| 21. |
- Fraser, Kathleen, 1984, et al.
(författare)
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Improving the Sensitivity and Specificity of MCI Screening with Linguistic Information.
- 2018
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Ingår i: Proceedings of the LREC workshop: Resources and ProcessIng of linguistic, para-linguistic and extra-linguistic Data from people with various forms of cognitive/psychiatric impairments (RaPID-2). 8th of May 2018, Miyazaki, Japan / Dimitrios Kokkinakis (ed.). - 9791095546269
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Konferensbidrag (refereegranskat)abstract
- The Mini-Mental State Exam (MMSE) is a screening tool for cognitive impairment. It has been extensively validated and is widely used, but has been criticized as not being effective in detecting mild cognitive impairment (MCI). In this study, we examine the utility of augmenting MMSE scores with automatically extracted linguistic information from a narrative speech task to better differentiate between individuals with MCI and healthy controls in a Swedish population. We find that with the addition of just four linguistic features, the F score (measuring a trade-off between sensitivity and specificity) is improved from 0.67 to 0.81 in logistic regression classification. These preliminary results suggest that the accuracy of traditional screening tools may be improved through the addition of computerized language analysis.
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| 22. |
- Fraser, Kathleen, 1984, et al.
(författare)
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Predicting MCI Status From Multimodal Language Data Using Cascaded Classifiers
- 2019
-
Ingår i: Frontiers in Aging Neuroscience. - : Frontiers Media SA. - 1663-4365. ; 11:205
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Tidskriftsartikel (refereegranskat)abstract
- Recent work has indicated the potential utility of automated language analysis for the detection of mild cognitive impairment (MCI). Most studies combining language processing and machine learning for the prediction of MCI focus on a single language task; here, we consider a cascaded approach to combine data from multiple language tasks. A cohort of 26 MCI participants and 29 healthy controls completed three language tasks: picture description, reading silently, and reading aloud. Information from each task is captured through different modes (audio, text, eye-tracking, and comprehension questions). Features are extracted from each mode, and used to train a series of cascaded classifiers which output predictions at the level of features, modes, tasks, and finally at the overall session level. The best classification result is achieved through combining the data at the task level (AUC = 0.88, accuracy = 0.83). This outperforms a classifier trained on neuropsychological test scores (AUC = 0.75, accuracy = 0.65) as well as the "early fusion" approach to multimodal classification (AUC = 0.79, accuracy = 0.70). By combining the predictions from the multimodal language classifier and the neuropsychological classifier, this result can be further improved to AUC = 0.90 and accuracy = 0.84. In a correlation analysis, language classifier predictions are found to be moderately correlated (rho = 0.42) with participant scores on the Rey Auditory Verbal Learning Test (RAVLT). The cascaded approach for multimodal classification improves both system performance and interpretability. This modular architecture can be easily generalized to incorporate different types of classifiers as well as other heterogeneous sources of data (imaging, metabolic, etc.).
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| 23. |
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| 24. |
- Göthlin, Mattias, 1978, et al.
(författare)
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Prognostic Accuracy of Mild Cognitive Impairment Subtypes at Different Cut-Off Levels.
- 2017
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 43:5-6, s. 330-341
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Tidskriftsartikel (refereegranskat)abstract
- The prognostic accuracy of mild cognitive impairment (MCI) in clinical settings is debated, variable across criteria, cut-offs, subtypes, and follow-up time. We aimed to estimate the prognostic accuracy of MCI and the MCI subtypes for dementia using three different cut-off levels.Memory clinic patients were followed for 2 (n = 317, age 63.7 ± 7.8) and 4-6 (n = 168, age 62.6 ± 7.4) years. We used 2.0, 1.5, and 1.0 standard deviations (SD) below the mean of normal controls (n = 120, age 64.1 ± 6.6) to categorize MCI and the MCI subtypes. Prognostic accuracy for dementia syndrome at follow-up was estimated.Amnestic multi-domain MCI (aMCI-md) significantly predicted dementia under all conditions, most markedly when speed/attention, language, or executive function was impaired alongside memory. For aMCI-md, sensitivity increased and specificity decreased when the cut-off was lowered from 2.0 to 1.5 and 1.0 SD. Non-subtyped MCI had a high sensitivity and a low specificity.Our results suggest that aMCI-md is the only viable subtype for predicting dementia for both follow-up times. Lowering the cut-off decreases the positive predictive value and increases the negative predictive value of aMCI-md. The results are important for understanding the clinical prognostic utility of MCI, and MCI as a non-progressive disorder.
