基于智能手机的帕金森病干扰测试的可行性。

Feasibility of Smartphone-Based Testing of Interference in Parkinson's Disease.

机构信息

Department of Neuroscience, The Alfred Hospital, Melbourne, Victoria, Australia.

Van Cleef Roet Centre for Nervous Diseases, Monash University, The Alfred Hospital, Melbourne, Victoria, Australia.

出版信息

Neurodegener Dis. 2018;18(2-3):133-142. doi: 10.1159/000488593. Epub 2018 Jun 25.

DOI:10.1159/000488593

PMID:29940579

Abstract

BACKGROUND

Interference refers to learned associations and established behaviors "interfering" with response to new material. It forms a core pillar of executive functions, which are commonly affected in Parkinson's disease (PD). Cognitive interference test (CIT) forms part of a smartphone application designed for ambulatory assessment in PD.

OBJECTIVE

The aims of this study were to establish that CIT could effectively demonstrate interference and would perform comparably to the Stroop Color-Word Test Victoria version (VST) despite PD-related motor impairment.

METHODS

Ninety-nine patients with PD were recruited. Initial evaluation included CIT, VST, Montreal cognitive assessment (MOCA), and Movement Disorders Society-sponsored revision of the -Unified Parkinson's Disease Rating Scale (MDS-UPDRS-III). A group of patients underwent repeat assessment within 2 weeks. Thirty-four healthy controls were recruited for comparison.

RESULTS

Patients' mean age was 66.2 years, disease duration was 8.7 years, on-state MDS-UPDRS-III was 22, and MOCA total score was 27. CIT effectively generated interference, whereby the total time taken to complete the incongruent task was 20% longer compared to that of the baseline task. CIT key test items demonstrated convergent validity to VST (r = 0.478-0.644, p < 0.0001) and satisfactory repeatability (intraclass correlation coefficient 0.46-0.808, p ≤ 0.0002). Performance on key CIT test parameters deteriorated with increasing age (r = 0.225-0.478, p < 0.01) and MDS-UPDRS-III total score (r = 0.354-0.481, p < 0.0001). When compared to controls and patients with less motor impairment, patients MDS-UPDRS-III > 30 took longer to complete CIT and VST and had lower MOCA-attention sub-score, implying that the degree of motor impairment could not be the sole explanation for reduced CIT performance.

CONCLUSIONS

We established that despite motor impairment, the novel approach of using smartphone technology to test interference in PD patients is feasible.

摘要

背景

干扰是指对新事物的反应受到已习得的联想和既定行为的“干扰”。它是执行功能的核心支柱之一，而执行功能在帕金森病（PD）中通常会受到影响。认知干扰测试（CIT）是专为 PD 患者的日常评估而设计的智能手机应用程序的一部分。

目的

本研究旨在证明 CIT 能够有效地显示干扰，并且尽管存在与 PD 相关的运动障碍，但与 Stroop 颜色-单词测试维多利亚版（VST）相比表现相当。

方法

招募了 99 名 PD 患者。初步评估包括 CIT、VST、蒙特利尔认知评估（MOCA）和运动障碍协会赞助的帕金森病修订统一评分量表（MDS-UPDRS-III）。一组患者在 2 周内进行了重复评估。招募了 34 名健康对照者进行比较。

结果

患者的平均年龄为 66.2 岁，疾病持续时间为 8.7 年，处于开启状态的 MDS-UPDRS-III 评分为 22 分，MOCA 总分为 27 分。CIT 有效地产生了干扰，与基线任务相比，完成不一致任务所花费的总时间延长了 20%。CIT 的关键测试项目与 VST 具有良好的相关性（r=0.478-0.644，p<0.0001），并且具有良好的可重复性（组内相关系数 0.46-0.808，p≤0.0002）。关键 CIT 测试参数的表现随着年龄的增长而恶化（r=0.225-0.478，p<0.01）和 MDS-UPDRS-III 总分（r=0.354-0.481，p<0.0001）。与对照组和运动障碍较轻的患者相比，MDS-UPDRS-III>30 的患者完成 CIT 和 VST 的时间更长，且 MOCA 注意力子评分较低，这表明运动障碍的严重程度不能完全解释 CIT 表现下降的原因。