Cognitive function evaluation method, cognition function inspection method, system, and computer program

By using 'staying time', 'travel time', 'position', and 'direction' as parameters in TMT tests, the method improves the accuracy and efficiency of cognitive function evaluation, addressing the limitations of existing TMT-based MMSE score estimation.

JP2025013830AActive Publication Date: 2025-01-28MAXELL LTD
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Patent Information

Application Number
JP2024176468
Authority / Receiving Office
JP · JP
Patent Type
Applications
Current Assignee / Owner
Filing Date
2024-10-08
Publication Date
2025-01-28
Estimated Expiration
2041-09-28

AI Technical Summary

Technical Problem

Existing methods for estimating MMSE scores based on TMT execution time have low accuracy and require a large number of TMT implementations, making it difficult to assess cognitive function accurately and efficiently.

Method used

A cognitive function evaluation method that incorporates 'staying time', 'travel time', 'position', and 'direction' as parameters in TMT tests, using stepwise analysis to improve correlation with MMSE scores, allowing for high-accuracy evaluation in a shorter time.

Benefits of technology

The method enhances the accuracy of cognitive function evaluation by increasing the correlation between TMT and MMSE scores, enabling precise assessment in fewer tests, suitable for early dementia screening and brain-training applications.

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Abstract

To provide a cognitive function evaluation method that enables highly accurate cognitive function evaluation to be performed in a short time and improves accuracy thereof.SOLUTION: A cognitive function evaluation method includes: a TMT execution step S1 of performing inspection based on a TMT of connecting a line so as to successively pass a plurality of passing points according to a predetermined rule; a data extraction step S3 of extracting, for all passing points, first inspection value data and second inspection value data from obtained inspection data, the first inspection value data being related to a retention time during which a drawing line drawn by successively passing the passing points stops at a first passing point from among the plurality of passing points after reaching the first passing point and before starting movement to a second passing point to pass next, the second inspection value data being related to a movement time required for the drawing line reaching the second passing point after starting movement from the first passing point; and an evaluation step S5 of evaluating a cognitive function on the basis of the extracted first inspection value data and the second inspection value data.SELECTED DRAWING: Figure 1
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Description

[Technical field]

[0001] The present invention relates to a cognitive function assessment method, a cognitive function testing method, a system, and a computer program capable of evaluating cognitive function based on the TMT (Trail Making Test). [Background technology]

[0002] In recent years, dementia has become a major concern in an aging society. It is generally recognized that dementia is a disease whose symptoms progress with age and whose onset is difficult to pinpoint. In addition, while it is difficult to recover from dementia once symptoms have progressed, it is also known that the onset can be prevented by paying attention to daily lifestyle habits, or that the progression can be delayed by taking appropriate measures at the early stage of onset. Therefore, today, various screening tests that can detect the risk of dementia early have been proposed and implemented in order to detect and respond to dementia early.

[0003] One such screening test is the Trail Making Test (hereinafter, simply referred to as TMT throughout this specification) (see, for example, Patent Document 1). The TMT is a test in which participants draw lines to connect numbers or alphabets (or hiragana or katakana) written randomly on a sheet of paper in order, and can comprehensively measure a wide range of attention, working memory, spatial search, processing speed, perseveration, impulsivity, and the like.

[0004] Specifically, the TMT test includes the TMT-A test, the TMT-B test, and the TMT-J test. In the TMT-A test, a sheet of paper on which numbers from 1 to 25 are randomly arranged according to a predetermined rule is used, and the tester draws lines from 1 to 25 in order with a writing implement, and the test ends when the test reaches 25, and the time required to complete the test is measured. On the other hand, in the TMT-B test, a sheet of paper on which 13 numbers from 1 to 13 and 12 alphabets from A to L or their equivalent hiragana (a, i, u...; i, ro, ha..., etc.) or katakana are randomly arranged according to a predetermined rule is used, and the tester draws lines alternately between the numbers and alphabets in order with a writing implement, and the time required to complete the test is measured in the same way. In addition, in the TMT-J test, several patterns are prepared in which the arrangement of numbers and alphabets is different from that of the TMT-A test and the TMT-B test, and similar tests are conducted based on these patterns.

[0005] In such TMT tests, the faster the time required to complete the test (the time required from the start to the end of the TMT; hereafter referred to as performance time), the faster the processing speed and the longer the ability to maintain attention and concentration are evaluated. In addition, in TMT, the actual test is always conducted after the corresponding practice. [Prior art documents] [Patent documents]

[0006] [Patent Document 1] JP 2017-144252 A Summary of the Invention [Problem to be solved by the invention]

[0007] However, it has been found that such TMT has a significant correlation with other known cognitive function tests such as the Mini-Mental State Examination (hereinafter, simply referred to as MMSE throughout this specification). Therefore, for example, in the correlation between TMT and MMSE, attempts have been made to estimate MMSE scores (scores obtained as a result of the MMSE test) based on the time required to perform TMT. In this way, the time required for cognitive testing can be reduced by estimating the score of MMSE, which generally requires a longer time than TMT, from the results of the TMT test.

[0008] However, it is difficult to say that the estimation of MMSE scores based on the time required to perform TMT has a high estimation accuracy. For example, even if the correlation coefficient (e.g., the value of K-fold R2) is examined by stepwise analysis (e.g., applying k-fold cross-validation and multiple regression analysis using cross-validation by R2 value), it has been found that a high positive correlation cannot be obtained unless the TMT test is repeated many times and the number of tests is increased. In other words, attempts to estimate MMSE scores based on the time required to perform TMT require a large number of TMT tests for estimation, making it difficult to obtain an estimated evaluation value of cognitive function with high accuracy in a short period of time.

[0009] The present invention has been made in consideration of the above circumstances, and aims to provide a cognitive function assessment method, cognitive function testing method, system, and computer program that can perform highly accurate cognitive function assessment that is highly correlated with TMT and MMSE in a short period of time, and can also improve the estimation accuracy of MMSE scores. [Means for solving the problem]

[0010] In order to solve the above problems, the cognitive function evaluation method of the present invention comprises: a TMT execution step of executing a test based on the TMT in which a subject connects a plurality of passing points with lines so as to pass through them in sequence according to a predetermined rule; a data extraction step of extracting, from the test data obtained by the TMT execution step, first test value data relating to a dwell time during which a drawn line drawn by the subject sequentially following the passing points stays at any one of the plurality of passing points from the time the drawn line reaches the first passing point until the drawn line starts to move to a second passing point that the subject must pass through next, and second test value data relating to a movement time required for the drawn line to move from the time the drawn line starts to move at the first passing point until the drawn line reaches the second passing point, for all passing points that the subject must pass through; an evaluation step of evaluating the cognitive function of the subject based on the first test value data and the second test value data extracted in the data extraction step; The present invention is characterized by comprising:

[0011] The inventor reviewed the conventional estimation of MMSE score based on the execution time of TMT, which is difficult to say that the estimation accuracy is high because the number of TMTs to be performed is large, and repeated trial and error was carried out to find out what parameters other than the execution time would increase the degree of correlation between TMT and MMSE. Specifically, in stepwise analysis (applying multiple regression analysis using k-fold cross-validation and R2-based cross-validation), various parameters were selected as variables and the correlation coefficient (R2-K division value) was examined. As a result, four parameters with high correlation between TMT and MMSE were identified. In other words, the inventor obtained the knowledge that by selecting "dwell time", "movement time", "position", and "direction" in TMT as parameters for evaluating cognitive function, it is possible to perform a highly accurate cognitive function evaluation with high correlation between TMT and MMSE in a short time, and to improve the estimation accuracy of MMSE score. Here, the term "dwell time" refers to the time that a drawn line drawn by a subject following multiple passing points in sequence based on a predetermined rule remains at a first passing point from the time it reaches any one of the multiple passing points until it starts moving to the second passing point that it must pass next, in a test based on TMT in which the subject connects multiple passing points with a line so that the subject passes through the multiple passing points in sequence according to a predetermined rule. Also, the term "movement time" refers to the time that the drawn line takes from the time it starts moving through the first passing point until it reaches the second passing point. Also, the term "position" refers to the position of each passing point, and the term "direction" refers to the direction of movement from the first passing point to the second passing point.

[0012] In fact, in the stepwise analysis mentioned above, when the correlation coefficient, which is the value of R2 K division, was examined while gradually adding "dwell time," "movement time," "location," and "direction" as cognitive function evaluation parameters, the empirical results showed that the degree of correlation between TMT and MMSE increased as the number of parameters added gradually increased. Specifically, in the stepwise analysis, when only "dwell time" and "movement time" were taken into account as cognitive function evaluation parameters and "location" and "direction" were not taken into account, the correlation coefficient (value of R2 K division) increased as the number of TMT administrations increased, and a high degree of correlation was obtained with fewer TMT administrations than the number of times required to estimate MMSE scores based on conventional execution time. In addition, when "location" and "direction" were taken into account as cognitive function assessment parameters and a stepwise analysis was performed based on the four cognitive function assessment parameters of "residence time," "movement time," "location," and "direction," a higher degree of correlation (a high correlation coefficient value exceeding 0.5) was obtained with fewer TMT administrations than when "location" and "direction" were not taken into account.

[0013] Therefore, in the cognitive function evaluation method of the present invention, the first test value data on the "dwell time" and the second test value data on the "movement time" are extracted from the test data obtained by the TMT execution step of executing a test based on the TMT for all passing points, and the cognitive function of the subject is evaluated based on the extracted first test value data and second test value data. This increases the correlation between the TMT and the MMSE, reduces the number of TMT runs required to estimate the MMSE score, and enables a highly accurate cognitive function evaluation to be performed in a short time. In addition to the first and second test value data, position data on the "position" of the passing points and movement direction data on the "movement direction" between the passing points are extracted for all passing points, and the cognitive function of the subject is evaluated based on the extracted first test value data, second test value data, position data, and movement direction data, making it possible to perform a highly accurate cognitive function evaluation with a higher correlation between the TMT and the MMSE in a shorter time. This type of cognitive function assessment is effective as an early screening method for identifying dementia and not only helps to detect dementia, but also has a wide range of applications, such as contributing to the assessment of judgment when driving a car and being applicable to brain training games.

[0014] In the above configuration of the present invention, the cognitive function evaluation method may further include a characteristic diagram generating step of generating a characteristic diagram that displays the first test value data or the second test value data and the position data or the movement direction data in association with each other, and the cognitive function may be evaluated based on the characteristic diagram generated in the generating step. According to this, since the generated characteristic diagram displays the test value and the position data or the movement direction data in association with each other, it is possible to visually grasp at a glance how the residence time and the movement time change for each position of the passing point or for each movement direction between the passing points, and therefore, for example, it is possible to enable a doctor to perform a detailed cognitive function evaluation, and it is possible to provide a useful display form that is helpful for cognitive function evaluation.

