Martin Roy, Sawrie Stephen, Gilliam Frank, Mackey Melissa, Faught Edward, Knowlton Robert, Kuzniekcy Ruben
Department of Neurology and UAB Epilepsy Center, University of Alabama at Birmingham, Birmingham, Alabama 35294-0021, USA.
Epilepsia. 2002 Dec;43(12):1551-8. doi: 10.1046/j.1528-1157.2002.23602.x.
Reliable change indices (RCIs) and standardized regression-based (SRB) change scores norms were established for the recently revised Wechsler Adult Intelligence Scale-III (WAIS-III) and Wechsler Memory Scale-III (WMS-III) in patients with complex partial seizures. Establishment of such standardized change scores can be useful in determining the effects of epilepsy surgery on cognitive functioning independent of test-retest artifacts including practice effects.
Forty-two nonoperated-on adult patients with complex partial seizures (primarily of temporal lobe onset) were administered the WMS-III and WAIS-III on two occasions (mean 7-month interval). All patients were receiving stable antiepileptic drug (AED) treatment at both testings. RCI and SRB change scores were calculated. Confidence interval cutoff scores (90% and 80%) and standardized regression equations were calculated for each of the WAIS-III and WMS-III Primary Indices and individual subtests. Age, gender, education, test-retest interval, preoperative test performance, seizure onset, and seizure duration were predictor variables for the SRB equations.
Test-retest reliabilities for the WAIS-III and WMS-III Primary Indices were within acceptable ranges, although considerable individual subtest variability was found. Preoperative performance was the single largest contributor to each of the predictive regression equations. Age, gender, education, seizure onset, and seizure duration contributed modest variance to several of the regression equations.
We calculated both RCI and SRB change score indices for the recently revised Wechsler instruments. These formulas help control for test-retest methodologic artifacts and provide a standardized method with which to examine both individual and group level cognitive change after epilepsy surgery.
为近期修订的韦氏成人智力量表第三版（WAIS - III）和韦氏记忆量表第三版（WMS - III）建立复杂部分性发作患者的可靠变化指数（RCI）和基于标准化回归的（SRB）变化分数常模。建立此类标准化变化分数有助于确定癫痫手术对认知功能的影响，而不受包括练习效应在内的重测假象的影响。
对42例未接受手术的成人复杂部分性发作患者（主要为颞叶起始）进行两次WMS - III和WAIS - III测试（平均间隔7个月）。所有患者在两次测试时均接受稳定的抗癫痫药物（AED）治疗。计算RCI和SRB变化分数。为WAIS - III和WMS - III的每个主要指数及各个子测验计算置信区间临界分数（90%和80%）以及标准化回归方程。年龄、性别、教育程度、重测间隔、术前测试表现、发作起始和发作持续时间是SRB方程的预测变量。
WAIS - III和WMS - III主要指数的重测信度在可接受范围内，尽管发现各个子测验存在相当大的变异性。术前表现是每个预测回归方程的最大单一贡献因素。年龄、性别、教育程度、发作起始和发作持续时间对几个回归方程贡献了适度的方差。
我们为近期修订的韦氏量表计算了RCI和SRB变化分数指数。这些公式有助于控制重测方法学假象，并提供一种标准化方法来检查癫痫手术后个体和群体水平的认知变化。
