido P, Delgado-Fernández J, Aragón Rubio JI, Sola RG. Prediction of Memory Impairment in Epilepsy Surgery by White Matter Diffusion. World Neurosurg 2020; 139:e78-e87. [PMID: 32229300 DOI: 10.1016/j.wneu.2020.03.103] [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: 01/27/2020] [Revised: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To analyze the relationship between cognitive performance and white matter integrity in patients with temporal lobe epilepsy (TLE) to establish radiologic criteria to help with patient selection for surgery. METHODS The study included 19 adults with temporal lobe epilepsy. A tractography analysis of fractional anisotropy and mean diffusivity (MD) of the following fascicles was performed: arcuate fascicle, cingulum, fornix, inferior fronto-occipital fascicle, inferior longitudinal fascicle, parahippocampal fibers of the cingulum, and uncinate fascicle. The Wechsler Memory Scale-Third Edition neuropsychological test was performed to evaluate short- and long-term verbal (Logical Memory I and II subtests) and nonverbal (Visual Reproduction I and II subtests) memory. Relationships between memory scores and diffusion were calculated. RESULTS Lower Logical Memory I subtest scores were correlated with lower MD of the right inferior fronto-occipital fascicle, while lower Logical Memory II subtest scores were related to higher values of fractional anisotropy in bilateral cingulum, right uncinate, and right parahippocampal fibers of the cingulum and lower MD in left cingulum fascicle. Finally, lower values in Visual Reproduction I subtest scores were associated with lower values in MD in right cingulum and inferior fronto-occipital fascicles. CONCLUSIONS Structural changes of some white matter tracts were associated with deterioration of both short- and long-term memory. These alterations were more associated with verbal memory than with nonverbal memory. These changes mainly consist of an increase in fractional anisotropy and a decrease in MD, which could be interpreted as reorganization phenomena. Diffusion tensor imaging could be a useful tool for cognitive assessment in surgical candidates with temporal lobe epilepsy who are not suitable for neuropsychological testing or in whom their results do not lead to definitive conclusions.
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Affiliation(s)
| | | | | | - Pilar Martín Plasencia
- Department of Biological and Health Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Rafael Manzanares
- Department of Radiology, University Hospital la Princesa, Madrid, Spain
| | | | - Marta Navas
- Department of Neurosurgery, University Hospital la Princesa, Madrid, Spain
| | - Paloma Pulido
- Department of Neurosurgery, University Hospital la Princesa, Madrid, Spain
| | | | - José I Aragón Rubio
- Department of Radiology, University Hospital Puerta de Hierro, Madrid, Spain
| | - Rafael G Sola
- Innovation in Neurosurgery of University Autonomous of Madrid, Madrid, Spain
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Guo B, Yang L, Li X, Liu X, Wei X, Guo L. The correlation between the evolution of bilateral basal ganglia hemorrhage using MR imaging and neurological damage recovery in an infant with methylmalonic aciduria. Brain Dev 2020; 42:357-362. [PMID: 31937422 DOI: 10.1016/j.braindev.2019.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/24/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE We report on one patient with methylmalonic acidemia (MMA) who presented with symmetrical hemorrhage of the caudate nucleus accompanied by severe ventricular dilatation, follow-up magnetic resonance imaging (MRI) findings from one year later, and the clinical manifestations, neuropsychological scores, genetic test results, urine and blood laboratory results and evolution of the disorder. MATERIALS AND METHODS This study describes the recent and remote neuropathologic findings, reviews the literature, and discusses the possible pathogenetic mechanisms of these central nervous system lesions. RESULTS Patients with MMA may have signs of basal ganglia hemorrhage during acute onset, and the hemorrhage may disappear after treatment. During the treatment, both laboratory examination indexes and neuropsychological scores improved. There was a correlation between the evolution of bilateral basal ganglia hemorrhage using MRI(magnetic resonance imaging) and neurological damage recovery in this infant with MMA. CONCLUSION There was a correlation between the evolution of the bilateral basal ganglia hemorrhage using MR imaging and neurological damage recovery in an infant with MMA. We recommend performing conventional MR and diffusion-weighted imaging (DWI) examinations in patients with MMA who present with neurological symptoms.
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Affiliation(s)
- Bin Guo
- Jinan Maternal and Child Care Hospital, Jianguo xiao jing-san Road No. 2, Jinan 250001, Shandong Province, China.
| | - Linfeng Yang
- Jinan Maternal and Child Care Hospital, Jianguo xiao jing-san Road No. 2, Jinan 250001, Shandong Province, China.
| | - Xue Li
- Jinan Maternal and Child Care Hospital, Jianguo xiao jing-san Road No. 2, Jinan 250001, Shandong Province, China.
| | - Xiangyu Liu
- Jinan Maternal and Child Care Hospital, Jianguo xiao jing-san Road No. 2, Jinan 250001, Shandong Province, China.
| | - Xinhong Wei
- Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jing-wu Road No. 324, Jinan 250021, Shandong, China.
| | - Lingfei Guo
- Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jing-wu Road No. 324, Jinan 250021, Shandong, China.
