title: Improved Necker Cube Drawing-Based Assessment Battery for Constructional Apraxia: The Mie Constructional Apraxia Scale (MCAS).
abstract: OBJECTIVE
  Constructional apraxia (CA) is usually diagnosed by having patients draw figures; however, the reported assessments only evaluate the drawn figure. We designed a new assessment battery for CA (the Mie Constructional Apraxia Scale, MCAS) which includes both the shape and drawing process, and investigated its utility against other assessment methods.
  
  
  METHODS
  We designed the MCAS, and evaluated inter- and intrarater reliability. We also investigated the sensitivity, specificity, and positive and negative predictive values in dementia patients, and compared MCAS assessment with other reported batteries in the same subjects.
  
  
  RESULTS
  Moderate interrater reliability was shown for speech therapists with limited experience. Moderate to substantial intrarater reliability was shown several weeks after initial assessment. When cutoff scores and times were set at 2/3 points and 39/40 s, sensitivity and specificity were 77.1 and 70.4%, respectively, with positive and negative predictive values of 80.0 and 66.7%, respectively. Dementia patients had significantly worse scores and times for Necker cube drawing than an elderly control group on the MCAS, and on other assessments.
  
  
  CONCLUSIONS
  We conclude that the MCAS, which includes both the assessment of the drawn Necker cube shape and the drawing process, is useful for detecting even mild CA.
authors: Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan.
authors: Masayuki
authors: M
authors: Satoh
authors: Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan.
authors: Chika
authors: C
authors: Mori
authors: Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan.
authors: Kana
authors: K
authors: Matsuda
authors: Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan.
authors: Yukito
authors: Y
authors: Ueda
authors: Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan.
authors: Ken-Ichi
authors: KI
authors: Tabei
authors: Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan.
authors: Hirotaka
authors: H
authors: Kida
authors: Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Department of Rehabilitation, Mie University Hospital, and Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan.
authors: Hidekazu
authors: H
authors: Tomimoto
keywords: Constructional apraxia; Dementia; Mie Constructional Apraxia Scale; Necker cube