scholarly journals Clinical Application of Standardized Cognitive Assessment Using fMRI. I. Matrix Reasoning

2008 ◽  
Vol 20 (3-4) ◽  
pp. 127-140 ◽  
Author(s):  
Mark D. Allen ◽  
Alina K. Fong
Keyword(s):  
Cognitive Assessment ◽  
Normative Data ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Fmri Data ◽  
Patient Evaluation ◽  
Clinical Neuropsychology ◽  
Reasoning Test ◽  
Assessment Approach ◽  
Matrix Reasoning

Functional MRI is increasingly recognized for its potential as a powerful new tool in clinical neuropsychology. This is likely due to the fact that, with some degree of innovation, it is possible to convert practically any familiar cognitive test into one that can be performed in the MRI scanning environment. However, like any assessment approach, meaningful interpretation of fMRI data for the purpose of patient evaluation crucially requires normative data derived from a sample of unimpaired persons, against which individual patients may be compared. Currently, no such normative data are available for any fMRI-based cognitive testing protocol. In this paper, we report the first of a series of fMRI-compatible cognitive assessment protocols, a matrix reasoning test (f-MRT), for which normative samples of functional activation have been collected from unimpaired control subjects and structured in a manner that makes individual patient evaluation possible in terms of familiar z-score distributions. Practical application of the f-MRT is demonstrated via a contrastive case-study of two individuals with cognitive impairment in which fMRI data identifies subtleties in patient deficits otherwise missed by conventional measures of performance.

scholarly journals Evaluation of the Montreal Cognitive Assessment as a screening tool for cognitive dysfunction in SLE

2021 ◽  
Vol 8 (1) ◽  
pp. e000580
Author(s):  
Sudha Raghunath ◽  
Yifat Glikmann-Johnston ◽  
Eric Morand ◽  
Julie C Stout ◽  
Alberta Hoi
Keyword(s):  
Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Cognitive Dysfunction ◽  
Predictive Value ◽  
Cognitive Assessment ◽  
Screening Tool ◽  
Cognitive Testing ◽  
Montreal Cognitive Assessment ◽  
Cognitive Test ◽  
Receiver Operating Curve

ObjectivesCognitive dysfunction in SLE is common and associated with significant morbidity but is currently underdetected. Early detection requires the use of screening tests, as formal diagnostic cognitive testing is time-consuming. This study aims to evaluate the Montreal Cognitive Assessment (MoCA) as a screening tool for cognitive dysfunction in SLE.MethodsPatients with SLE (n=95) and demographically matched healthy control participants (n=48) underwent cognitive testing using the 1-hour neuropsychiatric test battery recommended by the American College of Rheumatology for use in SLE and the MoCA. We used regression analyses to determine associations between MoCA and cognitive test scores. We assessed several MoCA cut-offs for predicting cognitive impairment in terms of sensitivity, specificity, positive predictive value and negative predictive value. Receiver operating curve analyses were used to determine the diagnostic accuracy of the MoCA cut-off thresholds.ResultsWe found a significant correlation between MoCA score and 9 of the 10 cognitive endpoints studied (all p<0.001). Receiver operating curve analysis suggested that a MoCA cut-off of <27 had highest diagnostic accuracy across the cognitive impairment definitions (area under the curve 0.76–0.78). Using a screening cut-off of <28, the MoCA had sensitivity of 83%–94% and specificity of 46%–59%, depending on the impairment definition used.ConclusionsThe MoCA correlates strongly with cognitive test results in SLE and has sufficient sensitivity for use as a screening tool with a cut-off of <28 as the optimal threshold. This tool can be incorporated into clinical practice for screening for cognitive dysfunction in SLE.

scholarly journals Saliva RNA biomarkers predict concussion duration and detect symptom recovery: a comparison with balance and cognitive testing

