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Automated Neuropsychological Assessment Metrics (ANAM)
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Core: Sport-Related Concussion (SRC)
Core: One of the Core Cognitive Assessment measures should be collected: Automated Neuropsychological Assessment Metrics (ANAM), Axon Sports Computerized Cognitive Assessment Tool (CCAT), CNS Vital Signs, or Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). Please note that these could be replaced by a pen or paper battery under the direction of a neuropsychologist.
Core: One of Core Symptoms Checklists should be collected: Automated Neuropsychological Assessment Metrics (ANAM), Axon Sports Computerized Cognitive Assessment Tool (CCAT), Child Sport Concussion Assessment Tool (Child-SCAT), Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Post Concussion Symptom Inventory (PCSI), Post Concussion Symptoms Scale (PCS-S), Sport Concussion Assessment Tool (SCAT-3) or (SCAT-5), Standardized Assessment of Concussion (SAC), or Rivermead Post-Concussive Symptoms Questionnaire (RPQ).
Supplemental: Acute Hospitalized, Concussion/Mild TBI, Epidemiology, Moderate/Severe TBI: Rehabilitation Traumatic Brain Injury (TBI), Mitochondrial Disease (Mito) and Myalgic encephalomyelitis/Chronic fatige syndrome (ME/CFS)
Exploratory:  Multiple Sclerosis (MS)
Short Description of Instrument
The Automated Neuropsychological Assessment Metrics (ANAM) is a computer-based neurocognitive assessment tool developed specifically for use in the military. United States service members must complete the ANAM within 12 months prior to deployment for a baseline record of the following aspects of neurocognitive function: speed and accuracy of attention, memory, and thinking ability. More recently, the ANAM has also been used in cognitive and neuroimaging studies in civilian populations including healthy adults (Morasch et al., 2015), individuals with Senile Dementia of the Alzheimers Type (SDAT; Levinson et al., 2005), multiple sclerosis (MS; Pellicano et al., 2013), sports concussion (Bleiberg et al., 2004), mild traumatic brain injury (mTBI; Sours et al., 2015), as well as Fibromyalgia (FM; Walitt et al., 2008; Cook et al., 2005). The ANAM is normed to be administered to individuals ranging in age from 16 to 65.
The TBI battery tests simple reaction time, code substitution, code substitution delayed, matching to sample, procedural reaction time, and mathematical processing and includes a sleepiness scale and a mood scale. If an injury is sustained during deployment, the test is repeated to measure changes in neurocognitive function.
The computer-based TBI battery of the ANAM takes 15–20 minutes to complete. A baseline test must be completed before deployment and a repeat test may be completed if there is suspicion of TBI.
ME/CFS Specific: To date, the ANAM has not yet been published as a cognitive tool used in a study specifically aimed at individuals with ME/CFS. However, given the cognitive weaknesses identified in the ME/CFS literature, it is recommended to use an ANAM battery used with populations with mTBI or sports concussions.
Limitations: Some ME/CFS patients have trouble taking computer driven tests. Specifically, as multi-tasking is generally problematic for this disease population, difficulties following instructions on how to access the task by using a computer keyboard may compete with task performance; therefore, training is essential. Some patients also have difficulties viewing computer screens due to photophobia.
Sleepiness Scale: Participant selects from 7 stages of alertness, from “Feeling very alert, wide awake, and energetic” to “Very sleepy and cannot stay awake much longer”
Mood Scale: Participant indicates on a scale of 0 to 6 their current state for each of Vigor, Happiness, Depression, Anger, Fatigue, Anxiety, and Restlessness with “0” as “Not at all” to “6” as “Very Much”
Simple reaction time: Reaction time is captured for 40 trials
Code substitution: Number of correct response to code substitution out of 72 trials
Procedural reaction time: Reaction time and processing efficiency measured for 32 trials
Mathematical processing: Number of correct responses out of 20 trials
Matching to sample: Number of correct responses in 20 trials
Code substitution delayed: Number of correct response to code substitution out of 36 trials
Automated Neuropsychological Assessment Metrics, 4th ed. Norman, OK: C-SHOP, 2007.
Bleiberg J, Cernich AN, Cameron K, Sun W, Peck K, Ecklund PJ, Reeves D, Uhorchak J, Sparling MB, Warden DL. Duration of cognitive impairment after sports concussion. Neurosurgery. 2004;54(5):1073–1078; discussion 1078–1080.
Cook DB, Nagelkirk PR, Peckerman A, Poluri A, Mores J, Natelson BH. Exercise and cognitive performance in chronic fatigue syndrome. Med Sci Sports Exerc. 2005;37(9):1460–1467.
Friedl KE, Grate SJ, Proctor SP, Ness JW, Lukey BJ, Kane RL. Army research needs for automated neuropsychological tests: monitoring soldier health and performance status. Arch Clin Neuropsychol. 2007;22 Suppl 1:S7–14.
Kane RL, Reeves D. Computerized test batteries. In A. Horton (Ed.), The Neuropsychological Handbook. New York, NY: Springer, 1997.
Levinson D, Reeves D, Watson J, Harrison M. Automated neuropsychological assessment metrics (ANAM) measures of cognitive effects of Alzheimer's disease. Arch Clin Neuropsychol. 2005;20(3):403–408.
Morasch KC, Aaron CL, Moon JE, Gordon RK. Physiological and neurobehavioral effects of cholinesterase inhibition in healthy adults. Physiol Behav. 2015;138:165–172.
National Defense Authorization Act for Fiscal Year 2008, Public Law 110-181. HR 1585, Sect. 1618, 110th Congress (2008).
Pellicano C, Kane RL, Gallo A, Xiaobai L, Stern SK, Ikonomidou VN, Evangelou IE, Ohayon JM, Ehrmantraut M, Cantor FK, Bagnato F. Cognitive impairment and its relation to imaging measures in multiple sclerosis: a study using a computerized battery. J Neuroimaging. 2013;23(3):445–452.
Reeves DL, Winter KP, Bleiberg J, Kane RL. ANAM genogram: historical perspectives, description, and current endeavors. Arch Clin Neuropsychol. 2007;22 Suppl 1:S15–37.
Sours C, Rosenberg J, Kane R, Roys S, Zhuo J, Shanmuganathan K, Gullapalli RP. Associations between interhemispheric functional connectivity and the Automated Neuropsychological Assessment Metrics (ANAM) in civilian mild TBI. Brain Imaging Behav. 2015;9(2):190–203. Erratum in: Brain Imaging Behav. 2015;9(2):353–354.
Vincent AS, Roebuck-Spencer T, Gilliland K, Schlegel R. Automated Neuropsychological Assessment Metrics (v4) Traumatic Brain Injury Battery: military normative data. Mil Med. 2012;177(3):256–269.
Walitt B, Roebuck-Spencer T, Bleiberg J, Foster G, Weinstein A. Automated neuropsychiatric measurements of information processing in fibromyalgia. Rheumatol Int. 2008;28(6):561–566.
Warden DL, Bleiberg J, Cameron KL, Ecklund J, Walter J, Sparling MB, Reeves D, Reynolds KY, Arciero R. Persistent prolongation of simple reaction time in sports concussion. Neurology. 2001;57(3):524–526.
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