Computational protocol: White matter integrity in dyskinetic cerebral palsy: Relationship with intelligence quotient and executive function

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Protocol publication

[…] A comprehensive neuropsychological test battery was used to assess the four domains of executive function according to : attentional control, cognitive flexibility, goal setting and information processing.Attentional control was assessed using the Stop signal task (SST) of the Cambridge neuropsychological test automated battery (CANTAB) (). The test instructs participants to respond as fast as possible to a simple arrow stimulus on a computer screen. The participant was told to press the left button when they see a left-pointing arrow and the right button when they see a right-pointing arrow. The task was switch adapted and participants were therefore able to respond pressing the buttons by hand, cheek, chin, head or feet to allow autonomous responses. On some trials, an auditory stop signal was presented, and participants are instructed to try and stop or inhibit their response. In the original version of the test, at the end of every assessed block, a feedback screen was displayed showing a graphical representation of the participant's performance. These resting stops were removed in the present study in order to increase the attentional component of the task. The number of correct responses on “stop” and “go” trials represents the total score. Higher scores indicate better performance.Cognitive flexibility was assessed using the 64-item computerized version of the Wisconsin card sorting test (WCST) (). This task, which is one of the most widely used tests of executive function in clinical and experimental neuropsychology, consists of four reference cards and 64 response cards with geometric figures that vary in colour, shape and number. The participant has to pair each response card with one of the four reference cards and discover the correct classification principle by trial and error and the computer feedback (). The score used was the number of perseverative errors. Higher scores indicate poorer performance and raw scores were converted into z scores using normative data provided with the test manual. To access the test, a mouse/joystick (controlled by hand or with the chin) and one switch (pressed by hand, cheek, head or foot) were used. In cases where an autonomous response was not possible, the examiner indicated the various response alternatives while asking the participant if it was his/her choice, and then the examiner executed the action.Goal setting was evaluated by means of the Stockings of Cambridge (SOC) test of CANTAB (). The SOC is a spatial planning test in which the participant is shown two displays containing three coloured balls. The participant must use the balls in the lower display to copy the pattern shown in the upper display. The outcome measure used for the analysis was the number of problems solved in minimum moves (). Higher scores indicate better performance. Raw scores were converted into z scores using normative data provided with the test manual. To access the test, a mouse/joystick (controlled by hand or with the chin) and one switch (pressed by hand, cheek, head or foot) were used. Some participants responded the test by pointing to the computer screen (with the finger, hand or an adapted pointer on the head). In cases where an autonomous response was not possible, the examiner indicated the various response alternatives while asking the participant if it was his/her choice, and then the examiner executed the action.Information processing was measured using the performance in a lexical verbal fluency task with three initial-letters (), a frequently used task in clinical practice. The test requires participants to generate as many words as possible beginning with P, M, and R and the score used was the number of words that the participant were able to say. Higher scores indicate better performance. [...] Descriptive statistics of neuropsychological performance were calculated. The cognitive performances of the CP and control groups against their matched controls were compared using t-tests or Mann–Whitney U tests, depending on the distribution of the data. Statistical analyses of neuropsychological data were performed using SPSS version 24 (IBM SPSS Statistics, IBM Corp. NY, USA). The level of significance was set at p-value < 0.05. Missing data were handled with pairwise deletion. […]

Pipeline specifications

Software tools CANTAB, SPSS
Applications Miscellaneous, Neuropsychology analysis
Organisms Homo sapiens
Diseases Basal Ganglia Diseases, Cerebral Palsy