Note: Descriptions are shown in the official language in which they were submitted.
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METHOD AND SYSTEM FOR QUANTITATIVE ASSESSMENT OF VISUAL MOTOR
RESPONSE
CROSS-REFERENCE TO RELATED APPLICATIONS
[001]The following applications are hereby incorporated in
their entirety:
Application No. 12560583 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF FUNCTIONAL IMPAIRMENT
Application No. 13899630 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF FUNCTIONAL IMPAIRMENT
Application No. 14464795 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF FUNCTIONAL IMPAIRMENT
Application No. 12560605 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF VISUAL MOTOR RESPONSE
Application No. 13899646 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF VISUAL MOTOR RESPONSE
Application No. 14464822 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF VISUAL MOTOR RESPONSE
Application No. 12560642 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF VISUAL CONTRAST SENSITIVITY
Application No. 12560683 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF VISUAL FORM DISCRIMINATION
Application No. 14332646 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF VISUAL FORM DISCRIMINATION
Application No. 12560746 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF VISUAL MOTION DISCRIMINATION
Application No. 12560916 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF SPATIAL DISTRACTOR TASKS
Application No. 12561010 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF LETTER IDENTIFICATION LATENCY
Application No. 13899651 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF LETTER IDENTIFICATION LATENCY
Application No. 14464850 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF LETTER IDENTIFICATION LATENCY
Application No. 12561048 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF VERBAL MEMORY
Application No. 12561110 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF FACIAL EMOTION SENSITIVITY
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Application No. 12561169 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF FACIAL EMOTION NULLING
Application No. 14464872 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF FACIAL EMOTION NULLING
Application No. 12561188 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF SOCIAL CUES SENSITIVITY
Application No. 14464894 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF FACIAL EMOTION NULLING
Application No. 12561223 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF SPATIAL SEQUENCE MEMORY
Application No. 14464794 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF SPATIAL SEQUENCE MEMORY
Application No. 12561240 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF WORD IDENTIFICATION LATENCY
Application No. 13899657 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF WORD IDENTIFICATION LATENCY
Application No. 14464831 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF WORD IDENTIFICATION LATENCY
Application No. 12561248 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF WORD RECOGNITION SENSITIVITY
Application No. 13899660 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF WORD RECOGNITION SENSITIVITY
Application No. 14464843 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF WORD RECOGNITION SENSITIVITY
Application No. 12561250 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF WORD DETECTION LATENCY
Application No. 13899681 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF WORD DETECTION LATENCY
Application No. 14464858 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF WORD DETECTION LATENCY
Application No. 12561253 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF SOCIAL INTERACTIONS NULLING TESTING
Application No. 13899766 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF SOCIAL INTERACTIONS NULLING TESTING
Application No. 14464869 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF SOCIAL INTERACTIONS NULLING TESTING
Application No. 12561257 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF SOCIAL INTERACTIONS NULLING TESTING
2
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Application No. 13899774
and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF VERBAL RECOGNITION MEMORY
Application No. 14464885 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF VERBAL RECOGNITION MEMORY
Application No. 14614124 and entitled METHOD AND SYSTEM FOR
QUANTITATIVE ASSESSMENT OF WORD RECOGNITION SENSITIVITY
THIS TECHNICAL FIELD
[002]This disclosure relates in general to the field of
psychophysics, and more particularly to perceptual
abnormalities associated with the neural processing of
sensory, cognitive, affective, and motor signals, and even
more particularly to quantitative assessment of functional
impairment attributable to neural
information processing
disorders (i.e., sensory, cognitive, affective, and motor
disorders) from any injury, disease, or disorder, from any
congenital or acquired abnormalities of nervous system
structure or function.
BACKGROUND
[0031 Substantial literature exists describing sensory,
cognitive, affective, and motor impairments due to
neurological, neuropsychiatric, and psychiatric disorders.
Sensory, cognitive, affective, and motor processing is
impaired by brain dysfunction. However, many such
abnormalities are unlikely to be uncovered during routine
clinical and clinical laboratory examinations.
[0041A method and system for quantitative assessment of
functional impairment facilitates the detection and diagnosis
of a variety of neurological diseases and disorders. A system
for sensory-cognitive, affective, and motor quantitative
neural assessment provides continuous feedback adjusted
stimulation and its standardized scoring algorithms may
provide for the detection of the early stages of brain changes
and impairments associated with a variety of diseases and
disorders. Quantitative assessment may aid in the
investigation of sensory, cognitive, affective, and motor
functions at various levels, including, but not limited to:
sensory sensitivities to the variety of parametric variables
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affecting stimuli; for example, but not limited to, motion,
object, depth, orientation, faces/expressions, hands/gestures,
and other categorical classes of visual stimuli; perceived in
the context of the comparison, detection, discrimination,
recognition, and differentiation of the types of information
analyzed by neural processing.
[0051 Further,
quantitative assessment may indicate the
detection, diagnosis, and distinguishing of a wide variety of
health issues including, but not limited to, neurological,
psychiatric, neuropsychiatric,
psychological,
neuropsychological, sensory, and motor diseases and disorders.
These may reflect single or combined pathological,
pathogenetic, and pathophysiological mechanisms including, but
not limited to, congenital, demyelinating, infectious,
metabolic, neoplastic, systemic, traumatic, and vascular
effects. These include, but are not limited to, the well-known
specific disease entities of Alzheimer's disease and other
dementias, Parkinson's disease and other movement disorders,
autism spectrum and other neuropsychiatric disorders, mood and
other psychiatric disorders, and social maladjustment and
other psychological disorders.
[60010ther tools, such as behavioral assessments, cognitive
testing, neurophysiological, and neuroimaging modalities have
drawbacks related to difficulties in their consistent
application, implementation, and interpretation. Paper and
pencil tests, and their computer presentation and scoring
tests do not consistently consider the results of initial
tests in the arrangement and presentation of subsequent tests.
[006]Additionally, since sensory, cognitive, affective, and
motor impairments have not been universally recognized as
closely linked, psychophysical neurobehavioral testing has not
commonly been conducted during routine medical evaluations.
Thus, a need exists, therefore, for developing appropriate
tests to quantify the impact of related disorders. Further,
although some consider neurobehavioral analysis to not be
quantifiable, many research studies indicate that functional
impairment can indeed be analyzed in a quantitative fashion.
Thus, a further need exists for improved systems for the
quantitative assessment of functional impairments to treat
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subjects with diseases, disorders, and dysfunction affecting
sensory, perceptual, cognitive, and affective impairments,
deficiencies, or disorders.
[0071 Yet a further need exists to identify the early phases of
the neurobehavioral disease or disorder.
[0081A further need exists for improved monitoring
neurobehavioral disease progress.
[009]Yet a further need exists for quantitative assessment of
functional impairment that has the ability to simplify
clinical research on sensory, cognitive, affective, motor
including studies of perceptual, memory, attention, executive,
and higher-order processing deficiencies.
[010]Still further improvement is needed in animal research
evaluations wherein quantitatively controlled variations in
sensory stimuli and motor tasks are shown to animal subjects
for the purposes of research, in basic and clinical science,
leading to veterinary and medical testing of diagnostic,
therapeutic, and other interventions.
[011]Yet a further need exists for laboratories of drug and
device companies and research facilities to research and
develop treatments for functional impairment testing of human
and animal subjects.
[012]Still further improvement is needed to identify meta-
parameters that may cause functional impairment and methods to
diagnose their exemplary diseases and disorders.
[0131A further need exists to generate real-time scores and
diagnosis based on quantitative assessment of functional
impairment.
[014]Still further improvement is needed in critical testing
of memory, attention, organizational, emotional, and social
cue analysis.
[0151A need exists for a treatment of development processes
that may cause functional impairment in human subjects.
[016]Yet a further need exists for maximizing stimulus
response compatibility in assessment of functional impairment
so as not to obscure aspects of neural processing.
[017]Still further improvement is needed in a functional
impairment assessment tool that captures all aspects of
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sensory input, cognitive transformation, affective
interpretation, and motoric response.
[018]Further, a need exists for the incorporation of
artificial intelligence, that is the machine implementation of
subject performance and characteristic data in the real-time
parametric control of automated assessments of functional
competence and impairment.
[019]Finally, likewise, a need exists for dynamic testing in
clinical research, wherein a system responds to the actions of
a subject.
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BRIEF SUMMARY OF THE INVENTION
[0201 The present invention
relates to a method for
quantitative assessment of functional impairment in an animal
or human subject, where the method presents visual scenes,
cues, and auditory locations or features to a subject,
determines an equilibrated scene parameter of a subject, and
generates output. For example, output may include the
assessment of attention in Attention Deficits disorders in
which the administration, titration, or discontinuation of
stimulant and other specific
pharmacotherapeutics,
supplements, behavioral therapeutics, sensory or electrical
stimulation or surgical intervention might be in part or
entirely be directed based on these and related assessments of
function. Or the assessment of memory in late-life dementias
such as, but not limited to, cerebrovascular or
neurodegenerative diseases in which the administration,
titration, or discontinuation of a nootropic and other
specific pharmacotherapeutics, supplements,
behavioral
therapeutics, sensory or electrical stimulation or surgical
intervention might be in part or entirely be directed based on
these and related assessments of function might be in part or
entirely directed based on these and related assessments of
function.
[02110ne aspect of the present disclosure includes an
apparatus for quantifying assessment of functional impairment
in a subject comprising an input device or devices, a visual,
auditory, or tactile stimulation devices, a control device,
and a tangible paper or computer readable output medium.
[02210ne aspect of the present disclosure includes a system
for performing functional impairment tests that may
continuously modulate specific perceptual domains of a
stimulus and transition across perceptual domains in a manner
to measure the response error relative to a specifically
tested, individual or group, established or extrapolated
normal range performance characteristics. In a simplified
embodiment, an assessment profile of functional capacity by
psychophysical responses is generated on a tangible computer
readable medium.
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[023]The present disclosure improves and simplifies complex
experimental paradigms in the context of behavioral,
psychophysical, electrophysiological, and imaging studies of
featural, spatial, temporal, and other categorically or
parametrically manipulated aspects of function and its
potential impairment or range of non-impaired variability
within or between human and animal test subjects.
[02411n accordance with the disclosed subject matter, the
quantification of the impact of neural diseases onto affected
sensory-cognitive-affective-motor functions is provided,
thereby substantially advancing or facilitating the diagnosis
and identification of the early and subsequent phases of
neural diseases and disorders, as well as with secondary
(after diagnosis) and tertiary (after initial therapy)
prevention of the consequences of such diseases and disorders.
[0251A need exists for developing appropriate tests to better
understand neurobehavioral deficiencies. The present
disclosure teaches a plurality of tests comprising a series of
sensory stimulus arrays. More specifically, the present
disclosure generates and presents complex dynamic scenes,
collects responses from a human or animal test subject or
patient, quantitatively refines results, calibrates a display
device relative to the interpreted feedback, and provides
clinically useful information regarding said subject or
patient in the determination of the diagnosis and treatment of
said subject or patient.
[026]These and other advantages of the disclosed subject
matter, as well as additional novel features, will be apparent
from the description provided herein and from the attached
figures. The intent of this summary is not to be a
comprehensive or exhaustive description of the claimed subject
matter, but rather to provide a short overview of exemplary
instances and applications of the subject matter's
functionality.
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BRIEF DESCRIPTION OF DRAWINGS
[027]The present subject matter will now be described in
detail with reference to the drawings, which are provided as
illustrative examples of the subject matter so as to enable
those skilled in the art to practice the subject matter.
Notably, the figures and examples are not meant to limit the
scope of the present subject matter to a single embodiment,
but other embodiments are possible by way of interchange of
some or all of the described or illustrated elements and,
further, wherein:
[028]FIGURE 1 is a simplified schematic illustration showing
aspects of a method of automated functional impairment testing
in an embodiment.
[029]FIGURE 2 is a simplified schematic illustration showing
aspects of a method of automated functional impairment testing
in an embodiment.
[0301 FIGURE 3 is a simplified illustration showing aspects of
a system for automated functional impairment testing.
[0311FIGURE 4 is a simplified schematic diagram showing
aspects of a computing system that may be used in a system for
automated functional impairment testing according to an
embodiment.
[032]FIGURE 5A is a simplified block diagram illustrating
aspects of a system for automated functional impairment
testing in an embodiment.
[0331FIGURE 5B is a simplified block diagram illustrating
aspects of a method for automated functional impairment
testing in an embodiment.
[034]FIGURE 5C is a simplified block diagram illustrating
aspects of a system for automated functional impairment
testing in an embodiment.
[035]FIGURE 5D is a simplified schematic diagram illustrating
aspects of a system for automated functional impairment
testing in an embodiment.
[036]FIGURE 5E is a simplified flow diagram illustrating
aspects of a method for automated functional impairment
testing in an embodiment.
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[037]FIGURE 5F is a simplified block diagram illustrating
aspects of a system for automated functional impairment
testing in an embodiment.
[038]FIGURE 6 is a representation of left posterior-lateral
view of the human brain.
[0391 FIGURE 7 shows an exemplary operator display in a system
for automated functional impairment testing.
[0401FIGURE 8 is a simplified illustration of physical
components in a system for automated functional impairment
testing.
[0411FIGURE 9 is simplified illustration of a rotary
manipulandum test subject response device in a system for
automated functional impairment testing.
[042]FIGURE 10 is a simplified illustration of a linear
manipulandum test subject response device in a system for
automated functional impairment testing.
[0431 FIGURE 1]. is a simplified illustration of an XY Cartesian
manipulandum test subject response device in a system for
automated functional impairment testing.
[044]FIGURE 12 is a simplified block diagram illustrating
aspects of a stimulus generator including hardware and
software for producing scene parameters in a system for
automated functional impairment testing.
[045]FIGURE 13 is a simplified illustration of manual input
components in a system for automated functional impairment
testing.
[046]FIGURE 14 is a simplified illustration of an operator
interface in a system for automated functional impairment
testing in an embodiment.
[0471 FIGURE 15 depicts an exemplary scoring output in a system
for automated functional impairment testing.
[048]FIGURE 16 is an enlarged view of an exemplary operator
display shown generally in FIGURE 7 and showing a graphical
user interface for a subject demographics entry interface
display.
[049]FIGURE 17 is an enlarged view of an exemplary operator
display similar to FIGURE 16 and showing a graphical user
interface for a subject medical history entry display.
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[0501 FIGURE 18A illustrates an exemplary operator display in a
system for automated functional impairment testing.
[0511FIGURE 18B illustrates an exemplary standard operations
test scoring display in a system for automated functional
impairment testing.
[052]FIGURE 19A is an enlarged simplified illustration of an
operator interface in a system for automated functional
impairment testing, as shown generally in FIGURE 14.
[0531FIGURE 19A is an enlarged simplified illustration of a
graphical display showing Current Test Performance for an
operator interface as shown generally in FIGURE 14.
[054]FIGURE 20A illustrates an exemplary standard operations
dynamic performance display of an operator interface.
[055]FIGURE 20B is an enlarged illustration of an exemplary
operator comments entry display as shown general in FIGURE
20A.
[056]FIGURE 21 is a simplified process flow diagram
illustrating aspects of a system initiation sequence and a
test initiation sequence in a system for automated functional
impairment testing.
[057]FIGURE 22 is a simplified process flow diagram
illustrating aspects of a test control sequence and a test
presentation sequence in a system for automated functional
impairment testing.
[058]FIGURE 23 is a simplified process flow diagram
illustrating aspects of a test sequencing and test closing
sequence in a system for automated functional impairment
testing.
[059]FIGURE 24 is a simplified process flow diagram
illustrating aspects of data archiving, operator interface and
accounts management in a system for automated functional
impairment testing.
[0601 FIGURE 25 shows starting phase of a visual saliency test,
in this case, an exemplary dynamic contrast test.
[0611 FIGURE 26 illustrates the intermediate phase of a visual
saliency test, in this case, an exemplary the dynamic contrast
test of FIGURE 25.
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[062]FIGURE 27 displays the termination phase of a visual
saliency test, in this case, an exemplary the dynamic contrast
test of FIGURES 25 and 26.
[0631FIGURE 28 shows starting phase of a visual contrast
sensitivity test.
[064]FIGURE 29 illustrates the intermediate phase of the
visual contrast sensitivity test of FIGURE 28.
[065]FIGURE 30 displays the termination phase of the visual
contrast sensitivity test of FIGURES 28 and 29.
[0661 FIGURE 31 portrays the starting phase of a visual motion
discrimination test.
[067]FIGURE 32 shows the intermediate phase of the visual
motion discrimination test of FIGURE 31.
[0681 FIGURE 33 illustrates the termination phase of the visual
motion discrimination test of FIGURES 31 and 32.
[069]FIGURE 34 depicts the initiation of a visual motion
discrimination test.
[0701FIGURE 35 shows the intermediate phase of the visual
motion discrimination test of FIGURE 34.
[0711 FIGURE 36 illustrates the termination phase of the visual
motion discrimination test of FIGURES 34 and 35.
[0721 FIGURE 37 depicts the superposition of visual motion and
visual form attention tests.
[0731 FIGURE 38 illustrates the intermediate phase of a visual
motion and visual form attention test of FIGURE 37.
[0741 FIGURE 39 represents the left-up form target and right-up
motion target of a visual motion and visual form attention
test of FIGURES 37 and 38.
[0751 FIGURE 40 displays the left-up form, low-distinct target
and right-up motion, high-coherence target of the visual
motion and visual form attention test of FIGURES 37 and 38.
[076]FIGURE 41 shows the left-up form, high-distinct target
and right-up motion, low-coherence target of the visual motion
and visual form attention test of FIGURES 37 and 38.
[0771 FIGURE 42 displays the left-up form, high-distinct target
and right-up motion, high-coherence target of the visual
motion and visual form attention test of FIGURES 37 and 38.
[078]FIGURE 43 displays the starting phase of a word
recognition test battery.
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[079]FIGURE 44 shows normal letters orientation of the word
recognition test battery of FIGURE 43.
[0801 FIGURE 45 shows mirror rotated letters orientation of the
word recognition test battery of FIGURES 43 and 44.
[0811 FIGURE 46 shows inverted letters orientation of the word
recognition test battery of FIGURES 43 and 44.
[082]FIGURE 47 shows the intermediate phase of the word
recognition test battery of FIGURE 43 and 44.
[083]FIGURE 48 shows the termination phase of the word
recognition test battery of FIGURE 43 and 44.
[0841FIGURE 49 illustrates the starting phase of the verbal
memory test battery.
[085]FIGURE 50 displays the intermediate phase of the verbal
memory test battery of FIGURE 49.
[0861 FIGURE 5]. illustrates the left-up target orientation with
high contrast of the verbal memory test battery of FIGURES 49
and 50.
[087]FIGURE 52 shows the right-up target orientation with
moderate contrast of the verbal memory test battery of FIGURES
49 and 50.
[0881 FIGURE 53 displays the right-down target orientation with
low contrast of the verbal memory test battery of FIGURES 49
and 50.
[089]FIGURE 54 shows a low difficulty facial emotion
sensitivity test.
[0901FIGURE 55 shows a moderate difficulty facial emotion
sensitivity test.
[0911FIGURE 56 shows a high difficulty facial emotion
sensitivity test.
[092]FIGURE 57 shows a low difficulty facial emotion nulling
test.
[093]FIGURE 58 shows a moderate difficulty facial emotion
nulling test.
[094]FIGURE 59 shows a high difficulty facial emotion nulling
test.
[095]FIGURE 60 illustrates a low difficulty social cues
sensitivity test.
[096]FIGURE 6]. illustrates a moderate difficulty social cues
sensitivity test.
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[097]FIGURE 62 illustrates a high difficulty social cues
sensitivity test.
[098]FIGURE 63 illustrates an exemplary position trace
representing target stimulus location (here as x-y display
position, ordinates) vs. time in the test (here as z,
abscissa).
[099]FIGURE 64 illustrates an exemplary speed trace plotting
the angular speed of the target (ordinate) vs. time in the
test (here as z, abscissa).
[0100] FIGURE 65 illustrates an exemplary acceleration
trace angular acceleration of the target (ordinate) vs. time
in the test (here as z, abscissa).
[0101] FIGURE 66 illustrates an exemplary 3D Signal-to-
Noise ratio (S/N or SNR) Gradient plot where the higher points
represent high SNR (high perceptual salience, easy to see) and
the lower points represent low SNR (low perceptual salience,
hard to see).
[0102] FIGURE 67 illustrates an exemplary S/N profile with
respect to vertical and horizontal target positions.
[0103] FIGURE 68 shows an exemplary position error function
profile (the x, y, or angular difference between stimulus
target position and subject response cursor position).
[0104] FIGURE 69 shows an exemplary sampled position error
function profile.
[0105] FIGURE 70 displays an exemplary velocity error
function profile.
[0106] FIGURE 7]. is a graphical representation of
instantaneous position error.
[0107] FIGURE 72 is a graphical representation of error
magnitude throughout a test (magnitude meaning the absolute
value of target-cursor error).
[0108] FIGURE 73 is a graphical representation of stimulus
obscuration over time (high obscuration being harder to see).
[0109] FIGURE 74 is a graphical representation of subject
position error relative to target position over time.
[0110] FIGURE 75 is a graphical representation of subject
velocity error relative to target velocity over time.
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[0111] FIGURE 76 is an exemplary chart illustration
summarizing results of automated functional impairment testing
displayed in a graphical user interface.
[0112] FIGURE 77 is a graphical representation showing
results of testing for functional impairment over time in an
exemplary diagnosis summary.
[0113] FIGURE 78A shows a display including two concentric
annuli in a system for automated impairment assessment testing
in which target stimuli in each annulus undergo linked or
independent control of obscuration, as the subject rotates a
wheel to control target position in one annulus (similar to
the cursor in a single annulus stimulus) while the target
position is controlled by the algorithm (similar to the target
in a single annulus stimulus).
[0114] FIGURE 78B shows a display including two concentric
annuli in a system for automated impairment assessment
testing.
[0115] FIGURE 78C shows a display including two concentric
annuli in a system for automated impairment assessment
testing.
[0116] FIGURE 79 is a simplified logic flow diagram showing
aspects of a system for automated functional impairment
testing.
[0117] FIGURE 80 is a simplified logic flow diagram showing
aspects of a system for automated functional impairment
testing.
[0118] FIGURE 8]. is a simplified logic flow diagram showing
aspects of a system for automated functional impairment
testing.
[0119] FIGURE 82 is a simplified logic flow diagram showing
aspects of a system for automated functional impairment
testing.
[0120] FIGURE 83 is a simplified block diagram showing
aspects of a system for automated functional impairment
testing.
[0121] FIGURE 84 is a visual depiction of a series of test
scenes in a system for automated functional impairment
testing.
