Abstract：
BACKGROUND: Cognitive impairment is a well-known result of a stroke, but for cerebellar stroke in young patients detailed knowledge on the nature and extent of cognitive deficits is limited. This study examined the prevalence and course of cognitive impairment in a large cohort of patients with cerebellar stroke.
METHODS: Sixty young (18-49 years) cerebellar stroke patients completed extensive neuropsychological assessments in the subacute (<9 months post-stroke) and/or chronic phase (≥9 months post-stroke). Performance and course were assessed using standardized scores and Reliable Change Index analyses. Associations between cognitive deficits and lesion locations were explored using subtraction analyses, and associations with subjective cognitive complaints and fatigue were examined.
RESULTS: Sixty patients (52% male) were included with a mean age at event of 43.1 years. Cognitive impairment was observed in 60.3% of patients in the subacute phase and 51.2% during the chronic phase. Deficits were most frequent for visuo-spatial skills and executive functioning (42.5-54.6%). Both improvement and decline were observed over time, in 17.9% and 41.0% of participants, respectively. Cognitive deficits seem to be associated with lesions in certain cerebellar regions, however, no distinct correlation was found for a specific subregion. Subjective cognitive complaints were present in the majority of participants (61-80.5%) and positively correlated with fatigue in both phases (ρ = -.661 and ρ = -.757, p < .001, respectively).
CONCLUSIONS: Cognitive impairment in cerebellar stroke patients is common, with deficits most pronounced for visuo-spatial skills and executive functioning, as in line with the Cerebellar Cognitive Affective Syndrome. The course of cognitive performance was heterogenous, with cognitive decline despite the fact that no recurrent strokes occurred. No clear association between lesion location and cognitive deficits was observed. Subjective cognitive complaints and fatigue were prevalent and positively correlated. Clinicians could use this information to actively screen for and better inform patients about possible cognitive sequalae.
METHODS: Sixty young (18-49 years) cerebellar stroke patients completed extensive neuropsychological assessments in the subacute (<9 months post-stroke) and/or chronic phase (≥9 months post-stroke). Performance and course were assessed using standardized scores and Reliable Change Index analyses. Associations between cognitive deficits and lesion locations were explored using subtraction analyses, and associations with subjective cognitive complaints and fatigue were examined.
RESULTS: Sixty patients (52% male) were included with a mean age at event of 43.1 years. Cognitive impairment was observed in 60.3% of patients in the subacute phase and 51.2% during the chronic phase. Deficits were most frequent for visuo-spatial skills and executive functioning (42.5-54.6%). Both improvement and decline were observed over time, in 17.9% and 41.0% of participants, respectively. Cognitive deficits seem to be associated with lesions in certain cerebellar regions, however, no distinct correlation was found for a specific subregion. Subjective cognitive complaints were present in the majority of participants (61-80.5%) and positively correlated with fatigue in both phases (ρ = -.661 and ρ = -.757, p < .001, respectively).
CONCLUSIONS: Cognitive impairment in cerebellar stroke patients is common, with deficits most pronounced for visuo-spatial skills and executive functioning, as in line with the Cerebellar Cognitive Affective Syndrome. The course of cognitive performance was heterogenous, with cognitive decline despite the fact that no recurrent strokes occurred. No clear association between lesion location and cognitive deficits was observed. Subjective cognitive complaints and fatigue were prevalent and positively correlated. Clinicians could use this information to actively screen for and better inform patients about possible cognitive sequalae.
摘要：
背景：认知障碍是众所周知的中风结果，但是对于小脑中风的年轻患者对认知缺陷的性质和程度的详细了解是有限的。这项研究检查了小脑卒中患者的认知障碍的患病率和病程。
方法：60名年轻（18-49岁）小脑卒中患者在亚急性（卒中后<9个月）和/或慢性期（卒中后≥9个月）完成了广泛的神经心理学评估。使用标准化分数和可靠变化指数分析评估绩效和课程。使用减法分析探索认知缺陷与病变位置之间的关联，并检查了与主观认知抱怨和疲劳的关联。
结果：60例患者（52%为男性）纳入研究，平均年龄为43.1岁。在亚急性期观察到认知障碍的患者占60.3％，在慢性期观察到51.2％。缺陷最常见的是视觉空间技能和执行功能（42.5-54.6％）。随着时间的推移，观察到改善和下降，在17.9%和41.0%的参与者中，分别。认知缺陷似乎与某些小脑区域的病变有关，然而,未发现特定子区域的明显相关性.大多数参与者（61-80.5％）存在主观认知不适，并且在两个阶段都与疲劳呈正相关（分别为ρ=-.661和ρ=-.757，p<.001）。
结论：小脑卒中患者的认知功能障碍是常见的，视觉空间技能和执行功能方面的缺陷最为明显，与小脑认知情感综合征一致。认知表现的过程是异质的，尽管没有复发性中风发生，但认知能力下降。未观察到病变位置与认知缺陷之间的明确关联。主观认知抱怨和疲劳普遍存在且呈正相关。临床医生可以使用这些信息来积极筛查并更好地告知患者可能的认知后遗症。
方法：60名年轻（18-49岁）小脑卒中患者在亚急性（卒中后<9个月）和/或慢性期（卒中后≥9个月）完成了广泛的神经心理学评估。使用标准化分数和可靠变化指数分析评估绩效和课程。使用减法分析探索认知缺陷与病变位置之间的关联，并检查了与主观认知抱怨和疲劳的关联。
结果：60例患者（52%为男性）纳入研究，平均年龄为43.1岁。在亚急性期观察到认知障碍的患者占60.3％，在慢性期观察到51.2％。缺陷最常见的是视觉空间技能和执行功能（42.5-54.6％）。随着时间的推移，观察到改善和下降，在17.9%和41.0%的参与者中，分别。认知缺陷似乎与某些小脑区域的病变有关，然而,未发现特定子区域的明显相关性.大多数参与者（61-80.5％）存在主观认知不适，并且在两个阶段都与疲劳呈正相关（分别为ρ=-.661和ρ=-.757，p<.001）。
结论：小脑卒中患者的认知功能障碍是常见的，视觉空间技能和执行功能方面的缺陷最为明显，与小脑认知情感综合征一致。认知表现的过程是异质的，尽管没有复发性中风发生，但认知能力下降。未观察到病变位置与认知缺陷之间的明确关联。主观认知抱怨和疲劳普遍存在且呈正相关。临床医生可以使用这些信息来积极筛查并更好地告知患者可能的认知后遗症。
