JP6100754B2 - Stimulus providing method for providing stimulus for confirming the onset of dementia, method for confirming the onset of dementia using the same, and stimulus providing apparatus - Google Patents

Description

  The present invention relates to a technique for confirming whether or not dementia has developed.

  Conventionally, as a method for measuring the recognition ability of the brain, for example, a method described in Patent Document 1 is known.

  The recognition ability measuring 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 degraded image perceived the subject (perceived that the subject is a horse) is measured. Then, based on the measured perception time and perception time measured in advance for a sufficiently large number of subjects, it is shown what position the subject is in the subject group.

  However, in the method of Patent Document 1, since the time for perceiving the subject is measured, there is a possibility that the perception time cannot be accurately measured according to the interest of the subject and the degree of interest in the subject.

  Specifically, when measuring the perception time of a subject with little or no interest from the subject, it is perceived that the perception time is long due to a decrease in the recognition ability of the brain or the subject itself is difficult to see. Cannot determine if time is getting longer.

JP 2006-87743 A

  An object of the present invention has been made in view of the above problems, and a method capable of providing a subject with a stimulus that hardly causes individual differences for each subject in order to confirm the presence or absence of the onset of dementia. It is in providing the method for confirming the presence or absence of the onset of the dementia which had, and the stimulus provision method.

  In order to solve the above problems, the present invention is a method for providing a test subject with a stimulus for confirming the presence or absence of dementia, having a V-shaped shape at a viewpoint perpendicular to a reference plane, and A holding step of holding the plurality of tactile stimuli so that the plurality of tactile stimuli protruding from the reference surface can be circulated, and the subject touches only one of the plurality of tactile stimuli with a fingertip. A covering step of covering the plurality of tactile stimuli held in the holding step with a covering member having an opening that opens as possible, and the plurality of tactile stimuli in the state where the covering step is performed. And a moving step of moving the plurality of tactile stimuli so that one of them sequentially faces the opening.

  In addition, the present invention is an apparatus for providing a subject with a stimulus for confirming the presence or absence of dementia, and has a V-shaped shape at a viewpoint orthogonal to the reference plane and a plurality of protrusions protruding from the reference plane. A tactile stimulus providing unit, a stimulus providing unit having a holding mechanism that holds the plurality of tactile stimulus so that the plurality of tactile stimulus can be circulated, and covering the stimulus providing unit and the plurality of tactile senses A covering member having an opening that allows the subject to touch only one of the stimuli with a fingertip; and one of the plurality of tactile stimuli sequentially facing the opening. There is provided a stimulus providing device including a drive unit that drives a holding mechanism.

  Furthermore, the present invention is a method for confirming the presence or absence of dementia using the stimulus providing method, wherein the angle between two V-shaped line segments of the two types of tactile stimuli. An answer process for inputting an answer from a subject as to whether or not he / she touched a large object first or later, using the input means, and after performing the moving process and the answer process a plurality of times, input in the answer process A method for confirming the presence or absence of dementia, including a correct answer rate calculating step of calculating the correct answer rate of the subject using the data processing means based on the answer and the correct answer stored in advance in the storage means provide.

  According to the present invention, it is possible to provide a subject with a stimulus that is hardly influenced by the subject's interest and interest, that is, a tactile stimulus having a V-shaped shape at a viewpoint orthogonal to the reference plane. Thereby, the information for confirming the presence or absence of dementia can be obtained, and the presence or absence of the onset of dementia can be confirmed.

It is the schematic which shows the state which is performing the test using the irritation | stimulation provision apparatus which concerns on this invention. It is the perspective view which looked at the providing apparatus main body shown in FIG. 1 from upper direction. It is a top view which shows the state which abbreviate | omitted the top plate of the provision apparatus main body shown in FIG. It is the IV-IV sectional view taken on the line shown in FIG. It is a perspective view which shows the relationship between the stimulation board of FIG. 3, and a stimulation board guide. It is side surface sectional drawing which shows the fixed state of a stimulation board and an endless belt. It is a top view which shows the state which provides the tactile stimulus. It is a table | surface which shows the combination of the visual stimulus formed in a stimulus board. It is a block diagram which shows the electrical structure of the stimulus provision apparatus shown in FIG. It is a flowchart which shows the process performed by PC shown in FIG. It is a graph which shows the content of the average correct answer rate memorize | stored in the memory | storage part of FIG. It is a graph which shows the approximated curve obtained by the average correct answer rate of FIG. It is a graph which shows the threshold value of the recognizable angle difference memorize | stored in the memory | storage part of FIG. It is the schematic which shows another provision method of a visual stimulus.

  Embodiments of the present invention will be described below with reference to the accompanying drawings. In addition, the following embodiment is an example which actualized this invention, Comprising: The thing of the character which limits the technical scope of this invention is not.

  As shown in FIGS. 1 and 7, the stimulus providing apparatus 1 according to the present embodiment sequentially provides tactile stimuli 11h so that the subject H1 can touch with the index finger. Specifically, the stimulus providing device 1 is a providing device main body 2 for providing a tactile stimulus 11h to the subject H1, and a PC that is electrically connected to the providing device main body 2 and controls driving of the providing device main body 2. (Personal Computer) 3. In the following description, the side on which the subject H1 is located at the time of the test will be the back side of the providing apparatus body 2, and the description will be made using the left-right direction viewed from the subject H1.

  2 to 4, the providing apparatus main body 2 includes a base 4 constituting a base, and a cover (covering member) 5 that covers the base 4 from above so as to form a storage chamber on the base 4. A partition plate 6 that divides the accommodation chamber formed in the cover 5 into a provision portion accommodation chamber S1 and a drive portion accommodation chamber S2 arranged in the front-rear direction, and a stimulus provision portion 7 accommodated in the provision portion accommodation chamber S1. And a drive unit 8 accommodated in the drive unit accommodating chamber S2.

  The base 4 is a substantially rectangular plate member in plan view.

  The cover 5 includes a peripheral wall 5a that rises from the peripheral edge of the base 4, and a top plate 5b that closes an upper opening of the peripheral wall 5a. In the present embodiment, the pair of left and right plates and the pair of front and rear plates can be separated from the peripheral wall 5a, and the pair of left and right plates are fixed to the base 4, while the pair of front and rear plates are attached to the top plate 5b. It is fixed. That is, by removing the top plate 5 b from the base 4, the pair of front and rear plate materials are also removed from the base 4. In addition, vent holes 5d are formed in the left and right plate members of the peripheral wall 5a. The vent 5d communicates the drive unit accommodation chamber S2 and the outside of the cover 5. An opening 5c penetrating the top plate 5b in the vertical direction is formed at a substantially central position on the left and right of the top plate 5b. The opening 5c is arranged at the front and rear positions corresponding to the providing unit accommodation chamber S1, and the subject H1 can touch only one of a plurality of tactile stimuli 11h (see FIG. 5) described later with a fingertip. It is formed in the size which becomes.

  The partition plate 6 is erected on the base 4 at a substantially central position in the front-rear direction. The left and right ends of the partition plate 6 are fixed to a pair of left and right plate members of the peripheral wall 5a. By this partition plate 6, between the cover 5 and the base 4, a providing portion accommodation chamber S1 and a drive portion accommodation chamber S2 extending in the left-right direction and arranged in the front-rear direction are formed. In the present embodiment, the providing unit accommodating chamber S1 is disposed in front of the driving unit accommodating chamber S2.

  The stimulus providing unit 7 holds the plurality of tactile stimuli 11h so that the plurality of tactile stimuli 11h (see FIG. 5) can be circulated. Specifically, the stimulus providing unit 7 is fixed to a pair of left and right pulleys 9 supported on the base 4, an endless belt 10 that is circulated by the pulleys 9, and an outer peripheral surface of the endless belt 10. Sixteen stimulation plates (stimulation members) 11, a regulation member 12 that regulates the vertical movement of the stimulation plate 11, and a detection sensor 14 that detects the circulation position of the stimulation plate 11 are provided.

