Netherlands Center for Occupational Diseases, Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, The Netherlands.
Neurotoxicology. 2012 Aug;33(4):710-26. doi: 10.1016/j.neuro.2012.03.010. Epub 2012 Apr 4.
The presence of neuropsychological impairment is a hallmark of chronic solvent-induced encephalopathy (CSE), and using clinical neuropsychological procedures to generate a valid assessment of the condition is crucial for its diagnosis. The goals of this consensus document are to provide updated knowledge of the neuropsychological characteristics of CSE and to provide internationally acceptable guidelines for using neuropsychological assessments in the process of diagnosing patients who are suspected of having CSE.
A European working group that was composed of experts in the field of the clinical diagnosis of CSE met at several round-table meetings and prepared this report. The first section of the consensus paper addresses a review of the relevant literature that was published between 1985 and March 2012. The second section addresses recommendations for the clinical neuropsychological assessment of patients who are suspected of having CSE.
The literature review indicates that the most common neuropsychological impairments in CSE patients are within the domains of attention, particularly the speed of information processing, memory, and motor performance. It appears that the influence of CSE on memory processes mainly involves immediate recall and generally involves verbal, visual and visuospatial material. In the second section, six recommendations are presented regarding important functional domains for the neuropsychological diagnostic process of CSE that relate to the evaluation of neuropsychological impairment, the assessment and evaluation of symptoms, differential diagnostic considerations, the reliability and validity of neuropsychological test results, and the retesting of patients.
These recommendations will contribute to the improvement of the process for accurately diagnosing CSE, better counselling for CSE patients, the comparability of epidemiological data between countries, and finally, by raising awareness, these recommendations will contribute to combating the adverse health effects of occupational exposure to solvents.
认知功能损伤的存在是慢性溶剂性脑损伤（CSE）的一个标志，使用临床神经心理学程序来对这种情况进行有效的评估对其诊断至关重要。本共识文件的目的是提供关于 CSE 的神经心理学特征的最新知识，并为使用神经心理学评估来诊断疑似 CSE 的患者提供国际上可接受的准则。
一个由 CSE 临床诊断领域的专家组成的欧洲工作组在几次圆桌会议上进行了会晤，并编写了这份报告。共识文件的第一部分是对 1985 年至 2012 年 3 月期间发表的相关文献进行综述。第二部分涉及对疑似 CSE 患者进行临床神经心理学评估的建议。
文献综述表明，CSE 患者最常见的认知功能损伤是在注意力领域，特别是信息处理速度、记忆和运动表现。CSE 对记忆过程的影响似乎主要涉及即时回忆，并且通常涉及言语、视觉和视空间材料。在第二部分，提出了与 CSE 神经心理诊断过程中与评估认知功能损伤、评估和评估症状、鉴别诊断考虑因素、神经心理学测试结果的可靠性和有效性以及患者的重新测试相关的六个重要功能领域的建议。
这些建议将有助于提高准确诊断 CSE 的过程，更好地为 CSE 患者提供咨询，增加各国之间的流行病学数据可比性，最后，通过提高认识，这些建议将有助于应对职业接触溶剂对健康的不利影响。