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[0122] FIGURE 85 is a visual depiction of a series of test
scenes in a system for automated functional impairment
testing.
[0123] FIGURE 86 is a visual depiction of a series of test
scenes in a system for automated functional impairment
testing.
[0124] FIGURE 87 is a visual depiction of a series of test
scenes in a system for automated functional impairment
testing.
[0125] FIGURE 88 is a visual depiction of a series of test
scenes in a system for automated functional impairment
testing.
[0126] FIGURE 89 is a simplified block diagram showing
aspects of a system for automated functional impairment
testing.
[0127] FIGURE 90 is a visual depiction of a series of test
scenes in a system for automated functional impairment
testing.
[0128] FIGURE 9]. is a visual depiction of a series of test
scenes in a system for automated functional impairment
testing.
[0129] FIGURE 92 is a visual depiction of a series of test
scenes in a system for automated functional impairment
testing.
[0130] FIGURE 93 is a visual depiction of a series of test
scenes in a system for automated functional impairment
testing.
[0131] FIGURE 94 is a visual depiction of a series of test
scenes in a system for automated functional impairment
testing.
[0132] FIGURE 95 is a simplified block diagram illustrating
aspects of a system for automated functional impairment
testing and including dual stimulus testing and single
stimulus testing alternatively, alternatingly, or singularly
deployed based on current or previous test performance, or on
subject, group, disease, or treatment criteria.
[0133] FIGURE 96 is a simplified schematic diagram
illustrating aspects of a system for automated functional
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impairment testing and including dual stimulus testing and
single stimulus testing.
[0134] FIGURE 97 is a simplified block diagram illustrating
aspects of a method for automated functional impairment
testing and including dual stimulus testing and single
stimulus testing.
[0135] FIGURE 98 is a simplified schematic diagram
illustrating aspects of a method for automated functional
impairment testing system and including dual stimulus testing
and single stimulus testing.
[0136] FIGURE 99 is a simplified schematic diagram showing
aspects of a computing system that may be used in a system for
automated functional impairment testing according to an
embodiment.
[0137] FIGURE 100A, 100B, 100C, 100D, 100E, and 100F detail
exemplary visual depictions of a series of test scenes that
may be employed by embodiments.
[0138] FIGURE 101A, 101B, 101C, 101D, 101E, and 101F detail
exemplary visual depictions of a series of test scenes that
may be employed by embodiments.
[0139] FIGURE 102 is a simplified block diagram
illustrating aspects of a system for automated functional
impairment testing in an embodiment
[0140] FIGURE 103 is a simplified block diagram
illustrating aspects of a system for automated functional
impairment testing in an embodiment
[0141] FIGURE 104 is a simplified block diagram
illustrating aspects of a system for automated functional
impairment testing in an embodiment.
[0142] FIGURE 105 presents an exemplary heuristic model as
may be employed by embodiments of the present disclosure. In
this case, dot array contrast sensitivity, presented across
background luminance and spatial frequency, is used as an
exemplary test. Analogous flow charts might use any other
stimulus domain (e.g., shapes, colors, letter, orientations,
etc.) might be combined with other tasks (e.g., detection,
discrimination, memory, etc.) in the context of other forms of
stimulus degradation (e.g., overall luminance, spatial
frequency filtering, random dot obscuration, etc.).
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DETAILED DESCRIPTION OF ILLUSTRATED EMBODIMENTS
[0143] The
present disclosure is related to the subject
matter disclosed in the following co-pending application filed
on September 16, 2009 and each naming Charles Joseph Duffy as
the inventor: Serial Number 12/560,583 and entitled METHOD AND
SYSTEM FOR QUANTITATIVE ASSESSMENT OF FUNCTIONAL IMPAIRMENT.
[0144] In
describing embodiments of the present invention
as illustrated in the drawings, specific terminology may be
employed for the sake of clarity. In the present
specification, an embodiment showing a singular component
should not be considered limiting. Rather, the subject matter
encompasses other embodiments including a plurality of the
same component, and vice-versa, unless explicitly stated
otherwise herein. Moreover, applicant does not intend for any
term in the specification or claims to be ascribed an uncommon
or special meaning unless explicitly set forth as such.
Further, the present subject matter encompasses present and
future known equivalents to the known components referred to
herein by way of illustration.
[0145]
Additional context regarding the field of this
disclosed subject matter is provided by the following patents,
all of which have common assignment and invented by Charles
Joseph Duffy, and all of which are incorporated by reference
in their entirety for all purposes into this detailed
description: U.S. Application No. US 10/703,101, entitled
"Method for Assessing Navigational Capacity", Duffy et al.;
U.S. Pat. No. US 6,364,845B1, entitled "Methods for
Diagnosing Visuospatial Disorientation Or Assessing
Visuospatial Orientation Capacity", Duffy et al.
[0146] Further
information regarding the field of this
disclosed subject matter appears in the following research
publications, all of which have common authorship by Charles
Joseph Duffy and all of which are incorporated by reference in
their entirety for all purposes into this detailed
description: Duffy, Charles J. et al., "Attentional Dynamics
and Visual Perception: Mechanisms of Spatial Disorientation In
Alzheimer's Disease", Brain, 126: 1173-1181 (2003); Duffy,
Charles J. et al., "Visual Mechanisms of Spatial
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Disorientation in Alzheimer's Disease", Cerebral Cortex, 11:
1083-1192 (2001).
[0147] It should be understood that wherein this disclosure
refers to specific diagnostic techniques, such diagnostic
techniques may be performed by operations of a diagnostic
computing system specifically implemented on, and calibrated
for, desktop, laptop, mobile, or network hardware computer
devices in communication with a suitable manual, ocular, or
physiological input device and display. In embodiments, a
suitable input device may be calibrated to provide known,
predetermined responsiveness to input of a processed output,
such as a pointer or cursor, that may be displayed for a user
to manipulate or control the movement of such a pointer or
cursor on or relative to a sensory stimulus field of display.
It will be understood that in embodiments response of
processed output such as a cursor or pointer to manual input
may be received in relation to an input device in a high
precision relationship.
[0148] In the present disclosure, the phrase "optic flow"
may be defined as the patterned visual motion seen by a moving
observer, or simulating what is seen by a moving observer,
that provides clues about heading direction and the three
dimensional structure of the visual environment (Duffy et al.,
"Visual Mechanisms of Spatial Disorientation in Alzheimer's
Disease"). Impaired optic flow processing is debilitating,
for example, as it relates to individual autonomy of
ambulatory or vehicular self-movement perception and control.
[0149] One direct example from the inventor's published
research related to how impaired optic flow perception may
include, but are not limited to, elementary visual motion
processing deficits and elevated perceptual thresholds.
Advantages of the present disclosure can be derived from
essentially any analysis of the impaired higher-order (complex
stimulus) recognition which may be rooted in elementary brain
processing impairments (e.g., optic flow), and how it relates
to the perceptual mechanisms of complex behavior (e.g.,
visuospatial orientation) that reflects the impaired
appreciation and control of behavior considering the relations
between the observer and features of the environment including
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earth-fixed objects and independently moving objects, persons,
or vehicles.
[0150] The present disclosure describes systems, methods,
and computer implemented code in a suitable accessible memory,
for diagnosis of a patient. Specifically, the present
disclosure describes systems, methods, and computer-
implemented code in suitable accessible memory, for diagnosis
of a patient including or utilizing a dual input mechanism.
Advantages of disclosed systems, methods, and computer
implemented code over previous diagnosis techniques include
but are not limited to:
the use of objective neural input systems including
single or multiple sensory stimulus arrays (e.g. size
and/or color and/or expression facial discrimination),
the use proscribed behavioral, cognitive, and emotional
tasks that engage the test subject in specific
information processing paradigms (e.g., manual pointing
or gaze shifting to the most asymmetrically shaped object
tree in the array of trees),
the use of objective behavioral or physiological response
monitoring systems for assessing and inter-relating
stimulus and task related effects reflecting neural
information processing (e.g., heart-rate changes and
speed of response to manually move a cursor to the most
threatening face),
the random setting of specific stimulus examples and
motor response requirements to create a diverse set of
conditions within test categories and parameters so that
each running of all tests for all subjects may be unique
(e.g., a different set of words and non-words is
presented in every stimulus of a word discrimination test
presented to each subject on each occasion),
the cross-calibration of a series of tests, within and
between test sessions, to standardize stimulus and
response parameters relative to the specific attributes
individual subject (e.g., handicapping for hand movement
slowing in assessing manual response speed to the most
unique stimulus in an array),
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the use of heuristic algorithms to select the next most
informative test to be administered to a test subject
based on that subject's performance on previous tests in
that test session, or in previous test sessions, or
based-on established or putative diagnoses, or based-on
the administration of therapeutic or response-provocative
agents (e.g., ),
the consistency of tests achieved by the elimination by
operator/administrator control or influence over the
pace, content and conduct of each test and of the
sequence of tests to assure complete consistency of those
categorical and parametric variables specifying the
details of the tests.
[0151]
Embodiments of the present disclosure may employ
visual salience testing, of which contrast testing for
example, may be a component, to determine threshold
competencies. For example, a contrast sensitivity test may
include manipulating the contrast of one or more dots and
observing results across the contrast range. Some embodiments
may likewise perform luminance and spatial frequency testing.
[0152]
Embodiments of the present disclosure may perform
additional tests, including but not limited to: perception and
memory tests, in determining diagnosis reports. In some tests,
of random clutter, noise, and other methods may be employed to
modify the presented signal to noise ratio. to change
the
SNR. Using the language of contrast sensitivity testing
greatly distracts from and diminishes the intellectual
property. 3) Please see the manuals for descriptions of some
ways in which the SNR is being manipulated.
[0153] A
simplistic representation of a test employed by
embodiments may be include:
a) presenting a stimulus domain, wherein exemplary
stimulus domain class include but are not limited to,
letters, shapes, motion, spatial arrangement, faces, and
hands;
b) modifying a stimulus parameter to vary the signal to
noise ratio, wherein
this may be subject to, or
dependent upon, prior test performance; and
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c) requesting input responsive to a particular task,
which creates the behavioral response paradigm. For
example, particular tasks may include but are not limited
to detection, memory, and attention tasks.
[0154] A further simplistic representation of an exemplary
test employed by embodiments may be considered to include:
a stimulus domain;
an SNR control parameter; and
a task.
[0155] A simplistic representation of some embodiments of
the present disclosure, includes a test scenario of:
performing a simple motor control test, the results of
which may be used to set the pace and scoring for
subsequent tests.
performing a visual salience test, the results of which
may be used set the contrast and size of the other tests.
[0156] Some embodiments may employ these derived parameters
to one or more subsequent tests. E.g. If someone is slow, slow
it down; and if someone has poor vision, make it easier to
see. In some embodiments, subsequent tests may maintain those
derived parameters without manipulated (same subject in the
same session, those parameters are fixed by the results of
those first tests). An exemplary test, independent of the
derived values, may include a stimulus SNR control parameter
(%random, angle changes, etc), which may be used in that
particular test to manipulate the SNR (task difficulty).
[0157] FIGURE 1 shows a conceptual framework of the
interacting subsystems 110 in the environment that is used to
assess functional impairment in a subject. As shown, an
exemplary process may commence by the registering of the
user's input 112, wherein the system scores the inputs 114.
The system may then modify the first stimulus location 116A,
and may modify the first stimulus targeting difficult or
presentation parameters 118A. The system may coincidently, or
at a pre-defined delay, modify the second stimulus location
116B, and may modify the second stimulus targeting difficult
or presentation parameters 118B. Thereafter, system may
composite the system output 120, record the stimulus response
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parameters 122, and/or may create a new sensory stimulus array
124, wherein the user's inputs are again registered 112.
[0158] FIGURE 2
displays an exemplary workflow method for
assessing functional impairment of a patient or subject. The
functional impairment 126 workflow commences at step of
register subject's manipulandum response 128. Immediately
thereafter is the step of calculate position error 130, which
is followed by the step of calculate velocity error 132. After
step 132, the step of determine if errors are increasing or
decreasing 134 occurs, which may be followed coincidently, or
at a defined delay, with the step of determining the first
target position and saliency changes 136A and the first target
position and saliency changes 136B. Immediately thereafter,
the step of change to new stimulus parameter 138 occurs;
thereafter, is the step of step of register subject's
manipulandum response 128, which results in repeating the
ensuing steps of the workflow of functional impairment 126.
[0159] As
appearing in the present disclosure, sensory
salience relates to the perceptibility of a stimulus as judged
by the observer's ability to respond to that stimulus, or for
a person or device to detect some change in the observer,
based on the presentation of that stimulus. Salience
can be
affected by any categorical or parametric change in the
physical properties of the stimulus. These
properties
include, but are not limited to, changes in luminance,
contrast, stimulus degradation, etc.
[0160] FIGURE 3
depicts a test environment 188 that may be
associated with quantitative assessment of functional
impairment. The test environment 188 may include, but is not
limited to those associated with research and development
laboratories, such as those present at medical centers,
universities, drug companies, and pharmaceutical companies.
Further, quantitative assessment of functional impairment may
be conducted in clinics as well as animal research facilities.
The present subject matter may be implemented in future known
equivalents.
[0161] Further, quantitative assessment of functional
impairment may be conducted remotely from any physical
location via the Internet or other network. In addition, the
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present disclosure may be utilized for performing therapy,
screening tests or more formal evaluations over the Internet.
[0162] The present disclosure may provide a test
environment 188, which may include a versatile psychophysical
testing environment that simplifies complex experimental
paradigms. The present disclosure may assist clinicians and/or
researchers with replicating fundamental studies and better
investigating visual functions that are impaired by aging and
neural dysfunctions, such as tone and synchrony of acoustic
stimuli and shape and motion of visual stimuli.
[0163] Further, the exemplary test environment 188, which
is depicted in FIGURE 3, may include a mounted shroud-box
enclosure that may shield the subject 192 from visual
distractors. In systems designed for quantitative assessment
of functional impairment, a variety of component and devices
comprise the necessary equipment. The test environment 188 in
the present disclosure may include, but is not limited to, a
subject 192, operator 190, subject display 198, stimulus area
199, operator display 194, a subject manipulandum 402, a
shroud 196, a subject earphones and a subject microphone, an
operator earphones and an operator microphone, and a computing
system 200. Further, the subject headset 426, which may
include a subject earphones and a subject microphone, is shown
in greater detail in FIGURE 8. Further, the operator headset
424, which may include an operator earphones and an operator
microphone, is shown in greater detail in FIGURE 8. More
particularly, the computing system 200 is shown in greater
detail in FIGURE 4.
[0164] The stimulus area may be presented on the subject
display 198 and/or the subject speakers/earphones, wherein the
subject earphones may be a component of subject headset or of
the surrounding test apparatus 426. Further, the cursor 1050
may be located on the subject display 198. The cursor 1050 may
extend from the center of the stimulus area 199 to the edge of
a stimulus area 199, such as a circular border 1302, which is
shown in greater detail in FIGURE 25.
[0165] Further, the cursor 1050 may be the same cursor that
is implemented in multiple tests of the present disclosure,
with the exception of superimposed tests. More particularly,
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functional impairment tests that include superimposed
phenomena, may require the alignment of one target area with
another target area, thereby requiring more than one cursor
1050.
[0166] Further, the test environment 188 may include a
mount device, which may be a pull-mount or a desk-mount.
Further, the subject display 198 may include, but is not
limited to, a display screen, wireless connection, etc. The
auditory stimulator (e.g., speakers of headset) or the visual
display (e.g., screen or goggles) may be used to display
instructions, to display an image of the operator 190 during
instructions or coaching, or to present the visual test
stimuli. The display device 22 may include, or could have
attached, a video camera directed at the subject 192 to show
an image of the subject 192 on operator display 194. The
subject display 198, which is that of the subject 192, may
include a shroud 196 mounted onto a box, in the form of a
shroud-mounted box, in order to shield the subject 192 from
the visual distractors, or may also include earphones in order
to present stimuli and shield the subject from audible
distractors.
[0167] With reference to FIGURE 4, an exemplary system
within a computing environment for implementing the invention
includes a general purpose computing device in the form of a
computing system 200, commercially available from Intel, IBM,
AND, Motorola, Cyrix and others. Components of the computing
system 202 may include, but are not limited to, a processing
unit 204, a system memory 206, and a system bus 236 that
couples various system components including the system memory
to the processing unit 204. The system bus 236 may be any of
several types of bus structures including a memory bus or
memory controller, a peripheral bus, and a local bus using any
of a variety of bus architectures.
[0168] Computing system 200 typically includes a variety of
computer readable media. Computer readable media can be any
available media that can be accessed by the computing system
200 and includes both volatile and nonvolatile media, and
removable and non-removable media. By way of example, and not
limitation, computer readable media may comprise computer
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storage media and communication media. Computer storage media
includes volatile and nonvolatile, removable and non-removable
media implemented in any method or technology for storage of
information such as computer readable instructions, data
structures, program modules, cloud storage, or other data
storage apparatus.
[0169] Computer memory includes, but is not limited to,
RAM, ROM, EEPROM, flash memory or other memory technology, CD-
ROM, digital versatile disks (DVD) or other optical disk
storage, magnetic cassettes, magnetic tape, magnetic disk
storage or other magnetic storage devices, or any other medium
which can be used to store the desired information and which
can be accessed by direct or transmitted connection to the
fixed or mobile computing system 200.
[0170] The system memory 206 includes computer storage
media in the form of volatile and/or nonvolatile memory such
as read only memory (ROM) 210 and random access memory (RAM)
212. A basic input/output system 214 (BIOS), containing the
basic routines that help to transfer information between
elements within computing system 200, such as during start-up,
is typically stored in ROM 210. RAM 212 typically contains
data and/or program modules that are immediately accessible to
and/or presently being operated on by processing unit 204. By
way of example, and not limitation, an operating system 216,
application programs 220, other program modules 220 and
program data 222 are shown.
[0171] Computing system 200 may also include other
removable/non-removable, volatile/nonvolatile computer storage
media. By way of example only, a hard disk drive 224 that
reads from or writes to non-removable, nonvolatile magnetic
media, a magnetic disk drive 226 that reads from or writes to
a removable, nonvolatile magnetic disk 228, and an optical
disk drive 230 that reads from or writes to a removable,
nonvolatile optical disk 232 such as a CD ROM or other optical
media could be employed to store the invention of the present
embodiment. Other removable / non-removable, volatile /
nonvolatile computer storage media directly connected, or
accessed by transmission-based connectivity, locally or
remotely, that can be used in the exemplary operating
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environment include, but are not limited to, magnetic tape
cassettes, flash memory cards, digital versatile disks,
digital video tape, solid state RAM, solid state ROM, and the
like. The hard disk drive 224 is typically connected to the
system bus 236 through a non-removable memory interface such
as interface 234, and magnetic disk drive 226 and optical disk
drive 230 are typically connected to the system bus 236 by a
removable memory interface, such as interface 238.
[0172] The drives and their associated computer storage
media, discussed above, provide storage of computer readable
instructions, data structures, program modules and other data
for the computing system 200. For example, hard disk drive 224
is illustrated as storing operating system 268, application
programs 270, other program modules 272 and program data 274.
Note that these components can either be the same as or
different from operating system 216, application programs 220,
other program modules 220, and program data 222. Operating
system 268, application programs 270, other program modules
272, and program data 274 are given different numbers hereto
illustrates that, at a minimum, they are different copies.
[0173] A user may enter commands and information into the
computing system 200 through input devices such as a tablet,
or electronic digitizer, 240, a microphone 242, a keyboard
244, and pointing device 246, commonly referred to as a mouse,
trackball, or touch pad. These and other input devices are
often connected to the processing unit 204 through a user
input interface 248 that is coupled to the system bus 208, but
may be connected by other interface and bus structures, such
as a parallel port, game port or a universal serial bus (USB).
[0174] A monitor 250 or other type of display device is
also connected to the system bus 208 via an interface, such as
a video interface 252. The monitor 250 may also be integrated
with a touch-screen panel or the like. Note that the monitor
250 and/or touch screen panel can be physically coupled to a
housing in which the computing system 200 is incorporated,
such as in a tablet-type personal computer or other mobile
computer linked device. In addition, computers such as the
computing system 200 may also include other peripheral output
devices such as speakers 254 and a computer linked printer
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256, which may be connected through an output peripheral
interface 258 or the like.
[0175] Computing system 200 may operate in a networked
environment using logical connections to one or more remote
computers, such as a remote computing system 260. The remote
computing system 260 may be a personal computer, a server, a
router, a network PC, a peer device, a personal mobile device,
or other common network node, and typically includes many or
all of the elements described above relative to the computing
system 200, although only a memory storage device 262 has been
illustrated. The logical connections depicted include a local
area network (LAN) 264 connecting through network interface
276 and a wide area network (WAN) 266 connecting via modem
278, but may also include other networks such as transmission
accessed storage media or processing devices. Such networking
environments are commonplace in offices, enterprise-wide
computer networks, intranets, the Internet, and cloud systems.
[0176] For example, in the present embodiment, the computer
system 200 may comprise the source machine from which data is
being generated/transmitted, and the remote computing system
260 may comprise the destination machine. Note however that
source and destination machines need not be connected by a
network or any other means, but instead, data may be
transferred via any media capable of being written by the
source platform and read by the destination platform or
platforms.
[0177] The central processor operating pursuant to
operating system software such as IBM OS/2% Linux, UNIX,
Microsoft Windows, Apple Mac OSX and other commercially
available operating systems provides functionality for the
services provided by the present invention. The operating
system or systems may reside at a central location or
distributed locations (i.e., mirrored or standalone).
[0178] Software programs or modules instruct the operating
systems to perform tasks such as, but not limited to,
facilitating client requests, system maintenance, security,
data storage, data backup, data mining, document/report
generation and algorithms. The provided functionality may be
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embodied directly in hardware, in a software module executed
by a processor or in any combination of the two.
[0179] Furthermore, software operations may be executed, in
part or wholly, by one or more servers or a client's system,
via hardware, software module or any combination of the two. A
software module (program or executable) may reside in RAM
memory, flash memory, ROM memory, EPROM memory, EEPROM memory,
registers, hard disk, a removable disk, a CD-ROM, DVD, optical
disk or any other form of storage medium known in the art. An
exemplary storage medium is coupled to the processor such that
the processor can read information from, and write information
to, the storage medium. In the alternative, the storage medium
may be integral to the processor. The processor and the
storage medium may also reside in an application specific
integrated circuit (ASIC). The bus may be an optical or
conventional bus operating pursuant to various protocols that
are well known in the art.
