Wai-Ling Bickerton | University of Birmingham (original) (raw)
Papers by Wai-Ling Bickerton
Applied Neuropsychology: Adult
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, Jan 4, 2017
Unilateral spatial neglect (USN) is a frequent consequence of acquired brain injury, especially f... more Unilateral spatial neglect (USN) is a frequent consequence of acquired brain injury, especially following right hemisphere damage. Traditionally, unilateral spatial neglect is assessed with cancellation tests such as the Bells test. Recently, a new cancellation test, the Apples test, has been proposed. The present study aims at comparing the accuracy of these two tests in detecting hemispatial neglect, on a sample of 56 right hemisphere stroke patients with a diagnosis of USN. In order to evaluate the agreement between the Apples and Bells tests, Cohen's kappa and McNemar's test were used to assess differences between the two methods of evaluation. Poor agreement and statistically significant differences emerged between the Apples and Bells tests. Overall, the Apples test was significantly more sensitive than the Bells test in detecting USN. Based on these results, the use of the Apples test for peripersonal neglect assessment is therefore highly recommended.
Preliminary findings on the reliability and validity
Alzheimer's & Dementia, 2021
Clinical and cognitive assessments are widely used as screening tools for dementia. There is need... more Clinical and cognitive assessments are widely used as screening tools for dementia. There is need to find cognitive tools that could differentiate dementia syndromes. This study explores the use of the Birmingham Cognitive Screen (BCoS), a one‐hour assessment of 5 cognitive domains, in revealing differential neurocognitive profiles for Alzheimer’s disease (AD), and vascular cognitive impairment with deep brain structure ischaemia (VCI‐DBSI).
Scientific Reports, 2019
The current study investigated the cognitive and neural substrates that underpin writing ability.... more The current study investigated the cognitive and neural substrates that underpin writing ability. We explored similarities and differences in writing numbers and words and compared these to language and manual actions in a large group of sub-acute, stroke patients (n = 740). The behavioral data showed association and dissociation in the ability to write words and numbers. Comorbidities of writing deficits with both language and motor impairments were prevalent, with less than a handful showing deficits restricted to the writing tasks. A second analysis with a subset of patients (n = 267) explored the neural networks that mediate writing abilities. Lesion to right temporal contributed to writing words, while lesions to left postcentral contributed to writing numbers. Overlapping neural mechanisms included the bilateral prefrontal cortex, right inferior parietal, left middle occipital and the right cerebellum. With the former regions associated with error pattern typical to writing ba...
NeuroImage: Clinical, 2016
Link to publication on Research at Birmingham portal General rights Unless a licence is specified... more Link to publication on Research at Birmingham portal General rights Unless a licence is specified above, all rights (including copyright and moral rights) in this document are retained by the authors and/or the copyright holders. The express permission of the copyright holder must be obtained for any use of this material other than for purposes permitted by law. • Users may freely distribute the URL that is used to identify this publication. • Users may download and/or print one copy of the publication from the University of Birmingham research portal for the purpose of private study or non-commercial research. • User may use extracts from the document in line with the concept of 'fair dealing' under the Copyright, Designs and Patents Act 1988 (?) • Users may not further distribute the material nor use it for the purposes of commercial gain. Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document. When citing, please reference the published version. Take down policy While the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive.
Procedia - Social and Behavioral Sciences, 2013
All in-text references underlined in blue are linked to publications on ResearchGate, letting you... more All in-text references underlined in blue are linked to publications on ResearchGate, letting you access and read them immediately.
This thesis consists of a research volume (one) and a clinical volume (two). Volume one presents ... more This thesis consists of a research volume (one) and a clinical volume (two). Volume one presents two research papers on the development of neuropsychological assessment and rehabilitation in dementia. The first is a systematic review on the evidence base of direct everyday action rehabilitation in dementia. Aspects of person-centred approach in dementia rehabilitation are adopted in a number of studies but the effects are yet to be investigated more systematically. Whilst studies of errorful interventions reported more consistent evidence of benefits, the category represents diverse approaches and there is a lack of direct comparisons of techniques to evaluate the relative merits. The limitations in the studies quality and in the current review impacted on the generalizability of the results. The second reports an empirical study of the utility of the Birmingham Cognitive Screen (BCoS) assessment in differentiating the neuropsychological profile between early onset Alzheimer’s disea...
