晶体智力和流体智力测试之间的差异分析：一种检测无症状颈动脉狭窄患者轻度认知障碍的新方法。

Discrepancy analysis between crystallized and fluid intelligence tests: a novel method to detect mild cognitive impairment in patients with asymptomatic carotid artery stenosis.

机构信息

Department of Neurosurgery, University of Toyama, Toyama, Japan.

出版信息

Eur J Neurol. 2018 Feb;25(2):313-319. doi: 10.1111/ene.13504. Epub 2017 Nov 23.

DOI:10.1111/ene.13504

PMID:29078025

Abstract

BACKGROUND AND PURPOSE

The present study was conducted to accurately determine the presence of mild cognitive impairment, which is often difficult to evaluate using only simple tests. Our approach focused on discrepancy analysis of fluid intelligence relative to crystallized intelligence using internationally recognized neuropsychological tests.

METHODS

One-hundred and five patients diagnosed with asymptomatic carotid artery stenosis were assessed. The neuropsychological tests included the two subtests (information and picture completion) of Wechsler Adult Intelligence Scale-Revised (WAIS-R-two-subtests): crystallized intelligence tests and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) (immediate memory, visuospatial/constructional, language, attention, delayed memory and total score) as fluid intelligence tests. Discrepancy analysis was used to assess cognitive impairment. The score for RBANS was subtracted from the score for WAIS-R-two-subtests, and if the score difference was greater than the 5% confidence limit for statistical significance, it was defined as a decline in cognitive function.

RESULTS

The WAIS-R-two-subsets was within normal limits when compared with the standardized values. However, all RBANS domains showed significant declines. Frequencies of decline in each RBANS domain were as follows: 69 patients (66%) in immediate memory, 26 (25%) in visuospatial/constructional, 54 (51%) in language, 63 (60%) in attention, 54 (51%) in delayed memory and 78 (74%) in the total score. Moreover, 99 patients (94%) showed decline in at least one RBANS domain.

CONCLUSIONS

Cognitive function is only preserved in a few patients with asymptomatic carotid artery stenosis. Mild cognitive impairment can be precisely detected by performing the discrepancy analysis between crystallized and fluid intelligence tests.

摘要

背景与目的

本研究旨在准确确定轻度认知障碍的存在，而仅使用简单测试往往难以评估。我们的方法侧重于使用国际公认的神经心理学测试来分析相对于晶体智力的流体智力的差异。

方法

评估了 105 名被诊断为无症状颈动脉狭窄的患者。神经心理学测试包括韦氏成人智力量表修订版（WAIS-R-两子测验）的两个子测验（信息和图片完成）：晶体智力测验和重复性成套神经心理状态评估（RBANS）（即时记忆、视觉空间/结构、语言、注意力、延迟记忆和总分）作为流体智力测验。使用差异分析评估认知障碍。从 WAIS-R-两子测验的分数中减去 RBANS 的分数，如果分数差异大于统计学显着性的 5%置信限，则定义为认知功能下降。

结果

与标准化值相比，WAIS-R-两子测验在正常范围内。然而，所有 RBANS 领域都显示出显着下降。每个 RBANS 领域的下降频率如下：即时记忆 69 例（66%），视觉空间/结构 26 例（25%），语言 54 例（51%），注意力 63 例（60%），延迟记忆 54 例（51%）和总得分 78 例（74%）。此外，99 名患者（94%）至少有一个 RBANS 领域下降。