Objective
To evaluate home-based teleneuropsychology in a pediatric cohort to determine if assessment via in-person and home-based videoconference yield similar results. The second objective was to determine the level of satisfaction with videoconference-based assessment among participants and caregivers.
Method
Fifty-eight participants, aged 6–20 years, were recruited through specialty programs for pediatric demyelinating disorders. Each participant was administered the same brief neuropsychological battery of common measures twice, once during an in-person session and once during a remote home-based videoconference session. Order of sessions was counterbalanced and time between assessments ranged from 1 to 50 days. It was hypothesized that results obtained through in-person vs. remote videoconference sessions would not be significantly different and that most participants and caregivers would rate the experience with teleneuropsychology as satisfactory.
Results
Mann–Whitney U tests showed no significant differences in results obtained in the in-person first vs. remote videoconference first sessions or the change in performance across sessions. Satisfaction ratings by participants and caregivers were largely favorable for the use of the videoconference testing format.
Conclusions
The current study is the first to validate home-based teleneuropsychology and is the first to validate teleneuropsychological assessment in a pediatric sample. Future studies should replicate these findings as well as expand on sample size, diversity of populations evaluated, and the assessment tools administered. Careful consideration of ethical and practical factors should be given before providing pediatric teleneuropsychology services.
Background: Essential tremor (ET) is among the most prevalent movement disorders. Comprehensive reviews of disease prevalence were published in 1998 and 2010 but not since then. We reviewed the prevalence of ET in population-based epidemiological studies, derived a precise summary estimate of prevalence from these studies, and examined differences in prevalence across studies. We used two methods: a descriptive-analytical approach and a meta-analysis.Methods: A PUBMED search yielded 14 published papers since the 2010 review.Results: There were 42 population-based prevalence studies (23 countries and 6 continents). In a meta-analysis, pooled prevalence (all ages) = 1.33%, with statistically significant heterogeneity across studies (I 2 = 99.3%, p < 0.0001). In additional descriptive analyses, median crude prevalence (all ages) = 0.4% and mean = 0.67%. Prevalence increased markedly with age, and especially with advanced age. In the meta-analysis, prevalence (age ≥ 65 years) = 5.79%, and in descriptive analyses, median crude prevalence (age ≥ 60-65) = 5.9% and mean = 8.0%. In the oldest age groups, median prevalence = 9.3%, with several studies reporting values >20%. The prevalence increased by 74% for every decade increase in age (p < 0.0001). Gender did not impact the prevalence of ET (p = 0.90).Discussion: Precise prevalence estimates are important because they form the numerical basis for public health initiatives and offer clues about underlying biological factors of mechanistic importance. The prevalence of ET among those age ≥ 65 is similar to that reported for Alzheimer's disease in elders, suggesting that ET may be the most common neurodegenerative disease.
BackgroundThe specificity of the aquaporin-4 antibody to predict recurrent
inflammatory central nervous system disease has led to the
design of the 2015 neuromyelitis optica spectrum disorder
criteria which capture all aquaporin-4 antibody seropositive
patients.ObjectiveThe purpose of this study was to compare treatment outcomes in
aquaporin-4 antibody seropositive patients who met the previous
2006 clinical criteria for neuromyelitis optica with patients
who meet the 2015 neuromyelitis optica spectrum disorder
criteria.MethodsThe study involved a three-center retrospective chart review of
clinical outcomes among aquaporin-4 patients diagnosed with
neuromyelitis optica and neuromyelitis optica spectrum
disorder.ResultsHazard ratios of relapse during immunosuppressive therapy, relative
to pre-therapy, were not significantly different for patients
who met the 2006 criteria of neuromyelitis optica versus the
2015 neuromyelitis optica spectrum disorder criteria among those
treated with azathioprine ( p = 0.24),
mycophenolate mofetil ( p = 0.63), or rituximab
( p = 0.97).ConclusionReductions in the hazard of relapse during treatment with
immunosuppressive therapies, relative to average pre-treatment,
were not different for aquaporin-4 antibody seropositive
patients categorized using the 2006 criteria of neuromyelitis
optica and the 2015 neuromyelitis optica spectrum disorder
criteria. These therapeutic findings support the design of the
2015 neuromyelitis optica spectrum disorder criteria which
capture all aquaporin-4 antibody seropositive patients.
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