Following different kinds of brain damage, including stroke, head injury, carbon monoxide poisoni... more Following different kinds of brain damage, including stroke, head injury, carbon monoxide poisoning, and degenerative change, people can experience a range of cognitive problems, in addition to any difficulties in motor function. These problems strongly influence a patient’s ability to recover, but often patients are not routinely screened to detect them. BCoS Cognitive Screen is a new test instrument. The test pack consists of a manual, a ringbound Test Book, the Auditory Attention Test stimuli on CD, a pack of 15 Examiner Booklets, a pack of 15 Examinee booklets, and a set of test objects, all contained in a durable messenger bag. Developed to screen patients for cognitive problems, it provides a novel 'cognitive profile' across a range of cognitive processes within a one-hour testing session, that will indicate whether a patient has a clinical impairment (related to norms) in five primary domains of cognition: Attention and executive function, Language, Memory, Number ski...
Cognitive Neuropsychology, 2010
1 Brenda Rapp, Editorial 3 Camille L. Julien, Jennifer C. Thompson, David Neary, and Julie S. Sno... more 1 Brenda Rapp, Editorial 3 Camille L. Julien, Jennifer C. Thompson, David Neary, and Julie S. Snowden, Understanding quantity in semantic dementia 30 C. Ellie Wilson, Romina Palermo, Laura Schmalzl, and Jon Brock, Specificity of impaired facial identity recognition in children with suspected developmental prosopagnosia 46 Sebastian J. Crutch and Elizabeth K. Warrington, The differential dependence of abstract and concrete words upon associative and similarity-based information: Complementary semantic interference and facilitation effects 72 Kevin Dent, Vaia Lestou, and Glyn W. Humphreys, Deficits in visual search for conjunctions of motion and form after parietal damage but with spared hMTþ /V5
Communication Disorders Quarterly
Cortex, 2015
Cognitive problems following stroke are typically analysed using either short but relatively unin... more Cognitive problems following stroke are typically analysed using either short but relatively uninformative general tests or through detailed but time consuming tests of domain specific deficits (e.g., in language, memory, praxis). Here we present an analysis of neuropsychological deficits detected using a screen designed to fall between other screens by being 'broad' (testing multiple cognitive abilities) but 'shallow' (sampling the abilities briefly, to be time efficient) - the BCoS. Assessment using the Birmingham Cognitive Screen (BCoS) enables the relations between 'domain specific' and 'domain general' cognitive deficits to be evaluated as the test generates an overall cognitive profile for individual patients. We analysed data from 287 patients tested at a sub-acute stage of stroke (<3 months). Graphical modelling techniques were used to investigate the associative structure and conditional independence between deficits within and across the domains sampled by BCoS (attention and executive functions, language, memory, praxis and number processing). The patterns of deficit within each domain conformed to existing cognitive models. However, these within-domain patterns underwent substantial change when the whole dataset was modelled, indicating that domain-specific deficits can only be understood in relation to linked changes in domain-general processes. The data point to the importance of using over-arching cognitive screens, measuring domain-general as well as domain-specific processes, in order to account for neuropsychological deficits after stroke. The paper also highlights the utility of using graphical modelling to understand the relations between cognitive components in complex datasets.
Neuropsychiatric Disease and Treatment, 2015
There are no currently effective cognitive assessment tools for patients who have suffered stroke... more There are no currently effective cognitive assessment tools for patients who have suffered stroke in the People's Republic of China. The Birmingham Cognitive Screen (BCoS) has been shown to be a promising tool for revealing patients' poststroke cognitive deficits in specific domains, which facilitates more individually designed rehabilitation in the long run. Hence we examined the reliability and validity of a Cantonese version BCoS in patients with acute ischemic stroke, in Guangzhou. A total of 98 patients with acute ischemic stroke were assessed with the Cantonese version of the BCoS, and an additional 133 healthy individuals were recruited as controls. Apart from the BCoS, the patients also completed a number of external cognitive tests, including the Montreal Cognitive Assessment Test (MoCA), Mini Mental State Examination (MMSE), Albert's cancellation test, the Rey-Osterrieth Complex Figure Test, and six gesture matching tasks. Cutoff scores for failing each subtest, ie, deficits, were computed based on the performance of the controls. The validity and reliability of the Cantonese BCoS were examined, as well as interrater and test-retest reliability. We also compared the proportions of cases being classified as deficits in controlled attention, memory, character writing, and praxis, between patients with and without spoken language impairment. Analyses showed high test-retest reliability and agreement across independent raters on the qualitative aspects of measurement. Significant correlations were observed between the subtests of the Cantonese BCoS and the other external cognitive tests, providing evidence for convergent validity of the Cantonese BCoS. The screen was also able to generate measures of cognitive functions that were relatively uncontaminated by the presence of aphasia. This study suggests good reliability and validity of the Cantonese version of the BCoS. The Cantonese BCoS is a very promising tool for the detection of cognitive problems in Cantonese speakers.
