基于平板电脑对轻度认知障碍患者绘制复杂图形表现的综合评定  

A tablet-based comprehensive evaluation of drawing complex graphics performance of patients with mild cognitive impairment

作　　者：张肖南 吕亮亮 李阳[3] 郁磊 赵娅蓉 闵国文[3] 王秋艳 申佳妮 陈金雨 Zhang Xiao-Nan;Lv Liang-Liang;Li Yang*;Yu Lei;Zhao Ya-Rong;Min Guo-Wen;Wang Qiu-Yan;Shen Jia-Ni;Chen Jin-Yu(Department of Medical Imaging,Shanxi Medical University,Taiyuan,Shanxi 030001,China;the First Clinical Medical College,Shanxi Medical University,Taiyuan,Shanxi 030001,China;Department of Neurology,the First Affiliated Hospital of Shanxi Medical University,Taiyuan,Shanxi 030001,China;Shanxi Provincial Key Laboratory of Mathematical Technology and Big Data Analysis for Disease Control and Prevention,Shanxi University,Taiyuan,Shanxi 030006,China)

机构地区：[1]山西医科大学影像学院,山西太原030001 [2]山西医科大学第一临床医学院,山西太原030001 [3]山西医科大学第一医院神经内科,山西太原030001 [4]山西大学疾病防控的数学技术与大数据分析山西省重点实验室,山西太原030006

出　　处：《解放军医学杂志》2023年第5期587-595,共9页Medical Journal of Chinese People's Liberation Army

基　　金：中央引导地方科技发展专项资金项目(YDZX20191400002563);山西省医学重点攻关专项(2020XM22)。

摘　　要：目的 评估基于平板电脑的数字化复杂图形测验(dCFT)软件检测遗忘型轻度认知障碍(aMCI)患者绘图表现的适用性。方法 选取2020年11月-2021年11月就诊于山西医科大学第一医院门诊的38例aMCI患者为观察组,26例认知功能正常者为对照组。两组均接受全面的神经心理测评,包括简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、Rey复杂图形测验及各认知域量表等。同时期完成dCFT测评(dCFT软件基于平板电脑,可自动化采集多维度绘图参数),包括临摹、3 min即刻回忆及20 min延迟回忆测验。采用Pearson相关系数评估原始与简化版Rey复杂图形测验分值的相关性,采用偏相关分析dCFT参数与各认知域综合分值的相关性。结果 (1)dCFT临摹测验中,两组间参数比较差异无统计学意义(均P>0.05);即刻回忆测验中,观察组思考总时间、元素延迟时间(s)均明显长于对照组[27.15(21.49,33.94) vs. 21.85(18.26,24.81),1.99(1.36,3.62) vs. 1.32(1.03,1.99),P<0.05];延迟回忆测验中,观察组短长笔画序列过渡时间、思考总时间、完成总时间、第一笔思考时间及元素延迟时间(s)均长于对照组[1.89(1.12,3.93)vs.1.19(0.42,2.41),23.94(18.86,36.87)vs.19.93(16.59,23.00),40.30(34.83,56.21)vs.34.52(29.96,42.15),7.92(6.20,9.83)vs.5.92(5.16,8.04),1.63(1.25,2.47)vs.1.08(0.83,1.55),P<0.05],前5笔长笔画率(%)、最长笔画速度(cm/s)及每分钟笔画数(个)均低于对照组[60(40,80) vs. 80(60,100),4.65(3.53,6.07) vs. 6.00(4.54,7.13),21(18,25)vs.26(21,27),P<0.05];两组其他dCFT参数差异均无统计学意义(P>0.05)。(2)控制年龄、性别及受教育程度后,相关分析显示,短长笔画序列过渡时间与注意力及执行功能呈负相关(r=±0.292,r=±0.275,P<0.05),最长笔画速度与执行功能呈正相关(r=0.302,P<0.05),思考总时间与记忆力、注意力、执行功能、视空间能力均呈负相关(r=±0.26,r=±0.408,r=±0.448,r=±0.264,P<0.05),完成总时间与注意�Objective To evaluate the usability of tablet-based digital complex figure test(dCFT)software on assessment of drawing strategies of patients with amnestic mild cognitive impairment(aMCI).Methods A total of 64 patients treated in a hospital from Nov.2020 to Nov.2021 were selected,including 26 cognitively normal people(control group)and 38 aMCI patients(aMCI group).All subjects underwent standardized neuropsychological assessments,including the mini-mental state examination(MMSE),the montreal cognitive assessment(MoCA),the Rey–Osterrieth Complex Figure(ROCF)test,and other cognitive domain scales.And then use the dCFT(including copying and recall)developed by our team to collect drawing parameters,such as stroke length,time,speed and number.The Pearson correlation coefficient was used to evaluate the correlation between the original and simplified ROCF test scores,and partial correlation used to analyze the correlation between the dCFT parameters and the comprehensive scores of each cognitive domain.Results(1)In the copying test,all dCFT parameters had no statistically significant between the two groups(P>0.05).In the immediate recall test,the total thinking time and element delay time in aMCI group were significantly longer than those in the control group[27.15(21.49,33.94)vs.21.85(18.26,24.81),1.99(1.36,3.62)vs.1.32(1.03,1.99),P<0.05].In the delayed recall test,the transition time of short and long stroke sequence,total thinking time,total completion time,first thinking time and element delay time of the aMCI group were significantly higher than those of control group[1.89(1.12,3.93)vs.1.19(0.42,2.41),23.94(18.86,36.87)vs.19.93(16.59,23.00),40.30(34.83,56.21)vs.34.52(29.96,42.15),7.92(6.20,9.83)vs.5.92(5.16,8.04),1.63(1.25,2.47)vs.1.08(0.83,1.55),P<0.05].The first 5 stroke ratios(%),speed of the longest stroke(cm/s)and strokes per minute of aMCI group were significantly lower than those of control group[60(40,80)vs.80(60,100),4.65(3.53,6.07)vs.6.00(4.54,7.13),21(18,25)vs.26(21,27),P<0.05].Other dCFT parameters

关 键 词：轻度认知障碍 复杂图形测验 神经心理测验 数字化测评 阿尔茨海默病 

分 类 号：R749.1[医药卫生—神经病学与精神病学]