Neuropsychological Screening Test Research Articles

Discriminant Power of Smartphone-Derived Keystroke Dynamics for Mild Cognitive Impairment Compared to a Neuropsychological Screening Test: Cross-Sectional Study.

Conventional neuropsychological screening tools for mild cognitive impairment (MCI) face challenges in terms of accuracy and practicality. Digital health solutions, such as unobtrusively capturing smartphone interaction data, offer a promising alternative. However, the potential of digital biomarkers as a surrogate for MCI screening remains unclear, with few comparisons between smartphone interactions and existing screening tools. This study aimed to investigate the effectiveness of smartphone-derived keystroke dynamics, captured via the Neurokeys keyboard app, in distinguishing patients with MCI from healthy controls (HCs). This study also compared the discriminant performance of these digital biomarkers against the Korean version of the Montreal Cognitive Assessment (MoCA-K), which is widely used for MCI detection in clinical settings. A total of 64 HCs and 47 patients with MCI were recruited. Over a 1-month period, participants generated 3530 typing sessions, with 2740 (77.6%) analyzed for this study. Keystroke metrics, including hold time and flight time, were extracted. Receiver operating characteristics analysis was used to assess the sensitivity and specificity of keystroke dynamics in discriminating between HCs and patients with MCI. This study also explored the correlation between keystroke dynamics and MoCA-K scores. Patients with MCI had significantly higher keystroke latency than HCs (P<.001). In particular, latency between key presses resulted in the highest sensitivity (97.9%) and specificity (96.9%). In addition, keystroke dynamics were significantly correlated with the MoCA-K (hold time: r=-.468; P<.001; flight time: r=-.497; P<.001), further supporting the validity of these digital biomarkers. These findings highlight the potential of smartphone-derived keystroke dynamics as an effective and ecologically valid tool for screening MCI. With higher sensitivity and specificity than the MoCA-K, particularly in measuring flight time, keystroke dynamics can serve as a noninvasive, scalable, and continuous method for early cognitive impairment detection. This novel approach could revolutionize MCI screening, offering a practical alternative to traditional tools in everyday settings. Thai Clinical Trials Registry TCTR20220415002; https://www.thaiclinicaltrials.org/show/TCTR20220415002.

Evaluation of the results of magnetic resonance imaging of the brain for cognitive impairment in patients with heart failure: A review

Cognitive impairment is a very common comorbidity in patients with heart failure (HF). Patients with HF show signs of memory decline, difficulty concentrating, and attention deficits. Cognitive dysfunction in HF is associated with a poor prognosis. However, the diagnosis of cognitive impairment in heart failure has received insufficient attention in routine clinical practice. Neuropsychological screening tests are available to screen for cognitive impairment, but they are used infrequently. Therefore, it is of practical interest to search for magnetic resonance equivalents of cognitive disorders. The use of magnetic resonance imaging as a tool for identifying and quantifying neural correlates of cognitive functions is discussed.

Extended High-Frequency Thresholds: Associations With Demographic and Risk Factors, Cognitive Ability, and Hearing Outcomes in Middle-Aged and Older Adults.

