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Original Article
Dementia and Neurocognitive Disorders 2010: 9: 4: 129-135

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위스콘신카드분류검사 수행에 관여하는 인지적 특성: 파킨슨병 환자를 대상으로
조희란∙박경원∙김재우
동아대학교 의과대학 신경과학교실
동아대학교병원 신경과
Cognitive Characteristics Associated with the Performance on Wisconsin Card Sorting Test in Patients with Parkinson’s Disease
Hui Ran Cho, Kyung Won Park, M.D., Jae Woo Kim, M.D.
Department of Neurology, Dong-A University College of Medicine, Dong-A University Medical Center, Busan, Korea
Background: It is well known that the Wisconsin Card Sorting Test (WCST) is a representativetest to evaluate executive function. Neuropsychological studies suggest that patients withfrontal lobe damage perform worse on the WCST than do patients with non-frontal lobe injury.However, neuropsychological studies found considerable discrepancies in performances onthe WCST in patients with frontal lobe damage. Established studies examined the neuro-cognitivefunctions in focal brain lesion patients. However, controversy remains over whether cognitiveimpairment is due to a focal brain lesion or due to diffuse brain lesions. Therefore, it is clinicallyvaluable to examine cognitive functions in the performance on the WCST. We comparedthe results of the WCST with the results of the other neuropsychological tests. We also analyzedcognitive functions in the performance of the WCST in patients with Parkinson's disease usingregression analyses. Methods: To examine cognitive functions in the performance of the WCST,we investigated the differences of WCST performance and other neuropsychological tests inpatients with Parkinson's disease (n=143). Stepwise multiple regression analyses were performedwith 4 indices (total correct response, perseverative response, perseverative errorsand categories completed) of the WCST as regressand. Attention, visual-spatial function, namingability, set shifting ability, verbal fluency, verbal delayed recall and non-verbal delayed recallwere regressor. Results: Influential variables of the 4 WCST indices in Parkinson's disease patientswere not only phonemic fluency and set shifting ability but also naming ability. Furthermore,the predicted variables included in this study explained WCST for only about 30%. The bestinfluential variable of total correct response was K-BNT. Phonemic fluency was the best influentialvariable of perseverative response, perseverative errors and categories completed. Conclusions:These results suggest that the performance on the WCST cannot specifically identifyfrontal lobe damage and that WCST is a multi-factorial and complex test.
Key Words: Wisconsin Card Sorting Test, Frontal lobe function, Parkinson’s disease
대한치매학회지 (Dementia and Neurocognitive Disorders)