scholarly journals Interictal Activity Is Associated With Slower Binocular Rivalry in Idiopathic Generalized Epilepsy

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiaonan Wu ◽  
Wei Ding ◽  
Xing Ye ◽  
Qiang Wei ◽  
Xinyi Lv ◽  
...  
Keyword(s):  
Standard Error ◽  
Cognitive Assessment ◽  
Characteristic Curve ◽  
Montreal Cognitive Assessment ◽  
Alternation Rate ◽  
Assessment Score ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
Perceptual Alternation ◽  
Generalized Epilepsy

Objective: Perceptual alternations evoked by binocular rivalry (BR) reflect cortical dynamics strongly dependent on the excitatory–inhibitory balance, suggesting potential utility as a biomarker for epileptogenesis. Therefore, we investigated the characteristics of BR in patients with idiopathic generalized epilepsy (IGE) and potential associations with clinical variables.Methods: Sixty-two healthy controls (HCs) and 94 IGE patients completed BR task. Perceptual alternation rates were compared between HC and IGE groups as well as among the HC group and IGE patients stratified according to the presence or absence of interictal activity on the ambulatory electroencephalogram (EEG), termed the abnormal ambulatory EEG group (AB-AEEG, n = 64) and normal ambulatory EEG group (N-AEEG, n = 30), respectively.Results: The IGE patients demonstrated a slower rate of BR perceptual alternation than HC subjects (t = −4.364, p < 0.001). The alternation rate also differed among the HC, AB-AEEG, and N-AEEG groups (F = 44.962, df = 2, p < 0.001), and post hoc comparisons indicated a significantly slower alternation rate in the AB-AEEG group compared with the N-AEEG and HC groups (0.28 vs. 0.46, and 0.43 Hz). Stepwise linear regression revealed positive correlations between the BR alternation rate and both the ambulatory EEG status (β, 0.173; standard error, 0.022 p < 0.001) and Montreal Cognitive Assessment score (β, 0.013; standard error, 0.004; p = 0.003). Receiver operating characteristic curve analysis of the BR alternation rate distinguished AB-AEEG from N-AEEG subjects with 90.00% sensitivity and 76.90% specificity (area under the curve = 0.881; 95% confidence interval = 0.801– 0.961, cut-off = 0.319). Alternatively, Montreal Cognitive Assessment score did not accurately distinguish AB-AEEG from N-AEEG subjects and the area under the receiver operating characteristic curve combining the BR alternation rate and Montreal Cognitive Assessment score was not markedly larger than that of the BR alternation rate alone (0.894, 95% confidence interval = 0.822–0.966, p < 0.001). K-fold cross-validation was used to evaluate the predictive performance of BR alternation rate, MoCA score, and the combination of both, which yielded average AUC values of 0.870, 0.584 and 0.847, average sensitivity values of 89.36, 92.73, and 91.28%, and average specificity values of 62.25, 13.42, and 61.78%, respectively. The number of interictal epileptiform discharges was significantly correlated with the alternation rate in IGE patients (r = 0.296, p = 0.018). A forward stepwise linear regression model identified the number of interictal epileptiform discharges (β, 0.001; standard error, 0.001; p = 0.025) as an independent factor associated with BR alternation rate in these patients.Conclusion: These results suggest that interictal epileptiform discharges are associated with disruptions in perceptual awareness, and that the BR may be a useful auxiliary behavioral task to diagnosis and dynamically monitor IGE patients with interictal discharge.

scholarly journals Concurrent validity of the short version of Montreal Cognitive Assessment (MoCA) for patients with stroke

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yali Feng ◽  
Jiaqi Zhang ◽  
Yi Zhou ◽  
Bo Chen ◽  
Ying Yin
Keyword(s):  
Neurological Disorders ◽  
Cognitive Assessment ◽  
Concurrent Validity ◽  
Operating Characteristic ◽  
Cognitive Impairments ◽  
Characteristic Curve ◽  
Cognitive Status ◽  
Montreal Cognitive Assessment ◽  
Short Version ◽  
External Criterion

AbstractThe aim of the present study was to examine the concurrent validity of 2 Chinese versions of the short version of the Montreal Cognitive Assessment (MoCA) in patients with stroke, i.e., MoCA 5-minute protocol and National Institute for Neurological Disorders and Stroke and Canadian Stroke Network (NINDS-CSN) 5-minute Protocol. A total of 54 patients and 27 healthy controls were enrolled in this study. In this study, the Neurobehavioural Cognitive Status Examination (NCSE) was used as an external criterion of cognitive impairment. We found that the 5-min protocol did not differ from the MoCA in differentiating patients with cognitive impairments from those without (area under the receiver operating characteristic curve, AUC, of 0.948 for the MoCA 5-min protocol v.s. 0.984 for MoCA, P = 0.097). These three assessments demonstrated equal performance in differentiating patients with stroke from controls. The Chinese version of the MoCA 5-min protocol can be used as a valid screening for patients with stroke.

