Browsing by Author "Freedman, Morris"
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Item Correction to: The Toronto cognitive assessment (TorCA): normative data and validation to detect amnestic mild cognitive impairment(2018-12-07) Freedman, Morris; Leach, Larry; Carmela Tartaglia, M.; Stokes, Kathryn A; Goldberg, Yael; Spring, Robyn; Nourhaghighi, Nima; Gee, Tom; Strother, Stephen C; Alhaj, Mohammad O; Borrie, Michael; Darvesh, Sultan; Fernandez, Alita; Fischer, Corinne E; Fogarty, Jennifer; Greenberg, Barry D; Gyenes, Michelle; Herrmann, Nathan; Keren, Ron; Kirstein, Josh; Kumar, Sanjeev; Lam, Benjamin; Lena, Suvendrini; McAndrews, Mary P; Naglie, Gary; Partridge, Robert; Rajji, Tarek K; Reichmann, William; Uri Wolf, M.; Verhoeff, Nicolaas P L G; Waserman, Jordana L; Black, Sandra E; Tang-Wai, David FUpon publication of this article [1], it was brought to our attention that one of the 303 participants in the normative study should have been deleted from the database.Item Delaying Onset of Dementia: Are Two Languages Enough?(2014-05-18) Freedman, Morris; Alladi, Suvarna; Chertkow, Howard; Bialystok, Ellen; Craik, Fergus I. M.; Phillips, Natalie A.; Duggirala, Vasanta; Raju, Surampudi Bapi; Bak, Thomas H.There is an emerging literature suggesting that speaking two or more languages may significantly delay the onset of dementia. Although the mechanisms are unknown, it has been suggested that these may involve cognitive reserve, a concept that has been associated with factors such as higher levels of education, occupational status, social networks, and physical exercise. In the case of bilingualism, cognitive reserve may involve reorganization and strengthening of neural networks that enhance executive control. We review evidence for protective effects of bilingualism from a multicultural perspective involving studies in Toronto and Montreal, Canada, and Hyderabad, India. Reports from Toronto and Hyderabad showed a significant effect of speaking two or more languages in delaying onset of Alzheimer’s disease by up to 5 years, whereas the Montreal study showed a significant protective effect of speaking at least four languages and a protective effect of speaking at least two languages in immigrants. Although there were differences in results across studies, a common theme was the significant effect of language use history as one of the factors in determining the onset of Alzheimer’s disease. Moreover, the Hyderabad study extended the findings to frontotemporal dementia and vascular dementia.Item Short-Term Effects of Rhythmic Sensory Stimulation in Alzheimer’s Disease: An Exploratory Pilot Study(IOS Press, 2016-05-10) Clements-Cortes, Amy; Ahonen, Heidi; Evans, Michael; Freedman, Morris; Bartel, LeeThis study assessed the effect of stimulating the somatosensory system of Alzheimer’s disease (AD) patients at three stages of their illness with 40 Hz sound. In this AB cross-over study design, 18 participants (6 mild, 6 moderate, 6 severe) each participated in 13 sessions: one intake and 12 treatment. Treatment A consisted of 40 Hz sound stimulation and Treatment B consisted of visual stimulation using DVDs, each provided twice a week over 6 weeks for a total of 6 times per treatment. Outcome measures included: St. Louis University Mental Status Test (SLUMS), Observed Emotion Rating Scale, and behavioral observation by the researcher. Data were submitted to regression analysis for the series of 6 SLUMS scores in treatment A and 6 scores in B with comparison by group. The slopes for the full sample and subgroups in the 40 Hz treatment were all significant beyond alpha = 0.05, while those for the DVD were not. A thematic analysis of qualitative observations supported the statistical findings. 40 Hz treatment appeared to have the strongest impact on persons with mild and moderate AD. Results are promising in terms of a potential new treatment for persons with AD, and further research is needed.Item The Toronto Cognitive Assessment (TorCA): normative data and validation to detect amnestic mild cognitive impairment(2018-07-18) Freedman, Morris; Leach, Larry; Carmela Tartaglia, M.; Stokes, Kathryn A; Goldberg, Yael; Spring, Robyn; Nourhaghighi, Nima; Gee, Tom; Strother, Stephen C; Alhaj, Mohammad O; Borrie, Michael; Darvesh, Sultan; Fernandez, Alita; Fischer, Corinne E; Fogarty, Jennifer; Greenberg, Barry D; Gyenes, Michelle; Herrmann, Nathan; Keren, Ron; Kirstein, Josh; Kumar, Sanjeev; Lam, Benjamin; Lena, Suvendrini; McAndrews, Mary