Applied Neuropsychology-Adult最新文献

Objective: The study was designed to evaluate the performance validity module of Advanced Clinical Solutions (ACS) against external criterion measures and compare two alternative aggregation methods for its five components.

Method: The ACS was evaluated against psychometrically defined criterion groups in a sample of 93 outpatients with TBI. In addition to the default method, the component performance validity tests (PVTs) were either dichotomized along a single cutoff (VI-ACS) or recoded to capture various degrees of failure (EI-ACS).

Results: The standard ACS model correctly classified 75-83% of the sample. The alternative aggregation methods produced superior overall correct classification: 80-91% (VI-ACS) and 86-91% (EI-ACS). Mild TBI was associated with higher failure rates than moderate/severe TBI. Failing just one of the five ACS components resulted in a 3- to 8-fold increase in the likelihood of failing criterion PVTs.

Conclusions: Results support the use of the standard PVT module for ACS: it is an effective measure of performance validity that is robust to moderate-to-severe TBI. Post-publication research on individual ACS components and methodological advances in PVT research provide an opportunity to enhance the overall classification accuracy of the ACS model. Passing stringent multivariate PVT cutoffs does not indicate valid performance.

Objective: Demonstrate how patient-level traumatic brain injury (TBI) data from studies in the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System can be harmonized and pooled to examine relationships between TBI and cognitive functioning.

Method: We harmonized and pooled data across studies and analyzed rates of probable cognitive functioning deficits by TBI history and severity.

Results: Four publicly available FITBIR studies with 3,445 participants included data on cognitive dysfunction, though only one included comparison groups (mild TBI vs. no history of TBI) and could be used in the final comparative analyses. Of the 1,539 participants, 82% had a history of mild TBI and 67% had data suggesting the presence of cognitive dysfunction. Participants with a history of mild TBI were mostly male (87%), 25-39 years old (53%), and Non-Hispanic White (60%). Conclusions: One publicly available FITBIR study reported cognitive dysfunction data as of January 2021, though findings were similar to prior research and supported an association between mild TBI and cognitive dysfunction. This proof-of-concept study shared newly developed methods including harmonization, analysis syntax, and meta-data via the FITBIR website to encourage dissemination of these TBI data resources in line with FAIR data goals.

Using diffusion tensor imaging (DTI), we assessed the extent to which fractional anisotropy values in the dorsal (i.e., arcuate fasciculus; AF) versus ventral (i.e., inferior fronto-occipital fasciculus; IFOF) distinction of structural white matter pathways associated with selected reading processes, could be replicated in skilled adult readers (N = 17) and extended to adults with reading impairments (N = 13). In addition to the AF and IFOF, motor-based tracts (i.e., posterior limb of the internal capsule (PLIC) and the frontal aslant tract (FAT)) were isolated to explore their role in reading performance. Several interesting relationships with reading performance emerged. First, orthographic awareness was related to the left IFOF in skilled readers, whereas orthographic awareness was related to left PLIC for impaired readers. Morphological awareness was related to left FAT for skilled readers, whereas morphological awareness was related to right AF, right IFOF and left PLIC for impaired readers. Overall, these findings support the notion that adult reading performance (both skilled and impaired) is related to the structural properties of the ventral white matter pathways. More consideration should be paid to motor pathways, particularly the PLIC, and their role in compensatory reading strategies in individuals with reading impairments.

Objectives: Neuropsychological tests (NPTs) are standard tools for assessing cognitive function. These tools can evaluate the cognitive status of a subject, which can be time-consuming and expensive for interpretation. Therefore, this paper aimed to optimize the systematic NPTs by machine learning and develop new classification models for differentiating healthy controls (HC), mild cognitive impairment, and Alzheimer's disease dementia (ADD) among groups of subjects.

