問診と神経心理学的検査

Medical Consultations and Neuropsychological Tests

Point

・脳神経外科医も認知症診療に関与する時代になった．

・初診時の情報収集において最も有効なのは，患者全体像，鑑別診断，重症度評価に役立つ問診票を活用することである．

・認知症の治療において，抗アミロイドβ抗体薬の投与を選択できるようになった．投与の適応となるのは，投与開始前1カ月以内のミニメンタルステート検査（MMSE）が，レケンビ^®（エーザイ）では「22〜30」，ケサンラ^®（日本イーライリリー）では「20〜28」であり，臨床認知症評価尺度（CDR）が「0.5または1」である．

　We are now in an era where neurosurgeons play an active role in the treatment of dementia. One of the most effective ways to gather essential clinical information during the initial consultation is through a structured questionnaire. This helps establish a comprehensive picture of the patient's condition, supports differential diagnosis, and aids in assessing disease severity. With the advent of anti-amyloid-beta antibody therapies, it is now possible to offer targeted treatment for certain types of dementia. Eligibility criteria for administration include a Mini Mental State Examination score of 22-30 for Rekenbi^® and 20-28 for Kesanra^®, measured within one month prior to treatment initiation. Additionally, patients should have a Clinical Dementia Rating of 0.5 or 1.