Garcia Basalo M M, Fernandez M C, Ojea Quintana M, Rojas J I, Garcia Basalo M J, Bogliotti E, Campora N, Fernandez M, Berrios W, Cristiano E, Golimstok A
Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina.
Neurology Department of Italian Hospital of Buenos Aires, Gascón 450, C1181ACH Buenos Aires, Argentina; Lewy Body Association Argentina (ALBA), Argentina.
Arch Gerontol Geriatr. 2017 May-Jun;70:67-75. doi: 10.1016/j.archger.2017.01.001. Epub 2017 Jan 5.
Early detection of neurodegenerative diseases is essential for treatment and proper care of these patients. Screening tools available today are effective for several types of dementia. However, there is no one specific for Lewy Body Dementia (LBD).
The aim of this paper is to present a tool for early detection of LBD, accessible even for non-medical staff.
We stratified subjects (MMSE>20) into four groups: health controls (HC), Mild Cognitive Impairment (MCI), LBD and other dementias (Alzheimer and vascular). All subjects (age range 50-90) were examined with a comprehensive neuropsychological and neuropsychiatric evaluation, as well as neuroimaging to differentiate diagnosis between groups, fulfilling corresponding criteria. Both neurologists and neuropsychologists were blind to the performance on clinical evaluations and ASI, respectively. The sensitivity and specificity of the instrument were determined to differentiate LBD from other groups.
We evaluated 427 subjects, 91 HC, 140 with MCI and 196 with dementia. In the dementia group, 75 were diagnosed with LBD and 121 with other dementias. ASI total score was 12.7±0.4 for LBD, 2.9±0.2 for HC, 5±0.7 for MCI, and 5.4±2.6 for other causes of dementia. ROC curve analysis showed a sensitivity of 90.7% and a specificity of 93.6% stands, with 9 as the cutoff with better test performance compared against other groups.
ASI is a brief screening tool for LBD with high sensitivity and specificity and useful even for non-medical staff.
神经退行性疾病的早期检测对于这些患者的治疗和妥善护理至关重要。目前可用的筛查工具对几种类型的痴呆症有效。然而,尚无一种专门针对路易体痴呆(LBD)的工具。
本文旨在介绍一种即使非医务人员也可使用的LBD早期检测工具。
我们将受试者(简易精神状态检查表得分>20)分为四组:健康对照(HC)、轻度认知障碍(MCI)、LBD和其他痴呆症(阿尔茨海默病和血管性痴呆)。所有受试者(年龄范围50 - 90岁)均接受了全面的神经心理学和神经精神学评估以及神经影像学检查,以区分各组诊断,符合相应标准。神经科医生和神经心理学家分别对临床评估和ASI的表现不知情。确定该工具区分LBD与其他组的敏感性和特异性。
我们评估了427名受试者,91名HC,140名MCI患者和196名痴呆症患者。在痴呆症组中,75人被诊断为LBD,121人被诊断为其他痴呆症。LBD组的ASI总分是12.7±0.4,HC组是2.9±0.2,MCI组是5±0.7,其他痴呆症病因组是5.4±2.6。受试者工作特征曲线分析显示,以9分为临界值时,敏感性为90.7%,特异性为93.6%,与其他组相比测试表现更佳。
ASI是一种用于LBD的简短筛查工具,具有高敏感性和特异性,甚至对非医务人员也有用。