Authors: Sacco, Guillaume | Ben-Sadoun, Grégory | Bourgeois, Jérémy | Fabre, Roxane | Manera, Valeria | Robert, Philippe
Article Type: Research Article
Abstract: Background: Neuropsychological tests are particularly important for the clinical evaluation and Alzheimer’s disease (AD) diagnosis. However, the tests currently employed for neuropsychological assessment have been developed several decades ago, and thus they do not fully exploit the potential provided by modern digital tools. One of the tests most commonly employed to assess attention and executive functions is the Trail Making Test (TMT). Objective: The aim of this study was to evaluate whether the TMT developed and used for the serious exergame X-Torp (TMTX-Torp ) can be used to evaluate cognitive functions such as mental flexibility. Methods: Adjusted multivariate mixed model …was used to compare performances in the TMTX-Torp to performances in the standard variant (TMTs ) in three populations. 21 participants with AD (78.6y±8.5 y), 27 with mild cognitive impairment (MCI) (76.8y±8.5 y), and 27 healthy (HEC) (71.8y±7.4 y) were included. Results: A difference was observed for the TMT A between AD and HEC and for the TMT B between AD and MCI and between AD and HEC. Whatever the variant of the TMT, we found a positive linear correlation between the time to complete the TMTX-Torp and the TMTs for HEC (TMT A: r = 0.75, p < 0.001; TMT B: r = 0.52, p = 0.008) and MCI participants (TMT A: r = 0.53, p = 0.005; TMT B: r = 0.48, p = 0.025) but not for AD participants. Conclusion: Although these versions of the TMT were not identical, the results showed that both versions were able to discriminate between HEC, MCI, and AD populations. Show more
Keywords: Alzheimer’s disease, executive function, neurocognitive disorders, serious games
DOI: 10.3233/JAD-180396
Citation: Journal of Alzheimer's Disease, vol. 68, no. 4, pp. 1657-1666, 2019
Authors: Zeghari, Radia | Manera, Valeria | Fabre, Roxane | Guerchouche, Rachid | König, Alexandra | Phan Tran, Minh Khue | Robert, Philippe
Article Type: Research Article
Abstract: Background: Apathy, a highly prevalent behavioral disorder in Alzheimer’s disease and other related disorders, is currently assessed using clinical scales as it is for all neuropsychiatric disorders. Objective: The aim of this study is to propose a new type of assessment using new technologies designed to assess loss of interest by a more implicit and indirect method. Methods: The Interest Game is a form of interactive self-report, where categories of interests are presented in order to quantify them and identify the activities that constitute them. Two indices can be extracted, the number of categories and the number of activities selected. …We compared the scores between three groups: Apathetic (A) and Non-Apathetic (NA) subjects (according to the Apathy Diagnostic Criteria) and controls with no objective cognitive impairment. Results: 95 subjects were included. Results showed that subjects from the A group had significantly less interests (both categories and images selected) than the NA group. As expected, the control group selected a higher number of categories than the other groups. The diagnosis (minor or major neurocognitive disorder) and level of education had also a significant effect on the number of categories selected. Furthermore, subjects with major neurocognitive disorder (NCD) had significantly less interests than minor NCD group. The number of categories measure was more sensitive than the number of images selected. Conclusion: The Interest Game is a promising tool to quantify and identify subject interests and differentiate between apathetic and non-apathetic subjects. Future studies should focus on including more apathetic subjects in the minor NCD group and validating this tool with the general population. Show more
Keywords: Apathy, interest, leisure activities, neurocognitive disorders, serious games
DOI: 10.3233/JAD-191282
Citation: Journal of Alzheimer's Disease, vol. 74, no. 2, pp. 669-677, 2020
Authors: David, Renaud | Manera, Valeria | Fabre, Roxane | Pradier, Christian | Robert, Philippe | Tifratene, Karim
