ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, Australia.
Clin Neuropsychol. 2012;26(6):926-41. doi: 10.1080/13854046.2012.704073. Epub 2012 Jul 18.
In patients with focal lesions, patterns of learning, retrieval, and recognition deficits vary according to site of damage. Because different brain regions are affected by the underlying pathology in Alzheimer's dementia (AD) and behavioral variant fronto-temporal dementia (bvFTD), one might predict that the two disorders would result in different sorts of memory deficits on the Rey Auditory Verbal Learning Test (RAVLT). The aim of this investigation was to find a way to differentiate AD, bvFTD, and normal controls (NC) reliably based on RAVLT scores from retrospective samples of 82 Italian and 43 Australian participants. Results indicated that the groups differed on measures of learning, retroactive interference, delayed recall, and delayed recognition. Although delayed recall distinguished participants in the three groups across both samples, no one set of cut-offs could be obtained with adequate sensitivity and specificity. However, when we created a combined score (the "RAVLT Memory Efficiency Index": {[(delayed recall A/15)/(RAVLT Trials 1-5/75)] + [(delayed recognition hits/15) - (false positive/total number of distractors)]}), we were able to find cut-offs that differentiated the groups with good sensitivity and specificity across variations in RAVLT methodology, participant samples, and languages. This index will increase the usefulness of the RAVLT in differential diagnoses of early dementia.
在有局灶性病变的患者中,学习、检索和识别缺陷的模式根据损伤部位而有所不同。由于阿尔茨海默病(AD)和行为变异额颞叶痴呆(bvFTD)的潜在病理会影响不同的大脑区域,因此人们可能会预测这两种疾病会在 Rey 听觉言语学习测试(RAVLT)上导致不同类型的记忆缺陷。本研究的目的是从 82 名意大利和 43 名澳大利亚参与者的回顾性样本中找到一种可靠区分 AD、bvFTD 和正常对照(NC)的方法,根据 RAVLT 评分进行。结果表明,各组在学习、逆行干扰、延迟回忆和延迟识别方面存在差异。尽管延迟回忆在两个样本中都能区分三组参与者,但无法获得具有足够敏感性和特异性的一组截止值。然而,当我们创建一个综合评分(“RAVLT 记忆效率指数”:{[(延迟回忆 A/15)/(RAVLT 试次 1-5/75)]+[(延迟识别正确数/15)-(错误数/总干扰数)]})时,我们能够找到区分这些组的截止值,该指数具有良好的敏感性和特异性,且适用于 RAVLT 方法学、参与者样本和语言的变化。该指数将提高 RAVLT 在早期痴呆症鉴别诊断中的实用性。