Examining virtual driving test performance and its relationship to individuals with HIV-associated neurocognitive disorders.
Examining virtual driving test performance and its relationship to individuals with HIV-associated neurocognitive disorders.
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DOI：
10.3389/fnins.2022.912766
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发表时间：
2022
影响因子：
4.3
通讯作者：
Wigdahl, Brian
中科院分区：
文献类型：
--
作者：
Grethlein, David;Pirrone, Vanessa;Devlin, Kathryn N.;Dampier, Will;Szep, Zsofia;Winston, Flaura K.;Ontanon, Santiago;Walshe, Elizabeth A.;Malone, Kim;Tillman, Shinika;Ances, Beau M.;Kandadai, Venk;Kolson, Dennis L.;Wigdahl, Brian
关键词：
现有的HIV相关神经认知障碍（HAND）的筛查工具在临床上通常不适用于检测较轻形式的损害。HAND的正式诊断需要评估认知和日常生活活动（ADL）的损害。为了满足识别可能患有HAND相关残疾的患者的迫切需求，我们在HIV感染者（PWH）的弱势群体中实施了一种低成本的筛查工具，即虚拟驾驶测试（VDT）平台。VDT提供了一个机会，以具有成本效益的屏幕为轻度形式的障碍，同时提供实用的指导，认知要求的日常生活能力。我们的目标是：（1）评价VDT性能变量是否与手征诊断相关，如果是，（2）系统地确定一个可管理的变量子集，用于未来的手征筛查模型。作为次要目的，我们检查了在用于诊断HAND的各个领域内识别的变量与损伤的相对关联。在一个横断面设计中，62名PWH从一个已建立的HIV队列中招募，并完成了全面的神经心理评估（CNPA），然后进行自我指导的VDT。确定了HAND特异性损伤和7个CNPA域中每一个内的损伤的二分诊断。一个系统的变量选择过程被用来减少大量的VDT数据生成，VDT变量的一个较小的子集，估计与手。此外，我们还研究了每个CNPA域中已识别变量与损伤之间的关联。超过一半的参与者（N = 35）确认存在HAND。分离出二十个VDT性能变量的子集，然后根据其与HAND的估计关联强度进行排名。此外，最终子集中的几个变量与运动功能、执行功能、注意力和工作记忆的损害有统计学显著相关性，与先前的研究一致。我们确定了一个与手相关的VDT性能变量的子集，并评估与手相关的个人功能能力。需要进一步的研究来开发和验证包含该子集的预测性HAND筛查模型。
Existing screening tools for HIV-associated neurocognitive disorders (HAND) are often clinically impractical for detecting milder forms of impairment. The formal diagnosis of HAND requires an assessment of both cognition and impairment in activities of daily living (ADL). To address the critical need for identifying patients who may have disability associated with HAND, we implemented a low-cost screening tool, the Virtual Driving Test (VDT) platform, in a vulnerable cohort of people with HIV (PWH). The VDT presents an opportunity to cost-effectively screen for milder forms of impairment while providing practical guidance for a cognitively demanding ADL. We aimed to: (1) evaluate whether VDT performance variables were associated with a HAND diagnosis and if so; (2) systematically identify a manageable subset of variables for use in a future screening model for HAND. As a secondary objective, we examined the relative associations of identified variables with impairment within the individual domains used to diagnose HAND. In a cross-sectional design, 62 PWH were recruited from an established HIV cohort and completed a comprehensive neuropsychological assessment (CNPA), followed by a self-directed VDT. Dichotomized diagnoses of HAND-specific impairment and impairment within each of the seven CNPA domains were ascertained. A systematic variable selection process was used to reduce the large amount of VDT data generated, to a smaller subset of VDT variables, estimated to be associated with HAND. In addition, we examined associations between the identified variables and impairment within each of the CNPA domains. More than half of the participants (N = 35) had a confirmed presence of HAND. A subset of twenty VDT performance variables was isolated and then ranked by the strength of its estimated associations with HAND. In addition, several variables within the final subset had statistically significant associations with impairment in motor function, executive function, and attention and working memory, consistent with previous research. We identified a subset of VDT performance variables that are associated with HAND and assess relevant functional abilities among individuals with HAND. Additional research is required to develop and validate a predictive HAND screening model incorporating this subset.
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作者：
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通讯作者：
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DOI：
10.1017/s1355617704102130
发表时间：
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DOI：
10.1080/13803395.2011.559157
发表时间：
2011-08
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通讯作者：
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