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1.
Chinese Journal of Anesthesiology ; (12): 40-43, 2019.
Article in Chinese | WPRIM | ID: wpr-745656

ABSTRACT

Objective To evaluate the the relationship between the mechanism underlying electroacupuncture (EA)-induced improvement of postoperative cognitive dysfunction and mitochondrion-depend-ent apoptosis in hippocampal neurons of aged rats.Methods Seventy-two healthy male Sprague-Dawley rats,aged 18 months,weighing 500-550 g,were divided into 3 groups (n =24 each) using a random number table method:control group (group C),operation group (group O) and group EA.EA was performed at Baihui and Dazhui acupoints for 30 min using disperse-dense waves,with a frequency 2/15 Hz and intensity 1 mA,once a day for 5 consecutive days in group EA.Laparotomy was performed under 3%sevoflurane anesthesia after the end of EA stimulation in O and EA groups.Morris water maze test was performed on 1 day before operation and 3 and 7 days after operation to assess the cognitive function.Rats were sacrificed after the end of Morris water maze test,brains were removed,and hippocampal tissues were obtained for detection of apoptosis rate of hippocampal neurons and expression of hippocampal caspase-3 and cytochrome c (Cyt c) by Western blot.Results Compared with group C,the escape latency was significantly prolonged after operation,the frequency of crossing the original platform was reduced,the apoptotic rate of hippocampal neurons was increased,and the expression of caspase-3 and Cyt c was up-regulated in O and A groups (P<0.05).Compared with group O,the escape latency was significantly shortened after operation,the frequency of crossing the original platform was increased,the apoptotic rate of hippocampal neurons was decreased,and the expression of caspase-3 and Cyt c was down-regulated in EA group (P<0.05).Conclusion The mechanism by which EA improves postoperative cognitive dysfunction may be related to inhibiting mitochondrion-dependent apoptosis in hippocampal neurons of aged rats.

2.
Chinese Journal of Anesthesiology ; (12): 139-142, 2019.
Article in Chinese | WPRIM | ID: wpr-755503

ABSTRACT

Objective To evaluate the effect of transversus abdominis plane (TAP) block on postoperative cognitive function in elderly patients undergoing laparoscopic surgery under general anesthesia.Methods Forty-eight male patients undergoing laparoscopic tension-free repair of inguinal hernia under general anesthesia,aged 65-75 yr,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,with body mass index of 20-28 kg/m2,were divided into 2 groups (n =24 each) using a random number table method:TAP block combined with general anesthesia group (group TG) and general anesthesia group (group G).Anesthesia was induced with midazolam,cisatracurium besylate,sufentanil and etomidate,and the patients were mechanically ventilated after laryngeal mask airway insertion.TAP block was performed through the anterior superior iliac spine approach,and 0.25% ropivacaine 30 ml was injected in group TG.Anesthesia was maintained by target-controlled infusion of propofol and remifentanil and muscle relaxation by intravenously injecting cisatracurium.The occurrence of cerebral regional oxygen saturation (rSO2) and low rSO2 events (rSO2 <60%) was recorded at 1 min before anesthesia induction (T0),5 min after inserting the laryngeal mask airway (T1),at skin incision (T2),30 min after skin incision (T3),and at the end of surgery (T4).The consumption of propofol and remifentanil was recorded during surgery.Montreal Cognitive Assessment (MoCA) was used to evaluate the cognitive function of patients at 1 day before surgery and 7 days after surgery,and the development of postoperative cognitive dysfunction (POCD,MoCA scores< 26) was recorded.Results Compared with group G,the intraoperative consumption of propofol and remifentanil was significantly reduced,rSO2 was increased at T2~,and the incidence of low rSO2 events was decreased,MoCA scores were increased at 7 days after surgery,and the incidence of POCD was decreased in group TG (P<0.05).Conclusion TAP block can reduce the incidence of POCD in elderly patients undergoing laparoscopic surgery under general anesthesia.