This study had two objectives: to examine associations between extended high-frequency (EHF) thresholds, demographic factors (age, sex, race/ethnicity), risk factors (cardiovascular, smoking, noise exposure, occupation), and cognitive abilities; and to determine variance explained by EHF thresholds for speech perception in noise, self-rated workload/effort, and self-reported hearing difficulties. This study was a retrospective analysis of a data set from the MUSC Longitudinal Cohort Study of Age-related Hearing Loss. Data from 347 middle-aged adults (45 to 64 years) and 694 older adults (≥ 65 years) were analyzed for this study. Speech perception was quantified using low-context Speech Perception In Noise (SPIN) sentences. Self-rated workload/effort was measured using the effort prompt from the National Aeronautics and Space Administration-Task Load Index. Self-reported hearing difficulty was assessed using the Hearing Handicap Inventory for the Elderly/Adults. The Wisconsin Card Sorting Task and the Stroop Neuropsychological Screening Test were used to assess selected cognitive abilities. Pure-tone averages representing conventional and EHF thresholds between 9 and 12 kHz (PTA (9 - 12 kHz) ) were utilized in simple linear regression analyses to examine relationships between thresholds and demographic and risk factors or in linear regression models to assess the contributions of PTA (9 - 12 kHz) to the variance among the three outcomes of interest. Further analyses were performed on a subset of individuals with thresholds ≤ 25 dB HL at all conventional frequencies to control for the influence of hearing loss on the association between PTA (9 - 12 kHz) and outcome measures. PTA (9 - 12 kHz) was higher in males than females, and was higher in White participants than in racial Minority participants. Linear regression models showed the associations between cardiovascular risk factors and PTA (9 - 12 kHz) were not statistically significant. Older adults who reported a history of noise exposure had higher PTA (9 - 12 kHz) than those without a history, while associations between noise history and PTA (9 - 12 kHz) did not reach statistical significance for middle-aged participants. Linear models adjusting for age, sex, race and noise history showed that higher PTA (9 - 12 kHz) was associated with greater self-perceived hearing difficulty and poorer speech recognition scores in noise for both middle-aged and older participants. Workload/effort was significantly related to PTA (9 - 12 kHz) for middle-aged, but not older, participants, while cognitive task performance was correlated with PTA (9 - 12 kHz) only for older participants. In general, PTA (9 - 12 kHz) did not account for additional variance in outcome measures as compared to conventional pure-tone thresholds, with the exception of self-reported hearing difficulties in older participants. Linear models adjusting for age and accounting for subject-level correlations in the subset analyses revealed no association between PTA (9 - 12 kHz) and outcomes of interest. EHF thresholds show age-, sex-, and race-related patterns of elevation that are similar to what is observed for conventional thresholds. The current results support the need for more research to determine the utility of adding EHF thresholds to routine audiometric assessment with middle-aged and older adults.

COGNITIVE IMPAIRMENT IN DIFFERENT CLINICAL FORMS OF MULTIPLE SCLEROSIS

Purpose: The aim of the study is to investigate cognitive impairment (CI) in patients with different clinical forms of Multiple Sclerosis (MS) and to propose a suitable cognitive evaluation based on available tools for diagnosis and monitoring purposes. Materials and Methods: The following tests were used: Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), Expanded Disability Status Scale (EDSS) and Magnetic Resonance Tomography 1.5Т (МRТ) in 60 consecutive patients; 22 were with first demyelination episode and 38 with MS. The control group of 40 healthy persons matched for sex, age and years of education. The follow-up period is three years. Results: The average screening values of PASAT, SDMT, BVSMT-R are considerably lower (р&lt;0.05) in MS patients compared to the controls and CIS patients. Point's number in the progressive forms in comparison with RRMS is reliably smaller. There was no significant difference in results between SPMS and PPMS patients at screening (р&gt;0.05). In the 3rd year, there is a significant cognitive progression in all studied groups and for all tests (р&lt;0.05). Conclusion: The use of a neuropsychological screening test is a valuable method for registering CI in patients with relapsing-remitting course, as well as in patients with a progressive course of the disease. We recommend the SDMT for screening annual follow-up because it is easy to apply, validate and reliably report the progression of CI. In patients with visual disturbances and with arm weakness, it is better to use PASAT, taking into account the level of education and depression.

