scholarly journals Saliva RNA biomarkers predict concussion duration and detect symptom recovery: a comparison with balance and cognitive testing

2021 ◽  
Author(s):  
Gregory Fedorchak ◽  
Aakanksha Rangnekar ◽  
Cayce Onks ◽  
Andrea C. Loeffert ◽  
Jayson Loeffert ◽  
...  
Keyword(s):  
Test Performance ◽  
Area Under The Curve ◽  
Prediction Rule ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Clinical Tool ◽  
Post Injury ◽  
Symptom Recovery ◽  
Cognitive Test Performance

Abstract Objective The goals of this study were to assess the ability of salivary non-coding RNA (ncRNA) levels to predict post-concussion symptoms lasting ≥ 21 days, and to examine the ability of ncRNAs to identify recovery compared to cognition and balance. Methods RNA sequencing was performed on 505 saliva samples obtained longitudinally from 112 individuals (8–24-years-old) with mild traumatic brain injury (mTBI). Initial samples were obtained ≤ 14 days post-injury, and follow-up samples were obtained ≥ 21 days post-injury. Computerized balance and cognitive test performance were assessed at initial and follow-up time-points. Machine learning was used to define: (1) a model employing initial ncRNA levels to predict persistent post-concussion symptoms (PPCS) ≥ 21 days post-injury; and (2) a model employing follow-up ncRNA levels to identify symptom recovery. Performance of the models was compared against a validated clinical prediction rule, and balance/cognitive test performance, respectively. Results An algorithm using age and 16 ncRNAs predicted PPCS with greater accuracy than the validated clinical tool and demonstrated additive combined utility (area under the curve (AUC) 0.86; 95% CI 0.84–0.88). Initial balance and cognitive test performance did not differ between PPCS and non-PPCS groups (p > 0.05). Follow-up balance and cognitive test performance identified symptom recovery with similar accuracy to a model using 11 ncRNAs and age. A combined model (ncRNAs, balance, cognition) most accurately identified recovery (AUC 0.86; 95% CI 0.83–0.89). Conclusions ncRNA biomarkers show promise for tracking recovery from mTBI, and for predicting who will have prolonged symptoms. They could provide accurate expectations for recovery, stratify need for intervention, and guide safe return-to-activities.

scholarly journals Exercise Test Performance Reveals Evidence of the Cardiorespiratory Fitness Hypothesis

2017 ◽  
Vol 25 (2) ◽  
pp. 240-246 ◽  
Author(s):  
Sandra A. Billinger ◽  
Eric D. Vidoni ◽  
Jill K. Morris ◽  
John P. Thyfault ◽  
Jeffrey M. Burns
Keyword(s):  
Aerobic Exercise ◽  
Test Performance ◽  
Cognitive Change ◽  
Cognitive Testing ◽  
Cognitive Domain ◽  
Cognitive Test ◽  
Cognitive Responses ◽  
Cognitive Benefit ◽  
Using Data ◽  
Cognitive Test Performance

Positive physiologic and cognitive responses to aerobic exercise have resulted in a proposed cardiorespiratory (CR) fitness hypothesis in which fitness gains drive changes leading to cognitive benefit. The purpose of this study was to directly assess the CR fitness hypothesis. Using data from an aerobic exercise trial, we examined individuals who completed cardiopulmonary and cognitive testing at baseline and 26 weeks. Change in cognitive test performance was not related to CR fitness change (r2 = .06, p = .06). However, in the subset of individuals who gave excellent effort during exercise testing, change in cognitive test performance was related to CR fitness change (r2 = .33, p < .01). This was largely due to change in the cognitive domain of attention (r2 = .36, p < .01). The magnitude of change was not explained by duration of exercise. Our findings support further investigation of the CR fitness hypothesis and mechanisms by which physiologic adaptation may drive cognitive change.

Investigating Effects of Sex Differences and Prior Concussions on Symptom Reporting and Cognition Among Adolescent Soccer Players

2018 ◽  
Vol 46 (4) ◽  
pp. 961-968 ◽  
Author(s):  
Brian L. Brooks ◽  
Noah Silverberg ◽  
Bruce Maxwell ◽  
Rebekah Mannix ◽  
Ross Zafonte ◽  
...  
Keyword(s):  
Learning Disability ◽  
Test Performance ◽  
Mental Health Problems ◽  
Cognitive Testing ◽  
Symptom Reporting ◽  
Soccer Players ◽  
Cognitive Test ◽  
Negative Effects ◽  
Youth Soccer ◽  
Cognitive Test Performance

