WO2012077313A1 - 認知症の発症の有無を確認するための方法及び装置 - Google Patents
認知症の発症の有無を確認するための方法及び装置 Download PDFInfo
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- WO2012077313A1 WO2012077313A1 PCT/JP2011/006754 JP2011006754W WO2012077313A1 WO 2012077313 A1 WO2012077313 A1 WO 2012077313A1 JP 2011006754 W JP2011006754 W JP 2011006754W WO 2012077313 A1 WO2012077313 A1 WO 2012077313A1
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- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
- G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/16—Devices for psychotechnics; Testing reaction times ; Devices for evaluating the psychological state
- A61B5/162—Testing reaction times
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/40—Detecting, measuring or recording for evaluating the nervous system
- A61B5/4076—Diagnosing or monitoring particular conditions of the nervous system
- A61B5/4088—Diagnosing of monitoring cognitive diseases, e.g. Alzheimer, prion diseases or dementia
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0033—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room
- A61B5/004—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room adapted for image acquisition of a particular organ or body part
- A61B5/0042—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room adapted for image acquisition of a particular organ or body part for the brain
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
- A61B5/055—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
Definitions
- the present invention relates to a method and apparatus for confirming the presence or absence of dementia.
- Patent Document 1 Conventionally, for example, a method described in Patent Document 1 is known as a method for measuring the recognition ability of the brain.
- Patent Document 1 The recognition ability measurement method described in Patent Document 1 is as follows. First, a deteriorated image in which information for perceiving the subject is deteriorated is prepared by performing predetermined processing on an original image having a meaningful subject (for example, a horse). Display on the display. Next, the perception time when the subject who has seen the deteriorated image perceives the subject (perceives that the subject is a horse) is measured. Then, based on the measured perception time and the perception time measured in advance for a sufficiently large number of subjects, it is shown what position the subject hits in the subject group.
- a meaningful subject for example, a horse
- the perception time when the subject who has seen the deteriorated image perceives the subject is measured. Then, based on the measured perception time and the perception time measured in advance for a sufficiently large number of subjects, it is shown what position the subject hits in the subject group.
- the object of the present invention has been made in view of the above problems, and a method and apparatus capable of obtaining information for confirming the onset of dementia while suppressing individual differences for each subject. It is to provide.
- the present invention is a method for confirming the presence or absence of dementia on a subject, wherein one of two alternative items that can be alternatively selected,
- a stimulus including at least one of auditory and visual information
- a stimulus providing step that is provided to the subject a plurality of times, a response from the subject regarding the stimulus provided in the stimulus providing step, and the stimulus
- a measurement step for measuring a response time from when the response is received until the response is received
- an average value calculation step for calculating an average value of the response times measured in the measurement step
- a dementia patient and others For a plurality of subjects including a preparation step of preparing a reference average value that is an average value of response times to the stimulus provided in the stimulus providing step in advance, and obtaining a specific subject in the average value calculating step When responded
- the average value of, and a comparison step of comparing the reference average value provides a confirmation method for the presence or absence of the onset of dementia.
- the present invention is an apparatus for confirming the presence or absence of dementia on a subject, wherein one of two selectable selection items is at least one of hearing and vision.
- An information providing unit that can be provided to the subject as a stimulus including the above information, and an operation that can output a command indicating that one of the two selection items has been selected according to the operation from the subject. And controlling the information providing unit to provide the selection item to the subject, and analyzing information for confirming the presence or absence of dementia based on the command input from the operation unit
- a stimulus providing unit that provides a stimulus indicating one of the two selection items a plurality of times via the information providing unit, and a stimulus is provided by the stimulus providing unit. After receiving a command output from the operation unit.
- a plurality of subjects including a measurement unit that measures response time until, an average time calculation unit that calculates an average value of response times measured by the measurement unit, and a patient with dementia and others
- a storage unit that stores in advance a reference average value that is prepared in advance and is an average value of response times to the stimulus provided by the stimulus providing unit, and a response time obtained by the average time calculation unit for a specific subject.
- a device for confirming the onset of dementia comprising a data creation unit for creating data that compares an average value with the reference average value.
- the present invention it is possible to obtain information for confirming the onset of dementia while suppressing individual differences for each subject.
- FIG. 3 is an image diagram displayed by the control unit of FIG. 2, in which (a) shows an auditory selective attention condition, (b) shows a visual selective attention condition, and (c) shows an audio-visual division attention condition.
- Is. It is the schematic which shows the state in which the visual stimulus is provided by the control part of FIG. It is the schematic which shows the state in which the auditory stimulus is provided by the control part of FIG. It is the schematic which shows the state in which the audiovisual stimulus is provided by the control part of FIG.
- FIG. 3 is a graph showing a promotion effect index for each group in the audiovisual division attention condition, and is stored in the storage unit of FIG. 2. It is a flowchart which shows the process performed by the control part of FIG. It is a flowchart which shows the information collection process of FIG. It is a flowchart which shows the process of the auditory selective attention condition test of FIG.
- FIG. 21 is a flowchart showing a process of the visual selective attention condition test of FIG. 20.
- FIG. FIG. 21 is a flowchart showing processing of the audiovisual division attention condition test of FIG. 20.
- FIG. 24 is a flowchart showing a stimulus providing process shown in FIGS. 21 to 23.
- FIG. 26 is a block diagram illustrating an electrical configuration of a control unit in FIG. 25. It is an image figure displayed by the control part of FIG. It is a timing chart of the task performed by the control part of FIG. It is the schematic which shows the ratio of the regular cue stimulus and invalid cue stimulus contained in the cue stimulus of FIG. It is a graph which shows the reference
- FIG. 36 shows the BOLD signal change rate and the brain activation site analyzed by the control unit in FIG. 36, and is a measurement result (1/2) at an interval of 200 ms.
- FIG. 36 shows the BOLD signal change rate and the brain activation site analyzed by the control unit in FIG. 36, and is a measurement result (2/2) at an interval of 200 ms.
- FIG. 36 shows the BOLD signal change rate and the brain activation site analyzed by the control unit in FIG. 36, and is a measurement result (2/2) at an interval of 200 ms.
- 36 shows the BOLD signal change rate and the brain activation site analyzed by the control unit in FIG. 36, and is a measurement result at an interval of 400 ms.
- 36 shows the BOLD signal change rate and the brain activation site analyzed by the control unit in FIG. 36, and is a measurement result (1/2) at an interval of 800 ms.
- FIG. 36 shows the BOLD signal change rate and the brain activation site analyzed by the control unit in FIG. 36, and is a measurement result (2/2) at an interval of 800 ms.
- FIG. 1 is a schematic diagram showing the overall configuration of a confirmation device for the presence or absence of dementia onset according to a preferred embodiment of the present invention.
- the confirmation device 1 can output visual information to the subject H (image display device: visual information providing unit) 2 and auditory information to the subject H.
- Display 2 displays a predetermined image in response to a command from control unit 5.
- the ear pads 3 and 3 each output a predetermined sound in response to a command from the control unit 5. Specifically, the ear pads 3 and 3 can output sound from both ear pads 3 and 3 at the same time, and can output sound from only one ear pad 3.
- the operation units 4 and 4 are each composed of a push button. Specifically, each of the operation units 4 and 4 can output a command to the control unit 5 to the effect that the operation has been received in response to a pressing operation from the subject.
- FIG. 2 is a block diagram showing an electrical configuration of the control unit of FIG.
- the control unit 5 controls image display by the display 2 and sound output by the ear pad units 3 and 3 and analyzes predetermined information based on commands input from the operation units 4 and 4.
- control unit 5 includes an information collection unit 6 for collecting information for confirming the presence or absence of dementia, an information analysis unit 7 for analyzing information collected by the information collection unit 6, and A storage unit 8 that stores information for comparison with information analyzed by the information analysis unit 7, and a screen control unit that controls image display on the display 2 in accordance with instructions from the information collection unit 6 and the information analysis unit 7 9 and an audio output unit 10 that controls the audio output by the ear pads 3 and 3 in response to instructions from the information collecting unit 6 and the information analyzing unit 7.
- the information collection unit 6 provides at least one of visual information and auditory information via the display 2 and the ear pads 3 and 3 and a response (operation) from the subject H to the provision of this information. (Commands from parts 4 and 4).
- the information collecting unit 6 includes a test condition selecting unit 11 that selects a test condition, a stimulus providing unit 12 that provides a stimulus under the conditions selected by the test condition selecting unit 11, and the stimulus providing unit 12. And a measuring unit 13 that measures a response time for the stimulus provided by the computer.
- the test condition selection unit 11 selects one of the three types of conditions as an auditory selective attention condition, a visual selective attention condition, and an audio-visual division attention condition as a test condition.
- the auditory selective attention condition is a condition for responding with attention only to information obtained through hearing.
- the visual selective attention condition is a condition for responding with attention only to information obtained through vision.
- the audiovisual division attention condition is a condition for responding with attention only to information obtained through hearing and vision.
- the test condition selection unit 11 displays the condition image D1 shown in FIG.
- the condition image D1 includes an image showing two ears arranged one above the other and a “+” image arranged between these images.
- the test condition selection unit 11 displays the condition image D2 shown in FIG.
- the condition image D2 includes an image showing two eyes arranged one above the other and a “+” image arranged between these images.
- the test condition selection unit 11 causes the display 2 to display a condition image D3 illustrated in (c) of FIG.
- the condition image D3 includes an image showing an ear, an image showing an eye arranged below the image, and a “+” image arranged between these images.
- the stimulus providing unit 12 presents the test conditions selected by the test condition selecting unit 11 to the subject H, and provides the subject H with three types of stimuli, an auditory stimulus, a visual stimulus, and an audiovisual stimulus.
- the auditory stimulation is information provided through the ear pads 3 and 3.
- a visual stimulus is information provided via the display 2.
- the audiovisual stimulus is information provided via the ear pads 3 and 3 and the display 2.
- the stimulus providing unit 12 outputs one of two selection items that can be alternatively selected from the ear pads 3 and 3 as an auditory stimulus. Specifically, the stimulus providing unit 12 outputs the sound S only from the left ear pad 3 as shown in FIG. 5, or outputs the sound S only from the right ear pad 3 as shown in FIG. . That is, in the present embodiment, “two selection items that can be alternatively selected” is an item that can be selected from the left and right. Note that the voice S has a frequency of 1000 Hz and a sound pressure of 70 dB.
- the stimulus providing unit 12 displays one of two selection items that can be alternatively selected as a visual stimulus on the display 2. Specifically, as shown in FIG. 4 or FIG. 6, the stimulus providing unit 12 displays the stimulus image D4 on the right or left side of the condition images D1 to D3.
- the stimulus image D4 is an image in which two squares located diagonally out of the four squares divided into the squares by line segments connecting the midpoints of two opposing sides of the square are blackened. is there.
- the stimulus providing unit 12 outputs one of two selection items that can be alternatively selected from the ear pads 3 and 3 as an audiovisual stimulus, and the two selection items that can be alternatively selected. One of them is displayed on the display 2. Specifically, as shown in FIG. 6, when providing the right stimulus, the stimulus providing unit 12 outputs the sound S only from the right ear pad 3 and condition images D1 to D3 on the display 2. The stimulus image D4 is displayed on the right side. On the other hand, when providing the left stimulus, the stimulus providing unit 12 outputs the sound S only from the left ear pad 3 and displays the stimulus image D4 on the left side of the condition images D1 to D3 on the display 2. . In the audiovisual stimulus, the display of the stimulus image D4 and the output of the sound S are continuously executed within the same period.
- the stimulus providing unit 12 provides the three types of stimuli a plurality of times with a preset response period. Specifically, as shown in FIG. 7, the stimulus providing unit 12 stops providing the stimulus from the start of the test to the time point Ta (for example, for 5 seconds). Next, the stimulus providing unit 12 provides the stimulus within a predetermined period (for example, 150 ms) from the time Ta, and stops providing the stimulus at the time Tb. The period from the time point Ta to the time point Tc is a response period of the subject H (for example, 3 to 4 seconds). Then, the stimulus providing unit 12 provides the stimulus in the period from the time Tc to the time Td, similarly to the period from the time Ta to the time Tb. Thereafter, the stimulus provision period and the stimulus stop period are repeated.
- a predetermined period for example, 150 ms
- the period from the time point Ta to the time point Tc is a response period of the subject H (for example, 3 to 4 seconds).
- the stimulus providing unit 12 provides the stimulus in the period from the time Tc
- the measurement unit 13 measures the response time from the start of providing the stimulus until the subject H responds. Specifically, the measurement unit 13 receives commands from the operation units 4 and 4 from the stimulus provision start time (for example, time point Ta in FIG. 7) to the end time of the response period (for example, time point Tb in FIG. 7). In response, the response time from the time when the stimulus is provided until the time when the command is received is measured.
- the stimulus provision start time for example, time point Ta in FIG. 7
- Tb time point
- the information analysis unit 7 calculates information required for confirming the presence or absence of dementia based on the response time obtained by the information collection unit 6, and calculates the calculated information and the information stored in the storage unit 8. Compare
- the information analysis unit 7 includes an average time calculation unit 14 that calculates an average value of the response times, a correct answer rate calculation unit 15 that calculates a correct answer rate of responses from the subject H, and audiovisual integration.
