INTRODUCTION: Interpretation and analysis of magnetic resonance imaging (MRI) scans in clinical settings comprise time-consuming visual ratings and complex neuroimage processing that require trained professionals. To combat these challenges, artificial intelligence (AI) techniques can aid clinicians in interpreting brain MRI for accurate diagnosis of neurodegenerative diseases but they require extensive validation. Thus, the aim of this study was to validate the use of AI-based AQUA (Neurophet Inc., Seoul, Republic of Korea) segmentation software in a Southeast Asian community-based cohort with normal cognition, mild cognitive impairment (MCI) and dementia. METHOD: Study participants belonged to the community-based Biomarker and Cognition Study in Singapore. Participants aged between 30 and 95 years, having cognitive concerns, with no diagnosis of major psychiatric, neurological or systemic disorders who were recruited consecutively between April 2022 and July 2023 were included. Participants underwent neuropsychological assessments and structural MRI, and were classified as cognitively normal, with MCI or with dementia. MRI pre-processing using automated pipelines, along with human-based visual ratings, were compared against AI-based automated AQUA output. Default mode network grey matter (GM) volumes were compared between cognitively normal, MCI and dementia groups. RESULTS: A total of 90 participants (mean age at visit was 63.32±10.96 years) were included in the study (30 cognitively normal, 40 MCI and 20 dementia). Non-parametric Spearman correlation analysis indicated that AQUA-based and human-based visual ratings were correlated with total (ρ=0.66; P<0.0001), periventricular (ρ=0.50; P<0.0001) and deep (ρ=0.57; P<0.0001) white matter hyperintensities (WMH). Additionally, volumetric WMH obtained from AQUA and automated pipelines was also strongly correlated (ρ=0.84; P<0.0001) and these correlations remained after controlling for age at visit, sex and diagnosis. Linear regression analyses illustrated significantly different AQUA-derived default mode network GM volumes between cognitively normal, MCI and dementia groups. Dementia participants had significant atrophy in the posterior cingulate cortex compared to cognitively normal participants (P=0.021; 95% confidence interval [CI] -1.25 to -0.08) and in the hippocampus compared to cognitively normal (P=0.0049; 95% CI -1.05 to -0.16) and MCI participants (P=0.0036; 95% CI -1.02 to -0.17). CONCLUSION Our findings demonstrate high concordance between human-based visual ratings and AQUA-based ratings of WMH. Additionally, the AQUA GM segmentation pipeline showed good differentiation in key regions between cognitively normal, MCI and dementia participants. Based on these findings, the automated AQUA software could aid clinicians in examining MRI scans of patients with cognitive impairment.
Humans ; Cognitive Dysfunction/pathology* ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Female ; Aged ; Artificial Intelligence ; Software ; Dementia/diagnostic imaging* ; Aged, 80 and over ; Adult ; Singapore ; Neuropsychological Tests ; Brain/pathology* ; Cohort Studies ; Gray Matter/pathology* ; Southeast Asian People

OBJECTIVES: To study the intellectual level and the factors influencing the intelligence in children aged 6-16 years with attention deficit hyperactivity disorder (ADHD). METHODS: A retrospective study was conducted on 2 861 children who were diagnosed with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition between October 2014 and September 2022 at Henan Children's Hospital. The Wechsler Intelligence Scale for Children-Fourth Edition was used to assess the intellectual levels of the ADHD children. Based on intelligence quotient (IQ) scores, the intellectual levels were classified into five categories: borderline (70-79), low average (80-89), average (90-109), high average (110-119), and superior (≥120). The intellectual levels among the children of different genders, grades, and parental education levels were compared. RESULTS: Among the 2 861 ADHD children, 569 (19.89%) were classified as borderline, 846 (29.57%) as low average, 1 304 (45.58%) as average, 111 (3.88%) as high average, and 31 (1.08%) as superior. The boys had lower scores in working memory, processing speed, and overall IQ than the girls (P<0.05). There were significant differences in perceptual reasoning, working memory, processing speed, and overall IQ scores among different grade groups (P<0.05). The scores in language comprehension, perceptual reasoning, working memory, processing speed, and overall IQ were found to be associated with parental education level in ADHD children (P<0.05). CONCLUSIONS The proportion of ADHD children with low average and borderline intellectual levels is relatively high. The IQ level of ADHD children is influenced by gender, grade level and parental education level.
Humans ; Male ; Child ; Female ; Attention Deficit Disorder with Hyperactivity ; Retrospective Studies ; Intelligence ; Intelligence Tests ; Cognition

