Fluids and Barriers of the CNS | |
A computerized neuropsychological test battery designed for idiopathic normal pressure hydrocephalus | |
Jan Malm3  Michael A Williams2  Cynthia Smith1  Eva Elgh5  Anders Eklund4  Anders Behrens3  | |
[1] Division of Neuropsychology, Sinai Hospital of Baltimore, Baltimore, MD, USA;Department of Neurology, Sinai Hospital of Baltimore, Baltimore, MD, USA;Department of Clinical Neuroscience, Umeå University, Umeå, Sweden;Department of Radiation Science, Umeå University, Umeå, Sweden;Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden | |
关键词: Software; Reliability and validity; Neuropsychology; Neuropsychological tests; Hydrocephalus, Normal pressure; Dementia; | |
Others : 1098244 DOI : 10.1186/2045-8118-11-22 |
|
received in 2014-09-17, accepted in 2014-09-23, 发布年份 2014 | |
【 摘 要 】
Background
A tool for standardized and repeated neuropsychological assessments in patients with idiopathic normal pressure hydrocephalus (INPH) is needed. The objective of this study was to develop a computerized neuropsychological test battery designed for INPH and to evaluate its reliability, validity and patient’s ability to complete the tests.
Methods
Based on a structured review of the literature on neuropsychological testing in INPH, the eight tests most sensitive to the INPH cognitive profile were implemented in a computerized format. The Geriatric Depression Scale (GDS) was also included. Tests were presented on a touch-screen monitor, with animated instructions and speaker sound. The battery was evaluated with the following cohorts: A. Test-retest reliability, 44 healthy elderly; B. Validity against standard pen and pencil testing, 28 patients with various cognitive impairments; C. Ability to complete test battery, defined as completion of at least seven of the eight tests, 40 investigated for INPH.
Results
A. All except the figure copy test showed good test-retest reliability, r = 0.67-0.90; B. A high correlation was seen between conventional and computerized tests (r = 0.66-0.85) except for delayed recognition and figure copy task; C. Seventy-eight percent completed the computerized battery; Patients diagnosed with INPH (n = 26) performed worse on all tests, including depression score, compared to healthy controls.
Conclusions
A new computerized neuropsychological test battery designed for patients with communicating hydrocephalus and INPH was introduced. Its reliability, validity for general cognitive impairment and completion rate for INPH was promising. After exclusion of the figure copy task, the battery is ready for clinical evaluation and as a next step we suggest validation for INPH and a comparison before and after shunt surgery.
Trial registration
ClinicalTrials.org NCT01265251.
【 授权许可】
2014 Behrens et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150131021425953.pdf | 641KB | download | |
Figure 3. | 29KB | Image | download |
Figure 2. | 100KB | Image | download |
Figure 1. | 77KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
Figure 3.
【 参考文献 】
- [1]Relkin N, Marmarou A, Klinge P, Bergsneider M, Black PM: Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery 2005, 57:4-16.
- [2]Thomas G, Mcgirt MJ, Woodworth G, Heidler J, Rigamonti D, Hillis AE, Williams MA: Baseline neuropsychological profile and cognitive response to cerebrospinal fluid shunting for idiopathic normal pressure hydrocephalus. Dement Geriatr Cogn Disord 2005, 20:163-168.
- [3]Hellström P, Edsbagge M, Archer T, Tisell M, Tullberg M, Wikkelsø C: The neuropsychology of patients with clinically diagnosed idiopathic normal pressure hydrocephalus. Neurosurgery 2007, 61:1219-1226.
- [4]Tullberg M, Hellström P, Piechnik SK, Starmark J-E, Wikkelsö C: Impaired wakefulness is associated with reduced anterior cingulate CBF in patients with normal pressure hydrocephalus. Acta Neurol Scand 2004, 110:322-330.
- [5]Donnet A, Schmitt A, Dufour H, Giorgi R, Grisoli F: Differential patterns of cognitive impairment in patients with aqueductal stenosis and normal pressure hydrocephalus. Acta Neurochir 2004, 146:1301-1308.
- [6]Iddon JL, Pickard JD, Cross JJ, Griffiths PD, Czosnyka M, Sahakian BJ: Specific patterns of cognitive impairment in patients with idiopathic normal pressure hydrocephalus and Alzheimer’s disease: a pilot study. J Neurol Neurosurg Psychiatr 1999, 67:723-732.