P; Naglie, Gary; Partridge, Robert; Rajji, Tarek K; Reichmann, William; Uri Wolf, M.; Verhoeff, Nicolaas P L G; Waserman, Jordana L; Black, Sandra E; Tang-Wai, David FAbstract Background A need exists for easily administered assessment tools to detect mild cognitive changes that are more comprehensive than screening tests but shorter than a neuropsychological battery and that can be administered by physicians, as well as any health care professional or trained assistant in any medical setting. The Toronto Cognitive Assessment (TorCA) was developed to achieve these goals. Methods We obtained normative data on the TorCA (n = 303), determined test reliability, developed an iPad version, and validated the TorCA against neuropsychological assessment for detecting amnestic mild cognitive impairment (aMCI) (n = 50/57, aMCI/normal cognition). For the normative study, healthy volunteers were recruited from the Rotman Research Institute registry. For the validation study, the sample was comprised of participants with aMCI or normal cognition based on neuropsychological assessment. Cognitively normal participants were recruited from both healthy volunteers in the normative study sample and the community. Results The TorCA provides a stable assessment of multiple cognitive domains. The total score correctly classified 79% of participants (sensitivity 80%; specificity 79%). In an exploratory logistic regression analysis, indices of Immediate Verbal Recall, Delayed Verbal and Visual Recall, Visuospatial Function, and Working Memory/Attention/Executive Control, a subset of the domains assessed by the TorCA, correctly classified 92% of participants (sensitivity 92%; specificity 91%). Paper and iPad version scores were equivalent. Conclusions The TorCA can improve resource utilization by identifying patients with aMCI who may not require more resource-intensive neuropsychological assessment. Future studies will focus on cross-validating the TorCA for aMCI, and validation for disorders other than aMCI.Item White Matter Disruption and Connected Speech in Non-Fluent and Semantic Variants of Primary Progressive Aphasia(Karger Publishers, 2017-03-02) Marcotte, Karine; Graham, Naida L; Fraser, Kathleen C; Meltzer, Jed A; Tang-Wai, David F; Chow, Tiffany W; Freedman, Morris; Leonard, Carol; Black, Sandra E; Rochon, ElizabethDifferential patterns of white matter disruption have recently been reported in the non-fluent (nfvPPA) and semantic (svPPA) variants of primary progressive aphasia (PPA). No single measure is sufficient to distinguish between the PPA variants, but connected speech allows for the quantification of multiple measures. The aim of the present study was to further investigate the white matter correlates associated with connected speech features in PPA. We examined the relationship between white matter metrics and connected speech deficits using an automated analysis of transcriptions of connected speech and diffusion tensor imaging in language-related tracts. Syntactic, lexical, and semantic features were automatically extracted from transcriptions of topic-directed interviews conducted with groups of individuals with nfvPPA or svPPA as well as with a group of healthy controls. A principal component analysis was performed in order to reduce the number of language measures and yielded a five-factor solution. The results indicated that nfvPPA patients differed from healthy controls on a syntactic factor, and svPPA patients differed from controls on two semantic factors. However, the patient groups did not differ on any factor. Moreover, a correlational analysis revealed that the lexical richness factor was significantly correlated with radial diffusivity in the left inferior longitudinal fasciculus, which suggests that semantic deficits in connected speech reflect a disruption of this ventral pathway, and which is largely consistent with the results of previous studies. Using an automated approach for the analysis of connected speech combined with probabilistic tractography, the present findings demonstrate that nfvPPA patients are impaired relative to healthy controls on syntactic measures and have increased radial diffusivity in the left superior longitudinal fasciculus, whereas the svPPA group was impaired on lexico-semantic measures relative to controls and showed increased radial diffusivity in the uncinate and inferior longitudinal fasciculus bilaterally.