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Yadav SK, Gupta RK, Hashem S, Nisar S, Azeem T, Bhat AA, Syed N, Garg RK, Venkatesh V, Kamal M, Fakhro K, Frenneaux MP, Haris M. Brain microstructural changes support cognitive deficits in HIV uninfected children born to HIV infected mothers. Brain Behav Immun Health 2020; 2:100039. [PMID: 34589830 DOI: 10.1016/j.bbih.2020.100039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/20/2020] [Accepted: 01/24/2020] [Indexed: 12/22/2022] Open
Abstract
Introduction Antiretroviral therapy (ART) is considered the most effective way to prevent perinatal transmission of human immunodeficiency virus (HIV). However, there is little knowledge about the effect of ART on the brain of HIV uninfected children born to HIV infected mothers (HUC). The current study evaluated the brain's microstructural integrity, and cognitive function in HUC compared to healthy children born to normal mothers (CHNM) and HIV infected children born to HIV infected mothers (HIC) to investigate the effect of in-utero exposure of ART on cerebral gray and white matter. Materials and methods Forty nine HIC, 12 HUC and 18 CHNM underwent neuropsychological (NP) assessment and a brain MRI. Diffusion tensor imaging (DTI) data was used to generate fractional anisotropy (FA) and mean diffusivity (MD) maps. Voxel wise comparison for FA and MD was performed between three groups using an analysis of covariance (ANCOVA) including age and sex as covariates, and correction for multiple comparisons (false discovery rate (FDR), p < 0.05 with minimum extended cluster size, 150 voxels). NP test scores were also compared between three groups using ANOVA with Post Hoc Bonferroni multiple comparison corrections (p < 0.05). Significantly changed FA and MD values in different brain regions in HIC and HUC compared to CHNM were used for correlation analysis with NP test scores using Pearson's correlation. Results HIC and HUC groups showed significantly decreased NP test scores in various domain compared to CHNM. Significantly lower NP test scores was observed in HIC than those of HUC. HIC showed decreased FA and increased MD in multiple brain sites as compared to both CHNM and HUC. Decreased FA along with both increased and decreased MD in different brain regions was present in HUC compared to CHNM. Both positive and negative correlation of altered FA and MD values from different brain regions in HIC and HUC with NP test scores was observed. Conclusion The presence of brain tissue changes and neurocognitive function deficit in absence of HIV infection in HUC indicates that ART may have a detrimental impact on the developing brain. The findings of the current study underscore the need for screening of ART exposed children for neurodevelopment and cognitive abnormalities at an early stage and call for access to early interventions, and nutritional and care programs.
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Kang MJ, Kim SY, Na DL, Kim BC, Yang DW, Kim EJ, Na HR, Han HJ, Lee JH, Kim JH, Park KH, Park KW, Han SH, Kim SY, Yoon SJ, Yoon B, Seo SW, Moon SY, Yang Y, Shim YS, Baek MJ, Jeong JH, Choi SH, Youn YC. Prediction of cognitive impairment via deep learning trained with multi-center neuropsychological test data. BMC Med Inform Decis Mak 2019; 19:231. [PMID: 31752864 PMCID: PMC6873409 DOI: 10.1186/s12911-019-0974-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/08/2019] [Indexed: 12/16/2022] Open
Abstract
Background Neuropsychological tests (NPTs) are important tools for informing diagnoses of cognitive impairment (CI). However, interpreting NPTs requires specialists and is thus time-consuming. To streamline the application of NPTs in clinical settings, we developed and evaluated the accuracy of a machine learning algorithm using multi-center NPT data. Methods Multi-center data were obtained from 14,926 formal neuropsychological assessments (Seoul Neuropsychological Screening Battery), which were classified into normal cognition (NC), mild cognitive impairment (MCI) and Alzheimer’s disease dementia (ADD). We trained a machine learning model with artificial neural network algorithm using TensorFlow (https://www.tensorflow.org) to distinguish cognitive state with the 46-variable data and measured prediction accuracies from 10 randomly selected datasets. The features of the NPT were listed in order of their contribution to the outcome using Recursive Feature Elimination. Results The ten times mean accuracies of identifying CI (MCI and ADD) achieved by 96.66 ± 0.52% of the balanced dataset and 97.23 ± 0.32% of the clinic-based dataset, and the accuracies for predicting cognitive states (NC, MCI or ADD) were 95.49 ± 0.53 and 96.34 ± 1.03%. The sensitivity to the detection CI and MCI in the balanced dataset were 96.0 and 96.0%, and the specificity were 96.8 and 97.4%, respectively. The ‘time orientation’ and ‘3-word recall’ score of MMSE were highly ranked features in predicting CI and cognitive state. The twelve features reduced from 46 variable of NPTs with age and education had contributed to more than 90% accuracy in predicting cognitive impairment. Conclusions The machine learning algorithm for NPTs has suggested potential use as a reference in differentiating cognitive impairment in the clinical setting.
