Cormack Francesca, Aarsland Dag, Ballard Clive, Tovée Martin J
Psychology Department, The Henry Wellcome Building For Neuroecology, Framlington Place, Newcastle University, Newcastle Upon Tyne, UK.
Int J Geriatr Psychiatry. 2004 Apr;19(4):371-7. doi: 10.1002/gps.1094.
Early and accurate diagnosis of Dementia with Lewy Bodies (DLB) to allow the appropriate clinical treatment is a priority, given reports of severe neuroleptic sensitivity and a preferential response to cholinesterase inhibitors in these patients. There have been suggestions that constructional apraxia is prevalent in DLB, and may provide a sensitive marker of the disease.
This study examined the pentagon drawings of 100 DLB patients, 50 Alzheimer's disease (AD) patients, 81 Parkinson's disease (PD) patients of whom 36 suffered from dementia (PDD). Performance on this task was correlated with cognitive performance on the MMSE and CAMCOG scales.
Patients with DLB were found to draw significantly worse pentagons than those with AD or PD, but not those with PDD. Drawing scores were significantly correlated with MMSE scores for the AD and PDD groups but not those with DLB. More detailed analysis of the neuropsychological correlates of constructional performance for patients with AD and DLB, revealed that those with AD showed a broad cognitive basis to their impairment, in DLB drawing was linked only to perception and praxis.
This study has suggests that DLB subjects show an impairment of pentagon copying that is dissociable from more global cognitive impairments, whereas PD patients are relatively unimpaired on pentagon copying and AD and PDD patients show a linkage of their impairment in copying with more global cognitive deficits.
鉴于有报道称路易体痴呆（DLB）患者对神经安定药高度敏感且对胆碱酯酶抑制剂有优先反应，早期准确诊断DLB以进行适当的临床治疗是当务之急。有观点认为，结构性失用在DLB中很普遍，可能是该疾病的一个敏感标志物。
本研究检查了100例DLB患者、50例阿尔茨海默病（AD）患者和81例帕金森病（PD）患者（其中36例患有痴呆，即帕金森病痴呆[PDD]）的五边形绘图。该任务的表现与简易精神状态检查表（MMSE）和剑桥认知检查表（CAMCOG）的认知表现相关。
发现DLB患者绘制五边形的表现明显比AD或PD患者差，但不比PDD患者差。AD组和PDD组的绘图分数与MMSE分数显著相关，但DLB组则不然。对AD和DLB患者结构性表现的神经心理学相关性进行更详细分析后发现，AD患者的损伤具有广泛的认知基础，而DLB患者的绘图仅与感知和实践有关。
本研究表明，DLB患者在复制五边形方面存在损伤，这与更全面的认知损伤不同，而PD患者在复制五边形方面相对未受损伤，AD和PDD患者在复制方面的损伤与更全面的认知缺陷有关。
