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      The need for harmonisation and innovation of neuropsychological assessment in neurodegenerative dementias in Europe: consensus document of the Joint Program for Neurodegenerative Diseases Working Group

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          Abstract

          Cognitive, behavioural, and functional assessment is crucial in longitudinal studies of neurodegenerative dementias (NDD). Central issues, such as the definition of the study population (asymptomatic, at risk, or individuals with dementia), the detection of change/decline, and the assessment of relevant outcomes depend on quantitative measures of cognitive, behavioural, and functional status.

          Currently, we are far from having available reliable protocols and tools for the assessment of dementias in Europe. The main problems are the heterogeneity of the tools used across different European countries, the lack of standardisation of administration and scoring methods across centres, and the limited information available about the psychometric properties of many tests currently in widespread use. This situation makes it hard to compare results across studies carried out in different centres, thus hampering research progress, in particular towards the contribution to a “big data” common data set.

          We present here the results of a project funded by the Joint Program for Neurodegenerative Diseases (JPND) and by the Italian Ministry of Health. The project aimed at providing a consensus framework for the harmonisation of assessment tools to be applied to research in neurodegenerative disorders affecting cognition across Europe. A panel of European experts reviewed the current methods of neuropsychological assessment, identified pending issues, and made recommendations for the harmonisation of neuropsychological assessment of neurodegenerative dementias in Europe.

          A consensus was achieved on the general recommendations to be followed in developing procedures and tools for neuropsychological assessment, with the aim of harmonising tools and procedures to achieve more reliable data on the cognitive-behavioural examination. The results of this study should be considered as a first step to enhancing a common view and practise on NDD assessment across European countries.

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          Separate visual pathways for perception and action.

          Accumulating neuropsychological, electrophysiological and behavioural evidence suggests that the neural substrates of visual perception may be quite distinct from those underlying the visual control of actions. In other words, the set of object descriptions that permit identification and recognition may be computed independently of the set of descriptions that allow an observer to shape the hand appropriately to pick up an object. We propose that the ventral stream of projections from the striate cortex to the inferotemporal cortex plays the major role in the perceptual identification of objects, while the dorsal stream projecting from the striate cortex to the posterior parietal region mediates the required sensorimotor transformations for visually guided actions directed at such objects.
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            The mini-cog: a cognitive 'vital signs' measure for dementia screening in multi-lingual elderly.

            The Mini-Cog, a composite of three-item recall and clock drawing, was developed as a brief test for discriminating demented from non-demented persons in a community sample of culturally, linguistically, and educationally heterogeneous older adults. All 129 who met criteria for probable dementia based on informant interviews and 120 with no history of cognitive decline were included; 124 were non-English speakers. Sensitivity, specificity, and diagnostic value of the Mini-Cog were compared with those of the Mini-Mental State Exam (MMSE) and Cognitive Abilities Screening Instrument (CASI). The Mini-Cog had the highest sensitivity (99%) and correctly classified the greatest percentage (96%) of subjects. Moreover, its diagnostic value was not influenced by education or language, while that of the CASI was adversely influenced by low education, and both education and language compromised the diagnostic value of the MMSE. Administration time for the Mini-Cog was 3 minutes vs 7 minutes for the MMSE. The Mini-Cog required minimal language interpretation and training to administer, and no test forms of scoring modifications were needed to compensate for the extensive linguistic and educational heterogeneity of the sample. Validation in clinical and population-based samples is warranted, as its brevity and ease of administration suggest that the Mini-Cog might be readily incorporated into general practice and senior care settings as a routine 'cognitive vital signs' measure. Copyright 2000 John Wiley & Sons, Ltd.
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              Separate visual pathways for perception and action

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                Author and article information