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Affiliation(s)
- Min Ju Kang
- Department of Neurology, Seoul National University College of Medicine & Seoul National University Bundang Hospital, Seoul, South Korea.,Department of Neurology, Veterans Health Service Medical Center, Seoul, South Korea
| | - Sang Yun Kim
- Department of Neurology, Seoul National University College of Medicine & Seoul National University Bundang Hospital, Seoul, South Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Byeong C Kim
- Department of Neurology, Chonnam National University Medical School, Gwangju, South Korea
| | - Dong Won Yang
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Hae Ri Na
- The Brain Fitness Center, Bobath Memorial Hospital, Seongnam, South Korea
| | - Hyun Jeong Han
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea
| | - Jae-Hong Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Jong Hun Kim
- Department of Neurology, Dementia Center, Ilsan Hospital, National Health Insurance Service, Goyang, South Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Hospital, Incheon, South Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A University College of Medicine and Institute of Convergence Bio-Health, Busan, South Korea
| | - Seol-Heui Han
- Department of Neurology, Konkuk University Medical Center, Seoul, South Korea
| | - Seong Yoon Kim
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Soo Jin Yoon
- Department of Neurology, Eulji University College of Medicine, Daejeon, South Korea
| | - Bora Yoon
- Department of Neurology, Konyang University Hospital, College of Medicine, Konyang University, Daejeon, South Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - YoungSoon Yang
- Department of Neurology, Veterans Health Service Medical Center, Seoul, South Korea
| | - Yong S Shim
- Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Min Jae Baek
- Department of Neurology, Seoul National University College of Medicine & Seoul National University Bundang Hospital, Seoul, South Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, South Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, South Korea
| | - Young Chul Youn
- Department of Neurology, College of Medicine, Chung-Ang University, Seoul, South Korea.
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Petton M, Perrone-Bertolotti M, Mac-Auliffe D, Bertrand O, Aguera PE, Sipp F, Batthacharjee M, Isnard J, Minotti L, Rheims S, Kahane P, Herbillon V, Lachaux JP. BLAST: A short computerized test to measure the ability to stay on task. Normative behavioral data and detailed cortical dynamics. Neuropsychologia 2019; 134:107151. [PMID: 31541659 DOI: 10.1016/j.neuropsychologia.2019.107151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 07/13/2019] [Accepted: 07/27/2019] [Indexed: 11/18/2022]
Abstract
This article provides an exhaustive description of a new short computerized test to assess on a second-to-second basis the ability of individuals to « stay on task », that is, to apply selectively and repeatedly task-relevant cognitive processes. The task (Bron/Lyon Attention Stability Test, or BLAST) lasts around 1 min, and measures repeatedly the time to find a target letter in a two-by-two letter array, with an update of all letters every new trial across thirty trials. Several innovative psychometric measures of attention stability are proposed based on the instantaneous fluctuations of reaction times throughout the task, and normative data stratified over a wide range of age are provided by a large (>6000) dataset of participants aged 8 to 70. We also detail the large-scale brain dynamics supporting the task from an in-depth study of 32 participants with direct electrophysiological cortical recordings (intracranial EEG) to prove that BLAST involves critically large-scale executive attention networks, with a marked activation of the dorsal attention network and a deactivation of the default-mode network. Accordingly, we show that BLAST performance correlates with scores established by ADHD-questionnaires.
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Affiliation(s)
- Mathilde Petton
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Lyon, France, France
| | | | - Diego Mac-Auliffe
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Lyon, France, France
| | - Olivier Bertrand
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Lyon, France, France
| | | | - Florian Sipp
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Lyon, France, France
| | | | - Jean Isnard
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and Université Lyon, Lyon, France
| | - Lorella Minotti
- Univ. Grenoble Alpes, Inserm, CHU Grenoble Alpes, GIN, Grenoble, France; CHU Grenoble-Alpes, Hôpital Michallon, Service de Neurologie, Grenoble, France
| | - Sylvain Rheims
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Lyon, France, France; Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and Université Lyon, Lyon, France
| | - Philippe Kahane
- Univ. Grenoble Alpes, Inserm, CHU Grenoble Alpes, GIN, Grenoble, France; CHU Grenoble-Alpes, Hôpital Michallon, Service de Neurologie, Grenoble, France
| | - Vania Herbillon
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Lyon, France, France
| | - Jean-Philippe Lachaux
- INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Lyon, France, France.
