轻度认知损害的神经心理研究  

Neuropsychological Research of Patients with Mild Cognitive Impairment

作　　者：程灶火[1] 蔡德亮[1] 王志强[1] 李萍[1] 周晓琴[1] 

机构地区：[1]无锡市精神卫生中心,江苏无锡214151

出　　处：《中国临床心理学杂志》2008年第5期512-515,543,共5页Chinese Journal of Clinical Psychology

基　　金：国家自然科学基金(30670714);江苏省自然科学基金(BK2006028)

摘　　要：目的:考查轻度认知损害(MCI)患者的神经心理损害模式和寻找MCI和AD痴呆早期诊断的神经心理学指标。方法:以139名社区正常老人、86名符合Petersen MCI诊断标准的社区样本和35名符合DSM-ⅣAD痴呆(DAT)标准的社区和门诊患者为研究对象,用18项神经心理测验分别评估被试的内隐记忆、再认记忆、日常记忆、自由回忆、工作记忆、学习能力、推理能力、空间/计算和加工速度。结果:MCI组的神经心理测验成绩低于正常对照组、高于DAT组(P<0.001),尤其是自由回忆、工作记忆、学习能力和加工速度的组间差异更大;神经心理学指标能甄别正常与MCI或MCI与DAT,归类正确率在90.9%～93.8%之间;神经心理指标在MCI和DAT诊断中具有较高的敏感性和特异性,尤其是自由回忆、工作记忆、学习能力和加工速度,对MCI的敏感性分别为0.763、0.806、0.748和0.727,对DAT的敏感性分别为0.930、0.884、0.965和0.919,对MCI的特异性分别为0.779、0.733、0.837和0.826,对DAT的特异性分别为0.743、0.686、0.686和0.829。结论:自由回忆、工作记忆、学习能力和加工速度是MCI和AD早期可靠的神经心理学诊断指标。Objective： To investigate neuropsychological deficit pattern of mild cognitively impaired （MCI） patients and identify neuropsychological marker in the diagnosis of MCI and early Alzheimer＇s disease. Methods： In present study, 139 normal elderly controls, 86 patients who met Petersen MCI criteria, and 35 dementia with Alzheimer type （DAT） who met DSM-IV criteria were selected from community and outpatient clinic. Eighteen neuropsychogical tests were used to assess subjects＇ implicit memory, recognition, everyday memory, free recall, working memory, learning ability, reasoning ability, spatialarithmetic, and processing speed. Results： Performances of the MCI were lower than normal controls and higher than DAT in the neuropsychological measures, particularly free recall, working memory, learning ability and processing speed（P〈0.001）. Neuropsychological measures discriminated MCI from normal elderly and DAT patients with accurately classifying rate of 90.9%-93.8%; neuropsychologieal measures, discriminated among normal controls, MCI and DAT, particularly free recall, working memory, learning ability and processing speed, with sensitivity of 0.763, 0.806, 0.748, and 0.727 for MCI, 0.930, 0.884, 0.965, and 0.919 for DAT; specificity of 0.779, 0.733, 0.837, and 0.826 for MCI, 0.743, 0.686, 0.686, and 0.829 for DAT. Conclusion： Free recall, working memory, learning ability and processing speed should be early and reliable neuropsychologieal marker in the diagnosis of MCI and AD.

关 键 词：神经心理测验 轻度认知损害 阿尔茨海默病 早期诊断 

分 类 号：R395.2[哲学宗教—心理学]