Brežná Zuzana, Typčuková Katarína Ďurčová, Necpál Ján
Parkinsonism and Movement Disorders Treatment Center, Zvolen Hospital, Zvolen, Slovakia.
Department of Neurology, Zvolen Hospital, Kuzmányho nábrežie 28, Zvolen, 960 01, Slovakia.
Neurol Sci. 2025 Mar;46(3):1103-1110. doi: 10.1007/s10072-024-07902-0. Epub 2024 Nov 28.
The three clap test (TCT) is a simple bedside test that can elicit the so-called applause sign (AS), manifesting with more than three claps after the examiner's instruction to clap three times. Although the AS was originally described as a useful sign differentiating patients with progressive supranuclear palsy (PSP) from patients with Parkinson's disease (PD) and frontotemporal dementia (FTD), it is also known to be present in PD, Alzheimer's disease and several other diseases. It reflects the so-called stopping impulsivity and cognitive and frontal lobe dysfunction. In addition to the AS, the TCT can also elicit the non-applause sign, linked with the apathy subtype of behavioural variant of FTD and the jumping the gun sign, a sign of waiting impulsivity, also seen in PSP. This review summarizes the up-to-date clinical aspects and pathophysiology of all these signs and discuss the benefit of using the TCT in the routine clinical praxis.
三拍试验（TCT）是一种简单的床边检查，可引出所谓的掌声征（AS），即在检查者指示拍三次手后出现三次以上拍手。虽然AS最初被描述为区分进行性核上性麻痹（PSP）患者与帕金森病（PD）和额颞叶痴呆（FTD）患者的有用体征，但在PD、阿尔茨海默病和其他几种疾病中也可见到。它反映了所谓的停止冲动以及认知和额叶功能障碍。除了AS，TCT还可引出与FTD行为变异型的淡漠亚型相关的无掌声征以及抢先征，后者是一种等待冲动的体征，在PSP中也可见到。本综述总结了所有这些体征的最新临床情况和病理生理学，并讨论了在常规临床实践中使用TCT的益处。
