Weintraub Daniel, Brumm Michael C, Kurth Ryan, York Michele K
Department of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Parkinson's Research, Education and Clinical Center, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.
Mov Disord. 2025 Mar;40(3):468-477. doi: 10.1002/mds.30111. Epub 2025 Jan 6.
Cognitive impairment is common at all stages of Parkinson's disease (PD), but there is no consensus on which neuropsychological tests to use or how to interpret cognitive battery results. A cognitive summary score (CSS) combines the richness of a neuropsychological battery with the simplicity of a single score.
The objective of this study was to determine whether a CSS created using robust norming can detect early cognitive deficits in de novo, untreated PD.
Baseline cognitive data from PD participants and healthy control participants (HCs) in the Parkinson's Progression Markers Initiative were used to (1) create a robust HC subgroup without cognitive decline, (2) generate regression-based z scores for six cognitive measures using this subgroup, and (3) create a CSS by averaging all z scores.
PD participants scored worse than HCs on all cognitive tests, with larger effects when compared with the robust HC subgroup rather than all HCs. Applying internally derived norms, the largest effects were for processing speed/working memory (Cohen's d = -0.55) and verbal episodic memory (Cohen's d = -0.48 and -0.52). Robust norming shifted PD performance from average (CSS z score = -0.01) to low average (CSS z score = -0.40), with a larger effect for the CSS (PD vs. robust HC subgroup; Cohen's d = -0.60) compared with individual tests.
Patients with PD perform worse cognitively than HCs, particularly in processing speed and verbal memory. Robust norming increases effect sizes and decreases PD scores to expected levels. The CSS outperformed individual tests and may detect cognitive changes in early PD, making it a useful outcome measure in clinical research. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
认知障碍在帕金森病（PD）的各个阶段都很常见，但对于使用哪些神经心理学测试以及如何解释认知成套测验结果尚无共识。认知综合评分（CSS）将神经心理学成套测验的丰富性与单一分数的简单性结合在一起。
本研究的目的是确定使用稳健常模创建的CSS是否能够检测初发、未治疗的PD患者的早期认知缺陷。
帕金森病进展标志物计划中PD参与者和健康对照参与者（HCs）的基线认知数据用于：（1）创建一个无认知衰退的稳健HC亚组；（2）使用该亚组为六项认知测量生成基于回归的z分数；（3）通过对所有z分数求平均值创建CSS。
在所有认知测试中，PD参与者的得分均低于HCs，与稳健HC亚组相比的效应大于与所有HCs相比。应用内部得出的常模，最大效应出现在加工速度/工作记忆（科恩d值=-0.55）和言语情景记忆（科恩d值=-0.48和-0.52）方面。稳健常模使PD的表现从平均水平（CSS z分数=-0.01）转变为低平均水平（CSS z分数=-0.40），与单个测试相比，CSS的效应更大（PD与稳健HC亚组相比；科恩d值=-0.60）。
PD患者在认知方面的表现比HCs差，尤其是在加工速度和言语记忆方面。稳健常模增加了效应量，并将PD分数降低到预期水平。CSS的表现优于单个测试，可能检测出早期PD的认知变化，使其成为临床研究中一种有用的结果指标。© 2025作者。《运动障碍》由威利期刊有限责任公司代表国际帕金森和运动障碍协会出版。