- An index calculation unit 16 that calculates an effect index
- a data creation unit 17 that creates data by comparing the information calculated by the calculation units 14 and 15 with the information stored in the storage unit 8 are provided.
- the average time calculation unit 14 calculates an average value of response times for each of the three types of stimuli in each of the three types of conditions. Of the responses from the subject H, those for which an erroneous selection has been made and those for which both the operation units 4 and 4 have been operated within the response period are excluded from the responses for calculating the average value. In addition, the average time calculation unit 14 obtains a standard deviation SD and an average response time MRT for the measurement values of a plurality of response times for the same stimulus under the same conditions, and response times RT corresponding to the following equations (1) and (2) Are excluded from the response time for calculating the average value.
- the storage unit 8 stores the information shown in FIGS. 8 and 9 for comparison with the average value calculated by the average time calculation unit 14.
- the storage unit 8 includes a dementia patient (shown as AD), a person with mild cognitive impairment (shown as MCI), a healthy elderly person (shown as Elderly), A reference average value that is an average value of response times calculated in advance for a plurality of subjects H belonging to four groups including healthy young people (shown as Young) is stored.
- the reference average value has an average value of response times for the respective stimuli in the three types of conditions.
- FIG. 8 illustrates reference average values for auditory stimuli in auditory selective attention conditions. In the reference average value shown in FIG.
- the average response time is longer in the order of Young, Elderly, MCI, and AD.
- the reference average value has a significant difference between the groups as indicated by “*” marks in FIGS. 8 and 9.
- “***” is a case where a significant difference is shown with P value ⁇ 0.001 in the result of analysis of variance of two-dimensional arrangement.
- “**” is a case where a significant difference is shown with P value ⁇ 0.01 in the result of analysis of variance of two-dimensional arrangement.
- “*” Indicates a case where a significant difference is indicated at a P value ⁇ 0.05 in the result of analysis of variance of a two-dimensional arrangement.
- Y means Young
- “E” means Elderly
- M means MCI
- “A” means AD.
- the test for obtaining the reference average value of the present embodiment is an AD patient with an average of 73.6 years old from 57 to 83 years old, an MCI patient with an average of 69.7 years old from 55 to 78 years old, and 67 to 76 years old.
- the data creation unit 17 uses the same stimulus under the same conditions among the average response time calculated for the specific subject H and the reference average value (see FIG. 8) stored in the storage unit 8. Create data that compares the average value for. Specifically, as shown in FIG. 8, the data creation unit 17 creates a graph in which the average value R1 of the response time calculated for the specific subject H is shown on the reference average value graph. Is displayed on the display 2.
- the correct answer rate calculation unit 15 calculates the correct answer rate for each of the three types of stimuli in each of the three types of conditions.
- the responses from the subject H those in which both the operation units 4 and 4 are operated within the response period are treated as erroneous responses.
- the visual selection under the auditory selective attention condition and the non-response to the auditory stimulation under the visual selective attention condition are correct selections. Therefore, the correct answer rate for the visual stimulus in the auditory selective attention condition and the auditory stimulus in the visual selective attention condition is not calculated.
- the storage unit 8 stores the information shown in FIGS. 10 and 11 for comparison with the average value calculated by the correct answer rate calculation unit 15.
- the storage unit 8 includes a dementia patient (shown as AD), a person with mild cognitive impairment (shown as MCI), a healthy elderly person (shown as Elderly), A reference correct answer rate which is a correct answer rate calculated in advance for a plurality of subjects H belonging to four groups including a young person (shown as Young) is stored.
- the reference average value has a correct answer rate for each of the stimuli under the three types of conditions.
- FIG. 10 illustrates the reference correct answer rate for the auditory stimulus in the auditory selective attention condition.
- the reference correct answer rate has a significant difference between the correct answer rate of the AD patient and the correct answer rate of the other person among the combinations of the respective stimuli in the above three conditions. There are several.
- the data creation unit 17 calculates the correct answer rate for the same stimulus under the same conditions among the correct answer rate calculated for the specific subject H and the reference correct answer rate (see FIG. 10) stored in the storage unit 8. Create data that compares Specifically, as shown in FIG. 10, the data creation unit 17 creates a graph in which the correct answer rate R2 calculated for a specific subject H is shown on the reference correct answer rate graph, and this graph is displayed on the display 2. To display.
- the index calculation unit 16 calculates an index of the audiovisual integration promotion effect for the specific subject H. Specifically, as shown in FIG. 12, the index calculation unit 16 estimates an auditory cumulative distribution probability G1, a visual cumulative distribution probability G2, a first audiovisual cumulative distribution probability G3, a second audiovisual cumulative distribution probability G4, and estimates. A value G5, a first subtraction value (promotion effect index) G6 (see FIG. 15), and a second subtraction value (promotion effect index) G7 (see FIG. 15) are calculated.
- the auditory cumulative distribution probability G1 is the cumulative distribution probability of the response time to the auditory stimulus under the auditory selective attention condition.
- the visual cumulative distribution probability G2 is the cumulative distribution probability of the response time to the visual stimulus under the visual selective attention condition.
- the first audio-visual cumulative distribution probability G3 is the cumulative distribution probability of the response time to the audio-visual stimulus under the auditory selective attention condition.
- the second audiovisual cumulative distribution probability G4 is a cumulative distribution probability for the audiovisual stimulus in the visual selective attention condition.
- the estimated value G5 is calculated based on the auditory cumulative distribution probability G1 and the visual cumulative distribution probability as an estimated value of the cumulative distribution probability of the response time to the audiovisual stimulus.
- the first subtraction value G6 is obtained by subtracting the estimated value G5 from the first audiovisual cumulative distribution probability G3.
- the second subtraction value G7 is obtained by subtracting the estimated value G5 from the second audiovisual cumulative distribution probability G4.
- the cumulative distribution probability means that the period from the start of stimulus supply to the end of the response period is divided into a plurality of equal periods (for example, 10 ms), and all measured response time data is classified into each section.
- the total quantity of data existing from the start of distribution and stimulus provision to each section is shown as a percentage of the total number of data.
- the estimated value G5 can be calculated using a race model as shown in FIG.
- the race model subtracts the logical product [P (S1) ⁇ P (S2)] from the sum [P (S1) + P (S2)] of the auditory cumulative distribution probability G1 and the visual cumulative distribution probability G2.
- a model for statistically calculating the estimated value G5 which is the logical sum [P (S1S2)].
- Subtraction value G7 is calculated. That is, each of the subtraction values G6 and G7 is actually provided with an audiovisual stimulus compared to a response time (estimated value G5) with respect to the audiovisual stimulus estimated from the response time when the auditory stimulus and the visual stimulus are provided independently. This is an index indicating how fast (or slow) the response time is.
- the index calculation unit 16 calculates a subtraction value (promotion effect index) G12 shown in FIG. 15 based on response times to the three types of stimuli in the audiovisual division attention condition.
- the index calculation unit 16 includes an auditory cumulative distribution probability G8, a visual cumulative distribution probability G9, an audiovisual cumulative distribution probability G10, an estimated value G11, and a subtraction value G12 (see FIG. 15). ) Is calculated.
- the auditory cumulative distribution probability G8 is the cumulative distribution probability of the response time with respect to the auditory stimulus in the audiovisual division attention condition.
- the visual cumulative distribution probability G9 is the cumulative distribution probability of the response time with respect to the visual stimulus under the audiovisual division attention condition.
- the audiovisual cumulative distribution probability G10 is the cumulative distribution probability of the response time to the audiovisual stimulus under the audiovisual division attention condition.
- the estimated value G11 is calculated using the race model based on the auditory cumulative distribution probability G8 and the visual cumulative distribution probability G9 as an estimated value of the cumulative distribution probability of the response time to the audiovisual stimulus.
- the subtraction value G12 is obtained by subtracting the estimated value G11 from the audiovisual cumulative distribution probability G10.
- the subtraction value G12 is an index indicating the degree of the effect of promoting audiovisual integration, similar to the subtraction values G6 and G7.
- the storage unit 8 stores information shown in FIGS. 16 to 18 for comparison with the subtraction values G6, G7, and G12 calculated by the index calculation unit 16.
- FIG. 16 is a graph showing the subtraction value in the auditory selective attention condition for each group.
- FIG. 17 is a graph showing the subtraction value in the visual selective attention condition for each group.
- FIG. 18 is a graph showing the subtraction value in the audiovisual division attention condition for each group.
- the chart showing Young in FIG. 16 corresponds to the subtraction value G6, the chart showing Young in FIG. 17 corresponds to the subtraction value G7, and the chart showing Young in FIG. 18 corresponds to the subtraction value G12.
- FIGS. 16 to 18 there is a significant difference between the subtraction values of each group at least within a predetermined response time range. For example, a significant difference is recognized between the subtraction value of MCI and the subtraction value of Elderly in FIG. 16 within a response time range of at least about 500 ms. Such a significant difference within the predetermined temperature range is recognized between all the groups in all the graphs of FIGS. Therefore, by comparing the subtraction value calculated for the specific subject H with the subtraction values shown in FIGS. 16 to 18 within the response time range in which a significant difference is recognized, the specific subject H Can be determined to which group. In particular, by using FIGS. 16 to 18, it is possible to distinguish between Elderly and CMI patients, which are difficult to accurately determine only with the response time described above.
- the data creation unit 17 calculates the subtraction value calculated for the specific subject H and the subtraction value under the same condition among the subtraction values shown in FIGS. 16 to 18 stored in the storage unit 8. Create the compared data. For example, the data creation unit 17 creates a graph showing the subtraction value R3 calculated for the specific subject H on the subtraction value graph of FIG. The data creation unit 17 can also create a graph showing the subtraction value calculated for a specific subject H on the subtraction value graphs of FIGS. 16 and 17. Further, the data creation unit 17 can display all the graphs created based on FIGS. 16 to 18 on the display 2.
- FIG. 19 is a flowchart showing a main routine of processing executed by the control unit 5 of FIG.
- step S1 it is determined whether or not the information (age, sex, etc.) of the subject H has been input using an input unit (keyboard or the like) not shown (step S1). ).
- the subject information is input (YES in step S1), the subject information is stored in the storage unit 8 (step S2).
- step S3 it is determined whether or not a start switch (not shown) is turned on (step S3).
- a start switch (not shown) is turned on (YES in step S3)
- an information collection process T is executed.
- Information collected in the information collection process T is analyzed in the subsequent information analysis process U.
- the information analyzed by the information analysis process U is displayed on the display 2 (step S4), and the process ends.
- FIG. 20 is a flowchart showing the information collection process of FIG.
- the order of the three types of conditions of the auditory selective attention condition, the visual selective attention condition, and the audiovisual division attention condition is determined, and the order is stored in the storage unit 8 (step T1).
- a test that provides stimulation under all three types of conditions is executed.
- test counter is a counter that increases each time one of the three types of conditions is selected.
- step T3 it is determined whether or not the read condition is an auditory selective attention condition. If it is determined that the read condition is an auditory selective attention condition (YES in step T3), the auditory selective attention condition is determined. Test V is executed, and then step T4 is executed.
- step T4 determines whether or not it is a visual selective attention condition. If it is determined in step T4 that the visual selective attention condition is satisfied, a visual selective attention condition test W is executed, and then step T5 is executed. On the other hand, if it is determined in the step T4 that it is not the visual selective attention condition, it is determined whether or not it is the audiovisual division attention condition (step T5).
- step T5 When it is determined in step T5 that the audiovisual division attention condition is satisfied, the audiovisual division attention condition test X is executed, and then step T6 is executed. On the other hand, if it is determined in step T5 that the condition is not an audiovisual division attention condition, it is determined whether or not the test counter is 3 (step T6). That is, in step T6, it is determined whether or not the test under all the three conditions is completed.
- step T6 If it is determined in step T6 that the test counter is not 3, the step T2 is repeatedly executed. On the other hand, if the test counter is determined to be 3, the test counter is reset to 0, and the main counter of FIG. Return to routine.
- FIG. 21 is a flowchart showing processing of the auditory selective attention condition test of FIG.
- an explanation screen regarding the test method is displayed (step V1).
- This explanation screen includes the following information (1) to (3).
- step V2 it is determined whether or not an input indicating that the above explanation screen is accepted has been made by the operation units 4 and 4 (step V2). If it is determined that the input has been made, the session counter is incremented by 1 (step V3). ). Here, the session counter counts the number of times a stimulus providing process Y described later is performed.
- step V4 presentation step
- the stimulus providing process Y is executed.
- step V5 it is determined whether or not the session counter is 3 (step V5). That is, in step V5, it is determined whether or not the stimulus providing process Y has been performed three times.
- step V5 If it is determined in step V5 that the session counter is not 3, the auditory selection condition image D1 is hidden and a message indicating that the test is to be resumed after a predetermined period is displayed (step V6). In step V6, a later-described stimulus number counter is also reset to zero. Then, it waits for a predetermined period to elapse (step V7). If it is determined in step V7 that the predetermined time has elapsed, step V3 is repeatedly executed.
- step V5 if it is determined in step V5 that the session counter is 3, the session counter and a stimulus counter described later are reset to 0 (step V8). Next, the auditory selection condition image D1 is hidden (step V9), and the process returns to the process of FIG.
