Bickerton Wai-Ling, Demeyere Nele, Francis Dawn, Kumar Viba, Remoundou Marietta, Balani Alex, Harris Lara, Williamson Jon, Lau Johnny K, Samson Dana, Riddoch M Jane, Humphreys Glyn W
School of Psychology, University of Birmingham.
Department of Experimental Psychology, University of Oxford.
Neuropsychology. 2015 Jul;29(4):638-48. doi: 10.1037/neu0000160. Epub 2014 Dec 29.
We examined the utility of the Birmingham Cognitive Screen (BCoS) in discriminating cognitive profiles and recovery of function across stroke survivors. BCoS was designed for stroke-specific problems across 5 cognitive domains: (a) controlled and spatial attention, (b) language, (c) memory, (d) number processing, and (e) praxis.
On the basis of specific inclusion criteria, this cross-section observational study analyzed cognitive profiles of 657 subacute stroke patients, 331 of them reassessed at 9 months. Impairments on 32 measures were evaluated by comparison with 100 matched healthy controls. Measures of affect, apathy, and activities of daily living were also taken. Between-subjects group comparisons of mean performance scores and impairment rates and within-subject examination of impairment rates over time were conducted. Logistic regressions and general linear modeling were used for multivariate analysis of domain-level effects on outcomes.
Individuals with repeated stroke experienced significantly less cognitive recovery at 9 months than those with a first stroke despite similar initial level of cognitive performance. Individuals with left hemisphere lesions performed more poorly than those with right hemisphere lesions, but both groups showed similar extent of recovery at 9 months. BCoS also revealed lesion-side-specific deficits and common areas of persistent problems. Functional outcome at 9 months correlated with domain-level deficits in controlled attention, spatial attention, and praxis over and above initial dependency and concurrent levels of affect and apathy.
The study demonstrates how BCoS can identify differential cognitive profiles across patient groups. This can potentially help predict outcomes and inform rehabilitation.
我们研究了伯明翰认知筛查量表（BCoS）在区分中风幸存者的认知特征和功能恢复方面的效用。BCoS是针对中风特定问题设计的，涵盖5个认知领域：（a）控制性和空间注意力，（b）语言，（c）记忆，（d）数字处理，以及（e）实践能力。
基于特定的纳入标准，这项横断面观察性研究分析了657例亚急性中风患者的认知特征，其中331例在9个月时进行了重新评估。通过与100名匹配的健康对照进行比较，评估了32项指标的损伤情况。还测量了情感、冷漠和日常生活活动情况。进行了受试者间平均表现得分和损伤率的组间比较，以及受试者内损伤率随时间的检查。使用逻辑回归和一般线性模型对领域水平对结果的影响进行多变量分析。
尽管初始认知表现水平相似，但复发性中风患者在9个月时的认知恢复明显少于首次中风患者。左半球病变患者的表现比右半球病变患者更差，但两组在9个月时的恢复程度相似。BCoS还揭示了病变侧特定的缺陷和持续存在问题的共同区域。9个月时的功能结局与控制性注意力、空间注意力和实践能力方面的领域水平缺陷相关，超出了初始依赖程度以及情感和冷漠的并发水平。
该研究证明了BCoS如何能够识别不同患者群体的认知特征差异。这可能有助于预测结局并为康复提供信息。
