Glen M Doniger

• PhD
• Researcher at Sheba Medical Center

Background Increasing prevalence of Alzheimer’s Disease (AD) and limited pharmacological intervention benefits to decelerate early neurodegeneration have prompted exploration of non‐pharmacological options. Recent studies indicate that combining cognitive‐motor training enhances outcomes. Methods In a single‐blind, parallel‐group, randomized contr...

Background Gait variability is a common feature in neurodegenerative diseases and has been linked to cognitive impairment. Despite this link, the influence of specific cognitive domains, such as memory, visual spatial skills, executive function, and verbal function on gait variability is not well-understood. Objective To investigate the predictive...

Background Spectral Optical Coherence Tomography (OCT) and Visual Evoked Potentials (VEPs) have both emerged as potentially useful biomarkers of cognitive decline in people with multiple sclerosis (PwMS). Their combined use may provide additional predictive value for identifying disease impact, progression, and remyelination capacity above-and-beyo...

Background: Multiple Sclerosis (MS), a chronic disease of the central nervous system (CNS), affects functional ability and quality of life (QoL). Depression, fatigue, and disability status are among the many factors that have been shown to impact QoL in people with MS, but the extent to which MS-related cognitive impairment is related to QoL is un...

Introduction: Multiple Sclerosis (MS) is a chronic inflammatory and degenerative disease of the central nervous system (CNS). The severity of disability in people with MS (PwMS) is generally measured with the Expanded Disability Status Scale (EDSS). A variant of MS known as 'benign MS' (BMS) has been defined as an EDSS score of 3 or lower, combine...

Background and purpose Impaired upper extremity (UE) motor function is a common disability after ischemic stroke. Exposure to extremely low frequency and low intensity electromagnetic fields (ELF-EMF) in a frequency-specific manner (Electromagnetic Network Targeting Field therapy; ENTF therapy) is a non-invasive method available to a wide range of...

Background Neurologists’ perceptions of the presence of cognitive impairment (CI) in people with multiple sclerosis (PwMS) may not always align with findings of objective cognitive assessment. The accuracy of self-reported CI in PwMS can also be highly variable across individuals, and may not align with objective measurement of cognitive disturbanc...

Objective Translations and adaptations of traditional neuropsychological tests to virtual reality (VR) technology bear the potential to increase their ecological validity since the technology enables simulating everyday life conditions in a controlled manner. The current paper describes our translation of a commonly used neuropsychological test to...

Background Fatigue is a common problem experienced by people with multiple sclerosis (PwMS) and can impact physical, cognitive, and psychosocial aspects of daily living and quality of life. Tracking meaningful longitudinal change in subjective fatigue occurring as a result of MS activity may be enhanced by incorporating objective neurophysiological...

EEG Signatures of Frequency-Tuned Non-invasive ELF-EMF Brain Stimulation over the Course of Stroke Recovery Clinical Trial

Background The Symbol Digit Modalities Test (SDMT) is a common screen of cognitive function for people with Multiple Sclerosis (pwMS) but growing acknowledgement that people with cognitive impairment are a heterogeneous population suggests that a single screen may provide limited information. Objective To assess the adequacy of the SDMT in capturi...

Objective Visual evoked potentials (VEPs) can provide insight into disease activity in people with multiple sclerosis (PwMS). However, few studies have tracked concurrent changes in VEPs and cognitive functioning over time in MS. To address this, we examined the longitudinal relationship between VEP and cognitive performance in PwMS over a two-year...

Prior studies have reported an association between visual evoked potentials (VEPs) and cognitive performance in people with multiple sclerosis (PwMS), but the specific mechanisms that account for this relationship remain unclear. We examined the relationship between VEP latency and cognitive performance in a large sample of PwMS, hypothesizing that...

Background: Fatigue in people with multiple sclerosis (PwMS) can impact physical, cognitive, and psychosocial domains of daily life. The experience of fatigue in PwMS is thought to originate from the central nervous system, particularly for the domain of cognitive fatigue. Here, we tested the hypothesis that fatigue scores in PwMS would be signifi...

Background : Fear of flying (FoF) is a phobia with 10–40% prevalence in the industrialized world. FoF is accompanied by severe economic, social, vocational, and emotional consequences. In recent years, virtual reality (VR)-based exposure therapy (VRET) for FoF has been introduced. Positive long-term efficacy of FoF-VRET has been reported by several...