scholarly journals Improvement in montreal cognitive assessment score following three-week pain rehabilitation program

2019 ◽  
Vol 6 (3) ◽  
pp. 201-209
Author(s):  
Joann E. Bolton ◽  
◽  
Elke Lacayo ◽  
Svetlana Kurklinsky ◽  
Christopher D. Sletten ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Rehabilitation Program ◽  
Montreal Cognitive Assessment ◽  
Assessment Score ◽  
Score Following

scholarly journals Subclinical Cognitive Impairment and Listing for Kidney Transplantation

2019 ◽  
Vol 14 (4) ◽  
pp. 567-575 ◽  
Author(s):  
Aditi Gupta ◽  
Robert N. Montgomery ◽  
Victor Bedros ◽  
John Lesko ◽  
Jonathan D. Mahnken ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Kidney Transplant ◽  
Cognitive Assessment ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Montreal Cognitive Assessment ◽  
Rank Test ◽  
Assessment Score ◽  
Lower Likelihood

Background and objectivesCognitive impairment is common in patients with kidney disease and can affect physicians’ perception and/or patients’ ability to complete the pretransplant evaluation. We examined whether cognitive impairment influences the likelihood for transplant listing and whether patients with cognitive impairment take longer to be listed.Design, setting, participants, & measurementsWe conducted a single-center longitudinal cohort study. Patients presenting for their index kidney transplant evaluation were screened for cognitive impairment using the Montreal Cognitive Assessment. A score <26 indicated cognitive impairment. The transplant selection committee was blinded to the scores. Kaplan–Meier analysis assessed time to active listing by level of cognition. A Cox proportional hazards model that included age, sex, race/ethnicity, smoking, coronary artery disease, and diabetes was constructed to evaluate the association between Montreal Cognitive Assessment score and listing for transplant.ResultsIn total, 349 patients who underwent Montreal Cognitive Assessment testing at their initial visit were included in the analysis. Patients with cognitive impairment were more likely to be older, black, and smokers. The time to listing in patients with cognitive impairment was longer than the time to listing in those with no cognitive impairment (median time, 10.6 versus 6.3 months; log rank test P=0.01). Cognitive impairment was independently associated with a lower likelihood of being listed for transplant (hazard ratio, 0.93 per unit lower Montreal Cognitive Assessment score; 95% confidence interval, 0.88 to 0.99; P=0.02). A lower proportion of patients with cognitive impairment were listed compared with patients without cognitive impairment at 1 month (2% versus 11%), 6 months (17% versus 37%), and 1 year (23% versus 41%), (P<0.001 for all).ConclusionsCognitive impairment is associated with a lower likelihood of being listed for kidney transplant, and is associated with longer time to transplant listing.

Montreal Cognitive Assessment for Screening Mild Cognitive Impairment: Variations in Test Performance and Scores by Education in Singapore

2015 ◽  
Vol 39 (3-4) ◽  
pp. 176-185 ◽  
Author(s):  
Tze Pin Ng ◽  
Lei Feng ◽  
Wee Shiong Lim ◽  
Mei Sian Chong ◽  
Tih Shih Lee ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Test Performance ◽  
Cognitive Assessment ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Montreal Cognitive Assessment ◽  
Community Based ◽  
Education Group ◽  
And Gender

Background: The Montreal Cognitive Assessment (MoCA) was developed as a screening instrument for mild cognitive impairment (MCI). We evaluated the MoCA's test performance by educational groups among older Singaporean Chinese adults. Method: The MoCA and Mini-Mental State Examination (MMSE) were evaluated in two independent studies (clinic-based sample and community-based sample) of MCI and normal cognition (NC) controls, using receiver operating characteristic curve analyses: area under the curve (AUC), sensitivity (Sn), and specificity (Sp). Results: The MoCA modestly discriminated MCI from NC in both study samples (AUC = 0.63 and 0.65): Sn = 0.64 and Sp = 0.36 at a cut-off of 28/29 in the clinic-based sample, and Sn = 0.65 and Sp = 0.55 at a cut-off of 22/23 in the community-based sample. The MoCA's test performance was least satisfactory in the highest (>6 years) education group: AUC = 0.50 (p = 0.98), Sn = 0.54, and Sp = 0.51 at a cut-off of 27/28. Overall, the MoCA's test performance was not better than that of the MMSE. In multivariate analyses controlling for age and gender, MCI diagnosis was associated with a <1-point decrement in MoCA score (η2 = 0.010), but lower (1-6 years) and no education was associated with a 3- to 5-point decrement (η2 = 0.115 and η2 = 0.162, respectively). Conclusion: The MoCA's ability to discriminate MCI from NC was modest in this Chinese population, because it was far more sensitive to the effect of education than MCI diagnosis.