[0180] FIGURE 5A shows the paradigm of a hierarchical
nature of parametric individualization. The word
"hierarchical" refers to some tests that may derive measures
that may be used as pre-sets for subsequent tests, or for
heuristically selected subsequent tests drawn from a fixed-set
or variably applied subsequent tests. Further, the word,
"hierarchical" is associated with the occurrence of start
values in subsequent tests, such that there may be an ordered
sequence of tests. In the hierarchy for parametric
individualization 300, the resulting data from a motor
adaptation test 302 may be applied to a visual saliency test
304, an auditory test 306, and/or a vibratory test 308. In
some embodiments, results may also be applied to perception
tests, and/or memory tests, as detailed herein. The results of
the one particular test or a combination of tests that may
include, but are not limited to, a visual saliency test 304,
an auditory test 306, and/or a vibratory test 308, may be
applied to the test batteries 310, which are further described
in the present disclosure.
[0181] FIGURE 5B shows the paradigm of a hierarchical
nature of parametric individualization. As shown, a system
employing the exemplary hierarchy for parametric
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individualization 300, may perform a movement test 303,
wherein the results of the movement test may be applied to a
visual saliency test 305, an auditory test 307, a vibratory
test 309, or combinations thereof.
[0182] FIGURE 5C illustrates an exemplary system and the
soring of a visual saliency test module 304, an auditory test
module 306, a vibratory test module 308, and a movement test
module 302, that may be actuated by system processor 314.
[0183] FIGURE 5D presents an exemplary process flow, as may
be employed by system embodiment of the present disclosure. As
shown, process flow 500, may include running a dual stimulus
motor test module 514, which may be followed by running a dual
stimulus sensory test module 518, which may be followed by
running a dual stimulus cognitive test module 526, which may
be followed by running a dual stimulus interaction test module
530, which may be followed by running a dual stimulus scoring
algorithm 534.
[0184] FIGURE 5E presents an exemplary method as employed
by embodiments of the present disclosure. As shown, method
550, may include performing a motor test 554, which may be
followed by performing a sensory test 558, which may be
followed by performing a cognitive test module 562, which may
be followed by performing a cognitive test module 566, which
may be followed by performing a interaction test 570, which
may be followed by results scoring 574.
[0185] FIGURE 5F presents an exemplary system architecture,
including storage of modules within a database 594. As shown,
database 594, may include a motor test module 584, sensory
test module 586, cognitive test module 588, stimulus and
interaction test modules 590, and final scoring algorithms
592.
[0186] FIGURE 6 portrays a representation of left
posterior-lateral view 320 of the human brain 322. The example
given is of the human visual system organized, as are other
cortical sensory systems, as a series of parallel information
processing pathways. In the eyes, there are two sensory
system, cone cells for daylight vision and rod cells for
twilight vision. In the optic nerves and visual pathways,
there are several different types of nerve fibers, of which
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the magnocellular pathway 324 and the parvocellular pathway
328 are the most important. The mangocellular pathway 324 is
considered by those skilled in the art to be the "where?"
pathway; the parvocellular pathway 328 is considered by those
skilled in the art to be the "what?" pathway. Further, the
magnocellular pathway 324 carries all transient, motion
related visual information and low contrast black and white
information. The parvocellular pathway 328 carries all color
information and is effective in carrying high contrast black
and white information. Further, the human brain 322 includes a
striate and pen-striate visual areas 326.
[0187] FIGURE 7 display an exemplary operator display 194,
which may display to an operator 190 perceived impairment data
for a subject 192. The operator display 194 may include, but
is not limited to, a real-time subject video display 332, a
stimulus display 334, a current test performance display 336,
and a subject error display 338. Further, the operator display
194 may display the current status 362, which may include, but
is not limited to, the current status of the current subject,
the current status of the current test, and the current status
of the current scores. Further, the test performance display
336 may show a graph of stimulus difficulty 350 versus the
time of time intervals 348.
[0188] The system may be configured to allow an operator
190 to select the appropriate test from test batteries 310 via
the option of select and store test batteries 340.
Alternatively, the system may recommend an appropriate test
based on historical patient data or other inputs with test
selection heuristics based-on immediately, or remotely,
previously administered performance tests, or other subject
characteristics, or the characteristics of specific
circumstances of interest related to that subject, as in
suspected disorders or brain function or expected
circumstances or high performance in particular areas. The
operator display 194 shared by or separate from the linked to
the subject display facilitates input commands, for example
start 342, pause 344, and stop 346 with respect to any
functional assessment test. A functional assessment test may
be symbolized as test battery A 352, test battery B 354, test
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battery C 356, test battery D 358, or test battery X 360, as
in shown on the exemplary operator display 194 of FIGURE 7.
[0189] Further, the operator display 194 may be used to
start and stop testing via a series of windows that may be
shown by the use of the computing system 200. The series of
windows may include the following:
A window for data entry regarding the subject 192,
operator 190, and test site.
A window for the operator 190 being able to view the
subject's stimulus for monitoring.
A window for the display of the current subject 192 and
ongoing test.
A window for the real-time display of graphical subject
error and numerical subject error.
A window for the display of the subject's video image to
the operator 190 for the monitoring of the subject's
position and gaze.
A window for the display of the subject's response
saliency function.
A window for the display of the subject's current basic
scores.
A window for the operator 190 to enter comments.
A window for the operator 190 to enter identifying,
medical history, treatment, etc.
[0190] The operator display 194 may be one component, of
many components, that may be utilized for quantitative
assessment of functional impairment. FIGURE 8 illustrates an
embodiment of the principal components of the presently
disclosed method for assessment of functional impairment. The
components may include, but are not limited to, basic
components 400, a subject manipulandum 402, an operator
interface 404, and closed-circuit communication 406. The basic
components 400 may be utilized in the test environment 188, as
is shown in FIGURE 3.
[0191] The operator interface 404, may include, but is not
limited to devices specifically for use by the operator 190,
such as a keyboard 244, herein called operator keyboard 408,
and a pointing device 246, which may be, but is not limited
to, an operator touchpad 410 or a mouse, herein called an
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operator mouse 412. An operator 190 may enter commands and
information into the computing system 200 through input
devices such as an operator touchpad 410 or an operator mouse
412. The operator 190 may utilize the operator interface 404
for entering identifying information, medical history,
treatment data, etc. to facilitate in quantitative assessment
of functional impairment.
[0192] Further, the closed-circuit communication 406 may
include, but is not limited to, an operator headset 424, which
may be utilized by the operator 190, and a subject headset
426, which may be utilized by the subject 192. The present
disclosure may include a closed-circuit auditory and visual
links 406 between the subject 192 and a human or simulated
operator, on-site or linked from a remote location, 190 that
consists of three components:
The subject 192 may utilize a subject headset 426 to
shield from audible distractors, thereby allowing for the
controlled presentation of auditory stimuli as task cues
or distractors, or cue elements of the task, which
include, but are not limited to, specific tones and
words, or for instructions or for coaching by the
operator 190. The subject headset 426 may include a co-
mounted subject microphone 428, which may always be on to
the operator 190, thereby allowing all comments by the
subject 192 and eliciting appropriate responses.
The operator 190 may wear an operator headset 424 that
may allow the operator 190 to hear any sounds from the
subject 192 but also may allow the operator 190 to hear
sounds from the surrounding environment. The operator
headset 424 may include a co-mounted operator microphone
425, which may allow the operator 190 to speak with the
subject 192. Further, the operator interface 404 may
allow for contact with the subject 192 via the operator
190 being able to enable or disable a virtual switch in
the operator display 194.
The present disclosure includes software, hardware, and
interface connections for controlling the state of the
subject-operator closed-circuit communication 406.
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[0193] Further components of the present disclosure may
include a subject manipulandum 402, which may be a physical
interfacing device that transforms input from a user. The
properties of the subject manipulandum 402 may be akin to the
properties of a pointing device 246 or other input devices,
which may include, but is not limited to a wheel, a joystick,
or a computer mouse device. Further, the subject manipulandum
402 may be a touch screen display panel, a movement, tilt,
contact, or pressure sensitive device, or a device that by
remote sensing monitors subject movements of hands, eyes,
head, or other body parts, or speech or automatic body
responses and 422 that can accommodate continuous or
intermittent input.
[0194] Similar to the operator interface 404, the subject
manipulandum 402 may include, but is not limited to devices,
such as a keyboard 244, herein called subject keyboard 409,
and a pointing device 246, which may be, but is not limited
to, a subject touchpad 411 or a mouse, herein called an
subject mouse 420 also including a movement, tilt, contact, or
pressure sensitive device, or a device that by remote sensing
monitors subject movements of hands, eyes, head, or other body
parts, or speech or automatic body responses. A subject 192
may enter commands and information into the computing system
200 through input devices such as a subject touchpad 411 or
mouse 420 or other direct or remote contact device.
[0195] Further, the system may be configured for exclusive
subject input by directly or remotely responding as
illustrated here by moving the position of the subject
response manipulandum 402. The subject manipulandum 402 may be
manipulated by the hand or other volitional movement, or non-
volitional response of the subject 192, and its purpose is to
maximize stimulus response compatibility so the sensory
processing and motor control aspects of brain function being
engaged by the stimuli presented and the task engaging the
subject. The subject 192 may provide input and respond to
sensory stimuli by movement of the subject manipulandum 402.
Exemplary arrangements of the subject response devices are
hand contact manipulandums, including rotary manipulandums
414, linear manipulandums 416, and xy Cartesian manipulandums
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418. Thus, the subject response manipulandum 402 may register
single or multi-axis responses such as moving in rotation
motion 440, a linear motion 442, x-axis motion in the
Cartesian coordinate system 444, y-axis motion in the
Cartesian coordinate system 446, and combinations thereof. In
addition, the movement of the subject response manipulandum
402 may be represented as a cursor 1050 on the subject display
198. The cursor may be, but is not limited to, a ball-and-
stick cursor.
[0196] With reference to FIGURES 9, 10, and 11, an
exemplary a rotary manipulandum 414, an exemplary linear
manipulandum 416, and an exemplary xy Cartesian manipulandum
418 are shown in greater detail but do not set these examples
apart from other subject response interface devices
contacting, or remotely sensing, of volitional movements such
as eye, head, and body movement or monitoring other body
responses such as heart rate, respiratory rate or brain
electrical responses measured by integral or attached machines
and evoked by the presented stimuli and tasks.
[0197] Further, the subject manipulandum 402 may be
designed to incorporate a means of monitoring whether the
subject 192 is contacting a handle through a capacitive
contact detector. Further, the subject manipulandum 402 may be
designed to incorporate a motorized system that can alter the
resistance offered by the subject manipulandum 402 to the
subject 192 by moving it for use in testing the motoric
control of the subject 192. Further, the subject manipulandum
402 may be designed to incorporate a vibrating element that
can create a variable amplitude, variable frequency vibration
of a handle as a cue or a distracting stimulus.
[0198] Further, the present disclosure may accommodate the
use of a plurality of subject response devices, here again
exemplified by the subject response manipulandum 402 to test
the motoric control of the subject 192. The present disclosure
may accommodate two manipulanda 402, one with each of the
subject's hands.
[0199] Further, the response of the subject manipulandum
402 may be implemented as separate box mounted devices or
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virtual devices on a touch screen display panel 422 that can
accommodate finger or stylus input, such as by text.
[0200] Further principal components of a computing system
200, may include a computer readable medium, a computing
process, that supports detailed operations by interfacing with
other hardware components and by representative software
described in the further in the present disclosure.
[0201] In the illustrated example shown in FIGURE 9, the
subject manipulandum 402 is shown as a rotary manipulandum 414
that moves in a rotational motion 440. The rotary manipulandum
414 may consists of a box mounted wheel 439, which may be
mounted such that it can rotate around its center, which may
be attached to a rotation circuit in the box 443. The box
mounted wheel 439 is moved by grasping an eccentric handle 441
that the subject 192 uses to rotate the angle of the rotary
manipulandum 414, which may be a displayed as a cursor 1050 on
the subject display 198. The motion of the rotary manipulandum
414 may be from zero to three-hundred sixty angular degrees,
which may be translated with as representative motion, also
from zero to three-hundred sixty angular degrees, in the form
of a cursor 1050 on the subject display 198.
[0202] FIGURE 10 presents further exemplary arrangements,
wherein a linear manipulandum 416 is used. A linear
manipulandum 416 may move in a linear motion 442. A linear
manipulandum 416 may consist of a box-mounted slot 445 from
which a handle 447 protrudes. The handle 447 is attached to
circuit in the box 443 that transduces the movement of the
handle 447 across the extent of the slot 445. The handle 447
may be grasped by the subject 192 and moved along the axis of
the slot 445, which may move the cursor 1050 on the subject
display 198. The movement of the cursor 1050 may be
represented as a displayed linear cursor on the subject
display 198. The displayed linear form of the cursor 1050 may
move in a variety of means, including, but not limited to, a
side-to-side motion or an up-and down motion, across a
corresponding axis of the stimulus area 199.
[0203] FIGURE 11 shows a further manipulandum arrangement,
shown as a xy Cartesian manipulandum 418 that moves in the
Cartesian coordinate system, which may be x-axis motion in the
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Cartesian coordinate system 444 or y-axis motion in the
Cartesian coordinate system 446. The xy Cartesian manipulandum
418 may consist of a box mounted handle 449 that is attached
to a xy Cartesian coordinate transducer circuit that registers
the position of the handle's angular deflection. The box
mounted handle 449 is tilted by the subject 192 to displace a
cursor 1050 across the xy surface of the subject display 198;
the xy surface of the subject display 198 may be shown from
the upper left to the lower right of the subject display 198.
[0204] FIGURE 12 portrays a block diagram of a stimulus
generator 450, which may further comprise the system software
452, the application hardware configuration 454, and the
system conceptualization of neural processing 456. Further,
the block diagram of a stimulus generator 450 may combine
hardware and software to produce a scene parameter.
[0205] The system software 452 may consider the test
subject error monitor 460 towards both the steps of derive new
target location 462 and derive new stimulus difficulty 464.
The results of the steps of derive new target location 462 and
derive new stimulus difficulty 464 may influence the step of
system test-module-specific stimulus generation 468.
[0206] Further, the steps involved in the system software
452 may influence the steps involved in the application
hardware configuration 454. More particularly, the results of
the step of system test-module-specific stimulus generation
468 may be applicable towards each of the steps that are
associated with the computer's sound's engine (firmware) 474,
the computer's graphics engine (firmware) 472, and the
computer's signal generator (firmware) 470.
[0207] The results of the step associated with the
computer's sound's engine (firmware) 474 may be applicable
towards the step associated with computer's sound interface
(hardware) 476. The results of the step associated with the
computer's graphics engine (firmware) 472 may be applicable
towards the step associated with computer's graphics
interface(hardware) 480. The results of the step associated
with the computer's signal generator (firmware) 470 may be
applicable towards the step associated with the computer's
digital interface(hardware) 484.
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[0208] Further, the results of the step associated with the
computer's sound interface (hardware) 476 may be applicable
towards the step associated with the subject's auditory
headset (hardware) 478. The results of the step associated
with the computer's graphics interface(hardware) 480 may be
applicable towards the step associated with the subject's
visual display (hardware) 482. The results of the step
associated with the computer's digital interface(hardware) 484
may be applicable towards the step associated with the
subject's vibro-tactile manipulandum (hardware) 486.
[0209] Further, the steps involved in the application
hardware configuration 454 may influence the steps involved in
the step of system test-module-specific stimulus generation
468. More particularly, the steps associated with either of
the subject's auditory headset (hardware) 478, the subject's
visual display (hardware) 482, or the subject's vibro-tactile
manipulandum (hardware) 486 may be associated with the step of
system test-module-specific stimulus generation 468.
[0210] FIGURE 13 shows a block diagram of the subject
manipulandums 550, which represents the necessary components
associated with the subject manipulandums 402. The components
a of the block diagram of the subject manipulandums 550 may
include, but is not limited to, the manipulandum handle and
transducer 552, a USB interface 554, signal conditioning 556,
and the USB connector to system computer 558. Further, the
manipulandum handle and transducer 552 may be associated with
either of the rotary manipulandum 414, linear manipulandum
416, or xy Cartesian manipulandum 418.
[0211] The output associated with the manipulandum handle
and transducer 552 is coupled to the signal conditioning 556,
which may either be applicable towards the USB interface or
directly with the USB connector to system computer 558. The
output associated with the USB interface is directly coupled
to the USB connector to system computer 558.
[0212] FIGURE 14 portrays an exemplary operator output
interface 570, which may include, but is not limited to, an
operator display 194 and an operator interface 404. The
operator display 194 is shown in greater detail in FIGURE 7
and its accompanying description. The operator interface 404
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is shown in greater detail in FIGURE 8 and its accompanying
description. Further, the operator display 194 may include an
exemplary real-time subject video display 332 for presenting
tests of a series of scenes for use with the presently
disclosed subject matter.
[0213] FIGURE 15 depicts a sub-component of the operator
display 194, the power user preset controls for visual
movement module 600, which may serve as a graphical user
interface with parameter adjustment sliders and buttons. The
operator 190 may control the power user preset controls for
visual movement module 600 in order to make changes to one,
several, or all of the settings associated with the movement
test 302. The power user preset controls for visual movement
module 600 may include, but is not limited to, slider bars,
with accompanying value ranges for the stimulus area 602, the
stimulus speed 604, the range of dot speeds 606, the dot color
608, the background color 610, the mean dot luminance 612, the
dot size (min, max) 614, the dot half-life (msec) 616, and the
dot overlap (max %) 618.
[0214] FIGURE 16 presents a window in the operator display
194, which in addition to the option of select and score test
batteries 340, may also include an exemplary subject
demographics entry display 650. The operator 190 may enter
subject demographics 652 for the subject 192 in the subject
demographics entry display 650, which may be a sub-component
of the operator display 194. The subject demographics may
include, but are not limited to, the full name 660, the stated
age 662, the date of birth 664, the gender identity 666, the
racial identity 668, and the ethnic identity 670.
[0215] FIGURE 17 shows a window in the operator display
194, which in addition to the option of select and score test
batteries 340, may also include an exemplary subject medical
history entry display 700. The operator 190 may enter the
medical history 710 and the functional capacities 712 for the
subject 192 in the subject medical history entry display 700,
which may be a sub-component of the operator display 194.
Further the medical history 710 may include, but is not
limited to, medicinal allergies 720, other allergies
(seasonal/food) 722, current medications 724, current
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supplements 726, current diagnoses 728, surgical procedures
730, planned surgeries 732, and history of trauma 734. Further
the functional capacities 712 may include, but is not limited
to, physical limitations 736, hearing impairments 738, visual
impairments 740, movement difficulties 742, highest
educational level 744, and preferred hand 746. The medical
history 710 and the functional capacities 712 may contribute
towards the quantitative assessment of functional impairment,
and thereby may contribute towards the treatment for the
subject 192.
[0216] FIGURE 18 shows a standard operations test scoring
display 750, which may be a window in the graphical user
interface for the display of the subject's current basic
scores. The standard operations test scoring display 750 may
be a display in addition to the option of select and score
test batteries 340, which may be a part of the operator
display 194.
[0217] The standard operations test scoring display 750 may
further display a more detailed test scoring display 752,
which may include, but is not limited to, the test subject
output 760, the test module output 762, the saliency scores
output 764, the mean over previous output 766, the interval
scores output 768, and the percentage time at five seconds
level output 770. Further, the test scoring display 752 may
show current data associated with a current, particular test
that may be for quantitative assessment of functional
impairment.
[02181 Further, the mean over previous output 766 may be
associated with the saliency scores output 764. Further, the
percentage time at five seconds level output 770 may be
associated with the interval scores output 768.
[0219] FIGURE 19 shows a window in the operator display
194, which in addition to the option of select and score test
batteries 340, may also include an exemplary standard
operations dynamic performance display 800. The current test
performance 802, which may be represented graphically as the
graph of current of current test performance 804, which may be
a graph of stimulus difficulty 350 versus ten seconds
intervals 806.
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[0220] Further, the ten seconds intervals 806 is an
exemplary representation of the time from the start of this
test 808. However, different time intervals may be represented
on as the time from the start of this test 808 on the graph of
current of current test performance 804.
[0221] Further,
the graph of current of current test
performance 804 may represent increasing task difficulty 812
with a higher value of stimulus difficulty 350. Further, the
graph of current of current test performance 804 may represent
decreasing task difficulty 810 with a lower value of stimulus
difficulty 350.
[0222] Further,
the current test performance 802 may be a
more detailed representation of the standard operations
dynamic performance display 800. Further, the current test
performance 802 may be associated with the subject's response
saliency function.
[0223] FIGURE 20
shows a window in the operator display
194, which in addition to the option of select and score test
batteries 340, may also include an exemplary operator comments
entry display 850. The operator 190 may enter comments on the
operator comments entry 852, which may be a sub-component of
the operator comments entry display 850. The operator comments
entry 852 may include, but is not limited to, prompts for
subject response to test experience 854, operator assessment
of subject performance 856, subject comments 858, and operator
comments 860.
[0224] Further,
the subject response to test experience 854
may be scored on a scale of subject response to test
performance 862, which may be scored, but is not limited to
being scored, from very unenjoyable 870 to moderately
unenjoyable 872 to moderate 874 to moderately enjoyable 876 to
very enjoyable 878. The operator assessment of subject
performance 856 may be scored on a scale of operator
assessment of subject performance 864, which may be scored,
but is not limited to being scored, from very unenjoyable 870
to moderately unenjoyable 872 to moderate 874 to moderately
enjoyable 876 to very enjoyable 878.
[0225] With
reference to FIGURE 21 through FIGURE 78, the
present disclosure includes multiple levels of system
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configurability implemented with an extensive multi-
dimensional parametric control system with a large number of
parametric adjustment controls. These parameters allow for the
flexible specialization of the present disclosure across many
application domains as well as the flexible specialization of
the present disclosure to specific medical diagnoses and
corresponding issues related to the wide variety of directly
foreseeable applications of this technology.
[0226] The
present disclosure allows for specialization of
parameters with regards to tests included for specific
applications, which may include, but is not limited to the
following:
selection of specific tests for specific applications,
such as a test battery that focuses on posterior cortical
and sub-cortical function in applications regarding
Alzheimer's Disease, and in contrast, a different test
battery in screening of frontal lobe and temporal lobe
function in applications regarding the fronto-temporal
dementias;
assessment of the underlying mechanisms for drug and
toxin exposures, including applications for drug and
toxin exposures that may be selected by experience
acquired from implementation of the present disclosure;
intrinsic configurability allows for implementing a
broad-based, non-specialized screening, including
measurement of the diverse dimensions of cognitive
function across their respective ranges in the normal
population, which may reflect the presence of, or the
potential for, the wide range or neuropsychiatric
disorders, or vulnerabilities to such disorders, seen in
the healthy and functional population;
a power-user test array configuration mode in which a
specific sub-set of tests from the present disclosure may
be included or excluded as best suited to the specific
interests of the customer or for specific applications;
variable total duration of testing resulting from the
intrinsic testing configurations.
