认知负荷对老年脑小血管病患者书写及绘画流畅性的影响

Effect of cognitive load on writing and drawing fluency in elderly cerebral small vessel disease patients

目的分析认知负荷对老年脑小血管病(cerebral small vessel disease,CSVD)患者书写及绘画流畅性的影响。方法选择2018年11月~2019年5月解放军总医院第七医学中心神经内科就诊的脑白质损害患者59例(CSVD组),同期选择本院年龄、性别相匹配的健康体检者42例(对照组)。应用蓝牙智能笔对受试者进行书写及绘画测试的双重任务,第1任务为书写及绘画测试,第2任务为听辨的认知测试,分别进行单独任务、双重任务及双重任务成本(dual task cost,DTC)测试。结果 CSVD组双重任务书写时间较单独任务书写时间明显延长[(53.76±11.25)s vs(40.29±8.83)s,P<0.01]。CSVS组双重任务书写时间较对照组明显延长[(53.76±11.25)s vs(41.21±8.60)s,P<0.01]。CSVD组双重任务书写听辨和绘画听辨正确个数较单独听辨正确个数明显减少[(12.31±2.36)个vs(13.31±2.61)个,P<0.05;(10.98±1.81)个vs(13.31±2.61)个,P<0.01]。CSVD组双重任务书写听辨和绘画听辨正确个数较对照组明显减少[(12.31±2.36)个vs(13.52±2.97)个,P<0.05;(10.98±1.81)个vs(13.29±3.16)个,P<0.01]。CSVD组双重任务书写时间DTC和绘画听辨正确个数DTC较对照组明显增多,差异有统计学意义(P<0.01)。结论认知负荷下,老年CSVD患者书写流畅性易受到影响。双重任务条件下,更易发现老年CSVD患者上肢运动功能障碍。

Objective To analyze the effect of cognitive load on writing and drawing fluency in elderly cerebral small vessel disease(CSVD) patients.Methods Fifty-nine white matter lesion patients admitted to our center from November 2018 to May 2019 served as a CSVD group and 42 age-and gender-matched healthy people served as a control group.The dual task of writing and drawing in elderly CSVD patients was tested with a bluetooth smart pen.The first task was a writing and drawing test,the second task was a listening test.The single task,dual task and its cost were tested,respectively.Results The writing time of dual task was significantly longer than that of single task in CSVD group(53.76±11.25 s vs 40.29±8.83 s,P<0.01) and in CSVD group than in control group(53.76±11.25 s vs 41.21±8.60 s,P<0.01).The number of correct writing and drawing listening times was significantly smaller in dual task than in single task(12.31±2.36 vs 13.31±2.61,P<0.05;10.98±1.81 vs 13.31±2.61,P<0.01) and was significantly higher in CSVD group than in control group(P<0.01).Conclusion The writing fluency is easily affected in elderly CSVD patients under cognitive load.The upper limb motor dysfunction is common in elderly CSVD patients under dual task.