与书写障碍相关的认知波动：阿尔茨海默病与路易体痴呆的比较。
Cognitive fluctuations in connection to dysgraphia: a comparison of Alzheimer's disease with dementia Lewy bodies.
作者信息
Onofri Emanuela, Mercuri Marco, Donato Giuseppe, Ricci Serafino
机构信息
Department of Anatomy, Histology, Legal Medicine and Orthopaedics, Sapienza University of Rome, Rome, Italy.
出版信息
Clin Interv Aging. 2015 Mar 26;10:625-33. doi: 10.2147/CIA.S79679. eCollection 2015.
BACKGROUND
The purpose of the present study was to examine the relationship between cognitive impairment and the performance of handwritten scripts presented as "letter-writing" to a close relative by patients with dementia Lewy bodies (DLB), as fluctuations of the symptoms phase, and in a matched group of patients with Alzheimer's disease (AD). The degree of writing disability and personal, spatial, and temporal orientation was compared in these two groups.
DESIGN AND METHODS
Fourteen simple questions, designed in a form that could be utilized by any general practitioner in order to document the level of cognitive functioning of each patient, were presented to 30 AD patients and 26 DLB patients. The initial cognition test was designated PQ1. The patients were examined on tests of letter-writing ability. Directly after the letter-writing, the list of 14 questions presented in PQ1 was presented again in a repeated procedure that was designated PQ2. The difference between these two measures (PQ1 - PQ2) was designated DΔ. This test of letter-writing ability and cognitive performance was administered over 19 days.
RESULTS
Several markedly strong relationships between dysgraphia and several measures of cognitive performance in AD patients and DLB patients were observed, but the deterioration of performance from PQ1 to PQ2 over all test days were markedly significant in AD patients and not significant in DLB patients. It is possible that in graphic expression even by patients diagnosed with moderate to relatively severe AD and DLB there remains some residual capacity for understanding and intention that may be expressed. Furthermore, the deterioration in performance and the differences noted in AD and DLB patients may be due to the different speed at which the process of the protein degradation occurs for functional modification of synapses.
CONCLUSION
Our method can be used as part of neuropsychological tests to differentiate the diagnosis between AD and DLB.
背景
本研究旨在探讨路易体痴呆（DLB）患者、作为症状阶段波动情况以及与匹配的阿尔茨海默病（AD）患者组向近亲“写信”时手写笔迹表现之间的关系。比较了这两组患者的书写残疾程度以及个人、空间和时间定向能力。
设计与方法
向30名AD患者和26名DLB患者提出了14个简单问题，这些问题以任何全科医生都可使用的形式设计，用于记录每位患者的认知功能水平。初始认知测试被指定为PQ1。对患者进行写信能力测试。写信后，立即以重复程序再次呈现PQ1中的14个问题列表，该程序被指定为PQ2。这两个测量值之间的差异（PQ1 - PQ2）被指定为DΔ。这项写信能力和认知表现测试在19天内进行。
结果
观察到AD患者和DLB患者的书写障碍与几种认知表现测量之间存在显著的强关系，但在所有测试日中，AD患者从PQ1到PQ2的表现恶化明显，而DLB患者则不明显。即使是被诊断为中度至相对重度AD和DLB的患者，在图形表达中可能仍保留一些可表达的理解和意图的残余能力。此外，AD和DLB患者表现的恶化以及所观察到的差异可能是由于蛋白质降解过程发生的速度不同，以便对突触进行功能修饰。
结论
我们的方法可作为神经心理学测试的一部分，用于区分AD和DLB的诊断。
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