中国人群帕金森病轻度认知障碍综合认知域评估量表的筛选及诊断效度分析
Screening and diagnostic validity of the comprehensive cognitive domain assessment scale for mild cognitive impair-ment in the Chinese population with Parkinson disease
薛晓帆 1吴志悦 1黄安琪 1安静 2刘国臻 3张丽娟 4许保磊 4冯焕焕 1陈彪 5许二赫1
作者信息
- 1. 首都医科大学宣武医院神经内科,北京 100053
- 2. 首都医科大学宣武医院神经生物学研究室,北京 100054
- 3. 北京帕云医疗科技有限公司,北京 100073
- 4. 首都医科大学宣武医院国家老年疾病临床医学研究中心,北京 100053
- 5. 首都医科大学宣武医院神经内科,北京 100053;首都医科大学宣武医院国家老年疾病临床医学研究中心,北京 100053
- 折叠
摘要
目的 帕金森病(PD)中轻度认知障碍(MCI)的诊断方法不一,目前适用PD-MCI的神经心理学量表缺乏共识,制定合适的综合量表势在必行.方法 本研究纳入92例诊断明确的PD非痴呆患者,进行中国版PD-MCI指南和运动障碍学会推荐的五大认知域综合量表.根据本课题组正常对照组在相同量表下计算的常模,将患者分为PD非认知障碍和PD-MCI.采用t检验观察量表一致性,应用受试者工作特征曲线分析各量表在识别PD-MCI各认知域损害敏感度特异度最高的临界值,结合二元Logistic回归最终确定PD-MCI综合认知域评估量表具体内容.结果 研究发现应用简版视空间记忆测验长时回忆、画钟、数字广度倒背、连线A时间、词语流畅性水果、连线B时间、相似性、波士顿命名、听觉词语学习测验长时回忆及逻辑记忆测验短时回忆组合下的十分制综合认知域评估量表在预测PD-MCI方面具有显著的诊断效度,曲线下面积为0.971(95%CI 0.941～1.000).结论 使用推荐的临界值后可以更好将PD-MCI进行亚型分析,便于临床观察各亚型PD-MCI转归及临床特异性,具有一定临床意义.
Abstract
Objective To develop an appropriate comprehensive scale for mild cognitive impairment in Parkinson dis-ease(PD-MCI)due to various diagnostic methods for PD-MCI and a lack of consensus on the applicable neuropsychological scales for PD-MCI.Methods A total of 92 non-dementia PD patients with a confirmed diagnosis were enrolled in this study,and all patients were assessed using the comprehensive scale of five cognitive domains recommended by the Chinese version of PD-MCI guidelines and Movement Disorder Society(MDS).Based on the norms of healthy controls assessed by the same scale,the patients were divided into non-cognitive impairment PD group and PD-MCI group.The t-test was used to observe the consistency between groups;the receiver operating characteristic(ROC)curve was used to investigate the cut-off value of each scale with the highest sensitivity and specificity in identifying the impairment in each cognitive domain of PD-MCI;a binary lo-gistic regression analysis was used to determine the specific contents of the comprehensive cognitive domain assessment scale for PD-MCI.Results This study showed that the ten-point comprehensive cognitive domain assessment scale based on long-time memory in Brief Visuospatial Memory Test,Clock Drawing Test,digit span backward test,Trail Making Test A,Verbal Flu-ency Test,Trail Making Test B,Similarities,Boston Naming Test,long-time recall memory in Auditory Verbal Learning Test,and short-time recall memory in Wechsler Memory Scale-IV Logical Memory Test had a significant diagnostic validity in predict-ing PD-MCI,with an area under the ROC curve of 0.971(95%CI 0.941‒1.000).Conclusion The recommended cut-off value can be used to perform a subtype analysis of PD-MCI and observe the outcome and clinical specificity of different subtypes of PD-MCI,and therefore,it has a certain clinical significance.
关键词
帕金森病/轻度认知障碍/神经心理量表Key words
Parkinson disease/Mild cognitive impairment/Neuropsychological scale引用本文复制引用
基金项目
国家重点研发计划(2021YFC2501200)
出版年
2024
国家科技期刊平台
NSTL
万方数据