简易精神状态检查评分正常的脑外伤患者行为记忆测评分析
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摘要
目的观察简易精神状态检查(MMSE)测评得分正常的脑外伤患者在蒙特利尔认知评估量表(MoCA)和Rivermead行为记忆测评(RBMT-3)中的表现。方法 2015年3月至2018年6月,选择有明确主诉,但MMSE筛查为认知功能正常的脑外伤患者40例(患者组),以及同期健康体检者30例(对照组),先后采用MMSE、MoCA和RBMT-3进行测试。结果患者组中14例MoCA评分正常。患者组MoCA总分、RBMT-3总粗分和总量表分均明显低于对照组(t>2.822, P <0.01);MoCA言语和延迟回忆分均明显低于对照组(t> 2.790, P <0.01),RBMT-3各项中故事延迟回忆、技能学习即时回忆和技能学习延迟回忆粗分和分量表分均低于对照组(t> 2.507, P <0.05),RBMT-3记住姓名延迟回忆和故事即时回忆粗分低于对照组(t> 2.018, P <0.05)。结论对存在明确主诉的脑外伤患者,建议联合使用MMSE和MoCA进行筛查,记忆损害症状明显的可进一步采用RBMT-3进行评定。
Objective To observe the performance of the traumatic brain injury(TBI) patients with normal results in Mini-Mental State Examination(MMSE) in the Montreal Cognitive Assessment(MoCA) and Rivermead Behavioral Memory Test-3(RBMT-3).Methods From March, 2015 to June, 2018,40 TBI patients with cognitive complaints but normally in MMSE and other30 healthy persons(controls) were assessed with MoCA and RBMT-3.Results There were 14 patients sounded normally in MoCA. The scores of MoCA, as well as both the raw score and scale score of RBMT-3, were less in the patients than in the controls(t > 2.822, P < 0.01), especially in the verbal and delayed recall subtests of MoCA(t > 2.790, P < 0.01), and delayed story recall, skill learning instant recall,delayed skills recall(both raw and scale scores)(t > 2.507, P < 0.05), and remember name delay recall and story instant recall(raw score only)(t > 2.018, P < 0.05) of RBMT-3.Conclusion For TBI patients with cognitive complaints, it is necessary to assesse with both MMSE and MoCA. If there is any memory impairment, RBMT-3 is needed.
Objective To observe the performance of the traumatic brain injury(TBI) patients with normal results in Mini-Mental State Examination(MMSE) in the Montreal Cognitive Assessment(MoCA) and Rivermead Behavioral Memory Test-3(RBMT-3).Methods From March, 2015 to June, 2018,40 TBI patients with cognitive complaints but normally in MMSE and other30 healthy persons(controls) were assessed with MoCA and RBMT-3.Results There were 14 patients sounded normally in MoCA. The scores of MoCA, as well as both the raw score and scale score of RBMT-3, were less in the patients than in the controls(t > 2.822, P < 0.01), especially in the verbal and delayed recall subtests of MoCA(t > 2.790, P < 0.01), and delayed story recall, skill learning instant recall,delayed skills recall(both raw and scale scores)(t > 2.507, P < 0.05), and remember name delay recall and story instant recall(raw score only)(t > 2.018, P < 0.05) of RBMT-3.Conclusion For TBI patients with cognitive complaints, it is necessary to assesse with both MMSE and MoCA. If there is any memory impairment, RBMT-3 is needed.
引文
[1] Dong Y, Sharma V K, Chan B P, et al. The Montreal Cognitive Assessment(MoCA)is superior to the Mini-Mental State Examination(MMSE)for the detection of vascular cognitive impairment after acute stroke[J]. J Neurol Sci, 2010, 299(1-2):15-18.
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[3] Monti J M, Voss M W, Pence A, et al. History of mild traumatic brain injury is associated with deficits in relational memory, reduced hippocampal volume, and less neural activity later in life[J]. Front Aging Neurosci, 2013, 5:41.
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[10] Lee S H, Cho A, Min Y K, et al. Comparison of the Montreal Cognitive Assessment and the Mini-Mental State Examination as screening tests in hemodialysis patients without symptoms[J]. Ren Fail, 2018, 40(1):323-330.
