Correlates of neuropsychiatric and motor tests with language assessment in patients with Lewy body dementia

Abstract Background Lewy body dementia (LBD) impairs performance in daily activities and affects motor, language and visuospatial tasks. Objective We aimed to correlate neuropsychiatric and motor assessments with language and visual organization tests in LBD. Methods Twenty-two patients with dementia with Lewy bodies and ten patients with Parkinson’s disease dementia participated on a cross-sectional study that assessed cognition, functionality, caregiver burden, verbal fluency, the primer-level dictation section of the Boston Diagnostic Aphasia Examination (PLD-BDAE), the Hooper Visual Organization Test, the Neuropsychiatric Inventory and the Movement Disorder Society – Unified Parkinson’s Disease Rating Scale. Results Language and visuospatial test results followed motor impairment and general cognitive performance. Whereas visual organization did not predict performance in the PLD-BDAE, visuospatial abilities and verbal fluency were concurrently associated, suggesting that linguistic impairment in LBD may be attributed to neuropsychological components of cognition and language. Only visual organization was associated with behaviour, suggesting that neuropsychiatric symptoms associate with differential impairment of visual organization in comparison with language in LBD. Schooling did not affect visual organization or language test performance, while the length of dementia was negatively associated with visual organization and verbal fluency. Discussion Though visual organization tests follow behaviour and motor performance in LBD, there is differential impairment regarding language skills.

【摘要】
**背景** 路易体痴呆（Lewy body dementia, LBD）可损害患者日常活动能力，并影响运动、语言及视觉空间任务的完成表现。
**研究目的** 本研究旨在探讨路易体痴呆患者的神经精神与运动评估结果，与其语言及视觉组织能力测试表现之间的相关性。
**研究方法** 本研究为横断面研究，共纳入22例路易体痴呆患者与10例帕金森病痴呆患者，对其认知功能、日常功能、照料者负担、言语流畅性、波士顿诊断性失语症检查基础听写分项（primer-level dictation section of the Boston Diagnostic Aphasia Examination，PLD-BDAE）、胡珀视觉组织测验（Hooper Visual Organization Test）、神经精神量表（Neuropsychiatric Inventory）以及运动障碍协会-统一帕金森病评定量表（Movement Disorder Society – Unified Parkinson’s Disease Rating Scale）开展评估。
**研究结果** 语言与视觉空间测试结果与运动损害及总体认知表现呈同步变化趋势。视觉组织能力无法预测PLD-BDAE测试表现，但视觉空间能力与言语流畅性存在显著共现关联，提示路易体痴呆患者的语言损害可能源于认知与语言的神经心理组分异常。仅视觉组织能力与行为症状存在关联，表明相较于语言功能，路易体痴呆患者的神经精神症状与视觉组织能力的差异性损害更为相关。受教育年限未对视觉组织或语言测试表现产生影响，而痴呆病程与视觉组织能力及言语流畅性呈负相关。
**讨论** 尽管路易体痴呆患者的视觉组织测试表现与行为及运动功能呈同步变化趋势，但语言技能存在差异性损害。