Are You Ready For a NBNZ Session?
Before the NBNZ test is administered, some basic information including but not limited to age, disease type, disease duration, medications and EDSS will be gathered from the patient. The responses to these questions will be inserted into the patient’s profile in the software. After the patient is informed about the test process and is put in the MRI device, the NBNZ test will begin and several tasks will be handed to the patient. Two types of tasks are used during the test:
Auditory :
- Paced Auditory Serial Addition Test (PASAT)
Visual :
- Paced Visual Serial Addition Test (PVSAT)
- N-Back Tasks with Different Levels of Complexity
The required time to take the PASAT and PVSAT is 6 minutes on average, and the average needed time to take N-Back is 14 minutes. Between each two tests, 2 minutes of rest is considered for patients. In each case, the patient will be in interaction with the NBNZ operator and answers the tasks using a response box. The tasks consist of simple questions with definite correct answers. Both the responses of the patient and the active parts of their brain when answering each task will be monitored and analyzed.
In fact, the input of the algorithm of NBNZ includes the correctness or incorrectness of the patient’s answer to each question as well as the signals and images of the active parts of their brain while responding to the question. Afterward, the inaccurate data will be detected and removed from the data pool in the pre-processing phase. Then, the processing will be done. The output of the algorithm indicates the probability of the MS patient suffering from cognitive disorders, the stage of these dysfunctions, and other related factors. The analysis will be presented graphically and numerically.
The schematic of the NBNZ algorithm is presented in above Figure. The results gained from our proposed software and the effectiveness of the algorithm have already been verified through research studies with both auditory and visual tasks.
Each patient will have a profile in the software where certain data including personal information and medical history as well as results of the NBNZ tests they have undergone are maintained.
Personal and medical data which includes name, gender, age, contact information, disease type, disease duration, number of attacks, and EDSS scores will be taken and entered in patients’ profile on their first visit. Some of these items such as age, disease type, and disease duration have dropdown lists that allow the operator to choose from. Moreover, the EDSS score of the patient should not be above 3.5 to enable the patient to perform tasks.
This profile along with the patients’ medical history are accessible in later visits through a username/ password or patient’s contact information
Once in a given patient’s dashboard, different tasks can be selected. Auditory tasks are mandatory but visual ones are optional and the patient may decide not to perform them at all.
As soon as the tasks are completed and before the data is used as input for the algorithm to evaluate the relationship parameters, the data needs to be preprocessed. Pre-processing has two levels. The first level is to control the quality of the registered data which includes slice timing correction, realignment, co-registering, segmentation, normalizing and smoothing and will determine whether the quality of data is of an acceptable level.
In the second level of preprocessing, there will be a statistical analysis.
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The two pre-processing levels will last between 3 to 6 minutes after which the software will enter the processing phase. The final processing will take 10 to 20 minutes. It goes without saying that the processing and pre-processing times will be improved gradually. These levels do not need to be monitored by the operator and the result will be saved automatically.
The result of the analysis which demonstrates the patient’s cognitive status can be extracted in the Pdf format or can be emailed to the patients to present to doctors or medical centers. It can also be printed out using the menu on the processing page. As soon as the result of the test is ready, the software informs the patient via SMS and a copy of the final result will be sent to the patient’s email address.