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对右半球损伤的血管性痴呆患者沟通障碍的观察性评估。

Observational assessment of communication disorders in vascular dementia patients with right hemisphere damage.

作者信息

Kawada Miyuki, Tanaka Naofumi, Yamaguchi Satoshi, Meguro Kenichi

机构信息

Division of Geriatric Behavioral Neurology, CYRIC, Tohoku University, Sendai, Japan.

出版信息

Psychogeriatrics. 2014 Sep;14(3):143-51. doi: 10.1111/psyg.12052.

Abstract

AIM

After stroke, communication disability often occurs, with left side brain-damaged (LBD) patients having aphasia and right side brain-damaged (RBD) patients having deficits in conversation, despite their apparent lack of any language disability. Herein, we developed an original scale, the Daily Communication Assessment Scale (DCAS) and compared the scores from the RBD and left side brain-damaged patients with their matched Mini-Mental State Examination (MMSE) scores.

METHODS

This cross-sectional survey involved three pairs of MMSE-matched patients (n = 6) with vascular dementia who met the following criteria: a history of stroke, unilateral localized basal ganglia legion (as shown by magnetic resonance imaging/computed tomography images), MMSE scores ≥9, and ability to engage in minimal conversation. Patients' MMSE scores were 11, 12, 15, 16, and 19. We interviewed patients' primary staff regarding their abilities to communicate over the previous 4 weeks in order to evaluate them using the DCAS.

RESULTS

In each MMSE-matched pair, the RBD patient had a lower Deviation score on the DCAS, and in two pairs, the left side brain-damaged patient had a lower score for Coarse speech.

CONCLUSION

We believe that communication disorder in the RBD patients may be evaluated with the DCAS. We plan to standardize the DCAS and apply it for use in rehabilitation in the future.

摘要

目的

中风后常出现沟通障碍,左侧脑损伤(LBD)患者会出现失语症,而右侧脑损伤(RBD)患者虽无明显语言障碍,但存在对话缺陷。在此,我们开发了一种原创量表——日常沟通评估量表(DCAS),并比较了RBD患者和左侧脑损伤患者的DCAS得分与其匹配的简易精神状态检查表(MMSE)得分。

方法

这项横断面调查纳入了三对MMSE匹配的血管性痴呆患者(n = 6),他们符合以下标准:有中风病史、单侧局限性基底节病变(磁共振成像/计算机断层扫描图像显示)、MMSE得分≥9,以及能够进行基本对话。患者的MMSE得分分别为11、12、15、16和19。我们就患者在过去4周内的沟通能力与其主要护理人员进行了访谈,以便使用DCAS对他们进行评估。

结果

在每对MMSE匹配的患者中,RBD患者的DCAS偏差得分较低,在两对患者中,左侧脑损伤患者的粗语言得分较低。

结论

我们认为DCAS可用于评估RBD患者的沟通障碍。我们计划对DCAS进行标准化,并在未来将其应用于康复治疗。

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