Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI48109, USA.
J Int Neuropsychol Soc. 2023 Nov;29(9):893-901. doi: 10.1017/S1355617723000073. Epub 2023 Feb 10.
OBJECTIVE: This observational study examined the feasibility, reliability, and validity of repeated ambulatory cognitive tests in fibromyalgia (FM). METHOD: Adults with FM ( = 50) and matched controls ( = 50) completed lab-based neuropsychological tests (NIH Toolbox) followed by eight days of smartphone-based ambulatory testing of processing speed (symbol search) and working memory (dot memory) five times daily. Feasibility was assessed based on response rates. Reliability was evaluated using overall average between-person reliabilities for the full assessment period and by determining the number of assessment days necessary to attain reliabilities of >.80 and >.90. To assess convergent validity, correlations were calculated between ambulatory test scores and NIH Toolbox scores. Test performance was contrasted between the FM and non-FM groups to examine known-groups validity. RESULTS: Average rates of response to the ambulatory cognitive tests were 89.5% in FM and 90.0% in non-FM. Overall average between-person reliabilities were ≥.96. In FM, between-person reliability exceeded .90 after two days for symbol search and three days for dot memory. Symbol search scores correlated with NIH Toolbox processing speed scores in both groups, though there were no significant group differences in symbol search performance. Dot memory scores correlated with NIH Toolbox working memory scores in both groups. FM participants exhibited worse dot memory performance than did non-FM participants. CONCLUSIONS: Repeated ambulatory tests of processing speed and working memory demonstrate feasibility and reliability in FM, though evidence for construct validity is mixed. The findings demonstrate promise for future research and clinical applications of this approach to assessing cognition in FM.
目的:本观察性研究旨在检验纤维肌痛(FM)患者重复进行动态认知测试的可行性、可靠性和有效性。
方法:50 名 FM 患者和 50 名匹配对照者完成了基于实验室的神经心理学测试(NIH 工具包),随后进行了八天的智能手机动态测试,每天五次测试处理速度(符号搜索)和工作记忆(点记忆)。根据应答率评估可行性。使用整个评估期的个体间总体平均可靠性评估可靠性,并确定需要多少天的评估才能达到>.80 和>.90 的可靠性来评估可靠性。为了评估收敛效度,计算了动态测试分数与 NIH 工具包分数之间的相关性。比较 FM 组和非 FM 组的测试表现,以检验已知组别的有效性。
结果:FM 患者和非 FM 患者对动态认知测试的平均应答率分别为 89.5%和 90.0%。个体间总体平均可靠性均≥.96。在 FM 中,符号搜索的两天后和点记忆的三天后,个体间可靠性超过了.90。符号搜索分数与两组的 NIH 工具包处理速度分数相关,但符号搜索表现无显著组间差异。点记忆分数与两组的 NIH 工具包工作记忆分数相关。FM 参与者的点记忆表现比非 FM 参与者差。
结论:在 FM 中,重复进行处理速度和工作记忆的动态测试具有可行性和可靠性,但结构有效性的证据不一。这些发现为未来使用这种方法评估 FM 认知提供了有希望的研究和临床应用。
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