[0015] The present invention also provides a cognitive function assessment system that applies such a cognitive function assessment method. That is, the present invention is a cognitive function assessment system that enables a TMT test to be performed on a display and is capable of evaluating and displaying the test results on the display, comprising: an inspection image generating circuit that electronically generates a TMT inspection image that is displayed on the display and has passing points set at a plurality of positions on a coordinate plane; a test data acquisition circuit that acquires time-series data of a trace drawn by a subject tracing the passing points in a predetermined order by moving a contact part while keeping the contact part in contact with the display surface of the TMT test image on the display; a data processing circuit for processing the data acquired by the test data acquisition circuit so as to display the processing result on the display as the test result; A control circuit for controlling the operation of each of the circuits; Equipped with the inspection data acquisition circuit includes a coordinate data acquisition circuit that acquires coordinate data corresponding to a position of the contact part on the coordinate plane based on a detection signal from a sensor that detects contact of the contact part with the display surface of the TMT inspection image, and a time data acquisition circuit that acquires time data associated with an acquisition time of each of the coordinate data using a timer; The data processing circuit includes a calculation circuit that calculates, based on the coordinate data and the time data of the contact unit, a first test value related to a stay time at any one of the plurality of passing points from when the contact unit reaches the first passing point until when the contact unit starts moving to a second passing point to be passed next, and a second test value related to a movement time required for the contact unit from when the contact unit starts moving through the first passing point until it reaches the second passing point, for all passing points to be passed; an evaluation circuit that evaluates the cognitive function of the subject based on the first test value and the second test value; and a test result output circuit that outputs a test result including a result of evaluation by the evaluation circuit. It is characterized by:

[0016] In this cognitive function evaluation system, as in the above-mentioned cognitive function evaluation method, the cognitive function of the subject is evaluated based on the first test value related to the "dwell time" and the second test value related to the "movement time", so that the correlation between TMT and MMSE is increased, the number of TMT runs required to estimate the MMSE score is reduced, and a highly accurate cognitive function evaluation can be performed in a short time. In this case, too, if position data related to the "position" of the passing points and movement direction data related to the "movement direction" between the passing points are obtained in addition to the first and second test values, and the cognitive function of the subject is evaluated based on the first test value data, the second test value data, the position data, and the movement direction data, a highly accurate cognitive function evaluation with a higher correlation between TMT and MMSE can be performed in a shorter time.

[0017] Also, in the cognitive function evaluation system of the above configuration, it is preferable that a characteristic image (corresponding to the characteristic diagram of the cognitive function evaluation method described above) that displays the first test value or the second test value and the position data or the movement direction data in association with each other is generated by the characteristic image generation circuit, and the evaluation circuit evaluates the cognitive function based on this characteristic image. According to this, since the generated characteristic image displays the test value and the position data or the movement direction data in association with each other, it is possible to visually grasp at a glance how the residence time and the movement time change for each position of the passing point or for each movement direction between the passing points, and therefore, for example, it is possible to enable a doctor to perform a detailed cognitive function evaluation, and it is possible to provide a useful display form that is helpful for cognitive function evaluation.

[0018] In addition, such a cognitive function evaluation system can also perform the following operations. That is, for example, when the test form of the TMT test is selected and input from the mode selection menu displayed on the display, the test image generating circuit generates a TMT test image (for example, an image for the TMT-A test, an image for the TMT-B test, or an image for the TMT-J test, etc.) according to the selected test form under the control of the control circuit, and the image is displayed on the display. Then, when the subject moves the contact part while keeping it in contact with the display surface of the displayed TMT test image and traces the passing points in a predetermined order, the test data acquiring circuit acquires the time-series data of the drawn trajectory thus drawn. The data acquired by the test data acquiring circuit is processed by the data processing circuit, and the processing results, including the evaluation of the subject's cognitive function, are displayed, for example, dynamically and / or statically on the display by the data processing circuit in the selected display form under the control of the control circuit, for example, by selecting and inputting the display form of the test results from the mode selection menu. In this way, according to the cognitive function evaluation system of the present invention, the series of processes from the execution of the test to the acquisition of the test results (display of the test results) can be automated, so that the examiner does not need to measure the time required for the test using a stopwatch or the like, and does not need to manually collect and analyze the obtained test data including the measured values. Therefore, the series of processes from the execution of the test to the acquisition of the test results (display of the test results) can be performed quickly and easily.

[0019] In addition to this, in the cognitive function assessment system of the present invention, the test data acquisition circuit includes a coordinate data acquisition circuit that acquires coordinate data corresponding to the position of the contact part on the coordinate plane based on a detection signal from a sensor that detects contact of the contact part with the display surface of the TMT test image, and a time data acquisition circuit that acquires time data associated with the acquisition time of each coordinate data using a timer, and the data processing circuit includes a calculation circuit that calculates first and second test values ​​related to "dwell time" and "movement time" based on the coordinate data and time data at the contact part, an evaluation circuit that evaluates the cognitive function of the subject based on the first test value and the second test value, and a test result output circuit that outputs test results including the results of the evaluation by the evaluation circuit. That is, the cognitive function evaluation system of the present invention can obtain the change over time of the position of the contact part on the coordinate plane as time-series coordinate data based on the electrical detection signal from the contact detection sensor, and can obtain the elapsed time accompanying the stagnation and movement of the contact part as time data using a timer based on the detection signal from the contact detection sensor, and can automatically evaluate the cognitive function of the subject by calculating the first and second test values, i.e., the dwell time and movement time of the contact part, based on these data. Therefore, it is possible to reliably capture various hidden information in the test process that cannot be obtained only by the measurement values ​​and drawing trajectories associated with manual measurement using a stopwatch or the like and drawing by the subject, and to use them for the cognitive function evaluation of the subject by a doctor or the like. In addition, according to such an automatic test form involving electrical processing, it is possible to eliminate human measurement errors and standardize the test conditions, thereby preventing the test results from fluctuating for each test, and improving the reliability of the test results.

[0020] Furthermore, such an automated cognitive function assessment system allows subjects to carry out the test by themselves, without the need for an examiner, and to check the results on the spot.

[0021] In the above configuration, the "contact part" may be anything that can be moved in contact with the display surface of the TMT test image to draw a drawing trajectory, and is a broad concept that includes electronic input devices such as a stylus pen operated by the subject, as well as the subject's own fingers. In the above configuration, the "sensor" may have any detection principle as long as it can detect the contact position of the contact part with respect to the display surface of the TMT test image, and may be provided on the contact part side or on the display surface side. In addition, the various circuits described above, the operation of which is controlled by the control circuit, may be provided physically separately, or a functional part (or device) that integrates at least some or all of these circuits may be configured (for example, electronically packaged into one). In short, the circuits may exist in any form as long as the functions of each of these circuits are ensured.

[0022] In addition, the cognitive function evaluation system having the above configuration preferably further includes a memory for storing the test data including the coordinate data and the time data and the characteristic image generated by the characteristic image generating circuit. This allows data to be stored in the memory and the necessary data to be read out at any time as needed. In addition, for example, it is possible to evaluate the progress of symptoms by comparing the stored history data with each other, or to make a final certification of the evaluation based on the data stored in the memory. Here, "test data" means all unprocessed data that can be acquired by the test data acquisition circuit.

[0023] In addition, in the above configuration, it is preferable that the characteristic image generating circuit includes a discrimination image generating circuit that divides the position data or movement direction data into a plurality of groups based on the position or direction on the coordinate plane, and generates characteristic images in a display form that allows the inspection values ​​corresponding to each group to be visually distinguished from one another. Here, a "visually distinguishable display form" refers to a display form that allows data (test values) corresponding to each group to be visually distinguished from one another at a glance, for example, by differences in color, line type, pattern, etc. Also, the grouping can be selected by the system user, including the examiner and the subject, for example, from the above-mentioned mode selection menu, and the control circuit controls the characteristic image generating circuit based on an input signal from the mode selection menu associated with the selection to generate a distinguishable display image.

[0024] According to such a distinguishable display function, for example, the coordinate plane is divided into four regions, top, bottom, left and right, i.e., the coordinate plane is divided into the first, second, third and fourth quadrants, and data (test values) corresponding to each quadrant are displayed in separate graphs (e.g., bar graphs or pie charts), or are colored in four colors on the same graph, or multiple (e.g., eight) boundary lines are set, each extending radially from the coordinate origin and spaced at equal angular intervals from the coordinate origin, and multiple areas defined by these boundary lines are displayed. By defining 100 (e.g., 8) regions in the coordinate plane and distinguishing and displaying the data (test values) corresponding to each of these regions with a number of colors (e.g., 8 colors) corresponding to the number of regions, or by dividing the 360° direction into several groups and displaying the data (test values) corresponding to each group in separate graphs (e.g., bar graphs or pie charts) or by color-coding them in four colors in the same graph, the tendency specific to each test value according to the display form can be grasped at a glance. For example, the tendency of the test results depending on whether the subject is left-handed or right-handed, the tendency of the test results caused by the damaged part of the brain, for example, the tendency of the test results associated with the decrease in vision of one eye or the decrease in local or overall physical function, etc. can be clearly grasped at a glance, and it becomes possible to easily evaluate the cognitive function of the subject by a doctor, etc.

[0025] In the above configuration, the calculation circuit may calculate a sum of the test values ​​for each group, and the identification image generation circuit may generate a characteristic image displaying the sum for each group. Alternatively, the calculation circuit may calculate a sum of the test values ​​for each group, and calculate a ratio of the sum of each group to the sum of all groups, and the identification image generation circuit may generate a characteristic image displaying the ratio for each group. This allows the tendency unique to each group to be grasped at a glance, and the degree of tendency of each group relative to the total group to be grasped, which may contribute to easy evaluation of cognitive function.

[0026] Moreover, the cognitive function assessment system configured as described above may further include a passage detection circuit that detects passage of the contact portion through a passing point based on a detection signal from the sensor, and the passage detection circuit may set, for each passing point, a first coordinate area for determining that the contact portion has passed through the passing point and a second coordinate area for determining that the contact portion is stagnating at the passing point, and detect an entry of the contact portion into the first coordinate area as passage of the contact portion through the passing point, detect movement of the contact portion within the second coordinate area as stagnation at the passing point by the contact portion, and detect movement of the contact portion from within the second coordinate area to outside the second coordinate area as movement from the passing point by the contact portion, and the calculation circuit may calculate a first test value and a second test value based on signals indicating stagnation and movement from the passage detection circuit. According to this configuration, the passage detection circuit can recognize a state where the subject moves the contact part somewhat in the second coordinate area after entering the first coordinate area at the first passage point while searching for the next second passage point (a fluctuating state of the contact part) as the contact part being stuck at the first passage point, and can recognize that the contact part has moved from inside the second coordinate area to outside the second coordinate area as the contact part having moved through the first passage point toward the second passage point. In other words, by clearly defining the boundary between the stuck state and the moving state in this way and eliminating an ambiguous state in which it is unclear whether the contact part has moved from the first passage point, it is possible to reliably automatically determine "stay" and "move", and to accurately calculate "stay time" and "move time".

[0027] In the above configuration, the passage detection circuit preferably includes a setting circuit for variably setting the range of the first coordinate region and the second coordinate region. With this, the setting circuit can set an allowable range for determining whether the contact part has passed the passage point, whether it is stagnating at the passage point, and whether it has moved from the passage point. In this case, while the judgment of passing, stagnating, and moving can be given discretion, a certain restriction can be imposed on the discretion by specifying the variable setting range with coordinates, and the variation in the inspection result due to the discretion can be minimized, and an inspection with a degree of freedom according to the situation can be performed.

