Methods Flashcards
Participants consist of?
47 patients with a clinical diagnosis of nfvPPA (12), lvPPA (13), SD (8), and multi-domain AD (14) who attended a specialist early-onset dementia clinic and agreed to take part in the study. These participants included new referrals and follow-up patients. Most patients were seen within a year of first presenting to the clinic
Which participants were excluded?
Participants with a history of alcohol abuse or head injury
Patient were diagnosed?
By experienced neurologists based on detailed clinical history, neuroimaging results, and neurological examination, using guidelines published by Snowden et al. (2011), which have been shown, in clinico-pathological correlation studies, to yield high levels of diagnostic accuracy.
All SD patients showed?
the language characteristics of svPPA
However, as three patients showed early face and object recognition problems, in addition to their language disorder, and had greater right than left temporal lobe atrophy, the term ?
SD is used to designate the group.
Diagnoses were supported by neuropsychological examination using ?
the Manchester Neuropsychological Profile
How many age-matced controls were recruited?
19, nineteen
There was a significant association between
Gender and group
The lvPPA group included a higher proportion of?
males than the control group and AD group
There was a significant group difference in ?
Age
Which group was significantly younger than the other groups?
The AD group
The youthful age of the AD patients, in part, reflects a ?
referral (lähete) bias of younger patients to the neurology clinic but also an inherent (luontainen/synnynnäinen) bias towards early onset in AD presenting with multi-domain impairment.
All participants provided?
written informed consent to take part in the study. The study was approved by North West NRES committee
Participants underwent a
neuropsychological test battery with a particular focus on language and working memory.
Language assessment included tests of
naming, single word comprehension, sentence
processing, narrative production, reading, and spelling.
Naming included?
Object and action naming,
Manchester picture naming. This test involves naming forty line drawings from the
Snodgrass and Vanderwart pictures
Single word comprehension included?
Manchester comprehension. This involves matching a printed word with one of four pictures (the same 40 target items are used as in the Manchester naming test).
Sentence processing tasks?
Modified PALPA 55 subtest Auditory sentence comprehension test and PALPA subtest 58 Auditory comprehension of locative relations
Manchester sentence ordering?
A locally constructed task, which requires participants to order five individually printed words to make a sentence.
Manchester tense (aikamuoto) production?
In this locally constructed task, participants are shown action pictures (e.g., a boy kicking a ball) accompanied by the written word ‘yesterday’ or ‘tomorrow’. Participants are asked to generate a descriptive sentence beginning with the word provided (e.g., Yesterday, the boy kicked the ball).
Measures of narrative production?
Cookie theft picture?
Participants were recorded describing the picture. The number of phonetic errors, phonemic errors, fluency disruptions, length of utterance, number of dependent clauses (lause) per utterance=comment, and percentage of well- formed sentences were calculated.
Reading test involves?
- Manchester reading. This test involves reading aloud the printed words used in the Manchester word-picture matching test.
- Modified PALPA subtest 36 Non-word reading.
- Modified PALPA test 31 Imageability/frequency reading.
- Spelling/sound regularity(säännöllisyys) reading
Spelling
Written spelling
Participants are requested to write 20 dictated (saneltu) words, drawn from the Manchester naming test.
Other tests evaluated?
working memory, praxis, calculation, and behaviour.
Working memory?
The tasks addressed both verbal (phonological) and visuospatial working memory. Verbal tasks encompassed (ympäröidä, käsittää, sisällyttää) those with written as well as spoken presentation and tasks requiring pointing as well as spoken responses.
Verbal (phonological) tasks ?
- Digits: Forwards and reverse Digit span
- Single words: Manchester word repetition. This test involves repetition of items from the Manchester naming/reading/comprehension tests.
Verbal (phonological) tasks jatkuu?
Word sequences?
Sentences?
Word Sequences: Manchester immediate and delayed word repetition. This is a locally constructed test, which involves repeating one or two words with variable delays of zero and five seconds.
- Sentences: PALPA test 12 Sentence repetition
- PALPA test 60 Pointing span for noun-verb sequences
Modified Brown-Peterson task of verbal working memory?
Modified Brown–Peterson task of verbal working memory.
In this test, participants are presented visually with three words. They are asked to repeat the words either immediately, following a five second delay or following a five second delay during which the participant reads aloud numbers.
Visuospatial tasks?
Visual patterns span, involving copying from memory grids of black and white squares to blank grids.
Visuospatial tasks? More
Visual array comparison test?
Visual array comparison test constructed and modified from and programmed in E-Prime 2.0
There are two subtests: colour and location. In both conditions, participants are briefly presented with one square and asked whether a second square is the same colour or in the same location as the first square. The arrays (taulukko, järjestys) increase in size to a maximum of 10 squares.
Praxis?
Orofacial and limb praxis were evaluated with the ?
