A Flexible and Integrated System for the Remote Acquisition of Neuropsychological Data in Stroke Research

Abstract

Background: Neuropsychological testing is a central aspect of stroke research because it provides critical information about the cognitive-behavioral status of stroke survivors, as well as the diagnosis and treatment of stroke-related disorders. Standard neuropsychological methods rely upon face-to-face interactions between a patient and researcher, which creates geographic and logistical barriers that impede research progress and treatment advances. Introduction: To overcome these barriers, we created a flexible and integrated system for the remote acquisition of neuropsychological data (RAND). The system we developed has a secure architecture that permits collaborative videoconferencing. The system supports shared audiovisual feeds that can provide continuous virtual interaction between a participant and researcher throughout a testing session. Shared presentation and computing controls can be used to deliver auditory and visual test items adapted from standard face-to-face materials or execute computerbased assessments. Spoken and manual responses can be acquired, and the components of the session can be recorded for offline data analysis. Materials and Methods: To evaluate its feasibility, our RAND system was used to administer a speechlanguage test battery to 16 stroke survivors with a variety of communication, sensory, and motor impairments. The sessions were initiated virtually without prior face-to-face instruction in the RAND technology or test battery. Results: Neuropsychological data were successfully acquired from all participants, including those with limited technology experience,

Cognitive Assessment of Patients With Alzheimer's Disease by Telemedicine: Pilot Study

“…Videoconferencing has been shown to be reliable not only in AD, but to assess the cognitive functions in other pathologies. Interesting results were provided for psychiatric patients [ 32 - 33 ], patients with Parkinson disease [ 34 ], and stroke patients [ 35 ], as well as in older adults [ 36 ]. Furthermore, videoconferencing has been found useful to evaluate the clinical status [ 37 ] and rehabilitation [ 38 ] of patients affected by different neurological disorders.…”

Can we trust computers to assess the cognition of stroke patients? A systematic review

“…A total of 30 studies on the computer-based cognitive assessment of stroke patients were identified. Of these, 21 studies on cognitive assessment tools focusing on evaluating multi-domain or global cognition featured the following tools: Computerized Activity Measure for Post-Acute Care (AM-PAC) ( 24 , 25 ), NeuroTrax™ (also known as MindStreams ® ) ( 26 – 29 ), NIH Toolbox Cognition Battery (NIHTB-CB) ( 30 – 32 ), CogState Battery (CogState Ltd., Australia) ( 33 , 34 ), Seoul Computerized Neuropsychological Test (SCNT, Maxmedica Inc.) ( 35 – 37 ), computerized shape cancellation task ( 38 , 39 ), computerized touchscreen cancellation, sustained attention and spatial working memory ( 40 ), computerized test of Attention Performance, Delis-Kaplan Executive Function System and Tower of London ( 41 ), Ryokansan touch panel-type screening test ( 42 ), Intelligent Cognitive Assessment System (ICAS) ( 43 ), and remote acquisition of neuropsychological data (RAND) ( 44 ). Meanwhile, nine studies reported tools for the assessment of cognition for a single domain, including computerized visual search task ( 45 , 46 ), the PC test Amunet (NeuroScios GmbH, Austria) ( 47 ), computerized Wisconsin Card Sorting Test ( 48 ), computerized Iowa Gambling Task (IGT) ( 49 ), Tablet-based Symbol Digit Modalities Test (T-SDMT) ( 50 ), computer adaptive testing in Neuro-QOL ( 51 ), auditory test of variables of attention (TOVA) ( 52 ), and computer-based visuomotor task ( 53 ) ( Table 1 ).…”

“…Besides, robot-based CCA could provide support for patients' limbs to reduce fatigue ( 18 ). Meanwhile, Durisko et al ( 44 ) emphasized the feasibility of using RAND system for virtual home-based assessment without prior face-to-face contact between a participant and researcher. Wallmark et al ( 52 ) suggested that the auditory versions of such tools could avoid the possible risk of epileptic seizures in patients exposed to flashing screens.…”

“…Except for the benefits reported by Sternin et al ( 8 ), 22 out of 42 articles expounded on the advantages of CCA tools. First, remote assessment, rather than in-person assessment, was assessed in seven studies ( 19 – 23 , 25 , 44 ). Remote CCA makes it possible to communicate with patients at home ( 22 , 44 ) or elsewhere over the telephone or via an app on a smartphone, without physical contact.…”

Adaptive Framework for Long-term Sensory Home Training: a Proof of Principle Study

“…The proposed solution contributes to the growing need for person-centered home-care technologies [42], comparable to similar applications in other contexts [43]. To ascertain whether the generalization of perceptual learning might occur using an adaptive framework, a larger sample is necessary, together with the evaluation of independent functional measures pre-and post-training.…”