Cipriani Giovanna, Bianchetti Angelo, Trabucchi Marco
Department of Medicine, S. Anna Hospital, Via del Franzone, 31, I-25127 Brescia, Italy.
Arch Gerontol Geriatr. 2006 Nov-Dec;43(3):327-35. doi: 10.1016/j.archger.2005.12.003. Epub 2006 Jan 31.
The aim of the present study is to evaluate the outcomes of a computer-based cognitive training on patients affected by Alzheimer's disease (AD) compared with the outcomes on patients affected by mild cognitive impairment (MCI), multiple system atrophy (MSA). Ten AD patients aged 74.1+/-5.6 years, with mini-mental state examination (MMSE) score at baseline of 23.9+/-2.4, and 10 MCI patients aged 70.6+/-6.0 years, with MMSE score of 28.0+/-1.4, attending our day-hospital of neurorehabilitation were selected for the study. Three MSA patients aged 69.0+/-9.5 years, MMSE scores 26.7+/-2.3 were selected from the same setting in order to have a different control group. Each patient attended two training programs and was evaluated according to cognitive and non-cognitive functions at baseline at the end of the second training program. The AD group showed a significant MMSE score improvement (p=0.010). On the contrary, MMSE scores at baseline and at follow-up remained quite stable in the other two groups. AD patients also showed significant improvement in the areas of verbal production (p=0.036) and executive functions (p=0.050). MCI patients significantly improved in behavioral memory (p=0.017; p=0.011). No significant improvement was observed in MSA group. Our data seem to indicate that the same individualized rehabilitative intervention could have different effects according to patient's diagnosis. MCI and AD patients had significant improvements in global cognitive status and/or in specific cognitive areas. On the contrary, MSA patients did not benefit at all.
本研究的目的是评估基于计算机的认知训练对阿尔茨海默病(AD)患者的效果,并与轻度认知障碍(MCI)、多系统萎缩(MSA)患者的训练效果进行比较。选取了10名年龄在74.1±5.6岁的AD患者,其基线简易精神状态检查表(MMSE)评分为23.9±2.4;以及10名年龄在70.6±6.0岁的MCI患者,其MMSE评分为28.0±1.4,这些患者均在我们的神经康复日间医院接受治疗,被选入本研究。从同一机构选取了3名年龄在69.0±9.5岁、MMSE评分为26.7±2.3的MSA患者,以组成不同的对照组。每位患者参加两个训练项目,并在基线、第二个训练项目结束时根据认知和非认知功能进行评估。AD组的MMSE评分有显著提高(p=0.010)。相反,其他两组的MMSE评分在基线和随访时保持相当稳定。AD患者在言语表达(p=0.036)和执行功能(p=0.050)方面也有显著改善。MCI患者在行为记忆方面有显著改善(p=0.017;p=0.011)。MSA组未观察到显著改善。我们的数据似乎表明,相同的个体化康复干预根据患者的诊断可能会产生不同的效果。MCI和AD患者在整体认知状态和/或特定认知领域有显著改善。相反,MSA患者根本没有受益。