3.
Chinese Journal of Pathophysiology ; (12): 878-883, 2018.
Article in Chinese | WPRIM | ID: wpr-701209

ABSTRACT

AIM:To observe whether selective inhibition of endothelin receptor A(ETRA)improves white matter lesions(WMLs),and explore the mechanism.METHODS:Sprague-Dawley rats(n=33)were randomly divided into sham operation group(n=9),treatment group[stroke-prone renovascular hypertensive rats-modified 2 vessel occlu-sion(RHRSP-modified 2VO)+ambrisentan(n=12)]and placebo group[RHRSP-modified 2VO +vehicle(n =12)].Drug and vehicle administration was performed from 17th to 20th week and monitoring of systolic arterial pressure was performed weekly.Morris water maze test was conducted to evaluate the function of cognition.The protein levels of en-dothelin-1(ET-1)in the cortex,corpus callosum and caudate putamen were quantitatively analyzed respectively.The se-verity of WMLs and the relationship between ET-1 and vessels were observed by the method of histopathology.RESULTS:The difference of systolic arterial pressure between treatment group and placebo group was not significant.The animals in treatment group exhibited shorter escape latency(P<0.05),more times of crossing platform(P<0.05), lower level of ET-1 in corpus callosum and caudate putamen(P<0.05),respectively,improved WMLs severity(P<0.05)and lower binding level of ET-1 to vessels compared with the placebo group.CONCLUSION: Selective inhibition of endothelin receptor A improves the severity of WMLs and ameliorates the cognitive function.

4.
Chinese Journal of Nervous and Mental Diseases ; (12): 608-611, 2017.
Article in Chinese | WPRIM | ID: wpr-703115

ABSTRACT

Objective To investigate the relationship between plasma tau protein, phosphorylated tau protein (p-tau) protein and cognitive function in subjects with generalized brain atrophy. Methods A total of 100 subjects with moderate and severe brain atrophy were divided into two groups according to cognitive function: normal group (n=50 cases) and dementia group (n=50 cases). And their gender, age, educational level, etc. are recorded. The tau protein and p-tau protein content in plasma were measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The differences between plasm tau and p-tau protein expression and their relationship with cognitive function were analyzed. Results Plasma tau protein and p-tau protein levels were significantly higher (P<0.05) in the dementia group [(210.92±43.79)pg/mL、(81.15±16.85)pg/mL] than in the normal group[(210.92±43.79)pg/mL、(81.15±16.85)pg/mL]. Plasma tau protein and p-tau protein levels were negatively correlated with the MMSE score (P<0.05) and had no significant correlation with the degree of brain atrophy (P>0.05). Conclusion Cognitive impairment may be associated with elevated tau protein levels in patients with extensive brain atrophy.

5.
Chinese Journal of Geriatrics ; (12): 387-390, 2017.
Article in Chinese | WPRIM | ID: wpr-608245

ABSTRACT

Objective To compare 6 sub-function scale differences of frontal lobe function rating scale or a Frontal Assessment Battery(FAB)among patients with two subtypes of vascular cognitive impairment(VCI) to provide clues for the distinctive intervention and disease prevention and control of patients with two subtypes.Methods Totally 220 non-dementia vascular cognitive impairment (NDVCI)patients and 68 patients with vascular dementia(VaD)with final diagnosis were selected.The overall function and six sub-function scores were tested by FAB.Analyzing the score difference and probing a progress tendency from NDVCI to VaD were performed.Results The scores of frontal lobe function rating scale were higher in NDVCI(14.0 ± 2.8)than in VaD (9.5±2.0) patients with significant difference(t =29.92,P =0.00).The scales of frontal lobe function rating score of conceptualization ability (t =6.24,P =0.00),intelligence flexibility (t =7.00,P =0.00),antiinterference ability(t =7.21,P =0.00) and attention suppression(t =5.32,P =0.00) were lower in VaD group than in NDVCI group.The conceptualization weight capacity was significantly lower in VaD group than in NDVCI group(0.04 versus 0.32).Conclusions During a transitive process from NDVCI to VaD,it is important to focus on the mutation and deterioration of conceptualization capacity.

