Can the 'head-turning sign' be a clinical marker of Alzheimer's disease?
Can the 'head-turning sign' be a clinical marker of Alzheimer's disease?
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“转向符号”可以成为阿尔茨海默氏病的临床标志吗？
DOI：
10.1159/000332605
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发表时间：
2011-01
影响因子：
2.3
通讯作者：
Kinno R
中科院分区：
文献类型：
--
作者：
Fukui T;Yamazaki T;Kinno R
[目的]了解不同类型痴呆患者中“回头头征”的发生率和严重程度，探讨其在阿尔茨海默病(AD)中的临床特点。我们调查了门诊AD患者[125例，包括4例AD+血管性痴呆(VAD)，8例遗忘性轻度认知损害(AMCI)，34例路易体痴呆(DLB)，8例进行性核上性瘫痪(PSP)和6例VAD]患者在接受短期认知测试(修订长谷川痴呆评定量表：HDSR)时HTS的发生率和严重程度。5种疾病组间HTS的发生率、严重程度及HDSR评分差异均有统计学意义。考虑到AD和DLB在后组分析中的显著差异，患者被分为AD相关组(AD和aMCI)和非AD相关组(PSP、DLB和VaD)。阿尔茨海默病相关组的发生率(41vs.17%，p=0.002)和严重程度(0.80vs.0.21vs.0.21±0.60，p=0.001)均显著高于对照组，而平均年龄和高密度脂蛋白反应评分在两组间无显著差异。AD相关疾病、女性和低HDSR评分对HTS的发生和严重程度有显著影响。HTS可以作为AD和aMCI的临床标志，也可以代表一种借口行为，以及对照顾者的依赖和信任的迹象。
To investigate the incidence and severity of the ‘head-turning sign’ (HTS), i.e. turning the head back to the caregiver(s) for help, in patients with various dementias and discuss its clinical specificity in Alzheimer's disease (AD). We investigated the incidence and severity of HTS while administering a short cognitive test (the revised Hasegawa Dementia Rating Scale: HDSR) in outpatients with AD [125 patients, including 4 with AD + vascular dementia (VaD)], 8 with amnestic mild cognitive impairment (aMCI), 34 with dementia with Lewy bodies (DLB), 8 with progressive supranuclear palsy (PSP) and 6 with VaD. Significant differences were found among the 5 disease groups in the incidence and severity of HTS, and HDSR scores. Given the significant differences between AD and DLB in post hoc analyses, patients were dichotomized into AD-related (AD and aMCI) and AD-nonrelated (PSP, DLB and VaD) groups. Both incidence (41 vs. 17%, p = 0.002) and severity of HTS (0.80 ± 1.13 vs. 0.21 ± 0.60, p = 0.001) were significantly higher in the AD-related group, while average age and HDSR scores were comparable between both groups. AD-related disease, female gender and low HDSR score contributed significantly to the occurrence and severity of HTS. HTS can be a clinical marker of AD and aMCI, and may represent a type of excuse behavior as well as a sign of dependency on and trust in the caregivers.