Prognostic role of Mini-Mental State Pediatric Examination (MMSPE) on neuropsychological functioning
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ORIGINAL ARTICLE
Prognostic role of Mini-Mental State Pediatric Examination (MMSPE) on neuropsychological functioning Elisa Cainelli 1,2 & Deborah Lidia Di Giacomo 2 & Giulia Mantegazza 3 & Luca Vedovelli 4 & Jacopo Favaro 2 & Clementina Boniver 2 Received: 29 July 2019 / Accepted: 5 November 2019 # Fondazione Società Italiana di Neurologia 2019
Abstract Objective The aim of this study was to evaluate the ability of the Mini-Mental State Pediatric Examinations (MMSPE) in the individuation of neuropsychological impairments. Method MMSPE was administered to 60 children attending a primary or lower secondary school suffering from neurological diseases, admitted to our neuropsychology services. All children performed both a MMSPE examination and a neuropsychological evaluation. Results of neuropsychological evaluation and MMSPE were dichotomized. Positive predictive value (PPV), negative predictive value (NPV), and accuracy were also calculated. Results The diagnostic performance of MMSPE showed a good overall accuracy (0.83, CI 95% 0.64–0.91), NPV (0.81, CI 95% 0.73–1.00), PPV (0.87, CI 95% 0.68–0.94), specificity (0.91, CI 95% 0.81–1.00), sensitivity (0.74, CI 95% 0.57–0.90), and odds ratio of 28.5 (CI 95% 6.6–123), p < 0.001. Conclusions MMSPE has a good prognostic ability in predicting neuropsychological problems in the context of different neurological pediatric diseases. We suggest that this instrument could greatly improve pediatric clinical practice in identifying high-risk children. Keywords Screening . Cognitive . Children . Clinical practice . Predictive
Introduction Over the past half century, neuropsychology played an increasing role in the diagnostic process of neurologic pathologies; cognitive assessment provided an essential contribution to the characterization of neurologic conditions, as demonstrated by the wide literature on patients with epilepsy, multiple sclerosis, stroke, and other conditions [1–7]. * Elisa Cainelli [email protected] 1
Department of Developmental Psychology and Socialization, University of Padova, Via Venezia 8, 35133 Padua, Italy
2
Paediatric Neurology and Neurophysiology Unit, Department of Women’s and Children’s Health, University Hospital of Padova, Padua, Italy
3
Child Neuropsychiatry of ASST Monza Brianza, Monza, Italy
4
Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
Patients suffering from neurological conditions are indeed at risk for several cognitive and neuropsychological impairments, which can greatly affect academic achievements and quality of life of both child and parents [5, 6, 8]. Furthermore, cognitive problems often appear early at the onset of the disease [4], because also minimal abnormalities in cerebral functioning may induce changes in cognition and behavior. The underlying neuropathology may lead to different problems depending on the onset age [4, 9]. However, the effects on child behavior and personality are complex and mult
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