轻度认知功能障碍患者的神经心理学研究

目的 探讨轻度认知功能障碍(MCI)患者神经心理学的特点. 方法 对42例MCI患者和55例健康对照者进行多项神经心理学检查,包括简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、临床痴呆评定量表(CDR)、语言流畅性测验(RVR)、韦氏智力测验(WAIS-RC)包括数字广度测验(DS)、积木测验(BD)、相似性测验]、韦氏记忆测验(WMS-R)(包括逻辑记忆、联想学习、视觉再认、图片回忆)、日常生活能力量表(ADL),比较2组患者上述量表评分和MMSE、MoCA量表各亚项评分的差异.结果 与对照者比较,MCI患者MMSE、MoCA总分和RVR、WAIS-RC、WMS-R分测验,MoCA量表各亚项(地点定向力除外),MMSE量表中计算与注意、延迟回忆两亚项评分较低,差异均有统计学意义(P<0.05).结论 MCI患者不仅记忆受损,其计算与注意力、命名、视空间结构能力、执行功能也可受损,尤以延迟回忆、计算与注意力受损明显.MoCA涵盖了重要的认知领域,能较全面评估MCI患者的认知功能,值的临床推广应用.

A neuropsychological study of patients with mild cognitive impairment

Objective To explore the neuropsychological features of patients with mild cognitive impairment (MCI). Methods Forty-two patients with MCI and 50 normal controls were examined with a series of neuropsychoiogieai tests. These test included mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), clinical dementia rating scale (CDR), rapid verbal retrieve (RVR), activity of daily living scale (ADL), Wechsler intelligence scale (WAIS-RC) and its sub-tests (digit spanDS], blocks design test BD], similarity test), Wechsler memory scale (WMS-R) and its sub-tests (logical memory, associative learning, visual recognition, picture recall). The difference of these data were compared and analyzed. Results The patients with MCI had significantly lower MMSE total score, MoCA total score, RVR score, WAIS-RC score and its sub-tests scores, WMS-R score and its sub-test scores than healthy controls (P<0.05), but no significant differences were found between the 2 groups in ADL score (P>0.05). For the MoCA sub-items, the patients with MCI had significantly lower scores than healthy controls in all the cognitive function measures except fixed orientation (P<0.05). Conclusions In addition to memory impairment, naming, visuospatial ability and executive function may also be impaired in patients with MCI; delayed recall, calculation and attention are obviously impaired in patients with MCI. MoCA, covering the important cognitive domains, can comprehensively assess the cognitive functions of patients with MCI and has its value in the clinical application.