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Karr JE, Ingram EO, Pinheiro CN, Ali S, Iverson GL. Test-Retest Reliability and Reliable Change on the NIH Toolbox Cognition Battery. Arch Clin Neuropsychol 2024; 39:702-713. [PMID: 38402512 PMCID: PMC11345114 DOI: 10.1093/arclin/acae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/22/2023] [Accepted: 01/25/2024] [Indexed: 02/26/2024] Open
Abstract
OBJECTIVE Researchers and practitioners can detect cognitive improvement or decline within a single examinee by applying a reliable change methodology. This study examined reliable change through test-retest data from the English-language National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) normative sample. METHOD Participants included adults (n = 138; age: M ± SD = 54.8 ± 20.0, range: 18-85; 51.4% men; 68.1% White) who completed test-retest assessments about a week apart on five fluid cognition tests, providing raw scores, age-adjusted standard scores (SS), and demographic-adjusted T-scores (T). RESULTS The Fluid Cognition Composite (SS: ICC = 0.87; T-score: ICC = 0.84) and the five fluid cognition tests had good test-retest reliability (SS: ICC range = 0.66-0.85; T-score: ICC range = 0.64-0.86). The lower and upper bounds of 70%, 80%, and 90% confidence intervals (CIs) were calculated around change scores, which serve as cutoffs for determining reliable change. Using T-scores, 90% CI, and adjustment for practice effects, 32.3% declined on one or more tests, 9.7% declined on two or more tests, 36.6% improved on one or more tests, and 5.4% improved on two or more tests. CONCLUSIONS It was common for participants to show reliable change on at least one test score, but not two or more test scores. Per an 80% CI, test-retest difference scores beyond these cutoffs would indicate reliable change: Dimensional Change Card Sort (SS ≥ 14/T ≥ 10), Flanker (SS ≥ 12/T ≥ 8), List Sorting (SS ≥ 14/T ≥ 10), Picture Sequence Memory (SS ≥ 19/T ≥ 13), Pattern Comparison (SS ≥ 11/T ≥ 8), and Fluid Cognition Composite (SS ≥ 10/T ≥ 7). The reliable change cutoffs could be applied in research or practice to detect within-person change in fluid cognition at the individual level.
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Affiliation(s)
- Justin E Karr
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, KY, USA
| | - Eric O Ingram
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, KY, USA
| | - Cristina N Pinheiro
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, KY, USA
| | - Sheliza Ali
- Department of Neurology, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
- Department of Physical Medicine and Rehabilitation, Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, MA, USA
- Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, USA
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Tabari F, Berger JI, Flouty O, Copeland B, Greenlee JD, Johari K. Speech, voice, and language outcomes following deep brain stimulation: A systematic review. PLoS One 2024; 19:e0302739. [PMID: 38728329 PMCID: PMC11086900 DOI: 10.1371/journal.pone.0302739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Deep brain stimulation (DBS) reliably ameliorates cardinal motor symptoms in Parkinson's disease (PD) and essential tremor (ET). However, the effects of DBS on speech, voice and language have been inconsistent and have not been examined comprehensively in a single study. OBJECTIVE We conducted a systematic analysis of literature by reviewing studies that examined the effects of DBS on speech, voice and language in PD and ET. METHODS A total of 675 publications were retrieved from PubMed, Embase, CINHAL, Web of Science, Cochrane Library and Scopus databases. Based on our selection criteria, 90 papers were included in our analysis. The selected publications were categorized into four subcategories: Fluency, Word production, Articulation and phonology and Voice quality. RESULTS The results suggested a long-term decline in verbal fluency, with more studies reporting deficits in phonemic fluency than semantic fluency following DBS. Additionally, high frequency stimulation, left-sided and bilateral DBS were associated with worse verbal fluency outcomes. Naming improved in the short-term following DBS-ON compared to DBS-OFF, with no long-term differences between the two conditions. Bilateral and low-frequency DBS demonstrated a relative improvement for phonation and articulation. Nonetheless, long-term DBS exacerbated phonation and articulation deficits. The effect of DBS on voice was highly variable, with both improvements and deterioration in different measures of voice. CONCLUSION This was the first study that aimed to combine the outcome of speech, voice, and language following DBS in a single systematic review. The findings revealed a heterogeneous pattern of results for speech, voice, and language across DBS studies, and provided directions for future studies.
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Affiliation(s)
- Fatemeh Tabari
- Human Neurophysiology and Neuromodulation Laboratory, Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge, LA, United States of America
| | - Joel I. Berger
- Human Brain Research Laboratory, Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, United States of America
| | - Oliver Flouty
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, United States of America
| | - Brian Copeland
- Department of Neurology, LSU Health Sciences Center, New Orleans, LA, United States of America
| | - Jeremy D. Greenlee
- Human Brain Research Laboratory, Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, United States of America
- Iowa Neuroscience Institute, Iowa City, IA, United States of America
| | - Karim Johari
- Human Neurophysiology and Neuromodulation Laboratory, Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge, LA, United States of America
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Jiao J, Brumbach BH, Hantke N, Wilhelmi M, Bonilla C, Safarpour D. Changes in Anticholinergic Burden in Parkinson's Disease After Deep Brain Stimulation. Neuromodulation 2024; 27:538-543. [PMID: 38085189 DOI: 10.1016/j.neurom.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/30/2023] [Accepted: 11/02/2023] [Indexed: 04/05/2024]
Abstract
OBJECTIVE This study aimed to evaluate the effect of deep brain stimulation (DBS) on anticholinergic burden in Parkinson's disease (PD) and the association of anticholinergic burden with cognition. MATERIALS AND METHODS A retrospective chart review in patients with PD who underwent bilateral subthalamic nucleus (STN) or globus pallidus internus (GPi) DBS from 2010 to 2020 reviewed medications with anticholinergic burden at baseline, six months, and one year (N = 216) after surgery. The cumulative anticholinergic burden at each visit was calculated using the Anticholinergic Risk Scale (ARS). RESULTS ARS scores were significantly lower for patients six months and one year after surgery than at baseline (z = 6.58, p < 0.0001; z = 6.99, p < 0.0001). Change in ARS scores at both six months and one year were driven by down-titration of PD medications (z = 9.35, p < 0.0001; z = 8.61, p < 0.0001), rather than changes in pain, psychiatric, or urinary medications with anticholinergic effects. There was no significant difference in change in ARS scores at one year between targets (t = 0.41, p = 0.68). In addition, there was no significant association between anticholinergic burden and cognitive performance. CONCLUSION GPi and STN DBS are associated with decreased anticholinergic burden due to PD medications in the first year after surgery.