[0028] The present invention also provides a method for testing a subject by connecting a plurality of passing points with lines in a sequential manner based on a predetermined rule, comprising: a data extraction step of extracting, from the test data obtained by the TMT execution step, first test value data relating to a dwell time during which a drawn line drawn by the subject sequentially following the passing points stays at any one of the plurality of passing points from the time the drawn line reaches the first passing point until the drawn line starts to move to a second passing point that the subject must pass through next, and second test value data relating to a movement time required for the drawn line to move from the time the drawn line starts to move at the first passing point until the drawn line reaches the second passing point, for all passing points that the subject must pass through; a data processing and displaying step of processing the first test value data and the second test value data extracted in the data extracting step and displaying the processing result as a test result; The present invention provides a method for testing cognitive function, comprising: Such a cognitive function testing method processes test value data and displays the processed results as test results, and therefore can contribute to doctors making appropriate judgments regarding cognitive function. Furthermore, in addition to the above-mentioned cognitive function assessment method and system, the present invention also provides a method and a computer program suitable for the automated assessment of cognitive function. Effect of the Invention

[0029] According to the present invention, at least a first test value related to "residence time" and a second test value related to "movement time" are calculated for all passing points from the test data obtained by executing TMT, and the cognitive function of the subject is evaluated based on these test values. Therefore, a highly accurate cognitive function evaluation that is highly correlated with TMT and MMSE can be performed in a short period of time, and the accuracy of estimating the MMSE score can also be improved. [Brief description of the drawings]

[0030] [Figure 1] 1 is a flowchart showing a conceptual flow of a cognitive function evaluation method according to the present invention. [Diagram 2] 1 is a block diagram showing a configuration of a cognitive function evaluation system according to an embodiment of the present invention. [Diagram 3] 3 is a flowchart showing an outline of a process for performing a TMT test using the cognitive function assessment system of FIG. 2 and displaying the test results. [Figure 4] (a) shows an example of a TMT test image for a TMT-A test displayed on a display, and (b) shows an example of a TMT test image for a TMT-B test displayed on a display. [Diagram 5] 1 shows an example of a display setting screen displayed on a display. [Figure 6] (a) shows an example of a TMT test image when the portrait version orientation is selected on the display setting screen of Figure 5, and (b) shows an example of a TMT test image when the landscape version orientation is selected on the display setting screen of Figure 5. [Figure 7](a) shows an example of a TMT test image when pattern A is selected on the display setting screen of Figure 5, (b) shows an example of a TMT test image when pattern B is selected on the display setting screen of Figure 5, (c) shows an example of a TMT test image when pattern C is selected on the display setting screen of Figure 5, and (d) shows an example of a TMT test image when pattern D is selected on the display setting screen of Figure 5. [Figure 8] In a display format in which the display line of the drawing trajectory drawn by the subject on the display surface of the TMT test image is gradually made thicker from level 1 to level 5, (a) shows the drawing trajectory on the TMT test image when the display line thickness is set to level 1 in the display setting screen of Figure 5, (b) shows the drawing trajectory on the TMT test image when the display line thickness is set to level 2 in the display setting screen of Figure 5, (c) shows the drawing trajectory on the TMT test image when the display line thickness is set to level 3 in the display setting screen of Figure 5, (d) shows the drawing trajectory on the TMT test image when the display line thickness is set to level 4 in the display setting screen of Figure 5, and (e) shows the drawing trajectory on the TMT test image when the display line thickness is set to level 5 in the display setting screen of Figure 5. [Figure 9] (a) shows the drawn trajectory on the TMT inspection image when the setting in the display setting screen of Figure 5 is made so that the color of the passing point changes when the contact part comes into contact with the passing point (passes through the passing point), and (b) shows the drawn trajectory on the TMT inspection image when the setting in the display setting screen of Figure 5 is made so that the color of the passing point does not change when the contact part comes into contact with the passing point (passes through the passing point). [Figure 10] (a) shows a TMT test image when the display setting screen of Figure 5 is set to not visually display the subject's drawn trajectory, (b) shows a TMT test image when the display setting screen of Figure 5 is set to visually display the subject's drawn trajectory only between the two most recent passing points (between the last passing point passed at the current point during drawing and the passing point passed just before that), and (c) shows a TMT test image when the display setting screen of Figure 5 is set to visually display the subject's drawn trajectory between all passing points. [Figure 11]FIG. 1A is a diagram showing the reference area, first coordinate area, and second coordinate area set at each passing point, and FIG. 1B is a diagram showing an example of a stationary trajectory followed by the contact unit at the first passing point, and a movement trajectory followed by the contact unit between the first passing point and the second passing point. [Figure 12] 1A is a diagram showing the coordinate plane of a TMT test image divided into four regions (quadrants) of top, bottom, left, and right, and FIG. 1B is a diagram showing four directions on the coordinate plane of FIG. [Figure 13] FIG. 13 is a diagram showing an example of a processed image displaying a first inspection value, a second inspection value, position data, and movement direction data in a table format. [Figure 14] FIG. 1A is a diagram showing an example of a characteristic image in which the dwell time, which is a first inspection value, and the position of the pass point are displayed in association with each other for all pass points, and FIG. 1B is a diagram showing an example of a characteristic image in which the dwell time, which is a first inspection value, and the direction of movement between pass points are displayed in association with each other for all pass points. [Figure 15] FIG. 1A is a diagram showing an example of a characteristic image in which the second inspection value, which is the travel time, and the positions of the pass points are displayed in relation to each other for all pass points, and FIG. 1B is a diagram showing an example of a characteristic image in which the second inspection value, which is the travel time, and the travel direction between pass points are displayed in relation to each other for all pass points. [Figure 16] FIG. 1A is a diagram showing an example of a characteristic image in which the dwell time, which is a first inspection value, and the position of the pass point are displayed in association with each other for each quadrant for all pass points, and FIG. 1B is a diagram showing an example of a characteristic image in which the dwell time, which is a first inspection value, and the direction of movement between pass points are displayed in association with each other for each quadrant for all pass points. [Figure 17] FIG. 1A is a diagram showing an example of a characteristic image in which the second inspection value, the travel time, and the positions of the pass points are displayed in association with each other for each quadrant for all pass points, and FIG. 1B is a diagram showing an example of a characteristic image in which the second inspection value, the travel time, and the travel direction between pass points are displayed in association with each other for each quadrant for all pass points. [Figure 18] 11A and 11B are diagrams showing examples of characteristic images in which a first inspection value related to dwell time and the positions of passing points are displayed in association with each other, where (a) is a diagram in which the total value of dwell time is displayed in a bar graph for each quadrant, (b) is a diagram in which the total value of dwell time is displayed in a pie chart with different colors or patterns for each quadrant, (c) is a diagram in which the total value of dwell time is displayed in a bar graph for each quadrant, and (d) is a diagram in which the total value of dwell time is displayed in a band graph with different colors or patterns for each quadrant. [Figure 19] 11A and 11B are diagrams showing examples of characteristic images in which a first test value related to dwell time and the positions of passing points are displayed in association with each other, in which (a) is a diagram in which the percentage of dwell time is displayed in a bar graph for each quadrant, (b) is a diagram in which the percentage of dwell time is displayed in a pie chart with different colors or patterns for each quadrant, (c) is a diagram in which the percentage of dwell time is displayed in a bar graph for each quadrant, and (d) is a diagram in which the percentage of dwell time is displayed in a band graph with different colors or patterns for each quadrant. [Figure 20] 11A and 11B are diagrams showing examples of characteristic images in which a first test value related to dwell time and a direction of movement between passing points are displayed in association with each other, where (a) is a diagram in which the total value of dwell time is displayed in a bar graph for each direction of movement, (b) is a diagram in which the total value of dwell time is displayed in a pie chart with different colors or patterns for each direction of movement, (c) is a diagram in which the total value of dwell time is displayed in a bar graph for each direction of movement, and (d) is a diagram in which the total value of dwell time is displayed in a band graph with different colors or patterns for each direction of movement. [Figure 21] 11A and 11B are diagrams showing examples of characteristic images in which a first test value related to dwell time and a direction of movement between passing points are displayed in association with each other, in which (a) is a diagram in which the percentage of dwell time is displayed in a bar graph for each direction of movement, (b) is a diagram in which the percentage of dwell time is displayed in a pie chart with different colors or patterns for each direction of movement, (c) is a diagram in which the percentage of dwell time is displayed in a bar graph for each direction of movement, and (d) is a diagram in which the percentage of dwell time is displayed in a bar graph with different colors or patterns for each direction of movement. [Figure 22]FIG. 1 is a conceptual diagram showing a state in which a terminal as a TMT test result display system according to one embodiment of the present invention is connected to a server via a communication means. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0031] Hereinafter, an embodiment of the present invention will be described with reference to the drawings. A conceptual flow of the cognitive function evaluation method according to the present invention is shown in Fig. 1. As shown in the figure, in the cognitive function evaluation method according to the present invention, first, a test based on the well-known TMT is performed in which a subject connects a plurality of passing points with a line so that the passing points are passed in sequence based on a predetermined rule (TMT execution step S1). In this TMT-based test, at least the time when a drawn line drawn by the subject following the passing points in sequence reaches each passing point, the time when the line starts moving from each passing point, etc. are measured as test data, and the moving direction between the passing points, the position of the passing points, etc. are also recorded. Then, when the test based on the TMT is completed (YES in step S2), the test data obtained by the test are then used to extract (obtain) a first test value data relating to the dwell time of the drawn line drawn by the subject sequentially tracing the passing points from the time the drawn line reaches any one of the passing points among the multiple passing points until the line starts moving to the second passing point that the subject must pass through, and a second test value data relating to the moving time required for the drawn line to reach the second passing point from the time the line starts moving through the first passing point (data extraction step S3).In this case, position data relating to the positions of the first and second passing points and moving direction data relating to the moving direction from the first passing point to the second passing point may be further extracted from the test data for all passing points that the subject must pass through.

[0032] After the test value data is extracted in this manner, the subject's cognitive function is evaluated based on the extracted first and second test value data (and also based on the position data and / or movement direction data) (evaluation step S5). Specifically, in such cognitive function evaluation, for example, corresponding cutoff values ​​(threshold values) are set for each measurement value (calculated value) related to the residence time at each passing point and the movement time between each passing point, and the subject's cognitive function is evaluated by comparing the cutoff values ​​with the measurement values. In this case, for example, in order to classify the subject into three types, namely, healthy subjects, MCI (mild cognitive impairment), and dementia patients, cutoff values ​​may be set for each of these. Alternatively, when evaluating the cognitive function of a subject based on the first test value data, the second test value data, the position data, and the movement direction data, for example, as shown in Fig. 12, which is associated with a TMT test image in which passing points are set at multiple positions on a coordinate plane, measurement data (calculated data) that lists the dwell time at each passing point and the movement time between each passing point depending on the position (quadrant position) of the passing point and the movement direction between the passing points may be obtained, and the subject may be classified into three groups, for example, a healthy subject, a patient with MCI (mild cognitive impairment), and a patient with dementia, by comparing the measurement data with cutoff values ​​set for the dwell time and movement time corresponding to each passing point. In this case, the total value of the measurement values ​​for each quadrant may be calculated, and the calculation result may be compared with the cutoff value corresponding to the total value. In this way, when the subject's cognitive function is evaluated based on the first test value data and the second test value data (and also based on the position data and / or movement direction data), as is clear from the inventors' empirical results described above, the correlation between TMT and MMSE increases, the number of TMT administrations required to estimate the MMSE score can be reduced, and a highly accurate cognitive function evaluation can be performed in a short period of time.