Article Type: Research Article
Abstract: Background: Safety warnings from health authorities are currently intended to limit the use of psychotropic agents in dementia-related conditions. Evidence concerning the use of antidepressants in dementia is, however, scarce and contradictory. Objective: To evaluate antidepressant use among individuals with Alzheimer’s disease (AD) and related disorders in the French population between 2010 and 2014. Method: Antidepressant prescriptions in individuals with AD, mixed dementia (MD), and vascular dementia (VaD) in the French National Alzheimer Database between 2010 and 2014 were analyzed (N = 199,544). Results: Multivariate analysis showed an annual significant increase (p < 0.001) in the prescription rate of antidepressants from 26% …(2010) to 31% (2014), and identified female gender, younger age, higher education, living in long-term facilities, more severe cognitive decline, and presence of vascular signs (VaD and MD) as associated factors for antidepressant prescribing. Conclusion: The annual increase of antidepressant prescribing among individuals with AD, MD, and VaD in French specialized settings may be partially related to the lack of current valuable medications for dementia-related behavioral symptoms. Show more
Keywords: Alzheimer’s disease, antidepressant, dementia, psychotropic medication
DOI: 10.3233/JAD-160238
Citation: Journal of Alzheimer's Disease, vol. 53, no. 4, pp. 1365-1373, 2016
Authors: Manera, Valeria | Galperti, Guenda | Rovini, Erika | Zeghari, Radia | Mancioppi, Gianmaria | Fiorini, Laura | Gros, Auriane | Mouton, Aurélie | Robert, Philippe | Cavallo, Filippo
Article Type: Research Article
Abstract: Background: Social apathy, a reduction in initiative in proposing or engaging in social activities or interactions, is common in mild neurocognitive disorders (MND). Current apathy assessment relies on self-reports or clinical scales, but growing attention is devoted to defining more objective, measurable and non-invasive apathy proxies. Objective: In the present study we investigated the interest of recording action kinematics in a social reach-to-grasp task for the assessment of social apathy. Methods: Thirty participants took part in the study: 11 healthy controls (HC; 6 females, mean age = 68.3±10.5 years) and 19 subjects with MND (13 females, mean age = 75.7±6.3 years). Based on the …Diagnostic Criteria for Apathy, MND subjects were classified as socially apathetic (A-MND, N = 9) versus non-apathetic (NA-MND, N = 10). SensRing, a ring-shaped wearable sensor, was placed on their index finger, and subjects were asked to reach and grasp a can to place it into a cup (individual condition) and pass it to a partner (social condition). Results: In the reach-to-grasp phase of the action, HC and NA-MND showed different acceleration and velocity profiles in the social versus individual condition. No differences were found for A-MND. Conclusion: Previous studies showed the interest of recording patients’ level of weekly motor activity for apathy assessment. Here we showed that a 10-min reach-to-grasp task may provide information to differentiate socially apathetic and non-apathetic subjects with MND, thus providing a tool easily usable in the clinical practice. Future studies with a bigger sample are needed to better characterize these findings. Show more
Keywords: Apathy, diagnosis, intention, motivation, motor activity, neurocognitive disorders, social behavior, social isolation
DOI: 10.3233/JAD-200966
Citation: Journal of Alzheimer's Disease, vol. 81, no. 2, pp. 569-582, 2021
Authors: Bensamoun, David | Guignard, Renaud | Furst, Ansgar J. | Derreumaux, Alexandre | Manera, Valeria | Darcourt, Jacques | Benoit, Michel | Robert, Philippe H. | David, Renaud
Article Type: Research Article