6.
Chinese Journal of Radiology ; (12): 191-195, 2016.
Article in Chinese | WPRIM | ID: wpr-490776

ABSTRACT

Objective To explore a new index for reflecting the topological information of brain functional networks in patients at high risk of Alzheimer disease using characteristics of resting-state functional connectivity strengths(FCS) in patients with amnestic mild cognitive impairment(aMCI). Methods Thirty-one aMCI patients and 42 age, gender and years of education matched normal controls were enrolled between September 2009 and April 2011 in this study. The resting-state functional MRI (rs-fMRI) data of all participants were acquired and preprocessed. Then the whole-brain functional connectivities were constructed for exploring the distribution characteristics of hub regions which had higher FCS values. Using two-sample t test to compare group differences in age, years of education and each neuropsychological assessment. In addition, using Chi-squared test to compare group differences in gender. Group differences in FCS values were analyzed by general linear model. Finally, correlation analyses were used to evaluate the relationships between the FCS values of the brain regions with group differences and behavioral scores in aMCI patients. Results The hub regions of the functional networks in the aMCI patients were mainly located in the association cortices such as the precuneuses, posterior cingulate cortices, medial prefrontal cortices, angular gyri, superior occipital gyri, fusiform gyri and lingual gyri. The distribution models in the aMCI patients were consistent with those in the normal controls. However, the FCS values of these brain regions were significantly lower in the aMCI patients than those in the normal controls. In comparison to the normal controls, the aMCI patients had significantly decreased FCS values in the bilateral fusiform gyri, lingual gyri, superior occipital gyri, left middle occipital gyrus and postcentral gyrus (the cluster was 389, 230, 187 and 107 voxels, respectively;P<0.05, respectively), and they had decreased trends of FCS values in the bilateral posterior cingulate cortices and right insulas. The correlation analysis with uncorrected conditions showed that the FCS values of the left postcentral gyri were correlatid with the clock drawing test (CDT) scores (r=0.436, P=0.026). Conclusions aMCI mainly attacks the hub regions of brain functional networks. The changes of functional connectivities in aMCI may reflect the early pathophysiologic alterations of AD.

7.
Tianjin Medical Journal ; (12): 663-665,666, 2015.
Article in Chinese | WPRIM | ID: wpr-601456

ABSTRACT

Objective To observe the effect of a variety dosage of dexmedetomidine on circulatory and cognitive func?tions in elderly patients who underwent hip orthopedic surgery. Methods A total of 120 patients who underwent hip ortho?pedic surgery, with age over 65 years old were recruited from 06/2013 to 09/2014 and were administered intravenously dex?medetomidine after epidural anesthesia. Based on the dosage of dexmedetomidine, patients were randomly divided into 3 groups with 40 cases in each group:Group A were given 0.2μg·h-1·kg-1 dexmedetomidine;Group B were given dexmedeto?midine 0.4μg · h-1 · kg-1, and group C were given 0.6μg · h-1 · kg-1. The heart rate (HR),mean arterial pressure (MAP), and pulse oxygen saturation (SpO2) were recorded at 6 time points, including the time entering operating room (T0), 10 min (T1), 20 min (T2) after drug administration, the time of drug withdrawal (T3), 10 min after drug withdrawal (T4) and the terminal time of surgery (T5) respectively. Cognitive function was evaluated by mini-mental state examination (MMSE) at the time points of 24 hours before surgery (t1), 12 hours (t2), 24 hours (t3), and 72 hours (t4) after surgery. Results All 3 groups of pa?tients show no significant difference of MAP, HR and SpO2 at T0 (P>0. 05).A significant decrease in MAP and HR were ob?served in Group C at T2 and T3 time points compared to those in Group A or Group B (P 0.05). However, compared to that in group A or group C, MMSE increased significantly at time point T2, T3 in group B (P<0.05). In addition, compared to group A or group C, the pa?tients in group B exhibited lower incidence of postoperative cognitive function disorder (P < 0.05). Conclusion Continu?ous intravenous infusion of Dexmedetomidine can be used in elderly patient who underwent hip orthopedic surgery at the dose of 0.4μg·h-1·kg-1 safely with little interference to circulatory and cognitive function in perioperative period.