[0033] In such an evaluation, a characteristic diagram may be used that displays the first or second test value data and the position data or the movement direction data in association with each other. In such a case, a characteristic diagram is generated based on the data extracted in the data extraction step S3 (characteristic diagram generation step S4), and in the evaluation step S5, the cognitive function is evaluated based on the characteristic diagram generated in the characteristic diagram generation step S4. Examples of the characteristic diagram include characteristic diagrams (characteristic images in the automated system described below) shown in Figs. 14 to 21, which will be described later. Specifically, in the cognitive function evaluation using such a characteristic diagram, the cognitive function may be evaluated by superimposing and comparing the characteristic diagram of the subject with that of a healthy subject (for example, an average characteristic diagram).

[0034] In addition, in the evaluation step S5, an MMSE score may be estimated as the cognitive function evaluation value of the subject based on the data extracted in the data extraction step S3. Specifically, such an estimation of the MMSE score may be calculated by using a weighting function that forms an N-th order polynomial. That is, for example, when a list of measurement data (calculated data) as shown in FIG. 13 described later is acquired, the MMSE score may be calculated as an estimated value according to the following formula by using the total examination time, the dwell time at each passing point (search time; first examination value data), the movement time between each passing point (drawing line time; second examination value data), the position of the passing point (quadrant position; position data), and the movement direction between the passing points (drawing direction; movement direction data) as indices (parameters), and adding up each of these indices with a weight. MMSE score = α1×total inspection time (1~25) +β1×SearchTime(2)+β2×SearchTime(3)+···+β24×SearchTime(25) +γ1×DrawingTime(2)+γ2×DrawingTime(3)+···+γ24×DrawingTime(25) +Δ1×Quadrant(2)+Δ2×Quadrant(3)+···+Δ24×Quadrant(25) +Ε1×Drawing direction (2)+Ε2×Drawing direction (3)+···+Ε24×Drawing direction (25) Here, in the formula, the numbers in parentheses are the target circle numbers, and α, β, γ, Δ, and E are coefficients (multipliers). Although all parameters may be added in this manner, the number of parameters may be reduced by dimension reduction before calculation.

[0035] The cognitive function evaluation method as described above is a method for supporting cognitive function evaluation by the evaluation parties including doctors and the like, and even by the subjects themselves, not only in the medical field but also in various industrial fields, and is also a method for detecting the cognitive state, and may be performed manually based on a normal TMT performed on paper, but such implementation is very cumbersome and extremely difficult because the time required to obtain the test data must be measured by a stopwatch or the like by a doctor or an examiner, or the test image must be recorded. In particular, it is cumbersome to manually obtain the above-mentioned first to fourth test value data, and it also requires a considerable amount of effort to collect and analyze the obtained data.

[0036] In the following, in order to overcome these drawbacks, we will describe an automated cognitive function assessment system, computer program, and method that enable TMT-based testing on a display and evaluates and displays the test results on the display.

[0037] In this embodiment, the cognitive function assessment system that enables the TMT test on a display and can display the test results on the display is configured as a terminal as an example, and, for example, as shown in Fig. 22, such a terminal 1 (cognitive function assessment system S) may be used in a form of use in which it is connected to a server 102 via a communication means (network) 100 (this will be described later), but any form of use may be adopted. In this embodiment, the terminal 1 is configured as a thin tablet computer, but it may be a personal computer, a smartphone, or the like.

[0038] In addition, in this embodiment, terminal 1 is equipped with a display and is therefore capable of performing the TMT test and displaying its test results (evaluation results) by itself, but it may also be configured as a system that enables the TMT test and display of its test results in cooperation with a separate display, or the cognitive function assessment system S may exist as a computer program that enables such a TMT test and display of its test results to be performed by a computer, or a computer program product in which such a computer program is stored.

[0039] 2 shows a conceptual configuration of the terminal 1 in a block diagram. As shown in the figure, the terminal 1 as the cognitive function evaluation system S includes a display 18 as, for example, a liquid crystal display device, and a CPU 10. The CPU 10 includes a test image generating circuit 25 that electronically generates a TMT test image I (described later with reference to FIG. 4 and subsequent figures) that is displayed on the display 18 and has passing points P (described later with reference to FIG. 4 and subsequent figures) set at multiple positions on a coordinate plane, a test data acquiring circuit 40 that acquires time-series data of a trace drawn by a subject moving a contact part 80 in contact with the display surface of the TMT test image I to trace the passing points P in a predetermined order, a data processing circuit 50 that processes the data acquired by the test data acquiring circuit 40 and enables the processing results to be displayed on the display 18 as test results, and a control circuit 30 that controls the operation of each circuit 25, 40, 50 based on an input signal from a mode selection menu 19 that is displayed on the display 18 and enables the selection of the test form of the TMT test and the display form of the test results. In this embodiment, the control circuit 30 controls the display circuit 17 provided in the display 18 to display various images on the display 18.

[0040] In addition, in this embodiment, the contact unit 80 is configured as an electronic input device such as a stylus pen operated by the subject, but it can be anything that can be moved in contact with the display surface of the TMT test image I to draw a drawing trajectory, and it can be, for example, a finger of the subject's own hand.

[0041] The inspection data acquisition circuit 40 includes a coordinate data acquisition circuit 42 that acquires coordinate data corresponding to the position of the contact portion 80 on the coordinate plane based on a detection signal from a sensor 14 that detects contact of the contact portion 80 with the display surface of the TMT inspection image I, and a time data acquisition circuit 44 that acquires time data associated with the acquisition time of each coordinate data using a timer 16. The data processing circuit 50 also includes a calculation circuit 52 that calculates, based on the coordinate data and time data of the contact unit 80, a first test value V1 related to the residence time that the contact unit 80 remains at the first passing point P1 from the time the contact unit 80 reaches any one of the multiple passing points P at the first passing point P1 until it starts moving to the second passing point P2 that it must pass through next, and a second test value V2 related to the movement time required from the time the contact unit 80 starts moving through the first passing point P1 to the time it reaches the second passing point P2, for all passing points P that must be passed through; an evaluation circuit 51 that evaluates the cognitive function of the subject based on the first test value V1 and the second test value V2; and a test result output circuit 53 that outputs test results including the results of the evaluation by the evaluation circuit 51.

[0042] In addition, in this embodiment, the test data acquisition circuit 40 can acquire position data regarding the positions of the first passing point P1 and the second passing point P2, and movement direction data regarding the direction of movement from the first passing point P1 to the second passing point P2, for all passing points that must be passed through, and correspondingly, the evaluation circuit 51 can evaluate the subject's cognitive function based on the first test value V1, the second test value V2, the position data, and the movement direction data.

[0043] In this embodiment, the data processing circuit 50 further includes a characteristic image generating circuit 54 that generates a characteristic image displaying the first test value V1 or the second test value V2 and the position data or the movement direction data in association with each other, and an image output circuit 58 that outputs a processed image including the characteristic image generated by the characteristic image generating circuit 54, and correspondingly, the evaluation circuit 51 can also evaluate the cognitive function based on the characteristic image generated by the characteristic image generating circuit 54. Here, the characteristic image is a visual representation that makes it easy for an evaluator to evaluate the results of the TMT test performed by the subject, and displays the test values ​​V1, V2 and the position data or the movement direction data in association with each other.

[0044] Here, the sensor 14 may use any detection principle as long as it can detect the contact of the contact unit 80 with the display surface of the TMT inspection image I. In addition, the sensor 14 is provided on the display 18 in this embodiment, but may be provided on the contact unit 80 side.

[0045] In addition, in this embodiment, the characteristic image generating circuit 54 includes a distinguishable image generating circuit 56 that divides the position data or movement direction data into a plurality of groups based on the position or direction on the coordinate plane, and generates the characteristic image in a display form that allows the test values ​​corresponding to each group to be visually distinguished from each other.

[0046] The CPU 10 further includes a passage detection circuit 32 that detects the passage of the contact part 80 through a passage point P based on the coordinates of the contact part 80 acquired by the coordinate data acquisition circuit 42 from the detection signal from the sensor 14, and a memory 20 consisting of, for example, a RAM and / or a ROM that stores at least the inspection data including the coordinate data and time data acquired by the inspection data acquisition circuit 40 and the characteristic image generated by the characteristic image generation circuit 54. In this case, the passage detection circuit 32 sets, for each passing point P, a first coordinate area F1 for determining that the contact part 80 has passed through the passing point P and a second coordinate area F2 for determining that the contact part 80 is stagnating at the passing point P (see FIG. 11), as described later, and detects the passage of the contact part 80 through the passing point P, the stagnation of the contact part 80 at the passing point P, and the movement of the contact part 80 from the passing point P. The passage detection circuit 32 also includes a setting circuit 34 for variably setting the ranges of the first coordinate area F1 and the second coordinate area F2.

[0047] In addition, although the various circuits described above, whose operation is controlled by the control circuit 30, are shown in FIG. 2 as being physically provided separately, a functional unit (or device) that integrates at least some or all of these circuits may be configured (e.g., electronically packaged into one), and in short, as long as the functionality of each of these circuits is ensured, the circuits may exist in any form.

[0048] Next, with reference to the flowchart in FIG. 3 and FIGS. 4 to 21, a process flow for performing a TMT test using the terminal 1 (cognitive function assessment system S) according to this embodiment and evaluating / displaying the test results will be described. First, a system user (hereinafter, simply referred to as a user), including a subject and an examiner such as a doctor, can display a mode selection menu 19 on the display 18 of the terminal 1 by performing a predetermined input, for example, on a touch panel of the display 18. For example, the mode selection menu 19 displays a user selection menu such as TMT-A examination, TMT-B examination, etc. This display is performed, for example, by the display circuitry 17 under the control of the control circuitry 30 based on an input signal from the display 18. Then, when the user selects the examination form of the TMT examination through this mode selection menu 19 (step S1), a TMT examination image I corresponding to the selection is displayed on the display 18. Specifically, for example, when a user selects the TMT-A examination on the mode selection menu 19, the examination image generating circuit 25 electronically generates a TMT examination image I for the TMT-A examination in which passing points are set at multiple positions on the coordinate plane based on an input signal from the mode selection menu 19 (display 18), and under the control of the control circuit 30, the display circuit 17 displays the TMT examination image I for the TMT-A examination as shown in Fig. 4(a) on the display 18 (examination image generating and displaying step S2). Particularly in this embodiment, after the introduction screen for the TMT-A examination shown in the upper part of Fig. 4(a) is displayed, the TMT examination image I for the TMT-A examination shown in the lower part of Fig. 4(a) is displayed. As shown in the figure, in the TMT test image I for this TMT-A test, round numbers from 1 to 25 are randomly placed as passing points P based on predetermined rules, and when performing the test, the user, who is the subject, moves the contact part 80 while it is in contact with the display surface of the TMT test image I, connecting the numbers 1 to 25 in order with lines. Until the test reaches 25 and the end, the timer 16 measures at least the time when the contact part 80 reaches each passing point P, the time when it starts moving from each passing point P, etc., and the direction of movement between the passing points P and the position of the passing points P are also recorded.

