Detecting Mild Cognitive Deficits in Parkinson's Disease: Comparison of Neuropsychological Tests


Jeroen Hoogland, Amsterdam UMC - University of Amsterdam
Lennard L. van Wanrooij, Amsterdam UMC - University of Amsterdam
Judith A. Boel, Amsterdam UMC - University of Amsterdam
Jennifer G. Goldman, Rush University Medical Center
Glenn T. Stebbins, Rush University Medical Center
John C. Dalrymple-Alford, Brain Research New Zealand - Rangahau Roro Aotearoa
Connie Marras, University of Toronto
Charles H. Adler, Banner Sun Health Research Institute
Carme Junque, Universitat de Barcelona
Kenn F. Pedersen, Stavanger University Hospital
Brit Mollenhauer, Universitätsmedizin Göttingen
Cyrus P. Zabetian, University of Washington School of Medicine
Paul J. Eslinger, Penn State Health Milton S. Hershey Medical Center
Simon J.G. Lewis, The University of Sydney
Ruey Meei Wu, National Taiwan University Hospital
Martin Klein, Amsterdam UMC - Vrije Universiteit Amsterdam
Maria C. Rodriguez-Oroz, Ikerbasque, the Basque Foundation for Science
Davide M. Cammisuli, Università di Pisa
Paolo Barone, Dipartimento di Medicina, Chirurgia e Odontoiatria “Scuola Medica Salernitana"
Roberta Biundo, Ospedale San Camillo
Rob M.A. de Bie, Amsterdam UMC - University of Amsterdam
Ben A. Schmand, Amsterdam UMC - University of Amsterdam
Alexander I. Tröster, Barrow Neurological Institute
David J. Burn, University of Newcastle upon Tyne, Faculty of Medical Sciences
Irene Litvan, Department of Neurosciences
J. Vincent Filoteo, Department of Neurosciences
Gert J. Geurtsen, Amsterdam UMC - University of Amsterdam
Daniel Weintraub, University of Pennsylvania Perelman School of Medicine

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Background: Numerous neuropsychological tests and test versions are used in Parkinson's disease research, but their relative capacity to detect mild cognitive deficits and their comparability across studies are unknown. The objective of this study was to identify neuropsychological tests that consistently detect cognitive decline in PD across studies. Methods: Data from 30 normed neuropsychological tests across 20 international studies in up to 2908 nondemented PD patients were analyzed. A subset of 17 tests was administered to up to 1247 healthy controls. A 2-step meta-analytic approach using standardized scores compared performance in PD with normative data. Results: Pooled estimates of the differences between PD and site-specific healthy controls identified significant cognitive deficits in PD patients on 14 test scores across 5 commonly assessed cognitive domains (attention or working memory, executive, language, memory, and visuospatial abilities), but healthy control performance was statistically above average on 7 of these tests. Analyses based on published norms only, as opposed to direct assessment of healthy controls, showed high between-study variability that could not be accounted for and led to inconclusive results. Conclusions: Normed neuropsychological tests across multiple cognitive domains consistently detect cognitive deficits in PD when compared with site-specific healthy control performance, but relative PD performance was significantly affected by the inclusion and type of healthy controls versus the use of published norms only. Additional research is needed to identify a cognitive battery that can be administered in multisite international studies and that is sensitive to cognitive decline, responsive to therapeutic interventions, and superior to individual cognitive tests. © 2018 International Parkinson and Movement Disorder Society.

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Movement Disorders









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