Salvadori Emilia, Poggesi Anna, Pracucci Giovanni, Inzitari Domenico, Pantoni Leonardo
NEUROFARBA Department, Neuroscience Section, University of Florence, Tuscany, Italy.
Stroke Unit and Neurology, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy.
J Alzheimers Dis. 2015;43(4):1313-23. doi: 10.3233/JAD-141449.
Vascular cognitive impairment may have a selective neuropsychological profile. We developed a battery for assessing mild cognitive impairment (MCI) in patients with small vessel disease (SVD), its applicability, and psychometric properties.
Among those proposed by the 2006 NINDS-CSN Consensus Conference, we selected tests for which norms based on healthy Italians and equivalent scores methodology were available. Confirmatory factor analysis was applied to ascertain the fit of the theoretically assumed dimensions to empirical data and to derive each cognitive dimension compound measures.
The entire battery was applied to 146 out of a cohort of 201 patients with MCI and SVD. Most tests showed good applicability. Fifty-five patients, who were older and cognitively more impaired, proved unable to complete the Trail Making Test part B, the Rey-Osterrieth Complex Figure, and the Stroop test, and were excluded from the analysis. Among the remaining patients, Mini-Mental State Examination proved largely normal, while Rey-Osterrieth Complex Figure, Symbol digit modalities test, and Trail Making Test part B were most frequently abnormal. Confirmatory factor analysis showed a good fit of the 4-factor theoretical model to empirical data. Praxis domain resulted in the highest percentage of abnormal performance (65%), followed by Memory and Attention/EF domains (19% and 15%), and Language (8%).
Our battery proved to be comprehensive, robust, and applicable. Attention-executive dysfunction and impaired memory and visuo-constructional abilities, were the prominent features. The assessment of the Consensus Conference, that included Trial Making Test, looks poorly applicable to older and cognitively impaired patients.
血管性认知障碍可能具有选择性神经心理学特征。我们开发了一套用于评估小血管病（SVD）患者轻度认知障碍（MCI）的测试组合、其适用性及心理测量特性。
在2006年美国国立神经疾病与中风研究所 - 加拿大卒中网络（NINDS-CSN）共识会议提出的测试中，我们选择了基于健康意大利人常模和等效分数方法的测试。应用验证性因素分析来确定理论假设维度与实证数据的拟合度，并得出每个认知维度的复合测量值。
该测试组合应用于201例MCI和SVD患者队列中的146例。大多数测试显示出良好的适用性。55例年龄较大且认知障碍更严重的患者无法完成连线测验B部分、雷 - 奥斯特里思复杂图形测验和斯特鲁普测验，被排除在分析之外。在其余患者中，简易精神状态检查表结果大多正常，而雷 - 奥斯特里思复杂图形测验、符号数字模式测验和连线测验B部分最常出现异常。验证性因素分析表明4因素理论模型与实证数据拟合良好。实践领域的异常表现百分比最高（65%），其次是记忆和注意力/执行功能领域（分别为19%和15%），以及语言领域（8%）。
我们的测试组合被证明是全面、可靠且适用的。注意力 - 执行功能障碍以及记忆和视觉结构能力受损是突出特征。共识会议中包括连线测验的评估，对于年龄较大和认知受损的患者适用性较差。