- the stimulus output pattern is determined and stored in the storage unit 8 (step Y1).
- the stimulus output pattern is a pattern including 24 auditory stimuli, 24 visual stimuli, and 24 audiovisual stimuli.
- the order of the stimuli included in the stimulus output pattern is random.
- step Y2 the next stimulus is read from the storage unit 8 (step Y2), and it is determined whether or not the read stimulus is an auditory stimulus (step Y3).
- step Y3 If it is determined in step Y3 that it is an auditory stimulus, the auditory stimulus is output for a predetermined period (for example, 150 ms) and stopped (step Y4: stimulus providing step), and then step Y5 is executed. On the other hand, if it is determined in step Y3 that the stimulus is not an auditory stimulus, it is determined whether or not the read stimulus is a visual stimulus (step Y5).
- a predetermined period for example, 150 ms
- step Y4 stimulus providing step
- step Y5 If it is determined in step Y5 that it is a visual stimulus, the visual stimulus is output for a predetermined period (for example, 150 ms) and stopped (step Y6: stimulus providing step), and then step Y7 is executed. On the other hand, if it is determined in step Y5 that the stimulus is not a visual stimulus, it is determined whether or not the read stimulus is an audiovisual stimulus (step Y7).
- a predetermined period for example, 150 ms
- step Y6 stimulus providing step
- step Y7 If it is determined in step Y7 that it is an audiovisual stimulus, the audiovisual stimulus is output for a predetermined period (for example, 150 ms) and stopped (step Y8: stimulus providing step), and then step Y9 is executed. On the other hand, if it is determined in step Y7 that it is not an audiovisual stimulus, it is determined whether or not a response is input by the operation unit 4 (step Y9).
- step Y9 If it is determined in step Y9 that a response has been input, the response time and response content are stored in the storage unit 8 (step Y10: measurement process), and the number counter is incremented by 1 (step Y13).
- step Y9 when it is determined in step Y9 that no response is input, it is determined whether or not the stimulus has been stopped for a predetermined period, that is, whether or not the response period has expired (step Y11). If it is determined at step Y11 that the response period has expired, the fact that the response to the stimulus is invalid is stored in the storage unit 8 (step Y12), and the number counter is incremented by one.
- step Y14 it is determined whether or not the number counter is 72 (step Y14). If it is determined in step Y14 that the number counter is not 72, step Y2 is repeatedly executed. If it is determined in step Y14 that the number counter is 72, the process returns to the process of FIG.
- step W1 when the visual selective attention condition test W is executed, an explanation screen regarding the test method is displayed (step W1).
- This explanation screen includes the following information (1) to (3).
- step W4 Presentation process
- step V5 If it is determined in step V5 that the session counter is not 3, the visual selection condition image D2 is hidden and a message indicating that the test is to be resumed after a predetermined period is displayed (step W6). In step W6, the number counter is also reset to zero.
- step V8 the visual selection condition image D2 is hidden (step W9), and the process returns to the process of FIG.
- FIG. 23 the contents of the processing of the audiovisual division attention condition test X in FIG. 20 will be described.
- FIG. 23 the same processes as those in the auditory selective attention condition test V in FIG.
- an explanation screen regarding the test method is displayed (step X1).
- This explanation screen includes the following information (1) to (4).
- step X4 presentation). Process
- step V5 If it is determined in step V5 that the session counter is not 3, the audiovisual condition image D3 is hidden and a message indicating that the test is to be resumed after a predetermined period is displayed (step X6). In step X6, the number counter is also reset to zero.
- step V8 the audiovisual condition image D3 is hidden (step X9), and the process returns to the process of FIG.
- step U1 whether the response from the subject H is correct or not is determined (step U1), and an average value of response times is calculated and stored in the storage unit 8 (step U2: average value calculation).
- step U2 average value calculation.
- the data for example, FIG. 8 which compared the average value of the response time calculated by step U2, and the reference
- step U4 correct answer rate calculating step.
- data for example, FIG. 10
- standard correct answer rate FIG. 10 and FIG. 11
- step U5 comparison step.
- step U6 cumulative distribution probabilities G1 to G4 and G8 to G10 (see FIGS. 12 and 14) are calculated based on the response time measured for the subject H and stored in the storage unit 8 (step U6).
- step U6 based on the cumulative distribution probabilities G1, G2, G8, and G9 calculated in Step U6, estimated values G5 and G11 (see FIGS. 12 and 14) are calculated and stored in the storage unit 8 (Step U7).
- subtraction values G6, G7, and G12 are calculated based on the estimated values G5 and G11 calculated in step U7 and the cumulative distribution probabilities G3, G4, and G10.
- step U8 first and second index calculation step.
- comparison data for example, FIG.
- step U9 comparison step
- an average value of response times (FIGS. 8 and 9) stored in advance for a plurality of subjects H including AD patients and a specific subject H
- the presence or absence of dementia can be confirmed for the specific subject H.
- the subject H is required to select one of two selection items (right or left) that can be alternatively selected.
- a plurality of subjects can respond at a relatively uniform speed regardless of the interest or interest in the provided information.
- a subtraction value as an index indicating the degree of the promotion effect by audio-visual integration which is prepared in advance (see FIG. 15), and calculated for a specific subject H (see FIG. By comparing FIG. 16 to FIG. 18), it is possible to distinguish a patient having MCI from a healthy elderly person.
- the promotion effect by audio-visual integration has a characteristic that it shows a higher effect as it gets older and decreases with a decrease in brain function. Therefore, by comparing this promotion effect, healthy elderly and patients with MCI And can be identified.
- a reference accuracy rate (FIGS. 10 and FIG. 10) prepared in advance using the characteristics of the accuracy rate (see FIG. 11) in which a significant difference is recognized between AD patients and others. It is possible to confirm whether AD has developed by comparing 11) with the correct answer rate calculated for a specific subject H.
- the display 2 displays data (FIGS. 8, 10, and 18) obtained by comparing the value measured for the specific subject H with the value stored in the storage unit 8. Therefore, the medical staff who has seen the display 2 can determine whether or not dementia has developed.
- condition image D1 indicating the auditory selective attention condition
- condition image D2 indicating the visual selective attention condition
- condition image D3 indicating the audiovisual division attention condition
- the confirmation device 1 displays data (FIGS. 8, 10, and 18) that compares the value measured for a specific subject H with the value stored in the storage unit 8.
- the confirmation device 1 may determine whether the specific subject H belongs to any group of AD, CMI, Elderly, or Young and display the determination result on the display 2.
- the average value of response times of AD patients and the average value of response times of persons other than AD patients are differentiated. It is possible to prepare a threshold value for this in advance and store this threshold value in the storage unit 8. And the data preparation part 17 determines whether the said specific subject H is an AD patient by comparing the average value of the response time calculated about the specific subject H with the said threshold value. Then, the determination result can be displayed on the display 2.
- the threshold value about a correct answer rate can also be prepared based on the correct answer rate shown in FIG. In this way, the data creation unit 17 determines whether or not the specific subject H is an AD patient, and the result is displayed on the display 2.
- threshold values for differentiating the subtraction values of the four groups of AD, MCI, Elderly, and Young are set.
- This threshold value can be prepared in advance and stored in the storage unit 8.
- the data preparation part 17 determines whether the said specific subject H belongs to the said four groups by comparing the subtraction value calculated about the specific subject H with the said threshold value. The determination result can be displayed on the display 2.
- the determination of which group a particular subject H belongs to can be made not only using one of FIGS. 16 to 18 but also using all of FIGS. 16 to 18. .
- three determination results are obtained by comparing the three subtraction values measured for the specific subject H under three types of conditions with the threshold values set in FIGS. 16 to 18, respectively. be able to. That is, by using the comparison shown in FIG. 16, it is possible to obtain a determination result obtained by comparing the subtraction value in the auditory selective condition with the threshold value.
- a determination result obtained by comparing the subtraction value in the visual selective condition with the threshold value can be obtained by the comparison using FIG.
- a determination result obtained by comparing the subtraction value and the threshold value in the audiovisual division attention condition can be obtained by comparison using FIG. Then, based on these three determination results, the group to which the subject H belongs and its possibility can also be determined.
- confirmation device 21 includes display (image display device: visual information providing unit) 2, operation unit 24 that outputs a command in response to an operation from subject H, display 2, And a control unit 25 electrically connected to the operation unit 24.
- the operation unit 24 has a pair of left and right operation buttons.
- the operation unit 24 outputs an electrical signal indicating a “right” response when the right button is pressed, and outputs an electrical signal indicating a “left” response when the left button is pressed.
- the operation unit 24 can be replaced with a mouse which is an input interface of a personal computer.
- control unit 25 collects information for confirming the presence or absence of dementia, and an information analysis unit 27 that analyzes information collected by the information collection unit 26. And a storage unit 8 that stores information for comparison with the information analyzed by the information analysis unit 27, and a screen control that controls image display on the display 2 in accordance with instructions from the information collection unit 26 and the information analysis unit 27 Part 9.
- the information collection unit 26 provides visual information via the display 2 and receives a response from the subject H (command from the operation unit 24) for the provision of this information.
- the information collecting unit 26 includes the stimulus providing unit 12 and the measuring unit 13.
- the stimulus providing unit 12 provides a visual stimulus to the subject H via the display 2. Specifically, the stimulus providing unit 12 provides the task shown in FIG. 28 to the subject H a plurality of times with an appropriate intertask interval Ti as shown in FIG.
- the stimulus providing unit 12 performs the task shown in FIG. 28 on one subject H 90 times.
- an interval of a period Ti 3000 ms
- the interval is inserted 30 times during the execution of 90 tasks. Therefore, in this embodiment, there are a case where an interval is provided between two consecutive tasks and a case where no interval is provided.
- the time required for the task is 3000 ms per time as shown in FIG.
- the test time Ttotal for one subject H is 6 min.
- the task includes a background period (1000 ms), a cue stimulation period (200 ms), an interval period (200 ms, 400 ms, 800 ms), a target stimulation period (100 ms), and a background period (1500 ms, 1300 ms, 900 ms). Included in order.
- the interval period is 200 ms
- the subsequent background period is 1500 ms
- the subsequent background period is 1300 ms
- the subsequent background period is 900 ms.
- 1/3 task has a 200 ms interval period
- 1/3 task has a 400 ms interval period
- 1/3 task has a 800 ms interval period.
- the stimulus providing unit 12 displays only the background image D5.
- the background image D5 has a pair of square images arranged on the left and right sides with an interval between them, and a “+” image arranged between these square images.
- the stimulus providing unit 12 displays a cue image (cue stimulus) D61 or a cue image (cue stimulus) D62 from above the “+” image of the background image D5.
- the cue image D61 is a rightward arrow
- the cue image D62 is a leftward arrow.
- the stimulus providing unit 12 displays only the background image D5.
- the stimulus providing unit 12 displays a target image (target stimulus) D71 or a target image (target stimulus) D72 in addition to the background image D5.
- the target image D71 is an “x” image displayed inside the square image on the right side of the background image D5.
- the target image D72 is an “x” image displayed inside the square image on the left side of the background image D5.
- the target image D71 requests a “right” response from the subject H
- the target image D72 requests a “left” response from the subject H.
- the stimulus providing unit 12 displays the cue images D61 and D62 and the target images D71 and D72 according to the first combination Ta1 or the second combination Ta2 shown in FIG.
- the first combination Ta1 is a combination in which the direction indicated by the cue images D61 and D62 matches the positions of the target images D71 and D72.
- FIG. 30 discloses a combination of a left-oriented cue image D62 and a left target image D72.
- the first combination Ta1 includes a combination of a right-oriented cue image D61 and a target image D71 arranged on the right. Is also included.
- the second combination Ta2 is a combination in which the direction indicated by the cue images D61 and D62 and the positions of the target images D71 and D72 are reversed.
- the second combination Ta2 also includes a combination of a right-pointed cue image D61 and a target image D72 located on the left. included.
- 90% (81 times in this embodiment) tasks have the first combination Ta1 and 10%
- the task (9 times in the present embodiment) has the second combination Ta2.
- the cue images D61 and D62 included in the first combination Ta1 correspond to legitimate cue stimuli
- the cue images D61 and D62 included in the second combination Ta2 correspond to invalid cue stimuli.
- the measurement unit 13 measures the response time from the start of display of the target images D71 and D72 until the subject H responds.
- the information analysis unit 27 calculates information necessary for confirming the presence or absence of dementia based on the response time obtained by the information collection unit 26, and calculates the calculated information and the information stored in the storage unit 8. Compare
- the information analysis unit 27 includes an average time calculation unit 14 that calculates an average value of the response times, a correct answer rate calculation unit 15 that calculates a correct answer rate of responses from the subject H, and each calculation unit 14. , 15 and a data creating unit 17 for creating data by comparing the information stored in the storage unit 8.
- the average time calculation unit 14 calculates the average value of the response time every interval period 200 ms, 400 ms, and 800 ms between the cue images D61 and D62 and the target images D71 and D72. Specifically, the average time calculator 14 excludes the following [1] to [3] in calculating the average response time.
- the average time calculation unit 14 can exclude the response time corresponding to the equations (1) and (2) from the response time for calculating the average value, as in the above embodiment.
