神经行为认知状态测验（NCSE）的信度和效度研究
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摘要
目的：汉化《神经行为认知状态测验》(NCSE)，并进行信度、效度的检验，以证实其临床价值，并将该量表与《简易精神状态检查法》(MMSE)进行对比，初步了解两者的异同。方法：1、将英文版的NCSE翻译成中文，经过“互译”、校对和修改后，用于健康受测者，建立常模；并用于的脑损伤患者，以检验信度和效度；2、将脑血管意外患者分为右侧脑损害、左侧脑损害和双侧多发脑损害三组，检验NCSE对不同侧脑损害的鉴别度；3、对其中34例患者用NCSE及MMSE进行评估，对两量表的评估结果进行对比分析。结果：1、汉化后的《神经行为认知状态测验》(NCSE)信度效度满意；2、NCSE对区分不同侧脑损伤的价值有限；3、用MMSE及NCSE同时评估的34例患者中，前者的阳性率为61％，而后者的阳性率为91％。结论：1、NCSE是一个可靠、值得推广的第二代认知功能筛查量表；2、与MMSE比较，NCSE对认知功能障碍的评估更敏感，而且提供的信息更具体全面。
Objective: 1 . To test reliability and validity of the neurobehavioral cognitive status examination(NCSE)of mandarin version; 2. Comparing NCSE with MMSE , to study if the two scales have any difference. Method: 1 . After translated and back-translated the NCSE of English version, then made some changes in some terms of NCSE. Used the modified NCSE of mandarin version in both healthy subjects and neurological inpatient to establish norms of Chinese and to test reliability and validity; 2. We divided 46 inpatients into tree group: left unilateral stroke . right unilateral stroke and bilateral stroke, and used NCSE in the three group to study the differentiation NCSE ; 3. We used the MMSE and NCSE to test 34 inpatients at the same time , and compared the results . Results: 1 - The NCSE of mandarin version had not only satisfying reliability but also satisfying validity ; 2. The differentiation of NCSE was limited in our study, further study was recommended . 3. When used MMSE and NCSE to test 34 patients , the MMSE had a positive rate: 61%, whereas the NCSE had a positive rate: 91%. conclusion:1. The NCSE is a reliable second-generation cognitive screening exam which worthy to spread use in clinical. 2. Compared with MMSE , the NCSE was more sensitive in assessment of cognitive impairment, and could offer more information for doctor.
Objective: 1 . To test reliability and validity of the neurobehavioral cognitive status examination(NCSE)of mandarin version; 2. Comparing NCSE with MMSE , to study if the two scales have any difference. Method: 1 . After translated and back-translated the NCSE of English version, then made some changes in some terms of NCSE. Used the modified NCSE of mandarin version in both healthy subjects and neurological inpatient to establish norms of Chinese and to test reliability and validity; 2. We divided 46 inpatients into tree group: left unilateral stroke . right unilateral stroke and bilateral stroke, and used NCSE in the three group to study the differentiation NCSE ; 3. We used the MMSE and NCSE to test 34 inpatients at the same time , and compared the results . Results: 1 - The NCSE of mandarin version had not only satisfying reliability but also satisfying validity ; 2. The differentiation of NCSE was limited in our study, further study was recommended . 3. When used MMSE and NCSE to test 34 patients , the MMSE had a positive rate: 61%, whereas the NCSE had a positive rate: 91%. conclusion:1. The NCSE is a reliable second-generation cognitive screening exam which worthy to spread use in clinical. 2. Compared with MMSE , the NCSE was more sensitive in assessment of cognitive impairment, and could offer more information for doctor.
引文
1．范晓华，刘燧．成人脑外伤认知与功能性独立的关系．国外医学物理医学与康复学分册，15(2)：71-72．
2. Caplan B. Neuropsychology in Rehabilitation: It's role in evaluation and intervention. Arch Phys Med Rehabilitation. 1982,63:362.
3．朱幼丽．认知功能障碍对脑卒中预后的影响．江苏医药，1999，25(11)：835-836．
4. Depaulo JR, Folstein MF. Psychiatric disturbances in neurological patients: detection, recognition, and hospital course, Ann neurol. 1978, 4:2225-2228.
