Mittal C, Gorthi S P, Rohatgi S
Clinical Research Department, Fortis Escorts Hospital, JLN Marg, Jaipur.
Associate Professor, Dept of Internal Medicine, AFMC, Pune-40.
Med J Armed Forces India. 2010 Jan;66(1):25-8. doi: 10.1016/S0377-1237(10)80087-5. Epub 2011 Jul 21.
Folstein's Mini Mental Status Examination (MMSE) often fails to identify executive dysfunction even if quite severe. Detailed neuropsychological tests and extensive bedside tests are available to evaluate executive function, but most of them are time consuming. This study was done to determine the value of a Clock Drawing Test (CDT) as a simple tool to identify cognitive dysfunction in various neurological disorders and to assess its utility as an adjunct to MMSE in identifying executive dysfunction in a a busy out patient department (OPD).
A total of 81 patients suffering from neurological disorders and 81 controls were studied. All subjects received the MMSE and the CDT. The CDT is divided into an unprompted task that is sensitive to executive control (CDT 1) and a copying task which is not (CDT 2).
All the three tests (CDT 1, CDT 2 and MMSE) could recognize cognitive and executive function deficits, when compared with age and sex matched controls (p < 0. 001). CDT scores correlated strongly with the level of executive function deficits. CDT+MMSE detected 95% cases as abnormal as compared to 47% detected by MMSE alone.
CDT along with MMSE can detect executive control deficits and cognitive deficits. The CDT 1 tests executive control performance, while CDT 2 tests posterior cortical deficits.
福尔斯坦简易精神状态检查表（MMSE）常常无法识别即使相当严重的执行功能障碍。有详细的神经心理学测试和广泛的床边测试可用于评估执行功能，但其中大多数耗时较长。开展本研究以确定画钟试验（CDT）作为一种识别各种神经疾病中认知功能障碍的简单工具的价值，并评估其作为MMSE的辅助手段在繁忙的门诊部（OPD）识别执行功能障碍的效用。
共研究了81例神经疾病患者和81名对照者。所有受试者均接受了MMSE和CDT测试。CDT分为对执行控制敏感的无提示任务（CDT 1）和不敏感的临摹任务（CDT 2）。
与年龄和性别匹配的对照者相比，所有三项测试（CDT 1、CDT 2和MMSE）均能识别认知和执行功能缺陷（p<0.001）。CDT评分与执行功能缺陷水平密切相关。与仅MMSE检测出47%的异常病例相比，CDT+MMSE检测出95%的异常病例。
CDT与MMSE一起可检测出执行控制缺陷和认知缺陷。CDT 1测试执行控制能力，而CDT 2测试后部皮质缺陷。
