Teleneuropsychology: Evidence for Video Teleconference-Based Neuropsychological Assessment

AbstractThe use of videoconference technology to deliver health care diagnostics and treatment continues to grow at a rapid pace. Telepsychiatry and telepsychology applications are well-accepted by patients and providers, and both diagnostic and treatment outcomes have generally been similar to traditional face-to-face interactions. Preliminary applications of videoconference-based neuropsychological assessment (teleneuropsychology) have yielded promising results in the feasibility and reliability of several standard tests, although large-scale studies are lacking. This investigation was conducted to determine the reliability of video teleconference (VTC) - based neuropsychological assessment using a brief battery of standard neuropsychological tests commonly used in the evaluation of known or suspected dementia. Tests included the Mini-Mental State Examination (MMSE), Hopkins Verbal Learning Test-Revised, Digit Span forward and backward, short form Boston Naming Test, Letter and Category Fluency, and Clock Drawing. Tests were administered via VTC and in-person to subjects, counterbalanced using alternate test forms and standard instructions. Two hundred two adult subjects were tested in both rural and urban settings, including 83 with cognitive impairment and 119 healthy controls. We found highly similar results across VTC and in-person conditions, with significant intraclass correlations (mean=.74; range: 0.55–0.91) between test scores. Findings remained consistent in subjects with or without cognitive impairment and in persons with MMSE scores as low as 15. VTC-based neuropsychological testing is a valid and reliable alternative to traditional face-to-face assessment using selected measures. More VTC-based studies using additional tests in different populations are needed to fully explore the utility of this new testing medium. (JINS, 2014, 20, 1–6)

Download Full-text

CLINICAL AND DEMOGRAPHIC PREDICTORS OF MILD COGNITIVE IMPAIRMENT - CROSS-SECTIONAL STUDY

Wiadomości Lekarskie ◽

10.36740/wlek201909201 ◽

2019 ◽

Vol 72 (9) ◽

pp. 1715-1722

Author(s):

Anna Rajtar-Zembaty ◽

Andrzej Sałakowski ◽

Jakub Rajtar-Zembaty ◽

Katarzyna Olszewska ◽

Roksana Epa ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Functioning ◽

Short Form ◽

Digit Span ◽

Verbal Learning ◽

Depression Scale ◽

Effective Prevention ◽

Level Of Education ◽

Demographic Predictors

Introduction: Cognitive limitations are a serious health and social problem, which concerns elderly people. Effective prevention and treatment of cognitive dysfunction is one of the challenges of modern medicine. There is not enough consistent data in the literature to indicate to indicate the relationship between various clinical and demographic factors with cognitive functioning in different age ranges. The aim: To analyze clinical and demographic predictors of mild cognitive impairment by age group. Material and methods: The analysis included 817 participants (669 with normal cognitive function and 148 people with MCI). The evaluation of the level of depressive symptoms was measured by the Short Form Geriatric Depression Scale. All participants were screened for cognitive functioning using the Mini-Mental State Examination and Addenbrooke’s Cognitive Examination-III. Different cognitive domains were evaluated with different neuropsychological tools: the Rey Auditory Verbal Learning test, Clock Drawing test, Verbal Fluency test, Digit Span Test and Trail Making test. Results: It has been shown that independently associated with MCI ware age (OR = 1.09, 95% CI: 1.05-1.13) and level of education (OR = 0.75, 95% CI: 0.69-0.81). Depending on the age, it turned out that in the younger MCI group, age, education and depression were significant, and the age and level of education were significant in the older MCI group. Conclusions: The identification of cognitive dysfunctions is an important element of the diagnostic and therapeutic process.

Download Full-text

Burning Fog: Cognitive Impairment in Burning Mouth Syndrome

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.727417 ◽

2021 ◽

Vol 13 ◽

Author(s):

Federica Canfora ◽

Elena Calabria ◽

Renato Cuocolo ◽

Lorenzo Ugga ◽

Giuseppe Buono ◽

...

