Liebermann-Jordanidis Hannah, Roheger Mandy, Boosfeld Lukas, Franklin Jeremy, Kalbe Elke
Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
Department of Neurology, University Medicine Greifswald, Greifswald, Germany.
J Parkinsons Dis. 2022;12(6):1749-1782. doi: 10.3233/JPD-223238.
Visuo-cognitive impairment is common in patients with Parkinson's disease with mild cognitive impairment (PD-MCI) and constitutes a prognostic factor for the conversion to Parkinson's disease dementia (PDD). However, systematic analyses on which neuropsychological tests are most suitable to assess visuo-cognition in PD-MCI and PDD and to differentiate these cognitive stages are lacking.
To review neuropsychological tests used to assess visuo-cognition including visuo-perceptual and visuo-spatial processing, visuo-constructive copying and drawing on command abilities; and to identify the visuo-cognitive subdomain as well as tests most suitable to discriminate between PD-MCI and PDD.
MEDLINE, PsycINFO, Web of Science Core Collection, and CENTRAL were systematically searched for relevant studies assessing visuo-cognitive outcomes in patients with PD-MCI and PDD. Risk of bias was assessed using a customized form based on well-established tools. Random-effect meta-analyses were conducted.
33 studies were included in the systematic review. Data of 19 studies were entered in meta-analyses. Considerable heterogeneity regarding applied tests, test versions, and scoring systems exists. Data indicate that visuo-constructive command tasks are the subdomain best suited to discriminate between PD-MCI and PDD. Furthermore, they indicate that the Rey-Osterrieth-Complex-Figure Test (ROCF), Corsi Block-Tapping Test, Judgment of Line Orientation (JLO), and Clock Drawing Test (CDT) are tests able to differentiate between the two stages.
We provide suggestions for suitable visuo-cognitive tests (Corsi Block-Tapping Test, or JLO, ROCF, CDT) to improve diagnostic accuracy. Methodological challenges (e.g., heterogeneity of definitions, tests) are discussed and suggestions for future research are provided.
https://www.crd.york.ac.uk/prospero/, ID: CRD42018088244.
视觉认知障碍在帕金森病伴轻度认知障碍（PD-MCI）患者中很常见，是转化为帕金森病痴呆（PDD）的一个预后因素。然而，目前缺乏关于哪些神经心理学测试最适合评估PD-MCI和PDD患者的视觉认知以及区分这些认知阶段的系统分析。
回顾用于评估视觉认知的神经心理学测试，包括视觉感知和视觉空间处理、视觉构建临摹和按指令绘图能力；确定最适合区分PD-MCI和PDD的视觉认知子领域以及测试。
系统检索MEDLINE、PsycINFO、科学引文索引核心合集和考克兰系统评价数据库，查找评估PD-MCI和PDD患者视觉认知结果的相关研究。使用基于成熟工具的定制表格评估偏倚风险。进行随机效应荟萃分析。
系统评价纳入33项研究。19项研究的数据纳入荟萃分析。在应用测试、测试版本和评分系统方面存在相当大的异质性。数据表明，视觉构建指令任务是最适合区分PD-MCI和PDD的子领域。此外，数据表明雷-奥斯特里赫复杂图形测试（ROCF）、科西块点击测试、线方向判断（JLO）和画钟测试（CDT）能够区分这两个阶段。
我们为合适的视觉认知测试（科西块点击测试、JLO、ROCF、CDT）提供建议，以提高诊断准确性。讨论了方法学挑战（如定义、测试的异质性）并提供了未来研究的建议。
