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ニューロサイエンスの旅 Vol.40

当科の言語聴覚士・高岩亜輝子さんの論文「無症候性頚動脈狭窄症では流動性知能は障害されるが、結晶性知能は温存される」が、EUr J Neurol誌に掲載されました。
これまでの研究では、無症候性頚動脈狭窄症が高次脳機能障害を招くのかどうかについて一致した見解は得られていませんでしたが、今回の研究によって、高次脳機能を流動性、結晶性知能に分けることで流動性知能が障害されることを初めて明らかにすることができました。

A Voyage to Depth of Neuroscience Vol. 40

Takaiwa A, Kuwayama N, Akioka N, Kashiwazaki D, Kuroda S
Discrepancy analysis between crystallized and fluid intelligence tests: a novel method to detect mild cognitive impairment in patients with asymptomatic carotid artery stenosis.
Eur J Neurol. 2017 Oct 27. doi: 10.1111/ene.13504. [Epub ahead of print]

Abstract
BACKGROUND AND PURPOSE:
The present study was conducted to accurately determine the presence of mild cognitive impairment, which is often difficult to evaluate using only simple tests. Our approach focused on discrepancy analysis of fluid intelligence relative to crystallized intelligence using internationally recognized neuropsychological tests.
METHODS:
One-hundred and five patients diagnosed with asymptomatic carotid artery stenosis were assessed. The neuropsychological tests included the two subtests (information and picture completion) of Wechsler Adult Intelligence Scale-Revised (WAIS-R-two-subtests): crystallized intelligence tests and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) (immediate memory, visuospatial/constructional, language, attention, delayed memory and total score) as fluid intelligence tests. Discrepancy analysis was used to assess cognitive impairment. The score for RBANS was subtracted from the score for WAIS-R-two-subtests, and if the score difference was greater than the 5% confidence limit for statistical significance, it was defined as a decline in cognitive function.
RESULTS:
The WAIS-R-two-subsets was within normal limits when compared with the standardized values. However, all RBANS domains showed significant declines. Frequencies of decline in each RBANS domain were as follows: 69 patients (66%) in immediate memory, 26 (25%) in visuospatial/constructional, 54 (51%) in language, 63 (60%) in attention, 54 (51%) in delayed memory and 78 (74%) in the total score. Moreover, 99 patients (94%) showed decline in at least one RBANS domain.
CONCLUSIONS:
Cognitive function is only preserved in a few patients with asymptomatic carotid artery stenosis. Mild cognitive impairment can be precisely detected by performing the discrepancy analysis between crystallized and fluid intelligence tests.

https://www.ncbi.nlm.nih.gov/pubmed/29078025

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