Cognitive archaeology: identifying and measuring the presymptomatic phase of dementia

Lead Research Organisation: St George's University of London
Department Name: Cardiovascular Medicine

Abstract

Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.

Technical Summary

Variations in lead-time between the onset of the earliest symptoms of cognitive inefficiency (or ‘mild cognitive impairment’ (MCI)) and clinical dementia have offered insights into the factors associated with the brain s capacity to maintain normal levels of cognitive function in the face of degenerative change ( cognitive reserve ). However, the diagnosis of MCI is one of expectation, phenotypically heterogeneous, and liable to a degree of self-selection bias. An alternative would be to use a retrospective approach, looking back at the earliest signs of cognitive change in patients who have already developed dementia. Language abilities are known to decline in early Alzheimer’s disease, and many individuals have left records in which evidence of change can be identified, measured and dated. That such records contain signs of developing dysfunction has been clearly shown by the findings of the Nun Study, and more recently the Iris Murdoch text analysis project. Measurement of preclinical language change at regular intervals in a larger population of patients will lead to robust quantification of the length of this phase, and allow examination of the factors associated with a long or short duration. This project will subject archived material, in both spoken and written formats, to a range of data-driven textual analyses that have been validated in the fields of textual classification and scholarship, with the aim of characterizing the nature and timing of the earliest changes in language processing abilities. Subjects will include members of the OPTIMA cohort, a group consisting of patients with dementia and elderly volunteers in whom physical and cognitive indices, including language, are assessed twice yearly until death. Samples of spontaneous speech from first entry into the cohort, and written texts in the form of letters, notebooks and diaries dating back over two to three decades, will be digitally encoded, and classified using a range of automated techniques.

Publications

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Ahmed S (2012) Logopenic aphasia in Alzheimer's disease: clinical variant or clinical feature? in Journal of neurology, neurosurgery, and psychiatry

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Garcia Reitboeck P (2017) Neuromyelitis optica: Application of computer diagnostics to historical case reports. in Journal of the history of the neurosciences

 
Title Happiest and Saddest Concordances 
Description Five yearly concordances of newspaper content on 'happiest' and 'saddest' days, from 2005 to 2020, by Susan Morris. 
Type Of Art Artwork 
Year Produced 2020 
Impact Peter Garrard and Susan Morris 'In conversation' event at Bartha Contemporary Art Gallery 13/02/2020 
URL http://www.barthacontemporary.com
 
Description Leverhulme Trust project grants
Amount £105,082 (GBP)
Funding ID RPG-2012-484 
Organisation The Leverhulme Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 06/2012 
End 05/2014
 
Description London Intercollegiate Doctoral Training Partnership
Amount £4,000,000 (GBP)
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 10/2016 
End 03/2020
 
Title Bone conducted speech samples 
Description Monitoring bone conducted speech by continuous electronic recording using an accelerometer fixed to a subjects temporo-mandibular joint. 
Type Of Material Technology assay or reagent 
Year Produced 2014 
Provided To Others? No  
Impact None yet, but funding for a larger study involving the technique on different patient groups will be made. 
 
Title Motif discovery in bone-conducted speech 
Description A procedure for identifying repeated segments of speech (perseverations) in patients with amnestic difficulties, such as Alzheimer's disease. 
Type Of Material Technology assay or reagent 
Year Produced 2014 
Provided To Others? No  
Impact We are about to undertake a pilot study of the technique in samples obtained by monitoring AD patients in their homes. 
 
Description 'Cases of Amnesia' book 
Organisation University of Edinburgh
Department Psychology
Country United Kingdom 
Sector Academic/University 
PI Contribution Contributed a chapter based on work completed under the Cognitive Archaeology grant, involving members of the MLSE project consortium.
Collaborator Contribution Sara MacPherson and Sergio Della Sala commissioned the chapter for inclusion in their edited volume: Cases of Amnesia: Contributions to Understanding Memory and the Brain. Routelegde: New York and London, 2019.
Impact Chapter 16: Iris Murdoch: Days Without Writing.
Start Year 2017
 