Keyword(s):

Cognitive Impairment ◽

Rating Scale ◽

Short Form ◽

Digit Span ◽

Verbal Learning ◽

Burning Mouth Syndrome ◽

Blood Biomarkers ◽

Age Related ◽

Sf 36 ◽

Burning Mouth

Background: Due to its common association with chronic pain experience, cognitive impairment (CI) has never been evaluated in patients with burning mouth syndrome (BMS). The purpose of this study is to assess the prevalence of CI in patients with BMS and to evaluate its relationship with potential predictors such as pain, mood disorders, blood biomarkers, and white matter changes (WMCs).Methods: A case-control study was conducted by enrolling 40 patients with BMS and an equal number of healthy controls matched for age, gender, and education. Neurocognitive assessment [Mini Mental State Examination (MMSE), Digit Cancellation Test (DCT), the Forward and Backward Digit Span task (FDS and BDS), Corsi Block-Tapping Test (CB-TT), Rey Auditory Verbal Learning Test (RAVLT), Copying Geometric Drawings (CGD), Frontal Assessment Battery (FAB), and Trail Making A and B (TMT-A and TMT-B)], psychological assessment [Hamilton Rating Scale for Depression and Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and 36-Item Short Form Health Survey (SF-36)], and pain assessment [Visual Analogic Scale (VAS), Total Pain Rating index (T-PRI), Brief Pain Inventory (BPI), and Pain DETECT Questionnaire (PD-Q)] were performed. In addition, blood biomarkers and MRI of the brain were recorded for the detection of Age-Related WMCs (ARWMCs). Descriptive statistics, the Mann-Whitney U-test, the Pearson Chi-Squared test and Spearman's correlation analysis were used.Results: Patients with BMS had impairments in most cognitive domains compared with controls (p < 0.001**) except in RAVLT and CGD. The HAM-D, HAM-A, PSQI, ESS, SF-36, VAS, T-PRI, BPI and PD-Q scores were statistically different between BMS patients and controls (p < 0.001**) the WMCs frequency and ARWMC scores in the right temporal (RT) and left temporal (LT) lobe were higher in patients with BMS (p = 0.023*).Conclusions: Meanwhile, BMS is associated with a higher decline in cognitive functions, particularly attention, working memory, and executive functions, but other functions such as praxis-constructive skills and verbal memory are preserved. The early identification of CI and associated factors may help clinicians to identify patients at risk of developing time-based neurodegenerative disorders, such as Alzheimer's disease (AD) and vascular dementia (VD), for planning the early, comprehensive, and multidisciplinary assessment and treatment.

Download Full-text

Comparison of Neuropsychological Assessment by Videoconference and Face to Face

Journal of the International Neuropsychological Society ◽

10.1017/s1355617721000679 ◽

2021 ◽

pp. 1-11

Author(s):

Richard Gnassounou ◽

Bénédicte Defontaines ◽

Séverine Denolle ◽

Stéphanie Brun ◽

Raphaël Germain ◽

...

Keyword(s):

