Jouvent Eric, Reyes Sonia, De Guio François, Chabriat Hugues
J Alzheimers Dis. 2015;47(2):413-9. doi: 10.3233/JAD-150083.
The assessment of early and subtle cognitive and behavioral effects of cerebral small vessel disease (SVD) requires specific and long-lasting evaluations performed by experienced neuropsychologists. Simpler tools would be helpful for daily clinical practice.
To determine whether a simple reaction time task that lasts 5 minutes and can be performed without external supervision on any tablet or laptop can be used as a proxy of early cognitive and behavioral alterations in CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy), a monogenic form of pure SVD related to NOTCH3 mutations.
Twenty-two genetically confirmed patients with CADASIL having preserved global cognitive abilities and without disability (MMSE >24 and modified Rankin's scale ≤1) were compared to 29 age-and-gender matched controls to determine group differences according to: 1) conventional neuropsychological and behavioral testing; 2) a computerized battery evaluating reaction time, processing speed, and executive functions. In a second step, correlations between reaction time and cognitive and behavioral alterations detected using both conventional and computerized testing were tested in patients.
Reaction time was significantly higher in patients than in controls (mean in patients: 283 ms - in controls: 254 ms, p = 0.03). In patients, reaction time was significantly associated with conventional and chronometric tests of executive functions, working memory, and apathy.
Reaction time obtained using a very simple task may serve as a proxy of early cognitive and behavioral alterations in SVD and could be easily used in daily clinical practice.
评估脑小血管病（SVD）早期细微的认知和行为影响需要由经验丰富的神经心理学家进行特定且长期的评估。更简单的工具将有助于日常临床实践。
确定一项持续5分钟且无需外部监督、可在任何平板电脑或笔记本电脑上进行的简单反应时间任务，是否可作为伴有皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病（CADASIL）早期认知和行为改变的替代指标，CADASIL是一种与NOTCH3突变相关的单基因形式的纯SVD。
将22名经基因确诊、整体认知能力保留且无残疾（简易精神状态检查表>24分且改良Rankin量表≤1分）的CADASIL患者与29名年龄和性别匹配的对照进行比较，以根据以下方面确定组间差异：1）传统神经心理学和行为测试；2）评估反应时间、处理速度和执行功能的计算机化测试组。第二步，在患者中测试反应时间与使用传统测试和计算机化测试检测到的认知和行为改变之间的相关性。
患者的反应时间显著高于对照组（患者平均反应时间：283毫秒 - 对照组：254毫秒，p = 0.03）。在患者中，反应时间与执行功能、工作记忆和冷漠的传统及计时测试显著相关。
使用非常简单的任务获得的反应时间可作为SVD早期认知和行为改变的替代指标，并且可轻松用于日常临床实践。
