Kim Joonho, Na Han Kyu, Byun Justin, Shin Jiwon, Kim Sungsoo, Lee Byung Hwa, Na Duk L
Yonsei University College of Medicine, Seoul, Republic of Korea.
Dement Geriatr Cogn Disord. 2017;44(1-2):105-117. doi: 10.1159/000478520. Epub 2017 Aug 3.
BACKGROUND/AIMS: Although the Mini-Mental State Examination (MMSE), Clinical Dementia Rating-Sum of Boxes (CDR-SOB), and neuropsychological batteries are widely used for evaluating cognitive function, it remains elusive which instrument best reflects the longitudinal disease progression in amnestic mild cognitive impairment (aMCI) and probable Alzheimer disease (AD). We investigated whether changes in these three instruments over time correlate with loss of cortical gray matter volume (cGMV).
We retrospectively investigated 204 patients (aMCI, n = 114; AD, n = 90) who had undergone MMSE, CDR-SOB, the dementia version of the Seoul Neuropsychological Screening Battery (SNSB-D), and 3-dimensional T1-weighted magnetic resonance images at least twice. We investigated the partial correlation between annual decline in test scores and percent change of cGMV.
In aMCI patients, changes in the SNSB-D total score (r = 0.340, p < 0.001) and CDR-SOB (r = 0.222, p = 0.020), but not MMSE, showed a correlation with cGMV loss, with the SNSB-D total score showing the strongest correlation. In AD patients, decline in all three test scores correlated significantly with cGMV loss, with MMSE exhibiting the strongest correlation (r = 0.464, p < 0.001).
In aMCI patients, neuropsychological battery, though time-consuming, was the most adequate tool in tracking disease progression. In AD patients, however, MMSE may be the most effective longitudinal monitoring tool when considering cost-effectiveness.
背景/目的:尽管简易精神状态检查表(MMSE)、临床痴呆评定量表总分(CDR-SOB)和神经心理成套测验被广泛用于评估认知功能,但哪种工具最能反映遗忘型轻度认知障碍(aMCI)和很可能的阿尔茨海默病(AD)的疾病纵向进展仍不清楚。我们研究了这三种工具随时间的变化是否与皮质灰质体积(cGMV)的减少相关。
我们回顾性研究了204例患者(aMCI患者114例,AD患者90例),这些患者至少接受过两次MMSE、CDR-SOB、首尔神经心理筛查量表痴呆版(SNSB-D)检查以及三维T1加权磁共振成像。我们研究了测试分数的年度下降与cGMV百分比变化之间的偏相关性。
在aMCI患者中,SNSB-D总分的变化(r = 0.340,p < 0.001)和CDR-SOB的变化(r = 0.222,p = 0.020)与cGMV减少相关,而MMSE与cGMV减少无关,其中SNSB-D总分的相关性最强。在AD患者中,所有三项测试分数的下降均与cGMV减少显著相关,MMSE的相关性最强(r = 0.464,p < 0.001)。
在aMCI患者中,神经心理成套测验虽然耗时,但却是追踪疾病进展的最适当工具。然而,在AD患者中,考虑到成本效益,MMSE可能是最有效的纵向监测工具。