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Fei B, Cheng Y, Liu Y, Zhang G, Ge A, Luo J, Wu S, Wang H, Ding J, Wang X. Intelligent cholinergic white matter pathways algorithm based on U-net reflects cognitive impairment in patients with silent cerebrovascular disease. Stroke Vasc Neurol 2024:svn-2023-002976. [PMID: 38569895 DOI: 10.1136/svn-2023-002976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/06/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVE The injury of the cholinergic white matter pathway underlies cognition decline in patients with silent cerebrovascular disease (SCD) with white matter hyperintensities (WMH) of vascular origin. However, the evaluation of the cholinergic white matter pathway is complex with poor consistency. We established an intelligent algorithm to evaluate WMH in the cholinergic pathway. METHODS Patients with SCD with WMH of vascular origin were enrolled. The Cholinergic Pathways Hyperintensities Scale (CHIPS) was used to measure cholinergic white matter pathway impairment. The intelligent algorithm used a deep learning model based on convolutional neural networks to achieve WMH segmentation and CHIPS scoring. The diagnostic value of the intelligent algorithm for moderate-to-severe cholinergic pathway injury was calculated. The correlation between the WMH in the cholinergic pathway and cognitive function was analysed. RESULTS A number of 464 patients with SCD were enrolled in internal training and test set. The algorithm was validated using data from an external cohort comprising 100 patients with SCD. The sensitivity, specificity and area under the curve of the intelligent algorithm to assess moderate and severe cholinergic white matter pathway injury were 91.7%, 87.3%, 0.903 (95% CI 0.861 to 0.952) and 86.5%, 81.3%, 0.868 (95% CI 0.819 to 0.921) for the internal test set and external validation set. for the. The general cognitive function, execution function and attention showed significant differences among the three groups of different CHIPS score (all p<0.05). DISCUSSION We have established the first intelligent algorithm to evaluate the cholinergic white matter pathway with good accuracy compared with the gold standard. It helps more easily assess the cognitive function in patients with SCD.
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Affiliation(s)
- Beini Fei
- Department of Neurology, Zhongshan Hospital Fudan University, Shanghai, China
| | - Yu Cheng
- Fudan University Institute of Science and Technology for Brain-inspired Intelligence, Shanghai, China
| | - Ying Liu
- Department of Neurology, Zhongshan Hospital Fudan University, Shanghai, China
| | - Guangzheng Zhang
- Department of Neurology, Zhongshan Hospital Fudan University, Shanghai, China
| | - Anyan Ge
- Department of Neurology, Zhongshan Hospital Fudan University, Shanghai, China
| | - Junyi Luo
- Fudan University Institute of Science and Technology for Brain-inspired Intelligence, Shanghai, China
| | - Shan Wu
- The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - He Wang
- Department of Neurology, Zhongshan Hospital Fudan University, Shanghai, China
- Fudan University Institute of Science and Technology for Brain-inspired Intelligence, Shanghai, China
| | - Jing Ding
- Department of Neurology, Zhongshan Hospital Fudan University, Shanghai, China
| | - Xin Wang
- Department of Neurology, Zhongshan Hospital Fudan University, Shanghai, China
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Villalobos D, Torres-Simón L, Pacios J, Paúl N, Del Río D. A Systematic Review of Normative Data for Verbal Fluency Test in Different Languages. Neuropsychol Rev 2023; 33:733-764. [PMID: 36098929 DOI: 10.1007/s11065-022-09549-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 07/04/2022] [Indexed: 01/04/2023]
Abstract
Verbal fluency tests are easy and quick to use in neuropsychological assessments, so they have been counted among the most classical tools in this context. To date, several normative data for verbal fluency tests have been provided in different languages and countries. A systematic review was carried out with studies that provide normative data for verbal fluency tests. Studies were collected from Scopus, PubMed and Web of Science. 183 studies were retrieved from the database search, of which 73 finally met the inclusion criteria. An analysis of the risk of bias regarding samples selection/characterization and procedure/results reports is conducted for each article. Finally, a full description of the normative data characteristics, considering country and language, verbal fluency task characteristics (type of task) and sample characteristics (number of subjects, gender, age, education) is included. The current systematic review provides an overview and analysis of internationally published normative data that might help clinicians in their search for valid and useful norms on verbal fluency tasks, as well as updated information about qualitative aspects of the different options currently available.
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Affiliation(s)
- Dolores Villalobos
- Department of Experimental Psychology, School of Psychology, Complutense University of Madrid, Madrid, Spain
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain
- Department of Psychology, Cardenal Cisneros University Center, Alcalá de Henares University. Madrid, Madrid, Spain
- European Neuroscience Center, Madrid, Spain
| | - Lucia Torres-Simón
- Department of Experimental Psychology, School of Psychology, Complutense University of Madrid, Madrid, Spain
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain
| | - Javier Pacios
- Department of Experimental Psychology, School of Psychology, Complutense University of Madrid, Madrid, Spain
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain
| | - Nuria Paúl
- Department of Experimental Psychology, School of Psychology, Complutense University of Madrid, Madrid, Spain
| | - David Del Río
- Department of Experimental Psychology, School of Psychology, Complutense University of Madrid, Madrid, Spain.
