Background

The Fist-Edge-Palm (FEP) test takes 0.5–3 min to complete and is highly sensitive in differentiating Alzheimer's disease and frontotemporal dementia from normal cognition, but it has not yet been studied in Parkinson's disease (PD).

Objective

To determine the sensitivity and specificity of the FEP test in screening patients with PD for cognitive impairment and dementia.

Methods

PD patients were recruited and divided into three groups based on cognitive status: normal cognition, mild cognitive impairment (MCI) and dementia according to 2015 MDS clinical diagnostic criteria for PD and clinical dementia rating scale (CDR) assessment for cognitive status. MMSE, FEP and clock drawing test (CDT) were tested in all recruited PD patients. Chi-square test was used to compare the sensitivity of FEP and CDT in detecting PDD and PD-MCI.

Results

A total of 108 PD patients were included: 52 normal cognition, 28 MCI, and 28 dementia. The sensitivity of FEP in differentiating PDD from PD-NC was 96.4% and the sensitivity for PD-MCI from PD-NC was 71.4%. The sensitivity of CDT in differentiating PDD from PD-NC was 71.4% and PD-MCI from PD-NC was 53.6%. The sensitivities of FEP and CDT were 83.9% and 62.5%, respectively, in identifying cognitive impairment (CDR ≥ 0.5) in PD patients.

Conclusion

FEP is a sensitive screening tool in differentiating PDD or PD-MCI from PD-NC, and it is much faster than MMSE and more sensitive than CDT. FEP may be a practical screening tool for daily clinical practice.

中文翻译：

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Fist-Edge-Palm (FEP) 测试在区分痴呆与帕金森病的正常认知方面具有很高的敏感性

背景

Fist-Edge-Palm (FEP) 测试需要 0.5-3 分钟才能完成，并且在区分阿尔茨海默病和额颞叶痴呆与正常认知方面高度敏感，但尚未在帕金森病 (PD) 中进行研究。

客观的

确定 FEP 测试在筛查 PD 患者认知障碍和痴呆方面的敏感性和特异性。

方法

根据 2015 年 MDS PD 临床诊断标准和认知状态临床痴呆评分量表 (CDR) 评估，招募 PD 患者并根据认知状态分为三组：正常认知、轻度认知障碍 (MCI) 和痴呆。在所有招募的 PD 患者中测试了 MMSE、FEP 和时钟绘图测试 (CDT)。卡方检验用于比较 FEP 和 CDT 检测 PDD 和 PD-MCI 的敏感性。

结果

共包括 108 名 PD 患者：52 名正常认知、28 名 MCI 和 28 名痴呆。FEP 区分 PDD 与 PD-NC 的灵敏度为 96.4%，PD-MCI 与 PD-NC 的灵敏度为 71.4%。CDT 区分 PDD 和 PD-NC 的敏感性为 71.4%，PD-MCI 和 PD-NC 的敏感性为 53.6%。FEP 和 CDT 在识别 PD 患者认知障碍（CDR ≥ 0.5）方面的敏感性分别为 83.9% 和 62.5%。

结论

FEP 是区分 PDD 或 PD-MCI 与 PD-NC 的灵敏筛选工具，它比 MMSE 快得多，比 CDT 更灵敏。FEP 可能是日常临床实践的实用筛选工具。