Background: There has been increasing concern regarding the possible effect of multiple concussions on the developing brain, especially for adolescent females. Hypothesis/Purpose: The objectives were to determine if there are differences in cognitive functioning, symptom reporting, and/or sex effects from prior concussions. In a very large sample of youth soccer players, it was hypothesized that (1) there would be no differences in cognitive test performance between those with and without prior concussions, (2) baseline preseason symptoms would be better predicted by noninjury factors than concussion history, and (3) males and females with prior concussions would not have differences in cognition or symptoms. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Participants included 9314 youth soccer players (mean = 14.8 years, SD = 1.2) who completed preseason baseline cognitive testing, symptom reporting, and a health/injury history questionnaire from the ImPACT battery (Immediate Post-concussion Assessment and Cognitive Testing). On the basis of injury history, athletes were grouped by number of prior concussions: 0 (boys, n = 4012; girls, n = 3963), 1 (boys, n = 527; girls, n = 457), 2 (boys, n = 130; girls, n = 97), or ≥3 (boys, n = 73; girls, n = 55). The primary measures were the 4 primary cognitive scores and the total symptom ratings from ImPACT. Primary outcomes were assessed across injury groups, controlling for age, sex, learning disability, attention-deficit/hyperactivity disorder (ADHD), treatment for headaches/migraines, substance abuse, and mental health problems. Results: Cognitive test performance was not associated with concussion history but was associated with sex, age, learning disability, ADHD, and prior mental health problems. Greater symptom reporting was more strongly associated with psychiatric problems, older age, learning disability, substance abuse, headaches, being female, and ADHD than with a history of multiple concussions. Boys and girls did not differ on cognitive scores or symptom reporting based on a history of concussion. Conclusion: In this very large sample of youth soccer players with prior concussion, there was no evidence of negative effects on cognition, very weak evidence of negative effects on symptom reporting, and no evidence of sex × concussion differences in cognition or symptom reporting.

Functional Connectivity of the Supplementary Motor Network Is Associated with Fried’s Modified Frailty Score in Older Adults

2020 ◽  
Vol 75 (12) ◽  
pp. 2239-2248 ◽  
Author(s):  
Florian Lammers ◽  
Norman Zacharias ◽  
Friedrich Borchers ◽  
Rudolf Mörgeli ◽  
Claudia Doris Spies ◽  
...  
Keyword(s):  
Older Adults ◽  
Functional Connectivity ◽  
Test Performance ◽  
Elective Surgery ◽  
Clinical Sample ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Geriatric Syndrome ◽  
Functional Changes ◽  
Cognitive Test Performance

Abstract Frailty is a geriatric syndrome defined by coexistence of unintentional weight loss, low physical reserve, or activity and is associated with adverse health events. Neuroimaging studies reported structural white matter changes in frail patients. In the current study, we hypothesized that clinical frailty is associated also with functional changes in motion-related cortical areas, that is, (pre-)supplementary motor areas (SMA, pre-SMA). We expected that observed functional changes are related to motor-cognitive test performance. We studied a clinical sample of 143 cognitively healthy patients ≥65 years presenting for elective surgery, enrolled in the BioCog prospective multicentric cohort study on postoperative cognitive disorders. Participants underwent preoperative resting-state functional magnetic resonance imaging, motor-cognitive testing, and assessment of Fried’s modified frailty criteria. We analyzed functional connectivity associations with frailty and motor-cognitive test performance. Clinically robust patients (N = 60) showed higher connectivity in the SMA network compared to frail (N = 13) and prefrail (N = 70) patients. No changes were found in the pre-SMA network. SMA connectivity correlated with motor speed (Trail-Making-Test A) and manual dexterity (Grooved Pegboard Test). Our results suggest that diminished functional connectivity of the SMA is an early correlate of functional decline in the older adults . The SMA may serve as a potential treatment target in frailty.

How to Correct for Computer Experience in Online Cognitive Testing?

