Remote Neuropsychological Assessment: A Proof-of-Concept Test

描述(由申请人提供)：中风是成人残疾的主要原因，很大一部分中风幸存者面临着沟通障碍，这显著降低了他们的生活质量。临床和基础研究人员依靠神经心理测试来评估中风幸存者的神经学和行为状态。获取神经心理学数据的困难阻碍了涉及这一群体的基础和临床研究。这一提议回应了对神经心理测试创新方法的需求。标准的神经心理测试管理依赖于面对面(F2F)的互动。这造成了地理限制和数据获取负担，降低了研究效率，并导致研究参与方面的差异。为了克服这些障碍，我们将开发工具和方案，允许中风幸存者通过地理上相距遥远的研究人员的虚拟支持，在自己的家中完成神经心理测试。我们将使用无线协作视频会议软件和易于操作的平板电脑(IPad)。我们的测试组将探测核心语言功能，我们的参与者将有左半球损伤。之所以选择这个最初的方向，是因为中风后失语症对个人和社会造成的负担很大，用于失语症研究的许多任务都很简单，先前的数据允许对预期结果进行预测，而且显然需要能够监测失语症状况和治疗结果的工具。我们的技术和协议的形成性可用性测试将用于在三种不同的条件下优化电池的管理：1)旨在模拟标准F2F神经心理测试的虚拟、研究人员指导的协议，2)旨在模拟测试管理的计算机化方法的虚拟、自我管理的协议，以及3)用作性能基准的标准面对面协议。一旦我们的方案到位，将从三组患有局灶性左半球病变的参与者那里获得数据。每个小组将通过我们的两个虚拟协议之一或标准的F2F协议，在他们的家中完成我们的语言任务。所有小组将在我们的研究实验室完成标准的F2F方案。将使用各种可用性指标来评估参与者和研究人员对我们的虚拟协议的满意度、信心和成功程度。这些行为数据将被用来测试当我们的任务在F2F测试条件下进行管理时，是否会获得类似的结果。对效率和设备可靠性的衡量将为以家庭为基础的远程神经心理评估的好处和局限性提供一个实用的视角。总体而言，我们的目标是开发一种基于家庭的远程神经心理测试的创新方法，该方法可以很容易地被其他研究人员改编和采用，以满足不同的研究需求。

DESCRIPTION (provided by applicant): Stroke is a leading cause of adult disability with a large portion of stroke survivors confronting a communication disorder that significantly diminishes the quality of their lives. Clinical and basic researchers rely upon neuropsychological testing to evaluate the neurologic and behavioral status of stroke survivors. The difficulties involved in obtaining neuropsychological data hinder basic and clinical research involving this population. This proposal responds to the need for innovative approaches to neuropsychological testing. Standard neuropsychological test administration relies upon face-to-face (F2F) interactions. This imposes geographic constraints and data acquisition burdens that reduce research efficiency and lead to disparities in research involvement. To overcome these barriers, we will develop tools and protocols that will allow stroke survivors to complete neuropsychological tests in their own homes, through the virtual support of a geographically distant investigator. We will use wireless collaborative videoconferencing software and easy-to-operate tablet computers (iPads). Our test battery will probe core language functions and our participants will have left-hemisphere lesions. This initial direction was chosen because the personal and societal burden of post-stroke aphasia is significant, many tasks used for aphasia research are straightforward, prior data permits predictions about expected results, and there is a clear need for tools that can monitor aphasia status and treatment outcomes. Formative usability tests of our technology and protocols will be used to optimize the administration of our battery under three different conditions: 1) a virtual, investigator-guided protocol that is designd to emulate standard F2F neuropsychological testing, 2) a virtual, self- administered protocol that is designed to emulate computerized approaches to test administration, and 3) a standard face-to-face protocol that is intended as a performance benchmark. Once our protocols are in place, data will be acquired from three groups of participants with focal left-hemisphere lesions. Each group will complete our battery of language tasks in their home, via one of our two virtual protocols or a standard F2F protocol. All groups will complete a standard F2F protocol in our research laboratory. A variety of usability metrics will be used to evaluate participant and researcher satisfaction, confidence, and success with our virtual protocols. The behavioral data will be used to test whether comparable results are obtained when our tasks are administered under versus F2F testing conditions. Measures of efficiency and equipment reliability will provide a practical perspective on the benefits and limitations of home-based remote neuropsychological assessment. Overall, we aim to develop an innovative method for home-based remote neuropsychological testing that can be readily adapted and adopted by other investigators to meet a diverse set of research needs.