Paced Visual Serial Addition Test Research Articles

Effect of Audiovisual Cross-Modal Conflict during Working Memory Tasks: A Near-Infrared Spectroscopy Study.

Cognitive conflict effects are well characterized within unimodality. However, little is known about cross-modal conflicts and their neural bases. This study characterizes the two types of visual and auditory cross-modal conflicts through working memory tasks and brain activities. The participants consisted of 31 healthy, right-handed, young male adults. The Paced Auditory Serial Addition Test (PASAT) and the Paced Visual Serial Addition Test (PVSAT) were performed under distractor and no distractor conditions. Distractor conditions comprised two conditions in which either the PASAT or PVSAT was the target task, and the other was used as a distractor stimulus. Additionally, oxygenated hemoglobin (Oxy-Hb) concentration changes in the frontoparietal regions were measured during tasks. The results showed significantly lower PASAT performance under distractor conditions than under no distractor conditions, but not in the PVSAT. Oxy-Hb changes in the bilateral ventrolateral prefrontal cortex (VLPFC) and inferior parietal cortex (IPC) significantly increased in the PASAT with distractor compared with no distractor conditions, but not in the PVSAT. Furthermore, there were significant positive correlations between Δtask performance accuracy and ΔOxy-Hb in the bilateral IPC only in the PASAT. Visual cross-modal conflict significantly impairs auditory task performance, and bilateral VLPFC and IPC are key regions in inhibiting visual cross-modal distractors.

Predicting Fatigue in Long Duration Mountain Events with a Single Sensor and Deep Learning Model.

Aim: To determine whether an AI model and single sensor measuring acceleration and ECG could model cognitive and physical fatigue for a self-paced trail run. Methods: A field-based protocol of continuous fatigue repeated hourly induced physical (~45 min) and cognitive (~10 min) fatigue on one healthy participant. The physical load was a 3.8 km, 200 m vertical gain, trail run, with acceleration and electrocardiogram (ECG) data collected using a single sensor. Cognitive load was a Multi Attribute Test Battery (MATB) and separate assessment battery included the Finger Tap Test (FTT), Stroop, Trail Making A and B, Spatial Memory, Paced Visual Serial Addition Test (PVSAT), and a vertical jump. A fatigue prediction model was implemented using a Convolutional Neural Network (CNN). Results: When the fatigue test battery results were compared for sensitivity to the protocol load, FTT right hand (R2 0.71) and Jump Height (R2 0.78) were the most sensitive while the other tests were less sensitive (R2 values Stroop 0.49, Trail Making A 0.29, Trail Making B 0.05, PVSAT 0.03, spatial memory 0.003). The best prediction results were achieved with a rolling average of 200 predictions (102.4 s), during set activity types, mean absolute error for ‘walk up’ (MAE200 12.5%), and range of absolute error for ‘run down’ (RAE200 16.7%). Conclusions: We were able to measure cognitive and physical fatigue using a single wearable sensor during a practical field protocol, including contextual factors in conjunction with a neural network model. This research has practical application to fatigue research in the field.

Effectiveness of Three-Dimensional Multiple-Object Tracking in Patients with Multiple Sclerosis: A Pilot Trial.

Computerized cognitive training remains an attractive supplemental modality to enhance rehabilitation in multiple sclerosis (MS). The objective of the present study was to assess the usability of three-dimensional multiple-object tracking (3D-MOT) in patients with MS. In this pilot study, 16 patients with relapsing-remitting MS and nine age-matched controls participated in four 30-minute training sessions of 3D-MOT. Computerized neuropsychological tests, including driving readiness (ie, Useful Field of View) and cognitive function (ie, Stroop Color and Word Test, Paced Visual Serial Addition Test, Symbol Digit Modalities Test) were conducted at baseline and at the conclusion of training. Although scoring lower in 3D-MOT, the MS group improved their 3D-MOT scores in similar magnitude as the control group. The 3D-MOT training led to significant improvements in driving readiness in the MS group. Taken together, 3D-MOT training showed similar effectiveness in patients with MS as in age-matched controls. Training with 3D-MOT may be an accessible and remotely administrable supplement to cognitive rehabilitation protocols for patients with MS.

Functional Magnetic Resonance Imaging Correlations Between Fatigue and Cognitive Performance in Patients With Relapsing Remitting Multiple Sclerosis.

