BackgroundThe present study aimed at assessing the diagnostic properties of the Montreal Cognitive Assessment in non-demented ALS patients and at exploring the MoCA administrability according to motor-functional status.MaterialsN = 348 patients were administered the MoCA and Edinburgh Cognitive and Behavioural ALS Screen. Administrability rates and prevalence of defective MoCA scores were compared across King’s and Milano-Torino clinical stages. Regression models were run to test whether the non-administrability of the MoCA and a defective score on it were (...) predicted, net of the ECAS-Total, by disease duration, ALS Functional Rating Scale-Revised and progression rate, computed as /disease duration. Intrinsic and post-test diagnostics were tested against a below-cut-off ECAS-total score.ResultsThe 79.9% of patients successfully underwent the MoCA, whose administrability rates decreased with advanced clinical stages, at variance with its defective score prevalence. The probability of the FAB not being administrable was predicted only by lower ALSFRS-R-bulbar and-upper-limb scores; no motor features, but the ECAS-Total, predicted a defective MoCA performance. The MoCA showed high accuracy and good intrinsic and post-test properties—being slightly more specific than sensitive.DiscussionIn non-demented ALS patients, the MoCA is featured by optimal diagnostics as a screener for cognitive impairment, especially for ruling-out its occurrence, as long as patients are in the early stages of the disease and have sufficiently spared bulbar and upper-limb functions. (shrink)

BackgroundThe Chinese version of the Mini-Mental State Examination and the Beijing version of the Montreal Cognitive Assessment are the most commonly used scales to screen for Alzheimer’s disease among Chinese patients; however, their consistency varies according to populations and languages. Equivalent conversion of MMSE-C and MoCA-BJ scores is important for meta-analysis.Materials and methodsMMSE-C and MoCA-BJ scoring were performed on the enrolled patients with AD. Consistency analysis of MMSE-C and MoCA-BJ scores of patients in the conversion groups was (...) performed. The circle-arc method was used to convert the MMSE-C scores of the conversion groups into MoCA-BJ scores, and the conversion formula was generated. The MMSE-C data of the verification group was converted to MoCA-BJ according to the formula, and the consistency analysis of the original MoCA-BJ of the verification group and the converted MoCA-BJ was performed to verify the conversion model.ResultsThe results of the consistency analysis of MMSE-C and MoCA-BJ in group A showed that the correlation coefficients of the total group, high education years subgroup, medium education years subgroup, and low education years subgroup were 0.905, 0.874, 0.949, and 0.874, respectively, with high consistency and statistical significance. After applying the circle-arc method for equivalent conversion, the consistency analysis results of the original and the converted MoCA-BJ of the patients in group B of the total group, high education years subgroup, medium education years subgroup, and low education years subgroup were 0.891, 0.894, 0.781, 0.909, respectively, with high consistency and statistical significance.ConclusionWe established and validated a model of MMSE-C and MoCA-BJ score conversion for Chinese patients with AD using the circle-arc method. This model could be useful for multi-centers clinical trials and meta-analysis. (shrink)

BackgroundThe cognitive level of post-stroke aphasia patients is generally lower than non-aphasia patients, and cognitive impairment affects the outcome of stroke. However, for different types of PSA, what kind of cognitive assessment methods to choose is not completely clear. We investigated the Montreal Cognitive Assessment, the Mini-Mental State Examination, and the Non-language-based Cognitive Assessment to observe the evaluation effect of CI in patients with fluent aphasia and non-fluent aphasia.Methods92 stroke patients were (...) included in this study. Demographic and clinical data of the stroke group were documented. The language and cognition were evaluated by Western Aphasia Battery, MoCA, MMSE, and NLCA. PSA were divided into FA and NFA according to the Chinese aphasia fluency characteristic scale. Pearson’s product–moment correlation coefficient test and multiple linear regression analysis were performed to explore the relationship between the sub-items of WAB and cognitive scores. The classification rate of CI was tested by Pearson’s Chi-square test or Fisher’s exact test.ResultsThe scores of aphasia quotient, MoCA, MMSE, and NLCA in NFA were lower than FA. AQ was positively correlated with MoCA, MMSE, and NLCA scores. Stepwise multiple linear regression analysis suggested that naming explained 70.7% of variance of MoCA and 79.9% of variance of MMSE; comprehension explained 46.7% of variance of NLCA. In the same type of PSA, there was no significant difference in the classification rate. The classification rate of CI in NFA by MoCA and MMSE was higher than that in FA. There was no significant difference in the classification rate of CI between FA and NFA by NLCA.ConclusionMoCA, MMSE, and NLCA can be applied in FA. NLCA is recommended for NFA. (shrink)

Background:Smart Aging is a serious game (SG) platform that generates a 3D virtual reality environment in which users perform a set of screening tasks designed to allow evaluation of global cognition. Each task replicates activities of daily living performed in a familiar environment. The main goal of the present study was to ascertain whether Smart Aging could differentiate between different types and levels of cognitive impairment in patients with neurodegenerative disease.Methods:Ninety-one subjects (mean age = 70.29 ± 7.70 years)—healthy older (...) adults (HCs,n= 23), patients with single-domain amnesic mild cognitive impairment (aMCI,n= 23), patients with single-domain executive Parkinson's disease MCI (PD-MCI,n= 20), and patients with mild Alzheimer's disease (mild AD,n= 25)—were enrolled in the study. All participants underwent cognitive evaluations performed using both traditional neuropsychological assessment tools, including the Mini-Mental State Examination (MMSE), Montreal Overall Cognitive Assessment (MoCA), and the Smart Aging platform. We analyzed global scores on Smart Aging indices (i.e., accuracy, time, distance) as well as the Smart Aging total score, looking for differences between the four groups.Results:The findings revealed significant between-group differences in all the Smart Aging indices: accuracy (p< 0.001), time (p< 0.001), distance (p< 0.001), and total Smart Aging score (p< 0.001). The HCs outperformed the mild AD, aMCI, and PD-MCI patients in terms of accuracy, time, distance, and Smart Aging total score. In addition, the mild AD group was outperformed both by the HCs and by the aMCI and PD-MCI patients on accuracy and distance. No significant differences were found between aMCI and PD-MCI patients. Finally, the Smart Aging scores significantly correlated with the results of the neuropsychological assessments used.Conclusion:These findings, although preliminary due to the small sample size, suggest the validity of Smart Aging as a screening tool for the detection of cognitive impairment in patients with neurodegenerative diseases. (shrink)

