Reliability and Validity of Smartphone Cognitive Testing for Frontotemporal Lobar Degeneration

Importance

Frontotemporal lobar degeneration (FTLD) is relatively rare, behavioral and motor symptoms increase travel burden, and standard neuropsychological tests are not sensitive to early-stage disease. Remote smartphone-based cognitive assessments could mitigate these barriers to trial recruitment and success, but no such tools are validated for FTLD.

Objective

To evaluate the reliability and validity of smartphone-based cognitive measures for remote FTLD evaluations.

Design, Setting, and Participants

In this cohort study conducted from January 10, 2019, to July 31, 2023, controls and participants with FTLD performed smartphone application (app)-based executive functioning tasks and an associative memory task 3 times over 2 weeks. Observational research participants were enrolled through 18 centers of a North American FTLD research consortium (ALLFTD) and were asked to complete the tests remotely using their own smartphones. Of 1163 eligible individuals (enrolled in parent studies), 360 were enrolled in the present study; 364 refused and 439 were excluded. Participants were divided into discovery (n = 258) and validation (n = 102) cohorts. Among 329 participants with data available on disease stage, 195 were asymptomatic or had preclinical FTLD (59.3%), 66 had prodromal FTLD (20.1%), and 68 had symptomatic FTLD (20.7%) with a range of clinical syndromes.

Exposure

Participants completed standard in-clinic measures and remotely administered ALLFTD mobile app (app) smartphone tests.

Main Outcomes and Measures

Internal consistency, test-retest reliability, association of smartphone tests with criterion standard clinical measures, and diagnostic accuracy.

Results

In the 360 participants (mean [SD] age, 54.0 [15.4] years; 209 [58.1%] women), smartphone tests showed moderate-to-excellent reliability (intraclass correlation coefficients, 0.77-0.95). Validity was supported by association of smartphones tests with disease severity (r range, 0.38-0.59), criterion-standard neuropsychological tests (r range, 0.40-0.66), and brain volume (standardized β range, 0.34-0.50). Smartphone tests accurately differentiated individuals with dementia from controls (area under the curve [AUC], 0.93 [95% CI, 0.90-0.96]) and were more sensitive to early symptoms (AUC, 0.82 [95% CI, 0.76-0.88]) than the Montreal Cognitive Assessment (AUC, 0.68 [95% CI, 0.59-0.78]) (z of comparison, -2.49 [95% CI, -0.19 to -0.02]; P = .01). Reliability and validity findings were highly similar in the discovery and validation cohorts. Preclinical participants who carried pathogenic variants performed significantly worse than noncarrier family controls on 3 app tasks (eg, 2-back β = -0.49 [95% CI, -0.72 to -0.25]; P < .001) but not a composite of traditional neuropsychological measures (β = -0.14 [95% CI, -0.42 to 0.14]; P = .32).

Conclusions and Relevance

The findings of this cohort study suggest that smartphones could offer a feasible, reliable, valid, and scalable solution for remote evaluations of FTLD and may improve early detection. Smartphone assessments should be considered as a complementary approach to traditional in-person trial designs. Future research should validate these results in diverse populations and evaluate the utility of these tests for longitudinal monitoring.

Distribution and Composition of Aquatic Macrophytes in Santhapettai Lake of Villupuram District in Tamil Nadu

Macrophytes are important component of the aquatic ecosystem and broad changes in the abundance of individual species and community composition provide valuable information on how and why an ecosystem might be changing. Santhapettai lake is one of the biggest fresh water lake in Villupuram district, Tamil Nadu. The physico-chemical parameters were analysed for one year (October 2012-September 2013). Quadrates were laid randomly and extending from shoreline towards the lake center. The macrophytes falling in each quadrate were sorted species wise, identified and data were recorded. The plants have been identified from fresh materials with the help of different floras. In this present investigation, a total of 33 species belonging to 23 families and 28 genera were identified under algae, pteridophytes, dicotyledons and monocotyledons. Further, the plants were classified in morphological group as floating (7), submerged (1), submerged anchored (13), floating leaved (1) and emergent anchored (11). The coverage/spread of macrophytes along the shorelines was higher compared to the centre of the lakes where the species composition was found reduced. Assessment of biota, continuous monitoring and conservation lake are the important components to safeguard the biological wealth of lentic and lotic freshwater ecosystem.