The correlation between fatigue and cognitive performance in multiple sclerosis (MS) is well reported, but the intimate mechanisms of the fatigue impact on cognition are not fully defined yet. The aim of this study is to investigate blood oxygen level–dependent (BOLD) activations in relapsing remitting MS (RRMS) patients with and without cognitive dysfunction and the impact of fatigue on cortical activations. Forty-two patients with RRMS were enrolled in the study. Cognitive functioning was assessed by the Symbol Digit Modalities Test (SDMT) and Paced Serial Addition Test (PASAT). A cutoff point of a total score of 55 on the SDMT was used to divide the patients into two groups: cognitively impaired (CI), SDMT score equal to or below 55 points, and cognitively preserved (CP), SMDT score above 55 points. Fatigue was assessed by the Modified Fatigue Impact Scale (MFIS). Participants were assessed with the Beck Depression Inventory (BDI) prior to inclusion in order to exclude major depressive episode. Functional Magnetic Resonance Imaging (fMRI) scanning was performed on a 3T MRI. The PVSAT (Paced Visual Serial Addition Test) paradigm was applied as a cognitive task. All functional data were analyzed with SPM12 and statistical analysis with SPSS 19.0. No statistically significant differences between CI and CP patients were found (p=0.953, p=0.322) in the MFIS and BDI score. Performance on the PASAT in CI patients was 34.07±13.721, for CP patients 46.42±11.453, and the SDMT performance in the CI patient group was 42.40±9.179, in the CP group 57.83±2.552. Between-group analysis revealed increased activations in left Brodmann area (BA) 40 in CP patients with several clusters located in the left supramarginal gyrus. Regression analysis showed increased BOLD signal in left BA 40, right BA 40, and left BA 6, associated with a higher score on MFIS. Stronger BOLD signal in left BA 31 was associated with a lower score on MFIS. Significance level was set to p<0.05, FWE (family-wise error) corrected. The differences in BOLD activations suggest the presence of cortical reorganization in our CP patients. The impact of fatigue on cortical activation during a cognitive task is demonstrated by inconformity of activated areas depending on the MFIS score. Our results suggest that activation in BA 40 may represent a mechanism for diminishing fatigue impact on cognitive functioning in CP patients.

Developing a Computerized Brief Cognitive Screening Battery for Botswana: A Feasibility Study

To determine the feasibility of using a brief computerized battery for assessing cognition in citizens of Botswana. A group of 134 healthy subjects were administered a brief computerized battery of tests (Stroop, Symbol Digit Modalities Test (c-SDMT), and 2 and 4 second versions of the Paced Visual Serial Addition Test (PVSAT)). Half the subjects were tested in English and the other half in Setswana. All subjects completed the 20 min battery. Participants administered the tests in English had more years of education (p < .001) and were more likely to be male (p = .024) than those administered the tests in Setswana. There were no significant cognitive differences between the English and Setswana groups. Predictors of cognition were education (c-SDMT, PVSAT 4 and 2 second versions), age (Stroop, c-SDMT), and sex (c-SDMT), with females performing better than males on the latter. Language was not associated with performance on any of the cognitive tests and there were no significant interactions between language and any of the demographic predictors of cognition. The results demonstrate that our brief computerized approach is feasible with similar findings obtained for both language groups. Two further phases to the development of the Botswana version of the brief computerized battery can now proceed. The first is to obtain normative data from a larger sample representative of Botswana society in general. The second will be to validate the cognitive measures in a sample of people with acquired brain injury using the normative data to determine thresholds for impairment.

Translational validity of PASAT and the effect of fatigue and mood in patients with relapsing remitting MS: A functional MRI study.