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Affiliation(s)
- Jocelyn Jiao
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA.
| | - Barbara H Brumbach
- Oregon Health and Science University-Portland State University School of Public Health, Biostatistics and Design Program, Oregon Health and Science University, Portland, OR, USA
| | - Nathan Hantke
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA; Mental Health and Clinical Neuroscience Division, Veterans Affairs Portland Health Care System, Portland, OR, USA
| | - Morgan Wilhelmi
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Christian Bonilla
- School of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Delaram Safarpour
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
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Euler MJ, Duff K, King JB, Hoffman JM. Recall and recognition subtests of the repeatable battery for the assessment of neuropsychological status and their relationship to biomarkers of Alzheimer's disease. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:885-902. [PMID: 36110031 PMCID: PMC10014490 DOI: 10.1080/13825585.2022.2124229] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/08/2022] [Indexed: 10/14/2022]
Abstract
Recently, two new recognition subtests for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were developed and initially validated in a cohort of older adults who were cognitively intact or classified as amnestic Mild Cognitive Impairment (MCI) or mild Alzheimer's disease (AD). The current paper extends that validation by comparing the recall and recognition subtests of the RBANS, including the existing and recently developed scores, to three commonly used biomarkers in AD in an expanded sample from the initial validation. One hundred fifty-four older adults (65 intact, 46 MCI, 43 AD) were administered the RBANS, which included the recently developed subtests for Story Recognition and Figure Recognition (hits, false positives, total correct), as part of a study on memory and biomarkers. Participants also completed magnetic resonance imaging to obtain hippocampal volumes, positron emission tomography to obtain amyloid plaque deposition, and a blood draw to obtain APOE ε4 status. Whereas correlations between recall scores and biomarkers tended to be moderate (average r = ±0.48), these correlations were comparable across the three recognition total scores (average r = ±0.42), but tended to be lower for recognition hits (average r = ±0.28) and false positives (average r = ±0.38). These results further validate the existing and recently developed recognition scores on the RBANS as providing useful information about brain and genetic pathology in older adults with intact and impaired cognitive functioning.
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Affiliation(s)
- Matthew J Euler
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Jace B King
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - John M Hoffman
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
- Radiology and Imaging Sciences, Center for Quantitative Cancer Imaging, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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Hammers DB, Suhrie KR, Porter SM, Dixon AM, Duff K. Validation of one-year reliable change in the RBANS for community-dwelling older adults with amnestic mild cognitive impairment. Clin Neuropsychol 2022; 36:1304-1327. [PMID: 32819188 PMCID: PMC7909751 DOI: 10.1080/13854046.2020.1807058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 07/24/2020] [Accepted: 08/01/2020] [Indexed: 10/23/2022]
Abstract
Objective: The current study sought to externally validate previously published standardized regression-based (SRB) equations for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Indexes administered twice over a one-year period. Method: Hammers and colleagues' SRB prediction equations were applied to two independent samples of community-dwelling older adults with amnestic Mild Cognitive Impairment (MCI), including those recruited from the community (n = 64) and those recruited from a memory disorders clinic (n = 58). Results: While Observed Baseline and Observed Follow-up performances were generally comparable for both MCI samples over one year, both samples possessed significantly lower Observed One-Year Follow-up scores than were predicted based on Hammers and colleagues' development sample across many RBANS Indexes. Relatedly, both amnestic MCI samples possessed a greater percentage of participants either "declining" or failing to exhibit a long-term practice effect over one year relative to expectation across most Indexes. Further, the clinic-recruited amnestic MCI sample displayed worse baseline performances, smaller long-term practice effects, and greater proportions of individual participants exhibiting a decline across one year relative to the community amnestic MCI sample. Conclusions: These findings validate Hammers and colleagues' SRB prediction equations by (1) indicating their ability to identify clinically meaningful change across RBANS Indexes in independent samples, and (2) discriminating rates of cognitive change among cognitively nuanced samples.
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Affiliation(s)
- Dustin B. Hammers
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
- Center on Aging, University of Utah
| | - Kayla R. Suhrie
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
| | - Sariah M. Porter
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
| | - Ava M. Dixon
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
| | - Kevin Duff
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
- Center on Aging, University of Utah
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Rački V, Hero M, Rožmarić G, Papić E, Raguž M, Chudy D, Vuletić V. Cognitive Impact of Deep Brain Stimulation in Parkinson’s Disease Patients: A Systematic Review. Front Hum Neurosci 2022; 16:867055. [PMID: 35634211 PMCID: PMC9135964 DOI: 10.3389/fnhum.2022.867055] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionParkinson’s disease (PD) patients have a significantly higher risk of developing dementia in later disease stages, leading to severe impairments in quality of life and self-functioning. Questions remain on how deep brain stimulation (DBS) affects cognition, and whether we can individualize therapy and reduce the risk for adverse cognitive effects. Our aim in this systematic review is to assess the current knowledge in the field and determine if the findings could influence clinical practice.MethodsWe have conducted a systematic review according to PRISMA guidelines through MEDLINE and Embase databases, with studies being selected for inclusion via a set inclusion and exclusion criteria.ResultsSixty-seven studies were included in this systematic review according to the selected criteria. This includes 6 meta-analyses, 18 randomized controlled trials, 17 controlled clinical trials, and 26 observational studies with no control arms. The total number of PD patients encompassed in the studies cited in this review is 3677, not including the meta-analyses.ConclusionCognitive function in PD patients can deteriorate, in most cases mildly, but still impactful to the quality of life. The strongest evidence is present for deterioration in verbal fluency, while inconclusive evidence is still present for executive function, memory, attention and processing speed. Global cognition does not appear to be significantly impacted by DBS, especially if cognitive screening is performed prior to the procedure, as lower baseline cognitive function is connected to poor outcomes. Further randomized controlled studies are required to increase the level of evidence, especially in the case of globus pallidus internus DBS, pedunculopontine nucleus DBS, and the ventral intermediate nucleus of thalamus DBS, and more long-term studies are required for all respective targets.
