认知知觉功能障碍评估

认知知觉功 评估和治中山大学附属第六医院康复医学额行为、智力、运

顶智力、阅读、感颞行为、听、语视

脑

小平衡、协基底节及丘开调节运抑协定义简感觉（sensation）是人脑对直接作用于感 的客观事物整体属性的综合映知觉（Perception）是指大脑将感觉信息综合为有认知（cognition）是泛指个人去接收及利用外界信息之基本能力，从而适应来环境之要求认知的内 标准化筛选评估(Screening 简明智能测试（Mini- NeurobehavioralCognitiveStautus OccupationalTherapyCognitiveAssessment,LOTCA）

专注力评 功能评 问题解决能力评 感知能力评（信息加工的过程Metacognition,Metamemory,Excutive元认知， ，执行能(awareness,reasoning,judgment&flexibility)（意识、推理、判断、思维灵活性 、长 Attention(orientation,（定向 RanchoLosAmigosGlasgowComaScale astandardizedsystemusedassessthedegreeofbrainimpairmentandtoidentifytheseriousnessofinjuryinrelationto GCSinvolvesthreeeyeverbalmotorresponses It’sscoring(within48hours)isdeterminedaccordingtothefollowinglevelsofseverity:SevereModerateMild

3- 9-=13-TheRanchoLosAmigosScaleMosthelpfulinassessingthepatientinthefirstweekormonthfollowinganinjurybecauseitdoesnotrequireanycooperationfromthepatient.Basedonobservingthepatient’sresponsestoexternalContainsadescriptiveguidelineonthevariousstageof Anunderstandingofitseight-leveledscaleprovidesgoodinsightintotheprogressthroughfromrecoverytorehabilitation.RanchoLosAmigos认知功能分RanchoLosAmigos认知功能分MMSE,MoCA,NCSE,神经科医师最广为应用于测试痴呆的检查项目之满分30测试范围人物、时间、地点定向（10分3项词句复述（3分注意力和计算能力（5分回忆（3分语言能力（8分空间结构能力（1分正常值：文盲>17分；小学>20学以上>24认知评估（MontrealCognitiveMoCA用于对轻度认知功能异常进完成MoCA检查大约10min，总分30分 版正常积分21分认知评估（MontrealCognitive神经行为认知状态（NeurobehaviroralCognitiveStatusExamination, 作业疗法认知评定量（LoeweisteinOccupationalTherapyCognitiveAssessment,1、定时间与地2、知物体鉴形状鉴辨 的图

复绘二维图插板拼

4、思维运范畴测试（物体性Riska无组织的形状分排列几何推辨认重要特征不明显不完成的物空间知肢体/工具运

绘钟注意 能力

注意的两个维度：广度（Capacity）及 持续注意力（SustainedAttention）eg.课堂上留 选择性注意力（SelectiveAttention）eg.旁人在说话，你 转移性注意力（AlternatingAttention）eg.暂停煮饭去开门，开完 分散性注意力（DividedAttention）eg.一边听课专门测 测试-顺背及倒背(William’sDigitSpanTest-Forward&Backward)TrailMaking日常生活专注力测试（TestofEverydayAttention融进其TrailMakingTest(TMT,Reitan, TMTmeasuresabilitiesSpeedofinformationprocessingPerformanceismeasuredbythetimerequiredtocompletethetest.通过计时评估结果29>7875>273TrailMakingTMT- TMT-Drawlinestoconnectthenumbersascendingorderwithoutliftingthe Connectthecirclesinanascendingpattern,betweenthenumbersandletters(i.e.,1-A-2-B-3-Clinical Itisabasiclevelofthinking.注意力是思维的 Mayexperiencedifficultyin:(Reed,2001;Sohlberg& Engagingselectivelytoinformations/hewishestoattend>E.g.Everythinginthesupermarketistoo Screeningoutirrelevant>E.g.EasilyfeelingSustained SustainingattentionoverSustained>E.g.Difficulttokeeptrackof Difficulttoshiftattentionfromonetasktoanother>E.g.Onlypushingthecarttofindhisway,butforgettolocatetheice-creamDividedDividedTheprocessbywhichinformationisencoded,stored,and3 短 ，工

3typesofstorage:STM,WM,短 、工 、长Givesustheabilitytodrawuponpastexperiencesandnewlearnedinformation.Typesof感 memory/

Visuospatial视空间Sketchpad

SemanticEpisodicArticulatory Shorttermmemory(STM)/sensory Storageoflimitedinformationforalimitedamountoftime.（限的信息，局限的时间 Asthefirststageofinformationprocessing（信息处理的第一阶段 Registrationof inginformationusingvariousorgans(i.e.,visual,auditory,tactile)Onlykeepinformationforafewmilliseconds（几微秒 Wheninformationisnotencoded,ortransfertoSTM,itsoonbereplaced ingnew若信息不被编码或者转化成短 ，它会被新输入信息所取WorkingMemoryWMinvolvesbothtemporarystorageandactivemanipulationofinformation（短期 StructureofArticulatory(Inner

Visuospatialpad(InnerStoreStoreOverallFunctionofWorking（工 的功能Concurrentperformanceoftwoormore(同时进行两个或者多个任务Withthehelpofselective&alternative inferences（谚语e.g.Killtwobirdswithonengarithmeticbyhearte.g.100-7-7),（心算LongTermMemoryInformationisstoredforanextendedperiod

陈述非陈述

GofExperiencede.g.memoryofUnconsciousrecallofskillsaction&procedures.（无意识地回忆起动作技巧、动作及程序Learnedhabitse.g.brushingSkilledmovementse.g.ridingaMotorlearningreliesonproceduralmemory（动作学习主要依赖程 ProspectiveMemory（前瞻 Referstotheabilityofrememberingtotoperformaplannedactionattheappropriatea:Rememberingtoattend10:30am

rememberto功能的评 缺失间期表（PTA）WestmeadtraumaticAmnesia 韦氏延 测试William’sDelayedRecall Rivermead行 能力测试BehavioralMemory 情 测试（CMT）ContextualMemory 日 问卷（EMQ）EverydayMemoryRivermeadBehavioralMemoryTest(RBMT)(Wilson,Cockburn&Baddeley,1991)Rivermead行 测（RivermeadBehavioralMemoryTest,RBMT-

问题解决能力评 决断能力行为测试（BADS）BehavioralAssessmentDysexecutive 后设认知能力面 ponential Raven’s变图形（PRM）Raven’sProgressive无指无表达能力 也可使影知觉功知觉功