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Brain and Nerve No to Shinkei Volume 58, Issue 8 （August 2006）

Brain and Nerve 脳と神経 58巻8号（2006年8月発行）

Japanese English

原著

頸動脈高度狭窄症における認知機能障害―RBANS，WAIS-R，NARTの臨床的意義 Cognitive Function in Patients with Severe Carotid Stenosis―Evaluation of RBANS, WAIS-R and NART Before Treatment of Carotid Revascularization 高岩亜輝子 ¹ , 桑山直也 ¹ , 林央周 ¹ , 久保道也 ¹ , 松井三枝 ² , 遠藤俊郎 ¹ Akiko Takaiwa ¹ , Naoya Kuwayama ¹ , Nakamasa Hayashi ¹ , Michiya Kubo ¹ , Mie Matsui ² , Shunro Endo ¹ ¹富山大学医学部脳神経外科 ²富山大学医学部心理学教室 ¹Department of Neurosurgery,University of Toyama ²Department of Psychology,University of Toyama キーワード： RBANS , carotid stenosis , cognitive function , preoperative assessment Keyword: RBANS , carotid stenosis , cognitive function , preoperative assessment pp.681-686

発行日 2006年8月1日 Published Date 2006/8/1

DOI https://doi.org/10.11477/mf.1406100208

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参考文献 Reference

　要旨　血流低下を伴う頸動脈高度狭窄症例に対してRBANS，WAIS-R，NARTを実施し，認知機能に対する臨床的意義を検討した。対象は，日常生活は自立，明らかな神経学的所見がない，失語，失行，失認および認知症を認めない25例であった。認知機能検査は，日本語版RBANS，WAIS-R簡易版，日本語版NART，を用いて評価した。結果，WAIS-RとNARTの間に有意差を認めなかったが，RBANS総指標は2つの検査に比して低かった。さらにRBANSでは下位項目の結果から記憶や注意など軽微な認知機能障害を捉えることができた。RBANSは認知機能障害の検出に，WAIS-RとNARTは各症例の病前における認知機能のベースラインに用いることで血行再建術前に認知機能障害の診断が可能と思われた。

Purpose:To evaluate the cognitive function in preoperative patients with severe carotid stenosis. Patients and Method : Twenty-five patients with severe carotid stenosis were examined on their cognitive function by RBANS （Japanese version）, WAIS-R （Japanese version）, and NART （Japanese version） before treatment of carotid revascularization （endarterectomy or stenting）. They had full activities of daily living without any hemiparesis, aphasia, agnosia, and apraxia at the time of the examinations. Results : Mean intelligent quotient （IQ） measured by WAIS-R and NART was 104.0＋/-10.7 and 101.3＋/-13.4, （ns） respectively. Mean total scale of RBANS was 90.0＋/-13.4, which was significantly lower than both the results of WAIS-R and NART. A mean value of each RBANS index was 91.3＋/-11.7 in immediate memory, 102.0＋/-18.2 in visuospatial/constructional, 93.2＋/-8.7 in language, 84.6＋/-14.7 in attention, and 92.1＋/-14.4 in delayed memory. RBANS index significantly declined in immediate memory, language, attention and delayed memory than visuospatial/constructional. Conclusions : Qualitative evaluation was available in RBANS, WAIS-R, and NART, which enabled the investigators to make a precise comparison between these methods. WAIS-R and NART showed a comparatively preserved function and were presumed to be useful for the evaluation of the baseline of cognitive function in preoperative patients. RBANS demonstrated a slight decrease in memory and attention in those patients and was expected to be useful to detect the cognitive dysfunction when compared with WAIS-R and NART.