- [7]Mataró M, Poca MA, Del Mar Matarín M, Catalan R, Sahuquillo J, Galard R: CSF galanin and cognition after shunt surgery in normal pressure hydrocephalus. J Neurol Neurosurg Psychiatr 2003, 74:1272-1277.
- [8]Miyoshi N, Kazui H, Ogino A, Ishikawa M, Miyake H, Tokunaga H, Ikejiri Y, Takeda M: Association between cognitive impairment and gait disturbance in patients with idiopathic normal pressure hydrocephalus. Dement Geriatr Cogn Disord 2005, 20:71-76.
- [9]Nowak DA, Gumprecht H, Topka H: CSF drainage ameliorates the motor deficit in normal pressure hydrocephalus: evidence from the analysis of grasping movements. J Neurol 2006, 253:640-647.
- [10]Nowak DA, Topka HR: Broadening a classic clinical triad: The hypokinetic motor disorder of normal pressure hydrocephalus also affects the hand. Exp Neurol 2006, 198:81-87.
- [11]Tsakanikas D, Katzen H, Ravdin LD, Relkin NR: Upper extremity motor measures of Tap Test response in Normal Pressure Hydrocephalus. Clin Neurol Neurosurg 2009, 111:752-757.
- [12]Klinge P, Rückert N, Schuhmann M, Dörner L, Brinker T, Samii M: Neuropsychological testing to improve surgical management of patients with chronic hydrocephalus after shunt treatment. Acta Neurochir Suppl 2002, 81:51-53.
- [13]Gustafson L, Hagberg B: Recovery in hydrocephalic dementia after shunt operation. J Neurol Neurosurg Psychiatr 1978, 41:940-947.
- [14]Duinkerke A, Williams MA, Rigamonti D, Hillis AE: Cognitive recovery in idiopathic normal pressure hydrocephalus after shunt. Cogn Behav Neurol 2004, 17:179-184.
- [15]Hellström P, Edsbagge M, Blomsterwall E, Archer T, Tisell M, Tullberg M, Wikkelsø C: Neuropsychological effects of shunt treatment in idiopathic normal pressure hydrocephalus. Neurosurgery 2008, 63:527-535.
- [16]Lenfeldt N, Larsson A, Nyberg L, Andersson M, Birgander R, Eklund A, Malm J: Idiopathic normal pressure hydrocephalus: increased supplementary motor activity accounts for improvement after CSF drainage. Brain 2008, 131:2904-2912.
- [17]Katzen H, Ravdin LD, Assuras S, Heros R, Kaplitt M, Schwartz TH, Fink M, Levin BE, Relkin NR: Postshunt cognitive and functional improvement in idiopathic normal pressure hydrocephalus. Neurosurgery 2011, 68:416-419.
- [18]Foss T, Eide PK, Finset A: Intracranial pressure parameters in idiopathic normal pressure hydrocephalus patients with or without improvement of cognitive function after shunt treatment. Dement Geriatr Cogn Disord 2007, 23:47-54.
- [19]Solana E, Sahuquillo J, Junqué C, Quintana M, Poca MA: Cognitive disturbances and neuropsychological changes after surgical treatment in a cohort of 185 patients with idiopathic normal pressure hydrocephalus. Arch Clin Neuropsychol 2012, 27:304-317.
- [20]Chaudhry P, Kharkar S, Heidler-Gary J, Hillis AE, Newhart M, Kleinman JT, Davis C, Rigamonti D, Wang P, Irani DN, Williams MA: Characteristics and reversibility of dementia in Normal Pressure Hydrocephalus. Behav Neurol 2007, 18:149-158.
- [21]Zemack G, Romner B: Adjustable valves in normal-pressure hydrocephalus: a retrospective study of 218 patients. Neurosurgery 2008, 62(Suppl 2):677-687.
- [22]Wild K, Howieson D, Webbe F, Seelye A, Kaye J: Status of computerized cognitive testing in aging: a systematic review. Alzheimers Dement 2008, 4:428-437.
- [23]Malm J, Jacobsson J, Birgander R, Eklund A: Reference values for CSF outflow resistance and intracranial pressure in healthy elderly. Neurology 2011, 76:903-909.