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Rivera D, Olabarrieta-Landa L, Brooks BL, Ertl MM, Benito-Sánchez I, Quijano MC, Rodriguez-Irizarry W, Aguayo Arelis A, Rodríguez-Agudelo Y, Arango-Lasprilla JC. Multivariate Base Rates of Low Scores on Tests of Learning and Memory Among Latino Adult Populations. J Int Neuropsychol Soc 2019; 25:834-44. [PMID: 31130149 DOI: 10.1017/S135561771900050X] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the prevalence of low scores for two neuropsychological tests with five total scores that evaluate learning and memory functions. METHOD N = 5402 healthy adults from 11 countries in Latin America and the commonwealth of Puerto Rico were administered the Rey-Osterrieth Complex Figure (ROCF) and the Hopkins Verbal Learning Test (HVLT-R). Two-thirds of the participants were women, and the average age was 53.5 ± 20.0 years. Z-scores were calculated for ROCF Copy and Memory scores and HVLT-R Total Recall, Delayed Recall, and Recognition scores, adjusting for age, age2, sex, education, and interaction variables if significant for the given country. Each Z-score was converted to a percentile for each of the five subtest scores. Each participant was categorized based on his/her number of low scoring tests in specific percentile cutoff groups (25th, 16th, 10th, 5th, and 2nd). RESULTS Between 57.3% (El Salvador) and 64.6% (Bolivia) of the sample scored below the 25th percentile on at least one of the five scores. Between 27.1% (El Salvador) and 33.9% (Puerto Rico) scored below the 10th percentile on at least one of the five subtests. Between 5.9% (Chile, El Salvador, Peru) and 10.3% (Argentina) scored below the 2nd percentile on at least one of the five scores. CONCLUSIONS Results are consistent with other studies that found that low scores are common when multiple neuropsychological outcomes are evaluated in healthy individuals. Clinicians should consider the higher probability of low scores when evaluating learning and memory using various sets of scores to reduce false-positive diagnoses of cognitive deficits.
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Jin HM, Li D, Yu YY, Zhang M, Liu XN, Li FY, Wu LY, Wang F. [Features of a modified WHO/UCLA AVLT performance in amnestic mild cognitive impairment and mild Alzheimer's disease]. Zhonghua Yi Xue Za Zhi 2019; 99:2423-2428. [PMID: 31434421 DOI: 10.3760/cma.j.issn.0376-2491.2019.31.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the features of a modified WHO/UCLA AVLT performance in the cognitive normal, amnestic mild cognitive impairment (aMCI) and mild Alzheimer's disease (mild AD) patients. Method: A total of 105 cases of cognitivenormal (CN), 48 aMCI and 50 mild AD patients were included between 2016 and 2018. All subjects undertook detailed neuropsychological tests and brain MRI/CT scan. Results: The total score of five learning trials in CN, aMCI and AD groups were 53.9±6.9, 34.6±8.3 and 23.7±6.2, respectively (P<0.001). The score of 20-min delay recallwere 12.5±1.6, 4.3±3.0 and 0.6±1.0, respectively (P<0.001) in three groups. The score of cued recall were 13.0±1.4, 7.0±2.4 and 2.6±2.0, respectively (P<0.001). The score of 20-min delay recall had the largest effect sizes between CN and aMCI groups (Cohen'd=3.8, 95%CI,3.3-4.4), and CN and mild AD groups (Cohen'd=8.1, 95%CI 7.1-9.1). Cued recall had the largest effect size between aMCI and mild AD groups (Cohen'd=2.04, 95%CI 1.5-2.5). The scores of learning total score, 20-min delay recall, cued recall and recognition had the strong relationships with the scores of mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) , but obtaining moderate relationships with Boston naming test and trail making test (TMT) and weak relationships with digit span and figure copy. Age and education had no relationship with the main indices of this modified AVLT. Conclusions: The modified WHO/UCLA AVLT is still an age and education fair test to assess memory domain function. Qualitative analysis of AVLT profiles may be useful to differentiate the CN, aMCI and mild AD in Chinese sample.
