A recent paper published in Movement Disorders Clinical Practice highlights the importance of patient-reported outcomes (PROs) in accurately identifying communication challenges in people with Parkinson’s disease.
Traditional methods of assessing candidates for deep brain stimulation (DBS) rely heavily on speech and language performance tests. However, such tests fail to completely capture the real-life communication challenges these patients face.
The study illustrates that traditional language assessments, while useful, may not encompass the real-world communication challenges faced by Parkinson’s patients, underscoring the need for more comprehensive approaches.
About the Study
The paper, entitled “Bridging the Gap: Association Between Objective and Subjective Outcomes of Communication Performance in People with Parkinson’s Disease Evaluated for Deep Brain Stimulation,” describes use of a novel PRO to assess communication interference in Parkinson’s patients and association with objective fluency measures.
The goals of the study were to:
- Examine subjective reporting of communication interference, as measured by the CPIB, in a sample of people with Parkinson’s considering DBS surgery and
- Investigate associations between performances on fluency and naming tests with CPIB scores.
The findings reveal discrepancies between how individuals with Parkinson’s disease perceive their communication abilities and their performance on objective language-based tests. It calls for “a patient-reported outcome that more precisely characterizes the source of communication difficulties.”
To assess this discrepancy, researchers compared these test responses with patient-reported outcomes captured through the Communication Participation Item Bank (CPIB). This approach not only highlighted the shortcomings of current assessment methods but also underscored the importance of incorporating patient perspectives into medical evaluations and treatment planning.
Researchers conducted a retrospective analysis of the medical records of 85 Parkinson’s patients being evaluated for DBS. Parkinson’s disease often impairs communication, and these difficulties may worsen after DBS.
The CPIB measured communication interference across various contexts, with patients rating their communication difficulties in ten scenarios. Researchers compared the CPIB findings with objective language ability measures from neuropsychological evaluations, including the Mattis Dementia Rating Scale, phonemic fluency tests, semantic fluency (animals), and confrontation naming from the Neuropsychological Assessment Battery (NAB).
They adjusted patient test performances for demographic factors and evaluated cognitive impairment. Most participants reported some difficulties with communication, particularly those who had more trouble with semantic fluency and those with more severe motor symptoms.
Traditional Objective Assessments Fall Short
Effective communication in Parkinson’s involves various factors, including language, non-language cognitive domains, speech articulation, and voice, which are not completely addressed by current assessments.
The study demonstrates that traditional language and speech assessments, while useful, fall short in capturing the full spectrum of communication difficulties experienced by Parkinson’s patients. This underscores the vital role of patient-reported outcomes in both the evaluation and treatment planning processes, particularly for DBS candidates. By bridging the gap between subjective perceptions and objective assessments, this research paves the way for more patient-centered approaches in both clinical practice and future studies.
 Rodríguez‐Porcel F, Deena Schwen Blackett, Hickok G, Bonilha L, Turner TH. Bridging the Gap: Association between Objective and Subjective Outcomes of Communication Performance in People with Parkinson’s Disease Evaluated for Deep Brain Stimulation. Movement Disorders Clinical Practice. 2023;10(12):1795-1799.
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