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[12] Webber D, Collins M, DeFilippis N, et al. Reliability of the Clinical Dementia Rating with a traumatic brain injury population:a preliminary study[J]. Appl Neuropsychol Adult, 2013, 20(2):145-151.
[13] Srivastava A, Rapoport M J, Leach L, et al. The utility of the MiniMental Status Exam in older adults with traumatic brain injury[J].Brain Inj, 2006, 20(13-14):1377-1382.
[14]张一,姚秋近,陈超.蒙特利尔认知评估量表对简易精神状态量表得分正常的颅脑创伤患者的认知功能评价[J].中华创伤杂志, 2015,31(7):604-607.
[15]张一,姚秋近,陈超,等.蒙特利尔认知评估量表在筛查颅脑创伤患者认知障碍中的应用研究[J].中华老年医学杂志, 2014, 33(7):729-732.
[16] de Guise E, Alturki A Y, LeBlanc J, et al. The Montreal Cognitive Assessment in persons with traumatic brain injury[J]. Appl Neuropsychol Adult, 2014, 21(2):128-135.
[17] Wilson B, Cockburn J, Baddeley A, et al. The development and validation of a test battery for detecting and monitoring everyday memory problems[J]. J Clin Exp Neuropsychol, 1989, 11(6):855-870.
[18] Kucukdeveci A A, Kutlay S, Elhan A H, et al. Construct validity and reliability of the Rivermead Behavioural Memory Test in the Turkish population[J]. Brain Inj, 2008, 22(1):75-82.
[19] Hynes S, Shiel A. Validating an Irish-language version of the Rivermead Behavioural Memory Test-Second Edition[J]. Br J Occup Ther,2014, 77(4):198-204.
[20]刘晶京,恽晓平.汉化版Rivermead为记忆测验第3版的信度和效度[J].中国康复理论与实践, 2016, 22(5):511-513.
[21] Fong K N K, Lee K K L, Tsang Z P Y, et al. The clinical utility, reliability and validity of the Rivermead Behavioural Memory Test-Third Edition(RBMT-3)in Hong Kong older adults with or without cognitive impairments[J]. Neuropsychol Rehabil, 2017, 29(1):144-159.
[22] Vakil E, Kraus A, Bor B, et al. Impaired skill learning in patients with severe closed-head injury as demonstrated by the serial reaction time(SRT)task[J]. Brain Cogn, 2002, 50(2):304-315.
[23] Skidmore E R. Training to optimize learning after traumatic brain injury[J]. Curr Phys Med Rehabil Rep, 2015, 3(2):99-105.
[24] Paxton J, Chiaravalloti N. Rule monitoring ability predicts eventbased prospective memory performance in individuals with TBI[J]. J Int Neuropsychol Soc, 2014, 20(7):673-683.
[25] Sawamura D, Ikoma K, Ogawa K, et al. Clinical utility of neuropsychological tests for employment outcomes in persons with cognitive impairment after moderate to severe traumatic brain injury[J]. Brain Inj,2018, 32(13-14):1670-1677.
[2] Ihara M, Okamoto Y, Takahashi R. Suitability of the Montreal Cognitive Assessment versus the Mini-Mental State Examination in detecting vascular cognitive impairment[J]. J Stroke Cerebrovasc Dis, 2013, 22(6):737-741.
[3] Monti J M, Voss M W, Pence A, et al. History of mild traumatic brain injury is associated with deficits in relational memory, reduced hippocampal volume, and less neural activity later in life[J]. Front Aging Neurosci, 2013, 5:41.
[4] McGinn M J, Povlishock J T. Pathophysiology of traumatic brain injury[J]. Neurosurg Clin N Am, 2016, 27(4):397-407.
[5] Peters M E. Traumatic brain injury(TBI)in older adults:aging with a TBI versus incident TBI in the aged[J]. Int Psychogeriatr, 2016, 28(12):1931-1934.
[6] LoBue C, Denney D, Hynan L S, et al. Self-reported traumatic brain injury and mild cognitive impairment:increased risk and earlier age of diagnosis[J]. J Alzheimers Dis, 2016, 51(3):727-736.