Bronchial asthma is a common chronic respiratory disease,and its diagnosis is mainly based on symptoms,signs,and pulmonary function test.Wheezing is a major symptom of asthma attack,which shows no obvious sign in the early stage while appears after the disease has progressed.Therefore,bronchial asthma is difficult to be detected in early stages,which often leads to worsening of the disease conditions.Pulmonary function test can effectively monitor upper and lower airway abnormalities and is currently the main means for monitoring asthma.However,its accuracy is highly dependent on patient's motivation and cooperation,which obviously limits the scope of application,especially for preschoolers and infants.Hence,there is an urgent need for a new technology with the function of long-term breath sound monitoring and automatic breathing detection to overcome the existing clinical deficiencies.Breath sound analysis emerges in the era of medical artificial intelligence,which can digitally process and convert the collected respiratory sounds by using a variety of different methods to form characteristic signal parameters and model the relationship between parameters and diseases.As we know,breath sounds are closely related to airway changes,and thus the detection and analysis of the sounds can provide reliable clinical information for the progress and control evaluation of asthma.This review mainly summaries the research progress of respiratory sound analysis in recent years,hoping to provide reference for further research.
Artificial Intelligence ; Asthma/diagnosis* ; Child ; Humans ; Respiration ; Respiratory Function Tests ; Respiratory Sounds/diagnosis*

OBJECTIVE: To study the intellectual characteristics of children with attention deficit hyperactivity disorder (ADHD) and developmental dyslexia (DD). METHODS: A total of 55 children with ADHD and DD (ADHD+DD group), 150 children with ADHD alone (ADHD group), and 22 children with DD alone (DD group) were enrolled as subjects. Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) was used to evaluate and compare intellectual characteristics among the three groups. RESULTS: There were significant differences in the scores of full-scale intelligence quotient (FSIQ), verbal comprehension index, perceptual reasoning index, and working memory index among the three groups ( CONCLUSIONS Compared with the children with ADHD alone, the children with ADHD and DD have more severe impairment of FSIQ, verbal comprehension, perceptual reasoning, and working memory, and therefore, it is suggested to enhance the training on similarities, vocabulary, matrix reasoning, picture concepts, and recitation for children with ADHD and DD in clinical practice.
Attention Deficit Disorder with Hyperactivity ; Child ; Dyslexia ; Humans ; Intelligence Tests ; Memory, Short-Term ; Wechsler Scales

Objective To analyze the differences in accuracy of different eye movement parameters in distinguishing the cooperation and non-cooperation during image completion test of patients with mental disorders caused by craniocerebral trauma. Methods One hundred and forty cases of patients with mental disorders caused by craniocerebral trauma who took psychiatric impairment assessments were collected. The 21 pictures from "image completion" of Wechsler intelligence test were used as stimulating pictures, then divided into cooperation group and non-cooperation group according to binomial forced-choice digit memory test and expert opinions. The eye movement parameters of research subjects during completion of images were obtained by the SMI eye-tracker. The accuracy of eye movement parameters in distinguishing the cooperation or non-cooperation of patients with mental disorders caused by craniocerebral trauma in psychiatric impairment assessments were evaluated by the ROC curve. Results During the process of the image completion test, the area under curve （AUC） value of frequency of blink, frequency of fixation, pupil size, frequency of saccade, latency of saccade, average acceleration of saccade, the average and peak longitudinal velocity of saccade was above 0.5. When it comed to a specific stimulating picture, the AUC value of frequency of blink in looking at a specific stimulating picture could be above 0.8, and the AUC value of X axis diameter of pupil size could be above 0.7. Conclusion The accuracy of eye movement parameters in distinguishing the cooperation or disguise of patients with mental disorders caused by craniocerebral trauma is related with the stimulating picture. The accuracy of frequency of blink in distinguishing cooperation and non-cooperation is better than that of other eye movement parameters.
Blinking ; Eye Movements ; Humans ; Intelligence Tests

