Deniz Çiğdem, Çelik Yahya, Özdemir Gültekin Tuğçe, Baran Gozde Eryiğit, Deniz Çağla, Asil Talip
Department of Neurology, Faculty of Medicine, Bezmialem Vakıf University, ˙Istanbul.
Department of Neurology, Faculty of Medicine, Trakya University, Edirne.
Neuropsychiatr Dis Treat. 2016 Aug 16;12:2039-48. doi: 10.2147/NDT.S102193. eCollection 2016.
We aimed to examine the incidence of cognitive impairment among patients with stroke, the associated risk factors, progression of the cognitive impairment, and the association between the localization of the lesion(s) as detected by magnetic resonance imaging and the affected areas of cognitive function.
A total of 40 patients over 18 years of age enduring a transient ischemic stroke or minor stroke within the past 3 months who had a minimum life expectancy of 1 year were included in this study. Same number, age-, and sex-matched individuals were included as controls. Patients were inquired on the presence of risk factors for stroke. A series of neuropsychological test batteries were administered in patient and control subjects for assessing cognitive functions. These tests were readministered at 6 and 12 months of follow-up to assess the progression of cognitive functions.
In this study among the patients with stroke, a significant impairment was seen in multiple cognitive functional tests following ischemic stroke as compared to control groups. The most common risk factors for stroke included hypertension (72.5%), hyperlipidemia, and cigarette smoking. The number of cognitive domains with an impairment was highest (in four cognitive tests) among those with coronary artery disease and atrial fibrillation, followed by those who had a >50% stenosis in Doppler (three cognitive tests). These findings suggest that the frequency of risk factors associated with stroke does not correlate with the frequency of risk factors associated with cognitive dysfunction. The stroke localizations were classified among the patients with stroke and reviewed in accordance with cognitive impairment.
Neuropsychological tests, clinical findings, and imaging studies should be used to document the poststroke cognitive dysfunction.
我们旨在研究卒中患者认知障碍的发生率、相关危险因素、认知障碍的进展情况,以及磁共振成像检测到的病变部位与认知功能受影响区域之间的关联。
本研究纳入了40例年龄在18岁以上、在过去3个月内发生过短暂性脑缺血发作或轻度卒中且预期寿命至少为1年的患者。选取数量、年龄和性别匹配的个体作为对照。询问患者是否存在卒中危险因素。对患者和对照者进行一系列神经心理测试组合,以评估认知功能。在随访的6个月和12个月时再次进行这些测试,以评估认知功能的进展情况。
在本研究的卒中患者中,与对照组相比,缺血性卒中后多项认知功能测试出现了显著损害。最常见的卒中危险因素包括高血压(72.5%)、高脂血症和吸烟。在患有冠状动脉疾病和心房颤动的患者中,认知功能受损的认知领域数量最多(四项认知测试),其次是多普勒检查显示狭窄>50% 的患者(三项认知测试)。这些发现表明,与卒中相关的危险因素频率与与认知功能障碍相关的危险因素频率不相关。对卒中患者的卒中部位进行分类,并根据认知障碍情况进行复查。
应使用神经心理测试、临床发现和影像学研究来记录卒中后认知功能障碍。