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Kolberg ER, Morales EEG, Thallmayer TW, Arnold ML, Burgard S, Chisolm TH, Coresh J, Couper D, Hayden KM, Huang AR, Lin FR, Mitchell CM, Mosley TH, Gravens‐Mueller L, Owens TA, Pankow JS, Pike JR, Reed NS, Sanchez V, Schrack JA, Deal JA, Goman AM. Hearing loss and cognition: A protocol for ensuring speech understanding before neurocognitive assessment. Alzheimers Dement 2024; 20:1671-1681. [PMID: 38081140 PMCID: PMC10947954 DOI: 10.1002/alz.13552] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/06/2023] [Accepted: 10/22/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION Many neurocognitive evaluations involve auditory stimuli, yet there are no standard testing guidelines for individuals with hearing loss. The ensuring speech understanding (ESU) test was developed to confirm speech understanding and determine whether hearing accommodations are necessary for neurocognitive testing. METHODS Hearing was assessed using audiometry. The probability of ESU test failure by hearing status was estimated in 2679 participants (mean age: 81.4 ± 4.6 years) using multivariate logistic regression. RESULTS Only 2.2% (N = 58) of participants failed the ESU test. The probability of failure increased with hearing loss severity; similar results were observed for those with and without mild cognitive impairment or dementia. DISCUSSION The ESU test is appropriate for individuals who have variable degrees of hearing loss and cognitive function. This test can be used prior to neurocognitive testing to help reduce the risk of hearing loss and compromised auditory access to speech stimuli causing poorer performance on neurocognitive evaluation.
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Affiliation(s)
- Elizabeth R. Kolberg
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Department of Otolaryngology‐Head and Neck SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Emmanuel E. Garcia Morales
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Tara W. Thallmayer
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Michelle L. Arnold
- Department of Communication Sciences and DisordersUniversity of South FloridaTampaFloridaUSA
| | - Sheila Burgard
- Collaborative Studies Coordinating CenterUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Theresa H. Chisolm
- Department of Communication Sciences and DisordersUniversity of South FloridaTampaFloridaUSA
| | - Josef Coresh
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- George W. Comstock Center for Public Health Research and PreventionJohns Hopkins Bloomberg School of Public HealthHagerstownMarylandUSA
- Department of General Internal MedicineJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - David Couper
- Collaborative Studies Coordinating CenterUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Kathleen M. Hayden
- Department of Social Sciences and Health PolicyWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Alison R. Huang
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Frank R. Lin
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Department of Otolaryngology‐Head and Neck SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Christine M. Mitchell
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Thomas H. Mosley
- Memory Impairment and Neurodegenerative Dementia CenterUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | - Lisa Gravens‐Mueller
- Collaborative Studies Coordinating CenterUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Tiffany A. Owens
- Memory Impairment and Neurodegenerative Dementia CenterUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | - James S. Pankow
- Division of EpidemiologyUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
| | - James Russell Pike
- Collaborative Studies Coordinating CenterUniversity of North CarolinaChapel HillNorth CarolinaUSA
- Department of BiostatisticsGillings School of Global Public HealthChapel HillNorth CarolinaUSA
| | - Nicholas S. Reed
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Victoria Sanchez
- Department of Communication Sciences and DisordersUniversity of South FloridaTampaFloridaUSA
| | - Jennifer A. Schrack
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Jennifer A. Deal
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Department of Otolaryngology‐Head and Neck SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Adele M. Goman
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- School of Health and Social CareEdinburgh Napier UniversityEdinburghUK