  Each pulley 9 holds the endless belt 10 so that it can circulate. Since the pair of left and right pulleys 9 have the same configuration, only the configuration of one pulley 9 will be described. Specifically, the pulley 9 includes a pair of front and rear pulley support portions 9a and 9b erected on the base 4, a support shaft 9c supported by the pulley support portions 9a and 9b and extending in the front-rear direction. And a pulley body (holding wheel) 9d rotatably supported by a support shaft 9c.

  The endless belt 10 is stretched between the pulley bodies 9d so that the endless belt 10 can be circulated when the pulley body 9d rotates.

  Since each stimulation plate 11 has the same configuration, only the configuration of one stimulation plate 11 will be described. As shown in FIGS. 5 and 6, the stimulation plate 11 includes a fixed plate 11 a fixed to the outer surface of the endless belt 10 and a stimulus forming plate 11 b fixed to the fixed plate 11 a.

  As shown in FIG. 6, the fixed plate 11 a is fixed to the endless belt 10 at one place in the longitudinal direction of the endless belt 10. As a result, each stimulation plate 11 is moved along the outer peripheral surface of the pulley main body 9d in a state where both ends of the fixed plate 11a and the endless belt 10 are separated from each other as in the stimulation plates 11 shown on the left and right sides of FIG. Can be made. Specifically, the fixing plate 11 a is fixed to the endless belt 10 by two front and rear belt mounting bolts 11 c (only one is shown in FIG. 6) disposed at one place in the longitudinal direction of the endless belt 10. The fixed plate 11 a is a substantially rectangular plate material, and is fixed to the endless belt 10 in a state where the longitudinal direction thereof is arranged along the circulation direction of the endless belt 10. Arc-shaped detection notches 11e are formed at the two front corners of the fixed plate 11a.

  As shown in FIGS. 5 and 6, the stimulus forming plate 11b is a substantially rectangular plate material having a width dimension in the front-rear direction smaller than the width dimension in the front-rear direction of the fixed plate 11a. The stimulus forming plate 11b is fixed to the outer surface of the fixed plate 11a with both end portions 11f and 11g (detection notches 11e) in the front-rear direction of the fixed plate 11a being opened. Specifically, the four corners of the stimulus forming plate 11b are fixed to the outer surface of the fixed plate 11a by four forming plate mounting bolts 11d. In addition, on the outer surface (reference surface) of the stimulus forming plate 11b, two tactile stimuli 11h having a V-shape and projecting from the outer surface of the stimulus forming plate 11b are formed at a viewpoint orthogonal to the outer surface. ing. The tactile stimuli 11h are arranged in a line in the circulation direction Y1 of the endless belt 10 shown in FIG. 7 and arranged so that two V-shaped line segments open toward the downstream side in the circulation direction Y1. Yes.

  When the tactile stimulus located on the downstream side in the circulation direction Y1 is the first stimulus and the tactile stimulus located on the upstream side in the circulation direction Y1 is the second stimulus, the first stimulus and the second stimulus in the 16 stimulus forming plates 11b The combination is shown in FIG. In addition, the numerical value shown in FIG. 8 shows the angle (henceforth only an angle) between two V-shaped line segments of the tactile stimulus 11h. The 16 stimulus forming plates 11b are always formed with a reference stimulus having an angle of 60 ° and a comparative stimulus having an angle larger than the reference stimulus. There are eight types of comparative stimuli having angles of 64 °, 68 °, 72 °, 76 °, 80 °, 84 °, 92 °, and 110 °. There are 16 combinations, which are a total of 8 combinations of the reference stimulus and 8 types of comparative stimuli and 8 combinations in which the first stimulus and the second stimulus are interchanged. One of these combinations is formed on each stimulus forming plate 11b. In FIG. 8, the combination of the first stimulus as the reference stimulus and the combination as the second stimulus are separated and the angles of the comparison stimuli are arranged in ascending order. However, each stimulus forming plate 11b according to the present embodiment is arranged. Are randomly arranged using pseudo-random numbers.

  With reference to FIGS. 3 to 5, the restricting member 12 restricts a plurality of stimulating plates 11 facing the opening 5 c of the cover 5 from moving to the back side of the opening 5 c. Specifically, as shown in FIG. 4, the regulating member 12 is provided between the pulleys 9 and is provided over a predetermined range on both the left and right sides with the opening 5 c as a reference. Specifically, the regulating member 12 includes a first rail 12a provided on the front side of the stimulation plate 11, a second rail 12b and a third rail 12c arranged side by side on the rear side of the stimulation plate 11, and first to third. A column 12d that supports the rails 12a to 12c on the base 4 is provided. The first rail 12a sandwiches the front end portion 11f of the fixed plate 11a in the vertical direction so that the fixed plate 11a can slide in the horizontal direction (circulation direction Y1) and is regulated in the vertical direction. Specifically, the first rail 12a has a groove 12e that opens rearward and extends in the left-right direction. The second rail 12b and the third rail 12c are arranged side by side in a state where they are separated from each other at an interval smaller than the length dimension of the fixed plate 11a. The second rail 12b and the third rail 12c have the rear end portion 11g of the fixed plate 11a in the vertical direction so that the fixed plate 11a can slide in the left-right direction (circulation direction Y1) and is regulated in the vertical direction. Pinch. Specifically, the second rail 12b and the third rail 12c have grooves 12f and 12g that open toward the front and extend in the left-right direction, respectively.

  The detection sensor 14 detects whether or not the endless belt 10 has been circulated by a distance corresponding to the length of the stimulation plate 11. Specifically, as shown in FIG. 5, the detection sensor 14 is provided between the second rail 12b and the third rail 12c and has a light emitting portion 14a and a light receiving portion 14b that face each other in the vertical direction. In addition, it is possible to detect whether or not the light from the light emitting unit 14a to the light receiving unit 14b is blocked. That is, in the detection sensor 14, the detection notch 11e passes between the light emitting portion 14a and the light receiving portion 14b and the rear end portion 11g of the fixing plate 11a passing between the light emitting portion 14a and the light receiving portion 14b. Can be detected. Further, the detection sensor 14 can output a signal related to the detection result to the PC 3 as shown in FIG.

  Referring to FIG. 3, the drive unit 8 includes a motor 15 that rotationally drives the pulley 9, a motor control unit 16 that controls the drive of the motor 15, and a cooling fan for taking outside air into the drive unit accommodating chamber S <b> 2. 17, a power source 18 that supplies power to the motor 15, the motor control unit 16, and the cooling fan 17, and an emergency switch 19 (see FIG. 2) for stopping the motor 15.

  The motor 15 includes a motor main body 15a disposed in the drive unit accommodation chamber S2, and a rotating shaft 15b extending forward from the motor main body 15a and penetrating the partition plate 6. The rotating shaft 15b is connected to the support shaft 9c of the right pulley 9 via a gear (not shown).

  The motor control unit 16 can control the rotation direction and the rotation speed of the motor 15. In the present embodiment, the motor control unit 16 controls the rotation direction of the motor 15 in the direction in which the endless belt 10 circulates counterclockwise in FIG. Further, the motor control unit 16 controls the rotational speed of the motor 15 so that the moving speed of the endless belt 10 (moving speed of the stimulation plate 11) is 5.0 mm / s.

