Diagnostic utility of letter fluency, category fluency, and fluency difference scores in Alzheimer's disease
Diagnostic utility of letter fluency, category fluency, and fluency difference scores in Alzheimer's disease
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DOI：
10.1076/clin.16.1.35.8326
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发表时间：
2002-01-01
影响因子：
3.9
通讯作者：
Boeve, BF
中科院分区：
文献类型：
--
作者：
Cerhan, JH;Ivnik, RJ;Boeve, BF
单词生成任务，特别是字母流畅度和类别流畅度，是临床神经心理学家用来测量语言和执行提取功能方面的大多数测试方案的标准部分。鉴于对这些测量作为临床工具的依赖，了解患者表现的诊断意义是重要的。在阿尔茨海默病(AD)中，类别流畅性通常被发现受到不成比例的损害，而字母流畅性通常受到较轻微的损害。有人提出，这种表现模式的出现是因为进入颞叶语义库是类别流畅所必需的，而不是字母流利所必需的。本研究考察了类别流利度、字母流畅度和差值(字母流利度减去类别流利度)对AD的诊断作用。对40例AD患者和221例正常对照进行类别流利性和字母流畅性测试。传统的t检验比较显示，这两个组在两个测试任务和平均差异分数方面存在显著差异。然而，使用敏感度和特异度来计算预测值，只有类别流利性和字母流利性(而不是差异分数)对预测个体的AD有用。此外，在这方面，类别流利性优于字母流利性。似然比表用于计算个别患者产生的特定类别流利度和字母流利度分数的AD的赔率。
Word generation tasks, specifically letter fluency and category fluency, are a standard part of most test protocols used by clinical neuropsychologists to measure aspects of language and executive retrieval functions. Given the reliance on these measures as clinical tools, it is important to understand the diagnostic implications of patients' performances. In Alzheimer's disease (AD), category fluency has generally been found to be disproportionately impaired, whereas letter fluency is usually more mildly impaired. It has been proposed that this performance pattern occurs because access to temporal-lobe semantic stores is necessary for category fluency but not letter fluency. In this study, the diagnostic utility of category fluency, letter fluency, and difference scores (letter fluency minus category fluency) in AD were examined. Forty AD patients and 221 normal control subjects took category fluency and letter fluency tests. Traditional t-test comparisons revealed that the groups differed significantly on the two test tasks and in terms of mean difference scores. However, using sensitivity and specificity to calculate predictive values, only category fluency and letter fluency (but not difference scores) were useful in predicting AD in individuals. Furthermore, category fluency was superior to letter fluency in this regard. Likelihood ratio tables are provided for use in calculating the odds of AD for specific category fluency and letter fluency scores generated by individual patients.