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| 25. |
- Janssen, O., et al.
(författare)
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Characteristics of subjective cognitive decline associated with amyloid positivity
- 2022
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Ingår i: Alzheimers & Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 18:10, s. 1832-1845
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Tidskriftsartikel (refereegranskat)abstract
- Introduction The evidence for characteristics of persons with subjective cognitive decline (SCD) associated with amyloid positivity is limited. Methods In 1640 persons with SCD from 20 Amyloid Biomarker Study cohort, we investigated the associations of SCD-specific characteristics (informant confirmation, domain-specific complaints, concerns, feelings of worse performance) demographics, setting, apolipoprotein E gene (APOE) epsilon 4 carriership, and neuropsychiatric symptoms with amyloid positivity. Results Between cohorts, amyloid positivity in 70-year-olds varied from 10% to 76%. Only older age, clinical setting, and APOE epsilon 4 carriership showed univariate associations with increased amyloid positivity. After adjusting for these, lower education was also associated with increased amyloid positivity. Only within a research setting, informant-confirmed complaints, memory complaints, attention/concentration complaints, and no depressive symptoms were associated with increased amyloid positivity. Feelings of worse performance were associated with less amyloid positivity at younger ages and more at older ages. Discussion Next to age, setting, and APOE epsilon 4 carriership, SCD-specific characteristics may facilitate the identification of amyloid-positive individuals.
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| 26. |
- Juhlin, F., et al.
(författare)
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Rey auditory verbal learning test in idiopathic normal pressure hydrocephalus and Alzheimer's disease
- 2023
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Ingår i: Clinical Neuropsychologist. - 1385-4046. ; 38:1, s. 202-18
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aims to evaluate the ability of the Rey Auditory Verbal Learning Test (RAVLT), to separate the early stages of idiopathic normal pressure hydrocephalus (iNPH) from Alzheimer's disease (AD), both in comparison to each other and to healthy individuals (HI). Method: The RAVLT performance regarding learning, recall and recognition, was analyzed in three matched samples comprising 30 HI, 84 participants with AD and 84 with iNPH. The clinical samples were divided into two subgroups based on scores on the MMSE, High performers (27-30 points, n = 30) and Medium performers (18-26 points, n = 54). Results: Memory performance was significantly impaired in both clinical samples relative to HI, even in the comparisons with the subgroups consisting of only High-MMSE performers. Despite similar results on measures capturing learning, the iNPH patients outperformed AD patients on measures of recall and recognition. Conclusions: Learning impairment occurs early in iNPH and AD alike, when MMSE performance is still within normal limits. RAVLT measures of delayed recall and recognition are less affected in iNPH than in AD and may serve as differential diagnostic neuropsychological markers.
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| 27. |
- Kokkinakis, Dimitrios, 1965, et al.
(författare)
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A Multifaceted Corpus for the Study of Cognitive Decline in a Swedish Population
- 2019
-
Ingår i: CLARe4 : Corpora for Language and Aging Research, 27 February – 1 March 2019, Helsinki, Finland.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- A potential, early-stage diagnostic marker for neurodegenerative diseases, such as Alzheimer’s disease, is the onset of language disturbances which is often characterized by subtle word-finding difficulties, impaired spontaneous speech, slight speech hesitancy, object naming difficulties and phonemic errors. Connected speech provides valuable information in a non-invasive and easy-to-assess way for determining aspects of the severity of language impairment. Data elicitation is an established method of obtaining highly constrained samples of connected speech that allows us to study the intricate interactions between various linguistic levels and cognition. In the paper, we describe the collection and content of a corpus consisting of spontaneous Swedish speech from individuals with Mild Cognitive Impairment (MCI), with Subjective Cognitive Impairment SCI) and healthy, age-matched controls (HC). The subjects were pooled across homogeneous subgroups for age and education, a sub-cohort from the Gothenburg-MCI study. The corpus consists of high quality audio recordings (including transcriptions) of several tasks, namely: (i)a picture description task – the Cookie-theft picture, an ecologically valid approximation to spontaneous discourse that has been widely used to elicitate speech from speakers with different types of language and communication disorders; (ii)a read aloud task (including registration of eye movements) – where participants read a text from the IREST collection twice, both on a computer screen (while eye movements are registered), and the same text on paper; (iii)a complex planning task – a subset of executive functioning that tests the ability to identify, organize and carry out (complex) steps and elements that are required to achieve a goal; (iv)a map task – a spontaneous speech production/semi-structured conversation in which the participants are encouraged to talk about a predefined, cooperative task-oriented topic; (v)a semantic verbal fluency task – category animals: where participants have to produce as many words as possible from a category in a given time (60 seconds). The fluency tests require an elaborate retrieval of words from conceptual (semantic) and lexical (phonetic) memory involving specific areas of the brain in a restricted timeframe. All samples are produced by Swedish speakers after obtaining written consent approved by the local ethics committee. Tasks (i) and (ii) have been collected twice in a diachronically apart period of 18 months between 2016 and 2018. The corpus represents an approximation to speech in a natural setting: The material for elicitation is controlled in the sense that the speakers are given specific tasks to talk about, and they do so in front of a microphone. The corpus may serve as a basis for many linguistic and/or speech technological investigations and has being already used for various investigations of language features.