BackgroundThe cognitive outcomes induced by subthalamic nucleus deep brain stimulation (STN-DBS) remain unclear, especially in PD patients with mild cognitive impairment (MCI). This study explored the cognitive effects of STN-DBS in PD patients with MCI.MethodsThis was a retrospective cohort study that included 126 PD patients who underwent STN-DBS; all patients completed cognitive and motor assessments before and at least 6 months after surgery. Cognitive changes were mainly evaluated by the Montreal cognitive assessment (...) (MoCA) scale and the seven specific MoCA domains, including visuospatial/executive function, naming, attention, language, abstract, delayed recall, and orientation. Motor improvement was evaluated by the UPDRS-III. Cognitive changes and motor improvements were compared between PD-MCI and normal cognitive (NC) patients. Logistic regression analyses were performed to explore predictors of post-operative cognitive change.ResultsAt the time of surgery, 61.90% of the included PD patients had MCI. Compared with the PD-MCI group, the PD-NC group had a significantly higher proportion of cases with post-operative cognitive decline during follow-up of up to 36 months (mean 17.34 ± 10.61 months), mainly including in global cognitive function, visuospatial/executive function and attention. Covariate-adjusted binary logistic regression analyses showed that pre-operative global cognitive status was an independent variable for post-operative cognitive decline. We also found that pre-operative cognitive specific function could predict its own decline after STN-DBS, except for the naming and orientation domains.ConclusionPD-MCI patients are at a lower risk of cognitive decline after STN-DBS compared with PD-NC patients. (shrink)

IntroductionCognition generally declines gradually over time due to progressive degeneration of the brain, leading to dementia and eventual loss of independent functions. The rate of regression varies among the six cognitive domains. Current modality of cognitive assessment using neuropsychological paper-and-pencil screening tools for cognitive impairment such as the Montreal Cognitive Assessment has limitations and is influenced by age. Virtual reality is considered as a potential alternative tool to assess cognition. A novel, fully immersive (...) automated VR system has been developed to assess the six cognitive domains. As cognition is associated with age, VR performance is postulated to vary with age using this system.AimsThis is a feasibility study to evaluate the VR performance of cognitively healthy adults aged between 35 and 74 years old, based on the performance score and completion time using the CAVIRE system.MethodsConducted in a public primary care clinic in Singapore, 25 multi-ethnic Asian adults were recruited in each of the four age groups in years: 35–44; 45–54; 55–64, and 65–74. The eligibility criteria included a MoCA score of 26 or higher to reflect normal cognition and understanding English instructions. They completed common daily activities ranging from brushing teething to shopping, across 13 VR segments. Their performances scores and completion time were automatically computed by the CAVIRE system. These VR performance indices were compared across the four age groups using one-way ANOVA, F-test of the hypothesis, followed by pair-wise comparisons in the event of a significant F-test.ResultsOne participant dropped out from Group 1. The demographic characteristics of 99 participants were similar across the 4 age groups. Overall, younger participants in Groups 1 and 2 attained higher VR performance scores and shorter completion time, compared to those in Groups 3 and 4, in all six cognitive domains.ConclusionThe CAVIRE VR performance scores and completion time significantly differ between the younger and older Asian participants with normal cognition. Enhancements to the system are needed to establish the age-group specific normal performance indices. (shrink)

BackgroundCognitive dysfunctions, both subjective and detectable at psychometric testing, may follow SARS-CoV-2 infection. However, the ecological-functional relevance of such objective deficits is currently under-investigated. This study thus aimed at investigating the association between objective cognitive measures and both physical and cognitive, ecological-functional outcomes in post-COVID-19.MethodsForty-two COVID-19-recovered individuals were administered the Mini-Mental State Examination and the Montreal Cognitive Assessment. The Functional Independence Measure was adopted to assess functional-ecological, motor/physical and cognitive outcomes at admission and discharge.ResultsWhen (...) predicting both T0/T1 FIM-total and-Motor scores based on MMSE/MoCA scores, premorbid risk for cognitive decline and disease-related features, no model yielded a significant fit. However, the MoCA - but not the MMSE significantly predicted T0/T1 FIM-Cognitive scores. The MoCA was significantly related only to T0/T1 FIM-Cognitive Memory items.DiscussionCognitive measures are not associated with physical/motor everyday-life outcomes in post-COVID-19 patients. The MoCA may provide an ecological estimate of cognitive functioning in this population. (shrink)

Background: Parkinson’s disease is a neurodegenerative disease in which the progressive loss of dopaminergic neurons leads to initially sporadic and eventually widespread damage of the nervous system resulting in significant musculoskeletal and cognitive deterioration. Loss of motor function alongside increasing cognitive impairment is part of the natural disease progression. Gait is often considered an automatic activity; however, walking is the result of a delicate balance of multiple systems which maintain the body’s center of mass over an ever-changing base (...) of support. It is a complex motor behavior that requires components of attention and memory to prevent falls and injury. In addition, evidence points to the critical role of salient visual information to gait adaptability. There is a growing understanding that treatment for PD needs to address movement as it occurs naturally and walking needs to be practiced in more complex environments than traditional therapy has provided.MethodsIn this single-blinded randomized-controlled pilot study, an immersive treadmill training was piloted to determine feasibility and preliminary efficacy on gait and cognition in people with PD. Eighteen participants with Hoehn and Yahr stages I-III PD were randomized to either an intervention or a waitlist control group. Following baseline data collection, the intervention group trained for 30 min, three times/week for 4 weeks on a split belt treadmill combined with a first-person immersive video game targeting visuospatial skills and working memory. Assessment was repeated after 4 weeks of training for the experimental group and 1-month after baseline for the control group. Primary motor outcomes were captured with the APDM Opal sensors during 6 MWT, TUG, and TUG Cognitive. Secondary outcomes of cognition were measured with the Montreal Cognitive Assessment, Verbal Fluency and the Symbol Digit Modality Test. Within subject differences were calculated using the Wilcoxon Signed Ranked Test and between subject comparisons were analyzed using the Mann Whitney U-test.ResultsThis novel treadmill training program was well-tolerated with all participants in the intervention group completing 4 weeks of training three times a week without any adverse effects. After immersive cognitive motor training, the experimental group made clinically relevant improvements in gait speed and walking distance during the 6 MWT while members of the control group showed no change or decreased gait speed and walking distance over the 1-month trial. In addition, the experimental group demonstrated significant improvement for the TUG Cognitive and those changes were greater than the control group. The experimental group also improved scores on MoCA and SDMT cognitive outcome measures while the control group did not.ConclusionThe use of immersive gaming technology to engage specific areas of cognition related to gait is feasible in PD. The treadmill training program paired with a customized interactive video game improved walking velocity in addition to non-significant but consistent improvements in other gait measures and cognitive performance in participants with early to mid-stage PD. (shrink)

