Frontotemporal lobar degeneration (FTLD) is relatively rare, behavioral and motor symptoms increase travel burden, and standard neuropsychological tests are not sensitive to early-stage disease. ...Remote smartphone-based cognitive assessments could mitigate these barriers to trial recruitment and success, but no such tools are validated for FTLD.
To evaluate the reliability and validity of smartphone-based cognitive measures for remote FTLD evaluations.
In this cohort study conducted from January 10, 2019, to July 31, 2023, controls and participants with FTLD performed smartphone application (app)-based executive functioning tasks and an associative memory task 3 times over 2 weeks. Observational research participants were enrolled through 18 centers of a North American FTLD research consortium (ALLFTD) and were asked to complete the tests remotely using their own smartphones. Of 1163 eligible individuals (enrolled in parent studies), 360 were enrolled in the present study; 364 refused and 439 were excluded. Participants were divided into discovery (n = 258) and validation (n = 102) cohorts. Among 329 participants with data available on disease stage, 195 were asymptomatic or had preclinical FTLD (59.3%), 66 had prodromal FTLD (20.1%), and 68 had symptomatic FTLD (20.7%) with a range of clinical syndromes.
Participants completed standard in-clinic measures and remotely administered ALLFTD mobile app (app) smartphone tests.
Internal consistency, test-retest reliability, association of smartphone tests with criterion standard clinical measures, and diagnostic accuracy.
In the 360 participants (mean SD age, 54.0 15.4 years; 209 58.1% women), smartphone tests showed moderate-to-excellent reliability (intraclass correlation coefficients, 0.77-0.95). Validity was supported by association of smartphones tests with disease severity (r range, 0.38-0.59), criterion-standard neuropsychological tests (r range, 0.40-0.66), and brain volume (standardized β range, 0.34-0.50). Smartphone tests accurately differentiated individuals with dementia from controls (area under the curve AUC, 0.93 95% CI, 0.90-0.96) and were more sensitive to early symptoms (AUC, 0.82 95% CI, 0.76-0.88) than the Montreal Cognitive Assessment (AUC, 0.68 95% CI, 0.59-0.78) (z of comparison, -2.49 95% CI, -0.19 to -0.02; P = .01). Reliability and validity findings were highly similar in the discovery and validation cohorts. Preclinical participants who carried pathogenic variants performed significantly worse than noncarrier family controls on 3 app tasks (eg, 2-back β = -0.49 95% CI, -0.72 to -0.25; P < .001) but not a composite of traditional neuropsychological measures (β = -0.14 95% CI, -0.42 to 0.14; P = .32).
The findings of this cohort study suggest that smartphones could offer a feasible, reliable, valid, and scalable solution for remote evaluations of FTLD and may improve early detection. Smartphone assessments should be considered as a complementary approach to traditional in-person trial designs. Future research should validate these results in diverse populations and evaluate the utility of these tests for longitudinal monitoring.
Background: For an accurate orthodontic diagnosis and management, knowledge of face development and progression is required. Objective: To evaluate the linear cranial base (LCB) and angular cranial ...base (ACB) measurements in various Anterior and Posterior (AP) skeletal correlations, research study used Bjork-Jarabak evaluation. Material and Methods: A total of 220 young participants presenting (120 females and 100 males; average ages of 19.34 ± 2.51 and 24.84 ± 2.81 years, correspondingly) at the Multan Medical and Dental College, Multan from March 2022 to September 2022, Pakistan, served as the basis for this retrospective cross-sectional study. Results: In comparison to Jarabak's standards, male dimensions revealed significant differences in the articular angle, AP cranial bases, ramus height, jaw length, anterior face height while women displayed low significant differences, with the exception of mandibular body length, which is longer in Pakistani women. Conclusion: Skeletal differences between Pakistani man and women were considerable, and a contrast to the study of Bjork Jarabak's standardized linear and angular values was also noteworthy.