                Contributors
                alberto.costa@unicusano.it
                thomas.bak@ed.ac.uk
                paolo.caffarra@unipr.it
                c.caltagirone@hsantalucia.it
                Mathieu-pierre.CECCALDI@ap-hm.fr
                f.collette@ulg.ac.be
                s.crutch@ucl.ac.uk
                sergio@ed.ac.uk
                Jean-Francois.Demonet@chuv.ch
                bruno.dubois@aphp.fr
                Emrah.duezel@dzne.de
                peter.nestor@dzne.de
                sokpapa@med.uoa.gr
                eric.salmon@ulg.ac.be
                s.sikkes@vumc.nl
                Pietro.Tiraboschi@istituto-besta.it
                WM.vdFlier@vumc.nl
                pj.visser@maastrichtuniversity.nl
                stefano.cappa@iusspavia.it
                Journal
                Alzheimers Res Ther
                Alzheimers Res Ther
                Alzheimer's Research & Therapy
                BioMed Central (London )
                1758-9193
                17 April 2017
                17 April 2017
                2017
                : 9
                : 27
                Affiliations
                [1 ]Niccolò Cusano University, via Don Carlo Gnocchi, 3, Rome, Italy
                [2 ]ISNI 0000 0001 0692 3437, GRID grid.417778.a, , IRCCS Fondazione Santa Lucia, ; via Ardeatina 354, Rome, Italy
                [3 ]ISNI 0000 0004 1936 7988, GRID grid.4305.2, , University of Edinburgh, ; 7 George Square, EH8 9JZ Edinburgh, Scotland UK
                [4 ]ISNI 0000 0004 1758 0937, GRID grid.10383.39, , University of Parma, ; Via Gramsci, 14, Parma, Italy
                [5 ]ISNI 0000 0001 2300 0941, GRID grid.6530.0, Medicina dei sistemi, , Tor Vergata University, ; Via Montpellier, 1, Rome, Italy
                [6 ]GRID grid.411266.6, , University Hospital La Timone, ; 264 Rue Saint-Pierre, Marseille, France
                [7 ]ISNI 0000 0001 2176 4817, GRID grid.5399.6, , Aix Marseille University, Jardin du Pharo, ; 58 Boulevard Charles Livon, Marseille, France
                [8 ]ISNI 0000 0004 0647 2148, GRID grid.424470.1, , National Fund for Scientific Research (F.R.S-FNRS), ; Quartier Agora place des Orateurs 1, Liège, Belgium
                [9 ]ISNI 0000 0001 0805 7253, GRID grid.4861.b, , Cyclotron Research Centre, University of Liege, ; Allée du VI août, 8, Liège, Belgium
                [10 ]ISNI 0000000121901201, GRID grid.83440.3b, Dementia Research Centre, UCL Institute of Neurology, , University College of London, ; Queen Square, WC1N 3BG London, UK
                [11 ]ISNI 0000 0001 0423 4662, GRID grid.8515.9, , Leenaards Memory Centre CHUV, Lausanne University Hospital, ; Rue du Bugnon 46, Lausanne, Switzerland
                [12 ]ISNI 0000 0001 2150 9058, GRID grid.411439.a, , Institut de la Mémoire et de la Maladie d’Alzheimer (IMMA), Hôpital de la Pitié-Salpêtrière, ; 47-83 Boulevard de l’Hôpital, Paris, France
                [13 ]ISNI 0000 0004 0438 0426, GRID grid.424247.3, , German Center for Neurodegenerative Diseases (DZNE), ; Holbeinstraße 13-15, Bonn, Germany
                [14 ]ISNI 0000 0001 2155 0800, GRID grid.5216.0, Medical School, , National and Kapodistrian University of Athens, ; Rimini street, 124 62 Haidari, Athens, Greece
                [15 ]ISNI 0000 0000 8607 6858, GRID grid.411374.4, , University Hospital of Liege, ; Liege, Belgium
                [16 ]ISNI 0000 0004 0435 165X, GRID grid.16872.3a, Alzheimer Center/dpt Neurology, , VU University Medical Center of Amsterdam, Amsterdam Neuroscience, ; De Boelelaan 1118, Amsterdam, The Netherlands
                [17 ]ISNI 0000 0001 0707 5492, GRID grid.417894.7, , Fondazione IRCCS Istituto Neurologico Carlo Besta, ; Via Giovanni Celoria, 11, Milan, Italy
                [18 ]GRID grid.412966.e, , Maastricht University Medical Centre, ; Dr. Tanslaan 12, Maastricht, The Netherlands
                [19 ]ISNI 0000 0001 0724 054X, GRID grid.30420.35, , IUSS Pavia, ; Piazza della Vittoria 15, 27100 Pavia, Italy
                [20 ]GRID grid.419422.8, , IRCCS Centro San Giovanni di Dio, ; via Pilastroni 4, Brescia, Italy
                Article
                254
                10.1186/s13195-017-0254-x
                5392959
                28412978
                e4fddb27-947c-4524-bb9e-dbed4a9a0b03
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Funding
                Funded by: JPND and Italian Ministry of Health
                Categories
                Review
                Custom metadata
                © The Author(s) 2017

                Neurology
                neurodegenerative dementia,cognitive assessment,behavioural assessment,neuropsychological tests,longitudinal studies,european research

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