Reduced body cell mass and functions in lower extremities are associated with mild cognitive impairment and Alzheimer’s dementia

This study examined the alterations of segmental body composition in individuals with Alzheimer’s pathology (AD), including mild cognitive impairment (MCI) and dementia. A multifrequency bioimpedance analysis (BIA) was used to provide segmental water and impedance variables from 365 cognitively normal (CN), 123 MCI due to AD, and 30 AD dementia participants. We compared the BIA variables between the three groups, examined their correlations with neuropsychological screening test scores, and illustrate their 95% confidence RXc graphs. AD dementia participants were older, more depressive, and had worse cognitive abilities than MCI due to AD and CN participants. Although the BIA variables showed weak partial correlations with the cognitive test scores, we found patterns of an increasing water content in lean mass, increasing extra to intracellular water ratio, and decreasing reactance and phase angle in the lower extremities with effect sizes ranging from 0.26 to 0.51 in the groups of MCI and dementia due to AD compared with CN individuals. The RXc graphs upheld the findings with a significant displacement downward and toward the right, dominantly in the lower extremities. Individuals with AD pathology exhibit a reduced body cell mass or cell strength, an abnormal cellular water distribution, and an overhydration status in lean mass, especially in the lower extremities.

Parietal/premotor lesions effects on visuomotor cognition in neuro-oncology patients: A multimodal study

BackgroundAssessing prior to surgery the functionality of brain areas exposed near the tumor requires a multimodal approach that combines the use of neuropsychological testing and fMRI tasks. Paradigms based on motor imagery, which corresponds to the ability to mentally evoke a movement, in the absence of actual action execution, can be used to test sensorimotor areas and the functionality of mental motor representations. MethodsThe most commonly used paradigm is the Limb Laterality Recognition Task (LLRT), requiring judgments about whether a limb belongs to the left or right side of the body. The group studied included 38 patients with high-grade (N = 21), low-grade (N = 11) gliomas and meningiomas (N = 6) in areas anterior (N = 21) and posterior (N = 17) to the central sulcus. Patients before surgery underwent neuropsychological assessment and fMRI. They performed the LLRT as an fMRI task. Accuracy, and neuroimaging data were collected and combined in a multimodal study. Structural MRI data analyses were performed by subtracting the overlap of volumes of interest (VOIs) plotted on lesions from the impaired patient group vs the overlap of VOIs from the spared group. The fMRI analyses were performed comparing the impaired patients and spared group. ResultsIn general, patients were within normal limits on many neuropsychological screening tests. Compared with the control group, 17/38 patients had significantly different performance. The subtraction between the VOIs overlay of the impaired patients' group vs. the VOIs overlay of the spared group revealed that the areas maximally involved by lesions in the impaired patients' group were the right postcentral gyrus, right inferior parietal lobe, right supramarginal gyrus, right precentral gyrus, paracentral lobule, left postcentral gyrus, right superior parietal lobe, left inferior parietal lobe, and left superior and middle frontal gyrus. Analysis of the fMRI data showed which of these areas contributes to a correct LLRT performance. The task (vs. rest) in the group comparison (spared vs. impaired patients) activated a cluster in the left inferior parietal lobe. ConclusionUnderlying the altered performance at LLRT in patients with lesions to the parietal and premotor areas of the right and left hemispheres is a difference in activation of the left inferior parietal lobe. This region is involved in visuomotor processes and those related to motor attention, movement selection, and motor planning.

Can the fNIRS-derived neural biomarker better discriminate mild cognitive impairment than a neuropsychological screening test?

Early detection of mild cognitive impairment (MCI), a pre-clinical stage of Alzheimer's disease (AD), has been highlighted as it could be beneficial to prevent progression to AD. Although prior studies on MCI screening have been conducted, the optimized detection way remain unclear yet. Recently, the potential of biomarker for MCI has gained a lot of attention due to a relatively low discriminant power of clinical screening tools. This study evaluated biomarkers for screening MCI by performing a verbal digit span task (VDST) using functional near-infrared spectroscopy (fNIRS) to measure signals from the prefrontal cortex (PFC) from a group of 84 healthy controls and 52 subjects with MCI. The concentration changes of oxy-hemoglobin (HbO) were explored during the task in subject groups. Findings revealed that significant reductions in HbO concentration were observed in the PFC in the MCI group. Specially, the mean of HbO (mHbO) in the left PFC showed the highest discriminant power for MCI, which was higher than that of the Korean version of montreal cognitive assessment (MoCA-K) widely used as a screening tool for MCI. Furthermore, the mHbO in the PFC during the VDST was identified to be significantly correlated to the MoCA-K scores. These findings shed new light on the feasibility and superiority of fNIRS-derived neural biomarker for screening MCI.