Assessment ◽  
2020 ◽  
pp. 107319112091109
Author(s):  
Philippe R. Lee Meeuw Kjoe ◽  
Joost A. Agelink van Rentergem ◽  
Ivar E. Vermeulen ◽  
Sanne B. Schagen
Keyword(s):  
Test Performance ◽  
Neuropsychological Test ◽  
Cognitive Testing ◽  
Self Report ◽  
Cognitive Test ◽  
Computer Experience ◽  
Cognitive Test Performance ◽  
Online Tests ◽  
Report Measure ◽  
A Performance

Objective: Since computerized cognitive test performance may be influenced by computer experience, correction for this measure might be needed. This study examined how to correct for computer experience by examining its influence on online and traditional tests. Method: 248 healthy adults completed an online neuropsychological test battery and 70 adults completed traditional equivalents of the tests. Computer experience was assessed by a performance-based and a self-report measure. Regression analyses were applied to examine their influence on the online and traditional tests. Results: After correction for demographics, the performance-based measure was associated with online and traditional, predominantly speed-based, tests. The self-report measure was also associated with speed-based online tests but not with most traditional tests. Conclusions: Correcting computerized neuropsychological tests using a performance-based measure of computer experience would be unwise, because this measure also seems to tap into cognitive functions. A correction using a self-report measure might be better and is appropriate.

Patterns of Cognitive Test Performance As Functions of the Lateral Localization of Cerebral Abnormalities in the Temporal Lobe

1957 ◽  
Vol 103 (433) ◽  
pp. 758-772 ◽  
Author(s):  
Victor Meyer ◽  
H. Gwynne Jones
Keyword(s):  
Test Performance ◽  
Right Hemisphere ◽  
Cognitive Test ◽  
Temporal Relationships ◽  
Verbal Tasks ◽  
Specific Locus ◽  
Left And Right ◽  
Spatio Temporal ◽  
Cognitive Test Performance ◽  
Lateral Localization

Various investigations into the effects of brain injury on psychological test performance (Weisenburg and McBride, 1935; Patterson and Zangwill, 1944; Anderson, 1951; McFie and Piercy, 1952; Bauer and Becka, 1954; Milner, 1954) suggest the overall conclusion that patients with left hemisphere lesions are relatively poor at verbal tasks, while those with right-sided lesions do worst at practical tasks, particularly the manipulation of spatial or spatio-temporal relationships. Heilbfun's (1956) study confirmed that verbal deficits result from left-sided lesions but his left and right hemisphere groups produced almost identical scores on spatial tests. In so far as these workers paid attention to the specific sites of the lesions, their findings indicate that the pattern of test performance is a function of the hemisphere in which the lesion occurs rather than of its specific locus.

Improvement of cognitive test performance in patients undergoing primary CABG and other CPB-assisted cardiac procedures

Perfusion ◽  
2008 ◽  
Vol 23 (5) ◽  
pp. 267-273 ◽  
Author(s):  
JM van den Goor ◽  
BK Saxby ◽  
JG Tijssen ◽  
KA Wesnes ◽  
BA de Mol ◽  
...  
Keyword(s):  
Cognitive Functions ◽  
Test Performance ◽  
Artery Bypass ◽  
Cardiac Surgical Procedures ◽  
Cognitive Test ◽  
Cardiac Procedures ◽  
Patient Groups ◽  
Cognitive Test Performance ◽  
Composite Scores ◽  
Cabg Patients

Cardiac surgical procedures assisted by cardiopulmonary bypass (CPB) impair cognitive functions. Several studies, however, showed that cognitive functions were unaffected in patients undergoing either primary coronary artery bypass grafting (CABG) or more complex surgery assisted by CPB. Therefore, we conducted a straightforward study to compare patient groups who differed significantly in terms of risk factors such as prolonged CPB times. Consecutive patients (n = 54) were included, undergoing either non-primary CABG, e.g. valve and/or CABG, (n = 30) or primary CABG (n = 24), assisted by CPB. Cognitive function was determined pre-operatively on the day of hospital admission, and post-operatively after one and six months using the Cognitive Drug Research computerized assessment battery. Data from the fourteen individual task variables were summarized in four composite scores: Power of Attention (PoA), Continuity of Attention (CoA), Quality of Episodic Memory (QoEM), and Speed of Memory (SoM). In the non-primary CABG patients, both CoA and QoEM improved after 1 month (p = 0.001 and p = 0.016, respectively), whereas, after 6 months, CoA (p = 0.002), QoEM (p = 0.002) and SoM (p < 0.001) were improved. In primary CABG patients, CoA improved at one month after surgery (p = 0.002) and, after six months, not only CoA (p = 0.003), but also QoEM and SoM were improved (p = 0.001 and p = 0.030, respectively). The test performance was similar in non-primary and primary CABG patients after surgery. Our present study shows a post-operative improvement of cognitive composite scores after cardiac surgery assisted by CPB in both non-primary CABG and in primary CABG patients.

