Comparison Trail Making Test between individuals with Parkinson’s disease and health controls: Suggestions of cutoff point.

AbstractBoth intrinsic and extrinsic motivation are believed to involve brain regions that are innervated by the dopaminergic pathway. Although dopaminergic neurons in the midbrain deteriorate in Parkinson’s disease (PD), it remains unclear whether intrinsic motivation is impaired in PD patients. To address this issue, we investigated intrinsic motivation in PD patients using a task designed to assess the “Pandora effect,” which constitutes a curiosity for resolving uncertainty, even if this curiosity is likely to result in negative consequences. Twenty-seven PD patients and 27 age-matched healthy controls (HCs) completed a curiosity task in which they were required to decide either to view or skip negative pictures (e.g., snakes, spiders) and an examination battery that included the Mini-Mental State Examination, a verbal fluency test, the Trail Making Test, 10-word recall tests, and questionnaires for behavioral inhibition/activation and depression. DaTSCAN images to assess the distribution of dopamine transporters in the striatum were acquired only from PD patients. The results revealed that PD patients, relative to the HCs, viewed the pictures less frequently under both the certain and uncertain conditions. However, both the PD patients and HCs viewed the pictures at a higher frequency under the uncertain condition than under the certain condition. In the PD patients, the proportion of pictures viewed under the certain condition was positively correlated with the distribution of dopamine transporters in the striatum. These results suggest that despite the overall decreasing level of interest in viewing negative pictures, the motivation to resolve uncertainty is relatively intact in PD patients.

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Evaluation of Motor and Cognitive Performance in People with Parkinson’s Disease Using Instrumented Trail-Making Test

Gerontology ◽

10.1159/000515940 ◽

2021 ◽

pp. 1-7

Author(s):

Ram kinker Mishra ◽

Catherine Park ◽

He Zhou ◽

Bijan Najafi ◽

T. Adam Thrasher

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Performance ◽

Pairwise Comparison ◽

Walking Test ◽

Cognitively Normal ◽

Early Results ◽

Trail Making ◽

Changes Over Time

Introduction: Parkinson’s disease (PD) progressively impairs motor and cognitive performance. The current tools to detect decline in motor and cognitive functioning are often impractical for busy clinics and home settings. To address the gap, we designed an instrumented trail-making task (iTMT) based on a wearable sensor (worn on the shin) with interactive game-based software installed on a tablet. The iTMT test includes reaching to 5 indexed circles, a combination of numbers (1–3) and letters (A&B) randomly positioned inside target circles, in a sequential order, which virtually appears on a screen kept in front of the participants, by rotating one’s ankle joint while standing and holding a chair for safety. By measuring time to complete iTMT task (iTMT time), iTMT enables quantifying cognitive-motor performance. Purpose: This study’s objective is to examine the feasibility of iTMT to detect early cognitive-motor decline in PDs. Method: Three groups of volunteers, including 14 cognitively normal (CN) older adults, 14 PDs, and 11 mild cognitive impaireds (MCI), were recruited. Participants completed MoCA, 20 m walking test, and 3 trials of iTMT. Results: All participants enabled to complete iTMT with <3 min, indicating high feasibility. The average iTMT time for CN-Older, PD, and MCI participants were 20.9 ± 0.9 s, 32.3 ± 2.4 s, and 40.9 ± 4.5 s, respectively. After adjusting for age and education level, pairwise comparison suggested large effect sizes for iTMT between CN-older versus PD (Cohen’s d = 1.7, p = 0.024) and CN-older versus MCI (d = 1.57, p < 0.01). Significant correlations were observed when comparing iTMT time with the gait speed (r = −0.4, p = 0.011) and MoCA score (r = −0.56, p < 0.01). Conclusion: This study demonstrated the feasibility and early results supporting the potential application of iTMT to determine cognitive-motor and distinguishing individuals with MCI and PD from CN-older adults. Future studies are warranted to test the ability of iTMT to track its subtle changes over time.

