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Robotic technology quantifies novel perceptual-motor impairments in patients with chronic kidney disease

Abstract

Background

Neurocognitive impairment is commonly reported in patients with chronic kidney disease (CKD). The precise nature of this impairment is unclear, due to the lack of objective and quantitative assessment tools used. The feasibility of using robotic technology to precisely quantify neurocognitive impairment in patients with CKD is unknown.

Methods

Patients with stage 4 and 5 CKD with no previous history of stroke or neurodegenerative disease were eligible for study enrollment. Feasibility was defined as successful study enrollment, high data capture rates (> 90%), and assessment tolerability. Our assessment included a traditional assessment: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and a robot-based assessment: Kinarm.

Results

Our enrollment rate was 1.6 patients/month. All patients completed the RBANS portion of the assessment, with a 97.8% (range 92–100%) completion rate on Kinarm. Missing data on Kinarm were mainly due to time constraints. Data from 49 CKD patients were analyzed. Kinarm defined more individuals as impaired, compared to RBANS, particularly in the domains of perceptual-motor function (17–49% impairment), complex attention (22–49% impairment), and executive function (29–37.5% impairment). Demographic features (sex and education) predicted performance on some, but not all neurocognitive tasks.

Conclusions

It is feasible to quantify neurocognitive impairments in patients with CKD using robotic technology. Kinarm characterized more patients with CKD as impaired, and importantly identified novel perceptual-motor impairments in these patients, when compared to traditional assessments.

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Availability of data and material

All individual patient data are located in the Supplemental Data.

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Acknowledgements

This work was funded by the Queen’s University Department of Medicine Innovation Fund. We would like to thank the patients for volunteering their time, along with Kim Moore and Simone Appaqaq for conducting the neurocognitive testing.

Funding

This work was funded by the Queen’s University Department of Medicine Innovation Fund.

Author information

Affiliations

Authors

Contributions

JGB and RH: designed the study; SS: developed and designed Kinarm; JV: gathered consent, analyzed, interpreted, and plotted the data, drafted and revised the manuscript; JGB, RH, and SS: were involved in revising the manuscript. All authors approved the final submission.

Corresponding author

Correspondence to John Gordon Boyd.

Ethics declarations

Conflict of interest

Stephen Scott is the co-founder and CSO of Kinarm that commercializes the robotic technology used in the present study. Jessica Vanderlinden, J. Gordon Boyd and Rachel Holden have no conflicts of interest to report.

Ethical approval

The study was approved by Queen’s University and Affiliated Hospitals Health Sciences Research Ethics Board.

Consent to participant

Each patient gave informed consent prior to any assessment or data collection.

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Supplementary Information

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Cite this article

Vanderlinden, J.A., Holden, R.M., Scott, S.H. et al. Robotic technology quantifies novel perceptual-motor impairments in patients with chronic kidney disease. J Nephrol 34, 1243–1256 (2021). https://doi.org/10.1007/s40620-020-00912-z

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Keywords

  • Chronic kidney disease (CKD)
  • The Repeatable Battery for the Neuropsychological Assessment (RBANS)
  • Kinarm
  • Neurocognitive impairment