Pal Gian D, Persinger Virginia, Bernard Bryan, Ouyang Bichun, Goetz Christopher G, Verhagen Metman Leo
Department of Neurological Sciences Rush University Medical Center Chicago Illinois USA.
Mov Disord Clin Pract. 2015 Jul 14;2(4):379-383. doi: 10.1002/mdc3.12213. eCollection 2015 Dec.
We examined tolerability of preoperative neuropsychological testing (the Core Assessment Program for Surgical Interventional Therapies in Parkinson's Disease [CAPSIT-PD] protocol) for DBS. We also examined factors that may influence tolerability, including fatigue, global cognitive function, depression, and patient-based characteristics.
In this retrospective study, we reviewed preoperative neuropsychological testing results from 35 patients who were scheduled to undergo DBS. We examined the overall tolerability of the full battery and the tolerability of each test. We placed attention on a test's placement in the fixed order of the battery to measure whether there was a clustering of poorly tolerated tests toward the end of the battery as an indication of fatigue. Spearman's rank correlation was used to determine the relationship between tolerability and (1) global cognitive function, (2) depression, and (3) patient-based characteristics.
Fourteen subjects (40%) were able to tolerate the full battery and completed all 10 tests. The domains that were least tolerated pertained to executive function and procedural memory. There was a consistent time-based tolerability pattern that was observed. There was a significant correlation between tolerability and global cognitive function (= 0.344; = 0.043), but not depression ( = 0.197). There was a significant correlation between tolerability and age (= -0.491; = 0.003) and disease duration (= -0.442; = 0.008), but not UPDRS-III scores ( = 0.284).
Our results have shown limited tolerability of the full neuropsychological battery as outlined by the CAPSIT-PD protocol. We suggest the consideration of updating the neuropsychological assessment used in the CAPSIT-PD protocol.
我们研究了帕金森病深部脑刺激术(DBS)术前神经心理学测试(帕金森病手术干预治疗核心评估程序[CAPSIT-PD]方案)的耐受性。我们还研究了可能影响耐受性的因素,包括疲劳、整体认知功能、抑郁和患者个体特征。
在这项回顾性研究中,我们回顾了35例计划接受DBS治疗患者的术前神经心理学测试结果。我们检查了整套测试的总体耐受性以及每项测试的耐受性。我们关注测试在固定测试顺序中的位置,以测量耐受性差的测试是否集中在测试序列末尾,以此作为疲劳的指标。采用斯皮尔曼等级相关分析来确定耐受性与以下因素之间的关系:(1)整体认知功能;(2)抑郁;(3)患者个体特征。
14名受试者(40%)能够耐受整套测试并完成了全部10项测试。耐受性最差的领域与执行功能和程序记忆有关。观察到一种基于时间的一致耐受性模式。耐受性与整体认知功能之间存在显著相关性(r = 0.344;P = 0.043),但与抑郁无关(r = 0.197)。耐受性与年龄(r = -0.491;P = 0.003)和病程(r = -0.442;P = 0.008)之间存在显著相关性,但与统一帕金森病评定量表第三部分(UPDRS-III)评分无关(r = 0.284)。
我们的结果表明,CAPSIT-PD方案所概述的整套神经心理学测试耐受性有限。我们建议考虑更新CAPSIT-PD方案中使用的神经心理学评估。