Background Neuropsychological tests of executive function have limited real-world predictive and functional relevance. An emerging solution for this limitation is to adapt the tests for implementation in virtual reality (VR). We thus developed two VR-based versions of the classic Color-Trails Test (CTT), a well-validated pencil-and-paper executive...

Individuals with substance use disorders are known to suffer from stress, poor sleep, and cognitive impairment. We investigated whether individuals with opioid use disorder would improve cognitive performance following a year of methadone maintenance treatment (MMT). Perceived Stress Scale (PSS), the Pittsburgh Sleep Quality Index (PSQI), and a sta...

Background: Computerized cognitive assessment facilitates the incorporation of multi-domain cognitive monitoring into routine clinical care. The predictive validity of computerized cognitive assessment among people with multiple sclerosis (PwMS) has scarcely been investigated. Objective: To explore the associations between brain volumes and cognit...

Split-belt treadmills (SBTM) contain force plates under each belt that measure ground reaction force (GRF). Initial contact (IC) detection for each gait cycle obtained from the GRF is used for calculating temporal gait parameters (e.g., gait variability, step time, stride time). Occasionally, the participant steps with one leg on the contralateral...

Background Fear of flying (FoF) is an anxiety disorder classified as a phobia. Its prevalence is estimated at 10–40% in the industrialized world, and it is accompanied by severe economic, social, vocational and emotional consequences. In recent years, virtual reality-based exposure therapy (VRET) for FoF has been introduced. One such FoF-VRET is of...

Background: Neuropsychological tests of executive function have limited real-world predictive and functional relevance. An emerging solution for this limitation is to adapt the tests for implementation in virtual reality (VR). We thus developed two VR-based versions of the classic Color-Trails Test (CTT), a well-validated pencil-and-paper executive...

Using advanced virtual reality technology, we demonstrate that exposure to virtual inclinations visually simulating inclined walking induces gait modulations in a manner consistent with expected gravitational forces (i.e., acting upon a free body), suggesting vision-based perception of gravity. The force of gravity critically impacts the regulation...

Background Multiple sclerosis (MS) may lead to cognitive decline over-time. Objectives Characterize cognitive performance in MS patients with long disease duration treated with disease modifying drugs (DMD) in relation to disability and determine the prevalence of cognitive resilience. Methods Cognitive and functional outcomes were assessed in 10...

Background: Computerized cognitive batteries may facilitate the integration of neuropsychological assessments into routine clinical care of patients with multiple sclerosis (PwMS). Objective: To assess the construct and criterion validity of a computerized, multi-domain cognitive assessment battery (CAB, NeuroTrax) in MS. Methods: 81 PwMS and 15 he...

Background: In recent years, there has been heightened interest in the short-term effects of physical exercise on cognition and mood state. However, personality traits that may account for individual differences have not been studied. Aim: To investigate whether conscientiousness is associated with improvement in visuospatial working memory (VS-WM)...

Introduction Ubiquity of Alzheimer's disease (AD) coupled with relatively ineffectual pharmacologic treatments has spurred interest in nonpharmacologic lifestyle interventions for prevention or risk reduction. However, evidence of neuroplasticity notwithstanding, there are few scientifically rigorous, ecologically relevant brain training studies fo...

Background: Evidence for an association of fasting plasma glucose (FPG) with cognitive function in adults free of diabetes is scarce and based on middle-aged and older adults. We examined the association of FPG, measured at age 30, and of change in FPG from age 30 to 43, with cognitive function at age 50. Methods: 505 nondiabetic participants of...

Background Growing ubiquity of AD coupled with lack of efficacious pharmacologic treatments to slow the associated incipient neurodegeneration has led to a shifting of focus toward prevention or risk reduction through lifestyle interventions. However, despite convincing evidence of neuroplasticity, there is a paucity of scientifically rigorous and...

Objectives: To confirm our previous findings of less cognitive impairments (based on cognitive screening tools) among Methadone Maintenance Treatment (MMT) patients who achieved take-home dose (THD) privileges. Methods: a random sample of 65 Israeli MMT patients were studied using computerized, age and education standardized, cognitive domains (...

Funding policy and medico-legal climate are part of physicians' reality and might permeate clinical decisions. This study evaluates the influence of maternal age and government funding on obstetrician/gynecologist recommendation for invasive prenatal testing (i.e. amniocentesis) for Down syndrome (DS), and its association with the physician's asses...

