Objective: The main purpose of this work is to propose modern Italian co-normed data for a battery of ten widely used neuropsychological tests for Parkinsons’ Disease (PD).

Background: Due to the lack of standardized criteria for PD neuropsychological assessment and heterogeneous results in PD with mild cognitive impairment (PD-MCI) diagnosis, Hoogland and collaborators in 2019 [1] emphasized the necessity of standardized national normative batteries for a second level assessment in PD.
“Validation of Mild Cognitive Impairment criteria in Italian Parkinson’s disease patients” is an Italian multicentric project (research code: GR-2016-02361986) with the purpose to fulfill above mentioned problems.
Tests’ selection for the neuropsychological battery, outlined the necessity to provide modern normative data for the Italian population from a representative Healthy Subjects (HS) cohort.

Method: An extensive cognitive battery (including more than seventeen tests) was identified by pooling data from three centers specialized in Parkinson care (Venice, Milan, Salerno), and administered to 132 Italian HS (mean age 54 years, range 21-84 years; 56 males, 76 females) living in those regions. Subjects has been selected to be equally stratified for age, education [figure 1] and sex. The whole sample underwent 3T MRI to exclude significant vascular problems. Raw scores for each test were collected and logistic regressions performed with both linear and non-linear models according to data distribution.
Normative data for ten neuropsychological tests [table 1] were generated with Crawford and Garthwaite (2006) formulas on RStudio (1.3.1056) to avoid the typical estimation bias of the Gaussian curve’s extremes.

Results: Age and education were the predictive regressors of each neuropsychological tests’ performance except for phonemic fluencies and Rey Osterrieth complex figure test (delayed recall) where education was not a significant regressor.
Age did not result as a significant predictive regressor for semantic fluencies.
To generate standardized data, age and education have been chosen as regressors despite their significance in predicting score distribution to produce normative data.

Conclusion: Italian normative were created, providing a co-normed battery of neuropsychological tests allowing a second level assessment of cognitive impairment in a wide age range Italian population.

References: [1] Hoogland J, Boel JA, de Bie RMA, Schmand BA, Geskus RB, Dalrymple-Alford JC, Marras C, Adler CH, Weintraub D, Junque C, Pedersen KF, Mollenhauer B, Goldman JG, Tröster AI, Burn DJ, Litvan I, Geurtsen GJ; MDS Study Group “Validation of Mild Cognitive Impairment in Parkinson Disease”. Risk of Parkinson’s disease dementia related to level I MDS PD-MCI. Mov Disord. 2019 Mar;34(3):430-435. doi: 10.1002/mds.27617. Epub 2019 Jan 17. PMID: 30653248.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-second-level-neuropsychological-battery-for-parkinsons-disease-normative-data-from-the-italian-population/