Department of Neurology, Maastricht University Medical Centre, The Netherlands.
Int J Geriatr Psychiatry. 2011 Jul;26(7):679-86. doi: 10.1002/gps.2581. Epub 2010 Oct 13.
Cognitive and emotional sequellae are commonly observed in stroke patients and these symptoms often co-occur. Diagnosis can be difficult since symptoms of depression and executive dysfunction overlap.
To study the longitudinal relationship between depressive symptoms and executive dysfunction in stroke patients.
The study comprises of 116 first-ever stroke patients who were followed-up for 2 years and who were assessed for emotional and cognitive sequellae after 1, 6, 12, and 24 months. Emotional disturbances were evaluated using the SCL-90 depression subscale. Executive functions were assessed using compound scores of a combination of the interference scores of the Stroop Colour Word Test and the Concept Shifting Test.
Twenty-five patients suffered from both depressive symptoms and executive dysfunction, 28 patients were depressed with no signs of executive dysfunction, and 13 patients showed executive dysfunction with no depressive symptoms. Patients with executive dysfunction had higher mean SCL-90-D scores compared to patients with no executive dysfunction (30.9 (SD 11.7) versus 26.2 (SD 11.1, p = 0.037). Depressive symptoms were predictive for executive dysfunction in a regression analysis corrected for age, sex, and diabetes mellitus but not after additional correction for pre-existent brain damage and other vascular risk factors. After 2 years 66.6 and 53.3% of patients with both depressive symptoms and executive dysfunction at baseline still had depressive symptoms and executive dysfunctions respectively and had worse prognostic outcome than patients with depressive symptoms or executive dysfunction alone.
Symptoms of depression and executive dysfunction are highly prevalent in stroke patients and often co-occur. These patients are more at risk for poor stroke outcome, chronic depression, and cognitive deterioration.
认知和情感后遗症在中风患者中很常见，这些症状经常同时出现。由于抑郁和执行功能障碍的症状有重叠，因此诊断可能很困难。
研究中风患者抑郁症状和执行功能障碍之间的纵向关系。
该研究包括 116 名首次中风的患者，他们在 2 年内接受了随访，并在 1、6、12 和 24 个月后评估了情绪和认知后遗症。使用 SCL-90 抑郁分量表评估情绪障碍。使用 Stroop 颜色词测试和概念转换测试的干扰分数组合的复合分数评估执行功能。
25 名患者同时患有抑郁症状和执行功能障碍，28 名患者抑郁但没有执行功能障碍，13 名患者执行功能障碍但没有抑郁症状。与没有执行功能障碍的患者相比，有执行功能障碍的患者的 SCL-90-D 评分平均值更高（30.9（SD 11.7）与 26.2（SD 11.1，p = 0.037）。在回归分析中，校正年龄、性别和糖尿病后，抑郁症状可预测执行功能障碍，但在进一步校正预先存在的脑损伤和其他血管危险因素后则不能。在 2 年后，基线时有抑郁症状和执行功能障碍的患者中，分别有 66.6%和 53.3%仍有抑郁症状和执行功能障碍，预后比仅有抑郁症状或执行功能障碍的患者更差。
抑郁症状和执行功能障碍在中风患者中非常普遍，且经常同时出现。这些患者发生不良中风结局、慢性抑郁和认知恶化的风险更高。