[0227] Further,
the present disclosure may provide for a
complete, streamline workflow of experimental design, display
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calibration, data collection, and data analysis for the
quantitative assessment of functional impairment.
[0228] Specialization of parameters for test configuration
to be used in specific applications may include, but is not
limited to, the following:
selection of all physical parameters of all the tests
described in the present disclosure, including altering
the speed of target motion, the rate of target saliency
increase or decrease, spatial and temporal frequency
composition of the stimuli and the nature of multi-modal
stimuli, such as visual stimuli alone, auditory stimuli
alone, hand-finger vibratory tactile stimuli alone, or
any combination of those modalities as cues or
distractors;
parametric adjustment setting may include all aspects of
the visual display, including, but not limited to,
luminance, contrast, spatial (size of stimulus elements)
and temporal (period of stimulus display) frequency
composition, target position or change n position
(movement);
adjustment of aspects of the test subject's motor control
medium, including but not limited to, adjusting response
sensitivity, filtering subject response signal frequency;
adjustment of aspects of auditory input to the subject,
including, but not limited to, visual and/or auditory
presentation of instructions, visual and/or auditory
presentation of test stimuli, such as words or tones, the
presentation of auditory stimuli as distractors, and the
amplitude and filtering of auditory stimuli.
parametric adjustment due to qualitative assessment. Such
parametric adjustment, including the ability to select
parameters that are derived from demographic
specification of the individual, which may include, but
is not limited to, age, gender, medical history, drug
treatments, or from the results of specific tests in a
testing array sequence, which may include, but is not
limited to, using a contrast sensitivity profile to alter
the contrast at which all other visual stimuli will be
presented, or using the speed and other subject movement
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parameters to alter the target movement parameters for
all other tests. These subject performance dependent
meta-parameters may be used as directly derived from that
subject's or subject group's performance or may be
algorithmically programmed.
a power-user test parametric configuration mode in which
computerized parameter adjustment sliders and buttons may
be presented to allow for the adjustment of parameters as
best suited to the specific interests of the customer or
for specific applications.
[0229] Further, specialization of the testing configuration
for applications to testing specific subjects may allow for
the selection of a language in which instructions and
linguistic stimulus cues that may be presented for testing
subjects in their primary language or in a previously acquired
secondary language.
[0230] Further, specialization of the testing configuration
for applications to testing specific subject may allow for the
selection of relevant cues such as geometric shapes or tones
or such as objects and recognizable sounds rather than
language cues in applications for age-appropriate,
developmental, or acquired impairments of language processing.
[0231] Further, specialization of testing configuration for
applications to testing specific subjects may allow for using
an individual subject's scores from a previous testing
session, at that site or another test site. Further,
specialization of testing configuration for applications to
testing specific subject may allow for using an individual
subject's scores to select the test to be administered, which
may potentially focus on abnormal or unreliable performance or
on application specific selected performance capacities, for
example detecting particular abilities affected by
neurological disorders or testing particular abilities
especially relevant to circumstances or tasks of special
relevance to that subject. Likewise, test configuration
parameters may be inherited from previous testing sessions to
match those tests or to extend testing in to a different
parametric domain.
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[0232] Further, specialization of the testing configuration
for applications to testing specific subject may allow for
operator entered alerts on areas of concern, which may be in
response to patient complaints alerting the physician or
operator regarding some function, such as memory, attention,
or the controlled of skilled movements.
[0233] The present disclosure may include the extensive
processing of subject performance data integrated with
information from sources that may include: i) subject
demographics, such as from scores standardized to normal for
age or education, ii) subject characteristics from established
or putative diagnoses or know treatment that may alter or
focus analysis, such as with motor response in Parkinsonism,
and/or iii) previous test scores, such as to focus on
measuring improvement, stability or decline.
[0234] The present disclosure may include on-line data
analysis, which may include the presentation and archiving of
summary scores at the termination of the administration of
each test. The scores from these tests may include: the mean
saliency, as percent of maximum score, in last fifteen, ten,
and five seconds of a test, the saliency at which the greatest
percentage of time was spent in a test, the saliency at which
the subject first lost track of the target. In another
embodiment, the present disclosure may generate real-time
score during the administration of each test.
[0235] The present disclosure may include off-line data
analysis, which may include the derivation of a variety of
dependent measures, including, but not limited to: i) the
subject's response curve fit parameters to an asymptotic
function, the salience level of that asymptote, and the time
it takes to achieve that asymptote, ii) the area under the
curve of the subject's response function, terminated by either
a preset time, such as one-hundred seconds of testing or
thirty seconds after the asymptote is reached, or the time to
three peak/troughs in the response function or the time until
a pre-selected cut-off is achieved, such as a saliency greater
than ninety-five percentage, iii) comparative evaluations such
as the differences between the measures of a subject's
performance on a selected test versus that from another
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selected test, iv) comparative measures such as the
differences between the basic measures of a subject on a test
and the measures from a selected group of comparison subjects,
such as the percentile scaled performance scores standardized
for age, gender, or education.
[0236] More particularly, system initiation and test
initiation, as applied to the quantitative assessment of
functional impairment as described in the present disclosure,
may be shown by way of illustration. FIGURE 21 shows an
embodiment of a testing flow process 1100 for the conceptual
framework for quantitative assessment. At the start step of
testing flow process 1100, the system initiation sequence 1102
may begin with the boot and self-test step 1106 and may
proceed to initiate operator interface at step 1108. Upon
receiving data entry input from the operator 190 via the
operator interface 1120 during the initiate operator interface
step 1108, the system initiation sequence 1102 may be
completed.
[0237] The ensuing test initiation sequence 1104 may
commence subsequently with the session script step 1122. Upon
receiving operator confirmation 1124 the session demonstration
1126 begins with the session demonstration stimulus 1128. At
step 1130 of patient responses, score results 1132 are
recorded. Thereafter, done query 1134 may ascertain whether
the session demonstration stimulus 128 has finished. If done
query 1134 is no, then the test initiation sequence 1104
reverts back to the session demonstration stimulus 1128. If
done query 1134 is yes, then the test initiation sequence 1104
proceeds with store results step 1136.
[0238] Thereafter, testable query 1138 may discern whether
the store results are testable. If testable query 1138 is no,
then the test initiation sequence 1104 determines a resulting
untestable script 1140, and thereby proceeds to the test
closing step 1144. If testable query 1138 is yes, then the
test initiation sequence 1104 proceeds to the test controller
that may operate as an integral or separate, local or remote,
automatic or human decision maker interfaced to the testing
device 1142, which is further depicted in FIGURE 22 with more
detailed steps.
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[0239] More particularly, test control and test
presentation, as applied to the quantitative assessment of
functional impairment as described in the present disclosure,
may be shown by way of illustration. FIGURE 22 displays a
sequence of test control steps 1152 and a sequence of test
presentation steps 1154. At the test control step 1142
indicated in FIGURE 21, the test initiation sequence 1104 may
progress into the sequence of test control steps 1152.
Initially after the test initiation or presentation step 1156,
the sequence of test control steps 1152 proceeds to the query
test selection 1160. Query test selection 1160 may search to
allocate an appropriate test to/from test sequencing 1158.
Upon achieving test selection 1160, the sequence of test
control steps 1152 may proceed to test closing step 1142 under
the assumption of no remaining tests. Further, upon achieving
test selection 1160, the sequence of test control steps 1152
may proceed to the test script step 1164 under the assumption
of remaining tests.
[0240] The operator enable step 1166 may promote the
introduction of the test demonstration stimulus 1168. The
sequence of test control steps 1152 may proceed with receiving
input via patient responses 1170, for which the testing flow
process 1100 records the score results 1132. If the sequence
of test control steps 1152 does not complete score results
1132, then the sequence of test control steps 1152 continues
with test demonstration stimulus 1168 in a control loop until
the sequence of test control steps 1152 completes score
results 1132.
[0241] Upon achieving score results 1132, the sequence of
test control steps 1152 may proceed to the store results step
1136 and then to the testable query 1138. If testable query
1138 is yes, then the sequence of test control steps 1152 may
proceed to step of to test presentation 1180 and initiates the
sequence of test presentation steps 1154, starting with the
step of from test control 1182. Then, at from test control
step 1182, the sequence of test presentation steps 1154 may
proceed with having a particular test x ready step 1184,
followed by the step of operator confirmation 1124.
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[0242] However, if testable query 1138 is no, then the
sequence of test control steps 1152 may proceed to the step of
to test control 1142. Afterward, the sequence of test control
steps 1152 may revert back to the test initiation or
presentation step 1156.
[0243] Upon receiving operator confirmation 1124, the
sequence of test presentation steps 1154 may present a
particular test x presenting a specifically selected stimulus
1188, and thereby promoting patient responses 1170.
Subsequently, the patient responses 1170 may be recorded in
the score and store step 1192, thereby prompting the test
time-out query 1194. If test time-out query 1194 is no, then
the sequence of test presentation steps 1154 proceeds to the
query of stable score 1196.
[0244] However, if test time-out query 1194 is yes, then
the sequence of test presentation steps 1154 may proceed to
the step of to test control 1142, thereby reverting to the
test initiation or presentation step 1156. If test time-out
query 1194 is no, then the sequence of test presentation steps
1154 may present the stable score query 1196. If stable score
query 1196 is no, then the sequence of test presentation steps
1154 may revert back to the step of operator confirmation
1124. However, if stable score query 1196 is yes, then the
sequence of test presentation steps 1154 to the step of to
test control 1142, may revert back to the test initiation or
presentation step 1156.
[0245] More particularly, test sequencing and test closing,
as applied to the quantitative assessment of functional
impairment as described in the present disclosure, may be
shown by way of illustration. FIGURE 23 illustrates the
process flow of test sequencing 1202 in greater detail than as
discerned at the step of from test control 1182 of FIGURE 22.
The subset of steps of from test control 1182 may begin with
the from test control 'select' step 1206 of test sequencing
1202. Thereafter, a new patient query 1208 inquires whether a
new patient has elected to participate in the test sequencing
1202. If no to new patient query 1208, then a first test query
1210 may be administered. If yes to new patient query prompt
1208, then the test sequencing 1202 proceeds to the step of
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access test battery 1216. Upon initiating first test query
1210, the test sequencing 1202 commences the step of load
patient parameters 1212. Thereafter, the step of reviewing
patient's parameters 1214 commences.
[0246] Further, the patient parameters reviewed 1215, which
may be considered in the step of reviewing patient's
parameters 1214, may include, but is not limited to the
following: confirm patient identity, special considerations
(e.g., age, gender, diagnosis), previous scores from earlier
test reports, testing priorities based-on putative diagnoses
or therapeutic interventions, and the need to resolve any
conflicting or highly variable results of previous tests.
[0247] Immediately following step of reviewing patient's
parameters 1214, the step of access test battery 1216 may
commence. Thereafter, the progression of tests may be
initiated in the step of next test in sequence 1218, which may
include a particular test type 1219. Further, the particular
test type 1219 may further include, but is not limited to,
tests associated with any, some, or all of motor, form,
motion, attention, word, and memory characteristics.
[0248] Further, the step of next test in sequence 1218 may
start a sequence of the step of load test and its pre-sets
1220, which is immediately followed by an analysis step of
this test's parameters battery 1222. More particularly, the
step of this test's parameters battery 1222 may include, but
is not limited to the details of type of parameter battery
1223, which is listed in list form detail in FIGURE 23.
[0249] The final step of test sequencing 1202 may be the
step of to test control 'selection' 1224, which returns the
testing flow process 1100 back to the sequence of test control
steps 1152, starting with the test initiation or presentation
step 1156. Upon completion of tests and saving test data at
the store results step 1136, the sequence of steps in test
closing 1204 begins with the step of from test initiation or
control 1226.
[0250] Thereafter, the step of request operator comments
1228 seeks operator comments 1230, which may be stored as
store comments 1232 via a data archiving mechanism 1234.
Subsequently, the user is prompted by the query of print
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results 1236 and the query of printer available 1238. If no to
the query of printer available 1238, then the step of flag
print reminder 1240. If yes to the query of printer available
1238, then the step of printer que 1242, immediately followed
by the prompt of another patient 1244 to print another
patient's test results.
[0251] Thereafter, a query of new patient requested 1246
may be initiated. If no to query of new patient requested
1246, then the step of auto logout and to system initiation
login 1248 appears to the user. If yes to query of new patient
requested 1246, then the step of to system initiation patient
ID 1249 appears to the user.
[0252] More particularly, data archiving, operator
interface, and accounts management, as applied to the
quantitative assessment of functional impairment as described
in the present disclosure, may be shown by way of
illustration. FIGURE 24 shows sub-sequences of the testing
flow process 1100, which may include the sequences of steps
for data archiving 1250, operator interface 1252, and accounts
management 1254. The process flow of data archiving 1250 may
commence from the end of the sequence of steps in test closing
1204 as shown in FIGURE 23.
[0253] Thereafter the steps for data archiving 1250 may
commence with the step of access all previous results 1256,
which are formatted in the step of format raw data and
reported data 1258. Upon formatting the data from the test
sequencing 1202, the data may be stored in the step of store
raw data and reported data 1260. Thereafter, the process flow
of data archiving 1250 may proceed with the step of flag type
of billing 1262 and the subsequent step of encrypt and lock
file 1264. The process flow of data archiving 1150 may end
with return to test closing 1266. Some embodiments include
data archiving includes secure archiving on the machine, data
archiving on a remote location, data archiving of regulatory
compliant de-identified data for use in other applications,
and combinations thereof.
[0254] FIGURE 24 also shows sub-sequences of the testing
flow process 1100 for the operator interface 1252, which may
begin with the step of from system initiation sequence 1282.
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Thereafter, the operator interface 1252 may proceed with the
step of create multi-function display 1268, which is
immediately followed by the step of start AV link to patient
1270. Next the operator interface 1252 may proceed the step of
start stimulus/response display and score 1272, which
initiates the subsequent step of start patient error display
and store 1274 and the ensuing step of display the test
battery and ready status 1276. Thereafter, the user may be
prompted the step of ready to go 1278, which may be
immediately followed by the step of to system initiation
session initiation 1280.
[0255] Moreover, FIGURE 24 also shows sub-sequences of the
testing flow process 1100 for accounts management 1254, which
may begin with the step of from system initiation 1282.
Thereafter, the user may be queried with the step of accounts
management system 1284. If no to the query of accounts
management system 1284, then the follow-up step may be the
query local admin 1294 to determine whether the user a local
administrator. If yes to the query of asking whether the user
is a local admin 1294, then accounts management 1254 may
proceed to the step of local tests and billing 1295. However,
if no to the query of asking whether the user is a local admin
1294, then accounts management 1254 may proceed to the step of
the asking whether the user is a local operator 1190 via the
query of local operator 1296. If yes to the query of local
operator 1296, then accounts management may proceed to the
step of to system initiation accounts management 1298;
otherwise, accounts management may proceed to the step of
system initiation and the presentation of a login prompt 1299.
[0256] Instead, if yes to the query of accounts management
system 1284, then the testing flow process 1100 for accounts
management 1254 may proceed with the step of pre-confirm and
permissions 1286, which may be immediately followed by the
step of confirming via the query confirmed 1288. If no to the
query confirmed 1288, then the testing flow process 100 for
accounts management 1254 may proceed to the step of poll
system server now 1292. Instead, if yes to the query step of
inquiring confirmed 1288, then the testing flow process 1100
for accounts management 1254 may proceed to the step of system
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access 1290. Thereafter step of system access 1290, accounts
management 1254 undergoes user exit mode and ends the accounts
management 1254 at the system initiation login prompt 1199.
[0257] With reference to FIGURE 25 through FIGURE 78, the
present disclosure includes a screening test battery with high
stimulus-response compatibility (the stimulus has a self-
evident relationship to the required response; e.g., a
stimulus on the left or right of the screen is highly
compatible with push-button responses through a device that
has one button on the left and one button on the right) to
facilitate engaging test subjects while surveying a range of
functional domains to detect and quantify a variety of
functional impairments.
[02581 The fundamental stimulus response contingency common
to all of these tests is the segmental presentation (some part
of the overall display) of a stimulus in the context of
relevant distractors (other parts of the overall display) to
evoke the subject's positioning of a cursor to indicate the
local stimulus.
[0259] In one embodiment of the present disclosure, the
tests are organized to captures all aspects of sensory input,
cognitive/affective interpretation and transformation, and
motoric response control, herein called sensory-motor
neurocognitive assessment, which may also be known as sensory-
cognitive-affective-motor assessment. The present disclosure
may couple sensory stimulation with the recording of motor
responses to assess cerebral cortical function. The stimulus-
response patterns are recorded in the context of the different
tests, which thereby allow for: 1) the quantification of
fundamental sensory and motor functions, 2) the quantification
of multiple levels of high cognitive function and of affective
(emotional) function by measuring its influence on motor
function, and 3) the detection of impairments or improvements
in any of these functions.
[0260] The tests may provide a graph of stimulus saliency
over time achieved by the test subject in tasks of sensory-
motor neurocognitive-affective assessment task (e.g., success
leads to more difficult tasks and stimuli so performance
capacity is reflected in the difficulty reached in testing).
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Further, the tests of the present disclosure may characterize
functional impairment in sensory-motor neurocognitive-
affective assessment through evaluation of quantifiable
characteristics.
[0261] One such quantifiable characteristic of impairment
in sensory-motor neurocognitive-affective assessment may be
high latency to the subject's optimal function in a sensory-
motor neurocognitive-affective assessment task, which may be a
less steep sensory-motor neurocognitive-affective assessment
function. This latency measure may be obtained by sudden
changes in the stimulus-response paradigms that require the
test subject to rapidly adapt to those changes (e.g., sudden
reversal of subject response wheel directional relationship to
screen cursor direction (i.e., subject must turn wheel
counterclockwise to turn the cursor clockwise).
[0262] Another such quantifiable characteristic of
impairment may be high variability of optimal function during
a sensory-cognitive-affective-motor neurocognitive assessment
task, which may be larger terminal fluctuations (i.e.,
subject's speed, accuracy, or other response measures) becomes
more variable as the stimulus becomes less readily
discriminated (more difficult to recognize). Yet another such
quantifiable characteristic of impairment may be low
enhancement of neurocognitive assessment function,
particularly being steeper or higher, by valid cueing. The
term "valid cueing" may refer to providing a stimulus that
allows the subject to have fore-knowledge of a subsequent
stimulus, accessing perception, attention, and memory that may
be able to provide a higher resolution view of sensory-
cognitive-affective-motor function.
[0263] Another such quantifiable characteristic of
impairment may be either an enhancement or a diminution of
neurocognitive assessment, (e.g., by comparing responses to
valid and invalid cueing. The term "invalid cueing"
representing test conditions in which attention or memory
provides incorrect information about the nature or content of
the stimulus in a motor neurocognitive assessment.
[0264] Further, an embodiment of the present disclosure may
include a pattern of visual motion associated with a stimulus
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area 199 that may be translational motion, rotational motion,
radial motion, or motion that may be in a combination of
translational, rotational, and radial motion. Further, the
motion associated with the stimulus area 199 may be random in
nature, as governed by a variety of visual noise generation
algorithms.
[0265] Further, another embodiment of the present
disclosure may include continuous feedback adjusted
stimulation. Wherein, a spatial sub-section of the stimulus is
distinct from the remainder of the stimulus by virtue of a
gradient or boundary of difference in a single stimulus
parameter or a selected set of stimulus parameters. Such a
boundary may reflect a single step change at some edge,
multiple step changes at successive distances steps away from
the target's center, or a graded function with distance from
the center of the target.
[0266] Further, the tests of the present disclosure may
continually change the location of the target in the stimulus
field. The present disclosure may include a continually
changing response from the subject 192. The target location
may change by either angular displacement around an axis of
rotation, displacement along a single axis or any fixed or
varying orientation, or displacement along multiple axes, such
as horizontal and vertical axes.
[0267] Additionally, the saliency of the target, which
refers to perceptual distinctness of the target from the
background and from other stimulus elements, may be
continually change during a neurocognitive assessment task to
alter the difficulty of the task and establish the
neurocognitive assessment response function of the subject 192
in that assessment domain.
[0268] Further, in the tests of the present disclosure, the
cursor 1050 may itself be the target zone of one of two
concurrently presented stimuli, in separate display areas or
superimposed on a single display area, in which the target
position is independently manipulated by an algorithm (as in a
single stimulus test) and the other target is independently
manipulated by the test subject or patient as with the cursor
in a single stimulus test 1050. A computer system 200 may
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control the saliency associated with the cursor stimulus 1050,
thereby allowing the subject 192 to perform two well-defined
neurocognitive tasks
concurrently, a circumstance which may
be associated with dual task interference or dual task
enhancement. More particularly, the subject 192 may be asked
to align one target area with another target area during
functional impairment testing associated with dual task
interference (e.g.: Two concentric annular target areas, or
two parallel linear target areas, are presented
simultaneously. Each target area contains a categorical target
imbedded in a field of non-target "foil" stimuli. The two
target areas may contain targets and foils of the same, or of
different stimulus categories. Within each target area, a
target and foils are presented as the salience of those
elements is parametrically co-varied, or independently varied,
in relation to how well the subject manipulates the response
interface device to align the target in one area with the
computer controlled moving location of the target in the other
area).
[0269] Further,
during the tests of the present disclosure,
the subject performance controls the rate and direction of
change in target location and saliency. The speed, maximum
acceleration, and rate of direction changes may be increased
when the subject 192 if off target and decreased when the
subject 192 is on target. The saliency may be increased when
the subject 192 if off target, decreased when on target; the
rate of change is proportionate to the size and duration of
subject error.
[0270] Additionally, the duration of testing may be
controlled by the size and duration of subject error. More
particularly, sustained, stable scores may lead to earlier
termination of testing. Multiple oscillations of scores around
a stable level may lead to the termination of that specific
test. The inability to capture the target at any saliency may
lead to the termination of that specific test.
[0271] Further, exemplary neurocognitive
assessment
response characterization protocols may be initiated using
configurations informed by previous tests. Motor control
response parameters, such as the maximum speed, maximum
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acceleration, and minimum direction reversal interval
generated by a subject, may be used to establish, in a
particular test or across tests, the then used standards for
parameters used in subsequent tests. Further, sensory contrast
sensitivity measures may be determined, in one or more sensory
modality or sub-modality, and used in subsequent tests to
provide each subject 192 with individually standardized
stimuli in later tests. Further, neurocognitive assessment
neural processing measures may be used for comparison to
adjust scores in attentional and memory manipulations
superimposed on those tests to further inform the assessment
in those tasks, degradation protocols, and tasks.
