scholarly journals Mutual Interaction of Clinical Factors and Specific microRNAs to Predict Mild Cognitive Impairment in Patients Receiving Hemodialysis

Cells ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 2303
Author(s):  
Jin-Bor Chen ◽  
Chiung-Chih Chang ◽  
Lung-Chih Li ◽  
Wen-Chin Lee ◽  
Chia-Ni Lin ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Test Performance ◽  
Roc Analysis ◽  
Neuron Specific Enolase ◽  
Area Under The Curve ◽  
Mutual Interaction ◽  
Uremic Toxin ◽  
Clinical Factors ◽  
Clinical Dementia Rating ◽  
Functional Scores

Cognitive impairment (CI) is not uncommon in dialysis patients. Various factors have been implicated. This study aims to examine mutual interaction of various clinical factors for CI in patients receiving hemodialysis. A total of 48 hemodialysis patients in outpatient clinic were recruited from 2015 to 2017. Demographics, circulating uremic toxin concentrations, miRNA concentrations, and nerve injury protein concentrations were collected. Clinical dementia rating (CDR) scores were used to stratify the functional scores of the patients. Receiver operating characteristic (ROC) analysis was used to evaluate diagnostic test performance for predicting dichotomous results, and cumulative ROC analysis was used to examine the combined contribution of clinical factors. CDR scale 0 included 15 patients (mean age, 59.1 years); CDR > 0.5 included 33 patients (mean age, 64.0 years). On cumulative ROC analysis, the major predictors of mild CI were hemoglobin, age, sex, homocysteine, neuron-specific enolase (NSE), and miR-486. The cumulative area under the curve (AUC) on combining hemoglobin, age, and miR-486 was the highest (0.897, 95% confidence interval 0.806–0.988). Two dichotomized variables reached 81.82% sensitivity and 86.67% specificity, with the likelihood ratio for positive and negative results being 6.14 and 0.21, respectively. In conclusion, hemoglobin, age, and miR-486 display high-degree combined effects on mild CI in patients receiving hemodialysis.

scholarly journals Mutual interaction of clinical factors and specific microRNAs to predict mild cognitive impairment in patients receiving dialysis

2020 ◽  
Author(s):  
Jin-Bor Chen ◽  
Chiung-Chih Chang ◽  
Lung-Chih Li ◽  
Wen-Chin Lee ◽  
Chia-Ni Lin ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Test Performance ◽  
Roc Analysis ◽  
Neuron Specific Enolase ◽  
Mutual Interaction ◽  
Uremic Toxin ◽  
Clinical Factors ◽  
Clinical Dementia Rating ◽  
Functional Scores

Abstract Background To examine mutual interaction of various clinical factors for cognitive impairment in patients receiving dialysis. Methods A total 48 dialysis patients with subjective memory complaints in outpatient clinic were recruited from 2015 to 2017. Demographics, circulating uremic toxin concentrations, miRNA concentrations and nerve injury protein concentrations were collected and measured. Clinical dementia rating (CDR) scores was used to stratify the functional scores of the patients. Receiver operating characteristic(ROC) analysis was used to evaluate diagnostic test performance for predicting dichotomous results, cumulative ROC analysis to examine the combined contribution of clinical factors. Results CDR scale 0 included 15 patients (mean age, 59.1 years; 5 men and 10 women); CDR > 0.5 included 33 patients (mean age, 64.0 years; 18 men and 15 women). On cumulative ROC analysis, the major predictors of mild cognitive impairment were hemoglobin, age, sex, homocysteine, neuron-specific enolase and miR-486. The cumulative AUC on combining hemoglobin, age, and miR-486 was the highest (0.897, 95% confidence interval 0.806–0.988). Two dichotomized variables reached 81.82% sensitivity and 86.67% specificity, with the likelihood ratio for positive and negative results being 6.14 and 0.21, respectively. Conclusion Hemoglobin, age, and miR-486 exerts combined effects on mild cognitive impairment in patients receiving dialysis.