[0049] On the other hand, when the user selects the TMT-B examination on the mode selection menu 19, the examination image generation circuit 25 electronically generates a TMT examination image I for the TMT-B examination, in which passing points are set at multiple positions on the coordinate plane, based on an input signal from the mode selection menu 19 (display 18), and under the control of the control circuit 30, the display circuit 17 displays the TMT examination image I for the TMT-B examination as shown in Fig. 4(b) on the display 18. In this case, too, after the introduction screen for the TMT-B examination shown in the upper part of Fig. 4(b) is displayed, the TMT examination image I for the TMT-B examination shown in the lower part of Fig. 4(b) is displayed. As shown in the figure, in the TMT test image I for this TMT-B test, 13 numbers from 1 to 13 and the corresponding 12 hiragana characters (a, i, u...sa, shi) are randomly arranged as passing points P based on a predetermined rule, and when the test is performed, the user, who is the subject, moves the contact part 80 while it is in contact with the display surface of the TMT test image I, connecting the numbers and hiragana characters alternately in order with lines. Until the test ends when it reaches 13, at least the time when the contact part 80 reaches each passing point P, the time when it starts moving from each passing point P, etc. are measured by the timer 16, and the direction of movement between the passing points P and the position of the passing point P are also recorded.

[0050] It should be noted that the TMT test image for the TMT-J test (not shown) comes in several patterns with different arrangements of numbers and letters, etc., than the test image I for the TMT-A test and the TMT-B test. When the user selects the TMT-J test on the mode selection menu 19, a TMT test image for the TMT-J test of a predetermined pattern randomly selected by the control circuit 30 is displayed on the display 18, and the user can start the TMT-J test.

[0051] Furthermore, when starting such a TMT test, the user can perform a predetermined input, for example, on the touch panel of the display 18 of the terminal 1, to display a display setting screen for the TMT test as shown in Fig. 5, and perform various settings related to the display. Specifically, for example, when the portrait version orientation is selected on the display setting screen of Fig. 5, the TMT test image I is displayed in portrait orientation on the display 18 by the display circuit 17 under the control of the control circuit 30, as shown in Fig. 6(a), and on the other hand, when the landscape version orientation is selected on the display setting screen of Fig. 5, the TMT test image I is displayed in landscape orientation, as shown in Fig. 6(b). Moreover, when pattern A is selected on the display setting screen of Fig. 5, under the control of the control circuit 30, a prescribed TMT test image I as shown in Fig. 7(a) is displayed on the display 18 by the test image generating circuit 25 and the display circuit 17. When pattern B is selected on the display setting screen of Fig. 5, a TMT test image I inverted left to right with respect to pattern A as shown in Fig. 7(b) is displayed on the display 18. When pattern C is selected on the display setting screen of Fig. 5, a TMT test image I inverted up and down with respect to pattern A as shown in Fig. 7(c) is displayed on the display 18. When pattern D is selected on the display setting screen of Fig. 5, a TMT test image I inverted up and down and left to right with respect to pattern A as shown in Fig. 7(d) is displayed on the display 18. When random is selected on the display setting screen of Fig. 5, a TMT test image I of a pattern randomly determined by the control circuit 30 from among patterns A to D is displayed on the display 18.

[0052] In addition, the display setting screen of Figure 5 allows the user to arbitrarily set the display format in which the display lines of the drawing trajectory drawn on the display surface of the TMT test image I gradually become thicker, for example from 1 to 5 levels (for example, it may be possible to set it in millimeters). For example, when the thickness of the display line is set to the first stage in the display setting screen of FIG. 5, under the control of the control circuit 30, the display circuit 17 displays the display line of the drawing trajectory T as shown in FIG. 8(a) on the TMT inspection image I; when the thickness of the display line is set to the second stage in the display setting screen of FIG. 5, the display line of the drawing trajectory T as shown in FIG. 8(b) is displayed on the TMT inspection image I; when the thickness of the display line is set to the third stage in the display setting screen of FIG. 5, the display line of the drawing trajectory T as shown in FIG. 8(c) is displayed on the TMT inspection image I; when the thickness of the display line is set to the fourth stage in the display setting screen of FIG. 5, the display line of the drawing trajectory T as shown in FIG. 8(d) is displayed on the TMT inspection image I; and when the thickness of the display line is set to the fifth stage in the display setting screen of FIG. 5, the display line of the drawing trajectory T as shown in FIG. 8(e) is displayed on the TMT inspection image I.

[0053] In addition, in the display setting screen of FIG. 5, it is possible to set whether or not to change the color of the passing point P when the contact part 80 touches the passing point P (passes the passing point P) (setting of color change at touch). Specifically, when the setting is made in the display setting screen of FIG. 5 so that the color of the passing point P changes when the contact part 80 passes (touches) the passing point P, the color of the passing point P passed by the contact part 80 drawing the drawing trajectory T on the TMT inspection image I is changed by the display circuit 17 under the control of the control circuit 30 as shown in FIG. 9(a) (in the figure, the circle number representing the color-changed passing point P is filled in black). On the other hand, when the setting is made in the display setting screen of FIG. 5 so that the color of the passing point P is not changed when the contact part 80 passes (touches) the passing point P, the color of the passing point P passed by the contact part 80 drawing the drawing trajectory T on the TMT inspection image I is not changed as shown in FIG. 9(b).

[0054] In addition, the display setting screen of FIG. 5 also allows the user, who is the subject, to set the display mode of the trace drawn by the subject. Specifically, when the display mode of the trace drawn is set to "hidden" (the trace drawn by the user is not visually displayed), the display circuit 17, under the control of the control circuit 30, does not display the trace drawn by the user by moving the contact unit 80 as a display line, as shown in FIG. 10(a) (however, as shown in the figure, the color of the communication point P that the contact unit 80 has already passed through may change). In addition, when the display mode of the trace drawn is set to "between two points", the trace drawn by the user T is visually displayed as a display line only between the two latest passing points P (between the passing point P that was last passed at the present time during drawing and the passing point P that was passed immediately before that) as shown in FIG. 10(b). For example, in this figure, when the contact unit 80 reaches the passing point P of the number 5, the display line L2 connecting the passing point P of the number 3 and the passing pattern P of the number 4 disappears, and only the display line L1 connecting the passing point P of the number 3 and the passing pattern P of the number 4 remains (however, as shown in the figure, the communication points P that the contact unit 80 has already passed through may change color). Also, when the display mode of the drawn trajectory is set to "all display" (the entire drawn trajectory of the user is visually displayed), as shown in (c) of FIG. 10, the entire drawn trajectory drawn over time by the user moving the contact unit 80 is displayed as a display line L (for example, as shown in the figure, the communication points P that the contact unit 80 has already passed through also change color). Note that the display setting screen of FIG. 5 can also be reset to the initial setting (default). Also, the user may be able to practice the TMT test using a practice screen that is prepared in advance prior to the start of the TMT test.

[0055] When the above TMT test is started by the user who is the subject (step S3), the test data acquisition circuit 40 acquires time-dependent data of the trace drawn by the user moving the contact part 80 while in contact with the display surface of the TMT test image I to trace the passing points P in a predetermined order (test data acquisition step S4). Specifically, in this test data acquisition step S4, the coordinate data acquisition circuit 42 acquires coordinate data corresponding to the position of the contact part 80 on the coordinate surface based on a detection signal from the sensor 14 that detects the contact of the contact part 80 with the display surface of the TMT test image I (coordinate data acquisition step), and the time data acquisition circuit 44 acquires time data associated with the acquisition time of each piece of coordinate data by the timer 16 (time data acquisition step). In this case, the coordinate data is also acquired as position data regarding the position of the passing point P and movement direction data regarding the movement direction between the passing points P (movement direction from the first passing point P1 to the second passing point P2), and these are acquired for all passing points to be passed.

[0056] Here, regarding the passage of the contact part 80 through the passage point P during the TMT test, as described above, the passage detection circuit 32 detects the passage of the contact part 80 through the passage point P based on the coordinates of the contact part 80 acquired by the coordinate data acquisition circuit 42 from the detection signal from the sensor 14 (passage detection step). In this case, the passage detection circuit 32 sets, for each passage point P, a first coordinate area F1 for determining that the contact part 80 has passed through the passage point P and a second coordinate area F2 for determining that the contact part 80 is stagnating at the passage point P, and detects the passage of the contact part 80 through the passage point P, the stagnation of the contact part 80 at the passage point P, and the movement of the contact part 80 from the passage point P (signals indicating the passage, stagnation, and movement detected in this way are output from the passage detection circuit 32 to the control circuit 30). Specifically, for example, as shown in (a) of FIG. 11, at each passing point P, a circular reference area F0 defined by a circular boundary line b0 having a predetermined diameter with a corresponding number, hiragana, or alphabet displayed inside, a circular first coordinate area F1 ([circular reference area F0]+[annular area f1 defined by boundary lines b0 and b1]) defined inside by a circular boundary line b1 concentric with the reference area F0 and having a diameter, for example, 1.5 times the diameter of the reference area F0, and a circular second coordinate area F2 ([circular reference area F0]+[annular area f1 defined by boundary lines b0 and b1]+[annular area f2 defined by boundary lines b1 and b2]) defined inside by a circular boundary line b2 concentric with the reference area F0 and having a diameter, for example, twice the diameter of the reference area F0 are set.11B, taking as an example a first passing point P1 (e.g., with a corresponding number N) among a plurality of passing points P on the TMT inspection image I and a second passing point P2 (e.g., with a corresponding number N+1) that is to be passed next, the passing detection circuit 32 detects the time when the contact portion 80 enters a first coordinate region F1 of the first passing point P1 (when it reaches point A on the boundary line b1) as the passing of the first passing point P1 by the contact portion 80, and detects the movement of the contact portion 80 within a second coordinate region F2 at the first passing point P1 (e.g., For example, movement of the contact portion 80 following the drawing path shown by dashed lines T1 and T2 in (b) of Figure 11 is detected as a stagnation at the first passing point P1 by the contact portion 80, movement of the contact portion 80 from within the second coordinate region F2 at the first passing point P1 to outside the second coordinate region F2 (movement crossing the boundary line b2) is detected as movement from the first passing point P1 by the contact portion 80, and the point at which the contact portion 80 enters the first coordinate region F1 of the second passing point P2 (when it reaches point B on the boundary line b1 of the second passing point P2) is detected as the passing of the second passing point P2 by the contact portion 80. Therefore, the drawing trajectory shown by the solid line T3 in (b) of Figure 11 becomes the point-to-point movement trajectory of the contact part 80 between the first passing point P1 and the second passing point P2, and the period of tracing this point-to-point movement trajectory becomes the movement time of the contact part 80 between the first passing point P1 and the second passing point P2, and this movement time is calculated by the calculation circuit 52 as described below. In particular, in this embodiment, the period of the drawing trajectory that is connected to the point-to-point movement trajectory that crosses the boundary line b1 and reaches the boundary line b2 (the period of the drawing trajectory shown by the thick dashed line T2 in (b) of Figure 11) is also regarded as the movement period, and the calculation circuit 52 calculates the movement time (second inspection value). Therefore, in this embodiment, the drawing trajectory indicated by the thin dashed line T1 in (b) of Figure 11 is regarded as a stagnation trajectory of the contact portion 80 at the first passing point P1, and the calculation circuit 52 calculates the period following this stagnation trajectory as the dwell time (first inspection value) of the contact portion 80 at the first passing point P1, as described below.However, the method of setting the coordinate region and the method of calculating the dwell time and movement time are not limited to these (for example, only the period of the drawn path shown by the solid line in FIG. 11(b) may be considered as the movement time of the contact part 80 between the first passing point P1 and the second passing point P2). For example, the setting circuit 34 can freely set the range of the first coordinate region F1 and the second coordinate region F2 (setting step), which allows discretion in determining passing, stagnation, and movement (enabling inspection with a degree of freedom according to the situation).