[7] LoBue C, Woon F L, Rossetti H C, et al. Traumatic brain injury history and progression from mild cognitive impairment to Alzheimer disease[J]. Neuropsychology, 2018, 32(4):401-409.
[8] de Guise E, Leblanc J, Champoux M C, et al. The mini-mental state examination and the Montreal Cognitive Assessment after traumatic brain injury:an early predictive study[J]. Brain Inj, 2013, 27(12):1428-1434.
[9] Arevalo-Rodriguez I, Smailagic N, RoquéI Figuls M, et al. Mini-Mental State Examination(MMSE)for the detection of Alzheimer's disease and other dementias in people with mild cognitive impairment(MCI)[J]. Cochrane Database Syst Rev, 2015(3):CD010783.
[10] Lee S H, Cho A, Min Y K, et al. Comparison of the Montreal Cognitive Assessment and the Mini-Mental State Examination as screening tests in hemodialysis patients without symptoms[J]. Ren Fail, 2018, 40(1):323-330.
[11] Lim M Y L, Loo J H Y. Screening an elderly hearing impaired population for mild cognitive impairment using Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)[J]. Int J Geriatr Psychiatry, 2018, 33(7):972-979.
[12] Webber D, Collins M, DeFilippis N, et al. Reliability of the Clinical Dementia Rating with a traumatic brain injury population:a preliminary study[J]. Appl Neuropsychol Adult, 2013, 20(2):145-151.
[13] Srivastava A, Rapoport M J, Leach L, et al. The utility of the MiniMental Status Exam in older adults with traumatic brain injury[J].Brain Inj, 2006, 20(13-14):1377-1382.
[14]张一,姚秋近,陈超.蒙特利尔认知评估量表对简易精神状态量表得分正常的颅脑创伤患者的认知功能评价[J].中华创伤杂志, 2015,31(7):604-607.
[15]张一,姚秋近,陈超,等.蒙特利尔认知评估量表在筛查颅脑创伤患者认知障碍中的应用研究[J].中华老年医学杂志, 2014, 33(7):729-732.
[16] de Guise E, Alturki A Y, LeBlanc J, et al. The Montreal Cognitive Assessment in persons with traumatic brain injury[J]. Appl Neuropsychol Adult, 2014, 21(2):128-135.
[17] Wilson B, Cockburn J, Baddeley A, et al. The development and validation of a test battery for detecting and monitoring everyday memory problems[J]. J Clin Exp Neuropsychol, 1989, 11(6):855-870.
[18] Kucukdeveci A A, Kutlay S, Elhan A H, et al. Construct validity and reliability of the Rivermead Behavioural Memory Test in the Turkish population[J]. Brain Inj, 2008, 22(1):75-82.
[19] Hynes S, Shiel A. Validating an Irish-language version of the Rivermead Behavioural Memory Test-Second Edition[J]. Br J Occup Ther,2014, 77(4):198-204.
[20]刘晶京,恽晓平.汉化版Rivermead为记忆测验第3版的信度和效度[J].中国康复理论与实践, 2016, 22(5):511-513.
[21] Fong K N K, Lee K K L, Tsang Z P Y, et al. The clinical utility, reliability and validity of the Rivermead Behavioural Memory Test-Third Edition(RBMT-3)in Hong Kong older adults with or without cognitive impairments[J]. Neuropsychol Rehabil, 2017, 29(1):144-159.
[22] Vakil E, Kraus A, Bor B, et al. Impaired skill learning in patients with severe closed-head injury as demonstrated by the serial reaction time(SRT)task[J]. Brain Cogn, 2002, 50(2):304-315.
[23] Skidmore E R. Training to optimize learning after traumatic brain injury[J]. Curr Phys Med Rehabil Rep, 2015, 3(2):99-105.
[24] Paxton J, Chiaravalloti N. Rule monitoring ability predicts eventbased prospective memory performance in individuals with TBI[J]. J Int Neuropsychol Soc, 2014, 20(7):673-683.
[25] Sawamura D, Ikoma K, Ogawa K, et al. Clinical utility of neuropsychological tests for employment outcomes in persons with cognitive impairment after moderate to severe traumatic brain injury[J]. Brain Inj,2018, 32(13-14):1670-1677.