Background The association between subjective cognitive fatigue and objective cognitive dysfunction in patients with multiple sclerosis (PwMS) has been studied, with conflicting results. Objective To explore the impact of fatigue on cognitive function, while controlling for the influence of depression, disability, comorbidities, and psychotropic m...

Background: Whether life course anthropometric indices relate to cognitive function in midlife remains insufficiently explored. Rarely was socioeconomic position (SEP) adequately accounted for. Objective: To examine the association of the cumulative life course burden of high-ranked body mass index (BMI), its trajectory, and stature with cognitive...

Carotid atherosclerosis may be associated with cognitive decline in elderly stroke-free non-demented individuals. However the studies are few, especially amongst adults in midlife. Rarely was socioeconomic status adequately accounted for.

Background: Inflammatory markers are elevated in patients with dementia. Evidence for an association between inflammation and cognitive function in dementia-free individuals is sparse, inconsistent, and predominantly restricted to the elderly. Assessment of inflammatory markers in young adults as predictors of cognitive function in midlife, well b...

Validity of neuropsychological assessment depends, inter alia, on the cooperation of the examinee, requiring separate assessment. Stand-alone tests devised for detecting negative response bias (NRB) are exposed to potential threats to their validity. In this study, an algorithm was developed for assessing NRB within a standardized, computerized neu...

Jill turns 40. Should this change how she evaluates her life, and would a similar change occur when she turns 41? Milestone age (e.g., 30, 40, 50)-a naturally occurring feature in personal timelines-has received much attention is popular culture, but little attention in academic inquiry. This study examines whether milestone birthdays change the wa...

Genetic testing for breast and ovarian cancer can help target prevention programs, and possibly reduce morbidity and mortality. A positive result of BRCA1/2 is a substantial risk factor for breast and ovarian cancer, and its detection often leads to risk reduction interventions such as increased screening, prophylactic mastectomy and oophorectomy....

Evidence for an association of leukocyte telomere length (LTL) with cognitive function, predominantly in older adults, is inconsistent. No report has examined the association of LTL dynamics (age-specific LTL and its attrition rate) with cognitive function. We aimed to examine the association of LTL dynamics over 13 years in young adulthood with co...

OBJECTIVE: Explore predictability and effect size of SDMT and NeuroTrax computerized cognitive testing (NT-CCT) in patients with MS (PwMS) who self-report employed or unemployed. BACKGROUND: Cognitive impairment is common in PwMS. Routine cognitive function screening in MS care is uncommon. Unemployment in PwMS varies widely. Cognitive impairment c...

OBJECTIVE: Explore predictability and effect size of SDMT and NeuroTrax computerized cognitive testing (NT-CCT) in patients with MS (PwMS) who self-report employed or unemployed.

A positive test result for BRCA1/2 gene mutation is a substantial risk factor for breast and ovarian cancer. However, testing is not always covered by insurance, even for high risk women. Variables affecting willingness to pay (WTP) have implications for clinic-based and direct-to-consumer testing. The relative impact of objective and subjective nu...

A positive test result for BRCA1/2 gene mutation is a substantial risk factor for breast and ovarian cancer. However, testing is not always covered by insurance, even for high risk women. Variables affecting willingness to pay (WTP) have implications for clinic-based and direct-to-consumer testing. The relative impact of objective and subjective nu...

Governmental health agencies frequently issue warnings about new health hazards (e.g., smoking and excessive drinking). This chapter discusses factors affecting adherence to governmental warnings against the use of household products previously perceived safe. To be effective, a health warning must reach its intended audience and bring about behavi...

Studies of happiness have examined the impact of demographics, personality and emotions accompanying daily activities on life satisfaction. We suggest that how people feel while contemplating aspects of their lives, including their weight, children and future prospects, is a promising yet uncharted territory within the internal landscape of life sa...

Large-scale population studies measuring rates and dynamics of cognitive decline in multiple sclerosis (MS) are lacking. In the current cross-sectional study we evaluated the patterns of cognitive impairment in MS patients with disease duration of up to 30 years. 1,500 patients with MS were assessed by a computerized cognitive battery measuring ver...

Variation in cognitive performance. (TIF)

Correlations between GAB and NSBMS in a group of 58 MS patients. (DOCX)

Multiple linear regression analysis: GCS as the dependent variable. (DOC)

% patients with cognitive impairment at the cutoff level of -1SD and -2SD by disease duration. (DOC)

Odds ratio estimates by logistic regression. (DOC)

The ability to perform complex as well as simple cognitive tasks engages a network of brain regions that is mediated by the white matter fiber bundles connecting them. Different cognitive tasks employ distinctive white matter fiber bundles. The temporal lobe and its projections subserve a variety of key functions known to deteriorate during aging....

