RESUMEN
The Scales for Outcomes in Parkinson's disease-Cognition (SCOPA-Cog) has been shown to be a clinimetrically rigorous and valid instrument for a disease-oriented neuropsychological assessment of Parkinson's disease (PD) patients. In the present study we evaluated the psychometric properties of the Italian version of the SCOPA-Cog in 121 PD patients. The scale explores memory, attention, and executive and visuospatial functions and takes approximately 20 minutes to administer. Data distribution (skewness= -0.23) and internal consistency (Cronbach's alpha= 0.78) were satisfactory. Standard error of measurement was 3.42. The outcome was significantly worse in patients with an abnormal Psychometric properties of the Italian version of the Scales for Outcomes in Parkinson's disease-Cognition (SCOPA-Cog) score on the Dementia Rating Scale (DRS) (SCOPACog mean score 14.6 ± 5.1 out of a total of 43) with respect to cognitively intact subjects (24.2 ± 4.3) (p<0.0001). The DRS showed good convergent validity (Spearman rho= 0.77, p<0.0001), and a high coefficient of variation (= 0.34). These findings support the goodness of the Italian SCOPA-Cog in terms of metrics and validity.
Asunto(s)
Trastornos del Conocimiento/diagnóstico , Pruebas Neuropsicológicas , Enfermedad de Parkinson/diagnóstico , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Italia , Masculino , Persona de Mediana Edad , PsicometríaRESUMEN
The detection of cognitive decline in Parkinson's disease (PD), at the Mild Cognitive Impairment (MCI) stage, has prognostic and treatment implications. The Movement Disorders Society (MDS) has recently published criteria and guidelines for the diagnosis of possible and probable PD-MCI. In the present study we assessed the ability of the Scales for Outcomes in Parkinson's disease-Cognition (SCOPA-Cog) to discriminate possible PD-MCI cases from patients with PD-dementia (PDD) and from cognitively intact PD subjects. Hundred-and-thirteen consecutive PD patients underwent the MMSE, the Dementia Rating Scale and an interview on independence in daily living, and were classified as cognitively intact (n = 49), or as possible PD-MCI (n = 33) or PDD (n = 31), according to MDS criteria. Logistic regression analysis was carried out with PD-MCI diagnosis (yes/no) as an outcome variable, and age, education and the SCOPA-Cog total score as covariates. Classification of cases according to the regression model was used for constructing Receiver Operating Characteristic (ROC) curves. Area Under the Curve (AUC) was 0.92 [95% CI 0.86-0.98], for the differential diagnosis between PD-MCI and cognitively normal patients, and 0.97 [95% CI 0.80-1.00], for the differential diagnosis between PD-MCI and PDD. Sensitivity and specificity were 90% and 73% for the PD-MCI versus no cognitive impairment differentiation, at the cutpoint ≥24, and 93% and 97% for the PD-MCI versus PDD discrimination, at the cutpoint ≥17. The SCOPA-Cog is a quick and psychometrically sound PD-specific scale. Our findings support its use for the screening of possible PD-MCI.
Asunto(s)
Disfunción Cognitiva/diagnóstico , Enfermedad de Parkinson/psicología , Anciano , Área Bajo la Curva , Disfunción Cognitiva/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Enfermedad de Parkinson/complicaciones , Curva ROCRESUMEN
The MiniMental Parkinson (MMP) has been derived from the MiniMental State Examination (MMSE) for the screening of cognitive impairment in Parkinson's disease by adding subtests that were focused on executive and visuo-spatial impairment more than on memory or language deficits. In this multicenter study, the psychometric and validity properties of the MMP have been evaluated in 69 cognitively intact and 52 cognitively impaired patients with Parkinson's disease, classified according to their performance at the Dementia Rating Scale. The MMP showed better metrics and convergent validity, and higher screening ability. However, its performance was not fully satisfying in terms of data distribution, coefficient of variation and specificity, and Receiver Operating Characteristic curves did not show clear cut superiority of either scale at their best sensitivity-specificity trade off. The MMP seems to be slightly preferable to the MMSE only at a cut off that favours sensitivity with respect to specificity, for screening purposes. The test is simple and quick, but has limitations in terms of validity.
Asunto(s)
Trastornos del Conocimiento/diagnóstico , Función Ejecutiva/fisiología , Escala del Estado Mental , Enfermedad de Parkinson/diagnóstico , Trastornos de la Percepción/diagnóstico , Percepción Espacial/fisiología , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Trastornos del Conocimiento/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Enfermedad de Parkinson/complicaciones , Trastornos de la Percepción/etiología , Psicometría , Curva ROC , Reproducibilidad de los ResultadosRESUMEN
OBJECTIVE: To describe the premorbid state of early onset schizophrenia (EOS). METHODS: Twenty-three adolescents with EOS were compared to a healthy control group (CG) and to a group of anorexic patients (AG). The premorbid state was studied through the CBCL and the data obtained were analyzed using ANOVA's and t-test. RESULTS: During the premorbid period EOS showed significantly higher scores on all scales, relative to the CG, and only on some scales (social, thought and attention problems, and school competencies) relative to the AG. CONCLUSIONS: Children who develop first episode psychosis during adolescence differ from children with normal development. The premorbid internalizing state is common to AG but social competencies and school problems are the most affected areas in EOS when compared to the AG. It is hypothesized that both EOS and AG can be considered as the expression of a previous vulnerability.
Asunto(s)
Trastornos de la Conducta Infantil/diagnóstico , Discapacidades para el Aprendizaje/diagnóstico , Esquizofrenia/diagnóstico , Psicología del Esquizofrénico , Trastorno de la Personalidad Esquizotípica/diagnóstico , Adolescente , Anorexia Nerviosa/diagnóstico , Anorexia Nerviosa/psicología , Niño , Trastornos de la Conducta Infantil/psicología , Preescolar , Progresión de la Enfermedad , Femenino , Humanos , Control Interno-Externo , Discapacidades para el Aprendizaje/psicología , Masculino , Determinación de la Personalidad , Escalas de Valoración Psiquiátrica , Trastorno de la Personalidad Esquizotípica/psicología , Ajuste SocialRESUMEN
Two electrophoretical methods have been compared, in order to evaluate the most precise and sensitive one as to recognize initial inflammatory conditions also of tumoral nature. Consequently, among 5,000 patients observed during one year, only 500 cases have been considered with pathologic electrophoretic diagram and, among those, 245 cases of which alteration of the electrophoretic diagram concerned the alfa 1 band and the alfa 2 band; among the latter only 127 cases were diagnosed various tumors. It is deduced from the obtained results that there is better sensitiveness with the capillary method, which is evidenced in the more substantial increase of the alfa 1. Such method allows, precociously, to put in evidence a possible presence of inflammation, induced by any kind of tumor, even in absence of positiveness of the specific tumoral markers, in 38% of examined cases.