Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain.
Departamento de Psicología y Salud, Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, Madrid, Spain.
Appl Neuropsychol Adult. 2024 May-Jun;31(3):238-247. doi: 10.1080/23279095.2021.2011727. Epub 2021 Dec 11.
An important proportion of patients with Parkinson's Disease (PD) present signs of cognitive impairment, although this is heterogeneous. In an attempt to classify this, the dual syndrome hypothesis distinguishes between two profiles: one defined by attentional and executive problems with damage in anterior cerebral regions, and another with mnesic and visuospatial alterations, with damage in posterior cerebral regions. The MoCA) is one of the recommended screening tools, and one of the most used, to assess cognitive impairment in PD. However, its ability to specifically identify these two profiles of cognitive impairment has not been studied. The aim of this study was, therefore, to analyze the capacity of the MoCA to detect cognitive impairment, and also to identify anterior and posterior profiles defined by the dual syndrome hypothesis. For this purpose, 59 patients with idiopathic PD were studied with the MoCA and a neuropsychological battery of tests covering all cognitive domains. Results of logistic regression analysis with ROC () curves showed that MoCA detected cognitive impairment and identified patients with a profile of anterior/attentional and executive deficit, with acceptable sensibility and specificity. However, it did not identify patients with a posterior/mnesic-visuospatial impairment. We discuss the reasons for the lack of sensitivity of MoCA in this profile, and other possible implications of these results with regards the usefulness of this tool to assess cognitive impairment in PD.
帕金森病（PD）患者中有相当一部分存在认知障碍的迹象，尽管这种情况存在异质性。为了对此进行分类，双重综合征假说将其分为两种类型：一种以注意力和执行问题为特征，与前脑区域损伤有关；另一种以记忆和视空间改变为特征，与后脑区域损伤有关。蒙特利尔认知评估量表（MoCA）是推荐用于评估 PD 患者认知障碍的筛查工具之一，也是使用最广泛的工具之一。然而，它是否能够特异性地识别这两种认知障碍类型尚未得到研究。因此，本研究旨在分析 MoCA 检测认知障碍的能力，并识别双重综合征假说定义的前脑/注意力和执行缺陷以及后脑/记忆和视空间改变两种认知类型。为此，我们对 59 例特发性 PD 患者进行了研究，使用 MoCA 及涵盖所有认知领域的神经心理学测试工具包。ROC 曲线的逻辑回归分析结果表明，MoCA 可检测认知障碍，并识别出具有前脑/注意力和执行缺陷特征的患者，具有可接受的敏感性和特异性。然而，它并未识别出具有后脑/记忆和视空间损害特征的患者。我们讨论了 MoCA 在这种类型中缺乏敏感性的原因，以及这些结果对评估 PD 患者认知障碍时该工具的有用性的其他可能影响。
