Szeto Jennifer Y Y, Mowszowski Loren, Gilat Moran, Walton Courtney C, Naismith Sharon L, Lewis Simon J G
Parkinson's Disease Research Clinic, Brain and Mind Research Institute, University of Sydney, NSW, Australia.
Parkinson's Disease Research Clinic, Brain and Mind Research Institute, University of Sydney, NSW, Australia; Healthy Brain Ageing Program, Brain and Mind Research Institute, University of Sydney, NSW, Australia.
Parkinsonism Relat Disord. 2015 Jan;21(1):31-5. doi: 10.1016/j.parkreldis.2014.10.020. Epub 2014 Oct 28.
Using the Movement Disorder Society (MDS) Task Force Level 1 criteria, this study examined the classification of mild cognitive impairment in Parkinson's Disease (PD-MCI) derived from a range of cut-off scores that have previously been suggested by the MDS Task Force. Furthermore, differences in PD-MCI frequencies were examined when comparing performance on current neuropsychological testing to the normative sample, as opposed to decline from premorbid functioning, as evidence of cognitive impairment.
Two hundred and thirty-four non-demented PD patients underwent neurological and neuropsychological assessment at the Parkinson's Disease Research Clinic at the Brain and Mind Research Institute, University of Sydney.
When cognitive impairment was defined as 1SD and 1.5SD below premorbid intellect, 109 patients (47%) and 76 (32%) patients met criteria for PD-MCI respectively. This proportion dropped considerably to 50 patients (21%) with a 2SD cut-off score. However, when calculating impairment based on comparisons with normative data, only 68 patients (29%) and 41 patients (18%) met PD-MCI criteria when a cut-off score of 1 and 1.5SD was employed. This proportion dropped to just 22 patients (9%) with a 2SD cut-off score.
Results from the present study suggest that the MDS PD-MCI criteria may be too broad, as substantial differences in frequencies of PD-MCI were observed with the application of differing criteria. We propose that a 1.5SD cut-off score below premorbid functioning may provide greater utility in characterizing PD-MCI than a 1.5SD cut-off below normative data, which has been widely applied in previous studies examining the MDS PD-MCI criteria.
本研究采用运动障碍协会（MDS）工作组一级标准，考察了根据MDS工作组先前提出的一系列临界值分数得出的帕金森病轻度认知障碍（PD-MCI）的分类。此外，将当前神经心理学测试表现与常模样本进行比较时，研究了PD-MCI频率的差异，而非将病前功能下降作为认知障碍的证据。
234名非痴呆型帕金森病患者在悉尼大学脑与心智研究所帕金森病研究诊所接受了神经学和神经心理学评估。
当将认知障碍定义为低于病前智力1个标准差和1.5个标准差时，分别有109名患者（47%）和76名患者（32%）符合PD-MCI标准。当临界值分数为2个标准差时，这一比例大幅降至50名患者（21%）。然而，在根据与常模数据的比较计算损伤时，当采用1个标准差和1.5个标准差的临界值分数时，分别只有68名患者（29%）和41名患者（18%）符合PD-MCI标准。当临界值分数为2个标准差时，这一比例降至仅22名患者（9%）。
本研究结果表明，MDS的PD-MCI标准可能过于宽泛，因为应用不同标准时观察到PD-MCI频率存在显著差异。我们建议，与在先前研究MDS的PD-MCI标准时广泛应用的低于常模数据1.5个标准差的临界值相比，低于病前功能1.5个标准差的临界值分数在表征PD-MCI方面可能更有用。
