Traditional neuropsychological correlates and reliability of the Automated Neuropsychological Assessment Metrics-4 battery for Parkinson's disease

Background: The Automated Neuropsychological Assessment Metrics Battery-4 for PD offers the promise of a computerized approach to cognitive assessment. Methods: To assess its utility, the ANAM4-PD was administered to 72 PD patients and 24 controls along with a traditional battery. Reliability was assessed by retesting 26 patients. Results: The Cognitive Efficiency Score (CES; a global score) exhibited high reliability (r = 0.86). Constituent variables exhibited lower reliability. The CES correlated strongly with the traditional battery global score, but displayed weaker relationships to UPDRS scores than the traditional score. Multivariate analysis of variance revealed a significant difference between the patient and control groups in ANAM4-PD performance, with three ANAM4-PD tests, Math, Tower, and Pursuit Tracking, displaying sizeable differences. In discriminant analyses these variables were as effective as the total ANAM4-PD in classifying cases designated as impaired based on traditional variables. Principal components analyses uncovered fewer factors in the ANAM4-PD relative to the traditional battery. ANAM4-PD variables correlated at higher levels with traditional motor and processing speed variables than with untimed executive, intellectual or memory variables. Conclusions: The ANAM4-PD displays high global reliability, but variable subtest reliability. The battery assesses a narrower range of cognitive functions than traditional tests, and discriminates between patients and controls less effectively. Three ANAM4-PD tests. Pursuit Tracking, Math, and Tower performed as Well as the total ANAM4-PD in classifying patients as cognitively impaired. These findings could guide the refinement of the ANAM4-PD as an efficient method of screening for mild to moderate cognitive deficits in PD patients. (C) 2012 Elsevier Ltd. All rights reserved.