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Affiliation(s)
- H M Jin
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - D Li
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Y Y Yu
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - M Zhang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - X N Liu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - F Y Li
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - L Y Wu
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - F Wang
- Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Dominguez JC, Phung TKT, de Guzman MFP, Fowler KC, Reandelar M, Natividad B, Waldemar G, Nielsen TR, Pamintuan Aquial MR, Holandez RL, Ligsay AD. Determining Filipino Normative Data for a Battery of Neuropsychological Tests: The Filipino Norming Project (FNP). Dement Geriatr Cogn Dis Extra 2019; 9:260-270. [PMID: 31572422 PMCID: PMC6751438 DOI: 10.1159/000500519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 04/23/2019] [Accepted: 04/23/2019] [Indexed: 01/12/2023] Open
Abstract
Background Filipino normative data for neuropsychological tests are lacking. Objectives This study aimed to determine the Filipino normative data for the Filipino Norming Project (FNP) Neuropsychological Battery, combining the Alzheimer's Disease Assessment Scale – Cognitive (ADAS-Cog) and the Neuropsychological Test Battery from the Uniform Dataset of Alzheimer's Disease Center (UDS-ADC). Methods We recruited participants 60 years and older with normal cognition (MMSE score of 25 and above and did not fulfill criteria for dementia according to DSM-IV criteria). Psychologists administered the tests to the study participants. We conducted multivariate analyses to study the effect of age, gender, and education on test performance. Results A total of 191 participants underwent the FNP Neuropsychological Test Battery. The mean age was 68.8 years (SD 5.4). The majority were female (84.1%). The mean score of ADAS-Cog was 9.98 (SD 4.74). The effect of education was prominent throughout the cognitive domains tested while the effect of age was limited to a few cognitive domains. The mean ADAS-Cog scores were 11.80 ± 4.40 for primary education, 9.93 ± 5.08 for secondary, and 8.15 ± 3.95 for tertiary. On average, women scored 2.75 points lower than men and performed better on the verbal components. Men performed better on the constructional praxis component. The same effect of education and gender was observed for the UDS-ADC. Conclusion For the first time, normative data are available for the ADAS-Cog and UDS-ADC for a Filipino older population. This study stresses the importance of establishing population-specific normative data, taking into account the specific sociocultural and linguistic context of that population.
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Affiliation(s)
| | - Thien Kieu Thi Phung
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Krizelle Cleo Fowler
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines
| | - Macario Reandelar
- Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, Philippines
| | - Boots Natividad
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines
| | - Gunhild Waldemar
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Rune Nielsen
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Zhang X, Cheng X, Chen J, Zhang B, Wu Q, Deng W, Li X, Lin Y, Yang C, Cao L. Association of subthreshold manic symptoms and cognitive impairments in euthymic patients with bipolar disorder I. Psychiatry Res 2019; 278:303-308. [PMID: 31255953 DOI: 10.1016/j.psychres.2019.06.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 02/05/2019] [Revised: 06/20/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
Abstract
Cognitive impairments exist during the euthymic period of bipolar disorder (BD). However, the impact of clinical factors (e.g., subthreshold symptoms and body mass index) on cognitive function in euthymic patients with bipolar disorder I is inconsistent. This cross-sectional study included 83 patients with euthymic BD I and 115 healthy controls. The Repeatable Battery for the Assessment of Neuropsychological Status indices were used to assess cognitive function. We assessed the relationship between cognitive function and clinical impact factors. Performance in language abilities, attention, and immediate memory was worse in euthymic BD I. Spearman's correlation revealed that indices for immediate memory and attention were negatively correlated with subthreshold manic symptoms, and indices for delayed memory were positively correlated with years of education. Linear regressions indicated that subthreshold manic symptoms were the best predictors of immediate memory and attention. Years of education predicted performance in most cognitive domains, except immediate memory. Individuals with euthymic BD I exhibited cognitive deficits in language learning, attention, and immediate memory. Our study highlights the importance of the effect of subthreshold manic symptoms on cognitive function in remitted BD; these symptoms should receive more attention and be targeted in personalized clinical therapeutic interventions.
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Affiliation(s)
- Xiaofei Zhang
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital). Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China.
| | - Xiongchao Cheng
- Department of Medical Psychology, Guilin Mental Health Center, Fuli Road 4, Guilin, Guangxi Zhuang Autonomous Region, 541000, China.
| | - Jianshan Chen
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital). Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China.
| | - Bin Zhang
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital). Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China.
| | - Qiuxia Wu
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital). Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China.
| | - Wenhao Deng
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital). Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China.
| | - Xuan Li
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital). Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China.
| | - Yin Lin
- Department of Psychology, Shenzhen Children's Hospital, Yitian Road 7019, Futian district, Shenzhen, 518000, China.
| | - Chanjuan Yang
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital). Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China.
| | - Liping Cao
- Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital). Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, 510370, China.
