1
|
Lillig R, Ophey A, Schulz JB, Reetz K, Wojtala J, Storch A, Liepelt-Scarfone I, Becker S, Berg D, Balzer-Geldsetzer M, Kassubek J, Hilker-Roggendorf R, Witt K, Mollenhauer B, Trenkwalder C, Roeske S, Wittchen HU, Riedel O, Dodel R, Kalbe E. A new CERAD total score with equally weighted z-scores and additional executive and non-amnestic "CERAD-Plus" tests enhances cognitive diagnosis in patients with Parkinson's disease: Evidence from the LANDSCAPE study. Parkinsonism Relat Disord 2021; 90:90-97. [PMID: 34418761 DOI: 10.1016/j.parkreldis.2021.07.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/23/2021] [Accepted: 07/31/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) is a renowned cognitive test battery, which has been extended in its German version to the CERAD-Plus including tests of executive functions and processing speed. The most commonly used total score (TS) is based on the restricted CERAD version and reflects the sum of selected raw-values (Chandler et al., 2005). The CERAD-Plus extensions might be of particular diagnostic utility for cognitive assessments in Parkinson's Disease (PD), as executive functions and processing speed belong to the most vulnerable domains in PD. OBJECTIVE The aim was to develop a CERAD-TS based on the extended CERAD-Plus' age-, gender-, and education-corrected z-scores and to evaluate its diagnostic accuracy compared to the established CERAD-Chandler-TS. METHODS Baseline data of n = 679 patients with PD (69% male, n = 277 PD without cognitive impairment, n = 307 PD-MCI, n = 95 PD-D) from the multicenter, prospective DEMPARK/LANDSCAPE study were analyzed. ROC-analyses were conducted for four different TS that were either based on the original CERAD or CERAD-Plus, on raw-values or z-scores, and equally-weighted or based on factor scores. AUC-comparisons were conducted to determine the best yet most parsimonious TS. RESULTS The newly designed CERAD-Plus-TS based on equally-weighted z-scores outperformed both the CERAD-Chandler-TS and cognitive screening instruments when differentiating between individuals with PD of varying cognitive impairment (0.78 ≤ AUC ≤ 0.98). CONCLUSION Results suggest a high relevance of non-amnestic subscales for the cognitive assessment in PD populations. The proposed CERAD-Plus-TS needs further validation. The extensions might offer diagnostic potential for non-PD populations as well.
Collapse
Affiliation(s)
- Robert Lillig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), 50937, Cologne, Germany.
| | - Anja Ophey
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), 50937, Cologne, Germany.
| | - Jörg B Schulz
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, 52074, Aachen, Germany.
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, 52074, Aachen, Germany.
| | - Jennifer Wojtala
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, 52074, Aachen, Germany.
| | - Alexander Storch
- Department of Neurology, University of Rostock and German Center for Neurodegenerative Diseases (DZNE) Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany.
| | - Inga Liepelt-Scarfone
- Hertie Institute for Clinical Brain Research Department of Neurodegenerative Diseases, Otfried-Müller-Straße 27, 72076, Tübingen, Germany; German Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-Straße 23, 72076, Tübingen, Germany; IB-Hochschule für Gesundheit und Soziales, Paulinenstraße 45, 70178, Stuttgart, Germany.
| | - Sara Becker
- Hertie Institute for Clinical Brain Research Department of Neurodegenerative Diseases, Otfried-Müller-Straße 27, 72076, Tübingen, Germany.
| | - Daniela Berg
- Hertie Institute for Clinical Brain Research Department of Neurodegenerative Diseases, Otfried-Müller-Straße 27, 72076, Tübingen, Germany; Department of Neurology, Christian-Albrechts-University of Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany.
| | - Monika Balzer-Geldsetzer
- Ethikkommission, Ludwig-Maximilians-Universität München, Pettenkoferstr. 8, 80336, München, Germany.
| | - Jan Kassubek
- Department of Neurology, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany.
| | | | - Karsten Witt
- Department of Neurology and Research Centre of Neurosensory Sciences, Carl von Ossietzky University, Carl-von-Ossietzky-Straße 9, 26129, Oldenburg, Germany.
| | - Brit Mollenhauer
- Paracelsus-Elena Klinik, Kassel, Department of Neurosurgery, University Medical Center, Goettingen, Klinikstraße 16, 34128, Kassel, Germany.
| | - Claudia Trenkwalder
- Paracelsus-Elena Klinik, Kassel, Department of Neurosurgery, University Medical Center, Goettingen, Klinikstraße 16, 34128, Kassel, Germany.
| | - Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE), Department of Clinical Research, Bonn, Sigmund-Freud-Str. 27, 53127, Bonn, Germany.
| | - Hans-Ullrich Wittchen
- Department of Psychiatry & Psychotherapy, University Hospital Munich, Ludwig-Maximilians-University Munich, Nußbaumstraße 7, 80336, München, Germany.
| | - Oliver Riedel
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Department of Clinical Epidemiology, Achterstraße 30, 28359, Bremen, Germany.
| | - Richard Dodel
- Department of Neurology, Philipps University Marburg, Baldingerstraße, 35043, Marburg, Germany; Department of Geriatric Medicine, University Hospital Essen, Germaniastrasse 1-3, 45356, Essen, Germany.
| | - Elke Kalbe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Medical Psychology
- Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), 50937, Cologne, Germany.
| |
Collapse
|