Neuropsychological evaluation of the child
Neuropsychological evaluation of the child
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儿童的神经心理学评估
DOI：
10.1002/ana.20046
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发表时间：
2004
影响因子：
11.2
通讯作者：
L. Speedie
中科院分区：
文献类型：
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作者：
L. Speedie
轻度认知障碍是第一次对轻度认知障碍（MCI）的各个方面进行全面回顾，MCI是一种临床综合征，在这十年中迅速成为神经科医生面临的主要临床挑战之一。MCI是一个有争议的概念：它本身是一种疾病状态，还是仅仅是阿尔茨海默病的早期阶段，或者在概念上最好被视为阿尔茨海默病的高风险状态，或者是一个短暂的标签，注定是过于模糊，模糊和异质性？临床神经学家肯定会被要求看到越来越多的老年患者出现越来越轻微的记忆丧失，这通常是由于公众越来越意识到阿尔茨海默病是一种现在可以治疗的疾病。如果目前的胆碱酯酶抑制剂（如多奈哌齐）在MCI中的试验产生积极的结果，MCI患者的流动可能会变成洪流！仅仅因为这个原因，轻度认知障碍应该引起社区和学术神经学家以及老年病学家和老年精神病学家的极大兴趣。彼得森召集了一批强大的作家来涵盖MCI问题的各个方面。一个优秀的第一部分解决了复杂的临床和概念问题周围的MCI和公正地提出了概念在其历史框架。Petersen承认，围绕正常衰老和痴呆之间的这种过渡状态存在相当大的困惑，并讨论了主要的影响因素，MCI患者的异质性，研究参与者的不同来源，关于“正常衰老”的界限的不确定性，以及使用不同的评级量表进行诊断。有强有力的章节解决各种神经精神综合征，目前在早期广告（由杰夫卡明斯）和详细的审查病理和神经影像学的MCI状态和早期阿尔茨海默氏病。此外，还有一组由来自马约诊所（史密斯和伊夫尼克）、锡拉丘兹大学和阿尔伯特·爱因斯坦大学（斯利温斯基、利普顿、布施克和瓦西雷辛）的神经心理学家撰写的章节，讨论了我们如何定义老年人认知功能中的“正常”这一关键问题。复杂的神经心理学方法的潜力“海岸我们”的有效性MCI强调。虽然外行人可能会觉得这两章关于认知老化的内容很难阅读，但这两章将引起痴呆症专家的兴趣，并有效地证明MCI需要神经学家和心理学家的互补技能。最终，神经学家希望我们能有简单的预测测试，表明哪些老年人在生活中会患上阿尔茨海默病（沿着可以预防这种疾病的有效疗法）。然而，在此之前，MCI代表了一个过渡区，它可能越来越多地成为疾病的目标：修改AD的药物。任何阅读轻度认知障碍的神经科医生都将为MCI的大量出现做好充分的准备
Mild Cognitive Impairment represents the first cohesive review of all aspects of mild cognitive impairment (MCI), a clinical syndrome which is rapidly emerging as one of the major clinical challenges to neurologists in this decade. MCI is a controversial concept: is it a disease state of its own, or simply an earlier stage of Alzheimer’s disease, or conceptionally best viewed as a high-risk state for Alzheimer’s disease, or a transient label that will be doomed as being too vague, fuzzy, and heterogeneous? Clinical neurologists are certainly being asked to see increasing numbers of elderly patients with increasingly mild degrees of memory loss, often driven by a growing public awareness of Alzheimer’s disease as a now treatable condition. This flow of MCI patients could turn into a torrent if current trials of cholinesterase inhibitors such as donepezil in MCI yield positive results! For this reason alone, Mild Cognitive Impairment should be of considerable interest to both community and academic neurologists as well as geriatricians and geriatric psychiatrists. Petersen has assembled a strong set of writers to cover all aspects of the MCI question. An excellent first section addresses the complex clinical and conceptual problems surrounding MCI and fairly presents the concept in its historical framework. Petersen acknowledges that there is considerable confusion surrounding this transition state between normal aging and dementia and discusses the main contributing factors, the heterogeneity of patients with MCI, the different sources of study participants, uncertainty regarding the limits of “normal aging,” and the use of different rating scales for diagnosis. There are strong chapters addressing the varied neuropsychiatric syndromes that present in early AD (by Jeff Cummings) and detailed reviews of the pathology and neuroimaging of the MCI state and early Alzheimer’s disease. In addition, there are a set of chapters by neuropsychologists from the Mayo Clinic (Smith and Ivnik) and Syracuse and Albert Einstein Universities (Sliwinski, Lipton, Buschke, and Wasylyshyn) addressing the crucial issue of how we can define “normality” in the cognitive functioning of the elderly. The potential of sophisticated neuropsychological approaches to “shore us” the validity of MCI is emphasized. Although the uninitiated may find these two chapters on cognitive aging hard reading, the chapters will intrigue dementia specialists and effectively demonstrate that complementary skills of neurologists and psychologists are needed in MCI.Ultimately, neurologists hope we will have simple predictive tests that will indicate which elderly individuals will develop Alzheimer’s disease during life (along with effective therapies that can prevent this). Until such time, however, MCI represents the transitional zone which is likely to increasingly become the target for disease: modifying medications for AD. Any neurologist reading Mild Cognitive Impairment will be well prepared for the multitude of MCI