Early Diagnosis of Cognitive Impairment in Mild TBI

Background: Traumatic brain injury (TBI) is the first cause of death and disability in the young and active population. In the context of TBI, Mild Traumatic brain Injury (m-TBI) is frequent and it is often associated with transient cognitive disorders. Aim: The aim of this study was to promote the early diagnosis of cognitive and behavioral disorders in patients with m-TBI and to prevent under-diagnosed and long-term symptoms, reducing the risk of a decline in patient’s quality life. Design: A Longitudinal observational study was conducted on subjects who received diagnosis of mTBI in emergency department along a period of time between October 2018 and June 2021. Setting: Patients were primarily evaluated in Emergency Department of the Buccheri La Ferla Hospital in Palermo. Rehabilitation and follow-ups were conducted in Rehabilitation Medicine Complex Operative Unit of the same medical center. Population: 520 patients were registered with a diagnosis of Head Trauma in Emergency Rooms during the observational period. 65 patients (12, 5%) had a diagnosis of non-commotional head injury and therefore the possibility of being part of the study. 49 patients were included, 9 patients were excluded, 4 patients refused to be part of the study. The average age was 46, 7 years. Methods: a first neuro-psychological evaluation of the patient with m-TBI was conducted within 48 hours of the event. Anamnestic data were collected and standardized neuro-psychological screening tests were administered. Patients were followed up by a team of doctors and neuro-psychologists for a period of 12 months in order to monitor cognitive and behavioral condition. Patients with a cognitive deficit underwent to neuro-psychological rehabilitation. Results: 41% of the patients showed cognitive deficits, especially in executive functions. Patients who underwent to neuro-psychological rehabilitation obtained a normal profile at subsequent follow-up evaluations. Conclusion: m-TBI can cause different clinical manifestations. Therefore, a multidisciplinary intervention is important in order to recognize the patients most at risk of developing long-term cognitive symptoms that can compromise social and occupational functioning. Clinical Rehabilitative Impact: Post-trauma neuropsychological evaluation allows for early recognition of cognitive disorders. Neuro-psychological rehabilitation improves the quality of life of patients and reduces healthcare cost.

Racial disparities in Alzheimer’s Disease (AD): Correlating a novel neuropsychological screening test to established AD fluid and imaging biomarkers in African Americans and Caucasians

AbstractBackgroundThe Montreal Cognitive Assessment (MoCA) is a commonly used screening tool for the diagnosis of neurocognitive disorders such as mild cognitive impairment (MCI) and Alzheimer’s Disease (AD). The current cut‐off threshold for detection of MCI on the MoCA increases risk for false positives, particularly in ethnic minorities and those of lower educational attainment. African Americans (AA) have experienced inaccurate detection of MCI and AD, leading to a delay in diagnosis and a decreased enrollment in AD‐related clinical trials. This underscores the importance of clarified cut‐offs for AD plasma biomarkers in AA and a standardized cognitive screening test independent of language and cultural norms. The Visual‐based Cognitive Assessment Test (VCAT) is a newly developed language‐neutral cognitive screening test that has good sensitivity (85.6%) and specificity (81.1%) in diagnosing MCI and mild AD. Our study will correlate VCAT scores to MRI brain findings and established AD plasma biomarkers in AA and Caucasians with and without cardiovascular diseases (i.e. prior myocardial infarction, stroke, and chronic kidney disease).MethodsAA and Caucasians diagnosed with MCI, AD, and normal cognition have been recruited (n=50) over a period of one year (recruitment remains ongoing). Plasma samples were collected, MRI brain imaging and Neuroquant data were obtained (for volumetric analyses), and the VCAT along with the MoCA were completed. Phosphorylated‐tau 181 (p‐tau 181) and phosphorylated‐tau 217 (p‐tau 217) will be measured in the samples using the Quanterix HDX device.ResultsPreliminary results reveal that levels of p‐tau 181 are elevated (from a normative cut‐off value of 1.81 pg/mL per the Youden index) in all groups, and highest in the group of patients with both CSF findings consistent with AD and a medical history of cardiovascular diseases (MI, CKD, and/or stroke).ConclusionEstablished cut‐off values for p‐tau 181 and p‐tau 217 in the literature likely underestimate these results in AA patients. In addition to elucidating the cut‐off normative values for established plasma AD biomarkers in a diverse cohort, our goal is to validate the VCAT, a cultural and language‐neutral screening assessment. This will allow for application to multilingual populations without the need for translation of its test contents.