[0272] Further, another embodiment of the present
disclosure may be to operate a system for quantitative
assessment of functional impairment with minimal intervention.
The present disclosure may include artificial intelligence
capabilities to enable dynamic testing (e.g., real-time test
selection based on previously entered or obtained
information). Further, each test of the present disclosure may
include an ability to dynamically respond to actions of
subject 192. Thus, each test in the present disclosure may
shorten or lengthen itself automatically in response to the
actions taken by the subject 192.
[0273] In one embodiment, ten tests may be administered to
assess functional impairment of the subject 192. Further, in
one embodiment, the tests may be administered in the order
described below. However, the methods in accordance with the
embodiments of the present disclosure may include the
performance of any other subset of the ten tests which may be
administered in any order. Further, the tests may encompass
present and future known equivalents to the known components
referred to herein by way of illustration.
[0274] FIGURE 25 illustrates the initiation of the dynamic
contrast test, which evaluates visuo-motor responses by
analysis of the sensory-cognitive-affective-motor function in
the domains of target movement speed, acceleration, and
direction reversal. A patch of high contrast may be comprised
of individual elements, which includes, but is not limited to,
circles, checkerboard, or stripes. The individual elements,
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herein called dots, may be equally displaced to either high or
low luminance levels and may be distinguished from an
intermediate luminance background otherwise filling the
stimulus area.
[0275] The starting phase of the dynamic contrast test 1300
may initiate movement of a high color/contrast patch on a
stimulus area 199. An equal number of darker dots 1304 and
lighter dots 1306 may be presented within the background
stimulus area 1308, which may be surrounded by the high or low
relative luminance border 1302. The darker dots 1304 and
lighter dots 1306 may be randomly assigned in a wide or narrow
range of sizes, thereby assessing spatial frequency dependence
distributed randomly, as white noise, pink noise, or other
spatial frequency distributions formed by dots displayed on
the screen. A high color/contrast/spatial frequency patch,
which may be an active stimulus target segment 1310, which may
move within the stimulus area 199. The active target segment
1310, which may be a twenty-five degrees section, that may be
manipulated to make the target segment larger or smaller,
within the annular/circular/linear stimulus area 1302, may
contain a number of relatively higher contrast level darker
and/or lighter dots 1312 with the remainder of the stimulus
area containing and relatively lower contrast level darker or
lighter dots 1314.
[0276] The higher contrast target dots segment of the
stimulus area 1304 may vary in contrast relative to the lower
contrast non-target remainder of the stimulus area and the
position of the higher lighter-contrast dots 1306 fade in and
may vary in position within the stimulus area. In addition,
the overall luminance of the stimulus area, and the non-
stimulus area sections of the display screen, may vary
separately 1308. The stimulus area's dots may be displayed
with randomly assigned life time periods that are chosen
within a range of time intervals creating a continually
changing pattern of dots. A test developer, implementing
modifications of test parameters 190 may pre-set the overall
luminance brightness level of the neutral-contrast background
stimulus area 1308, the number of higher-contrast dots 1304
and lower-contrast dots 1306 within the circular border 1302,
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and the relative color of the of the neutral or intermediate-
contrast background stimulus area 1308 relative to the color
of the higher and lower-contrast dots 1304 1306, and the
maximum size of the higher-contrast target dot area 1304 and
lower-contrast non-target dot area 1306.
[0277] A stimulus generator 450 supplies an algorithm that
may be applied to relatively higher contrast level target dots
1312 and relatively lower contrast level non-target dots 1314
within the active stimulus target segment 1310, which may make
the relatively higher contrast level dots 1312 achieve greater
perceptual salience compared to the dots in the lower or
neutral-contrast non-target stimulus area or non-stimulus area
background 1308 1314 1308.
[02781 The developer 190 may pre-set settings for the
active stimulus target segment 1310, the brightness level of
the overall stimulus area segment 1310, the number of
relatively higher contrast level target dots 1312 and
relatively lower contrast level non-target dots 1314 within
the active stimulus target segment 1310, the relative color of
the of the active stimulus target segment 1310 relative to the
color of relatively higher contrast level target dots 1312 and
relatively lower contrast level non-target dots 1314, and the
maximum diameter of the relatively higher contrast level
target dots 1312 and relatively lower contrast level non-
target dots 1314.
[0279] During the starting phase of the dynamic contrast
test 1300, the active stimulus radial segment 1310 may
generate the highest contrast level for either, or both, the
relatively higher contrast level dots 1312 and the lowest
contrast level for the relatively lower contrast level dots
1314 within the active stimulus radial segment 1310. Then, the
active stimulus target segment 1310 may begin to move
continuously, and while doing so, the active stimulus target
segment 1310 may change direction in either a clockwise or
counterclockwise direction and/or it can accelerate or
decelerate.
[0280] The subject 192 may be asked to identify and to
parallel the movement of the active stimulus radial segment
1310 using a subject manipulandum 1402 during the starting
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phase of the dynamic contrast test 1300. The subject's control
and movement of an subject manipulandum 1402 may be tracked on
the subject display 198 with a cursor 1050. The active
stimulus radial segment 1310 may be tracked with the cursor
1050 via the subject's control.
[0281] As the active stimulus target segment 1310 moves
around the neutral-contrast background stimulus area 1308, the
contrast level within the active stimulus target segment 1310
may begin to change along with the location, direction, and
speed of the active stimulus target segment 1310. As the
contrast level of the active stimulus target segment 1310
begins to decline, the subject 192 will find it to be more
difficult to follow the movements of the active stimulus
target segment 1310. Therefore, the operator 190 may gauge an
approximate threshold for the relative contrast level of the
active stimulus target segment 1310 that the user can
decipher.
[0282] FIGURE 26 shows the intermediate phase of the
dynamic contrast module test 1320, a phase marked by a
discontinuous nature. During this discontinuous phase, the
active stimulus target segment 1310 may move about in a
discontinuous fashion, beginning with fade-out stage of a low
contrast level for the active stimulus radial segment 1310 at
a level equal to or lower than the initial contrast level of
the starting phase of the dynamic contrast test 1300.
[0283] During this fade-out period, the active stimulus
target segment 1310 may fade-out initially (becoming
progressively less perceptually salient). Subsequently, the
active stimulus target segment 1310 may fade-in (become
progressively more perceptually salient) with the relatively
higher contrast level target dots 1312 1314 within the active
stimulus target segment 1310 being recreated in contrast
conditions according to original randomization conditions;
however, the recreated relatively higher contrast level target
dots 1312 1314 are moved, via a motion herein analogous to a
jumping motion, to a new location within the neutral-contrast
background stimulus area 1308, which is filled with -contrast
dots 1304 306 and may also be surrounded by the higher or
lower contrast border 1302.
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[0284] Whenever the subject 192 moves the subject
manipulandum 402, the cursor 1050 may be moved by the subject
to track the target active stimulus target segment 1310; if
the subject 192 can successfully track the active stimulus
target segment 1310 within predetermined limits, a separate
signal, such as a bright flash and beep that may signal or may
confirm the action of the subject 192. The intermediate phase
of the dynamic contrast test 1320 may continue with further
jumps until the test subject's stimulus-response performance
190 defines a further refined threshold; subsequent restarting
of the intermediate phase of the dynamic contrast test 1320
may continue at varying levels of contrast and rates of
contrast increase and decrease, resulting in a repeat process
until that subject's perceptual threshold may be estimated.
[0285] FIGURE 27 illustrates the termination phase of the
dynamic contrast test 1322, during which the subject 192 may
no longer be able to distinguish the presence of an active
stimulus target segment 1310 within the lower or neutral
background of the stimulus area 1308. At this point, the final
movement dynamics of the subject's response manipulandum, and
the related movement of cursor 1050, may mark the critical
threshold as part of that subject's performance score, for
which the data of the threshold in used in the ensuing tests.
Immediately following the critical threshold point, the
higher-contrast dots 1304 and lower-contrast dots 1306 may
fill the entire stimulus area 1308, which may be surrounded by
the border on the display 1302.
[0286] FIGURE 28 depicts the starting phase of the visual
contrast sensitivity test 1324, which may involve the
implementation of a patch of high luminance elements 1325 onto
an active stimulus target segment 1310, which may be within a
high contrast border 1302. The patch of high luminance
elements 1325 may include, but are not limited, to being
circles, checkerboard, or stripes. The individual elements may
be distinguished from intermediate luminance background
elements to vary saliency. The subject 192 controls the
position and movement of a cursor 1050 to match that of the
target.
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[0287] During the starting phase of the visual contrast
sensitivity test 1324, high luminance elements 1325 may be
distinguished from the darker-contrast dots 1304 and lighter-
contrast dots 1306 that may be randomly assigned in the
neutral-contrast background stimulus area 1308.
[02881 FIGURE 29 depicts the intermediate phase of the
visual contrast sensitivity test 1326. The high luminance
elements 1325 may be automatically transitioned to becoming
low luminance, thereby becoming low luminance elements 1327,
during the intermediate phase of the visual contrast
sensitivity test 1325. The transition to becoming low
luminance elements 1327 may enable the subject 192 to
determine the threshold.
[0289] FIGURE 30 illustrates the termination phase of the
visual contrast sensitivity test 1328, during which the
subject 192 may be presented with both a mixed luminance
elements, comprising both high luminance elements 1325 and low
luminance elements 1327, within the active stimulus radial
segment 1310. During the process of the stimulus radial
segment 1310 gradually presenting a mixed luminance, the
subject 192 may be cued to determine the threshold to achieve
an equal number of high luminance elements 1325 and low
luminance elements 1327 within the active stimulus radial
segment 1310. At the point when the subject 192 may determine
an equal number of high luminance elements 1325 and low
luminance elements 1327, the final location of the cursor 1050
may mark the critical threshold, for which the data of the
threshold in used in the ensuing tests.
[0290] FIGURE 31 depicts the initiation of the visual form
discrimination test, during which patches of regular shapes
may be distorted to distinguish target area shapes from their
background. During the visual form discrimination test,
patches of regular shapes may be distorted to distinguish the
target area shapes from the background. The patches of regular
shape may be distorted in a manner including, but not limited
to, size, shape, aspect ratio, line thickness, and/or
orientation. The subject 192 may control the position and
movement of cursor 1050 to match that of the target.
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[0291] During the starting phase of the visual form
discrimination test 1330, an equal number of darker-contrast
rectangles 1332 and lighter-contrast rectangles 1334 may be
presented within a neutral-contrast background stimulus area
1308, which may be surrounded by a stimulus area border 1302.
The darker-contrast rectangles 1332 and lighter-contrast
rectangles 1334 may be randomly assigned in sizes of one unit
length width and three unit lengths height across the screen.
An active visual form module stimulus radial segment 1336,
which may be a twenty-five degrees section, larger or smaller
if being dynamically modulated, within the circular border
1302, contains a number of relatively higher contrast level
darker rectangles 1332 and relatively lower contrast level
lighter rectangles 1334.
[0292] A test developer 190 may pre-set the brightness
level of the neutral-contrast background stimulus area 1308,
the number of darker-contrast rectangles 1332 and lighter-
contrast rectangles 1334 within the circular border 1302, the
relative color of the of the neutral-contrast background
stimulus area 1308 relative to the color of the darker-
contrast rectangles 1332 and lighter-contrast rectangles 1334,
and the maximum diameter of the darker-contrast dots 1304 and
lighter-contrast dots 1306.
[0293] The darker-contrast rectangles 1332 and lighter-
contrast rectangles 1334 may fade in and out in the neutral-
contrast background stimulus area 1308 with assigned life time
periods that may chosen within a timed interval set between
thirty-six and one-hundred eight frames at seventy-two frames
per second with emergence and fading occurring over three
frames. Further, the darker-contrast rectangles 1332 and
lighter-contrast rectangles 1334 may fade in and out in the
neutral-contrast background stimulus area 1308 while moving to
random new positions.
[0294] The subject 192 may be asked to identify the active
visual form module stimulus target segment 1336 using a
manipulandum 402, during the starting phase of the visual form
discrimination test 1330. The subject's control and movement
of a subject manipulandum 402 may be tracked on the subject
display 198 with a cursor 1050. The active visual form module
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stimulus radial segment 1336 may be tracked with the cursor
1050 via the subject's control.
[0295] FIGURE 32 displays the intermediate phase of the
visual form discrimination test 1340, a phase marked by a
discontinuous nature. During this discontinuous phase, the
rectangular elements within the active visual form module
stimulus radial segment 1336 may vary in size, shape, and
orientation while the active visual form module stimulus
radial segment 1336 moves continuously around the circular
border 1302 with varying levels of distinctiveness. More
particularly, the active visual form module stimulus radial
segment 1336 may move continuously around the circular border
1302 while accelerating or decelerating and/or moving
clockwise or counterclockwise; furthermore, the rectangular
elements within the active visual form module stimulus radial
segment 1336 may change direction of movement from clockwise
to counterclockwise or vice-a-versa.
[0296] The subject 192 may be asked to match the movement
of the active visual form module stimulus target segment 1336
using a cursor 1050, which a may be physical interface akin to
a wheel or a joystick, during the intermediate phase of the
visual form module test 1340. Subsequently, the active visual
form module stimulus target segment 1336 fades-in with the
relatively higher contrast level darker or lighter than
background rectangles 1332 1334 within the active visual form
module stimulus target segment 1336 being recreated in
contrast conditions according to original randomization
conditions; however, the re-created relatively higher contrast
rectangles 1332 1334 may be moved, via a motion herein
analogous to either a drifting or jumping motion, to a new
location within the neutral-contrast background stimulus area
1308.
[0297] Whenever the subject 192 moves the cursor 1050 into
the target active stimulus segment 1310, an instant bright
flash and beep may signal and may confirm the action of the
subject 192. The intermediate phase of the visual form module
test 1340 may continue with further jumps until the operator
190 develops a further refined threshold; subsequent
restarting of the intermediate phase of the intermediate phase
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of the visual form module test 1340 may continue at varying
levels of contrast and rates of contrast increase, resulting
in a repeat process until an ensuing threshold is attained.
[0298] FIGURE 33 illustrates the termination phase of the
dynamic contrast discrimination test 1348, during which the
subject 192 may no longer distinguish the presence of the
active visual form module stimulus radial segment 1336 within
the neutral-contrast background stimulus area 1308. Hence, the
darker high contrast 1332 and lighter high contrast rectangles
1334 may be distributed throughout the entire the neutral-
contrast background stimulus area 1308, which may be
surrounded by the border 1302. At this point, the final
location and movement of the subject's response manipulandum
and the related location and movement of the cursor 1050 may
mark the critical threshold, for which the data of the
threshold may be used in the ensuing tests.
[0299] FIGURE 34 depicts the initiation of the visual
motion discrimination test, during which spots move in a
planar, radial or circular pattern or create a motion defined
edge or a point. The subject 192 may control the position and
movement of a cursor 1050 to match of the target. During the
visual motion discrimination test, the salience of the target
may be decreased by shifting more elements to random motion
with fewer elements moving in compliance with the pattern of
movement.
[0300] The starting phase of the visual motion
discrimination test 1350 may include segmental presentations
of a radial center of motion in optic flow. An equal number of
darker high contrast dots 1304 and lighter high-contrast dots
1306 may be presented within a neutral-contrast stimulus area
1308, which may be surrounded by a border 1302. The perceptual
salience of the motion pattern may be manipulated by a variety
of stimulus parameters. For example, The contrast levels for
the darker high-contrast dots 1304 and lighter high-contrast
dots 1306 may be set two confidence intervals above the
threshold established in the starting phase of the dynamic
contrast test 1300. The darker high-contrast dots 1304 and
lighter high-contrast dots 1306 may move in an outward radial
pattern 1354 by moving away from a focus of expansion 1352,
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which may be a designated point within the stimulus area 1302
or toward a focus of contraction which may be a designated
point within the stimulus area. Alternatively, as detailed
below, the perceptual salience of a motion pattern stimulus
may be manipulated by replacing moving elements in the pattern
with randomly placed elements or elements moving independently
of the pattern.
[0301] More particularly, the focus of expansion, or the
focus of contraction 1352 may be located anywhere within the
stimulus area; however, the eccentricity of the focus of
expansion or contraction 1352 may be pre-set. Further, the
darker high-contrast dots 1304 and lighter high-contrast dots
1306 may be randomly assigned in size in the range of three
degrees or smaller, thereby maintaining a pink noise spatial
frequency composition of dots across the screen. Moreover, the
control variables may include background brightness neutral-
contrast background stimulus area 1308 and dot density, color,
spatial frequency, and speed of the darker-contrast dots 1304
and lighter-contrast dots 1306. The ratio of dots that may be
moving in the pattern to the number of total dots may be known
as the coherence ratio. Of note, the ratio may be full
coherence, with a ratio of one to one (all dots move in the
pattern), or no coherence (all dots move randomly), with a
ratio of zero to one.
[0302] The darker-contrast dots 1304 and lighter-contrast
dots 1306 may fade and emerge with a random lifespan between
thirty-six and seventy-two frames with three frames for
emergence and three frames for fading. The speed of the
darker-contrast dots 1304 and lighter-contrast dots 1306 may
be a sin' function of the angular distance from the focus of
expansion 1352 the product of which may be algorithmically
manipulated a assess subject sensitivity to direction and
speed gradients within the pattern. The starting phase of the
visual motion discrimination test 1350 may begin with full
coherence where the subject 192 can all points moving in an
outward radial pattern 1354 away from the singular point known
as the focus of expansion 1352.
[0303] FIGURE 35 shows the intermediate phase of the visual
motion discrimination test 1360, a phase during which the
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focus of expansion 1352 may move with varying movements of
coherence, location, direction, and speed. The darker-contrast
dots 1304 and lighter-contrast dots 1306 may move in an
outward radial pattern 1354 or in a random fashion 1356 from a
frame to another frame. The subject's cursor may be identified
as a twenty-five-degree cursor segment, that may be modulated
from higher to lower sizes. The subject 192 may move the
manipulandum so that the cursor moves 1050 to the focus of
expansion or contraction 1352.
[0304] When the subject 192 moves the cursor 1050 to enter
the twenty-give degree segment, then the intermediate phase of
the visual motion discrimination test 1360 may produce a
bright flash and beep of may transition directly to the next
stimulus or task. Starting with a high level of coherence
(high SNR), the focus of expansion 1352 may move in a
discontinuous fashion, jumping motion around the stimulus area
1302 with potential changes in coherence with each fade and
emergence sequence; with each such jump, the coherence level
increases (gets easier) if the subject shows poor performance
and decreases (gets harder) if the subject shows good
performance.
[0305] FIGURE 36 illustrates the termination phase of the
visual motion discrimination test 1370, during which the
subject 192 may no longer distinguish the location of the
focus of expansion or contraction 1352. Hence, the darker-
contrast dots 1304 and lighter-contrast dots 1306 may fill the
entire the neutral-contrast background stimulus area 1308,
which may be surrounded by the circular border 1302. At this
point, the final location of the cursor 1050 may mark the
critical threshold, for which the data of the threshold in
used in the ensuing tests. Ultimately, this threshold may be
achieved by successively constraining the starting coherence
and the rate of increase.
[0306] With reference to FIGURES 34, 35, and 36, may
include, but is not limited to, presentations of a radial
center of motion in optic flow, which may include the focus of
expansion 1352 or contraction in the stimulus area 199.
comparable stimulus sets may be composed of planar or circular
patterns of movement, wherein the subject 192 may orient a
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cursor 1050, which may include, but is not limited to, any of
the previously described and illustrated subject interface
response devices. Depending on the stimulus set and the
behavioral task, the subject is to move the cursor in the
direction of motion or to a motion define point or edge.
Further, equivalents of the present subject matter may present
a circular pattern of motion with the center of rotation
moving around the stimulus area 199 just as the focus of
expansion 1352 may move around in a radial optic flow field.
Further, the circular and radial stimuli may be summed to
create a spiral in which the center of the spiral may move
around the stimulus area 199.
[0307] FIGURE 37 depicts the superposition of form and
motion tests, herein called the spatial distractor tasks test,
to assess the combination of visual motion and visual form.
The subject 192 may control the position and movement of
cursor 1050 to match that of the target, while form, motion,
or other basic stimuli are combined with brief visual or
auditory distracters to interfere with the task.
[0308] The starting phase of the spatial distractor tasks
test 1380 may include the superimposed darker-contrast
rectangles 1332 and lighter-contrast rectangles 1334 from the
starting phase of the visual form discrimination test 1330 in
FIGURE 31 together with relatively higher contrast level
darker dots 1312 and relatively lower contrast level lighter
dots 1314 within the active stimulus radial segment 1310 from
the starting phase of the dynamic contrast test 1300 in FIGURE
25.
[0309] The number of darker-contrast rectangles 1332 and
lighter-contrast rectangles 1334 in the starting phase of the
spatial distractor tasks test 1380 may be fewer or more than
the number of the equivalent elements of the starting phase of
the other tests 1330. The number of relatively higher contrast
level darker dots 1312 and relatively higher contrast level
lighter dots 1314 within the active stimulus radial segment
1310 may be fewer or more than the number of the equivalent
structures of in the starting phase of the dynamic contrast
test 1300. Hence, both patterns may be shown with higher or
lower cue element density than previously with the starting
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phase of other tests 1330 or, for another example, the
starting dynamic contrast of the test 1300. This apportionment
of cue elements may depend on the subject's performance on
other tests or on other factors relevant to that subject's
assessment.
[0310] Additionally, the darker rectangles 1332 and lighter
rectangles 1334 in the starting phase of the spatial
distractor tasks test 1380 have distinction levels set between
the previously established threshold for distinctiveness, for
example, as derived from the termination phase of the dynamic
contrast discrimination test 1348 of FIGURE 33. As described
in great detail in the detailed description of the starting
phase of the visual form discrimination test 1330, the darker
rectangles 1332 and lighter rectangles 1334 may fade in and
out in the neutral background stimulus area 1308 while moving
to random new positions.
[0311] Additionally, relatively darker dots 1312 and
relatively lighter dots 1314 within the active stimulus radial
segment 1310 in the starting phase of the spatial distractor
tasks test 1380 have contrast levels set between two
confidence intervals below and above the established threshold
for coherence from the termination phase of the dynamic
contrast test 1322 in FIGURE 27. It should be noted, that
wherein this disclosure makes specific reference to
performance of a dynamic contrast test, further embodiments
may likewise perform a visual saliency test in a manner as
described. It should be further noted, that wherein this
disclosure, specific references are made to determination of
contrast threshold, further embodiments of the present
disclosure may employ the methodology to also determine
additional coherence thresholds without departing from the
scope of the present disclosure. Furthermore, these coherence
thresholds may be employed in a similar manner. For example,
some embodiments of the present disclosure may be configured
to determine one or more coherence thresholds for various
visual factors, including but not limited to, a brightness
competency threshold, a contrast competency threshold, a
background luminance competency threshold, and a frequency
composition competency threshold. As described in great detail
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in the detailed description of the starting phase of the
visual form discrimination test 1330, relatively higher
contrast level darker dots 1312 and relatively lower contrast
level lighter dots 1314 within the active stimulus radial
segment 1310 may fade in and out in the neutral-contrast
background stimulus area 1308 with randomly assigned life time
periods that are chosen within a timed interval.