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain.
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Iñesta C, Oltra-Cucarella J, Sitges-Maciá E. Regression-Based Normative Data for Independent and Cognitively Active Spanish Older Adults: Verbal Fluency Tests and Boston Naming Test. Int J Environ Res Public Health 2022; 19:11445. [PMID: 36141718 PMCID: PMC9517509 DOI: 10.3390/ijerph191811445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 06/02/2023]
Abstract
An increased cognitive reserve is associated with changes in the pattern of cognitive decline during aging. Thus, normative data adapted to the characteristics of the target population are needed to reduce the possibility of false diagnoses. The aim of this work was to develop normative data for the Phonemic Verbal Fluency test, the Semantic Verbal Fluency test and the Boston Naming Test (BNT). METHOD Regression-based normative data were calculated from a sample of 118 non-depressed, cognitively active, independent community-dwelling adults aged 55 or older (64.4% women) from SABIEX (University for Seniors at the Universidad Miguel Hernández de Elche). Raw scores were regressed on age, sex, and education. RESULTS The effects of age and education varied across neuropsychological measures. No effect of sex was found in any of the tests assessed. Statistically significant differences were found in the proportion of low scores using SABIEX or population-based normative datasets. The level of agreement identifying individuals labeled as showing one or more low scores was only fair-to-good. CONCLUSIONS Normative data obtained from the general population might not be sensitive to identify low scores in cognitively active older adults, increasing the risk of misdiagnoses. A friendly calculator is available for neuropsychological assessment.
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Affiliation(s)
- Clara Iñesta
- SABIEX, Universidad Miguel Hernández de Elche, Av. de la Universidad, 03207 Elche, Spain
| | - Javier Oltra-Cucarella
- SABIEX, Universidad Miguel Hernández de Elche, Av. de la Universidad, 03207 Elche, Spain
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Elche, Spain
| | - Esther Sitges-Maciá
- SABIEX, Universidad Miguel Hernández de Elche, Av. de la Universidad, 03207 Elche, Spain
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Elche, Spain
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Núñez-Fernández S, Rivera D, Arroyo-Anlló EM, Ortiz Jiménez XA, Camino-Pontes B, Salinas Martínez R, Arango-Lasprilla JC. Validation of the Norma Latina Neuropsychological Assessment Battery in Patients with Alzheimer's Disease in Mexico. Int J Environ Res Public Health 2022; 19:11322. [PMID: 36141594 PMCID: PMC9517570 DOI: 10.3390/ijerph191811322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
To our knowledge, this is the first study reported in the literature that has validated the Norma Latina Battery in a population of people with Alzheimer's disease (AD) in Mexico. The objective of the study was to determine the discriminant validity of the Norma Latina Battery in a group of Mexican individuals with AD and a group of heathy controls (HC). The Norma Latina Battery was administered to 234 Mexican participants (117 HC and 117 individuals with AD). Results show that: (1) the Norma Latina Battery has high discriminative capacity between groups in all domains; (2) participants with AD presented worse scores in each of the cognitive domains compared to the HC and a greater number of low scores in each of the established thresholds or cut-off points; and finally, (3) the Norma Latina Battery had optimal sensitivity and specificity, especially when a set was observed ≥5 scores below the 10th percentile or ≥4 scores below the 5th percentile. In conclusion, it is recommended that both clinicians and researchers use this battery in the evaluation of Mexican people with AD to better understand the prognosis of the disease and its subsequent treatment.