- the storage unit 8 stores information shown in FIG. 31 for comparison with the average value calculated by the average time calculation unit 14.
- the storage unit 8 includes a plurality of subjects belonging to two groups including a dementia patient (shown as AD) and a healthy elderly person (shown as Elderly Control: EC).
- a reference average value that is an average value of response times calculated in advance for the person H is stored (preparation step).
- the reference average value is calculated by the average time calculation unit 14.
- the reference average value is calculated for each of the cases where the interval between the cue images D61 and D62 and the target images D71 and D72 (interval between the cue and target) is 200 ms, 400 ms, and 800 ms.
- AD 200 ms and EC 200 ms There is a significant difference between AD 200 ms and EC 200 ms, between AD 400 ms and EC 400 ms, and between AD 800 ms and EC 800 ms, respectively, with a P value ⁇ 0.05. Further, there is a significant difference between AD 200 ms and EC 200 ms, and between AD 400 ms and EC 400 ms, even at a P value ⁇ 0.001.
- “attention” includes passive attention that works when reflexively paying attention to sudden changes in unexpected stimuli, and intentionally directing the attention spotlight to a certain position.
- active attention is applied to the subject H by instructing one of two selection items that can be alternatively selected by the cue images D61 and D62. .
- the ability of the other person is higher than the patient with dementia, the ability to take in the item which a target stimulus shows in the state which worked this active attention is considered that the above-mentioned significant difference exists.
- the reference average value shown in FIG. 31 is calculated for the subject H shown in FIG.
- the CDR score is an abbreviation of Clinical Dementia Rating score.
- the MMSE score is an abbreviation for Mini-MentalentState Examination score.
- Each of these CDR score and MMSE score is an index serving as a measure of the degree of dementia.
- the data creation unit 17 creates data that compares the average response time calculated for a specific subject H with the reference average value (see FIG. 31) stored in the storage unit 8. To do. Specifically, as shown in FIG. 31, the data creation unit 17 creates a graph showing the average values R4 to R6 of the response times calculated for a specific subject H on the reference average value graph, This graph is displayed on the display 2.
- the average value R4 is an average value of response times with a queue-target interval of 200 ms.
- the average value R5 is an average value of response times with a queue-target interval of 400 ms.
- the average value R6 is an average value of response times with a queue-target interval of 800 ms.
- the correct answer rate calculation unit 15 calculates the correct answer rate for each queue-target interval period.
- the correct answer rate calculated by the correct answer rate calculating unit 15 is used when the average value and the reference average value are calculated by the average time calculating unit 14.
- control unit 25 processing executed by the control unit 25 will be described with reference to FIG. 19 and FIGS.
- the main routine executed by the control unit 25 is the same as that shown in FIG. In the present embodiment, the contents of the information collection process T and the information analysis process U in FIG. 19 are different from those in the embodiment. Therefore, the information collection process T and the information analysis process U according to the present embodiment will be described.
- step T11 when the information collection process T is started, a combination of tasks is determined (step T11). Specifically, in step T11, the order of 90 tasks and the timing for inserting an interval among the tasks are determined.
- the combination of tasks may be stored in advance in the storage unit 8 and read from the storage unit 8 in the step T11.
- the background image D5 is displayed on the display 2 (step T12), and the task counter is incremented by 1 (step T13).
- step T14 it is determined whether or not the standby time set in advance as the display time of the background image D5 has arrived. If it is determined that the standby time has arrived, the queue image D61 or the background image D5 is added. D62 is displayed (step T15: stimulus providing step).
- step T16 When the cue image D61 or D62 is displayed, it is determined whether or not a cue display time limit preset as the display time has come (step T16). The background image D5 and the cue image D61 or D62 are displayed until the cue display time limit comes (during step T16 NO). On the other hand, when the cue display time limit has come (YES in step T16), the cue image is not displayed (step T17).
- step T18 it is determined whether or not an interval time limit between the queue and the target has arrived. That is, only the background image D5 is displayed within the interval time limit, and if it is determined that the interval time limit has come, the response acceptance process Z is executed.
- step Z1 stimulus providing step
- step Z2 when the target image D71 or D72 is displayed, it is determined whether or not a response by the subject H to the target image D71 or D72 has been input (step Z2).
- the response time and response content (right or left) are stored (step Z4: measurement process), and the target image D71 or D72 is not displayed, and the process of FIG.
- step Z2 determines whether or not a display time limit preset as the display time of the target images D71 and D72 has arrived (step Z5).
- step Z1 is repeatedly executed.
- step Z6 determines whether or not the display deadline has come.
- step Z7 it is determined whether or not a response time limit set in advance as a time for the response of the subject H has elapsed from the start of display of the target images D71 and D72 (step Z7). If it is determined that the response time limit has not arrived, the step Z2 is repeatedly executed. On the other hand, if it is determined that the response time limit has arrived, the fact that the response by the subject H is invalid is stored, and the process returns to the process of FIG.
- step T19 when the response acceptance process is completed, it is determined whether or not the time limit (waiting time limit) of the background period after the elapse of the target stimulus period shown in FIG. 28 has arrived.
- step T19 it is determined whether or not there is an interval between tasks indicated by the symbol Ti in FIG. 29 (step T20). If it is determined that there is no interval, step T22 is executed. If it is determined that an interval exists, the process waits for the expiration date (step T21), and then executes step T22.
- step T22 it is determined whether or not the task counter is 90. If it is determined that the task counter is not 90 (NO in step T22), step T13 is executed. On the other hand, if it is determined that the task counter is 90, the process returns to the main routine shown in FIG.
- step U11 when information analysis process U is executed, the correctness of the response from subject H is determined and stored in storage unit 8 (step U11), and the correct answer rate is calculated and stored in storage unit. 8 (step U12).
- step U13 average value calculating step
- comparison data shown in FIG. 31 is created by comparing the average value calculated in step U13 with the reference average value stored in the storage unit 8 (step U14: comparison process), and the main routine shown in FIG.
- comparison data is created by superimposing the average values R4 to R6 of the response time of the subject H measured this time in the reference average value graph shown in FIG. This comparison data is displayed on the display 2 in step S4 of FIG. Therefore, the doctor who has seen the comparison data can determine whether or not the subject H has developed dementia.
- the target images D71 and D72 are provided, so that more powerful information for confirming the presence or absence of dementia is collected.
- active attention is applied to the subject H by instructing one of two selection items that can be alternatively selected by the cue images D61 and D62. Can do.
- the response time which shows the high capability of taking in the item which target image D71 and D72 show in the state which worked this active attention is acquirable.
- the presence or absence of dementia can be reliably confirmed by comparing the average response time measured for a specific subject H with the reference average.
- the first combination Ta1 and the second combination Ta2 exist as combinations of the cue images D61 and D62 and the target images D71 and D72. Therefore, it is possible to ignore the target images D71 and D72 and prevent the subject H from responding based only on the cue images D61 and D62. Further, by excluding the response time for the second combination Ta2 from the comparison target, it is possible to reliably obtain the response time corresponding to the ability to incorporate the items indicated by the target images D71 and D72 with the active attention applied. Can do.
- intervals of 200 ms, 400 ms, and 800 ms are provided between the cue images D61 and D62 and the target images D71 and D72.
- the subject H is given time to wait for the target images D71 and D72 with active attention applied. Can do. Therefore, it is possible to prevent the response time from changing due to the confusion between the cue images D61 and D62 and the target images D71 and D72.
- the response time by the subject H having a correct answer rate of 70% or more is used as the reference average value.
- the reference average value more accurately indicates the response time for the target images D71 and D72 in a state where active attention is applied.
- the correct answer rate is 50% even if the target images D71 and D72 are not confirmed. Therefore, as in the above-described embodiment, by extracting a response time with a correct answer rate of 70% or more, calculating a reference average value based on a response time that is highly likely to be confirmed by confirming the target images D71 and D72. Can do.
- the said confirmation apparatus 21 displays the data (FIG. 31) which compared the value measured about the specific subject H, and the value memorize
- the confirmation device 21 may determine whether the specific subject H belongs to the AD or EC group, and display the determination result on the display 2.
- a threshold value for differentiating AD and EC is prepared in advance, and this threshold value is stored in the storage unit 8 Can do.
- the data preparation part 17 compares the average value of the response time calculated about the specific subject H with the said threshold value, and is whether this specific subject H is AD or EC. The determination result can be displayed on the display 2.
- the confirmation device 31 performs the test using the cue images D61 and D62 and the target images D71 and D72 in the second embodiment, and the activity of the subject's brain based on the fMRI detection signal. Analyze state changes.
- the confirmation device 31 includes a projector 32 (image display device: visual information providing unit) that can display an image on the paper screen 32a, the operation unit 24, and the activity state of the brain of the subject H.
- An fMRI (functional magnetic resonance) 33 for detecting a change and a control unit 35 electrically connected to the projector 32, the operation unit 24 and the fMRI 33 are provided.
- FIG. 36 discloses a state in which the fMRI 33 is located away from the subject H, but the fMRI 33 is arranged so as to cover the head of the subject H during the test.
- control unit 35 collects information for confirming the presence or absence of dementia, and an information analysis unit 37 that analyzes information collected by the information collection unit 26. And a screen control unit 9 that controls image display by the projector 32 in accordance with instructions from the information collection unit 26 and the information analysis unit 37.
- the information collection unit 26 provides visual information via the projector 32 and receives a response from the subject H to the provision of this information. Specifically, the information collecting unit 26 includes the stimulus providing unit 12 and the measuring unit 13.
- the measurement unit 13 measures the response time from the start of display of the target images D71 and D72 until the subject H responds, as in the above embodiment. Furthermore, the measurement unit 13 in the present embodiment is in an enforcement period from when the cue image D61 is displayed until a response is received from the operation unit 24, and during other periods (period Ti in FIG. 29). The detection value by fMRI33 is acquired.
- the information analysis unit 37 calculates information necessary for confirming the presence or absence of dementia based on the response time obtained by the information collection unit 26 and the detection unit of the fMRI 33, and stores the calculated information in the storage unit 8 Compare with stored information.
- the information analysis unit 37 includes the average time calculation unit 14, the correct answer rate calculation unit 15, an activity state analysis unit 40 that analyzes a change in the brain activity state of the subject H, and an activity state analysis.
- a data creation unit 17 is provided for creating data obtained by comparing the information analyzed by the unit 40 with the information stored in the storage unit 8.
- the activity state analysis unit 40 analyzes the change in the activity state of the brain of the subject H based on the detection value obtained by the fMRI 33 acquired by the measurement unit 13. Specifically, the activity state analysis unit 40 detects the MRI signal detected during the enforcement period from the start of display of the cue images D61 and D62 until receiving a response from the operation unit 24, and the interval Ti in FIG. The rate of change with the MRI signal thus obtained (hereinafter referred to as the BOLD signal rate of change) is calculated.
- the BOLD signal change rate indicates a change in the activity state of the brain between the enforcement period when the brain is stimulated and the interval Ti. Specifically, when the brain is stimulated (when activated), the amount of deoxyhemoglobin (deoxy-Hb) in the brain increases with the increase in brain oxygen consumption, and the blood in the brain As the flow increases, the amount of oxyhemoglobin (hereinafter referred to as Oxy-Hb) increases. More specifically, the increase amount of Oxy-Hb which is a diamagnetic material is extremely large with respect to an increase of Deoxy-Hb which is a paramagnetic material.
- BOLD BitloodlooOxygenation Level Dependent
- the activity state analysis unit 40 excludes the detection value by the fMRI 33 while the test for the second combination Ta2 (see FIG. 30) is being performed. As a result, it is possible to obtain information regarding the change in the activity state of the brain of the subject H who has received active provision of appropriate cue stimulation (valid cue stimulation).
- the activity state analysis unit 40 analyzes the change in the activity state of the brain of the subject H by calculating the BOLD signal change rate.
- the storage unit 8 stores the reference analysis values shown in FIGS. 38 to 42 for comparison with the BOLD signal change rate calculated by the activity state analysis unit 40 (preparation step). Specifically, the storage unit 8 calculates the BOLD signal change rate calculated in advance for a plurality of subjects H (in this embodiment, the subjects shown in FIG. 32) belonging to two groups including AD and EC. Are stored in advance.
- 38 and 39 are diagrams showing the BOLD signal change rate and the brain activation site when the cue-target interval is 200 ms. 38 and 39, the BOLD signal change rate at the activation site is such that EC is all changed to positive and AD is all changed to negative. There is a significant difference between the EC BOLD signal change rate and the AD BOLD signal change rate with a P value ⁇ 0.01.
- the activation sites shown in FIG. 38 are TPJ, Talamus, and RMFG (outlined portions), and the activation sites shown in FIG. 39 are IFG, LMFG, aINS, SMA, and PCG (outlined portions). The formal names of activation sites will be listed later.
- FIG. 40 is a diagram showing the BOLD signal change rate and the brain activation site when the cue-target interval is 400 ms.
- the BOLD signal change rate at the activation site shown in FIG. 40 all the ECs change to positive and all the ADs change to negative.
- part shown in FIG. 40 is Amygdala and SMA.
- 41 and 42 are diagrams showing the BOLD signal change rate and the brain activation site when the cue-target interval is 800 ms.
