Split Molly, Pluim McDowell Celina, Lopez Francesca V, Almklov Erin, Filoteo J Vincent, Lessig Stephanie, Litvan Irene, Schiehser Dawn M
Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA.
Department of Psychological and Brain Sciences, Boston University, Boston, USA.
J Clin Exp Neuropsychol. 2024 Apr;46(3):207-217. doi: 10.1080/13803395.2024.2340812. Epub 2024 May 9.
Difficulties in executive functioning (EF) are common in PD; however, the relationship between subjective and objective EF is unclear. Understanding this relationship could help guide clinical EF assessment. This study examined the relationship between subjective self-reported EF (SEF) and objective EF (OEF) and predictors of SEF-OEF discrepancies in PD.
One-hundred and sixteen non-demented PD participants completed measures of OEF (i.e. problem-solving, cognitive flexibility, inhibition, and working memory) and SEF (Frontal Systems Behavior Scale-Self Executive Dysfunction Subscale). Pearson bivariate correlations and linear regressions were performed to examine the relationship between SEF and OEF and the non-motor symptoms (e.g. mood, fatigue), demographic, and PD characteristic (e.g. MCI status) predictors of discrepancies between OEF and SEF (|OEF minus SEF scores|). Correlates of under-, over-, and accurate-reporting were also explored.
Greater SEF complaints and worse OEF were significantly associated ( =.200, = .009) and 64% of participants accurately identified their level of OEF abilities. Fewer years of education and greater symptoms of depression, anxiety, and fatigue significantly correlated with greater discrepancies between OEF and SEF. Fatigue was the best predictor of EF discrepancy in the overall sample (β = .281, = .022). Exploratory analyses revealed apathy and fatigue associated with greater under-reporting, while anxiety associated with greater over-reporting.
SEF and OEF are significantly related in PD. Approximately 64% of non-demented persons with PD accurately reported their EF skill level, while 28% under-reported and 8% over-reported. SEF-OEF discrepancies were predicted by fatigue in the overall sample. Preliminary evidence suggests reduced apathy and fatigue symptoms relate to more under-reporting, while anxiety relates to greater over-reporting. Given the prevalence of these non-motor symptoms in PD, it is important to carefully consider them when assessing EF in PD.
执行功能（EF）障碍在帕金森病（PD）中很常见；然而，主观和客观执行功能之间的关系尚不清楚。了解这种关系有助于指导临床执行功能评估。本研究探讨了帕金森病患者主观自我报告的执行功能（SEF）与客观执行功能（OEF）之间的关系以及SEF - OEF差异的预测因素。
116名非痴呆帕金森病参与者完成了客观执行功能（即解决问题、认知灵活性、抑制和工作记忆）和主观执行功能（额叶系统行为量表 - 自我执行功能障碍子量表）的测量。进行Pearson双变量相关性分析和线性回归，以研究主观执行功能与客观执行功能之间的关系，以及客观执行功能与主观执行功能差异（|客观执行功能减去主观执行功能得分|）的非运动症状（如情绪、疲劳）、人口统计学和帕金森病特征（如轻度认知障碍状态）预测因素。还探讨了报告不足、报告过度和准确报告的相关因素。
更高的主观执行功能抱怨与更差的客观执行功能显著相关（r = 0.200，p = 0.009），64%的参与者准确识别了自己的客观执行功能能力水平。受教育年限较少以及抑郁、焦虑和疲劳症状较重与客观执行功能和主观执行功能之间的差异较大显著相关。疲劳是总体样本中执行功能差异的最佳预测因素（β = 0.281，p = 0.022）。探索性分析显示，冷漠和疲劳与报告不足较多相关，而焦虑与报告过度较多相关。
帕金森病患者的主观执行功能和客观执行功能显著相关。约64%的非痴呆帕金森病患者准确报告了他们的执行功能技能水平，而28%报告不足，8%报告过度。总体样本中，疲劳可预测主观执行功能与客观执行功能的差异。初步证据表明，冷漠和疲劳症状减轻与报告不足较多有关，而焦虑与报告过度较多有关。鉴于这些非运动症状在帕金森病中的普遍性，在评估帕金森病患者的执行功能时仔细考虑这些症状很重要。
