Mahoney Jeannette R, George Claudene J, Verghese Joe
Department of Neurology, Division of Cognitive & Motor Aging, Albert Einstein College of Medicine, Bronx, New York, USA.
Department of Medicine, Division of Geriatrics, Albert Einstein College of Medicine, Bronx, New York, USA.
J Percept Imaging. 2022;5. doi: 10.2352/j.percept.imaging.2022.5.000407.
To date, only a few studies have investigated the clinical translational value of multisensory integration. Our previous research has linked the magnitude of visual-somatosensory integration (measured behaviorally using simple reaction time tasks) to important cognitive (attention) and motor (balance, gait, and falls) outcomes in healthy older adults. While multisensory integration effects have been measured across a wide array of populations using various sensory combinations and different neuroscience research approaches, multisensory integration tests have not been systematically implemented in clinical settings. We recently developed a step-by-step protocol for administering and calculating multisensory integration effects to facilitate innovative and novel translational research across diverse clinical populations and age-ranges. In recognizing that patients with severe medical conditions and/or mobility limitations often experience difficulty traveling to research facilities or joining time-demanding research protocols, we deemed it necessary for patients to be able to benefit from multisensory testing. Using an established protocol and methodology, we developed a multisensory falls-screening tool called CatchU (an iPhone app) to quantify multisensory integration performance in clinical practice that is currently undergoing validation studies. Our goal is to facilitate the identification of patients who are at increased risk of falls and promote physician-initiated falls counseling during clinical visits (e.g., annual wellness, sick, or follow-up visits). This will thereby raise falls-awareness and foster physician efforts to alleviate disability, promote independence, and increase quality of life for our older adults. This conceptual overview highlights the potential of multisensory integration in predicting clinical outcomes from a research perspective, while also showcasing the practical application of a multisensory screening tool in routine clinical practice.
迄今为止,仅有少数研究调查了多感官整合的临床转化价值。我们之前的研究已将视觉-躯体感觉整合的程度(通过简单反应时任务进行行为测量)与健康老年人的重要认知(注意力)和运动(平衡、步态及跌倒)结果联系起来。虽然已使用各种感官组合和不同的神经科学研究方法在广泛的人群中测量了多感官整合效应,但多感官整合测试尚未在临床环境中系统地实施。我们最近制定了一个逐步方案,用于管理和计算多感官整合效应,以促进针对不同临床人群和年龄范围的创新型转化研究。鉴于患有严重疾病和/或行动受限的患者往往难以前往研究机构或参与耗时的研究方案,我们认为让患者能够从多感官测试中受益很有必要。我们使用既定的方案和方法,开发了一种名为CatchU(一款iPhone应用程序)的多感官跌倒筛查工具,以在临床实践中量化多感官整合表现,该工具目前正在进行验证研究。我们的目标是便于识别跌倒风险增加的患者,并在临床就诊(如年度健康检查、疾病诊疗或随访)期间促进医生发起的跌倒咨询。这将进而提高对跌倒的认识,并促进医生为减轻老年人的残疾、促进其独立性和提高生活质量所做的努力。这一概念概述从研究角度突出了多感官整合在预测临床结果方面的潜力,同时也展示了多感官筛查工具在常规临床实践中的实际应用。