Determining reliable cognitive change after epilepsy surgery: Development of reliable change indices and standardized regression-based change norms for the WMS-III and WAIS-III
Determining reliable cognitive change after epilepsy surgery: Development of reliable change indices and standardized regression-based change norms for the WMS-III and WAIS-III
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DOI：
10.1046/j.1528-1157.2002.23602.x
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发表时间：
2002-12-01
期刊：
影响因子：
5.6
通讯作者：
Kuzniekcy, R
中科院分区：
文献类型：
--
作者：
Martin, R;Sawrie, S;Kuzniekcy, R
目的：建立新近修订的韦氏成人智力量表(WAIS-III)和韦氏记忆量表-III(WMS-III)对复杂部分性癫痫患者的可靠变化指数(RCIS)和标准化回归(SRB)变化评分标准。建立这种标准化的变化评分对确定癫痫的影响是有用的。手术对认知功能的影响，不依赖于测试-重测伪影，包括练习效果。方法：42例复杂部分性发作(主要为颞叶发作)的非手术成人患者接受了两次WMS-III和WAIS-III的测试，平均间隔7个月。所有患者在两次试验中均接受稳定的抗癫痫药物(AED)治疗。计算RCI和SRB改变评分。计算WAIS-III和WMS-III初级指数和单项分测验的可信区间截断分数(90%和80%)和标准化回归方程。年龄、性别、教育程度、复测间隔、术前测试表现、癫痫发作和发作持续时间是SRB方程的预测变量。结果：WAIS-III和WMS-III初级指数的重测信度在可接受的范围内，尽管存在较大的个体分测验变异性。术前表现是影响每个预测回归方程的最大因素。年龄、性别、教育程度、发作开始时间和发作持续时间对几个回归方程的影响不大。结论：我们计算了最近修订的韦氏量表的RCI和SRD变化得分指数。这些公式有助于控制重测方法学伪影，并提供了一种标准化方法，用于检查癫痫手术后个体和群体水平的认知变化。
Purpose: Reliable change indices (RCIs) and standardized regression-based (SRB) change scores norms were established for the recently revised Wechsler Adult Intelligence Scale-III (WAIS-III) and Wechsler Memory Scale-III (WMS-III) in patients with complex partial seizures. Establishment of such standardized change scores can be useful in determining the effects of epilepsy. surgery on cognitive functioning independent of test-retest artifacts including practice effects.Methods: Forty-two nonoperated-on adult patients with complex partial seizures (primarily of temporal lobe onset) were administered the WMS-III and WAIS-III on two occasions (mean 7-month interval). All patients were receiving stable antiepileptic drug.(AED) treatment at both testings. RCI and SRB change scores were calculated. Confidence interval cutoff scores (90% and 80%) and standardized regression equations were calculated for each of the WAIS-III and WMS-III Primary Indices and individual subtests. Age, gender, education, test-retest interval, preoperative test performance, seizure onset, and seizure duration were predictor variables for the SRB equations.Results: Test-retest reliabilities for the WAIS-III and WMS-III Primary Indices were within acceptable ranges, although considerable individual subtest variability was found. Preoperative performance was the single largest contributor to each of the predictive regression equations. Age, gender, education, seizure onset, and seizure duration contributed modest variance to several of the regression equations.Conclusions: We calculated both RCI and SRD change score indices for the recently revised Wechsler instruments. These formulas help control for test-retest methodologic artifacts and provide a standardized method with which to examine both individual and group level cognitive change after epilepsy surgery.