大脳皮質基底核変性症と進行性核上性麻痺の神経心理学的検討

大脳皮質基底核変性症 (CBD) 患者と進行性核上性麻痺 (PSP) 患者に神経心理学検査を行い比較検討した. 対象はCBD8例 (年齢70.1歳, MMSE26.4), PSP5例 (65.2歳, 24.6), 健常者12例 (67.0歳, 28.9) である. 記憶機能検査として Rey's complex figure test (RCFT), Rey's auditory verbal learning test (RAVLT), 数字順唱・逆唱を施行した. 実行機能検査として仮名ひろいテスト, Verbal fluency test (VFT), Trail ma...

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Published in日本老年医学会雑誌 Vol. 37; no. 7; pp. 541 - 547
Main Authors 杉田, 實, 立花, 久大, 渋谷, 直美, 奥田, 文悟
Format Journal Article
LanguageJapanese
Published 一般社団法人 日本老年医学会 25.07.2000
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ISSN0300-9173
DOI10.3143/geriatrics.37.541

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Abstract 大脳皮質基底核変性症 (CBD) 患者と進行性核上性麻痺 (PSP) 患者に神経心理学検査を行い比較検討した. 対象はCBD8例 (年齢70.1歳, MMSE26.4), PSP5例 (65.2歳, 24.6), 健常者12例 (67.0歳, 28.9) である. 記憶機能検査として Rey's complex figure test (RCFT), Rey's auditory verbal learning test (RAVLT), 数字順唱・逆唱を施行した. 実行機能検査として仮名ひろいテスト, Verbal fluency test (VFT), Trail making test (TMT), Stroop test (ST), Wisconsin card sorting test (WCST), Hanoi の塔課題 (Hanoi) を施行した. 記憶機能ではRCFTで両疾患群とも copy で得点は低下し, CBDでは再生障害がみられた. RAVLTではPSP群は他2群に比し, 自由再生は低下していたが再認には差はなかった. 数字の順唱・逆唱は3群間で差はなかった. 実行機能では健常者に比し, 仮名ひろいテストではCBDで成績低下, VFTはCBD, PSPとも低下, TMT, STではCBD, PSP群とも遂行に時間を要した. WCSTではCBD群で Nelson 型保続が多くみられた. Hanoi では3群間に差はなかった. 以上CBD群, PSP群とも実行機能, 記憶機能障害を認めたが一部検査では障害度に差がみられ, 病態の違いが示唆された.
AbstractList 大脳皮質基底核変性症 (CBD) 患者と進行性核上性麻痺 (PSP) 患者に神経心理学検査を行い比較検討した. 対象はCBD8例 (年齢70.1歳, MMSE26.4), PSP5例 (65.2歳, 24.6), 健常者12例 (67.0歳, 28.9) である. 記憶機能検査として Rey's complex figure test (RCFT), Rey's auditory verbal learning test (RAVLT), 数字順唱・逆唱を施行した. 実行機能検査として仮名ひろいテスト, Verbal fluency test (VFT), Trail making test (TMT), Stroop test (ST), Wisconsin card sorting test (WCST), Hanoi の塔課題 (Hanoi) を施行した. 記憶機能ではRCFTで両疾患群とも copy で得点は低下し, CBDでは再生障害がみられた. RAVLTではPSP群は他2群に比し, 自由再生は低下していたが再認には差はなかった. 数字の順唱・逆唱は3群間で差はなかった. 実行機能では健常者に比し, 仮名ひろいテストではCBDで成績低下, VFTはCBD, PSPとも低下, TMT, STではCBD, PSP群とも遂行に時間を要した. WCSTではCBD群で Nelson 型保続が多くみられた. Hanoi では3群間に差はなかった. 以上CBD群, PSP群とも実行機能, 記憶機能障害を認めたが一部検査では障害度に差がみられ, 病態の違いが示唆された.
Author 立花, 久大
奥田, 文悟
渋谷, 直美
杉田, 實
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References 16) 金子満雄: 痴呆と前頭葉機能. 失語研1990; 10: 127-131.
5) Litvan I, Cummings JL, Mega M: Neuropsychiatric features of corticobasal degeneration. J Neurol Neurosug Psychiatry 1998; 65: 717-721.
1) Rebeitz JJ, Kolodny EH, Richardson EJ: Corticodentatonigral degeneration with neuronal achromasia. Arch Neurol 1968; 18: 20-33.
25) Pillon B: Troubles visuo-constructifs et methodes de compensation: Results de 85 patients atteints de lesions cerebrales. Neuropsychologia 1981; 19: 375-383.
2) Gibb WR, Luthert PJ, Marsden CD: Corticobasal degeneration. Brain 1989; 112: 1171-1192.
