Search

Compared with other health disciplines, there is a stagnation in technological innovation in the field of clinical neuropsychology. Traditional paper-and-pencil tests have a number of shortcomings, such as low-frequency data collection and limitations in ecological validity. While computerized cognitive assessment may help overcome some of these issues, current computerized paradigms do not address the majority of these limitations. In this paper, we review recent literature on the applications of novel digital health approaches, including ecological momentary assessment, smartphone-based assessment and sensors, wearable devices, passive driving sensors, smart homes, voice biomarkers, and electronic health record mining, in neurological populations. We describe how each digital tool may be applied to neurologic care and overcome limitations of traditional neuropsychological assessment. Ethical considerations, limitations of current research, as well as our proposed future of neuropsychological practice are also discussed. [ABSTRACT FROM AUTHOR]

This study examined preliminary evidence of construct validity in a stand-alone memory concerns scale constructed from the Patient-Reported Outcomes Measurement Information System (PROMIS®) Cognitive Function item bank. A sample of 396 individuals, ages 18–75 (M = 33.7, SD = 12.7), from Spain and Latin America completed an online survey regarding lifetime exposure to factors associated with neurological compromise. The sample was 69.4% female. Respondents completed 8 items from the PROMIS® Cognitive Function item bank v1.0 dealing with memory concerns (MCS-8) along with the PROMIS® 8-item short form reflecting general cognitive concerns (CCS-8). The MCS-8 had high internal consistency reliability (Cronbach's alpha = 0.90), and represented a factor distinct from general cognitive concerns items on the CCS-8 in confirmatory factor analysis. Analysis of covariance controlling for sex, age, and education, showed that individuals endorsing history of exposure to sources of neurological compromise scored significantly lower T-scores on the MCS-8 than those who did not report any such history, F(1,390) = 6.4, p = 0.012. Older age was significantly associated with greater memory concerns, a relationship with age not observed with the CCS-8. As a stand-alone self-report measure, the MCS-8 appears to measure a construct distinct from general cognitive concerns that may be of interest for further research in clinical populations. [ABSTRACT FROM AUTHOR]

Am J Physiol Renal Physiol 298: F205-F208, 2010. First published October 21, 2009; doi: 10.1152/ajprenal.00312.2009.--The characteristics of the glomerular filtration barrier (GFB) are challenging to measure, as macromolecular solutes in blood may be metabolized or transported by various cells in the kidney. Urinary solute concentrations generally reflect the cumulative influence of multiple transport processes rather than the intrinsic behavior of the GFB alone. Synthetic tracer molecules which are not secreted, absorbed, or modified by the kidney are useful tools. Ficoll, a globular polymer of epichlorohydrin and sucrose, is round, physiologically inert, and easily labeled, making it a nearly ideal glomerular probe. Fissell et al. reported filtration data suggesting that Ficoll was not as spherical as had been previously suggested (Fissell WH, Manley S, Dubnisheva A, Glass J, Magistrelli J, Eldridge AN, Fleischman AJ, Zydney AL, Roy S. Am J Physiol Renal Physiol 293: F1209-F1213, 2007). More recently, two investigators published comparisons of neutral and anionic Ficoll clearance that suggest Ficoll may undergo conformational changes when chemically derivatized (Asgeirsson D, Venturoli D, Rippe B, Rippe C. Am J Physiol Renal Physiol 291: F1083-F1089, 2006; Guimaraes MAM, Nikolovski J, Pratt LM, Greive K, Comper WD. Am J Physiol Renal Physiol 285: Fll18-Fl124, 2003). To investigate Ficoll's characteristics further, we examined two commercial preparations, Ficoll 70 and Ficoll 400, by size-exclusion chromatography using a differential refractive index detector combined with light-scattering and viscosity detectors. A slope of 0.45 was obtained from the plot of the logarithm of molecular mass against the logarithm of root-mean square radius. The Mark-Houwink exponent values of 0.34 and 0.36 were calculated for Ficoll 70 and Ficoll 400, respectively. These results suggest Ficoll's conformation in physiological saline solution is likely intermediate between a solid sphere and a well-solvated linear random coil. The measurements help explain our previous observations and guide interpretation of in vivo experiments. glomerular permeability; light-scattering; viscosity; size-exclusion chromatography

Sleep dysfunction is prevalent among patients with schizophrenia. Although sex differences have been identified in schizophrenia, sex differences in sleep patterns among patients with schizophrenia are not established. Therefore, the current study examined sex differences in subjective sleep quality patterns in people with schizophrenia utilizing a standardized inventory. Study sample consisted of 75 patients with schizophrenia and 82 healthy controls (HC). Participants completed the Pittsburgh Sleep Quality Index (PSQI). Compared to HC, patients with schizophrenia were more likely to report being poor sleepers (PSQI global score > 5), longer sleep duration, more sleep disturbances, longer sleep onset latency, increased daytime dysfunction due to poor sleep, and more frequent use of sleep medications. Regarding sex differences, female patients were more likely to report being poor sleepers and endorsed more sleep disturbances than female HC, while male patients reported longer sleep duration, more daytime dysfunction, and poorer overall sleep quality relative to male HC. Additionally, higher level of sleep dysfunction was linked to higher symptom severity in male patients only. Patients with schizophrenia endorsed a range of sleep difficulties, and male and female patients with schizophrenia differ compared to their HC counterparts. Implications for treatment of sleep complaints among patients with schizophrenia are discussed. [ABSTRACT FROM AUTHOR]

• Olfactory functions are impaired in MS. • Olfactory dysfunction is associated with worse cognitive and everyday life performance and as well as with lower quality of life. • Olfactory function should be considered as a clinical marker related to MS disability. Olfactory dysfunction is a common symptom of multiple sclerosis (MS). The questions of whether and to what degree olfactory dysfunction can serve as a clinical marker of MS disability (i.e. cognitive impairments and functional limitations) are not yet answered. The current study aimed to explore associations between olfactory function (i.e. smell identification) with cognitive capacities, functional performance and quality of life (QOL) in persons with MS. Olfactory function was measured by the University of Pennsylvania Smell Identification Test (UPSIT). Functional ability was assessed by the Actual RealityTM (AR) task. QOL was assessed by the Multiple Sclerosis Quality of Life-54 (MSQOL-54). Cognition was assessed by the Brief International Cognitive Assessment for MS (BICAMS) in 23 MS patients and 15 matched healthy controls. MS patients had lower UPSIT scores than healthy controls. Worse UPSIT scores were associated with reduced performances on the BICAMS and AR task as well as lower MSQOL-54 scores. Specifically, UPSIT scores were related to MSQOL-54 scores independent of BICAMS composite scores, while the relationship between UPSIT score and AR performance was mediated by BICAMS composite score. This study confirms previous studies which concluded that olfactory function is impaired in MS. Furthermore, olfactory dysfunction is related to limitations in activity performance and QOL. Taken together with previous studies, olfactory function may be considered as a clinical marker related to MS disability. Longitudinal studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]