Patients and methods: A total dataset of 14,926 subjects was obtained from the formal 46 NPTs based on the Seoul Neuropsychological Screening Battery (SNSB). The statistical values of the dataset included an age of 70.18 ± 7.13 with an education level of 8.18 ± 5.50 and a diagnosis group of three; HC, MCI, and ADD. The dataset was preprocessed and classified in two- and three-way machine-learning classification from scikit-learn (www.scikit-learn.org) to differentiate between HC versus MCI, HC versus ADD, HC versus Cognitive Impairment (CI) (MCI + ADD), and HC versus MCI versus ADD. We compared the performance of seven machine learning algorithms, including Naïve Bayes (NB), random forest (RF), decision tree (DT), k-nearest neighbors (KNN), support vector machine (SVM), AdaBoost, and linear discriminant analysis (LDA). The accuracy, sensitivity, specificity, positive predicted value (PPV), negative predictive value (NPV), area under the curve (AUC), confusion matrixes, and receiver operating characteristic (ROC) were obtained from each model based on the test dataset.

Results: The trained models based on 29 best-selected NPT features were evaluated, the model with the RF algorithm yielded the best accuracy, sensitivity, specificity, PPV, NPV, and AUC in all four models: HC versus MCI was 98%, 98%, 97%, 98%, 97%, and 99%; HC versus ADD was 98%, 99%, 96%, 97%, 98%, and 99%; HC versus CI was 97%, 99%, 92%, 97%, 97%, and 99% and HC versus MCI versus ADD was 97%, 96%, 98%, 97%, 98%, and 99%, respectively, in predicting of cognitive impairment among subjects.

Conclusion: According to the results, the RF algorithm was the best classification model for both two- and three-way classification among the seven algorithms trained on an imbalanced NPTs SNSB dataset. The trained models proved useful for diagnosing MCI and ADD in patients with normal NPTs. These models can optimize cognitive evaluation, enhance diagnostic accuracy, and reduce missed diagnoses.

Patients with aphasia (PWA), particularly those with agrammatic aphasia, experience problems in sentence comprehension. Studies have found that Mapping Therapy (MT) can improve sentence processing in PWA. This paper aims to review the literature on therapeutic studies using MT for the treatment of sentence processing in PWA. All studies on the treatment of sentence comprehension using MT were found by searching Cochrane Library, ISI Web of Knowledge, Google Scholar, Pubmed, and Scopus from 1986 until December 2023, with the combination of these search keywords: 'aphasia, sentence, comprehension, mapping therapy, treatment, rehabilitation'. All studies (single-subject or group design) on the treatment of sentence comprehension using MT in PWA were reviewed. An adaptation of the Cochrane Collaboration's risk of bias (RoB) tool was used to assess the risk of bias (RoB) in the reviewed studies. A total of 14 studies on 81 participants were selected and reviewed. All studies (13 studies) had employed a single-subject design, except for one study that had used a group design. Twelve studies (86%) showed that MT is effective in the remediation of sentence comprehension in PWA. Generalization to untrained sentences similar to the trained structure was also observed in 12 studies (86%). Generalization to untrained structures (usually passive sentences) was limited. In addition, cross-modal improvement in sentence production was observed in 8 studies (57%). This review highlights the need for a more detailed investigation of the effect of MT on cross-modal generalization using elicited production of the sentence types trained during comprehension treatment.

Semantic and phonemic verbal fluency tests are widely used neuropsychological assessments of executive functions and language skills and are easy to administer. The aim of this study was to determine the impact of age, education, and gender on semantic and phonemic verbal fluency tests and to establish normative data for Turkish adults aged between 18 and 86 years. The results revealed significant main effects of age and education on all subscores of verbal fluency tests. Furthermore, an interaction effect between age and education was observed on semantic fluency and letter K fluency scores. While no significant differences were found among the 18-29, 30-39, and 40-49 age groups in any of the subscores, performance on the tests decreased with increasing age. Significant differences were observed among all education groups in all subscores. No main or interaction effects of gender were found on any subscore. These normative data could prove useful in clinical and research settings for the assessment of cognitive impairment.

