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1.
长春西汀对认知功能障碍的疗效观察   总被引:29,自引:3,他引:26  
目的:探讨长春西汀对恢复期精神裂症患者认知功能障碍的治疗作用。方法:对31例疗效已达显著进步以上的精神分裂症患者,随机分为研究组(16例)和对照组(15例),在予长春西汀治疗前、后、对两组患者分别评定其认知障碍及脑血流状况,进行分析。结果:研究组治疗前后有显著好转,而对照组差异无显著性。结论:长春西汀对改善精神分裂症患者的认知障碍有益。  相似文献
2.
OBJECTIVES: Mild cognitive impairment (MCI) has been suggested as a term for a boundary area between normal aging and dementia, especially Alzheimer's disease (AD). In follow-up studies, more than 50% of MCI subjects have been converted to dementia in 3-4 years. However, the epidemiology of MCI is not well known. This study was designed to determine the prevalence of MCI in an elderly population. METHODS: A total of 806 subjects (60-76 years of age) from a population-based random sample of 1150 subjects living in the city of Kuopio in eastern Finland were evaluated. Neuropsychological tests and a structured interview including the modified Clinical Dementia Rating (CDR) were used to apply the diagnostic criteria of MCI as proposed by Mayo Clinic Alzheimer's Disease Research Centre. Thus, subjects having a test score more than 1.5 SDs below the age appropriate mean in memory tests and a CDR score of 0.5 but no dementia, were diagnosed as having MCI. RESULTS: A total of 43 subjects, 5.3%, met the MCI criteria. MCI was more prevalent in older and less-educated subjects, but no difference was found between men and women. The CDR appeared to be the most important part of the criteria. The memory tests had less impact on prevalence variables. CONCLUSIONS: The low prevalence of MCI indicate that in a population-based study design its criteria may identify a more homogeneous group of subjects at the lower end of the cognitive continuum as contrasted with various other criteria of cognitive impairment in the elderly population. This is compatible with follow-up studies showing a high probability of dementia in the MCI group. Thus, probable candidates for trials of preventive intervention for dementia can be screened from the elderly population using these diagnostic criteria.  相似文献
3.
Defining dementia: clinical criteria for the diagnosis of vascular dementia   总被引:14,自引:0,他引:14  
The recognition of cerebrovascular disease (CVD) as a contributing factor and a cause of dementia has led to the development of clinical criteria for vascular dementia (VaD). Due to high specificity, the consensus criteria developed by the National Institute for Neurological and Communicative Disorders and Stroke (NINDS)–Association Internationale pour la Recherche et l'Enseignement en Neurosciences (AIREN) have been used in controlled clinical trials to select patients with pure VaD. VaD is predominantly a subcortical frontal form of dementia with prominent executive dysfunction. In contrast, the criteria of the NINCDS–Alzheimer's Disease and Related Disorders Association (ADRDA) emphasize memory loss as the main feature to distinguish Alzheimer's disease (AD) from VaD and from other forms of dementia. Moreover, CVD may precipitate the clinical expression of AD. Although no criteria have been created specifically for patients having AD with CVD, the ischemic score, the Informant Questionnaire on Cognitive Decline in the Elderly and a history of prestroke mild cognitive impairment (MCI) may be useful for identifying patients with this mixed form of dementia.  相似文献
4.
We investigated retrieval and encoding of episodic memory in normal aging and patients with mild cognitive impairment (MCI). There was significant decline in the function of orientation, language and praxis besides memory impairment in the MCI group. Impairment of encoding and retrieval of episodic memory was observed in the MCI group. Encoding of episodic memory is vulnerable to be impaired in the MCI group.  相似文献
5.
轻度认知功能障碍的神经心理学和脑血流灌注研究   总被引:13,自引:4,他引:9  
目的 用神经心理学和脑血流灌注检查探讨轻度认知功能障碍 (MCI)特点 ,分析其与阿尔茨海默病 (AD)和健康衰老的差异。方法 对 2 1例MCI ,18例AD和 19例健康老人进行简易智力状态检查 (MMSE) ,日常生活能力量表(ADL)和总体衰退量表 (GDS)评定 ,韦克斯勒记忆测验 (WMS)及SPECT检查。SPECT结果作半定量分析 (以放射性计数比值 -RAR表示 )。结果 认知功能评定结果 :与健康老人相比 ,MCI除ADL成绩外 ,其余均显著降低 ;与AD相比 ,MMSE、ADL、GDS以及WMS中的短时记忆和语言记忆成绩均显著优于AD(P <0 0 5 )。脑血流灌注比较结果 :MCI组与健康老人各部位的RAR无差异 ;与AD组相比 ,扣带回、左基底节、左枕叶、右颞上回、双侧额叶、双侧颞下回和双侧顶叶RAR均显著增高 (P <0 0 5 )。以顶叶RAR为变量作聚类分析产生两类MCI(MCI 4和MCI 16) ,MCI 16在左丘脑的血流灌注低于健康老人(P <0 0 1) ,在双侧颞下回和右颞上回高于AD(P <0 0 1)。结论 MCI为一组异质性疾病 ,认知功能缺损和脑血流灌注的改变均存在多种类型。顶叶能对MCI进行有效分类。  相似文献
6.
