Acessibilidade / Reportar erro

Executive cognitive tests for the evaluation of patients with Parkinson's disease

Testes cognitivos que examinam funções executivas em pessoas com doença de Parkinson

Abstract

Parkinson's disease (PD) is characterized by changes in movement, which are later followed by cognitive, behavioral and psychological changes. The objective of the present study was to correlate different tests used to examine executive functions in PD patients followed at a specialized outpatient clinic.

Methods:

Thirty-five patients with idiopathic PD aged 63.0 years on average and with mean schooling of 5.5±4.2 years, were examined using the following tests: Mattis Dementia Rating Scale (MDRS), Scales for Outcomes of Parkinson's Disease-Cognition (SCOPA-COG), Wisconsin Card Sorting Test (WCST), Frontal Assessment Battery (FAB), Digit Span - Inverse Order (IO) (a subtest of the WAIS III) and Verbal Fluency Test (category animals).

Results:

Significant correlations were detected between FAB and MDRS Conceptualization (0.814), MDRS Initiation/Perseveration (I/P) and SCOPA-COG Executive Function (0.643), FAB and MDRS I/P (0.601), FAB and Verbal Fluency (0.602), MDRS I/P and MDRS Conceptualization (0.558), Verbal Fluency and MDRS I/P (0.529), MDRS Attention and SCOPA-COG Executive Function (0.495), MDRS Conceptualization and SCOPA-COG Executive Function (0.520), FAB and Digit Span (OI) (0.503), Verbal Fluency and MDRS Conceptualization (0.501), and WCST perseverative errors and FAB (-0.379), WCST perseverative errors and MDRS Conceptualization (0.445), WCST perseverative errors and MDRS I/P (-0.407) and WCST categories completed and MDRS Conceptualization (0.382).

Discussion:

The results demonstrated strong correlations between most of the tests applied, but no associations were detected between the WCST and the other tests, a fact that may be explained by the heterogeneity of scores obtained in the tests by the patients evaluated. A difficulty of the present study was the lack of a control groups for the establishment of adequate standards for this population.

Key words:
Parkinson's disease; executive functions; cognitive tests.

Resumo

A doença de Parkinson (DP) caracteriza-se por alterações do movimento, cognitivas, comportamentais e psicológicas. O objetivo do presente estudo foi correlacionar diferentes testes que examinam funções executivas em pacientes com DP acompanhados em um ambulatório especializado.

Métodos:

Foram avaliados 35 pacientes com DP idiopática com idade média de 63,0 anos e escolaridade média de 5,5±4,2 utilizando os seguintes testes: Escala de Avaliação de demência de Mattis (EADM), Escala de Desfechos da Doença de Parkinson (SCOPA-COG), Teste Wisconsin de Classificação de Cartas (WCST), Bateria de Avaliação Frontal (BAF), Amplitude de Dígitos-Ordem Inversa (OI) (subteste do WAIS III) e Teste de Fluência Verbal (categoria animais).

Resultados:

Foram encontradas correlações significativas entre BAF e EADM Conceituação (0,814), EADM Iniciativa/Perseveração (I/P) e SCOPA-COG Funções Executivas (0,643), BAF e EADM I/P (0,601), BAF e Fluência Verbal (0,602) e EADM I/P e EADM Conceituação (0,558), Fluência Verbal e EADM I/P (0,529), EADM Atenção e SCOPA-COG Funções Executivas (0,49), EADM Conceituação e SCOPA-COG Funções Executivas (0,495), BAF e Amplitude de dígitos (OI) (0,503), Fluência Verbal e EADM Conceituação (0,501), WCST Erros Perseverativos e BAF (-0,379), WCST erros perseverativos e MDRS Conceptualization (-0,445), WCST erros perseverativos e EADM I/P (-0,407) e WCST categorias completas e EADM Conceituação (0,382).

Discussão:

Os resultados evidenciaram fortes correlações entre a maioria dos testes aplicados. Uma dificuldade do estudo presente diz respeito à falta de grupo controle para estabelecer padrões adequados a essa população.

