Jennifer A. Foley

Screening for cognition and behaviour changes in ALS.

Abstract This study presents the Edinburgh Cognitive and Behavioural ALS Screen (ECAS), developed for ALS patients with physical disability for use by health care professionals. The screen is designed to detect the specific profile of cognition and behaviour changes in ALS and to differentiate it from other disorders. Forty-eight ALS patients (none with evident dementia), 40 healthy controls and 20 carers were recruited. The ECAS, a 15–20-min screen, includes an ALS-Specific score (executive functions and social cognition; fluency; language); an ALS Non-specific score (memory; visuospatial functions); and a carer behaviour screen of five domains characteristic of frontotemporal dementia (FTD). Data from healthy controls produced abnormality cut-offs of 77/100 ALS-Specific score; 24/36 ALS Non-specific score; 105/136 ECAS Total. Twenty-nine percent of patients showed abnormal ALS-Specific scores, and 6% also showed abnormal ALS Non-specific scores. The most prevalent deficit occurred in language functions (35%) followed by executive functions and fluency (23% each). Forty percent of carers reported behaviour change in at least one domain, while 15% met criteria for possible FTD. In conclusion, the ECAS is an effective within-clinic assessment for ALS that determines the presence, severity and type of cognitive and/or behavioural changes, an essential first step to managing these symptoms.

Validation of the Edinburgh Cognitive and Behavioural Amyotrophic Lateral Sclerosis Screen (ECAS): A cognitive tool for motor disorders

Abstract Our objective was to assess the validity of the Edinburgh Cognitive and Behaviour ALS Screen (ECAS), a multi-domain screen designed to detect cognitive deficits in patients with motor disorders. Forty ALS patients (without pre-diagnosed dementia) and 40, age-, gender- and education-matched healthy controls were recruited. All participants underwent extensive neuropsychological assessment and the ECAS. Performance at neuropsychological assessment across five domains (fluency, executive function, language, memory and visuospatial function) was compared to the ECAS ALS-Specific (fluency, executive functions and social cognition, language), ALS Non-specific (memory, visuospatial functions), and Total scores. Data from the healthy controls produced population-based abnormality cut-offs: composite score performance ≤ 2 SD in any domain classified impairment at neuropsychological assessment. Thirty-three percent of patients were impaired, most commonly in a single domain (executive or language dysfunction). Receiver Operator Curve (ROC) analyses using ECAS Total scores and ALS-Specific scores revealed 85% sensitivity and 85% specificity in the detection of cognitive impairment characteristic of ALS (fluency, executive function, language). A five-point borderline range produced optimal values (ALS-Specific Score 77–82, and ECAS-Total Score 105–110). In conclusion, validation against gold standard extensive neuropsychology demonstrated that the ECAS is a screening tool with high sensitivity and specificity to impairment characteristic of ALS.

Assessing dual-task performance using a paper-and-pencil test: Normative data

Although several studies have described dual-tasking ability in normal aging, Mild Cognitive Impairment and Alzheimers disease, no normative data for dual-task performance exist. Dual-tasking ability of 436 healthy individuals, aged 16-88 years, was assessed using a new paper-and-pencil dual-task paradigm. In this study, no age effect was detected, providing strong evidence that age does not affect dual-tasking abilities. Psychometric data for this new assessment are presented, which may enable clinicians and researchers to use this paradigm as a means of examining attentional control in dual-tasking.