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 Cognitive Status & Dementia Severity in CVLT-II-SF Forced Choice Recognition: Implications for Effort Assessment

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 656-657
Author(s):  
Karl Grewal ◽  
Michaella Trites ◽  
Megan O'Connell ◽  
Andrew Kirk ◽  
Stuart MacDonald ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Test Performance ◽  
Short Form ◽  
Verbal Learning ◽  
Cognitive Status ◽  
Forced Choice ◽  
Future Research ◽  
Clinical Dementia Rating ◽  
Significant Group ◽  
Impairment Severity

Abstract Effort testing is critical to neuropsychological practice, including dementia assessment. Questions exist around whether cognitive status or impairment severity impacts effort test performance in this population. Presently, we examined whether scores on an embedded effort test - the California Verbal Learning Test II Short Form (CVLT-II-SF) Forced Choice Recognition (FCR) - differed across diagnostic cognitive status groups and how severity of impairment modulated test performance. In a sample of memory clinic patients, three cognitive status groups were identified: subjective cognitive impairment (SCI; n = 92), amnestic mild cognitive impairment (a-MCI; n = 18), and dementia due to Alzheimer’s Disease (AD; n = 70). Significant group differences in FCR performance were observed using one-way ANOVA (p &lt; .001), with post-hoc analysis indicating the AD group performed significantly worse scores than the other groups. Using multiple regression, FCR performance was modelled as a function of cognitive status, impairment severity indexed MMSE, and their interaction, with a parallel analysis for the Clinical Dementia Rating Sum of Boxes (CDR-SOB) scores as an alternate severity measure. Results yielded significant main effects for MMSE (p = 0.019) and cognitive status (p = 0.026), as well as a significant interaction (p = 0.021). Thus, increases in impairment severity disproportionately impaired FCR performance for persons with AD, calling into question research-based cut scores for effort determination in dementia contexts. Corresponding CDR-SOB analyses were non-significant. Future research should examine whether CVLT-II-SF-FCR is an appropriately specific inclusion in a best-practice testing battery for evaluating effort in dementia populations.

scholarly journals Operational Determination of Subjective Cognitive Decline, Mild Cognitive Impairment, and Dementia Using Sum of Boxes of the Clinical Dementia Rating Scale

2021 ◽  
Vol 13 ◽  
Author(s):  
Yu-Wan Yang ◽  
Kai-Cheng Hsu ◽  
Cheng-Yu Wei ◽  
Ray-Chang Tzeng ◽  
Pai-Yi Chiu
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Abilities ◽  
Rating Scale ◽  
Area Under The Curve ◽  
Subjective Cognitive Decline ◽  
Clinical Dementia Rating ◽  
Two Phase

Objectives: The Clinical Dementia Rating (CDR) Scale is the gold standard for the staging of dementia due to Alzheimer's disease (AD). However, the application of CDR for the staging of subjective cognitive decline (SCD) and mild cognitive impairment (MCI) in AD remains controversial. This study aimed to use the sum of boxes of the CDR (CDR-SB) plus an SCD single questionnaire to operationally determine the different stages of cognitive impairment (CI) due to AD and non-AD.Methods: This was a two-phase study, and we retrospectively analyzed the Show Chwan Dementia registry database using the data selected from 2015 to 2020. Individuals with normal cognition (NC), SCD, MCI, and mild dementia (MD) due to AD or non-AD with a CDR &lt; 2 were included in the analysis.Results: A total of 6,946 individuals were studied, including 875, 1,009, 1,585, and 3,447 with NC, SCD, MCI, and MD, respectively. The cutoff scores of CDR-SB for NC/SCD, SCD/MCI, and MCI/dementia were 0/0.5, 0.5/1.0, and 2.5/3.0, respectively. The receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) values of the test groups were 0.85, 0.90, and 0.92 for discriminating NC from SCD, SCD from MCI, and MCI from dementia, respectively. Compared with the Cognitive Abilities Screening Instrument or the Montreal Cognitive Assessment, the use of CDR-SB is less influenced by age and education.Conclusion: Our study showed that the operational determination of SCD, MCI, and dementia using the CDR-SB is practical and can be applied in clinical settings and research on CI or dementia.

scholarly journals The Persian Version of the Quick Mild Cognitive Impairment Screen (Qmci-Pr): Psychometric Properties among Middle-Aged and Older Iranian Adults

2021 ◽  
Vol 18 (16) ◽  
pp. 8582
Author(s):  
Mohammad Rezaei ◽  
Behnam Shariati ◽  
David William Molloy ◽  
Rónán O’Caoimh ◽  
Vahid Rashedi
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Area Under The Curve ◽  
Reliability And Validity ◽  
Cognitive Screening ◽  
Middle Aged ◽  
Subjective Memory ◽  
Clinical Dementia Rating ◽  
Persian Version ◽  
Normal Controls