  As shown in FIG. 3, the cooling fan 17 is disposed to face the left plate of the peripheral wall 5 a. Therefore, when the cooling fan 17 is driven, outside air is introduced from the right plate vent hole 5d of the peripheral wall 5a, passes through the drive unit housing chamber S2, and is led out from the left plate vent hole 5d of the peripheral wall 5a. Thereby, the motor 15, the motor control part 16, and the power supply 18 can be cooled. In the present embodiment, the motor 15, the motor control unit 16, and the power source 18 that serve as heat sources are concentrated in the drive unit accommodation chamber S2, and the ventilation holes 5d for taking outside air into the drive unit accommodation chamber S2. Is formed on the peripheral wall 5a. Therefore, the drive unit 8 can be effectively cooled by driving the cooling fan 17. In addition, the stimulus providing unit 7 is disposed in the providing unit storage chamber S1 different from the drive unit storage chamber S2. Therefore, the influence which the heat which generate | occur | produces in the drive part 8 has on the stimulus provision part 7 can be reduced.

  The emergency switch 19 stops the driving of the motor 15 by receiving an operation from the subject H1. Specifically, the emergency switch 19 has an operation part for the subject H1 to operate as shown in FIG. 2 arranged outside the cover 5, and a command for stopping the motor 15 as shown in FIG. Is electrically connected to the motor control unit 16.

  Referring to FIG. 9, PC 3 has an input unit 20, a motor command unit 21 that outputs a command to motor control unit 16 in response to an instruction from input unit 20, and data processing that processes data obtained from the subject. Unit 22, a storage unit 24 for storing predetermined data, a comparison unit 25 for comparing data processed by data processing unit 22 with data stored in storage unit 24, and a comparison result by comparison unit 25 is displayed. And a display unit (output unit) 26.

  The input unit 20 can input a start instruction for starting provision of the tactile stimulus 11h by the stimulus providing unit 7 and data obtained from the subject H1. Specifically, the data obtained from the subject H1 has previously touched a comparative stimulus with a large angle among the two tactile stimuli 11h (reference stimulus and comparative stimulus) formed on one stimulus plate 11 (first It is data indicating whether it is a stimulus) or touched later (whether it is a second stimulus).

  The motor command unit 21 outputs a command for driving the motor 15 to the motor control unit 16 in response to a start instruction from the input unit 20. The motor command unit 21 outputs a command for stopping the motor 15 to the motor control unit 16 in response to receiving a signal from the detection sensor 14 that the detection notch 11e of the stimulation plate 11 has been detected. That is, in the detection sensor 14, the motor control unit 16, and the motor command unit 21 according to the present embodiment, two tactile stimuli 11h formed on one stimulation plate 11 are continuously received in response to a start instruction from the input unit 20. Then, a control unit that controls driving of the motor 15 is configured so that the motor 15 stops after passing through the opening 5c.

  Further, the motor command unit 21 drives the motor 15 so as to obtain 80 pieces of data from the specific subject H1. Specifically, in the present embodiment, the intermittent operation of the motor 15 is repeatedly executed until the sixteen stimulation plates 11 make five rounds.

  The data processing unit 22 calculates the average correct answer rate of the subject H1 based on the data (answer) from the subject H1 input by the input unit 20 and the correct answer stored in the storage unit 24 described later. Further, the data processing unit 22 is an angle difference between the two tactile stimuli 11h touched in one test, and the magnitude of the angle can be identified with a specified probability (75% in this embodiment) or more by the tactile sense of the fingertip. The identifiable angle difference that can be determined is calculated. Specifically, as shown in FIG. 12, the approximate curve shown in the following formula 1 is specified based on the relationship between the angle difference between the two tactile stimuli 11h touched in one test and the correct answer rate.

  Here, AC is a correct answer rate (Accuracy), d is a regression coefficient, SA is a reference stimulus angle (60 °), and CA is a comparative stimulus angle. That is, Formula 1 is a theoretical function indicating that the correct answer rate approaches 100% as the angle difference between the reference stimulus and the comparative stimulus approaches infinity, and the correct answer rate approaches 50% as the angle difference approaches 0. is there. By using the regression coefficient d obtained from Equation 1, an average threshold value of identifiable angle difference (angle discrimination threshold: DT) for obtaining a correct answer rate of 75% or more is calculated by the following Equation 2. .

  Here, X is a correct answer rate (75%).

  The storage unit 24 determines whether the comparative stimulus having a large angle is the upstream side (whether it is the first stimulus) or the downstream side of the two tactile stimuli 11h (reference stimulus and comparative stimulus) formed on one stimulus plate 11. Information on the correct answer indicating (whether it is the second stimulus) is stored in advance.

  Moreover, the memory | storage part 24 is about each of a dementia patient (Alzheimer's Disease: AD), a mild cognitive impairment patient (Mild Cognitive Impairment: MCI), and a healthy elderly person (a healthy control person: Normal CONTROL: NC). The average correct answer rate shown in FIG. 11 is stored in advance. In the storage unit 24 according to the present embodiment, average correct answer rates are stored in advance for 13 ADs, 10 MCIs, and 14 NCs. As shown in FIG. 11, the average correct answer rate has a significant difference between AD, MCI, and NC. Specifically, “**” in FIG. 11 indicates that the P value is less than 0.001. The “*” mark indicates that the P value is less than 0.05. In addition, although it is possible to memorize | store the average correct answer rate by an elderly person rather than a healthy elderly person, since the correct answer rate by an elderly person exceeds a healthy elderly person, it abbreviate | omits.

  Further, the storage unit 24 stores in advance the average threshold value of the identifiable angle difference shown in FIG. 13 for each of AD, MCI, and NC. The average threshold value of the identifiable angle difference shown in FIG. 13 is calculated based on the average correct answer rate shown in FIG. As shown in FIG. 13, there is a significant difference among AD, MCI, and NC in the average threshold value of the identifiable angle difference. Specifically, “**” in FIG. 13 indicates that the P value is less than 0.001. The “*” mark indicates that the P value is less than 0.05. Specific numerical values are 25.2 ° ± 4.2 ° for AD, 13.8 ° ± 2.7 ° for MCI, and 8.7 ° ± 0.8 ° for NC.

  Here, with reference to FIG. 8, the content of the tactile stimulus 11h (reference stimulus and comparative stimulus) stored in the storage unit 24 will be described.

  First, a reference angle that is an angle of two line segments of the reference stimulus is set to 60 °. In order for the subject H1 to grasp the magnitude of the angle of the tactile stimulus 11h, the reference angle includes both the end E (see FIG. 7) and the corner portion A (see FIG. 7) of the tactile stimulus 11h. The angle that can be recognized in a well-balanced manner is confirmed in advance by experiments.

  Since the reference stimulus is included in the first stimulus or the second stimulus in this way, the relative angle of the comparison stimulus is surely determined using the reference stimulus that makes it easy for the subject H1 to grasp the magnitude of the angle. be able to.

  The comparison angles, which are the angles of the two line segments of the comparison reference, are 64 °, 68 °, 72 °, 76 °, 80 °, 84 °, 92 °, and 110 °. Types (92 °, 110 °) of comparison standards (hereinafter referred to as large angle side comparison standards) having a larger angle difference with respect to the reference angle than the identifiable angle difference for AD (first identifiable angle difference: 25.2 °) Is a type of comparison standard (hereinafter referred to as a small-angle side comparison standard) having a smaller angle difference with respect to the reference angle than the identifiable angle difference for dementia patients (64 °, 68 °, 72 °, 76 °, 80 °, And 84 °).

  The identifiable angle difference for AD is larger than the identifiable angle difference for persons other than AD (NC and MCI) (see FIG. 13). Therefore, even if the type (number) of large-angle side comparison stimuli is reduced, information for identifying AD and other persons can be obtained. In other words, as shown in FIG. 12, in the range of angular differences larger than the identifiable angular difference L1 for AD, an extremely high correct answer rate is expected for all the subjects H1, so the test is performed in this angular difference range. The need to perform is low. Therefore, by adjusting the number of types of comparative stimuli as described above, it is possible to reduce the number of tests for obtaining information for identifying AD and other persons.