Ethnoveterinary Practices in Villupuram District, Tamil Nadu, India

Ayurvedic medicines are considered to be the best systems of treatment in India and this system is spreading now globally. Natural products are also a part of our everyday life. Ethno veterinary medicine is developed by farmers in field and barns rather than and in scientific laboratories. It is less systematic, less formalized and usually transferred by word of mouth rather than writing. An ethnobotanical survey was conducted in 10 selected sites of Villupuram district. Twenty six plant species belonging to fourteen families were documented in the present study, to cure different diseases in animals. Interviews and detailed personal discussions were conducted with the traditional healers and local people to identify the plants and their medicinal information for six months. The study revealed that the different parts of these plants were used for treatment of different diseases. Leaves are the mostly used part to prepare medicine

Ethnoveterinary Practices in Villupuram District, Tamil Nadu, India

Ayurvedic medicines are considered to be the best systems of treatment in India and this system is spreading now globally. Natural products are also a part of our everyday life. Ethno veterinary medicine is developed by farmers in field and barns rather than and in scientific laboratories. It is less systematic, less formalized and usually transferred by word of mouth rather than writing. An ethnobotanical survey was conducted in 10 selected sites of Villupuram district. Twenty six plant species belonging to fourteen families were documented in the present study, to cure different diseases in animals. Interviews and detailed personal discussions were conducted with the traditional healers and local people to identify the plants and their medicinal information for six months. The study revealed that the different parts of these plants were used for treatment of different diseases. Leaves are the mostly used part to prepare medicine

Ethnomedicinal Aspects of some Weeds from Paddy Fields of Villupuram District in Tamil Nadu, India

The present investigation has been carried out to enumerate the ethnomedicinal plant growing in the paddy field of Villupuram district, Tamil Nadu. Ten selected sites in the Villupuram district was taken for investigation. Random quadrate method was adapted for studying the phytosociological attributes of the weeds. A total of 145 plant species belonging to 22 families were identified, out of which 39 plant species are medicinally important to cure different diseases in human beings directly. Amaranthaceae and Euphorbiaceae was the dominant family seen during observation. Frequency, Relative frequency, Density, Relative density, Abundance, Relative abundance and Important Value Index (IVI) of the species were calculated.

Ethnomedicinal Aspects of some Weeds from Paddy Fields of Villupuram District in Tamil Nadu, India

The present investigation has been carried out to enumerate the ethnomedicinal plant growing in the paddy field of Villupuram district, Tamil Nadu. Ten selected sites in the Villupuram district was taken for investigation. Random quadrate method was adapted for studying the phytosociological attributes of the weeds. A total of 145 plant species belonging to 22 families were identified, out of which 39 plant species are medicinally important to cure different diseases in human beings directly. Amaranthaceae and Euphorbiaceae was the dominant family seen during observation. Frequency, Relative frequency, Density, Relative density, Abundance, Relative abundance and Important Value Index (IVI) of the species were calculated.

Ethnomedicinal and Ecological Studies of some Weeds in Sugarcane Fields of Villupuram District

The present communication pertains to ethnobotany of major weeds of sugarcane fields in Villupuram district, Tamil Nadu. Present study was conducted in ten selected sites of Villupuram district in the sugarcane crop fields. Random quadrate method was adopted for studying phytosociological attributes of weeds. A total of 80 plant species belonging to 25 families were identified, out of which 46 plant species are medicinally important to cure different diseases in human beings directly. Amaranthaceae and Euphorbiaceae was the dominant family seen during observation. Frequency, Relative frequency, Density and Relative density of the species were calculated.

Ethnomedicinal and Ecological Studies of some Weeds in Sugarcane Fields of Villupuram District

The present communication pertains to ethnobotany of major weeds of sugarcane fields in Villupuram district, Tamil Nadu. Present study was conducted in ten selected sites of Villupuram district in the sugarcane crop fields. Random quadrate method was adopted for studying phytosociological attributes of weeds. A total of 80 plant species belonging to 25 families were identified, out of which 46 plant species are medicinally important to cure different diseases in human beings directly. Amaranthaceae and Euphorbiaceae was the dominant family seen during observation. Frequency, Relative frequency, Density and Relative density of the species were calculated.