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The contribution of trail making to the prediction of performance-based instrumental activities of daily living in Parkinson's disease without dementia

Journal of Clinical and Experimental Neuropsychology ◽

10.1080/13803395.2013.798397 ◽

2013 ◽

Vol 35 (5) ◽

pp. 530-539 ◽

Cited By ~ 15

Author(s):

Christopher I. Higginson ◽

Kimberly Lanni ◽

Karen A. Sigvardt ◽

Elizabeth A. Disbrow

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Activities Of Daily Living ◽

Daily Living ◽

Instrumental Activities ◽

Trail Making

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Changes in Executive Function After Acute Bouts of Passive Cycling in Parkinson’s Disease

Journal of Aging and Physical Activity ◽

10.1123/japa.19.2.87 ◽

2011 ◽

Vol 19 (2) ◽

pp. 87-98 ◽

Cited By ~ 46

Author(s):

Angela L. Ridgel ◽

Chul-Ho Kim ◽

Emily J. Fickes ◽

Matthew D. Muller ◽

Jay L. Alberts

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Executive Function ◽

Motor Deficits ◽

Leg Cycling ◽

Before And After ◽

Trail Making ◽

The Difference ◽

B Test ◽

Pharmacologic Therapies

Individuals with Parkinson’s disease (PD) often experience cognitive declines. Although pharmacologic therapies are helpful in treating motor deficits in PD, they do not appear to be effective for cognitive complications. Acute bouts of moderate aerobic exercise have been shown to improve cognitive function in healthy adults. However, individuals with PD often have difficulty with exercise. This study examined the effects of passive leg cycling on executive function in PD. Executive function was assessed with Trail-Making Test (TMT) A and B before and after passive leg cycling. Significant improvements on the TMT-B test occurred after passive leg cycling. Furthermore, the difference between times to complete the TMT-B and TMT-A significantly decreased from precycling to postcycling. Improved executive function after passive cycling may be a result of increases in cerebral blood flow. These findings suggest that passive exercise could be a concurrent therapy for cognitive decline in PD.

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iPAD-BASED ASSESSMENT IN PARKINSON'S DISEASE

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2015-312379.94 ◽

2015 ◽

Vol 86 (11) ◽

pp. e4.189-e4

Author(s):

Rupert Noad ◽

Craig Newman ◽

Camille Carroll ◽

John Zajicek

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Disease Progression ◽

Visual Memory ◽

Initial Study ◽

Early Disease ◽

Early Disease Detection ◽

Trail Making ◽

Usability Data ◽

Moca Score

BackgroundIn order to facilitate neuroprotective trials in Parkinson's disease (PD), there is a need for improved means of early disease detection and measuring disease progression. Computerised assessment may afford easier and increasingly accurate administration of motor and cognitive tests, as well as measurement of indices not readily accessible with standard testing paradigms.AimTo develop and validate iPad-based cognitive and motor measures in PD.Method62 PD patients and 42 age-matched controls completed traditional and iPad versions of the Trail Making Test (TMT) (executive function) and Knox Cube Test (visual memory), as well as a range of other measures.ResultsMedian age was 68 years; median MOCA score was 26. No participant had previously used an iPad. There was significant correlation between traditional and iPad measures: TMTa r=0.74, p<0.001; TMTb r=0.76, p<0.001; Knox r=0.63, p<0.001. Usability data were strong, 90% of participants providing positive feedback.ConclusionThis initial study has demonstrated that two iPad-based measures of cognition are acceptable to PD patients and perform similarly to traditional pen-and-paper tests. Further work will extend the analysis of the measured indices in longitudinal studies to determine correlation with disease progression, and extend the battery of iPad-based tests available for PD assessment.

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Neuropsychological Characteristics and Their Association with Higher-Level Functional Capacity in Parkinson's Disease

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000381333 ◽

2015 ◽

Vol 5 (2) ◽

pp. 271-284 ◽

Cited By ~ 6

Author(s):

Kayoko Miura ◽

Mie Matsui ◽

Shutaro Takashima ◽

Kortaro Tanaka

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Executive Function ◽

Functional Capacity ◽

Social Role ◽

Control Group ◽

Intellectual Activity ◽

Trail Making ◽

Neuropsychological Characteristics ◽

One Year

Background/Aims: Little is known about the relationship between cognitive functions and higher-level functional capacity (e.g. intellectual activity, social role, and social participation) in Parkinson's disease (PD). The purpose of this study was to clarify neuropsychological characteristics and their association with higher-level functional capacity in PD patients. Methods: Participants were 31 PD patients and 23 demographically matched healthy controls. Neuropsychological tests were conducted. One year later, a questionnaire survey evaluated higher-level functional capacity in daily living. Results: The PD group scored significantly lower than the control group in all cognitive domains, particularly executive function and processing. Executive function, processing speed, language, and memory were significantly correlated with higher-level functional capacity in PD patients. Stepwise regression showed that only executive function (Trail Making Test-B), together with disease severity (HY stage), predicted the higher-level functional capacity. Conclusion: Our findings provide evidence of a relationship between executive function and higher-level functional capacity in patients with PD.

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