Neurosurgery of NeuroCenter, Kuopio University Hospital and Unit of Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
J Alzheimers Dis. 2021;81(3):1117-1130. doi: 10.3233/JAD-201363.
The usefulness of CERAD Neuropsychological Battery for describing the cognitive impairment in idiopathic normal pressure hydrocephalus (iNPH) is unknown.
To compare the cognitive profile of patients with iNPH to patients with mild Alzheimer's disease (AD) and age-matched cognitively healthy individuals by using the CERAD-NB.
We studied CERAD-NB subtest results, including the Mini-Mental State Examination (MMSE), between 199 patients with probable iNPH, 236 patients with mild AD, and 309 people with normal cognition, using age, education, and gender adjusted multivariate linear regression model. In addition, the effects of AD-related brain pathology detected in frontal cortical brain biopsies in iNPH patients' cognitive profiles were examined.
The iNPH patients performed worse than cognitively healthy people in all CERAD-NB subtests. Despite similar performances in the MMSE, AD patients outperformed iNPH patients in Verbal Fluency (p = 0.016) and Clock Drawing (p < 0.001) tests. However, iNPH patients outperformed AD patients in the Boston Naming Test and Word List Recall and Recognition (p < 0.001). AD-related pathology in brain biopsies did not correlate with the CERAD-NB results.
At the time of the iNPH diagnosis, cognitive performances differed from cognitively healthy people in all CERAD-NB subtests. When the iNPH and AD patients' results were compared, the iNPH patients performed worse in Verbal Fluency and Clock Drawing tests while the AD group had more pronounced episodic memory dysfunctions. This study demonstrates significant differences in the CERAD-NB subtests between cognitive profiles of iNPH and AD patients. These differences are not captured by the MMSE alone.
CERAD 神经心理学成套测验对于描述特发性正常压力脑积水（iNPH）患者的认知障碍的作用尚不清楚。
通过 CERAD-NB 比较 iNPH 患者、轻度阿尔茨海默病（AD）患者和年龄匹配的认知正常个体的认知特征。
我们使用年龄、教育和性别调整的多元线性回归模型，研究了 199 例可能患有 iNPH、236 例轻度 AD 和 309 例认知正常的患者的 CERAD-NB 子测验结果，包括简易精神状态检查（MMSE）。此外，还检查了 iNPH 患者认知特征中 AD 相关脑病理在额皮质脑活检中的作用。
与认知正常的个体相比，iNPH 患者在所有 CERAD-NB 子测验中的表现均较差。尽管在 MMSE 中的表现相似，但 AD 患者在言语流畅性（p=0.016）和时钟绘图（p<0.001）测试中的表现优于 iNPH 患者。然而，iNPH 患者在波士顿命名测试、词汇列表回忆和识别（p<0.001）中表现优于 AD 患者。脑活检中的 AD 相关病理学与 CERAD-NB 结果无关。
在 iNPH 诊断时，与认知正常的个体相比，所有 CERAD-NB 子测验的认知表现均不同。当比较 iNPH 和 AD 患者的结果时，iNPH 患者在言语流畅性和时钟绘图测试中的表现更差，而 AD 组的情景记忆功能障碍更为明显。本研究表明，iNPH 和 AD 患者的 CERAD-NB 子测验之间的认知特征存在显著差异。这些差异无法仅通过 MMSE 捕捉到。