Abstract: Background: Neuropsychiatric symptoms, also known as behavioral and psychological symptoms of dementia (BPSD), affect the majority of patients with dementia, and result in a greater cognitive and functional impairment. Objective: To investigate associations between BPSD and amyloid cerebral deposition as measured by 18 F-Florbetapir-PET quantitative uptake in elderly subjects with and without cognitive impairment. Methods: Participants with cognitive impairment [mild cognitive impairment (MCI) or Alzheimer’s disease (AD)] and healthy controls (HC) from the ADNI cohort (Alzheimer Disease Neuroimaging Initiative) who underwent an 18 F-florbetapir PET scan between May 2010 and March 2014 were included. Clinical assessments included the Clinical Dementia …Rating, the Mini-Mental State Examination (MMSE), and the Neuropsychiatric Inventory. Freesurfer software was used to extract PET counts based on T1-based structural ROI (frontal, cingulate, parietal, and temporal). Spearman’s partial correlation scores between BPSD severity and regional amyloid uptake were calculated. Results: Data for 657 participants [age = 72.6 (7.19); MMSE = 27.4 (2.67)] were analyzed, including 230 HC [age = 73.1 (6.02); MMSE = 29 (1.21)], 308 MCI [age = 71.5 (7.44); MMSE = 28.0 (1.75)], and 119 AD subjects [age = 74.7 (8.05); MMSE = 23.1 (2.08)]. Considering all diagnostic groups together, positive significant correlations were found between anxiety and 18 F-florbetapir uptake in the frontal (r = 0.102; p = 0.009), cingulate (r = 0.083; p = 0.034), and global cerebral uptake (r = 0.099; p = 0.011); between irritability and frontal (r = 0.089; p = 0.023), cingulate (r = 0.085; p = 0.030), parietal (r = 0.087; p = 0.025), and global cerebral uptake (r = 0.093; p = 0.017); in the MCI subgroup, between anxiety and frontal (r = 0.126; p = 0.03) and global uptake (r = 0.14; p = 0.013); in the AD subgroup, between irritability and parietal uptake (r = 0.201; p = 0.03). Conclusion: Anxiety and irritability are associated with greater amyloid deposition in the neurodegenerative process leading to AD. Show more
Keywords: ADNI, Alzheimer’s disease, amyloid, anxiety, behavioral and psychological symptoms of dementia, dementia, cingulate, frontal, irritability, neuroimaging, neuropsychiatric symptoms
DOI: 10.3233/JAD-150181
Citation: Journal of Alzheimer's Disease, vol. 49, no. 2, pp. 387-398, 2016
Authors: Ben-Sadoun, Grégory | Sacco, Guillaume | Manera, Valeria | Bourgeois, Jérémy | König, Alexandra | Foulon, Pierre | Fosty, Baptiste | Bremond, François | d’Arripe-Longueville, Fabienne | Robert, Philippe
Article Type: Research Article
Abstract: Background: The use of Serious exerGames (SeG) as enriched environments (EE), which promotes cognitive simulation with physical activity in a positive emotional context, has been proposed to represent a powerful method to slow down the decline due to neurodegenerative diseases (ND), such as Alzheimer’s disease (AD). However, so far, no SeG targeting EE has been tested in ND subjects. Objective: This study aimed at evaluating the usability and short-term training effects of X-Torp, an action SeG designed for elderly ND subjects with mild cognitive impairment (MCI) and AD. Methods: X-Torp is a SeG played using the Microsoft® Kinect™. 10 ND …subjects and 8 healthy elderly controls (HEC) were enrolled in a 1-month program with three training sessions per week. Usability was evaluated through game time, game performance, the aerobic intensity level reached, perceived emotions, and perceived usability. Results: All participants successfully completed the training program. ND subjects played less and had a lower game performance compared to HEC. During the sessions, ND subjects maintained a light intensity of aerobic activity, while HEC maintained a moderate intensity. Both groups experienced only positive emotions, and reported a ‘moderate’ to ‘high’ perceived competence, a ‘moderate’ game difficulty, and a ‘high’ interest in the game. Conclusion: Usability results suggest that X-Torp represents a usable EE for healthy subjects and persons with MCI and AD. However, in order to reach moderate or high intensity of aerobic activity, X-Torp control modes should be adapted to become more physically stimulating. Show more
Keywords: Aerobic activity, Alzheimer’s disease, cognition, enriched environment, mild cognitive impairment, sep serious game
DOI: 10.3233/JAD-160268
Citation: Journal of Alzheimer's Disease, vol. 53, no. 4, pp. 1299-1314, 2016
