影响癫痫患者智力状况的多因素分析

目的：探讨影响癫痫患者智力状况的主要因素。方法：用韦氏儿童智力量表（ＷＩＳＣ－ＣＲ）和韦氏成人智力量表（ＷＡＩＳ－ＲＣ）以２０５名５￣６０岁的癫痫患者进行智力测试并对结果与影响和的因素进行分析,结果：癫痫患者ＦＩＱ均分为８７．７４±２３．６７,智力低下者为２０％。逐步回归分析提示影响患者语言智商（ＶＩＱ）的主要因素依次为文化程度低、低年龄、无职业、有脑病史及药物治疗效果差;影响患者操作智商（ＰＩＱ     

癫痫患者智力及个性研究

癫痫患者智力及个性研究何及栾清明何任丁福忠李玉梅我们从１９９６年２月至１９９７年１０月，采用韦氏智力量表（ＷＡＩＳ－ＲＣ［１］，ＷＩＳＣ－ＲＣ［２］）和艾森克个性问卷（ＥＰＱ［３］）对１１４例癫痫患者与５４３名（儿童４２１名，成人１２２名）正常人的智...     

卡马西平对癫痫患者染色体畸变率和姐妹染色单体交换频率的影响及与叶酸的

目的 研究卡马西平（ＣＢＺ）的诱变性及其与叶酸的关系,探讨ＣＢＺ致畸及叶酸防止致畸的机制。方法 应用细胞遗传学方法,检测１５例单服ＣＢＺ及１５例ＣＢＺ加叶酸的癫痫患者外周血淋巴细胞染色体畸变率（ＣＡＲ）、姐妹染色单体交换（ＳＣＥ）频率,同时用放免法测定血清叶酸含量,并与未服药癫痫对照组及正常对照组进行比较。结果 单服ＣＢＺ组患者的ＣＡＲ和ＳＣＥ频率较对照组增高,其血清叶酸含量较正常对照组下降;单服ＣＢＺ组患者的ＣＡＲ和ＳＣＥ频率较服ＣＢＺ加叶酸组增高;ＣＢＺ血药浓度与叶酸水平ＣＡＲ及ＳＣＥ之间未发现明显相关性。结论 ＣＢＺ具有ＤＮＡ损伤效应,其损伤效应可能与ＣＢＺ干扰叶酸代谢有关,补充叶酸可以有效防止ＣＢＺ引起的ＤＮＡ损伤。     

脑卒中患者智能测试方法的比较

目前在临床上所采用的智能测试方法大多针对严重智力损害痴呆患者，而且在其有效性和操作可行性方面也存在一定的局限［１］。本文通过对３３例脑卒中患者先后做韦氏成人智力量表（ＷＡＩＳ－Ｒ）、韦氏记忆量表（ＷＡＭＳ－Ｒ）、长谷川痴呆量表（ＨＤＳ）结果的比较分析...     

CISA在老年痴呆患者中的应用

目的：探讨中国成人智力量表（ＣＩＳＡ）在老年痴呆患者中的临床应用价值。方法：采用ＣＩＳＡ、韦氏记忆量表（ＷＭＳ）、简易智力状态检查（ＭＭＳＥ）、老年抑郁量表（ＧＤＳ）、长谷川痴呆量表（ＨＤＳ）和日常生活能力量表（ＡＤＬ）等分别用于测验老年痴呆组和正常老年组。结果：两组被试在ＣＩＳＡ各量表分、智商和因素商均有明显差异,老年痴呆组的ＣＩＳＡ各量表分与ＷＭＳ的ＭＱ、ＧＤＳ、ＨＤＳ和ＡＤＬ均有明显相关。结论：ＣＩＳＡ在应用于老年痴呆患者中具有较高的效度,能够反映患者的智力状部和智力因素的各个方面,他们学习新知识和解决问题的能力下降速度较快。     

癫痫患者智能障碍与事件相关电位P300的探讨

应用韦氏成人智力量表（ＷＡＩＳ－ＲＣ）及事件相关电位（ＥＲＰ，Ｐ３００）对癫痫患者的智能损害进行评价，发现总智商（ＦＩＱ）低于正常者占４８．４８％，而Ｐ３００异常率为５１．６％。影响因素分析表明：发作频度越高，抗癫痫药物（ＡＥＤｓ）越多，病程越长，初发年龄越小，脑电图（ＥＥＧ）改变越重，其智能的损害越严重。其中发作频度对智能障碍影响最大，ＡＥＤｓ次之。Ｐ３００与癫痫各级的智能（ＦＩＱ）关系表明，Ｐ３００有可能成为反映癫痫患者智能障碍动态变化的客观指标之一。     