2021 ◽  
Author(s):  
Gregory Fedorchak ◽  
Aakanksha Rangnekar ◽  
Cayce Onks ◽  
Andrea C. Loeffert ◽  
Jayson Loeffert ◽  
...  
Keyword(s):  
Test Performance ◽  
Area Under The Curve ◽  
Prediction Rule ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Clinical Tool ◽  
Post Injury ◽  
Symptom Recovery ◽  
Cognitive Test Performance

Abstract Objective The goals of this study were to assess the ability of salivary non-coding RNA (ncRNA) levels to predict post-concussion symptoms lasting ≥ 21 days, and to examine the ability of ncRNAs to identify recovery compared to cognition and balance. Methods RNA sequencing was performed on 505 saliva samples obtained longitudinally from 112 individuals (8–24-years-old) with mild traumatic brain injury (mTBI). Initial samples were obtained ≤ 14 days post-injury, and follow-up samples were obtained ≥ 21 days post-injury. Computerized balance and cognitive test performance were assessed at initial and follow-up time-points. Machine learning was used to define: (1) a model employing initial ncRNA levels to predict persistent post-concussion symptoms (PPCS) ≥ 21 days post-injury; and (2) a model employing follow-up ncRNA levels to identify symptom recovery. Performance of the models was compared against a validated clinical prediction rule, and balance/cognitive test performance, respectively. Results An algorithm using age and 16 ncRNAs predicted PPCS with greater accuracy than the validated clinical tool and demonstrated additive combined utility (area under the curve (AUC) 0.86; 95% CI 0.84–0.88). Initial balance and cognitive test performance did not differ between PPCS and non-PPCS groups (p > 0.05). Follow-up balance and cognitive test performance identified symptom recovery with similar accuracy to a model using 11 ncRNAs and age. A combined model (ncRNAs, balance, cognition) most accurately identified recovery (AUC 0.86; 95% CI 0.83–0.89). Conclusions ncRNA biomarkers show promise for tracking recovery from mTBI, and for predicting who will have prolonged symptoms. They could provide accurate expectations for recovery, stratify need for intervention, and guide safe return-to-activities.

scholarly journals Patient and provider perceptions of a novel cognitive functioning report for patients with systemic lupus erythematosus: a qualitative study

2021 ◽  
Vol 8 (1) ◽  
pp. e000476
Author(s):  
Laura Plantinga ◽  
Ann Vandenberg ◽  
Felicia Goldstein ◽  
Brian Jones ◽  
Jeremy Johnson ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Cognitive Assessment ◽  
Exploratory Study ◽  
Cognitive Test ◽  
Test Results ◽  
Assessment Data ◽  
Provider Perceptions ◽  
Potential Barriers ◽  
Cognitive Information ◽  
Multiple Domains

ObjectiveTo determine whether and how cognitive assessment data should be included in a report for patients with SLE and their providers.MethodsLeveraging experiences from prior studies, we created a cognitive report that included a hypothetical patient’s results on tests of multiple domains based on the NIH Toolbox Fluid Cognition Battery. In focus groups that comprised patients with SLE (two groups) and their providers (two groups), feedback was sought on the presentation of results as well as the potential value of the report in the clinical setting.ResultsFeedback regarding the presentation of the report was generally positive. Both patients with SLE and their providers liked its simple graphics and use of a colour-gradated scale to indicate performance. However, both groups stressed the importance of using non-stigmatising language in describing results. Several potential purposes of the report, including distinguishing cognitive versus other issues, explaining cognitive challenges, improving patient–provider interactions, guiding decision-making, improving functioning or preventing impairment and tracking cognitive function over time, were noted by the participants. Potential barriers, such as inadequate clinical staffing or time and lack of potential treatments for identified issues, were also discussed.ConclusionIn this exploratory study, we found that both patients with SLE and their providers were receptive to the idea of a patient-friendly report of cognitive test results. This study provides important information to guide future pragmatic research to optimise the delivery of cognitive information to patients with SLE.

scholarly journals A Comparative Meta-Analysis of the Effects of Concussion on a Computerized Neurocognitive Test and Self-Reported Symptoms