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Affiliation(s)
- Valentino Rački
- Department of Neurology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
- Clinic of Neurology, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Mario Hero
- Department of Neurology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
- Clinic of Neurology, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | | | - Eliša Papić
- Department of Neurology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
- Clinic of Neurology, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Marina Raguž
- Department of Neurosurgery, Clinical Hospital Dubrava, Zagreb, Croatia
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia
| | - Darko Chudy
- Department of Neurosurgery, Clinical Hospital Dubrava, Zagreb, Croatia
- Department of Surgery, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Vladimira Vuletić
- Department of Neurology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
- Clinic of Neurology, Clinical Hospital Center Rijeka, Rijeka, Croatia
- *Correspondence: Vladimira Vuletić,
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Hammers DB, Kostadinova R, Unverzagt FW, Apostolova LG. Assessing and validating reliable change across ADNI protocols. J Clin Exp Neuropsychol 2022; 44:85-102. [PMID: 35786312 PMCID: PMC9308719 DOI: 10.1080/13803395.2022.2082386] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 05/23/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Reliable change methods can aid in determining whether changes in cognitive performance over time are meaningful. The current study sought to develop and cross-validate 12-month standardized regression-based (SRB) equations for the neuropsychological measures commonly administered in the Alzheimer's Disease Neuroimaging Initiative (ADNI) longitudinal study. METHOD Prediction algorithms were developed using baseline score, retest interval, the presence/absence of a 6-month evaluation, age, education, sex, and ethnicity in two different samples (n = 192 each) of robustly cognitively intact community-dwelling older adults from ADNI - matched for demographic and testing factors. The developed formulae for each sample were then applied to one of the samples to determine goodness-of-fit and appropriateness of combining samples for a single set of SRB equations. RESULTS Minimal differences were seen between Observed 12-month and Predicted 12-month scores on most neuropsychological tests from ADNI, and when compared across samples the resultant Predicted 12-month scores were highly correlated. As a result, samples were combined and SRB prediction equations were successfully developed for each of the measures. CONCLUSIONS Establishing cross-validation for these SRB prediction equations provides initial support of their use to detect meaningful change in the ADNI sample, and provides the basis for future research with clinical samples to evaluate potential clinical utility. While some caution should be considered for measuring true cognitive change over time - particularly in clinical samples - when using these prediction equations given the relatively lower coefficients of stability observed, use of these SRBs reflects an improvement over current practice in ADNI.
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Affiliation(s)
- Dustin B. Hammers
- Indiana University School of Medicine, Department of Neurology, Indianapolis, IN, USA
| | - Ralitsa Kostadinova
- Indiana University School of Medicine, Department of Neurology, Indianapolis, IN, USA
| | | | - Liana G. Apostolova
- Indiana University School of Medicine, Department of Neurology, Indianapolis, IN, USA
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Jahanshahi M, Leimbach F, Rawji V. Short and Long-Term Cognitive Effects of Subthalamic Deep Brain Stimulation in Parkinson's Disease and Identification of Relevant Factors. JOURNAL OF PARKINSON'S DISEASE 2022; 12:2191-2209. [PMID: 36155529 DOI: 10.3233/jpd-223446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Subthalamic nucleus deep brain stimulation (STN-DBS) successfully controls the motor symptoms of Parkinson's disease (PD) but has associated cognitive side-effects. OBJECTIVE Establish the short- and long-term cognitive effects of STN-DBS in PD. METHODS Both the short-term and long-term effects of STN-DBS on cognition were examined through evaluation of the controlled studies that compared patients with STN-DBS to unoperated PD patients, thus controlling for illness progression. We also reviewed the literature to identify the factors that influence cognitive outcome of STN-DBS in PD. RESULTS The meta-analysis of the short-term cognitive effects of STN-DBS revealed moderate effect sizes for semantic and phonemic verbal fluency and small effect sizes for psychomotor speed and language, indicating greater decline in the STN-DBS operated than the unoperated patients in these cognitive domains. The longer-term STN-DBS results from controlled studies indicated rates of cognitive decline/dementia up to 32%; which are no different from the rates from the natural progression of PD. Greater executive dysfunction and poorer memory pre-operatively, older age, higher pre-operative doses of levodopa, and greater axial involvement are some of the factors associated with worse cognition after STN-DBS in PD. CONCLUSION This evidence can be used to inform patients and their families about the short-term and long-term risks of cognitive decline following STN-DBS surgery and aid the team in selection of suitable candidates for surgery.
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Affiliation(s)
- Marjan Jahanshahi
- Unit of Functional Neurosurgery, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, The National Hospital for Neurology & Neurosurgery, London, UK
| | - Friederike Leimbach
- Unit of Functional Neurosurgery, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, The National Hospital for Neurology & Neurosurgery, London, UK
| | - Vishal Rawji
- Unit of Functional Neurosurgery, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, The National Hospital for Neurology & Neurosurgery, London, UK
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Combs HL, Wyman-Chick KA, Erickson LO, York MK. Development of standardized regression-based formulas to assess meaningful cognitive change in early Parkinson's disease. Arch Clin Neuropsychol 2021; 36:734-745. [PMID: 33103727 DOI: 10.1093/arclin/acaa104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/29/2020] [Accepted: 10/01/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Longitudinal assessment of cognitive and emotional functioning in patients with Parkinson's disease (PD) is helpful in tracking progression of the disease, developing treatment plans, evaluating outcomes, and educating patients and families. Determining whether change over time is meaningful in neurodegenerative conditions, such as PD, can be difficult as repeat assessment of neuropsychological functioning is impacted by factors outside of cognitive change. Regression-based prediction formulas are one method by which clinicians and researchers can determine whether an observed change is meaningful. The purpose of the current study was to develop and validate regression-based prediction models of cognitive and emotional test scores for participants with early-stage idiopathic PD and healthy controls (HC) enrolled in the Parkinson's Progression Markers Initiative (PPMI). METHODS Participants with de novo PD and HC were identified retrospectively from the PPMI archival database. Data from baseline testing and 12-month follow-up were utilized in this study. In total, 688 total participants were included in the present study (NPD = 508; NHC = 185). Subjects from both groups were randomly divided into development (70%) and validation (30%) subsets. RESULTS Early-stage idiopathic PD patients and healthy controls were similar at baseline. Regression-based models were developed for all cognitive and self-report mood measures within both populations. Within the validation subset, the predicted and observed cognitive test scores did not significantly differ, except for semantic fluency. CONCLUSIONS The prediction models can serve as useful tools for researchers and clinicians to study clinically meaningful cognitive and mood change over time in PD.
