Foley Jennifer A, Niven Elaine H, Paget Andrew, Bhatia Kailash P, Farmer Simon F, Jarman Paul R, Limousin Patricia, Warner Thomas T, Morris Huw R, Bak Thomas H, Abrahams Sharon, Cipolotti Lisa
National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
UCL Institute of Neurology, Queen Square, London, UK.
Parkinsons Dis. 2018 May 9;2018:2426012. doi: 10.1155/2018/2426012. eCollection 2018.
Disentangling Parkinson's disease (PD) and progressive supranuclear palsy (PSP) may be a diagnostic challenge. Cognitive signs may be useful, but existing screens are often insufficiently sensitive or unsuitable for assessing people with motor disorders. We investigated whether the newly developed ECAS, designed to be used with people with even severe motor disability, was sensitive to the cognitive impairment seen in PD and PSP and able to distinguish between these two disorders. Thirty patients with PD, 11 patients with PSP, and 40 healthy controls were assessed using the ECAS, as well as an extensive neuropsychological assessment. The ECAS detected cognitive impairment in 30% of the PD patients, all of whom fulfilled the diagnostic criteria for mild cognitive impairment. The ECAS was also able to detect cognitive impairment in PSP patients, with 81.8% of patients performing in the impaired range. The ECAS total score distinguished between the patients with PSP and healthy controls with high sensitivity (91.0) and specificity (86.8). Importantly, the ECAS was also able to distinguish between the two syndromes, with the measures of verbal fluency offering high sensitivity (82.0) and specificity (80.0). In sum, the ECAS is a quick, simple, and inexpensive test that can be used to support the differential diagnosis of PSP.
区分帕金森病（PD）和进行性核上性麻痹（PSP）可能是一项诊断挑战。认知症状可能有用，但现有的筛查往往不够敏感，或者不适用于评估患有运动障碍的人群。我们研究了新开发的ECAS，它旨在用于即使是严重运动残疾的人群，是否对PD和PSP中出现的认知障碍敏感，以及能否区分这两种疾病。使用ECAS以及广泛的神经心理学评估对30名PD患者、11名PSP患者和40名健康对照进行了评估。ECAS在30%的PD患者中检测到认知障碍，所有这些患者均符合轻度认知障碍的诊断标准。ECAS也能够在PSP患者中检测到认知障碍，81.8%的患者表现为受损范围。ECAS总分以高敏感性（91.0）和特异性（86.8）区分了PSP患者和健康对照。重要的是，ECAS也能够区分这两种综合征，语言流畅性测量具有高敏感性（82.0）和特异性（80.0）。总之，ECAS是一种快速、简单且廉价的测试，可用于支持PSP的鉴别诊断。
