Nagashima Kazuaki, Makioka Kouki, Fujita Yukio, Ikeda Masaki, Ikeda Yoshio
Department of Neurology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
Department of Neurology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
J Neurol Sci. 2019 Oct 15;405:116414. doi: 10.1016/j.jns.2019.07.032. Epub 2019 Jul 31.
Cognitive impairment is a common non-motor symptom of amyotrophic lateral sclerosis (ALS); however, scales suitable for detecting cognitive impairment in ALS patients in clinical practice are unclear. In this study, the Mini-Mental State Examination, Frontal Assessment Battery, and Montreal Cognitive Assessment (MoCA) were evaluated in 68 patients with ALS. The patients were classified into 3 groups based on the results of these clinical scales: group N, patients with scores higher than the cut-offs in all clinical scales; group M, patients with a score lower than the cut-off in one clinical scale; and group D, patients with scores lower than the cut-offs in two or three clinical scales. Clinical data were compared among the groups. Age at onset was significantly lower, and educational period was longer in group N than in group D. MoCA test reported the highest number of patients with a score lower than the cut-off value. The evaluation item of language in MoCA showed the lowest correct answer rate in group N, and evaluation items of executive function and memory in MoCA showed the lowest correct answer rates in group D. MoCA is the most sensitive clinical scale for evaluating cognitive impairment in ALS among the three scales.
认知障碍是肌萎缩侧索硬化症（ALS）常见的非运动症状；然而，在临床实践中适合检测ALS患者认知障碍的量表尚不清楚。在本研究中，对68例ALS患者进行了简易精神状态检查表、额叶评估量表和蒙特利尔认知评估量表（MoCA）评估。根据这些临床量表的结果，将患者分为3组：N组，所有临床量表得分均高于临界值的患者；M组，一个临床量表得分低于临界值的患者；D组，两个或三个临床量表得分低于临界值的患者。对各组的临床资料进行比较。N组的发病年龄显著低于D组，受教育年限长于D组。MoCA测试报告得分低于临界值的患者数量最多。MoCA中语言评估项目在N组的正确回答率最低，MoCA中执行功能和记忆评估项目在D组的正确回答率最低。在这三个量表中，MoCA是评估ALS患者认知障碍最敏感的临床量表。
