Shao Xu, Wang Kang, Zhang Yulian, Zhen Xueke, Dong Fen, Tian Hong, Yu Yanbing
Department of Neurosurgery, China-Japan Friendship Hospital, Beijing, China.
Department of Neurology, China-Japan Friendship Hospital, Beijing, China.
Front Aging Neurosci. 2023 Feb 23;15:1108166. doi: 10.3389/fnagi.2023.1108166. eCollection 2023.
Visuospatial dysfunction and cognitive impairment are common in Parkinson's disease (PD), which draw increasing attention in the current literature. But clinicians still lack rapid, effective and unified cognitive battery for visuospatial assessment.
A new approach was studied to explore the feasibility of using mobile application software (APP) to evaluate visuospatial dysfunction in patients with PD and compared with traditional assessment tools. We aimed to verify the threshold score of the APP for early diagnosis.
A total of 41 patients with PD underwent assessments using several test modules including Digit Symbol Test (DST), Visual Organization Test (VOT), Facial Recognition Test (FRT), Vocabulary Memory Test (VMT) of this APP, as well as Clock Drawing Test (CDT), Cube Copying Test (CCT) and the Mini-Mental State Examination (MMSE) for comparison. Among the 41 PD patients, 30 individuals were found to have visuospatial dysfunction based on CDT score < 5 and CCT score of<18 while the remaining 11 patients served as control.
There were statistically significant differences in DST, VOT, and FRT scores (all ≤ 0.001 for group comparisons). DST, VOT, and FRT-1 were significantly correlated with MMSE, CDT and CCT and the correlations were moderate or fairly strong. For visuospatial dysfunction diagnosis, all the areas under curves (AUC) of DST, VOT, and FRT-1 were statistically significant ( < 0.0001, = 0.0002, and = 0.0002, respectively). The estimates and 95% confidence intervals of AUC were 0.8303 (0.6868, 0.9739), 0.8045 (0.6423, 0.9668), and 0.7833 (0.6344, 0.9322), respectively. Their cut-off points for visuospatial dysfunction were 26, 17, and 19, respectively. After dichotomization by the cut-off points, DST had high sensitivity of 96.67% while VOT and FRT-1 had high specificity of 81.82 and 90.91%.
This study demonstrated that visuospatial disorders was highly prevalent in PD patients, and the APP used in study could be a practical clinical screening tool for visuospatial ability assessment with high sensitivity and specificity.
视觉空间功能障碍和认知障碍在帕金森病（PD）中很常见，这在当前文献中受到越来越多的关注。但临床医生仍缺乏用于视觉空间评估的快速、有效且统一的认知测试组合。
研究一种新方法，探讨使用移动应用软件（APP）评估PD患者视觉空间功能障碍的可行性，并与传统评估工具进行比较。我们旨在验证该APP用于早期诊断的阈值分数。
共41例PD患者接受了评估，使用了该APP的几个测试模块，包括数字符号测试（DST）、视觉组织测试（VOT）、面部识别测试（FRT）、词汇记忆测试（VMT），以及用于比较的画钟试验（CDT）、复制立方体测试（CCT）和简易精神状态检查表（MMSE）。在这41例PD患者中，根据CDT得分<5分和CCT得分<18分，发现30例个体存在视觉空间功能障碍，其余11例患者作为对照。
DST、VOT和FRT得分存在统计学显著差异（组间比较均≤0.001）。DST、VOT和FRT-1与MMSE、CDT和CCT显著相关，且相关性为中度或较强。对于视觉空间功能障碍的诊断，DST、VOT和FRT-1的曲线下面积（AUC）均具有统计学显著性（分别为<0.0001、=0.0002和=0.0002）。AUC的估计值和95%置信区间分别为0.8303（0.6868，0.9739）、0.8045（0.6423，0.9668）和0.7833（0.6344，0.9322）。它们用于视觉空间功能障碍的截断点分别为26、17和19。经截断点二分法处理后，DST具有96.67%的高灵敏度，而VOT和FRT-1具有81.82%和90.91%的高特异性。
本研究表明视觉空间障碍在PD患者中高度普遍，研究中使用的APP可以作为一种实用的临床筛查工具，用于视觉空间能力评估，具有高灵敏度和特异性。
