Objective: The aims of this study were to (i) develop age, sex and education stratified norm values of our smartphone app-based application of Stroop Test; (ii) validate against the analog Stroop testing; (iii) compare to self-awareness and (iv) examine user-experience of this application.

Background: The phenomenon of anosognosia refers to the impairment to understand and perceive a disease or their disease-related symptoms and has been described for various neurological diseases. Maier et al. (2015) observed the phenomenon of impaired self-awareness (ISA) in non-demented and non-depressed patients with Parkinson’s disease (PD). Currently, ISA has mainly been reported for motor symptoms, but ISA may also occur for cognitive or other non-motor symptoms.

During the course of disease, increasing executive dysfunctions with the resulting changes in goal-directed planning and organization in the daily life of patients significantly affect the quality of life of PD patients and their relatives. Qualified assessment of executive dysfunction in the medical examination during outpatient appointments has been impossible up to now.

Method: After age-, sex-, and education-stratified norm values were formed from the data of 172 non-demented and non-depressed healthy controls (male: 76; female: 96; age: 60 ± 9.62 years), 30 non-demented and non-depressed PD patients (male: 13; female: 7; age: 62 ± 8.2  years; HY: 2 ± 0.59) underwent the smartphone App-based Stroop test, followed by an analog Stroop test, recording their self-awareness and a survey to assess the user experience.

Results: According to age, gender and education stratified norm values, the results of the smartphone App-based Stroop test showed in a part of PD patients a worse test performance, which could be even verified by analog Stroop testing. Furthermore, the self-awareness of the test performance was impaired in a large part of the patients, while the user experience of this application was above average.

Conclusion: The study provides an inexpensive, and simple method by smartphone App-based Stroop test as a surrogate to measure the self-awareness in PD. In the future, this qualified assessment can be used to examine executive dysfunction within the medical appointment.

References: Maier F, Ellereit AL, Eggers C, Lewis CJ, Pelzer EA, Kalbe E, Ernstmann N, Prigatano GP, Fink GR, Timmermann L: Development and psychometric evaluation of a scale to measure impaired self-awareness of hyper- and hypokinetic movements in Parkinson’s disease. J Int Neuropsychol Soc. 2015 Mar;21(3):221-30.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/smartphone-app-based-stroop-test-as-a-surrogate-for-impaired-self-awareness-in-parkinsons-disease/