NEUROPHYSIOLOGICAL ATTENTION MULTIPLEXING TEST

描述（由申请人提供）：在任务或刺激之间分配有限的心理资源并有效转移注意力的“内部聚光灯”的能力对于在要求苛刻和复杂的世界中的适应性功能至关重要。人类大脑的前额叶区域对于多路复用注意力至关重要，而多路复用注意力在与额叶病理相关的神经和神经精神疾病中经常受损。目前的静态“额叶执行系统”任务来自传统的纸和笔神经心理测试有一些局限性，最重要的是不能适应困难，并提供一个具有不同能力的受试者一致的挑战性水平。该项目旨在开发一种动态的、适应性的注意力转换“压力测试”，即多路复用测试（MT），以满足对这一基本认知功能进行现代测试的需求。作为一种研究和临床评估工具，无论是否使用脑功能监测，MT都可以作为一种标准化的激活程序，用于测试由于疾病、药物副作用或年龄增长而导致注意力多路复用能力下降的患者，并作为改善认知障碍的治疗措施的结果。在为年轻人和儿童开发MT的项目的成就的基础上，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个有和没有轻度认知投诉的新受试者。结果表明，MT是适合这个群体，产生高度可靠的任务性能和相关的EEG和诱发电位数据的数据，从年轻的受试者，但不同的老年受试者之间的客观迹象和轻微的执行功能障碍。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强有力的支持。在第二阶段，我们计划扩展和进一步验证MT的健康正常人群的中年和老年人和轻度执行障碍的患者，整合MT与我们的自动认知神经生理脑电图测试系统，并由合作者进行独立评估。从这些研究中收集的数据将用于确定该测试在该人群中的心理测量特性及其对评估正常衰老和影响中老年人的几种常见疾病（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））对注意力复用的影响的适用性。MT还将用于一项合作性的先导性fMRI研究，MT性能加上EEG结果将与MCI患者子集的FDG PET扫描进行比较。公共卫生相关性：在当今复杂的世界中，有效转换注意力的能力对于发挥功能至关重要，而痴呆症等许多疾病都会削弱这种能力。令人惊讶的是，没有现代测试这种基本的认知功能。多路复用测试（MT）是下一代注意力转换的动态和适应性测试，适用于6至90岁以上的人。MT旨在与EEG、fMRI或PET同时测量大脑功能，以改善研究和患者护理。除了将MT作为SAM考试自动化、高通量、临床神经生理学测试系统的重要组成部分进行商业化之外，MT还将作为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.