主观与告知者报告的认知投诉在隐藏的脑小血管疾病中具有差异性的临床意义
Anne Arola1,2, Hanna M Laakso1,2, Heidi Heinonen1
1Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Cerebral circulation - cognition and behavior
|September 25, 2023
概括
在脑小血管疾病 (cSVD) 中,主观认知投诉并不反映客观认知衰退. 然而,信息员的报告与功能障碍和大脑变化相关,这表明早期cSVD的自我意识有限.
科学领域:
- 神经学 神经学
- 神经心理学 神经心理学
- 老年病的医生 老年病的医生
背景情况:
- 主观认知投诉在脑小血管疾病 (cSVD) 中很常见.
- 这些投诉,告密者评估,客观认知功能和cSVD中的大脑变化之间的关系尚未得到充分理解.
- 这项研究调查了老年人患有cSVD的这些关联.
研究的目的:
- 检查主观认知投诉,信息员报告,客观认知表现和cSVD患者的神经成像发现之间的关联.
- 为了确定主观和告密者报告的认知投诉是否与客观认知状态和大脑病理相一致.
- 探索信息者评估在识别cSVD中的功能障碍方面的实用性.
主要方法:
- 赫尔辛基SVD研究包括152名白质超强度 (WMH) 的老年人,但没有中风或痴呆症.
- 参与者接受了全面的神经心理评估,包括记忆和执行功能测试.
- 使用前性和后性记忆问卷 (PRMQ) 和Dysexecutive问卷 (DEX) (主观和告知者版本) 评估认知投诉. 功能能力 (A-IADL) 和抑郁症状 (GDS-15) 也被测量. 大脑MRI被用来评估WMH体积.
主要成果:
- 主观认知投诉与告密者报告有显著的相关性 (r=0.40-0.50,p<0.001).
- 在对人口统计学进行控制后,主观或告知者报告的认知投诉都与轻度认知障碍 (MCI) 或客观记忆和执行功能表现无关.
- 主观投诉与抑郁症状相关 (GDS-15),而告密者报告与WMH体积和功能障碍相关 (A-IADL).
结论:
- 主观和告知者报告的认知投诉与早期cSVD的客观认知表现没有相关性.
- 告知者评估与功能障碍和更严重的WMH相关,这表明它们更能表明疾病负担.
- 主观的抱怨主要与抑郁症状有关,突出了cSVD认知缺陷的潜在有限自我意识,以及告知者数据对于识别功能障碍的重要性.
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