Description Cognitive Archaeology 
Organisation Oxford University Hospitals NHS Foundation Trust
Department NIHR Oxford Biomedical Research Centre
Country United Kingdom 
Sector Academic/University 
PI Contribution OPTIMA based research assistant funded by MRC grant
Collaborator Contribution Availability of unique longitudinal samples of connected spoken language of elderly (AD and controls).
Impact Methodological papers in press
Start Year 2008
 
Description Cognitive Impairment in King George III 
Organisation University of Birmingham
Country United Kingdom 
Sector Academic/University 
PI Contribution Joint application to the Wellcome Trust History of Medicine Stream for preliminary funding; outcome awaited.
Collaborator Contribution Emeritus professor of clincal biochemistry; expert on porphyria and published extensively on alternatives to the porphyria theory of King George III's encephalopathic episodes.Historian; consultant on a project proposal to fund textual analysis of letters of King George III for potential diagnostic information.
Impact Article on Augustus d'Este currently in submission
Start Year 2009
 
Description Cognitive Impairment in King George III 
Organisation University of Southampton
Department Department of History
Country United Kingdom 
Sector Academic/University 
PI Contribution Joint application to the Wellcome Trust History of Medicine Stream for preliminary funding; outcome awaited.
Collaborator Contribution Emeritus professor of clincal biochemistry; expert on porphyria and published extensively on alternatives to the porphyria theory of King George III's encephalopathic episodes.Historian; consultant on a project proposal to fund textual analysis of letters of King George III for potential diagnostic information.
Impact Article on Augustus d'Este currently in submission
Start Year 2009
 
Description Cross linguistic analysis of AD speech in English and Greek 
Organisation National Centre for Scientific Research (NCSR) Demokritos
Country Greece 
Sector Academic/University 
PI Contribution Data sharing of the OPITMA transcripts used in three of the Cognitive Archaeology papers.
Collaborator Contribution Inclusion of SGUL as partners on a successful H2020 consortium application; employment of one postdoctoral research fellow and a research assistant.
Impact The collaboration is multidisciplinary, involving neuroscience and neurology (SGUL) in collaboration with European centres with expertise in data science, machine learning, computer science, and software development. There is a separate arm exploring the applicability of the iASiS platform to big data in non small cell lung cancer.
Start Year 2017
 
Description Development of computational linguistic and machine learning methods 
Organisation University of Colorado Boulder
Country United States 
Sector Academic/University 
PI Contribution Setting up a 3 month visit to UC Boulder for Natasha Clarke (MRC-LID PhD student at SGUL)
Collaborator Contribution UC Boulder allowed Ms Clarke to monitor classes on applied machine learning, Python programming and computational linguistics and enabled her to pilot some analyses of the Cognitive Archaeology data under the supervision of Prof Peter Foltz.
Impact A literature review is in progress.
Start Year 2015
 
Description Latent semantic analysis in dementia speech samples 
Organisation National Center for Biotechnology Information (NCBI)
Country United States 
Sector Public 
PI Contribution Acquiring pilot data to support a grant application for the acquisition of a historically appropriate semantic space within which to analyse the correspondence of King George III
Impact No publications yet
Start Year 2010
 
Description Neural correlates of discourse space in semantic dementia 
Organisation University of California, San Francisco
Department Memory and Ageing Centre UCSF
Country United States 
Sector Academic/University 
PI Contribution I sponsored a final year medical student to visit the Memory and Aging Centre at the University of California at San Francisco to learn voxel based morphometry, and apply the technique to the results of a principal components analysis of semantic dementia patients discourse, as described in Garrard and Forsyth, 2011
Impact This is a collaboration involving neurologists, neurolinguists, and neuroimaging analysts. We hope to publish the results of a comparison of discourse produced by patients with right and left hemisphere dominant temporal lobe atrophy, but the imaging correlates will need more work.
Start Year 2011
 
Title Novoic Ltd. 
Description Online platform for assessment of cognitive status based on a recording of narrative speech. 
Type Of Technology Webtool/Application 
Year Produced 2019 
Impact Private equity has been invested and formal trials of the product are about to be launched. The MLSE will be used as a clinical reference point to assist with data interpretation. 
URL http://novoic.com
 
Description AAIC 2012 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact The AAIC is the largest international meeting on dementia research, and acceptance of an abstract for oral presentation is highly prestigious. The paper was presented by the postdoctoral researcher on the project at a session featuring some of the most important figures currently active in Alzheimer's disease and MCI research, and was given a warm reception by a large audience. The experience and prestige that this afforded to the postdoctoral researcher was considerable. The exposure that it provided to the work of the project was likewise highly significant.

