Are the criteria for PD-MCI diagnosis comprehensive? A Machine Learning study with modified criteria.

BACKGROUND: Mild cognitive impairment in Parkinson's disease (PD-MCI) includes deficits in different cognitive domains, and one domain to explore for neurocognitive impairment following the DSM-V is social cognition. However, this domain is not included in current criteria for PD-MCI diagnosis. Moreover, tests vary across studies. It is, therefore, crucial to optimize cognitive assessment in PD-MCI. We aimed to do so by using Machine Learning. METHODS: 275 PD patients were included. Four cognitive batteries were created: two Standard ones (Levels I and II), applying current criteria and "traditional" tests; two Alternative ones (Levels I and II), which incorporated a test of social cognition. These batteries were included in the Random Forest (RF) classifier. To assess RF performance, the AUC was considered, and the Variable Importance Index was estimated to understand the contribution of each test in PD-MCI classification. RESULTS: Standard Level I and II showed an AUC of 0.852 and 0.892, while Alternative Level I and II showed an AUC of 0.898 and of 0.906. Variable Importance Index revealed that TMT B-A, Ekman test, RAVLT-IR, MoCA, and Action Naming were tests that most contributed to PD-MCI classification. CONCLUSION: The Alternative level I assessment demonstrated a similar classification capacity to the Standard level II assessment. This finding suggests that in the cognitive assessment of PD patients, it is crucial to consider the most affected cognitive domains in this clinical population, including social cognition. Taken together, these results suggest to revise current criteria for the diagnosis of PD-MCI.

Genuine Memory Deficits as Assessed by the Free and Cued Selective Reminding Test (FCSRT) in the Behavioural Variant of Frontotemporal Dementia. A Systematic Review and Meta-analysis Study.

The current diagnostic criteria for the behavioural variant of frontotemporal dementia (bvFTD) foresee a relative sparing of long-term memory. Although bvFTD patients were thought to report secondary memory deficits associated with prefrontal dysfunctions, some studies indicated the presence of a "genuine memory deficit" related to mesial temporal lobe dysfunctions. Among various neuropsychological tests, the Free and Cue Selective Reminding Test (FCSRT) has been recommended to distinguish genuine from apparent amnesia. We conducted a systematic review and a random effect Bayesian meta-analysis to evaluate the nature and severity of memory deficit in bvFTD. Our objective was to determine whether the existing literature offers evidence of genuine or apparent amnesia in patients with bvFTD, as assessed via the FCSRT. On 06/19/2021, we conducted a search across four databases (PMC, Scopus, Web of Science, and PubMed). We included all studies that evaluated memory performance using the FCSRT in patients with bvFTD, as long as they also included either cognitively unimpaired participants or AD groups. We tested publication bias through the Funnel plot and Egger's test. To assess the quality of studies, we used the Newcastle-Ottawa quality assessment scale adapted for cross-sectional studies. We included 16 studies in the meta-analysis. The results showed that bvFTD patients perform better than AD patients (pooled effects between 0.95 and 1.14), as their memory performance stands between AD and control groups (pooled effects between - 2.19 and - 1.25). Moreover, patients with bvFTD present both genuine and secondary memory disorders. As a major limitation of this study, due to our adoption of a rigorous methodology and stringent inclusion criteria, we ended up with just 16 studies. Nonetheless, our robust findings can contribute to the ongoing discussion on international consensus criteria for bvFTD and the selection of appropriate neuropsychological tools to facilitate the differential diagnosis between AD and bvFTD.

Visuo-Spatial Working Memory and Mathematical Skills in Children: A Network Analysis Study.

Visuo-spatial working memory is one of the main domain-general cognitive mechanisms underlying mathematical abilities and their development in children. However, if visuo-spatial working memory involves different processes and components, then the term 'mathematics' refers to a broad concept that includes multiple domains and skills. The aim of this present study was to investigate the relationship between different visuo-spatial working memory components and several mathematical abilities in a sample of third- to fifth-grade Italian children. To assess the relationships between different visuo-spatial working memory components and different mathematical abilities, we relied on Network Analysis (NA). Results indicate that some but not all visuo-spatial working memory components are associated with some mathematical abilities.

The Simple View of Reading in Children Acquiring a Regular Orthography (Italian): A Network Analysis Approach.