Brief cognitive screening instruments are used to identify patients presenting with cognitive symptoms that warrant further assessment. This study aimed to evaluate the reliability and validity of the Persian version of the Quick Mild Cognitive Impairment (Qmci-Pr) among middle-aged and older Iranian adults. Consecutive patients aged ≥55 years and caregivers attending with them as normal controls (NCs) were recruited from geriatric outpatient clinics and a hospital in Tehran, Iran. All patients completed the Qmci-Pr before completing an independent detailed neuropsychological assessment and staging using the Clinical Dementia Rating (CDR) Scale. NCs underwent the same assessment. In all, 92 participants with a median age of 70 years (±13) were available. Of these, 20 participants were NCs, 24 had subjective memory complaints (SMC), 24 had mild cognitive impairment (MCI), and 24 had Alzheimer’s disease (AD). The Qmci-Pr had good accuracy in differentiating SMC and NC from MCI (area under the curve (AUC): 0.80 (0.69–0.91)) and in identifying cognitive impairment (MCI and mild AD) (AUC: 0.87 (0.80–0.95)) with a sensitivity of 88% and specificity of 80%, at an optimal cut-off of <53/100. The Qmci-Pr is an accurate short cognitive screening impairment for separating NC and patients with SMC from MCI and identifying cognitive impairment. Further research with larger samples and comparison with other widely used instruments such as the Montreal Cognitive Assessment is needed. Given its established brevity, the Qmci-Pr is a useful screen for Iranian adults across the spectrum of cognitive decline.

scholarly journals Neuropsychiatric Symptoms Among Hispanics: Results of the Maracaibo Aging Study

2021 ◽  
pp. 1-11
Author(s):  
Mario Gil ◽  
Ney Alliey-Rodriguez ◽  
Juan Carlos Lopez-Alvarenga ◽  
Vincent Diego ◽  
Ciro A. Gaona ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Motor Behavior ◽  
Neuropsychiatric Symptoms ◽  
Area Under The Curve ◽  
Serum Glucose ◽  
Consensus Conference ◽  
Cognitive Status ◽  
Clinical Dementia Rating ◽  
Severe Cognitive Impairment ◽  
Aging Study

Background: Neuropsychiatric symptoms play an important role in diagnosing and clinical follow-up of cognitive impairment and dementia. Objective: We investigated the relationship between neuropsychiatric symptoms, cognitive impairment, and dementia in Hispanics. Methods: We included 529 participants (age ≥40 years) from the Maracaibo Aging Study with standardized neuropsychiatric assessments, including the Neuropsychiatric Inventory (NPI). Based on the Clinical Dementia Rating and the Mini-Mental State Examination scores, participants’ cognitive status was categorized into normal cognition, mild/moderate, and severe cognitive impairment. Diagnosis of dementia was established in a consensus conference. Statistical analyses included multivariable logistic regression models and area under the curve (AUC). Results: The mean age of participants was 59.3 years, and 71.8%were women. The proportion of dementia was 6.8%. Disturbed sleep, anxiety, and depression were the most common neuropsychiatric symptoms in the study sample. In crude analyses, the proportions of hallucinations, aberrant motor behavior, agitation/aggression, apathy, delusions, irritability, eating disturbance, depression, and euphoria were differently distributed among cognitive status groups (p <  0.05). After accounting for confounders, aberrant motor behavior and agitation/aggression remained significantly associated with cognitive impairment and dementia (p <  0.05). The inclusion of the NPI domains significantly improved the AUC to discriminate severe cognitive impairment and dementia above of a basic model that included sex, age, education, alcohol, obesity, serum glucose, total cholesterol, hypertension, and stroke. Conclusion: Neuropsychiatric symptoms are associated with severe cognitive impairment and dementia. The addition of NPI items to the global cognitive assessment might help early detection of dementia in primary care settings.

scholarly journals Saliva RNA biomarkers predict concussion duration and detect symptom recovery: a comparison with balance and cognitive testing