22) Taylor AE, Saint-Cyr JA, Long AE: Frontal lobe dysfunction in Parkinson's disease. The cortical focus of neostriatal outflow. Brain 1986; 109: 845-883.
10) Okuda B, Tachibana H, Kawabata K, Takeda M, Sugita M: Cerebral blood flow in corticobasal degeneration and progressive supranuclear palsy. Alz Dis Assoc Dis, 2000; 14: 46-52.
7) 美馬達哉, 柴崎浩: 進行性核上性麻痺 (PSP) と corticobasal degeneration. 生理学的側面. 神経内科1995; 43: 8-16.
24) Litvan I, Grafman J, Gomez C, Chase TN: Memory impairment in patients with progressive supranuclear palsy. Arch Neurol 1989; 46: 765-767.
3) Bergeron C, Davis A, Long AE: Corticobasal ganglionic degeneration and progressive supranuclear palsy presenting with cognitive decline. Brain Pathol 1998; 8: 355-365.
8) Takeda M, Tachibana H, Okuda B, Kawabata K, Sugita M: Electrophysiological comparison between corticobasal degeneration and progressive supranuclear palsy. Clin Neurol Neurosurg 1998; 100: 94-98.
19) Okuda B, Tachibana H, Takeda M, Kawabata K, Sugita M, Fukuchi M: Focal cortical hypoperfusion in corticobasal degeneration demonstrated by three-dimensional surface display with 123I-IMP: a possible cause of apraxia. Neuroradiology 1995; 37: 642-644.
23) Kobari M, Fukuuchi Y, Shinohara T, Nogawa S, Takahashi K: Local cerebral blood flow and its response to intravenous levodopa in progressive supranuclear palsy. Comparison with Parkinson's disease. Arch Neurol 1992; 49: 725-730.
9) 長濱康弘, 福山秀直: 進行性核上性麻痺 (PSP) と corticobasal degeneration. 脳血流代謝の面から. 神経内科1995; 43: 22-29.
20) Okuda B, Tanaka H, Tomino Y, Kawabata K, Tachibana H, Sugita M: The role of the left somatosensory cortex in human hand movement. Exp Brain Res 1995; 106: 493-498.
21) Levin BE, Llabre MM, Weiner WJ: Cognitive impairments associated with early Parkinson's disease. Neurology 1989; 39: 557-561.
4) Dickson DW: Neuropathologic differentiation of progressive supranuclear palsy and Corticobasal degeneration. J Neurol 1999; 246 (Suppl 2): II/6-II/15.
11) Pillon B, Bun J, Vidailhet M, Deweer B, Sirigu A, Dubois B, et al.: The neuropsychological pattern of corticobasal degeneration and progressive supranuclear palsy and Alzheimer's disease. Neurology 1995; 45: 1477-1483.
12) 森松光紀: 大脳皮質基底核変性症. 神経内科1998; 49: 325-330.
13) Dubois B, Pillon B, Legault F, Agid Y, Lhermitte F: Slowing of cognitive processing in progressive supranuclear palsy: A comparison with Parkinson's disease. Arch Neurol 1988; 45: 1194-1199.
17) 鹿島晴雄, 加藤元一朗: Wisconsincard sorting test (Keio version) (KWCST). 脳と精神の医学1995; 6: 209-216.
15) Spreen O, Strauss E: A compedium of neuropsychological tests. Administration, norms and commentary. Oxford University Press, New York, 1991, p149-167.
14) Litvan I, Agid Y, Calne D, Cambell G, Dubois B, Duvoisin RC, et al.: Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steel-Richardson-Olszewski syndrome): Report of the NINDS-SPSP international workshop. Neurology 1996; 47: 1-9.
18) Rinne JO, Lee MS, Thompson PD, Marsden CD: Corticobasal degeneration. A clinical study of 36 cases. Brain 1994; 117: 1183-1196.
6) Litvan I. Grimes DA, Lang AE, Jankovic J, Mckee A, Verny M, et al.: Clinical features differentiating patients with postmortem confirmed progressive supranuclear palsy and corticobassal degeneration. J Neurol 1999; 246 (Supple 2): II/1-II/5.
References_xml – reference: 16) 金子満雄: 痴呆と前頭葉機能. 失語研1990; 10: 127-131.
– reference: 2) Gibb WR, Luthert PJ, Marsden CD: Corticobasal degeneration. Brain 1989; 112: 1171-1192.
– reference: 8) Takeda M, Tachibana H, Okuda B, Kawabata K, Sugita M: Electrophysiological comparison between corticobasal degeneration and progressive supranuclear palsy. Clin Neurol Neurosurg 1998; 100: 94-98.