scholarly journals A Comparative Meta-Analysis of the Effects of Concussion on a Computerized Neurocognitive Test and Self-Reported Symptoms

2017 ◽  
Vol 52 (9) ◽  
pp. 834-846 ◽  
Author(s):  
Bara Alsalaheen ◽  
Kayla Stockdale ◽  
Dana Pechumer ◽  
Steven P. Broglio ◽  
Gregory F. Marchetti
Keyword(s):  
Test Performance ◽  
Fixed Effects ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Fixed Effects Model ◽  
Symptom Scale ◽  
Additional Information ◽  
Neurocognitive Test

Context:  Meta-analyses examining construct-specific cognitive impairment concurrently with self-reported symptoms postconcussion are sparse. Objective:  To review the literature on the effects of concussion on construct-specific neurocognitive declines and to compare them with self-reported symptoms before 1 week and between 1 and 3 weeks postconcussion. Data Sources:  Relevant studies in PubMed, CINAHL, and PsycINFO published from January 1, 1999 through November 30, 2015. Study Selection:  Studies were included if participants completed the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) before and after concussion and if test performance and Postconcussion Symptom Scale (PCSS) scores were reported at both times. Data Extraction:  After reviewing the full texts, we extracted data from 17 studies consisting of 29 independent samples; therefore, this meta-analysis consisted of 1777 unique participants. Data Synthesis:  The Hedges g effect size (ES) was estimated. A random-effects or fixed-effects model was used based on heterogeneity findings. When heterogeneity was present, we used meta-regression to assess unexplained between-studies variance. Within the first week of injury, the ESs were small to moderate for cognitive declines, ranging from −0.43 (95% confidence interval [CI] = −0.52, −0.35) to −0.67 (95% CI = −0.77, −0.58), and large for the PCSS score (Hedges g = −0.81; 95% CI = −0.91, −0.71). After 1 week, the ESs for cognitive declines (Hedges g range = −0.25 [95% CI = −0.35, −0.15] to −0.37 [95% CI = −0.55, −0.19]) and PCSS score (Hedges g = −0.38; 95% CI = −0.53, −0.22) were also small. Within 2 weeks of injury, PCSS score and time since injury weakly moderated the cognitive ES. Conclusions:  When a neurocognitive test was administered within 1 week of injury, the ES was larger for self-reported symptoms than for ImPACT scores generated at the same session. After 1 week of injury, the ESs for ImPACT and PCSS scores were comparable. If the athlete reports symptoms within 1 week of injury, administering a cognitive test does not appear to offer additional information to the clinician. However, if the athlete does not report symptoms postconcussion, cognitive testing may inform the clinical management of the injury.

scholarly journals The effects of gamelike features and test location on cognitive test performance and participant enjoyment

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2184 ◽  
Author(s):  
Jim Lumsden ◽  
Andy Skinner ◽  
Andy T. Woods ◽  
Natalia S. Lawrence ◽  
Marcus Munafò
Keyword(s):  
Test Performance ◽  
Cognitive Task ◽  
Reaction Times ◽  
Error Rates ◽  
Cognitive Testing ◽  
Quality Data ◽  
Cognitive Test ◽  
Test Location ◽  
Gamelike Features ◽  
Time Accuracy

Computerised cognitive assessments are a vital tool in the behavioural sciences, but participants often view them as effortful and unengaging. One potential solution is to add gamelike elements to these tasks in order to make them more intrinsically enjoyable, and some researchers have posited that a more engaging task might produce higher quality data. This assumption, however, remains largely untested. We investigated the effects of gamelike features and test location on the data and enjoyment ratings from a simple cognitive task. We tested three gamified variants of the Go-No-Go task, delivered both in the laboratory and online. In the first version of the task participants were rewarded with points for performing optimally. The second version of the task was framed as a cowboy shootout. The third version was a standard Go-No-Go task, used as a control condition. We compared reaction time, accuracy and subjective measures of enjoyment and engagement between task variants and study location. We found points to be a highly suitable game mechanic for gamified cognitive testing because they did not disrupt the validity of the data collected but increased participant enjoyment. However, we found no evidence that gamelike features could increase engagement to the point where participant performance improved. We also found that while participants enjoyed the cowboy themed task, the difficulty of categorising the gamelike stimuli adversely affected participant performance, increasing No-Go error rates by 28% compared to the non-game control. Responses collected online vs. in the laboratory had slightly longer reaction times but were otherwise very similar, supporting other findings that online crowdsourcing is an acceptable method of data collection for this type of research.

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