[0057] When the user completes the TMT examination while acquiring various test data in the manner described above (step S5) (or in parallel with the TMT examination), the data processing circuit 50 processes the data acquired by the test data acquisition circuit 40 so that the processing results can be displayed on the display 18 as the test results (data processing and display step). Specifically, based on the coordinate data and time data of the contact portion 80 and the signal indicating the above-mentioned stagnation and movement from the passage detection circuit 32, the calculation circuit 52 of the data processing circuit 50 calculates a first inspection value related to the dwell time that the contact portion 80 stagnates at the first passing point P1 from the time it reaches any one of the multiple passing points until it starts moving to the second passing point P2 that it must pass through next, and a second inspection value related to the movement time required from the time the contact portion 80 starts moving through the first passing point P1 to the time it reaches the second passing point P2, for all passing points P that it must pass through (calculation step S6), and the characteristic image generation circuit 54 of the data processing circuit 50 generates a characteristic image that displays the first inspection value or the second inspection value calculated by the calculation circuit 52 in association with the position data or the movement direction data obtained from the coordinate data acquired by the inspection data acquisition circuit 40 (characteristic image generation step S7).

[0058] The first and second inspection values ​​calculated by the calculation circuit 52 and the position data and movement direction data obtained from the coordinate data acquired by the inspection data acquisition circuit 40 may be displayed on the display 18 via the image output circuit 58 as a processed image in the form of a table, for example, as shown in Fig. 13. Here, the table in Fig. 13 is shown as data in a TMT inspection image I in which passing points P are set at multiple positions on the coordinate plane, for example, as shown in Fig. 12. In Fig. 13, "Target Circle Num" indicates the number of the target passing point P to be passed next, and for example, when "Target Circle Num" is "4", it indicates movement from passing point P with the number "3" to passing point P with the number "4". In addition, in FIG. 13, "Circle IN Time" indicates the time when the corresponding passing point P is reached (the time when the first coordinate area F1 of the passing point P corresponding to "Target Circle Num" is entered), and "Circle OUT Time" indicates the time when the movement starts from the corresponding passing point P (in this embodiment, in which the period of the drawing path that is connected to the point-to-point movement path that crosses the boundary line b1 and reaches the boundary line b2 (the period of the drawing path shown by the thick dashed line T2 in FIG. 11(b)) is also considered to be the movement period, the time when the boundary line b1 of the passing point P corresponding to "Target Circle Num" is crossed). In addition, in FIG. 13, "Search Time" indicates the residence time at the corresponding passing point P, and "Drawing Line Time" indicates the movement time to the corresponding passing point P, that is, for example, when "Target Circle Num" is "4", the time associated with the movement from the passing point P with the number "3" to the passing point P with the number "4".Also, in FIG. 13, "quadrant (position)" indicates the position of the corresponding passing point P on the coordinate plane; specifically, when the coordinate plane is divided into four regions, top, bottom, left and right, as shown in FIG. 12(a), namely, the first quadrant, second quadrant, third quadrant and fourth quadrant, the number of the quadrant indicates in which quadrant the corresponding passing point is located (for example, since the passing point P with the number "2" in FIG. 12 is located in the third quadrant, in the table of FIG. 13, when "Target Circle Num" is "2", its "quadrant (position)" is indicated by the number "3"). Also, in FIG. 13, "drawing (direction)" indicates the direction of movement to the corresponding passing point P, that is, for example, when "Target Circle Num" is "4", the direction of movement from the passing point P with the number "3" to the passing point P with the number "4". In particular, as shown by the arrows in FIG. 12(b), the movement direction is divided into four directions, namely, the direction toward the "upper right", the direction toward the "upper left", the direction toward the "lower left", and the direction toward the "lower right", and the direction toward the "upper right" is indicated by the number "1", the direction toward the "upper left" is indicated by the number "2", the direction toward the "lower left" is indicated by the number "3", and the direction toward the "lower right" is indicated by the number "4". Therefore, for example, in the table of FIG. 13, when the "Target Circle Num" is "3", the movement direction is the "lower right" direction from the pass point P with the number "2" to the pass point P with the number "3", so the "line drawing (direction)" is indicated by the number "4", and the "Target Circle When “Num” is “4”, the direction of movement is “upper right” from the passing point P with the number “3” to the passing point P with the number “4”, so the “line drawing (direction)” is indicated by the number “1”.

[0059] 14 to 21 show an example of a characteristic image generated by the characteristic image generating circuit 54. The characteristic image shown in (a) of FIG. 14 is an image in which the dwell time (search time in milliseconds for searching for the next passing point P to be passed) which is the first inspection value calculated by the calculation circuit 52 in relation to the data shown in FIG. 13 and the position of the passing point P obtained from the coordinate data acquired by the inspection data acquiring circuit 40 are displayed in association with each other for all passing points (passing points with numbers 1 to 25), with the horizontal axis indicating the numbers associated with each of the 25 passing points and the vertical axis indicating the dwell time. In particular, this characteristic image is generated by the identification image generating circuit 56 as a characteristic image in a display form in which the first inspection values ​​(dwell times) corresponding to each group are divided into a plurality of groups based on the position on the coordinate plane, that is, a first quadrant group, a second quadrant group, a third quadrant group, and a fourth quadrant group, and the first inspection values ​​(dwell times) corresponding to each group are visually distinguishable from each other (identification image generating step). Here, as a "visually distinguishable display form," the data (first test values) corresponding to each group are displayed so as to be visually distinguishable from one another at a glance by differences in color or pattern (displayed as dots with colors or patterns), but other differences may be used to make the data (test values) corresponding to each group visually distinguishable from one another at a glance. In addition, such grouping can be selected by the user from the mode selection menu 19, and the control circuit 80 controls the characteristic image generating circuit 54 (discrimination image generating circuit 56) based on an input signal from the mode selection menu associated with the selection to generate a discrimination display image.

[0060] 14(b) is an image in which the dwell time (search time for searching for the next passing point P: milliseconds) which is the first inspection value calculated by the calculation circuit 52 in relation to the data shown in FIG. 13 and the movement direction between the passing points P obtained from the coordinate data acquired by the inspection data acquisition circuit 40 are displayed in association with each other for all passing points (passing points with numbers 1 to 25), with the horizontal axis indicating the numbers associated with each of the 25 passing points and the vertical axis indicating the dwell time. In particular, this characteristic image classifies the movement direction data into a plurality of groups based on the direction on the coordinate plane, that is, into a group of movement directions toward the "upper right", a group of movement directions toward the "upper left", a group of movement directions toward the "lower left", a group of movement directions toward the "lower right", and generates the characteristic image generating circuit 56 as a characteristic image in a display form in which the first inspection values ​​(dwell times) corresponding to each group can be visually distinguished from each other (identification image generating step). Again, as a "visually identifiable display form," the data (first test values) corresponding to each group are displayed so as to be visually distinguishable from one another at a glance by differences in color or pattern (displayed as dots with colors or patterns), but the data (test values) corresponding to each group may be displayed so as to be visually distinguishable from one another at a glance by other differences.

[0061] The characteristic image shown in Fig. 15(a) is an image in which the travel time (the line drawing time to draw a line toward the next passing point P: milliseconds) which is the second inspection value calculated by the calculation circuit 52 in relation to the data shown in Fig. 13 and the position of the passing point P obtained from the coordinate data acquired by the inspection data acquisition circuit 40 are displayed in association with each other for all passing points (passing points with numbers 1 to 25), with the horizontal axis indicating the number associated with each of the 25 passing points and the vertical axis indicating the travel time. In particular, this characteristic image is generated by dividing the position data into a plurality of groups, i.e., a first quadrant group, a second quadrant group, a third quadrant group, and a fourth quadrant group, based on the position on the coordinate plane, and the identification image generating circuit 56 generates characteristic images in a display form in which the second inspection values ​​(travel times) corresponding to each group can be visually distinguished from one another (identification image generating step). Again, as a "visually identifiable display form," the data (first test values) corresponding to each group are displayed so as to be visually distinguishable from one another at a glance by differences in color or pattern (displayed as dots with colors or patterns), but the data (test values) corresponding to each group may be displayed so as to be visually distinguishable from one another at a glance by other differences.

[0062] 15(b) is an image in which the movement time (the line drawing time to draw a line toward the next passing point P: milliseconds) which is the second inspection value calculated by the calculation circuit 52 in relation to the data shown in FIG. 13 and the movement direction between the passing points P obtained from the coordinate data acquired by the inspection data acquisition circuit 40 are displayed in association with each other for all passing points (passing points with numbers 1 to 25), with the horizontal axis indicating the numbers associated with each of the 25 passing points and the vertical axis indicating the movement time. In particular, this characteristic image classifies the movement direction data into a plurality of groups based on the direction on the coordinate plane, that is, into a group of movement directions toward the "upper right", a group of movement directions toward the "upper left", a group of movement directions toward the "lower left", and a group of movement directions toward the "lower right", and the second inspection values ​​(movement times) corresponding to each group are generated by the identification image generation circuit 56 as characteristic images in a display form in which they can be visually distinguished from each other (identification image generation step). Again, as a "visually identifiable display form," the data (first test values) corresponding to each group are displayed so as to be visually distinguishable from one another at a glance by differences in color or pattern (displayed as dots with colors or patterns), but the data (test values) corresponding to each group may be displayed so as to be visually distinguishable from one another at a glance by other differences.