BackgroundAging and type 2 diabetes mellitus are important risk factors for the development of cognitive deterioration and dementia. The objective of this research was to investigate the effects of an exercise intervention on cognitive function in older T2DM patients.MethodsEight literature databases were searched from inception to 20 January 2022. The researchers examined randomized controlled trials that evaluated the impact of exercise on the cognitive performance of older T2DM patients. The Cochrane risk-of-bias tool for RCTs was used to (...) assess each study. The quality of evidence was assessed using the GRADE approach. The mini-mental state examination, Modified MMSE, and Montreal cognitive assessment were used to evaluate the cognitive outcomes. We performed a subgroup analysis with stratification according to exercise intervention modality, duration, and cognitive impairment.ResultsFive trials were eligible, with a total of 738 T2DM patients. The combined findings revealed that exercise improved global cognitive function significantly. In the studies that were included, no relevant adverse events were reported.ConclusionExercise is beneficial in improving global cognitive function in older adults with T2DM. Studies with bigger sample sizes and higher quality are additionally expected to draw more definite conclusions.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO/#recordDetails], identifier [CRD42022296049]. (shrink)

Type 2 diabetes mellitus is related to a variety of cognitive impairments that may even progress to dementia. Studies have found the angular gyrus is a cross-modal integration hub that is involved in a variety of cognitive processes. However, few studies have focused on the patterns of resting-state functional connections of the AG in patients with T2DM. This study explored the functional connection between the AG and the whole brain and the relationship between the FC and clinical/cognitive (...) variables in patients with T2DM. 44 patients with T2DM and 43 sex-, age-, and education-matched healthy controls underwent resting-state fMRI and received neuropsychological assessments. Compared with the control group, the T2DM group showed abnormal rsFCs between the AG and multiple brain regions. The FC between the left AG and the left medial temporal lobe in the T2DM group was positively correlated with scores on the Montreal Cognitive Assessment, after a Bonferroni correction. Collectively, patients with T2DM have abnormal FCs between the AG and extensive brain regions that may be related to various cognitive processes. (shrink)

ObjectiveThis study aimed to develop a diagnostic model of multi-kinematic parameters for patients with amnestic mild cognitive impairment (aMCI).MethodIn this cross-sectional study, 94 older adults were included (33 cognitively normal, CN; and 61 aMCI). We conducted neuropsychological battery tests, such as global cognition and cognitive domains, and collected gait parameters by an inertial-sensor gait analysis system. Multivariable regression models were used to identify the potential diagnostic variables for aMCI. Receiver operating characteristic (ROC) curves were applied to assess the (...) diagnostic accuracy of kinematic parameters in discriminating aMCI from healthy subjects.ResultsMultivariable regression showed that multi-kinematic parameters were the potential diagnostic variables for aMCI. The multi-kinematic parameter model, developed using Timed Up and Go (TUG) time, stride length, toe-off/heel stride angles, one-leg standing (OLS) time, and braking force, showed areas under ROC (AUC), 0.96 [95% confidence interval (CI), 0.905–0.857]; sensitivity, 0.90; and specificity, 0.91. In contrast, a single kinematic parameter’s sensitivity was 0.26–0.95 and specificity was 0.21–0.90. Notably, the separating capacity of multi-kinematic parameters was highly similar to Montreal Cognitive Assessment (MoCA; AUC: 0.96 vs. 0.95). Compared to cognitive domain tests, the separating ability was comparable to Auditory Verbal Learning Test (AVLT) and Boston Naming Test (BNT; AUC: 0.96 vs. 0.97; AUC: 0.96 vs. 0.94).ConclusionWe developed one diagnostic model of multi-kinematic parameters for patients with aMCI in Foshan. (shrink)

PurposeThe aim of this study was to investigate and compare impulsiveness, negative emotion, cognitive function, and P300 components among gamma-hydroxybutyrate -addicted patients, heroin-dependent patients, and methadone maintenance treatment subjects.MethodsA total of 48 men including 17 GHB addicts, 16 heroin addicts, 15 MMT subjects, and 15 male mentally healthy controls were recruited. All subjects were evaluated for symptoms of depression, anxiety, impulsiveness, and cognitive function through the Patient Health Questionnaire, the Generalized Anxiety Disorder 7-item, the Barratt Impulsiveness Scale version (...) II, the Beijing version of the Montreal Cognitive Assessment, the behavioral test, and event-related potential P300 detection.Results The mean scores of BIS-II in the GHB addiction group, heroin dependence group, and MMT group were significantly higher than those of the HC group. The total scores of BJ-MOCA in GHB addiction group was the worst among the four groups, followed by heroin addiction, MMT group and HC group. The response time in the GHB addiction group was the longest among the four groups, followed by the heroin addiction, MMT, and HC groups. The amplitude and latency of P300 in GHB addiction subjects were significantly lower and longer than those of the MMT group and the HC group. For the three types of addiction, the P300 amplitudes at Fz, Cz, Pz, T5, and T6 were negatively correlated with the scores of GAD-7, PHQ-9, and BIS-II; the P300 latencies were positively correlated with the response time and negatively correlated with the scores of the BJ-MoCA.ConclusionPeople with an addiction were likely to have increased impulsiveness. The cognitive function of the GHB and heroin-addicted subjects, including the heroin detoxification and the MMT groups, was severely impaired, especially for the GHB-addicted patients. The impairment manifested as abnormalities of BJ-MoCA, response time, and P300 components. (shrink)

PurposeThe aim of this study was to investigate the differential effects of Tai Chi vs. brisk walking on cognitive function among individuals aged 60 and greater.Patients and MethodsFor participant recruitment, a health talk was arranged at two communities in which two different exercise modalities were assigned to participants of each community free of charge. The intervention programs lasted 10 weeks, with three 60-min training sessions per week. General cognitive ability and specific cognitive outcomes were measured using the (...) Chinese version of the Montreal Cognitive Assessment.ResultsA significant interaction on total scores of the MoCA was observed. Post hoc analysis indicated significant improvements on general cognitive performance as measured in performance on the MoCA for both exercise groups at the end of 10 weeks. A significant interaction was only observed on the delayed recall sub-domain. Results from post hoc analysis indicate that the Tai Chi group had a significantly better memory performance relative to brisk walking group. Specifically, significant improvement was observed in Tai Chi group, but not in the brisk walking group. Both exercise groups demonstrated significant improvements from baseline to Week 10, which emerged in visualspatial ability and attention performance. Lastly, animal naming and orientation significantly benefited from brisk walking and Tai Chi training, respectively.ConclusionTai Chi and brisk walking as the most commonly used, culture-specific mind-body exercise method have been proven to be effective in improving general cognitive performance and specific cognitive domains. Furthermore, differential effects of two different exercise modalities on cognitive domains were observed, which has provided insightful information for customized exercise programs. Finally, aging individuals who are experiencing cognitive decline should either take Tai Chi classes regularly or engage in brisk walking, which could contribute to brain health. (shrink)

