The Quality Assurance and Quality Control Protocol for Neuropsychological Data Collection and Curation in the Ontario Neurodegenerative Disease Research Initiative (ONDRI) Study

McLaughlin, Paula; Sunderland, Kelly M; Beaton, Derek; Binns, Malcolm A.; Kwan, Donna; Levine, Brian; Orange, J. B.; Peltsch, Alicia; Roberts, Angela; Strother, Stephen C.; Troyer, Angela K.

doi:10.1177/1073191120913933

Cited by 23 publications

(28 citation statements)

References 29 publications

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“…As demonstrated, only corrected cortical estimations correlated with a measure of global cognitive status. Future work will examine cross-sectional and longitudinal relationships between cortical thickness, vascular risk factors, neurodegeneration, and associations with comprehensive neuropsychological testing (80).…”

Section: Discussionmentioning

confidence: 99%

Cortical thickness estimation in individuals with cerebral small vessel disease, focal atrophy, and chronic stroke lesions

Ozzoude

Ramirez

Raamana³

et al. 2020

Preprint

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BackgroundRegional changes to cortical thickness in individuals with neurodegenerative and cerebrovascular diseases can be estimated using specialised neuroimaging software. However, the presence of cerebral small vessel disease, focal atrophy, and cortico-subcortical stroke lesions, pose significant challenges that increase the likelihood of misclassification errors and segmentation failures.PurposeThe main goal of this study was to examine a correction procedure developed for enhancing FreeSurfer’s cortical thickness estimation tool, particularly when applied to the most challenging MRI obtained from participants with chronic stroke and cerebrovascular disease, with varying degrees of neuro-vascular lesions and brain atrophy.MethodsIn 155 cerebrovascular disease patients enrolled in the Ontario Neurodegenerative Disease Research Initiative (ONDRI), FreeSurfer outputs were compared between a fully automated, unmodified procedure and a corrected procedure that accounted for potential sources of error due to atrophy and neurovascular lesions. Quality control (QC) measures were obtained from both procedures. Association between cortical thickness and global cognitive status as assessed by the Montreal Cognitive Assessment (MoCA) score was also investigated from both procedures.ResultsCorrected procedures increased ‘Acceptable’ QC ratings from 18% to 76% for the cortical ribbon and from 38% to 92% for tissue segmentation. Corrected procedures reduced ‘Fail’ ratings from 11% to 0% for the cortical ribbon and 62% to 8% for tissue segmentation. FreeSurfer-based segmentation of T1-weighted white matter hypointensities were significantly greater in the corrected procedure (5.8mL vs. 15.9mL, p<0.001). The unmodified procedure yielded no significant associations with global cognitive status, whereas the corrected procedure yielded positive associations between MoCA total score and clusters of cortical thickness in the left superior parietal (p=0.018) and left insula (p=0.04) regions. Further analyses with the corrected cortical thickness results and MoCA subscores showed a positive association between left superior parietal cortical thickness and Attention (p<0.001).ConclusionsThese findings suggest that correction procedures that account for brain atrophy and neurovascular lesions can significantly improve FreeSurfer’s segmentation results, reduce failure rates, and potentially increase sensitivity to examine brain-behaviour relationships. Future work will examine relationships between cortical thickness, cerebral small vessel disease, and neurodegenerative disease in the ONDRI study.

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Section: Discussionmentioning

confidence: 99%

Cortical thickness estimation in individuals with cerebral small vessel disease, focal atrophy, and chronic stroke lesions

Ozzoude

Ramirez

Raamana³

et al. 2020

Preprint

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“…Neuropsychology data underwent rigorous monitoring and preprocessing. 17 All ONDRI data underwent a data evaluation procedure using multivariate outlier detection to identify anomalous observations, providing guidance on additional areas of possible error. 18 All participants provided informed consent and met extensive eligibility criteria for the larger ONDRI study.…”

Section: Methods Participantsmentioning

confidence: 99%

“…A detailed comprehensive neuropsychological battery with standardized tests was used to assess and characterize cognitive impairment. 3,4,17 Second, to improve diagnostic classification and reduce the number of people in the indeterminate category, we conducted two additional analyses. First, based on the literature showing specific deficits in executive function and processing speed in vascular pathology, [5][6][7] we examined whether subdomain scores on the MoCA would provide additional predictive utility over and above the total score.…”

Section: The Present Studymentioning

confidence: 99%

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Methods for Improving Screening for Vascular Cognitive Impairment Using the Montreal Cognitive Assessment

Zaidi

Rich

Sunderland

et al. 2020

Can. J. Neurol. Sci.

