Objective: To propose a neuropsychological battery for assessing cognitive abilities in Parkinson’s disease (PD) that also fulfills proposed MDS diagnostic criteria for PD mild cognitive impairment (PD-MCI).

Background: Cognitive deficits are increasingly recognized in PD as being both common and detrimentally affecting quality of life. To diagnose PD-MCI by MDS Level II criteria, a detailed neuropsychological assessment is the gold standard. However, many different tests are used by different studies, which limits comparability of results. Therefore, having a research-informed Parkinson’s Neuropsychological Battery (PNB) would be desirable for pooling data across sites and for use in research trials.

Methods: Neuropsychological test data from 22 centers participating in the MDS PD-MCI Validation Study Group were analyzed. Neuropsychological tests administered in at least two countries were selected (N=28). Z-scores based on published norms were determined. The main outcome was the discriminative ability of tests to separate non-demented PD patients from Healthy Controls (HC). The discriminative ability, expressed by effect sizes, was determined in two ways: (1) the average z-score for each test was compared between PD patients and the theoretical population mean of zero and then ranked, and (2) z-scores were compared between PD patients and HCs for those centers with a HC population. Moreover, regression techniques (least absolute shrinkage and selection operator [LASSO]) were used to analyze the z-scores based on published norms as well as the z-scores based on de HCs. By combining these different statistical methods tests were ranked on sensitivity to detect cognitive impairment in non-demented PD patients.

Results: Twenty-eight tests were analyzed of which 7 in the Attention and Working Memory domain, 6 in the Memory, 7 in the Executive Functioning, 3 in the Language and 5 in the Visuospatial/Visuoconstructive domain. Data from 22 centers were included, containing 3434 non-demented PD patients and 1225 HCs. Analyses are ongoing and will be completed in time to present at the upcoming MDS meeting.

Conclusions: We expect to be able to propose a comprehensive PNB based on our research findings. A subsequent step will be to analyze the sensitivity of the PNB tests to detect cognitive decline using longitudinal data.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-proposed-parkinsons-disease-neuropsychological-battery-pnb/