Working Memory Impairment in Transient Ischaemic Attack: N-back as a Sensitive Measure for Detection

2021 ◽  
pp. 1-8
Author(s):  
Laura J. Smith ◽  
Polly Gregory ◽  
Philip Clatworthy ◽  
Lucy Gallop ◽  
George Stothart
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Transient Ischaemic Attack ◽  
Vascular Cognitive Impairment ◽  
Screening Tools ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
Sensitive Measure ◽  
Brain Structure And Function ◽  
Ischaemic Attack

Abstract Background: Transient ischaemic attack (TIA) can lead to lasting changes in brain structure and function resulting in cognitive impairment. Cognitive screening tools may lack sensitivity for detecting cognitive impairments, particularly executive function, which tends to be the earliest affected domain in vascular cognitive impairment. Aim: In this preliminary study, we examine a working memory (WMem) task as a sensitive measure of cognitive impairment in TIA. Method: Patients referred to a TIA clinic for transient neurological symptoms completed a general cognitive screening tool (Montreal Cognitive Assessment; MoCA), and a WMem task (2-N-back) in a cross-sectional design. Results: TIA patients (n = 12) showed significantly reduced WMem performance on the N-back compared to patients diagnosed with mimic clinical conditions with overlapping symptoms (n = 16). No group differences were observed on the MoCA. Conclusions: Assessing WMem may provide a sensitive measure of cognitive impairment after TIA, with implications for cognitive screening in TIA services to triage patients for further neuropsychological support, or for interventions to prevent vascular dementia.

scholarly journals Normal-tension glaucoma is associated with cognitive impairment

2021 ◽  
pp. bjophthalmol-2020-317461
Author(s):  
Sean Mullany ◽  
Lewis Xiao ◽  
Ayub Qassim ◽  
Henry Marshall ◽  
Puya Gharahkhani ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Vision Loss ◽  
Linear Trend ◽  
Normal Tension Glaucoma ◽  
Cognitive Screening ◽  
Visual Interpretation ◽  
Cross Sectional ◽  
High Tension ◽  
Advanced Glaucoma

Background/aimsRecent research suggests an association between normal-tension glaucoma (NTG) and dementia. This study investigated whether cognitive impairment is more strongly associated with NTG than high tension glaucoma (HTG) using cognitive screening within an Australiasian Glaucoma Disease Registry.MethodsThe authors completed a case–control cross-sectional cognitive screening involving 290 age-matched and sex-matched NTG participants and HTG controls aged ≥65 randomly sampled from the Australian and New Zealand Registry of Advanced Glaucoma. Cognitive screening was performed using the Telephone Version of the Montreal Cognitive Assessment (T-MoCA). The T-MoCA omits points requiring visual interpretation, accounting for confounding factors related to vision loss in visually impaired participants. Cognitive impairment was defined by a T-MoCA score of <11/22. Cognition was compared between NTG and HTG participants using predetermined thresholds and absolute screening scores.ResultsA total of 290 participants completed cognitive assessment. There were no differences in NTG (n=144) and HTG (n=146) cohort demographics or ocular parameters at baseline. Cognitive impairment was more prevalent in the NTG cohort than the HTG cohort (OR=2.2; 95% CI 1.1 to 6.7, p=0.030). Though a linear trend was also observed between lower absolute T-MoCA scores in the NTG cohort when compared with the HTG cohort, this association was not statistically significant (p=0.108).ConclusionThis study demonstrated an association between NTG status and poor cognition, supporting the hypothesis that there exists a disease association and shared pathoaetiological features between NTG and dementia.

scholarly journals HUBUNGAN NILAI P300 DENGAN MOCA-INA PADA PASIEN DENGAN GANGGUAN KOGNITIF VASKULAR PASCASTROKE ISKEMIK

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Susilo Susilo ◽  
Yudy Goysal ◽  
Abdul Muis ◽  
Muhammad Akbar ◽  
Andi Kurnia Bintang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Human Life ◽  
Strong Predictor ◽  
Vascular Cognitive Impairment ◽  
P300 Amplitude ◽  
P300 Latency ◽  
Cross Sectional ◽  
Neurology Clinic ◽  
Cross Sectional Design