IntroductionPreoperative neurocognitive disorder is a common condition affecting 14–51. 7% of the elderly population. General anesthesia has already been associated with the one-year post-operative neurocognitive disorder, specifically, a deficit in executive function, measured by the Trail Making Test B, but its long-term effects on cognitive function have not been investigated. We aimed to detect preO-NCD prevalence in patients scheduled for cardiac surgery and further investigate the possible role of previous general anesthesia in general preoperative cognitive status [measured via (...) the Montreal Cognitive Assessment ] and/or in executive functioning.MethodsIn this observational, prospective study, 151 adult patients scheduled for elective cardiac surgery underwent MoCA and TMT-B. Data on age, education, pGA, comorbidities, and laboratory results were collected.ResultsWe discovered a general cognitive function impairment of 79.5% and an executive function impairment of 22%. Aging is associated with an increased likelihood and education with a decreased likelihood of general cognitive impairment, but only education was significantly associated with a decreased likelihood of executive function impairment. While pGA did not significantly affect preO-NCD, a noteworthy interaction between aging and pGA was found, resulting in a synergistic effect, increasing the likelihood of executive function impairment.ConclusionWe found a high prevalence of preO-NCD in patients scheduled for cardiac surgery. General cognitive function impairment is highly associated with advancing age. However, older patients with at least one pGA appeared to be at an increased risk of preO-NCD, especially executive function impairment, suggesting that TMT-B should be associated with MoCA in the preoperative cognitive evaluation in this population. (shrink)

Summer School in Cognitive Science: Minds and Societies. Communication par affiche dans un congrès, Montréal, 26 juin - 06 juillet 2008.

Major neurocognitive changes occur during adolescence, making this phase as one of the most critical developmental period of life. Furthermore, this phase in life is also the time in youth substance use has its onset. Several studies demonstrated the differential associations of alcohol and cannabis use concerning the neurocognitive functioning of both males and females. Past and contemporary literature on gender-specific effects in neuroscience of addiction is predominantly based on cross-sectional datasets and data that is limited in terms of measurement (...) variability. Given the importance of gender-specific effects in addiction studies, and in order to address the two above-mentioned gaps in the literature, the present study aimed to compare neurocognitive functioning of male and female adolescents in the context of cannabis and alcohol use, while employing a longitudinal design with multiple repeated measurements. Participants were 3,826 high school students (47% female; mean age, 12.7), which were recruited from 31 high schools in the greater Montreal area. Participants were requested to complete annual surveys for five consequent years, from 7th to 11th grade, assessing their alcohol/cannabis use and neurocognitive functioning (working memory, delayed recall memory, perceptual reasoning, and inhibition control). The analytical strategy was focused on the longitudinal association between each predictor (female, male) and each of the outcomes (domains of neurocognitive functioning). Multilevel linear models assessed the association of alcohol and cannabis consumption and the four domains of neurocognitive functioning. Results revealed a gender by within-subject interaction, suggesting a weaker effect of yearly fluctuation of cannabis use on working memory among males compared to females. Our findings suggest a different pattern of neurocognitive impairment of female and male working memory after using cannabis over the course of adolescence. Early initiation of cannabis use potentially results in more spatial working memory deficits in female adolescents. This may negatively influence young females’ capacity in academic settings and lead to significant impairment in adulthood, which critically decreases the individual’s quality of life. (shrink)

School performance and cognitive competence can be conceptualized as social and relational constructs. Thus, we expect their association to vary as a function of other socially-embedded variables which have proven meaningful in the academic domain. The present study takes a critical theory approach to assess gender-related and contextual variability in the association between peer-assessed school performance and self-perceived cognitive competence. The sample consisted of 719 preadolescents living in lower- and upper-middle-class neighborhoods in Montreal, Canada and Barranquilla, Columbia. (...) Multigroup comparisons revealed that peer-assessed school competence was more strongly associated with self-perceived cognitive competence for upper-middle-class than lower-middle-class participants from Barranquilla, whereas the opposite pattern was observed with Montreal participants, and that the association between communal orientation and self-perceived cognitive competence was stronger for girls than for boys across the sample, especially in the upper-middle-class school in Montreal. These findings highlight the nuanced degree of gender differences in preadolescents’ perceived academic competence and emphasize the role of SES in shaping self-perceptions. (shrink)

ObjectiveType 2 diabetes mellitus (T2DM) is a high risk of cognitive decline and dementia, but the underlying mechanisms are not yet clearly understood. This study aimed to explore the functional connectivity (FC) and topological properties among whole brain networks and correlations with impaired cognition and distinguish T2DM from healthy controls (HC) to identify potential biomarkers for cognition abnormalities.MethodsA total of 80 T2DM and 55 well-matched HC were recruited in this study. Subjects’ clinical data, neuropsychological tests and resting-state functional magnetic (...) resonance imaging data were acquired. Whole-brain network FC were mapped, the topological characteristics were analyzed using a graph-theoretic approach, the FC and topological characteristics of the network were compared between T2DM and HC using a general linear model, and correlations between networks and clinical and cognitive characteristics were identified. The support vector machine (SVM) model was used to identify differences between T2DM and HC.ResultsIn patients with T2DM, FC was higher in two core regions [precuneus/posterior cingulated cortex (PCC)_1 and later prefrontal cortex_1] in the default mode network and lower in bilateral superior parietal lobes (within dorsal attention network), and decreased between the right medial frontal cortex and left auditory cortex. The FC of the right frontal medial-left auditory cortex was positively correlated with the Montreal Cognitive Assessment scales and negatively correlated with the blood glucose levels. Long-range connectivity between bilateral auditory cortex was missing in the T2DM. The nodal degree centrality and efficiency of PCC were higher in T2DM than in HC (P < 0.005). The nodal degree centrality in the PCC in the SVM model was 97.56% accurate in distinguishing T2DM patients from HC, demonstrating the reliability of the prediction model.ConclusionFunctional abnormalities in the auditory cortex in T2DM may be related to cognitive impairment, such as memory and attention, and nodal degree centrality in the PCC might serve as a potential neuroimaging biomarker to predict and identify T2DM. (shrink)