[0063] 16(a) is an image (data of each passing point P is shown by a dot) in which the dwell time (search time in milliseconds for searching for the next passing point P to be passed) which is the first inspection value calculated by the calculation circuit 52 in relation to the data shown in FIG. 13 and the position of the passing point P obtained from the coordinate data acquired by the inspection data acquisition circuit 40 are displayed in association with each other for all passing points, with the horizontal axis indicating the position of the quadrant on the coordinate plane and the vertical axis indicating the dwell time. That is, this characteristic image is generated by the distinguishable image generation circuit 56 as a characteristic image in a display form in which the first inspection values ​​(dwell times) corresponding to each group are divided into a plurality of groups based on the position on the coordinate plane, that is, a first quadrant group, a second quadrant group, a third quadrant group, and a fourth quadrant group, and the first inspection values ​​(dwell times) corresponding to each group are visually distinguishable from each other.

[0064] The characteristic image shown in (b) of Figure 16 is an image (data for each passing point P is shown by a dot) in which the dwell time (search time in milliseconds for searching for the next passing point P to be passed through), which is the first inspection value calculated by the calculation circuit 52 in relation to the data shown in Figure 13, and the movement direction between passing points P obtained from the coordinate data acquired by the inspection data acquisition circuit 40 are displayed in association with each other for all passing points, with the horizontal axis indicating the movement direction on the coordinate plane (the direction toward the "upper right" is indicated by the number "1", the direction toward the "upper left" is indicated by the number "2", the direction toward the "lower left" is indicated by the number "3", and the direction toward the "lower right" is indicated by the number "4"), and the vertical axis indicating the dwell time. That is, this characteristic image is generated by the distinguishable image generating circuit 56 by dividing the movement direction data into a plurality of groups based on the direction on the coordinate plane, namely, a group of movement directions toward the "upper right", a group of movement directions toward the "upper left", a group of movement directions toward the "lower left", and a group of movement directions toward the "lower right", and then dividing the first test values ​​(dwell times) corresponding to each of these groups into characteristic images in a display form that allows them to be visually distinguished from one another.

[0065] 17(a) is an image (data of each passing point P is shown by a dot) in which the travel time (line drawing time: milliseconds for drawing a line toward the next passing point P) which is the second inspection value calculated by the calculation circuit 52 in relation to the data shown in FIG. 13 and the position of the passing point P obtained from the coordinate data acquired by the inspection data acquisition circuit 40 are displayed in association with each other for all passing points, with the horizontal axis indicating the position of the quadrant on the coordinate plane and the vertical axis indicating the travel time. That is, this characteristic image is generated by the distinguishable image generation circuit 56 as a characteristic image in a display form in which the second inspection values ​​(travel times) corresponding to each group are divided into a plurality of groups based on the position on the coordinate plane, that is, a first quadrant group, a second quadrant group, a third quadrant group, and a fourth quadrant group, and the second inspection values ​​(travel times) corresponding to each group are visually distinguishable from each other.

[0066] The characteristic image shown in (b) of Figure 17 is an image (data for each passing point P is shown by a dot) in which the second inspection value, which is the travel time (the time it takes to draw a line toward the next passing point P: milliseconds) calculated by the calculation circuit 52 in relation to the data shown in Figure 13, and the travel direction between passing points P obtained from the coordinate data acquired by the inspection data acquisition circuit 40 are displayed in association with each other for all passing points, with the horizontal axis indicating the travel direction on the coordinate plane (the direction toward the "upper right" is indicated by the number "1", the direction toward the "upper left" is indicated by the number "2", the direction toward the "lower left" is indicated by the number "3", and the direction toward the "lower right" is indicated by the number "4"), and the vertical axis indicating the travel time. That is, this characteristic image is generated by the distinguishable image generating circuit 56 by dividing the movement direction data into a plurality of groups based on the direction on the coordinate plane, namely, a group of movement directions toward the "upper right", a group of movement directions toward the "upper left", a group of movement directions toward the "lower left", and a group of movement directions toward the "lower right", and then dividing the second test values ​​(movement times) corresponding to each group into characteristic images in a display form that allows them to be visually distinguished from one another.

[0067] Each characteristic image shown in Fig. 18 is an image that displays the first inspection value related to the dwell time (search time: milliseconds) calculated by the calculation circuit 52 and the position of the pass point obtained from the coordinate data acquired by the test data acquisition circuit 40 in association with each other in relation to the data shown in Fig. 13, and is an identification image that divides the position data into a plurality of groups based on the position on the coordinate plane, i.e., a group of the first quadrant (upper right), a group of the second quadrant (upper left), a group of the third quadrant (lower left), and a group of the fourth quadrant (lower right), and displays the first inspection values ​​corresponding to each group in a visually distinguishable display form from each other. Specifically, each characteristic image shown in Fig. 18 is generated by the calculation circuit 52 calculating the sum of the dwell times at each pass point P for each group, and the identification image generation circuit 56 generating the identification image that displays the sum for each group. That is, the characteristic image in Fig. 18(a) displays the total value of the residence time for each quadrant as a bar graph, with the horizontal axis indicating the total value of the residence time and the vertical axis indicating each quadrant, while the characteristic image in Fig. 18(b) displays the total value of the residence time for each quadrant as a pie chart with different colors or patterns. Meanwhile, the characteristic image in Fig. 18(c) displays the total value of the residence time for each quadrant as a bar graph, with the horizontal axis indicating each quadrant and the vertical axis indicating the total value of the residence time, while the characteristic image in Fig. 18(d) displays the total value of the residence time for each quadrant as a band chart with different colors or patterns.

[0068] Each characteristic image shown in Fig. 19 is an image that displays the first inspection value related to the dwell time (search time: milliseconds) calculated by the calculation circuit 52 and the position of the pass point obtained from the coordinate data acquired by the test data acquisition circuit 40 in association with each other in relation to the data shown in Fig. 13, and is an identification image that divides the position data into a plurality of groups based on the position on the coordinate plane, i.e., a group in the first quadrant (upper right), a group in the second quadrant (upper left), a group in the third quadrant (lower left), and a group in the fourth quadrant (lower right), and displays the first inspection values ​​corresponding to each group in a visually distinguishable display form. Specifically, each characteristic image shown in Fig. 19 is generated by the calculation circuit 52 calculating the sum of the dwell times at each pass point P for each group and calculating the ratio of the sum of the values ​​of each group to the sum of all groups, and the identification image generation circuit 56 generating the ratio for each group. That is, the characteristic image in Fig. 19(a) displays the proportion (%) of residence time for each quadrant in a bar graph, with the horizontal axis indicating the proportion of residence time and the vertical axis indicating each quadrant, and the characteristic image in Fig. 19(b) displays the proportion of residence time for each quadrant in a pie chart with different colors or patterns. On the other hand, the characteristic image in Fig. 19(c) displays the proportion of residence time for each quadrant in a bar graph, with the horizontal axis indicating each quadrant and the vertical axis indicating the proportion of residence time, and the characteristic image in Fig. 19(d) displays the proportion of residence time for each quadrant in a band chart with different colors or patterns.

[0069] Each characteristic image shown in Fig. 20 is an image that displays the first inspection value related to the dwell time (search time: milliseconds) calculated by the calculation circuit 52 in relation to the data shown in Fig. 13 in association with the movement direction (line drawing direction) between the passing points obtained from the coordinate data acquired by the inspection data acquisition circuit 40, and is an identification image that divides the movement direction data into a plurality of groups based on the direction on the coordinate plane, that is, a group of movement directions toward the "Upper Right", a group of movement directions toward the "Upper Left", a group of movement directions toward the "Lower Left", and a group of movement directions toward the "Lower Right", and displays the first inspection values ​​corresponding to each group in a display form that allows them to be visually distinguished from each other. Specifically, each characteristic image shown in Fig. 20 is generated by the calculation circuit 52 calculating the sum of the dwell times at each passing point P for each group, and the identification image generation circuit 56 generating the identification image that displays the sum for each group. That is, the characteristic image in Fig. 20(a) is a bar graph that distinguishes the total value of the residence time for each direction of movement, with the horizontal axis indicating the total value of the residence time and the vertical axis indicating each direction of movement, and the characteristic image in Fig. 20(b) is a pie chart that distinguishes the total value of the residence time for each direction of movement, with a color or pattern. On the other hand, the characteristic image in Fig. 20(c) is a bar graph that distinguishes the total value of the residence time for each direction of movement, with the horizontal axis indicating each direction of movement and the vertical axis indicating the total value of the residence time, and the characteristic image in Fig. 20(d) is a band chart that distinguishes the total value of the residence time for each direction of movement, with a color or pattern.

[0070] Each characteristic image shown in FIG. 21 is an image that displays, in association with the data shown in FIG. 13, a first inspection value related to the dwell time (search time: milliseconds) calculated by the calculation circuit 52 and a movement direction (line drawing direction) between passing points obtained from the coordinate data acquired by the inspection data acquisition circuit 40, and is an identification image that divides the movement direction data into a plurality of groups based on the direction on the coordinate plane, namely, a group of movement directions toward the "Upper Right," a group of movement directions toward the "Upper Left," a group of movement directions toward the "Lower Left," and a group of movement directions toward the "Lower Right," and displays the first inspection values ​​corresponding to each group in a display form that allows them to be visually distinguished from each other. Specifically, the characteristic images shown in Fig. 21 are generated by the arithmetic circuit 52 by calculating the sum of the residence time at each passing point P for each group and calculating the ratio of the sum of the residence time for each group to the sum of all groups, and the identification image generating circuit 56 generates the identification image for each group to display the ratio. That is, the characteristic image in Fig. 21(a) displays the ratio (%) of the residence time for each moving direction in a bar graph, with the horizontal axis indicating the ratio of the residence time and the vertical axis indicating each moving direction, and the characteristic image in Fig. 21(b) displays the ratio of the residence time for each moving direction in a pie chart with different colors or patterns. On the other hand, the characteristic image in Fig. 21(c) displays the ratio of the residence time for each moving direction in a bar graph, with the horizontal axis indicating each moving direction and the vertical axis indicating the ratio of the residence time, and the characteristic image in Fig. 21(d) displays the ratio of the residence time for each moving direction in a bar graph with different colors or patterns.

[0071] The first and second test values ​​obtained by the calculation by the calculation circuit 52 in this way, the position data and the movement direction data obtained from the coordinate data acquired by the test data acquisition circuit 40, and the characteristic image generated by the characteristic image generation circuit 54 are used for the cognitive function evaluation by the evaluation circuit 51. That is, the evaluation circuit 61 evaluates the cognitive function of the user who is the subject who has taken the TMT test based on the first and second test values, or based on the first and second test values, the position data, and the movement direction data, or based on the characteristic image, or based on any combination of these (evaluation step S8). In this case, the cognitive function evaluation by the evaluation circuit 51 is performed, for example, by the method described above at the beginning of this embodiment. The evaluation circuit 51 can also estimate the MMSE score based on the first and second test values, the position data, and the movement direction data, or any combination of these. The estimation in this case is also performed, for example, by the method described above at the beginning of this embodiment.

[0072] The inspection results including the results of the evaluation by the evaluation circuit 51 are output by the inspection result output circuit 53 and displayed on the display 18 (inspection result output display step S9). In addition, the characteristic image generated by the characteristic image generation circuit 54 is output by the image output circuit 58 and displayed on the display 18 (image output display step).

