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Quantifying motor-cognitive reserve using a novel multi-modal stress test.

Tal Kozlovski1,2, Inbal Maidan1,3,4, Eran Gazit5

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This summary is machine-generated.

A new motor cognitive reserve (MCR) index accurately quantifies combined motor and cognitive reserve using a virtual reality stress test. This validated tool shows high sensitivity for detecting neurological deficits and predicting decline.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Biomedical Engineering

Background:

  • Physiological reserve capacity is crucial for demanding situations, but quantifying motor and cognitive reserves (MCR) is challenging.
  • Current proxies like education and brain volume are indirect and limited.
  • Existing definitions of motor and cognitive reserves are artificially separated, ignoring their integrated nature in daily function.

Purpose of the Study:

  • To assess the validity of a novel graded motor cognitive stress test designed to quantify combined motor and cognitive reserve (MCR).
  • To develop and validate a new MCR index score using a machine learning algorithm and wearable sensor data.

Main Methods:

  • A cohort of 144 participants (18-85 years) with varying reserve capacities, including healthy individuals and those with Parkinson's disease, Alzheimer's disease, dementia with Lewy bodies, and mild cognitive impairment.
  • Participants underwent a virtual reality-based stress test involving treadmill walking with concurrent motor and cognitive challenges.
  • A semi-supervised machine learning algorithm integrated performance data and wearable sensor metrics to generate an MCR index score.

Main Results:

  • The MCR index demonstrated strong face validity, with performance declining significantly as motor and cognitive challenges increased (P < 0.001).
  • The index accurately discriminated between healthy controls and individuals with neurological conditions (AUC = 0.89), outperforming existing proxies.
  • Significant correlations were found between the MCR index and established MCR proxies (0.56 ≤ r ≤ 0.79) and MRI-derived brain volumes (grey matter, white matter, caudate nucleus, inferior frontal gyrus).

Conclusions:

  • The novel MCR index is a valid and sensitive tool for quantifying individual motor and cognitive reserve.
  • This innovative approach can aid in screening for motor and cognitive deficits.
  • The MCR index holds potential for predicting motor and cognitive decline in neurodegenerative diseases.