Objective

Timed neuropsychological tests do not take into account physical impairment during scoring procedures. Dysarthria and upper limb impairment can be easily measured with the PATA rate test (PRT) and the nine-hole pegboard test (9HPT). We recently validated a normalization method for timed neuropsychological tests using the PRT and 9HPT (p9NORM). We now validate the p9NORM in Parkinson’s disease (Yarnall et al. Neurology 82(4):308–316; 2014) and multiple system atrophy (MSA).

Methods

We enrolled twenty-six patients with PD, eighteen patients with MSA, and fifteen healthy controls (HC). p9NORM was applied to patients with abnormal PRT and/or 9HPT. All subjects were tested with a comprehensive neuropsychological battery.

Results

No differences emerged in demographics across groups: (PD: mean age ± SD 66 ± 8; education 9 ± 4 years; MSA: age 60 ± 8; education 10 ± 4 years; HC: age 61 ± 12; education 9 ± 4 years). In MSA patients, the scores on the trail making test (TMT-A p = 0.003; TMT-B p = 0.018), attentional matrices (AM; p = 0.042), and symbol digit modalities test (SDMT p = 0.027) significantly differed following application of p9NORM. In PD patients, the TMT-A (p < 0.001), TMT-B (p = 0.001), and AM (p = 0.001) differed after correction. PD and MSA showed cognitive impairment relative to HC performance. When comparing MSA with PD, the SDMT, AM, and fluencies were similar. TMT-A and -B raw scores were different between groups (p = 0.006; p = 0.034), but these differences lost significance after p9NORM corrections (p = 0.100; p = 0.186).

Conclusions

We confirm that the p9NORM can be successfully used in both PD and MSA patients, as it mitigates the impact of disability on timed tests, resulting in a more accurate analysis of cognitive domains.

中文翻译：

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p9NORM校正方法在帕金森氏病和多系统萎缩的定时神经心理学测试中的应用。

目的

定时的神经心理学测试在计分过程中未考虑身体损伤。使用PATA速率测试（PRT）和九孔钉板测试（9HPT）可以轻松测量构音障碍和上肢损伤。我们最近验证了使用PRT和9HPT（p9NORM）进行定时神经心理学测试的标准化方法。现在，我们在帕金森氏病（Yarnall等人，Neurology 82（4）：308-316； 2014）和多系统萎缩症（MSA）中验证p9NORM。

方法

我们招募了26例PD患者，18例MSA患者和15例健康对照（HC）。p9NORM用于异常PRT和/或9HPT的患者。所有受试者均经过全面的神经心理学测试。

结果

各组之间的人口统计学无差异：（PD：平均年龄±SD 66±8；受教育程度9±4岁； MSA：60±8岁；受教育程度10±4岁； HC：61±12岁；受教育程度9±4岁）。在MSA患者中，追踪测试（TMT-A p = 0.003; TMT-B p = 0.018），注意矩阵（AM; p = 0.042）和符号数字模态测试（SDMT p = 0.027）的得分存在显着差异以下是p9NORM的应用。在PD患者中，TMT-A（p <0.001），TMT-B（p = 0.001）和AM（p= 0.001）在校正后有所不同。PD和MSA相对于HC表现出认知障碍。将MSA与PD进行比较时，SDMT，AM和流畅度相似。两组之间的TMT-A和-B原始分数不同（p = 0.006；p = 0.034），但是在p9NORM校正后（p = 0.100；p = 0.186），这些差异失去了意义。

结论

我们确认p9NORM可以成功地用于PD和MSA患者，因为它可以减轻残疾对定时测试的影响，从而对认知域进行更准确的分析。