Neuropsychological Assessment ◽

Digit Span ◽

Cognitive Disorders ◽

Face To Face ◽

Complex Figure ◽

Selective Reminding ◽

Trail Making ◽

Neuropsychological Assessments ◽

Figure Test ◽

Selective Reminding Test

Abstract Objective: To compare the administration of neuropsychological tests by teleneuropsychology (TeleNP) and face to face (F-F) in order to determine the feasibility and reliability of TeleNP. Method: At the inclusion visit, all participants underwent a traditional F-F neuropsychological assessment as part of their standard care. Four months after inclusion, they were randomized to undergo an additional neuropsychological assessment either by F-F administration or by TeleNP. Results: A total of 150 adults with cognitive complaints, but with no major cognitive or sensorial impairment were included. At 4 months, 69 participants were randomized in the F-F arm and 71 in TeleNP arm (10 lost in the follow-up). The overall satisfaction was high: 87.1% in the TeleNP arm were “very satisfied”, and 82.9% indicated no preference between F-F and TeleNP. In agreement with previous data from the literature, neuropsychological assessments gave similar results across both administration conditions for a large majority of tests [Mini-Mental State Examination (MMSE), Free and Cued Selective Reminding Test (FCSRT) French version, Mahieux gestural praxis battery, Frontal Assessment Battery (FAB), time of completion of the Trail making Test (TMT) A and B, number of errors of the TMT B, Rey complex figure test, categorical et phonological verbal fluency tests] and minor differences for others [80-picture naming test (DO-80), FAB, Digit Span forward and backward and number of errors in the TMT A]. Conclusions: TeleNP is a promising method to be able to test patients as an alternative to F-F condition. Before this procedure can be generalized, it is now necessary to standardize the adaptation of certain tests and to test them in populations with more significant cognitive disorders.

Download Full-text

Speech Discrimination Tasks: A Sensitive Sensory and Cognitive Measure in Early and Mild Multiple Sclerosis

Frontiers in Neuroscience ◽

10.3389/fnins.2020.604991 ◽

2020 ◽

Vol 14 ◽

Author(s):

Pippa Iva ◽

Joanne Fielding ◽

Meaghan Clough ◽

Owen White ◽

Branislava Godic ◽

...

Keyword(s):

Multiple Sclerosis ◽

Speech Intelligibility ◽

Digit Span ◽

Neuropsychological Testing ◽

Verbal Learning ◽

Ease Of Use ◽

Clinical Use ◽

Speech Discrimination ◽

Cognitive Changes ◽

Functional Scores

There is a need for reliable and objective measures of early and mild symptomology in multiple sclerosis (MS), as deficits can be subtle and difficult to quantify objectively in patients without overt physical deficits. We hypothesized that a speech-in-noise (SiN) task would be sensitive to demyelinating effects on precise neural timing and diffuse higher-level networks required for speech intelligibility, and therefore be a useful tool for monitoring sensory and cognitive changes in early MS. The objective of this study was to develop a SiN task for clinical use that sensitively monitors disease activity in early (<5 years) and late (>10 years) stages of MS subjects with mild severity [Expanded Disability Status Scale (EDSS) score < 3]. Pre-recorded Bamford-Kowal-Bench sentences and isolated keywords were presented at five signal-to-noise ratios (SNR) in one of two background noises: speech-weighted noise and eight-talker babble. All speech and noise were presented via headphones to controls (n = 38), early MS (n = 23), and late MS (n = 12) who were required to verbally repeat the target speech. MS subjects also completed extensive neuropsychological testing which included: Paced Auditory Serial Addition Test, Digit Span Test, and California Verbal Learning Test. Despite normal hearing thresholds, subjects with early and late mild MS displayed speech discrimination deficits when sentences and words were presented in babble – but not speech-weighted noise. Significant correlations between SiN performance and standardized neuropsychological assessments indicated that MS subjects with lower functional scores also had poorer speech discrimination. Furthermore, a quick 5-min task with words and keywords presented in multi-talker babble at an SNR of −1 dB was 82% accurate in discriminating mildly impaired MS individuals (median EDSS = 0) from healthy controls. Quantifying functional deficits in mild MS will help clinicians to maximize the opportunities to preserve neurological reserve in patients with appropriate therapeutic management, particularly in the earliest stages. Given that physical assessments are not informative in this fully ambulatory cohort, a quick 5-min task with words and keywords presented in multi-talker babble at a single SNR could serve as a complementary test for clinical use due to its ease of use and speed.

