Talebi Mahnaz, Majdi Alireza, Kamari Farzin, Sadigh-Eteghad Saeed
Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.; Department of Persian Medicine, Faculty of Persian Medicine, Tabriz University of Medical Sciences, Tabriz, Iran..
Mult Scler Relat Disord. 2020 Aug;43:102172. doi: 10.1016/j.msard.2020.102172. Epub 2020 May 15.
We determined how the Cambridge Neuropsychological Test Automated Battery (CANTAB) compared to the Minimal Assessment of Cognitive Function in multiple sclerosis (MACFIMS) in terms of sensitivity, specificity, and predictive values in detecting cognitive impairment in multiple sclerosis (MS) patients.
Sixty MS patients were recruited, 2 of whom were lost to follow-up. On the first day of the neuropsychological examination, the standard MACFIMS battery and the day after, the CANTAB (paired-associate learning (PAL), reaction time (RTI), rapid visual information processing (RVP), and spatial working memory tasks (SWM)) were completed by the patients. The sensitivity, specificity, and predictive values of the CANTAB in the differentiation of cognitively impaired (CI) patients from not cognitively impaired (NCI) ones were compared with those of the MACFIMS battery using appropriate statistical tests.
Fifty-eight patients were categorized into two groups of CI (n=16 (27.58%)) and NCI (n=42 (72.41%)) based on the MACFIMS battery standard criteria. The best reporter indices and their cut-off scores for differentiation of CI from NCI patients in each task of the CANTAB were "total errors=13" for PAL, "between errors=26" for SWM, "five-choice reaction time=368.57" for RTI, and "mean latency=522.14" for RVP. The optimal cut-off point for distinguishing CI from NCI in the CANTAB was found to be an impaired function in 3 or more tasks [(AUC (95% CI): 0.97 (0.94-1.00); p<0.001)]. Accordingly, 36.20% of the patients were CI based on the CANTAB criteria. The inter-test agreement (CANTAB and MACFIMS batteries) was found to be the highest (Cohen's κ (95% CI): 0.80 (0.64-0.96)).
Results confirm that the CANTAB can discriminate CI from NCI MS patients with high accuracy, and its results are comparable to those of the MACFIMS battery; thus, they might be interchangeably used in the clinical practice.
我们确定了剑桥神经心理测试自动成套系统（CANTAB）与多发性硬化症认知功能简易评估（MACFIMS）在检测多发性硬化症（MS）患者认知障碍方面的敏感性、特异性和预测价值。
招募了60例MS患者，其中2例失访。在神经心理检查的第一天，患者完成标准的MACFIMS成套测试，第二天完成CANTAB测试（配对联想学习（PAL）、反应时间（RTI）、快速视觉信息处理（RVP）和空间工作记忆任务（SWM））。使用适当的统计检验，将CANTAB在区分认知受损（CI）患者和未认知受损（NCI）患者方面的敏感性、特异性和预测价值与MACFIMS成套测试进行比较。
根据MACFIMS成套测试的标准标准，58例患者被分为CI组（n = 16（27.58%））和NCI组（n = 42（72.41%））。CANTAB各任务中区分CI患者和NCI患者的最佳报告指标及其临界值分别为：PAL的“总错误数 = 13”、SWM的“组间错误数 = 26”、RTI的“五项选择反应时间 = 368.57”和RVP的“平均潜伏期 = 522.14”。发现CANTAB中区分CI和NCI的最佳临界点是3项或更多任务功能受损[（AUC（95%CI）：0.97（0.94 - 1.00）；p < 0.001）]。因此，根据CANTAB标准，36.20%的患者为CI。发现测试间一致性（CANTAB和MACFIMS成套测试）最高（科恩κ系数（95%CI）：0.80（0.64 - 0.96））。
结果证实，CANTAB能够高精度地区分MS患者中的CI和NCI，其结果与MACFIMS成套测试相当；因此，它们在临床实践中可能可互换使用。
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