The Correlation between a New Online Cognitive Test (the Brain Assessment) and Widely Used In-Person Neuropsychological Tests

<b><i>Introduction:</i></b> There are several problems with standard in-person neuropsychological assessments, such as habituation, necessity of human resources, and difficulty of in-person assessment under societal conditions during the outbreak of coronavirus disease 2019. Thus, we developed an online cognitive test (the Brain Assessment [BA]). In this study, we investigated the correlation between the results of the BA and those of established neuropsychological tests. <b><i>Participants and Methods:</i></b> Seventy-seven elderly persons (mean 71.3 ± 5.1 years old; range 65–86; male:female = 45:32) were recruited through the internet. Correlations were evaluated between the BA and the following widely used neuropsychological tests: the mini-mental state examination (MMSE), the Raven’s colored progressive matrices (RCPM), the logical memory I and II of the Rivermead Behavioral Memory Test, the word fluency (WF) test, and the Trail-Making TestA/B. <b><i>Results:</i></b> We found moderate correlations between the total cognitive score of the BA and the total score of the MMSE (<i>r</i> = 0.433, <i>p</i> &#x3c; 0.001), as well as between the total BA score and the total RCPM score (<i>r</i> = 0.582, <i>p</i> &#x3c; 0.001) and time to complete the RCPM (<i>r</i> = 0.455, <i>p</i> &#x3c; 0.001). Moderate correlations were also observed between the cognitive score of the memory of words BA subtest and the LM-I (<i>r</i> = 0.518, <i>p</i> &#x3c; 0.001), the mental rotation subtest and figure drawing (<i>r</i> = 0.404, <i>p</i> &#x3c; 0.001), the logical reasoning subtest and total RCPM score (<i>r</i> = 0.491, <i>p</i> &#x3c; 0.001), and the memory of numbers and words subtests and WF (memory of numbers and total WF: <i>r</i> = 0.456, <i>p</i> &#x3c; 0.001; memory of words and total WF: <i>r</i> = 0.571, <i>p</i> &#x3c; 0.001). <b><i>Discussion:</i></b> We found that the BA showed moderate correlations between established neuropsychological tests for intellect, memory, visuospatial function, and frontal function. The MMSE and the RCPM reflect Spearman’s s-factor and g-factor, respectively, and thus the BA also covered both factors. <b><i>Conclusion:</i></b> The BA is a useful tool for assessing the cognitive function of generally healthy elderly persons.

The Profile of Task Performances for Cognitive-communicative Intervention in the Oldest-Old

Purpose: The “oldest-old” is the heterogeneous population compared with the younger-old in several cognitive-communication aspects. Accordingly, it is necessary to intervene in them discriminately. This study aimed to suggest the performance profiles by cognitive-communication tasks for intervention in oldest-old.Methods: Sixty-four oldest-old subjects aged 80 or older years performed 16 subtasks for the five cognitive-communication domains. And the performance profiles of group I (84.00 ± 2.62 years) and II (93.38 ± 1.61 years) were analyzed.Results: The main findings were as follows. Firstly, two groups had significant differences in performances of most tasks including working memory, reasoning, word fluency, and subjective communication. Secondly, five communication tasks were significantly correlated with all cognitive tasks and were predicted by the reasoning tasks like similarity in group I. Thirdly, word fluency and pragmatic expression tasks were significantly correlated with all cognitive tasks. Tasks including verbal problem solving were found to be the best predictors of confrontation naming in group II.Conclusion: Current study provides evidence-based information to support cognitive-communication intervention for the oldest-old. These results also can contribute to increase the efficacy of the cognitive-communicative intervention.