2021 ◽  
Author(s):  
Gregory Fedorchak ◽  
Aakanksha Rangnekar ◽  
Cayce Onks ◽  
Andrea C. Loeffert ◽  
Jayson Loeffert ◽  
...  
Keyword(s):  
Test Performance ◽  
Area Under The Curve ◽  
Prediction Rule ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Clinical Tool ◽  
Post Injury ◽  
Symptom Recovery ◽  
Cognitive Test Performance

Abstract Objective The goals of this study were to assess the ability of salivary non-coding RNA (ncRNA) levels to predict post-concussion symptoms lasting ≥ 21 days, and to examine the ability of ncRNAs to identify recovery compared to cognition and balance. Methods RNA sequencing was performed on 505 saliva samples obtained longitudinally from 112 individuals (8–24-years-old) with mild traumatic brain injury (mTBI). Initial samples were obtained ≤ 14 days post-injury, and follow-up samples were obtained ≥ 21 days post-injury. Computerized balance and cognitive test performance were assessed at initial and follow-up time-points. Machine learning was used to define: (1) a model employing initial ncRNA levels to predict persistent post-concussion symptoms (PPCS) ≥ 21 days post-injury; and (2) a model employing follow-up ncRNA levels to identify symptom recovery. Performance of the models was compared against a validated clinical prediction rule, and balance/cognitive test performance, respectively. Results An algorithm using age and 16 ncRNAs predicted PPCS with greater accuracy than the validated clinical tool and demonstrated additive combined utility (area under the curve (AUC) 0.86; 95% CI 0.84–0.88). Initial balance and cognitive test performance did not differ between PPCS and non-PPCS groups (p > 0.05). Follow-up balance and cognitive test performance identified symptom recovery with similar accuracy to a model using 11 ncRNAs and age. A combined model (ncRNAs, balance, cognition) most accurately identified recovery (AUC 0.86; 95% CI 0.83–0.89). Conclusions ncRNA biomarkers show promise for tracking recovery from mTBI, and for predicting who will have prolonged symptoms. They could provide accurate expectations for recovery, stratify need for intervention, and guide safe return-to-activities.

scholarly journals Serum Extracellular Vesicle-Derived circHIPK3 and circSMARCA5 Are Two Novel Diagnostic Biomarkers for Glioblastoma Multiforme

2021 ◽  
Vol 14 (7) ◽  
pp. 618
Author(s):  
Michele Stella ◽  
Luca Falzone ◽  
Angela Caponnetto ◽  
Giuseppe Gattuso ◽  
Cristina Barbagallo ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Roc Analysis ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Digital Pcr ◽  
Extracellular Vesicle ◽  
Size Exclusion ◽  
Circular Rnas ◽  
Diagnostic Biomarkers ◽  
Exclusion Chromatography

Glioblastoma multiforme (GBM) is the most frequent and deadly human brain cancer. Early diagnosis through non-invasive biomarkers may render GBM more easily treatable, improving the prognosis of this currently incurable disease. We suggest the use of serum extracellular vesicle (sEV)-derived circular RNAs (circRNAs) as highly stable minimally invasive diagnostic biomarkers for GBM diagnosis. EVs were isolated by size exclusion chromatography from sera of 23 GBM and 5 grade 3 glioma (GIII) patients, and 10 unaffected controls (UC). The expression of two candidate circRNAs (circSMARCA5 and circHIPK3) was assayed by droplet digital PCR. CircSMARCA5 and circHIPK3 were significantly less abundant in sEVs from GBM patients with respect to UC (fold-change (FC) of −2.15 and −1.92, respectively) and GIII (FC of −1.75 and −1.4, respectively). Receiver operating characteristic curve (ROC) analysis, based on the expression of sEV-derived circSMARCA5 and circHIPK3, allowed us to distinguish GBM from UC (area under the curve (AUC) 0.823 (0.667–0.979) and 0.855 (0.704 to 1.000), with a 95% confidence interval (CI), respectively). Multivariable ROC analysis, performed by combining the expression of sEV-derived circSMARCA5 and circHIPK3 with preoperative neutrophil to lymphocyte (NLR), platelet to lymphocyte (PLR) and lymphocyte to monocyte (LMR) ratios, three known diagnostic and prognostic GBM markers, allowed an improvement in the GBM diagnostic accuracy (AUC 0.901 (0.7912 to 1.000), 95% CI). Our data suggest sEV-derived circSMARCA5 and circHIPK3 as good diagnostic biomarkers for GBM, especially when associated with preoperative NLR, PLR and LMR.

