认知功能障碍康复评估方法的研究进展  

Research Progress of Rehabilitation Assessment Methods for Cognitive Dysfunction

作　　者：周季桦 高林 赵晓庆 邰先桃 ZHOU Jihua;GAO Lin;ZHAO Xiaoqing;TAI Xiantao(Yunnan University of Traditional Chinese Medicine,Kunming,Yunnan 650500)

机构地区：[1]云南中医药大学,云南昆明650500

出　　处：《中医康复》2025年第1期76-80,共5页Traditional Chinese Medicine Rehabilitation

基　　金：云南省科技厅科技计划项目(202102AA100016);云南省针灸推拿防治脑病创新团队(202405AS350007);云南省教育厅科学研究基金项目(2023Y0462);云南省教育厅科学研究基金(2024Y388)。

摘　　要：认知功能障碍是多种慢性疾病常见的并发症之一,如脑卒中、痴呆、脑性瘫痪、糖尿病等均可导致,其发病率上升带来严重社会问题,早期识别与干预对康复至关重要。本文主要从神经心理学、神经影像学、神经电生理学三方面评估认知功能障碍,发现神经心理学评估以量表为主,如Gesell量表评估儿童智力发育:简易精神状态检查量表(MMSE)应用广泛,但对轻度认知损害不敏感;蒙特利尔认知评估量表(MoCA)特异性高、应用广;日常生活能力评估包括基本和工具性生活能力。神经影像学评估包括结构性磁共振成像(sMRI)、磁共振弥散张量成像(DTI)、功能性近红外光谱(fNIRS),可提供大脑结构和功能信息,辅助诊断和鉴别认知障碍。神经电生理学评估通过定量脑电图(QEEG)、事件相关电位(ERP)等反映大脑皮层活动,评估脑功能变化,且比前两者更直观地提供脑功能的状态和脑细胞损害程度。尽管各方法有局限,但数字化技术发展为认知障碍评估带来新可能,有望提高诊疗效率和准确性,推动脑健康数字诊疗一体化。Cognitive dysfunction is one of the common complications of many chronic diseases,such as stroke,dementia,cerebral palsy,diabetes mellitus and so on,and its rising incidence has brought about serious social problems,and early identification and inter-vention are crucial for rehabilitation.This paper focuses on the assessment of cognitive dysfunction from three aspects:neuropsychol-ogy,neuroimaging,and neuroelectrophysiology,and finds that neuropsychological assessment is based on scales,such as the Gesell Scale for assessing children's intellectual development;the Brief Mental State Examination(MMSE)is widely used,but is insensitive to mild cognitive impairment;the Montreal Cognitive Assessment(MoCA)has high specificity and is widely used;and the assessment of daily living Ability assessments include basic and instrumental living skills.Neuroimaging assessments include structural magnetic resonance imaging(sMRI),magnetic resonance diffusion tensor imaging(DTI),and functional near-infrared spectroscopy(fNIRS),which provide information on brain structure and function and assist in the diagnosis and differentiation of cognitive impairment.Neu-roelectrophysiological assessment reflects cortical activity and assesses changes in brain function through quantitative electroencepha-lography(QEEG)and event-related potentials(ERP),and provides a more intuitive picture of the state of brain function and the extent of brain cell damage than the first two.Despite the limitations of each method,the development of digital technology has brought new possibilities for cognitive impairment assessment,which is expected to improve the efficiency and accuracy of diagnosis and treatment,and to promote the integration of digital diagnosis and treatment for brain health.

关 键 词：认知功能障碍 康复 评估方法 蒙特利尔认知评估量表 结构性磁共振成像 功能性近红外光谱 定量脑电图 

分 类 号：R742.1[医药卫生—神经病学与精神病学]