摘要
目的 探讨眼动检查的视觉空间记忆眼球追踪实验(visuospatial memory eye-tracking task,VisMET)在社区老年人群中进行轻度认知功能障碍(mild cognitive impairment,MCI)筛查的适应性及其应用价值.方法 本研究以杨浦区认知症友好社区60岁以上老人为研究对象,按照MCI的诊断标准筛选病例组及对照组,每组各70例.通过对病例组及健康对照组两组老人进行眼动检查的视觉空间记忆眼球追踪测验,并对两组老人眼动检查中的"关键区域"的眼球运动指标的差异,即"关键区域"的注视点数及注视时间百分比进行比较分析,与MCI的Petersen诊断标准进行对比,绘制ROC曲线,得到眼动检查的VisMET范式任务进行MCI筛查的灵敏度、特异度及界值.结果 对照组的"关键区域"的注视点数及注视时间百分比均高于病例组,差异具有统计学意义(P＜0.05);两组测试对象在"关键区域"的注视点数及注视时间百分比与MoCA-B评分显著相关(相关系数分别为0.579、0.516,P均＜0.01).用"关键区域"的注视点数对两组进行区分时,其曲线下面积(AUC)为0.974,灵敏度为88.6％,特异度为89.7％.用"关键区域"的注视时间百分比对两组进行区分时,其曲线下面积(AUC)为0.929,灵敏度为87.1％,特异度为86.8％.结论 眼动检查的VisMET范式测试在进行MCI的筛查中具有较好的区分度,对轻度认知功能障碍老人与正常老人进行区分时具备效果显著的特征,且对操作者要求低、简便、高效,可作为社区老年人群MCI初步筛查的一种简易、敏感的工具.
Abstract
Objective To evaluate the application of visuospatial memory eye tracking test(VisMET)in screening of mild cognitive impairment(MCI)among community-dwelling elderly.Methods Seventy patients with MCI(case group)and 70 individuals with normal cognition aged over 60 years(control group)were enrolled from communities of Shanghai Yangpu district.All subjects underwent VisMET.The eye movement indicators in the"critical area"were compared between two groups.The application value of eye movement test was assessed with ROC curve,with Petersen diagnostic criteria for MCI as gold standard,the sensitivity,specificity,and cut-off value of the VisMET parameters for MCI screening was calculated.Results The number of fixation points and the percentage of fixation time in the control group were significantly higher than those in the case group(P＜0.05).The scores of MoCA-B were significantly correlated with the number of fixation points and the percentage of fixation time in the"critical area"(r=0.579 and 0.516,P＜0.01).For these two parameters,the area under the ROC curve(AUC)in determining MCI was 0.974 and 0.929,the sensitivity was 88.6% and 87.1% ,and the specificity was 89.7% and 86.8% ,respectively.Conclusion The VisMET of eye movement examination can effectively distinguish MCI from normal cognition,indicating that it may be used in MCI screening among community-dwelling elderly.
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