失智症病程不同階段中的認知功能與反應時間波動的相關性

The relationship between cognitive function and variability of reaction time in patients with different progression of dementia

陳建彰(Chien-Chang Chen)

指導教授 ： 蕭世朗

高雄醫學大學/醫學院/神經學科研究所/碩士(2009年)

https://doi.org/10.6832/KMU.2009.00093

摘要

阿茲海默氏症是一神經退化性疾病，多在老人盛行；過去的研究著重疾病的流性病學及病理的探究，近年來則是希望能找到此疾病的生物性指標，以期能提早發現及早治療，更甚於在未發病前就能透過生物性指標來預測疾病的發生。過去利用外在行為表現的差異來探討腦部功能的研究不多，近來有學者發現「作業表現幅度波動大，日後認知功能衰退程度大；反之作業表現幅度波動小，日後認知功能下降程度小」，本研究採用此一概念來了解阿茲海默氏症患者的作業表現穩定度和認知功能的相關性，進而期待能成為一生物性指標。本研究招募三組受試者：輕度失智症組 (26名)、早期失智症組 (16) 和正常組 (12)，年齡介於57至87歲間，招募條件為1. 意識清楚，能夠理解指導語；2. 排除精神以及其他或共患的神經疾病史；3. 行動自如，未坐輪椅或手腳顫抖。前兩組進行認知功能評估、認知作業與動作作業，而正常組則只進行認知作業與動作作業。資料分析則是將其作業的平均反應時間及斜率作組內的變異數分析來了解三組間的作業效率與作業穩定性的差異，此外也將作業的平均反應時間及斜率和知能篩選量表 (CASI) 作相關性分析。結果發現到作業表現的平均反應時間會隨著認知功能變差而變長，而作業表現的穩定性也隨著認知功能變差而變小。含有認知能力需求之反應時間作業為有效之指標可應用於測量阿茲海默氏症患者之認知功能的衰退。

關鍵字

輕度阿茲海默氏症 ； 反應時間 ； 旁側夾擊作業 ； 穩定性 ； 表現差異性

並列摘要

Alzheimer’s disease is the most common neurodegenerative disease on elder people. The past studies mainly focused on the epidemiology and pathology of disease, but the recent studies tried to find out early diagnostic biomarkers. A new behavioral biomarker is on performance fluctuation. A performance based on cognitive control is finely tuned by the brain circuitry such that it is highly consistent. But the performance consistency may deteriorate as the frontal lobe functions decline. And there was a study indicating that inconsistent reaction time precedes and predicts progression speed of long-term cognitive decline. Our research measured performance variability in the tasks involving motor control and cognitive control to study whether performance variability may be related to progression in dementia. We recruited three groups 54 participants, one is mild Alzheimer’s disease group (n=26), another is early-stage Alzheimer’s disease group (n=16), and the other is normal control group (n=12) in our research. Their ages are between 57 and 87 years-old. The including criteria are 1. Consciousness, and comprehend instruction. 2. Ruling out any psychiatric and neurological disorder history. 3. Free to mobile. The Alzheimer’s disease participants went through cognitive function assessment, cognitive task, and motor task; the normal elder people went through only cognitive task and motor task. The scores from the CDR and CASI, as well as from the cognitive task and motor task were analyzed to find the relationship between cognitive function and reaction time variability. The results indicated that the greater is the cognitive function declination, the more the variability in reaction time become. The performance inconsistency in the tasks involving cognitive control appears to be a valid biomarker for predicting progression of dementia.

並列關鍵字

performance variability ； mild Alzheimer's disease ； reaction time ； consistency ； cognitive control

參考文獻

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