8.
Chinese Journal of Behavioral Medicine and Brain Science ; (12): 720-723, 2014.
Article in Chinese | WPRIM | ID: wpr-455551

ABSTRACT

Objective To observe changes of cognitive function and the expression of tumor necrosis factor alpha(TNF-α),interleukin 10(IL-10) in hippocampus of diabetic rats,and assess the role of inflammation in the possible pathogenesis of diabetic encephalopathy (DE).Methods 30 male SD rats were randomly divided into control group and diabetes mellitus group.After 4 weeks of feeding high fat diet,diabetes mellitus group according to 30mg/kg injected with streptozotocin to establish type 2 diabetic rat model.At the end of the experiment,cognition were evaluated using water maze test.The concentration of beta-amyloid(Aβ) in hippocampus of diabetic rats were detected through enzyme linked immunosorbent assay,and the expression of TNF-α,IL-10 were detected by Western blotting.The expression of Aβ,TNF-α,IL-10 were observed through immunohistochemistry.Results Time spent in the target quadrant in diabetes mellitus group was shorter than that in control group ((38.21± 3.68)s vs (42.10±2.62)s,t=3.105,P<0.01).The frequency of crossing original platform site was less than that in control group((2.62±0.77) vs(3.69±0.95),t=3.184,P<0.01).Compared with control group the expression of Aβ,TNF-α were higher(BothP<0.01),and IL-10 were lower(P<0.01)in diabetes mellitus group.The positive expression of Aβ,TNF-α were obviously and IL-10 were less obviously observed in diabetes mellitus group according to immunohistochemistry.Conclusion The cognitive decline in diabetic rats is possibly related to inflammatory cytokines expressing out of balance.

9.
Dement. neuropsychol ; 7(4): 439-443, dez. 2013. ilus, tab
Article in English | LILACS | ID: lil-696483

ABSTRACT

HTLV-I-associated myelopathy (HAM/TSP) is the most common neurological manifestation of HTLV-I, causing progressive weakness, sensory disturbance, and sphincter dysfunction. Although motor disorders have been well described, few studies have associated cognitive disorders and HTLV-I infection. In areas endemic for HTLV-I infection, the differential diagnosis between HAM/TSP and other myelopathy etiologies can be difficult, particularly if the patient has signs and symptoms of brain involvement, since seropositive HTLV-I patients can present other neurological diseases. Here, we report one case initially diagnosed as Multiple Sclerosis (MS) which, upon further investigation, was found to be HTLV-I seropositive.


HTLV-I causando fraqueza progressiva, alterações de sensibilidade e disfunção esfincteriana. As alterações motoras são bem descritas, mas ainda são poucos os estudos que examinam a possibilidade de ocorrência de transtornos cognitivos na infecção pelo HTLV-I. Em áreas endêmicas para o HTLV-I, o diagnóstico diferencial com outras causas de mielopatias pode ser difícil, particularmente se o paciente tem sinais e sintomas de acometimento encefálico, já que a sorologia positiva para o HTLV-I pode ser detectada em pacientes com outras doenças neurológicas. Aqui relata-se o caso de uma paciente inicalmente diagnosticada com Esclerose Múltipla e que, na investigação posterior, foi encontrado soropositividade para HTLV-I.


Subject(s)
Humans , Magnetic Resonance Spectroscopy , Human T-lymphotropic virus 1 , Paraparesis, Tropical Spastic , Cognitive Dysfunction , Multiple Sclerosis
10.
Chinese Journal of Geriatrics ; (12): 1042-1046, 2013.
Article in Chinese | WPRIM | ID: wpr-442785