OBJECTIVE: Alcohol-induced blackout (blackout) is a typical early symptom of cognitive impairment caused by drinking. However, the first onset age of blackout or the duration after onset of blackout has not been directly compared in previous studies. The purpose of this study was to investigate the differences in cognitive function to the first start age of blackouts and their duration. METHODS: Thirty-one male subjects were included in this study. Their age at the first blackout and the duration after the onset of blackout were investigated. Neuropsychological tests were conducted to determine their attention, memory, and executive function. Subjects were divided into three groups according to their age of the first onset blackout (group O1, < 20 years; group O2, 21–39 years; and group O3, > 40 years). Subjects were also divided into three groups by duration after the onset of blackout (P1, < 10 years; P2, 10–29 years; and P3, > 30 years). We then examined differences in neurocognitive function among these groups. RESULTS: O1 tended to have a lower memory score than O2 (F = 3.28, p = 0.053). Significant differences were observed in attention and executive function between groups P1 and P3 (Digit Span_backward: F = 6.07, p < 0.05; visual span_forward: F = 4.19, p < 0.05; executive intelligence quotient: F = 3.55, p < 0.05). CONCLUSION: Greater memory impairment was detected in subjects having an earlier age of the first blackout. The longer the duration after the onset of blackout, the more impaired their attention and executive function skills.
Age of Onset ; Alcohol-Induced Disorders ; Amnesia, Retrograde ; Cognition Disorders ; Cognition ; Drinking ; Executive Function ; Humans ; Intelligence ; Male ; Memory ; Neuropsychological Tests

PURPOSE: The aim of this study was to investigate the safety and the effects of elevated doses of solifenacin and trospium on cognitive function and health-related quality of life (HRQoL) in elderly women receiving treatment for urinary incontinence. METHODS: The study included 312 women aged 60–83 years (mean age, 69.4 years). All participants had scored at least 24 points on the Mini-Mental State Examination (MMSE) scale, and all of them had been diagnosed with urge urinary incontinence (UUI) or mixed urinary incontinence (MUI). The women were randomly assigned to 3 groups: group A, individuals who were simultaneously administered solifenacin at a high dosage of 20 mg per day and trospium at a high dosage of 60 mg per day; group B, persons taking solifenacin and trospium at the usual dosage of 10 and 30 mg per day, respectively; and group C, persons who received a placebo. Participants’ cognitive status was assessed by the MMSE, Controlled Oral Word Association Test, Wechsler Adult Intelligence Scale-Revised, Wechsler Memory Scale III, Colour Trails Test, and California Verbal Learning Test scales. The HRQoL assessment was performed using the Medical Outcomes Study 36-Item Health Survey. RESULTS: The cognitive function parameters did not differ at the start and end of the study across the groups (P>0.05). Additionally, the cognitive function parameters did not differ significantly within each group between the start and end of the study (P>0.05). The values of most HRQoL parameters regarding the functional state of the lower urinary tract (LUT) after the termination of treatment significantly improved in groups A and B (P < 0.05). A significant correlation between cognitive status and HRQoL or LUT parameters was absent (r < 0.3), while the correlations between HRQoL and LUT parameters were r=0.31–0.83, P < 0.05. CONCLUSIONS: The use of elevated doses of solifenacin and trospium did not increase the risk of cognitive impairment in women with UUI and MUI. The combination of solifenacin and trospium at a double dosage may be recommended to elderly women with treatment-resistant symptoms of UUI and MUI. However, the safety of combining antimuscarinic drugs in women with an increased volume of residual urine requires further study.
Adult ; Aged ; California ; Cognition Disorders ; Cognition* ; Female ; Health Surveys ; Humans ; Intelligence ; Memory ; Muscarinic Antagonists ; Quality of Life* ; Solifenacin Succinate* ; Urinary Incontinence* ; Urinary Tract ; Verbal Learning ; Weights and Measures ; Word Association Tests

BACKGROUND AND PURPOSE: Patients with moyamoya vasculopathy (MMV) may experience cognitive impairment, but its reported frequency, severity, and nature vary. In a systematic review and metaanalysis, we aimed to assess the presence, severity, and nature of cognitive impairments in children and adults with MMV. METHODS: We followed the MOOSE guidelines for meta-analysis and systematic reviews of observational studies. We searched Ovid Medline and Embase for studies published between January 1, 1969 and October 4, 2016. Independent reviewers extracted data for mean intelligence quotient (IQ) and standardized z-scores for cognitive tests, and determined percentages of children and adults with cognitive deficits, before and after conservative or surgical treatment. We explored associations between summary measures of study characteristics and cognitive impairments by linear regression analysis. RESULTS: We included 17 studies (11 studies reporting on 281 children, six on 153 adults). In children, the median percentage with impaired cognition was 30% (range, 13% to 67%); median IQ was 98 (range, 71 to 107). Median z-score was –0.39 for memory, and –0.43 for processing speed. In adults, the median percentage with impaired cognition was 31% (range, 0% to 69%); median IQ was 95 (range, 94 to 99). Median z-scores of cognitive domains were between –0.9 and –0.4, with multiple domains being affected. We could not identify determinants of cognitive impairment. CONCLUSIONS: A large proportion of children and adults with MMV have cognitive impairment, with modest to large deficits across various cognitive domains. Further studies should investigate determinants of cognitive deficits and deterioration, and the influence of revascularization treatment on cognitive functioning.
Adult* ; Child* ; Cognition Disorders ; Cognition* ; Humans ; Intelligence ; Linear Models ; Memory ; Moyamoya Disease ; Neuropsychological Tests

