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Development and psychometric evaluation of a scale to measure impaired self-awareness of hyper- and hypokinetic movements in Parkinson’s disease

Published online by Cambridge University Press:  17 February 2015

Franziska Maier ,
Anna L. Ellereit ,
Carsten Eggers ,
Catharine J. Lewis ,
Esther A. Pelzer ,
Elke Kalbe ,
Nicole Ernstmann ,
George P. Prigatano ,
Gereon R. Fink  and
Lars Timmermann
Franziska Maier*
Affiliation:
Department of Neurology, University of Cologne, Cologne, Germany
Anna L. Ellereit
Affiliation:
Department of Neurology, University of Cologne, Cologne, Germany
Carsten Eggers
Affiliation:
Department of Neurology, University of Cologne, Cologne, Germany
Catharine J. Lewis
Affiliation:
Department of Neurology, University of Cologne, Cologne, Germany
Esther A. Pelzer
Affiliation:
Department of Neurology, University of Cologne, Cologne, Germany
Elke Kalbe
Affiliation:
Department of Neurology, University of Cologne, Cologne, Germany Institute of Gerontology, Psychological Gerontology & Center for Neuropsychological Diagnostics and Intervention, University of Vechta, Vechta, Germany
Nicole Ernstmann
Affiliation:
Centre for Health Services Research Cologne (ZVFK), Medical Department of the University of Cologne, Germany Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Germany
George P. Prigatano
Affiliation:
Department of Clinical Neuropsychology, Barrow Neurological Institute, St. Joseph’s Hospital & Medical Center, Phoenix, Arizona, USA
Gereon R. Fink
Affiliation:
Department of Neurology, University of Cologne, Cologne, Germany Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM3), Research Center Juelich, Germany
Lars Timmermann
Affiliation:
Department of Neurology, University of Cologne, Cologne, Germany
*
Correspondence to: Dr. Franziska Maier, Department of Neurology, University Hospital Cologne, Kerpener Str. 62, D-50937 Cologne, Germany, Tel: +49 221 47886180; Fax: +49 221 47889002, e-mail: [email protected]
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Abstract

Objective: Patients with Parkinson’s disease (PD) can show impaired self-awareness of motor deficits (ISAm). We developed a new scale that measures ISAm severity of hyper- and hypokinetic movements in PD during medication on state and defined its psychometric criteria. Method: Included were 104 right-handed, non-depressed, non-demented patients. Concerning ISAm, 38 motor symptoms were assessed using seven tasks, which were performed and self-rated concerning presence of deficit (yes/no) by all patients. The whole procedure was videotaped. Motor symptoms were then evaluated by two independent experts, blinded for patient’s ratings, concerning presence, awareness of deficit, and severity. Exploratory principal component analysis (promax rotation) was applied to reduce items. Principal axis factoring was conducted to extract factors. Reliability was examined regarding internal consistency, split-half reliability, and interrater reliability. Validity was verified by applying two additional measures of ISAm. Results: Of the initial 38 symptoms, 15 remained, assessed in five motor tasks and merged to a total severity score. Factor analysis resulted in a four factor solution (dyskinesia, resting tremor right hand, resting tremor left hand, bradykinesia). For all subscales and the total score, measures of reliability (values 0.64–0.89) and validity (effect sizes>0.3) were satisfactory. Descriptive results showed that 66% of patients had signs of ISAm (median 2, range 0–15), with ISAm being most distinct for dyskinesia. Conclusions: We provide the first validation of a test for ISAm in PD. Using this instrument, future studies can further analyze the pathophysiology of ISAm, the psychosocial sequelae, therapeutic strategies and compliance with therapy. (JINS, 2015, 21, 1–10)

Keywords

anosognosianeurodegenerative disordersstatistical factor analysispsychometricsneuropsychological testhyperkinesiamotor skills
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 21 , Supplement 3 , March 2015 , pp. 221 - 230
Copyright
Copyright © The International Neuropsychological Society 2015 