ABSTRACT

Objective To compare the clinical value of three visual rating scales (VRS) for white matter lesions (WML) in Alzheimer's disease (AD) and mild cognitive impairment (MCI).Methods Totally 184 subjects (including 107 AD patients,47 MCI patients and 30 normal controls)were recruited.All subjects underwent comprehensive neuropsychological tests and were examined with a standard protocol of MR imaging.WML burden was rated with the Age-Related White Matter Changes (ARWMC) rating scale,Cholinergic Pathways Hyperintensities Scale (CHIPS) and Fazekas scale.Consistence of the three rating scales were analyzed,and detection results of WML in AD/ MCI/NC group with the three rating scales were compared.The relationship between WML and cognitive function in AD and MCI groups were explored.Results ARWMC rating scale,CHIPS and Fazekas scales were moderately to highly correlated with WML (r=0.61-0.78,all P<0.01).ARWMC showed that WML were in the left and right frontal lobes in AD and MCI groups and in the right frontal lobe and left temporal lobe in NC group,which had significant differences (F=4.20,4.69,4.69,3.36,respectively,all P<0.05).WML in the left temporal lobe had a significant difference between MCI group and NC group (F=3.36,P<0.05).CHIPS showed that WML in the front left side of centrum semiovale in AD and MCI groups had significant difference as compared with that in NC group (F=4.88,P<0.05),and WML in the rear right side of low external capsule had a significant difference between AD and NC groups (F=3.04,P<0.05).Fazekas scale showed that there was no difference in WML among AD,MCI and NC groups.ARWMC showed that scores of WML in right temporal lobe were positively correlated with concentration and visual construction,and bilateral basal ganglia were negatively correlated with the concentration.Fazekas scale showed that scores of WML in periventricular were negatively correlated with concentration,MMSE and orientation,scores of WML in deep white matter were negatively correlated with concentration,abstraction and judgment,and the whole scores were negatively correlated with concentration.CHIPS showed that the scores of WML in the rear left side of low external capsule were negatively correlated with short-term memory in MCI group.Conclusions The three rating scales well consistent with each other.ARWMC rating scale and CHIPS can detect the differences in WML between AD,MCI and NC groups.The scores of CHIPS in WML are related with cognition in MCI group,while scores of ARWMC and Fazekas scale in WML are correlated with many aspects in cognitive function in AD group.In general speaking,CHIPS in MCI patients and ARWMC rating scale in AD patients show more advantages in the detection of WML and have better correlation with cognitive function.

11.
Chinese Journal of Internal Medicine ; (12): 777-780, 2012.
Article in Chinese | WPRIM | ID: wpr-420861

ABSTRACT

Objective To examine the validity and reliability of the application of Chinese version of AD8 among patients with Alzheimer's disease (AD),and to explore the discriminative properties of AD8 including score boundaries,sensitivity and specificity in differentiating AD and normal controls.Methods A total of 240 subjects were recruited,including 75 cognitively intact subjects as normal control and 165patients with AD.Normal control and patients with AD were assessed with Clinical Dementia Rating (CDR),Mini-Mental State Examination (MMSE),and Clock Drawing Test (CDT).All informed normal controls and informants of patients with AD were asked about Chinese version of AD8,among which,158informants of patients with AD received AD8 examination again.Results (1) The Cronbach alpha for Chinese version of AD8 was 0.78.The intraclass correlation coefficient (ICC) of retest reliability was 0.96(P < 0.01).(2) The correlation coefficients between each item of AD8 ranged from 0.36 to 0.69(P< 0.01).Chinese version of AD8 total scores were strongly positively correlated with CDR global score (r =0.82,P < 0.01),and CDR-SB(r =0.80,P < 0.01),and negatively correlated with the total score of MMSE (r =-0.75,P <0.01)and CDT(r =-0.53,P <0.01).(3) For discrimination between normal controls and patients with AD,the AUC was 0.93.Using a cutoff of 2 or greater on Chinese version of AD8 to discriminate dementia,the sensitivity was 93.9%,and specificity was 76.0%.Conclusion Chinese version of AD8 is a brief and sensitive screening measure with good validity and reliability.

12.
Chinese Journal of General Practitioners ; (6): 680-682, 2012.
Article in Chinese | WPRIM | ID: wpr-427990

ABSTRACT

A total of 192 patients with sepsis were tested by Montreal Cognitive Assessment (MoCA) for a preliminary diagnosis of whether or not there was sepsis associated encephalopathy (SAE) according to their test results.SAE was diagnosed or excluded after consultations and comprehensive analysis on the basis of clinical manifestations and auxiliary examination results.The scores of the patients in this group were (25.7 ± 3.3) points.The sensitivity of MoCA for screening SAE was 0.776 and its specificity 0.963.The rate of diagnostic coincidence between MoCA and comprehensive analysis for SAE was 0.880.The diagnostic concordance between two diagnostic methods of SAE was excellent (kappa value =0.753 ± 0.048,P =0.000).The area under the receiver operating characteristic (ROC) curve of MoCA for screening SAE was 0.929 ± 0.019 (P =0.000) ; the optimal cutoff value was 25.5 points; and its sensitivity was 0.779 and specificity 0.962.And negative correlations existed between score of MoCA and age,disease course and co-existing shock or multiple organ dysfunction syndrome (P < 0.05).