Word Fluency Test Performance in Primary Progressive Aphasia and Primary Progressive Apraxia of Speech

Purpose This study compared performance on three-word fluency measures among individuals with primary progressive aphasia (PPA) and primary progressive apraxia of speech (PPAOS), and examined the relationship between word fluency and other measures of language and speech. Method This study included 106 adults with PPA and 30 adults with PPAOS. PPA participants were divided into three clinical subgroups: semantic (svPPA), logopenic (lvPPA), and nonfluent/agrammatic with or without apraxia of speech (nfPPA). Category fluency, letter fluency, and action/verb fluency tasks were administered to all participants. Results The four clinical groups performed abnormally on the word fluency measures, although not to a degree that represented high sensitivity to their PPA or PPAOS diagnosis. All PPA subgroups produced fewer words compared to individuals with PPAOS on all word fluency measures. Moderate correlations were found between word fluency and aphasia severity and naming performance in some of the clinical groups. Conclusions Word fluency measures are often challenging for individuals with PPA and PPAOS, but they are not of equal difficulty, with letter fluency being the most difficult. Differences among word fluency tests also vary to some degree as a function of the clinical group in question, with least impairment in PPAOS. However, the findings of this study do not support statistically significant differences in word fluency task performance among the PPA subgroups. Correlations suggest that word fluency performance in PPA is at least partly related to aphasia severity.

Monthlong Intubated Patient with Life-Threatening COVID-19 and Cerebral Microbleeds Suffers Only Mild Cognitive Sequelae at 8-Month Follow-up: A Case Report

Objective To elaborate on possible cognitive sequelae related to COVID-19, associated cerebrovascular injuries as well as the general consequences from intensive care. COVID-19 is known to have several, serious CNS-related consequences, but neuropsychological studies of severe COVID-19 are still rare. Methods M., a 45-year-old man, who survived a severe COVID-19 disease course including Acute Respiratory Distress Syndrome (ARDS), cerebral microbleeds, and 35 days of mechanical ventilation, is described. We elaborate on M’s recovery and rehabilitation process from onset to the 8-month follow-up. The cognitive functions were evaluated with a comprehensive screening battery at 4 weeks after extubation and at the 8-month follow-up. Results Following extubation, M. was delirious, reported visual hallucinations, and had severe sleeping difficulties. At about 3 months after COVID-19 onset, M. showed mild to moderate deficits on tests measuring processing speed, working memory, and attention. At assessments at 8 months, M. performed better, with results above average on tests measuring learning, memory, word fluency, and visuospatial functions. Minor deficits were still found regarding logical reasoning, attention, executive functioning, and processing speed. There were no lingering psychiatric symptoms. While M. had returned to a part-time job, he was not able to resume previous work-tasks. Conclusion This case-study demonstrates possible cognitive deficits after severe COVID-19 and emphasizes the need of a neuropsychological follow-up, with tests sensitive to minor deficits. The main findings of this report provide some support that the long-term prognosis for cognition in severe COVID-19 may be hopeful.

Differential effects of body mass index on domain-specific cognitive outcomes after stroke

Although the obesity paradox is an important modifiable factor in cardiovascular diseases, little research has been conducted to determine how it affects post-stroke cognitive function. We aimed to investigate the association between body mass index (BMI) and domain-specific cognitive outcomes, focusing on the subdivision of each frontal domain function in post-ischemic stroke survivors. A total of 335 ischemic stroke patients were included in the study after completion of the Korean-Mini Mental Status Examination (K-MMSE) and the vascular cognitive impairment harmonization standards neuropsychological protocol at 3 months after stroke. Frontal lobe functions were analyzed using semantic/phonemic fluency, processing speed, and mental set shifting. Our study participants were categorized into four groups according to BMI quartiles. The z-scores of K-MMSE at 3 months differed significantly between the groups after adjustment for initial stroke severity (p = 0.014). Global cognitive function in stroke survivors in the Q1 (the lowest quartile) BMI group was significantly lower than those in Q2 and Q4 (the highest quartile) BMI groups (K-MMSE z-scores, Q1: − 2.10 ± 3.40 vs. Q2: 0.71 ± 1.95 and Q4: − 1.21 ± 1.65). Controlled oral word association test findings indicated that phonemic and semantic word fluency was lower in Q4 BMI group participants than in Q2 BMI group participants (p = 0.016 and p = 0.023 respectively). BMI might differentially affect cognitive domains after ischemic stroke. Although being underweight may negatively affect global cognition post-stroke, obesity could induce frontal lobe dysfunctions, specifically phonemic and semantic word fluency.