  Further, based on the difference value (5.1 °) obtained by subtracting the identifiable angle difference (8.7 °) for NC from the identifiable angle difference (13.8 °) for MCI, the angle between each comparison stimulus The difference is set as follows. Specifically, when the comparative stimuli are arranged in ascending order of angle, the angular difference between the comparative stimuli adjacent to each other is the difference value (5) for the large-angle comparative stimulus (110 ° −92 ° = 18 °). .1 °) and smaller angle comparison stimulus (4 °) is smaller than the difference value.

  Thereby, since the test can be performed at an interval (angle difference) smaller than the difference value, information for identifying a person with non-dementia and a patient with mild cognitive impairment can be obtained with certainty.

  As a method for providing the tactile stimulus 11h, as shown in FIG. 14, it is also possible to provide the tactile stimulus 11h by changing the direction for each set of two tactile stimuli 11h. However, when provided in this way, 14 types of tactile stimuli 11h are required, and it has been confirmed that these 14 types of tactile stimuli 11h need to be directed in four directions. Specifically, 14 types of tactile stimuli 11h having angles of 60 ° ± 2 °, 4 °, 6 °, 8 °, 10 °, 12 °, and 14 ° are required. When these 14 types of tactile stimuli 11h are directed in four directions, 56 combinations of tactile stimuli 11h need to be prepared. As a result, the combination shown in FIG.

  The comparison unit 25 compares the average correct answer rate stored in the storage unit 24 with the average correct answer rate calculated by the data processing unit 22. Specifically, as illustrated in FIG. 11, the comparison unit 25 according to the present embodiment includes the average correct answer rate D1 of the subject H1 calculated by the data processing unit 22 with respect to the graph of the average correct answer rate stored in the storage unit 24. Create data that shows The comparison unit 25 determines whether the subject H1 is AD or other based on the average correct answer rate stored in the storage unit 24 and the average correct answer rate calculated by the data processing unit 22. Also good.

  The comparison unit 25 also compares the average threshold value of the identifiable angle difference stored in the storage unit 24 with the average threshold value of the identifiable angle difference calculated by the data processing unit 22. Specifically, as illustrated in FIG. 13, the comparison unit 25 according to the present embodiment includes the subject H1 calculated by the data processing unit 22 with respect to the average threshold graph of the identifiable angle difference stored in the storage unit 24. Data indicating the average threshold value D2 of the identifiable angle difference is created. The comparison unit 25 determines whether the subject H1 is AD based on the average threshold of the identifiable angle difference stored in the storage unit 24 and the average threshold of the identifiable angle difference calculated by the data processing unit 22, or the MCI. Or other than that (NC).

  The display unit 26 displays the comparison result by the comparison unit 25. Specifically, in the present embodiment, the graphs shown in FIGS. 11 and 13 created by the comparison unit 25 are displayed. When the comparison unit 25 determines that the subject H1 is AD, MCI, or other non-dementia person, the display unit 26 can display the determination result by the comparison unit 25. Moreover, although the display unit 26 according to the present embodiment visually shows the comparison result by the comparison unit 25, it may be output as auditory information (for example, sound).

  Hereinafter, the procedure for confirming the presence or absence of the onset of dementia using the stimulus providing apparatus 1 will be described.

  First, the average correct answer rate and the average threshold value of the identifiable angle difference are calculated and stored in the storage unit 24 for the AD, MCI, and NC of multiple persons (angle difference preparation step). Here, the prepared average correct answer rate and the average threshold value of the identifiable angle difference are acquired by a procedure described later using the stimulus providing apparatus 1.

  Next, the stimulus providing apparatus 1 described above is prepared. That is, the stimulus providing unit 7 that holds the plurality of tactile stimuli 11h is prepared so that the plurality of tactile stimuli 11h illustrated in FIG. 8 can be circulated (stimulus preparation step and holding step). Furthermore, the providing device body 2 in which the stimulus providing unit 7 is covered with the cover 5 having an opening 5c that opens so that the subject H1 can touch only one of the plurality of tactile stimuli 11h with the fingertip. Is prepared (coating process).

  And it tests about the specific test subject H1 using the stimulus provision apparatus 1 prepared in this way. In addition, although the test subject H1 shown in FIG. 1 wears the eye mask H2, wearing of the eye mask H2 is not essential.

  FIG. 10 is a flowchart showing processing executed by the PC 3 shown in FIG.

  When processing by the PC 3 is started, first, information on the subject H1 is input by the input unit 20 (step S1). The information of the subject H1 includes, for example, age, sex, dominant hand, presence / absence of symptoms affecting the tactile test, MMSE (Mini-Mental State Examination) score, and the like.

  Next, it waits for an instruction to start providing the stimulus by the input unit 20 (step S2). That is, until the stimulus provision start instruction is input (NO in step S2), the information in step S1 can be input.

  On the other hand, when it is determined in step S2 that an instruction to start providing stimulus is performed by the input unit 20, the driving of the motor 15 is started (step S3), and whether or not the input from the detection sensor 14 is performed. It is determined (step S4). Here, when it is determined that there is no input from the detection sensor 14, the driving of the motor 15 in step S3 is continued, whereas when it is determined that there is an input from the detection sensor 14, the motor 15 is stopped. That is, in steps S3 to S5, the drive period of the motor 15 is controlled so that the single stimulation plate 11 passes under the opening 5c (movement process).

  Next, it is determined whether or not an answer from the subject H1 has been input (step S6). Specifically, the tester causes the subject H1 to answer whether a comparative stimulus having a large angle is touched first or later among the two types of tactile stimuli 11h (reference stimulus and comparative stimulus) formed on the stimulus plate 11. (Answer process), this answer is input using the input unit 20.

  When an answer is input in step S6, it is determined whether or not the specified number of tests (80 in this embodiment) has been completed (step S7). If it is determined that the specified number of tests have not been completed (NO in step S7), the system waits for an instruction from the input unit 20 (step S8), and repeats step S3 when the instruction is input. Run.

  On the other hand, if it is determined in step S7 that the prescribed number of tests have been completed, the average correct answer rate is calculated based on the answer input by the input unit 20 and the correct answer stored in the storage unit 24 (step S9: correct answer). Rate calculation step).

  Next, a correct answer rate approximate curve is specified based on the average correct answer rate calculated in step S9 and the mathematical formula 1 (step S10). That is, in step S10, the regression coefficient d of Formula 1 is calculated.

  In step S11, an average threshold DT of identifiable angle differences for the correct answer rate to be 75% or more is calculated based on the regression coefficient d calculated in step S10 and the mathematical formula 2 (angle difference calculating step). ).

  Next, the average threshold value DT calculated in step S11 is compared with the average threshold value of the discriminable angle difference serving as a reference shown in FIG. 13 stored in the storage unit 24 (step S12: comparison process). Specifically, in the present embodiment, as shown in FIG. 13, data indicating the average threshold value D <b> 2 calculated by the data processing unit 22 is created on the graph stored in the storage unit 24.

  In step S12 according to the present embodiment, the average correct answer rate calculated in step S9 is compared with the average correct answer rate that is stored in the storage unit 24 and serves as a reference shown in FIG. Specifically, in the present embodiment, as shown in FIG. 11, data indicating the average correct answer rate D <b> 1 calculated by the data processing unit 22 is created on a graph stored in the storage unit 24.

  Next, the comparison data created in step S12 is displayed on the display unit 26 (step S13). Thereby, the tester can determine whether the subject H1 is AD, MCI, or other non-dementia by confirming the content displayed on the display unit 26. it can. In step S12, when it is determined whether the subject H1 is AD, MCI, or non-demented, the determination result can be displayed in step S13.

  As described above, in the stimulus providing apparatus 1 according to the embodiment, the interest of the subject H1 such as the tactile stimulus 11h having a V-shaped shape at the viewpoint orthogonal to the reference plane (the outer surface of the stimulus forming plate 11b) A stimulus that is less affected by interest can be provided to the subject H1. Thereby, the information for confirming the presence or absence of dementia can be obtained.