This study aims to present the adaptation, evidence of content validity and results of a pilot study of the Cognitive Screening Test - Online (TRIACOG-Online) in a clinical sample of patients after stroke. The process comprised four stages: 1) Adaptation of the instructions, stimulus and responses; 2) Seven experts analyzed the equivalence between the previous printed version and the online version; 3) A pilot study was carried out with seven adults who had experienced a stroke in order to check the comprehension and feasibility of the items; and 4) The development of the final version of TRIACOG-Online. Expert validity testing of the questionnaire yielded a content validity index (CVI) of 100% for correspondence and construct in 13 items, and a CVI of 87.71% in four items. In the pilot study, problems related to the internet led to the decision to use a single section form. No difficulties were observed in carrying out the tasks and understanding the instructions. Participants reported being able to adequately visualize the stimuli and remain motivated to complete the tasks presented. It was shown that TRIACOG-Online evaluated the same constructs as the pencil-and-paper version, can be used in remote neuropsychological assessments and face-to-face settings.

Performance validity tests are susceptible to false positives from genuine cognitive impairment (e.g., dementia); this has not been explored with the short form of the California Verbal Learning Test II (CVLT-II-SF). In a memory clinic sample, we examined whether CVLT-II-SF Forced Choice Recognition (FCR) scores differed across diagnostic groups, and how the severity of impairment [Clinical Dementia Rating Sum of Boxes (CDR-SOB) or Mini-Mental State Examination (MMSE)] modulated test performance. Three diagnostic groups were identified: subjective cognitive impairment (SCI; n = 85), amnestic mild cognitive impairment (a-MCI; n = 17), and dementia due to Alzheimer's Disease (AD; n = 50). Significant group differences in FCR were observed using one-way ANOVA; post-hoc analysis indicated the AD group performed significantly worse than the other groups. Using multiple regression, FCR performance was modeled as a function of the diagnostic group, severity (MMSE or CDR-SOB), and their interaction. Results yielded significant main effects for MMSE and diagnostic group, with a significant interaction. CDR-SOB analyses were non-significant. Increases in impairment disproportionately impacted FCR performance for persons with AD, adding caution to research-based cutoffs for performance validity in dementia. Caution is warranted when assessing performance validity in dementia populations. Future research should examine whether CVLT-II-SF-FCR is appropriately specific for best-practice testing batteries for dementia.

Cognitive deficits are common after brain injury and can be measured in various ways. Many neuropsychological tests are designed to measure specific cognitive deficits, and self-report questionnaires capture cognitive complaints. Measuring cognition in daily life is important in rehabilitating the abilities required to undertake daily life activities and participate in society. However, assessment of cognition in daily life is often performed in a non-standardized manner. In this opinion paper we discuss the various types of assessment of cognitive functioning and their associated instruments. Drawing on existing literature and evidence from experts in the field, we propose a framework that includes seven dimensions of cognition measurement, reflecting a continuum ranging from controlled test situations through to measurement of cognition in daily life environments. We recommend multidimensional measurement of cognitive functioning in different categories of the continuum for the purpose of diagnostics, evaluation of cognitive rehabilitation treatment, and assessing capacity after brain injury.

The Color Trails Test ("CTT") is among the most popular neuropsychological assessment tests of executive function, targeting sustained visual attention (Trails A), and divided attention (Trails B). During the pen-and-paper (P&P) test, the participant traces 25 consecutive numbered targets marked on a page, and the completion time is recorded. In many cases, multiple assessments are performed on the same individual, either under varying experimental conditions or at several timepoints. However, repeated testing often results in learning and fatigue effects, which confound test outcomes. To mitigate these effects, we set the grounds for developing shorter versions of the CTT (<25 targets), using virtual reality (VR) based CTT (VR-CTT). Our aim was to discover the minimal set of targets that is sufficient for maintaining concurrent validity with the CTT including differentiation between age groups, and the difference between Trails A and B. To this aim, healthy participants in three age groups (total N = 165; young, middle-aged, or older adults) performed both the P&P CTT, and one type of VR-CTT (immersive head-mounted-device VR, large-scale 3D VR, or tablet). A subset of 13 targets was highly correlated with overall task completion times in all age groups and platforms (r > 0.8). We tested construct validity and found that the shortened-CTT preserved differences between Trails A and B (p < 0.001), showed concurrent validity relative to the P&P scores (r > 0.5; p < 0.05), and differentiated between age groups (p < 0.05). These findings open the possibility for shortened "CTT-versions", to be used in repeated-measures experiments or longitudinal studies, with potential implications for shortening neurocognitive assessment protocols.