- the BOLD signal change rate at the activation site shown in FIGS. 41 and 42 all the ECs are changed to positive, and all the ADs are changed to negative. There is a significant difference between the EC BOLD signal change rate and the AD BOLD signal change rate with a P value ⁇ 0.01.
- 41 and 42 are DLPFC, SFG, PCC, ACC, and Tharamus.
- ACC anterior cingulate cortex: frontal cortex aINS: anterior insula: frontal cortex
- Amygdala amygdala
- DLPFC dorsalateral prefrontal cortex: dorsolateral prefrontal cortex
- IFG inferior frontal gyrus: inferior frontal gyration
- RMFG right middle frontal gyrus: right middle frontal gyrus
- LMFG left middle frontal gyrus: left middle frontal gyrus
- PCC posterior cingulated cortex: posterior cingulate cortex
- PCG postcentral gyrus: central posterior
- SFG superior frontal gyrus: upper frontal gyrus
- SMA supplementary motor area: Supplemental motor cortex Thalamus: Thalamus TPJ: temporal parietal junction: Temporal parietal junction
- the data creating unit 17 compares the BOLD signal change rate calculated for the specific subject H with the reference analysis value (FIGS. 38 to 42) stored in the storage unit 8. create. Specifically, as shown in FIG. 38, the data creation unit 17 creates a graph showing the BOLD signal change rates R7 to R9 calculated for a specific subject H on the reference analysis value graph. Display the graph. This graph may be displayed by the projector 32, but can also be displayed on the display 2 in the same manner as in the above embodiment.
- the main routine executed by the control unit 35 is the same as that shown in FIG. Moreover, the difference from FIG. 33 and FIG. 36 among the information collection processing T and the information analysis processing U which the control part 35 performs is mainly demonstrated.
- step T131 detection by fMRI 33 is started (step T131). That is, the fMRI 33 detection is started simultaneously with the start of the task shown in FIG. Thereafter, the same processing as in FIG. 33 is executed, and when it is determined in step T19 that the waiting time limit has come, the detection by fMRI 33 is terminated (step T191), and the detection result by fMRI 33 is stored in storage unit 8 (step T192). Thereby, the detection (first detection step) by the fMRI 33 can be executed during the enforcement period from when the queue images D61 and D62 are displayed until a response is received.
- step T20 when there is an interval between tasks (YES in step T20), detection by fMRI33 is started, and when the interval ends (YES in step T21), detection by fMRI33 is ended (step T211), and the detection result Is stored in the storage unit 8 (step T212). Thereby, the detection (second detection step) by the fMRI 33 in the inter-task interval can be executed.
- step U15 transition will be described below.
- step U14 the BOLD signal change rate is calculated based on the detected value by fMRI 33 (step U15: activity state analysis step).
- step U16 comparison step
- comparison data that compares the calculated BOLD signal change rate with the reference analysis value is created and stored in the storage unit 8 (step U16: comparison step). Specifically, in step U16, as shown in FIG. 38, comparison data is created by superimposing the calculated BOLD signal change rates R7 to R9 on a graph of reference analysis values. Therefore, the doctor who has seen the comparison data can determine whether or not the subject H has developed dementia.
- the BOLD signal change rate is calculated for the specific subject H, and the BOLD signal change rate is compared with the reference analysis value.
- the said confirmation apparatus 31 displays the data (FIG. 38) which compared the value measured about the specific subject H, and the value memorize
- the confirmation device 31 may determine whether the specific subject H belongs to the AD or EC group and display the determination result.
- a threshold value for differentiating AD and EC is prepared in advance, and this threshold value is stored in the storage unit 8 Can be made.
- the data preparation part 17 determines whether the said specific subject H is AD or EC by comparing the BOLD signal change rate calculated about the specific subject H with the said threshold value. The determination result can be displayed.
- the present invention is a method for confirming the presence or absence of the onset of dementia in a subject, wherein one of two alternatively selectable items is information on at least one of auditory and visual information.
- a stimulus providing step to be provided to the subject a plurality of times, and a response from the subject regarding the stimulus provided in the stimulus providing step, and the response after the stimulus is provided
- a plurality of subjects including a measuring step for measuring response time until, an average value calculating step for calculating an average value of response times measured in the measuring step, and a dementia patient and other people
- a comparison step of comparing the bets provide confirmation method of the presence or absence of the onset of dementia.
- the present invention is an apparatus for confirming the presence or absence of dementia on a subject, wherein one of two selectable selection items is at least one of hearing and vision.
- An information providing unit that can be provided to the subject as a stimulus including the above information, and an operation that can output a command indicating that one of the two selection items has been selected according to the operation from the subject. And controlling the information providing unit to provide the selection item to the subject, and analyzing information for confirming the presence or absence of dementia based on the command input from the operation unit
- a stimulus providing unit that provides a stimulus indicating one of the two selection items a plurality of times via the information providing unit, and a stimulus is provided by the stimulus providing unit. After receiving a command output from the operation unit.
- a plurality of subjects including a measurement unit that measures response time until, an average time calculation unit that calculates an average value of response times measured by the measurement unit, and a patient with dementia and others
- a storage unit that stores in advance a reference average value that is prepared in advance and is an average value of response times to the stimulus provided by the stimulus providing unit, and a response time obtained by the average time calculation unit for a specific subject.
- a device for confirming the onset of dementia comprising a data creation unit for creating data that compares an average value with the reference average value.
- comparing a reference average value of response times prepared in advance for a plurality of subjects including patients with dementia and an average value of response times obtained for a specific subject thus, the presence or absence of dementia can be confirmed for the specific subject.
- AD Alzheimer's dementia
- a stimulus including at least one of auditory and visual information is supplied to a subject multiple times. It was confirmed that there was a significant difference in the response time between the patients and other patients (see FIG. 8, FIG. 9 and FIG. 31). Therefore, as in the present invention, it is possible to confirm whether or not dementia has occurred by comparing a reference average value prepared in advance with an average value calculated for a specific subject. .
- the subject is requested to select (respond) one of two selection items that can be alternatively selected. Therefore, unlike the conventional case where a meaningful subject is specified, a plurality of subjects can respond at a relatively uniform speed regardless of interest or interest in the provided information.
- Alzheimer-type dementia is a symptom satisfying all of the following A to F according to DSM-IV (The Diagnostic and Manual Statistical of Manual Disorders-IV).
- a cognitive deficit causes significant impairment of social function.
- C. The course is characterized by gradual onset and persistent cognitive decline.
- D. The cognitive deficiency of A is not due to other dementias.
- E. A cognitive deficit does not appear only during the course of delirium.
- F. This disorder of dementia cannot be well explained by other first-line diseases (such as schizophrenia).
- two selection items that can be alternatively selected means, for example, characters and figures that mean contradicting directions such as left and right, up and down, or contradicting contents such as XX and ON / OFF. Or a symbol or a combination thereof.
- a target stimulus that provides one of the two selection items as visual information is provided a plurality of times, and the plurality of target stimuli are provided.
- a cue stimulus that is visual information indicating one of the two selection items is provided for a preset period, and in the measuring step, the target stimulus is provided. It is preferable to measure the time from receiving the response to receiving the response as the response time.
- the information providing unit includes a visual information providing unit capable of providing visual information to a subject, and the stimulus providing unit is configured to select the two selection items. Providing one of the target stimuli as visual information multiple times and indicating one of the two selection items before providing each of the multiple times of the target stimulus A cue stimulus that is visual information is provided for a preset period, and the measurement unit measures, as the response time, a time from when the target stimulus is provided until the command output from the operation unit is received. It is preferable.
- the target stimulus is provided after providing the cue stimulus, more powerful information for confirming the presence or absence of the onset of dementia can be collected.
- the inventors of the present application provided a cue stimulus as a clue to the item indicated by the target stimulus, with respect to the average value of the response time to the target stimulus, between the demented patient and the other patients. It has been confirmed that a significant difference exists (see FIG. 31).
- the reason why such a significant difference exists is considered to be “attention” that works when a person collects information from the outside through vision.
- “attention” includes passive attention that works when reflexively paying attention to sudden changes in unexpected stimuli, and intentionally directing a spotlight of attention to a certain position.
- active attention that works.
- the active attention is applied to the subject by instructing one of two selection items that can be alternatively selected by a cue stimulus. And since the ability of the other person is higher than the patient with dementia, the ability to take in the item which a target stimulus shows in the state which worked this active attention is considered that the above-mentioned significant difference exists.
- the presence or absence of dementia can be more reliably confirmed by comparing the average value of response times measured for a specific subject with the reference average value.
- each of the target stimulus and the cue stimulus is provided as visual information. Therefore, the contents of the test can be simplified as compared with the case where auditory stimulation is provided to the subject in addition to vision.
- a plurality of cue stimuli provided in the stimulus providing step include a valid cue stimulus that preliminarily indicates an item indicated by the target stimulus, and an item indicated by the target stimulus. Includes an invalid cue stimulus that indicates the opposite item in advance, and the average value calculating step calculates an average value of response times excluding a response time to the target stimulus after the invalid cue stimulus is provided.
- the preparation step it is preferable to calculate a reference average value excluding a response time to the target stimulus after the invalid cue stimulus is provided.
- the cue stimulus is instructed in advance with a valid cue stimulus instructing an item indicated by the target stimulus in advance and an item opposite to the item indicated by the target stimulus.
- An invalid cue stimulus is included, and the average time calculation unit calculates an average value of response times excluding a response time to the target stimulus after the invalid cue stimulus is provided, and the storage unit Preferably, a reference average value excluding the response time to the target stimulus after the invalid cue stimulus is provided is stored in advance.
- the cue stimulus includes the valid cue stimulus and the invalid cue stimulus, and the average value and the reference average value excluding the response time to the target stimulus after the invalid cue stimulus is provided are calculated.
- the target stimulus can be ignored, and the subject can be prevented from responding based only on the cue stimulus.
- the response time for the target stimulus after the invalid cue stimulus is provided from the comparison target, the response time corresponding to the ability to incorporate the item indicated by the target stimulus with the active attention applied is ensured. Can get to.
- a predetermined interval is provided between the cue stimulus and the target stimulus in the stimulus providing step.
- the stimulus providing unit provides the target stimulus with a predetermined interval after the provision of the cue stimulus.
- an interval is provided between the cue stimulus and the target stimulus.
- the cue stimulus and the target stimulus are continuously provided, it is possible to give the subject time to wait for the target stimulus in a state where active attention is exerted by the cue stimulus. Therefore, it is possible to suppress the response time from changing due to the confusion between the cue stimulus and the target stimulus.
- the method further includes a correct answer rate calculating step of calculating a correct answer rate for a response from the subject, and in the preparing step, the correct answer rate among a plurality of subjects. It is preferable to prepare the reference average value for subjects who are 70% or more.
- the device further comprises a correct answer rate calculating unit that calculates a correct answer rate for the response from the subject, and the storage unit includes the plurality of subjects among the subjects. It is preferable to previously store the reference average value for subjects whose correct answer rate is 70% or more.
- the response time by the subject whose correct answer rate is 70% or more is used as the reference average value.
- the reference average value more accurately indicates the response time to the target stimulus in a state where active attention is applied.
- the target stimulus shows two selection items that can be alternatively selected
- the correct answer rate is 50% even if a response is made without confirming the target stimulus. Therefore, as in each of the above embodiments, by extracting a response time with a correct answer rate of 70% or more, it is possible to calculate a reference average value based on a response time with a high possibility of confirming and responding to the target stimulus.
- a method for detecting oxygen consumption and blood flow in a subject's brain using fMRI during an execution period in which the stimulus providing step and the measurement step are performed 1 detection step, a second detection step of detecting oxygen consumption and blood flow in the brain of the subject using fMRI during a period other than the enforcement period, the first detection step, and the second detection step Further comprising an activity state analysis step of analyzing a change in the brain activity state of the subject between the enforcement period and a period other than the enforcement period based on the detection value by the dementia patient in the preparation step
- a reference analysis value obtained by analyzing a change in the brain activity state is prepared in advance, and in the comparison step, the activity state analysis step for a specific subject Of brain activity obtained in It is preferable to compare the reduction and the reference analysis values.
- the fMRI for detecting the oxygen consumption and blood flow in the brain of the subject and the cue stimulus provided by the stimulus providing unit, the output from the operation unit Activity for analyzing changes in the brain activity state of the subject based on the detected value by the fMRI during the enforcement period until the command is received and the detected value by the fMRI during a period other than the enforcement period
- the storage unit stores in advance a reference analysis value obtained by analyzing a change in the activity state of the brain for a plurality of subjects including dementia patients and other people, It is preferable that the data creation unit creates data comparing a change in brain activity state obtained by the activity state analysis unit with the reference analysis value for a specific subject.
- the inventor of the present application stated that the change in brain activity during the period from the provision of cue stimulation to receiving a response and during the period other than the period of dementia is a dementia patient and others (See FIGS. 38 to 42).
- the amount of deoxyhemoglobin (deoxy-Hb) in the brain increases with the increase in brain oxygen consumption, and the blood in the brain
- the amount of oxyhemoglobin hereinafter referred to as Oxy-Hb
- the increase amount of Oxy-Hb which is a diamagnetic material is extremely large with respect to an increase of Deoxy-Hb which is a paramagnetic material.