2017 ◽  
Vol 52 (9) ◽  
pp. 834-846 ◽  
Author(s):  
Bara Alsalaheen ◽  
Kayla Stockdale ◽  
Dana Pechumer ◽  
Steven P. Broglio ◽  
Gregory F. Marchetti
Keyword(s):  
Test Performance ◽  
Fixed Effects ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Fixed Effects Model ◽  
Symptom Scale ◽  
Additional Information ◽  
Neurocognitive Test

Context:  Meta-analyses examining construct-specific cognitive impairment concurrently with self-reported symptoms postconcussion are sparse. Objective:  To review the literature on the effects of concussion on construct-specific neurocognitive declines and to compare them with self-reported symptoms before 1 week and between 1 and 3 weeks postconcussion. Data Sources:  Relevant studies in PubMed, CINAHL, and PsycINFO published from January 1, 1999 through November 30, 2015. Study Selection:  Studies were included if participants completed the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) before and after concussion and if test performance and Postconcussion Symptom Scale (PCSS) scores were reported at both times. Data Extraction:  After reviewing the full texts, we extracted data from 17 studies consisting of 29 independent samples; therefore, this meta-analysis consisted of 1777 unique participants. Data Synthesis:  The Hedges g effect size (ES) was estimated. A random-effects or fixed-effects model was used based on heterogeneity findings. When heterogeneity was present, we used meta-regression to assess unexplained between-studies variance. Within the first week of injury, the ESs were small to moderate for cognitive declines, ranging from −0.43 (95% confidence interval [CI] = −0.52, −0.35) to −0.67 (95% CI = −0.77, −0.58), and large for the PCSS score (Hedges g = −0.81; 95% CI = −0.91, −0.71). After 1 week, the ESs for cognitive declines (Hedges g range = −0.25 [95% CI = −0.35, −0.15] to −0.37 [95% CI = −0.55, −0.19]) and PCSS score (Hedges g = −0.38; 95% CI = −0.53, −0.22) were also small. Within 2 weeks of injury, PCSS score and time since injury weakly moderated the cognitive ES. Conclusions:  When a neurocognitive test was administered within 1 week of injury, the ES was larger for self-reported symptoms than for ImPACT scores generated at the same session. After 1 week of injury, the ESs for ImPACT and PCSS scores were comparable. If the athlete reports symptoms within 1 week of injury, administering a cognitive test does not appear to offer additional information to the clinician. However, if the athlete does not report symptoms postconcussion, cognitive testing may inform the clinical management of the injury.

scholarly journals The effects of gamelike features and test location on cognitive test performance and participant enjoyment

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2184 ◽  
Author(s):  
Jim Lumsden ◽  
Andy Skinner ◽  
Andy T. Woods ◽  
Natalia S. Lawrence ◽  
Marcus Munafò
Keyword(s):  
Test Performance ◽  
Cognitive Task ◽  
Reaction Times ◽  
Error Rates ◽  
Cognitive Testing ◽  
Quality Data ◽  
Cognitive Test ◽  
Test Location ◽  
Gamelike Features ◽  
Time Accuracy

Computerised cognitive assessments are a vital tool in the behavioural sciences, but participants often view them as effortful and unengaging. One potential solution is to add gamelike elements to these tasks in order to make them more intrinsically enjoyable, and some researchers have posited that a more engaging task might produce higher quality data. This assumption, however, remains largely untested. We investigated the effects of gamelike features and test location on the data and enjoyment ratings from a simple cognitive task. We tested three gamified variants of the Go-No-Go task, delivered both in the laboratory and online. In the first version of the task participants were rewarded with points for performing optimally. The second version of the task was framed as a cowboy shootout. The third version was a standard Go-No-Go task, used as a control condition. We compared reaction time, accuracy and subjective measures of enjoyment and engagement between task variants and study location. We found points to be a highly suitable game mechanic for gamified cognitive testing because they did not disrupt the validity of the data collected but increased participant enjoyment. However, we found no evidence that gamelike features could increase engagement to the point where participant performance improved. We also found that while participants enjoyed the cowboy themed task, the difficulty of categorising the gamelike stimuli adversely affected participant performance, increasing No-Go error rates by 28% compared to the non-game control. Responses collected online vs. in the laboratory had slightly longer reaction times but were otherwise very similar, supporting other findings that online crowdsourcing is an acceptable method of data collection for this type of research.

