Parkinson 病の認知機能障害を MMSE と MoCA により評価した多施設共同研究 : 慶應 PD データベース Cognitive impairment in Parkinson s disease patients evaluated by the Montreal Cognitive Assessment and the Mini-Mental State Examination. A multicenter study of Keio PD database. 国家公務員共済組合連合会立川病院神経内科 / 部長 * 慶應義塾大学医学部神経内科 / 教授 **. はじめに Parkinson PD PD 0 PD 78 PDPD-D PD-D PDPD-MCI.PD 患者の認知機能低下のスクリーニング法 The Parkinson Study Group PD MCI Montreal Cognitive AssessmentMoCA 図 MoCA PD 4 PD 6 D Mini-Mental State Examination MMSE4PD 図 MMSE MoCA 0 MMSE MoCA MMSE 4 MMSE MoCA MMSE MoCA * Kouichi Ohta : Director, Department of Neurology, Tachikawa Hospital ** Norihiro Suzuki : Professor and Chairman, Department of Neurology, Keio University School of Medicine - -
Vol.0 No. 0 図 Montreal Cognitive AssessmentMoCA orientation visuospatial attention orientation 4 visuospatial executive MMSE MoCA language language memory memory attention copy pentagons serial 7 subtraction or spell WORLD backwards immediate recall delayed recall naming repeat a sentence -stage command reading writing orientation time orientation place copy cube trail making verbal abstraction serial 7 subtraction delayed recall repeat sentences orientation place draw clock phonemic fluency digit span target tapping naming orientation time 図 Mini-Mental State ExaminationMMSE Montreal Cognitive AssessmentMoCA 0 - -
Parkinson MMSE MoCA PD MoCA 6 PD-MCI 90 7 MoCA PD-D 8 9. 慶應 PD データベース研究にみる PD の認知機能障害 6 008 PD,078 PD 図 0 PD 96 04 70.68. 6.6. Hoehn & Yahr stage.70.7 MMSE MoCA MMSE 6..6 0 MoCA 0.9.0 0 MoCA MMSE MoCA 008 年度 60 症例 009 年度 症例 ROC MoCA MMSE 6 89 8 PD-D The Movement Disorder Society PD-D MMSE6 MoCA PD-D MMSE MoCA 6 PDMMSE 6 MoCA 6 PD-MCIMMSE 6 PD-D 847 図 4 PD 04 MoCA MoCA 40 08 9 98 8 98 PD PD-MCI PD-D MoCA 図 repeat sentences 0 年度 96 症例 合計 078 症例 00 % 90 図 PD 80 70 60 0 40 PD-D MMSE<6 % MMSE 6 & MoCA 6 8% PD 0 0 0 0 MMSE 6 & MoCA<6 47% PD-MCI low MOCA -8 n=98 middle MOCA 9- n=98 high MOCA 4-0 n=08 図 4 Parkinson 04 MMSE MoCA PDPD PDPD-MCI PDPD-D 図 Parkinson 04 MoCA MoCA - -
Vol.0 No. 0 phonemic fluencydelayed recall 図 namingorientaion 図 4. おわりに MoCA PD PD 謝辞 Parkinson Parkinson Parkinson 文献 Emre M, Aarsland D, Brown R, et al. Clinical diagnostic criteria for dementia associated with Parkinson s disease. Mov Disord 007;:689-707. Chou KL, Amick MM, Brandt J, et al. A recommended scale for cognitive screening in clinical trials of Parkinson s disease. Mov Disord 00;:0-07. Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 00;:69-699. 4 Fujiwara Y, Suzuki H, Yasunaga M, Sugiyama M, Ijuin M, Sakuma N, Inagaki H, Iwasa H, Ura C, Yatomi N, Ishii K, Tokumaru AM, Homma A, Nasreddine Z, Shinkai S. Brief screening tool for mild cognitive impairment in older Japanese: validation of the Japanese version of the Montreal Cognitive Assessment. Geriatr Gerontol Int 00; 0:-. Dalrymple-Alford JC, MacAskill MR, Nakas CT, et al. The MoCA: well-suited screen for cognitive impairment in Parkinson disease. Neurology 00; 7(9):77-. 6 Seki M, Takahashi K, Koto A, et al., on behalf of Keio Parkinson s Disease Database. Camptocormia in Japanese Patients with Parkinson s Disease: a Multicenter Study. Move Disord 0;6(4):67-7. 7 Nihei Y, Takahashi K, Koto A, et al. REM sleep behavior disorder in Japanese patientswith Parkinson s disease: a multicenter study using the REM sleep behavior disorder screening questionnaire. J Neurol 0;9:606 6. 8 Seki M, Takahashi K, Uematsu D, et al. Clinical features and varieties of non-motor fluctuations in Parkinson s disease: a Japanese multicenter study. Parkinsonism and Related Disorders 0;9:04-8. 9 Dubois B, Burn D, Goetz C, et al, Diagnostic procedures for Parkinson s disease dementia: - 4 -
Parkinson MMSE MoCA PD Recommendations from the Movement Disorder Society Task Force. Mov Disord 007;:4-4. 0 Ohta K, Osada T, Shinohara Y, et al. Vulnerable cognitive domains in Parkinson s disease evaluated by Montreal Cognitive Assessment (MoCA). A multicenter study of Keio PD database. Neurodegenerative Diseases (suppl. ), 0, in press. 7 7 7 - -