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Vos SH, Kessels RPC, Vinke RS, Esselink RAJ, Piai V. The Effect of Deep Brain Stimulation of the Subthalamic Nucleus on Language Function in Parkinson's Disease: A Systematic Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2794-2810. [PMID: 34157249 DOI: 10.1044/2021_jslhr-20-00515] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose This systematic review focuses on the effect of bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) on language function in Parkinson's disease (PD). It fills an important gap in recent reviews by considering other language tasks in addition to verbal fluency. Method We critically and systematically reviewed the literature on studies that investigated the effect of bilateral STN-DBS on language function in PD. All studies included a matched PD control group who were on best medical treatment, with language testing at similar baseline and follow-up intervals as the DBS PD group. Results Thirteen identified studies included a form of a verbal fluency task, seven studies included picture naming, and only two studies included more language-oriented tasks. We found that verbal fluency was negatively affected after DBS, whereas picture naming was unaffected. Studies investigating individual change patterns using reliable change indices showed that individual variability is larger for picture naming than for verbal fluency. Conclusions Verbal fluency is the most frequently investigated aspect of language function. Our analysis showed a pattern of decline in verbal fluency across multiple studies after STN-DBS, whereas picture naming was unaffected. Data on more language-oriented tests in a large DBS sample and best medical treatment control group are sparse. The investigation of language function in PD after DBS requires sensitive language tests (with and without time pressure) and experimental designs as used in the studies reviewed here. Reliable change index statistics are a promising tool for investigating individual differences in performance after DBS. Supplemental Material https://doi.org/10.23641/asha.14794458.
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Affiliation(s)
- Sandra H Vos
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Roy P C Kessels
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - R Saman Vinke
- Department of Neurosurgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Rianne A J Esselink
- Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Vitória Piai
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
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Hammers DB, Suhrie KR, Dixon A, Porter S, Duff K. Validation of one-week reliable change methods in cognitively intact community-dwelling older adults. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2021; 28:472-492. [PMID: 32613913 PMCID: PMC7775875 DOI: 10.1080/13825585.2020.1787942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/23/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Reliable change methods can assist the determination of whether observed changes in performance are meaningful. The current study sought to validate previously published standardized regression-based (SRB) equations for commonly administered cognitive tests using a cognitively intact sample of older adults, and extend findings by including relevant demographic and test-related variables known to predict cognitive performance. Method: This study applied previously published SRB prediction equations to 107 cognitively intact older adults assessed twice over one week. Prediction equations were also updated by pooling the current validation sample with 93 cognitively intact participants from original development sample to create a combined development sample. Results: Significant improvements were seen between observed baseline and follow-up scores on most measures. However, few differences were seen between observed follow-up scores and those predicted from these SRB algorithms, and the level of practice effects observed based on these equations were consistent with expectations. When SRBs were re-calculated from this combined development sample, predicted follow-up scores were mostly comparable with these equations, but standard errors of the estimate were consistently smaller. Conclusions: These results help support the validity of of these SRB equations to predict cognitive performance on these measures when repeated administration is necessary over short intervals. Findings also highlight the utility of expanding SRB models when predicting follow-up performance serially to provide more accurate assessment of reliable change at the level of the individual. As short-term practice effects are shown to predict cognitive performance annually, they possess the potential to inform clinical decision-making about individuals along the Alzheimer's continuum.
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Affiliation(s)
- Dustin B. Hammers
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
- Center on Aging, University of Utah
| | - Kayla R. Suhrie
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
| | - Ava Dixon
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
| | - Sariah Porter
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
| | - Kevin Duff
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah
- Center on Aging, University of Utah
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Hammers DB, Suhrie KR, Dixon A, Porter S, Duff K. Reliable change in cognition over 1 week in community-dwelling older adults: a validation and extension study. Arch Clin Neuropsychol 2021; 36:347-358. [PMID: 32026948 PMCID: PMC8245079 DOI: 10.1093/arclin/acz076] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Reliable change methods can aid neuropsychologists in understanding if performance differences over time represent clinically meaningful change or reflect benefit from practice. The current study sought to externally validate the previously published standardized regression-based (SRB) prediction equations developed by Duff for commonly administered cognitive measures. METHOD This study applied Duff's SRB prediction equations to an independent sample of community-dwelling participants with amnestic mild cognitive impairment (MCI) assessed twice over a 1-week period. A comparison of MCI subgroups (e.g., single v. multi domain) on the amount of change observed over 1 week was also examined. RESULTS Using pairwise t-tests, large and statistically significant improvements were observed on most measures across 1 week. However, the observed follow-up scores were consistently below expectation compared with predictions based on Duff's SRB algorithms. In individual analyses, a greater percentage of MCI participants showed smaller-than-expected practice effects based on normal distributions. In secondary analyses, smaller-than-expected practice effects were observed in participants with worse baseline memory impairment and a greater number of impaired cognitive domains, particularly for measures of executive functioning/speeded processing. CONCLUSIONS These findings help to further support the validity of Duff's 1-week SRB prediction equations in MCI samples and extend previous research by showing incrementally smaller-than-expected benefit from practice for increasingly impaired amnestic MCI subtypes.
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Affiliation(s)
- Dustin B Hammers
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
- Center on Aging, University of Utah
| | - Kayla R Suhrie
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
| | - Ava Dixon
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
| | - Sariah Porter
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
| | - Kevin Duff
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah
- Center on Aging, University of Utah
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Hammers DB, Duff K. Application of Different Standard Error Estimates in Reliable Change Methods. Arch Clin Neuropsychol 2021; 36:339-346. [PMID: 31732736 PMCID: PMC8060987 DOI: 10.1093/arclin/acz054] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/16/2019] [Accepted: 09/04/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study attempted to clarify the applicability of standard error (SE) terms in clinical research when examining the impact of short-term practice effects on cognitive performance via reliable change methodology. METHOD This study compared McSweeney's SE of the estimate (SEest) to Crawford and Howell's SE for prediction of the regression (SEpred) using a developmental sample of 167 participants with either normal cognition or mild cognitive impairment (MCI) assessed twice over 1 week. One-week practice effects in older adults: Tools for assessing cognitive change. Using these SEs, previously published standardized regression-based (SRB) reliable change prediction equations were then applied to an independent sample of 143 participants with MCI. RESULTS This clinical developmental sample yielded nearly identical SE values (e.g., 3.697 vs. 3.719 for HVLT-R Total Recall SEest and SEpred, respectively), and the resultant SRB-based discrepancy z scores were comparable and strongly correlated (r = 1.0, p < .001). Consequently, observed follow-up scores for our sample with MCI were consistently below expectation compared to predictions based on Duff's SRB algorithms. CONCLUSIONS These results appear to replicate and extend previous work showing that the calculation of the SEest and SEpred from a clinical sample of cognitively intact and MCI participants yields similar values and can be incorporated into SRB reliable change statistics with comparable results. As a result, neuropsychologists utilizing reliable change methods in research investigation (or clinical practice) should carefully balance mathematical accuracy and ease of use, among other factors, when determining which SE metric to use.
