TY - JOUR
T1 - Evaluating Mild Cognitive Impairment in Essential Tremor
T2 - How Many and Which Neuropsychological Tests?
AU - Cersonsky, Tess E.K.
AU - Morgan, Sarah
AU - Kellner, Sarah
AU - Robakis, Daphne
AU - Liu, Xinhua
AU - Huey, Edward D.
AU - Louis, Elan D.
AU - Cosentino, Stephanie
N1 - Funding Information:
This work was supported by the National Institutes of Health (grant number NINDSR01NS086736). This funding body played no role in the design of the study, the collection, analysis, and interpretation of data, or the writing of the manuscript. No authors have conflicts of interest or competing financial interests.
Publisher Copyright:
© 2018 The International Neuropsychological Society.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Objectives: Essential tremor (ET) confers an increased risk for developing both amnestic and non-amnestic mild cognitive impairment (MCI). Yet, the optimal measures for detecting mild cognitive changes in individuals with this movement disorder have not been established. We sought to identify the cognitive domains and specific motor-free neuropsychological tests that are most sensitive to mild deficits in cognition as defined by a Clinical Dementia Rating (CDR) of 0.5, which is generally associated with a clinical diagnosis of MCI. Methods: A total of 196 ET subjects enrolled in a prospective, longitudinal, clinical-pathological study underwent an extensive motor-free neuropsychological test battery and were assigned a CDR score. Logistic regression analyses were performed to identify the neuropsychological tests which best identified individuals with CDR of 0.5 (mild deficits in cognition) versus 0 (normal cognition). Results: In regression models, we identified five tests in the domains of Memory and Executive Function which best discriminated subjects with CDR of 0.5 versus 0 (86.9% model classification accuracy). These tests were the California Verbal Learning Test II Total Recall, Logical Memory II, Verbal-Paired Associates I, Category Switching Fluency, and Color-Word Inhibition. Conclusions: Mild cognitive difficulty among ET subjects is best predicted by combined performance on five measures of memory and executive function. These results inform the nature of cognitive dysfunction in ET and the creation of a brief cognitive battery to assess patients with ET for cognitively driven dysfunction in life that could indicate the presence of MCI. (JINS, 2018, 24, 1084-1098)
AB - Objectives: Essential tremor (ET) confers an increased risk for developing both amnestic and non-amnestic mild cognitive impairment (MCI). Yet, the optimal measures for detecting mild cognitive changes in individuals with this movement disorder have not been established. We sought to identify the cognitive domains and specific motor-free neuropsychological tests that are most sensitive to mild deficits in cognition as defined by a Clinical Dementia Rating (CDR) of 0.5, which is generally associated with a clinical diagnosis of MCI. Methods: A total of 196 ET subjects enrolled in a prospective, longitudinal, clinical-pathological study underwent an extensive motor-free neuropsychological test battery and were assigned a CDR score. Logistic regression analyses were performed to identify the neuropsychological tests which best identified individuals with CDR of 0.5 (mild deficits in cognition) versus 0 (normal cognition). Results: In regression models, we identified five tests in the domains of Memory and Executive Function which best discriminated subjects with CDR of 0.5 versus 0 (86.9% model classification accuracy). These tests were the California Verbal Learning Test II Total Recall, Logical Memory II, Verbal-Paired Associates I, Category Switching Fluency, and Color-Word Inhibition. Conclusions: Mild cognitive difficulty among ET subjects is best predicted by combined performance on five measures of memory and executive function. These results inform the nature of cognitive dysfunction in ET and the creation of a brief cognitive battery to assess patients with ET for cognitively driven dysfunction in life that could indicate the presence of MCI. (JINS, 2018, 24, 1084-1098)
KW - Cognition
KW - Executive function
KW - Memory
KW - Memory and learning tests
KW - Mental status and dementia tests
KW - Movement disorders
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U2 - 10.1017/S1355617718000747
DO - 10.1017/S1355617718000747
M3 - Article
C2 - 30303051
AN - SCOPUS:85055005066
SN - 1355-6177
VL - 24
SP - 1084
EP - 1098
JO - Journal of the International Neuropsychological Society
JF - Journal of the International Neuropsychological Society
IS - 10
ER -