Validity of a novel computerized cognitive battery for mild cognitive impairment.

Tzvi Dwolatzky,Howard Chertkow,Ely S Simon,Avraham Schweiger,Victor Whitehead,Glen M Doniger,Dena Jaffe

doi:10.1186/1471-2318-3-4

Abstract

BackgroundThe NeuroTrax Mindstreams computerized cognitive assessment system was designed for widespread clinical and research use in detecting mild cognitive impairment (MCI). However, the capability of Mindstreams tests to discriminate elderly with MCI from those who are cognitively healthy has yet to be evaluated. Moreover, the comparability between these tests and traditional neuropsychological tests in detecting MCI has not been examined.MethodsA 2-center study was designed to assess discriminant validity of tests in the Mindstreams Mild Impairment Battery. Participants were 30 individuals diagnosed with MCI, 29 with mild Alzheimer's disease (AD), and 39 healthy elderly. Testing was with the Mindstreams battery and traditional neuropsychological tests. Receiver operating characteristic (ROC) analysis was used to examine the ability of Mindstreams and traditional measures to discriminate those with MCI from cognitively healthy elderly. Between-group comparisons were made (Mann-Whitney U test) between MCI and healthy elderly and between MCI and mild AD groups.ResultsMindstreams outcome parameters across multiple cognitive domains significantly discriminated among MCI and healthy elderly with considerable effect sizes (p < 0.05). Measures of memory, executive function, visual spatial skills, and verbal fluency discriminated best, and discriminability was at least comparable to that of traditional neuropsychological tests in these domains.ConclusionsMindstreams tests are effective in detecting MCI, providing a comprehensive profile of cognitive function. Further, the enhanced precision and ease of use of these computerized tests make the NeuroTrax system a valuable clinical tool in the identification of elderly at high risk for dementia.

Highlights

The NeuroTrax Mindstreams computerized cognitive assessment system was designed for widespread clinical and research use in detecting mild cognitive impairment (MCI)
Discriminant Validity of Mindstreams Outcome Parameters: Effect Sizes Results of an Receiver operating characteristic (ROC) analysis measuring the ability of Mindstreams outcome parameters to discriminate MCI from cognitively healthy elderly are presented in Table 2, subdivided by cognitive domain
Significant discriminability was found for attention outcome parameters from the Go-NoGo test, with an Area under the curve (AUC) of 0.771 for GoNoGo reaction time (RT) and 0.706 for Go-NoGo standard deviation of RT

Summary

Introduction

The NeuroTrax Mindstreams computerized cognitive assessment system was designed for widespread clinical and research use in detecting mild cognitive impairment (MCI). 12–15% of MCI subjects per year convert to clinical dementia with functional disability [4,5]. For this reason, much interest has centered on the development of standardized techniques for quantification of cognitive deficits in MCI and potential therapeutic interventions for treatment of these high-risk individuals [6]. We chose to evaluate MindstreamsTM (NeuroTrax Corp, NY), a new commercially available computerized testing system for comprehensive clinical assessment of cognitive impairment, designed primarily for use in the elderly. The present study is the first to assess discriminant validity of the computerized tests as compared with that of traditional neuropsychological tests

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Discussion

Conclusion