Paced Auditory Serial Addition Test (PASAT) is used for assessment of information processing speed, attention, and working memory, which are the most frequently affected cognitive domains in multiple sclerosis (MS) patients, and may be significantly affected by fatigue. However, the effect of fatigue and mood on the PASAT performance in MS patients translationally validated by fMRI has not been studied yet. The aim of this study is to investigate the translational validity of the PASAT, using fMRI during a paced visual serial addition test (PVSAT) paradigm in patients with relapsing remitting MS (RRMS) and to assess the impact of fatigue and mood on test performance. Fourteen patients with RRMS in remission and 14 healthy controls, matched by sex, age, and educational status, were enrolled in the study. The subjects underwent a standard neurological examination, neuropsychological evaluation with the PASAT 3', fMRI scanning with a PVSAT paradigm, and Beck Depression Inventory. All patients were assessed by the Modified Fatigue Impact Scale. Paced Auditory Serial Addition Test score was lower in patients (41.4±15.5 vs 51.6±7.5, P=.035). A moderate negative correlation (P=-0.563, P=0.036) was found between PASAT and MIFS scores. The fMRI scanning showed significant activations in several clusters that differed between patients and controls. The patient group presented wider cluster activation; Brodmann area (BA) 6-bilaterally; left BA7, 8, and 9; and right BA40, while controls presented with activations in left BA6 and BA44. Significant negative correlations between PASAT score and cortical activations in left BA23, right BA32, and left BA7 were observed in patients only. Our results show that poorer performance on the PASAT is associated with higher activation in areas connected with working memory, attention, and emotional processes during the fMRI assessment with PVSAT paradigm, which provides evidence for the translational validity of the PASAT in patients with RRMS.

Detecting cognitive dysfunction in a busy multiple sclerosis clinical setting: a computer generated approach

This study aims to explore the effectiveness of a brief, computerized battery of tests in detecting cognitive differences between clinically isolated syndromes (CIS), relapsing-remitting multiple sclerosis (RRMS), primary progressive multiple sclerosis (PPMS) and secondary progressive multiple sclerosis (SPMS) patients. Four groups of patients between the ages of 18 and 63 were enrolled from two hospital-based multiple sclerosis clinics: CIS (n = 42), RRMS (n = 44), PPMS (n = 15) and SPMS (n = 37). All subjects were administered a validated battery of five computerized cognitive tests: the STROOP Color-Word Test, the Computerized Symbol Digit Modalities Test, the Paced Visual Serial Addition Test (PVSAT) 4 s and 2 s trials, and a speed of cognition index obtained by subtracting simple reaction time from choice reaction time. Results were recorded by the test administrator. Significant between-group differences in cognition were evident on all tests (P < 0.01) with the exception of the PVSAT 2 s trial. CIS patients were the least impaired, SPMS the most. RRMS and PPMS patients generally had a similar cognitive profile, more impaired than the CIS patients but less so than the SPMS patients. These differences persisted after controlling for the effects of age and education. The ability of this computerized cognitive battery to distinguish the progression of cognitive deficits across the entire multiple sclerosis disease spectrum from CIS through to SPMS enhances its construct validity. This finding, coupled with the battery's brevity (20 min) and ease of administration, highlights its potential utility in a busy clinic setting.

Cerebellar-parietal dysfunctions in multiple sclerosis patients with cerebellar signs

Consistent findings have shown that the cerebellum is critically implicated in a broad range of cognitive processes including executive functions. Of note, cerebellar symptoms and a number of cognitive deficits have been widely reported in patients with multiple sclerosis (MS). This study investigated for the first time the role of cerebellar symptoms in modulating the neural networks associated with a cognitive task broadly used in MS patients (Paced Visual Serial Addition Test (PVSAT)). Twelve relapsing–remitting (RR) MS patients with prevalent cerebellar signs and symptoms (RR-MSc), 15 RR-MS patients without cerebellar manifestation (RR-MSnc) and 16 matched-healthy controls were examined during functional magnetic resonance imaging (fMRI). We tested whether the RR-MSc patients displayed abnormal activations within “cognitive” cerebellar regions and other areas typically engaged in working memory and tightly connected with the cerebellum.Despite similar behavioral performances during fMRI, RR-MSc patients displayed, relatively to both RR-MSnc patients and controls, significantly greater responses in the left cerebellar Crus I/Lobule VI. RR-MSc patients also displayed reduced functional connectivity between the left cerebellar Crus I and the right superior parietal lobule (FWE<.05).These results demonstrated that the presence of the cerebellar signs drastically impacts on the neurofunctional networks underlying working memory in MS. The altered communication between the cerebellum and a cortical area implicated in short-term buffering and storage of relevant information, offer new insights into the pathophysiological mechanisms of cognition in MS.

