视觉认知障碍在帕金森病伴轻度认知障碍(PD-MCI)患者中很常见,是帕金森病痴呆(PDD)转化的预后因素。然而,缺乏最适合评估PD-MCI和PDD的视觉认知以及区分这些认知阶段的神经心理学测试的系统分析。
回顾用于评估视觉认知的神经心理学测试,包括视觉感知和视觉空间处理,视觉建设性的复制和命令能力的绘制;并确定视觉认知子域以及最适合区分PD-MCI和PDD的测试。
MEDLINE,PsycINFO,WebofScience核心合集,和CENTRAL系统搜索评估PD-MCI和PDD患者视觉认知结局的相关研究。使用基于完善的工具的定制表格评估偏差风险。进行随机效应荟萃分析。
33项研究纳入系统评价。19项研究的数据被输入到荟萃分析中。关于应用测试的相当大的异质性,测试版本,和评分系统存在。数据表明,视觉构造命令任务是最适合区分PD-MCI和PDD的子域。此外,它们表明Rey-Osterrieth-复图检验(ROCF),Corsi块攻丝试验,线路方向判断(JLO)和时钟绘制测试(CDT)是能够区分两个阶段的测试。
我们为合适的视觉认知测试(Corsi块攻丝测试,或者JLO,ROCF,CDT)以提高诊断准确性。方法论挑战(例如,定义的异质性,测试)进行了讨论,并为未来的研究提供了建议。
https://www。crd.约克。AC.英国/普华永道/,ID:CRD42018088244。
Visuo-cognitive impairment is common in patients with Parkinson\'s disease with mild cognitive impairment (PD-MCI) and constitutes a prognostic factor for the conversion to Parkinson\'s disease dementia (PDD). However, systematic analyses on which neuropsychological tests are most suitable to assess visuo-cognition in PD-MCI and PDD and to differentiate these cognitive stages are lacking.
To
review neuropsychological tests used to assess visuo-cognition including visuo-perceptual and visuo-spatial processing, visuo-constructive copying and drawing on command abilities; and to identify the visuo-cognitive subdomain as well as tests most suitable to discriminate between PD-MCI and PDD.
MEDLINE, PsycINFO, Web of Science Core Collection, and CENTRAL were systematically searched for relevant studies assessing visuo-cognitive outcomes in patients with PD-MCI and PDD. Risk of bias was assessed using a customized form based on well-established tools. Random-effect meta-analyses were conducted.
33 studies were included in the systematic
review. Data of 19 studies were entered in meta-analyses. Considerable heterogeneity regarding applied tests, test versions, and scoring systems exists. Data indicate that visuo-constructive command tasks are the subdomain best suited to discriminate between PD-MCI and PDD. Furthermore, they indicate that the Rey-Osterrieth-Complex-Figure Test (ROCF), Corsi Block-Tapping Test, Judgment of Line Orientation (JLO), and Clock Drawing Test (CDT) are tests able to differentiate between the two stages.
We provide suggestions for suitable visuo-cognitive tests (Corsi Block-Tapping Test, or JLO, ROCF, CDT) to improve diagnostic accuracy. Methodological challenges (e.g., heterogeneity of definitions, tests) are discussed and suggestions for future research are provided.
https://www.crd.york.ac.uk/prospero/, ID: CRD42018088244.