轻度血管性认知障碍神经心理评估量表的构建

目的制定适合轻度血管性认知障碍(mVCI)患者的神经心理评估量表。方法选择mVCI患者共80例(mVCI组),其中皮质下小血管病导致的mVCI(with subcortical small vessel disease,mVCI-SSVD)患者56例(mVCI-SSVD组),多发性梗死或关键部位梗死导致的mVCI(with multi-infarct or strategic infarct,mVCI-MI/SI)患者24例(mVCI-MI/SI组),另选健康志愿者80例(正常对照组)进行广泛认知测查,确定损害认知域,筛选出每个认知域中对mVCI及其亚型识别能力最好的单项测验组成综合评估量表,探讨其敏感度和特异度。结果mVCI组及其mVCI-SSVD组、mVCI-MI/SI组患者均为多认知域损害。综合量表对区别mVCI组、mVCI-SSVD组、mVCI-MI/SI组和正常对照组有较好的敏感度和特异度,对认知损害极轻的患者仍有很好的判别能力。结论综合评估量表对mVCI组及其mVCI-SSVD组、mVCI-MI/SI组患者具有较高的识别能力,有重要的应用价值。

Development of neuropsychological rating scale for mild vascular cognitive impairment

Objective To develop a neuropsychological rating scale for mild vascular cognitive impairment(mVCI).Methods Detailed cognitive evaluation was carried out in 80 mVCI patients(mVCI with subcortical small vessel disease,mVCI-SSVD,n=56;mVCI with multi-infarct or key site infarct,mVCI-MI/SI,n=24) and 80 normal control subjects.The results were compared between groups.Impaired cognitive domains in each patient were determined.The excellent discriminating single tests were selected to form a comprehensive rating scale.Results mVCI and its subtypes were the impairment in multiple domains.Six individual tests were chosen from 4 impaired domains for the comprehensive rating scale.The rating scale achieved good sensitivity and specificity in differentiating mVCI,mVCI-SSVD,and mVCI-MI/SI patients from normal controls.Similar high discriminant validity was obtained in subjects with MMSE scores of 28 or above.Conclusions The comprehensive rating scale showed good discrimination in detecting mVCI and its subtypes and might be potentially useful in clinical work.