Wang Ching-Tsu, Hung Guang-Uei, Wei Cheng-Yu, Tzeng Ray-Chang, Chiu Pai-Yi
Department of Neurology, Tainan Municipal Hospital, Tainan, Taiwan.
Department of Nuclear Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.
Front Neurosci. 2020 Jan 31;14:44. doi: 10.3389/fnins.2020.00044. eCollection 2020.
Visuospatial dysfunction (VSD) is one of the most important symptoms for the diagnosis of dementia with Lewy bodies (DLB). The aim of this study was to validate a novel VSD questionnaire and determine the cutoff score for the screening for VSD in DLB.
This is a retrospective analysis of data from a project of the History-based Artificial Intelligent Clinical Dementia Diagnostic System (HAICDDS). VSD of non-demented control (NDC), Alzheimer's disease (AD), and DLB participants were analyzed and compared using the visuospatial questionnaire in the HAICDDS (HAI-VSQ), the Draw subscale in the Cognitive Abilities Screening Instrument (CASI-Draw), and the visuospatial subscale in Montreal Cognitive Assessment (MoCA-VS).
A total of 440 individuals were studied, including 154 NDC, 229 AD, and 57 DLB participants. Compared to NDC or AD participants, DLB participants showed a higher total score on HAI-VSQ after adjustment for age. Using HAI-VSQ, a cutoff score ≥ 2 was useful for the screening for VSD in DLB with a sensitivity of 0.77 and a specificity of 0.94. Compared with CASI-Draw or MoCA-VS, HAI-VSQ was least influenced by gender, age, and education and had the highest correlation with the sum of boxes of the Clinical Dementia Rating scale. After adjustment for age, education, gender, and global cognitive function, HAI-VSQ significantly discriminated DLB from AD and NDC whereas MoCA-VS or CASI-Draw did not.
Our study showed that the newly designed simple questionnaire was a practical screening tool for VSD in DLB that can be applied in clinical practice as well as on a registration platform.
视觉空间功能障碍（VSD）是路易体痴呆（DLB）诊断的最重要症状之一。本研究的目的是验证一种新型VSD问卷，并确定DLB中VSD筛查的临界值。
这是一项对基于病史的人工智能临床痴呆诊断系统（HAICDDS）项目数据的回顾性分析。使用HAICDDS中的视觉空间问卷（HAI-VSQ）、认知能力筛查工具中的绘画分量表（CASI-Draw）和蒙特利尔认知评估中的视觉空间分量表（MoCA-VS），对非痴呆对照（NDC）、阿尔茨海默病（AD）和DLB参与者的VSD进行分析和比较。
共研究了440名个体，包括154名NDC、229名AD和57名DLB参与者。与NDC或AD参与者相比，DLB参与者在调整年龄后HAI-VSQ总分更高。使用HAI-VSQ，临界值≥2对DLB中VSD的筛查有用，敏感性为0.77，特异性为0.94。与CASI-Draw或MoCA-VS相比，HAI-VSQ受性别、年龄和教育程度的影响最小，与临床痴呆评定量表的方框总和相关性最高。在调整年龄、教育程度、性别和整体认知功能后，HAI-VSQ能显著区分DLB与AD和NDC，而MoCA-VS或CASI-Draw则不能。
我们的研究表明，新设计的简单问卷是DLB中VSD的实用筛查工具，可应用于临床实践以及注册平台。