Huntington病的智能障碍

用修订韦氏成人智力量表（ＷＡＩＳ—ＲＣ）检查两个Ｈｕｎｔｉｎｇｔｏｎ病（ＨＤ）家族中部分患者，其亲属（有患病危险成员）及健康对照组。结果表明，除ＨＤ患者智商明显低下外，有患病危险成员的智商比年龄和文化匹配的对照组显著性低（Ｐ＜０．００１），对其中一个家族追踪１０年，发现该家族的大多数ＨＤ患者中，大多数智能减退比舞蹈症症状的出现要早。     

首发精神分裂症的认知功能与阴,阳性症状和抗精神病药物效应的关系

目的 探讨首发精神分裂症认知功能与阴、阳性症状和抗精神病药物效应的关系。方法 对７８例精神分裂症患者给予氯丙嗪或氯氮平治疗,于治疗前及治疗１２周末各作一次Ｗｉｓｃｏｎｓｉｎ卡片分类测验（ＷＣＳＴ）、韦氏成人智力量表（ＷＡＩＳＲ）、韦氏记忆量表（ＷＭＳ）、语言流利性测验等。另外,４５例正常人也做了上述测验。结果 首发精神分裂症患者存在广泛的认知功能障碍,上述则查结果均较正常对照组差,尤以ＷＣＳＴ明显     

血管性痴呆和脑梗塞患者载脂蛋白E基因多态性的分析比较

目的探讨ＡＰＯＥ多态性与血管性痴呆（ＶＤ）和脑梗塞（ＣＩ）的关系。方法应用ＰＣＲ－ＲＦＬＰ技术分析２０例ＶＤ、２４例ＣＩ及２４例健康老年人的ＡＰＯＥ基因型。结果ＶＤ和ＣＩ患者ε３频率均降低（Ｐ＜０．０５），ε４频率均升高（Ｐ＜０．０５），而两组患者间各等位基因频率差异均无统计学意义（Ｐ＞０．０５）；且ε４与血清ＡＰＯＥ、ＡＰＯＢ、ＴＣ、ＬＤＬ－Ｃ正相关，与ＡＰＯＡ、ＨＤＬ－Ｃ负相关。结论ＡＰＯＥ多态性与ＶＤ和ＣＩ的发病机制有关，其在这两种疾病中的作用可能相似。     

WISC—cRs与WISC—cR临床应用对比分析

本文对３２５例初一学生进行韦氏智力量表测试，将测得的１２个分测验的原始分，分别应用上海常模（ＷＩＳＣ－ＣＲｓ）和全国常模（ＷＩＳＣ－ＣＲ）查出量表分、言语、操作智商和总智商，并对二常模的各结果进行对比分析。结果表明，上海常模明显严于全国常模，全国常模得出的量表分和智商高于上海常模。     

Sex interaction of white matter microstructure and verbal IQ in corpus callosum in typically developing children and adolescents

BackgroundChildhood is an extremely important time for neural development that has a critical role in human intelligence. Efficient information processing is crucial for higher intelligence, so the intra- or inter-hemispheric interaction is vital. However, the relationship between neuroanatomical connections and intelligence in typically developing children, as well as sex differences in this relationship, remains unknown.MethodsParticipants were 253 typically developing children (121 boys and 132 girls) aged 5–18. We acquired diffusion tensor imaging data and intelligence using an age-appropriate version of the IQ test; Wechsler Intelligence Scale for Children (WISC) or Wechsler Adult Intelligence Scale (WAIS). We conducted whole-brain multiple regression analysis to investigate the association between fractional anisotropy (FA), which reflects white matter microstructural properties, and each composite score of IQ test (full-scale IQ, performance IQ, and verbal IQ).ResultsFA was positively correlated with full-scale IQ in bilateral inferior occipitofrontal fasciculus, genu, and splenium of corpus callosum (CC). FA in the right superior longitudinal fasciculus, bilateral inferior longitudinal fasciculus, and splenium of CC were also positively correlated with performance IQ. Furthermore, we found significant sex interaction between FA in the CC and verbal IQ. FA was positively correlated in boys, and negatively correlated in girls.ConclusionResults suggest that efficient anatomical connectivity between parietal and frontal regions is crucial for children’s intelligence. Moreover, inter-hemispheric connections play a critical role in verbal abilities in boys.     