[0312] Further, the active stimulus radial segment 1310 may
undergo the same sequence of settings and conditions outlined
by the algorithm of the stimulus generator 450 as described in
great detail in the starting phase of the visual form
discrimination test 1330. Meanwhile, auditory, tactile, or
visual distracters or other basic stimuli may interfere with
the task, which may be associated with dual task interference.
Further, dual task interference may require the subject to
align one target area on top of another target area. Further,
the subject may need to utilize two functions of its brain,
which may cause interference amongst those brain functions.
[0313] FIGURE 38 illustrates the intermediate phase of the
spatial distractor tasks test 1390, a phase during which the
focus of expansion 1352 moves with varying movements of motion
coherence, location, direction, and speed outlined by the
detailed description of the intermediate phase of the visual
motion discrimination test 1360 in FIGURE 35. The variations
with the focus of expansion 1352 may be superimposed with
active stimulus radial segment 1310 described in detail in the
starting phase of the spatial distractor tasks test 1380 of
FIGURE 37. This superimposition of tasks may test the
subject's cognitive processing ability while the subject 192
must utilize two functions of its brain, wherein the functions
may interfere with each other.
[0314] In order to ensure that the subject 192 understands
the complexity of the superimposed test iteration present in
the intermediate phase of the spatial distractor tasks test
1390, the first continuous movement may be performed at two
confidence intervals above the threshold established in
termination phase of the dynamic contrast module test 1322 and
two confidence intervals below the threshold established in
the termination phase of the dynamic contrast discrimination
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test 1348. Subsequently, the continuous movement may be
performed at two confidence intervals above the threshold
established in termination phase of the dynamic contrast
module test 1322 and two confidence intervals below the
threshold established in the termination phase of the dynamic
contrast discrimination test 1348.
[0315] The subject's control and movement of a subject
manipulandum 402 may be implemented to track to the form
target and the motion target onto the subject display 198 with
the use of a cursor 1050. The form target and the motion
target locations may be separated by a predetermined
separation distance within the range of one-hundred fifty
degrees and two-hundred ten degrees.
[0316] The subject 192 may use the cursor 1050 to track a
form target, which includes the form changes of the darker-
contrast rectangles 1332 and lighter-contrast rectangles 1334.
The subject 192 may use the cursor 1050 to track motion of
motion target, which includes the relatively higher contrast
level darker dots 1312 and relatively lower contrast level
lighter dots 1314. Further, the cursor 1050 may also be
implemented to track the motion and to track the form in the
respective tests of FIGURES 39, 40, and 41 as outlined in
greater detail in the accompanying descriptions of those
respective figures.
[0317] After a pre-selected or contextually derived time
limit, the two stimuli of motion and form shift places in the
paradigm and the subject 192 may be instructed to shift tasks.
[0318] FIGURE 39 represents the left-up form target and
right-up motion target of the visual motion and visual form
attention test 1400. Both the patterns of darker-contrast
rectangles 1332 and lighter-contrast rectangles 1334 and
relatively higher contrast level darker dots 1312 and
relatively lower contrast level lighter dots 1314 within the
active stimulus radial segment 1310 may be superimposed during
phase 1400.
[0319] FIGURE 40 displays the left-up form, low-distinct
target and right-up motion, high-coherence target of the
visual motion and visual form attention test 1410. Both the
patterns of darker-contrast rectangles 1332 and lighter-
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contrast rectangles 1334 and relatively higher contrast level
darker dots 1312 and relatively lower contrast level lighter
dots 1314 within the active stimulus radial segment 1310 may
be superimposed during the phase of the left-up form, low-
distinct target and right-up motion, high-coherence target of
the visual motion and visual form attention test 1410.
[0320] FIGURE 41 shows the left-up form, high-distinct
target and right-up motion, low-coherence target of the visual
motion and visual form attention test 1420. Both the patterns
of darker-contrast rectangles 1332 and lighter-contrast
rectangles 1334 and relatively higher contrast level darker
dots 1312 and relatively lower contrast level lighter dots
1314 within the active stimulus radial segment 1310 may be
superimposed during the phase of the left-up form, high-
distinct target and right-up motion, low-coherence target of
the visual motion and visual form attention test 1420.
[0321] FIGURE 42 portrays the left-up form, high-distinct
target and right-up motion, high-coherence target of the
visual motion and visual form attention test 1430. Both the
patterns of darker-contrast rectangles 1332 and lighter-
contrast rectangles 1334 and relatively higher contrast level
darker dots 1312 and relatively lower contrast level lighter
dots 1314 within the active stimulus radial segment 1310 may
be superimposed during the phase of the left-up form, high-
distinct target and right-up motion, high-coherence target of
the visual motion and visual form attention test 1330.
[0322] Further, the spatial distractor tasks testing of the
subject matter regarding FIGURES 37, 38, 39, 40, 41, and 42,
may be added to any test of the present disclosure. The radial
optic flow stimulus may be the substrate for the spatial
distractor tasks testing; however any other functional
assessment test may be associated with the stimulus for the
substrate of the spatial distractor tasks testing. The present
disclosure describes a subject 192 that is performing a
spatial discrimination task and may position the cursor 1050,
which may be any of the previously described or illustrated
subject interface responses devices , at the location on the
stimulus area 199 where the subject 192 sees a high saliency
wedge within the stimulus area 199. The present disclosure may
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superimpose the intermittent addition of an alternative, high
saliency cue somewhere else, such that the subject 192 may
transiently shift attention to that distractor so that the
distractor is not task relevant and also not to degrade the
target following in the main task. The distractor may include,
but is not limited to, a wedge of unique stimulus elements
flashing for one to three seconds at a position far from the
target wedge, an area of unique elements flashing on for one
to three seconds at a position far from the target edge, or
the transient displacement of the cursor 1050 to some place
other than that specified by the subject 192.
[0323] Further, the spatial distractor tasks testing of the
subject matter regarding FIGURES 37, 38, 39, 40, 41, and 42,
may be associated with spatial memory testing, in which the
spatial memory of a subject 192 may be used to augment the
subject's response sensitivity in any of the main tasks, which
may include, but it not limited to, form, motion, and words.
In these main tasks, the target wedge may transiently flash to
some high saliency cue, which may include, but it not limited
to one hundred percent saliency of the target cue, or all
white, or all black, and then may revert to its near threshold
saliency and makes a stereotyped movement or selected number
of movements. After repeated exposures, the subject 192 may
implicitly, that is without being told, acquire knowledge of
the flashes' meaning. The subject 192 may use that information
to enhance the ability to follow the target stimulus through
that spatial sequence; for instance, the subject 192 may
further use movement as a stimulus for learning a sequence of
movements. Further, spatial memory testing may include, but is
not limited to sequence memory or location memory. Further,
spatial memory testing may be a combination of testing
associated with sequence memory and location memory.
[0324] FIGURE 43 displays the starting phase of the word
identification latency module 1440, during which equal numbers
of alternating black-colored letter sets 1442 and white-
colored letter sets 1444 may be presented in a fixed sequence
around the edge of circular, stimulus area 1446. The three
letters words may be distributed in the background, which may
comprise a cluster of other three letter sets and also a real
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word that defines a target. Further, a word may be associated
with correct letters that may be imbedded in a stimulus ring
with three letter figures made of non-letters.
[0325] The three letters for the alternating black-colored
letter sets 1442 and white-colored letter sets 1444 may fall
into the following categories of: 1) target word, 2) legal-
non-words, 3) illegal non-words, 4) flipped illegal non-words,
and 5) flipped and rotated non-word. The three letters may be
in different orientations or may utilize false fonts as
further outlined in FIGURES 44, 45, and 46.
[0326] Font, size, and position of the black-colored letter
sets 1442 and white-colored letter sets 1444 may be determined
by the pre-sets from the starting phase of the visual motion
discrimination test 1350 and the starting phase of the visual
form discrimination test 1330. The contrast of the letters may
be set at being two confidence intervals above the subject's
contrast threshold obtained in the termination phase of the
visual motion discrimination test 1370.
[0327] Herein, the words vs non-words task may be made more
difficult in a variety of ways including. Difficulty variety
may include, but not be limited to: 1) the superimposition of
random dots on the entire stimulus area with greater numbers
or sizes of dots increasing task difficulty, 2) the varying
the relative position of letters in the words and non-word
foils so as to crowd or separate, tilt, or misalign the
letters, with greater such effects or combinations of effects
increasing task difficulty, and/or 3) the selection of legal
non-word foils (e.g., having the regular consonant-vowel-
consonant structure of words) versus illegal non-words (e.g.,
consonant-consonant-consonant structure not seen in words),
wherein the legally structured non-words may be more difficult
to reject as candidate target words than illegally structured
non-words.
[0328] FIGURE 44 shows normal letters orientation 1450,
which may be applied towards the three letters that were
described previously in the starting phase of the letter
identification latency module 1440 of FIGURE 43.
[0329] FIGURE 45 shows mirror rotated letters orientation
1454, which may be applied towards the three letters that were
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described previously in the starting phase of the letter
identification latency module 1440 of FIGURE 43.
[0330] FIGURE 46 shows inverted letters orientation 1458,
which may be applied towards the three letters that were
described previously in the starting phase of the letter
identification latency module 1440 of FIGURE 43.
[0331] FIGURE 47 shows the intermediate phase of the letter
identification latency module 1460, during which the three
letters of the black-colored letter sets 1442 and white-
colored letter sets 1444, which may be within the circular
stimulus area 1446, may be partially obscured to reduce their
saliency and to establish the cursor tracking response
function. During the start of the test paradigm of the
intermediate phase of the letter identification latency module
1460, the subject 192 may be presented with the highest level
of letter continuity. A plurality of the item stimulus may set
drift around the stimulus area 199, which may be a ring, in
unison. The subject 192 may move the cursor 1050 to the real
word and follow it for a predetermined time period or a
predetermined extent as angular degrees of drift. The score
may be derived from the time it takes the subject 192 to
register the location of the real word that may be captured
and tracked.
[0332] Subsequently, word continuity may be continually and
algorithmically disrupted by the superimposition of background
color line segments that occlude a set percentage of the
length of the line segments forming the characters in the
display. The subject 192 may be asked to follow the letter
sets using the cursor 1050 during the continuous movement of
the letter sets around the around the edge of circular
stimulus area 1446.
[0333] The letter sets in the array may drift in unison
around the display circle or may emerge and fade to take-up
new positions on the screen with a full field random cycle
length in a settable range, which may be typically thirty six
to one-hundred eight frames at seventy-two hertz with
emergence and fading each occurring over three frames. The
position and continuity of the letter sets may be subjected to
the algorithmic control of the stimulus generator 450. Each
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position shift may trigger the transition of all character
sets to other specific example of each set type in the
corresponding relative positions.
[0334] In an alternate embodiment of the intermediate phase
of the letter identification latency module 1460, a word may
be made of correct letters imbedded within the stimulus area
199, which may be a ring, with other similar length, correct
letter, non-words. All of the three-letter items may drift
around the ring in unison. The subject 192 may move the cursor
1050 to the real word and follow it for a predetermined time
period or a predetermined angular degrees of drift. The score
may be derived from the time it takes the subject 192 to
register the location of the real word that may be captured
and tracked.
[0335] In yet another embodiment of the intermediate phase
of the letter identification latency module 1460, correct
letter words may be imbedded in the stimulus area 199, which
may be a ring, with other similar length, correct letter, non-
words. All of the three-letter items my drift around the ring
in unison. The content of the ring, which may refer to its
real words and non-words, my change regularly as the content
drifts so there is always a wedge, which may be a ring
segment, containing real words and the remainder of the ring
contains non-words. Further, as the subject 192 moves the
cursor 1050 to the real word and follows it for some
predetermined time period or a predetermined angular degrees
of drift, the saliency of all of the letters of the words and
non-words may be slowly decreased. The saliency may be
decreased either by crossing-out parts of all of the letters
with a background colored set of thin lines, or by rotating
the individual letters, or by covering the ring with
flickering letter-colored dots. The subject 192 may continue
to find the real words as algorithmic adjusting of the
saliency determines that subject's threshold saliency. The
score is derived from the saliency level as described for the
other tests of the present disclosure.
[0336] FIGURE 48 shows the termination phase of the letter
identification latency module 1470, during which an
approximate threshold may be defined. There remains continuous
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movement of the target character set and subject tracking
during continuous varying of the continuity and exchange of
all character sets across cycles towards the end of
intermediate phase of the letter identification latency module
1460.
[0337] Later, during the termination phase of the letter
identification latency module 1470, while in discontinuous
movement, the target segment may fade to the background
parameters and then may emerge at a new location where it may
undergo increasing continuity until the subject's cursor may
enter the target segment area. Immediately thereafter, there
may be an instantaneous bright flash and beep. Subsequent
iterations of this trial may yield a refined threshold.
[03381 FIGURE 49 illustrates the starting phase of the
verbal memory module 1480. This test paradigm may present a
series of words 1482 in a list to be memorized. The sample
consists of a series of words 1482 that may be arranged around
the edge of the stimulus area 199 and headed by the label
"Words might be" 1484. The sample words are positioned at
selected locations with selected light and dark luminance.
During the starting phase of the verbal memory module 1480,
the subject 192 may be presented a predetermined series of
short words, each with a predetermined number of letters in a
set sequence.
[0339] FIGURE 50 displays the intermediate phase of the
verbal memory module 1490. The subject 192 may track the
target word in the series of words 1482, starting form low
saliency and successively becoming more salient, via the
presentation of sample and match across contrast stimuli 1492.
A particular word in a series of words 1482 may be presented
one-at-a-time along with words not on the list. In other
words, in this series of stimuli, the word target may be
either sample words or not.
[0340] During the intermediate phase of the verbal memory
module 1490, the subject 192 may be first shown a series of
ten high contrast black or white words for a pre-set
adjustable time period, which may be for five seconds. The
subject 192 may then be shown a series of the same type of
stimuli that may have been used in the starting phase of the
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letter identification latency module 1440 as was shown in
FIGURE 43. The presentation of sample and match across
contrast stimuli 1492, which may be implemented in the
intermediate phase of the verbal memory module 1490, may be
the same fade-jump-emerge contrast modulation sequence that
may have been used in the intermediate phase of the letter
identification latency module 1460.
[0341] In an alternate embodiment of the intermediate phase
of the verbal memory module 1490, the target word from a
predetermined ordered list may be presented at very low
saliency after each presentation of a predetermined series of
short words. That target word from a predetermined ordered
list may drift around the stimulus ring imbedded in with other
drifting three-letter sets that are not words. While the
subject 192 remains off target, the saliency of the word and
the three letter non-words may slowly increase until the word
is recognizable as the only word on the screen. The subject
192 may move the cursor 1050, which may be any of the direct
or remote contact subject interface response devices, to the
target word and follow it for some predetermined time period
or a predetermined degrees of angular movement to register
correct acquisition. When the subject 192 has correctly
identified the target word, the score for that trial is
recorded as the current saliency level. Then, the next word
from the list may be imbedded in a new set of three letter
non-words at very low saliency and the task continues. The
cycle of first viewing the list presentation of these
predetermined list of words and then testing on finding the
words at the lowest saliency possible may be repeated three
times. Scoring of the test may include the number of words
correctly acquired, the saliency level at which they were
acquired, and the slope of the average saliency levels across
the three repetitions of the task.
[0342] In yet another embodiment of the intermediate phase
of the verbal memory module 1490, only one target word may be
implemented. In this exemplary embodiment, after the saliency
score is calculated, the number of target words may be slowly
increased to repeatedly derive that subject's saliency
threshold as the word list length increases. If one knows the
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word one is looking for, then it may be relatively easy to
find it; however, the degree of difficulty may increase with
an increase in the number of words. Each subject 192 may have
a function of saliency versus list length and that may be a
measure of verbal memory's ability to enhance word
recognition.
[0343] An alternate embodiment of the intermediate phase of
the verbal memory module 1490, may include, but is not limited
to, a ring with only correct letter words. As the subject 192
correctly follows the initially single word around the ring,
another word will be added and the subject 192 may shift to
following the new word. Throughout the test, new words may be
added and may be monitored for how long it takes the subject
192 to identify and shift to the new word most recently added
to the subject display 198. Scoring may be accomplished by
measuring the new word identification latency, as a function
of the total number of words in the display during that
response.
[0344] The responses to the stimuli from the intermediate
phase of the verbal memory module 1490 may be used to
establish response dynamics in the stimulus contrast domain
and the kinematics domain. During the intermediate phase of
the verbal memory module 1490, the target orientation may be
placed towards the left or towards the right of the stimulus
area 199, and may be either high, moderate, or low contrast.
FIGURES 51, 52, and 53 show the various placement
configurations and contrast conditions that may be implemented
during the intermediate phase of the verbal memory module
1490.
[0345] With reference to FIGURES 51, 52, and 53, equal
numbers of alternating black-colored symbol sets 1502 and
white-colored symbol sets 1504 may be presented in a fixed
sequence around the edge of circular stimulus area 1446. The
three letters symbol sets may be distributed in the background
that may comprise a cluster of other three letter symbol sets
and also a real word that defines the target.
[0346] The three symbols for the alternating black-colored
symbol sets 1502 and white-colored symbol sets 1504 may
include, but are not limited to, symbols, target words, legal-
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non-words, illegal non-words, flipped illegal non-words,
flipped and rotated non-words. Further, the three letters
symbol sets may be in any orientation. Further, the font,
size, and position of the black-colored symbol sets 1502 and
white-colored letter symbol sets 1504 may be determined by the
pre-sets from the starting phase of the visual motion
discrimination test 1350 and the starting phase of the visual
form discrimination test 1330. The contrast of the black-
colored symbol sets 1502 and white-colored letter symbol sets
1504 may be set at being two confidence intervals above the
subject's contrast threshold obtained in the termination phase
of the visual motion discrimination test 1370.
[0347] More particularly, FIGURE 51 illustrates the left-up
target orientation with black-colored symbol sets 1502 and
white-colored symbol sets 1504 in high contrast. FIGURE 52
shows the right-up target orientation with black-colored
symbol sets 1502 and white-colored symbol sets 1504 in
moderate contrast. FIGURE 53 displays the right-down target
orientation with black-colored symbol sets 1502 and white-
colored symbol sets 1504 in low contrast.
[0348] With reference to FIGURES 54, 55, and 56, facial
emotion sensitivity tests may be presented to the subject 192.
More particularly, FIGURE 54 shows a low difficulty facial
emotion sensitivity test 1530, FIGURE 55 shows a moderate
difficulty facial emotion sensitivity test 1540, and FIGURE 56
shows a high difficulty facial emotion sensitivity test 1550,
for any of which a display of faces 1532 may be presented to
the subject 192. A plurality of faces, may be all of the same
person or may be a pseudo-person composite of other faces.
[0349] Subsequently, the affective emotion may be
modulated, such as from grimace or frown to a wide-eyed or
smile emotion. There may be a gradient of emotion expressions
distributed across the faces, from happy faces at one point to
sad faces one hundred eighty degrees from that point. The
subject 192 may locate and may track the happiest face or the
saddest face. The subject 192 may be asked to use the subject
manipulandum 1402 to point to the happier faces as the
differences between the happier and sadder faces may be
narrowed with good performance or widened with poor
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performance. The subject 192 may demonstrate a minimal
difference in affective expression required for their
identifying the most positive or happy expression. The subject
192 may use the rotatory manipulandum 414 to rotate and to
align the cursor 1050 to the happiest face 1538 as the range
from sad to happy is increased, thereby making task easier, or
decreased, thereby making task harder. The subject 192 may
rotate the rotatory manipulandum 414 in a clockwise rotation
1534 or in a counterclockwise rotation 1536.
[0350] The algorithm associated with the present disclosure
may alter the range of faces, which may be from very happy to
very sad, very calm to very anxious, very passive to very
aggressive. The algorithm associated with the present
disclosure may alter the range of faces, which may vary
continually along the aforementioned continua, i.e., from
slightly happy to slightly sad. The mid-point may be from
happy to neutral, or in an alternative embodiment may be from
neutral to sad. Further, the algorithm associated with the
present disclosure may be easy or difficult. Further, the
subject's score may be a reflection of the minimal range,
which may be of greatest difficulty, at which the subject 192
may accurately locate and track the target, i.e., happiest or
saddest or most neutral face.
[0351] The low difficulty facial emotion sensitivity test
1530, moderate difficulty facial emotion sensitivity test
1540, and high difficulty facial emotion sensitivity test 1550
differ in the level of difficulty within each test. Further,
the low difficulty facial emotion sensitivity test 1530,
moderate difficulty facial emotion sensitivity test 1540, and
high difficulty facial emotion sensitivity test 1550 may help
determine the test subject's perceptual threshold range scored
relative to a normal range derived from comparison subject
groups. Facial gender, age, and identity may be randomly
shifted during intervals of the test session. Future known
equivalents of the low difficulty facial emotion sensitivity
test 1530, moderate difficulty facial emotion sensitivity test
1540, and high difficulty facial emotion sensitivity test 1550
may use only one gender, age, etc. facial identity group or
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can use alternative target, which may include, but is not
limited to, the saddest face.
[0352] With reference to FIGURES 57, 58, and 59, facial
emotion nulling tests may be presented to the subject 192.
More particularly, FIGURE 57 shows a low difficulty facial
emotion nulling test 1570, FIGURE 58 shows a moderate
difficulty facial emotion nulling test 1580, and FIGURE 59
shows a high difficulty facial emotion nulling test 1590, for
any of which a display of a particular facial expression 1572
is presented to the subject 192.
[0353] During either the low difficulty facial emotion
nulling test 1570, moderate difficulty facial emotion nulling
test 1580, or a high difficulty facial emotion nulling test
1590, a single image of a same gender face is presented and
the system varies the affective expression of the face from a
sadder to a happier expression and vice-a-versa.
[0354] The emotional expression of the single face may be
varied as described in the low difficulty facial emotion
sensitivity test 1530, moderate difficulty facial emotion
sensitivity test 1540, and high difficulty facial emotion
sensitivity test 1550. During either the low difficulty facial
emotion nulling test 1570, moderate difficulty facial emotion
nulling test 1580, or a high difficulty facial emotion nulling
test 1590, the subject 192 may uses the subject manipulandum
402 to make the face appear neutral, which may refer to being
neither happy nor sad. The subject 192 may be asked to rotate
the rotary manipulandum 414 with counter-clockwise rotation
1534, thereby making the expression sadder with the use of the
turn to make sadder feature 1576, or with clockwise rotation,
thereby making the expression happier with the use of the turn
to make happier feature 1574.