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Wong KMF, Yuen SSY, Mak ADP. Neurocognitive Characteristics of Individuals with Irritable Bowel Syndrome. East Asian Arch Psychiatry 2019; 29:48-56. [PMID: 31237246] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Irritable bowel syndrome (IBS) is a systems-based brain-gut axis disorder. Cognitive functions reflect central affective and attentional processes that are driven by genetic and epigenetic influences and effect complex brain-gut interactions. These interactions include stress-induced changes in hypothalamic-pituitary-adrenal axis and autonomic nervous system, remodelling of the immune system, and alterations in microbiota composition. This review summarises current neurocognitive findings on patients with IBS. 13 studies of neurocognition in IBS patients were identified from PubMed, Ovid MEDLINE, EMBASE, and PsycINFO. The methodology and relevant findings were systematically analysed. There are alterations in both hot and cold cognitions in IBS patients. Consistently, attentional bias towards negative emotionally valenced and gastrointestinal symptom-related stimuli is found in hot cognition tasks, with other cold cognition differences including frontal executive dysfunction and stress-related hippocampal-mediated cognitive alterations. The effect of psychiatric comorbidity on a disorder level, as well as illness chronicity, on cognitive alterations requires further examination. Attentional bias and executive dysfunction in IBS gave support to its neural network alterations accounting for visceral hypersensitivity. Further prospective neuropsychological studies should examine the effect of chronicity, current symptom severity, and psychiatric comorbidity on the cognition in different IBS subtypes.
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Affiliation(s)
- K M F Wong
- Department of Psychiatry, Shatin Hospital, Hong Kong
| | - S S Y Yuen
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - A D P Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
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Iuliano E, di Cagno A, Cristofano A, Angiolillo A, D'Aversa R, Ciccotelli S, Corbi G, Fiorilli G, Calcagno G, Di Costanzo A. Physical exercise for prevention of dementia (EPD) study: background, design and methods. BMC Public Health 2019; 19:659. [PMID: 31142290 PMCID: PMC6542067 DOI: 10.1186/s12889-019-7027-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 05/22/2019] [Indexed: 02/08/2023] Open
Abstract
Background Several observational studies have shown that exercise reduces the risk of cognitive decline; however, evidences from long-term, well-conducted, randomized controlled trials are scanty. The principal aim of this study is to verify whether a long-term program of multimodal supervised exercise improves the cognitive function and/or reduces the rate of cognitive decline in older adults at different degrees of risk for dementia. Methods/design EPD is a parallel group, double-blind, randomized controlled trial. Community-dwelling volunteers aged 50 years or more are being recruited from different community centers and screened for eligibility. Enrolled subjects are being divided in 3 groups: a) without subjective or objective cognitive impairment, b) with subjective memory complaints, and c) with mild cognitive impairments. Participants in each group (at least 180) are being randomly assigned (1:1) to an experimental group, performing a supervised training including aerobic and resistance exercises of moderate/high intensity, or to a control group. Primary outcome will be 48-months changes in Mini Mental State Examinations. Secondary outcomes will be changes in several cognitive tests including a composite cognitive score. Time points will be at baseline, and at 6, 12, 24, 36 and 48 months. Statistical analysis will be done as intention to treat, complete case and mixed model analysis. Discussion EPD is the first trial to examine the effects of a long exercise program (48 months) on cognitive performances. If successful, this trial may provide evidence for using long-term and multimodal exercise interventions for dementia prevention programs in the aging population. Trial registration The study is registered at ClinicalTrials.gov with the code NCT02236416.
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Affiliation(s)
- Enzo Iuliano
- Faculty of Psychology, eCampus university, Via Isimbardi 10, 22060, Novedrate, Italy.,Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - Alessandra di Cagno
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico, Piazza Lauro De Bosis 6, 00135, Rome, Italy
| | - Adriana Cristofano
- Center for Research and Training in Medicine of Aging, Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - Antonella Angiolillo
- Center for Research and Training in Medicine of Aging, Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - Rita D'Aversa
- Center for Research and Training in Medicine of Aging, Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - Santina Ciccotelli
- Center for Research and Training in Medicine of Aging, Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - Giovanni Fiorilli
- Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - Giuseppe Calcagno
- Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy.