      ASSOCIATION OF P300 VALUE WITH MOCA-INA IN VASCULAR COGNITIVE IMPAIRMENT POST-ISCHEMIC STROKE PATIENTSABSTRACTIntroduction: Stroke is a major threat in human life because it can cause disability and mortality. Cognitive impairment in early stroke is strong predictor for long term vascular cognitive impairment while neuropsychology method is superior than conventional method to diagnose cognitive impairment, especially P300.Aim: To identify the association between P300 values and MoCA-Ina in vascular cognitive impairment post ischemic stroke patients.Methods: It is a cross sectional design study for ischemic stroke patients who suffered from vascular cognitive impairment during April to June 2018 in Neurology Clinic of Dr. Wahidin Sudirohusodo Hospital, Makassar. The statistical analysis was performed by Pearson’s correlation test.Result: There were 20 samples, male (60%) and female (40%). The average MoCA-Ina score was 19.35±6.06; the average P300 latency in Fz, Cz, and Pz were 370.22±49.01ms, 360.78±38.27ms, and 361.02±44.45ms, respectively; the average P300 in Fz, Cz, and Pz amplitude were 6.09±3.10µV, 5.67±3.49µV, and 6.10±2.77µV, respectively. The Pearson’s showed that P300 latency had significantly correlation  with MoCA-Ina score while no correlation between the P300 amplitude and MoCA-Ina.Discussion: There was correlation between P300 latency with MoCA-Ina in vascular cognitive impairment post ischemic stroke patients.Keywords: Ischemic stroke, MoCA-Ina, P300 value, vascular cognitive impairment.ABSTRAKPendahuluan: Stroke merupakan suatu ancaman terbesar di kehidupan manusia karena dapat menimbulkan kecacatan dan kematian. Gangguan kognitif pada awal stroke merupakan prediktor kuat untuk gangguan kognitif vaskular jangka panjang dan metode neuropsikologi lebih unggul daripada metode konvensional untuk mendiagnosis gangguan kognitif, terutama P300.Tujuan: Untuk mengetahui hubungan nilai P300 dengan MoCA-Ina pada pasien gangguan kognitif vaskular pascastroke iskemik.Metode: Desain studi potong lintang terhadap pasien stroke iskemik yang mengalami gangguan kognitif vaskular selama bulan April sampai Juni 2018 di Poliklinik Saraf RSUP Dr. Wahidin Sudirohusodo, Makassar. Data diolah menggunakan uji korelasi Pearson’s.Hasil: Didapatkan 20 orang sampel laki-laki (60%) dan perempuan (40%). Nilai MoCA-Ina rata-rata 19,35±6,06; hasil rata-rata latensi gelombang P300 di Fz, Cz, dan Pz   masing-masing adalah 370,22±49,01, 360,78±38,27, dan 361,02±44,45; rata-rata tinggi amplitudo P300 di Fz masing-masing adalah 6,09±3,10, 5,67±3,49, dan 6,10±2,77. Hasil uji korelasi Pearson’s menunjukkan latensi P300 berkorelasi signifikan terhadap MoCA-Ina, sedangkan amplitudo P300 tidak.Pembahasan: Ada hubungan antara latensi gelombang P300 dengan MoCA-Ina pada pasien gangguan kognitif vaskular pascastroke iskemik.Kata kunci: Gangguan kognitif vaskular, MoCA-Ina, nilai P300, stroke iskemik  

scholarly journals Utility of MemTrax and Machine Learning Modeling in Classification of Mild Cognitive Impairment

2020 ◽  
Vol 77 (4) ◽  
pp. 1545-1558
Author(s):  
Michael F. Bergeron ◽  
Sara Landset ◽  
Xianbo Zhou ◽  
Tao Ding ◽  
Taghi M. Khoshgoftaar ◽  
...  
Keyword(s):  
Machine Learning ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Performance Metrics ◽  
Early Stage ◽  
Characteristic Curve ◽  
Classification Performance ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
Machine Learning Classification

Background: The widespread incidence and prevalence of Alzheimer’s disease and mild cognitive impairment (MCI) has prompted an urgent call for research to validate early detection cognitive screening and assessment. Objective: Our primary research aim was to determine if selected MemTrax performance metrics and relevant demographics and health profile characteristics can be effectively utilized in predictive models developed with machine learning to classify cognitive health (normal versus MCI), as would be indicated by the Montreal Cognitive Assessment (MoCA). Methods: We conducted a cross-sectional study on 259 neurology, memory clinic, and internal medicine adult patients recruited from two hospitals in China. Each patient was given the Chinese-language MoCA and self-administered the continuous recognition MemTrax online episodic memory test on the same day. Predictive classification models were built using machine learning with 10-fold cross validation, and model performance was measured using Area Under the Receiver Operating Characteristic Curve (AUC). Models were built using two MemTrax performance metrics (percent correct, response time), along with the eight common demographic and personal history features. Results: Comparing the learners across selected combinations of MoCA scores and thresholds, Naïve Bayes was generally the top-performing learner with an overall classification performance of 0.9093. Further, among the top three learners, MemTrax-based classification performance overall was superior using just the top-ranked four features (0.9119) compared to using all 10 common features (0.8999). Conclusion: MemTrax performance can be effectively utilized in a machine learning classification predictive model screening application for detecting early stage cognitive impairment.

Comparison of Three Cognitive Screening Tools in Older Urban and Regional Aboriginal Australians

2015 ◽  
Vol 40 (1-2) ◽  
pp. 22-32 ◽  
Author(s):  
Kylie Radford ◽  
Holly A. Mack ◽  
Brian Draper ◽  
Simon Chalkley ◽  
Kim Delbaere ◽  
...  
Keyword(s):  
Characteristic Curve ◽  
Good Alternative ◽  
Screening Tools ◽  
Cognitive Screening ◽  
Community Based ◽  
Cross Sectional ◽  
Aboriginal Australians ◽  
Cultural Considerations ◽  
Aboriginal Populations ◽  
State Examination

Background: Validated cognitive screening tools for use in urban and regional Aboriginal populations in Australia are lacking. Methods: In a cross-sectional community-based study, 235 participants were assessed on the Mini-Mental State Examination (MMSE), the Rowland Universal Dementia Assessment Scale (RUDAS) and an urban modification of the Kimberley Indigenous Cognitive Assessment (mKICA). Performance on these cognitive screening tools was compared to dementia diagnosis by clinical consensus. Results: All tests were culturally acceptable with good psychometric properties. Receiver operating characteristic curve analyses revealed that the MMSE and mKICA were the most accurate. Conclusion: The MMSE is an effective cognitive screening tool in urban Aboriginal populations. The mKICA is a good alternative when illiteracy, language or cultural considerations deem it appropriate. The RUDAS also has adequate validity in this population.

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