Recently, cognitive assessments of patients with Fabry disease highlighted neurocognitive impairment using test batteries that are time and labor intensive. To introduce a user-friendly self-administered tool for cognitive testing in patients with Fabry disease. We used a computerized system requiring about 1 hour for patient follow-up. All patient...

The most effective tests for detection of negative response bias (NRB) are based on the forced choice paradigm, but patients coached prior to their administration may easily discern their purpose. Algorithms for NRB detection based upon parameters from standard neuropsychological tests may be more difficult for patients to discern and thus more eff...

The objective of this study is to compare a computerized deep brain stimulation (DBS) screening module (Comparing Private Practice vs. Academic Centers in Selection of DBS Candidates [COMPRESS], NeuroTrax Corp., Bellaire, TX, USA) with traditional triage by a movement disorders specialized neurologist as the gold standard. The COMPRESS consists of...

Shared decision making (SDM) - involving patients in decisions relevant to their health - has been increasingly influential in medical thought and practice around the world. This paper reviews the current status of SDM in Israel, including efforts to promote SDM in the legislation and healthcare system, its influence in medical training and the nat...

WHAT ABOUT POLICY REGARDING SDM? Though informed consent and patients' right to information are regulated by Israeli law, there is a low level of formal activities focused on shared decision making (SDM) in Israel. Further, there are few organized programs to promote SDM among medical professionals or the public, and governmental support of SDM-rel...

The involvement of brain structures in specific cognitive functions is not straightforward. In order to characterize the brain micro-structural correlates of cognitive domains, 52 healthy subjects, age 25-82 years, completed a computerized neuropsychological battery and were scanned using magnetic resonance diffusion tensor imaging. Factor analysis...

The Food and Drug Administration (FDA) warned against administering over-the-counter cough and cold medicines to children under 2. This study evaluated whether experienced parents show poorer adherence to the FDA warning, as safe experiences are predicted to reduce the impact of warnings, and how adherence can be improved. Participants included 218...

Computerized cognitive assessment tools have been developed to make precise neuropsychological assessment readily available to clinicians. Mindstreams batteries for mild impairment have been validated previously. We examined the validity of a Mindstreams battery designed specifically for evaluating those with moderate cognitive impairment. 170 part...

Aging is associated with a variety of structural and pathological brain changes. Memory, or the ability to store and retrieve information, declines significantly during aging. In order to characterize the brain micro-structural correlates of memory performance, 52 healthy subjects, age 25-82 years, completed a computerized non-verbal memory test an...

Few objective cognitive assessment tools have been validated for mild cognitive impairment (MCI) in African Americans despite higher prevalence of disease. This preliminary study evaluated discriminant validity of a computerized cognitive assessment battery for MCI in an urban African American cohort. Twenty-seven participants with MCI and 22 cogni...

To test neurocognitive function in patients with late-onset Tay-Sachs disease (LOTS) using a computerized system to assess whether cognition is a clinically relevant outcome measure of possible therapeutic intervention in LOTS. Ten adults with Tay-Sachs disease were administered at least one battery of the Mindstreams Neurotrax system for evaluatio...

Neuropsychological assessment is critically dependent upon comparison to a standard normative database. While generally appropriate for individuals of near-average intelligence, high-intelligence individuals may be erroneously scored as unimpaired and low-intelligence individuals as impaired on cognitive measures. The current paper describes an app...

Early detection and diagnosis are critical to dementia care. However, many early cases remain undiagnosed as a result of the impracticality of neuropsychological testing, particularly in primary care. Mindstreams is an office-based computerized system for measuring cognitive function in multiple domains, with demonstrated validity, test-retest reli...

Cognitive impairment is amongst the main symptoms affecting multiple sclerosis (MS) and should be comprehensively and accurately assessed. To study the added value of a computerized neuropsychological battery enabling the measurement of response times in the cognitive domains, 58 randomly selected MS patients and 71 age-, gender- and education-matc...

Despite interest in causes of dementia in older persons, particularly in post-menopausal women, it is unclear whether hormone replacement therapy (HRT) is a risk factor. To assess cognitive function in post-menopausal women with high educational status receiving HRT, compared to non-users. Cognitive functioning was assessed with in women aged 55-60...