5. Vonammon Cavanaugh S. The prevalence of emotional and cognitive dysfunction in a general medical population: using the MMSE, GHQ, and BDI. Gen Hosp Psychiatry. 1983,5:15-24.
6. Croog SH, Levine S, Testa MA, et al. The effects of antihypertensive therapy on the quality of life. N Engl J Med. 1986, 314: 1657-1664.
7. Abramowicz M, ed. Drugs that cause psychiatric symptoms. Med Lett Drugs Ther. 1986, 28: 81-86.
8. Thompson PJ, Trimble MR. Anticonvulsant drugs and cognitive functions. Epilepsia. 1982, 23: 531-544.
9. Van Dyke C, Mueller J, Kieman RJ. The case for psychiatrist as authorities on cognition. Psychiatry. 1987, 28: 87-89.
10. Plum F. Dementia: an approaching epidemic. Nature. 1979, 279: 372-373.
11. Terry RD, Katzman R. Senile Dementia of the Alzheimer type. Ann Neurol.
1983,14：497-506．
12．汤慈美，主编．神经心理学，北京：人民军医出版社，2001．342-345．
13. Northem Califomia Neurobehavioral Group, Inc. Manual for the Neurobehavioral Cognitive Status Examination. Fairfax, CA. 2001.
14．张瑛，陈俊宁．脑卒中认知功能的神经心理学评估．国外医学脑血管疾病分册，1996，4(4)：220—223．
15．林崇德，主编．心理测量学．北京：人民教育出版社，2001．52-86．
16．彭凯平，主编．心理测验．原理与实践．北京：华夏出版社，1989．67-76．
17．南登昆，主编．康复医学．北京：人民卫生出版社，2001．84-88．
18. Ralph J. Kieman. Ph.D. et al. The Neurobehavioral Cognitive Status Examination: a brief but quantitative a, pproach to cognitive assessment. Ann Intern Med, 1987, Oct, 107(4): 481-485.
19．林果为，沈福民，主编．现代临床流行病学．上海：复旦大学出版社，2001, 232-236．
20. Schwamm LH, Van Dyke C, et al. The Neurobehavioral Cognitive Status Examination: Comparison with the Cognitive Capacity Screening Examination and the Mini-Mental State Examination in a neurosurgical population. Annals of Internal Medicine, 1987, 107(4): 486-491.
21. Albert, M.S., Heller, H.S, et al. Changes in naming ability with age. Psychology and Aging, 1988, 3:173-178.
22. Botwinick, J. Neurology of aging. Handbook of clinical neuropsychology. New York: John wiley, 1981,135-171.
23. Cunningham,W.R. Intellectual abilities and age. Annual review of gerontology and geriatrics. New York: Springer. 1987, 7: 117-134.
24. Stankov, L. Aging, attention, and intelligence. Psychology and Aging, 1988, 3: 59-74.
25．王荪，蒲道学，主编．临床神经心理学，昆明：云南科技出版社，
1990,48-49.
26. Osmon DC,Smet. IC, Winegarden B,Gandhavadi B. Neurobehavioral Cognitive Status Examination: Its use with unilateral Stroke Patients in a rehabilitation Setting. Arcb Phys Med Rehabil, 1992, 73: 414-418.
27. Rothlind. JC. Evaluating Cognitive dysfunction in Community geriatric Patients using the neurobehavioral Cognitive status Examination. Poster presented at the 1995 Annual Meeting of the American psychological Association, Division of Neuropsychology, New York, NY. 1995, August 11, 40.
28. Craig VD, Jonathan M, et al. The case for psychiatrist as authorities on cognition. Cognition. 1987. vol 28.2:87-89.
29. Feinberg TD, Farah MJ. Behavioral Neurology and Neuropsychology. 北京：世界图书馆出版公司，2000，25-35．
2. Caplan B. Neuropsychology in Rehabilitation: It's role in evaluation and intervention. Arch Phys Med Rehabilitation. 1982,63:362.