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Affiliation(s)
- Silvia Núñez-Fernández
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Neuroscience Institute of Castilla-León, University of Salamanca, 37007 Salamanca, Spain
| | - Diego Rivera
- Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Eva María Arroyo-Anlló
- Department of Psychobiology, Neuroscience Institute of Castilla-León, University of Salamanca, 37007 Salamanca, Spain
| | | | - Borja Camino-Pontes
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Biomedical Research Doctorate Program, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Ricardo Salinas Martínez
- Department of Geriatrics, “José Eleuterio González” University Hospital, Autonomous University of Nuevo León, Monterrey 64460, Mexico
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Henríquez F, Cabello V, Baez S, de Souza LC, Lillo P, Martínez-Pernía D, Olavarría L, Torralva T, Slachevsky A. Multidimensional Clinical Assessment in Frontotemporal Dementia and Its Spectrum in Latin America and the Caribbean: A Narrative Review and a Glance at Future Challenges. Front Neurol 2022; 12:768591. [PMID: 35250791 PMCID: PMC8890568 DOI: 10.3389/fneur.2021.768591] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/13/2021] [Indexed: 12/14/2022] Open
Abstract
Frontotemporal dementia (FTD) is the third most common form of dementia across all age groups and is a leading cause of early-onset dementia. The Frontotemporal dementia (FTD) includes a spectrum of diseases that are classified according to their clinical presentation and patterns of neurodegeneration. There are two main types of FTD: behavioral FTD variant (bvFTD), characterized by a deterioration in social function, behavior, and personality; and primary progressive aphasias (PPA), characterized by a deficit in language skills. There are other types of FTD-related disorders that present motor impairment and/or parkinsonism, including FTD with motor neuron disease (FTD-MND), progressive supranuclear palsy (PSP), and corticobasal syndrome (CBS). The FTD and its associated disorders present great clinical heterogeneity. The diagnosis of FTD is based on the identification through clinical assessments of a specific clinical phenotype of impairments in different domains, complemented by an evaluation through instruments, i.e., tests and questionnaires, validated for the population under study, thus, achieving timely detection and treatment. While the prevalence of dementia in Latin America and the Caribbean (LAC) is increasing rapidly, there is still a lack of standardized instruments and consensus for FTD diagnosis. In this context, it is important to review the published tests and questionnaires adapted and/or validated in LAC for the assessment of cognition, behavior, functionality, and gait in FTD and its spectrum. Therefore, our paper has three main goals. First, to present a narrative review of the main tests and questionnaires published in LAC for the assessment of FTD and its spectrum in six dimensions: (i) Cognitive screening; (ii) Neuropsychological assessment divided by cognitive domain; (iii) Gait assessment; (iv) Behavioral and neuropsychiatric symptoms; (v) Functional assessment; and (vi) Global Rating Scale. Second, to propose a multidimensional clinical assessment of FTD in LAC identifying the main gaps. Lastly, it is proposed to create a LAC consortium that will discuss strategies to address the current challenges in the field.
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Affiliation(s)
- Fernando Henríquez
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department – Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Laboratory for Cognitive and Evolutionary Neuroscience (LaNCE), Department of Psychiatry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Victoria Cabello
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department – Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Sandra Baez
- Universidad de los Andes, Departamento de Psicología, Bogotá, Colombia
| | - Leonardo Cruz de Souza
- Programa de Pós-Graduação em Neurociências da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Patricia Lillo
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Departamento de Neurología Sur, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Unidad de Neurología, Hospital San José, Santiago, Chile
| | - David Martínez-Pernía
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Loreto Olavarría
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department – Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Teresa Torralva
- Institute of Cognitive and Translational Neuroscience (INCYT), Instituto de Neurología Cognitiva Foundation, Favaloro University, Buenos Aires, Argentina
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department – Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Department of Neurology and Psychiatry, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
- *Correspondence: Andrea Slachevsky
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Rivera D, Usuga DR, Mendoza EMF, Arelis AA, Barajas BVR, Islas MÁM, Krch D, Lequerica AH, Arango-Lasprilla JC. Validation of the Norma Latina neuropsychological assessment battery in individuals with multiple sclerosis in Mexico. Mult Scler Relat Disord 2022; 59:103685. [DOI: 10.1016/j.msard.2022.103685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/23/2022] [Accepted: 02/11/2022] [Indexed: 10/19/2022]
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Dassanayake TL, Hewawasam C, Baminiwatta A, Ariyasinghe DI. Regression-based, demographically adjusted norms for Victoria Stroop Test, Digit Span, and Verbal Fluency for Sri Lankan adults. Clin Neuropsychol 2021; 35:S32-S49. [PMID: 34499569 DOI: 10.1080/13854046.2021.1973109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Lack of test norms is a major limitation in neuropsychological assessment in many non-English-speaking countries. Our objective was to generate sex-, age-, and education-adjusted, regression-based norms for three pen-and-paper-based executive function/working memory tests, viz. Victoria Stroop Test (VST), Digit Span, and Verbal Fluency, for Sinhala-Speaking Sri Lankan adults. METHOD Six-hundred and six healthy, community-living, Sinhala-speaking adults (273 men) aged 19-83 years completed VST, Digit Span (forward and backward), and Phonemic (Sinhala phonemes "N," "P," and "S") and Category (animals and vegetables) Fluency tests. We conducted multiple linear regression analyses with sex, age, and years of education fitted as predictors to model the test outcome variables. RESULTS Younger age was associated with better performance in all tests except in Phonemic Fluency. Longer education was associated with better performance in all outcomes except VST errors and interference. Women had a significant but small advantage over men in VST Neutral and Color Word tests, and Phonemic Fluency. We report regression equations to predict norms for the test performance measures based on sex, age, and years of education; and the test variances accounted by these factors. CONCLUSIONS We propose demographically adjusted norms for VST, Digit Span, and Verbal Fluency for Sinhala-speaking Sri Lankans aged 19-83 years, and supplement the regression formulae with a calculator that produces predicted and standard scores. These norms would help in interpreting the results of clinical samples in the future, taking into account the variability introduced by sex, age, and education.
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Affiliation(s)
| | - Chandana Hewawasam
- Department of Physiology, Faculty of Medicine and Allied Health Sciences, Rajarata University of Sri Lanka, Saliyapura 50008, Sri Lanka
| | - Anuradha Baminiwatta
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya 20400, Sri Lanka
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