Working memory function in Chinese dyslexic children: A near-infrared spectroscopy study

The deficiency theories of dyslexia are quite contradictory and the cross-cultural studies in recent years mainly focused on whether the dyslexics among cultures shared the same cognitive profile or just based on the language. This study used Near-Infrared Spectroscopy (NIRS) imaging to measure the regional cerebral blood volume (BV) and the changes of cerebral activation in the left prefrontal cortex of 12 Chinese dyslexic children and their 12 age-matched normal controls during the Paced Visual Serial Addition Test (PVSAT). Results showed that the scores of PVSAT of dyslexic children were significantly lower than those of the normal children (t=3.33, P<0.01). The activations of the left prefrontal cortex in the normal group were significantly greater than those of dyslexic children (all P<0.01). Our results indicated that Chinese dyslexia had a general deficiency in working memory and this may be caused by the abnormal metabolic activity of brain blood volume in the left prefrontal cortex and the deficits in brain function might be the basis of neuropathology of Chinese dyslexia. Present study supports the difference on brain activation of dyslexics from different languages may be caused by the same cognitive system related to reading.

Manufacture and Validation of Paced Visual Serial Addition Test (PVSAT) for an Iranian Population

Abstract Some neurological injury affect on sustaining attention. Attention is the most sensitive component of cognitive processes in front of traumas. The aim of this study was to predispose using PVSAT (paced visual serial addition task) in Iran by designing the test and perform a pilot study on Iranians, while its reliability and validity were assessed. In Paced Visual Serial Addition Test, participant has to add the last digit presented to the preceding digit which presented on the screen of the computer then verbalizes the answer. The test has two trials, in trial 1 the digits are presented at the rate of 3 seconds, and in trial 2 at 2 second. Its traditional total correct score seemingly reflects multiple cognitive abilities, including attention, concentration, working memory, and processing speed. This test was performed on 80 normal Iranian participants(45 females and 35 males) who ranged in age from 15 to 55 years old with a mean of 27 years old, and in three educated groups (less than 12 years education, between 12–16 years of education, and more than 16 years of education) with a mean of 14 years of education. People with serious neurological disease or mental disorder, with history of head trauma, with visual or auditoria problem didn’t enter to test. To determine the validity of the test, after one month 35 participants (20 female and 15 male) were assessed again. Results with the demographic factors like age ( M = 27 , S D : 7.7 ) , and education ( M = 14 , S D = 3 ) showed : true answers in trial 1was ( M = 53 , S D = 6.5 ) ,true answers in trial 2 was ( M = 49 , S D = 9 ) . The validity of this test in Iran was 0.91. This result was completely similar to last studies. This test can be used, both in clinical psychology and studies that are related to mild brain disorder, MS, ADHD and many other problems correlated with memory, attention and concentration.

Cognitive consequences of drug abuser: comparison with abuse of stimulants and opioid with regard to attention and working memory

Existence of disharmony in sustaining attention and working memory in stimulants abusers and opioids abusers in Iran is observable. The performance of tree group of people included 30 normal person, 27 opioids addict, and 26 stimulant addicts in Paced visual Serial Addition Test (PVSAT) as a measure of sustaining attention and working memory was assessed in this research. Significant difference were observed in sustaining attention, and working memory between tree groups of control (whom never use drugs) and experiments (those are addicted to opioids or stimulants); but there were no significant between two groups of addicted subjects which use opioids or stimulants.

Structural connectivity influences brain activation during PVSAT in Multiple Sclerosis

To assess the influence of white matter pathology on cortical reorganization, we probed the fronto-parietal attention network in Multiple Sclerosis (MS) patients by combining the Paced Visual Serial Addition Test (PVSAT) with fMRI-guided fiber tractography (FT). During the PVSAT, the control subjects activated the left inferior parietal lobule, superior temporal gyrus, precuneus, precentral gyrus, and medial and middle frontal gyri; while the precuneus and the inferior parietal lobule gyrus bilaterally, the left precentral and angular gyri and the right superior parietal lobule were activated in the MS group. At fMRI-guided FT, the superior longitudinal fasciculus (SLF) was the main white matter tract connecting areas active during the PVSAT. We then identified two subgroups of MS patients according to the SLF mean Fractional Anisotropy, used as indicator of integrity. The activations of the MS patients with a less damaged tract were in the left hemisphere, similarly to controls; while the patients with a more damaged SLF showed bilateral cortical activations. The MS subgroups, however, did not differ in PVSAT performance. This approach could be useful to investigate the relationship between brain structural and functional plastic changes and to identify different MRI endophenotypes related to the same level of cognitive impairment.