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Batistuzzo MC, Sheshachala K, Alschuler DM, Hezel DM, Lewis-Fernándes R, de Joode NT, Vriend C, Lempert KM, Narayan M, Marincowitz C, Lochner C, Stein DJ, Narayanaswamy JC, van den Heuvel OA, Simpson HB, Wall M. Cross-national harmonization of neurocognitive assessment across five sites in a global study. Neuropsychology 2023; 37:284-300. [PMID: 35786960 PMCID: PMC10164281 DOI: 10.1037/neu0000838] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Cross-national work on neurocognitive testing has been characterized by inconsistent findings, suggesting the need for improved harmonization. Here, we describe a prospective harmonization approach in an ongoing global collaborative study. METHOD Visuospatial N-Back, Tower of London (ToL), Stop Signal task (SST), Risk Aversion (RA), and Intertemporal Choice (ITC) tasks were administered to 221 individuals from Brazil, India, the Netherlands, South Africa, and the USA. Prospective harmonization methods were employed to ensure procedural similarity of task implementation and processing of derived task measures across sites. Generalized linear models tested for between-site differences controlling for sex, age, education, and socioeconomic status (SES). Associations with these covariates were also examined and tested for differences by site with site-by-covariate interactions. RESULTS The Netherlands site performed more accurately on N-Back and ToL than the other sites, except for the USA site on the N-Back. The Netherlands and the USA sites performed faster than the other three sites during the go events in the SST. Finally, the Netherlands site also exhibited a higher tolerance for delay discounting than other sites on the ITC, and the India site showed more risk aversion than other sites on the RA task. However, effect size differences across sites on the five tasks were generally small (i.e., partial eta-squared < 0.05) after dropping the Netherlands (on ToL, N-Back, ITC, and SST tasks) and India (on the RA task). Across tasks, regardless of site, the N-Back (sex, age, education, and SES), ToL (sex, age, and SES), SST (age), and ITC (SES) showed associations with covariates. CONCLUSIONS Four out of the five sites showed only small between-site differences for each task. Nevertheless, despite our extensive prospective harmonization steps, task score performance deviated from the other sites in the Netherlands site (on four tasks) and the India site (on one task). Because the procedural methods were standardized across sites, and our analyses were adjusted for covariates, the differences found in cognitive performance may indicate selection sampling bias due to unmeasured confounders. Future studies should follow similar cross-site prospective harmonization procedures when assessing neurocognition and consider measuring other possible confounding variables for additional statistical control. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Marcelo C. Batistuzzo
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, SP, Brazil
| | - Karthik Sheshachala
- OCD clinic, Department of Psychiatry, National Institute of Mental health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Dianne M. Hezel
- The New York State Psychiatric Institute, New York, NY, 10032, USA
- Columbia University Irving Medical Center, Columbia University, New York, NY, 10032, USA
| | | | - Niels T. de Joode
- Depaartment of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, de Boelelaan 1117, Amsterdam, Netherlands
- Department of Anatomy and Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, de Boelelaan 1117, Amsterdam, Netherlands
| | - Chris Vriend
- Depaartment of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, de Boelelaan 1117, Amsterdam, Netherlands
- Department of Anatomy and Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, de Boelelaan 1117, Amsterdam, Netherlands
| | - Karolina M. Lempert
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104
| | - Madhuri Narayan
- OCD clinic, Department of Psychiatry, National Institute of Mental health and Neurosciences, Bengaluru, Karnataka, India
| | - Clara Marincowitz
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Christine Lochner
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Dan J. Stein
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Janardhanan C. Narayanaswamy
- OCD clinic, Department of Psychiatry, National Institute of Mental health and Neurosciences, Bengaluru, Karnataka, India
| | - Odile A. van den Heuvel
- Depaartment of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, de Boelelaan 1117, Amsterdam, Netherlands
