Li Xudong, Shen Miaoxin, Han Ziling, Jiao Jinsong, Tong Xiaopeng
Department of Cognitive Disorder, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Front Neurol. 2022 Jul 29;13:950730. doi: 10.3389/fneur.2022.950730. eCollection 2022.
Dementia with Lewy bodies (DLB) is the second most common type of neurodegenerative dementia following Alzheimer's disease dementia (ADD). This study investigated the diagnostic role of the gesture imitation test in detecting DLB and differentiating DLB from ADD.
A total of 63 patients with DLB, 93 patients with ADD, and 88 healthy controls were included in this study. All participants were administered the gesture imitation test, the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), the clock drawing test (CDT), and other neuropsychological tests.
The patients with DLB performed worse than the healthy controls in the global scores and on every item of the gesture imitation test ( < 0.001). The area under the curve (AUC) for the global scores was 0.889 ( < 0.001) in differentiating the DLB and control groups. Item 4 was a better discriminator, with a sensitivity of 79.37% and a specificity of 79.55%. The AUC for the global scores decreased to 0.593 and the difference was marginal ( = 0.079) in differentiating the DLB and ADD groups. The patients with DLB performed worse on Items 1 and 4 compared with the patients with ADD ( = 0.040, 0.004). The gesture imitation test was positively correlated with the scores of the MMSE ( = 0.355, = 0.017), the MoCA ( = 0.382, = 0.010), and the CDT ( = 0.407, = 0.005) in patients with DLB.
The gesture imitation test is an easy, rapid tool for detecting DLB and has a role in differentiating DLB from ADD, especially in Items 1 and 4.
路易体痴呆(DLB)是继阿尔茨海默病性痴呆(ADD)之后第二常见的神经退行性痴呆类型。本研究调查了手势模仿测试在检测DLB以及区分DLB与ADD方面的诊断作用。
本研究共纳入63例DLB患者、93例ADD患者和88名健康对照者。所有参与者均接受了手势模仿测试、简易精神状态检查表(MMSE)、蒙特利尔认知评估量表(MoCA)、画钟试验(CDT)以及其他神经心理学测试。
DLB患者在手势模仿测试的总分及各个项目上的表现均比健康对照者差(<0.001)。在区分DLB组和对照组时,总分的曲线下面积(AUC)为0.889(<0.001)。项目4是更好的鉴别指标,敏感性为79.37%,特异性为79.55%。在区分DLB组和ADD组时,总分的AUC降至0.593,差异不显著(=0.079)。与ADD患者相比,DLB患者在项目1和项目4上的表现更差(=0.040,0.004)。在DLB患者中,手势模仿测试与MMSE评分(=0.355,=0.017)、MoCA评分(=0.382,=0.010)以及CDT评分(=0.407,=0.005)呈正相关。
手势模仿测试是一种简便、快速的检测DLB的工具,在区分DLB与ADD方面具有作用,尤其是在项目1和项目4中。