  In particular, in the stimulus providing device 1, by moving the plurality of tactile stimuli 11h while the stimulus providing unit 7 is covered with the cover 5, it is possible to suppress each tactile stimulus 11h from being visually recognized by the subject H1. The subject H1 can be touched one by one by the tactile stimulus 11h. Thereby, it can control that subject H1's learning ability works. Specifically, it can be suppressed that the subject H1 visually recognizes the difference in angle between the plurality of tactile stimuli 11h and / or the subject H1 stores the arrangement of the plurality of tactile stimuli 11h. Therefore, it is possible to reduce the influence of the learning ability of the subject H1 on the confirmation result of the presence or absence of dementia.

  In the stimulus providing apparatus 1 according to the embodiment, the tactile stimulus 11 h formed on the plurality of stimulus plates 11 can be circulated by circulating the endless belt 10 held by the pulley 9. Therefore, a plurality of tactile stimuli can be formed on the disk, and the stimulus providing unit 7 can be made compact as compared with the case where the disk is rotated about its central axis.

  However, this is not intended to exclude the stimulus providing unit 7 having a disk on which a plurality of tactile stimuli 11h are formed.

  In the stimulus providing apparatus 1 according to the embodiment, the restriction member 12 restricts the movement of the opening 5c of the stimulus plate 11 to the back side. Thereby, the subject H1 can be made to touch the subject H1 more accurately by restricting the stimulus plate 11 from moving (escape from the subject H1) by the fingertip of the subject H1.

  In the stimulus providing apparatus 1 according to the embodiment, two tactile stimuli 11 h having different V-shaped two line segments are formed on one stimulus plate 11. Thereby, when the one stimulation board 11 passes the opening part 5c, the test subject H1 can be touched by the said 2 tactile stimulation 11h. Therefore, the presence or absence of the above-mentioned dementia can be easily confirmed.

  In the stimulus providing apparatus 1 according to the embodiment, the stimulus plate 11 passes through the opening 5c one by one in response to an instruction from the input unit 20. Therefore, the time between the provision of the two tactile stimuli 11h and the provision of the next two tactile stimuli 11h can be used as the time for obtaining an answer from the subject H1.

  According to the stimulus providing apparatus 1 according to the embodiment, the correct answer rate of the subject H1 can be automatically calculated based on the correct answer stored in the storage unit 24 and the answer input by the input unit 20. Therefore, this correct answer rate can be used to confirm the presence or absence of dementia.

  In the stimulus providing apparatus 1 according to the embodiment, the identifiable angle difference stored in the storage unit 24 is compared with the identifiable difference of the subject calculated by the data processing unit 22. Thereby, the presence or absence of the onset of dementia can be confirmed more reliably.

  In the method according to the embodiment, the presence or absence of dementia is confirmed by providing the subject H1 with a stimulus that is less affected by the interest and interest of the subject H1, such as the tactile stimulus 11h having a V-shape. be able to.

  Specifically, in the method, two types of tactile stimuli 11h having different angles between two V-shaped line segments are sequentially provided, and the tactile stimuli 11h having a larger angle are touched first, Ask subject H1 to answer later. As shown in FIG. 11, the correct answer rate obtained after performing this procedure (moving process and answering process) a plurality of times has significant differences among AD, MCI, and NC. Therefore, according to the method, it is possible to confirm the presence or absence of dementia by providing a stimulus that hardly causes individual differences for each subject H1.

  In the method according to the embodiment, the identifiable angle difference prepared in the angle difference preparation step is compared with the identifiable angle difference calculated in the angle difference calculation step. Thereby, the presence or absence of the onset of dementia can be confirmed more reliably.

  Specifically, as shown in FIG. 13, there is a significant difference between AD, MCI, and NC (part of persons with non-dementia other than AD and MCI) in the identifiable angle difference. . Therefore, by comparing the identifiable angle difference prepared in the angle difference preparation step with the identifiable angle difference of the subject, not only whether it belongs to AD, but any of AD, MCI, and NC Can be confirmed.

  In addition, the following modified example can also be employ | adopted.

  The stimulation plate 11 according to the embodiment may be omitted, and the tactile stimulation 11h may be directly formed on the endless belt 10.

  Further, the tactile stimulus 11 h may be formed on the disk, and the disk may be rotated by the motor 15. Even in this case, each tactile stimulus 11h can be circulated.

  The specific embodiments described above mainly include inventions having the following configurations.

  In order to solve the above problems, the present invention is a method for providing a test subject with a stimulus for confirming the presence or absence of dementia, having a V-shaped shape at a viewpoint perpendicular to a reference plane, and A holding step of holding the plurality of tactile stimuli so that the plurality of tactile stimuli protruding from the reference surface can be circulated, and the subject touches only one of the plurality of tactile stimuli with a fingertip. A covering step of covering the plurality of tactile stimuli held in the holding step with a covering member having an opening that opens as possible, and the plurality of tactile stimuli in the state where the covering step is performed. And a moving step of moving the plurality of tactile stimuli so that one of them sequentially faces the opening.

  In addition, the present invention is an apparatus for providing a subject with a stimulus for confirming the presence or absence of dementia, and has a V-shaped shape at a viewpoint orthogonal to the reference plane and a plurality of protrusions protruding from the reference plane. A tactile stimulus providing unit, a stimulus providing unit having a holding mechanism that holds the plurality of tactile stimulus so that the plurality of tactile stimulus can be circulated, and covering the stimulus providing unit and the plurality of tactile senses A covering member having an opening that allows the subject to touch only one of the stimuli with a fingertip; and one of the plurality of tactile stimuli sequentially facing the opening. There is provided a stimulus providing device including a drive unit that drives a holding mechanism.

  According to the present invention, it is possible to provide a subject with a stimulus that is hardly influenced by the subject's interest and interest, that is, a tactile stimulus having a V-shaped shape at a viewpoint orthogonal to the reference plane. Thereby, the information for confirming the presence or absence of dementia can be obtained.

  Specifically, for example, two types of tactile stimuli having different angles between two V-shaped line segments are provided in succession, and one of these tactile stimuli having a larger angle is touched first or later. Ask the subject to answer. As shown in FIG. 11, the correct answer rate when this procedure is repeated is as follows. Dementia patients (Alzheimer's Disease: AD), mild cognitive impairment patients (Mild Cognitive Impairment: MCI), and healthy elderly (healthy) There is a significant difference between the control (Normal CONTROL: NC). Therefore, by providing tactile stimulation as in the present invention, information for confirming the presence or absence of dementia can be obtained.

  In particular, in the present invention, by moving a plurality of tactile stimuli in a state in which the plurality of tactile stimuli are covered by the covering member, one tactile stimulus is suppressed while suppressing each tactile stimulus from being visually recognized by the subject. The subject can be touched one by one. Thereby, it can suppress that a test subject's learning ability works. Specifically, the subject visually recognizes a difference in types of a plurality of tactile stimuli (for example, a difference in angle between V-shaped line segments) and / or the subject has an arrangement of a plurality of tactile stimuli. Can be suppressed. Therefore, it is possible to reduce the influence of the learning ability of the subject on the confirmation result of the presence or absence of dementia.

The “dementia” is a symptom that satisfies all of the following A to F according to DSM-IV (The Diagnostic and Statistical Manual of Mental Disorders IV).
A. The development of various cognitive deficits reveals one or more symptoms of memory impairment, aphasia, apraxia, agnosia, and impaired behavioral function.
B. 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).

In addition, the “mild cognitive dysfunction” refers to a state in which abilities such as cognitive function and memory are lower than expected in the course of normal aging, but symptoms are not as severe as dementia. In addition, it is known that 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.
A. There is a complaint of forgetting by the person or family.
B. General cognitive function is normal.
C. Daily life movements are independent.
D. Not dementia.
E. There are memory disorders that cannot be explained only by the effects of age and education level.