- BOLD BreastlooOxygenation Level Dependent
- fMRI Functional Magnetic Resonance Imaging
- This change in BOLD effect shows different behaviors between demented patients and other people at specific activation sites in the brain (see FIGS. 38 to 42). Therefore, the presence or absence of dementia can be confirmed by comparing the reference analysis value prepared (stored) in advance with the change in the brain activity state obtained for the specific subject.
- an auditory selective attention condition that responds with attention only to information obtained through hearing
- a visual selective attention condition that responds with attention only to information obtained through vision
- hearing And a selection step for selecting one of three types of audio-visual division attention conditions that respond with attention only to information obtained through vision, and a presentation step for presenting the conditions selected by the selection step to the subject.
- the stimulus providing step an auditory stimulus that provides one of the two selection items as auditory information under the condition selected in the selection step, and one of the two selection items
- Three types of stimuli visual stimuli that provide visual information and audiovisual stimuli that provide one of the two selection items as auditory information and visual information.
- a predetermined response period is provided to the subject, and in the measurement step, the response time for at least one of the three types of stimuli provided in the stimulus provision step is measured.
- the preparation step an average value of response times for each stimulus in each of the three types of conditions is prepared in advance as the reference average value, and in the comparison step, the average value calculation step is performed for a specific subject. It is preferable to compare the average value of the response times obtained in step 1 and the average value of the response times for the same stimulus under the same conditions among the reference average values.
- the information providing unit includes an auditory information providing unit capable of providing auditory information to the subject, and visual information capable of providing visual information to the subject.
- a provision unit wherein the control unit responds by listening only to information obtained through hearing, responds only to information obtained through vision, and receives visual selection and attention.
- One of the three types of audio-visual division attention conditions that respond with attention only to information obtained through vision is selected, and the selected condition is received through at least one of the auditory information providing unit and the visual information providing unit.
- a test condition selection unit to be presented to the examiner, wherein the stimulus providing unit provides one of the two selection items via the auditory information providing unit, the two selections A visual stimulus providing one of the eyes via the visual information providing unit, and an audiovisual stimulus providing one of the two selection items via the auditory information providing unit and the visual information providing unit
- the three types of stimuli are provided to the subject a plurality of times, and the measuring unit measures the response time for at least one type of the three types of stimuli provided from the stimulus providing unit.
- the storage unit stores in advance, as the reference average value, an average value of response times for each stimulus in each of the three types of conditions, and the data generation unit performs the above-described processing for a specific subject. It is preferable to create data in which the average value of the response times obtained by the average time calculation unit is compared with the average value of the response times for the same stimulus under the same condition among the reference average values.
- the presence or absence of dementia can be confirmed using auditory stimuli, visual stimuli, and audiovisual stimuli.
- the inventors of the present application provide the subject with the three stimulations a plurality of times under one condition selected from the three conditions, thereby allowing the patient to have dementia and other persons. It was confirmed that there was a significant difference in response time (see FIGS. 8 and 9). Therefore, as in each of the above embodiments, it is possible to confirm whether or not dementia has developed by comparing a reference average value prepared in advance with an average value calculated for a specific subject. it can.
- “at least one of the three types of stimuli” means at least one of an auditory stimulus and an audiovisual stimulus in an auditory selective attention condition, and a visual stimulus and an audiovisual stimulus in a visual selective attention condition.
- At least one of the audiovisual division attention conditions means at least one of auditory stimulation, visual stimulation, and audiovisual stimulation.
- “response time to each stimulus in each of the three types of conditions” is a response time to an auditory stimulus and an audiovisual stimulus in an auditory selective attention condition, and a visual stimulus and an audiovisual in a visual selective attention condition. It is a response time to a stimulus, and means a response time to an auditory stimulus, a visual stimulus, and an audiovisual stimulus in the audiovisual division attention condition. That is, for example, since it is assumed that there is “no response” for a visual stimulus in an auditory selective attention condition, the response to the visual stimulus in this case is excluded. The same applies to visual stimuli under auditory selective attention conditions.
- the selection step after the measurement step is performed for the previously selected condition, a condition other than the previously selected condition among the three types of conditions is newly set. It is preferable to perform the presenting step, the stimulus providing step, and the measuring step for the condition that is selected and newly selected in the selection step.
- the test condition selection unit is selected last time among the three types of conditions after the measurement of the response time by the measurement unit is completed for the previously selected condition. It is preferable to select a new condition other than the selected condition.
- an average value of response times under two or more conditions can be obtained. Therefore, the presence or absence of dementia can be confirmed more accurately by increasing the number of average values compared with the reference average value.
- the three types of conditions It is preferable to measure the response time for each stimulus in each.
- the test condition selection unit sequentially selects all of the three types of conditions for the specific subject, and the measurement unit selects the three types of conditions. It is preferable to measure the response time for each stimulus in each.
- At least the auditory selective attention condition and the visual selective attention condition are sequentially selected in the selection step, and in the measurement step, auditory perception is performed in the auditory selective attention condition.
- the response time of the subject with respect to the stimulus and the audiovisual stimulus is measured, and the response time of the subject with respect to the visual stimulus and the audiovisual stimulus is measured under the visual selective attention condition, and the response measured in the measurement step
- the promotion effect index is prepared in advance for the subject, and in the comparison step, the promotion effect index calculated in the first index calculation step is prepared. It is preferable to compare and promoting effect index that has been prepared by the preparation process and.
- the test condition selection unit sequentially selects at least the auditory selective attention condition and the visual selective attention condition
- the measurement unit includes the auditory selective attention.
- a response time to the auditory stimulus and the audiovisual stimulus in the condition, respectively, and a response time to the visual stimulus and the audiovisual stimulus in the visual selective attention condition, respectively, and the control unit measures the response time measured by the measurement unit
- a first index calculation unit that calculates a promotion effect index indicating a degree of the promotion effect by audio-visual integration based on the information
- the storage unit includes a plurality of subjects including a patient with mild cognitive impairment and a healthy elderly person.
- index is memorize
- the said data preparation part is the acceleration effect parameter
- the promotion effect index indicating the degree of the promotion effect due to audiovisual integration is compared with the preliminarily prepared one and the one calculated for the specific subject.
- MCI Mild Cognitive Impairment
- Elderly a healthy elderly person
- the inventors of the present application when comparing the response times described above, can discriminate between AD patients and others, but sufficiently distinguish between patients with MCI and healthy elderly people Faced with the problem that it is difficult to perform (see the EM column of the audiovisual attention condition in FIG. 9). Accordingly, the inventors of the present application have focused on the following (1) to (4) and have come up with a method for comparing promotion effect indexes indicating the degree of the promotion effect by audiovisual integration.
- rCMRglc brain metabolic rate
- the “audio-visual integration” means that information about hearing and information about vision affect each other.
- the “promotion effect” means that information obtained from two or more intervals strengthen each other. Specifically, it is observed when auditory and visual information that is semantically compatible is provided, such as when a red visual stimulus and an auditory stimulus of the word red are provided simultaneously. Note that the promotion effect varies depending on attention conditions, and when visual information and auditory information are provided, a higher effect may be observed under audiovisual division attention conditions than when visual or auditory information is selectively noted. Known (see Exhibit (3) above).
- the “mild cognitive dysfunction” means a state in which cognitive function and memory ability are lower than expected in the process of normal aging, but symptoms are not as severe as dementia.
- a person with mild cognitive dysfunction is more likely to develop dementia than a healthy elderly person. According to the operational diagnostic criteria for amnestic mild cognitive impairment proposed at the MCI Consensus Conference (1999, Chicago), MCI is diagnosed when all of the following A to E are met.
- the “healthy elderly” is a person who has no physical or mental disabilities, in particular, no abnormality in nerve functions such as vision, hearing and memory.
- an auditory cumulative distribution probability of a response time to an auditory stimulus under the auditory selective attention condition and a response to the visual stimulus under the visual selective attention condition A visual cumulative distribution probability of time; a first audiovisual cumulative distribution probability of response time to the audiovisual stimulus in the auditory selective attention condition; and a second audiovisual cumulative distribution probability of response time to the audiovisual stimulus in the visual selective attention condition;
- the first index calculation unit includes an auditory cumulative distribution probability of a response time to the auditory stimulus in the auditory selective attention condition and a visual stimulus in the visually selective attention condition.
- Visual cumulative distribution probability of response time, first audiovisual cumulative distribution probability of response time to audiovisual stimulus under the auditory selective attention condition, and second audiovisual cumulative distribution probability of response time to audiovisual stimulus under the visual selective attention condition An estimated value of the cumulative distribution probability of the response time to the audiovisual stimulus based on the auditory cumulative distribution probability and the visual cumulative distribution probability, and a first effect as the promotion effect index obtained by subtracting the estimated value from the first audiovisual cumulative distribution probability 1 subtraction value and a second subtraction value as the promotion effect index obtained by subtracting the estimated value from the second audiovisual cumulative distribution probability Calculation it is preferable to.
- the index of the promotion effect is based on the estimated value of the cumulative distribution probability of the response time to the audiovisual stimulus and the actually measured value of the cumulative distribution probability of the response time to the audiovisual stimulus (audiovisual cumulative distribution probability).
- a first subtraction value and a second subtraction value can be obtained.
- the “cumulative distribution probability” means that the period from the start of stimulus provision to the end of a preset response period is divided into a plurality of equal periods, and all measured response time data is assigned to each section. The total quantity of data existing from the start of stimulus provision to each category is shown as a percentage of the total number of data.
- the “estimated value” can be calculated using, for example, a race model (COGNITIVE PSYCHOLOGY 14, 247-279 (1982) V: JEFF MILLER).
- the race model is for calculating an estimated value of the audiovisual cumulative distribution probability, which is the logical sum of these cumulative distribution probabilities, based on the auditory cumulative distribution probability and the visual cumulative distribution probability.
- the audiovisual division attention condition is selected, and in the measurement step, the response time is measured for each of the three types of stimuli, and the measurement step And a second index calculation step of calculating a promotion effect index indicating the degree of the promotion effect by audiovisual integration based on the response time measured in the step, wherein the preparation step includes a patient with mild cognitive impairment and a healthy elderly person.
- the promotion effect index is prepared in advance for the plurality of subjects including, and in the comparison step, the promotion effect index calculated in the second index calculation step is compared with the promotion effect index prepared in the preparation step It is preferable to do.
- the test condition selection unit selects the audio-visual division attention condition
- the measurement unit measures the response time for each of the three types of stimuli.
- the control unit further includes a second index calculation unit that calculates a promotion effect index indicating a degree of the promotion effect by audiovisual integration based on the response time measured by the measurement unit, and the storage unit has a mild cognitive function.
- the promotion effect index is stored in advance for the plurality of subjects including patients with disabilities and healthy elderly persons, and the data creation unit includes the promotion effect index calculated by the second index calculation unit and the storage unit It is preferable to create data that compares the promotion effect index stored in.
- the time for obtaining the promotion effect index can be shortened.
- the response time is measured only with the audiovisual division attention condition.
- the auditory cumulative distribution probability of the response time to the auditory stimulus in the audiovisual division attention condition and the response time to the visual stimulus in the audiovisual division attention condition Of the visual cumulative distribution probability, the audiovisual cumulative distribution probability of the response time to the audiovisual stimulus in the audiovisual division attention condition, and the cumulative distribution probability of the response time to the audiovisual stimulus based on the auditory cumulative distribution probability and the visual cumulative distribution probability It is preferable to calculate a value and a subtraction value as the promotion effect index obtained by subtracting the estimated value from the audiovisual cumulative distribution probability.
- the second index calculation unit includes an auditory cumulative distribution probability of a response time to an auditory stimulus in the audiovisual division attention condition and a visual stimulus in the audiovisual division attention condition. Cumulative distribution probability of response time to audiovisual stimuli based on the cumulative visual distribution probability of response time, the audiovisual cumulative distribution probability of response time to audiovisual stimuli in the audiovisual division attention condition, and the auditory cumulative distribution probability and visual cumulative distribution probability It is preferable to calculate an estimated value of the probability and a subtracted value as the promotion effect index obtained by subtracting the estimated value from the audiovisual cumulative distribution probability.
- the index of the promotion effect is based on the estimated value of the cumulative distribution probability of the response time to the audiovisual stimulus and the actually measured value of the cumulative distribution probability of the response time to the audiovisual stimulus (audiovisual cumulative distribution probability). A subtraction value can be obtained.
- the method further comprises a correct answer rate calculating step of calculating a correct answer rate for the response from the subject, and in the preparing step, the response from the plurality of subjects A reference correct answer rate is prepared in advance, and in the comparison step, the correct answer rate obtained in the correct answer rate calculating step for a specific subject is compared with the correct answer rate for the same stimulus in the same condition in the reference correct answer rate. Is preferred.
- the control unit further includes a correct answer rate calculating unit that calculates a correct answer rate for a response from the subject, and the storage unit includes the plurality of subjects.
- the reference correct answer rate prepared for the response from is stored, and the comparison unit is the same among the correct answer rate obtained by the correct answer rate calculating unit for the specific subject and the reference correct answer rate stored in the storage unit It is preferable to compare the correct answer rate for the same stimulus under the conditions.
- the presence or absence of dementia can be confirmed for a specific subject.
