相似性测验在诊断轻度认知损害和阿尔茨海默病的效用研究
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摘要
目的:分析相似性测验在识别轻度认知损害(mild cognitive impairment,MCI)和阿尔茨海默病(Alzheimer’s disease,AD)的价值。方法:该研究纳入125例单纯遗忘型MCI、160例多领域损害遗忘型MCI患者,139例AD患者,132例正常对照者,均进行包含有相似性测验(similarities test,ST)的全套神经心理学测试,其中简易精神状态量表(mini-mental state examination,MMSE)和听觉词语测验(auditory-verbal learning test,AVLT)用于初步筛查,根据筛查结果再进一步评估检查。相似性测验包含13个项目,每条项目按0、1、2三级计分,最高分26分。结果:4个测试组的总分进行比较,结果提示有统计学差异(r=0.15～0.47,P<0.01)。相似性测验得分与语言相关的测试如动物言语流畅性(animal fluency test,AFT)、波士顿命名(Boston naming test,BNT)得分有显著相关性。相似性测验得分(26分制划界分12分)用于识别AD的ROC曲线下面积0.881(P<0.01,95%CI=0.842～0.920)。结论:13个项目的相似性测验可用于检测语言相关的认知功能和识别单纯遗忘型MCI、多领域损害遗忘型MCI和AD患者。
Objectives:To evaluate the value of similarities test(ST) in the diagnosis of mild cognitive impairment(MCI) and Alzheimer's disease(AD). Methods:One hundred and twenty-five patients with amnestic MCI-single domain(aMCI-SD),160 patients with amnestic MCI-multiple domain(aMCI-MD),139 AD patients,and 132 normal controls were all evaluated by a complete set of neuropsychological tests including ST. Among these tests,mini-mental state examination(MMSE)and auditory-verbal learning test(AVLT)were used for preliminary screening,and further evaluation and examination were carried out according to the screening results. The similarities test consisted of 13 items,and each item was scored at three levels:0,1 and 2,with a maximum score of 26.Results:The total scores of the four groups were then compared,and the results showed that there were significant differences(r=0.15-0.47,P<0.01). ST scores were found to have a significant correlation with the scores of tests reflecting language function such as animal fluency test and Boston naming test(BNT). The area under the ROC curve of ST score(total score:26;cut-off score:12)for the diagnosis of AD was 0.881(95% confidence interval:0.842-0.920,P<0.01). Conclusion:ST with 13 items can be used to test language-related cognitive function and is effective for identifying aMCI-SD,aMCI-MD,and AD patients.
Objectives:To evaluate the value of similarities test(ST) in the diagnosis of mild cognitive impairment(MCI) and Alzheimer's disease(AD). Methods:One hundred and twenty-five patients with amnestic MCI-single domain(aMCI-SD),160 patients with amnestic MCI-multiple domain(aMCI-MD),139 AD patients,and 132 normal controls were all evaluated by a complete set of neuropsychological tests including ST. Among these tests,mini-mental state examination(MMSE)and auditory-verbal learning test(AVLT)were used for preliminary screening,and further evaluation and examination were carried out according to the screening results. The similarities test consisted of 13 items,and each item was scored at three levels:0,1 and 2,with a maximum score of 26.Results:The total scores of the four groups were then compared,and the results showed that there were significant differences(r=0.15-0.47,P<0.01). ST scores were found to have a significant correlation with the scores of tests reflecting language function such as animal fluency test and Boston naming test(BNT). The area under the ROC curve of ST score(total score:26;cut-off score:12)for the diagnosis of AD was 0.881(95% confidence interval:0.842-0.920,P<0.01). Conclusion:ST with 13 items can be used to test language-related cognitive function and is effective for identifying aMCI-SD,aMCI-MD,and AD patients.
引文
[1]Taylor MJ,Heaton RK.Sensitivity and specificity of WAIS-III/WMS-Ⅲdemographically corrected factor scores in neuropsychological assessment[J].J Int Neuropsychol Soc,2001,7(7):867-874.
[2]Dubois B,Slachevsky A,Litvan I,et al.The FAB:a frontal assessment battery at bedside[J].Neurology,2000,55(11):1621-1626.
[3]Lin KN,Wang PN,Liu CY,et al.Cutoff scores of the cognitive abilities screening instrument,Chinese version in screening of dementia[J].Dement Geriatr Cogn Disord,2002,14(4):176-182.
[4]Nasreddine ZS,Phillips NA,Bédirian V,et al.The Montreal Cognitive Assessment,MoCA:a brief screening tool for mild cognitive impairment[J].J Am Geriatr Soc,2005,53(4):695-699.
[5]Winblad B,palmer K,Kivipelto M,et al.Mild cognitive impairment-beyond controversies,towards a consensus:report of the international working group on mild cognitive impairment[J].Intern Med,2004,256(3):240-246.
[6]Mckhann G,Drachman D,Folstein M,et al.Clinical diagnosis of Alzheimers’s disease:report of the NINCDS-ADRDA working group under the auspices of department of health and human services task force on Alzheimers’s disease[J].Neurology,1984,34(7):939-944.
[7]徐俊,张颖冬.阿尔茨海默病新的NINCDS-ADRDA诊断标准介绍[J].诊断学理论与实践,2009,8(4):367-371.