- [24]Terwee CB, Mokkink LB: Measurement in Medicine. New York: Cambridge University Press; 2011.
- [25]Smith G, Eberhard Nyman G, Hentschel U: Manual till CWT - serialt färgordtest. Stockholm: Psykologiförlaget; 1986.
- [26]Reitan R: Validity of the Trail Making Test as an indicator of organic brain damage. Percept Mot Skills 1958, 8:271-276.
- [27]Morris JC, Heyman A, Mohs RC, Hughes JP, van Belle G, Fillenbaum G, Mellits ED, Clark CR: The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer’s disease. Neurology 1989, 39:1159-1165.
- [28]Chang S, Agarwal S, Williams MA, Rigamonti D, Hillis AE: Demographic factors influence cognitive recovery after shunt for normal-pressure hydrocephalus. Neurologist 2006, 12:39-42.
- [29]Saito M, Nishio Y, Kanno S, Uchiyama M, Hayashi A, Takagi M, Kikuchi H, Yamasaki H, Shimomura T, Iizuka O, Mori E: Cognitive profile of idiopathic normal pressure hydrocephalus. Dement Geriatr Cogn Dis Extra 2011, 1:202-211.
- [30]Raftopoulos C, Deleval J, Chaskis C, Leonard A, Cantraine F, Desmyttere F, Clarysse S, Brotchi J: Cognitive recovery in idiopathic normal pressure hydrocephalus: a prospective study. Neurosurgery 1994, 35:397-404.
- [31]Ogino A, Kazui H, Miyoshi N, Hashimoto M, Ohkawa S, Tokunaga H, Ikejiri Y, Takeda M: Cognitive impairment in patients with idiopathic normal pressure hydrocephalus. Dement Geriatr Cogn Disord 2006, 21:113-119.
- [32]Wikkelsö C, Andersson H, Blomstrand C, Lindqvist G: The clinical effect of lumbar puncture in normal pressure hydrocephalus. J Neurol Neurosurg Psychiatr 1982, 45:64-69.
- [33]Yam C-S: Using macromedia flash for electronic presentations: a new alternative. AJR Am J Roentgenol 2006, 187:209-217.
- [34]Arnold K, Gosling J, Holmes D: The Java (TM) Programming Language. Boston, MA: Addison-Wesley; 2006.
- [35]Allén S: Nusvensk frekvensordbok: baserad på tidningstext. Stockholm: Almqvist & Wiksell; 1970.
- [36]Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO: Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982, 17:37-49.
- [37]Gottfries GG, Noltorp S, Nørgaard N: Experience with a Swedish version of the Geriatric Depression Scale in primary care centres. Int J Geriatr Psychiatry 1997, 12:1029-1034.
- [38]Schlegel RE, Gilliland K: Development and quality assurance of computer-based assessment batteries. Arch Clin Neuropsychol 2007, 22:49-61.
- [39]Dikmen S, Heaton RK, Grant I, Temkin NR: Test-retest reliability and practice effects of expanded Halstead-Reitan Neuropsychological Test Battery. J Int Neuropsychol Soc 1999, 5:346-356.
- [40]Solana E, Poca MA, Sahuquillo J, Benejam B, Junqué C, Dronavalli M: Cognitive and motor improvement after retesting in normal-pressure hydrocephalus: a real change or merely a learning effect? J Neurosurg 2010, 112:399-409.
- [41]Paul RH, Lawrence J, Williams LM, Richard CC, Cooper N, Gordon E: Preliminary validity of “integneuro”: a new computerized battery of neurocognitive tests. Int J Neurosci 2005, 115:1549-1567.
- [42]Proctor SP, Letz R, White RF: Validity of a computer-assisted neurobehavioral test battery in toxicant encephalopathy. Neurotoxicology 2000, 21:703-714.
- [43]Hellström P, Klinge P, Tans J, Wikkelsø C: The neuropsychology of iNPH: findings and evaluation of tests in the European multicentre study. Clin Neurol Neurosurg 2012, 114:130-134.
- [44]Herrmann LL, Goodwin GM, Ebmeier KP: The cognitive neuropsychology of depression in the elderly. Psychol Med 2007, 37:1693-1702.
- [45]Hellstrom P, Klinge P, Tans J, Wikkelso C: A new scale for assessment of severity and outcome in iNPH. Acta Neurol Scand 2012, 126:229-237.