| | - Alfonso Di Costanzo
- Center for Research and Training in Medicine of Aging, Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
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Wang LJ, Lee SY, Chou MC, Lee MJ, Chou WJ. Dehydroepiandrosterone sulfate, free testosterone, and sex hormone-binding globulin on susceptibility to attention-deficit/hyperactivity disorder. Psychoneuroendocrinology 2019; 103:212-218. [PMID: 30711898 DOI: 10.1016/j.psyneuen.2019.01.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/03/2019] [Accepted: 01/21/2019] [Indexed: 02/07/2023]
Abstract
The neuroendocrine system may affect the pathophysiology of gender differences in attention deficit/hyperactivity disorder (ADHD). This study examines whether the relationships among dehydroepiandrosterone sulfate (DHEA-S), free testosterone, or sex hormone-binding globulin (SHBG) and ADHD presentations exhibit gender differences. A total of 113 boys and 35 girls with ADHD (all drug naïve) and 46 and 26 healthy control boys and girls, respectively, were recruited. Blood samples were obtained to measure the serum levels of DHEA-S, free testosterone, and SHBG in each child. The Swanson, Nolan, and Pelham Scale for ADHD Version IV (SNAP-IV) was used to evaluate behavioral symptoms and the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) and the Conners' Continuous Performance Test (CPT) were utilized to assess neurocognitive functions. Patients with ADHD had lower DHEA-S levels than male and female healthy control subjects, and no significant differences were observed in free testosterone and SHBG levels between the patients and the controls. DHEA-S levels were negatively correlated with children's impulsivity performance in the CPT. SHBG levels were negatively correlated with ADHD behavior symptoms among boys. Free testosterone levels were not significantly correlated with either ADHD clinical symptoms or neuropsychological functions. We propose that DHEA-S serves as a potential biomarker of ADHD and is consistently involved in the pathogenesis of ADHD in both boys and girls. SHBG may be involved in behaviors associated with ADHD in boys. Additional studies with basic scientific measures are warranted to elucidate the relationship between androgen hormones and clinical presentations of ADHD.
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Affiliation(s)
- Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sheng-Yu Lee
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Miao-Chun Chou
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Min-Jing Lee
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Luo DH, Tseng WYI, Chang YL. White matter microstructure disruptions mediate the adverse relationships between hypertension and multiple cognitive functions in cognitively intact older adults. Neuroimage 2019; 197:109-119. [PMID: 31029871 DOI: 10.1016/j.neuroimage.2019.04.063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 02/19/2019] [Revised: 04/23/2019] [Accepted: 04/23/2019] [Indexed: 01/01/2023] Open
Abstract
Although hypertension is a prominent vascular risk factor for late-life cognitive decline, the underlying pathophysiological mechanism remains unclear. Accordingly, the aim of this study was to examine the role of white matter microstructural integrity in hypertension-related cognitive detriments. We recruited 66 cognitively normal older adults, comprising 41 hypertensive patients and 25 normotensive controls. All participants underwent a comprehensive neuropsychological battery. White matter microstructural integrity was assessed using a tract-based automatic analysis approach derived from diffusion spectrum imaging. Mediating effects of white matter integrity were evaluated using structural equation modeling analyses. The results revealed that hypertensive older adults displayed poorer processing speed, executive function, and memory encoding. Lower white matter microstructural integrity was observed in the hypertensive elderly patients, primarily in long-range association fiber bundles. In particular, low microstructural integrity in specific tract bundles connecting frontal and posterior cerebral regions was found to underlie the adverse relationships between hypertension and multiple cognitive domains, including processing speed, executive function, memory encoding, and memory retention. Our findings suggest that hypertension may impair multiple cognitive functions by undermining white matter microstructures, even in cognitively intact older adults, thus further highlighting the necessity of monitoring vascular health to prevent cognitive decline.
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Affiliation(s)
- Di-Hua Luo
- Department of Psychology, College of Science, National Taiwan University, Taipei, 10617, Taiwan
| | - Wen-Yih Isaac Tseng
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, 10617, Taiwan; Graduate Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, 10051, Taiwan; Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, 10051, Taiwan; Department of Medical Imaging, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, 10048, Taiwan
| | - Yu-Ling Chang
- Department of Psychology, College of Science, National Taiwan University, Taipei, 10617, Taiwan; Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, 10617, Taiwan; Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, 10617, Taiwan; Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, 10048, Taiwan.
