NEUROPHYSIOLOGICAL ATTENTION MULTIPLEXING TEST

描述(由申请人提供)：在任务或刺激中分配有限的精神资源，并有效地转移注意力的“内部聚光灯”的能力，对于在一个要求苛刻和复杂的世界中的适应功能至关重要。人类大脑的前额叶区域对于多路转移注意力至关重要，在与额叶病理相关的神经和神经精神疾病中，这一区域经常受到损害。目前从传统纸质和铅笔神经心理测试中衍生出来的静态“前额执行系统”任务有许多局限性，最重要的是无法在困难中适应，并在不同能力的受试者之间提供一致的具有挑战性的水平。该项目旨在开发一种动态的、自适应的注意力转换“压力测试”，即多重测试(MT)，以满足对这一基本认知功能的现代测试的需求。作为一种研究和临床评估工具，无论有没有脑功能监测，MT都可以作为一种标准化的激活程序，用于测试因疾病、药物副作用或年龄增加而可能降低注意力多路转换能力的患者，并可作为改善认知障碍的治疗努力的结果衡量标准。在为年轻人和儿童开发MT的项目成果的基础上，在第一阶段，我们对MT进行了试点测试和改进，以用于老年受试者，然后将其应用于22名有和没有轻度认知障碍的新受试者。结果表明，MT适合于这一人群，它产生了高度可靠的任务表现和相关的脑电和诱发电位数据，与来自年轻受试者的数据相当，但在有和没有轻度执行功能障碍的客观体征的老年受试者中有所不同。这些结果为MT作为一种适用于整个生命周期的执行脑功能测试的科学和技术可行性提供了有力的支持。在第二阶段，我们计划在中老年健康正常人群和轻度执行障碍患者上推广并进一步验证MT，将MT与我们的自动化认知神经生理学EEG测试系统集成，并由合作者进行独立评估。从这些研究中收集的数据将被用来确定这项测试在这一人群中的心理测量特性，以及它是否适合评估正常衰老和几种影响中老年人的常见疾病对注意力多路转换的影响，包括多发性硬化症、阻塞性睡眠呼吸暂停和轻度认知障碍(MCI)。MT还将用于合作的试点功能磁共振研究，MT的性能加上EEG结果将与部分MCI患者的FDG PET扫描进行比较。与公共健康相关：有效地转移注意力的能力对于在当今复杂的世界中发挥作用至关重要，而许多疾病，如痴呆症，都会损害这一能力。令人惊讶的是，没有对这一基本认知功能的现代测试。多路转换测试(MT)是一种下一代动态和自适应的注意力转换测试，适用于6岁至90岁以上的人。MT设计用于与EEG、fMRI或PET同时测量大脑功能，以改进研究和患者护理。除了将MT商业化作为SAM考试自动化、高通量、临床神经生理测试系统的重要组成部分外，MT还将作为一项独立测试免费提供给联邦资助的认知神经科学研究人员。

DESCRIPTION (provided by applicant): The ability to distribute limited mental resources among tasks or stimuli and to efficiently shift the "internal spotlight" of attention is critical to adaptive functioning in a demanding and complicated world. The prefrontal regions of the human brain are critical for multiplexing attention, which is frequently impaired in neurological and neuropsychiatric conditions associated with frontal pathology. Current static "frontal executive system" task derived from traditional paper and pencil neuropsychological tests have a number of limitations, foremost the inability to adapt in difficulty and provide a consistently challenging level across subjects with varying ability. This project aims to develop a dynamic, adaptive attention switching "stress test," the Multiplexing Test (MT), to address the need for a modern test of this essential cognitive function. As a research and clinical assessment instrument used with or without brain function monitoring, the MT could serve as a standardized activation procedure for testing patients whose attentional multiplexing abilities might be diminished due to illness, medication side-effects or advancing age, and as an outcome measure in treatment efforts to ameliorate cognitive impairments. Building on the achievements of projects that developed the MT for young adults and children, in Phase I we pilot tested and refined the MT for use with elderly subjects, and then applied it to 22 new subjects with and without mild cognitive complaints. The results demonstrated that the MT is suitable for this population, producing highly reliable task performance and associated EEG and evoked potential data comparable to data from younger subjects, yet differed between elderly subjects with and without objective signs of mild executive dysfunction. The results provide strong support for the scientific and technical feasibility of the MT as an executive brain function test applicable across the life span. In Phase II we plan to extend and further validate the MT on a healthy normative population of middle-aged and elderly adults and on patients with disorders producing mild executive impairment, integrate the MT with our automated cognitive neurophysiological EEG testing system, and subject it to independent evaluation by collaborators. The data collected from these studies will be used to determine the test's psychometric properties in this population and its suitability for evaluating the effects on attentional multiplexing of normal aging and several common disorders that affect middle age and elderly people, including multiple sclerosis, obstructive sleep apnea and Mild Cognitive Impairment (MCI). The MT will also be used in a collaborative pilot fMRI study, and MT performance plus EEG results will be compared with FDG PET scans in a subset of the MCI patients. PUBLIC HEALTH RELEVANCE: The ability to efficiently switch attention is critical to functioning in today's complex world, and many diseases like dementia impair it. Surprisingly, there is no modern test of this fundamental cognitive function. The Multiplexing Test (MT) is a next-generation dynamic and adaptive test of attention switching that is applicable across the lifespan from 6 to 90+ years of age. The MT is designed for simultaneous measurement of brain function with EEG, fMRI or PET for improved research and patient care. In addition to commercializing the MT as an essential part of the SAM Exam automated, high-throughput, clinical neurophysiological testing system, The MT will also be made available as a stand-alone test at no charge to Federally funded cognitive neuroscience researchers.