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Use of a Modified STROOP Test to Assess Color Discrimination Deficit in Parkinson's Disease.

ABSTRACT: Objective: To objectively measure color vision dysfunction in idiopathic Parkinson's disease (iPD) using an easily administered, essentially free, modified Stroop test. Methods: Sixty-one iPD patients and 26 age-matched controls (HC) were enrolled after IRB approval and performed congruent (CST) and incongruent (IST) modified Stroop tests consisting of 40 words in 10 colors arranged in a 5 x 8 grid. The scorer was blinded to participant diagnosis. Errors on IST were defined as type 1 (written word reported rather than color) or type 2 (color reported different from the written word or its color). Results: The iPD group and the control group completed testing with similar CST performance. On the IST, 75.4% of iPD patients had type 2 errors (p = 0.001, OR 4.907, 95%CI 1.838-13.097) compared to 38.5% HC, with a positive predictive value of 82%. The mean number of type 2 errors was also higher in the iPD group, even with MoCA scores as a covariate in the analysis. Type 1 errors were not significantly different between the groups. A univariate logistic regression model with age, gender, MoCA, normalized IST completion time and the presence/absence of type 2 errors also resulted in type 2 errors as the only significant factor in the equation (p = 0.026). Conclusions: The modified Stroop test incorporated into the clinical evaluation of a patient may provide a quick and inexpensive objective measure of a non-motor feature of iPD, which could help in the clinical diagnosis of iPD in conjunction with the motor assessments currently used by neurologists.

SUBMITTER: Langston RG

PROVIDER: S-EPMC6143680 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Use of a Modified STROOP Test to Assess Color Discrimination Deficit in Parkinson's Disease.

Langston Rebekah G RG Virmani Tuhin T

Frontiers in neurology 20180912

<b>Objective:</b> To objectively measure color vision dysfunction in idiopathic Parkinson's disease (iPD) using an easily administered, essentially free, modified Stroop test. <b>Methods:</b> Sixty-one iPD patients and 26 age-matched controls (HC) were enrolled after IRB approval and performed congruent (CST) and incongruent (IST) modified Stroop tests consisting of 40 words in 10 colors arranged in a 5 x 8 grid. The scorer was blinded to participant diagnosis. Errors on IST were defined as type ...[more]

PMID: 30258399

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Project description:Background: In sports psychology research, the Stroop test and its derivations are commonly used to investigate the benefits of exercise on cognitive function. The measures of the Stroop test and the computed interference often have different interclass correlation coefficients (ICC). However, the ICC is never reported in cross-over designs involving multiple variances associated with individual differences. Objective: We investigated the ICC of the Stroop neutral and incongruent tests and interference (neutral test-incongruent test), and reverse Stroop task using the linear mixed model. Methods: Forty-eight young adults participated in a cross-over design experiment composed of 2 factors: exercise mode (walking, resistance exercise, badminton, and seated rest as control) and time (pre- and post-tests). Before and after each intervention, participants completed the Stroop neutral and incongruent, and the reverse-Stroop neutral and incongruent tests. We analyzed for each test performance and interference and calculated ICC using the linear mixed model. Results: The linear mixed model found a significant interaction of exercise mode and time for both the Stroop and reverse-Stroop tasks, suggesting that exercise mode influences the effect of acute exercise on inhibitory function. On the other hand, there was no significant effect of exercise mode for both the Stroop and reverse-Stroop interference. The results also revealed that calculating both the Stroop and reverse-Stroop interference resulted in smaller ICCs than the ICCs of the neutral and incongruent tests for both the Stroop and reverse-Stroop tasks. Conclusion: The Stroop and reverse-Stroop interferences are known as valid measures of the inhibitory function for cross-sectional research design. However, to understand the benefits of acute exercise on inhibitory function comprehensively by cross-over design, comparing the incongruent test with the neutral test also seems superior because these tests have high reliability and statistical power.