Journal of Cognitive Neuroscience, 2014
■ Deficits in the ability to draw objects, despite apparently intact perception and motor abiliti... more ■ Deficits in the ability to draw objects, despite apparently intact perception and motor abilities, are defined as constructional apraxia. Constructional deficits, often diagnosed based on performance on copying complex figures, have been reported in a range of pathologies, perhaps reflecting the contribution of several underlying factors to poor figure drawing. The current study provides a comprehensive analysis of brain-behavior relationships in drawing disorders based on data from a large cohort of subacute stroke patients (n = 358) using whole-brain voxelwise statistical analyses linked to behavioral measures from a complex figure copy task. We found that (i) overall poor performance on figure copying was associated with subcortical lesions (BG and thalamus), (ii) lateralized deficits with respect to the midline of the viewer were associated with lesions within the posterior parietal lobule, and (iii) spatial positioning errors across the entire figure were associated with lesions within visual processing areas (lingual gyrus and calcarine) and the insula. Furthermore, deficits in reproducing global aspects of form were associated with damage to the right middle temporal gyrus, whereas deficits in representing local features were linked to the left hemisphere lesions within calcarine cortex (extending into the cuneus and precuneus), the insula, and the TPJ. The current study provides strong evidence that impairments in separate cognitive mechanisms (e.g., spatial coding, attention, motor execution, and planning) linked to different brain lesions contribute to poor performance on complex figure copying tasks. The data support the argument that drawing depends on several cognitive processes operating via discrete neuronal networks and that constructional problems as well as hierarchical and spatial representation deficits contribute to poor figure copying. ■
Psychological Assessment, 2015
Applied Neuropsychology: Adult
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, Jan 4, 2017
Unilateral spatial neglect (USN) is a frequent consequence of acquired brain injury, especially f... more Unilateral spatial neglect (USN) is a frequent consequence of acquired brain injury, especially following right hemisphere damage. Traditionally, unilateral spatial neglect is assessed with cancellation tests such as the Bells test. Recently, a new cancellation test, the Apples test, has been proposed. The present study aims at comparing the accuracy of these two tests in detecting hemispatial neglect, on a sample of 56 right hemisphere stroke patients with a diagnosis of USN. In order to evaluate the agreement between the Apples and Bells tests, Cohen's kappa and McNemar's test were used to assess differences between the two methods of evaluation. Poor agreement and statistically significant differences emerged between the Apples and Bells tests. Overall, the Apples test was significantly more sensitive than the Bells test in detecting USN. Based on these results, the use of the Apples test for peripersonal neglect assessment is therefore highly recommended.
Preliminary findings on the reliability and validity
Alzheimer's & Dementia, 2021
Clinical and cognitive assessments are widely used as screening tools for dementia. There is need... more Clinical and cognitive assessments are widely used as screening tools for dementia. There is need to find cognitive tools that could differentiate dementia syndromes. This study explores the use of the Birmingham Cognitive Screen (BCoS), a one‐hour assessment of 5 cognitive domains, in revealing differential neurocognitive profiles for Alzheimer’s disease (AD), and vascular cognitive impairment with deep brain structure ischaemia (VCI‐DBSI).
Scientific Reports, 2019
The current study investigated the cognitive and neural substrates that underpin writing ability.... more The current study investigated the cognitive and neural substrates that underpin writing ability. We explored similarities and differences in writing numbers and words and compared these to language and manual actions in a large group of sub-acute, stroke patients (n = 740). The behavioral data showed association and dissociation in the ability to write words and numbers. Comorbidities of writing deficits with both language and motor impairments were prevalent, with less than a handful showing deficits restricted to the writing tasks. A second analysis with a subset of patients (n = 267) explored the neural networks that mediate writing abilities. Lesion to right temporal contributed to writing words, while lesions to left postcentral contributed to writing numbers. Overlapping neural mechanisms included the bilateral prefrontal cortex, right inferior parietal, left middle occipital and the right cerebellum. With the former regions associated with error pattern typical to writing ba...
