帕金森病或原发性震颤患者对深部脑刺激认知改变的感知：认知改变指数的效用。
Perception of cognitive change by individuals with Parkinson's disease or essential tremor seeking deep brain stimulation: Utility of the cognitive change index.
机构信息
Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA.
出版信息
J Int Neuropsychol Soc. 2024 May;30(4):370-379. doi: 10.1017/S1355617723000620. Epub 2023 Oct 6.
OBJECTIVE
The Cognitive Change Index (CCI-20) is a validated questionnaire that assesses subjective cognitive complaints (SCCs) across memory, language, and executive domains. We aimed to: (a) examine the internal consistency and construct validity of the CCI-20 in patients with movement disorders and (b) learn how the CCI-20 corresponds to objective neuropsychological and mood performance in individuals with Parkinson's disease (PD) or essential tremor (ET) seeking deep brain stimulation (DBS).
METHODS
216 participants ( = 149 PD; = 67 ET) underwent neuropsychological evaluation and received the CCI-20. The proposed domains of the CCI-20 were examined via confirmatory (CFA) and exploratory (EFA) factor analyses. Hierarchical regressions were used to assess the relationship among subjective cognitive complaints, neuropsychological performance and mood symptoms.
RESULTS
PD and ET groups were similar across neuropsychological, mood, and CCI-20 scores and were combined into one group who was well educated ( = 15.01 ± 2.92), in their mid-60's ( = 67.72 ± 9.33), predominantly male (63%), and non-Hispanic White (93.6%). Previously proposed 3-domain CCI-20 model failed to achieve adequate fit. Subsequent EFA revealed two CCI-20 factors: memory and non-memory ( < 0.001; CFI = 0.924). Regressions indicated apathy and depressive symptoms were associated with greater memory and total cognitive complaints, while poor executive function and anxiety were associated with more non-memory complaints.
CONCLUSION
Two distinct dimensions were identified in the CCI-20: memory and non-memory complaints. Non-memory complaints were indicative of worse executive function, consistent with PD and ET cognitive profiles. Mood significantly contributed to all CCI-20 dimensions. Future studies should explore the utility of SCCs in predicting cognitive decline in these populations.
目的
认知变化指数（CCI-20）是一种经过验证的问卷，可评估记忆、语言和执行领域的主观认知主诉（SCC）。我们的目的是：（a）检验 CCI-20 在运动障碍患者中的内部一致性和结构效度；（b）了解 CCI-20 在接受深部脑刺激（DBS）的帕金森病（PD）或特发性震颤（ET）个体中的客观神经心理学和情绪表现如何对应。
方法
216 名参与者（=149 例 PD；=67 例 ET）接受了神经心理学评估并接受了 CCI-20。通过验证性（CFA）和探索性（EFA）因子分析来检查 CCI-20 的拟议领域。分层回归用于评估主观认知主诉、神经心理学表现和情绪症状之间的关系。
结果
PD 和 ET 组在神经心理学、情绪和 CCI-20 评分方面相似，并且合并为一组，教育程度较高（=15.01±2.92），年龄在 60 多岁（=67.72±9.33），主要为男性（63%）和非西班牙裔白人（93.6%）。先前提出的 3 域 CCI-20 模型未能达到足够的拟合。随后的 EFA 显示 CCI-20 有两个因素：记忆和非记忆（<0.001；CFI=0.924）。回归表明，淡漠和抑郁症状与更大的记忆和总体认知主诉相关，而执行功能较差和焦虑与更多的非记忆主诉相关。
结论
在 CCI-20 中确定了两个不同的维度：记忆和非记忆主诉。非记忆主诉与较差的执行功能有关，与 PD 和 ET 的认知特征一致。情绪显著影响 CCI-20 的所有维度。未来的研究应该探索 SCC 在预测这些人群认知下降中的作用。
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