Inhibitory control and ability to maintain response in obesity and binge eating disorder

The aim of this study was to analyse the inhibitory control and the ability to maintain response in obese patients with and without Binge Eating Disorder (BED), compared to normalweight subjects. A total of 114 participants comprised three different groups (obese with BED, obese without BED and normal-weight) completed the Frontal Assessment Battery, the Stroop Neuropsychological Screening Test and the Wisconsin Card Sorting Test. The results showed differences between the obese groups and normal-weight group, to inhibitory control. There were also differences between the two obese groups in the ability to maintain the response. These results suggest that low inhibitory control, characterizes obesity and the difficulties to maintain the response, characterizes the binge eating disorder.

Validation of the Computerized Cognitive Assessment Test: NNCT.

Population aging brings with it cognitive impairment. One of the challenges of the coming years is the early and accessible detection of cognitive impairment. Therefore, this study aims to validate a neuropsychological screening test, self-administered and in software format, called NAIHA Neuro Cognitive Test (NNCT), designed for elderly people with and without cognitive impairment. This test aims to digitize cognitive assessments to add greater accessibility than classic tests, as well as to present results in real time and reduce costs. To this end, a comparison is made with tests such as MMSE, Clock Drawing Test (CDT) and CAMCOG. For this purpose, the following statistical analyses were performed: correlations, ROC curves, and three ANOVAs. The NNCT test evaluates seven cognitive areas and shows a significant and positive correlation with other tests, at total and subareas levels. Scores are established for the detection of both mild cognitive impairment and dementia, presenting optimal sensitivity and specificity. It is concluded that the NNCT test is a valid method of detection of cognitive impairment.

The Tree Drawing Test in Evolution: An Explorative Longitudinal Study in Alzheimer's Disease.

To study the evolution of the Tree Drawing Test (TDT) in a group of Alzheimer's disease (AD) patients. A total of 33 AD patients were consecutively evaluated by Mini Mental State Evaluation (MMSE) and TDT. The evolution of the TDT parameters, trunk-to-crown (TC) and space occupation (SO) index, were analyzed. The median age at first visit was 79years. Globally, trees drawn by patients showed an evolution characterized by a progressive reduction of the crown compared to the trunk. TC index showed a significant linear growth change (2.52 points per year) while SO index did not significantly increase. No significant associations were found examining the relations between MMSE and TC and SO index. TDT could represent a complementary technique to the main neuropsychological screening tests for orienting cognitive impairment diagnosis and an aid in following the evolution of cognitive impairment over time in AD patients.