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| 28. |
- Kokkinakis, Dimitrios, 1965, et al.
(författare)
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Kan textforskning bidra till tidigare och säkrare demensdiagnostik?
- 2018
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Ingår i: Forum för textforskning 13 , Lund 7 – 8 juni 2018.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Tidigare forskning har visat att subtila språkstörningar kan finnas vid de tidigaste förstadierna till demens, flera år innan en klinisk diagnos kan ställas. Inom ramen för projektet ”Språkliga och extra-lingvistiska parametrar för tidig upptäckt av kognitiv svikt” (finansierat av Riksbankens Jubileumsutlysning, 2016-19) undersöker vi med hjälp av språkteknologi och språkanalysstudier hur dessa språkstörningar yttrar sig. Kan språkteknologi användas för att upptäcka dessa tidiga språkrelaterade symtom och därmed bidra med nyanserad, komplementär och användbar kunskap? Kan användning av språkteknologi särskilja personer med de allra tidigaste kognitiva avvikelserna från personer med mer godartad, åldersrelaterad kognitiv svikt? Vilka språkliga förmågor drabbas? Hur yttrar sig dessa förändringar och vilka slags empiriska material finns att tillgå? Dessa är några av de frågor vi söker svar på. Vi gör inspelningar som vi analyserar för att kunna ta fram ny kunskap om subtila språkliga kännetecken som kan föregå demensutveckling. Denna kunskap kan användas för att eventuellt kunna förutsäga vilka individer som befinner sig i riskzonen för att utveckla demens, och kan vara användbar som komplementerande beslutsunderlag till domänexperter. Vi utvinner, analyserar och undersöker om det finns samband mellan olika språkrelaterade parametrar från spontan talinteraktion, transkriptioner men även ögonrörelser och neuropsykologiska tester från personer med subjektiv eller lindrig kognitiv nedsättning och friska kontrollpersoner. Många gånger är det svårt att avgöra huruvida lindriga kognitiva symtom är en del av det normala åldrandet eller början på en neurodegenerativ process. Vi förväntar oss inte heller att varje enskild person med kognitiv nedsättning kommer att uttrycka sig eller läsa på samma sätt utan snarare att dessa personer tidigt i sjukdomsförloppet kommer att börja uppvisa olika slags avvikande läsmönster, eller göra fonologiska, lexikala, syntaktiska eller semantiska fel. I studien utvecklar vi verktyg för att automatiskt hitta dessa avvikelser, och målet är att detta sedan ska kunna användas som komplement till tidig diagnostik samt som prognostiskt eller screeningverktyg. Deltagarna i vår studie har rekryterats från en pågående longitudinell studie, ”Demens i Tidigt Skede”, (eng. ”The Gothenburg MCI study”) på Minnesmottagningen i Göteborg, och vårt projekt har godkänts av den lokala etiknämnden. Alla deltagare i studien (kontrollgruppen [HC], personer med subjektiv kognitiv nedsättning [SCI] och personer med mild kognitiv nedsättning [MCI]) har genomgått baslinjeundersökning och gett informerat skriftligt samtycke (demografisk information finns i tabell 1). Vårt projekt är f.n. pågående och vi kommer presentera resultat baserade på inspelningstillfälle nr ett (aug. 2016-mars 2017). En ny inspelningsomgång, med samma deltagare, började i februari 2018 och förväntas vara avslutat i december 2018. Under presentationen kommer vi ge exempel på olika tal-, text- och ögonrörelseanalyser vi har genomfört och diskutera metodval och resultat baserade på studiens första fas. Vi kommer vidare ge en kort inblick i den nya, pågående inspelningsomgången och de nya testmoment vi använder. Vi vill med vårt arbete visa hur språkteknologisk analys kan bidra till att utöka vår kunskap inom området så att den kan vara användbar för tidig diagnostik och optimal omvårdnad. Enligt Socialstyrelsen (2017) finns det i Sverige över 160 000 personer med någon demenssjukdom. Våra resultat kan ha en betydelse för vårdpersonal som snabbare vill diagnostisera och identifiera individer med olika former av kognitiv funktionsnedsättning innan allvarliga symtom blir påtagliga. Utvecklingsmöjligheterna är många: nya eller förbättrade kognitiva screeningtester som skulle kunna användas inom primär- och specialistvården, samt utveckling och tillämpning av insatser som kan påverka beteendemönster och träna upp individens kommunikativa förmåga, kan på sikt leda till positiva konsekvenser som minskade vårdköer samt effektivare behandling avseende kostnader och behandlingsutfall.
