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. 2018 Jul 5;18(1):220.
doi: 10.1186/s12888-018-1795-7.

A new device-aided cognitive function test, User eXperience-Trail Making Test (UX-TMT), sensitively detects neuropsychological performance in patients with dementia and Parkinson's disease

Naomi Kokubo  1   2   3 , Yuma Yokoi  4   5 , Yuji Saitoh  6 , Miho Murata  6 , Kazushi Maruo  7 , Yoshitake Takebayashi  8   9 , Issei Shinmei  8 , Sadanobu Yoshimoto  10 , Masaru Horikoshi  8
Affiliations

A new device-aided cognitive function test, User eXperience-Trail Making Test (UX-TMT), sensitively detects neuropsychological performance in patients with dementia and Parkinson's disease

Naomi Kokubo et al. BMC Psychiatry. .

Abstract

Background: A newer generation neuropsychological tests can take advantage of touch screen and mobile technology. We have developed a new Android application termed "User eXperience-Trail Making Test (UX-TMT)" for neurocognitive assessment and training. This study investigated the utility, including the reliability and the validity, of the UX-TMT as a screening test for cognitive decline in adults.

Methods: A total of 84 individuals aged 27-86 years were divided into three groups; healthy controls ([HC] n = 29), people with Parkinson's disease (PD; n = 28), and people with mild cognitive impairment (MCI) and dementia (MCI&D; n = 27). We examined the distributions of the scores and the time required, and the effects of age and group on these distributions. We analyzed internal consistency and convergent validity in all samples and applied receiver operator characteristic (ROC) analysis to determine a cutoff score that could differentiate the MCI & D group from the HC group.

Results: 97.6% of the participants completed all of the tasks, and the average total test time required for UX-TMT was 428.8 (± 109.1) s in the HC, 542.0 (± 168.7) s in the PD, and 777.5 (± 256.1) s in the MCI&D groups, respectively. The MCI&D group showed significantly lower UX-TMT scores and longer total time in completing the task than the HC group. In an ROC analysis, a score of 21 showed high sensitivity (.83) and specificity (.92), and the UX-TMT score plus age improved sensitivity to .96. Additionally, the UX-TMT scores showed significant correlation with the Mini-Mental State Examination (Japanese version) scores (r = .77, p = .001), and Cronbach's alpha (.71-.83) indicated acceptable internal consistency.

Conclusion: The UX-TMT demonstrated high reliability and validity to detect cognitive decline in Japanese adults, highlighting its utility as a screening tool for epidemiological and clinical research.

Keywords: Application; Cognitive function; Dementia; Parkinson’s disease; Screening.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Institutional Review Committee of the National Center of Neurology and Psychiatry (approval number A2016–062). All Participants received verbal and written descriptions of the study and provided their written informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Schematic illustration of cognitive tasks on UX-TMT on 10.1-in. android tablet. a TMT-B, “Fixed”, “Randomized”, and “Floating” condition on item 5. 5 digits and 5 Japanese hiragana characters on the screen, b Single digit and a single button on item 6, c The name of color and 5 colored button on item 7, and d Instructing sentence on the top, a set of 6-choice words in the middle, and enter button on the bottom on item 8
Fig. 2
Fig. 2
Distribution of UX-TMT score, total test time and MMSE-J score. a Distribution of UX-TMT score against MMSE-J score, and b distribution of total test time for UX-TMT and MMSE-J score. Triangle: Healthy Control (HC), cross: Parkinson’s disease (PD), circle: Mild Cognitive Impairment & Dementia (MCI&D), (n = 81)
Fig. 3
Fig. 3
Receiver Operating Characteristic curve with UX-TMT or MMSE-J scores and age for differentiation. To differentiate HC from MCI&D groups (n = 53), a score of 21 in UX-TMT showed high sensitivity (.83) and specificity (.92), and UX-TMT score plus age improved sensitivity to .96. Long and short dashed line: MMSE-J score, long dashed line: MMSE-J score plus age, dotted line: UX-TMT score, solid line: UX-TMT score plus age
See this image and copyright information in PMC

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