Automatic Speech Classifier for Mild Cognitive Impairment and Early Dementia

The World Health Organization estimates that 50 million people are currently living with dementia worldwide and this figure will almost triple by 2050. Current pharmacological treatments are only symptomatic, and drugs or other therapies are ineffective in slowing down or curing the neurodegenerative process at the basis of dementia. Therefore, early detection of cognitive decline is of the utmost importance to respond significantly and deliver preventive interventions. Recently, the researchers showed that speech alterations might be one of the earliest signs of cognitive defect, observable well in advance before other cognitive deficits become manifest. In this article, we propose a full automated method able to classify the audio file of the subjects according to the progress level of the pathology. In particular, we trained a specific type of artificial neural network, called autoencoder, using the visual representation of the audio signal of the subjects, that is, the spectrogram. Moreover, we used a data augmentation approach to overcome the problem of the large amount of annotated data usually required during the training phase, which represents one of the most major obstacles in deep learning. We evaluated the proposed method using a dataset of 288 audio files from 96 subjects: 48 healthy controls and 48 cognitively impaired participants. The proposed method obtained good classification results compared to the state-of-the-art neuropsychological screening tests and, with an accuracy of 90.57%, outperformed the methods based on manual transcription and annotation of speech.

Effects of ApoE genotype on clinical phenotypes in early-onset and late-onset Alzheimer's disease in China: Data from the PUMCH dementia cohort.

IntroductionTo investigate the heterogeneous effect of Apolipoprotein E (ApoE) genotype on clinical phenotypes in early‐onset Alzheimer's disease (EOAD) and late‐onset Alzheimer's disease (LOAD), respectively.Methods785 probable AD patients were enrolled from the dementia cohort of Peking Union Medical College Hospital (PUMCH), China. There were 386 EOAD and 399 LOAD cases. All individuals finished history inquiry, neurological examination, blood biochemical test, neuropsychological screening test, electroencephalography, brain CT/MRI, and ApoE genotyping. Some participants had neuropsychological domain assessment (n = 317), MRI morphometry (n = 130), CSF testing of Aβ42, p‐tau, t‐tau (n = 144), or DNA sequencing (n = 690). The variables were compared mainly between ɛ4 carriers and non‐carriers in EOAD and LOAD, respectively.ResultsIn LOAD, ɛ4 carriers showed female predominance; worse performance in trail making test, delayed recall of auditory verbal learning test (AVLT) and rey complex figure; smaller hippocampal, parahippocampal, and entorhinal volume, as compared to ɛ4 non‐carriers. In EOAD, ɛ4 carriers had lower scores in AVLT, episodic memory and modified Luria's tapping task; but less cortical atrophy in entorhinal, middle cingulate, inferior frontal, and parieto‐occipital regions, in comparison to ɛ4 non‐carriers. 6.2% (43/690) subjects harbored potential causative mutations in APP, PSEN1, and PSEN2. In both EOAD and LOAD, no differences were observed between ɛ4 carriers and non‐carriers in CSF levels of Aβ42, p‐tau, t‐tau, or mutation frequency.ConclusionsApoE exerts a heterogeneous effect on clinical phenotypes in EOAD and LOAD, which might be related to the different genetic and pathological basis underlying them.

An automatic Alzheimer’s disease classifier based on spontaneous spoken English

According to the World Health Organization, the number of people suffering from dementia worldwide will grow to 150 million by mid-century, and Alzheimer’s disease is the most common form of dementia contributing to 60%–70% of cases. The problem is compounded by the fact that current pharmacologic treatments are only symptomatic, and therapies are ineffective in slow down or cure the degenerative process. An automatic and standardize classifier for Alzheimer’s disease is thereby extremely important to rapidly respond and deliver as preventive as possible interventions. Speech alterations might be one of the earliest signs of cognitive defect and, recently, the researchers showed that they can be observable well in advance other cognitive deficits become manifest. In this paper, we propose a full automated method able to classify the spontaneous spoken production of the subjects. In particular, we trained an artificial neural network using the spectrogram of the audio signal, which is the visual representation of the speech of the subject. Moreover, to overcome the problem of the large amount of annotated data usually required for training deep learning models, we used a specific data augmentation approach that avoids distorting the original samples. We evaluated the proposed method using the English Pitt Corpus from DementiaBank. The used dataset consists of 180 subjects: 43 healthy controls and 137 Alzheimer’s disease patients. The proposed method outperformed the other approaches in the literature based on manual and semi-automatic transcription and annotation of speech, improving the classification capability by 5.93%, and obtained good classification results compared to the state-of-the-art neuropsychological screening tests (i.e., the Mini-Mental State Examination and the Activities of Daily Living portion of the Blessed Dementia Rating Scale) exhibiting an accuracy of 93.30% and an F1 score of 88.50%.

