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Abstract: TH-PO1112

Robotic Technology Quantifies Cognitive Deficits in Multiple Domains for ESRD Patients

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Vanderlinden, Jessica, Queen's University, Kingston, Ontario, Canada
  • Scott, Stephen H., Queen's University, Kingston, Ontario, Canada
  • Holden, Rachel M., Queen's University, Kingston, Ontario, Canada
  • Boyd, J. gordon G., Queen's University, Kingston, Ontario, Canada
Background

Cognitive impairment is highly reported among chronic kidney disease (CKD) patients, particularly in stage 5 CKD. Lack of validated assessments for quantifying cognition in CKD patients can lead to difficulty in determining the prevalence and degree of this impairment. Robotic technology, such as the KINARM, may be able to detect cognitive deficits associated with CKD, particularly because the KINARM has been shown to identify subtle neurocognitive deficits in ischemic stroke patients. Importantly, these subtle deficits may correlate better with quality of life assessments than routine clinical testing.
Objective: To quantify the neurocognitive deficits of patients with stage 5 CKD.

Methods

Recruitment was performed at a CKD clinic in a tertiary medical centre. Eligible patients were stage 5 CKD patients with no history of neurodegenerative disease or stroke. Consented patients performed a neuropsychological battery that included: the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and a robotic assessment (KINARM, BKIN Technologies, Kingston ON). The RBANS measures 5 cognitive domains along with giving an overall composite score, whereas the KINARM Standard Tests quantifies sensorimotor and neurocognitive control of the upper limb.

Results

From July 2015-April 2018, 30 patients were recruited. On the RBANS, only 3/30 patients scored outside the normative range (defined as >1.96 SD, representing the 95% performance of healthy controls) on the composite total score which measures global impairment. There was variability of impairment across domains, ranging from 0/30 on language to 8/30 on the visuospatial domain. In contrast, compared to age and gender matched controls, approximately one-third of patients were impaired on six of the nine tasks performed. These tasks correspond to deficits in: attention (10/30), sensorimotor (9/30), visuospatial (13/30), visuomotor (11/30), overriding of automatic response (10/13), and executive function (11/30).

Conclusion

Robotic technology can detect cognitive impairments in a higher proportion of patients with stage 5 CKD compared to a traditional neuropsychological assessment tool. The clinical relevance of these cognitive impairments needs further investigation.

Funding

  • Government Support - Non-U.S.