Objective: To investigate the differences between patients returning to work and those who did not after brain tumor surgery.Methods: Patients were evaluated before surgery and after 3 months. The Montreal Cognitive Assessment test, Trail-Making Test, 15-word Rey–Osterrieth Word List, F-A-S tests, and Karnosfky Performance Status were used to assess cognitive status, attention, executive functions, memory, word fluency, and functional status. Patient-reported outcome measures used to evaluate emotional distress and disability were the Hospital Anxiety and Depression Scale (...) and World Health Organization Disability Assessment Schedule. Clinical and work-related variables, PROMs, and cognitive tests were compared using chi-squared, t-test or Mann–Whitney U test.Results: Sixty patients were included. Patients returning to work were 61.3 and 31.0% among people with meningioma and glioma, respectively. They reported lower postoperative disability and lesser home-to-work travel time. Patients with meningioma also showed better preoperative and postoperative attention and executive functions, better postoperative functional and cognitive status, and lower frequency of treatments.Conclusions: These variables should be considered in a clinical context to plan interventions for people who need support during return to work and in future research to investigate preoperative and postoperative predictive factors of going back to work. (shrink)

Cognition is predominantly seen as information processing in multidisciplinary landscape of cognition studies, despite having had a formidable opposition from embodied and embedded perspectives in the last few decades. This paper analyses cognitive processes involved in different task domains of Kashmiri carpet weaving practice from the theoretical frameworks of cognitivism and situated-distributed cognition. After introducing the practice and its task domains (Section −1), paradigmatic cognitive activities involved in them are discussed and how these are explained by the two (...) theoretical paradigms and why the latter framework explains these processes better (Section-2). During this discussion (Section – 3), a way via culture impacts the practice and resultant cognitive operations turns out to be workspace of the actors. (shrink)

ObjectivesThe present study explores the effect of visual art training on people with dementia, utilizing a randomized control trial design, in order to investigate the effects of an 8-week visual art training program on cognition. In particular, the study examines overall cognition, delayed recall, and working memory, which show deficits in people with dementia.MethodFifty-three individuals with dementia were randomly assigned into either an art training or usual-activity waitlist control group. Overall cognition and delayed recall were assessed with the Montreal (...) Cognitive Assessment, and working memory was assessed with the Backward Digit Span task.ResultsThere were no group differences in overall cognition, or working memory, while a difference in delayed recall was undetermined, based on post-test—pre-test difference scores. Groups were comparable at baseline on all measures.ConclusionThe measures of cognition, delayed recall, and working memory used in this study were not affected by an 8-week visual art training program.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT03175822. (shrink)

BackgroundPost-stroke depression is one of the most common neuropsychiatric diseases in patients with stroke, and it can increase the disability rate, mortality, and recurrence rate of stroke. Currently, many clinical studies have indicated that traditional Chinese medicine, such as acupuncture and herbs, Western medicine, rehabilitation, repeated transcranial magnetic stimulation, and other treatment methods, are effective in treating PSD. However, no study has formulated a comprehensive treatment plan that integrates TCM, Western medicine, and rehabilitation for PSD. Thus, this trial aims to (...) assess the efficacy and safety of integrative medicine for treating PSD.MethodsThis multicenter, prospective, randomized, controlled study aims to form a set of effective clinical treatment schemes that integrate TCM, Western medicine, and rehabilitation for PSD. A total of 202 participants recruited from four centers will be randomized into either the integrative medicine or standard care group. Standard care—basic treatment, general nursing care, and exercise therapy—will be provided to all participants. The integrative medicine group will also receive acupuncture, Chinese herbs, and repeated transcranial magnetic stimulation. Participants will receive acupuncture and rTMS treatments five times per week for 4 weeks and will be administered Chinese herbs, basic treatment, general nursing care, and exercise therapy for 4 weeks. The primary outcomes include the Hamilton Depression Scale, Self-Rating Depression Scale, and Activity of Daily Living Scale. And the secondary outcomes include the Montreal Cognitive Assessment Scale, the Fugl-Meyer Assessment Scale, and the Pittsburgh Sleep Quality Index. All outcome measures will be evaluated at baseline, week 4, and week 8. Safety assessments will be performed throughout the study.DiscussionThis study is expected to verify the efficacy and safety of integrative medicine for treating PSD, providing an evidence-based clinical reference for the future development of a standardized scheme.Clinical trial registrationClinicalTrials.gov, identifier: NCT05187975. (shrink)

Background: Falls in older adults are a major public health problem. White matter hyperintensities are highly prevalent in older adults and are a risk factor for falls. In the absence of a cure for WMHs, identifying potential strategies to counteract the risk of WMHs on falls are of great importance. Physical activity is a promising countermeasure to reduce both WMHs and falls risk. However, no study has yet investigated whether PA attenuates the association of WMHs with falls risk. We hypothesized (...) that PA moderates the association between WMHs and falls risk.Methods: Seventy-six community-dwelling older adults aged 70–80 years old were included in this cross-sectional study. We indexed PA using the Physical Activity Score for the Elderly Questionnaire. Falls risk was assessed using the Physiological Profile Assessment, and WMH volume was determined by an experienced radiologist on T2-weighted and PD-weighted MRI scans. We first examined the independent associations of WMH volume and PASE score with PPA. Subsequently, we examined whether PASE moderated the relationship between WMH volume and PPA. We plotted simple slopes to interpret the interaction effects. Age, sex, and Montreal Cognitive Assessment score were included as covariates in all models.Results: Participants had a mean age of 74 years and 54 were female. Forty-nine participants had a Fazekas score of 1, 19 had a score of 2, and 6 a score of 3. Both PASE and WMH volume were each independently associated with PPA score. The interaction model indicated that PASE score moderated the association between WMH volume and PPA, whereby higher PASE score attenuated the association between WMHs and falls risk.Conclusion: PA is an important moderator of falls risk. Importantly, older adults with WMH can reduce their risk of falls by increasing their PA. (shrink)

ObjectiveStatic regional homogeneity based on the resting-state functional magnetic resonance imaging has been used to study intrinsic brain activity in Alzheimer’s disease. However, few studies have examined dynamic ReHo in AD. In this study, we used rs-fMRI and dReHo to investigate the alterations in dynamic IBA in patients with AD to uncover dynamic imaging markers of AD.MethodIn total, 111 patients with AD, 29 patients with mild cognitive impairment, and 73 healthy controls were recruited for this study ultimately. After the (...) rs-fMRI scan, we calculated the dReHo values using the sliding window method. ANOVA and post hoc two-sample t-tests were used to detect the differences among the three groups. We used the mini-mental state examination and Montreal Cognitive Assessment to evaluate the cognitive function of the subjects. The associations between the MMSE score, MoCA score, and dReHo were assessed by the Pearson correlation analysis.ResultsSignificant dReHo variability in the right middle frontal gyrus and right posterior cingulate gyrus was detected in the three groups through ANOVA. In post hoc analysis, the AD group exhibited significantly greater dReHo variability in the right MFG than the MCI group. Compared with the HC group, the AD group exhibited significantly increased dReHo variability in the right PCG. Furthermore, dReHo variability in the right PCG was significantly negatively correlated with the MMSE and MoCA scores of patients with AD.ConclusionDisrupted dynamic IBA in the DMN might be an important characteristic of AD and could be a potential biomarker for the diagnosis or prognosis of AD. (shrink)