NeuroImage: Clinical, 2016
Link to publication on Research at Birmingham portal General rights Unless a licence is specified... more Link to publication on Research at Birmingham portal General rights Unless a licence is specified above, all rights (including copyright and moral rights) in this document are retained by the authors and/or the copyright holders. The express permission of the copyright holder must be obtained for any use of this material other than for purposes permitted by law. • Users may freely distribute the URL that is used to identify this publication. • Users may download and/or print one copy of the publication from the University of Birmingham research portal for the purpose of private study or non-commercial research. • User may use extracts from the document in line with the concept of 'fair dealing' under the Copyright, Designs and Patents Act 1988 (?) • Users may not further distribute the material nor use it for the purposes of commercial gain. Where a licence is displayed above, please note the terms and conditions of the licence govern your use of this document. When citing, please reference the published version. Take down policy While the University of Birmingham exercises care and attention in making items available there are rare occasions when an item has been uploaded in error or has been deemed to be commercially or otherwise sensitive.
Procedia - Social and Behavioral Sciences, 2013
All in-text references underlined in blue are linked to publications on ResearchGate, letting you... more All in-text references underlined in blue are linked to publications on ResearchGate, letting you access and read them immediately.
This thesis consists of a research volume (one) and a clinical volume (two). Volume one presents ... more This thesis consists of a research volume (one) and a clinical volume (two). Volume one presents two research papers on the development of neuropsychological assessment and rehabilitation in dementia. The first is a systematic review on the evidence base of direct everyday action rehabilitation in dementia. Aspects of person-centred approach in dementia rehabilitation are adopted in a number of studies but the effects are yet to be investigated more systematically. Whilst studies of errorful interventions reported more consistent evidence of benefits, the category represents diverse approaches and there is a lack of direct comparisons of techniques to evaluate the relative merits. The limitations in the studies quality and in the current review impacted on the generalizability of the results. The second reports an empirical study of the utility of the Birmingham Cognitive Screen (BCoS) assessment in differentiating the neuropsychological profile between early onset Alzheimer’s disea...
Following different kinds of brain damage, including stroke, head injury, carbon monoxide poisoni... more Following different kinds of brain damage, including stroke, head injury, carbon monoxide poisoning, and degenerative change, people can experience a range of cognitive problems, in addition to any difficulties in motor function. These problems strongly influence a patient’s ability to recover, but often patients are not routinely screened to detect them. BCoS Cognitive Screen is a new test instrument. The test pack consists of a manual, a ringbound Test Book, the Auditory Attention Test stimuli on CD, a pack of 15 Examiner Booklets, a pack of 15 Examinee booklets, and a set of test objects, all contained in a durable messenger bag. Developed to screen patients for cognitive problems, it provides a novel 'cognitive profile' across a range of cognitive processes within a one-hour testing session, that will indicate whether a patient has a clinical impairment (related to norms) in five primary domains of cognition: Attention and executive function, Language, Memory, Number ski...
Cognitive Neuropsychology, 2010
1 Brenda Rapp, Editorial 3 Camille L. Julien, Jennifer C. Thompson, David Neary, and Julie S. Sno... more 1 Brenda Rapp, Editorial 3 Camille L. Julien, Jennifer C. Thompson, David Neary, and Julie S. Snowden, Understanding quantity in semantic dementia 30 C. Ellie Wilson, Romina Palermo, Laura Schmalzl, and Jon Brock, Specificity of impaired facial identity recognition in children with suspected developmental prosopagnosia 46 Sebastian J. Crutch and Elizabeth K. Warrington, The differential dependence of abstract and concrete words upon associative and similarity-based information: Complementary semantic interference and facilitation effects 72 Kevin Dent, Vaia Lestou, and Glyn W. Humphreys, Deficits in visual search for conjunctions of motion and form after parietal damage but with spared hMTþ /V5
Communication Disorders Quarterly
Cortex, 2015
Cognitive problems following stroke are typically analysed using either short but relatively unin... more Cognitive problems following stroke are typically analysed using either short but relatively uninformative general tests or through detailed but time consuming tests of domain specific deficits (e.g., in language, memory, praxis). Here we present an analysis of neuropsychological deficits detected using a screen designed to fall between other screens by being 'broad' (testing multiple cognitive abilities) but 'shallow' (sampling the abilities briefly, to be time efficient) - the BCoS. Assessment using the Birmingham Cognitive Screen (BCoS) enables the relations between 'domain specific' and 'domain general' cognitive deficits to be evaluated as the test generates an overall cognitive profile for individual patients. We analysed data from 287 patients tested at a sub-acute stage of stroke (<3 months). Graphical modelling techniques were used to investigate the associative structure and conditional independence between deficits within and across the domains sampled by BCoS (attention and executive functions, language, memory, praxis and number processing). The patterns of deficit within each domain conformed to existing cognitive models. However, these within-domain patterns underwent substantial change when the whole dataset was modelled, indicating that domain-specific deficits can only be understood in relation to linked changes in domain-general processes. The data point to the importance of using over-arching cognitive screens, measuring domain-general as well as domain-specific processes, in order to account for neuropsychological deficits after stroke. The paper also highlights the utility of using graphical modelling to understand the relations between cognitive components in complex datasets.
