轻度认知损害患者的空间结构能力障碍

目的 研究轻度认知损害(mild cognitive impairment,MCI)患者空间结构能力的缺损与保持状况.方法 将被试者分为3组:健康对照组122名,其中男51名、女71名;MCI组205例,男95例、女110例,其中遗忘型MCI(aMCI)133例,非遗忘型MCI(naMCI)72例;阿尔茨海默病(AD)组75例,男36例、女39例.全部进行Rey-Osterrieth复杂图形测验(CFT)、画钟测验(CDT)、搭火柴测验3个结构能力测验,同时完成简易精神状态量表(MMSE)等测验.健康对照组、MCI组和AD组MMSE平均得分分别为28.24±1.74、27.39±1.83和19.98±3.23.采用SPSS for windows 11.5统计软件,计数资料采用卡方检验,3组间比较采用One-way方差分析,然后采用Bonferroni(LSD)法进行多重比较.结果(1)以健康组为对照,CFT模仿得分和CDT总分与年龄、教育年限没有显著相关性,搭火柴测验-旋转部分(STR)与年龄有相关性(r=-0.179,P＜0.05),与教育年限没有显著相关性.(2)CFT模仿得分与CDT总分(r=0.337)、STR(r=0.232),CDT总分与STR(r =0.235),均有显著相关性(均P＜0.01).(3)CFr模仿和CDT总分分别与反映执行功能的连线测验B、Stroop色词测验卡片C耗时数的相关性最高,而STR与反映记忆的指标听觉词语学习测验的相关性高.CFT模仿、CDT总分和STR在健康对照组、MCI组和AD组之间差异有统计学意义.(4)在识别MCI方面,经过对3组结构测验表现的比较得出STR优于CFT模仿、CDT总分.结论 结构能力损害是MCI的表现之一,空间旋转能力的评估在识别MCI方面优于CFT模仿、CDT总分.

Visuospatial-visuoconstructional ability in mild cognitive impairment

Objective To investigate visuospatial-visuoconstructional ability in patients with mild cognitive impairment(MCI).Methods The subjects were divided into three groups:122(51 males and 71 females)in the normal control group; 205(95 males and 110 females)in the MCI group,including 133 amnestic MCI(aMCI)and 72 non-amnestic MCI(naMCI),and 75(36 males and 39 females)in the Alzheimer' s disease(AD)group.The subjects were assessed for visuospatial-visuoconstructional ability by three tests:Rey-Osterrieth Complement Fixation Test(CFT),Clock Drawing Task(CDT),and Stick Test.Mini-mental State Examination(MMSE)was also performed in all groups.SPSS 11.5 statistical software was used for statistic analysis; Chi-square test was used to analyze enumeration data; One-way analysis of variance was used in pairwise comparison between the groups,and Bonferroni and LSD methods were used for multiple comparison.Results(1)The average MMSE score in the normal control group,MCI group and AD group was 28.24 ± 1.74,27.39 ± 1.83 and 19.98 ±3.23,respectively.(2)In the normal control group,either CFT imitating score or total CDT score had no obvious correlation with age or education,while Stick Test-Rotating part(STR)was correlated with age(r =-0.179,P ＜ 0.05),but had no significant correlation with education.(3)There were correlations between CFT imitating score and total CDT score (r =0.337),CFT imitating score and STR(r =0.232),and total CDT score and STR(r =0.235).The correlations were statistically significant(P ＜ 0.01).(4)CFT imitating and total CDT showed the greatest correlation with Trail Making Test B and Stroop Color Word Test Card C time consumption,an indicator of executive function.STR had greatest correlation with Auditory Verbal Learning Test,an index of memory.There were significant differences in CFT imitating,total CDT score and STR among the normal,MCI and AD groups(P ＜ 0.01).(5)STR is a more informative test to be used in diagnosis of MCI than CFT imitating and total CDT score,as shown by comparison of these tests in three subjects groups.Conclusion Visuospatial-visuoconstructional ability impairment is one of the symptoms of MCI.In detection of MCI,the assessment of space rotating ability is better than CFT imitating and total CDT score.