Brief cognitive assessment for patients with cerebral small vessel disease
Brief cognitive assessment for patients with cerebral small vessel disease
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DOI：
10.1136/jnnp.2004.045963
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发表时间：
2005-08-01
影响因子：
11
通讯作者：
Markus, HS
中科院分区：
文献类型：
--
作者：
O'Sullivan, M;Morris, RG;Markus, HS
背景：脑小血管疾病是认知功能障碍和血管性痴呆的常见原因。认知障碍与阿尔茨海默病不同，执行/注意功能障碍更严重，情节记忆相对完整。目的：开发更适合脑小血管疾病神经心理学特征的简明评估工具。方法：32名50~84岁的缺血性脑白质疏松患者和17名年龄和教育程度匹配的对照组进行了简短的执行评估，评估时间为20分钟，并进行了广泛的附加测试。结果：简明执行评估对缺血性脑白质疏松症的诊断具有良好的灵敏度和特异度(灵敏度88%，特异度88%，采用最佳评分组合)。最好的单项测验是连线测验和数字符号测验，两者都比简易精神状态检查(MMSE)敏感得多。在患有MMSE>；27的受试者和整个年龄段的受试者中，区分不同群体的能力保持不变。简明执行评估与整个测试相比表现良好，额外的测试仅解释了组间差异的12%。结论：简短执行评估对缺血性脑白质疏松的缺陷很敏感，并将其与健康老龄化的认知影响区分开来。该评估具有床边使用的潜力，并可作为临床试验的认知终点。
Background: Cerebral small vessel disease is a common cause of cognitive impairment and vascular dementia. The cognitive deficit differs from that in Alzheimer's disease, with greater executive/ attentional dysfunction and relatively intact episodic memory.Objective: To develop brief assessment tools that are better adapted to the neuropsychological profile of cerebral small vessel disease.Methods: 32 subjects with ischaemic leukoaraiosis ( history of lacunar stroke and leukoaraiosis on MRI), aged 50 to 84 years, and 17 age and education matched controls had a brief executive assessment, which took 20 minutes to administer, and a wide range of additional tests. The ability of the brief executive assessment to discriminate between groups - both individually and in combination - was evaluated and compared with that of the whole battery.Results: The brief executive assessment provided good sensitivity and specificity for identifying subjects with ischaemic leukoaraiosis ( sensitivity 88%, specificity 88%, using the optimal combination of scores). The best individual tests were trail making and digit symbol, which were both far more sensitive than the mini-mental state examination (MMSE). The ability to discriminate between groups was maintained in subjects with MMSE >27 and across the whole age range. The brief executive assessment performed well compared with the whole battery, with additional tests accounting for only a further 12% of between-group variance.Conclusions: The brief executive assessment was sensitive to deficits found in ischaemic leukoaraiosis and discriminated them from the cognitive effects of healthy aging. The assessment has potential for bedside use and as a cognitive end point for clinical trials.