Center for Memory Disturbances, Lab of Clinical Neurochemistry, Section of Neurology, Department of Medicine and Surgery, University of Perugia, Piazzale Gambuli 1, 06132, Perugia, Italy.
J Neurol. 2021 Dec;268(12):4789-4795. doi: 10.1007/s00415-021-10592-9. Epub 2021 May 15.
Mini-Mental State Examination (MMSE) lacks of sensitivity in detecting cognitive deficits associated with subcortical damage. The HIV-Dementia Scale (HDS), a screening tool originally created for detecting cognitive impairment due to subcortical damage in HIV + patients, has proved to be useful in other neurological diseases. Until now, an Italian version of the HDS is not available. We aimed at: (1) validating the HDS Italian version (HDS-IT) in a cohort of cognitively healthy subjects (CN); (2) exploring the suitability of HDS-IT in detecting cognitive impairment due to subcortical damage (scCI). The psychometric properties of the HDS-IT were assessed in 180 CN (mean age 67.6 ± 8.3, range 41-84) with regard to item-total correlation, test-retest reliability and convergent validity with MMSE. Item-total correlations ranged 0.44-0.72. Test-retest reliability was 0.70 (p < 0.001). The HDS-IT scores were positively associated with MMSE score (rS = 0.49, p < 0.001). Then, both the HDS-IT and the MMSE were administered to 44 scCI subjects (mean age 64.9 ± 10.6, range 41-84). Mean HDS-IT total score was close to the original version and significantly lower in the scCI group compared to CN (8.6 ± 3.6 vs. 12.6 ± 2.5, p < 0.001). ROC analysis yielded an optimal cutoff value of 11, with sensitivity of 0.70 and specificity of 0.82. Patients showed poorer scores on HDS-IT compared to CN (12.6 ± 2.5 vs. 8.6 ± 3.6, p < 0.001). Our results support the use of HDS-IT as a screening tool suitable for detecting cognitive deficits with prevalent subcortical pattern, being complementary to MMSE in clinical practice.
简易精神状态检查（MMSE）在检测与皮质下损伤相关的认知缺陷方面缺乏敏感性。HIV 痴呆量表（HDS）是一种最初为检测 HIV+患者皮质下损伤引起的认知障碍而创建的筛查工具，已被证明在其他神经疾病中有用。到目前为止，还没有意大利语版的 HDS。我们的目的是：（1）在认知健康受试者（CN）队列中验证 HDS 意大利语版（HDS-IT）；（2）探讨 HDS-IT 在检测皮质下损伤引起的认知障碍（scCI）中的适用性。在 180 名 CN（平均年龄 67.6±8.3，范围 41-84）中评估了 HDS-IT 的心理测量特性，涉及项目-总分相关性、重测信度和与 MMSE 的会聚效度。项目-总分相关性范围为 0.44-0.72。重测信度为 0.70（p<0.001）。HDS-IT 评分与 MMSE 评分呈正相关（rS=0.49，p<0.001）。然后，44 名 scCI 患者同时接受了 HDS-IT 和 MMSE 测试（平均年龄 64.9±10.6，范围 41-84）。HDS-IT 总分接近原始版本，在 scCI 组中明显低于 CN 组（8.6±3.6 与 12.6±2.5，p<0.001）。ROC 分析得出最佳截断值为 11，灵敏度为 0.70，特异性为 0.82。与 CN 相比，患者在 HDS-IT 上的得分较差（12.6±2.5 与 8.6±3.6，p<0.001）。我们的结果支持使用 HDS-IT 作为一种筛查工具，适用于检测常见皮质下模式的认知缺陷，在临床实践中与 MMSE 互补。