[0355] The goal of the subject 192 may be to continue to
rotate the rotary manipulandum 414 to make the expression
neutral as the present disclosure makes sustained changes in
the affective expression of the facial display. The subject
192 may use the rotatory manipulandum 414 to morphologically
transform facial expression across the spectrum from sadder,
which may be through repeated counterclockwise rotation 1536,
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to happier, which may be through repeated clockwise rotation
1534, to keep the facial expression neutral.
[0356] The algorithm of the present disclosure may
continually shift the emotional content of the facial
expression and the subject 192 may have to change it back
toward neutral. Such a test may be associated with being a
nulling task, wherein only the parameter is changed, and the
subject 192 has to perceive the direction and magnitude of the
change and set it back to where it was. The scoring may
reflect the magnitude of change required to trigger the
subject's response, the point called neutral from happy and
the point called neutral from sad.
[0357] The low difficulty facial emotion nulling test 1570,
moderate difficulty facial emotion nulling test 1580, or a
high difficulty facial emotion nulling test 1590 each may be
sixty to one-hundred eighty seconds in duration. The system
repeatedly may drift the facial expression to a sadder or to a
happier condition as the subject 192 may try to null that
effect and may try maintain a neutral expression on the
display. The system may use an adaptive staircase protocol to
determine the smallest perturbation of facial expression that
may provoke an appropriate counter-response from the test
subject 192 as a facial expression perceptual threshold, which
may be scored relative to normal range identifiable by others
in the comparison subject group.
[0358] Facial gender, age, and identity may be randomly
shifted during intervals of the test session. Future known
equivalents of the low difficulty facial emotion nulling test
1570, moderate difficulty facial emotion nulling test 1580, or
a high difficulty facial emotion nulling test 1590 may use
only one gender, age, etc.
[0359] Further, the low difficulty facial emotion nulling
test 1570, moderate difficulty facial emotion nulling test
1580, or a high difficulty facial emotion nulling test 1590
each differ in the level of difficulty within each test.
[0360] With reference to FIGURES 60, 61, and 62, social
cues sensitivity tests may be presented to the subject 192.
More particularly, FIGURE 60 illustrates the low difficulty
social cues sensitivity test 1610, FIGURE 61 illustrates the
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moderate difficulty social cues sensitivity test 1620, and
FIGURE 62 illustrates the high difficulty social cues
sensitivity test 1630, for each of which a display of varying
aggressiveness levels 1612 may be presented to the subject.
[0361] In one embodiment, the display of varying
aggressiveness levels 1612 may show a number of whole body
images of different persons. The subject 192 may use the
rotatory manipulandum 414 to align the cursor 1050 to the
image of the person being most aggressive, herein called the
most aggressive person 1614. The subject 192 may rotate the
rotatory manipulandum 414 in a clockwise rotation 1534 or in a
counterclockwise rotation 1536 to indicate the most aggressive
person 1614 on the display of varying aggressiveness levels
1612. As the range from submissive to aggressive is increased,
thereby making the task easier, or decreased, thereby making
the task harder, the perceptual threshold of the subject 192
relative to a normal range may be characterized in comparison.
[0362] In an
alternate embodiment, a variety of different
body positional attributes may be displayed. For example, the
body positional attribute may be associated with the
most/least worried or the most/least frightened or the
most/least leadership ability or the most/least assertive. The
body positional attribute of least worried may be associated
with, but is not limited to, smiling, titled head and
shoulders, and hands at the side. The body positional
attribute of most worried may be associated with, but is not
limited to, pursed-lips, slouched head and shoulders, and
hands tightly clasped in front of the lower face. The body
positional attribute of most frightened may be associated
with, but is not limited to, eyes bulging, limbs flexed, and
jerky movements. The body positional attribute of least
frightened may be associated with, but is not limited to,
smiling, upright, and slow movements.
[0363] Person
gender, age, ethnic group, and other
identifying facial characteristics may be randomly shifted
during intervals of the test session for any or all of the low
difficulty social cues sensitivity test 1610, the moderate
difficulty social cues sensitivity test 1620, or the high
difficulty social cues sensitivity test 1630. Future known
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equivalents of any or all of the low difficulty social cues
sensitivity test 1610, the moderate difficulty social cues
sensitivity test 1620, or the high difficulty social cues
sensitivity test 1630 may use only one gender, age, etc.
postural identity group or can use alternative target
features, which may include, but is not limited to, the most
submissive person.
[0364] Further, the low difficulty social cues sensitivity
test 1610, the moderate difficulty social cues sensitivity
test 1620, or the high difficulty social cues sensitivity test
1630 may also consider the interactions between the persons
depicted in the display of varying aggressiveness levels 1612
such that the subject 192 indicates who may be the most likely
to be leader of the group. The subject 192 may change the
cursor 1050 to indicate who they see as the likely leader with
differences between target leaders' traits and those of the
person least likely to assume leadership are successively
changed.
[0365] Further, the low difficulty social cues sensitivity
test 1610, the moderate difficulty social cues sensitivity
test 1620, or the high difficulty social cues sensitivity test
1630 each differ in the level of difficulty within each test.
[0366] In an alternative embodiment of social perception
domain testing, nulling adjustments may be evaluated in the
social interactions nulling test, which may include, but is
not limited to, a full body representation of two people
standing side-by-side in an ongoing social interaction. One
person may stand on the left side and another person may stand
on the right side. One person may be a man, and the other
person may be a woman; alternatively, both persons may be of
the same sex. Further, one person may be of a particular
ethnic background; another person may be of a different ethnic
background; alternatively, both persons may be of the same
ethnic background. During social interactions nulling testing,
postures, facial expressions, and/or gestures may be
distinctive among the two people; however, the two persons may
not interact with words. The subject 192 may be instructed to
adjust the left or right person to make one more dominant and
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the algorithm will change the balance, thereby making nulling
adjustments.
[0367] With reference to FIGURES 63, 64, and 65, typical
target traces are presented, which may be, but are not limited
to, sixty seconds traces. FIGURE 63 shows an exemplary
position trace 1650. FIGURE 64 illustrates an exemplary speed
trace 1660. FIGURE 65 depicts an exemplary acceleration trace
1670.
[03681 The exemplary position trace 1650, the exemplary
speed trace 1660, and the exemplary acceleration trace 1670
may show the target location, which may be driven in a
tracking fashion by the stimulus generator 450 or in
discontinuous fashion by jumping movements. Further, the
exemplary position trace 1650, the exemplary speed trace 1660,
and the exemplary acceleration trace 1670 may show initially,
the highest signal-to-noise stimuli that may trigger the
subject capture, which may refer to the positioning near the
center of the highest signal-to-noise segment.
[0369] The exemplary tests of the present disclosure
capture may be followed by irregular tracking movements with
graded signal-to-noise fade-emerge cycles that may trigger
capture cycles. Further, the exemplary tests of the present
disclosure capture may include increasing, then decreasing,
position and velocity error. During the exemplary tests of the
present disclosure, escape, which may refer to gradually
increasing error, may trigger either: 1) fixed-position re-
emergence to trigger re-capture and then continuing movement,
or 2) full-fading, jump to a new site, and re-emergence there
until re-capture triggers new tracking movements. Further,
uniformity of the distribution of capture position may be
assisted by jumps and movement parameters may during signal-
to-noise (S/N) fading cycles that may be based on subject
error.
[0370] With reference to FIGURE 66, an exemplary 3D S/N
Gradient 1680, wherein S/N may refer to signal-to-noise
ration, is presented. The exemplary 3D S/N Gradient 1680 may
be representative of being across all stimulus domains. The
exemplary tests of the present disclosure may be implemented
to achieve a three-fold signal-to-noise gradient. More
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particularly, during the exemplary tests of the present
disclosure, from the point furthest from the target in the
stimulus area 199, there may be a gradual increase to one-
third of the current peak signal-to-noise ratio at the edges
of the target segment, which may be a thirty degrees segment.
Further, another one-third signal-to-noise ratio increase may
extend from the thirty degrees edges to a ten degrees segment
in the stimulus area 199. The exemplary tests of the present
disclosure may be structured such that the peak signal-to-
noise should extend uniformly across the ten degrees segment,
which may result in the hypothetical 3D S/N Gradient 1680.
[0371] With reference to FIGURE 67 an exemplary S/N profile
1690 with respect to vertical and horizontal positions is
presented. An exemplary S/N profile 1690 may be reflective of
subject 192 response analyses that indicate the subject 192
may accurately track to yield reliable performance across all
domains. Such reliable performance may be achieved via
following of recommendations, which may be, but is not limited
to:
The first stimulus cycles of each test of the present
disclosure may be at low motion parameters and high
signal-to-noise ratios so that the subject 192 may
understand the task.
Motor performance may be established by imposing a series
of movement acceleration-deceleration cycles or direction
reversal cycles in at least two of the four quadrants of
the hypothetical S/N profile 1690.
Subsequent cycles may include cue fading, which may
result from decreasing the signal-to-noise ratio, such
that when the cue escapes, the motion may slow in order
to see whether the subject 192 may reduce the error
distance. If the subject 192 catches-up, then the slower
speed may become the new base speed. However, if error
reduction does not occur, then the target slows down to a
stop and the signal-to-noise ratio is increased until re-
capture triggers the resumption of movement.
There may be a jump to a new position near the current
response position by slowly increasing the signal-to-
noise ratio.
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Repeated test cycles may be used to refine the impression
of the signal-to-noise threshold and fastest speed and
acceleration that the subject may accurately track to
yield reliable performance across all conditions.
[0372] FIGURE 68 shows an exemplary position error function
profile 1700, which may be a plot of error by signal-to-noise
to describe the performance of the subject 192. A graph of the
position error axis 1701 versus the signal-to-noise percentage
axis 1703 that may be present in the position error function
profile 1700. The position error maximum 1702 and the position
error minimum 1705 may be asymptotic projections, which may
capture the best and the worst performance of the subject 192.
The position error peak slope 1706 may be the mid point in the
range of plus or minus five percent of the highest slope. The
position error area 1704 under the curve of the position error
function profile 1700 may describe the overall performance of
the subject 192. Further, the position error function profile
1700 may be qualitatively grouped into profiles based on
degree of differences, such as being good, fair, and poor.
[0373] FIGURE 69 shows an exemplary sampled position error
function profile 1710, which may be a plot of the position
error axis 1701 versus the signal-to-noise percentage axis
1703, on a sampled basis. The exemplary sampled position error
function profile 1710 may be based on a threshold and a
variance measure from the tests of the present disclosure. For
instance, in the visual motion discrimination test, which is
further described in FIGURES 34, 35, and 36, the threshold is
taken to be the signal-to-noise ratio under the point on the
sampled position error function profile 1710 that is two
position error significant digits back on along the sampled
position error function profile 1710 curve. The present
disclosure may utilize the range of the signal-to-noise
covered by the two position error significant digit steps as a
variance measures. The measures that may be implemented in the
position error function profile 1700 and the sampled position
error function profile 1710 may be sensitive to best
performance, capture escape variability, and the local slope
of the position error curve.
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[0374] FIGURE 70 displays an exemplary velocity error
function profile 1720, which may be a plot of the velocity
error axis 1708 versus the signal-to-noise percentage axis
1703. The velocity error function profile 1720 may show a
representation of the difference between the stimulus and the
response velocity.
[0375] FIGURE 71 portrays the instantaneous position error
1800 of the subject 192. The subject error 1802 may be a
function of the subject position 1804, the angular error 1806,
and the target position 1808. The subject error 1802 may be an
error in the selection of the target on the stimulus area 199
by the subject 192. The subject position 1804 may be an error
in the position of the target on the stimulus area 199 by the
subject 192. The angular error 1806 may be an error in the
angular position of the target on the stimulus area 199 by the
subject 192.
[0376] FIGURE 72 shows an exemplary output for graphical
representation of the error magnitude throughout test 1850,
which may be a plot of the position error in degrees 1852
versus the time from the start of this test 808. For
illustration purposes, the exemplary output details a ten
second intervals 806. However, the system may utilize greater
or shorter time intervals. Further outputs that the system may
output include detailing the error magnitude throughout test
1850, and the presence, or lack thereof, of increasing
positional error 1854 with a higher value of time from the
start of this test 808. Further outputs, may detail decreasing
positional error 1854 with a lower value of time from the
start of this test 808.
[0377] Further, the error associated with the error
magnitude throughout test 1850 may peak at an escape event,
during which a subject 192 may lose track of the target, but
may decrease when the subject 192 re-captures the target to
successively converge on subject's typical error margin. The
error may be signed as being plus or minus one-hundred and
eighty degrees relative to the direction of target movement,
with the subject 192 being ahead or behind that movement.
[0378] FIGURE 73 depicts the stimulus obscuration over time
1950 output of the present disclosure. This output may
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illustrate the task difficulty over time. More particularly,
the graph of stimulus obscuration over time 1956 may be a
graph of percentage stimulus obscuration 1952 versus time
since start of test module in this session 1954. Further, the
time since start of test module in this session 1954 may be
represented, but is not limited to, as being five seconds
intervals.
[0379] FIGURE 74 displays an exemplary output for the
subject position error input relative to target position 1960.
The subject position error input relative to target position
1960 may be a graph of subject position error over time 1962,
which may be represented as a graph of position error in
degrees 1964 versus time since start of test module in this
session 1954. Further, the time since start of test module in
this session 1954 may be represented, but is not limited to,
as being five seconds intervals.
[0380] FIGURE 75 depicts an exemplary output of the present
disclosure for subject velocity error relative to target
velocity 1970. More particularly, the graph of subject
velocity error relative to target velocity 1972 may be
graphically represented as subject minus target as percent
maximum 1974 versus time since start of test module in this
session 1954. Further, the time since start of test module in
this session 1954 may be represented as subject minus target
as percent maximum versus but is not limited to, as being five
seconds intervals.
[0381] FIGURE 76 shows an exemplary results summary 2000
output that may be displayed by the present disclosure via a
graphical user interface. The results summary may include, but
is not limited to, a representation of the quantitative
assessment of language processing 2002, verbal memory 2004,
motion perception 2006, shape perception 2008, contrast
sensitivity 2010, and spatial attention 2012. The results
summary 2000 may determine a quantitative score and pass/fail
assessment in relation to functional impairment. More
particularly, the sensory-motor neurocognitive assessment
associated with the results summary 2000 may result in
characterization protocols that may yield response functions
relating time and saliency that may generate real-time scores
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based on: the average final saliency score over three periods,
the saliency at which the most time may be spent during
testing, and the total time that may be spent in the test.
[0382] Additional, the present disclosure may assess the
algorithmic fit for an asymptotic function against the
response function generated for each sensory-motor
neurocognitive assessment protocol. The present disclosure may
then assess performance and generate secondary measures, which
may include, but are not limited to: 1) basic measures such as
the fit parameters, asymptote and area under the curve, 2)
comparative measures as the differences between the basic
measures of a subject on a particular sensory-motor
neurocognitive assessment protocol and that subject from other
selected sensory-motor neurocognitive assessment protocols, 3)
comparative measures as the differences between the basic
measures of a subject on a test and the measures from a
selected group of comparison subjects.
[0383] Sensory-motor neurocognitive assessment measures
associated with the results summary 2000 may be derived in
real-time, or near real-time, for each test and may be
transformed as standardized scores relative to an age-based
comparison group. These standardized scores may be derived
separately for each sensory-motor neurocognitive assessment
protocol.
[0384] Sensory-motor neurocognitive assessment protocol
scores associated with the results summary 2000 may be shown
on a radial plot, grouped by cognitive relatedness sensory-
motor neurocognitive assessments. Differences between age-
normal function and a test subject's function may be colored
in particular color to indicate sub-normal function and
colored in a different color to indicate supernormal function.
Differences that may be induced by the negative impact of
invalid cues and the positive impact of valid cues may be
shown as closely related functions.
[0385] Further, the present disclosure may determine
differences between a subject's function and age-normal
function from aggregated data.
[0386] FIG. 77 is a graphical representation showing
functional impairment over time in an exemplary diagnosis
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summary 2050. Diagnosis summary 2050 may include a clinical
diagnosis and/or a recommendation medications listing. The
suggested diagnosis summary 2050 may include, but is not
limited to, a functional impairment characteristic profile
2052 and one or more suggested diagnoses of specific types of
processing impairment and likely or commonly associated
underlying pathophysiologies that include conditions,
diseases, disorders, intoxications, and other mechanisms of
brain functional impairment. Alternatively, specific links to
particular pathophysiologies may be established and would be
provided in this clinical guide. All such single device
diagnostic suggestions are to be considered in the clinical
context of testing, and particularly likely or common
contextual considerations may also be enumerated and suggested
for consideration. In addition, further diagnostic evaluations
including further testing on the current device or by other
devices or clinical maneuvers may be suggested. These
suggestions are intended to clarify the underlying conditions,
diseases, disorders, intoxications, and other mechanisms of
brain functional impairment may be suggested to assist the
individual or involved clinical practitioners in realizing a
more complete evaluation 2054. The functional impairment
characteristic profile 2052 may be shown graphically on a plot
of the rating of the functional impairment characteristic
versus the calendar time range 2056. More particularly, the
scale for the rating of the functional impairment
characteristic of the functional impairment characteristic
profile 2052 may range from normal for age 2060 to more
impaired 2062.
[0387] FIGURE 78A illustrates aspects of a system 2100
including a display 2112 having two concentric annuli 2116 in
a system for automated impairment assessment testing. It will
be understood that system 2100 including such a display 2112
including two concentric annuli 2116 may provide initiation of
an integration and interaction test 2300 (shown in FIGURE 80).
Referring to FIGURE 80, it will be understood that such an
integration and interaction test 2300 may include dual visual
stimuli (referenced as "dual stimulus" or "dual stimulus
test"). Such a dual stimulus test may include an inner
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annulus test cycle 2304, outer annulus test cycle 2308 and
combined inner annulus and outer annulus test cycle 2312. Such
an integration and interaction test 2300 may include
evaluating visuo-motor responses by analysis of the sensori-
cognito/affecto-motor function in the domains of target
movement speed, acceleration, and direction reversal.
Referring to FIGURE 78A, an exemplary test 2100 may include
presenting to the subject (not shown in FIG. 78A) a view of
two concentric annular displays, particularly an inner annular
display and an outer annular display, which may be separated
by a thin annular gap (schematized in FIG. 78A). Test 2100
facilitates the receiving and recording of inputs tracking
data, such as response wheel position data (such as reading
and storing response wheel positions 2412, as shown in FIG.
81). The subject manually rotating such a response wheel (not
shown) provides such inputs as otherwise described hereinabove
as the subject attempts to control the inner annular display
(see FIG. 78A), where the inner annular display may
correspondingly rotate about a center of the two concentric
annular displays. In some embodiments, correlation between the
rotation of the input and the rotation of the inner annular
display may be systematically deviated during test
administration as gain, speed, or offset changes. In addition
to the test input linking an inner annulus to a control
device, the environment may include an outer annular
display(see FIG. 78A) configured to rotate in accordance with
an algorithm for controlling variables such as, for example,
display characteristics, subject performance, and other
variables. In some embodiments, the test may be configured to
receive inputs from a subject attempting to align the target
in the inner annulus with that in the outer annulus and then
to maintain that alignment throughout a period of outer
annulus algorithmic display changes that rotate the location
of the target. The inner and out annuli may contain a number
of imbedded targets and foils (see FIG. 78A). As used herein,
"targets" are stimuli having some specific characteristics
that distinguish them as the goal item in an ongoing stimulus-
response task. As used herein, "foils" are stimuli that are
of that same class as the target but do not share the complete
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set of defining characteristics of the target. In addition to
target location, the device may alter which targets and foils
are presented at a given time, the target's and foil's
perceptual salience, and the subject's response
characteristics as registered through a subject interface
response device and is recorded by the system.
[0388] In
embodiments, a system may include one or more
foils. It will be understood that in methods as disclosed, one
or more foils may be displayed. In an embodiment, one or more
foils may be provided to the display, for example, from
functioning of a Foils Parameters module.
[0389] Referring to FIGURES 78A, 78B and 78C, in
embodiments the two annular stimulus areas may each display
one or more selected stimulus types from a group of identified
test domains (e.g., letters, numbers, words, symbols, shapes,
faces, motion, optic flow, kinetic edges, etc.). A test domain
selected for display in one annulus may be the same as, or
different from, a test domain to be displayed in the other
annulus. A test domain selected for display in one annulus, or
the other annulus, may be the same as, or different from,
another test domain selected for display in the one annulus,
or in the other annulus, in a previous display in a series
presented to the subject or in a previous or subsequent test
of the subject. A single target from the selected domain may
be presented in the assigned annulus (e.g., one letter for the
outer annulus and one number for the inner annulus). Multiple
foil stimuli (non-targets of the same or a different type) may
be distributed around the non-target areas of the annuli. The
foil types may be the same or different within or between the
two annuli or the same or different from those in previous or
subsequent tests. The location of foils and targets, as well
as display and response characteristics, may be continuously
varied (direction and speed of movement), varied in a discrete
manner, or varied in any suitable manner during testing, such
as, for example, by being varied continuously based on pre-set
test condition parameters and subject performance in the same
test, current test, the same test performed previously, and/or
other tests.
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[0390] A person of ordinary skill in the art will
understand that specific applications of the present
disclosure will include many variations. For the purposes of
clarity, exemplary embodiments of systems and methods for
testing described herein. It should be understood that
application of the present disclosure may utilize some or all
of the steps in exemplary embodiments. Furthermore, additional
steps may be included. The steps may be performed in order, or
alternatively in different orders. The term "sequence" as
used herein refers to presentation of a specific item or
specific items in a continuous or discontinuous sequence from
an otherwise defined set of stimuli, e.g., vowels from the set
of letters, or spoons from the set of eating utensils. The
term "set" as used herein refers to a complete list of
specific items that may be used in testing in the domain of
those items. "Domain" refers to a superset or supersets from
which a set may be drawn, e.g., the set of letters from the
domain of all symbols and from the domain of all shapes; or
e.g., the set of eating utensils from the domain of manual
tools or from the domain of household items.
