不同病因轻度认知障碍患者神经认知功能障碍的特点

O. Chyniak
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We used the psychometric method and the following scales: the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment Scale (MoCA), the Frontal Assessment Battery (FAB), the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-cog), the Clinical Dementia Rating (CDR); the results were analyzed using the method of statistical processing.\nResults. According to the results of neurocognitive testing, no significant differences were found in the total scores (p = 0.6209), in particular, using the MMSE scale in patients with non-anamnestic (nMCD) and anamnestic (aMCD) мild cognitive disorder and мild cognitive disorder (aMCD). However, patients with nMCD showed significantly lower results with subtests: \"attention and calculation\" (p = 0.0443). According to the MoCA scale, patients with nMCD had a higher score vs. patients with aMCD (p = 0.0457), namely in the \"delayed recall\" subtests (p = 0.0102). 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引用次数: 0

摘要

介绍。轻度认知障碍(MCD)是一种异质性综合征,涉及记忆、语言和思维问题,这些问题不明显,不影响患者的独立性和日常生活。本文考虑了不同病因的轻度认知障碍患者神经认知谱的异同。材料和方法。我们检查了60人:30名年龄在50至83岁之间,患有各种病因的轻度认知障碍,30名相对健康的个体作为对照组。所有患者都接受了脑部磁共振成像(MRI)检查。我们采用心理测量法和以下量表:迷你精神状态检查(MMSE)、蒙特利尔认知评估量表(MoCA)、额叶评估量表(FAB)、阿尔茨海默病评估量表-认知子量表(ADAS-cog)、临床痴呆评分(CDR);结果采用统计处理方法进行分析。神经认知测试结果显示,两组总分差异无统计学意义(p = 0.6209),特别是非遗忘性(nMCD)和遗忘性(aMCD) мild认知障碍和мild认知障碍(aMCD)患者的MMSE量表差异无统计学意义(p = 0.6209)。然而,nMCD患者在“注意力和计算”亚测试中表现出明显较低的结果(p = 0.0443)。根据MoCA量表,nMCD患者比aMCD患者得分更高(p = 0.0457),即在“延迟回忆”子测试中(p = 0.0102)。nMCD患者的“注意与计算”亚测试结果显著低于nMCD患者(p = 0.0468)。根据FAB量表检测结果,MCD患者组间无显著差异(p = 0.4778)。根据ADAS-cog量表的部分子测试,aMCD患者在“单词回忆”测试(p = 0.0069)和“单词识别”测试(p = 0.0350)中表现出较差的结果。在nMCD患者中,“注意力和注意力分散”亚测试(p = 0.0468)、“数字消除任务”(p = 0.0217)和“通过迷宫”(p = 0.0015)的得分较低。aMCD患者的认知能力明显低于nMCD患者。因此,aMCD患者进展为阿尔茨海默病的风险可能很高。通过对神经认知谱数据的比较,我们确定了遗忘性мild认知障碍患者的临床表现为明显的记忆障碍,特别是回忆延迟,而非遗忘性мild认知障碍患者的临床表现为调节性认知障碍(注意力和计算、思维速度降低、活动计划受损)。与MMSE量表相比,MoCA和ADAS-cog评分对轻度认知障碍的检测和鉴别诊断具有更好的诊断准确性和特异性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
FEATURES OF NEUROCOGNITIVE IMPAIRMENTS IN PATIENTS WITH MILD COGNITIVE DISORDER OF DIFFERENT ETIOLOGY
Introduction. Mild cognitive disorder (MCD) is a heterogeneous syndrome that involves problems with memory, speech, and thinking that are inconspicuous and do not affect the patient's independence and daily life. The article considers similarities and differences in the neurocognitive profiles of patients with mild cognitive disorders of various etiologies. Materials and methods. We examined 60 people: 30 subjects aged 50 to 83 years with a mild cognitive disorder of various etiologies and 30 relatively healthy individuals as the control group. All patients underwent a magnetic resonance imaging (MRI) examination of the brain. We used the psychometric method and the following scales: the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment Scale (MoCA), the Frontal Assessment Battery (FAB), the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-cog), the Clinical Dementia Rating (CDR); the results were analyzed using the method of statistical processing. Results. According to the results of neurocognitive testing, no significant differences were found in the total scores (p = 0.6209), in particular, using the MMSE scale in patients with non-anamnestic (nMCD) and anamnestic (aMCD) мild cognitive disorder and мild cognitive disorder (aMCD). However, patients with nMCD showed significantly lower results with subtests: "attention and calculation" (p = 0.0443). According to the MoCA scale, patients with nMCD had a higher score vs. patients with aMCD (p = 0.0457), namely in the "delayed recall" subtests (p = 0.0102). Patients with nMCD had significantly lower results with the "attention and calculation" subtest (p = 0.0468). No significant differences were found between the groups of patients with MCD according to the results of testing with the FAB scale (p = 0.4778). According to some subtests of the ADAS-cog scale, patients with aMCD showed worse results with the "word recall" test (p = 0.0069) and "word recognition" (p = 0.0350). In patients with nMCD, lower scores were observed for the subtests "concentration and distractibility" (p = 0.0468), "number cancellation task" (p = 0.0217), and "passing the labyrinth" (p = 0.0015). Patients with aMCD showed significantly lower cognitive abilities than patients with nMCD. Consequently, patients with aMCD may be significantly at high risk of progression to Alzheimer's disease. Conclusions. After comparing the data of neurocognitive profiles, we established that in patients with anamnestic мild cognitive disorder, the clinical picture presented with a pronounced memory disorder, especially delayed recall, while the patients with non-anamnestic мild cognitive disorder were characterized by regulatory cognitive impairment (attention and calculation, reduced speed of thinking, impaired planning of activities). The MoCA and ADAS-cog scores had better diagnostic accuracy and specificity for the detection and differential diagnosis of mild cognitive disorders than the MMSE scale.
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