  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.

  In the stimulation providing apparatus, the stimulation providing unit further includes a plurality of stimulation members each having at least one tactile stimulation, and the holding mechanism includes an endless belt that holds the plurality of stimulation members, and the endless belt. It is preferable that the holding unit is configured to be able to circulate, and the driving unit is capable of rotationally driving the holding wheel.

  In the above aspect, the tactile stimulation formed on the plurality of stimulation members can be circulated by circulating the endless belt held by the holding ring. Therefore, a plurality of tactile stimuli can be formed on the disk, and the holding mechanism can be made compact as compared with the case where the disk is rotated about its central axis.

  However, this is not intended to exclude a holding mechanism having a disk on which a plurality of tactile stimuli are formed.

  In the stimulation providing apparatus, it is preferable that the stimulation providing unit further includes a regulating member that regulates movement of a member facing the opening among the plurality of stimulation members to the back side of the opening.

  In this aspect, the movement to the back side of the opening of the stimulation member is restricted by the restriction member. Thereby, a subject can be made to touch a tactile stimulus more correctly by regulating that a stimulus member moves (escapes from a subject) by a subject's fingertip.

  In the stimulus providing method, in the moving step, the plurality of tactile stimuli may be moved so that two types of tactile stimuli having different angles between two V-shaped line segments sequentially face the opening. preferable.

  In the stimulation providing apparatus, the plurality of tactile stimuli include a plurality of types of tactile stimuli having different angles between two V-shaped line segments, and the plurality of stimulation members include the V-shaped 2 It is preferable that each of the two tactile stimuli has different angles between the two line segments.

  In the method, two types of tactile stimuli having different V-shaped line segment angles can sequentially face the opening. Moreover, in the said apparatus, the two tactile stimuli from which the angle of two V-shaped line segments mutually differ is formed in one stimulation member. Thereby, a test subject can be made to touch said 2 tactile stimulation by one stimulation member passing an opening part. Therefore, it is possible to easily confirm the presence or absence of dementia using the presence of the significant difference shown in FIG.

  In the stimulus providing apparatus, an input unit for inputting an instruction to start providing tactile stimulation by the stimulus providing unit, and two tactile sensations formed on one stimulus member in response to an instruction from the input unit It is preferable that the apparatus further includes a control unit that controls driving of the driving unit so that the driving unit stops after the stimulus continuously passes through the opening.

  In this aspect, the stimulation members pass through the openings one by one in response to an instruction from the input unit. Therefore, the time between the provision of two tactile stimuli and the provision of the next two tactile stimuli can be used as the time for obtaining an answer from the subject.

  In the stimulus providing method, a plurality of reference stimuli in which the angles of the two V-shaped line segments are set to a predetermined reference angle, and a plurality of types in which the angles of the two V-shaped line segments are larger than the reference angle. A stimulus preparing step of preparing the plurality of tactile stimuli including a plurality of types of comparative stimuli set at respective comparison angles, wherein in the moving step, the reference stimulus and the comparative stimulus are alternately provided in the opening. It is preferable to move the plurality of tactile stimuli so as to face.

  In the stimulus providing apparatus, the plurality of tactile stimuli may include a plurality of reference stimuli in which an angle of two V-shaped line segments is set to a predetermined reference angle and an angle of the two V-shaped line segments. Preferably includes a plurality of types of comparative stimuli set to a plurality of types of comparative angles larger than the reference angle, and the plurality of stimulation members each include the reference stimulus and the comparative stimulus.

  Here, in each aspect, the “predetermined reference angle” means two end portions (portion E of FIG. 7) and corner portions in the tactile stimulus so that the subject can grasp the magnitude of the angle of the tactile stimulus. This means an angle (for example, 60 °) at which both can be recognized with good balance (portion A in FIG. 7).

  In each aspect, the reference stimulus and the comparison stimulus are set as one set, and a plurality of sets of stimuli are sequentially provided. As described above, the reference stimulus is included in each group, so that the relative angle of the comparison stimulus can be more reliably determined using the reference stimulus that allows the subject to easily grasp the magnitude of the angle as described above. be able to.

  In the stimulus providing method, a first identifiable angle difference is prepared in advance, which is a difference between the reference angle and the comparison angle, and allows a dementia patient to identify the magnitude of the angle with a tactile sense of a fingertip with a specified probability or more. An angle difference preparatory step, wherein in the stimulus preparatory step, the type of the large-angle side comparison stimulus that is the comparative stimulus having a larger angle difference with respect to the reference angle than the first distinguishable angle difference is the first identification. It is preferable to prepare the plurality of tactile stimuli so that the angle difference with respect to the reference angle is smaller than the possible angle difference and is smaller than the type of the small angle side comparison stimulus.

  In the stimulus providing apparatus, a first identifiable angle difference that is a difference between the reference angle and the comparison angle and that allows a dementia patient to identify the magnitude of the angle with a tactile sense of a fingertip with a predetermined probability or more is set in advance. The plurality of types of comparative stimuli include a large angle side comparative stimulus larger than the first identifiable angle difference and a small angle side comparative stimulus smaller than the first identifiable angle difference, and the large angle It is preferable that the number of side comparison stimuli is less than the type of the small angle side comparison stimuli.

  The 1st discriminable angle difference about a dementia patient is larger than the discriminable angle difference about persons other than a dementia patient (refer FIG. 13). Therefore, even if the type (number) of large-angle side comparison stimuli having a larger angle difference with respect to the reference angle than the first distinguishable angle difference is reduced, information for identifying the dementia patient and the other person is obtained. be able to. In other words, in the range of angular differences larger than the first identifiable angular difference (see L1 in FIG. 12), an extremely high correct answer rate is expected for all the subjects H1, so the test is performed in this angular difference range. The need is low. Therefore, according to each said aspect, the frequency | count of the test for obtaining the information for confirming the presence or absence of the onset of dementia can be decreased.

  In the stimulus providing method, in the angle difference preparing step, a patient with mild cognitive impairment may identify the angle with a sense of fingertip more than the specified probability, which is a difference between the reference angle and the comparison angle. A second identifiable angle difference that can be identified, and a third identifiable person whose non-dementia person other than the dementia patient and the mild cognitive impairment patient can identify the magnitude of the angle with the tactile sensation of the fingertip with the specified probability or more. An angle difference is prepared in advance, and in the stimulus preparing step, when the plurality of comparative stimuli are arranged in ascending order of angle, the angular difference between the adjacent comparative stimuli is the first difference for the large angle side comparative stimulus. The plurality of types set to be larger than a difference value obtained by subtracting the third identifiable angle difference from two identifiable angle differences, and smaller than the difference value for the small-angle side comparison stimulus. It is preferable to prepare the 較刺 intense.

  Further, in the stimulus providing apparatus, a second identification is possible, which is a difference between the reference angle and the comparison angle, and allows a patient with mild cognitive impairment to identify the magnitude of the angle with the tactile sensation of a fingertip with the specified probability or more. An angle difference and a third identifiable angle difference that allows a person with non-dementia other than the dementia patient and the mild cognitive impairment patient to identify the magnitude of the angle with a fingertip or greater than the specified probability in advance. And when the plurality of types of comparative stimuli are arranged in ascending order of angle, the angular difference between the adjacent comparative stimuli is determined from the second identifiable angular difference for the large-angle comparative stimulus. 3 It is preferable that the difference value obtained by subtracting the distinguishable angle difference is set to be larger than the difference value, and the small-angle side comparison stimulus is set to be smaller than the difference value.

  In these aspects, when the comparative stimuli are arranged in ascending order, the angle difference between the small-angle side comparative stimuli is set smaller than the difference value obtained by subtracting the third identifiable angle difference from the second identifiable angle difference. . Thereby, since the test can be performed at an interval (angle difference) smaller than the difference value, information for identifying a person with non-dementia and a patient with mild cognitive impairment can be obtained with certainty.

