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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*
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: franziska.maier@uk-koeln.de

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)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2015 

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