Many medical treatments produce subtle changes in working and intermediate term memory and executive functioning in the elderly. Some medical treatments may have negative cognitive side effects, whereas other treatments improve cognitive function. Prior work demonstrates that combinations of EEG, event related potential and cognitive task performance data are sensitive and specific indicators of level of alertness and ability to sustain attention and hold information in working and intermediate term memory. We propose to develop a specialized automated device utilizing multivariate combinations of these measures to detect treatment related changes in neurocognitive function in the elderly. In Phase I feasibility was evaluated by analyzing task performance and EEG data from elderly subjects after they ingested a common OTC drug, the antihistamine diphenhydramine. We computed multivariate indices from these data, and determined that they could discriminate post-drug conditions from placebo. Additionally, we identified improvements required for use of our automated task presentation and signal processing algorithms with elderly subjects, and designed modifications to a system for administering, analyzing and tracking tests and results. In Phase II, the system will be fully implemented and independently tested in collaboration with scientists and clinicians at four university medical centers.
The proposed system will enable researchers to better evaluate how medical treatments affect neurocognitive function in the elderly. The market for such a device is sufficient to sustain the product. The system may also prove clinically useful as a means for titrating drug dosages and for tracking neurocognitive changes in the treatment of individual patients. Thus, a second-generation device may serve as a more general clinical tool for monitoring changes in cognitive status in the elderly. There is a large and rapidly growing market for such a clinical device.
| Gevins, Alan; Ilan, Aaron B; Jiang, An et al. (2011) A method to combine cognitive and neurophysiological assessments of the elderly. Dement Geriatr Cogn Disord 31:7-19 |
| Meador, Kimford J (2009) The essential neurologic examination: what should medical students be taught? Neurology 73:2133-4; author reply 2134 |