情感障碍对癫患者认知障碍影响的事件相关电位研究

目的应用事件相关电位研究和探讨不同抗癫痫药对癫痫患者认知功能的影响以及情感障碍对癫痫患者认知障碍的影响。方法收集湛江中心人民医院神经内科门诊和住院的癫痫患者320例,正常对照组56例。分别进行韦氏智能测定和情感测定,同时结合抗抑郁剂治疗,并应用事件相关电位P300、N400研究,对比分析癫痫患者认知功能和情感障碍的特征。结果386例癫痫患者中,认知水平低于正常者达76．940。结果显示丙戊酸钠、妥泰、卡马西平单药服药组之间认知水平无差异,但药物联合应用认知功能损害严重。且患者职业、文化程度、病程、发作次数、用药选择以及是否存在脑部继发性疾病等对认知功能影响显著。伴随着认知功能和情感障碍,癫痫患者P300和N400潜伏期明显延长、波幅降低。百忧解治疗后R300和N400潜伏期和波幅明显改善,且颞顶叶脑区的波幅明显升高。结论抗癫痫药可造成癫痫患者认知功能的损害,单药应用较联合用药对癫痫患者认知功能损害轻。抗抑郁治疗可改善癫痫患者的认知功能,认知事件相关电位也明显改善。     

Comparison of WAIS and WAIS-R scores of mildly and moderately mentally retarded adults

The Wechsler Adult Intelligence Scale (WAIS) and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) were administered to 29 mildly and moderately mentally retarded adults. The WAIS Verbal and Full Scale IQs were significantly lower than were corresponding WAIS-R IQs. This difference is an exception to the general pattern of IQs being higher for tests that were standardized earlier. The present results suggest that WAIS-R IQs will be much higher than WISC-R IQs.     

癫痫患者智能状况与事件相关电位P300的研究

目的探讨癫痫患者智能状况、事件相关电位P300(ERP P300)的特点及ERP P300对癫痫患者智能状况的评定价值.方法对40例癫痫患者进行智商及ERP P300测定.结果40例癫痫患者中总智商FIQ≤89者14例,占35%;P300异常者16例,占40%.癫痫智能障碍组的VIQ、PIQ、FIQ、P300 PL分别与智能正常组及正常对照组比较,均具有显著性差异(P<0.01).且癫痫患者P300PL与VIQ、PIQ、FIQ呈负相关.结论癫痫患者易发生智能损害,且智能损害无选择性.智力量表和ERPP300二种检测方法对评判癫痫患者智能障碍具有良好的一致性,而ERP P300能更早期、更客观、快捷、准确地评价癫痫患者智能状况.     

Intelligence or years of education: which is better correlated with memory function in normal elderly Japanese subjects?

Background: We compared differences in intelligence and memory function between normal elderly Japanese subjects with more years of education and those with fewer years of education. We also investigated clinical and neuropsychological factors that are strongly correlated with memory function. Methods: There were 118 normal elderly subjects who underwent the Mini‐Mental State Examination, Wechsler Adult Intelligence Scale, 3rd edition (WAIS‐III), and Wechsler Memory Scale Revised. Subjects with at least 13 years of education were categorized as the H group, and those with 12 years of education or less were categorized as the L group. Results: Age and Mini‐Mental State Examination scores were not significantly different between the two groups. On the WAIS‐III, there were significant differences between the two groups in Verbal IQ and Full Scale IQ. On the Wechsler Memory Scale Revised, there were significant differences between the two groups in Visual Memory, General Memory, and Delayed Recall. Correlation coefficients between memory function and the other factors demonstrated significant but weak correlations between years of education and General Memory (R = 0.22) and between years of education and Delayed Recall (R = 0.20). Strong correlations were found between Verbal IQ and Verbal Memory (R = 0.45), between Verbal IQ and General Memory (R = 0.49), between Full Scale IQ and General Memory (R = 0.50) and between Full Scale IQ and Delayed Recall (R = 0.48). Conclusions: In normal elderly Japanese subjects, years of education weakly correlated with memory function while Verbal IQ, Full Scale IQ and Verbal Comprehension on WAIS‐III had stronger correlations with memory function. Verbal IQ and Verbal Comprehension on WAIS‐III were found to be insusceptible to the cognitive decline characteristic of Alzheimer's disease or amnestic mild cognitive impairment. Therefore, verbal intelligence, as measured by Verbal IQ and Verbal Comprehension, may be the most useful factor for inferring premorbid memory function in Alzheimer's disease or amnestic mild cognitive impairment patients.     

Intellect declines in healthy elderly subjects and cerebellum

Scores of the performance scale of the Wechsler Adult Intelligence Scale (WAIS) declined linearly with age from the 6th decade, whereas those of the verbal scale did not. This decrease in performance intelligence was thought to be related to an age-related frontal atrophy. The relationship between scores of the WAIS and changes in regional cortical gray matter density were examined in healthy elderly subjects using voxel-based morphometry. Thirty healthy non-demented individuals >50 years of age were tested with the WAIS and scanned with brain magnetic resonance imaging (MRI). The right neocerebellum was significantly associated with scores of the performance intelligence scale while frontal lobes were not. The current study suggests that the cerebellum may play an important role in changes of intellectual capacity in old age.     

