Computer-Based Assessment: Dual-Task Outperforms Large-Screen Cancellation Task in Detecting Contralesional Omissions

Objective: Traditionally, asymmetric spatial processing (i.e., hemispatial neglect) has been assessed with paper-and-pencil tasks, but growing evidence indicates that computer-based methods are a more sensitive assessment modality. It is not known, however, whether simply converting well-established paper-and-pencil methods into a digital format is the best option. The aim of the present study was to compare sensitivity in detecting contralesional omissions of two different computer-based methods: a “digitally converted” cancellation task was compared with a computer-based Visual and Auditory dual-tasking approach, which has already proved to be very sensitive.Methods: Participants included 40 patients with chronic unilateral stroke in either the right hemisphere (RH patients, N = 20) or the left hemisphere (LH patients, N = 20) and 20 age-matched healthy controls. The cancellation task was implemented on a very large format (173 cm × 277 cm) or in a smaller (A4) paper-and-pencil version. The computer-based dual-tasks were implemented on a 15′′ monitor and required the detection of unilateral and bilateral briefly presented lateralized targets.Results: Neither version of the cancellation task was able to show spatial bias in RH patients. In contrast, in the Visual dual-task RH patients missed significantly more left-sided targets than controls in both unilateral and bilateral trials. They also missed significantly more left-sided than right-sided targets only in the bilateral trials of the Auditory dual-task.Conclusion: The dual-task setting outperforms the cancellation task approach even when the latter is implemented on a (large) screen. Attentionally demanding methods are useful for revealing mild forms of contralesional visuospatial deficits.

Cardiovascular disease risk factors and cognitive functions in older Russian adults

Background The prevalence of cardiovascular diseases (CVD) is increasing due to the global trend towards an aging population. CVD and cerebrovascular disease have a negative impact on cognitive health, and CVD risk factors may also be associated with cognitive decline with aging. Purpose To investigate associations of modifiable risk factors for CVD with cognitive functions (CF) in older Russian adults. Methods A random population sample (3153 men and women, aged 55–84 years) was examined in our city in the 3rd wave of the Russian arm of the international project HAPIEE (Health, Alcohol, and Psychosocial Factors in Eastern Europe). We used standardized epidemiological and instrumental methods for assessment of risk factors, history and treatment of CVD. Cognitive tests included the assessment of memory indicators (immediate and delayed recall), semantic verbal fluency (animal naming), attention, concentration and processing speed (letter cancellation task). Associations between CVD risk factors and cognitive indices were analyzed cross-sectionally. Results Mean age in men was of 69.2±7.0 years (n=1198), in women - 69.7±6.9 (n=1955). In both sexes all cognitive domains were positively associated with education and negatively with age (p<0.001 for all cases). In men, after adjusting for health and lifestyle conditions, systolic blood pressure had inverse association with semantic verbal fluency (p=0.015); level of plasma glucose (p=0.003), waist-to-hip ratio (p=0.013) and smoking (p=0.028) were negative associated with letter cancellation task. In multivariate analyses in women, frequency of alcohol consumption (p<0.001 for all CF) and total cholesterol (p=0.042 for memory scores; p=0.001 for letter cancellation task) had positive relationship with CF indices, waist-to-hip ratio (p=0.002 for memory scores, p=0.038 for semantic fluency), level of plasma glucose (p=0.002 for memory scores, p<0.001 for letter cancellation task) and smoking (p<0.001 for letter cancellation task) had inverse relationships with cognition. Conclusion Our results show that metabolic risk factors (systolic blood pressure, plasma glucose, waist-to-hip ratio) and smoking had inverse relationship with CF indices in both sexes, and the level of blood lipids (total cholesterol and high-density lipoprotein cholesterol) and frequency of alcohol consumption (more pronounced in women) had positive associations with cognitive domains. These associations were independent from age. In multivariate analyses, some of these correlations were attenuated, and most associations were at least partly mediated by education. These findings highlight the importance of managing CVD risk factors to prevent cognitive decline. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Russian Foundation for Basic Research (20-313-90016),Russian Academy of Sciences (AAAA-A17-117112850280-2)

Unilateral Stroke: Computer-based Assessment Uncovers Non-Lateralized and Contralesional Visuoattentive Deficits