Assessment of cognitive screening tests as predictors of driving cessation: A prospective cohort study of a median 4-year follow-up.

Assessing fitness to drive and predicting driving cessation remains a challenge for primary care physicians using standard screening procedures. The objective of this study was to prospectively evaluate the properties of neuropsychological screening tests, including the Trail Making Test (TMT), Clock Drawing Test (CDT), Montreal Cognitive Assessment (MoCA), Useful Field of View (UFOV), and Timed Up and Go (TUG) test, in predicting driving cessation for health reasons in drivers older than 70 years of age. This prospective cohort study, with a median follow-up of 4 years for drivers of 70 years old or older with an active driving license in Switzerland, included 441 participants from a driving refresher course dedicated to volunteer senior drivers. Cases were drivers reported in the national driving registry who lost their license following a health-related accident, who were reported as unfit to drive by their physician or voluntarily ceased driving for health reasons. Survival analysis was used to measure the hazard ratio of driving cessation by adjusting for age and sex and to evaluate the predictive value of combining 3 or more positive tests in predicting driving cessation during a 4-year follow-up. A total of 1738 person-years were followed-up in the cohort, with 19 (4.3%) having ceased driving for health reasons. We found that participants with a TMT-A < 54 sec and TMT-B < 150 sec at baseline had a significantly lower cumulative hazard of driving cessation in 4 years than those with slower performance (adjusted HR 3, 95% CI: 1.16-7.78, p = 0.023). Participants who performed a CDT ≥ 5 had a significantly lower cumulative hazard of driving cessation (adjusted HR 2.89, 95% CI: 1.01-7.71, p = 0.033). Similarly, an MoCA score ≥ 26, TUG test <12 sec or a UFOV of low risk showed a lower but not significant cumulative risk at a median follow-up of 4 years. When using tests as a battery, those with three or more positive tests out of five were 3.46 times more likely to cease driving (95% CI: 1.31-9.13, p = 0.012). The CDT and the TMT may predict driving cessation in a statistically significant way, with a better performance than the UFOV and MoCA tests during a median 4-year follow-up. Combining tests may increase the predictability of driving cessation. Although our results are consistent with current evidence, they should be interpreted with precaution; more than 95% of the participants above the set threshold were able to continue driving for 4 years without any serious incident.

Risks of Obesity in Adolescence: The Role of Physical Activity in Executive Functions

The aim of this study was to analyze the efficiency of a physical activity program on executive performance in obese adolescents. Fifteen adolescents (5 males and 10 females), with a mean age of 14.73 years and an IMC mean of 36.74 participated in the study. None of the participants presented a compulsive eating disorder when screened by the Binge Eating Scale. A pretest and posttest assessment, twelve months later, was conducted by using a neuropsychological battery that evaluated the cognitive flexibility (Comprehensive Trail Making Test), inhibition control (Stroop Neuropsychological Screening Test and by the Frontal Assessment Battery), and planning (Tower of London). ANOVA of repeated measures was performed. The within-subjects tests demonstrated significant statistical differences between the two moments of evaluation at the level of inhibitory control and cognitive flexibility tasks, with higher performances in the second evaluation. These results suggest that the inclusion of obese adolescents in such programs may promote their executive capacities.

