MMSE和MoCA测试对颅脑损伤患者行为记忆障碍的预测价值

Prediction of behavioral memory impairments among brain injury patients using the mini-mental state examination and Montreal cognitive assessment scale

摘要:

目的： 研究分析认知筛查量表在颅脑损伤患者中对行为记忆障碍的预测功效。 方法： 58名颅脑损伤患者接受简易智力状况检查量表（mini-mental state examination，MMSE）、蒙特利尔认知评估量表（Montreal cognitive assessment scale，MoCA）及Rivermead行为记忆测验（第三版）（Rivermead behavioural memory test-third edition，RBMT-3）3种认知量表测试，对测试结果进行分析比较。 结果： 行为记忆（RBMT-3得分）与MMSE子项目中注意力和计算（MMSE-AC：P=0.007，β=0.371）以及回忆（MMSE-Re：P=0.016，β=0.352）显著相关，MMSE两个子项目得分之和以及MMSE总分对行为记忆障碍均具备中间预测价值（AUC=0.845、0.793）。行为记忆与MoCA子项目中视空间/执行（MoCA-VE：P=0.004，β=0.278）、语言（MoCA-L：P=0.003，β=0.250）、延迟回忆（MoCA-DR：P<0.001，β=0.479）和定向（MoCA-O：P=0.002，β=0.240）存在显着相关性，MoCA四个子项目得分之和以及MoCA总分对于行为记忆障碍具有高预测值（AUC=0.953、0.938），当MoCA四个子项目得分低于13.5，或总分低于24.5提示患者行为记忆障碍可能。 结论： 可以根据颅脑损伤患者MMSE或MoCA得分预判行为记忆障碍，其中MoCA的诊断价值更高。

Abstract:

Objective: To study and analyze the predictive effect of cognitive screening scale on behavioral memory impairments in patients with brain injury. Methods: A total of 58 brain injury patients were included in the study. Each patient completed the minimental state examination (MMSE), Montreal cognitive assessment scale (MoCA), and Rivermead behavioural memory test-third edition (RBMT-3), and the results were analyzed and compared. Results: Behavioral memory (RBMT-3 score) was significantly related to attention and calculation (MMSE-AC: P=0.007, β=0.371) and recall (MMSE-Re: P=0.016, β=0.352) in the MMSE sub-items. The sum of the scores of each sub-item and the total score of the MMSE scale had intermediate predictive value for behavioral memory impairments (AUC=0.845, 0.793). Behavioral memory and visual space/execution (MoCA-VE: P=0.004, β=0.278), language (MoCA-L: P=0.003, β=0.250), delayed recall (MoCA-DR: P<0.001, β=0.479) and orientation (MoCA-O: P=0.002, β=0.240) were significantly correlated. The sum of the scores of the four sub-items of MoCA and the total score of the MoCA scale had high levels of behavioral memory impairments (AUC=0.953, 0.938). When the score of the four sub-items of MoCA was lower than 13.5, or the total score was lower than 24.5, it indi cated that the patient could have behavioral memory impairments. Conclusion: The behavioral memory impairments can be predicted based on the scores of MMSE or MoCA scale in patients with brain injury, and the diagnostic value of MoCA scale is higher.