老年精神科患者计算机断层扫描（CT）变化的行为相关性。

Behavioral correlates of computed tomographic (CT) scan changes in older psychiatric patients.

作者信息

Swigar M E, Benes F M, Rothman S L, Opsahl C, Dowds M M

出版信息

J Am Geriatr Soc. 1985 Feb;33(2):96-103. doi: 10.1111/j.1532-5415.1985.tb02273.x.

DOI:10.1111/j.1532-5415.1985.tb02273.x

Abstract

Fifty psychiatric inpatients aged 50 and over, with no hard neurologic findings, and with a variety of DSM-III diagnoses (adjustment disorder, affective illness, and dementia), were rated for behavioral and psychiatric symptoms using the Geriatric Rating Scale and the Nurse's Assessment of Global Symptomatology-Elderly. These clinical ratings were correlated with computed tomographic (CT) scan assessments of various superficial cerebral regions as well as with linear measures of ventricular size. Behavioral deficits in activities of daily living (ADL) plus an interactional variable, inability to respond to requests, were correlated with superior temporal and inferior parietal CT abnormalities, particularly on the left side. Suspiciousness and peculiar thinking, mood lability and irritability, as well as impaired memory with confusion, perplexity, and disorientation were also associated with atrophy in these same regions. Prefrontal area defects correlated with mood lability and deficits in visual-interactional responsiveness. Statistically controlling for effects of age and alcohol abuse did not alter the basic nature of these results. Regional cerebral specialization in relation to these results are discussed using concepts developed by Luria.

摘要

五十名年龄在50岁及以上的精神病住院患者，没有明显的神经学检查结果，患有多种《精神疾病诊断与统计手册》第三版（DSM - III）诊断的疾病（适应障碍、情感性疾病和痴呆症），使用老年评定量表和护士对老年人总体症状的评估对其行为和精神症状进行评分。这些临床评分与大脑各浅表区域的计算机断层扫描（CT）评估以及脑室大小的线性测量结果相关。日常生活活动（ADL）中的行为缺陷加上一个交互变量，即无法回应请求，与颞上叶和顶下叶CT异常相关，特别是在左侧。多疑和奇特思维、情绪不稳定和易怒，以及伴有混乱、困惑和定向障碍的记忆受损也与这些相同区域的萎缩有关。前额叶区域缺陷与情绪不稳定和视觉交互反应能力缺陷相关。对年龄和酒精滥用的影响进行统计学控制并没有改变这些结果的基本性质。使用卢里亚提出的概念讨论了与这些结果相关的大脑区域特化情况。