The impact of self-citation

Citation rates are used to calculate journal impact factors and for measuring the personal impact of individual scientists (Aksnes, 2003; Fowler and Aksnes, 2007), which can affect chances of academic appointments, advance in career, pay increases and grant funding (Hyland, 2003; Adler, 2009). However, the current method used to calculate citation rates has its limitations. The most widely used index published by the Institute of Scientific Information is the 2-year impact factor (Della Sala and Grafman, 2007, 2009) which calculates citation rate by summing the total citations during a given year to articles published in the previous two years and dividing this by the number of ‘source items’. What constitutes a ‘source item’ is unclear, but the number of source items can obviously affect citation rate (see Della Sala and Brooks, 2008), and can be manipulated to affect journal impact factor (see Brumback, 2009). Journal impact factors can also be highly influenced by the publication of a few highly cited papers (Buchtel and Della Sala, 2006) and it has been suggested that around 20% of all articles tend to account for 80% of all citations. In addition, it has been argued that the arbitrarily set time window of two-years disadvantages slowmoving disciplines, such as neuropsychology (Della Sala and Crawford, 2006, 2007; Della Sala and Grafman, 2009). Another factor that may affect citation rate is self-citation. Authors may choose to cite their own work in order to make their earlier work visible, to help reinforce an argument, to create an image of scientific authority (Hyland, 2003) or simply for self-aggrandizement (Hyland, 2003; Fowler and Aksnes, 2007). Self-citation can inflate the perception of an article’s or a scientist’s scientific impact, particularly when an article has many authors, increasing the possible number of self-citations (Schreiber, 2007; Della Sala and Brooks, 2008), and thus there have been calls to remove self-citations from citation rates (Schreiber, 2007). However, Fowler and Aksnes (2007)

Dual-task performance in Alzheimer's disease, mild cognitive impairment, and normal ageing.

Although several studies have shown that dual-tasking ability is impaired in Alzheimers disease (AD), the stage at which this deficit manifests remains unclear. This study investigated if a new paper-and-pencil assessment of dual-tasking ability could distinguish between AD, mild cognitive impairment (MCI) and normal ageing in a sample of 50 people with AD, 49 people with MCI, and 50 healthy age-matched controls. The AD group demonstrated a significant impairment in dual-task ability. There was no effect of either MCI or healthy ageing on dual-task performance, indicating that the dual-task impairment is specific to AD.

Dual task performance and post traumatic brain injury

Primary objective: To determine if people with traumatic brain injury (TBI) display deficits in dual tasking ability. Research design: Observational and correlational research design used, to identify and describe the nature of dual task impairment in people with TBI. Methods and procedures: Eighty-six people with TBI were assessed using a new standardized paper-and-pencil assessment of dual tasking ability and a number of other neuropsychological tests assessing attention, executive functioning and memory. Main outcome and results: Twenty-three out of the 86 people with TBI (26.74%) performed below the cut-off for normal performance, suggesting that only one quarter of the TBI sample assessed had deficits in attentional control. Conclusions: Deficits in task co-ordination are not a necessary consequence of TBI.

No dual-task practice effect in Alzheimer's disease

Diagnosis of Alzheimers disease (AD) requires evidence of progressive decline in cognitive function. However, many tests used to assess cognitive function suffer from considerable practice effects, reducing their reliability. Several studies have reported that the ability to do two things at once, or dual tasking, is impaired in AD, but unaffected by healthy ageing. The apparent specificity of this impairment suggests that this assessment may be particularly useful in the early diagnosis of AD, but the reliability of this assessment remains unknown. Therefore, this study investigated simultaneous performance of digit recall and tracking tasks across six testing sessions in eight people with AD, eight healthy older adults and eight healthy younger adults. The results found that dual-task performance was unaffected by healthy ageing, but significantly impaired in AD, with no effect of repeated exposure. The absence of any improvements in performance despite increased familiarity with the tasks demands suggests that not only is the dual-task assessment well suited for monitoring progression over time, but also that dual tasking involves a specific cognitive function which is impaired in the AD brain.

Dual task performance in Parkinson's disease

Several studies have found dual tasking to be impaired in Alzheimers disease (AD), but unaffected by healthy ageing. It is not known if this deficit is specific to AD, or also present in other neurodegenerative disorders that can occur in later life, such as Parkinsons disease (PD). Therefore, this study investigated dual tasking in 13 people with PD, 26 AD and 42 healthy age-matched controls. The people with AD demonstrated a specific impairment in dual tasking, which worsened with increasing disease severity. The people with PD did not demonstrate any deficits in dual tasking ability, when compared to healthy controls, suggesting that the dual task impairment is specific to AD.