- the inventors of the present application provide AD patients and others by supplying the three stimuli multiple times with a predetermined response period under one condition selected from the three conditions. It was confirmed that there was a significant difference in the correct answer rate (see FIGS. 10 and 11). Therefore, as in the present invention, it is possible to confirm whether AD has developed by comparing a reference correct answer rate prepared in advance with a correct answer rate calculated for a specific subject.
- the visual information providing unit includes an image display device capable of displaying a predetermined image, and the data creation unit displays the created data on the image display device. It is preferable.
- data obtained by comparing the average value of the measured response times with the average value of the response times stored in advance is displayed on the image display unit. Therefore, the medical staff who has seen this image display unit can determine whether or not dementia has developed.
- the visual information providing unit includes an image display device capable of displaying a predetermined image, and the test condition selection unit indicates an ear under the auditory selective attention condition. It is preferable to display two images, display two images showing eyes under the visual selective attention condition, and display one image showing ears and one image showing eyes under the audiovisual division attention conditions. .
- the subject it is possible to cause the subject to recognize that the condition is an auditory selective attention condition by displaying two images showing the ears. Further, by displaying two images showing eyes, it is possible to make the subject recognize that it is a visually selective attention condition. Furthermore, the subject can be made aware of the audio-visual division attention condition by displaying an image showing the ear and an image showing the eye one by one.
- the storage unit includes an average value of response times calculated in advance for patients with dementia and an average value of response times calculated in advance for persons other than dementia patients.
- a threshold for differentiation is stored in advance, and the data creation unit compares the threshold with the average value of response times calculated for the specific subject. It is preferable to determine whether or not is a dementia patient.
- the storage unit differentiates between a promotion effect index calculated in advance for healthy elderly people and a promotion effect index calculated in advance for those with mild cognitive impairment.
- a threshold value for the specific subject is stored in advance, and the data creation unit compares the threshold value with the acceleration effect index calculated for the specific subject so that the specific subject is a healthy elderly person. It is preferable to determine whether the person has mild cognitive dysfunction.
- the specific subject is a healthy elderly person or a person with mild cognitive dysfunction by calculating the promotion effect index for the specific subject. it can.
- the present invention it is possible to obtain information for confirming the onset of dementia while suppressing individual differences for each subject.
- D1-D3 Condition image D4 Stimulus image D5 Background image D61, D62 Cue image (cue stimulus) D71, D72 Target image (target stimulation) G1, G8 Auditory cumulative distribution probability G2, G9 Visual cumulative distribution probability G3, G4, G10 Cumulative distribution probability G5, G11 Estimated value G6, G7, G12 Subtracted value H Subject R1 Average value R2 Correct answer rate R3 Subtracted value 1,21 , 31 Confirmation device 2 Display (visual information providing unit, image display device) 3 ear pads (auditory information provider) 4, 24 Operation unit 5, 25, 35 Control unit 8 Storage unit 11 Test condition selection unit 12 Stimulus providing unit 13 Measurement unit 14 Average time calculation unit 15 Correct answer rate calculation unit 16 Index calculation unit 17 Data creation unit 32 Projector (visual information) Providing unit, image display device) 37 Information Analysis Department 40 Activity State Analysis Department
Abstract
Description
MRT-2×SD>RT・・・(2)
(2)右側の耳当て部3から音声Sが聞こえたときは右の操作部4を操作するとともに、左側の耳当て部3から音声Sが聞こえたときは左の操作部4を操作すること。
(3)上記(1)及び(2)を了解した場合には、操作部4、4を操作すること。
(2)ディスプレイ2の右側に刺激画像D4が表示されたときは右の操作部4を操作するとともに、ディスプレイ2の左側に刺激画像D4が表示されたときは左の操作部4を操作すること。
(3)上記(1)及び(2)を了解した場合には、操作部4、4を操作すること。
(2)右の耳当て部3から音声Sが聞こえたとき、及びディスプレイ2の右側に刺激画像D4が表示されたときに右側の操作部4を操作すること。
(3)左の耳当て部3から音声Sが聞こえたとき、及びディスプレイの2の左側に刺激画像D4が表示されたときに左側の操作部4を操作すること。
(4)上記(1)及び(2)を了解した場合には、操作部4、4を操作すること。
[2]前記第2の組合せTa2についての応答時間。
[3]誤った応答(操作部24の両方のボタンを操作した場合を含む)。
ACC:anterior cingulate cortex:前帯状皮質
aINS:anterior insula:前頭皮質
Amygdala:へん桃体
DLPFC:dorsalateral prefrontal cortex:背外側前頭前野
IFG:inferior frontal gyrus:下前頭回
RMFG:right middle frontal gyrus:右中前頭回
LMFG:left middle frontal gyrus:左中前頭回
PCC:posterior cingulated cortex:後帯状皮質
PCG:postcentral gyrus:中心後回
SFG:superior frontal gyrus:上前頭回
SMA:supplementary motor area:補充運動皮質
Thalamus:視床
TPJ:temporal parietal junction:側頭頭頂接合部
その後、図33と同様の処理を実行し、ステップT19において待機期限が到来したと判定されると、fMRI33による検出を終了し(ステップT191)、fMRI33による検出結果を記憶部8に記憶する(ステップT192)。これにより、キュー画像D61、D62を表示してから応答を受けるまでの施行期間中において、fMRI33による検出(第1検出工程)を実行することができる。
B.Aの認知欠損は、社会的機能の著しい障害を引き起こす。
C.経過は、緩やかな発症と持続的な認知の低下により特徴付けられる。
D.Aの認知欠損は、他の認知症によるものではない。
E.Aの認知欠損は、せん妄の経過中にのみ現れるものではない。
F.この認知症による障害は、他の第1軸の疾患(統合失調症など)ではうまく説明できない。
B.全般的な認知機能は、正常である。
C.日常生活動作は、自立している。
D.認知症ではない。
E.年齢や教育レベルの影響のみでは説明できない記憶障害が存在する。
D4 刺激画像
D5 背景画像
D61、D62 キュー画像(キュー刺激)
D71、D72 ターゲット画像(ターゲット刺激)
G1、G8 聴覚累積分布確率
G2、G9 視覚累積分布確率
G3、G4、G10 累積分布確率
G5、G11 推定値
G6、G7、G12 減算値
H 被検者
R1 平均値
R2 正答率
R3 減算値
1、21、31 確認装置
2 ディスプレイ(視覚情報提供部、画像表示装置)
3 耳当て部(聴覚情報提供部)
4、24 操作部
5、25、35 制御部
8 記憶部
11 試験条件選択部
12 刺激提供部
13 測定部
14 平均時間算出部
15 正答率算出部
16 指標算出部
17 データ作成部
32 プロジェクタ(視覚情報提供部、画像表示装置)
37 情報解析部
40 活動状態解析部
Claims (32)
- 被検者について認知症の発症の有無を確認するための方法であって、
択一的に選択可能な2つの選択項目のうちの1つを、聴覚及び視覚の少なくとも一方の情報を含む刺激として、複数回、被検者に提供する刺激提供工程と、
前記刺激提供工程で提供された刺激について被検者からの応答を受けるとともに、前記刺激が提供されてから前記応答を受けるまでの応答時間を測定する測定工程と、
前記測定工程で測定された応答時間の平均値を算出する平均値算出工程と、
認知症患者とそれ以外の人とを含む複数人の被検者について、前記刺激提供工程で提供された刺激に対する応答時間の平均値である基準平均値を予め準備する準備工程と、
特定の被検者について前記平均値算出工程で得られた応答時間の平均値と、前記基準平均値とを比較する比較工程とを含む、認知症の発症の有無の確認方法。 - 前記刺激提供工程では、前記2つの選択項目のうちの1つを視覚の情報として提供するターゲット刺激を複数回提供するとともに、前記複数回のターゲット刺激のそれぞれを提供する前に、前記2つの選択項目のうちの1つの項目を指示する視覚の情報であるキュー刺激を予め設定された期間提供し、
前記測定工程では、前記ターゲット刺激が提供されてから前記応答を受けるまでの時間を前記応答時間として測定する、請求項1に記載の認知症の発症の有無の確認方法。 - 前記刺激提供工程において提供される複数回のキュー刺激には、前記ターゲット刺激が示す項目を予め指示する正当キュー刺激と、前記ターゲット刺激が示す項目とは逆の項目を予め指示する無効キュー刺激とが含まれており、
前記平均値算出工程では、前記無効キュー刺激が提供された後のターゲット刺激に対する応答時間を除いた応答時間の平均値を算出し、
前記準備工程では、前記無効キュー刺激が提供された後のターゲット刺激に対する応答時間を除いた基準平均値を算出する、請求項2に記載の認知症の発症の有無の確認方法。 - 前記刺激提供工程では、前記キュー刺激と前記ターゲット刺激との間に予め設定されたインターバルを空ける、請求項2又は3に記載の認知症の発症の有無の確認方法。
- 前記被検者からの応答について正答率を算出する正答率算出工程をさらに含み、
前記準備工程では、複数人の被検者のうち、前記正答率が70%以上の被検者について、前記基準平均値を準備する、請求項2~4の何れか1項に記載の認知症の有無の確認方法。 - 前記刺激提供工程及び前記測定工程を実行している施行期間中に、fMRIを用いて被検者の脳の酸素消費量及び血流量を検出する第1検出工程と、
前記施行期間以外の期間中に、fMRIを用いて被検者の脳の酸素消費量及び血流量を検出する第2検出工程と、
前記第1検出工程及び前記第2検出工程による検出値に基づいて、前記施行期間と施行期間以外の期間との間における被検者の脳の活動状態の変化を解析する活動状態解析工程とをさらに含み、
