Souza Carolina Pinto, Oliveira Guiomar Nascimento, Foss Maria Paula, Tumas Vitor
Department of Neuroscience and Behavior, Ribeirão Preto School of Medicine, University of São Paulo, University Campus, Ribeirão Preto, SP 14049-900, Brazil.
Department of Neuroscience and Behavior, Ribeirão Preto School of Medicine, University of São Paulo, University Campus, Ribeirão Preto, SP 14049-900, Brazil.
J Clin Neurosci. 2016 Jul;29:145-8. doi: 10.1016/j.jocn.2015.09.026. Epub 2016 Mar 5.
The interlocking finger test (ILFT) is a bedside screening test in which the subject must imitate four bimanual finger gestures without symbolic meaning. We assessed the utility of the test in the cognitive evaluation of patients with Parkinson's disease (PD). We evaluated 88 healthy subjects and 101 patients with PD using a simplified motor score of the Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr and Schwab and England scales, Geriatric Depression Scale, Pfeffer Functional Activities Questionnaire, Clinical Dementia Rating, Mini-Mental State Examination, clock drawing test, digit span, word list battery of the Consortium to Establish a Registry for Alzheimer's Disease assessment, Frontal Assessment Battery, semantic verbal fluency test, and the ILFT. Diagnoses of mild cognitive impairment and dementia were made using the Movement Disorder Society diagnostic criteria. ILFT scores in healthy subjects correlated significantly with age (p=0.001) and only one healthy subject scored 2 in the test. ILFT scores were significantly lower in patients with PD and dementia (p=0.001) and significantly correlated with cognitive and functional tests, but not with depressive symptoms (p=0.607), Hoehn and Yahr scores (p=0.907), or Schwab and England scores (p=0.701). Twenty-five patients with dementia, three patients with mild cognitive impairment, and six patients with apparently normal cognition scored less than 3 in the ILFT. The area under the receiver operating characteristic curve for the ILFT to discriminate patients with dementia from those without it was 0.76 (cut-off score of 3/2: sensitivity of 61%, specificity of 0.85). In conclusion, the ILFT seems to be a useful bedside test to assess cognitive impairment in patients with PD.
交锁手指试验（ILFT）是一种床边筛查试验，受试者必须模仿四种无象征意义的双手手指动作。我们评估了该试验在帕金森病（PD）患者认知评估中的效用。我们使用统一帕金森病评定量表（UPDRS）的简化运动评分、霍恩和雅尔分级量表、施瓦布和英格兰量表、老年抑郁量表、 Pfeffer功能活动问卷、临床痴呆评定量表、简易精神状态检查表、画钟试验、数字广度、阿尔茨海默病评估注册协会的单词表测验、额叶评估量表、语义言语流畅性测试以及ILFT，对88名健康受试者和101名PD患者进行了评估。使用运动障碍协会的诊断标准对轻度认知障碍和痴呆进行诊断。健康受试者的ILFT评分与年龄显著相关（p = 0.001），且只有一名健康受试者在该试验中得分为2分。PD伴痴呆患者的ILFT评分显著更低（p = 0.001），并且与认知和功能测试显著相关，但与抑郁症状（p = 0.607）、霍恩和雅尔评分（p = 0.907）或施瓦布和英格兰评分（p = 0.701）无关。25名痴呆患者、3名轻度认知障碍患者和6名认知明显正常的患者在ILFT中的得分低于3分。ILFT区分痴呆患者与非痴呆患者的受试者工作特征曲线下面积为0.76（截断分数为3/2：灵敏度为61%，特异性为0.85）。总之，ILFT似乎是评估PD患者认知障碍的一种有用的床边试验。