– reference: 19) Okuda B, Tachibana H, Takeda M, Kawabata K, Sugita M, Fukuchi M: Focal cortical hypoperfusion in corticobasal degeneration demonstrated by three-dimensional surface display with 123I-IMP: a possible cause of apraxia. Neuroradiology 1995; 37: 642-644.
– reference: 21) Levin BE, Llabre MM, Weiner WJ: Cognitive impairments associated with early Parkinson's disease. Neurology 1989; 39: 557-561.
– reference: 4) Dickson DW: Neuropathologic differentiation of progressive supranuclear palsy and Corticobasal degeneration. J Neurol 1999; 246 (Suppl 2): II/6-II/15.
– reference: 22) Taylor AE, Saint-Cyr JA, Long AE: Frontal lobe dysfunction in Parkinson's disease. The cortical focus of neostriatal outflow. Brain 1986; 109: 845-883.
– reference: 11) Pillon B, Bun J, Vidailhet M, Deweer B, Sirigu A, Dubois B, et al.: The neuropsychological pattern of corticobasal degeneration and progressive supranuclear palsy and Alzheimer's disease. Neurology 1995; 45: 1477-1483.
– reference: 5) Litvan I, Cummings JL, Mega M: Neuropsychiatric features of corticobasal degeneration. J Neurol Neurosug Psychiatry 1998; 65: 717-721.
– reference: 1) Rebeitz JJ, Kolodny EH, Richardson EJ: Corticodentatonigral degeneration with neuronal achromasia. Arch Neurol 1968; 18: 20-33.
– reference: 24) Litvan I, Grafman J, Gomez C, Chase TN: Memory impairment in patients with progressive supranuclear palsy. Arch Neurol 1989; 46: 765-767.
– reference: 14) Litvan I, Agid Y, Calne D, Cambell G, Dubois B, Duvoisin RC, et al.: Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steel-Richardson-Olszewski syndrome): Report of the NINDS-SPSP international workshop. Neurology 1996; 47: 1-9.
– reference: 23) Kobari M, Fukuuchi Y, Shinohara T, Nogawa S, Takahashi K: Local cerebral blood flow and its response to intravenous levodopa in progressive supranuclear palsy. Comparison with Parkinson's disease. Arch Neurol 1992; 49: 725-730.
– reference: 6) Litvan I. Grimes DA, Lang AE, Jankovic J, Mckee A, Verny M, et al.: Clinical features differentiating patients with postmortem confirmed progressive supranuclear palsy and corticobassal degeneration. J Neurol 1999; 246 (Supple 2): II/1-II/5.
– reference: 18) Rinne JO, Lee MS, Thompson PD, Marsden CD: Corticobasal degeneration. A clinical study of 36 cases. Brain 1994; 117: 1183-1196.
– reference: 20) Okuda B, Tanaka H, Tomino Y, Kawabata K, Tachibana H, Sugita M: The role of the left somatosensory cortex in human hand movement. Exp Brain Res 1995; 106: 493-498.
– reference: 13) Dubois B, Pillon B, Legault F, Agid Y, Lhermitte F: Slowing of cognitive processing in progressive supranuclear palsy: A comparison with Parkinson's disease. Arch Neurol 1988; 45: 1194-1199.
– reference: 9) 長濱康弘, 福山秀直: 進行性核上性麻痺 (PSP) と corticobasal degeneration. 脳血流代謝の面から. 神経内科1995; 43: 22-29.
– reference: 3) Bergeron C, Davis A, Long AE: Corticobasal ganglionic degeneration and progressive supranuclear palsy presenting with cognitive decline. Brain Pathol 1998; 8: 355-365.
– reference: 7) 美馬達哉, 柴崎浩: 進行性核上性麻痺 (PSP) と corticobasal degeneration. 生理学的側面. 神経内科1995; 43: 8-16.
– reference: 25) Pillon B: Troubles visuo-constructifs et methodes de compensation: Results de 85 patients atteints de lesions cerebrales. Neuropsychologia 1981; 19: 375-383.
– reference: 12) 森松光紀: 大脳皮質基底核変性症. 神経内科1998; 49: 325-330.
– reference: 10) Okuda B, Tachibana H, Kawabata K, Takeda M, Sugita M: Cerebral blood flow in corticobasal degeneration and progressive supranuclear palsy. Alz Dis Assoc Dis, 2000; 14: 46-52.
– reference: 17) 鹿島晴雄, 加藤元一朗: Wisconsincard sorting test (Keio version) (KWCST). 脳と精神の医学1995; 6: 209-216.
– reference: 15) Spreen O, Strauss E: A compedium of neuropsychological tests. Administration, norms and commentary. Oxford University Press, New York, 1991, p149-167.
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SubjectTerms 大脳皮質基底核変性症
実行機能
記憶
進行性核上性麻痺
Title 大脳皮質基底核変性症と進行性核上性麻痺の神経心理学的検討
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