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References

Amanzio, M., Monteverdi, S., Giordano, A., Soliveri, P., Filippi, P., & Geminiani, G. (2010). Impaired awareness of movement disorders in Parkinson’s disease. Brain Cogn, 72(3), 337–346. doi: 10.1016/j.bandc.2009.10.011 Google Scholar
Appelros, P., Karlsson, G.M., & Hennerdal, S. (2007). Anosognosia versus unilateral neglect. Coexistence and their relations to age, stroke severity, lesion site and cognition. Eur J Neurol, 14(1), 54–59. doi: 10.1111/j.1468-1331.2006.01544.x CrossRefGoogle ScholarPubMed
Beck, A.T., Steer, R.A., Ball, R., & Ranieri, W. (1996). Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients. J Pers Assess, 67(3), 588–597.Google Scholar
Bergman, H., & Deuschl, G. (2002). Pathophysiology of Parkinson’s disease: from clinical neurology to basic neuroscience and back. Mov Disord, 17(Suppl 3), S28–S40.Google Scholar
Bisiach, E., Vallar, G., Perani, D., Papagno, C., & Berti, A. (1986). Unawareness of disease following lesions of the right hemisphere: anosognosia for hemiplegia and anosognosia for hemianopia. Neuropsychologia, 24(4), 471–482.Google Scholar
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, New Jersey: Lawrence Erlbaum Associates.Google Scholar
Costello, A.B., & Osborne, J. (2005). Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Practical Assessment Research & Evaluation, 10(7), 1–9.Google Scholar
de Boer, A.G., van Lanschot, J.J., Stalmeier, P.F., van Sandick, J.W., Hulscher, J.B., de Haes, J.C., & Sprangers, M.A. (2004). Is a single-item visual analogue scale as valid, reliable and responsive as multi-item scales in measuring quality of life? Qual Life Res, 13(2), 311–320.CrossRefGoogle ScholarPubMed
Diener, H.C., & Putzki, N. (Eds.). (2008). [Leitlinien für Diagnostik und Therapie in der Neurologie] (4th ed.). Stuttgart: Georg Thieme Verlag.Google Scholar
Fahn, S., Elton, R.L., & Committee, U.D. (1987). Unified Parkinson’s Disease Rating Scale. In S. Fahn, C.D. Marsden, D. Calne & M. Goldstein (Eds.), Recent developments in Parkinson’s disease (pp. 153–163). Floral Park, NY: MacMillan Healthcare Information.Google Scholar
Feinberg, T.E., Roane, D.M., & Ali, J. (2000). Illusory limb movements in anosognosia for hemiplegia. J Neurol Neurosurg Psychiatry, 68(4), 511–513.CrossRefGoogle ScholarPubMed
Field, A. (2009). Discover Statistics using SPSS (3rd ed.). London, England: SAGE.Google Scholar
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 12(3), 189–198. doi: 0022-3956(75)90026-6 [pii]CrossRefGoogle ScholarPubMed
Guillemin, F., Bombardier, C., & Beaton, D. (1993). Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol, 46(12), 1417–1432.CrossRefGoogle ScholarPubMed
Hallgren, K.A. (2012). Computing Inter-Rater Reliability for Observational Data: An Overview and Tutorial. Tutor Quant Methods Psychol, 8(1), 23–34.CrossRefGoogle ScholarPubMed
Hautzinger, M., Keller, F., & Kühner, C. (2006). [BDI-II; Beck Depressions-Inventar Revision]. Franfurt am Main: Harcourt Test Services.Google Scholar
Hoehn, M.M., & Yahr, M.D. (1967). Parkinsonism: onset, progression and mortality. Neurology, 17(5), 427–442.Google Scholar
Hughes, A.J., Daniel, S.E., Blankson, S., & Lees, A.J. (1993). A clinicopathologic study of 100 cases of Parkinson’s disease. Arch Neurol, 50(2), 140–148.Google Scholar
Jenkinson, P.M., Edelstyn, N.M., Stephens, R., & Ellis, S.J. (2009). Why are some Parkinson disease patients unaware of their dyskinesias? Cogn Behav Neurol, 22(2), 117–121. doi: 10.1097/WNN.0b013e3181a722b0 Google Scholar
Kaiser, H.F. (1974). An index of factorial simplicity. Psychometrica, 35, 31–36.Google Scholar
Kessler, J., Markowitsch, H.J., & Denzler, P. (2000). [Mini-Mental-Status-Test (MMST)]. Göttingen: Beltz Test GMBH.Google Scholar
