Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
J Neurol Neurosurg Psychiatry. 2013 Mar;84(3):337-41. doi: 10.1136/jnnp-2012-303926. Epub 2012 Dec 6.
To evaluate the sensitivity of measuring cognitive processing in the ocular motor system as a marker for recovery of deficit in post stroke patients.
15 patients (mean age 60.6 years, mean National Institutes of Health Stroke Scale (NIHSS) score 2.25) and 10 age matched control subjects (mean age 63.3 years) participated in the study. We included mildly affected acute stroke patients without a visual field defect or gaze palsy. Patients were examined at onset and at 1 month and 3 months post stroke by testing ocular motor function, NIHSS, modified Rankin Scale (mRS) and standard cognitive function assessments.
Significant differences were found in measures of ocular motor function between groups at stroke onset as well as between the first test and follow-up in patients. At 3 months, function had not returned to normal baseline. Ocular motor function was more sensitive in identifying cognitive dysfunction and improvement compared with NIHSS or mRS.
Standard neurological assessments of stroke patients are weighted significantly towards motor and sensory function, underestimating cognitive deficits. Ocular motor assessment demonstrates cognitive effects of even mild stroke and may provide improved quantifiable measurements of cognitive recovery post stroke. We demonstrated abnormality in patients just after onset, extending beyond 3 months, when there was apparent full recovery of motor and sensory function, implying more widespread disruption of cognitive mechanisms, consistent with the subjective complaints received from patients. This may provide insight into cognitive rehabilitation strategies leading to improved functional outcomes.
评估眼动系统认知加工测量的敏感性，作为评估中风后患者缺陷恢复的标志物。
15 名患者（平均年龄 60.6 岁，平均 NIHSS 评分 2.25）和 10 名年龄匹配的对照组受试者（平均年龄 63.3 岁）参与了研究。我们纳入了轻度急性中风患者，无视野缺损或凝视麻痹。患者在发病时、发病后 1 个月和 3 个月进行眼动功能、NIHSS、改良 Rankin 量表（mRS）和标准认知功能评估。
在发病时以及患者首次测试和随访时，眼动功能的测量值在组间存在显著差异。在 3 个月时，功能尚未恢复到正常基线。与 NIHSS 或 mRS 相比，眼动功能更能识别认知功能障碍和改善。
对中风患者的标准神经评估严重偏向于运动和感觉功能，低估了认知缺陷。眼动评估显示，即使是轻度中风也会对认知产生影响，并且可能为中风后认知恢复提供更可量化的测量。我们在发病后不久就发现了患者的异常，并且持续了 3 个月以上，此时运动和感觉功能已经完全恢复，这意味着认知机制受到了更广泛的破坏，与患者的主观抱怨一致。这可能为认知康复策略提供了深入了解，从而改善功能结果。
