轻度心理行为障碍(mild behavioral impairment,MBI)是一种痴呆前综合征,主要在知觉、思维、情感、行为、人格等方面表现异常,可增加个体发生痴呆的风险。痴呆的精神行为症状(behavioral and psychological symptoms of dementia,BPSD)...轻度心理行为障碍(mild behavioral impairment,MBI)是一种痴呆前综合征,主要在知觉、思维、情感、行为、人格等方面表现异常,可增加个体发生痴呆的风险。痴呆的精神行为症状(behavioral and psychological symptoms of dementia,BPSD)指痴呆病程中出现的精神和行为问题,该症状的发生可增加照料负担与患者的死亡率。MBI和BPSD组成痴呆相关的神经精神症状(neuropsychiatric symptoms,NPS)。MBI作为新的概念,为轻度认知功能障碍(mild cognitive impairment,MCI)和痴呆的临床治疗与研究提供了新的视角,并引起了广泛的关注。该文回顾了MBI与NPS相关文献,综述MBI的临床表现以及与认知障碍的神经生物学联系,并提出了MBI更合理的翻译应为痴呆前心理行为障碍。展开更多
目的通过分析阿尔茨海默病(Alzheimer’s disease,AD)与轻度认知功能障碍(mild cognitive impairment,MCI)患者精神行为症状的异同,为阿尔茨海默病与轻度认知功能障碍的精神行为症状(behavioral and psychological symptoms of dementia...目的通过分析阿尔茨海默病(Alzheimer’s disease,AD)与轻度认知功能障碍(mild cognitive impairment,MCI)患者精神行为症状的异同,为阿尔茨海默病与轻度认知功能障碍的精神行为症状(behavioral and psychological symptoms of dementia,BPSD)诊疗提供指导。方法采用神经精神问卷(neuropsychiatric inventory,NPI)评估来自云南省的71例AD患者、31例MCI患者精神行为症状的发生率、严重程度,并与70例正常对照者比较。结果抑郁、焦虑、易激惹的发生率及严重程度,AD与MCI组比较差异无统计学意义(P>0.05),而MCI组高于正常对照组(P<0.05)。淡漠发生率AD组与MCI组比较差异无统计学意义(P>0.05),淡漠严重程度AD组高于MCI组(P<0.05);而MCI组淡漠发生率及严重程度高于正常对照组(P<0.05)。NPI总分、其余症状发生率或严重程度AD组高于MCI组(P<0.05),而MCI组发生率或严重程度与正常对照组比较差异无统计学意义(P>0.05)。结论AD患者总体BPSD较MCI患者严重,而抑郁、焦虑、易激惹症状在AD与MCI患者之间无差异,MCI处于正常衰老与AD之间的认知变化过渡阶段,伴有这些症状的MCI患者需要重视,及早干预。展开更多
Background： Rapid eye movement （REM） sleep behavior disorder （RBD） may be a risk factor for cognitive impairment in patients with Parkinson＆#39;s disease （PD）.However, little is known regarding the relation be...Background： Rapid eye movement （REM） sleep behavior disorder （RBD） may be a risk factor for cognitive impairment in patients with Parkinson＆#39;s disease （PD）.However, little is known regarding the relation between the severity of RBD and the different domains of cognitive impairment.The aim of this study was： （1） to investigate the domains of cognitive impairment in patients with PD and RBD, and （2） to explore risk factors for PD-mild cognitive impairment （PD-MCI） and the relationship between RBD severity and impairment in different cognitive domains in PD.Methods： The participants were grouped as follows： PD without RBD （PD-RBD;n =42）, PD with RBD （PD ＋ RBD;n =32）, idiopathic RBD （iRBD;n =15）, and healthy controls （HCs;n =36）.All participants completed a battery of neuropsychological assessment of attention and working memory, executive function, language, memory, and visuospatial function.The information of basic demographics, diseases and medication history, and motor and nonmotor manifestations was obtained and compared between PD-RBD and PD ＋ RBD groups.Particular attention was paid to the severity of RBD assessed by the RBD Questionnaire-Hong Kong （RBDQ-HK） and the RBD Screening Questionnaire （RBDSQ）, then we further examined associations between the severity of RBD symptoms and cognitive levels via correlation analysis.Results： Compared to PD-RBD subjects, PD ＋ RBD patients were more likely to have olfactory dysfunction and their Epworth Sleepiness Scale scores were higher （P 〈 0.05）.During neuropsychological testing, PD ＋ RBD patients performed worse than PD-RBD patients, including delayed memory function, especially.The MCI rates were 33%, 63%, 33%, and 8% for PD-RBD, PD ＋ RBD, iRBD, and HC groups, respectively.RBD was an important factor for the PD-MCI variance （odds ratio =5.204, P =0.018）.During correlation analysis, higher RBDSQ and RBDQ-HK scores were significantly associated with poorer performance on the Trail Making Test-B （errors） and Auditory Verbal Learning Test （delayed recall） and higher RBD-HK scores were also associated with Rey-Osterrieth complex figure （copy） results.Conclusions： When PD-RBD and PD ＋ RBD patients have equivalent motor symptoms, PD ＋ RBD patients still have more olfactory dysfunction and worse daytime somnolence.RBD is an important risk factor for MCI, including delayed memory.Deficits in executive function, verbal delayed memory, and visuospatial function were consistently associated with more severe RBD symptoms.展开更多
