Robotic Assessment of Processing Speed and Longitudinal Cognitive Changes in Epilepsy
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Authors
Falah, Adam Mizied
Date
2024-08-30
Type
thesis
Language
eng
Keyword
Epilepsy , Processing Speed , Robotics , Kinarm , Cognition
Alternative Title
Abstract
Despite extensive research on cognition in epilepsy, processing speed (PS) impairments remain underexplored and often overlooked. Additionally, accelerated cognitive decline in epilepsy has been shown in multiple studies.
Generally, traditional pen-and-paper neuropsychological assessments are used to determine cognitive status. However, these do not come without limitations. Therefore, this study aims to address these limitations and enhance the assessment of PS impairments and cognitive decline by using Kinarm Robotic Technology.
The Symbol Digit Modalities Test (SDMT) is a commonly used traditional assessment for PS, recording only one parameter: the number of correct answers. Recently, a novel robotic version of SDMT has been developed on the Kinarm platform to improve assessment by recording multiple parameters. These parameters reflect both the speed and behavior of participants' during the test.
The first part of this study focused on validating the robotic SDMT. To do this, we recruited 32 epilepsy patients and 30 controls. Both groups completed the two versions SDMT. Our results showed that patients had reduced performance on both versions of the SDMT compared to controls. Significant correlations were found between the two assessments in the number of correct selections (r = 0.79, p = 2.06e-14). Speed-based parameters of the Kinarm SDMT (e.g., mean time of correct selections) showed significant differences between patients and controls. Ratio-based parameters, which examine participants' behavior (e.g., ratio of time for correct vs. incorrect answers), did not show such differences. This indicates that PS is primarily impaired in epilepsy, not the participants’ strategy. Additionally, the Kinarm SDMT correlated with established PS assessments, including the Trail Making Test A, Grooved Pegboard Test, and the Coding subtest of the RBANS.
In the second part of the study, cognitive decline was assessed after a ~3-year interval. Nine patients from a previous study were reassessed. Contrary to expectations, more cognitive improvements were observed. However, this finding was not considered conclusive due to study limitations.
Overall, our findings highlight the presence of PS impairment in epilepsy and validate the use of robotics in PS assessment. Future studies with larger cohorts are needed to better understand the longitudinal cognitive trajectories in epilepsy.
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ProQuest PhD and Master's Theses International Dissemination Agreement
Intellectual Property Guidelines at Queen's University
Copying and Preserving Your Thesis
This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.