Mild cognitive impairment is associated with characteristic neuropsychiatric symptoms
Mild cognitive impairment is associated with characteristic neuropsychiatric symptoms
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DOI：
10.1097/00002093-200401000-00004
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发表时间：
2004-01-01
影响因子：
2.1
通讯作者：
Cummings, JL
中科院分区：
文献类型：
--
作者：
Hwang, TJ;Masterman, DL;Cummings, JL
轻度认知障碍（MCI）已成为一种可识别的病症，在很多情况下是可诊断的阿尔茨海默病（AD）之前的过渡状态。遗忘型MCI的神经生物学和神经影像学特征已得到研究，但全面的神经精神病学研究报道较少。这项初步研究的目的是确定遗忘型MCI的神经精神病学特征，并将其与轻度AD和正常对照组进行比较。使用神经精神量表（NPI）对三个年龄和教育程度相当的组（即28名MCI患者、124名轻度AD患者和50名正常受试者）的神经精神症状进行评估。对MCI患者与其他两组之间的10种NPI症状的各个子分数和NPI总分进行了比较。这项初步调查的结果显示，MCI患者经常表现出神经精神症状。MCI组最常见的症状是烦躁不安（39%）、冷漠（39%）、易怒（29%）和焦虑（25%）。MCI组和对照组在冷漠、烦躁不安、易怒、焦虑、躁动和异常运动行为方面存在显著差异；相比之下，与轻度AD相比，妄想在MCI中明显不太常见。MCI组和对照组在NPI总分上存在显著差异（p = 0.001），但MCI组和轻度AD组之间无显著差异（p = 0.304）。遗忘型MCI与显著的神经精神症状相关，尤其是情绪障碍和冷漠。精神病性症状在AD早期比在MCI中明显更常见。这些结果来自有限的临床样本，需要在基于社区的纵向调查中进行验证。
Mild cognitive impairment (MCI) has emerged as an identifiable condition and in many cases is a transitional state preceding diagnosable Alzheimer disease (AD). Neurobiological and neuroimaging characteristics of amnestic-type MCI have been investigated, but few comprehensive neuropsychiatric studies have been reported. The aim of this preliminary study was to define the neuropsychiatric features of the amnestic-type MCI and compare them with those of mild AD and normal controls. The Neuropsychiatric Inventory (NPI) was used to assess the neuropsychiatric symptoms in three age and education comparable groups, i.e., 28 MCI, 124 mild AD, and 50 normal subjects. Individual subscores of the 10 NPI symptoms and total NPI scores were compared between the MCI patients and the other 2 groups. The results of this preliminary investigation showed that MCI patients frequently manifested neuropsychiatric symptoms. The most common symptoms in the MCI group were dysphoria (39%), apathy (39%), irritability (29%), and anxiety (25%). There were significant differences in apathy, dysphoria, irritability, anxiety, agitation, and aberrant motor behavior between the MCI and control groups; in contrast, only delusions were significantly less common in MCI compared with mild AD. There was a significant difference between the MCI and control groups on total NPI scores (p = 0.001), but not between the MCI and mild AD groups (p = 0.304). Amnestic MCI is associated with significant neuropsychiatric symptoms, especially mood disturbances and apathy. Psychotic symptoms are significantly more common in the early stage of AD than in MCI. These results are derived from a limited clinical sample and require confirmation in longitudinal community-based investigations.