Validation of the NINDS VCI Neuropsychology Protocols

描述(申请人提供)：中风后认知障碍和痴呆症很常见。然而，对伴有血管认知障碍(VCI)的卒中患者进行描述和分类的标准尚不清楚。以前的诊断系统依赖于对血管性痴呆等疾病的共识标准，但这导致了疾病的患病率以及标准的敏感性和特异性不一致，这取决于使用的诊断系统。现在，人们呼吁建立数据驱动的诊断系统，而不是采用一致的标准。2005年4月，NINDS和加拿大卒中网络在华盛顿特区共同主办了一次协调研讨会，通过在神经心理学、神经成像、流行病学、病理学和实验研究领域开发标准方案，促进VCI社区的多中心合作和沟通。希望这些标准方案的使用将导致对VCI进行多点合作研究，这是建立诊断标准、检查潜在机制(如遗传因素)和促进治疗研究所必需的。作为研讨会的一部分，神经心理学工作组建立了三个神经心理学方案，根据完成这些方案所需的时间长度确定：60分钟方案、30分钟方案和5分钟方案。该项目的目的是在100名缺血性中风患者和100名人口统计学上匹配的对照组的多中心样本中测试这些方案的可靠性和有效性。该项目的一个组成部分是通过检查它们与已知神经成像因素的关系来评估神经心理学测试方案的同时有效性，这些因素包括中风病变的大小和位置、皮质下高信号以及大脑萎缩变化的程度。此外，该项目将探索神经心理学测试方案与丘脑体积和扩散张量指数之间的关系，如分数各向异性。可靠和有效的VCI神经心理学测试方案是改善诊断标准和更好地了解VCI的机制和开发新的治疗方案的必要的第一步。

DESCRIPTION (provided by applicant): Cognitive impairment and dementia are common after stroke. However, the criteria with which to describe and categorize stroke patients with vascular cognitive impairment (VCI) are not clear. Previous diagnostic systems have relied upon consensus criteria for conditions such as vascular dementia, but this has led to inconsistencies in the prevalence rate of the condition and the sensitivity and specificity of the criteria, depending upon which diagnostic system is used. Instead of consensus criteria, there is now a call for data- driven diagnostic systems. In April 2005, NINDS and the Canadian Stroke Network co-sponsored a Harmonization Workshop in Washington DC to foster multi-center collaboration and communication in the VCI community by developing standard protocols in the areas of neuropsychology, neuroimaging, epidemiology, pathology, and experimental research. It is hoped that use of these standard protocols will lead to the multi-site, collaborative study of VCI that is necessary to establish diagnostic criteria, examine underlying mechanisms, such as genetic factors, and promote treatment research. As part of the workshop, the Neuropsychology Working Group established three neuropsychology protocols, defined by the length of time necessary to complete them: a 60 Minute Protocol, a 30 Minute Protocol and a Five Minute Protocol. The aim of this project is to test the reliability and validity of these protocols in a multi-center sample of 100 ischemic stroke patients and 100 demographically matched controls. An integral part of the project is to assess the concurrent validity of the neuropsychology test protocols by examining their relationship to known neuroimaging factors, such as the size and location of stroke lesions and subcortical hyperintensities and the extent of cerebral atrophic changes. In addition, the project will explore relationships between the neuropsychology test protocols and both thalamic volumes and diffusion tensor indices, such as fractional anisotropy. Reliable and valid VCI neuropsychology test protocols are a necessary first step to improved diagnostic criteria and a better understanding of both the mechanisms of VCI and the development of new treatment options.