Schedlich-Teufer Charlotte, Jost Stefanie Theresa, Krack Paul, Witt Karsten, Weintraub Daniel, Baldermann Juan Carlos, Sommerauer Michael, Amstutz Deborah, van Eimeren Thilo, Dafsari Haidar Salimi, Kalbe Elke, Visser-Vandewalle Veerle, Fink Gereon Rudolf, Kessler Josef, Barbe Michael Thomas
Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland.
J Parkinsons Dis. 2021;11(3):1417-1430. doi: 10.3233/JPD-202375.
Assessment of affective-behavioral states in patients with Parkinson's disease (PD) undergoing deep brain stimulation (DBS) is essential.
To analyze well-established questionnaires as a pilot-study with the long term aim to develop a screening tool evaluating affective-behavioral dysfunction, including depression, anxiety, apathy, mania, and impulse control disorders, in PD patients screened for DBS.
Two hundred ninety-seven inpatients with PD underwent standardized neuropsychiatric testing including German versions of Beck Depression Inventory-II, Hospital Anxiety and Depression Scale, Apathy Evaluation Scale, Self-Report Manic Inventory, and Questionnaire for Impulsive-Compulsive Disorders in PD-Rating Scale, to assess appropriateness for DBS. Statistical item reduction was based on exploratory factor analysis, Cronbach's alpha, item-total correlations, item difficulty, and inter-item correlations. Confirmatory factor analysis was conducted to assess factorial validity. An expert rating was performed to identify clinically relevant items in the context of PD and DBS, to maintain content validity. We compared the shortened subscales with the original questionnaires using correlations. To determine cutoff points, receiver operating characteristics analysis was performed.
The items of the initial questionnaires were reduced from 129 to 38 items. Results of confirmatory factor analyses supported the validity of the shortened pool. It demonstrated high internal consistency (Cronbach's alpha = 0.72-0.83 across subscales), and the individual subscales were correlated with the corresponding original scales (rs = 0.84-0.95). Sensitivities and specificities exceeded 0.7.
The shortened item pool, including 38 items, provides a good basis for the development of a screening tool, capturing affective-behavioral symptoms in PD patients before DBS implantation. Confirmation of the validity of such a screening tool in an independent sample of PD patients is warranted.
对接受脑深部电刺激（DBS）的帕金森病（PD）患者的情感行为状态进行评估至关重要。
作为一项初步研究，分析成熟的问卷，长期目标是开发一种筛查工具，用于评估接受DBS筛查的PD患者的情感行为功能障碍，包括抑郁、焦虑、冷漠、躁狂和冲动控制障碍。
297例PD住院患者接受了标准化的神经精神测试，包括德文版的贝克抑郁量表第二版、医院焦虑抑郁量表、冷漠评估量表、自评躁狂量表和PD冲动控制障碍问卷-评定量表，以评估DBS的适用性。统计项目缩减基于探索性因素分析、克朗巴赫α系数、项目总分相关性、项目难度和项目间相关性。进行验证性因素分析以评估因素效度。进行专家评级以确定PD和DBS背景下的临床相关项目，以保持内容效度。我们使用相关性将缩短后的子量表与原始问卷进行比较。为了确定临界值，进行了受试者工作特征分析。
初始问卷的项目从129项减少到38项。验证性因素分析结果支持缩短后的项目池的有效性。它显示出高内部一致性（各子量表的克朗巴赫α系数=0.72-0.83），并且各个子量表与相应的原始量表相关（rs=0.84-0.95）。敏感性和特异性超过0.7。
包括38项的缩短后的项目池为开发一种筛查工具提供了良好基础，该工具可在DBS植入前捕捉PD患者的情感行为症状。有必要在独立的PD患者样本中确认这种筛查工具的有效性。
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