위스콘신카드분류검사 수행에 관여하는 인지적 특성: 파킨슨병 환자를 대상으로
Cognitive Characteristics Associated with the Performance on Wisconsin Card Sorting Test in Patients with Parkinson’s Disease
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Background: It is well known that the Wisconsin Card Sorting Test (WCST) is a representative test to evaluate executive function. Neuropsychological studies suggest that patients with frontal lobe damage perform worse on the WCST than do patients with non-frontal lobe injury. However, neuropsychological studies found considerable discrepancies in performances on the WCST in patients with frontal lobe damage. Established studies examined the neuro-cognitive functions in focal brain lesion patients. However, controversy remains over whether cognitive impairment is due to a focal brain lesion or due to diffuse brain lesions. Therefore, it is clinically valuable to examine cognitive functions in the performance on the WCST. We compared the results of the WCST with the results of the other neuropsychological tests. We also analyzed cognitive functions in the performance of the WCST in patients with Parkinson’s disease using regression analyses. Methods: To examine cognitive functions in the performance of the WCST, we investigated the differences of WCST performance and other neuropsychological tests in patients with Parkinson’s disease (n=143). Stepwise multiple regression analyses were performed with 4 indices (total correct response, perseverative response, perseverative errors and categories completed) of the WCST as regressand. Attention, visual-spatial function, naming ability, set shifting ability, verbal fluency, verbal delayed recall and non-verbal delayed recall were regressor. Results: Influential variables of the 4 WCST indices in Parkinson’s disease patients were not only phonemic fluency and set shifting ability but also naming ability. Furthermore, the predicted variables included in this study explained WCST for only about 30%. The best influential variable of total correct response was K-BNT. Phonemic fluency was the best influential variable of perseverative response, perseverative errors and categories completed. Conclusions: These results suggest that the performance on the WCST cannot specifically identify frontal lobe damage and that WCST is a multi-factorial and complex test.
Abstract
Background: It is well known that the Wisconsin Card Sorting Test (WCST) is a representative test to evaluate executive function. Neuropsychological studies suggest that patients with frontal lobe damage perform worse on the WCST than do patients with non-frontal lobe injury. However, neuropsychological studies found considerable discrepancies in performances on the WCST in patients with frontal lobe damage. Established studies examined the neuro-cognitive functions in focal brain lesion patients. However, controversy remains over whether cognitive impairment is due to a focal brain lesion or due to diffuse brain lesions. Therefore, it is clinically valuable to examine cognitive functions in the performance on the WCST. We compared the results of the WCST with the results of the other neuropsychological tests. We also analyzed cognitive functions in the performance of the WCST in patients with Parkinson’s disease using regression analyses. Methods: To examine cognitive functions in the performance of the WCST, we investigated the differences of WCST performance and other neuropsychological tests in patients with Parkinson’s disease (n=143). Stepwise multiple regression analyses were performed with 4 indices (total correct response, perseverative response, perseverative errors and categories completed) of the WCST as regressand. Attention, visual-spatial function, naming ability, set shifting ability, verbal fluency, verbal delayed recall and non-verbal delayed recall were regressor. Results: Influential variables of the 4 WCST indices in Parkinson’s disease patients were not only phonemic fluency and set shifting ability but also naming ability. Furthermore, the predicted variables included in this study explained WCST for only about 30%. The best influential variable of total correct response was K-BNT. Phonemic fluency was the best influential variable of perseverative response, perseverative errors and categories completed. Conclusions: These results suggest that the performance on the WCST cannot specifically identify frontal lobe damage and that WCST is a multi-factorial and complex test.
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