Ko Pan-Woo, Lee Ho-Won, Kang Kyunghun
Department of Neurology, Kyungpook National University School of Medicine, Daegu, South Korea.
Eur Neurol. 2017;77(5-6):327-332. doi: 10.1159/000472712. Epub 2017 May 5.
Our aim in this study was to assess whether the frontal assessment battery (FAB) could contribute to the differential diagnosis of cerebrospinal fluid tap test (CSFTT) responders and nonresponders with the hypothesis that CSFTT nonresponders had greater frontal lobe dysfunction. We also explored whether a relationship exists between FAB scores and gait disturbance in idiopathic normal-pressure hydrocephalus (INPH) patients.
INPH subjects were selected in a consecutive order from a prospectively enrolled INPH registry. Fifty-one INPH patients constituted the final sample for analysis.
Logistic regression analysis using the FAB score as independent variable showed a significant influence of the FAB on the differential diagnosis of CSFTT responders and nonresponders (p = 0.025; OR 1.186; 95% CI 1.022-1.377). The FAB scores were negatively correlated with the Timed Up and Go test score (r = -0.382; p = 0.007), 10-meter walking test score (r = -0.351; p = 0.014), Gait Status Scale score (r = -0.382; p = 0.007), and INPH Grading Scale gait score (r = -0.370; p = 0.009).
Our findings may indicate a possibility for considering FAB scores in patients with ventriculomegaly as potential cognitive markers for the prediction of CSFTT response. Association between gait function and FAB scores suggests the involvement of similar circuits producing gait symptom and frontal lobe functions in INPH.
本研究的目的是评估额叶评估量表(FAB)是否有助于鉴别脑脊液穿刺试验(CSFTT)反应者和无反应者,我们的假设是CSFTT无反应者存在更严重的额叶功能障碍。我们还探讨了FAB评分与特发性正常压力脑积水(INPH)患者步态障碍之间是否存在关联。
从前瞻性纳入的INPH登记册中按顺序选取INPH受试者。51例INPH患者构成最终分析样本。
以FAB评分为自变量的逻辑回归分析显示,FAB对CSFTT反应者和无反应者的鉴别诊断有显著影响(p = 0.025;OR 1.186;95%CI 1.022 - 1.377)。FAB评分与计时起立行走测试评分(r = -0.382;p = 0.007)、10米步行测试评分(r = -0.351;p = 0.014)、步态状态量表评分(r = -0.382;p = 0.007)和INPH分级量表步态评分(r = -0.370;p = 0.009)呈负相关。
我们的研究结果可能表明,对于脑室扩大的患者,FAB评分有可能作为预测CSFTT反应的潜在认知标志物。步态功能与FAB评分之间的关联表明,INPH中产生步态症状和额叶功能的神经回路存在相似性。