Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
Clinical Epidemiology and Biometric Unit, Scientific Direction, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.
J Sleep Res. 2023 Oct;32(5):e13873. doi: 10.1111/jsr.13873. Epub 2023 Mar 23.
The objective of this study was to assess the role of cognitive evaluation in the prediction of phenoconversion in polysomnography-confirmed idiopathic or isolated rapid eye movement sleep behaviour disorder, through a scoping review focussing on a longitudinal comprehensive neuropsychological assessment of patients with idiopathic REM sleep behaviour disorder. A literature search (2006-2022) yielded 1034 records, and 20 were selected for analysis. The sample included 899 patients from eight different cohorts and five countries. We extracted data on clinical evolution, mild cognitive impairment diagnosis, neuropsychological tests used, and classification of cognitive domains. Tests, cognitive domains, and mild cognitive impairment definitions were heterogeneous across the studies, precluding a meta-analysis. Ten studies (50%) evaluated the presence of mild cognitive impairment; 14 studies (70%) grouped neuropsychological tests into between three (6 studies, 21.4%) and seven (1 study, 7.1%) cognitive domains. The most frequently used tests were semantic fluency, Stroop colour word test, trail making test A and B, digit span, Rey auditory verbal learning test, and Rey-Osterrieth figure. All except digit span showed a role in predicting phenoconversion. The authors did not consistently assign tests to specific cognitive domains. In conclusion, we discuss methodological differences between the studies and highlight the need for a standardised framework for neuropsychological data acquisition and presentation, based on a multilevel approach covering test selection, domain assignment, and mild cognitive impairment diagnostic criteria.
本研究旨在通过对特发性 REM 睡眠行为障碍患者进行纵向全面的神经心理学评估，评估认知评估在预测多导睡眠图确诊的特发性或孤立性快动眼睡眠行为障碍向表型转化中的作用。通过对文献（2006-2022 年）的检索，共获得了 1034 条记录，其中有 20 条被选入进行分析。样本包括来自 8 个不同队列和 5 个国家的 899 名患者。我们提取了关于临床演变、轻度认知障碍诊断、使用的神经心理学测试以及认知领域分类的数据。研究之间的测试、认知领域和轻度认知障碍的定义存在异质性，因此无法进行荟萃分析。10 项研究（50%）评估了轻度认知障碍的存在；14 项研究（70%）将神经心理学测试分为 3 项（6 项研究，21.4%）和 7 项（1 项研究，7.1%）认知领域。最常用的测试是语义流畅性、Stroop 颜色词测试、连线测试 A 和 B、数字跨度、 Rey 听觉言语学习测试和 Rey-Osterrieth 图。除了数字跨度外，所有测试都在预测表型转化中发挥了作用。作者并没有始终将测试分配到特定的认知领域。总之，我们讨论了研究之间的方法学差异，并强调需要基于多层次方法，包括测试选择、领域分配和轻度认知障碍诊断标准，制定神经心理学数据获取和呈现的标准化框架。