[8]Folstein SE,McHugh PR.“Mini-mental state”.A practical method for grading cognitive state of patients for clinician[J].J Psychiatr Res,1975,12(3):189-198.
[9]Kataman R,Zhang MY,Ouang YQ,et al.A Chinese version of the Mini-Mental State Examination;impact of illiteracy in a Shanghai dementia survey[J].J Clin Epidemiol,1988,41(10):971-978.
[10]郭起浩,孙一忞,袁晶,等.8种执行功能测验在上海社区老年人中的应用[J].中国行为医学科学,2007,16(7):628-631.
[11]陆骏超,郭起浩,洪震,等.连线测验(中文修订版)在早期识别阿尔茨海默病中的作用[J].中国临床心理学杂志,2006,14(2):118-121.
[12]郭起浩,洪震,吕传真,等.Stroop色词测验在早期识别阿尔茨海默病中的作用[J].中华神经医学杂志,2005,4(7):701-704.
[13]郭起浩,吕传真,洪震.听觉词语记忆测验在中国老人中的试用分析[J].中国心理卫生杂志,2001,15(1):13-16.
[14]郭起浩,吕传真,洪震.Rey-Osterrieth复杂图形测验在中国正常老人中的应用[J].中国临床心理学杂志,2008,8(4):205-207.
[15]郭起浩,洪震.神经心理评估[M].2版.上海:上海科学技术出版社,2013:80-194.
[16]Neyens V,Bruffaerts R,Liuzzi AG,et al.Representation of semantic similarity in the left intraparietal sulcus:functional magnetic resonance imaging evidence[J].Front Hum Neurosci,2017,4(11):402.
[17]Beltrami D,Gagliardi G,Rossini Favretti R,et al.Speech analysis by natural language processing techniques:a possible tool for very early detection of cognitive decline?[J].Front Aging Neurosci,2018,13(10):369.
[18]Yang L,Mo L.The effects of similarity on high-level visual working memory processing[J].Adv Cogn Psychol,2017,13(4):296-305.
[2]Dubois B,Slachevsky A,Litvan I,et al.The FAB:a frontal assessment battery at bedside[J].Neurology,2000,55(11):1621-1626.
[3]Lin KN,Wang PN,Liu CY,et al.Cutoff scores of the cognitive abilities screening instrument,Chinese version in screening of dementia[J].Dement Geriatr Cogn Disord,2002,14(4):176-182.
[4]Nasreddine ZS,Phillips NA,Bédirian V,et al.The Montreal Cognitive Assessment,MoCA:a brief screening tool for mild cognitive impairment[J].J Am Geriatr Soc,2005,53(4):695-699.
[5]Winblad B,palmer K,Kivipelto M,et al.Mild cognitive impairment-beyond controversies,towards a consensus:report of the international working group on mild cognitive impairment[J].Intern Med,2004,256(3):240-246.
[6]Mckhann G,Drachman D,Folstein M,et al.Clinical diagnosis of Alzheimers’s disease:report of the NINCDS-ADRDA working group under the auspices of department of health and human services task force on Alzheimers’s disease[J].Neurology,1984,34(7):939-944.
[7]徐俊,张颖冬.阿尔茨海默病新的NINCDS-ADRDA诊断标准介绍[J].诊断学理论与实践,2009,8(4):367-371.
[8]Folstein SE,McHugh PR.“Mini-mental state”.A practical method for grading cognitive state of patients for clinician[J].J Psychiatr Res,1975,12(3):189-198.
[9]Kataman R,Zhang MY,Ouang YQ,et al.A Chinese version of the Mini-Mental State Examination;impact of illiteracy in a Shanghai dementia survey[J].J Clin Epidemiol,1988,41(10):971-978.
[10]郭起浩,孙一忞,袁晶,等.8种执行功能测验在上海社区老年人中的应用[J].中国行为医学科学,2007,16(7):628-631.
[11]陆骏超,郭起浩,洪震,等.连线测验(中文修订版)在早期识别阿尔茨海默病中的作用[J].中国临床心理学杂志,2006,14(2):118-121.
[12]郭起浩,洪震,吕传真,等.Stroop色词测验在早期识别阿尔茨海默病中的作用[J].中华神经医学杂志,2005,4(7):701-704.
[13]郭起浩,吕传真,洪震.听觉词语记忆测验在中国老人中的试用分析[J].中国心理卫生杂志,2001,15(1):13-16.
[14]郭起浩,吕传真,洪震.Rey-Osterrieth复杂图形测验在中国正常老人中的应用[J].中国临床心理学杂志,2008,8(4):205-207.
[15]郭起浩,洪震.神经心理评估[M].2版.上海:上海科学技术出版社,2013:80-194.
[16]Neyens V,Bruffaerts R,Liuzzi AG,et al.Representation of semantic similarity in the left intraparietal sulcus:functional magnetic resonance imaging evidence[J].Front Hum Neurosci,2017,4(11):402.
[17]Beltrami D,Gagliardi G,Rossini Favretti R,et al.Speech analysis by natural language processing techniques:a possible tool for very early detection of cognitive decline?[J].Front Aging Neurosci,2018,13(10):369.
[18]Yang L,Mo L.The effects of similarity on high-level visual working memory processing[J].Adv Cogn Psychol,2017,13(4):296-305.