目的:卒中后执行功能障碍已有文献记载,但人们对它是否发生在轻度中风患者中知之甚少。该研究的目的是调查该人群的执行障碍,并探讨执行功能测试与其他领域的认知测试之间的相关性。
方法:进行了横断面研究,比较了139名40-80岁的轻度缺血性卒中患者(美国国立卫生研究院卒中量表(NIHSS)≤7)与131名年龄匹配的正常对照者,性别和教育水平。所有参与者都接受了神经心理学测试,包括三种执行功能的测量:时钟绘制测试(CDT),试制测试-A和B(TMT-A和B),和Stroop颜色词测试(SCWT)。使用三个定量评分指标评估CDT,总分分别为3,10,18分,并采用了6类错误的定性评分法。采用Spearman相关性分析执行功能测试与其他神经心理学测试的相关性。
结果:在大多数执行功能测试中,对照组的表现优于卒中组,具有统计学意义。定性CDT显示“图形困难”的错误,“概念缺陷”和“空间和/或计划缺陷”经常发生在轻度中风的早期阶段。相关数据表明,在执行功能测试中,TMT-B时间与全球认知相关程度最高。
结论:即使是轻度中风,执行功能障碍也很常见,以及相对简短的措施,如CDT,作为康复计划的一部分,可以在出院前采用TMT和SCWT。
OBJECTIVE: Executive dysfunction following stroke is well documented, but less is known about whether it occurs in mild stroke patients. The purpose of the study was to investigate executive impairment in this population and explore the correlation between executive function tests and cognitive tests of other domains.
METHODS: Cross-sectional study was undertaken to compare 139 mild ischemic stroke patients (National Institute of Health Stroke Scale (NIHSS) ≤ 7) aged 40-80 with 131 normal controls matched age, gender and levels of education. All participants were administered a neuropsychological test battery including three measures of executive functioning: Clock Drawing Test (CDT), Trial Making Test-A and B (TMT-A and B), and Stroop Color Word Test (SCWT). The CDT was evaluated using three quantitative scoring rubrics, with a total score of 3,10,18, respectively and a qualitative scoring method with six types of errors. Spearman\'s correlations were made to analyze the correlation between executive function tests and other neuropsychological tests.
RESULTS: Control group performed better than stroke group on most executive function tests at a statistical significance. Qualitative CDT showed that errors of \"graphic difficulties\", \"conceptual deficits\" and \"spatial and/or planning deficits\" occurred frequently in the early stage of mild stroke. Correlation data clarified that among the executive function tests, time for TMT-B correlated with global cognition most.
CONCLUSIONS: Executive dysfunction is common following even mild strokes, and that relatively brief measures such as CDT, TMT and SCWT can be employed for it before discharge as part of rehabilitation planning.