- Department of Anatomy and Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, de Boelelaan 1117, Amsterdam, Netherlands
| | - Helen Blair Simpson
- The New York State Psychiatric Institute, New York, NY, 10032, USA
- Columbia University Irving Medical Center, Columbia University, New York, NY, 10032, USA
| | - Melanie Wall
- The New York State Psychiatric Institute, New York, NY, 10032, USA
- Columbia University Irving Medical Center, Columbia University, New York, NY, 10032, USA
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Tantik Pak A, Otcu H, Sengul HS, Corakci Z, Sengul Y, Alkan A. Cognitive and brain micro-structural correlates of alexithymia in essential tremor patients. Appl Neuropsychol Adult 2020; 29:536-545. [PMID: 32657147 DOI: 10.1080/23279095.2020.1786693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Essential tremor (ET) is the most common movement disorder which has both motor and non-motor findings such as neuropsychiatic symptoms. Alexithymia is defined as inability to identify and describe emotions experienced by one's self or others. In our study, we aimed to evaluate the neurocognitive and brain micro-structural correlates of alexithymia in ET. 40 ET patients (mean age = 53.05 ± 19.74 years), were included. Fahn-Tolosa-Marin Tremor Rating Scale, Toronto Alexithymia Scale (TAS), Beck Depression Inventory, Beck Anxiety Inventory and detailed neurocognitive evaluation were applied to all patients. The patients were divided into three groups based on their TAS scores: no alexithymia, probable alexithymia, definite alexithymia. Diffusion Tensor Imaging (DTI) was performed in all patients. The mean TAS score was 50.05 ± 10.06. Depressive symptoms and anxiety levels were higher in definite alexithymia (p < 0.001, p < 0.01). Partial correlation controlling for age, gender and educational level between alexithymia scores and each cognitive test showed significant association between similarities (p < 0.001) and phonemic verbal fluency (p = 0.04). Left orbitofrontal cortex average diffusion coefficient (ADC) value (p = 0.05), left anterior cingulate cortex fractional anisotropy (FA) value (p = 0.04), right cuneus FA value (p = 0.04), left amygdala ADC value (p = 0.01) and left insula ADC value (p = 0.02) were differed between groups. TAS and DTImetrics were not found to be independently associated with the level of anxiety (p < 0.001) and depressive symptoms (p < 0.01). As a conclusion, impairments in executive function and complex attention were correlated with higher levels of alexithymia in ET. Many micro-structural alterations were determined to be correlated with alexithymia levels.
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Affiliation(s)
- Aygul Tantik Pak
- Department of Neurology, Ministry of Health University, Gaziosmanpasa Research and Training Hospital, Istanbul, Turkey
| | - Hafize Otcu
- Department of Radiology, Bezmialem Foundation University Hospital, Istanbul, Turkey
| | - Hakan Serdar Sengul
- Department of Psychiatry, Ministry of Health University, Gaziosmanpasa Research and Training Hospital, Istanbul, Turkey
| | - Zeynep Corakci
- Department of Occupational Therapy, Bezmialem Foundation University Hospital, Istanbul, Turkey
| | - Yildizhan Sengul
- Department of Neurology, Bezmialem Foundation University Hospital, Istanbul, Turkey
| | - Alpay Alkan
- Department of Radiology, Bezmialem Foundation University Hospital, Istanbul, Turkey
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Guvakov D, Bezinover D, Lomivorotov VV, Postnov VG, Weiss SJ, Cheung AT, Swain J, Lomivorotov VN. The "Ice Age" in Cardiac Surgery: Evolution of the "Siberian" Method of Brain Protection During Deep Hypothermic Perfusionless Circulatory Arrest. J Cardiothorac Vasc Anesth 2019; 33:3366-3374. [PMID: 31129071 DOI: 10.1053/j.jvca.2019.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 03/06/2019] [Accepted: 04/02/2019] [Indexed: 11/11/2022]
Abstract
Deep hypothermic perfusionless circulatory arrest was the first practical neuroprotective technique used for open-heart surgery. It was refined at the Novosibirsk Medical Research Center in Siberia and was actively used from the mid-1950s until 2001.This review describes the development of this technique and its contribution to our understanding of the dynamic changes in human physiology during induced hypothermia for circulatory arrest without extracorporeal perfusion. Deep hypothermic perfusionless circulatory arrest was an important stepping stone in the development of modern approaches in neuroprotection and monitoring during cardiac surgery.
