Institute Cardiovascular and Medical Sciences, School of Medicine, University of Glasgow, Glasgow, UK.
Stroke. 2012 Jun;43(6):1678-80. doi: 10.1161/STROKEAHA.112.653303. Epub 2012 Apr 24.
International guidelines recommend cognitive and mood assessments for stroke survivors; these assessments also have use in clinical trials. However, there is no consensus on the optimal assessment tool(s). We aimed to describe use of cognitive and mood measures in contemporary published stroke trials.
Two independent, blinded assessors reviewed high-impact journals representing: general medicine (n=4), gerontology/rehabilitation (n=3), neurology (n=4), psychiatry (n=4), psychology (n=4), and stroke (n=3) January 2000 to October 2011 inclusive. Journals were hand-searched for relevant, original research articles that described cognitive/mood assessments in human stroke survivors. Data were checked for relevance by an independent clinician and clinical psychologist.
Across 8826 stroke studies, 488 (6%) included a cognitive or mood measure. Of these 488 articles, total number with cognitive assessment was 408 (83%) and mood assessment tools 247 (51%). Total number of different assessments used was 367 (cognitive, 300; mood, 67). The most commonly used cognitive measure was Folstein's Mini-Mental State Examination (n=180 articles, 37% of all articles with cognitive/mood outcomes); the most commonly used mood assessment was the Hamilton Rating Scale of Depression(n=43 [9%]).
Cognitive and mood assessments are infrequently used in stroke research. When used, there is substantial heterogeneity and certain prevalent assessment tools may not be suited to stroke cohorts. Research and guidance on the optimal cognitive/mood assessment strategies for clinical practice and trials is required.
国际指南建议对脑卒中幸存者进行认知和情绪评估；这些评估也可用于临床试验。然而，对于最佳评估工具尚未达成共识。我们旨在描述当前发表的脑卒中试验中认知和情绪测量的使用情况。
两名独立的、盲法评估员审查了代表以下领域的高影响力期刊：普通医学（n=4）、老年病学/康复（n=3）、神经病学（n=4）、精神病学（n=4）、心理学（n=4）和脑卒中（n=3），时间范围为 2000 年 1 月至 2011 年 10 月。通过手工检索这些期刊，寻找描述脑卒中幸存者认知/情绪评估的相关原始研究文章。由独立临床医生和临床心理学家对数据进行了相关性检查。
在 8826 项脑卒中研究中，有 488 项（6%）包含认知或情绪评估。在这 488 篇文章中，有认知评估的文章总数为 408 篇（83%），有情绪评估工具的文章为 247 篇（51%）。总共使用了 367 种不同的评估工具（认知评估 300 种，情绪评估 67 种）。最常用的认知评估工具是 Folstein 简易精神状态检查（n=180 篇文章，占具有认知/情绪结果的所有文章的 37%）；最常用的情绪评估工具是汉密尔顿抑郁量表（n=43 [9%]）。
认知和情绪评估在脑卒中研究中很少使用。在使用时，存在很大的异质性，某些常见的评估工具可能不适合脑卒中队列。需要对最佳认知/情绪评估策略进行研究和指导，以适应临床实践和临床试验。