Download Full-text

Neuropsychological Test Norms in Cognitively Intact Oldest-Old

Journal of the International Neuropsychological Society ◽

10.1017/s1355617719000122 ◽

2019 ◽

Vol 25 (05) ◽

pp. 530-545 ◽

Cited By ~ 3

Author(s):

Zarui A. Melikyan ◽

Maria M. Corrada ◽

Malcolm B. Dick ◽

Christina Whittle ◽

Annlia Paganini-Hill ◽

...

Keyword(s):

Cognitive Impairment ◽

Short Form ◽

Oldest Old ◽

Neuropsychological Test ◽

Verbal Learning ◽

Test Norms ◽

Increased Risk ◽

Neuropsychological Test Norms ◽

Cognitively Intact ◽

Fluency Test

AbstractObjectives: Individuals aged 90 or older (oldest-old), the fastest growing segment of the population, are at increased risk of developing cognitive impairment compared with younger old. Neuropsychological evaluation of the oldest-old is important yet challenging in part because of the scarcity of test norms for this group. We provide neuropsychological test norms for cognitively intact oldest-old. Methods: Test norms were derived from 403 cognitively intact participants of The 90+ Study, an ongoing study of aging and dementia in the oldest-old. Cognitive status of intact oldest-old was determined at baseline using cross-sectional approach. Individuals with cognitive impairment no dementia or dementia (according to DSM-IV criteria) were excluded. Participants ranged in age from 90 to 102 years (mean=94). The neuropsychological battery included 11 tests (Mini-Mental Status Examination, Modified Mini-Mental State Examination, Boston Naming Test – Short Form, Letter Fluency Test, Animal Fluency Test, California Verbal Learning Test-II Short Form, Trail Making Tests A/B/C, Digit Span Forward and Backwards Test, Clock Drawing Test, CERAD Construction Subtests), and the Geriatric Depression Scale. Results: Data show significantly lower scores with increasing age on most tests. Education level, sex, and symptoms of depression were associated with performance on several tests after accounting for age. Conclusions: Provided test norms will help to distinguish cognitively intact oldest-old from those with cognitive impairment. (JINS, 2019, 25, 530–545)

Download Full-text

Intermittent Hypoxia Training for Treating Mild Cognitive Impairment: A Pilot Study

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/1533317519896725 ◽

2020 ◽

Vol 35 ◽

pp. 153331751989672 ◽

Cited By ~ 3

Author(s):

Hong Wang ◽

Xiangrong Shi ◽

Hannah Schenck ◽

James R. Hall ◽

Sarah E. Ross ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Pilot Study ◽

Elderly Patients ◽

Intermittent Hypoxia ◽

Short Term Memory ◽

Cerebral Oxygenation ◽

Word Association ◽

Digit Span ◽

Verbal Learning

Although intermittent hypoxia training (IHT) has proven effective against various clinical disorders, its impact on mild cognitive impairment (MCI) is unknown. This pilot study examined IHT’s safety and therapeutic efficacy in elderly patients with amnestic MCI (aMCI). Seven patients with aMCI (age 69 ± 3 years) alternately breathed 10% O2 and room-air, each 5 minutes, for 8 cycles/session, 3 sessions/wk for 8 weeks. The patients’ resting arterial pressures fell by 5 to 7 mm Hg ( P < .05) and cerebral tissue oxygenation increased ( P < .05) following IHT. Intermittent hypoxia training enhanced hypoxemia-induced cerebral vasodilation ( P < .05) and improved mini-mental state examination and digit span scores from 25.7 ± 0.4 to 27.7 ± 0.6 ( P = .038) and from 24.7 ± 1.2 to 26.1 ± 1.3 ( P = .047), respectively. California verbal learning test score tended to increase ( P = .102), but trail making test-B and controlled oral word association test scores were unchanged. Adaptation to moderate IHT may enhance cerebral oxygenation and hypoxia-induced cerebrovasodilation while improving short-term memory and attention in elderly patients with aMCI.

