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非痴呆型帕金森病患者中 Frontal Assessment Battery(FAB)意大利版的临床计量学和可行性。

Clinimetrics and feasibility of the Italian version of the Frontal Assessment Battery (FAB) in non-demented Parkinson's disease patients.

机构信息

Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, MI, Italy.

Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.

出版信息

J Neural Transm (Vienna). 2023 May;130(5):687-696. doi: 10.1007/s00702-023-02624-7. Epub 2023 Mar 28.

Abstract

BACKGROUND

This study aimed at assessing the cross-sectional and longitudinal clinimetrics and feasibility of the Frontal Assessment Battery (FAB) in non-demented Parkinson's disease (PD) patients.

METHODS

N = 109 PD patients underwent the FAB and the Montreal Cognitive Assessment (MoCA). A subsample of patients further underwent a thorough motor, functional and behavioral evaluation (the last including measures of anxiety, depression and apathy). A further subsample was administered a second-level cognitive battery tapping on attention, executive functioning, language, memory, praxis and visuo-spatial abilities. The following properties of the FAB were tested: (1) concurrent validity and diagnostics against the MoCA; (2) convergent validity against the second-level cognitive battery; (4) association with motor, functional and behavioral measures; (5) capability to discriminate patients from healthy controls (HCs; N = 96); (6) assessing its test-retest reliability, susceptibility to practice effects and predictive validity against the MoCA, as well as deriving reliable change indices (RCIs) for it, at a ≈ 6-month interval, within a subsample of patients (N = 33).

RESULTS

The FAB predicted MoCA scores at both T0 and T1, converged with the vast majority of second-level cognitive measures and was associated with functional independence and apathy. It accurately identified cognitive impairment (i.e., a below-cut-off MoCA score) in patients, also discriminating patients from HCs. The FAB was reliable at retest and free of practice effects; RCIs were derived according to a standardized regression-based approach.

DISCUSSION

The FAB is a clinimetrically sound and feasible screener for detecting dysexecutive-based cognitive impairment in non-demented PD patients.

摘要

背景

本研究旨在评估 Frontal Assessment Battery(FAB)在非痴呆帕金森病(PD)患者中的横断面和纵向临床计量学和可行性。

方法

n = 109 名 PD 患者接受了 FAB 和蒙特利尔认知评估(MoCA)测试。患者的一个亚组进一步接受了全面的运动、功能和行为评估(最后包括焦虑、抑郁和冷漠的测量)。进一步的亚组接受了二级认知测试,包括注意力、执行功能、语言、记忆、动作和视空间能力的测试。测试了 FAB 的以下特性:(1)与 MoCA 的同时效和诊断;(2)与二级认知测试的收敛效度;(4)与运动、功能和行为测量的相关性;(5)区分患者和健康对照者(HCs;n = 96)的能力;(6)评估其在 ≈ 6 个月间隔内的重测信度、对练习效果的敏感性和对 MoCA 的预测效度,并为其推导可靠的变化指数(RCIs),在患者的一个亚组中(n = 33)。

结果

FAB 预测了 T0 和 T1 时的 MoCA 分数,与大多数二级认知测试高度一致,并与功能独立性和冷漠相关。它准确地识别了患者的认知障碍(即 MoCA 得分低于临界值),也能区分患者和 HCs。FAB 在重测时可靠且无练习效应;根据标准化回归方法推导了 RCIs。

讨论

FAB 是一种临床计量学上合理且可行的工具,可用于检测非痴呆 PD 患者的执行功能认知障碍。

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