Abstract 22: Visit-to-Visit Variability in Blood Pressure is Related to Late-Life Cognitive Decline

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Bo Qin ◽  
Anthony J Viera ◽  
Linda S Adair ◽  
Brenda L Plassman ◽  
Lloyd J Edwards ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Verbal Memory ◽  
Repeated Measures ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Nutrition Survey

Introduction: Recent studies suggest higher visit-to-visit variability of blood pressure (BP) is associated with worse cognitive function, but evidence based on longitudinal cognitive testing has not been reported. Hypothesis: We assessed the hypothesis that higher visit-to-visit variability in BP, but not mean BP, would be associated with faster decline in cognitive function among community-dwelling older adults. Methods: This prospective cohort study comprised 1213 adults who had two or more waves of BP measurements as part of the China Health and Nutrition Survey from 1991, up to their first cognitive tests, and completed a cognitive screening test at two or more waves in 1997, 2000 or 2004. Mean (SD) age at first cognitive test was 64 (6) y. Outcomes were repeated measures of global cognitive scores (baseline mean ± SD: 19 ± 6 points), standardized composite cognitive and verbal memory scores (standardized units [SU]). Visit-to visit BP variability was expressed as the standard deviation [SD] or as the variation independent of mean (SD/mean^x, with x derived from curve fitting) in BP measures obtained at a mean interval of 3.6 years. Multivariable-adjusted linear mixed-effects models were used to determine the association of changes in cognitive scores with visit-to visit BP variability. Results: Higher visit-to-visit variability in systolic BP, but not mean systolic BP, was associated with a faster decline of cognitive function (adjusted mean difference [95% CI] for high vs. low tertile of SD in variability (Figure): global score -0.23 points/y [-0.41 to -0.04], composite scores -0.029 SU/y [-0.056 to -0.002] and verbal memory -0.044 SU/y [-0.075 to -0.012]). Higher visit-to-visit variability in diastolic BP was associated with a faster decline of global cognitive function only among adults 55-64 years, independent of mean diastolic BP. Conclusion: Higher long-term BP visit-to-visit variability predicted a faster rate of cognitive decline among older adults.

scholarly journals CogniSoft: A Platform for the Automation of Cognitive Assessment and Rehabilitation of Multiple Sclerosis

Computers ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. 93
Author(s):  
Dessislava Petrova-Antonova ◽  
Ivaylo Spasov ◽  
Yanita Petkova ◽  
Ilina Manova ◽  
Sylvia Ilieva
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Assessment ◽  
Cognitive Rehabilitation ◽  
Large Scale ◽  
Cognitive Disorders ◽  
Cognitive Status ◽  
Machine Learning Algorithms ◽  
Cognitive Test ◽  
Economic Research ◽  
Medical Software

Cognitive disorders remain a major cause of disability in Multiple Sclerosis (MS). They lead to unemployment, the need for daily assistance, and a poor quality of life. The understanding of the origin, factors, processes, and consequences of cognitive disfunction is key to its prevention, early diagnosis, and rehabilitation. The neuropsychological testing and continuous monitoring of cognitive status as part of the overall evaluation of patients with MS in parallel with clinical and paraclinical examinations are highly recommended. In order to improve health and disease understanding, a close linkage between fundamental, clinical, epidemiological, and socio-economic research is required. The effective sharing of data, standardized data processing, and the linkage of such data with large-scale cohort studies is a prerequisite for the translation of research findings into the clinical setting. In this context, this paper proposes a software platform for the cognitive assessment and rehabilitation of patients with MS called CogniSoft. The platform automates the Beck Depression Inventory (BDI-II) test and diagnostic tests for the evaluation of memory and executive functions based on the nature of Brief International Cognitive Assessment for MS (BICAMS), as well as implementing a set of games for cognitive rehabilitation based on BICAMS. The software architecture, core modules, and technologies used for their implementation are presented. Special attention is given to the development of cognitive tests for diagnostics and rehabilitation. Their automation enables better perception, avoids bias as a result of conducting the classic paper tests of various neurophysiologists, provides easy administration, and allows data collection in a uniform manner, which further enables analysis using statistical and machine learning algorithms. The CogniSoft platform is registered as medical software by the Bulgarian Drug Agency and it is currently deployed in the Neurological Clinic of the National Hospital of Cardiology in Sofia, Bulgaria. The first experiments prove the feasibility of the platform, showing that it saves time and financial resources while providing subjectivity in the interpretation of the cognitive test results.

