Screening for cognitive dysfunction in ALS: validation of the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) using age and education adjusted normative data
Screening for cognitive dysfunction in ALS: validation of the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) using age and education adjusted normative data
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DOI：
10.1080/21678421.2016.1249887
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发表时间：
2017-02-01
影响因子：
2.8
通讯作者：
Pender, Niall
中科院分区：
文献类型：
--
作者：
Pinto-Grau, Marta;Burke, Tom;Pender, Niall
背景：认知和行为改变是肌萎缩侧索硬化症(ALS)的一个重要方面。爱丁堡ALS认知和行为筛查(ECAS)简要评估了ALS的这些变化。目的：以标准化的神经心理学成套测验为参照，验证ECAS量表的有效性，并用年龄和教育程度调整的截断值来评估其敏感性和特异性。方法：对30例肌萎缩侧索硬化症患者进行ECAS和神经心理成套评定。年龄和教育调整后的临界值是从82名健康对照样本中得出的。结果：ECAs综合得分(总得分、ALS特异性得分和非特异性得分)与电池综合得分高度相关。ECAS和全电池认知域和分测试之间也有很高的相关性。ECAS总分、ALS特异值和非特异值对认知损害高度敏感。ECAs、ALS特有的认知域也显示出高度的敏感性。个别分测验的敏感度为中等至低，这表明在解释这些分数时应谨慎行事。较低的阳性预测值表明存在假阳性。结论：使用年龄和教育调整的常模的ECAS的心理测量学特性表明，当ECAS被用作认知衰退的总体测量时，是高度敏感的。对于在ECAS上表现为受损的患者，需要进一步的全面评估。
Background: Cognitive and behavioural changes are an important aspect in Amyotrophic Lateral Sclerosis (ALS). The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) briefly assesses these changes in ALS. Objective: To validate the ECAS against a standardised neuropsychological battery and assess its sensitivity and specificity using age and education adjusted cut-off scores. Method: 30 incident ALS cases were assessed on both, ECAS and neuropsychological battery. Age and education adjusted cut-off scores were created from a sample of 82 healthy controls. Results: ECAS composite scores (Total, ALS Specific and Non-Specific) were highly correlated with battery composite scores. High correlations were also observed between ECAS and full battery cognitive domains and subtests. The ECAS Total, ALS Specific and Non-Specific scores were highly sensitive to cognitive impairment. ECAS ALS-Specific cognitive domains also evidenced high sensitivity. Individual subtest sensitivity was medium to low, suggesting that caution should be used when interpreting these scores. Low positive predictive values indicated the presence of false positives. Conclusions: Psychometric properties of the ECAS using age and education adjusted norms indicate that the ECAS, when used as an overall measure of cognitive decline, is highly sensitive. Further comprehensive assessment is required for patients that present as impaired on the ECAS.