Palombo M O, Foran A M
School of Psychology, University of Adelaide, Adelaide, Australia.
Neuropsychol Rev. 2025 Apr 17. doi: 10.1007/s11065-025-09658-6.
The aging population is increasing the prevalence of dementia, neurodegenerative disorders, and mild cognitive impairment, which are associated with cognitive declines in executive functioning. In people with these disorders, accurate tests can aid in the early detection of executive functioning decline and facilitate access to interventions. The Hayling and Brixton tests (HBTs) are popular executive functioning tests that assess inhibitory control. The HBTs may be especially effective for detecting people with disorders that are associated with disinhibition, such as behavioral-variant frontotemporal dementia (bvFTD). However, the effectiveness of the HBTs for detecting cognitive decline in dementia, neurodegenerative disorders, and mild cognitive impairment has yet to be collated. A comprehensive search of five databases identified 50 studies that compared the HBTs performances of adults aged 40 years and over with a dementia, neurodegenerative disorder, or mild cognitive impairment (e.g., Parkinson's disease, Alzheimer's dementia, bvFTD) and cognitively-healthy controls. Hedges' g effect sizes compared groups on the five HBTs scores (Inhibition Errors, Inhibition Reaction Time (RT), Automatic RT, Inhibition minus Automatic RT, and Brixton Errors). The disorders (combined) showed negative effects on all HBTs scores (g - 0.37 to - 1.13), with dementia (combined) performing the worst (g - 0.54 to - 1.56). Automatic RT and Inhibition Errors were the most effective scores for detecting cognitive decline in dementia (g - 1.55; g - 1.34). The dementia types performed similar after outliers were removed and only studies with low risk-of-bias were analyzed. Overall, the HBTs are effective for detecting cognitive decline in middle to older aged adults, especially those with dementia. However, no score type can be recommended for differentiating the dementia types, such as AD and bvFTD.
人口老龄化导致痴呆症、神经退行性疾病和轻度认知障碍的患病率不断上升，这些都与执行功能的认知衰退有关。在患有这些疾病的人群中，准确的测试有助于早期发现执行功能衰退，并便于获得干预措施。海林和布里克斯顿测试（HBTs）是常用的评估抑制控制能力的执行功能测试。HBTs对于检测与去抑制相关的疾病患者可能特别有效，如行为变异型额颞叶痴呆（bvFTD）。然而，HBTs在检测痴呆症、神经退行性疾病和轻度认知障碍中的认知衰退方面的有效性尚未得到整理。对五个数据库进行全面检索后，确定了50项研究，这些研究比较了40岁及以上患有痴呆症、神经退行性疾病或轻度认知障碍（如帕金森病、阿尔茨海默病性痴呆、bvFTD）的成年人与认知健康对照组的HBTs表现。通过赫奇斯g效应量比较了两组在五项HBTs分数上的差异（抑制错误、抑制反应时间（RT）、自动RT、抑制减去自动RT以及布里克斯顿错误）。这些疾病（综合起来）对所有HBTs分数都有负面影响（g值在-0.37至-1.13之间），痴呆症（综合起来）表现最差（g值在-0.54至-1.56之间）。自动RT和抑制错误是检测痴呆症认知衰退最有效的分数（g值分别为-1.55和-1.34）。去除异常值并仅分析低偏倚风险的研究后，不同类型的痴呆症表现相似。总体而言，HBTs对于检测中老年人尤其是痴呆症患者的认知衰退是有效的。然而，没有一种分数类型可用于区分不同类型的痴呆症，如阿尔茨海默病和bvFTD。