文摘目的通过分析阿尔茨海默病(Alzheimer’s disease,AD)与轻度认知功能障碍(mild cognitive impairment,MCI)患者精神行为症状的异同,为阿尔茨海默病与轻度认知功能障碍的精神行为症状(behavioral and psychological symptoms of dementia,BPSD)诊疗提供指导。方法采用神经精神问卷(neuropsychiatric inventory,NPI)评估来自云南省的71例AD患者、31例MCI患者精神行为症状的发生率、严重程度,并与70例正常对照者比较。结果抑郁、焦虑、易激惹的发生率及严重程度,AD与MCI组比较差异无统计学意义(P>0.05),而MCI组高于正常对照组(P<0.05)。淡漠发生率AD组与MCI组比较差异无统计学意义(P>0.05),淡漠严重程度AD组高于MCI组(P<0.05);而MCI组淡漠发生率及严重程度高于正常对照组(P<0.05)。NPI总分、其余症状发生率或严重程度AD组高于MCI组(P<0.05),而MCI组发生率或严重程度与正常对照组比较差异无统计学意义(P>0.05)。结论AD患者总体BPSD较MCI患者严重,而抑郁、焦虑、易激惹症状在AD与MCI患者之间无差异,MCI处于正常衰老与AD之间的认知变化过渡阶段,伴有这些症状的MCI患者需要重视,及早干预。
文摘Background： Rapid eye movement （REM） sleep behavior disorder （RBD） may be a risk factor for cognitive impairment in patients with Parkinson＆#39;s disease （PD）.However, little is known regarding the relation between the severity of RBD and the different domains of cognitive impairment.The aim of this study was： （1） to investigate the domains of cognitive impairment in patients with PD and RBD, and （2） to explore risk factors for PD-mild cognitive impairment （PD-MCI） and the relationship between RBD severity and impairment in different cognitive domains in PD.Methods： The participants were grouped as follows： PD without RBD （PD-RBD;n =42）, PD with RBD （PD ＋ RBD;n =32）, idiopathic RBD （iRBD;n =15）, and healthy controls （HCs;n =36）.All participants completed a battery of neuropsychological assessment of attention and working memory, executive function, language, memory, and visuospatial function.The information of basic demographics, diseases and medication history, and motor and nonmotor manifestations was obtained and compared between PD-RBD and PD ＋ RBD groups.Particular attention was paid to the severity of RBD assessed by the RBD Questionnaire-Hong Kong （RBDQ-HK） and the RBD Screening Questionnaire （RBDSQ）, then we further examined associations between the severity of RBD symptoms and cognitive levels via correlation analysis.Results： Compared to PD-RBD subjects, PD ＋ RBD patients were more likely to have olfactory dysfunction and their Epworth Sleepiness Scale scores were higher （P 〈 0.05）.During neuropsychological testing, PD ＋ RBD patients performed worse than PD-RBD patients, including delayed memory function, especially.The MCI rates were 33%, 63%, 33%, and 8% for PD-RBD, PD ＋ RBD, iRBD, and HC groups, respectively.RBD was an important factor for the PD-MCI variance （odds ratio =5.204, P =0.018）.During correlation analysis, higher RBDSQ and RBDQ-HK scores were significantly associated with poorer performance on the Trail Making Test-B （errors） and Auditory Verbal Learning Test （delayed recall） and higher RBD-HK scores were also associated with Rey-Osterrieth complex figure （copy） results.Conclusions： When PD-RBD and PD ＋ RBD patients have equivalent motor symptoms, PD ＋ RBD patients still have more olfactory dysfunction and worse daytime somnolence.RBD is an important risk factor for MCI, including delayed memory.Deficits in executive function, verbal delayed memory, and visuospatial function were consistently associated with more severe RBD symptoms.
