Department of Psychology, York University.
Neurosciences and Mental Health Program, The Hospital for Sick Children.
Neuropsychology. 2021 May;35(4):388-398. doi: 10.1037/neu0000729.
We evaluated performance on the Penn Computerized Neurocognitive Battery (PCNB), a tool assessing accuracy and response time across four cognitive domains, alongside the Symbol Digit Modalities Test (SDMT), a measure of processing speed commonly used in MS. We determined whether performance decrements are more likely to be detected on measures of accuracy versus response time in pediatric-onset multiple sclerosis (POMS).
Performance on the SDMT, accuracy on PCNB tests belonging to four domains (executive function, episodic memory, complex cognition, social cognition), and response time on the PCNB were compared for 65 POMS patients (age range: 8-29 years) and 76 healthy controls (HCs) by ANCOVA. Associations between the Overall PCNB score and SDMT were examined for both groups, and their agreement in classifying impairment was assessed using Cohen's kappa.
POMS patients (age at testing = 18.3 ± 4.0 years; age at POMS onset = 14.9 ± 2.3 years) demonstrated reduced accuracy relative to HCs on tests of working memory, attention/inhibition, verbal memory, and visuospatial processing, after adjusting for response time (p ≤ .002). Patients demonstrated slower overall response time on the PCNB (p = .003), while group differences on the SDMT did not meet significance (p = .03). Performance on the PCNB and SDMT were correlated (MS: r = 0.43, HC: r = 0.50, both p < .001), however, the degree of agreement for impairment was minimal (k = 0.22, p = .14).
Specific cognitive deficits exist independently of slowed information processing speed in POMS, and may represent more significant areas of dysfunction. Delineation of accuracy and response time in neuropsychological assessment is important to identify areas of cognitive deficit in POMS. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
我们评估了宾夕法尼亚计算机神经认知测试（PCNB）的表现，该测试工具评估了四个认知领域的准确性和反应时间，以及符号数字模态测试（SDMT）的表现，后者是一种常用于多发性硬化症（MS）的处理速度测量方法。我们确定在儿科发病多发性硬化症（POMS）中，准确性测量还是反应时间测量更容易检测到表现下降。
通过方差分析（ANCOVA）比较了 65 名 POMS 患者（年龄范围：8-29 岁）和 76 名健康对照（HCs）的 SDMT 表现、PCNB 四个领域（执行功能、情景记忆、复杂认知、社会认知）的准确性测试和 PCNB 的反应时间。还检查了两组患者的 PCNB 总分与 SDMT 之间的相关性，并使用 Cohen's kappa 评估了两者在分类损伤方面的一致性。
调整反应时间后，POMS 患者（测试时年龄=18.3±4.0 岁；POMS 发病年龄=14.9±2.3 岁）在工作记忆、注意力/抑制、言语记忆和视空间处理测试中的准确性相对 HCs 降低（p≤0.002）。患者的 PCNB 整体反应时间较慢（p=0.003），而 SDMT 的组间差异无统计学意义（p=0.03）。PCNB 和 SDMT 的表现呈相关（MS：r=0.43，HC：r=0.50，均 p<0.001），但损伤的一致性程度较低（k=0.22，p=0.14）。
POMS 存在特定的认知缺陷，独立于信息处理速度的减慢，可能代表更显著的功能障碍领域。神经心理评估中准确性和反应时间的划分对于识别 POMS 的认知缺陷领域很重要。