Download Full-text

Cognitive Impairment in Major Depressive Disorder and Severe Depressive Episode with Psychotic Symptoms

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1983 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S143-S144

Author(s):

S. Fedorová ◽

M. Blažková ◽

P. Humpolíček ◽

R. Barteček

Keyword(s):

Major Depressive Disorder ◽

Cognitive Impairment ◽

Depressive Disorder ◽

Cognitive Performance ◽

Depressive Episode ◽

Digit Span ◽

Verbal Learning ◽

Psychotic Symptoms ◽

Major Depressive ◽

Depressive Episodes

IntroductionCognitive impairment in patients with depressive disorder is a subject of intensive research.ObjectivesThis study deals with the cognitive impairment in patients with severe depressive episode with psychotic symptoms and patients with major depressive disorder during the acute state of illness.AimsThe aim was to define domains and the level of cognitive impairment in both groups of patients.The next aim was to compare profiles of cognitive impairment in both groups of patients.The last aim was to find out a relationship between cognitive performance and severity of depressive episode during the acute state of illness.MethodsWe have used neuropsychological test battery (Auditory–Verbal Learning Test, Rey-Osterrieth Complex Figure Test, Logical Memory, Digit span test, Trail making test, Verbal Fluency Test, Block Design and Benton Visual Retention Test) for the evaluation of the cognitive functions in patients with severe depressive episode with psychotic symptoms (n = 5) and patients with major depressive disorder (n = 8).ResultsWe found cognitive impairment in all examined domains in both groups of patients.More profound cognitive impairment was found in patients with severe depressive episode with psychotic symptoms, particularly in visual memory, visuo-constructive abilities, speed of cognitive processing and executive functions. We found no correlation between cognitive performance and severity of depressive episodes.ConclusionsOur findings suggest a strong correlation between psychotic symptoms in depression and cognitive performance.

Download Full-text

Validity of Teleneuropsychological Assessment in Older Patients with Cognitive Disorders

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acx140 ◽

2018 ◽

Vol 33 (8) ◽

pp. 1040-1045 ◽

Cited By ~ 26

Author(s):

Hannah E Wadsworth ◽

Kaltra Dhima ◽

Kyle B Womack ◽

John Hart ◽

Myron F Weiner ◽

...

Keyword(s):

Cognitive Impairment ◽

Repeated Measures ◽

Neuropsychological Testing ◽

Cognitive Disorders ◽

Cognitively Impaired ◽

Clinical Diagnoses ◽

Aging Populations ◽

Alternate Test ◽

Testing Medium ◽

Main Effects

Abstract Objective The feasibility and reliability of neuropsychological assessment at a distance have been demonstrated, but the validity of this testing medium has not been adequately demonstrated. The purpose of this study was to determine the ability of video teleconferencing administration of neuropsychological measures (teleneuropsychology) in discriminating cognitively impaired from non-impaired groups of older adults. It was predicted that measures administered via video teleconference would distinguish groups and that the magnitude of differences between impaired and non-impaired groups would be similar to group differences achieved in traditional administration. Methods The sample consisted of 197 older subjects, separated into two groups, with and without cognitive impairment. The cognitive impairment group included 78 individuals with clinical diagnoses of mild cognitive impairment or Alzheimer’s disease. All participants completed counterbalanced neuropsychological testing using alternate test forms in both a teleneuropsychology and a traditional face-to-face (FTF) administration condition. Tests were selected based upon their common use in dementia evaluations, brevity, and assessment of multiple cognitive domains. Results from FTF and teleneuropsychology test conditions were compared using individual repeated measures ANCOVA, controlling for age, education, gender, and depression scores. Results All ANCOVA models revealed significant main effects of group and a non-significant interaction between group and administration condition. All ANCOVA models revealed non-significant main effects for administration condition, except category fluency. Conclusions Results derived from teleneuropsychologically administered tests can distinguish between cognitively impaired and non-impaired individuals similar to traditional FTF assessment. This adds to the growing teleneuropsychology literature by supporting the validity of remote assessments in aging populations.