scholarly journals Test Accuracy of the Montreal Cognitive Assessment in Screening for Early Poststroke Neurocognitive Disorder

Stroke ◽  
2021 ◽  
Vol 52 (1) ◽  
pp. 317-320
Author(s):  
Ragnhild Munthe-Kaas ◽  
Stina Aam ◽  
Ingvild Saltvedt ◽  
Torgeir Bruun Wyller ◽  
Sarah T. Pendlebury ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Cognitive Assessment ◽  
Test Battery ◽  
Montreal Cognitive Assessment ◽  
Cognitive Domain ◽  
Cognitive Test ◽  
Test Accuracy ◽  
Neurocognitive Disorder ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual

Background and Purpose: We determined the diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) for poststroke neurocognitive disorder defined according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria in a prospective observational study. Methods: Consecutive participants able to complete a cognitive test battery and MoCA 3 months poststroke were included. The reference standard of neurocognitive disorder was defined as a score of ≥1.5 SD below the normative mean in ≥1 cognitive domain on the cognitive test battery. Results: Among 521 participants (43.6% women; mean age/SD, 71.5/12.0 years; mean education/SD, 12.4/3.8 years), the area under the receiver operating characteristic curve of MoCA for neurocognitive disorder was 0.80 (95% CI, 0.76–0.84). Using the standard MoCA cutoff <26, sensitivity was 0.71 (0.69–0.79) with specificity of 0.73 (0.66–0.76). MoCA cutoff of <27 gave higher sensitivity (0.82 [0.77–0.85]) at the expense of specificity (0.60 [0.53–0.66]). Discussion: MoCA has reasonable accuracy for poststroke neurocognitive disorder diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02650531.

THE DYNAMIC INTER-RELATIONSHIP BETWEEN OBESITY AND SCHOOL PERFORMANCE: NEW EMPIRICAL EVIDENCE FROM AUSTRALIA

2017 ◽  
Vol 50 (5) ◽  
pp. 683-705 ◽  
Author(s):  
Son Nghiem ◽  
Viet-Ngu Hoang ◽  
Xuan-Binh Vu ◽  
Clevo Wilson
Keyword(s):  
School Performance ◽  
Simultaneous Equation ◽  
Estimation Methods ◽  
Reasoning Test ◽  
Obesity Status ◽  
The Matrix ◽  
Lagged Effects ◽  
Matrix Reasoning ◽  
National Tests ◽  
The Relationship

SummaryThis paper proposes a new empirical model for examining the relationship between obesity and school performance using the simultaneous equation modelling approach. The lagged effects of both learning and health outcomes were included to capture both the dynamic and inter-relational aspects of the relationship between obesity and school performance. The empirical application of this study used comprehensive data from the first five waves of the Longitudinal Study of Australian Children (LSAC), which commenced in 2004 (wave 1) and was repeated every two years until 2018. The study sample included 10,000 children, equally divided between two cohorts (infants and children) across Australia. The empirical results show that past learning and obesity status are strongly associated with most indicators of school outcomes, including reading, writing, spelling, grammar and numeracy national tests, and scores from the internationally standardized Peabody Picture Vocabulary Test and the Matrix Reasoning Test. The main findings of this study are robust due to the choice of obesity indicator and estimation methods.

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