Institute of Molecular Medicine, Faculty of Medicine of the University of Lisbon, Lisbon, Portugal.
Eur J Neurol. 2012 Feb;19(2):291-7. doi: 10.1111/j.1468-1331.2011.03508.x. Epub 2011 Sep 6.
Apathy is a frequent disturbance in stroke patients. The aim of this case-control study was to elucidate whether apathy: (i) was secondary to stroke or related to hospitalization, (ii) was related to thalamic and striatocapsular stroke lesions, (iii) was independent from cognitive impairment and depression in the acute phase of stroke, (iv) was associated with clinical and demographical variables and (v) was associated with a worse functional outcome at discharge.
We assessed a sample of 94 consecutive patients with an acute (≤4 days) stroke (22 intracerebral haemorrhages, 72 cerebral infarcts), and a control group of 50 patients with acute coronary syndrome, with the 10-item Apathy Evaluation Scale-Clinical. We related apathy with cognition (MMSE), depression (Montgomery Åsberg Depression Rating Scale) and with outcome (modified Rankin Scale).
Apathy was present in 36 (38.3%) acute stroke patients but was also frequent in patients with acute coronary syndrome (24%). Stroke patients were more inaccurate in understanding their problems than patients with acute coronary syndrome (P=0.005). Logistic regression identified cerebral haemorrhage (OR=3.5), low educational level (OR=4.7) and a trend of right hemispherical lesion (OR=3.0) as independent predictors for apathy (R(2)=32.3%). Cognitive impairment and depression were not associated to apathy. Apathy was associated with a worse outcome (P=0.03).
Apathy was frequent in acute stroke patients, and it was predicted by acute intracerebral haemorrhage and right hemispherical acute stroke lesion.
淡漠是脑卒中患者常见的障碍。本病例对照研究旨在阐明淡漠是否：（i）继发于脑卒中或与住院相关；（ii）与丘脑和纹状体壳核卒中病变相关；（iii）在脑卒中急性期与认知障碍和抑郁无关；（iv）与临床和人口统计学变量相关；（v）与出院时的功能结局较差相关。
我们评估了 94 例连续急性（≤4 天）脑卒中患者（22 例脑出血，72 例脑梗死）和 50 例急性冠状动脉综合征患者的样本，使用 10 项淡漠评估量表-临床版。我们将淡漠与认知（MMSE）、抑郁（蒙哥马利抑郁评定量表）和结局（改良 Rankin 量表）相关联。
36 例（38.3%）急性脑卒中患者存在淡漠，而急性冠状动脉综合征患者也有 24%存在淡漠。脑卒中患者在理解自己的问题时比急性冠状动脉综合征患者更不准确（P=0.005）。Logistic 回归确定脑出血（OR=3.5）、低教育水平（OR=4.7）和右侧半球病变的趋势（OR=3.0）是淡漠的独立预测因素（R²=32.3%）。认知障碍和抑郁与淡漠无关。淡漠与较差的结局相关（P=0.03）。
淡漠在急性脑卒中患者中很常见，由急性脑出血和右侧半球急性脑卒中病变预测。
