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中风后失语症中的认知缺陷。

Cognitive deficits in post-stroke aphasia.

作者信息

Bonini Milena V, Radanovic Márcia

机构信息

Departamento de Neurologia, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, BR.

出版信息

Arq Neuropsiquiatr. 2015 Oct;73(10):840-7. doi: 10.1590/0004-282X20150133.

Abstract

The assessment of aphasics' cognitive performance is challenging and such patients are generally excluded from studies that describe cognitive deficits after stroke. We evaluated aphasics' performance in cognitive tasks compared to non-aphasic subjects. A sample of 47 patients (21 aphasics, 17 non-aphasics with left hemisphere lesions and 9 non-aphasics with right hemisphere lesions) performed cognitive tasks (attention, verbal and visual memory, executive functions, visuospatial skills and praxis). Aphasic patients performed poorer than all non-aphasics in Digit Span (p < 0.001), Clock-Drawing Test (p = 0.006), Verbal memory (p = 0.002), Visual Memory (p < 0.01), Verbal Fluency (p < 0.001), and Gesture Praxis (p < 0.001). Aphasia severity correlated with performance in Trail Making test part B (p = 0.004), Digit Span forward (p < 0.001) and backwards (p = 0.011), and Gesture Praxis (p = 0.002). Aphasia is accompanied by deficits not always easy to be evaluated by cognitive tests due to speech production and motor impairments. Assessment of cognitive functions in aphasics might contribute to optimize therapeutic intervention.

摘要

评估失语症患者的认知表现具有挑战性,此类患者通常被排除在描述中风后认知缺陷的研究之外。我们将失语症患者在认知任务中的表现与非失语症受试者进行了比较。47名患者(21名失语症患者、17名左半球损伤的非失语症患者和9名右半球损伤的非失语症患者)参与了认知任务(注意力、言语和视觉记忆、执行功能、视觉空间技能和运用能力)。失语症患者在数字广度测试(p < 0.001)、画钟试验(p = 0.006)、言语记忆(p = 0.002)、视觉记忆(p < 0.01)、言语流畅性(p < 0.001)和手势运用能力(p < 0.001)方面的表现均不如所有非失语症患者。失语症严重程度与连线测验B部分的表现(p = 0.004)、顺背数字广度(p < 0.001)、倒背数字广度(p = 0.011)以及手势运用能力(p = 0.002)相关。由于言语表达和运动障碍,失语症常伴有一些认知测试难以评估的缺陷。对失语症患者认知功能的评估可能有助于优化治疗干预。

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