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E-ISSN : 2733-4538
시계 그리기 검사(Clock Drawing Test: CDT)는 빠른 시간 내에 신경인지기능의 여러 영역을 평가할 수 있는 강점이 있으나, 대부분의 연구들은 주로 치매환자들에 대한 CDT의 변별 효율성에 초점을 맞추어왔다. 본 연구에서는 CDT가 치매환자의 변별뿐만 아니라 외상성 뇌손상 환자의 뇌손상 심도도 제대로 반영해 줄 수 있는 검사인지를 알아보고자 수행되었다. 두부외상으로 인한 정신장애 환자 69명을 대상으로 임상적 특징에 대한 조사와 함께 CDT 및 K-WAIS를 실시하였다. Golden과 Golden(2003)의 뇌손상 심도분류를 기초로 하여 환자들을 두 집단(경도에서 중등도 집단, 심한 정도에서 매우 심한 정도 집단)으로 분류한 후, 집단간 CDT 반응의 3개 하위 채점체계 점수와 총점을 비교하였다. 또한, 분류된 두 집단의 K-WAIS 수행과 CDT 반응간의 상관 및 뇌손상의 심도와 오류유형 간의 관련성을 검증하였다. 그 결과, 뇌손상이 심할 수록 CDT 점수가 더 낮았다. 아울러, CDT 점수는 뇌손상이 경도에서 중등도인 집단에서 보다는 심한 정도에서 매우 심한 정도의 뇌손상을 보이는 집단에서 K-WAIS의 소검사 점수 및 지능지수와 더 상관이 높았다. 심한 정도에서 매우 심한 정도의 뇌손상 집단은 시계의 크기와 그림에서의 어려움 오류를 더 많이 나타냈으나, 그 밖의 오류에서는 차이가 없었다. 이러한 결과는 CDT가 치매환자들뿐만 아니라 외상성 뇌손상 환자들의 신경인지기능을 평가하는 데에도 유용하게 사용될 수 있음을 시사한다. 끝으로, 본 연구의 시사점, 제한점 및 향후 연구방향이 간략하게 논의되었다.
The Clock Drawing Test(CDT) has the strength to evaluate several domains of the neurocognitive function in a short period of time. However, most studies have been focused mainly on the efficiency of the CDT for differentiating dementia patients. The purpose of this study was to investigate whether the CDT could correctly reflect the severity of brain injury in patients with traumatic brain injury as well as differentiating dementia patients or not. After the clinical characteristics were examined, the CDT and the Korean-Wechsler Adult Intelligence Test(K-WAIS) were administered to 69 patients with mental disorders due to traumatic brain injury. Based on the severity classification of brain injury by Golden and Golden(2003), the patients were classified into two groups; mild to moderate and severe to very severe. The two groups' scores on 3 subscoring systems and the total scores of the CDT were compared. The correlations between the performance of the K-WAIS and the CDT response and the relationships between the severity of brain injury and the error type of the CDT response were tested. As a result, there were correlations between the severity of brain injury and lower CDT scores in patients. Additionally, the CDT score was more correlated with the subtest scores and IQ of the K-WAIS in the severe to very severe group than the mild to moderate group. The group with severe to very severe brain injury showed much more errors in size of the clock and graphic difficulties but didn't show the others of the errors types. These results suggest that the CDT can be useful in assessing the neurocognitive function of the traumatic brain injured patients as well as the dementia patients. Finally, the suggestions, limitations and further issues for future study were discussed.
(1999) 치매진단을 위한 단축형 Korean-Boston Naming Test 의 개발,
(1997) 치매환자들을 대상으로 한 K-MMSE의 타당도 연구,
(2002) 뇌손상 심도에 따른 외상성 뇌손상 환자의 지능장애와 기억장애 비교,
(2000) 외상성 뇌손상 아동의 임상적 특징과 KEDI-WISC 반응의 관계,
(2000) 외상성 두뇌 손상 환자의 지능장애와 기억장애,
(2004) 경도 치매와 노인성 우울의 변별을 위한 시계 그리기 검사의 효율성,
(2001) 치매 선별 검사로서 시계 그리기 검사의 효율성,
(1998) The Clock-drawing test,
(1992) Cognitive effects of mild head injury in children and adolescents,
(1990) Neuropathology of traumatic brain injury,
(1986) Neurobehavioral sequelae of closed head injury Neuropsychological assessment of neuropsychiatric disorders, Oxford University Press
(1997) The Clock Drawing Test for dementia of the Alzheimer's type:A comparison of three scoring methods in a memory disorders clinic,
(1996) Screening for dementia of the Alzheimer type in the community The utility of the Clock Drawing Test Archives of Clinical Neuropsychology,
(1988) Clinical neuropsychology:Prospects and problems,
(1998) Clock Drawing Test in very mild Alzheimer's disease,
(1996) Does the Clock Drawing Test predict cognitive decline in older persons independent of the Mini-Mental State Examination Journal of American Geriatric Society,
(1991) Clock drawing in acute stroke,
(2003) Impact of brain injury severity on personality dysfunction,
(1996) Neuropsychological assessment of neuropsychiatric disorders, Oxford University Press
(1981) Memory and information processing capacity after closed head injury Journal of Neurology,
(1989) Behavioral assessment during the acute stages of traumatic brain injury Assessment of the behavioral consequences of head trauma Frontiers of clinical neuroscience,
(1999) The use of clock tests in schizophrenia,
(1992) Clock drawing in the screening assessment of cognitive impairment in an ambulatory care setting,
(1984) Neuroepidemiology,
(1983) Differential drawing size associated with unilateral brain damage,
(1982) Neurobehavioral consequences of closed head injury, Oxford University Press
(1982) The battering of neuropsychology by the An appeal for peace and reason Paper presented at the 10th annual meeting of the International Neuropsychological Society,
(1992) Limitation of the Glascow Coma Scale in predicting outcome in children with traumatic brain injury,
(1981) The short-term outcome of severe blunt head injury as reported by relatives of the injured persons Journal of Neurology,
(1984) Psychological functioning at 1 month after head injury,
(1992) Development of scoring criteria for the clock drawing task in Alzheimer's disease Journal of the American Geriatric Society,
(1985) Social adjustment after closed head injury a further follow up seven years after injury Journal of Neurology,
(1992) Personality disturbances associated with traumatic brain injury,
(1962) Human figure drawings before and after chemosurgery of the basal ganglia in Parkinsonism Journal of Nervous and Mental Disease,
(1996) Longitudinal analysis of clock drawing in Alzheimer's disease patients,
(1992) Quantitative and qualitative analyses of clock drawings in Alzheimer's and Huntington's disease,
(1999) Executive control function:a rational basis for the diagnosis of vascular dementia,
(1995) Reversal of visuospatial deficit on the Clock Drawing Test in Parkinson's disease by treatment with weak electromagnetic fields,
(1998) A compendium of neuropsychological tests, Oxford University Press
(1989) Clock drawing in Alzheimer's disease a novel measure of dementia severity Journal of the American Geriatric Society,
(1992) A sensitive measure to differentiate normal elderly from those with Alzheimer's disease Journal of the American Geriatric Society,
(1988) Problem solving deficits after focal cerebral lesions,
(1993) Clock completion:an objective screening test for dementia,
(1981) WAIS-R manual, The Psychological Corporation
(1987) Acquired brain damage and driving:A review,