a Department of Clinical Psychology , Xavier University , Cincinnati, OH , USA.
Clin Neuropsychol. 2014;28(2):300-16. doi: 10.1080/13854046.2014.881555. Epub 2014 Feb 17.
Executive dysfunction predicts functional recovery post-stroke. However, traditional neuropsychological tests have limitations with this population due to required verbal response, complex motor response, and lengthy administration time. This study examined the ecological validity and performance characteristics of a relatively new measure of executive function, the Brixton Spatial Anticipation Test, which does not place the aforementioned demands on these patients. A total of 57 ischemic stroke patients with frontal lobe and subcortical lesions were administered the Brixton, on average 2 weeks post-stroke, during inpatient rehabilitation and assessed using the Functional Independence Measure (FIM) upon discharge. Brixton performance was significantly correlated with the FIM Total and FIM Cognitive Subtotal at discharge but unrelated to FIM Motor Subtotal. After controlling for global ability measured by the RBANS, Brixton performance accounted for additional variance in predicting FIM Total score at discharge. Interestingly, patients with subcortical strokes in the thalamus and basal ganglia performed significantly worse than patients with strokes in the frontal cortex on the Brixton, supporting the role of subcortical structures in the frontal lobe circuitry and executive function. Based on the present findings, the Brixton is a sensitive measure conducive to the stroke population and has strong ecological validity for identifying cognitive functional outcomes post-stroke.
执行功能障碍可预测中风后功能恢复。然而，由于需要口头反应、复杂的运动反应和冗长的管理时间，传统的神经心理学测试在该人群中存在局限性。本研究考察了一种相对较新的执行功能测量方法——Brixton 空间预测测试的生态有效性和性能特征，该方法对这些患者没有上述要求。共有 57 名额叶和皮质下病变的缺血性中风患者在住院康复期间接受了 Brixton 测试，平均在中风后 2 周进行，在出院时使用功能性独立测量（FIM）进行评估。Brixton 的表现与 FIM 总分和 FIM 认知子总分在出院时显著相关，但与 FIM 运动子总分无关。在控制 RBANS 测量的整体能力后，Brixton 的表现可以解释出院时 FIM 总分的额外差异。有趣的是，丘脑和基底节皮质下中风患者在 Brixton 上的表现明显差于额叶中风患者，支持皮质下结构在额叶回路和执行功能中的作用。基于目前的研究结果，Brixton 是一种对中风患者敏感的测量方法，对识别中风后认知功能结果具有很强的生态有效性。