Fine tuning of the digit symbol paired associate recall test for practitioner purposes in clinical and research settings

Guidelines are presented to facilitate the use of the WAIS Digit Symbol measure of paired associate recall as a neuropsychological instrument. Currently three formal variants of the test exist with accompanying normative data (the original WAIS-R-NI form; a WAIS-R Short Form; a longer WAIS-III form), providing a potential source of confusion which may limit its application. To circumvent this, the present article critically evaluates: (i) variations in test forms and their advantages; (ii) available norms in terms of age and education, with pointers for more differentiated guidelines in this regard; and (iii) the desirability of incorporating a delayed recall variant of the test. Finally, a synopsis of data is presented that supports the screening potential of Digit Symbol paired associate recall in cases of mild neurocognitive dysfunction. For the purposes of this paper, the term WAIS is used with broad reference to all variations of the original Wechsler Adult Intelligence Scale (1955) upon which they were based, including the WAIS-R (1981) and WAIS-III (1997) updated editions, and the South African WAIS (1969). The terms South African WAIS (South African Wechsler Adult Intelligence Scale), WAIS-R (Wechsler Adult Intelligence Scale - Revised), and WAIS-III (Wechsler Adult Intelligence Scale-III), refer to these specific versions of the test.     

CARBAMAZEPINE (TEGRETOL) AS AN ANTICONVULSANT A CONTROLLED DOUBLE-BLIND COMPARISON WITH DIPHENYLHYDANTOIN (DILANTIN)

A large double blind crossover study of carbamazepine (CBZ) in comparison to diphenylhydantoin (DPH) is underway, and the results are presented for the first 20 patients to complete the protocol. The importance of preparatory steps is outlined – beginning with the gathering of preliminary kinetic data about half-life and peak-time in epileptic patients. A detailed pilot study was performed with open administration of the agents and hospitalization during the crossover. Detailed blood level monitoring and dose-equivalence calculations lead to the design of blind crossover protocol from the pilot study.
Of the 20 patients reported on at this point, 12 had fewer seizures on CBZ, but 4 of these preferred DPH because of the CBZ side effects. Of the 8 having fewer seizures on DPH, 3 preferred CBZ – leading to a final disposition of 11 on CBZ and 9 on DPH. Mean serum levels were 34.1 μg/ml for DPH and 10.6 μg/ml for CBZ. The patients having fewer seizures on DPH had higher serum DPH levels than those doing better on CBZ, but the opposite was found for the CBZ levels. The implications of this difference are discussed. Over all, DPH and CBZ are effective anticonvulsants of the same general magnitude, but individual patient responses to effects and side-effects will influence their usefulness in any given case.     

Intelligence in children with moyamoya disease: evaluation after surgical treatments with special reference to changes in cerebral blood flow

The effect of surgical treatment upon the intelligence of 20 children with moyamoya disease was evaluated and related to changes in cerebral blood flow (CBF). The patients were treated by various surgical revascularization procedures, mainly by encephalo-myo-synangiosis. Intelligence was tested using the Wechsler intelligence scale for children (WISC) in 19 children and the Wechsler adult intelligence scale (WAIS) in one child. Measurements of regional CBF were performed by a 133Xe inhalation method. In the preoperative state, the degree of reduction in the intelligence quotient (IQ) correlated well with the age of the patients; the older patients revealed a more marked reduction of IQ, and the patients with lower intelligence scores in general showed a tendency for more marked depression of mean CBF. Postoperatively, most of the patients showed increase in IQ, especially in performance IQ which improved significantly in 10 patients, remained unchanged in 3 and deteriorated in 2. Mean CBF increased by an average of 11.4%, and postoperative changes in mean CBF correlated well with the changes in IQ in most patients. This may show that the postoperative increase in CBF is quite possibly responsible for the changes in IQ.     

Use of the Wechsler Adult Intelligence Scale Digit Span subtest for malingering detection: a meta-analytic review

Twenty-four studies utilizing the Wechsler Adult Intelligence Scale (WAIS) Digit Span subtest--either the Reliable Digit Span (RDS) or Age-Corrected Scaled Score (DS-ACSS) variant--for malingering detection were meta-analytically reviewed to evaluate their effectiveness in detecting malingered neurocognitive dysfunction. RDS and DS-ACSS effectively discriminated between honest responders and dissimulators, with average weighted effect sizes of 1.34 and 1.08, respectively. No significant differences were found between RDS and DS-ACSS. Similarly, no differences were found between the Digit Span subtest from the WAIS or Wechsler Memory Scale (WMS). Strong specificity and moderate sensitivity were observed, and optimal cutting scores are recommended.