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Duarte-Rojo A, Allampati S, Thacker LR, Flud CR, Patidar KR, White MB, Klair JS, Heuman DM, Wade JB, Gavis EA, Bajaj JS. Diagnosis of covert hepatic encephalopathy: a multi-center study testing the utility of single versus combined testing. Metab Brain Dis 2019; 34:289-295. [PMID: 30506333 PMCID: PMC6351159 DOI: 10.1007/s11011-018-0350-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 03/05/2018] [Accepted: 11/21/2018] [Indexed: 12/11/2022]
Abstract
Covert hepatic encephalopathy (CHE) affects cognition in a multidimensional fashion. Current guidelines recommend performing Psychometric Hepatic Encephalopathy Score (PHES) and a second test to diagnose CHE for multi-center trials. We aimed to determine if a two-test combination strategy improved CHE diagnosis agreement, and accuracy to predict overt hepatic encephalopathy (OHE), compared to single testing. Cirrhotic outpatients without baseline OHE performed PHES, Inhibitory Control Test (ICT), and Stroop EncephAlapp (StE) at three centers. Patients were followed for OHE development. Areas under the receiver operation characteristic curve (AUROC) were calculated. We included 437 patients (399 with follow-up data). CHE prevalence varied with testing strategy: PHES+ICT 18%, ICT + StE 25%, PHES+StE 29%, ICT 35%, PHES 37%, and StE 54%. Combination with best test agreement was PHES+StE (k = 0.34). Sixty patients (15%) developed OHE. Although CHE by StE showed the highest sensitivity to predict OHE, PHES and PHES+StE were more accurate at the expense of a lower sensitivity (55%, AUROC: 0.587; 36%, AUROC: 0.629; and 29%, AUROC: 0.623; respectively). PHES+ICT was the most specific (85%) but all strategies including ICT showed sensitivities in the 33-45% range. CHE diagnosis by PHES (HR = 1.79, p = 0.04), StE (HR = 1.69, p = 0.04), and PHES+StE (HR = 1.72, p = 0.04), were significant OHE predictors even when adjusted for prior OHE and MELD. Our results demonstrate that combined testing decreases CHE prevalence without improving the accuracy of OHE prediction. Testing with PHES or StE alone, or a PHES+StE combination, is equivalent to diagnose CHE and predict OHE development in a multi-center setting.
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Affiliation(s)
- Andres Duarte-Rojo
- Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sanath Allampati
- Division of Internal Medicine and Gastroenterology, Cleveland Clinic, Cleveland, OH, USA
| | - Leroy R Thacker
- Family and Community Health Nursing and Biostatistics, Richmond, Virginia, USA
| | - Christopher R Flud
- Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Kavish R Patidar
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, 1201 Broad Rock Boulevard, Richmond, Virginia, 23249, USA
| | - Melanie B White
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, 1201 Broad Rock Boulevard, Richmond, Virginia, 23249, USA
| | - Jagpal S Klair
- Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Douglas M Heuman
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, 1201 Broad Rock Boulevard, Richmond, Virginia, 23249, USA
| | - James B Wade
- Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Edith A Gavis
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, 1201 Broad Rock Boulevard, Richmond, Virginia, 23249, USA
| | - Jasmohan S Bajaj
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, 1201 Broad Rock Boulevard, Richmond, Virginia, 23249, USA.
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NESAYAN A, ASADI GANDOMANI R, MOIN N. Effect of Neurofeedback on Perceptual Organization, Visual and Auditory Memory in Children with Attention Deficit/Hyperactivity Disorder. Iran J Child Neurol 2019; 13:75-82. [PMID: 31327971 PMCID: PMC6586458] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 07/01/2018] [Accepted: 10/22/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Neurofeedback is a noninvasive treatment that changes brain activity in children with attention-deficit/hyperactivity disorder and thereby improves performance in these children. We examined the effect of neurofeedback on perceptual organization, visual and auditory memory in children with attention-deficit/hyperactivity disorder. MATERIALS & METHODS This study was quasi-experimental with pre-test, post-test design, and control group. The sample included 20 children with attention-deficit/hyperactivity disorder were selected through convenience sampling in Khorramabad, central Iran in 2017. The sample was divided into control and experimental groups. Pre-test included Rey-Osterrieth complex figure and Wechsler digit span. Rey-Osterrieth complex figure test was used to measure perceptual organization and visual memory. Wechsler digit span was used to measure auditory memory. After conducting pre-test, the experimental group participated in neurofeedback training sessions. Theta/Beta protocol was applied for all participants. The control group did not receive any intervention. Then post-test was conducted on two groups. RESULTS Neurofeedback training significantly improved visual memory (P<0.001) but neurofeedback training had no significant effect on the perceptual organization (P>0.05). Moreover, neurofeedback training enhanced auditory short-term memory and auditory working memory (P<0.05). CONCLUSION Neurofeedback improved neurocognitive abilities in children with attention-deficit/hyperactivity disorder.
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Affiliation(s)
- Abbas NESAYAN
- Department of Psychology, Faculty of Humanities, University of Bojnord, Bojnord, Iran
| | | | - Narges MOIN
- Department of Speech Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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