A number of inquiries were made by high profile research groups into the methods used in this work.
Year(s) Of Engagement Activity 2012
 
Description Article for the Iris Murdoch Review 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? Yes
Geographic Reach International
Primary Audience Other audiences
Results and Impact Brief article outlining the principles of text analysis and its role in dementia research.

Publication in the Journal.
Year(s) Of Engagement Activity 2008
 
Description Australian National Dementia Conference - keynote address 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited to deliver keynote address at the annual Australian Dementia Conference in Melbourne: the largest national conference on dementia in Australia.
Year(s) Of Engagement Activity 2020
URL https://www.informa.com.au/event/conference/national-dementia-conference/
 
Description Cognitive Archaeology project publicised in national newspaper 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Dr James le Fanu described the project and its aims in his weekly medical column for the Daily Telegraph.

Many text donations were offered and have been received and processed as a result of this nationwide publicity.
Year(s) Of Engagement Activity 2011
 
Description Inaugural lecture 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I delivered my inaugural lecture as Professor of Neurology at St George's, University of London. It was published on YouTube, where it has been viewed 216 times at the date this entry was submitted.
Year(s) Of Engagement Activity 2018
URL https://www.youtube.com/watch?v=mYYBGHGc4k8
 
Description Iris Murdoch Society 100th anniversary conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Invited to deliver a public lecture to mark the 100th anniversary of the birth of Iris Murdoch.
Year(s) Of Engagement Activity 2019
 
Description Stand at 'Who do you think you are?' convention - Olympia, London 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact We distributed leaflets and made publicity material available to members of the public attending this event for family history enthusiasts

Several text donations were made as a result of face-to-face enquiries from interested visitors to the convention
Year(s) Of Engagement Activity 2011
 
Description TED Talk and TEDxWandsworth event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Invited talk entitled 'From the power of linguistics to the linguistics of power'. Part of a local TEDx event ('Be the Change') sponsored by Wandsworth Council, showcasing medical, scientific, charitable, and industry activity in the local region. Links to high quality video recordings of all talks became available through the TED web pages after the event.
Year(s) Of Engagement Activity 2015
URL https://www.ted.com/tedx/events/15988
 
Description Talk at ARUK Yorkshire network conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach Regional
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Presentation of the methods and preliminary results from the Cognitive Archaeology project to members of the Yorkshire network of the Alzheimer's Research UK at their annual meeting. The meetings are attended by representatives of all research groups working on ageing and Alzheimer's disease in the region, including the CFAS study.

I responded to questions and and gave advice toy a number of junior researchers during the poster viewing component of the meeting.
Year(s) Of Engagement Activity 2011
 
Description Talk to local medical fund-raising group in Hampshire 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Fifteen minute description of the importance of language in dementia research

Audience members and their friends volunteered diary samples for the diary study that forms part of the MRC funded research project.
Year(s) Of Engagement Activity 2009
 
Description Talks to local Alzheimer Society meetings 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Diary and letter contributions for analysis under the cognitive archaeology project

The project now has 90% of the samples required to beginthe analysis
Year(s) Of Engagement Activity 2010,2011
 
Description Television interview: 'Fit to Rule?' 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact The PI was interviewed by the historian Dr Lucy Worsley as part of a BBC television programme on the physical and mental health of British monarchs. The techniques and results that were discussed in the interview were among those that had been developed for the analysis of presymptomatic language in AD for the Cognitive Archaeology project.

Enthusiastic feedback from the programme production team on the clarity and interest of the work presented.
Year(s) Of Engagement Activity 2013
 
Description The Linguistics of Power 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? Yes
Type Of Presentation Keynote/Invited Speaker
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact >150 participants including local school students; very positively received

Many requests for further info
Year(s) Of Engagement Activity 2013
URL http://www.sgul.ac.uk/research/public-engagement/linguistics-of-power