In the present study, we explored the unique contribution of reading accuracy, reading fluency and linguistic comprehension within the frame of Simple View of Reading (SVR). The experimental sample included 118 3rd to 5th grade children learning Italian, a language with a highly regular orthography. We adopted a flexible method of analysis, i.e., the Network Analysis (NA), particularly suited for exploring relations among different domains and where the direct relations between a set of intercorrelated variables is the main interest. Results indicated an independent and unique contribution of syntactic comprehension skills as well as reading fluency and reading accuracy in the comprehension of a written text. The decoding measures were not directly associated with non-verbal reasoning and the latter was not directly associated with reading comprehension but was strongly related to oral syntactic comprehension. Overall, the pattern of findings is broadly consistent with the predictions of SVR and underscores how, in an orthographically regular language, reading fluency and reading accuracy as well as oral comprehension skills directly influence reading comprehension. Data are discussed in a cross-linguistic perspective. Implications for education and rehabilitation are also presented.

Neuropsychological and socio-cognitive deficits in patients with obstructive sleep apnea.

Introduction: Patients with obstructive sleep apnea (OSA) suffer from several neurocognitive deficits. We investigated the cognitive and socio-cognitive profiles of patients with severe OSA, controlling for potentially relevant mediating variables (i.e. age, body-mass index, cognitive reserve and depression). Moreover, we studied the neuropsychological profile of a high-risk OSA phenotype characterized by severe OSA and severe nocturnal hypoxemia.Method: We assessed 29 previously untreated severe OSA patients with a mean age of 55.6 (± 9.9 years) and a mean apnea-hypopnea index (AHI) of 53.1 (± 17.4). A control group of 34 healthy participants was also enrolled. Participants completed an extensive neuropsychological battery that included social cognition, a relatively new investigation area among OSA patients.Data analysis: Data were analyzed with a Bayesian approach. Specifically, Bayesian ANCOVA was used to investigate whether the grouping variable could predict test performance. Age, body-mass index, cognitive reserve and state of depression were added as covariates to the null model to weight the effects of these potential confounding factors. Three groups were analyzed: healthy controls (H), OSA with severe apnea and severe nocturnal oxygen desaturation (D+), and OSA with severe apnea non-desaturators (D-). Performances on the various neuropsychological tests were treated as the dependent variables.Results: The results indicate that non-verbal reasoning, the theory of mind skills, and mental shifting ability were impaired in OSA patients. Patients with severe nocturnal hypoxemia underperformed compared to patients with the same severity of apnea but non-desaturators. Additionally, we observed a trend toward a worse performance among OSA desaturator patients in the following abilities: constructional ability, short term verbal memory, phonological fluency, and the ability to inhibit automatic and dominant responses.Conclusion: The data suggest a key role of hypoxemia in affecting cognitive functioning in OSA patients. Executive functions and the concomitant involvement of social cognition are particularly affected.

A Network Analysis of the Relationship among Reading, Spelling and Maths Skills.

Background. Skill learning (e.g., reading, spelling and maths) has been predominantly treated separately in the neuropsychological literature. However, skills (as well as their corresponding deficits), tend to partially overlap. We recently proposed a multi-level model of learning skills (based on the distinction among competence, performance, and acquisition) as a framework to provide a unitary account of these learning skills. In the present study, we examined the performance of an unselected group of third- to fifth-grade children on standard reading, spelling, and maths tasks, and tested the relationships among these skills with a network analysis, i.e., a method particularly suited to analysing relations among different domains. Methods. We administered a battery of reading, spelling, and maths tests to 185 third-, fourth-, and fifth-grade children (103 M, 82 F). Results. The network analysis indicated that the different measures of the same ability (i.e., reading, spelling, and maths) formed separate clusters, in keeping with the idea that they are based on different competences. However, these clusters were also related to each other, so that three nodes were more central in connecting them. In keeping with the multi-level model of learning skills, two of these tests (arithmetic facts subtest and spelling words with ambiguous transcription) relied heavily on the ability to recall specific instances, a factor hypothesised to underlie the co-variation among learning skills. Conclusions. The network analysis indicated both elements of association and of partial independence among learning skills. Interestingly, the study was based on standard clinical instruments, indicating that the multi-level model of learning skills might provide a framework for the clinical analysis of these learning skills.