  In the stimulus providing apparatus, the input unit touches the touching stimulus having a large angle between the two V-shaped line segments first, or touches the touching stimulus among the two tactile stimuli respectively formed on the stimulus members. The stimulus providing apparatus can input a tactile stimulus having a large angle between two V-shaped line segments first with respect to each of the stimulation members. Data processing for calculating a correct answer rate of a subject based on a storage unit that stores in advance a correct answer whether to pass or to pass later, an answer input by the input unit, and a correct answer stored in the storage unit It is preferable to further include a portion.

  According to this aspect, the correct answer rate of the subject can be automatically calculated based on the correct answer stored in the storage unit and the answer input by the input unit. Therefore, this correct answer rate can be used to confirm the presence or absence of dementia.

  In the stimulus providing device, the storage unit is a difference in angle between two V-shaped line segments in two tactile stimuli, and the magnitude of the angle is identified with a predetermined probability or more by a tactile sense of a fingertip. A discriminable angle difference that can be discriminated in advance for each of a dementia patient, a patient with mild cognitive impairment, and a person with non-dementia other than these, and the data processing unit is based on the correct answer rate of the subject. The stimulus providing apparatus further includes a comparison unit that compares the identifiable angle difference stored in the storage unit with the identifiable angle difference calculated by the data processing unit. It is preferable to provide.

  In this aspect, the identifiable angle difference stored in the storage unit is compared with the identifiable difference of the subject calculated by the data processing unit. Thereby, the presence or absence of the onset of dementia can be confirmed more reliably.

  Specifically, as shown in FIG. 13, there is a significant difference between AD, MCI, and NC (part of persons with non-dementia other than AD and MCI) in the identifiable angle difference. . Therefore, by comparing the identifiable angle difference stored in the storage unit with the identifiable angle difference of the subject, not only whether or not it belongs to AD, but also belongs to any of AD, MCI, and NC Can be confirmed.

  In the stimulation providing apparatus, it is preferable that the comparison unit determines that the subject is a dementia patient, a mild cognitive impairment patient, or another person with non-dementia.

  According to this aspect, the presence or absence of dementia can be automatically determined.

  It is preferable that the stimulation providing apparatus further includes an output unit that outputs a comparison result by the comparison unit.

  According to this aspect, the user can confirm the comparison result by the comparison unit.

  The present invention is also a method for confirming the presence or absence of dementia using the stimulus providing method, wherein the angle between two V-shaped line segments of the two types of tactile stimuli. An answer process for inputting an answer from a subject as to whether or not he / she touched a large object first or later, using the input means, and after performing the moving process and the answer process a plurality of times, input in the answer process A method for confirming the presence or absence of dementia, including a correct answer rate calculating step of calculating the correct answer rate of the subject using the data processing means based on the answer and the correct answer stored in advance in the storage means provide.

  In the method according to the present invention, the presence or absence of onset of dementia is provided by providing the subject with a tactile stimulus having a V-shaped shape at a viewpoint orthogonal to the reference plane, which is less affected by the subject's interest and interest. Can be confirmed.

  Specifically, in the method, two types of tactile stimuli having different angles between two V-shaped line segments are sequentially provided, and one of the tactile stimuli having a larger angle is touched first or later. Ask the subject to answer. As shown in FIG. 11, the correct answer rate obtained after performing this procedure (moving process and answering process) a plurality of times has significant differences among AD, MCI, and NC. Therefore, according to the method of the present invention, it is possible to confirm the presence or absence of dementia by providing a stimulus that hardly causes individual differences for each subject.

  In particular, in the method according to the present invention, by moving a plurality of tactile stimuli in a state where the covering step is performed, one tactile stimulus is suppressed while suppressing each tactile stimulus from being visually recognized by the subject. The subject can be touched one by one. Thereby, it can suppress that a test subject's learning ability works. Specifically, the subject visually recognizes the difference in angle between the V-shaped line segments for the plurality of tactile stimuli and / or suppresses the subject from memorizing the arrangement of the plurality of tactile stimuli. be able to. Therefore, it is possible to reduce the influence of the learning ability of the subject on the confirmation result of the presence or absence of dementia.

  In the method for confirming the presence or absence of the onset of dementia, an angle difference between two V-shaped line segments in two tactile stimuli, and the angle magnitude is greater than a specified probability by tactile sense of a fingertip. An identifiable angle difference that can be identified is prepared in advance for each of a dementia patient, a mild cognitive impairment patient, and a person with non-dementia, and stored in the storage means; and Based on the correct answer rate of the subject calculated in the correct answer rate calculating step, the angle difference calculating step of calculating the identifiable angle difference for the subject using the data processing means, and the angle difference preparation using the comparing means It is preferable to include a comparison step of comparing the identifiable angle difference prepared in the step with the identifiable angle difference calculated in the angle difference calculation step.

  In this method, the identifiable angle difference prepared in the angle difference preparation step is compared with the identifiable angle difference calculated in the angle difference calculation step. Thereby, the presence or absence of the onset of dementia can be confirmed more reliably.

  Specifically, as shown in FIG. 13, there is a significant difference between AD, MCI, and NC (part of persons with non-dementia other than AD and MCI) in the identifiable angle difference. . Therefore, by comparing the identifiable angle difference prepared in the angle difference preparation step with the identifiable angle difference of the subject, not only whether it belongs to AD, but any of AD, MCI, and NC Can be confirmed.

  In the method for confirming the presence or absence of the onset of dementia, in the comparison step, the comparison means is used to determine that the subject is a dementia patient, a mild cognitive impairment patient, or a person with non-dementia. It is preferable to do.

  According to this method, the presence or absence of dementia can be determined.

  According to the stimulus providing apparatus according to the present invention, it is possible to provide a subject with a stimulus that hardly causes individual differences for each subject in order to confirm the presence or absence of dementia.

  In addition, according to the method of the present invention, it is possible to confirm the presence or absence of dementia by providing a stimulus that hardly causes individual differences for each subject.

A corner portion D1 average correct answer rate D2, DT average threshold E end H1 subject L1 first distinguishable angle difference 1 stimulus providing device 2 providing device main body 3 PC
4 Base 5 Cover (Coating member)
5c Opening part 7 Stimulus providing part 8 Drive part 9 Pulley (holding mechanism)
10 Endless belt (holding mechanism)
11 Stimulation plate (stimulation member)
11h tactile stimulation 12 regulating member 14 detection sensor (control unit)
15 Motor 16 Motor control unit (control unit)
20 Input section 21 Motor command section (control section)
22 data processing unit 24 storage unit 25 comparison unit 26 display unit

Claims (20)

