Utility of Boston Qualitative Scoring System for Rey-Osterrieth Complex Figure: evidence from a Parkinson’s Diseases sample

Abstract

This study examined the ability of the Boston Qualitative Scoring System (BQSS) in comparison to the Osterrieth scoring method to separate Parkinson's Disease patients without dementia from healthy controls at the Rey-Osterrieth Complex Figure (ROCF) copy. 30 PD participants and 30 healthy participants completed ROCF copy. The performance was scored according to both methods. The results indicated that PD patients performed significantly worse on ROCF. According to ROC analyses, BQSS Copy Total score represented the most suitable index to distinguish between the two groups: a score below or equal to 16 indicates an impaired performance. Moreover, PD participants reported lower performance in the BQSS scores of Planning and Neatness. PD patients' poor performance in ROCF copy was related to executive difficulties, specifically in terms of planning and impulsivity, instead of global visuo-constructional impairments. An extensive evaluation of copy drawings allowing to disentangle between different involved cognitive domains would be suitable, specifically in those clinical conditions like PD, in which motor impairments affect drawing performance.

Cluster analysis reveals distinct patterns of saccade impairment and their relation to cognitive profiles in Parkinson's disease

“…According to the dual syndrome hypothesis, reduced visuoconstructive abilities (as observed in cluster 1) and a decrease in semantic verbal fluency (as observed in cluster 2) have both been associated with an increased risk of progressive cognitive decline, while pure executive dysfunction may bear a lower risk to evolve into multidomain impair- ment (Williams-Gray et al, 2009). As executive dysfunction-in particular low planning and organization skills-have been related to poor performance in the RCF copying task in PD (Scarpina et al, 2016), it is not unequivocal to attribute the reduced copying score in cluster 1 to visuoconstructive deficits. Furthermore, the subsequently reduced recall score should not be interpreted as visual memory impairment since primary storage of information might have been diminished by impaired copying (Shin et al, 2006).…”

Approach to Cognitive Impairment in Parkinson's Disease

“…However, as with many bedside tests, clinical correlation and interpretation is required given the lack of standardization. Similarly, for testing visual construction and visual memory, the Rey-Osterrieth complex figure has been validated in PD, but requires a specific and detailed scoring system [83]. Given the complexity and time required for this complex figure, for bedside testing, a simpler figure such as a geometric doodle could be utilized.…”

Overview of the Complex Figure Test and Its Clinical Application in Neuropsychiatric Disorders, Including Copying and Recall

“…The process scoring method is a comprehensive scoring method that can comprehensively evaluate cognitive function. The executive variables of BQSS can distinguish executive disorders from normal people, including vascular dementia ( 9 ), Parkinson's disease ( 39 ), schizophrenia ( 40 ), attention deficit hyperactivity disorder ( 41 ), and senile depression ( 42 ), and it is more valuable in exploring poor performance in the recall—for example, a BQSS-based visuospatial memory study found that poor recall performance in schizophrenia is mediated by a defect in the organizational strategy of copying ( 40 ). However, due to the shortcomings of process scoring methods, such as time-consuming and standardized training, it is not widely used in clinical practice ( 31 ).…”

“…Cognitive impairment (PD-MCI) is more common, and 70–80% of PD patients can progress to dementia with severe executive dysfunction. Scarpina et al ( 39 ) found that the Boston Qualitative Scoring System's copy total score can distinguish PD patients from normal people. The low planning and neatness scores of PD patients indicate that poor copying performance is related to executive function, especially planning and impulsivity, rather than impaired visuo-constructional ability ( 39 ).…”

“…Scarpina et al ( 39 ) found that the Boston Qualitative Scoring System's copy total score can distinguish PD patients from normal people. The low planning and neatness scores of PD patients indicate that poor copying performance is related to executive function, especially planning and impulsivity, rather than impaired visuo-constructional ability ( 39 ). Since the subthalamic nucleus plays a vital role in optimal planning, planning defects are related to the dysfunction of the frontal basal ganglia network (regulatory response inhibition) ( 51 ).…”