Efficacy of the ANAM General Neuropsychological Screening battery (ANAM GNS) for Detecting Neurocognitive Impairment in a Mixed Clinical Sample

Abstract

The Automated Neuropsychological Assessment Metrics (ANAM) is a computerized neuropsychological assessment battery that has demonstrated utility in a variety of clinical populations including multiple sclerosis, systemic lupus erythematosus, Parkinson's disease, acquired brain injury, migraine headaches, and Alzheimer's disease. This study utilized selected tests from the ANAM General Neuropsychological Screening Battery (ANAM GNS), a newly defined subset of tests from the broader ANAM library designed for general clinical assessment of cognition. ANAM GNS is an expansion of the ANAM Core battery which has been utilized in a military setting. The efficacy of the ANAM GNS was explored in a mixed clinical sample relative to well-established, traditional neuropsychological measure, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). It was hypothesized that scores from the ANAM GNS would accurately predict participants as either impaired (n = 30) or normal (n = 113). Participants were grouped a priori based on RBANS Total Index scores with impairment defined as scores ≤ 15th percentile. Logistic regression analysis was conducted to evaluate the classification accuracy of the ANAM GNS. The predictor variables were the Throughput scores from seven selected ANAM GNS subtests. The full model significantly predicted impairment status, sensitivity was 81% and specificity was 89.1%. Overall classification rate was 87.9% and the Odds Ratio for the overall model was 34.65. Positive predictive value was 56.7% and negative predictive value was 96.4%. This study represents the first clinical data on the ANAM GNS, and documents that it has good concurrent and predictive validity with a well-established neuropsychological measure.

Challenges of Diagnosing Cognitive Dysfunction With Neuropsychiatric Systemic Lupus Erythematosus in Childhood

“…The ANAM measures a wide range of cognitive functions, including simple and complex reaction time, attention, processing speed, working memory, visual‐spatial processing, and short‐term recognition memory. It includes a large battery of tests, but specific batteries of tests have been validated for specific groups and purposes in comparison with many diseases, including SLE . Some of the most commonly used test scales in the ANAM include simple reaction time, code substitution, matching grids, matching to sample, mathematical processing, continuous performance test, code substitution delayed, and the Sternberg memory test.…”

Are Motor and Cognitive Control, Impulsivity and Risk-Taking Behaviour as Well as Moral Decision Making Determined by the Activity of Prefrontal Cortex During Stroop Test?

“…Assessment of cognitive performance. To assess cognitive performance, the Automated Neuropsychological Assessment Metric (ANAM-4, VistaLifeSciences, USA) was administered (Reeves et al, 2007;Woodhouse et al, 2013). The test battery included the following chosen tasks measuring three scores: accuracy defined as the percentage of correct responses, mean reaction time for responses time, and throughput which is considered a measure of effectiveness or cognitive efficiency, and is a combination of reaction time and accuracy (Thorne, 2006).…”

“…Mathematical Processing Task (MPT) evaluates working memory (Reeves et al, 2007;Woodhouse et al, 2013). During this task, an arithmetic problem requiring an addition and subtraction of three single-digit numbers was displayed (e.g., "4 -2 + 1 =").…”

“…Code Substitution (CST) and Code Substitution Delayed Tasks (CSDT) evaluate immediate and delayed recognition memory (Reeves et al, 2007;Woodhouse et al, 2013). Participant was presented to 9 different symbol-digit pairs and was instructed to remember as many symbol-digit pairs as possible, in any order, as they will be asked to recall them later.…”

Performance of the Automated Neuropsychological Assessment Metrics (ANAM) in detecting cognitive impairment in heart failure patients

“…52 Recently, in a mixed clinical sample, the ANAM significantly predicted CI status with a sensitivity of 81% and specificity of 89.1%. 53 The ANAM has also demonstrated high sensitivity to CI among patients with Alzheimer's disease—correctly classifying 100% of the participants in a pilot study based on a discriminant function analysis of throughput scores—as well as the potential capacity to detect earlier, more subtle cognitive changes in the disease process. 54 …”