ABSTRACT The objective of this study was to determine the accuracy of a brief informed consent quiz to detect consent comprehension in individuals with cognitive impairment and to explore the degree to which cognitive domains and recent substance use, independently, predict comprehension. We performed a secondary analysis of two cross-sectional studies in individuals with substance use disorders. The ICQ total score was used as the index test and the Montreal Cognitive Assessment as reference standard in (...) receiver operating characteristic curves. Two independent multiple binary logistic regression models were performed using cognitive domains and days of recent substance use as predictors of ICQ outcome. We analyzed data from 215 and 251 participants, respectively. The ICQ showed moderate accuracy for major cognitive impairment and lower accuracy for mild impairment. Optimal cutoff score was set at 10 points or less for detecting comprehension difficulty. Lower scores in Short-Term Memory, Attention, Language, and Orientation increased the probability of failing the ICQ. A procedure including both the ICQ and cognitive screening measure could improve the accuracy of consent comprehension assessments. (shrink)

Literature on driving research suggests a relationship between cognition and driving performance in older and younger drivers. There is little research on adults and driving, despite them being the largest age cohort behind the wheel. Among the cognitive domains, visuospatial abilities are expected to be highly predictive of driving skills and driving fitness. The relationship between specific spatial mental transformation skills and driving performance has not yet been examined. The present study aimed to investigate the relationship between overall (...) class='Hi'>cognitive functioning, self and object-based spatial mental transformation skills, and driving performance in a sample of younger and older adult drivers. Participants were comprised of one hundred younger and 83 older adult Italian drivers. Participants completed a computerized driving test assessing traffic stress resilience, visual and motor reaction time, and the ability to obtain an overview of the traffic scenario. The Mental Rotation Test and the Object Perspective Taking Test were administered in order to assess object-based and self-based spatial mental transformation skills. The Montreal Cognitive Assessment Test was administered control for global cognitive functioning. The effects of education and gender were also controlled in the analysis. The results of the present study suggested that: The effect of age, favoring younger participants, was found in DT, vRT, mRT, and ATAVT tests. The effect of global cognitive functioning was found in DT and ATAV tests. The effect of the spatial mental transformation tests was found in DT, vRT, and ATAVT tests. Taken together, these results suggest the specific contribution of spatial mental transformation skills in the execution of complex behaviors connected to the fitness to drive. Prospectively, the results of the present study relating spatial mental transformation skills and driving processes may be a valuable source of knowledge for researchers dealing with the relationship between cognitive resources and navigation aids. (shrink)

Objectives: To explore the effect of social support and ability perception on stress coping strategies for competitive stress, and to reveal the mediating effects of primary and secondary evaluation, so as to further improve the theoretical model of stress coping in soccer players.Methods: A total of 331 male athletes from 22 teams in the Chengdu Middle School Campus Football League were taken as survey samples, and surveys were conducted on their stress experience, social support, ability perception, cognitive assessment, (...) and coping strategies for competition stress. SPSS 21.0 and AMOS 21.0 statistical analysis software were used. Descriptive statistics, correlation analysis, exploratory factor analysis, and confirmatory factor analysis were used to process the obtained data.Results: Positive primary assessment acted as a full mediator in the relationship between social support and secondary assessments, and negative primary assessment acted as a partial mediator in the relationship between competence perception and secondary assessments; Secondary assessment played a partial mediating role between positive primary assessment and positive coping strategies, and a full mediating role between negative primary assessment and positive coping strategies; Secondary assessments played the mediator neither between social support and a coping strategy for stress nor competence perception and a coping strategy for stress; Positive primary assessment, positive negative assessment, and secondary assessment all had significant positive benefits for positive coping. Still, the impact of positive primary assessment on positive coping was significantly better than negative primary assessment and secondary assessment.Conclusion: The coping strategy for the competitive stress model proposed by this study has a very good fit for the causal model. It can be used to explain the observed data from soccer players in middle schools. The primary and secondary assessments play different roles in the model. The combination of problem focuses and emotional focus on the positive stress coping strategy is suitable in the field of competitive sports. Still, the relevant research results need to be further explored and verified in the future. (shrink)

Rapid individual cognitive phenotyping holds the potential to revolutionize domains as wide‐ranging as personalized learning, employment practices, and precision psychiatry. Going beyond limitations imposed by traditional lab‐based experiments, new efforts have been underway toward greater ecological validity and participant diversity to capture the full range of individual differences in cognitive abilities and behaviors across the general population. Building on this, we developed Skill Lab, a novel game‐based tool that simultaneously assesses a broad suite of cognitive abilities while (...) providing an engaging narrative. Skill Lab consists of six mini‐games as well as 14 established cognitive ability tasks. Using a popular citizen science platform (N = 10,725), we conducted a comprehensive validation in the wild of a game‐based cognitive assessment suite. Based on the game and validation task data, we constructed reliable models to simultaneously predict eight cognitive abilities based on the users’ in‐game behavior. Follow‐up validation tests revealed that the models can discriminate nuances contained within each separate cognitive ability as well as capture a shared main factor of generalized cognitive ability. Our game‐based measures are five times faster to complete than the equivalent task‐based measures and replicate previous findings on the decline of certain cognitive abilities with age in our large cross‐sectional population sample (N = 6369). Taken together, our results demonstrate the feasibility of rapid in‐the‐wild systematic assessment of cognitive abilities as a promising first step toward population‐scale benchmarking and individualized mental health diagnostics. (shrink)

The Coronavirus Disease 2019 pandemic prompted the need for a teleneuropsychology protocol for the cognitive assessment of older adults, who are at increased risk for both COVID-19 and dementia. Prior recommendations for teleneuropsychological assessment did not consider many of the unique challenges posed by COVID-19. The field is still in need of clear guidelines and standards of care for the assessment of older adults under the current circumstances. Advantages of teleneuropsychological assessment during the COVID-19 pandemic (...) include reduced risk of contracting the virus, eliminating travel time and reducing cost, and more rapid access to needed services. Challenges include disparities in technology access among patients, reduced control over the testing environment, impeded ability to make behavioral observations, and limited research on valid and reliable cognitive assessment measures. The aim of this perspective review is to propose a teleneuropsychological protocol to facilitate neuropsychological assessment utilizing a virtual platform. The proposed protocol has been successful with our clinical and research populations and may help neuropsychologists implement teleneuropsychology services without compromising validity or reliability. However, there is increasing need for research on teleneuropsychological assessment options for both clinical and research purposes. (shrink)