Objective: Patients with unilateral stroke commonly show hemispatial neglect or milder contralesional visuoattentive deficits, but spatially non-lateralized visuoattentive deficits have also been reported. The aim of the present study was to compare spatially lateralized (i.e., contralesional) and non-lateralized (i.e., general) visuoattentive deficits in left and right hemisphere stroke patients. Method: Participants included 40 patients with chronic unilateral stroke in either the left hemisphere (LH group, n = 20) or the right hemisphere (RH group, n = 20) and 20 healthy controls. To assess the contralesional deficits, we used a traditional paper-and-pencil cancellation task (the Bells Test) and a Lateralized Targets Computer Task. To assess the non-lateralized deficits, we developed a novel large-screen (173 × 277 cm) computer method, the Ball Rain task, with moving visual stimuli and fast-paced requirements for selective attention. Results: There were no contralesional visuoattentive deficits according to the cancellation task. However, in the Lateralized Targets Computer Task, RH patients missed significantly more left-sided than right-sided targets in bilateral trials. This omission distribution differed significantly from those of the controls and LH patients. In the assessment of non-lateralized attention, RH and LH patients missed significantly more Ball Rain targets than controls in both the left and right hemifields. Conclusions: Computer-based assessment sensitively reveals various aspects of visuoattentive deficits in unilateral stroke. Patients with either right or left hemisphere stroke demonstrate non-lateralized visual inattention. In right hemisphere stroke, these symptoms can be accompanied by subtle contralesional visuoattentive deficits that have remained unnoticed in cancellation task.

Is the Letter Cancellation Task a Suitable Index of Ego Depletion?

The aim was to quantify ego depletion and measure its effect on inhibitory control. Adults ( N = 523) received the letter “e” cancellation ego depletion task and were subsequently tested on Stroop task performance. Difficulty of the cancellation task was systematically manipulated by modifying the text from semantically meaningful to non-meaningful sentences and words (Experiment 1) and by increasing ego depletion rule complexity (Experiment 2). Participants’ performance was affected by both text and rule manipulations. There was no relation between ego depletion task performance and subsequent Stroop performance. Thus, irrespective of the difficulty of the ego depletion task, Stroop performance was unaffected. The widely used cancellation task may not be a suitable inducer of ego depletion if ego depletion is considered as a lack of inhibitory control.

Immediate Effect of a Yoga Breathing Practice on Attention and Anxiety in Pre-Teen Children

Pre-teen children face stressors related to their transition from childhood to adolescence, with a simultaneous increase in academic pressure. The present study compared the immediate effects of 18 min of (i) high frequency yoga breathing with (ii) yoga-based breath awareness and (iii) sitting quietly, on (a) attention and (b) anxiety, in 61 pre-teen children (aged between 11 and 12 years; 25 girls). Attention was assessed using a six letter cancellation task and Spielberger’s State Trait Anxiety Inventory STAI-S was used to measure anxiety before and after the three practices, practiced on separate days. Repeated measures ANOVA, followed by Bonferroni adjusted post-hoc analyses showed an increase in total attempts and net scores after high frequency yoga breathing (p < 0.05), while wrong attempts increased after yoga based breath awareness (p < 0.05). Anxiety decreased comparably after all three interventions. The 25 girls in the group had the same trend of results as the whole group with respect to the attention-based cancellation task, while boys showed no, how since change. For both girls and boys, anxiety decreased after all three 18min interventions. The results suggest that high frequency yoga breathing could be a short, useful school based practice to improve attention and reduce anxiety.

An Examination of Concentration and Mental Toughness in Professional Basketball Players

This study was carried out to investigate the concentration and mental toughness of professional basketball players. A total of 290 professional basketball players aged 16–26 years who played in the Turkish Basketball First and Second Leagues participated in the study. The “Sport Mental Toughness Questionnaire (SMTQ-14)” developed by Sheard et al. (2009) was used to determine mental toughness levels of the basketball players participating in the study, and the “Letter Cancellation Task” scale developed by Kumar and Telles (2009) was used to determine their concentration levels. Data were analyzed by using the Kolmogorov-Smirnov test, an independent samples t-test, and one-way analyses of variance (ANOVA).Results show that the concentration ability of the basketball players did not significantly differ in terms of gender, age and sports age. There were statistically significant differences in overall mental toughness, confidence and control. The players’ mental toughness and confidence scores differed significantly based on sports age. It is interesting to find that overall mental toughness was higher in the basketball players with a sports age of 1–5 years. According to their positions in the play, the players’ concentration ability was found to be significantly different between guards and pivots in favor of the guards. The concentration ability of the players playing at the guard position was higher than that of the players playing at other positions. Overall mental toughness and its sub-dimensions had no significant differences according to the positions. However, it is striking that overall mental toughness scores and its sub-dimension scores were high in guards and pivots.