LASSI-L detects early cognitive changes in pre-motor manifest Huntington’s disease: a replication and validation study
Background and objectivesCognitive decline is an important early sign in pre-motor manifest Huntington’s disease (preHD) and is characterized by deficits across multiple domains including executive function, psychomotor processing speed, and memory retrieval. Prior work suggested that the Loewenstei...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1191718/full |
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| author | Luis A. Sierra Shelby B. Hughes Shelby B. Hughes Clementina J. Ullman Andrew Hall Sarbesh R. Pandeya Robin Schubert Samuel A. Frank Samuel A. Frank Mark A. Halko Mark A. Halko Jody Corey-Bloom Simon Laganiere Simon Laganiere |
| author_facet | Luis A. Sierra Shelby B. Hughes Shelby B. Hughes Clementina J. Ullman Andrew Hall Sarbesh R. Pandeya Robin Schubert Samuel A. Frank Samuel A. Frank Mark A. Halko Mark A. Halko Jody Corey-Bloom Simon Laganiere Simon Laganiere |
| author_sort | Luis A. Sierra |
| collection | DOAJ |
| description | Background and objectivesCognitive decline is an important early sign in pre-motor manifest Huntington’s disease (preHD) and is characterized by deficits across multiple domains including executive function, psychomotor processing speed, and memory retrieval. Prior work suggested that the Loewenstein-Acevedo Scale for Semantic Interference and Learning (LASSI-L)–a verbal learning task that simultaneously targets these domains - could capture early cognitive changes in preHD. The current study aimed to replicate, validate and further analyze the LASSI-L in preHD using larger datasets.MethodsLASSI-L was administered to 50 participants (25 preHD and 25 Healthy Controls) matched for age, education, and sex in a longitudinal study of disease progression and compared to performance on MMSE, Trail A & B, SCWT, SDMT, Semantic Fluency (Animals), and CVLT-II. Performance was then compared to a separate age-education matched-cohort of 25 preHD participants. Receiver operating curve (ROC) and practice effects (12 month interval) were investigated. Group comparisons were repeated using a preHD subgroup restricted to participants predicted to be far from diagnosis (Far subgroup), based on CAG-Age-Product scaled (CAPs) score. Construct validity was assessed through correlations with previously established measures of subcortical atrophy.ResultsPreHD performance on all sections of the LASSI-L was significantly different from controls. The proactive semantic interference section (PSI) was sensitive (p = 0.0001, d = 1.548), similar across preHD datasets (p = 1.0), reliable on test–retest over 12 months (spearman rho = 0.88; p = <0.00001) and associated with an excellent area under ROC (AUROC) of 0.855. In the preHD Far subgroup comparison, PSI was the only cognitive assessment to survive FDR < 0.05 (p = 0.03). The number of intrusions on PSI was negatively correlated with caudate volume.DiscussionThe LASSI-L is a sensitive, reliable, efficient tool for detecting cognitive decline in preHD. By using a unique verbal learning test paradigm that simultaneously targets executive function, processing speed and memory retrieval, the LASSI-L outperforms many other established tests and captures early signs of cognitive impairment. With further longitudinal validation, the LASSI-L could prove to be a useful biomarker for clinical research in preHD. |
| first_indexed | 2024-03-12T23:06:56Z |
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| id | doaj.art-b4034b8b7a0e4e6da169f687a9e855e9 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-12T23:06:56Z |
| publishDate | 2023-07-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-b4034b8b7a0e4e6da169f687a9e855e92023-07-18T16:12:36ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-07-011410.3389/fneur.2023.11917181191718LASSI-L detects early cognitive changes in pre-motor manifest Huntington’s disease: a replication and validation studyLuis A. Sierra0Shelby B. Hughes1Shelby B. Hughes2Clementina J. Ullman3Andrew Hall4Sarbesh R. Pandeya5Robin Schubert6Samuel A. Frank7Samuel A. Frank8Mark A. Halko9Mark A. Halko10Jody Corey-Bloom11Simon Laganiere12Simon Laganiere13Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, United StatesDepartment of Neurosciences, School of Medicine, University of California, San Diego, CA, United StatesSan Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United StatesDepartment of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, United StatesDepartment of Neurosciences, School of Medicine, University of California, San Diego, CA, United StatesDepartment