Brain-computer interfaces (BCIs) have been successfully used by adults, but little information is available on BCI use by children, especially children with severe multiple impairments who may need technology to facilitate communication. Here we discuss the challenges of using non-invasive BCI with children, especially children who do not have another established method of communication with unfamiliar partners. Strategies to manage these challenges require consideration of multiple factors related to accessibility, cognition, and participation. These factors include decisions regarding where (home, clinic, (...) or lab) participation will take place, the number of sessions involved, and the degree of participation necessary for success. A strategic approach to addressing the unique challenges inherent in BCI use by children with disabilities will increase the potential for successful BCI calibration and adoption of BCI as a valuable access method for children with the most significant impairments in movement and communication. (shrink)

The aim of this article is to introduce the concept of Cognitive Fitness (CF), identify its key ingredients underpinning both real-time task performance and career longevity in high-risk occupations, and to canvas a holistic framework for their assessment, training, and augmentation. CF as a capacity to deploy neurocognitive resources, knowledge and skills to meet the demands of operational task performance, is likely to be multi-faceted and differentially malleable. A taxonomy of CF constructs derived from Cognitive Readiness (CR) (...) and Mental fitness (MF) literature maps into phases of operational cycles from foundational to advanced, mission-ready and recovery. Foundational cognitive attributes, such as attention, executive control and co-action, were hypothesized to be trainable at the initial Cognitive Gym phase. More advanced training targets at the CR phase included stress and arousal regulation, adaptability, teamwork, situation awareness (including detection, sense-making and prediction) and decision making (de-biasing and confidence calibration). The mission-ready training phase is focused on tolerances (to sleep loss, monotony, pain, frustration, uncertainty) and resistance (to distraction, deception or manipulation). Operational Augmentation phase relies on support tools such as decision aids and fatigue countermeasures, while the Recovery phase employs reflexive (e.g., mindfulness), and restorative practices (e.g., nutrition and sleep hygiene). The periodization of cognitive training in this cycle is hypothesized to optimize both real-time cognitive performance and the resilience that enables life-long thriving. One of the most promising avenues of validating this hypothesis is by developing an expert consensus on the key CF ingredients and their relative importance in high-performance settings. (shrink)

The Cognitive Reflection Test (CRT; Frederick, 2005) is designed to measure the tendency to override a prepotent response alternative that is incorrect and to engage in further reflection that leads to the correct response. It is a prime measure of the miserly information processing posited by most dual process theories. The original three-item test may be becoming known to potential participants, however. We examined a four-item version that could serve as a substitute for the original. Our data show that (...) it displays a.58 correlation with the original version and that it has very similar relationships with cognitive ability, various thinking dispositions, and with several other rational thinking tasks. Combining the two versions into a seven-item test resulted in a measure of miserly processing with substantial reliability (.72). The seven-item version was a strong independent predictor of performance on rational thinking tasks after the variance accounted for by cognitive ability and thinking dispositions had been partialled out. (shrink)

Cognitive moral development (CMD) theory has been accepted as a construct to help explain business ethics, social responsibility and other organizational phenomena. This article critically assesses CMD as a construct in business ethics by presenting the history and criticisms of CMD. The value of CMD is evaluated and problems with using CMD as one predictor of ethical decisions are addressed. Researchers are made aware of the major criticisms of CMD theory including disguised value judgments, invariance of stages, and gender (...) bias in the initial scale development. Implications for business ethics research are discussed and opportunities for future research delineated. (shrink)

Advocates of dynamical systems theory (DST) sometimes employ revolutionary rhetoric. In an attempt to clarify how DST models differ from others in cognitive science, I focus on two issues raised by DST: the role for representations in mental models and the conception of explanation invoked. Two features of representations are their role in standing-in for features external to the system and their format. DST advocates sometimes claim to have repudiated the need for stand-ins in DST models, but I argue (...) that they are mistaken. Nonetheless, DST does offer new ideas as to the format of representations employed in cognitive systems. With respect to explanation, I argue that some DST models are better seen as conforming to the covering-law conception of explanation than to the mechanistic conception of explanation implicit in most cognitive science research. But even here, I argue, DST models are a valuable complement to more mechanistic cognitive explanations. (shrink)

This systematic review identifies and critically evaluates instruments that have been developed to measure clinical trial informed consent comprehension in non-cognitively-impaired adults.Literature searches were carried out on Medline (Ovid), PsycInfo, CINHAL, ERIC, ScienceDirect, and Cochrane Library for English language articles published between January 1980 and September 2008. Instruments were excluded if they focused on consent onto paediatric trials, the construct under study was primarily capacity or competency, or the instrument was developed specifically for psychiatric or cognitively-impaired populations. Instruments selected for (...) review were evaluated against the following criteria: (1) method of item generation; (2) type and format of test items; (3) administration and interpretation of test results; and (4) psychometric properties.Three instruments met our defined inclusion criteria: the Deaconess Informed Consent Comprehension Test (DICCT), the Quality of Informed Consent (QuIC) questionnaire and the Brief Informed Consent Protocol (BICEP). Each instrument varied in terms of content measured. Significantly, these are the first standardized instruments developed to assess comprehension in non-cognitively-impaired adults. Yet, each instrument had its own set of limitations such as the lack of generalizability and the absence of details pertaining to how test results should be used to guide clinical decision-making.Standardized clinical trial informed consent comprehension assessments have been developed to identify gaps in research participants' understanding and ensure that respect for patient autonomy is satisfied. (shrink)

The development of neuropsychological assessment methods using virtual reality (VR) is a valid and promising option for the detection of cognitive impairment in the older people, focusing on activities composed of tasks of multiple demands. This study verified the association of age, schooling, and general cognitive status on the performance of neurologically healthy older adults in ECO-VR, a virtual reality task of multiple demands for neuropsychological assessment. A total of 111 older adults answered a sociodemographic questionnaire, (...) the Mini Mental State Examination, the Vocabulary subtest of the Wechsler Intelligence Scale for Adults (third edition), and the ECO-VR. Correlation analyses, multiple linear regression, and comparisons between groups (effects by age and schooling groups) were used to evaluate the results. The ECO-VR total score was significantly associated with age, years of education, MMSE, and Vocabulary subtest. The linear regression models identified that age was the main predictor for total score and rule breaking of ECO-VR. According to the univariate analysis, it was identified the main effect of age group and schooling group in the total ECO-VR score, but there was no interaction effect. The results are discussed in order to understand the role of sociodemographic characteristics in the performance of older adults in a virtual reality task of multiple demands. It was also verified the possibility use of virtual reality for neuropsychological assessment of older adults. (shrink)

