Abstract
Background: In Huntington disease (HD), cognitive changes due to disease-progression or treatment are potentially confounded by "practice effects" (PE) - performance improvement from prior exposure to test materials. Objective: A practice run-in ("dual baseline") was used in an HD cognitive trial to determine if PE could be minimized and evaluate performance trajectories over multiple visits. Methods: Non-depressed adults (N= 36) with mild to moderate HD-related cognitive deficits participated in a clinical trial to examine the efficacy of citalopram to enhance cognition. Cognitive tests were administered at three visits (2 weeks separating each visit), before active treatment randomization. Some tests were also administered at screening. Therefore 3-4 pre-treatment repetitions were available. We examined test improvement using repeated-measures ANOVAs with planned pairwise comparisons. Results: Despite the practice run-in and use of alternate test forms, results indicated ongoing improvements over at least three test sessions on all three UHDRS cognitive tests. Trails A and B showed improvements between the third and fourth session, which suggests that one pre-baseline visit may not be effective in reducing practice on this important and commonly used test. Conclusions: Overall, 7 out of 13 variables showed some degree of short-term PE, even after multiple sessions and alternate forms. Tests assessing processing speed and memory may be particularly confounded by ongoing PE across at least 2-3 sessions. Practice run-in periods and alternate forms may help minimize the impact of such effects in HD clinical trials but awareness of which tests are most susceptible to PE is important in clinical trial design.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 251-260 |
| Number of pages | 10 |
| Journal | Journal of Huntington's disease |
| Volume | 4 |
| Issue number | 3 |
| DOIs | |
| State | Published - Sep 29 2015 |
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Keywords
- cognitive disorders/dementia
- Huntington disease
- neuropsychological assessment
- practice effects
ASJC Scopus subject areas
- Clinical Neurology
- Cellular and Molecular Neuroscience
Cite this
Practice Effects and Stability of Neuropsychological and UHDRS Tests over Short Retest Intervals in Huntington Disease. / Beglinger, Leigh J.; Adams, William H.; Fiedorowicz, Jess G.; Duff, Kevin; Langbehn, Douglas; Biglan, Kevin; Caviness, John Nathaniel; Olson, Blair; Paulsen, Jane S.
In: Journal of Huntington's disease, Vol. 4, No. 3, 29.09.2015, p. 251-260.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Practice Effects and Stability of Neuropsychological and UHDRS Tests over Short Retest Intervals in Huntington Disease
AU - Beglinger, Leigh J.
AU - Adams, William H.
AU - Fiedorowicz, Jess G.
AU - Duff, Kevin
AU - Langbehn, Douglas
AU - Biglan, Kevin
AU - Caviness, John Nathaniel
AU - Olson, Blair
AU - Paulsen, Jane S.
PY - 2015/9/29
Y1 - 2015/9/29
N2 - Background: In Huntington disease (HD), cognitive changes due to disease-progression or treatment are potentially confounded by "practice effects" (PE) - performance improvement from prior exposure to test materials. Objective: A practice run-in ("dual baseline") was used in an HD cognitive trial to determine if PE could be minimized and evaluate performance trajectories over multiple visits. Methods: Non-depressed adults (N= 36) with mild to moderate HD-related cognitive deficits participated in a clinical trial to examine the efficacy of citalopram to enhance cognition. Cognitive tests were administered at three visits (2 weeks separating each visit), before active treatment randomization. Some tests were also administered at screening. Therefore 3-4 pre-treatment repetitions were available. We examined test improvement using repeated-measures ANOVAs with planned pairwise comparisons. Results: Despite the practice run-in and use of alternate test forms, results indicated ongoing improvements over at least three test sessions on all three UHDRS cognitive tests. Trails A and B showed improvements between the third and fourth session, which suggests that one pre-baseline visit may not be effective in reducing practice on this important and commonly used test. Conclusions: Overall, 7 out of 13 variables showed some degree of short-term PE, even after multiple sessions and alternate forms. Tests assessing processing speed and memory may be particularly confounded by ongoing PE across at least 2-3 sessions. Practice run-in periods and alternate forms may help minimize the impact of such effects in HD clinical trials but awareness of which tests are most susceptible to PE is important in clinical trial design.
AB - Background: In Huntington disease (HD), cognitive changes due to disease-progression or treatment are potentially confounded by "practice effects" (PE) - performance improvement from prior exposure to test materials. Objective: A practice run-in ("dual baseline") was used in an HD cognitive trial to determine if PE could be minimized and evaluate performance trajectories over multiple visits. Methods: Non-depressed adults (N= 36) with mild to moderate HD-related cognitive deficits participated in a clinical trial to examine the efficacy of citalopram to enhance cognition. Cognitive tests were administered at three visits (2 weeks separating each visit), before active treatment randomization. Some tests were also administered at screening. Therefore 3-4 pre-treatment repetitions were available. We examined test improvement using repeated-measures ANOVAs with planned pairwise comparisons. Results: Despite the practice run-in and use of alternate test forms, results indicated ongoing improvements over at least three test sessions on all three UHDRS cognitive tests. Trails A and B showed improvements between the third and fourth session, which suggests that one pre-baseline visit may not be effective in reducing practice on this important and commonly used test. Conclusions: Overall, 7 out of 13 variables showed some degree of short-term PE, even after multiple sessions and alternate forms. Tests assessing processing speed and memory may be particularly confounded by ongoing PE across at least 2-3 sessions. Practice run-in periods and alternate forms may help minimize the impact of such effects in HD clinical trials but awareness of which tests are most susceptible to PE is important in clinical trial design.
KW - cognitive disorders/dementia
KW - Huntington disease
KW - neuropsychological assessment
KW - practice effects
UR - http://www.scopus.com/inward/record.url?scp=84961711406&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84961711406&partnerID=8YFLogxK
U2 - 10.3233/JHD-150159
DO - 10.3233/JHD-150159
M3 - Article
C2 - 26444022
AN - SCOPUS:84961711406
VL - 4
SP - 251
EP - 260
JO - Journal of Huntington's disease
JF - Journal of Huntington's disease
SN - 1879-6397
IS - 3
ER -