Cardiorespiratory fitness: A predictor of cortical plasticity in multiple sclerosis

Deficits in cognitive abilities are commonly observed among individuals with multiple sclerosis (MS). Recent neuroimaging studies have provided evidence for the existence of cortical plasticity in MS, with cognitively impaired participants recruiting additional brain areas to perform challenging tasks. The existence of altered cerebral activations in MS provides hope for the utilization of neural resources to reduce cognitive deficits that challenge everyday living in MS by employing alternative interventions such as cognitive and fitness training. In this study, we examined whether higher physical fitness levels enhance cognitive and neural plasticity in MS patients. The present study is the first to investigate the impact of cardiorespiratory fitness on cerebrovascular functioning of MS patients. 24 participants with relapsing–remitting MS were recruited for the study. All participants went through a fitness assessment and were scanned in a 3 T MRI system during the Paced Visual Serial Addition Test (PVSAT). Higher fitness levels were associated with faster behavioral performance and greater recruitment of right IFG/MFG, a region of the cerebral cortex recruited by MS patients during performance of PVSAT to purportedly compensate for the cognitive deterioration attributable to MS. In contrast, lower levels of fitness were associated with enhanced ACC activity, suggestive of the presence of greater interference and the potential for error in lower fit MS participants. These results are promising, suggesting the need for further investigation of the utility of aerobic fitness training as a possible method to support the development of additional cortical resources in an attempt to counter the cognitive decline resulting from MS.

Paced visual serial addition test in multiple sclerosis

The paced auditory serial addition test (PASAT), a subtest of the multiple sclerosis functional composite score (MSFC), is increasingly used in the evaluation of cognitive function in multiple sclerosis (MS). While patient acceptance for the PASAT is low, its visual version, the paced visual serial addition test (PVSAT), is perceived to be better tolerated. The aim of this study was to investigate the interchangeability of PVSAT and PASAT in the evaluation of cognitive function in MS. Twenty-one normal controls and 50 patients with clinically definite MS were tested with PASAT and PVSAT. Both for PASAT and PVSAT, 3 and 2-second versions of two parallel test forms were used. In the PVSAT, the PASAT stimuli were shown on a computer screen. Patients were also tested with the other two MSFC subtests, i.e. the nine-hole pegboard test and timed 25-foot walk test, to calculate MSFC scores. PASAT-3 correlated highly with both PVSAT-3 and PVSAT-2. MSFC-v scores calculated with PVSAT-2 and PVSAT-3 values correlated highly with MSFC scores calculated with PASAT-3 results. The results suggest that the PVSAT can be used as an alternative for the PASAT in the MSFC.

Striatal contribution to cognition: working memory and executive function in Parkinson's disease before and after unilateral posteroventral pallidotomy.

The basal ganglia are intimately connected to the frontal cortex via five fronto-striatal circuits. While the role of the frontal cortex in cognition has been extensively studied, the contribution of the basal ganglia to cognition has remained less clear. In Parkinson's disease, posteroventral pallidotomy (PVP) involves surgical lesioning of the internal section of the globus pallidus (GPi, the final output pathway from the basal ganglia) to relieve the motor symptoms of the disorder. PVP in Parkinson's disease provides a unique opportunity to investigate the impact of disruption of striatal outflow to the frontal cortex on cognition. We assessed executive function and working memory after withdrawal of medication in 13 patients with Parkinson's disease before and 3 months after unilateral PVP compared to 12 age- and IQ-matched normals assessed twice with an interval of 3 months. The tests used were: Wisconsin Card Sorting (WCST), Self-Ordered Random Number Sequences, Missing Digit Test, Paced Visual Serial Addition Test (PVSAT), and Visual Conditional Associative Learning Test (VCALT). After PVP, the patients performed significantly better on the Self-Ordered Random Number Sequences and the WCST, an improvement that was also observed in the normals across the two assessment and is therefore likely to reflect practice effects. Relative to the normals, the patients showed significant differential change following PVP on the Missing Digit Test and PVSAT, on which they performed worse after compared to before surgery, while the controls performed better on the second assessment. For the patients, performance on the VCALT also indicated deterioration after PVP, but the changes approached significance. The side of PVP had no effect on the results. The pattern of change observed 3 months after PVP was maintained at 15-month follow-up. The results suggest that striatal outflow to the frontal cortex may be essential for those aspects of executive function that showed deterioration after PVP.