Dementia and Neurocognitive Disorders (대한치매학회지)

Korean Dementia Association (대한치매학회)
권호 표지

Attentional Differences according to the Subcortical White Matter Hyperintensities in Patients with Alzheimer Disease and Subcortical Vascular Dementia using Attention Questionnaire Scale

주의력 설문지 척도(Attention Questionnaire Scale)를 이용한 알츠하이머병과 피질하혈관성치매 환자의 피질하 고신호병변에 따른 주의집중력의 차이

  • Ku, Bon-D. (Department of Neurology, Myongji Hospital, Kwandong University College of Medicine) ;
  • Kim, Sang-Yun (Department of Neurology, Seoul National University Bundang Hospital & Seoul National University College of Medicine)
  • 구본대 (관동대학교 의과대학 명지병원 신경과) ;
  • 김상윤 (서울대학교 의과대학 신경과학교실 분당서울대학교병원 신경과)
  • Published : 2011.09.30
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Abstract

Background: Attention is too difficult to measure quantification due to the numerous affected variables. Attention Questionnaire Scale (AQS) is a newly developed scale for the evaluation of the patient's attention. The aim of this study was to adapt AQS to evaluate the correlation between attention and subcortical hyperintensities (SH) to the patients with mild to moderate Alzheimer disease (AD) or subcortical vascular dementia (SVD). Methods: Patients with mild to moderate AD or SVD were recruited from March 2008 to February 2010. On magnetic resonance imaging, deep white matter (DWM) hyperintensities were classified into D1 (the longest diameter of DWM lesion <10 mm), D2 (10 mm${\leq}$DWM${\leq}$24 mm), and D3 (25 mm $17.5{\pm}5.7$ and that of the CDR was $1.3{\pm}0.9$. Mean score of AQS was $17.1{\pm}7.9$. The correlation between AQS and other scales such as K-MMSE, CDR and GDS were all significant (the correlation coefficiency was 0,317, -0.474, -0.472, respectively). Unlike other scales AQS showed significant differences between minimal and moderate or severe SH group ($18.7{\pm}7.7$, $15.2{\pm}6.6$, $15.4{\pm}8.6$, p=0.007). Conclusions: AQS is a useful dementia scale for the evaluation of the degree of SH in the patients with mild to moderate AD or SVD.

