评价NINDS-CSN 5分钟方案作为检测帕金森病痴呆的认知筛查试验:一项巴西样本研究

IF 1.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Sao Paulo Medical Journal Pub Date : 2023-01-01 DOI:10.5327/1516-3180.141s1.679

I. Teixeira, Vanessa Pereira de Alencar Souza, V. Borges, H. Ferraz

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引用次数: 0

摘要

由于帕金森病(PD)的患病率及其对疾病发展、生活质量和治疗反应的干扰，许多认知筛查测试已被研究用于诊断帕金森病痴呆(PDD)。因此，需要更有效、更快速的认知筛选测试。目的:评价NINDS-CSN 5分钟方案评估(NC5MPA)在PD患者中作为PDD筛查试验的有用性，并检验与立方体绘制试验(CDT)联合是否能提高检测的准确性。方法:采用NC5MPA，结合CDT、Mini Mental State Examination、Montreal Cognitive Assessment (MoCA)对98例PD患者进行评估。这些患者还通过临床痴呆评定量表(CDR)评估轻度认知障碍(MCI)和痴呆。结果:测试分数与PDD之间有良好的相关性(P值< 0.00)，但MCI的3项测试结果为bb0 0.05。NC5MPA检测的敏感性为78.5%，特异性为85.7%，准确率为82.6%，阳性预测值为80.4%，阴性预测值为84.2%，平均表现时间为3.2 min(3.8 ~ 3.31)。与CDT的关联导致敏感性略有显著增加，特异性和准确性下降，同时增加了测试执行时间。在评估受教育程度的干扰时，受5 ~ 8年受教育群体的样本量较小，结果受到影响。结论:NC5MPA检测已被证明是一种较好的PDD筛查方法，而且更快、更容易进行，但需要更多的人群进行更多的检测，以评估该检测对MCI的准确性，并评估是否存在教育水平对测试准确性的干扰。

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Evaluation of the NINDS-CSN 5-minutes protocol as a cognitive screening test to detect Parkinson’s disease dementia: a study of a Brazilian sample

Introduction: Many cognitive screening tests have been investigated for the diagnosis of Parkinson’s disease dementia (PDD), due to its prevalence and its interference in the evolution of the disease, quality of life and in the treatment response of the patients with Parkinson’s disease (PD). Therefore, more effective and faster cognitive screening tests are needed. Objectives: To evaluate the usefulness of the NINDS-CSN 5-minutes protocol assessment (NC5MPA) in PD patients as screening test for the detection of PDD, as well as to test if the association with the cube drawing test (CDT) can increase the test accuracy. Methods: A total of 98 patients with PD were evaluated using the NC5MPA, combined with the CDT, Mini Mental State Examination and the Montreal Cognitive Assessment (MoCA). These patients were also evaluated for mild cognitive impairment (MCI) and dementia by the Clinical Dementia Rating Scale (CDR). Results: There was a good correlation (with P value < 0.00) between the test scores and PDD, but the results of the 3 tests for MCI was > 0.05. The NC5MPA test has had sensitivity of 78.5%, specificity of 85.7%, accuracy of 82.6%, positive predictive value of 80.4% and negative predictive value of 84.2%, in addition to demonstrate an average performance time of 3.2 minutes (3.08–3.31). The association with the CDT has led to a little significant increase in sensitivity and has showed a decrease in specificity and accuracy, besides increase the test performance time. In assessing the interference of education level, the results were influenced by the small sample size of the 5 to 8 years of education group. Conclusion: The NC5MPA test has proven up to be a good screening test for PDD, being even faster and easier to perform, but more tests with larger populations are necessary to assess the accuracy of this test for MCI and to assess if there is interference of education level in the test accuracy.

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来源期刊

Sao Paulo Medical Journal 医学-医学：内科

CiteScore

2.20

自引率

7.10%

发文量

210

审稿时长

6-12 weeks

期刊介绍： Published bimonthly by the Associação Paulista de Medicina, the journal accepts articles in the fields of clinical health science (internal medicine, gynecology and obstetrics, mental health, surgery, pediatrics and public health). Articles will be accepted in the form of original articles (clinical trials, cohort, case-control, prevalence, incidence, accuracy and cost-effectiveness studies and systematic reviews with or without meta-analysis), narrative reviews of the literature, case reports, short communications and letters to the editor. Papers with a commercial objective will not be accepted.