Abstract

Objective

Teleneuropsychology (TNP) has been shown to be a valid assessment method compared with in-person neuropsychological evaluations. Interest in delivering TNP directly to patients’ homes has arisen in response to the coronavirus disease 2019 (COVID-19) pandemic. However, prior research has typically involved patients tested in clinical settings, and the validity of in-home TNP testing has not yet been established. The present study aims to explore the validity and clinical utility of in-home TNP testing in a mixed clinical sample in the wake of COVID-19.

Methods

Test profiles for 111 in-home TNP patients were retrospectively compared with 120 patients who completed in-person evaluations. The TNP test battery consisted of tests measuring attention/processing speed, verbal memory, naming, verbal fluency, and visuoconstruction. TNP scores of cognitively normal (CN) patients were compared with patients with neurocognitive disorders (NCD), and score profiles were examined among suspected diagnostic groups of Alzheimer’s disease (AD), Parkinson’s disease (PD), and vascular disease (VaD).

Results

TNP test scores did not significantly differ from in-person testing across all tests except the Hopkins Verbal Learning Test-Revised Discrimination Index. Within the TNP group, significant differences between the CN and NCD groups were found for all tests, and the memory and semantic fluency tests yielded large effect sizes (d ≥ 0.8). Score profiles among the AD, PD, and VaD groups were explored.

Conclusions

These findings support the validity of in-home TNP testing compared with in-person neuropsychological testing. Practice considerations, limitations, and future directions are discussed.

中文翻译：

---

COVID-19 后居家远程神经心理测试的有效性

摘要

客观的

与面对面的神经心理学评估相比，远程神经心理学 (TNP) 已被证明是一种有效的评估方法。为了应对 2019 年冠状病毒病 (COVID-19) 大流行，人们对将 TNP 直接运送到患者家中产生了兴趣。然而，先前的研究通常涉及在临床环境中测试的患者，并且尚未确定家庭 TNP 测试的有效性。本研究旨在探索在 COVID-19 之后混合临床样本中家庭 TNP 测试的有效性和临床效用。

方法

对 111 名在家中 TNP 患者的测试概况与完成面对面评估的 120 名患者进行了回顾性比较。TNP 测试组包括测量注意力/处理速度、语言记忆、命名、语言流畅性和视觉结构的测试。将认知正常 (CN) 患者的 TNP 评分与神经认知障碍 (NCD) 患者进行比较，并在阿尔茨海默病 (AD)、帕金森病 (PD) 和血管疾病 (VaD) 的疑似诊断组中检查评分概况。

结果

除了霍普金斯语言学习测试修订后的歧视指数外，TNP 测试分数与所有测试中的面对面测试没有显着差异。在 TNP 组内，所有测试都发现 CN 和 NCD 组之间存在显着差异，并且记忆和语义流畅性测试产生了较大的效应量 ( d  ≥ 0.8)。研究了 AD、PD 和 VaD 组之间的得分概况。

结论

与面对面的神经心理学测试相比，这些发现支持家庭 TNP 测试的有效性。讨论了实践注意事项、局限性和未来方向。