3．朱幼丽．认知功能障碍对脑卒中预后的影响．江苏医药，1999，25(11)：835-836．
4. Depaulo JR, Folstein MF. Psychiatric disturbances in neurological patients: detection, recognition, and hospital course, Ann neurol. 1978, 4:2225-2228.
5. Vonammon Cavanaugh S. The prevalence of emotional and cognitive dysfunction in a general medical population: using the MMSE, GHQ, and BDI. Gen Hosp Psychiatry. 1983,5:15-24.
6. Croog SH, Levine S, Testa MA, et al. The effects of antihypertensive therapy on the quality of life. N Engl J Med. 1986, 314: 1657-1664.
7. Abramowicz M, ed. Drugs that cause psychiatric symptoms. Med Lett Drugs Ther. 1986, 28: 81-86.
8. Thompson PJ, Trimble MR. Anticonvulsant drugs and cognitive functions. Epilepsia. 1982, 23: 531-544.
9. Van Dyke C, Mueller J, Kieman RJ. The case for psychiatrist as authorities on cognition. Psychiatry. 1987, 28: 87-89.
10. Plum F. Dementia: an approaching epidemic. Nature. 1979, 279: 372-373.
11. Terry RD, Katzman R. Senile Dementia of the Alzheimer type. Ann Neurol.
1983,14：497-506．
12．汤慈美，主编．神经心理学，北京：人民军医出版社，2001．342-345．
13. Northem Califomia Neurobehavioral Group, Inc. Manual for the Neurobehavioral Cognitive Status Examination. Fairfax, CA. 2001.
14．张瑛，陈俊宁．脑卒中认知功能的神经心理学评估．国外医学脑血管疾病分册，1996，4(4)：220—223．
15．林崇德，主编．心理测量学．北京：人民教育出版社，2001．52-86．
16．彭凯平，主编．心理测验．原理与实践．北京：华夏出版社，1989．67-76．
17．南登昆，主编．康复医学．北京：人民卫生出版社，2001．84-88．
18. Ralph J. Kieman. Ph.D. et al. The Neurobehavioral Cognitive Status Examination: a brief but quantitative a, pproach to cognitive assessment. Ann Intern Med, 1987, Oct, 107(4): 481-485.
19．林果为，沈福民，主编．现代临床流行病学．上海：复旦大学出版社，2001, 232-236．
20. Schwamm LH, Van Dyke C, et al. The Neurobehavioral Cognitive Status Examination: Comparison with the Cognitive Capacity Screening Examination and the Mini-Mental State Examination in a neurosurgical population. Annals of Internal Medicine, 1987, 107(4): 486-491.
21. Albert, M.S., Heller, H.S, et al. Changes in naming ability with age. Psychology and Aging, 1988, 3:173-178.
22. Botwinick, J. Neurology of aging. Handbook of clinical neuropsychology. New York: John wiley, 1981,135-171.
23. Cunningham,W.R. Intellectual abilities and age. Annual review of gerontology and geriatrics. New York: Springer. 1987, 7: 117-134.
24. Stankov, L. Aging, attention, and intelligence. Psychology and Aging, 1988, 3: 59-74.
25．王荪，蒲道学，主编．临床神经心理学，昆明：云南科技出版社，
1990,48-49.
26. Osmon DC,Smet. IC, Winegarden B,Gandhavadi B. Neurobehavioral Cognitive Status Examination: Its use with unilateral Stroke Patients in a rehabilitation Setting. Arcb Phys Med Rehabil, 1992, 73: 414-418.
27. Rothlind. JC. Evaluating Cognitive dysfunction in Community geriatric Patients using the neurobehavioral Cognitive status Examination. Poster presented at the 1995 Annual Meeting of the American psychological Association, Division of Neuropsychology, New York, NY. 1995, August 11, 40.
28. Craig VD, Jonathan M, et al. The case for psychiatrist as authorities on cognition. Cognition. 1987. vol 28.2:87-89.
29. Feinberg TD, Farah MJ. Behavioral Neurology and Neuropsychology. 北京：世界图书馆出版公司，2000，25-35．