Reliability and validity of the Chinese version of the Scale for Assessment and Rating of Ataxia

Background The Scale for the Assessment and Rating of Ataxia （SARA） was shown to be a reliable and valid measurement for patients with spinocerebellar ataxia （SCA）. The Brazilian version and the Japanese version of SARA were favorable for good reliability and validity. This study aimed to translate SARA into Chinese and test its reliability and validity in measurement of cerebellar ataxia. Methods SARA was translated into Chinese. A total 39 patients with degeneration cerebellar ataxia were evaluated independently by two neurologists with the Chinese version of SARA. Then the patients were evaluated by one of above neurologists with International Cooperative Ataxia Rating Scale （ICARS）. The statistical analyses were performed using SPSS 17.0 for Windows. Results The Cronbach＇s alpha coefficient of the Chinese version of SARA was 0.78, which represents a good internal consistence. The correlation coefficient of the Chinese version of SARA scores between the two evaluators was 0.86, illustrating that the inter-rater reliability of Chinese version of SARA was good. The correlation coefficient between the Chinese version of SARA and ICARS was 0.91, illustrating that the criterion validity of Chinese version of SARA was not bad. Conclusions The Chinese version of SARA is reliable and effective for the assessment of degeneration cerebellar ataxia. Compared with ICARS, the evaluation of Chinese version of SARA is more objective, the assessment time is shortened, and the maneuverability is better.

脊髓小脑性共济失调3型/Machado-Joseph病ICARS与SARA评分相关因素分析(英文)

目的:探讨国际协作共济失调评估量表(ICARS)与共济失调等级量表(SARA)评估脊髓小脑性共济失调3型/M achado-Joseph病患者的相关因素。方法:应用ICARS与SARA对126例基因检测明确诊断为脊髓小脑性共济失调3型患者进行评估,分析ICARS评分、SARA评分与发病年龄、病程、CAG重复次数的相关性。结果:ICARS总评分(Y1)、SARA总评分(Y2)与病程(X2)呈正相关(r=0.586,P<0.05;r=0.643,P<0.05),回归方程分别为Y1=13.072+2.388X2(F=68.874,P<0.05),Y2=4.403+0.961X2(F=87.254,P<0.05)。ICARS总评分、SARA总评分与年龄的比值分别与CAG重复次数呈正相关(r=0.328,P<0.05;r=0.335,P<0.05)。ICARS各项评分、SARA各项评分与病程均呈正相关(r=0.257～0.589,P<0.05;r=0.432～0.623,P<0.05)。ICARS各项评分、SARA各项评分与年龄比值分别与CAG重复次数呈正相关(r=0.263～0.403,P<0.05;r=0.189～0.366,P<0.05)。ICARS总评分、SARA总评分均随着病情严重程度增加而增加。结论:ICARS与SARA评分量表均能够有效地反映共济失调患者的病情严重程度,研究者可根据实际需要选用合适的量表。

脊髓小脑性共济失调3型/Machado-Joseph病患者小脑的磁共振波谱分析(英文)

目的:通过研究脊髓小脑共济失调3型(SCA3/MJD)患者小脑蚓部、桥臂、小脑皮质、齿状核的氢质子磁共振波谱(1H-MRS)的特点,探讨1H-MRS评估SCA3型疾病严重程度的价值。方法:对36例SCA3/MJD患者与27例性别、年龄与之匹配的健康对照进行单体素1H-MRS测定,比较2组间小脑上述各脑区N-乙酰天门冬氨酸(NAA)/肌酸(Cr),胆碱(Cho)/Cr,NAA/Cho比值的差别;同时对34例患者进行MJD1基因中(CAG)n重复次数的测定,应用共济失调等级量表(SARA)对其进行评分,并结合上述各脑区代谢物比值进行相关性分析。结果:SCA3/MJD患者的SARA评分与其病程、发病年龄、CAG重复次数呈正相关,与发病年龄呈负相关;SCA3/MJD患者上述各脑区NAA/Cr值及齿状核、蚓部NAA/Cho值较正常对照明显降低(P<0.01);SCA3/MJD患者小脑各区的1H-MRS与病程、发病年龄、CAG重复次数、SARA评分存在相关性。结论:1H-MRS技术可以检测SCA3/MJD患者小脑的神经代谢改变,且可较好地反应SCA3/MJD的疾病严重程度。

