Laursen P
Danish National Institute of Occupational Health, Copenhagen, Denmark.
Acta Neurol Scand Suppl. 1990;131:1-108.
With the growing importance of occupational behavioural neurotoxicology the demand for a standardized and reliable cognitive test battery has become urgent. The present study deals with the compilation of a test battery, the purpose of which is to be sensitive to mild brain dysfunction and suitable for modern microcomputer administration and scoring. The battery comprises tests of learning and memory functions specific for each brain hemisphere (Face Recognition Test and Number Learning Test), visuomotor function separately for continuous and discrete tasks (Figure Drawing Test and Pen-to-Point Test), visuospatial function (Parallelogram Test), visual and auditive perception, attention and vigilance (Bourdon-Wiersma Test and Continuous Reaction-Time Test), and concentration (Continuous Graphics Test). The complete test battery was administered and scored on a slightly modified Tektronix 4052 computer with a Tektronix 4956 digitizer as a peripheral device. The validity of the battery was analysed on the basis of a sample of the normal Danish population (N = 1262) stratified for the ages 30, 40, 50, and 60 years, the two sexes, and residence in one of 11 municipalities in the western part of Copenhagen County. Using a 16-dimensional multivariate model comprising biological, social, psychological, and environmental factors, and also examiner behaviour, statistical analyses confirmed hypotheses of influence by the factors Age, Sex, Schooling, and Social Group, i.e. these factors partially explained the variance in the case of almost all the test parameters. Moreover, psychic stress, as determined in a questionnaire, had explanatory power with tests demanding attention and concentration. Hypotheses of effects on test performance by Smoking Status and psychophysiological diurnal or annual rhythms, i.e. Time of Day, and Time of Year, were confirmed for a few parameters, but the effects differed to some extent from those described in the literature. Alcohol Consumption, Drug Consumption Affecting the CNS, Cardiovascular Diseases or Disorders, Metabolic Diseases or Disorders, CNS Injuries or Disorders, and Occupational Activity Status, all revealed by questionnaire, were not found to show the assumed significant effects on test performance. However, a hypothesis of an effect originating in differences between different examiners' behaviour was confirmed for a number of test parameters, although all the test measurements and scorings were done automatically by computer. On the basis of a re-examination of 19 patients previously diagnosed as suffering from diffuse organic psychosyndrome, the sensitivity of the test battery was estimated to be 0.79. The specificity was estimated to be 0.79 on the basis of the results of the original sample.(ABSTRACT TRUNCATED AT 400 WORDS)
随着职业行为神经毒理学的重要性日益增加,对标准化且可靠的认知测试组合的需求变得紧迫。本研究涉及一种测试组合的编制,其目的是对轻度脑功能障碍敏感,并适用于现代微机管理和评分。该测试组合包括针对每个脑半球的学习和记忆功能测试(面部识别测试和数字学习测试)、针对连续和离散任务的视觉运动功能单独测试(图形绘制测试和点笔测试)、视觉空间功能测试(平行四边形测试)、视觉和听觉感知、注意力和警觉性测试(布尔登 - 维尔斯马测试和连续反应时间测试)以及注意力集中测试(连续图形测试)。完整的测试组合在一台稍作修改的泰克4052计算机上进行管理和评分,该计算机配备泰克4956数字化仪作为外围设备。基于对丹麦正常人群样本(N = 1262)的分析来评估该测试组合的有效性,该样本按年龄30、40、50和60岁、性别以及居住在哥本哈根县西部11个市之一进行分层。使用一个包含生物、社会、心理和环境因素以及考官行为的16维多变量模型,统计分析证实了年龄、性别、受教育程度和社会群体等因素的影响假设,即这些因素在几乎所有测试参数的情况下都部分解释了方差。此外,通过问卷调查确定的心理压力,对需要注意力和集中力的测试具有解释力。吸烟状况以及心理生理昼夜或年度节律(即一天中的时间和一年中的时间)对测试表现影响的假设,在一些参数上得到了证实,但这些影响在一定程度上与文献中描述的不同。通过问卷调查揭示的饮酒、影响中枢神经系统的药物使用、心血管疾病或紊乱、代谢疾病或紊乱、中枢神经系统损伤或紊乱以及职业活动状况,均未发现对测试表现有假定的显著影响。然而,尽管所有测试测量和评分都是由计算机自动完成的,但对于一些测试参数,不同考官行为差异产生影响的假设得到了证实。基于对19名先前被诊断患有弥漫性器质性精神综合征的患者的重新检查,估计该测试组合的敏感性为0.79。根据原始样本的结果,特异性估计为0.79。(摘要截取自400字)