the Wisconsin card sorting test(WCST) in Alzheimer 's disease (AD) amd parkinson's disease (PD): comparison between four modality of evaluation

The WCST is considered a fiontal lest, mainly suitable tu evaluate aspects of 'problem solving'. The several evaluation criteria are due to the different modalities of the test used in the neuropsychological field. AIM: to consider some modalities of the test in order to define which could offer more informations when applied to two degenerative pathologies: PD and AD. METHODS: The modalities proposed by Grant-Berg(GB), Milner(M), Taylor(T) and Heaton(H) have been chosen. 44 AD pts and 31 PD pts have been enrolled For each patient two control subjects with the same age, have been chosen among 546 sbjs.(S) enrolled to obtain the WCST's normal values. The parameters(prt) St(stages), Rc( corrected answers). El( total errors), Ep(perseverative errors), Enp(non perseverative errors), U( 'special' answers) were considered for GB,M and T. In addition to the above mentioned prt, the following were considered for H too. Rp( perseverative answers), %Ep(% of perseverative errors), NTPS( cards to complete the first St). CLR and %CLR ( nc and % of answers of conceptual level), FMS (failure to mantain the set) and I Tl. (learning to learn measure) The statistical analysis requires the study of the frequency distribution, indicator of central tendency, indicator of dispersion, analysis of variance. RESULTS 1)AD vs S: AD performance was statistically worse in the following prt:-St(in all modalities);-Rc(in T and M);-U(in T, M, GB ): -Enp (inH) ;-Et (inT.M andH);-NTPS,CLR,%CLR inH. 2)PD vs S no differences were found in the four modalities. The analysis of the patients divided according to a therapeutic criteria(14 pts with a<1? mnths and 17 pts with a >12 mnths L-dopa therapy) has shown a worse statistically significant performance for the prt St(in T and H) and Rp,Ep,%Ep,%CLR in H in longer therapy pts. DISCUSSION: the GB modality is more applicable in AD and the H more useful in PD.