Download Full-text

Predicting outcome in mild cognitive impairment: 4-year follow-up study

The British Journal of Psychiatry ◽

10.1192/bjp.bp.110.077958 ◽

2010 ◽

Vol 197 (2) ◽

pp. 135-140 ◽

Cited By ~ 24

Author(s):

Jane A. Lonie ◽

Mario A. Parra-Rodriguez ◽

Kevin M. Tierney ◽

Lucie L. Herrmann ◽

Claire Donaghey ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Neuropsychological Assessment ◽

Verbal Learning ◽

Cognitive Screening ◽

Prognostic Information ◽

Predictive Values ◽

Diagnosis And Prognosis ◽

Demographic Indices ◽

Sensitivity Specificity

BackgroundCognitive impairment precedes the diagnosis of Alzheimer's disease. It is unclear which psychometric measures predict dementia, and what cut-off points should be used. Replicable cognitive measures to provide information about differential diagnosis and prognosis would be clinically useful.AimsIn a prospective cohort study we investigated which measures distinguish between individuals with amnestic mild cognitive impairment (aMCI) that converts to dementia and those whose impairment does not, and which combination of measures best predicts the fate of people with aMCI.MethodForty-four participants with aMCI underwent extensive neuropsychological assessment at baseline and annually thereafter for an average of 4 years. Differences in baseline cognitive performance of participants who were converters and non-converters to clinically diagnosed dementia were analysed. Classification accuracy was estimated by sensitivity, specificity, positive and negative predictive values and using logistic regression.ResultsForty-one percent of participants had progressed to dementia by the end of study, with a mean annual conversion rate of 11%. Most (63%) showed persisting or progressive cognitive impairment, irrespective of diagnosis. The Addenbrooke's Cognitive Examination together with the discrimination index of the Hopkins Verbal Learning Test – Revised (but none of the demographic indices) differentiated the participants who were converters from the non-converters at baseline with 74% accuracy.ConclusionsTargeted neuropsychological assessment, beyond simple cognitive screening, could be used in clinical practice to provide individuals with aMCI with prognostic information and aid selective early initiation of monitoring and treatment among those who progress towards a clinically diagnosable dementia.

Download Full-text

Preliminary Validation of the Global Neuropsychological Assessment in Alzheimer’s Disease and Healthy Volunteers

Assessment ◽

10.1177/1073191121991221 ◽

2021 ◽

pp. 107319112199122

Author(s):

Lauren T. Olson ◽

Alan Smerbeck ◽

Christina M. Figueroa ◽

Jeremy M. Raines ◽

Kinga Szigeti ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Neuropsychological Assessment ◽

Performance Test ◽

Digit Span ◽

Intraclass Correlation ◽

Healthy Controls ◽

Adult Intelligence Scale

Methods We administered the Global Neuropsychological Assessment (GNA), an abbreviated cognitive battery, to 105 adults aged 73.0 ± 7.1 years, including 28 with probable Alzheimer’s disease, 9 with amnestic mild cognitive impairment, and 68 healthy controls. We examined group differences in baseline performance, test–retest reliability, and correlations with other conventional tests. Results Healthy adults outperformed patients on all five GNA subtests. Test–retest intraclass correlation coefficients were significant for all GNA subtests. Among patients with healthy controls, GNA Story Memory correlated best with Wechsler Memory Scale–Revised (WMS-R) Logical Memory for learning and delayed recall, GNA Digit Span correlated most highly with the Wechsler Adult Intelligence Scale–Third Edition (WAIS-III) Digit Span, GNA Perceptual Comparison correlated most highly with the Trail Making Test, and GNA Animal Naming correlated most highly with Supermarket Item Naming. Conclusions Preliminary findings suggest that the GNA shows good test–retest validity, clear convergent and discriminant construct validity, and excellent diagnostic criterion validity for dementia and mild cognitive impairment in an American sample.

Download Full-text