Related Experiment Video
Updated: Jul 20, 2025
Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease
Published on: July 24, 2019
Contributions of Cardiovascular Burden, Peripheral Inflammation, and Brain Integrity on Digital Clock Drawing
Catherine Dion1, Jared J Tanner1, David J Libon2,3
1Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
Insights
Cardiovascular risk, inflammation, and brain health impact digital clock drawing test performance in older adults. These factors help explain subtle graphomotor deficits, potentially signaling early disease vulnerability.
Area of Science:
- Neurology
- Neuropsychology
- Cardiology
Background:
- Cardiovascular burden and peripheral inflammation are linked to executive dysfunction and increased risk of vascular dementia.
- The digital clock drawing test (dCDT) aids in identifying vascular-related neuropsychological dysfunction.
- The combined impact of cardiovascular risk, inflammation, and brain integrity on cognitive function remains unclear.
Purpose of the Study:
- To investigate the influence of cardiovascular burden, inflammation, and MRI-assessed brain integrity on dCDT performance in older adults.
- To analyze the relationship between these factors and dCDT latency and graphomotor metrics.
Main Methods:
- 184 non-demented older adults underwent dCDT, vascular assessment, blood tests, and brain MRI.
- Key dCDT metrics included total completion time (TCT) and digit misplacement.
- Cardiovascular risk (Framingham Stroke Risk Profile-10), inflammation markers (IL-6, IL-8, IL-10, TNF-α, hs-CRP), and brain integrity (entorhinal cortex volume, ventricular volume, leukoaraiosis) were assessed.
Main Results:
- Cardiovascular burden, inflammation, and brain integrity collectively explained 14.6% of the variance in TCT, with cardiovascular risk being the primary driver.
- These factors also explained 17.0% of the variance in digit misplacement, again largely influenced by cardiovascular risk.
Conclusions:
- Subtle graphomotor behaviors measured by dCDT (TCT, digit misplacement) are partially explained by cardiovascular burden, inflammation, and brain integrity.
- These findings suggest potential vulnerability to underlying disease processes in older adults.
Background:
Greater cardiovascular burden and peripheral inflammation are associated with dysexecutive neuropsychological profiles and a higher likelihood of conversion to vascular dementia. The digital clock drawing test (dCDT) is useful in identifying neuropsychological dysfunction related to vascular etiology. However, the specific cognitive implications of the combination of cardiovascular risk, peripheral inflammation, and brain integrity remain unknown.
Objective:
We aimed to examine the role of cardiovascular burden, inflammation, and MRI-defined brain integrity on dCDT latency and graphomotor metrics in older adults.
Methods:
184 non-demented older adults (age 69±6, 16±3 education years, 46% female, 94% white) completed dCDT, vascular assessment, blood draw, and brain MRI. dCDT variables of interest: total completion time (TCT), pre-first hand latency, digit misplacement, hour hand distance from center, and clock face area. Cardiovascular burden was calculated using the Framingham Stroke Risk Profile (FSRP-10). Peripheral inflammation markers included interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor-alpha, and high sensitivity C-reactive protein. Brain integrity included bilateral entorhinal cortex volume, lateral ventricular volume, and whole brain leukoaraiosis.
Results:
FSRP-10, peripheral inflammation, and brain integrity explained an additional 14.6% of the variance in command TCT, where FSRP-10 was the main predictor. FSRP-10, inflammatory markers, and brain integrity explained an additional 17.0% in command digit misplacement variance, with findings largely driven by FSRP-10.
Conclusion:
Subtle graphomotor behavior operationalized using dCDT metrics (i.e., TCT and digit misplacement) is partly explained by cardiovascular burden, peripheral inflammation, and brain integrity and may indicate vulnerability to a disease process.
More Related Videos
Related Concept Videos
01:26Aging
Cellular Clock Theory
The cellular clock theory posits that the human lifespan is closely tied to the finite capacity of cells to divide, a phenomenon governed by telomeres, which are protective caps at the ends of...
01:30Cognitive Development During Adulthood