Papers from international collaborations have higher impact.

Adair and Huynh (2012) noted that, within psychological research, the number of single-authored papers has progressively declined since the 1990s. It has become increasingly common for papers to have multiple authors, and, more recently, multiple authors from multiple institutions and countries. The rise of such international collaboration is perhaps a reflection of our digital age, where data can be shared electronically and analysed by different researchers at different locations across the globe. International collaborations tend to be dominated by better-funded countries, with status, proximity and cultural/ linguistic factors likely influencing chances of collaboration (Adair & Huynh, 2012). Some studies also report a negative correlation between country size and number of external collaborations (Frame & Carpenter, 1979; Melin & Persson, 1998; Schubert & Braun, 1990), suggesting that larger countries with larger scientific communities have little need to collaborate with researchers from other countries. International collaboration is associated with greater scientific impact. It has been observed that studies originating from international collaborations are more cited and are published in journals with higher impact factors (Basu & Aggarwal, 2001; Bordons, Gómez, Fernández, Zulueta, & Méndez, 1996) than those run within national communities. For example, Bordons et al. (1996) found that research papers from Spanish institutions, including those published in the field of neuroscience, had a significantly greater average impact factor when featuring an international collaboration, and that the most productive authors had the greatest number of collaborations, both domestic and international. The association between international collaboration and greater productivity and visibility may be due to practical factors; collaboration reduces each researcher’s individual workload, enabling them to work on multiple projects. The fact that collaborations allow for expertise to be shared, enabling better research to be performed, may also be important. In addition, productive academics are more likely to be successful in bids for highly-competitive international grant funding (from agencies such as the European Commission), which increasingly require evidence of international networking and collaboration, and be able to choose from a wider pool of internationally-mobile doctoral and postdoctoral students, thereby facilitating more international collaborations. Accordingly, such international collaboration is encouraged by university departments, and is often considered when making decisions about staff hiring, tenure and promotion. We were interested in the frequency and nature of international collaboration featured in the papers published in Cortex, and their impact, as measured by number of citations (2-year impact factor). In 2011 and 2012, a total of 263 peer-reviewed articles were published in Cortex; 33 of these were written by a single author. The remaining 230 articles had up to 14 authors (mean 1⁄4 4.12, SD 1⁄4 2.53). Of these, 64 (24.30%) were written by authors from two countries and 21 (8.00%) from three countries. Just under half of all international collaborations were between G8 member states (n 1⁄4 42, 49.41% (including Canada, France, Germany, Italy, Japan, UK and USA); e.g., Yeterian, Pandya, Tomaiuolo, & Petrides, 2012; Zappalà et al., 2012) and many of these were from within Europe only (n 1⁄4 18, 21.18%, e.g., Klemen, Hoffman, & Chambers, 2012). The commonest collaborations were between Italy and UK (n 1⁄4 9,

Geographical distribution of Cortex publications.

UK (n1⁄4 53) Ahmed et al. (2008) Averbeck et al. (2009) Bate et al. (2008) Bengtsson et al. (2009) Butler and Harvey (2008) Caine et al. (2009) Cappelletti et al. (2008) Carey et al. (2009) Catani and Mesulam (2008) Catani and Thiebaut De Schotten (2008) Dannhauser et al. (2008) Easton et al. (2009) Eglinton and Annett (2008) ffytche (2008) Fischer (2008) Fotopoulou et al. (2008) French et al. (2009) French et al. (2008) Fyfe et al. (2008) Gaffan and Wilson (2008) Glickstein and Berlucchi (2008) Grahn and Brett (2009) Grube and Griffiths (2009) Hanley and Nickels (2009) Hirnstein et al. (2009) Hudson (2008)