Project description:BackgroundThe Modified Fresno Test has been used to evaluate the use of the Evidence-Based Physiotherapy (EBP). So far, none of the versions of the Fresno Test were subjected to analysis of the factorial structure. The objective of the study was to describe the exploratory and confirmatory factor structure of the Modified Fresno Test adapted to the Portuguese-Brazilian and analyze the statistical feasibility for the elaboration of a short version.MethodsThe questionnaire was applied with a convenience sample of 57 physiotherapists, being 36 professionals (13 of these also professors) and 21 students from the last semester of the physiotherapy course. Exploratory Factor Analysis (EFA) was performed by the method of principal components. Confirmatory Factor Analysis (CFA) was performed by the method of maximum likelihood. The total score of the answers in the test and retest was evaluated, totalling 228 observations. Reliability was assessed by means of internal consistency, using Cronbach's alpha coefficient.ResultsReliability was satisfactory (α 0.81) for all questions of the instrument. The coefficient α calculated for the corrected item-total showed values higher than 0.20 except for item 9. Preliminary tests for Exploratory Factor Analysis showed acceptable values with Kaiser-Meyer-Olkin (KMO = 0.80) and Bartlett's test of sphericity [chi-square (78) = 1149.615, p < 0.001], indicating that the correlations were sufficient for analysis. The analysis revealed the presence of 3 factors (eigenvalues> 1), which explains 60.9% of the instrument's total variance. In Confirmatory Factor Analysis, none of the indices came close to an acceptable level (≥ 0.90), however, the second model which tested a three-factor structure provided a better fit to the data. From the results of this study the Modified Fresno Test short version was drawn.ConclusionThe analysis showed good factor validity and adequate internal consistency for the use of the instrument consisting of 13 questions and 3 factors. This model proved to be better than the original model. The short version consisting of 9 questions may be an appropriate alternative for use in the population of interest.

Project description:Progress in understanding the neural bases of cognitive control has been supported by the paradigmatic color-word Stroop task, in which a target response (color name) must be selected over a more automatic, yet potentially incongruent, distractor response (word). For this paradigm, models have postulated complementary coding schemes: dorsomedial frontal cortex (DMFC) is proposed to evaluate the demand for control via incongruency-related coding, whereas dorsolateral PFC (DLPFC) is proposed to implement control via goal and target-related coding. Yet, mapping these theorized schemes to measured neural activity within this task has been challenging. Here, we tested for these coding schemes relatively directly, by decomposing an event-related color-word Stroop task via representational similarity analysis. Three neural coding models were fit to the similarity structure of multivoxel patterns of human fMRI activity, acquired from 65 healthy, young-adult males and females. Incongruency coding was predominant in DMFC, whereas both target and incongruency coding were present with indistinguishable strength in DLPFC. In contrast, distractor information was strongly encoded within early visual cortex. Further, these coding schemes were differentially related to behavior: individuals with stronger DLPFC (and lateral posterior parietal cortex) target coding, but weaker DMFC incongruency coding, exhibited less behavioral Stroop interference. These results highlight the utility of the representational similarity analysis framework for investigating neural mechanisms of cognitive control and point to several promising directions to extend the Stroop paradigm.SIGNIFICANCE STATEMENT How the human brain enables cognitive control - the ability to override behavioral habits to pursue internal goals - has been a major focus of neuroscience research. This ability has been frequently investigated by using the Stroop color-word naming task. With the Stroop as a test-bed, many theories have proposed specific neuroanatomical dissociations, in which medial and lateral frontal brain regions underlie cognitive control by encoding distinct types of information. Yet providing a direct confirmation of these claims has been challenging. Here, we demonstrate that representational similarity analysis, which estimates and models the similarity structure of brain activity patterns, can successfully establish the hypothesized functional dissociations within the Stroop task. Representational similarity analysis may provide a useful approach for investigating cognitive control mechanisms.

Dataset Information

Use of a Modified STROOP Test to Assess Color Discrimination Deficit in Parkinson's Disease.

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Use of a Modified STROOP Test to Assess Color Discrimination Deficit in Parkinson's Disease.

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