■中风后行为抑制(PSBD)在中风幸存者中很常见,通常表现为冲动,不得体的或粗俗的行为。然而,它通常仍未被诊断,因此未经治疗,即使它可能导致在康复设施中停留更长的时间。拟议的研究将旨在评估临床,神经心理学和磁共振成像(MRI)与卒中幸存者队列中的PSBD相关,并描述其12个月的病程.
■这项前瞻性队列研究将招募237名患者,并将在威尔士亲王医院神经内科进行。项目期限为24个月。患者将通过多种MRI方法进行检查,包括弥散加权成像,中风发作后1周内。患者及其护理人员将在中风发作后3、9和15个月(分别为T1、T2和T3)在研究诊所接受详细评估。额叶系统行为量表(FrSBe)的去抑制子量表将由每个受试者和护理人员完成,分数≥65将被认为表明PSBD。将进行逐步逻辑回归以评估感兴趣区域(ROI)中病变的重要性,以及单变量分析中确定的其他重要变量。对于T1时患有PSBD的患者,将比较有和没有ROI梗塞的患者组之间的FrSBe抑制评分,使用协方差分析。人口统计,将在T2和T3通过逻辑回归再次检查临床和MRI变量。
■该项目将是针对卒中幸存者的PSBD的首次MRI研究。结果将揭示眶额皮质病变的关联,颞叶和皮质下脑结构与PSBD的风险。获得的数据将促进我们对中风中PSBD的发病机制和临床过程的理解,以及其他神经系统疾病。因此,这些发现可能适用于有PSBD风险的神经系统疾病患者的大量人群,并有望刺激该领域的进一步研究。
UNASSIGNED: Post-stroke behavioral disinhibition (PSBD) is common in stroke survivors and often presents as impulsive, tactless or vulgar behavior. However, it often remains undiagnosed and thus untreated, even though it can lead to a longer length of stay in a rehabilitation facility. The proposed study will aim to evaluate the clinical, neuropsychological and magnetic resonance imaging (MRI) correlates of PSBD in a cohort of stroke survivors and describe its 12-month course.
UNASSIGNED: This prospective cohort study will recruit 237 patients and will be conducted at the Neurology Unit of the Prince of Wales Hospital. The project duration will be 24 months. The patients will be examined by multiple MRI methods, including diffusion-weighted imaging, within 1 week after stroke onset. The patients and their caregivers will receive a detailed assessment at a research clinic at 3, 9 and 15 months after stroke onset (T1, T2 and T3, respectively). The disinhibition subscale of the Frontal Systems Behavior Scale (FrSBe) will be completed by each subject and caregiver, and scores ≥65 will be considered to indicate PSBD.A stepwise logistic regression will be performed to assess the importance of lesions in the regions of interest (ROIs), together with other significant variables identified in the univariate analyses. For patients with PSBD at T1, the FrSBe disinhibition scores will be compared between the groups of patients with and without ROI infarcts, using covariance analysis. The demographic, clinical and MRI variables of remitters and non-remitters will be examined again at T2 and T3 by logistic regression.
UNASSIGNED: This project will be the first MRI study on PSBD in stroke survivors. The results will shed light on the associations of lesions in the orbitofrontal cortex, anterior temporal lobe and subcortical brain structures with the risk of PSBD. The obtained data will advance our understanding of the pathogenesis and clinical course of PSBD in stroke, as well as other neurological conditions. The findings are thus likely to be applicable to the large population of patients with neurological disorders at risk of PSBD and are expected to stimulate further research in this field.