13.
Chinese Journal of Behavioral Medicine and Brain Science ; (12): 132-134, 2012.
Article in Chinese | WPRIM | ID: wpr-424931

ABSTRACT

ObjectiveTo investigate the effect of expressional chimeric faces on the attentional bias in unilateral spatial neglect (USN) patients.Methods12 USN patients and 30 matched healthy controls (HC) were involved in this study.All of them were performed with happy-neutral and sad-neutral expressional chimeric faces (ECF) and the attentional deviation scores were compared between and within groups.ResultsThere were statistically significant differences of attentional deviation scores ( happy-neutral ECF:t =15.550,P < 0.0l ; sadneutral ECF:t=12.192,P<0.01 ) between the USN group (happy-neutral ECF:0.78 ±0.22;sad-neutral ECF:0.50 ±0.20) and the HC group (happy-neutral ECF:-0.31 ±0.20;sad-neutral ECF:-0.25 ±0.17),with rightward bias in the USN group and small leftward bias in the HC group.For the USN group,the magnitude of rightward bias in the sad-neutral ECF condition was reduced than in the happy-neutral ECF condition ( t =3.954,P=0.002 ).There were no statistically differences under happy-and sad-neutral ECF conditions within the HC group ( t =- 1.302,P =0.203 ).ConclusionsUSN patients show rightward attentional bias under both happyand sad-neutral ECF conditions.However,the magnitude of rightward bias under the sad-neutral ECF condition are reduced significantly.This might be attributed to the unconscious processing of stimuli in the neglected side and emotion cognition of the brain hemispheres.

14.
Chinese Journal of Diabetes ; (12): 31-33, 2010.
Article in Chinese | WPRIM | ID: wpr-403882

ABSTRACT

Objective To investigate the cognitive impairment of middle-aged patients with type 2 diabetes mellitus(T2DM). Methods Wechsler adult intelligence scale-Chinese revised edition (WATS-RC) was used as the tool to examine the cognitive function of middle-aged patients with T2DM and the healthy controls in 51 cases. The t-test was used to compare the differences in score between patients and the control group. The patients were divided into two groups with or without cognitive dysfunction. The logistic regression analysis was made for all the variables to confirm risk factors for the cognitive dysfunction in diabetes. Results The WAITS-RC scores of digit-symbol coding test and block design test were much lower(P<0.05) in diabetes versus control group. The other tests showed no significant difference. The cognitive function was negatively correlated with HbA_1>c and HOMA-IR by logistic regression analysis. Conclusions For middle-aged patients with type 2 diabetes, their cognitive functions such as learning ability, analysis and comprehensive capabilities are impaired. The cognitive function is closely related with HbA_1c and HOMA-IR.

15.
Chinese Journal of Anesthesiology ; (12): 290-293, 2010.
Article in Chinese | WPRIM | ID: wpr-390087

ABSTRACT

Objective To investigate the relationship between the changes in intracranial excitatory amino acid(EAA) levels and the incidence of postoperative cognitive dysfunction (POCD) in eldedy patients after general anesthesia. Methods Forty ASA Ⅰ-Ⅲ patients of both sexes aged 65-79 yr weighing 48-76 kg undergoing elective non-cardiac surgery under general anesthesia were studied.Anesthesia was induced with midazolam,fentanyl,etomidate and succinylcholine and maintained with continuous iv infusion of propofol,remifentanil,isoflurane inhalation and intermittent iv boluses of vecuronium.The right internal jugular vein was cannulated with a catheter which was advanced cephalad until jugular bulb.The jugular bulb venous blood samples were taken before (T0,baseline),at the end of (T1) and at 24,48 and 72h(T2-4) after operation for measurement of plasma concentrations of glutamate (Glu),aspartate (Asp) and glycine (Gly) by RP-HPLC.The cognitive function was evaluated by mini-mental state examination (MMSE) at T0 and T4.Results Eleven of the 40 patients developed POCD (28%).The plasma Gh,Asp and Gly concentrations were significantly increased after operation as compared with the baseline values in POCD patients and were significantly higher than in non-POCD patients.The plasma concentrations of Glu and Asp were negatively correlated with MMSE score(Glu:r=-0.86.P<0.01;Asp:r=-0.99,P<0.01).Conclusion Elderly patients may develop POCD after operation performed under general anesthesia through increase in intracranial EAA levels.