The aim of this study was to assess the therapeutic efficacy of the serotonin norepinephrine reuptake inhibitor (SNRI), milnacipran, on both cognitive impairment and depression in post-stroke depression (PSD) patients. A total of 18 PSD patients, approximately 3 months after stroke, were divided into two groups, milnacipran and control. A total of 10 patients were assigned to the milnaciprane group and eight were assigned to control group. Their cognitive impairment and mood symptoms were measured using the Mini-Mental State Examination (MMSE) and Hamilton Depression Rating Scale (HAM-D) both at the time of admission and at discharge, an interval of approximately 3 months. This study examined the changes in both MMSE and HAM-D scores during the study period. A significant time-by-group interaction for results of the MMSE was observed, although there was no significant difference between the two groups on the HAM-D. Amelioration of cognitive impairment was greater in the milnacipran group than the control group. For PSD patients, milnacipran is effective in improving cognitive dysfunction.  相似文献
7.
帕金森病患者的抑郁与认知功能障碍   总被引:12,自引:4,他引:8  
目的探讨帕金森病(PD)患者的抑郁与认知功能障碍之间的关系。方法对60名PD患者和38名对照组进行抑郁和认知功能评定。结果PD组HAMD均分(16.8±0.6),对照组(7.2±2.8);PD组的认知功能与对照组相比下降;PD并抑郁患者的认知功能与PD并非抑郁患者的认知功能相比有显著性差异(P<0.05)。结论PD患者存在抑郁与认知功能障碍,抑郁可能是导致认知功能下降的重要因素。  相似文献
8.
Amygdala, hippocampus and six cortical gyri were examined for the Lewy body (LB) degeneration and Alzheimer’s disease (AD) type changes in 45 patients with Parkinson’s disease (PD). For detection of LBs, the brain areas were stained with an antibody against alpha-synuclein. The extent of neuropathological lesions was investigated in relation to cognitive dysfunction and apolipoprotein E (apoE) ɛ4 allele dosage. At least one cortical LB was found in 95% of cases (43/45). Furthermore, 40% of cases (18/45) had histological findings of definite AD (CERAD class C). Those PD cases with the apoE ɛ4 allele had a significantly greater number of cortical LBs than those without the apoE ɛ4 allele, but this was statistically significant only in precentral, angular and temporal gyri. The LB density correlated better with the number of plaques than with the density of tangles. The number of LBs in several cortical areas correlated significantly with the cognitive impairment. In stepwise linear regression analysis, the number of LBs in the cingulate gyrus and the amount of tangles in the temporal cortex remained statistically significant. When the CERAD class C was excluded, the correlation between cognitive decline and the number of LBs in cortical areas became even more pronounced. A stepwise linear regression analysis in these cases found the number of LBs in the frontal gyrus to be the statistically most significant predictor of cognitive impairment. This study shows, for the first time, that in PD, alpha-synuclein-positive cortical LBs are associated with cognitive impairment independent of AD-type pathology. Received: 20 August 1999 / Revised, accepted: 4 November 1999  相似文献
9.
To determine whether the medial temporal lobe is atrophic in subjects with mild cognitive impairment, and whether atrophy of this structure is a better predictor of dementia than memory dysfunction. Forty-five noninstitutionalized subjects aged 65–85 years were randomly selected from a population based study to obtain a sample with Alzheimer’s disease (AD; n = 7), and a clinically nondemented sample (n = 38). Twenty of the latter subjects displayed some cognitive impairment and fulfilled CAMDEX criteria for “minimal dementia.” Coronal T1-weighted magnetic resonance imaging was used to visualize the medial temporal lobe. The volume of the parahippocampal gyrus and hippocampus was measured, and medial temporal lobe atrophy was assessed qualitatively. The memory subscore from the CAMCOG was used as a measure of memory functioning. The follow-up period was 3 years. Nine subjects who were diagnosed as being minimally demented at baseline met the criteria for AD during follow-up. At baseline the volume of the parahippocampal gyrus of these subjects was smaller than that of the other subjects with minimal dementia. The memory score was the best predictor of clinical outcome. All medial temporal lobe measures increased the accuracy of prediction compared with only the memory score, by reducing the number of false-negative classifications of dementia. Severe medial temporal lobe atrophy is present even in some subjects with mild cognitive impairment and is an indicator of subsequent AD. The absence of medial temporal lobe atrophy, however, does not exclude the development of dementia. In the majority of subjects memory impairment was a better predictor of dementia than atrophy of the medial temporal lobe. The combination of the two increased predictive accuracy. Nondemented subjects with severe atrophy of the medial temporal lobe could be enrolled in drug trials aimed at slowing the progression of AD. Received: 18 June 1998 Received in revised form: 28 September 1998Accepted: 4 November 1998  相似文献
10.
Recent research has identified a transitional state between the cognitive changes of normal aging and Alzheimer's disease (AD), known as mild cognitive impairment (MCI). MCI patients experience memory loss to a greater extent than one would expect for age, yet they do not meet currently accepted criteria for clinically probable AD. An issue currently under investigation is whether MCI represents the preclinical stages of AD or a distinct and static cognitive aetiology. In an attempt to address this issue, the present investigations are adopting a convergent approach to the detection of preclinical AD, where multiple risk factors are considered when making a diagnosis. Currently, one of the most important tools when assessing early cognitive changes is neuropsychological evaluation. MCI subjects typically record neuropsychological performance between that of healthy older individuals and demented patients. Tests assessing new learning, delayed recall and attention/executive function seem to provide valuable information for screening and diagnosis of MCI and early AD if interpreted properly. Recommendations concerning methodological issues and the early management of neuropsychological MCI studies were made.  相似文献
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