Effect of cognitive fluctuation on neuropsychological performance in aging and dementia

Escandon, Adriana; Al-Hammadi, Noor; Galvin, James E.

doi:10.1212/wnl.0b013e3181ca017d

Cited by 55 publications

(96 citation statements)

References 35 publications

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“…Validation of our mobile application in patients who cannot visit research facilities, for example, hospitalized patients undergoing neuropsychological assessment, is a logical next step. Also, studies designed to investigate longitudinal changes, such as infradian effects of sex hormones like estradiol (e.g., Cowell et al, 2011; Hjelmervik et al, 2012) on laterality, or symptoms-related cognitive fluctuations (e.g., Green et al, 1994; Escandon et al, 2010), as well as molecular genetic studies with the need to recruit large cohorts (e.g., Ocklenburg et al, 2011) could benefit from data collection using MDs.…”

Section: Resultsmentioning

confidence: 99%

“Right on all Occasions?” – On the Feasibility of Laterality Research Using a Smartphone Dichotic Listening Application

Bless¹,

Westerhausen²,

Arciuli³

et al. 2013

Front. Psychology

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Most psychological experimentation takes place in laboratories aiming to maximize experimental control; however, this creates artificial environments that are not representative of real-life situations. Since cognitive processes usually take place in noisy environments, they should also be tested in these contexts. The recent advent of smartphone technology provides an ideal medium for such testing. In order to examine the feasibility of mobile devices (MD) in psychological research in general, and laterality research in particular, we developed a MD version of the widely used speech laterality test, the consonant-vowel dichotic listening (DL) paradigm, for use with iPhones/iPods. First, we evaluated the retest reliability and concurrent validity of the DL paradigm in its MD version in two samples tested in controlled, laboratory settings (Experiment 1). Second, we explored its ecological validity by collecting data from the general population by means of a free release of the MD version (iDichotic) to the iTunes App Store (Experiment 2). The results of Experiment 1 indicated high reliability (rICC = 0.78) and validity (rICC = 0.76–0.82) of the MD version, which consistently showed the expected right ear advantage (REA). When tested in real-life settings (Experiment 2), participants (N = 167) also showed a significant REA. Importantly, the size of the REA was not dependent on whether the participants chose to listen to the syllables in their native language or not. Together, these results establish the current MD version as a valid and reliable method for administering the DL paradigm both in experimentally controlled as well as uncontrolled settings. Furthermore, the present findings support the feasibility of using smartphones in conducting large-scale field experiments.

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Section: Resultsmentioning

confidence: 99%

“Right on all Occasions?” – On the Feasibility of Laterality Research Using a Smartphone Dichotic Listening Application

Bless¹,

Westerhausen²,

Arciuli³

et al. 2013

Front. Psychology

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“…Yet it is in this initial period that the brain progressively disengages from the external world. Investigation of the neural network correlates of this state, in which the individual may either transition to stable sleep or return to wakefulness, may provide insights into pathological conditions characterized by instability in external versus internal awareness (cognitive fluctuations, Escandon et al, 2010; narcolepsy, Zorick et al, 1986; sundowning, Bachman and Rabins, 2006; sleep attacks in Parkinson's disease, Moller et al, 2009). …”

Section: Introductionmentioning

confidence: 99%

Modulation of the brain’s functional network architecture in the transition from wake to sleep

Larson‐Prior

Power

Vincent

et al. 2011

Slow Brain Oscillations of Sleep, Resting State and Vigilance

124

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The transition from quiet wakeful rest to sleep represents a period over which attention to the external environment fades. Neuroimaging methodologies have provided much information on the shift in neural activity patterns in sleep, but the dynamic restructuring of human brain networks in the transitional period from wake to sleep remains poorly understood. Analysis of electrophysiological measures and functional network connectivity of these early transitional states shows subtle shifts in network architecture that are consistent with reduced external attentiveness and increased internal and self-referential processing. Further, descent to sleep is accompanied by the loss of connectivity in anterior and posterior portions of the default-mode network and more locally organized global network architecture. These data clarify the complex and dynamic nature of the transitional period between wake and sleep and suggest the need for more studies investigating the dynamics of these processes.

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“…Fluctuations, as measured by the Mayo Fluctuations Scale, 26 occurred in 80% of the autopsy DLB group, but also occurred in 40% of our non-DLB cohort with advanced disease and has been shown by others to be fairly common in advanced AD. 35 When fluctuations were excluded from the analysis, specificity improved to 85% (along with a concurrent improvement in positive predictive value), with a mild drop in sensitivity to 83%.…”

mentioning

confidence: 98%

Inclusion of RBD improves the diagnostic classification of dementia with Lewy bodies

Ferman¹,

Boeve²,

Smith³

et al. 2011

Neurology

240

168

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Objective: To determine whether adding REM sleep behavior disorder (RBD) to the dementia with Lewy bodies (DLB) diagnostic criteria improves classification accuracy of autopsy-confirmed DLB. Methods:We followed 234 consecutive patients with dementia until autopsy with a mean of 4 annual visits. Clinical diagnoses included DLB, Alzheimer disease (AD), corticobasal syndrome, and frontotemporal dementia. Pathologic diagnoses used the 2005 DLB consensus criteria and included no/low likelihood DLB (non-DLB; n ϭ 136) and intermediate/high likelihood DLB (DLB; n ϭ 98). Regression modeling and sensitivity/specificity analyses were used to evaluate the diagnostic role of RBD.Results: Each of the 3 core features increased the odds of autopsy-confirmed DLB up to 2-fold, and RBD increased the odds by 6-fold. When clinically probable DLB reflected dementia and 2 or more of the 3 core features, sensitivity was 85%, and specificity was 73%. When RBD was added and clinically probable DLB reflected 2 or more of 4 features, sensitivity improved to 88%. When dementia and RBD were also designated as probable DLB, sensitivity increased to 90% while specificity remained at 73%. The VH, parkinsonism, RBD model lowered sensitivity to 83%, but improved specificity to 85%. Dementia with Lewy bodies (DLB) is considered the second most common cause of neurodegenerative disease after Alzheimer disease (AD), with an estimated prevalence of up to 30%. Conclusions: 1-3Validation of older versions of the DLB criteria tend to show high specificity at the expense of poor sensitivity, 4 -8 though more acceptable ranges are found with the use of standardized measures.9 It is critical to properly diagnose DLB during life in order to optimize symptom management, reduce iatrogenic treatment complications, and develop new therapies designed to prevent or interfere with disease progression.In 2005, the DLB diagnostic criteria were modified to include 3 new features in a category termed "suggestive features." With this revision, clinically probable DLB is represented by 2 or more core features (fluctuations, parkinsonism, or visual hallucinations), or by one core feature plus one suggestive feature. 10 The suggestive features include severe neuroleptic sensitivity, reducedFrom the Department of Psychiatry and Psychology (T

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Effect of cognitive fluctuation on neuropsychological performance in aging and dementia

Abstract: Background:Cognitive fluctuations are spontaneous alterations in cognition, attention, and

Cited by 55 publications

References 35 publications

“Right on all Occasions?” – On the Feasibility of Laterality Research Using a Smartphone Dichotic Listening Application

“Right on all Occasions?” – On the Feasibility of Laterality Research Using a Smartphone Dichotic Listening Application

Modulation of the brain’s functional network architecture in the transition from wake to sleep

Inclusion of RBD improves the diagnostic classification of dementia with Lewy bodies

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