December 1, 2020 Journal article Open Access

Miia Kivipelto; Philip Scheltens; Sanna-Kaisa Herukka; Anne M. Remes; Patrizia Mecocci; Hanneke Fm. Rhodius Meester; Teemu Paajanen; Wiesje M. van der Flier; Steen G. Hasselbalch; Jyrki Lötjönen; Hilkka Soininen; Frederik Barkhof; Mark van Gils; Shadi Mahdiani; Tiia Ngandu; Juha Koikkalainen; Tuomo Hänninen

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{
  "@context": "https://schema.org/", 
  "@id": "https://doi.org/10.1002/alz.042626", 
  "@type": "ScholarlyArticle", 
  "creator": [
    {
      "@type": "Person", 
      "name": "Miia Kivipelto"
    }, 
    {
      "@type": "Person", 
      "name": "Philip Scheltens"
    }, 
    {
      "@type": "Person", 
      "name": "Sanna-Kaisa Herukka"
    }, 
    {
      "@type": "Person", 
      "name": "Anne M. Remes"
    }, 
    {
      "@type": "Person", 
      "name": "Patrizia Mecocci"
    }, 
    {
      "@type": "Person", 
      "name": "Hanneke Fm. Rhodius Meester"
    }, 
    {
      "@type": "Person", 
      "name": "Teemu Paajanen"
    }, 
    {
      "@type": "Person", 
      "name": "Wiesje M. van der Flier"
    }, 
    {
      "@type": "Person", 
      "name": "Steen G. Hasselbalch"
    }, 
    {
      "@type": "Person", 
      "name": "Jyrki L\u00f6tj\u00f6nen"
    }, 
    {
      "@type": "Person", 
      "name": "Hilkka Soininen"
    }, 
    {
      "@type": "Person", 
      "name": "Frederik Barkhof"
    }, 
    {
      "@type": "Person", 
      "name": "Mark van Gils"
    }, 
    {
      "@type": "Person", 
      "name": "Shadi Mahdiani"
    }, 
    {
      "@type": "Person", 
      "name": "Tiia Ngandu"
    }, 
    {
      "@type": "Person", 
      "name": "Juha Koikkalainen"
    }, 
    {
      "@type": "Person", 
      "name": "Tuomo H\u00e4nninen"
    }
  ], 
  "datePublished": "2020-12-01", 
  "description": "AbstractBackgroundDifferential diagnostics in dementia is challenging. To date, the basic assessment still includes imaging of the brain and cognitive testing with pen and paper. Web\u2010based cognitive tests however hold potential for standardized and low\u2010cost screening in clinical workup. How they perform when combined with imaging of the brain is unknown. We therefore evaluated the accuracy of a new web\u2010based cognitive battery (Muistikko [1]) detecting different types of dementia, when combined with brain MRI, and compared this to traditional cognitive testing and MRI.MethodWe included 229 subjects from two memory clinic cohorts (PredictND and VPH\u2010DARE), consisting of 188 controls, 29 patients with Alzheimer's dementia (AD), 7 with frontotemporal dementia (FTD) and 5 with vascular dementia (VaD) (Table 1). All patients performed a traditional cognitive test battery (consisting of MMSE, RAVLT, TMT\u2010A and B, Animal Fluency), web\u2010based cognitive testing and had MRI of the brain. Although Muistikko is composed of seven subtasks, only global cognitive score (GCS) was used as defined in [1]. From MRI, multiple imaging biomarkers were defined [2]. Disease\u2010state index classifier was developed from the predictors [2]. Cross\u2010validation was used to calculate balanced accuracy (BACC; average of sensitivities for each diagnostic group). Given the class imbalance, we also calculated prevalence corrected accuracy (PACC).ResultBACC was 66 % and PACC 64% when using the traditional cognitive test battery + MRI. Both BACC and PAC were 69 % when using the web\u2010based cognitive testing + MRI (Table 2). Of note, since we compare four diagnostic groups, BACC by guessing would be 25%.ConclusionThis study shows that combining web\u2010based cognitive tests with MRI data results in high accuracy when separating different types of dementia. The results were comparable with the standard traditional work\u2010up. Web\u2010based cognitive testing is therefore a promising tool to support the clinician in the daily challenge of differential diagnostics, especially when combined with MRI data. References: [1] Paajanen, S. et al. Detecting cognitive disorders using Muistikko web\u2010based cognitive test battery. Alzheimer's & Dementia 13(7):Supplement,P234\u2010P235,2017 [2] Bruun, M. et al. Evaluating combinations of diagnostic tests to discriminate different dementia types. Alzheimers Dement 2018 Aug17;10:509\u201051.", 
  "headline": "Neuropsychology/computerized neuropsychological assessment", 
  "identifier": "https://doi.org/10.1002/alz.042626", 
  "image": "https://zenodo.org/static/img/logos/zenodo-gradient-round.svg", 
  "inLanguage": {
    "@type": "Language", 
    "alternateName": "eng", 
    "name": "English"
  }, 
  "keywords": [
    "Netherlands", 
    "Aurora Universities Network", 
    "Psychiatry and Mental health", 
    "Cellular and Molecular Neuroscience", 
    "Geriatrics and Gerontology", 
    "Neurology (clinical)", 
    "Developmental Neuroscience", 
    "Health Policy", 
    "Epidemiology"
  ], 
  "license": "", 
  "name": "Neuropsychology/computerized neuropsychological assessment", 
  "url": "https://www.openaccessrepository.it/record/77499"
}