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Affiliation(s)
- Dustin B Hammers
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
- Center on Aging, University of Utah, Salt Lake City, UT, USA
| | - Kevin Duff
- Center for Alzheimer’s Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
- Center on Aging, University of Utah, Salt Lake City, UT, USA
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Wang J, Pan R, Cui Y, Wang Z, Li Q. Effects of Deep Brain Stimulation in the Subthalamic Nucleus on Neurocognitive Function in Patients With Parkinson's Disease Compared With Medical Therapy: A Meta-Analysis. Front Neurol 2021; 12:610840. [PMID: 33737902 PMCID: PMC7960912 DOI: 10.3389/fneur.2021.610840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/27/2021] [Indexed: 12/21/2022] Open
Abstract
Background: DBS has been shown to significantly affect motor symptoms in Parkinson's disease (PD). However, some studies have suggested that it may have adverse effects on patients' neurocognitive function. To clarify this operation's effect on neurocognitive function, we collected studies containing neurocognitive function evaluation for qualitative and quantitative analysis. Methods: We searched relevant clinical studies through Pubmed and Embase databases and extracted and sorted out information such as sample size, post-operative scores, pre-operative and post-operative evaluation interval, PD course, and exclusion criteria, from articles meeting the standards. The magnitude and variance of the DBS group's combined effects and the drug therapy group in each neurocognitive domain were calculated and analyzed by the random-effects model. Results: Compared with the drug treatment group, the verbal fluency of patients in the experimental group was significantly decreased at least moderately (ES = −0.553), in which the phonemic fluency declines greatly (ES = −0.842), learning and memory ability was slightly decreased (ES = −0.305), and other neurocognitive functions were not significantly decreased. Conclusion: STN-DBS can affect verbal fluency and damage learning and memory. There was no significant correlation between the above effects and disease progression itself, and it was more likely to be associated with STN-DBS. It is suggested that post-operative patients should be trained and evaluated regularly for their verbal fluency and learning and memory ability. The safety of STN-DBS is acceptable for the majority of patients with motor symptoms.
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Affiliation(s)
- Jiazhen Wang
- Department of Neurology, Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, China
| | - Ru Pan
- Pathology Department of Huzhou Central Hospital, Huzhou, China
| | - Ying Cui
- Department of Neurology, Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, China.,Department of Neurology, Xiangya Hospital of Central South University, Changsha, China
| | - Zhigang Wang
- Department of Neurology, Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, China
| | - Qinghua Li
- Guangxi Clinical Research Center for Neurological Diseases, Affiliated Hospital of Guilin Medical University, Guilin Medical University, Guilin, China
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Hammers DB, Porter S, Dixon A, Suhrie KR, Duff K. Validating 1-Year Reliable Change Methods. Arch Clin Neuropsychol 2021; 36:87-98. [PMID: 32885234 PMCID: PMC7809650 DOI: 10.1093/arclin/acaa055] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/24/2020] [Accepted: 07/01/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE reliable change methods can assist in the determination of whether observed changes in performance are meaningful. The current study sought to validate previously published 1-year standardized regression-based (SRB) equations for commonly administered neuropsychological measures that incorporated baseline performances, demographics, and 1-week practice effects. METHOD Duff et al.'s SRB prediction equations were applied to an independent sample of 70 community-dwelling older adults with either normal cognition or mild cognitive impairment, assessed at baseline, at 1 week, and at 1 year. RESULTS minimal improvements or declines were seen between observed baseline and observed 1-year follow-up scores, or between observed 1-year and predicted 1-year scores, on most measures. Relatedly, a high degree of predictive accuracy was observed between observed 1-year and predicted 1-year scores across cognitive measures in this repeated battery. CONCLUSIONS these results, which validate Duff et al.'s SRB equations, will permit clinicians and researchers to have more confidence when predicting cognitive performance on these measures over 1 year.
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Affiliation(s)
- Dustin B Hammers
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
- Center on Aging, University of Utah, Salt Lake City, UT, USA
| | - Sariah Porter
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
| | - Ava Dixon
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
| | - Kayla R Suhrie
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
| | - Kevin Duff
- Department of Neurology, Center for Alzheimer’s Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
- Center on Aging, University of Utah, Salt Lake City, UT, USA
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Hammers DB, Suhrie KR, Porter SM, Dixon AM, Duff K. Generalizability of reliable change equations for the RBANS over one year in community-dwelling older adults. J Clin Exp Neuropsychol 2020; 42:394-405. [PMID: 32212958 DOI: 10.1080/13803395.2020.1740654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Reliable change methods can assist neuropsychologists in determining whether observed changes in a patient's performance are clinically meaningful. The current study sought to validate previously published standardized regression-based (SRB) equations for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Indexes and subtests.Methods: Duff and colleagues's SRB prediction equations, developed from 223 cognitively intact primary care patients, were applied to an independent sample of robustly cognitively intact (n = 129) community-dwelling older adults assessed with the RBANS twice over a one-year period.Results: Results suggest that the cognitively intact participants in the current validation sample possessed significantly better Observed Follow-up scores than was predicted based on Duff's developmental sample across most RBANS Indexes and many RBANS subtests, though significantly lower Observed Follow-up scores were observed for the Visuospatial/Constructional Index than was predicted. As a result of these findings, the current study calculated updated prediction algorithms for the RBANS Index and subtest scores from the sample of 129 cognitively intact participants.Conclusions: Duff's 2004 and 2005 SRB prediction equations for the RBANS Index and subtest scores failed to generalize to a sample of cognitively intact community-dwelling participants recruited from senior living centers and independent assisted living facilities. These updated SRB prediction equations - being developed from a more medically "clean" sample of cognitively intact older adults who remained stable over 12 months - have the potential to provide a more accurate assessment of reliable change in an individual patient.