Manchester praxis screen, a locally constructed instrument taken from the Manchester neuropsychological profile, which is described previously. Participants are asked to carry out the actions described below. If participants are unable to carry out the action to command, they are shown the action to copy.
Orofacial praxis tasks consist of five actions, including tongue protrusion and coughing, three speech sounds (alternating repetitive vowel sounds, consonant sounds, and maintaining an extended phoneme),
three emotional gestures (surprise, anger, and happiness),
and three pantomimes (sniffing, sucking, and blowing).
Upper limb praxis tasks included four gestures and four pantomimes. Each action is performed with both left and right upper limbs.
Calculation?
The Manchester calculation test involves 12 calculations; 6 administered verbally and 6 in writing.
Behaviour?
A locally constructed behavioural questionnaire was given to relatives/carers to complete. The questionnaire includes questions aiming to evaluate changes in areas of behaviour, which are known to be affected in bvFTD and are described below. Each question is rated on the basis of three options: increase, decrease, or no change.
The behavioural domains have been found sensitive in distinguishing (tunnusomainen) ?
bvFTD (behavioural variant frontotemporal dementia) from other forms of dementia and within subtypes of FTD and are incorporated within contemporary diagnostic criteria for bvFTD
Behaviour questions?
- Social behaviour and interactions with others: interest and enjoyment being around others, social greetings and courtesies, amount of eye contact and frequency of personal questions, and comments of a complimentary or critical nature.
- Social emotions: happiness, sadness, fear, anger, guilt, surprise, disgust, embarrass- ment, empathy, laughter, and sense of humour.
- Response to environment: awareness of danger and response to painful and neutral stimuli.
- Eating and drinking: quantity and range of food eaten.
- Self-care:frequencyofwashing/bathing,changingclothes,andcareaboutappearance.
- Hobbies, order, and routine: frequency of doing puzzles, TV quizzes, clockwatching, carrying out simple or complex repetitive behaviour, and hoarding(hamstraus).
Statistical analyses were conducted with ? And p?
SPSS version 22. A p value of
Group comparisons of demographic data were carried out with
ANOVAs and non- parametric equivalents as appropriate
Group comparisons on neuropsychological measures were analysed with?
Kruskal–Wallis tests.
Due to the variation in ages and duration of symptoms across the cohort, group comparisons among the patient groups were also carried out with ?
Quade’s non-parametric rank analysis of covariance (ANCOVA), with age and duration of illness entered as nuisance covariates.
Post-hoc
Fisher’s LSD tests were performed. A p value of ?
P value of <0.05 was adopted.
Multiple post-hoc comparisons were corrected for ?
using Bonferroni corrections (i.e.,
for comparisons of all groups, p < .005 was adopted and for comparisons of the patient groups p < .0083 was adopted).
Sensitivity, specificity
positive and negative predictive values of individual tests were calculated.
The tests and groups were chosen on the basis of ?
Group comparisons.
Any test where a patient group scored significantly worse relative to the other patient groups was ?
included in the sensitivity and specificity analyses.
Receiver operating characteristics curves were fitted to the data and Louden’s index was used to
Determine cut-offs.
a principal components analysis (PCA) was carried out to ?
delineate (describe) core factors underlying (primary, fundamental) language, working memory, and behavioural deficits in these conditions.
Which variable ratio has yielded to good results for PCA?
A participant to variable ratio of 1.2
In order to have a reasonable participant to variable ratio, only scores from tests with both sensitivities and specificities greater than ?
50 % were included in the analysis.
For variables in which both ‘total’ and ‘subtests’ reached the threshold, for example, buccofacial praxis, only ?
subtest variables were entered into the PCA?
In total how many variables were included in the PCA?
25 variables
Once missing data are taken into account, this study gives a 1.32 ratio. Factors above the inflection point on a scree plot were retained. In order to interpret factor loadings, a variance maximizing (varimax) rotation was performed. Factor loadings were used to gain individual participants’ factor scores, which provide information about the participants’ performance on the cognitive tests that cluster on said factor.
SUOMEKSI?
ABOUT SINNE PÄIN:
Kun puuttuvat tiedot on otettu huomioon, tämä tutkimus antaa 1,32-suhteen. Leikkauspisteen taivutuspisteen yläpuolella olevat tekijät säilytettiin. Tekijäkuormitusten tulkitsemiseksi suoritettiin varianssin maksimoiva (varimax) kierto. Faktorikuormituksia käytettiin yksittäisten osallistujien tekijäpisteiden saamiseksi, jotka antavat tietoa osallistujien suorituskyvystä kognitiivisissa testeissä, jotka keskittyvät kyseiseen tekijään.
LDA?
Linear canonical discriminant analysis
Individual participants’ factor scores were used for a stepwise linear canonical discriminant analysis (LDA) to ?
to determine the strongest neuropsychological discriminators between the four groups (nfvPPA, lvPPA, SD, and multi-domain AD).