[0073] Furthermore, the processed images including the characteristic images, the test results including the evaluation results, and the test data including the coordinate data and time data acquired by the test data acquisition circuit 40 are stored in the memory 20 (data storage step S10). If the test data and the like can be stored in the memory 20 in this way, it is possible to accumulate data in the memory and read out the necessary data at the appropriate time as required. In addition, for example, it is possible to evaluate the progress of symptoms by comparing the accumulated history data with each other, or to make a final determination of the evaluation based on the data accumulated in the memory.

[0074] Furthermore, the terminal 1 configured as above can be used in such a manner that it is connected to the server 102 via a communication means (network) 100, as shown in the above-mentioned Fig. 22. In this case, the communication means 100 exchanges information between the terminal 1 and the server 102, and may be either wired communication or wireless communication. Examples of such communication means 100 include a line using a wired cable, a wired telephone line, a mobile phone line, and a WiFi line.

[0075] In such a usage form, the terminal 1 also includes a communication circuit 12 (see FIG. 2) that enables data to be transmitted and received between the terminal 1 and the server 102 via the communication means 100. As a result, the terminal 1 can, for example, send test data obtained by itself to the server 102 to be used for cognitive function evaluation on the server 102 side, while also changing and increasing various functions based on information from the server 102 (for example, analysis functions can be updated (analysis programs can be downloaded to the tablet (terminal 1))...more detailed analysis functions can be provided on the server 102 side, and analysis results from the server 102 can be sent to the tablet). In addition, the database in the server 102 may store the subject's user ID, personal data such as the subject's age, address, and sex, the test implementation date, the test results, and the like (main function). In addition, it is preferable that the server 102 can be accessed by any medical institution. In addition, it is preferable that the database can be utilized as big data related to dementia.

[0076] As described above, according to the terminal 1 (cognitive function evaluation system S) of this embodiment, the first test value data related to the "dwell time" and the second test value data related to the "movement time" are extracted from the test data obtained by performing the test based on the TMT for all passing points, and the cognitive function of the subject is evaluated based on the extracted first test value data and second test value data. This increases the correlation between the TMT and the MMSE, reduces the number of TMT runs required to estimate the MMSE score, and enables a highly accurate cognitive function evaluation to be performed in a short time. In addition to the first and second test value data, position data related to the "position" of the passing points and movement direction data related to the "movement direction" between the passing points are extracted for all passing points, and the cognitive function of the subject can be evaluated based on the extracted first test value data, second test value data, position data, and movement direction data, so that a highly accurate cognitive function evaluation with a higher correlation between the TMT and the MMSE can be performed in a shorter time.

[0077] The present invention is not limited to the above-mentioned embodiment, and can be modified in various ways without departing from the gist of the present invention. For example, in the present invention, another process may be added between the above-mentioned processing steps, and the order of the steps may be partially changed. In the above-mentioned embodiment, the TMT test and its evaluation are automated by the terminal, but it goes without saying that the present invention can be applied to any action in which cognitive function evaluation and MMSE score estimation are performed using the residence time without being entirely automated. In addition, the above-mentioned embodiments may be combined in part or in whole, or a part of the configuration may be omitted from one of the above-mentioned embodiments, without departing from the gist of the present invention. [Explanation of symbols]

[0078] 1 Device 14 Sensors 16 Timers 18 Display 19 Mode Selection Menu 20 Memory 25 Inspection image generation circuit 30 Control circuit 32 Passage detection circuit 34 Setting circuit 40 Inspection data acquisition circuit 42 Coordinate data acquisition circuit 44 Hourly data acquisition circuit 50 Data Processing Circuit 51 Evaluation circuit 52 Arithmetic circuit 53 Inspection result output circuit 54 Characteristic image generating circuit 56 Identification image generation circuit 58 Image output circuit 80 Contact part S Cognitive Function Assessment System

Claims

1. A system that enables a TMT-based test on a display in which a subject connects a plurality of passing points with lines so that the subject passes through the passing points in sequence based on a predetermined rule, an inspection image generating circuit for electronically generating a TMT inspection image displayed on the display and having passing points set at a plurality of positions on a coordinate plane; a sensor for detecting contact of a contact portion of a subject with a display surface of the TMT examination image; a passage detection circuit that detects passage of the contact portion at the passage point based on a detection signal from the sensor; a calculation circuit that calculates, for all passing points to be passed through, a first inspection value related to a residence time during which the contact part remains at any one of the plurality of passing points from when the contact part reaches the first passing point until when the contact part starts to move to a second passing point to be passed through next, based on coordinate data corresponding to a position of the contact part on the coordinate plane obtained based on a detection signal from the sensor and time data associated with an acquisition time of each coordinate data, and a second inspection value related to a movement time required for the contact part to remain at the first passing point from when the contact part starts to move at the first passing point until it reaches the second passing point; Equipped with the passage detection circuit sets, for each passing point, a first coordinate area for determining that the contact portion has passed through the passing point and a second coordinate area for determining that the contact portion is stagnating at the passing point, detects an entry of the contact portion into the first coordinate area as the passage of the contact portion through the passing point, detects a movement of the contact portion within the second coordinate area as the stagnation of the contact portion at the passing point, and detects a movement of the contact portion from within the second coordinate area to outside the second coordinate area as a movement of the contact portion from the passing point, the calculation circuit calculates the first inspection value and the second inspection value based on the signal indicating the stagnation and the movement from the passage detection circuit; A system characterized by:

2. The system according to claim 1, characterized in that each passing point is set with a circular reference area defined by a circular first boundary line having a predetermined diameter, the first coordinate area defined inside by a circular second boundary line concentric with the reference area and having a diameter larger than the diameter of the reference area, and the second coordinate area defined inside by a circular third boundary line concentric with the reference area and having a diameter larger than the diameter of the first coordinate area.

3. 3. The system of claim 2, wherein the first coordinate area is formed from the reference area having a circular shape and an annular area defined by the first boundary line and the second boundary line, and the second coordinate area is formed from the reference area having a circular shape, an annular area defined by the first boundary line and the second boundary line, and an annular area defined by the second boundary line and the third boundary line.

4. 4. The system according to claim 1, wherein the passage detection circuit includes a setting circuit for variably setting the ranges of the first coordinate area and the second coordinate area.

5. A computer program that enables a test based on TMT, in which a subject connects a plurality of passing points with lines so that the subject passes through the passing points in sequence based on a predetermined rule, on a display, an inspection image generating step of electronically generating a TMT inspection image displayed on the display and having passing points set at a plurality of positions on a coordinate plane; a detection step of detecting a contact of a contact part of a subject with a display surface of the TMT test image by a sensor; a passage detection step of detecting passage of the contact portion at the passage point based on a detection signal from the sensor; a calculation step of calculating, for all passing points to be passed through, a first inspection value related to a residence time during which the contact part remains at any one of the plurality of passing points from when the contact part reaches the first passing point until when the contact part starts to move to a second passing point to be passed through next, based on coordinate data corresponding to a position of the contact part on the coordinate plane obtained based on a detection signal from the sensor and time data associated with an acquisition time of each coordinate data, and a second inspection value related to a movement time required for the contact part to remain at the first passing point from when the contact part starts to move at the first passing point until when the contact part reaches the second passing point; on the computer, the passage detection step sets, for each passing point, a first coordinate area for determining that the contact portion has passed through the passing point and a second coordinate area for determining that the contact portion is stagnating at the passing point, detects an entry of the contact portion into the first coordinate area as a passage of the contact portion through the passing point, detects a movement of the contact portion within the second coordinate area as a stagnation of the contact portion at the passing point, and detects a movement of the contact portion from within the second coordinate area to outside the second coordinate area as a movement of the contact portion from the passing point, The calculation step calculates the first inspection value and the second inspection value based on the signals indicating the stagnation and the movement from the passage detection step. A computer program comprising:

6. The computer program according to claim 5, characterized in that a circular reference area defined by a first boundary line having a predetermined diameter, the first coordinate area defined inside by a second boundary line concentric with the reference area and having a diameter larger than the diameter of the reference area, and the second coordinate area defined inside by a third boundary line concentric with the reference area and having a diameter larger than the diameter of the first coordinate area are set for each passing point.

7. 7. The computer program product of claim 6, wherein the first coordinate area is formed from the reference area having a circular shape and an annular area defined by the first boundary line and the second boundary line, and the second coordinate area is formed from the reference area having a circular shape, an annular area defined by the first boundary line and the second boundary line, and an annular area defined by the second boundary line and the third boundary line.

8. 8. The computer program according to claim 5, wherein the passage detection step includes a setting step for variably setting ranges of the first coordinate area and the second coordinate area.

9. A method for enabling a TMT-based test on a display in which a subject connects a plurality of passing points with lines so as to pass through them in sequence based on a predetermined rule, comprising: an inspection image generating step of electronically generating a TMT inspection image displayed on the display and having passing points set at a plurality of positions on a coordinate plane; a detection step of detecting a contact of a contact part of a subject with a display surface of the TMT test image by a sensor; a passage detection step of detecting passage of the contact portion at the passage point based on a detection signal from the sensor; a calculation step of calculating, for all passing points to be passed through, a first inspection value related to a residence time during which the contact part remains at any one of the plurality of passing points from when the contact part reaches the first passing point until when the contact part starts to move to a second passing point to be passed through next, based on coordinate data corresponding to a position of the contact part on the coordinate plane obtained based on a detection signal from the sensor and time data associated with an acquisition time of each coordinate data, and a second inspection value related to a movement time required for the contact part to remain at the first passing point from when the contact part starts to move at the first passing point until when the contact part reaches the second passing point; Including, the passage detection step sets, for each passing point, a first coordinate area for determining that the contact portion has passed through the passing point and a second coordinate area for determining that the contact portion is stagnating at the passing point, detects an entry of the contact portion into the first coordinate area as a passage of the contact portion through the passing point, detects a movement of the contact portion within the second coordinate area as a stagnation of the contact portion at the passing point, and detects a movement of the contact portion from within the second coordinate area to outside the second coordinate area as a movement of the contact portion from the passing point, The calculation step calculates the first inspection value and the second inspection value based on the signals indicating the stagnation and the movement from the passage detection step. A method comprising:

10. 10. The method according to claim 9, wherein a circular reference area is set for each passing point, the circular reference area being defined by a first boundary line having a predetermined diameter, the first coordinate area being defined inside by a second boundary line concentric with the reference area and having a diameter larger than the diameter of the reference area, and the second coordinate area being defined inside by a third boundary line concentric with the reference area and having a diameter larger than the diameter of the first coordinate area.

11. 11. The method of claim 10, wherein the first coordinate area is formed from the reference area having a circular shape and an annular area defined by the first boundary line and the second boundary line, and the second coordinate area is formed from the reference area having a circular shape, an annular area defined by the first boundary line and the second boundary line, and an annular area defined by the second boundary line and the third boundary line.

12. 12. The method according to claim 9, wherein the passage detection step includes a setting step for variably setting ranges of the first coordinate region and the second coordinate region.

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