[0391] Referring to FIGURE 80, in embodiments a system 2300
for performing an integration and interaction test may include
implementation of Sequence A by an inner ring test cycle
module 2304. Sequence A implementation may provide as follows:
The inner annulus may contain a single target cursor element
shown at 100% signal-to-noise ratio (SNR) that may be moved by
subject wheel rotation. The outer annulus targets and foils
may be moved separately, for example, by the inner ring test
cycle module 2304 or another suitable module. The system 2300
may be configured to receive inputs from the subject
responding to changes in the position, direction, and speed of
the outer target through changes in the outer target SNR,
initially, with no foils, then with 1, 2, and/or 3 non-target
foils of another type (e.g., shapes instead of letters). In an
embodiment, the amount of non-target foils may change within
one run of the Sequence A of the integration and interaction
test. In an embodiment, the amount of non-target foils may not
change within one run of the Sequence A of the integration and
interaction test.
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[0392] Referring to FIGURE 80, in embodiments, an
integration and interaction test may include implementation of
Sequence B by an outer ring test cycle module 2308. Sequence B
implementation may provide as follows: The outer target with a
single element at 100% SNR may be moved. The inner target
cursor may change SNR initially, with no foils, then with 1,
2, and then 3 non-target foils of other class (e.g., shapes
instead of letters). While the outer target is moved by the
outer ring test cycle module 2308, the subject may try to
match the position, direction, and speed of the outer target
across inner SNR and foils changes. In embodiments, the amount
of non-target foils may change within one run of the Sequence
B of the integration and interaction test. In embodiments, the
amount of non-target foils may not change within one run of
the Sequence B of the integration and interaction test.
[0393] Referring to FIGURE 80, in embodiments, a system
2300 providing an integration and interaction test may include
implementation of Sequence C by a combination test cycle
module 2312. Sequence C implementation may provide as follows:
The inner target may start at a critical SNR and target speed
derived for the subject in Sequence B and may be moved by the
subject. The outer target may start at critical SNR and target
speed derived for the subject in Sequence A and may be moved
by the combination test cycle module 2312. The subject may try
to match the position, direction, and speed of the outer
target through successive changes in the inner and outer SNRs,
initially, with no foils, then with 1, 2, and then 3 foils of
other (non-target) classes (e.g., shapes instead of letters)
successively and separately added to the inner and outer
annuli. In embodiments, the amount of non-target foils may
change within one run of the Sequence C of the integration and
interaction test. In embodiments, the amount of non-target
foils may not change within one run of the Sequence C of the
integration and interaction test.
[0394] Referring to FIGURE , in embodiments, an
integration and interaction test may include implementation of
Sequence D by the combination test cycle module 2312. Sequence
D implementation may provide as follows: The inner target may
start at Sequence B critical SNR and target speed and may be
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moved by the subject. The outer target may start at Sequence A
critical SNR and target speed and may be moved by the
combination test cycle module 2312. Before each test run, a
pair of stimuli may be presented in the center consisting of
one element from the outer annulus class and one element from
the inner annulus element class. In embodiments, the two
specific elements must be aligned for successful performance,
ignoring the other elements of the same classes in their
respective annuli. Initially, there may be just one element of
each class in the respective annuli. Subsequently, there may
be non-target foils of the target class added to the
respective annuli, first 1, 2, and then 3 non-target foils of
the target class separately added to each annulus. The subject
may try to match the position, direction, and speed of the
outer target through separate changes (SNRs and number of
foils) in both the inner and the outer annuli. In embodiments,
the amount of non-target foils may change within one run of
the Sequence D of the integration and interaction test. In
embodiments, the amount of non-target foils may not change
within one run of the Sequence D of the integration and
interaction test.
[0395] Referring to FIGURE , in embodiments, an
integration and interaction test may include implementation of
Sequence E by a combination test module. Sequence E
implementation may provide as follows: The inner target may
start at Sequence B critical SNR and target speed and may be
moved by the subject with one of two response wheels. The
outer target may start at the Sequence A critical SNR and
target speed and may be moved by the subject with the other of
two response wheels. Both annuli may move at different speeds
and directions under program control and the subject may move
the two wheels to keep the targets in the concentric circles
aligned. Initially, there may be just one element of each
class in the respective annuli. Subsequently, there may be
non-target foils of a non-target class added to the respective
annuli, first with 1, 2, and then 3 non-target foils of the
non-target class added separately to the two annuli. The
subject may try to match the position, direction, and speed of
the inner and outer targets through changes in both the inner
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and the outer annuli (SNRs and number of foils). In
embodiments, the amount of non-target foils may change within
one run of the Sequence E of the integration and interaction
test. In other embodiments, the amount of non-target foils may
not change within one run of the Sequence E of the integration
and interaction test.
[0396] Referring to FIGURES 86 - 94 in embodiments an
integration and interaction test 2700 may include Set A of
Letters provided by a Letters module. Set A (Letters) may
include English (or other) language letters with imposed
atypicality that may be presented as a continuous variable
(i.e. salience) affecting the detection and discrimination of
elements in this set. Variables that may be controlled and
changed in such a test include: Clutter, Orientation,
Brightness, Size, and Thickness. As used herein, "Clutter"
means pixel degeneration of the letter, character, etc. with
pixel addition outside of the confines of the character. As
used herein, "Orientation" means rotation around the center-
of-mass of the character in, or out of, the plane of the
screen. As used herein, "Brightness" means dimming character
lines/pixels with linked or separate changes in background
luminance. As used herein, "Size" means dimensional size of
characters. As used herein, "Thickness" means lines, dots, or
make up characters, which may be made larger or smaller.
[0397] Referring to FIGURE 86 - 94 in embodiments an
integration and interaction test may include, for example, a
Set B of Words provided by a Words parameter module. Such Set
B (Words) may include English (or other) language words with
imposed atypicality presented as a continuous variable (e.g.
SNR) affecting the detection and discrimination of elements in
this class.
[0398] Referring to FIGURE 86 - 94, in embodiments an
integration and interaction test may include, for example, Set
C of Regular Shapes characteristics provided by a Regular
Shapes parameters module. Such Set C (Regular Shapes) may
include geometric shapes (e.g., circles, squares, triangle,
etc.) with imposed atypicality presented as a continuous
variable (e.g. SNR) affecting the detection and discrimination
of elements in this class.
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[0399] Referring
to FIGURES 86 - 94, in embodiments an
integration and interaction test may include, for example, a
Set D of Irregular Shapes characteristics that may be provided
by an Irregular Shapes parameters module. Such a Set D
(Irregular Shapes) may include irregular line and curve sets
with branching and intersecting composition forming open and
closed areas (e.g., false fonts) with imposed atypicality
presented as a continuous variable (e.g. SNR) affecting the
detection and discrimination of elements in this class.
[0400] Referring
to FIGURES 86 - 94, in embodiments an
integration and interaction test may include, for example, a
Set E of Planar Motion characteristics that may be provided by
a Planar Motion parameters module. Such a Set E (Planar
Motion) characteristics may include, for example, uniform
movement of dots, lines, or dot/line patterns with imposed
parametric changes presented as a continuous variable (e.g.
SNR) affecting the detection and discrimination of the planar
motion direction, speed, or acceleration.
[0401] Referring
to FIGURES 86 - 94 in an embodiment, an
integration and interaction test may include, for example, a
Set F of Optic Flow characteristics that may be provided by an
Optic Flow parameters module. Such Set F (Optic Flow)
characteristics may include, for example, uniform movement of
dots, blobs, or shapes moving in radial, circular, or shear
patterns (or combinations of those patterns) simulating the
visual scene observed during self-motion through the
environment with imposed parametric changes presented as a
continuous variable (e.g. SNR) affecting the detection and
discrimination of elements in this class.
[0402] Referring
to FIGURES 86 - 94 in an embodiment an
integration and interaction test may include, for example, a
Set G of Kinetic Edges that may be provided by a Kinetic Edges
parameters module. Such Set G (Kinetic Edges) may include
regionally distinct coherent movement of dots, blobs, or
shapes moving in two or more adjacent or approximate area to
form an edge between those areas that is visible because of
the perception of the differences in the motion with imposed
parametric changes presented as a continuous variable (e.g.
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SNR) affecting the detection and discrimination of elements in
this class.
[0403] Referring to FIGURES 86 - 94 in an embodiment an
integration and interaction test may include, for example, a
Set H of Motioned Defined Objects that may be provided by a
Motioned Defined Objects parameters module. Such Set H
(Motioned Defined Objects) may include parameters of, for
example, spatially linked coordinated movement of dots, blobs,
or shapes moving to simulate that of an animate or inanimate
object with imposed parametric changes presented as a
continuous variable (e.g. SNR) affecting the detection and
discrimination of elements in this class.
[0404] Referring to FIGURE 82, systems and methods
according to disclosed subject matter may include imposing
parametric changes in task difficulty (SNR) and scoring input
results along parameters of speed, accuracy, and adaptability
in relation to such parametric changes in task difficulty
(SNR). In embodiments, for example, an imposed parameter may
include length or duration of the testing period. In
embodiments, for example, an imposed parameter may include
linking length or duration of the testing period to
relationships between stimulus and response characteristics.
[0405] Referring to FIGURE 82 in embodiments, for example,
a parameter of sequential changes in test domains may be
included. Such sequential changes in test domains may, for
example, create series of sub-tests that may be scored
separately, with summary scoring derived from the administered
series of sub-tests. Referring to FIGURE 82, in embodiments
including a sequential changes parameter such as, for example,
sequence A and B, each yields data that may be represented in
an SNR/Speed/Accuracy 3-space. Inflection points may be used
as starting values, or critical starting values, for other
sequences that manipulate SNR from that critical level.
[0406] Referring to FIGURES 78A, 78B and 78C embodiments of
the present disclosure may include a system configured for
invoking responses in two restricted sets of cortical areas.
Such an embodiment may include, for example, two concentric
annuli as shown generally in FIGURES 78A, 78B and 78C. Through
application of a module, two concentric annuli as shown
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generally in FIGURES 78A, 78B and 78C may be displayed, for
example, to invoke responses in two restricted sets of
cortical areas. Referring to FIGURE 81, in some embodiments a
system 2400 may include a stimulus control module 2404 having
at least one stimulus noise modulation parameter for
controlling and altering stimulus noise. Referring to FIGURE
82, in an embodiment system 2500 may include foils control
module 2508 having to include at least one foils control
parameter for focusing on at least one specific target-foil
domain. Referring to FIGURE 81, in an embodiment system 2400
may include task characteristics control module 2408 having at
least one task characteristics or task difficulty parameter.
In embodiments, an inputs recording module 2412 may record
tracking inputs in response to the stimuli, foils and tasks,
for testing or assessment of processing characteristics of
each cortical-subcortical network during their combined and
interacting activation.
[0407] Referring to FIGURE 83, a system 2600 may include:
visou-motor testing module 2604, perceptual processing module
2608, memory maintenance module 2612, reporting generation
module 2616 configured to generate a combined activation
stimulus-response profile that reflects interactions between
the activated networks of the brain, and individualized
calibration module 2620. System 2600 may also include a module
configured to probe such interactions with respect to, for
example, continuous cost/benefits of co-activation, and also
the discontinuous cost/benefits of intermittent co-activation,
which may be triggered or produced by stimulus-task modulation
or by intrinsic processes consequent to co-activation of
networks.
[04081 Referring to FIG. 95, a system 3000 may include both
a dual stimulus testing module 3010 and a single stimulus
testing module 3050. As shown in FIG. 96, dual stimulus
testing module 3010 may include a dual stimulus motor test
sub-module 3014. Dual stimulus testing module 3010 may include
a dual stimulus sensory test sub-module 3018. Dual stimulus
testing module 3010 may include a dual stimulus cognitive test
sub-module 3022. In some embodiments, dual stimulus testing
module 3010 may include a second dual stimulus cognitive test
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sub-module 3026. Dual stimulus testing module 3010 may include
a dual stimulus interaction test sub-module 3030. Dual
stimulus testing module 3010 may include a dual stimulus score
algorithm 3034. Single stimulus testing module 3050 may
include a single stimulus motor test sub-module 3054. Single
stimulus testing module 3050 may include a single stimulus
sensory test sub-module 3058. Single stimulus testing module
3050 may include a single stimulus cognitive test sub-module
3062. In some embodiments, single stimulus testing module 3050
may include a second single stimulus cognitive test sub-module
3066. Single stimulus testing module 3050 may include a single
stimulus interaction test sub-module 3070. Single stimulus
testing module 3050 may include single stimulus score
algorithm 3074.
[0409] Referring to FIG. 97, a method 3100 for automated
visual impairment testing may include both performing 3110
dual stimulus tests and performing 3150 single stimulus tests.
As shown in FIG. 96, performing 3110 dual stimulus tests may
include performing 3014 dual stimulus motor tests. Performing
3110 dual stimulus tests may include performing 3118 dual
stimulus sensory tests. Performing 3110 dual stimulus tests
may include performing 3122 dual stimulus cognitive tests. In
some embodiments, performing 3110 dual stimulus tests may
include performing 3126 second dual stimulus cognitive tests.
Performing 3110 dual stimulus tests may include performing
3130 dual stimulus interaction tests. Performing 3110 dual
stimulus tests may include dual stimulus scoring 3134.
Performing 3150 single stimulus tests may include performing
3154 single stimulus motor tests. Performing 3150 single
stimulus tests may include performing 3158 single stimulus
sensory tests. Performing 3150 single stimulus tests may
include performing 3162 single stimulus cognitive tests. In
some embodiments, performing 3150 single stimulus tests may
include performing 3166 second single stimulus cognitive
tests. Performing 3150 single stimulus tests may include
performing 3170 single stimulus interaction tests. sub-module
3070. Performing 3150 single stimulus tests may include single
stimulus scoring 3074.
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[0410] Disclosed subject matter may provide automated
quantitative assessment of functional impairment in
individuals by performing automated visual motor response
testing, and may provide reports of the same. Such automated
quantitative assessment of functional impairment in an
individual may comprise automated dual stimulus testing. In
some embodiments, dual stimulus testing may be performed alone
to provide quantitative assessment of functional impairment.
In embodiments, dual stimulus testing may be performed in
combination with single stimulus testing. For example, dual
stimulus testing may be performed for initial assessment or
diagnosis, in combination with single stimulus testing which
may be performed for detailed assessment or diagnosis.
According to the disclosure, systems and methods may perform
automated functional impairment testing that quantitatively
measures and assesses response characteristics of the brain in
a subject.
[0411] FIGURE 99 shows a paradigm of a hierarchical nature
of parametric individualization. In the exemplary hierarchy,
320, the resulting data from a movement test 3204 may be
applied to a visual saliency test 3208, a perception test
3212, and/or a memory test 3216. Each of these test may be
stored in a database, and each test may be performed 3220 by
operation of the specific module.
[0412] FIGURE 100A, 100B, 100C, 100D, 100E, and 100F as
well as FIGURE 101A, 101B, 101C, 101D, 101E, and 101F detail
exemplary visual depictions of a series of test scenes that
may be employed by embodiments. Embodiments may employ a
variety of stimuli throughout the testing environments.
Exemplary stimuli that may be employed by embodiments are
shown in FIGURE 102. As shown, embodiments may employ static
stimuli 3304, including but not limited to letters, shapes,
words, and textures. Embodiments may also employ motion
stimuli 3306, including but not limited to, motion directions,
motion speed, motion patterns, element defined motion
patterns, kinetic edges, and kinetic shapes. Embodiments may
include complex stimuli 3308, including but not limited to,
spatial patterns, landscape configurations, facial age, facial
expressions, body postures, hand shapes, and gestures.
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Embodiments may include stimulus interactions by co-
presentation 3310, including but not limited to, pairs of
elementary stimuli, sound and object coordinated appearance or
movement, and lip movement and speech. In some embodiments,
these stimuli may be used independently or in combination. Use
of the stimuli may be executed by the computer processor in
accordance with system rules.
[0413] An exemplary rule, or heuristic model, employed by
embodiments of the present disclosure includes perceptual
salience cue degradation, as shown in FIGURE 103. As shown,
tests, including memory and perception tests, may employ a
variety of means to distort the ease of recognition of the
stimuli. An exemplary means for distorting recognition of the
stimuli, includes elementary degradation 3314. Elementary
degradation 3314, may include but is not limited to,
decreasing stimulus size, luminance, contrast, duration and
flicker rates, continually varying stimulus position.
Embodiments may also employ domain specific degradation 3316.
Domain specific degradation 3316, may include but is not
limited to, missing pieces of stimuli, adding extraneous
pieces to stimuli, a combination of missing and extraneous
pieces, varying orientation, and varying background.
Embodiments may also employ pre-cued stimuli 3318. Pre-cued
stimuli, may include but is not limited to, class exceptions,
perception distractors, perception aids, natural combinations
of images and sounds, and non-natural combinations of images
and sounds. Embodiments may also employ remembered stimuli
3320. Exemplary remembered 3320 stimuli, include but are not
limited to, specific instance remembering, knowledge of prior
items or prior exposure.
[0414] Further examples of heuristics that may be employed
include the use of Words vs. non-word letter sets, decreasing
the contrast of the target, adding static noise elements
(e.g., obscuring dots), adding positional noise (e.g.,
shaking), and adding geometric distortions (e.g., twisted),
and presentation changes (e.g., letters in words closer
together).
[0415] Furthermore, memory and perception tests modules may
be configured for determining accuracy of subject inputs in
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identified matching not-matching words across different
modality (e.g., spoken words in the auditory modality),
specific word identified by pre-cueing a specific location in
the display (e.g., a flashed red dot preceding a list of
words, the word at the flashed location being the target)
where the target will be subsequently presented, specific
words cued conceptually, either specifically (e.g., a common
word) or categorically (e.g., your job or name), etc.
[0416] FIGURE 104 is a simplified block diagram
illustrating exemplary behavioral tasks 3322 that may be
employed by embodiments of the present disclosure. As shown,
exemplary paradigms 3324 that may be used include but are not
limited to, perceptual detection, perceptual discrimination,
group membership, location distraction, location pre-cueing,
location pattern derivation and prediction, item/list
immediate memory, item/list long-term memory, memory masking,
item class shifting and return to class, cue conflict.
[0417] FIGURE 105 illustrates an exemplary heuristic model
that may be employed by embodiments of the present disclosure.
As shown, the system may determine a visual saliency profile
3358 by initially presenting a stimuli for a default 3330, or
pre-set brightness, contrast, background luminance, and
spatial frequency composition. In accordance with rules of the
system, the system may vary each of brightness 3332, contrast
3338, background luminance 3344, and spatial frequency
composition 3350 in a chosen order, individually, or in
combination, to determine a threshold value at which each
parameter inputs become inaccurate. Upon determination of each
threshold value, a system may employ an aggregation algorithm
3356 to determine a visual saliency profile. In some
embodiments, this visual saliency profile may be deployed or
considered in the determination or deployment of subsequent
tests.
[0418] Some embodiments of the present disclosure, may in
addition to, instead of, or in combination with visual
testing, perform audio, and/or tactile modal testing. In some
embodiments, this may further include initial calibration
testing. In some embodiments, quantification or diagnosis
determination testing may be performed.
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[0419] Some embodiments of the present disclosure may
include diagnosis specific testing. In these embodiments,
performance in behavioral tasks, along or in combination with
one or more specific degradation techniques, may be indicative
of the specific disorder. In these embodiments, behavioral
tasks, or behavioral tasks with pre-set degradation may be
stored in a database with one or more disorder identifiers.
[0420] In some embodiments, broadening diagnosis tests may
be included to prevent false positive disorder determination.
[0421] In some embodiments, disorder determination may
operate in accordance with heuristic models. In these
embodiments, known diagnosis may be compared to one or more
patient profiles to identify one or more correlation factors
from test results. In some embodiments, heuristic models may
determine the behavioral task presented, the degradation
technique, or combinations thereof. In some embodiments,
heuristic models may be self selecting or refining.
[0422] Some embodiments may be configured for detection of
input deterioration. In one arrangement, input may be
constantly modeled to determine patient tiredness or mobility
impairment impact behavioral task response. In some
embodiments, detection of input deterioration may initiate
suspension of test for a defined time period, and/or provide
warning notice to operator.
[0423] In some embodiments, system heuristics may formulate
the presentation of behavioral tasks, the degradation of
stimuli, and combinations thereof. System heuristics may be
configured to consider previous patient results, statistical
analysis, task priority, and patient demographics, including
but not limited, age, weight, medication, etc.
[0424] Some embodiments may be configured for one or more
simultaneous inputs. For example, one embodiment may be
configured, with one or more rotatable wheels, one or more
pedals. A further embodiment may be configured with two
manipulandum. In this arrangement, tests may be configured to
require simultaneous, or coordinated movement across both
inputs. In other arrangements, input across multiple input
mechanisms may be time delayed, and/or disabled.
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[0425] In some embodiments, behavioral perception tasks may
comprise the presentation of two or more distinct stimuli
classes, either concurrently, or at a predefined interval.
[0426] Some embodiments may employ an analysis module to
assess the impact of dual stimulus presentation and/or dual
stimulus tests. In this arrangement, correlation factors
system may be identified and compared to diagnosis
identifiers.
[0427] All references, including publications, patent
applications, and patents, cited herein are hereby
incorporated by reference to the same extent as if each
reference were individually and specifically indicated to be
incorporated by reference and were set forth in its entirety
herein.
[0428] The methods, systems, process flows and logic of
disclosed subject matter associated with a computer readable
medium may be described in the general context of computer-
executable instructions, such as, for example, program
modules, which may be executed by a computer. Generally,
program modules may include routines, programs, objects,
components, data structures, etc. that perform particular
tasks or implement particular abstract data types. The
disclosed subject matter may also be practiced in distributed
computing environments wherein tasks are performed by remote
processing devices that are linked through a communications
network. In a distributed computing environment, program
modules may be located in local and/or remote computer storage
media including memory storage devices.
[0429] The detailed description set forth herein in
connection with the appended drawings is intended as a
description of exemplary embodiments in which the presently
disclosed subject matter may be practiced. The term
"exemplary" used throughout this description means "serving
as an example, instance, or illustration," and should not
necessarily be construed as preferred or advantageous over
other embodiments.
[0430] This detailed description of illustrative
embodiments includes specific details for providing a thorough
understanding of the presently disclosed subject matter.
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However, it will be apparent to those skilled in the art that
the presently disclosed subject matter may be practiced
without these specific details. In some instances, well-known
structures and devices are shown in block diagram form in
order to avoid obscuring the concepts of the presently
disclosed method and system.
[0431] The foregoing description of embodiments is provided
to enable any person skilled in the art to make and use the
subject matter. Various modifications to these embodiments
will be readily apparent to those skilled in the art, and the
novel principles and subject matter disclosed herein may be
applied to other embodiments without the use of the innovative
faculty. The claimed subject matter set forth in the claims is
not intended to be limited to the embodiments shown herein,
but is to be accorded the widest scope consistent with the
principles and novel features disclosed herein. It is
contemplated that additional embodiments are within the spirit
and true scope of the disclosed subject matter.
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