Keywords

References

  1. Perry RJ, Hodges JR. Attention and executive deficits in Alzheimer's disease. A critical review. Brain 1999; 122: 383-404. https://doi.org/10.1093/brain/122.3.383
  2. Parasuraman R, Haxby, James V. Attention and brain function in Alzheimer's disease: a review. Neuropsychology 1993; 7: 242-72. https://doi.org/10.1037/0894-4105.7.3.242
  3. Chan RC. Dysexecutive symptoms among a non-clinical sample: a study with the use of the Dysexecutive Questionnaire. Br J Psychol 2001; 92: 551-65. https://doi.org/10.1348/000712601162338
  4. Dywan J, Segalowitz SJ. Self- and family ratings of adaptive behavior after traumatic brain injury: psychometric scores and frontally generated ERPs. J Head Trauma Rehabil 1996; 11: 79-95. https://doi.org/10.1097/00001199-199604000-00008
  5. Burgess PW, Alderman N, Evans J, Emslie H, Wilson BA. The ecological validity of tests of executive function. J Int Neuropsychol Soc 1998; 4: 547-58.
  6. Ray C, Phillips L, Weir WR. Quality of attention in chronic fatigue syndrome: subjective reports of everyday attention and cognitive difficulty, and performance on tasks of focused attention. Br J Clin Psychol 1963; 32: 357-64.
  7. Doddy RS, Massman PJ, Mawad M, Nance M. Cognitive consequences of subcortical magnetic resonance imaging changes in Alzheimer's disease: comparison to small vessel ischemic vascular dementia. Neuropsychiatry Neuropsychol Behav Neurol 1998; 11: 191-9.
  8. Binetti G, Magni E, Padovani S, Cappa SF, Bianchetti A, Trabucchi M. Excutive dysfunction on early Alzheimer's disease. J Neurol Neurosurg Psychiatry 1996; 60: 91-3. https://doi.org/10.1136/jnnp.60.1.91
  9. Kim SY, Park MH, Han SH, Na HR, Cho S, Choi MS, et al. Validation analysis of the attention questionnaire Scale. J Alzheimers Dis 2011; 24: 393-402.
  10. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 1984; 34: 939-44. https://doi.org/10.1212/WNL.34.7.939
  11. Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 1993; 43: 250-60. https://doi.org/10.1212/WNL.43.2.250
  12. Kalaria RN, Ballard C. Overlap between pathology of Alzheimer disease and vascular dementia. Alzheimer Dis Assoc Disord 1999: 13: 115-23.
  13. Garde E, Mortensen EL, Krabbe K, Rostrup E, Larsson HB. Relation between age-related decline in intelligence and cerebral white-matter hyperintensities in healthy octogenarians: a longitudinal study. Lancet 2000; 356: 628-34. https://doi.org/10.1016/S0140-6736(00)02604-0
  14. Paul RH, Haque O, Gunstad J, Tate DF, Grieve SM, Hoth K, et al. Subcortical hyperintensities impact cognitive function among a select subset of healthy elderly. Arch Clin Neuropsychol 2005; 20: 697-704. https://doi.org/10.1016/j.acn.2005.02.004
  15. De Groot JC, De Leeuw FE, Oudkerk M, Van Gijn J, Hofman A, Jolles J, et al. Periventricular cerebral white matter lesions predict rate of cognitive decline. Ann Neurol 2002; 52: 335-41. https://doi.org/10.1002/ana.10294
  16. Debette S, Bombois S, Bruandet A, Delbeuck X, Lepoittevin S, Delmaire C, et al. Subcortical hyperintensities are associated with cognitive decline in patients with mild cognitive impairment. Stroke 2007; 38: 2924-30. https://doi.org/10.1161/STROKEAHA.107.488403
  17. Kang YW, Na DL, Hahn SH. Validity study on the Korean mini-mental state examination (K-MMSE) in dementia patients J Kor Neurol Assoc 1997; 15: 300-8.
  18. Choi SH, Na DL, Lee BH, Ham DS, Jung JH, Yoon SJ, et al. Estimating the validity of the Korean version of expanded clinical dementia rating (CDR) scale. J Kor Neurol Assoc 2001; 19: 585-91.
  19. Kim HJ, Moon SY, Kim S, Han SH. Assessment of the quality of life in patients with Alzheimer's disease. J Korean Neurol Assoc 2008; 26: 308-13.
  20. Selden NR, Gitelman DR, Salamon-Murayama N, Parrish TB, Mesulam MM. Trajectories of cholinergic pathways within the cerebral hemispheres of the human brain. Brain 1998; 121:2249-57. https://doi.org/10.1093/brain/121.12.2249
  21. Cummings JL. Frontal-subcortical circuits and human behavior. J Psychosom Res 1998; 44:627-8. https://doi.org/10.1016/S0022-3999(98)00034-8
  22. Tekin S, Cummings JL. Frontal-subcortical neuronal circuits and clinical neuropsychiatry: an update. J Psychosom Res 2002;53:647-54. https://doi.org/10.1016/S0022-3999(02)00428-2
  23. Snowdon DA, Greiner LH, Mortimer JA, Riley KP, Greiner PA, Markesbery WR. Brain infarction and the clinical expression of Alzheimer disease. The Nun study. JAMA 1997; 277: 813-7 . https://doi.org/10.1001/jama.1997.03540340047031
  24. Sasaki M. Pitfalls in the interpretation of central nervous system disorders from structural magnetic resonance images Brain Nerve 2010;62:469-75.
  25. Bocti C, Swartz RH, Gao FQ, Sahlas DJ, Behl P, Black SE. A new visual rating scale to assess strategic white matter hyperintensities within cholinergic pathways in dementia. Stroke 2005; 36: 2126-31. https://doi.org/10.1161/01.STR.0000183615.07936.b6