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Affiliation(s)
- Dmitri Guvakov
- Department of Anesthesiology and Perioperative Medicine, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA.
| | - Dmitri Bezinover
- Department of Anesthesiology and Perioperative Medicine, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA
| | - Vladimir V Lomivorotov
- Department of Anesthesiology, E. Meshalkin National Medical Research Center (MNMRC), Novosibirsk, Russia
| | - Vadim G Postnov
- Department of Anesthesiology, E. Meshalkin National Medical Research Center (MNMRC), Novosibirsk, Russia
| | - Stuart J Weiss
- Department of Anesthesia and Critical Care, University of Pennsylvania Health System, Philadelphia, PA
| | - Albert T Cheung
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA
| | - Julie Swain
- Department of Clinical Performance, Mount Sinai Health System, New York, NY
| | - Vladimir N Lomivorotov
- Department of Anesthesiology, E. Meshalkin National Medical Research Center (MNMRC), Novosibirsk, Russia
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Lafay-Cousin L, Fay-McClymont T, Johnston D, Fryer C, Scheinemann K, Fleming A, Hukin J, Janzen L, Guger S, Strother D, Mabbott D, Huang A, Bouffet E. Neurocognitive evaluation of long term survivors of atypical teratoid rhabdoid tumors (ATRT): The Canadian registry experience. Pediatr Blood Cancer 2015; 62:1265-9. [PMID: 25787232 DOI: 10.1002/pbc.25441] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/02/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Because atypical teratoid rhabdoid tumor(ATRT) is a rare disease of infancy carrying a grim prognosis, focus on long-term outcome, especially neurocognitive remained very limited. With new era of multimodality therapy, an increasing proportion of patients are now long-term survivors. PROCEDURE Retrospective review of neuropsychological (NP) status of survivors from the Canadian ATRT registry. RESULTS Among 77 patients diagnosed between 1995-2012, 16(22%) were survivors. Formal NP assessments were available in eight patients. Partial information on academic achievement was available on three additional patients. There were four girls and seven boys diagnosed at a median age of 27.5 months. Seven patients underwent complete resection and three had metastatic disease. All but one received sequential high dose chemotherapy. Five patients received intrathecal chemotherapy. Three patients underwent radiation. Median age at time of formal NP assessment was 7.6 years (3.9-9.8). Full Scale Intellectual Quotient (FSIQ) ranged from less than 50-119 (mean 78). Simple expressive and receptive language appeared relatively preserved. Three recently diagnosed patients (median time assessment from diagnosis 2.6 years (1.6-4.7)) had average to high average FSIQ, academic and visual spatial skills, visual, and verbal memory. Five other patients diagnosed earlier and tested at a median time of 4.9 years (3.3-8.3) post-diagnosis had a FSIQ ranging from <50 to 71. Approximately 50% of their scores were in the impaired range. CONCLUSION Overall this cohort appears significantly impaired at school age despite the absence of systematic radiotherapy. Larger series focusing on neurocognitive outcome are needed in the current context where treatment strategies include adjuvant radiation.
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Affiliation(s)
- Lucie Lafay-Cousin
- Division of Hematology Oncology Bone Marrow Transplantation, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Taryn Fay-McClymont
- Division of Hematology Oncology Bone Marrow Transplantation, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Donna Johnston
- Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Chris Fryer
- Children and Women Hospital of British Columbia, Vancouver, British Columbia, Canada
| | | | - Adam Fleming
- Children's Hospital of Montreal, Montreal, Quebec, Canada
| | - Juliette Hukin
- Children and Women Hospital of British Columbia, Vancouver, British Columbia, Canada
| | - Laura Janzen
- Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sharon Guger
- Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Douglas Strother
- Division of Hematology Oncology Bone Marrow Transplantation, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Donald Mabbott
- Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Annie Huang
- Pediatric Brain Tumor Program, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Eric Bouffet
- Pediatric Brain Tumor Program, Hospital for Sick Children, Toronto, Ontario, Canada
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