16.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 30(4): 316-321, Dec. 2008. graf, tab
Article in English | LILACS | ID: lil-501861

ABSTRACT

OBJECTIVE: To describe the neuropsychological profile of mild cognitive impairment subtypes (amnestic, non-amnestic and multiple-domain) of a clinical sample. We further address the diagnostic properties of the Mini-Mental State Examination and the Cambridge Cognitive Examination for the identification of the different mild cognitive impairment subtypes in clinical practice. METHOD: Cross-sectional clinical and neuropsychological evaluation of 249 elderly patients attending a memory clinic at a university hospital in Sao Paulo, Brazil. RESULTS: The performance of patients with mild cognitive impairment was heterogeneous across the different subtests of the neuropsychological battery, with a trend towards an overall worse performance for amnestic (particularly multiple domain) mild cognitive impairment as compared to non-amnestic subtypes. Screening tests for dementia (Mini-Mental State Examination and Cambridge Cognitive Examination) adequately discriminated cases of mild Alzheimer's disease from controls, but they were not accurate to discriminate patients with mild cognitive impairment (all subtypes) from control subjects. CONCLUSIONS: The discrimination of mild cognitive impairment subtypes was possible only with the aid of a comprehensive neuropsychological assessment. It is necessary to develop new strategies for mild cognitive impairment screening in clinical practice.


OBJETIVO: Descrever o perfil neuropsicológico dos subtipos de comprometimento cognitivo leve, amnéstico, não-amnéstico e múltiplos domínios, de uma amostra clínica. Além disto, avaliou-se as propriedades diagnósticas do Mini-exame do Estado Mental e do Cambridge Cognitive Examination na identificação dos diferentes subtipos de comprometimento cognitivo leve na prática clínica. MÉTODO: Avaliação clínica e neuropsicológica transversal de 249 idosos em uma clínica de memória de um hospital universitário em São Paulo, Brasil. RESULTADOS: Testes de rastreio para demência (Mini-exame do Estado Mental e Cambridge Cognitive Examination) identificam corretamente casos de doença de Alzheimer leve, mas não apresentam boa acurácia para diferenciar os diversos subtipos de comprometimento cognitivo leve. A performance dos sujeitos portadores de comprometimento cognitivo leve foi heterogênea nos diferentes testes da bateria neuropsicológica, com uma tendência a uma pior performance global nos pacientes com o subtipo amnéstico (especialmente os com envolvimento de múltiplos domínios cognitivos) em relação ao comprometimento cognitivo leve não-amnéstico. CONCLUSÕES: A discriminação dos diferentes subtipos de comprometimento cognitivo leve foi possível somente a partir de uma avaliação neuropsicológica detalhada. Desta maneira, é necessário o desenvolvimento de novas estratégias de rastreio para esta condição na prática clínica.


Subject(s)
Aged , Female , Humans , Male , Alzheimer Disease/diagnosis , Amnesia/diagnosis , Cognition Disorders/diagnosis , Neuropsychological Tests , Case-Control Studies , Geriatric Assessment/methods , Mental Status Schedule , Multivariate Analysis , Reproducibility of Results
17.
Journal of Clinical Neurology ; (6)1993.
Article in Chinese | WPRIM | ID: wpr-591991

ABSTRACT

Objective To investigate the changes and its clinical significance of serum brain-derived neurotrophic factor (BDNF) level and plasma tissue plasminogen activator( t-PA ) level in patients with amnestic mild cognitive impairment (aMCI). Methods 99 aMCI patients (aMCI group) and 99 matched normal controls (NC group) were recruited for the present study. Multi-dimension neuropsychologic tests were used to extensively assess cognitive function of subjects. An enzyme-linked immunosorbent assay was applied to measure serum BDNF level and plasma t-PA level. The correlation analysis between serum BDNF level and plasma t-PA level tested by ELISA and cognitive function were also made. Results (1) The results neuropsychologic tests in aMCI guoup were significantly lower than those in NC group (all P

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