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Affiliation(s)
- Dustin B Hammers
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA.,Center on Aging, University of Utah, Salt Lake City, UT, USA
| | - Kayla R Suhrie
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Sariah M Porter
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Ava M Dixon
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA.,Center on Aging, University of Utah, Salt Lake City, UT, USA
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Davalos DB, Luxton I, Thaut M, Cross JE. B Sharp-The cognitive effects of a pilot community music program for people with dementia-related disorders. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2019; 5:592-596. [PMID: 31650015 PMCID: PMC6804583 DOI: 10.1016/j.trci.2019.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Introduction Dementia has been described as the greatest global challenge for healthcare in the 21st century. Pharmaceutical interventions have dominated dementia treatment despite limited efficacy. There is increasing interest in alternatives to delay the progression of cognitive decline, such as community-based programs, promoting social and stimulating experiences. This article discusses a pilot music-based community program (B Sharp) for persons with dementia-related disorders. Method In the pilot study, we assessed 23 persons with dementia-related disorders who, with their caregivers, attended the symphony season and accompanying social hours over a 10-month period. Participants completed a baseline and follow-up brief neuropsychological test to assess cognitive changes. Results Significant improvements were observed between the pre– and post–B Sharp program assessments (P < .010). Discussion Results support the feasibility of the B Sharp program as a community-based program to target cognitive decline. Additional research is needed to understand the mechanisms involved in the improvements observed in this program.
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Affiliation(s)
- Deana B Davalos
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - India Luxton
- Department of Sociology, Colorado State University, Fort Collins, CO, USA
| | - Michael Thaut
- Biomedical Research in Music, Colorado State University, Fort Collins, CO, USA.,Music and Health Science Research Collaboratory, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer E Cross
- Department of Sociology, Colorado State University, Fort Collins, CO, USA
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Pavol MA. Inpatient Neuropsychological Assessment in Older Adults. HANDBOOK ON THE NEUROPSYCHOLOGY OF AGING AND DEMENTIA 2019. [DOI: 10.1007/978-3-319-93497-6_7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Foki T, Hitzl D, Pirker W, Novak K, Pusswald G, Lehrner J. Individual cognitive change after DBS-surgery in Parkinson's disease patients using Reliable Change Index Methodology. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2018; 32:149-158. [PMID: 29767379 PMCID: PMC6132487 DOI: 10.1007/s40211-018-0271-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 04/23/2018] [Indexed: 11/24/2022]
Abstract
Long-term therapy of Parkinson's disease (PD) with levodopa (L-DOPA) is associated with a high risk of developing motor fluctuations and dyskinesia. Deep brain stimulation (DBS) in PD patients of the subthalamic nucleus can improve these motor complications. Although the positive effect on motor symptoms has been proven, postoperative cognitive decline has been documented. To tackle the impact of PD-DBS on cognition, 18 DBS patients were compared to 25 best medically treated Parkinson's patients, 24 Mild Cognitive Impairment (MCI) patients and 12 healthy controls using the Neuropsychological Test Battery Vienna-long (NTBV-long) for cognitive outcome 12 months after first examination. Reliable change index methodology was used. Overall, there was cognitive change in individual patients, but the change was very heterogeneous with gains and losses. Further research is needed to identify the mechanisms that lead to improvement or deterioration of cognitive functions in individual cases.
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Affiliation(s)
- Thomas Foki
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
| | - Daniela Hitzl
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
| | - Walter Pirker
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
- Department of Neurology, Wilhelminenspital Wien, Vienna, Austria
| | - Klaus Novak
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Gisela Pusswald
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
| | - Johann Lehrner
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria.
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20
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Foki T, Hitzl D, Pirker W, Novak K, Pusswald G, Auff E, Lehrner J. Assessment of individual cognitive changes after deep brain stimulation surgery in Parkinson's disease using the Neuropsychological Test Battery Vienna short version. Wien Klin Wochenschr 2017; 129:564-571. [PMID: 28176003 PMCID: PMC5552840 DOI: 10.1007/s00508-017-1169-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 01/18/2017] [Indexed: 12/16/2022]
Abstract
Long-term therapy of Parkinson’s disease with L‑DOPA is associated with a high risk of developing motor fluctuations and dyskinesia. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) can improve these motor complications. Although the positive effect on motor symptoms has been proven, postoperative cognitive decline has been documented. To tackle the impact of DBS on cognition, 18 DBS patients were compared to 25 best medically treated Parkinson’s patients, 24 patients with mild cognitive impairment (MCI) and 12 healthy controls using the Neuropsychological Test Battery Vienna short version (NTBV-short) for cognitive outcome 12 months after the first examination. Reliable change index methodology was used. Roughly 10% of DBS patients showed cognitive decline mainly affecting the domains attention and executive functioning (phonemic fluency). Further research is needed to identify the mechanisms that lead to improvement or deterioration of cognitive functions in individual cases.
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Affiliation(s)
- Thomas Foki
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
| | - Daniela Hitzl
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
| | - Walter Pirker
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
- Department of Neurology, Wilhelminenspital Wien, Vienna, Austria
| | - Klaus Novak
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Gisela Pusswald
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
| | - Eduard Auff
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria
| | - Johann Lehrner
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria.