Following the levels of intentionality and semiosis distinguished by the Semiotic Hierarchy, and the distinction between original agency and enhanced agency, we propose a model of an agency hierarchy, consisting of six layers. Consistent with the phenomenological orientation of cognitive semiotics, a central claim is that agency and subjectivity are complementary aspects of intentionality. Hence, there is no agency without at least the minimal sense/feeling of agency. This perspective rules out all artefacts as genuine agents, as well as simple (...) organisms, since it is highly unlikely that e.g. bacteria have any first-person perspective. Using this model, we review and assess recent proposals on the nature of agency from cognitive science, and neuroscience, and draw conclusions on how to incorporate aspects of them within a synthetic cognitive-semiotic framework. (shrink)

The Metacognitive, Affective, Cognitive Experience questionnaire was designed to assess metacognition across sleep and waking . The present research evaluates the psychometric properties of the MACE. Data from two recent studies were used to assess the inter-item consistency, test–retest reliability, and factorial, convergent, and discriminant validity of the MACE. Results show that the MACE is a reliable measure with good construct validity. Exploratory factor analyses revealed one self-regulation and two monitoring factors. One monitoring factor emphasized monitoring internal conditions; the (...) other emphasized monitoring external conditions. This factor structure is consistent with the Metacognitive Model . Tests of convergent and discriminant validity suggest that the MACE is assessing metacognition and is appropriately related to similar constructs such as mindfulness and self-consciousness. The implication of these findings as well as suggestions for research and clinical applications of the MACE are discussed. (shrink)

This article gives a brief introduction to the MacArthur Competence Assessment Tool-Treatment (MacCAT-T) and critically examines its theoretical presuppositions. On the basis of empirical, methodological and ethical critique it is emphasised that the cognitive bias that underlies the MacCAT-T assessment needs to be modified. On the one hand it has to be admitted that the operationalisation of competence in terms of value-free categories, e.g. rational decision abilities, guarantees objectivity to a great extent; but on the other hand (...) it bears severe problems. Firstly, the cognitive focus is in itself a normative convention in the process of anthropological value-attribution. Secondly, it misses the complexity of the decision process in real life. It is therefore suggested that values, emotions and other biographic and context specific aspects should be considered when interpreting the cognitive standards according to the MacArthur model. To fill the gap between cognitive and non-cognitive approaches the phenomenological theory of personal constructs is briefly introduced. In conclusion some main demands for further research to develop a multi-step model of competence assessment are outlined. (shrink)

Our study explores the relationships between psychological and driving-related personality traits, fluid intelligence and cognitive abilities for drivers whose driving licence has been revoked due to intoxicated driving (alcohol and/or drugs). We were able to show that highly significant impacts on cognitive functions derive from the participants’ age and fluid intelligence. In addition, driving-related personality traits such as emotional instability, a sense of responsibility and self-control contributed significantly to some of the cognitive abilities that are important for (...) fitness to drive. Additionally, the mediating effects of fluid intelligence in the model are discussed. Traffic psychologists can use this knowledge in their assessment of drivers, mainly regarding the possible compensation of cognitive deficits regarding the fitness to drive. (shrink)

Extended and distributed cognition theories argue that human cognitive systems sometimes include non-biological objects. On these views, the physical supervenience base of cognitive systems is thus not the biological brain or even the embodied organism, but an organism-plus-artifacts. In this paper, we provide a novel account of the implications of these views for learning, education, and assessment. We start by conceptualising how we learn to assemble extended cognitive systems by internalising cultural norms and practices. Having a (...) better grip on how extended cognitive systems are assembled, we focus on the question: If our cognition extends, how should we educate and assess such extended cognitive systems? We suggest various ways to minimize possible negative effects of extending one’s cognition and to efficiently find and organise (online) information by adopting a virtue epistemology approach. Educational and assessment implications are foregrounded, particularly in the case of Danish students’ use of the Internet during exams. (shrink)

The article proposes a universal dual-axis intelligent systems assessment scale. The scale considers the properties of intelligent systems within the environmental context, which develops over time. In contrast to the frequent consideration of the “mind” of artificial intelligent systems on a scale from “weak” to “strong”, we highlight the modulating influences of anticipatory ability on their “brute force”. In addition, the complexity, the ”weight“ of the cognitive task and the ability to critically assess it beforehand determine the actual (...) set of cognitive tools, the use of which provides the best result in these conditions. In fact, the presence of ”common sense“ options is what connects the ability to solve a problem with the correct use of such an ability itself. The degree of ”correctness“ and ”adequacy“ is determined by the combination of a suitable solution with the temporal characteristics of the event, phenomenon, object or subject under study. The proposed approach can be applied in the evaluation of various intelligent agents in different contexts including AI and humans performing complex domain-specific tasks with high uncertainty. (shrink)

Objective: The establishment of patient-centered measures capable of empirically determining meaningful cognitive change after surgery can significantly improve the medical care of epilepsy patients. Thus, this study aimed to develop reliable change indices (RCIs) and standardized regression-based (SRB) change norms for a comprehensive neuropsychological test battery in the German language. Methods: Forty-seven consecutive patients with temporal lobe epilepsy underwent neuropsychological assessments, both before and 12 months after surgery. Practice-effect-adjusted RCIs and SRB change norms for each test score were computed. (...) To assess their usefulness, the presented methods were applied to a clinical sample, and binary logistic regression analyses were conducted to model the odds of achieving improvement in quality of life (QOL) after surgery. Results: The determined RCIs at 90% confidence intervals, and the SRB equations for each test score included in the test battery are provided. Cohen’s kappa analyses revealed a moderate mean agreement between the two measures, varying from slight to almost perfect agreement across test scores. Using these measures, a negative association between improvement in QOL and decline in verbal memory functions after surgery was detected. Significance: To the best of our knowledge, this study is the first to provide RCIs and SRB change norms necessary for the objective determination of neuropsychological change in a comprehensive test battery in the German language, facilitating the individual monitoring of improvement and decline in each patients’ cognitive functioning and psychosocial situations after epilepsy surgery. The application of the described measures revealed a strong negative association between improvement in QOL and decline in verbal memory functions after surgery. (shrink)