血管性认知损害与轻度认知损害的神经心理学比较

目的探讨血管性认知损害(VCI)和轻度认知损害(MCI)的神经心理学特点。方法用Bristol最新神经心理量表中文修订版(BMDC-NPTB-CR)和日常生活能力量表(ADL)评价神经心理和日常生活能力,用《美国精神障碍诊断和统计手册》第4版(DSM-Ⅳ)、《疾病国际分类》第10版(ICD-10)、临床痴呆量表(CDR)的标准,诊断痴呆、可疑痴呆(QD)和认知正常。用Hachinski缺血量表(HIS)和Cornell抑郁量表(CSDD)进行鉴别诊断。结果VCI组(n=44)与MCI组(n=62)相比,量表总分(239.33±38.35,273.90±50.53,P<0.001)、MMSE语言部分(7.29±0.94,7.76±0.94,P<0.05)、WAIS-R积分(30.25±4.19,33.26±6.17,P<0.01)、相似性(9.23±2.12,10.81±2.97,P<0.01)、完成图画(9.07±1.77,10.06±2.60,P<0.05)、认知速度(79.66±25.84,104.29±22.49,P<0.001)等方面VCI组均低于MCI组,差异有统计学意义。而在语言中枢执行功能分量表得分、MMSE总分、记忆总分、视空间功能等方面无显著差异。结论VCI比MCI总体认知损害严重,在认知速度、抽象思维、语言等方面尤为显著。

Neuropsychological Differences between Vascular Cognitive Impairment and Mild Cognitive Impairment

Objective To compare the neuropsychological performance between vascular cognitive impairment (VCI) and mild cognitive impairment (MCI).Methods The patients were measured by BMDC-NPTB-CR and ADL. The diagnosis of dementia, questionable dementia and normal ability based on the DSM-Ⅳ and the ICD-10 criteria, Hachinski Ischemia Scale, Cornell Scale of Depression in Dementia and the Clinical Dementia Rating.Results VCI group( n =44)had lower scores than MCI group( n =62) in total score(239.33±38.35, 273.90±50.53, P <0.001), language in MMSE(7.29±0.94, 7.76±0.94, P <0.05), WAIS-R score(30.25±4.19, 33.26±6.17, P <0.01), similarities(9.23±2.12, 10.81±2.97, P <0.01), picture completion(9.07±1.77, 10.06±2.60, P <0.05), speed(79.66±25.84, 104.29±22.49, P <0.001), and no significant differences in visuospatial function subtest and total scores of language and central executive, MMSE, memory test.Conclusion The cognitive function is worse in VCI patients than that of in MCI, especially in cognitive speed, abstract thought and language function.