~1H-MRS对SCA3/MJD的诊断价值及与临床病程的关系

目的:探讨氢质子波谱(proton magnetic resonance spectroscopy,~1H-MRS)在脊髓小脑型共济失调3型/马查多–约瑟夫病(hereditary spinocerebellar ataxias 3 and Machado-Joseph,SCA3/MJD)诊断中的价值,同时探讨其与临床病程评分之间的联系。方法:SCA3/MJD起病患者、SCA3/MJD未起病患者及年龄匹配健康志愿者进行~1H-MRS检查,经数据后处理获得N–乙酰天门冬氨酸(N-acetylaspartate,NAA),肌酸(creatine,Cr),胆碱(choline-containing compounds,Cho),肌醇(myo-inositol,m I)值及NAA/Cr,Cho/Cr,m I/Cr比值。将以上数据进行对比研究;同时对于SCA3/MJD起病患者进行国际协作共济失调评估量表(International Cooperative Ataxia Rating Scale,ICARS)及共济失调等级量表(Scale for the Assessment and Rating of Ataxia,SARA)评估,计算NAA/Cr,Cho/Cr,m I/Cr比值与临床评分之间的相关性。结果:SCA3/MJD起病患者在桥脑及齿状核的NAA/Cr值较正常对照组明显减低。SCA3/MJD起病患者小脑齿状核NAA/Cr值与ICARS评分有明显相关性。结论:SCA3/MJD的病变主要位于小脑及脑干,ICARS评分与小脑病变的程度有相关性,能较好地反映临床表现的轻重程度。~1H-MRS对于SCA3/MJD的诊断有一定的应用前景。

Nerve Growth Factor for the Treatment of Spinocerebellar Ataxia Type 3： An Open-label Study

Background： Spinocerebellar ataxia type 3 （SCA3） is the most common subtype of SCA worldwide, and runs a slowly progressive and unremitting disease course. There is currently no curable treatment available. Growing evidence has suggested that nerve growth factor （NGF） may have therapeutic effects in neurodegenerative diseases, and possibly also in SCA3. The objective of this study was to test the efficacy of NGF in SCA3 patients. Methods： We performed an open-label prospective study in genetically confirmed adult （〉18 years old） SCA3 patients. NGF was administered by intramuscular injection （18 μg once daily） fbr 28 days consecutively. All the patients were evaluated at baseline and 2 and 4 weeks after treatment using the Chinese version of the scale for assessment and rating of ataxia （SARA）. Results： Twenty-one SCA3 patients （ 10 men and 11 women, mean age 39.14 ± 7.81 years, mean disease duration 4.14 ± 1.90 years, mean CAG repeats number 77,57 ± 2.27） were enrolled. After 28 days of NGF treatment, the mean total SARA score decreased significantly from a baseline of 8.48± 2.40 to 6.30 ± 1.87 （P 〈 0.001 ）. Subsections SARA scores also showed significant improvements in stance （P = 0.003）, speech （P = 0.023）, finger chase （P = 0.015）, fast alternating hand movements （P = 0.009）, and heel-shin slide （P = 0.001）. Conclusions： Our preliminary data suggest that NGF may be effective in treating patients with SCA3.

事件相关电位P300预测脊髓小脑共济失调3型患者认知功能障碍的价值

目的研究脊髓小脑共济失调3型(SCA3)患者事件相关电位P300的特点,并探讨其对患者认知功能障碍的评估价值。方法选取2013年7月至2015年7月在神经内科住院部或门诊就诊的经基因测序确诊的SCA3型患者11例(SCA3组)作为研究对象,并选择13例健康体检者为对照组。对所有受试者进行听觉P300检查,并采用简易智能状态量表(MMSE)、蒙特利尔认知评估量表(Mo CA)评估认知功能,采用国际协作共济失调评估量表(ICARS)进行共济失调严重程度评分。结果 (1)SCA3组MMSE和Mo CA评分均明显低于正常对照组(P均<0.05);MMSE量表评分结果显示,SCA3组存在认知功能障碍5例(45.45%),对照组无认知功能障碍者;Mo CA量表评分结果显示,SCA3组存在认知功能障碍6例(54.55%),对照组无认知功能障碍者。(2)SCA3组中P300的潜伏期为(440.18±43.34)ms,波幅为(14.95±6.85)μV;正常对照组P300的潜伏期为(321.08±23.80)ms,波幅为(15.26±7.00)μV,两组P300潜伏期差异有统计学意义(P<0.01),而波幅差异无统计学意义(P>0.05)。(3)Spearmans相关性分析显示,SCA3组MMSE评分与P300的潜伏期呈负相关(r=-0.690,P<0.05),Mo CA评分与P300的潜伏期呈负相关(r=-0.828,P<0.01),P300波幅及ICARS评分与认知障碍无明显相关性。结论SCA3患者部分存在认知功能损害,P300的潜伏期可以预测患者的认知障碍程度。