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Background: Vascular cognitive impairment (VCI) post-stroke is frequent but may go undetected, which highlights the need to better screen cognitive functioning following a stroke. Aim: We examined the clinical utility of the Montreal Cognitive Assessment (MoCA) in detecting cognitive impairment against a gold standard neuropsychological battery. Methods: We assessed cognitive status with a comprehensive battery of neuropsychological tests in 161 individuals who were at least 3-months post-stroke. We used ROC curves to identify two cut points for the MoCA to maximize sensitivity and specificity at a minimum 90% threshold. We examined the utility of the Symbol Digit Modalities Test, a processing speed measure, to determine whether this additional metric would improve classification relative to the MoCA total score alone. Results: Using two cut points, 27% of participants scored ≤ 23 and were classified as high probability of cognitive impairment (sensitivity 92%), and 24% of participants scored ≥ 28 and were classified as low probability of cognitive impairment (specificity 91%). The remaining 48% of participants scored from 24 to 27 and were classified as indeterminate probability of cognitive impairment. The addition of a processing speed measure improved classification for the indeterminate group by correctly identifying 65% of these individuals, for an overall classification accuracy of 79%. Conclusions: The utility of the MoCA in detecting cognitive impairment post-stroke is improved when using a three-category approach. The addition of a processing speed measure provides a practical and efficient method to increase confidence in the determined outcome while minimally extending the screening routine for VCI.

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“…To account for the more rapid motoric and respiratory decline of individuals with ALS, participants in that cohort completed clinical, neuropsychology, and eye tracking assessments at 6-month intervals. Additional information pertaining to the assessment platforms is provided elsewhere 11,[24][25][26][27][28][29][30][31] .…”

Section: Assessment Platformsmentioning

confidence: 99%

The Ontario Neurodegenerative Disease Research Initiative

Sunderland¹,

Beaton²,

Arnott³

et al. 2020

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Objective: In individuals over the age of 65, concomitant neurodegenerative pathologies contribute to cognitive and/or motor decline and can be aggravated by cerebrovascular disease, but our understanding of how these pathologies synergize to produce the decline represents an important knowledge gap. The Ontario Neurodegenerative Disease Research Initiative (ONDRI), a multi-site, longitudinal, observational cohort study, recruited participants across multiple prevalent neurodegenerative diseases and cerebrovascular disease, collecting a wide array of data and thus allowing for deep investigation into common and unique phenotypes. This paper describes baseline features of the ONDRI cohort, understanding of which is essential when conducting analyses or interpreting results. Methods: Five disease cohorts were recruited: Alzheimer's disease/amnestic mild cognitive impairment (AD/MCI), amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), Parkinson's disease (PD), and cerebrovascular disease (CVD). Assessment platforms included clinical, neuropsychology, eye tracking, gait and balance, neuroimaging, retinal imaging, genomics, and pathology. We describe recruitment, data collection, and data curation protocols, and provide a summary of ONDRI baseline characteristics. Results: 520 participants were enrolled. Most participants were in the early stages of disease progression. Participants had a median age of 69 years, a median Montreal Cognitive Assessment score of 25, a median percent of independence of 100 for basic activities of daily living, and a median of 93 for instrumental activities. Variation between disease cohorts existed for age, level of cognition, and geographic location. Conclusion: ONDRI data will enable exploration into unique and shared pathological mechanisms contributing to cognitive and motor decline across the spectrum of neurodegenerative diseases.

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The Quality Assurance and Quality Control Protocol for Neuropsychological Data Collection and Curation in the Ontario Neurodegenerative Disease Research Initiative (ONDRI) Study

Cited by 23 publications

References 29 publications

Cortical thickness estimation in individuals with cerebral small vessel disease, focal atrophy, and chronic stroke lesions

Cortical thickness estimation in individuals with cerebral small vessel disease, focal atrophy, and chronic stroke lesions

Methods for Improving Screening for Vascular Cognitive Impairment Using the Montreal Cognitive Assessment

The Ontario Neurodegenerative Disease Research Initiative

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