Leritz, E., Loftis, C., Crucian, G., Friedman, W., & Bowers, D. (2004). Self-awareness of deficits in Parkinson disease. Clin Neuropsychol, 18(3), 352–361. doi: 10.1080/1385404049052412 Google Scholar
Maier, F., Prigatano, G.P., Kalbe, E., Barbe, M.T., Eggers, C., Lewis, C.J., & Timmermann, L. (2012). Impaired self-awareness of motor deficits in Parkinson’s disease: association with motor asymmetry and motor phenotypes. Mov Disord, 27(11), 1443–1447. doi: 10.1002/mds.25079 Google Scholar
Matsunaga, M. (2010). How to Factor-Analyze your data right: Do’s, Don’ts, and How-To’s. International journal of psychological research, 3(1), 97–110.Google Scholar
McGraw, K.O., & Wong, S.P. (1996). Forming inferences about some intraclass correlation coefficients. Psychological Methods, 1(1), 30–46.Google Scholar
Nunnally, J., & Berstein, I. (1994). Psychometric theory (3rd ed.). New York: McGraw-Hill.Google Scholar
Oldfield, R.C. (1971). The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia, 9(1), 97–113.Google Scholar
Orfei, M.D., Caltagirone, C., & Spalletta, G. (2010). The behavioral Measurement of Anosognosia as a Multifaceted Phenomenon. In G.P. Prigatano (Ed.), The Study of Anosognosia (pp. 429–452). New York, New York: Oxford University Press, Inc.Google Scholar
Pietracupa, S., Fasano, A., Fabbrini, G., Sarchioto, M., Bloise, M., Latorre, A., & Berardelli, A. (2013). Poor self-awareness of levodopa-induced dyskinesias in Parkinson’s disease: Clinical features and mechanisms. Parkinsonism Relat Disord. doi: 10.1016/j.parkreldis.2013.07.002 CrossRefGoogle ScholarPubMed
Pietracupa, S., Latorre, A., Berardelli, A., & Fabbrini, G. (2014). Parkinsonian Patients and Poor Awareness of Dyskinesias. Front Neurol, 5, 32. doi: 10.3389/fneur.2014.00032 Google Scholar
Robertson, I.H. (2010). Anosognosia and error processing in various clinical disorders. In G.P. Prigatano (Ed.), The Study of Anosognosia (pp. 321–331). New York, NY, USA: Oxford University Press.Google Scholar
Schrag, A., Jahanshahi, M., & Quinn, N. (2000). How does Parkinson’s disease affect quality of life? A comparison with quality of life in the general population. Mov Disord, 15(6), 1112–1118.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
Sitek, E.J., Soltan, W., Wieczorek, D., Robowski, P., & Slawek, J. (2011). Self-awareness of memory function in Parkinson’s disease in relation to mood and symptom severity. Aging Ment Health, 15(2), 150–156. doi: 10.1080/13607863.2010.508773 CrossRefGoogle ScholarPubMed
Starkstein, S.E., Fedoroff, J.P., Price, T.R., Leiguarda, R., & Robinson, R.G. (1992). Anosognosia in patients with cerebrovascular lesions. A study of causative factors. Stroke, 23(10), 1446–1453.Google Scholar
Stevens, J.P. (2002). Applied multivariate statistics for the social sciences. (4th ed.). Hillsdale, NJ: Erlbaum.Google Scholar
Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach’s alpha. International journal of medical education, 2, 53–55.Google Scholar
Truong, D.D., Bhidayasiri, R., & Wolters, E. (2008). Management of non-motor symptoms in advanced Parkinson disease. J Neurol Sci, 266(1–2), 216–228. doi: 10.1016/j.jns.2007.08.015 CrossRefGoogle ScholarPubMed
Vitale, C., Pellecchia, M.T., Grossi, D., Fragassi, N., Cuomo, T., Di Maio, L., & Barone, P. (2001). Unawareness of dyskinesias in Parkinson’s and Huntington’s diseases. Neurol Sci, 22(1), 105–106.Google Scholar
Vossel, S., Weiss, P.H., Eschenbeck, P., Saliger, J., Karbe, H., & Fink, G.R. (2012). The neural basis of anosognosia for spatial neglect after stroke. Stroke, 43(7), 1954–1956. doi: 10.1161/STROKEAHA.112.657288 CrossRefGoogle ScholarPubMed
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