Fostering word fluency of struggling third graders from Germany through motivational peer-tutorial reading racetracks

Automation of frequently used words is a key component in the development of reading fluency. However, acquiring fast word recognition skills is a serious challenge for many children in their early years of formal education. Lagging word recognition leads to general reading problems, as fluency is a vital prerequisite for text comprehension. Recent research shows that the percentage of struggling elementary school readers in Germany is increasing, speaking to the need for widespread implementation of effective word recognition interventions. This pilot study aims to provide preliminary evidence of the effectiveness of peer-tutorial reading racetrack training with an integrated motivational system for the sight word fluency of German struggling elementary school students. The intervention comprised twelve 15-min teaching units over a period of three weeks. To encourage reading motivation, the intervention included graphing of performance scores and a group contingency procedure. A control-experimental group design (N = 44) with pre-, post-, and two follow-up measurements (each after five weeks) was employed to investigate the impact of the treatment on decoding sight words at an appropriate speed. Results demonstrated a significant performance increase in the treatment group, relative to the control group. The effect size can be considered very high (partial η2 = .76), indicating that this brief training has the potential to enhance the word recognition of struggling elementary students.

Altered Glutamate and Glutamine Kinetics in Autism Spectrum Disorder

Objectives Recent studies suggest that glutamate (GLU) signaling abnormalities are involved in the etiology of Autism Spectrum Disorder (ASD), suggesting perturbations in GLU and glutamine (GLN) metabolism. Although GLU and GLN plasma concentrations have been linked to cognitive decline, the actual production of GLU and GLN have never been measured in ASD and linked to ASD severity score and neurocognitive and mood changes. Methods 19 young adults with high functioning ASD (age 24.3 ± 1.0y, Autism Quotient (AQ): 31.4 ± 1.7), and 46 control subjects (age 23.4 ± 0.3y)) were enrolled. ASD severity and subscores as well as cognitive function and mood were assessed (MOCA, TMT, word fluency, Stroop, HADS). Postabsorptive amino acid kinetics (production of GLU and GLN, and its interconversion rates (GLU &gt; &gt;GLN and GLN &gt; &gt;GLU)) were measured by pulse stable isotope administration and subsequent blood sampling for 4 hours. Plasma amino acid enrichments and concentrations were analyzed by LC-MS/MS. Stats were done by ANCOVA, post hoc analysis and Pearson correlation. Significance was set at p &lt; 0.05. Results No differences were present in word fluency, but higher values in ASD for TMTb (p = 0.066), depression (p = 0.0004), anxiety (p = 0.0006) and lower values for MOCA (0.0054). The ASD group was characterized by lower plasma GLN and GLU concentrations (p &lt; 0.05). Although the production rates of GLN and GLU were not different between the groups, in ASD GLN &gt; &gt;GLU was higher (p = 0.0018) and GLU &gt; &gt;GLN lower (p = 0.016) and a higher GLN clearance rate (p = 0.006). Significant relationships were found in the ASD group between several GLU and GLN kinetic markers and AQ subscores (e.g., attention to detail, attention switching and/or communication) and word fluency (p &lt; 0.05). Conclusions Disturbances in GLN and GLU metabolism in ASD are associated with changes in ASD subscores but less with neurocognitive dysfunction or mood changes. Funding Sources None.

The Efficacy of Cognitive-Communicative Intervention in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

Mild cognitive impairment (MCI) is the sign of dementia, and is critical for prediction and preventing its progressions. This study aimed to review literature on cognitive communication intervention of MCI patients systematically, and propose the evidence-based data, including their effect sizes using a meta-analysis method. Thirty-eight researches published since 2012, meeting the inclusion and exclusion criteria, were entered into this analysis. They were analyzed in qualitative aspects, and their effect sizes were calculated in a level of mean and each domain. Outcome measures included the domains of 10 cognitions and 4 communications. The main findings were as follows. Firstly, the general target population for studies was MCI over the age of 50, and intervention programs were designed diversely in a session or mode. Secondly, several domains, including attention, memory, and executive function held a large portion of the intervention programs. Thirdly, the average effect size of interventions was large. Lastly, processing speed and word fluency were very effective and significant among domains in the results of treatment. Current study provides evidence-based information to support cognitive-communication intervention for individuals with MCI. These results also can contribute to diversify intervention approaches and verify their efficacies. Given this, it is possible to facilitate the cognitive-communication intervention for MCI in clinical settings.