Background: Language is a valuable source of clinical information in Alzheimer’s disease, as it declines concurrently with neurodegeneration. Consequently, speech and language data have been extensively studied in connection with its diagnosis. Objective: Firstly, to summarize the existing findings on the use of artificial intelligence, speech, and language processing to predict cognitive decline in the context of Alzheimer’s disease. Secondly, to detail current research procedures, highlight their limitations, and suggest strategies to address them. Methods: Systematic review of original research between 2000 and 2019, registered in PROSPERO (reference CRD42018116606). An interdisciplinary search covered six databases on engineering (ACM and IEEE), psychology (PsycINFO), medicine (PubMed and Embase), and Web of Science. Bibliographies of relevant papers were screened until December 2019. Results: From 3,654 search results, 51 articles were selected against the eligibility criteria. Four tables summarize their findings: study details (aim, population, interventions, comparisons, methods, and outcomes), data details (size, type, modalities, annotation, balance, availability, and language of study), methodology (pre-processing, feature generation, machine learning, evaluation, and results), and clinical applicability (research implications, clinical potential, risk of bias, and strengths/limitations). Conclusion: Promising results are reported across nearly all 51 studies, but very few have been implemented in clinical research or practice. The main limitations of the field are poor standardization, limited comparability of results, and a degree of disconnect between study aims and clinical applications. Active attempts to close these gaps will support translation of future research into clinical practice.
IntroductionDecreasing the incidence of Alzheimer’s disease (AD) is a global public health priority. Early detection of AD is an important requisite for the implementation of prevention strategies towards this goal. While it is plausible that patients at the early stages of AD may exhibit subtle behavioural signs of neurodegeneration, neuropsychological testing seems unable to detect these signs in preclinical AD. Recent studies indicate that spontaneous speech data, which can be collected frequently and naturally, provide good predictors for AD detection in cohorts with a clinical diagnosis. The potential of models based on such data for detecting preclinical AD remains unknown.Methods and analysisThe PREVENT-Elicitation of Dialogues (PREVENT-ED) study builds on the PREVENT Dementia project to investigate whether early behavioural signs of AD may be detected through dialogue interaction. Participants recruited through PREVENT, aged 40–59 at baseline, will be included in this study. We will use speech processing and machine learning methods to assess how well speech and visuospatial markers agree with neuropsychological, biomarker, clinical, lifestyle and genetic data from the PREVENT cohort.Ethics and disseminationThere are no expected risks or burdens to participants. The procedures are not invasive and do not raise significant ethical issues. We only approach healthy consenting adults and all participants will be informed that this is an exploratory study and therefore has no diagnostic aim. Confidentiality aspects such as data encryption and storage comply with the General Data Protection Regulation and with the requirements from sponsoring bodies and ethical committees. This study has been granted ethical approval by the London-Surrey Research Ethics Committee (REC reference No: 18/LO/0860), and by Caldicott and Information Governance (reference No: CRD18048). PREVENT-ED results will be published in peer-reviewed journals.
This fMRI work studies brain activity of healthy volunteers who manipulated a virtual object in the context of a digital game by applying two different control methods: using their right hand or using their gaze. The results show extended activations in sensorimotor areas, not only when participants played in the traditional way (using their hand) but also when they used their gaze to control the virtual object. Furthermore, with the exception of the primary motor cortex, regional motor activity was similar regardless of what the effector was: the arm or the eye. These results have a potential application in the field of the neurorehabilitation as a new approach to generate activation of the sensorimotor system to support the recovery of the motor functions.
Background: Communication difficulties are one of the primary symptoms associated with dementia, and mobile applications have shown promise as tools for facilitating communication in patients with dementia (PwD). The literature regarding mobile health (mHealth) applications, especially communications-based mHealth applications, is limited. Objective: This review aims to compile the existing literature on communications-based mobile applications regarding dementia and assess their opportunities and limitations. A PICO framework was applied with a Population consisting of PwD, Interventions consisting of communication technology, focusing primarily on mobile applications, Comparisons between patient well-being with and without technological intervention, and Outcomes that vary but can include usability of technology, quality of communication, and user acceptance. Methods: Searches of PubMed, IEEE XPLORE, and ACM Digital Library databases were conducted to establish a comprehensive understanding of the current literature on dementia care as related to 1) mobile applications, 2) communication technology, and 3) communications-based mobile applications. Applying certain inclusion and exclusion criteria, yielded a set of articles (n = 11). Results: The literature suggests that mobile applications as tools for facilitating communication in PwD are promising. Mobile applications are not only feasible socially, logistically, and financially, but also produce meaningful communication improvements in PwD and their caregivers. However, the number of satisfactory communications-based mobile applications in the mHealth marketplace and their usability is still insufficient. Conclusion: Despite favorable outcomes, more research involving PwD using these applications are imperative to shed further light on their communication needs and on the role of mHealth.
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