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Sánchez-Benavides G, Peña-Casanova J, Casals-Coll M, Gramunt N, Manero RM, Puig-Pijoan A, Aguilar M, Robles A, Antúnez C, Frank-García A, Fernández-Martínez M, Blesa R, Oliva R, Gómez-Ansón B, Monte G, Alayrach E, Sainz A, Caprile C, Sánchez-Benavides G, Gramunt N, Böhm P, González S, Buriel Y, Quintana M, Quiñones S, Sánchez-Benavides G, Manero RM, Cucurella G, Ruiz E, Serradell M, Torner L, Badenes D, Casas L, Cerulla N, Ramos S, Cabello L, Rodríguez D, Payno M, Villanueva C, Carles R, Jiménez J, Antequera M, Gata JM, Duque P, Jiménez L, Sanz A, Aguilar MD, Molano A, Lasa M, Sol JM, Hernández F, Quevedo I, Salvà A, Alfonso V, Pla C, Ribas R. One-Year Reference Norms of Cognitive Change in Spanish Old Adults: Data from the NEURONORMA Sample. Arch Clin Neuropsychol 2016; 31:378-88. [DOI: 10.1093/arclin/acw018] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gonzalo Sánchez-Benavides
- Neurofunctionality and Language Group, Neurosciences Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
- Clinical Research Program, Barcelona β Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Jordi Peña-Casanova
- Neurofunctionality and Language Group, Neurosciences Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
- Section of Behavioral Neurology, Neurology Department, Hospital del Mar, Parc Salut Mar, Barcelona, Spain
| | - Marta Casals-Coll
- Neurofunctionality and Language Group, Neurosciences Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Nina Gramunt
- Clinical Research Program, Barcelona β Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Rosa Maria Manero
- Neurofunctionality and Language Group, Neurosciences Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
- Section of Behavioral Neurology, Neurology Department, Hospital del Mar, Parc Salut Mar, Barcelona, Spain
| | - Albert Puig-Pijoan
- Neurofunctionality and Language Group, Neurosciences Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
- Section of Behavioral Neurology, Neurology Department, Hospital del Mar, Parc Salut Mar, Barcelona, Spain
| | - Miguel Aguilar
- Neurology Department, Hospital Mútua de Terrassa, Terrassa, Spain
| | - Alfredo Robles
- Neurology Department, Hospital La Rosaleda, Santiago de Compostela, Spain
| | - Carmen Antúnez
- Neurology Department, Hospital Virgen Arrixaca, Murcia, Spain
| | | | | | - Rafael Blesa
- Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Verbal Fluency in Parkinson's Patients with and without Bilateral Deep Brain Stimulation of the Subthalamic Nucleus: A Meta-analysis. J Int Neuropsychol Soc 2016; 22:478-85. [PMID: 26831827 DOI: 10.1017/s1355617716000035] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Patients with Parkinson's disease often experience significant decline in verbal fluency over time; however, deep brain stimulation of the subthalamic nucleus (STN-DBS) is also associated with post-surgical declines in verbal fluency. The purpose of this study was to determine if Parkinson's patients who have undergone bilateral STN-DBS have greater impairment in verbal fluency compared to Parkinson's patients treated by medication only. METHODS A literature search yielded over 140 articles and 10 articles met inclusion criteria. A total of 439 patients with Parkinson's disease who underwent bilateral STN-DBS and 392 non-surgical patients were included. Cohen's d, a measure of effect size, was calculated using a random effects model to compare post-treatment verbal fluency in patients with Parkinson's disease who underwent STN-DBS versus those in the non-surgical comparison group. RESULTS The random effects model demonstrated a medium effect size for letter fluency (d=-0.47) and a small effect size for category fluency (d=-0.31), indicating individuals with bilateral STN-DBS had significantly worse verbal fluency performance than the non-surgical comparison group. CONCLUSIONS Individuals with Parkinson's disease who have undergone bilateral STN-DBS experience greater deficits in letter and category verbal fluency compared to a non-surgical group.
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Cognition and Depression Following Deep Brain Stimulation of the Subthalamic Nucleus and Globus Pallidus Pars Internus in Parkinson’s Disease: A Meta-Analysis. Neuropsychol Rev 2015; 25:439-54. [DOI: 10.1007/s11065-015-9302-0] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/05/2015] [Indexed: 01/19/2023]
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Kurt M, Karakaya İ, Safaz İ, Ateş G. Differential Item Functioning by Education and Sex in Subtests of the Repeatable Battery Assessment of Neuropsychological Status. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2015. [DOI: 10.1027/1015-5759/a000198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The main objective of this study is to evaluate functions of the items changing with the gender and educational level in the List Learning and the Picture Naming subtests in the Repeatable Battery Assessment of Neuropsychological Status. The study was implemented on 315 volunteers consisting of 157 women and 158 males in the 20–79 age group with three different educational levels (107 graduates of primary school, 102 graduates of high school, and 106 graduates of university). Logistic Regression method was used to determine the items that included differential item functioning (DIF). As a result of the analyses, DIF was encountered in the Picture Naming that could cause bias in several items in levels B and C based on the gender and education variables. Although DIF was not found in the List Learning based on the gender variable, DIF was found in some items based on the education variable.
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Affiliation(s)
- Murat Kurt
- Department of Psychology, Ondokuz Mayıs University, Samsun, Turkey
| | - İsmail Karakaya
- Department of the Education Sciences, Gazi University, Ankara, Turkey
| | - İsmail Safaz
- Department of Physical Medicine and Rehabilitation, Gulhane Military Medical Academy, Turkish Army Forces Rehabilitation and Care Center, Ankara, Turkey
| | - Gönül Ateş
- Department of Physical Medicine and Rehabilitation, Gulhane Military Medical Academy, Turkish Army Forces Rehabilitation and Care Center, Ankara, Turkey
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Asahi T, Nakamichi N, Takaiwa A, Kashiwazaki D, Koh M, Dougu N, Takashima S, Tanaka K, Kuroda S. Impact of bilateral subthalamic stimulation on motor/cognitive functions in Parkinson's disease. Neurol Med Chir (Tokyo) 2014; 54:529-36. [PMID: 24872253 PMCID: PMC4533462 DOI: 10.2176/nmc.oa.2013-0364] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
It is still unclear whether deep brain stimulation targeted to the bilateral subthalamic nucleus (STN-DBS) affects cognitive function in Parkinson's disease (PD). This prospective study was aimed to systemically evaluate the impact of bilateral STN-DBS on motor and cognitive functions in patients with PD. This study included totally 11 Japanese patients with medically intolerant PD. Neurological and cognitive status was precisely evaluated before and 1 year after bilateral STN-DBS, using unified Parkinson's disease rating scale (UPDRS), levodopa equivalent doses, mini-mental state examination (MMSE), Japanese adult reading test (JART), repeatable battery for the assessment of neuropsychological status (RBANS), and Wechsler adult intelligence scale-revised (WAIS-R). Preoperative RBANS and WAIS-R identified cognitive dysfunction that could not be detected by MMSE and JART. Before surgery, PD patients had significantly impaired immediate memory and attention. Motor function significantly improved 1 year after bilateral STN-DBS. Bilateral STN-DBS did not affect any score on cognitive examinations. However, postoperative improvements of total score on RBANS and performance intelligence quotient (PIQ) scores on WAIS-R were closely related to those of UPDRS part III off (R2 = 0.61, P < 0.01; R2 = 0.39, P < 0.05, respectively). These findings strongly suggest that bilateral STN-DBS may significantly improve cognitive function in a certain subgroup of patients whose therapeutic effects on motor function are prominent.