scholarly journals “The Dichotic Digit Test” as an Index Indicator for Hearing Problem in Dementia: Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Nattawan Utoomprurkporn ◽  
Chris J.D. Hardy ◽  
Joshua Stott ◽  
Sergi G. Costafreda ◽  
Jason Warren ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Speech Processing ◽  
Test Performance ◽  
Meta Analysis ◽  
Control Group ◽  
People With Dementia ◽  
Ear Advantage ◽  
Right Ear Advantage ◽  
Dementia Onset

Abstract Background Patients with dementia commonly have problems processing speech in the presence of competing background speech or noise. This difficulty can be present from the very early stages of dementia, and may be a preclinical feature of Alzheimer's disease. Purpose This study investigates whether people with dementia perform worse on the dichotic digit test (DDT), an experimental probe of speech processing in the presence of competing speech, and whether test performance may predict dementia onset. Research Design Systematic review and meta-analysis. Data Collection and Analysis A literature search was conducted in Medline, Embase, Scopus, and Psycinfo. We included (1) studies that included people with a diagnosis of dementia and a healthy control group with no cognitive impairment; (2) studies that reported results from a DDT in a free-recall response task; and (3) studies that had the dichotic digit mean correct percentage score or right-ear advantage, as outcome measurements. Results People with dementia had a lower DDT total score, with a pooled mean difference of 18.6% (95% confidence interval [CI]: 21.2–15.9). Patients with dementia had an increased right-ear advantage relative to controls with a pooled difference of 24.4% (95% CI: 21.8–27.0). Conclusion The DDT total scores are lower and the right-ear advantage increased in cognitively impaired versus normal control participants. The findings also suggest that the reduction of dichotic digit total score and increase of right-ear advantage progress as cognitive impairment increases. Whether abnormalities in dichotic digit scores could predict subsequent dementia onset should be examined in further longitudinal studies.

scholarly journals Can sonographic features of microcalcification predict thyroid nodule malignancy? a prospective observational study

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Mehrdad Nabahati ◽  
Rahele Mehraeen ◽  
Zoleika Moazezi ◽  
Naser Ghaemian
Keyword(s):  
Thyroid Nodule ◽  
Roc Analysis ◽  
Thyroid Nodules ◽  
Area Under The Curve ◽  
Positive Association ◽  
Needle Aspiration ◽  
Northern Iran ◽  
Significant Positive Association ◽  
Irregular Margin ◽  
Benign Nodules

Abstract Background The aim of this study was to investigate the diagnostic accuracy of microcalcification, as well as its associated sonographic features, for prediction of thyroid nodule malignancy. We prospectively assessed the patients with thyroid nodule, who underwent ultrasound-guided fine-needle aspiration during 2017–2020 in Babol, northern Iran. The ultrasonographic characteristics of the nodules, as well as their cytological results, were recorded. We used regression analysis to evaluate the relation between sonographic findings and nodule malignancy. A receiver operator characteristics (ROC) analysis was also used to estimate the ability of ultrasound to predict the characteristic features of malignancy, as estimated by the area under the curve (AUC). Results Overall, 1129 thyroid nodules were finally included in the study, of which 452 (40%) had microcalcification. A significant positive association was found between nodule malignancy and microcalcification in both univariate (OR=3.626, 95% CI 2.258–5.822) and multivariable regression analyses (OR=1.878, 95% CI 1.095–3.219). In the nodules with microcalcification, significant positive relations were seen between malignancy and hypoechogenicity (OR=3.833, 95% CI 1.032–14.238), >5 microcalcification number (OR=3.045, 95% CI 1.328–6.982), irregular margin (OR=3.341, 95% CI 1.078–10.352), and lobulated margin (OR=5.727, 95% CI 1.934–16.959). The ROC analysis indicated that AUC for hypoechogenicity, >5 microcalcification number, irregular margin, and lobulated margin were 60%, 62%, 55%, and 60%, respectively, in predicting malignant thyroid nodules. Conclusion The findings indicated that microcalcification can be a potential predictor of thyroid nodule malignancy. Also, the presence of irregular or lobulated margins, multiple intranodular microcalcification (>5 microcalcifications), and/or hypoechogenicity can improve the ability of microcalcification in distinguishing malignant from benign nodules.

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