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| 29. |
- Linz, Nicklas, et al.
(författare)
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Temporal Analysis of Semantic Verbal Fluency Tasks in Persons with Subjective and Mild Cognitive Impairment.
- 2019
-
Ingår i: Sixth Workshop on Computational Linguistics and Clinical Psychology: Reconciling Outcomes. Minneapolis, Minnesota, USA, June 6, 2019 / Kate Niederhoffer, Kristy Hollingshead, Philip Resnik, Rebecca Resnik, Kate Loveys (Editors). - Stroudsburg, PA : Association for Computational Linguistics. - 9781948087957
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Konferensbidrag (refereegranskat)abstract
- The Semantic Verbal Fluency (SVF) task is a classical neuropsychological assessment where persons are asked to produce words belonging to a semantic category (e.g., animals) in a given time. This paper introduces a novel method of temporal analysis for SVF tasks utilizing time intervals and applies it to a corpus of elderly Swedish subjects (mild cognitive impairment, subjective cognitive impairment and healthy controls). A general decline in word count and lexical frequency over the course of the task is revealed, as well as an increase in word transition times. Persons with subjective cognitive impairment had a higher word count during the last intervals, but produced words of the same lexical frequencies. Persons with MCI had a steeper decline in both word count and lexical frequencies during the third interval. Additional correlations with neuropsychological scores suggest these findings are linked to a person’s overall vocabulary size and processing speed, respectively. Classification results improved when adding the novel features (AUC = 0.72), supporting their diagnostic value.
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| 30. |
- Rolstad, Sindre, 1976, et al.
(författare)
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Biomarkers in relation to cognitive reserve in patients with mild cognitive impairment--proof of concept.
- 2009
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 27:2, s. 194-200
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The concept of the cognitive reserve (CR) posits that factors such as education enable compensation for the effect of brain pathology. Consequently, pathology should be more pronounced in individuals with higher CR before becoming clinically apparent. Biomarkers such as total tau (t-tau) and beta-amyloid 42 (Abeta42) may be surrogates for pathology in relation to CR in patients with neurodegenerative disease. OBJECTIVE: To examine the applicability of biomarkers as surrogates for pathology in relation to the CR in patients with mild cognitive impairment (MCI) either converting to dementia or remaining stable at follow-up. METHOD: Comparisons of baseline t-tau, Abeta42, educational years and global cognition for MCI patients either converting to dementia (n = 57) or remaining stable (n = 91) were made. Patients converting to dementia were grouped on the basis of educational level and compared considering biomarkers and neuropsychological tests. RESULTS: Stable MCI patients were better educated, performed better cognitively, had higher Abeta42 levels and lower levels of t-tau. Converting MCI patients with higher education had lower levels of Abeta42 and performed equally in neuropsychological tests compared to those with lower education. CONCLUSION: Our results suggest that highly educated MCI patients subsequently converting to dementia display more amyloid pathology.
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