Assessing various sensorimotor and cognitive functions in people with epilepsy is feasible with robotics

Abstract

Background: Epilepsy is a common neurological disorder characterized by recurrent seizures, along with comorbid cognitive and psychosocial impairment. Current gold standards of assessment can quantify cognitive and motor performance, but may not capture all subtleties of behavior. Here, we study the feasibility of assessing various upper limb sensorimotor and cognition functions in people with epilepsy using the Kinarm robotic assessment system. We quantify performance across multiple behavioral domains and additionally consider the possible effects of epilepsy subtype and medication. Methods: We recruited individuals with a variety of epilepsy subtypes. Participants performed 8 behavioral tasks that tested motor, cognitive, and sensory domains. We collected data on the same tasks from a group of control participants that had no known neurological impairments. We quantified performance using Task Scores, which provide a composite measure of overall performance on a given task and are adjusted for age, sex, and handedness. Results: We collected data from 46 individuals with epilepsy and 92 control participants. The assessment was well-tolerated, with no adverse events recorded. Cognitive tasks testing spatial working memory, executive function, and motor response inhibition were the most frequently impaired in the epilepsy cohort, with 33/46 (72%) being outside the normal range on at least one of these tasks. Additionally, 29/46 (63%) were impaired on at least one task testing primarily motor skill, and 14/46 (30%) were impaired on a proprioceptive sensory task. People with either focal epilepsy or generalized epilepsy performed significantly worse on both motor and cognitive tasks than control participants after correcting for multiple comparisons. There were no statistical differences between generalized and focal epilepsy groups on Task Scores. Finally, individuals taking topiramate trended toward having worse performance on a spatial working memory task than other individuals with epilepsy who were not taking topiramate. Conclusions: Kinarm robotic assessment is feasible in individuals with epilepsy and is well-tolerated. Our robotic paradigm can detect impairments in various sensorimotor and cognitive functions across the population with epilepsy. Future studies will explore the role of epilepsy subtype and medications.

Saracatinib, a Src Tyrosine Kinase Inhibitor, as a Disease Modifier in the Rat DFP Model: Sex Differences, Neurobehavior, Gliosis, Neurodegeneration, and Nitro-Oxidative Stress

“…Prior to euthanasia, we assessed the second cohort of animals (~20 min CS) for behavioral comorbidities, as epilepsy is associated with changes in learning, memory, anxiety, depression, and motor coordination [ 123 , 124 , 125 , 126 ]. Importantly, none of these tests, nor brain pathology, showed significant changes in animals treated with SAR on its own (without DFP challenge).…”

“…Furthermore, of note, in the horizontal bar test, all treatment groups improved their time to reach the safety box on the first day compared to the second day, which suggests there was no effect of treatment on motor learning. There is some evidence that epilepsy leads to a change in motor ability, though mostly in children [ 126 , 140 ]. Possibly, there is no change in gross motor behavior in these animals, or the deficits are more present in fine motor skills.…”

The feasibility of assessing cognitive and motor function in multiple sclerosis patients using robotics

“… 39 Prior work has demonstrated common bimanual upper limb impairment in individuals with high EDSS (>5.5). 40 …”

“…We previously demonstrated that some tasks have a higher than 5% impairment rate for a subset of the control group, 34 however we chose to use a 5% theoretical impairment rate in this study for more convenient comparisons across tasks and because we have reported on a subset of the control groups previously. 34 …”

Unimanual and bimanual motor performance in children with developmental coordination disorder (DCD) provide evidence for underlying motor control deficits

“…Here we use two robotic behavioural tasks-a visually guided reaching task and a bimanual object hitting task-to investigate dominant and non-dominant limb performance in children with DCD. Robotic technology provides an avenue for objective, reliable and accurate assessment of sensorimotor performance 26,27 ; in particular, the visually guided reaching and bimanual object hitting tasks used in the current study have been shown to be clinically valid assessments of motor impairment in adult and pediatric populations with motor difficulties, including stroke [28][29][30] , cerebral palsy 31 , traumatic brain injury 32 and epilepsy 33 . Using robotics, we can examine decision making abilities, motor control and planning abilities as well as dominant, non-dominant and bimanual limb performance, all within a fairly rapid assessment time (10 min).…”