Neuropsychiatric Disease and Treatment, 2015
There are no currently effective cognitive assessment tools for patients who have suffered stroke... more There are no currently effective cognitive assessment tools for patients who have suffered stroke in the People's Republic of China. The Birmingham Cognitive Screen (BCoS) has been shown to be a promising tool for revealing patients' poststroke cognitive deficits in specific domains, which facilitates more individually designed rehabilitation in the long run. Hence we examined the reliability and validity of a Cantonese version BCoS in patients with acute ischemic stroke, in Guangzhou. A total of 98 patients with acute ischemic stroke were assessed with the Cantonese version of the BCoS, and an additional 133 healthy individuals were recruited as controls. Apart from the BCoS, the patients also completed a number of external cognitive tests, including the Montreal Cognitive Assessment Test (MoCA), Mini Mental State Examination (MMSE), Albert's cancellation test, the Rey-Osterrieth Complex Figure Test, and six gesture matching tasks. Cutoff scores for failing each subtest, ie, deficits, were computed based on the performance of the controls. The validity and reliability of the Cantonese BCoS were examined, as well as interrater and test-retest reliability. We also compared the proportions of cases being classified as deficits in controlled attention, memory, character writing, and praxis, between patients with and without spoken language impairment. Analyses showed high test-retest reliability and agreement across independent raters on the qualitative aspects of measurement. Significant correlations were observed between the subtests of the Cantonese BCoS and the other external cognitive tests, providing evidence for convergent validity of the Cantonese BCoS. The screen was also able to generate measures of cognitive functions that were relatively uncontaminated by the presence of aphasia. This study suggests good reliability and validity of the Cantonese version of the BCoS. The Cantonese BCoS is a very promising tool for the detection of cognitive problems in Cantonese speakers.
Journal of Cognitive Neuroscience, 2014
■ Deficits in the ability to draw objects, despite apparently intact perception and motor abiliti... more ■ Deficits in the ability to draw objects, despite apparently intact perception and motor abilities, are defined as constructional apraxia. Constructional deficits, often diagnosed based on performance on copying complex figures, have been reported in a range of pathologies, perhaps reflecting the contribution of several underlying factors to poor figure drawing. The current study provides a comprehensive analysis of brain-behavior relationships in drawing disorders based on data from a large cohort of subacute stroke patients (n = 358) using whole-brain voxelwise statistical analyses linked to behavioral measures from a complex figure copy task. We found that (i) overall poor performance on figure copying was associated with subcortical lesions (BG and thalamus), (ii) lateralized deficits with respect to the midline of the viewer were associated with lesions within the posterior parietal lobule, and (iii) spatial positioning errors across the entire figure were associated with lesions within visual processing areas (lingual gyrus and calcarine) and the insula. Furthermore, deficits in reproducing global aspects of form were associated with damage to the right middle temporal gyrus, whereas deficits in representing local features were linked to the left hemisphere lesions within calcarine cortex (extending into the cuneus and precuneus), the insula, and the TPJ. The current study provides strong evidence that impairments in separate cognitive mechanisms (e.g., spatial coding, attention, motor execution, and planning) linked to different brain lesions contribute to poor performance on complex figure copying tasks. The data support the argument that drawing depends on several cognitive processes operating via discrete neuronal networks and that constructional problems as well as hierarchical and spatial representation deficits contribute to poor figure copying. ■
Psychological Assessment, 2015