of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, United StatesGeorge-Huntington-Institute, Muenster, GermanyDepartment of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, United StatesHarvard Medical School, Boston, MA, United StatesHarvard Medical School, Boston, MA, United StatesDepartment of Psychiatry, McLean Hospital, Belmont, MA, United StatesDepartment of Neurosciences, School of Medicine, University of California, San Diego, CA, United StatesDepartment of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, United StatesHarvard Medical School, Boston, MA, United StatesBackground and objectivesCognitive decline is an important early sign in pre-motor manifest Huntington’s disease (preHD) and is characterized by deficits across multiple domains including executive function, psychomotor processing speed, and memory retrieval. Prior work suggested that the Loewenstein-Acevedo Scale for Semantic Interference and Learning (LASSI-L)–a verbal learning task that simultaneously targets these domains - could capture early cognitive changes in preHD. The current study aimed to replicate, validate and further analyze the LASSI-L in preHD using larger datasets.MethodsLASSI-L was administered to 50 participants (25 preHD and 25 Healthy Controls) matched for age, education, and sex in a longitudinal study of disease progression and compared to performance on MMSE, Trail A & B, SCWT, SDMT, Semantic Fluency (Animals), and CVLT-II. Performance was then compared to a separate age-education matched-cohort of 25 preHD participants. Receiver operating curve (ROC) and practice effects (12 month interval) were investigated. Group comparisons were repeated using a preHD subgroup restricted to participants predicted to be far from diagnosis (Far subgroup), based on CAG-Age-Product scaled (CAPs) score. Construct validity was assessed through correlations with previously established measures of subcortical atrophy.ResultsPreHD performance on all sections of the LASSI-L was significantly different from controls. The proactive semantic interference section (PSI) was sensitive (p = 0.0001, d = 1.548), similar across preHD datasets (p = 1.0), reliable on test–retest over 12 months (spearman rho = 0.88; p = <0.00001) and associated with an excellent area under ROC (AUROC) of 0.855. In the preHD Far subgroup comparison, PSI was the only cognitive assessment to survive FDR < 0.05 (p = 0.03). The number of intrusions on PSI was negatively correlated with caudate volume.DiscussionThe LASSI-L is a sensitive, reliable, efficient tool for detecting cognitive decline in preHD. By using a unique verbal learning test paradigm that simultaneously targets executive function, processing speed and memory retrieval, the LASSI-L outperforms many other established tests and captures early signs of cognitive impairment. With further longitudinal validation, the LASSI-L could prove to be a useful biomarker for clinical research in preHD.https://www.frontiersin.org/articles/10.3389/fneur.2023.1191718/fullsemantic interferencecognitiveHuntington diseaseexecutive functionpre-motor manifest HDLASSI-L |
| spellingShingle | Luis A. Sierra Shelby B. Hughes Shelby B. Hughes Clementina J. Ullman Andrew Hall Sarbesh R. Pandeya Robin Schubert Samuel A. Frank Samuel A. Frank Mark A. Halko Mark A. Halko Jody Corey-Bloom Simon Laganiere Simon Laganiere LASSI-L detects early cognitive changes in pre-motor manifest Huntington’s disease: a replication and validation study Frontiers in Neurology semantic interference cognitive Huntington disease executive function pre-motor manifest HD LASSI-L |
| title | LASSI-L detects early cognitive changes in pre-motor manifest Huntington’s disease: a replication and validation study |
| title_full | LASSI-L detects early cognitive changes in pre-motor manifest Huntington’s disease: a replication and validation study |
| title_fullStr | LASSI-L detects early cognitive changes in pre-motor manifest Huntington’s disease: a replication and validation study |
| title_full_unstemmed | LASSI-L detects early cognitive changes in pre-motor manifest Huntington’s disease: a replication and validation study |
| title_short | LASSI-L detects early cognitive changes in pre-motor manifest Huntington’s disease: a replication and validation study |
| title_sort | lassi l detects early cognitive changes in pre motor manifest huntington s disease a replication and validation study |
| topic | semantic interference cognitive Huntington disease executive function pre-motor manifest HD LASSI-L |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1191718/full |
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