Distinguishing Between Genuine and Feigned Dementia Using Event-related Potentials.
Distinguishing Between Genuine and Feigned Dementia Using Event-related Potentials.
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DOI：
10.1097/wnn.0000000000000311
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发表时间：
2022-09-01
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可能患有阿尔茨海默病（AD）的个体可能在传统的基于记忆的表现有效性测试（PVTs）中表现低于截止值。先前的研究已经发现，使用事件相关电位（ERP）可以成功检测年轻人群中的假装神经认知障碍。评估听觉oddball任务结合P3b峰振幅区分可能AD和模拟痴呆的效用。20名可能患有AD的患者和20名老年健康对照（HC）接受了ERP听觉oddball协议和记忆伪装测试（TOMM）。HC被要求在一种情况下诚实地表现，而在另一种情况下模拟痴呆。可能患有AD的人被要求诚实地表现。P3b峰振幅和按钮按下的准确性，从每个参与者收集，并进行分析，以确定其有效性检测性能的有效性。在HC组中，无论行为状况如何，P3b峰振幅保持稳定。当与TOMM试验2评分相结合时，P3b峰值幅度进一步提高了正确区分可能患有AD的个体与HC模拟痴呆的能力，灵敏度为100%，特异性为90%。与HC模拟痴呆相比，P3b峰振幅被认为是可能患有AD的个体中认知障碍的有效生理测量。当与TOMM试验2评分相结合时，P3b峰值振幅作为区分可能患有AD的个体与HC模拟痴呆的个体的有希望的性能有效性测量。
Individuals with probable Alzheimer disease (AD) may perform below cutoffs on traditional, memory-based performance validity tests (PVTs). Previous studies have found success using event-related potentials (ERPs) to detect feigned neurocognitive impairment in younger populations. To evaluate the utility of an auditory oddball task in conjunction with the P3b peak amplitude to distinguish probable AD from simulated dementia. Twenty individuals with probable AD and 20 older healthy controls (HC) underwent an ERP auditory oddball protocol and the Test of Memory Malingering (TOMM). The HC were asked to perform honestly for one condition and to simulate dementia for the other. The individuals with probable AD were asked to perform honestly. The P3b peak amplitude and button press accuracy were collected from each participant and were analyzed to determine their effectiveness in detecting performance validity. The P3b peak amplitude remained stable regardless of behavioral condition in the HC group. When combined with the TOMM Trial 2 score, the P3b peak amplitude further improved the ability to correctly differentiate individuals with probable AD from HC simulating dementia with 100% sensitivity and 90% specificity. The P3b peak amplitude was found to be an effective physiologic measure of cognitive impairment in individuals with probable AD compared with HC simulating dementia. When combined with the TOMM Trial 2 score, the P3b peak amplitude served as a promising performance validity measure for differentiating individuals with probable AD from HC simulating dementia.