Palavras-chave:
doença de Parkinson; funções executivas; testes cognitivos.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

References

  • 1
    Melo LMB, Barbosa ER, Caramelli P. Declínio cognitivo e demência associados à doença de Parkinson: características clínicas e tratamento. Rev Psiq Clín 2007;34:176-183.
  • 2
    Tolosa E, Wenning G, Poewe W. The Diagnosis of Parkinson's disease. Lancet Neurol 2006;5: 75-86.
  • 3
    Padovani AC, Gilbert CN, Borroni B. Parkinson's disease and dementia. Neurol Sci 2006; 27:S40-S43.
  • 4
    Galvin JEG, Cognitive change in Parkinson Disease. Alzheimer Dis Assoc Disord 2006;20:302-310.
  • 5
    Shobhas SR, Hofmann LA, Shakil A. Parkinson's disease: diagnosis and treatment. Am Fam Phisician 2006;74:2046-2053.
  • 6
    Galvin JE, Pollack J, Morris JC. Clinical phenotype of Parkinson disease dementia. Neurology 2006;67:1605-1611.
  • 7
    Bosboom JLW, Stoffers D, Wolters EC. Cognitive dysfunction and dementia in Parkinson's disease. J Neural Transm 2004;111:1303-1315.
  • 8
    Janvin CC, Aarsland D, Larsen JP. Cognitive predictors of dementia in Parkinson's disease: a community-based, 4-year longitudinal study. J Geriatr Psychiatry Neurol 2005;18:149-154.
  • 9
    Silva-Filho, J.H., Validade e normas do Wisconsin Card Sorting Test em adultos da região de Ribeirão Preto, in Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Tese. Departamento de Psicologia e Educação; Universidade de São Paulo: Ribeirão Preto, SP; 2007.
  • 10
    Gelb DJ, Oliver E, Gilman S. Diagnostic criteria for Parkinson's disease. Arch Neurol 1999;56:33-39.
  • 11
    Tumas V, Rodrigues GGR, Farias TLA, Crippa JAS. A precisão do diagnóstico de depressão na doença de Parkinson: um estudo comparativo entre a UPDRS, a escala geriátrica de depressão e o inventário de depressão de Beck. Arq Neuropsiquiatr 2008;66:152-156.
  • 12
    Rabey JM, Bass H, Bonuccelli U, et al. Evaluation of the Short Parkinson´s Evaluation Scale: a new friendly scale for the evaluation of Parkinson's disease in clinical drug trials. Clin Neuropharmacol 1997;20:322-337.
  • 13
    Tumas V, Ujikawa LT, Ferreira GM. Utility and reliability of a simplified clinical scale for Parkinson's disease. Arq Neuropsiquiatr 2004;62(suppl. 2):220-221.
  • 14
    Porto CS, Fichman HC, Caramelli P, BahiaVS, Nitrini R. Brazilian version of the Mattis Dementia Rating Scale: diagnosis of mild dementia in Alzheimer's Disease. Arq Neuropsiquiatr 2003;61:339-345.
  • 15
    Carod-Artal FJ, Martínez-Martin P, Kummer W, Ribeiro Lda S. Psychometric attributes of the SCOPA-COG Brazilian version. Mov Disord 2008;23:81-87.
  • 16
    Marinus J, Visser M, Verwey NA, et al. Assessment of cognition in Parkinson's disease. Neurology 2003;61:1222-1228.
  • 17
    Heaton KR, Chelune GJ, Talley JL, Kay GG, Curtiss G. Manual do teste Winsconsin de Classificação de Cartas. São Paulo: Casa do Psicólogo; 2005.
  • 18
    Dubois B, Slachevsky A, Litivan I, et al. The FAB: a frontal assessment battery at bedside. Neurology 2000; 55:1621-1626.
  • 19
    Wechsler, D., WAIS III: Administration and scoring manual. San Antonio: The Psychology Corporation; 1997.
  • 20
    Nitrini R, Caramelli P, Bottino CMC, Damasceno BP, Brucki, SMD, Anghinah R. Diagnóstico de doença de Alzheimer no Brasil: avaliação cognitiva e funcional. Recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia. Arq Neuropsiquiatr 2005;63:720-727.
  • 21
    Royall DR, Lauterbach EC, Cummings JL, et al. Executive control function: a review of its promise and challenges for clinical research. J Neuropsychiatry Clin Neurosci 2002;14: 377-405.
  • 22
    Júri C,Viviani P, Chaná P. Features associated with the development of non-motor manifestations in Parkinson's disease. Arq Neuropsiquiatr 2008;66:22-25.
  • 23
    Bassett SS. Cognitive impairment in Parkinson's disease. Clinical Focus Primary Psychiatry 2005;12:50-55.

Publication Dates

  • Publication in this collection
    Jul-Sep 2008

History

  • Received
    11 July 2008
  • Accepted
    21 Aug 2008
Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br