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Affiliation(s)
- Takashi Asahi
- Department of Neurosurgery, Toyama University Hospital
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Florin E, Müller D, Pfeifer J, Barbe MT, Fink GR, Timmermann L. Subthalamic stimulation modulates self-estimation of patients with Parkinson's disease and induces risk-seeking behaviour. ACTA ACUST UNITED AC 2013; 136:3271-81. [PMID: 24071530 DOI: 10.1093/brain/awt241] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Patients with Parkinson's disease with deep brain stimulation in the subthalamic nucleus postoperatively often display higher impulsivity and therefore may experience difficulties in social interactions. Here, we examined social interactions of patients with Parkinson's disease with and without deep brain stimulation in the subthalamic nucleus in competitive situations. We hypothesized altered self-estimation and risk-seeking behaviour in this patient group induced by deep brain stimulation in the subthalamic nucleus. To test the hypothesis, an experimental setting was used in which participants performed a calculation task and chose their preferred compensation. Based on their actual calculation performance, more patients with Parkinson's disease with deep brain stimulation chose a competitive tournament compensation. Assuming rational behaviour, this self-selection pattern reflects increased risk tolerance. Since patients who performed in the lowest quartile chose the tournament option, the data suggest that deep brain stimulation in the subthalamic nucleus results in a loss of the correct reference frame against which patients with Parkinson's disease evaluate their performance. The stimulation-induced combination of overestimation of their own performance, increased risk-taking, and preference for competitive environments despite poor performance is likely to impact considerably on the patients' social and work life.
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Affiliation(s)
- Esther Florin
- 1 Department of Neurology, University Hospital Cologne, Germany
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27
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Collins-Praino LE, Paul NE, Ledgard F, Podurgiel SJ, Kovner R, Baqi Y, Müller CE, Senatus PB, Salamone JD. Deep brain stimulation of the subthalamic nucleus reverses oral tremor in pharmacological models of parkinsonism: interaction with the effects of adenosine A2Aantagonism. Eur J Neurosci 2013; 38:2183-91. [DOI: 10.1111/ejn.12212] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 03/03/2013] [Accepted: 03/04/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Lyndsey E. Collins-Praino
- Division of Behavioral Neuroscience; Department of Psychology; University of Connecticut; Storrs; CT; USA
| | - Nicholas E. Paul
- Division of Behavioral Neuroscience; Department of Psychology; University of Connecticut; Storrs; CT; USA
| | - Felicia Ledgard
- Division of Neurosurgery; Department of Surgery; University of Connecticut Health Center; Farmington; CT; USA
| | - Samantha J. Podurgiel
- Division of Behavioral Neuroscience; Department of Psychology; University of Connecticut; Storrs; CT; USA
| | - Rotem Kovner
- Division of Behavioral Neuroscience; Department of Psychology; University of Connecticut; Storrs; CT; USA
| | - Younis Baqi
- Pharma-Zentrum Bonn; Pharmazeutisches Institut, Pharmazeutische Chemie; Universität Bonn; Bonn; Germany
| | - Christa E. Müller
- Pharma-Zentrum Bonn; Pharmazeutisches Institut, Pharmazeutische Chemie; Universität Bonn; Bonn; Germany
| | - Patrick B. Senatus
- Division of Neurosurgery; Department of Surgery; University of Connecticut Health Center; Farmington; CT; USA
| | - John D. Salamone
- Division of Behavioral Neuroscience; Department of Psychology; University of Connecticut; Storrs; CT; USA
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28
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King LC, Bailie JM, Kinney DI, Nitch SR. Is the Repeatable Battery for the Assessment of Neuropsychological Status Factor Structure Appropriate for Inpatient Psychiatry? An Exploratory and Higher-Order Analysis. Arch Clin Neuropsychol 2012; 27:756-65. [DOI: 10.1093/arclin/acs062] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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29
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Duff K. Evidence-based indicators of neuropsychological change in the individual patient: relevant concepts and methods. Arch Clin Neuropsychol 2012; 27:248-61. [PMID: 22382384 DOI: 10.1093/arclin/acr120] [Citation(s) in RCA: 284] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Repeated assessments are a relatively common occurrence in clinical neuropsychology. The current paper will review some of the relevant concepts (e.g., reliability, practice effects, alternate forms) and methods (e.g., reliable change index, standardized based regression) that are used in repeated neuropsychological evaluations. The focus will be on the understanding and application of these concepts and methods in the evaluation of the individual patient through examples. Finally, some future directions for assessing change will be described.
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Affiliation(s)
- Kevin Duff
- Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City, USA.
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Schoenberg MR, Rinehardt E, Duff K, Mattingly M, Bharucha KJ, Scott JG. Assessing reliable change using the repeatable battery for the assessment of neuropsychological status (RBANS) for patients with Parkinson's Disease undergoing deep brain stimulation (DBS) surgery. Clin Neuropsychol 2012; 26:255-70. [PMID: 22332733 DOI: 10.1080/13854046.2011.653587] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Parkinson's disease (PD) is progressive neurological disease characterized by resting tremor, rigidity, akinesia, postural instability and cognitive changes. The symptoms of PD are debilitating and often become unsatisfactorily treated by medication. Deep brain stimulation (DBS) is an effective treatment to significantly reduce the cardinal motor symptoms of PD. However, the neuropsychological effects of this treatment are less clear. This study examined pre- to post-DBS scores on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) using Reliable Change Indices (RCIs) derived from 20 patients with PD who were medically managed, and then compared to 20 patients with PD treated with DBS and medication. When using group statistical analyses and false discovery rate correction, no significant differences between or within groups were evident at baseline or at follow-up. However, when using the RCIs more patients in the DBS group exhibited reliable change in RBANS scores than did the Med Tx group. Although preliminary, these RCIs provide clinicians and researchers a foundational tool for assessing the effects of interventions (e.g., DBS) independent of the effects of PD and measurement error when using the RBANS.
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Affiliation(s)
- Mike R Schoenberg
- Department of Psychiatry and Neurosciences, University of South Florida College of Medicine, Florida, USA.
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