Comparison on Well-Being, Engagement and Perceived School Climate in Secondary School Students with Learning Difficulties and Specific Learning Disorders: An Exploratory Study.

Reading and writing skills influence the social status of students, exerting effects not only on learning, but also on wellbeing. This study aimed to assess the impact of diagnosis of specific learning disorder on well-being in secondary-school students, comparing students with a diagnosis of specific learning disorder (SLD-group), students showing learning difficulties without diagnosis (LD-group) and students without learning difficulties (control-group). Students were tested with neuropsychological screening tests in order to identify learning difficulties and were further assessed by means of psychological and school well-being questionnaires. The results show that LD group perceive themselves as having a low sense of mastery and autonomy, less interest and engagement in daily activities and low peer social support than their schoolmates. This result highlights, for the LD group, a low well-being experience, which is not observed in the SLD and control groups. On the contrary, SLD group students do not differ from control group students in any dimensions except for the perceived parents’ support and involvement in school life, in which the SLD group show the highest scores. This work underlines the importance of having a diagnosis as it seems to work as a protective factor for both the psychological and school well-being of the student.

Neuropsychological and executive screening in obstructive sleep apnea: early effect of ventilatory therapy.

Obstructive sleep apnea (OSA) is often associated with clinical, psychological and neuropsychological comorbidities such as Mild Cognitive Impairment (MCI). This study evaluated changes in clinical, psychosocial, Health Related Quality of Life (HRQoL) and neuropsychological profile in OSA subjects after ventilatory therapy, making comparison with normative data. The aim of the study was to verify the suitability of the HRQoL and neuropsychological screening tests in detecting variations in OSA subjects. At baseline, 32 OSA subjects underwent the following assessment: EuroQol (EQ-5D-3L) and EQ VAS, Hospital Anxiety and Depression Scale (HADS), Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB). After the ventilatory titration, 31 OSA subjects repeated the EQ VAS, MoCA and FAB assessment. The analyzed subjects (77% male, 58.97±10.06 years old and 47.34±26.67 AHI [ev*hr-1]) showed low emotive distress, a lower perception of HRQoL than normative data and 35.48% of them exhibited executive deficits, too. MCI was detected in 3.2% and 48.4% of subjects after normative Italian and international correction, respectively. Subsequently the ventilatory therapy and the rehabilitative interdisciplinary treatment, subjects improved in EQ VAS (68.23±18.73 vs. 87.13±10.80, P=0.0001), FAB scores (15,30±2.03 vs. 16,65±1,40, P=0.007) and MoCA memory subtest scores (2.16±1.34 vs. 3.06±1.63, P=0.008). Ventilatory therapy provided during a rehabilitative and interdisciplinary program increased subjects' HRQoL, executive functions and verbal memory.

Multimodal Neurocognitive Screening of Military Personnel With a History of Mild Traumatic Brain Injury Using the Bethesda Eye & Attention Measure.

To evaluate a neurocognitive eye tracking task, the Bethesda Eye & Attention Measure (BEAM), for use in cognitive screening of patients with a history of mild traumatic brain injury (TBI). US military TBI rehabilitation clinic. Cross-sectional study of 191 military personnel receiving outpatient services related to history of mild TBI. Main measures: BEAM; neuropsychological screening measures of attention, processing speed, executive function, and memory. Medium effect sizes were found for partial correlations (controlling for age) between key BEAM metrics and neuropsychological screening tests. Linear regression analyses demonstrated that BEAM saccadic eye movements and manual (button press) metrics each provided complementary value in measurement of cognitive performance, above and beyond effects of demographic factors and clinical characteristics. This study provides initial support for the use of BEAM neurocognitive eye tracking in cognitive screening of adults with a history of mild TBI. BEAM saccadic metrics appear to be particularly well-suited for the assessment of visual attention. Study findings also highlight opportunities for greater cognitive sensitivity or testing efficiency that may be missed by tests measuring only one response modality at a time.