A method of providing a subject with a stimulus for confirming the presence or absence of dementia,
Holding the plurality of tactile stimuli so that the plurality of tactile stimuli protruding from the reference surface can be circulated at a viewpoint orthogonal to the reference surface;
A covering step of covering the plurality of tactile stimuli held in the holding step with a covering member having an opening that allows the subject to touch only one of the plurality of tactile stimuli with a fingertip. When,
And a moving step of moving the plurality of tactile stimuli so that one of the plurality of tactile stimuli sequentially faces the opening in a state where the covering step is performed.   2. The stimulus according to claim 1, wherein in the moving step, the plurality of tactile stimuli are moved so that two types of tactile stimuli having different angles between two V-shaped line segments sequentially face the opening. How to provide. A plurality of reference stimuli in which the angle of the two V-shaped line segments is set to a predetermined reference angle and a plurality of types of comparison angles in which the angles of the two V-shaped line segments are larger than the reference angle are set. A stimulus preparing step of preparing the plurality of tactile stimuli including a plurality of types of comparative stimuli,
The stimulus providing method according to claim 2, wherein, in the moving step, the plurality of tactile stimuli are moved so that the reference stimulus and the comparative stimulus alternately face the opening. An angle difference preparation step for preparing in advance a first identifiable angle difference that is a difference between the reference angle and the comparison angle and that allows a dementia patient to identify the angle magnitude with a fingertip or more with a specified probability or more. In addition,
In the stimulus preparing step, the type of the large-angle side comparison stimulus that is the comparison stimulus having a larger angle difference with respect to the reference angle than the first identifiable angle difference is greater than the first identifiable angle difference with respect to the reference angle. The stimulus providing method according to claim 3, wherein the plurality of tactile stimuli are prepared so as to be smaller than types of the small-angle side comparison stimuli that are the comparative stimuli having a small angle difference. In the angle difference preparation step, a second identifiable angle that is a difference between the reference angle and the comparison angle, and that allows a patient with mild cognitive impairment to identify the magnitude of the angle with the tactile sensation of a fingertip with the specified probability or more. A difference and a third identifiable angle difference that allows a person with non-dementia other than the patient with dementia and the patient with mild cognitive impairment to distinguish the magnitude of the angle with the tactile sensation of the fingertip above the specified probability are prepared in advance. And
In the stimulus preparation step, when the plurality of comparative stimuli are arranged in order of increasing angle, the angle difference between the adjacent comparative stimuli is different from the second distinguishable angle difference for the large angle side comparative stimulus. 5. The plurality of types of comparative stimuli that are set to be larger than a difference value obtained by subtracting an identifiable angle difference and smaller than the difference value for the small-angle side comparison stimulus are prepared according to claim 4. How to provide stimulation. A method for confirming the presence or absence of dementia using the stimulus providing method according to claim 2,
An answering step of inputting an answer from the subject as to whether or not the two types of tactile stimuli that touched the V-shaped line segment with the large angle between the first and second touches are input using the input means; ,
After performing the moving step and the answer step a plurality of times, the correct answer for calculating the correct answer rate of the subject using the data processing means based on the answer input in the answer step and the correct answer stored in advance in the storage means The method for confirming the presence or absence of the onset of dementia including a rate calculation process. A difference in angle between two V-shaped line segments in two tactile stimuli, and the identifiable angle difference that can distinguish the magnitude of the angle with a fingertip tactile sense with a specified probability or higher, An angle difference preparation step of preparing in advance for each of a patient with mild cognitive impairment and a person with non-dementia other than these and storing it in the storage means,
Based on the correct answer rate of the subject calculated in the correct answer rate calculating step, an angle difference calculating step of calculating the identifiable angle difference for the subject using the data processing means;
The dementia according to claim 6, comprising a comparison step of comparing the identifiable angle difference prepared in the angle difference preparation step with the identifiable angle difference calculated in the angle difference calculation step using a comparison unit. A method for confirming the presence or absence of onset.   The presence or absence of onset of dementia according to claim 7, wherein in the comparison step, the comparison means is used to determine that the subject is a dementia patient, a mild cognitive impairment patient, or a non-dementia person. A way to check. A stimulus providing device that provides a subject with a stimulus for confirming the presence or absence of dementia,
A plurality of tactile stimuli having a V shape at a viewpoint perpendicular to the reference plane and projecting from the reference plane, and the plurality of tactile stimuli are held so that the plurality of tactile stimuli can be circulated. A stimulus providing unit having a holding mechanism;
A covering member that covers the stimulus providing unit and has an opening that opens so that a subject can touch only one of the plurality of tactile stimuli with a fingertip;
And a driving unit that drives the holding mechanism so that one of the plurality of tactile stimuli sequentially faces the opening. The stimulus providing unit further includes a plurality of stimulus members each having at least one tactile stimulus,
The holding mechanism includes an endless belt that holds the plurality of stimulation members, and a holding ring that holds the endless belt in a circulating manner.
The stimulus providing apparatus according to claim 9, wherein the driving unit is capable of rotationally driving the holding wheel.   The stimulus providing apparatus according to claim 10, wherein the stimulus providing unit further includes a regulating member that regulates movement of a member facing the opening among the plurality of stimulating members to the back side of the opening. . The plurality of tactile stimuli includes a plurality of types of tactile stimuli having different angles between two V-shaped line segments,
The stimulus providing apparatus according to claim 10 or 11, wherein each of the plurality of stimulation members includes two tactile stimuli having different angles between two V-shaped line segments. An input unit for inputting an instruction to start providing tactile stimulation by the stimulus providing unit;
In response to an instruction from the input unit, driving of the driving unit is controlled such that the driving unit stops after two tactile stimuli formed on one stimulation member pass through the opening continuously. The stimulus providing apparatus according to claim 12, further comprising a control unit that performs the operation. The input unit determines whether the first touch or the second touch of a tactile stimulus formed on each of the stimulation members has a large angle between two V-shaped line segments. You can enter an answer,
The stimulus providing device includes:
For each of the stimulation members, a storage unit that stores in advance a correct answer whether a tactile stimulus having a large angle between two V-shaped line segments passes through the opening first or later,
The stimulus provision according to claim 12 or 13, further comprising a data processing unit that calculates a correct answer rate of the subject based on the answer input by the input unit and the correct answer stored in the storage unit. apparatus. The storage unit is an angle difference between two V-shaped line segments in two tactile stimuli, and an identifiable angle difference that allows the magnitude of the angle to be identified by a tactile sense of a fingertip with a specified probability or more. Memorize in advance for each patient with dementia, mild cognitive impairment, and other non-dementia,
The data processing unit calculates the identifiable angle difference for the subject based on the correct answer rate of the subject,
The stimulus providing device includes:
The stimulus providing apparatus according to claim 14, further comprising a comparison unit that compares the identifiable angle difference stored in the storage unit with the identifiable angle difference calculated by the data processing unit.   The stimulus providing apparatus according to claim 15, wherein the comparison unit determines that the subject is a dementia patient, a mild cognitive impairment patient, or another person with non-dementia.   The stimulus providing apparatus according to claim 15 or 16, further comprising an output unit configured to output a comparison result by the comparison unit. The plurality of tactile stimuli include a plurality of reference stimuli in which two V-shaped line segments are set to a predetermined reference angle, and a plurality of V-shaped two line segments having a larger angle than the reference angle. Including multiple types of comparative stimuli set for each type of comparison angle,
The stimulation providing apparatus according to claim 12, wherein the plurality of stimulation members respectively include the reference stimulation and the comparative stimulation. The difference between the reference angle and the comparison angle, a first identifiable angle difference that allows a dementia patient to identify the magnitude of the angle with a fingertip sense with a specified probability or more is preset,
The plurality of types of comparative stimuli include a large-angle side comparative stimulus having a larger angle difference with respect to the reference angle than the first distinguishable angle difference, and a small angle having a smaller angle difference with respect to the reference angle than the first distinguishable angle difference. Side comparison stimuli,
19. The stimulus providing apparatus according to claim 18, wherein the type of the large angle side comparison stimulus is smaller than the type of the small angle side comparison stimulus. A difference between the reference angle and the comparison angle, wherein a patient with mild cognitive dysfunction can distinguish the magnitude of the angle with the tactile sensation of a fingertip with the specified probability or more, and the patient with dementia And a third identifiable angle difference that allows a person with non-dementia other than the patient with mild cognitive impairment to identify the magnitude of the angle with the tactile sensation of the fingertip with the specified probability or more, is preset.
When the plurality of types of comparative stimuli are arranged in ascending order of angle, the angular difference between the adjacent comparative stimuli is the third identifiable angular difference from the second identifiable angular difference for the large-angle comparative stimulus. The stimulus providing apparatus according to claim 19, wherein the stimulus providing apparatus is set so as to be larger than a difference value obtained by subtracting and to be smaller than the difference value for the small-angle side comparison stimulus.

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