Schmitz-Peiffer Henning, Aust Elisa, Linse Katharina, Rueger Wolfgang, Joos Markus, Löhle Matthias, Storch Alexander, Hermann Andreas
Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany.
Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) Dresden, 01307 Dresden, Germany.
J Clin Med. 2022 Feb 3;11(3):814. doi: 10.3390/jcm11030814.
Cognitive function is tested through speech- or writing-based neuropsychological instruments. The application and validity of those tests is impeded for patients with diseases that affect speech and hand motor skills. We therefore developed a "motor-free" gaze-controlled version of the Trail Making Test (TMT), including a calibration task to assess gaze accuracy, for completion by means of an eye-tracking computer system (ETCS). This electronic TMT version (eTMT) was evaluated for two paradigmatic "motor-neurodegenerative" diseases, Parkinson's disease (PD) and amyotrophic lateral sclerosis (ALS). We screened 146 subjects, of whom 44 were excluded, e.g., because of vision deficits. Patients were dichotomized into subgroups with less (ALS-, PD-) or severe motor affection (ALS+, PD+). All 66 patients and all 36 healthy controls (HC) completed the eTMT. Patients with sufficient hand motor control (ALS-, PD-, PD+) and all HC additionally completed the original paper-pencil-based version of the TMT. Sufficient and comparable gaze fixation accuracy across all groups and the correlations of the eTMT results with the TMT results supported the reliability and validity of the eTMT. PD+ patients made significantly more errors than HC in the eTMT-B. We hereby proved the good applicability of a motor-free cognitive test. Error rates could be a particularly sensitive marker of executive dysfunction.
认知功能通过基于言语或书写的神经心理学工具进行测试。对于患有影响言语和手部运动技能疾病的患者，这些测试的应用和有效性受到阻碍。因此，我们开发了一种“无需运动”的凝视控制版连线测验（TMT），包括一个用于评估凝视准确性的校准任务，以便通过眼动追踪计算机系统（ETCS）来完成。对两种典型的“运动神经退行性”疾病——帕金森病（PD）和肌萎缩侧索硬化症（ALS），对这个电子TMT版本（eTMT）进行了评估。我们筛查了146名受试者，其中44名被排除，例如因为视力缺陷。患者被分为运动影响较轻（ALS-、PD-）或严重（ALS+、PD+）的亚组。所有66名患者和所有36名健康对照（HC）完成了eTMT。手部运动控制足够的患者（ALS-、PD-、PD+）以及所有HC还额外完成了原始的纸笔版TMT。所有组的凝视固定准确性足够且具有可比性，以及eTMT结果与TMT结果的相关性支持了eTMT的可靠性和有效性。在eTMT-B中，PD+患者比HC犯的错误明显更多。我们在此证明了一种无需运动的认知测试具有良好的适用性。错误率可能是执行功能障碍的一个特别敏感的指标。
