Rousseaux M, Castelnot E, Rigaux P, Kozlowski O, Danzé F
Dr M Rousseaux, Service de Rééducation Neurologique, Hôpital Swynghedauw, CHRU, 59037 Lille Cedex, France.
J Neurol Neurosurg Psychiatry. 2009 Feb;80(2):166-70. doi: 10.1136/jnnp.2007.128686. Epub 2008 Oct 23.
Previous research on cognition and locked-in syndrome (LIS) is limited to single case reports, and usually reported normality of performance. Here, cognitive disorders in a group of LIS patients are investigated, using a specific test relying only on a yes/no response indicated by eye movements or verbally.
Nine patients with LIS resulting from brainstem stroke were compared with seven patients with frontal or frontotemporal lesions and 16 matching normal control subjects. The test comprised 19 subtests of perception (visual and auditory recognition), oral comprehension (identity, words and sentences), written comprehension (words and sentences), orientation (in time and place), immediate and delayed memories (verbal and visuo-spatial information), calculation and problem solving, and analysis of verbal logic.
LIS patients showed significant difficulties in auditory recognition (associative level), oral comprehension of complex sentences, delayed visuospatial memory, mental calculation and problem solving. Patients with hemispheric lesions were more severely impaired. Single case analysis revealed that four LIS patients showed cognitive disorders in at least three subtests. These disorders were not related to a specific localisation of lesions.
Moderate and selective cognitive disorders can be observed in LIS patients. Systematic assessment is needed, because of their possible consequences for communication and rehabilitation protocols.
以往关于认知与闭锁综合征（LIS）的研究仅限于单病例报告，且通常报告表现正常。在此，使用一种仅依赖眼球运动或口头表示的是/否反应的特定测试，对一组LIS患者的认知障碍进行研究。
将9例因脑干卒中导致LIS的患者与7例额叶或额颞叶病变患者以及16名匹配的正常对照受试者进行比较。该测试包括19个关于感知（视觉和听觉识别）、口语理解（身份、单词和句子）、书面理解（单词和句子）、定向（时间和地点）、即时和延迟记忆（言语和视觉空间信息）、计算和问题解决以及言语逻辑分析的子测试。
LIS患者在听觉识别（联想水平）、复杂句子的口语理解、延迟的视觉空间记忆、心算和问题解决方面存在显著困难。半球病变患者受损更严重。单病例分析显示，4例LIS患者在至少3个子测试中表现出认知障碍。这些障碍与病变的特定定位无关。
LIS患者可观察到中度和选择性认知障碍。由于其对沟通和康复方案可能产生的影响，需要进行系统评估。