OBJECTIVES: The objective of this study was to investigate the concordance of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV and DSM-5) diagnostic criteria for autism spectrum disorder (ASD). METHODS: We retrospectively reviewed the medical records of 170 subjects (age range: 3–23, 140 boys) with developmental delay or social deficit from January 2011 to July 2016 at the Department of Psychiatry of Asan Medical Center. The Autism Diagnostic Interview-Revised (ADI-R), the Autism Diagnostic Observation Schedule (ADOS), and intelligence tests were performed for each subject. Diagnosis was reviewed and confirmed for each subject with DSM-IV Pervasive Developmental Disorder (PDD) and DSM-5 ASD criteria, respectively. RESULTS: Fifty-eight of 145 subjects (34.1%) who were previously diagnosed as having PDD in DSM-IV did not meet DSM-5 ASD criteria. Among them, 28 (48.3%) had Asperger's disorder based on DSM-IV. Most algorithm scores on ADOS and all algorithm scores on ADI-R were highest in subjects who met both DSM-IV PDD criteria and DSM-5 ASD criteria (the Convergent group), followed by subjects with a DSM-IV PDD diagnosis who did not have a DSM-5 ASD diagnosis (the Divergent group), and subjects who did not meet either DSM-IV PDD or DSM-5 ASD criteria (the non-PDD group). Intelligence quotient was lower in the Convergent group than in the Divergent group. CONCLUSION: The results of our study suggest that ASD prevalence estimates could be lower under DSM-5 than DSM-IV diagnostic criteria. Further prospective study on the impact of new DSM-5 ASD diagnoses in Koreans with ASD is needed.
Appointments and Schedules ; Asperger Syndrome ; Autism Spectrum Disorder* ; Autistic Disorder* ; Chungcheongnam-do ; Diagnosis* ; Diagnostic and Statistical Manual of Mental Disorders ; Intelligence ; Intelligence Tests ; Medical Records ; Prevalence ; Prospective Studies ; Retrospective Studies

OBJECTIVE: This study examined the association between the wave form in quantitative electroencephalography (QEEG) and the cognitive and behavioral characteristics measured by the Korean version of Wechsler Intelligence Scale for Children 4th edition (K-WISC-IV), Korean version of the attention deficit/hyperactivity disorder Rating Scale (K-ARS), and Korean version of Child Behavior Checklist (K-CBCL) in children diagnosed with ADHD. METHOD: A retrospective cross-sectional study was performed on children aged 8 to 13 years, who were diagnosed with ADHD at Samsung Medical Center from November 2011 to March 2017. A total of 57 ADHD children were selected by a medical chart review. Their QEEG findings and psychological test results, including K-WISC-IV, K-CBCL, and K-ARS (n=42), were collected. The QEEG was analyzed by the ranges of Hz: delta (1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), and beta (12–25 Hz) and transformed to the z-scored relative power. The collected data were analyzed using Pearson and Partial correlation analysis. RESULTS: The Letter-Number Sequencing scores of K-WISC was positively correlated with fronto-central alpha. The hyperactivity/impulsivity scores of K-ARS were positively correlated with the theta/beta ratio. Among the items of K-CBCL, social immaturity was positively correlated with delta and theta, and negatively correlated with alpha. Social competence was negatively correlated delta and theta, and positively correlated with alpha. CONCLUSION: These results suggest that the resting state QEEG results of children with ADHD may reflect their cognitive and behavioral characteristics, especially in working memory/executive function, hyperactivity/impulsivity, and sociality.
Checklist ; Child ; Child Behavior ; Cross-Sectional Studies* ; Electroencephalography* ; Humans ; Intelligence ; Methods ; Psychological Tests ; Retrospective Studies* ; Social Skills