Characteristics of Agraphia in Chinese Patients with Alzheimer's Disease and Amnestic Mild Cognitive Impairment.
Characteristics of Agraphia in Chinese Patients with Alzheimer's Disease and Amnestic Mild Cognitive Impairment.
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中国阿尔茨海默病和遗忘性轻度认知障碍患者失写症特征
DOI：
10.4103/0366-6999.184467
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发表时间：
2016-07-05
影响因子：
6.1
通讯作者：
Li HL
中科院分区：
文献类型：
--
作者：
Zhou J;Jiang B;Huang XH;Kong LL;Li HL
阿尔茨海默病(AD)患者的写作能力呈进行性下降。大多数关于AD失写的研究都是在字母系统中进行的，比如英语。然而，这些发现可能不适用于其他书面语言系统。中国文字的独特性可能会影响中国AD患者的失写模式。本研究旨在探讨中国人阿尔茨海默病(AD)和遗忘性轻度认知障碍(a-MCI)患者书写错误的特点及其与神经心理功能的关系。在这项研究中，我们对17名AD患者、14名a-MCI患者和16名老年健康对照组进行了观察性研究。我们分析了这些受试者的写作错误，并研究了他们的写作错误与神经心理功能的关系。我们的研究表明，在母语为汉语的患者中，书写能力在MCI期相对较好地保存下来，但当疾病发展到AD阶段时，书写能力显著受损。无论是错误类型还是出现率，写作错误都随着认知衰退的严重程度而相应增加。对写作错误的分析表明，单词替换和生僻单词是三个研究组中最常见的错误类型。阿尔茨海默病组的难词发生率显著高于非认知功能障碍组(P=0.024)和对照组(P=0.018)。此外，AD组(P=0.013)和a-MCI组(P=0.037)的单词替换发生率也显著高于对照组。而完全无反应、视空间障碍、段落失写、表意文字、持久性书写错误等错误仅见于AD组。此外，我们还发现AD组中视觉结构错误的发生率很高(13.3%)。我们的研究证实，失写是AD患者的一个重要特征。与使用字母语言系统的患者相比，母语为中文的患者的书写错误特征是独特的。
Patients with Alzheimer's disease (AD) manifest progressive decline in writing abilities. Most studies on agraphia in AD have been performed in the alphabetic system, such as English. However, these findings may not be applicable to other written language systems. The unique features of the Chinese written script could affect the patterns of agraphia in Chinese AD patients. The aim of this study was to explore the features of writing errors in Chinese patients with AD and amnestic mild cognitive impairment (a-MCI), as well as to study the relationship between their writing errors and neuropsychological functions. In this study, we performed an observational study in a group of subjects including 17 AD patients, 14 patients with a-MCI, and 16 elderly healthy controls. We analyzed the writing errors in these subjects and also studied the relationship between their writing errors and neuropsychological functions. Our study showed that in patients whose mother tongue is Chinese, writing ability was comparatively well preserved in the MCI phase but significantly impaired when the disease progressed to the stage of AD. The writing errors showed corresponding increase with the severity of cognition decline, both in the types of errors and rate of occurrence. Analysis of the writing errors showed that word substitution and unintelligible words were the most frequent error types that occurred in all the three study groups. The occurrence rate of unintelligible words was significantly higher in the AD group compared with the a-MCI group (P = 0.024) and control group (P = 0.018). In addition, the occurrence rates of word substitution were also significantly higher in AD (P = 0.013) and a-MCI groups (P = 0.037) than that of control group. However, errors such as totally no response, visuospatial impairment, paragraph agraphia, ideograph, and perseverative writing errors were only seen in AD group. Besides, we also found a high occurrence rate of visuoconstructional errors (13.3%) in our AD group. Our study confirmed that agraphia is an important feature in patients with AD. The writing error profile in patients whose native language is Chinese was unique compared to patients using the alphabetic language system.