前記準備工程では、認知症患者とそれ以外の人とを含む複数人の被検者について、前記脳の活動状態の変化を解析した基準解析値を予め準備し、
前記比較工程では、特定の被検者について前記活動状態解析工程で得られた脳の活動状態の変化と前記基準解析値とを比較する、請求項2~5の何れか1項に記載の認知症の発症の有無の確認方法。 - 聴覚を通じて得られる情報のみに注意して応答する聴覚選択的注意条件、視覚を通じて得られる情報のみに注意して応答する視覚選択的注意条件、及び聴覚及び視覚を通じて得られる情報のみに注意して応答する視聴覚分割注意条件の3種類の条件から1つを選択する選択工程と、
前記選択工程により選択された条件を被検者に提示する提示工程とをさらに含み、
前記刺激提供工程では、前記選択工程で選択された条件において、前記2つの選択項目のうちの1つを聴覚の情報として提供する聴覚刺激、前記2つの選択項目のうちの1つを視覚の情報として提供する視覚刺激、及び前記2つの選択項目のうちの1つを聴覚の情報及び視覚の情報として提供する視聴覚刺激の3種類の刺激を、複数回、それぞれ所定の応答期間を空けて被検者に提供し、
前記測定工程では、前記刺激提供工程で提供された前記3種類の刺激のうち、少なくとも1種類の刺激についての前記応答時間を測定し、
前記準備工程では、前記3種類の条件のそれぞれにおける各刺激に対する応答時間の平均値を、前記基準平均値として予め準備し、
前記比較工程では、特定の被検者について前記平均値算出工程で得られた応答時間の平均値と、前記基準平均値のうち同一条件における同一刺激に対する応答時間の平均値とを比較する、請求項1に記載の認知症の発症の有無の確認方法。 - 前記選択工程では、前回選択された条件について前記測定工程が行われた後に、前記3種類の条件のうち前回選択された条件以外の条件を新たに選択し、
前記選択工程で新たに選択された条件について前記提示工程、前記刺激提供工程、及び前記測定工程を行う、請求項7に記載の認知症の発症の有無の確認方法。 - 前記選択工程、前記提示工程、前記刺激提供工程、及び前記測定工程を3巡行うことにより、前記特定の被検者について、前記3種類の条件のそれぞれにおける各刺激に対する前記応答時間を測定する、請求項8に記載の認知症の発症の有無の確認方法。
- 前記選択工程では、少なくとも前記聴覚選択的注意条件及び前記視覚選択的注意条件が順次選択され、
前記測定工程では、前記聴覚選択的注意条件においては聴覚刺激及び視聴覚刺激に対する被検者の応答時間をそれぞれ測定するとともに、前記視覚選択的注意条件においては視覚刺激及び視聴覚刺激に対する被検者の応答時間をそれぞれ測定し、
前記測定工程で測定された応答時間に基づいて視聴覚統合による促進効果の程度を示す促進効果指標を算出する第1指標算出工程をさらに含み、
前記準備工程では、軽度認知機能障害を持つ患者及び健常高齢者を含む前記複数人の被検者について前記促進効果指標を予め準備し、
前記比較工程では、前記第1指標算出工程で算出された促進効果指標と前記準備工程で準備された促進効果指標とを比較する、請求項8又は9に記載の認知症の発症の有無の確認方法。 - 前記第1指標算出工程では、前記聴覚選択的注意条件における聴覚刺激に対する応答時間の聴覚累積分布確率と、前記視覚選択的注意条件における視覚刺激に対する応答時間の視覚累積分布確率と、前記聴覚選択的注意条件における視聴覚刺激に対する応答時間の第1視聴覚累積分布確率と、前記視覚選択的注意条件における視聴覚刺激に対する応答時間の第2視聴覚累積分布確率と、前記聴覚累積分布確率と前記視覚累積分布確率とに基づく視聴覚刺激に対する応答時間の累積分布確率の推定値と、前記第1視聴覚累積分布確率から前記推定値を減算した前記促進効果指標としての第1減算値と、前記第2視聴覚累積分布確率から前記推定値を減算した前記促進効果指標としての第2減算値とを算出する、請求項10に記載の認知症の発症の有無の確認方法。
- 前記選択工程では、前記視聴覚分割注意条件が選択され、
前記測定工程では、前記3種類の刺激のそれぞれについて前記応答時間を測定し、
前記測定工程で測定された応答時間に基づいて視聴覚統合による促進効果の程度を示す促進効果指標を算出する第2指標算出工程をさらに含み、
前記準備工程では、軽度認知機能障害を持つ患者及び健常高齢者を含む前記複数人の被検者について前記促進効果指標を予め準備し、
前記比較工程では、前記第2指標算出工程で算出された促進効果指標と前記準備工程で準備された促進効果指標とを比較する、請求項7~11の何れか1項に記載の認知症の発症の有無の確認方法。 - 前記第2指標算出工程では、前記視聴覚分割注意条件における聴覚刺激に対する応答時間の聴覚累積分布確率と、前記視聴覚分割注意条件における視覚刺激に対する応答時間の視覚累積分布確率と、前記視聴覚分割注意条件における視聴覚刺激に対する応答時間の視聴覚累積分布確率と、前記聴覚累積分布確率と前記視覚累積分布確率とに基づく視聴覚刺激に対する応答時間の累積分布確率の推定値と、前記視聴覚累積分布確率から前記推定値を減算した前記促進効果指標としての減算値とを算出する、請求項12に記載の認知症の発症の有無の確認方法。
- 前記被検者からの応答について正答率を算出する正答率算出工程をさらに含み、
前記準備工程では、前記複数人の被検者からの応答についての基準正答率を予め準備し、
前記比較工程では、特定の被検者について正答率算出工程で得られた正答率と、前記基準正答率のうち同一条件における同一刺激に対する正答率とを比較する、請求項7~13の何れか1項に記載の認知症の発症の有無の確認方法。 - 被検者について認知症の発症の有無を確認するための装置であって、
択一的に選択可能な2つの選択項目のうちの1つを、聴覚及び視覚の少なくとも一方の情報を含む刺激として被検者に提供可能な情報提供部と、
前記被検者からの操作に応じて、前記2つの選択項目のうちの1つが選択された旨の指令を出力可能な操作部と、
前記選択項目を被検者に提供するために前記情報提供部を制御するとともに、前記操作部から入力された指令に基づいて認知症の発症の有無を確認するための情報を解析する制御部とを備え、
前記制御部は、
前記2つの選択項目のうちの1つを示す刺激を前記情報提供部を介して複数回提供する刺激提供部と、
前記刺激提供部により刺激が提供されてから、前記操作部から出力された指令を受けるまでの応答時間を測定する測定部と、
前記測定部により測定された応答時間の平均値を算出する平均時間算出部と、
認知症患者とそれ以外の人とを含む複数人の被検者について予め準備され、前記刺激提供部により提供された刺激に対する応答時間の平均値である基準平均値を予め記憶する記憶部と、
特定の被検者について前記平均時間算出部により得られた応答時間の平均値と、前記基準平均値とを比較したデータを作成するデータ作成部とを有する、認知症の発症の有無の確認装置。 - 前記情報提供部は、視覚の情報を被検者に提供可能な視覚情報提供部を有し、
前記刺激提供部は、前記2つの選択項目のうちの1つを視覚の情報として提供するターゲット刺激を複数回提供し、かつ、前記複数回のターゲット刺激のそれぞれを提供する前に、前記2つの選択項目のうちの1つの項目を指示する視覚の情報であるキュー刺激を予め設定された期間提供し、
前記測定部は、前記ターゲット刺激が提供されてから、前記操作部から出力された指令を受けるまでの時間を前記応答時間として測定する、請求項15に記載の認知症の発症の有無の確認装置。 - 前記キュー刺激には、前記ターゲット刺激が示す項目を予め指示する正当キュー刺激と、前記ターゲット刺激が示す項目とは逆の項目を予め指示する無効キュー刺激とが含まれており、
前記平均時間算出部は、前記無効キュー刺激が提供された後のターゲット刺激に対する応答時間を除いた応答時間の平均値を算出し、
前記記憶部は、前記無効キュー刺激が提供された後のターゲット刺激に対する応答時間を除いた基準平均値を予め記憶する、請求項16に記載の認知症の発症の有無の確認装置。 - 前記刺激提供部は、前記キュー刺激の提供の後に予め設定されたインターバルを空けて前記ターゲット刺激を提供する、請求項16又は17に記載の認知症の発症の有無の確認装置。
- 前記被検者からの応答について正答率を算出する正答率算出部をさらに備え、
前記記憶部は、複数人の被検者のうち、前記正答率が70%以上の被検者についての前記基準平均値を予め記憶する、請求項16~18の何れか1項に記載の認知症の有無の確認装置。 - 被検者の脳の酸素消費量及び血流量を検出するfMRIと、
前記刺激提供部によりキュー刺激が提供されてから、前記操作部から出力された指令を受けるまでの施行期間中における前記fMRIによる検出値と、前記施行期間以外の期間中における前記fMRIによる検出値とに基づいて、被検者の脳の活動状態の変化を解析する活動状態解析部とをさらに備え、
前記記憶部は、認知症患者とそれ以外の人とを含む複数人の被検者について、前記脳の活動状態の変化を解析した基準解析値を予め記憶し、
前記データ作成部は、特定の被検者について前記活動状態解析部により得られた脳の活動状態の変化と前記基準解析値とを比較したデータを作成する、請求項16~19に記載の認知症の発症の有無の確認装置。 - 前記情報提供部は、聴覚の情報を被検者に提供可能な聴覚情報提供部と、視覚の情報を被検者に提供可能な視覚情報提供部とを備え、
前記制御部は、聴覚を通じて得られる情報のみに注意して応答する聴覚選択的注意条件、視覚を通じて得られる情報のみに注意して応答する視覚選択的注意条件、及び聴覚及び視覚を通じて得られる情報のみに注意して応答する視聴覚分割注意条件の3種類の条件から1つを選択するとともに、選択された条件を前記聴覚情報提供部及び前記視覚情報提供部の少なくとも一方を通じて被検者に提示する試験条件選択部をさらに備え、
前記刺激提供部は、前記2つの選択項目のうちの1つを前記聴覚情報提供部を介して提供する聴覚刺激、前記2つの選択項目のうちの1つを前記視覚情報提供部を介して提供する視覚刺激、及び前記2つの選択項目のうちの1つを前記聴覚情報提供部及び前記視覚情報提供部を介して提供する視聴覚刺激の3種類の刺激を、複数回、被検者に提供し、
前記測定部は、前記刺激提供部から提供された前記3種類の刺激のうち、少なくとも1種類の刺激についての前記応答時間を測定する測定部と、
前記記憶部は、前記3種類の条件のそれぞれにおける各刺激に対する応答時間の平均値を、前記基準平均値として予め記憶し、
前記データ作成部は、特定の被検者について前記平均時間算出部により得られた応答時間の平均値と、前記基準平均値のうち同一条件における同一刺激に対する応答時間の平均値とを比較したデータを作成する、認知症の発症の有無の確認装置。 - 前記試験条件選択部は、前回選択された条件について前記測定部による応答時間の測定が完了した後に、前記3種類の条件のうち前回選択された条件以外の条件を新たに選択する、請求項21に記載の認知症の発症の有無の確認装置。
- 前記試験条件選択部は、前記特定の被検者について、前記3種類の条件の全てを順次選択し、
前記測定部は、前記3種類の条件のそれぞれにおける各刺激に対する応答時間を測定する、請求項22に記載の認知症の発症の有無の確認装置。 - 前記試験条件選択部は、少なくとも前記聴覚選択的注意条件及び前記視覚選択的注意条件を順次選択し、
前記測定部は、前記聴覚選択的注意条件における聴覚刺激及び視聴覚刺激に対する応答時間をそれぞれ測定するとともに、前記視覚選択的注意条件における視覚刺激及び視聴覚刺激に対する応答時間をそれぞれ測定し、
前記制御部は、前記測定部により測定された応答時間に基づいて視聴覚統合による促進効果の程度を示す促進効果指標を算出する第1指標算出部をさらに備え、
前記記憶部は、軽度認知機能障害を持つ患者及び健常高齢者を含む前記複数人の被検者について前記促進効果指標を予め記憶し、
前記データ作成部は、前記第1指標算出部により算出された促進効果指標と前記記憶部に記憶された促進効果指標とを比較したデータを作成する、請求項22又は23に記載の認知症の発症の有無の確認装置。 - 第1指標算出部は、前記聴覚選択的注意条件における聴覚刺激に対する応答時間の聴覚累積分布確率と、前記視覚選択的注意条件における視覚刺激に対する応答時間の視覚累積分布確率と、前記聴覚選択的注意条件における視聴覚刺激に対する応答時間の第1視聴覚累積分布確率と、前記視覚選択的注意条件における視聴覚刺激に対する応答時間の第2視聴覚累積分布確率と、前記聴覚累積分布確率と前記視覚累積分布確率とに基づく視聴覚刺激に対する応答時間の累積分布確率の推定値と、前記第1視聴覚累積分布確率から前記推定値を減算した前記促進効果指標としての第1減算値と、前記第2視聴覚累積分布確率から前記推定値を減算した前記促進効果指標としての第2減算値とを算出する、請求項24に記載の認知症の発症の有無の確認装置。
- 前記試験条件選択部は、前記視聴覚分割注意条件を選択し、
前記測定部は、前記3種類の刺激のそれぞれについて前記応答時間を測定し、
前記制御部は、前記測定部により測定された応答時間に基づいて視聴覚統合による促進効果の程度を示す促進効果指標を算出する第2指標算出部をさらに備え、
前記記憶部は、軽度認知機能障害を持つ患者及び健常高齢者を含む前記複数人の被検者について前記促進効果指標を予め記憶し、
前記データ作成部は、前記第2指標算出部により算出された促進効果指標と前記記憶部に記憶された促進効果指標とを比較したデータを作成する、請求項21~25の何れか1項に記載の認知症の発症の有無の確認装置。 - 前記第2指標算出部は、前記視聴覚分割注意条件における聴覚刺激における聴覚刺激に対する応答時間の聴覚累積分布確率と、前記視聴覚分割注意条件における視覚刺激に対する応答時間の視覚累積分布確率と、前記視聴覚分割注意条件における視聴覚刺激に対する応答時間の視聴覚累積分布確率と、前記聴覚累積分布確率と前記視覚累積分布確率とに基づく視聴覚刺激に対する応答時間の累積分布確率の推定値と、前記視聴覚累積分布確率から前記推定値を減算した前記促進効果指標としての減算値とを算出する、請求項26に記載の認知症の発症の有無の確認装置。
- 前記制御部は、前記被検者からの応答について正答率を算出する正答率算出部をさらに備え、
前記記憶部は、前記複数人の被検者からの応答について準備された基準正答率を記憶し、
前記比較部は、特定の被検者について正答率算出部により得られた正答率と、前記記憶部に記憶された基準正答率のうち同一条件における同一刺激に対する正答率とを比較する、請求項21~27の何れか1項に記載の認知症の発症の有無の確認装置。 - 前記視覚情報提供部は、所定の画像を表示可能な画像表示装置からなり、
前記データ作成部は、作成されたデータを前記画像表示装置に表示させる、請求項16~28の何れか1項に記載の認知症の発症の有無の確認装置。 - 前記視覚情報提供部は、所定の画像を表示可能な画像表示装置からなり、
前記試験条件選択部は、前記聴覚選択的注意条件下において耳を示す画像を2つ表示し、前記視覚選択的注意条件下において目を示す画像を2つ表示し、前記視聴覚分割注意条件下において耳を示す画像と目を示す画像を1つずつ表示する、請求項21~28の何れか1項に記載の認知症の発症の有無の確認装置。 - 前記記憶部は、認知症患者について予め算出された応答時間の平均値と、認知症患者以外の者について予め算出された応答時間の平均値とを差別化するための閾値を予め記憶しており、
前記データ作成部は、前記特定の被検者について算出された応答時間の平均値と前記閾値とを比較することにより、当該特定の被検者が認知症患者であるか否かを判定する、請求項15~30の何れか1項に記載の認知症の発症の有無の確認装置。 - 前記記憶部は、健常高齢者について予め算出された促進効果指標と、軽度認知機能障害を持つ者について予め算出された促進効果指標とを差別化するための閾値を予め記憶しており、
前記データ作成部は、前記特定の被検者について算出された促進効果指標と前記閾値とを比較することにより、当該特定の被検者が健常高齢者であるか軽度認知機能障害を持つ者であるかを判定する、請求項24~28の何れか1項に記載の認知症の発症の有無の確認装置。
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CN108463175B (zh) * | 2016-02-22 | 2020-11-06 | 松下知识产权经营株式会社 | 痴呆症状检测系统以及记录介质 |
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