scholarly journals Automated Inter-Ictal Epileptiform Discharge Detection from Routine EEG

2021 ◽  
Author(s):  
Duong Nhu ◽  
Mubeen Janmohamed ◽  
Lubna Shakhatreh ◽  
Ofer Gonen ◽  
Patrick Kwan ◽  
...  
Keyword(s):  
Royal Melbourne Hospital ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
Model Variant ◽  
Eeg Recordings ◽  
Generalized Epilepsy ◽  
Electroencephalogram Eeg ◽  
Health Hospital ◽  
Epilepsy Monitoring

Epilepsy is the most common neurological disorder. The diagnosis commonly requires manual visual electroencephalogram (EEG) analysis which is time-consuming. Deep learning has shown promising performance in detecting interictal epileptiform discharges (IED) and may improve the quality of epilepsy monitoring. However, most of the datasets in the literature are small (n≤100) and collected from single clinical centre, limiting the generalization across different devices and settings. To better automate IED detection, we cross-evaluated a Resnet architecture on 2 sets of routine EEG recordings from patients with idiopathic generalized epilepsy collected at the Alfred Health Hospital and Royal Melbourne Hospital (RMH). We split these EEG recordings into 2s windows with or without IED and evaluated different model variants in terms of how well they classified these windows. The results from our experiment showed that the architecture generalized well across different datasets with an AUC score of 0.894 (95% CI, 0.881–0.907) when trained on Alfred’s dataset and tested on RMH’s dataset, and 0.857 (95% CI, 0.847–0.867) vice versa. In addition, we compared our best model variant with Persyst and observed that the model was comparable.

Screening utility of the Montreal Cognitive Assessment (MoCA): in place of – or as well as – the MMSE?

2011 ◽  
Vol 24 (3) ◽  
pp. 391-396 ◽  
Author(s):  
A. J. Larner
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Characteristic Curve ◽  
The Elderly ◽  
Montreal Cognitive Assessment ◽  
Test Accuracy ◽  
Diagnostic Utility ◽  
Memory Clinic ◽  
Index Study ◽  
In Series

ABSTRACTBackground: This aim of this study was to assess the clinical utility of the Montreal Cognitive Assessment (MoCA) as a screening instrument for cognitive impairment in patients referred to a memory clinic, alone and in combination with the Mini-Mental State Examination (MMSE).Methods: This was a pragmatic prospective study of consecutive referrals attending a memory clinic (n = 150) over an 18-month period. Patients were diagnosed using standard clinical diagnostic criteria for dementia (DSM-IV) and mild cognitive impairment (MCI; cognitive impairment prevalence = 43%) independent of MoCA test scores.Results: MoCA proved acceptable to patients and was quick and easy to use. Using the cut-offs for MoCA and MMSE specified in the index paper (≥26/30), MoCA was more sensitive than MMSE (0.97 vs 0.65) but less specific (0.60 vs 0.89), with better diagnostic accuracy (area under Receiver Operating Characteristic curve 0.91 vs 0.83). Downward adjustment of the MoCA cut-off to ≥20/30 maximized test accuracy and improved specificity (0.95) for some loss of sensitivity (0.63). Combining MoCA with the MMSE – either in series or in parallel – did not improve diagnostic utility above that with either test alone.Conclusions: In a memory clinic population, MoCA proved sensitive for the diagnosis of cognitive impairment. Use of a cut-off lower than that specified in the index study may be required to improve overall test accuracy and specificity for some loss of sensitivity in populations with a high prior probability of cognitive impairment. Combining the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) with the MMSE did not improve diagnostic utility.

Focal interictal epileptiform discharges in idiopathic generalized epilepsy

2016 ◽  
Vol 37 (7) ◽  
pp. 1071-1077 ◽  
Author(s):  
Eman H. Esmail ◽  
Amani M. Nawito ◽  
Dalia M. Labib ◽  
Mye A. Basheer
Keyword(s):  
Idiopathic Generalized Epilepsy ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
Generalized Epilepsy
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