Maggi Gianpaolo, Altieri Manuela, Risi Mario, Rippa Valentina, Borgo Riccardo Maria, Sacco Rosaria, Buonanno Daniela, D'Ambrosio Alessandro, Bisecco Alvino, Santangelo Gabriella, Gallo Antonio
Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
Neurol Sci. 2024 Aug;45(8):3931-3938. doi: 10.1007/s10072-024-07388-w. Epub 2024 Feb 28.
The present study aimed to explore the suitability of the vocabulary knowledge (VOC) test as an accurate and reliable proxy of cognitive reserve (CR) by evaluating its psychometric properties and discrimination accuracy compared with other CR measures in multiple sclerosis (MS).
Sixty-eight consecutive people with multiple sclerosis (pwMS), followed at our MS outpatient clinic, completed a clinical evaluation and neuropsychological assessment including: VOC, Brief Repeatable Battery of Neuropsychological Tests (BRB-N), Cognitive Reserve Index Questionnaire (CRIq), Beck Depression Inventory-II, and State-Trait Anxiety Inventory. Reliability, convergent and divergent validity, and discrimination accuracy of the VOC were assessed using educational level as reference standard. The possible effects of sociodemographic and clinical factors on VOC and their role in predicting global cognitive status were also explored.
VOC demonstrated good internal consistency (Cronbach's α = 0.894) and adequate construct validity. It showed an acceptable level of discrimination between pwMS with high and low CR, comparable to the CRIq score. Education strongly affected VOC scores, which in turn were independent of MS features. VOC emerged as an independent predictor of global cognitive status together with MS-related disability.
We demonstrated the validity of VOC as a reliable CR measure in pwMS. Thus, CR may also be estimated using fixed objective measures, independent of brain pathology and clinical features. Early CR estimation may help clinicians identify pwMS at a higher risk of cognitive decline and plan strict neuropsychological monitoring and cognitive interventions.
本研究旨在通过评估词汇知识（VOC）测试的心理测量特性和与多发性硬化症（MS）中其他认知储备（CR）测量方法相比的辨别准确性，来探讨其作为认知储备准确可靠替代指标的适用性。
在我们的MS门诊连续随访的68例多发性硬化症患者（pwMS）完成了临床评估和神经心理学评估，包括：VOC、简短可重复神经心理测试电池（BRB-N）、认知储备指数问卷（CRIq）、贝克抑郁量表第二版以及状态-特质焦虑量表。以教育水平作为参考标准，评估VOC的信度、收敛效度和区分效度以及辨别准确性。还探讨了社会人口统计学和临床因素对VOC的可能影响及其在预测整体认知状态中的作用。
VOC显示出良好的内部一致性（Cronbach's α = 0.894）和足够的结构效度。它在高CR和低CR的pwMS之间显示出可接受的区分水平，与CRIq评分相当。教育对VOC分数有强烈影响，而VOC分数又独立于MS特征。VOC与MS相关残疾一起成为整体认知状态的独立预测因子。
我们证明了VOC作为pwMS中可靠的CR测量方法的有效性。因此，也可以使用独立于脑病理学和临床特征的固定客观测量方法来估计CR。早期CR估计可能有助于临床医生识别认知下降风险较高的pwMS，并规划严格的神经心理学监测和认知干预。
