Development of specific measures of Localization and Precision for the Rey-Osterrieth Complex Figure Test: preliminary evidence of validity and reliability.

Introduction: Visuospatial abilities are crucial for various daily activities, playing a significant role in navigation and spatial awareness. These abilities can be affected by brain damage, including that caused by COVID-19. The specific mechanisms underlying these cognitive alterations remain poorly understood. There is a lack of cognitive testing methods and correction strategies associatedwith imaging exams. This study aims to propose and evaluate the validity and reliability of a new scoring system for the Rey-Osterrieth Complex Figure Test (ROCFT), which separates scores intoLocalization and Precision, based on the dual-pathway model theory. Methods: The sample consisted of 268 patients with a confirmed diagnosis of COVID-19 through RT-PCR testing, with a mean age of 38 years (± 10.3). Additionally, there were 128 control participants, with a mean age of 30 years (± 12). This resulted in a total of 396 highly educated participants, with an average of 16.15 years (± 3.00) of formal education. Rey-Osterrieth Complex Figure Test (ROCFT), Five-Point Test, and Trail Making Test (TMT) were used to assess nonverbal skills associated with visuoconstruction. Analyses were conducted using the Wilcoxon test to compare Localization and Precision scores, Spearman’s rank-order correlations were used to verify the association between the classifications. Reliability was estimated using Cronbach's alpha. Results: Results revealed significant differences between Localization and Precision across all ROCFT measures, with COVID-19 group performing worse than the control group. Notably, the Precision scores were consistently lower than the Localization scores in all assessments. Correlations between new measures and other neuropsychological assessments were significant, indicating relative independence between the constructs. The reliability of the new measures was moderate to high (>0.72) Conclusion: This study suggests that incorporating Localization and Precision scores in the ROCFT allows for a more comprehensive assessment of the visuospatial abilities involved in copying and recalling this traditional neuropsychological test.