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心脏骤停后短暂性全面性脑缺血患者的冷漠与认知缺陷

Apathy and Cognitive Deficits in Patients with Transient Global Ischemia After Cardiac Arrest.

作者信息

Frisch Stefan, Thiel Friederike, Schroeter Matthias L, Jentzsch Regina Tina

机构信息

Institute of Psychology, Goethe University, Frankfurt am Main, Germany.

Department of Neurology, University Hospital Frankfurt/Goethe University, Frankfurt am Main, Germany.

出版信息

Cogn Behav Neurol. 2017 Dec;30(4):172-175. doi: 10.1097/WNN.0000000000000139.

Abstract

BACKGROUND AND OBJECTIVE

Despite the extensive literature on cognitive deficits in the course of transient global ischemia after cardiac arrest with delayed resuscitation, apathy has been studied less frequently and systematically. We aimed to evaluate the frequency of apathy, defined as changes in drive or lack of motivation, and its relation to cognition as well as depression in people with transient global ischemia after cardiac arrest.

METHODS

In a retrospective study using the clinical data of 38 cardiac arrest survivors, we analyzed the frequency and severity of deficits in four cognitive domains (attention, memory spans, long-term memory, and executive functions) as well as apathy.

RESULTS

As in previous studies, long-term memory problems were predominant, but occurred rarely in isolation. Problems in drive were frequent and correlated with the severity of deficits in all cognitive domains except memory spans (and executive functions only as a trend). Influences of apathy were independent of the presence of a depressive syndrome.

CONCLUSIONS

Transient global ischemia after cardiac arrest generally leads to a broad pattern of cognitive decline with predominating memory deficits. Apathy is a frequent sequela and is associated with cognitive deficits, independent of depression. Studies investigating the cognitive profile after cardiac arrest should account for modulating influences of apathy.

摘要

背景与目的

尽管关于心脏骤停后延迟复苏所致短暂性全面性脑缺血过程中认知缺陷的文献众多,但对淡漠的研究较少且缺乏系统性。我们旨在评估淡漠(定义为动力改变或缺乏动机)的发生率,及其与心脏骤停后短暂性全面性脑缺血患者认知及抑郁的关系。

方法

在一项回顾性研究中,我们利用38名心脏骤停幸存者的临床资料,分析了四个认知领域(注意力、记忆广度、长期记忆和执行功能)缺陷以及淡漠的发生率和严重程度。

结果

与既往研究一样,长期记忆问题最为突出,但很少单独出现。动力问题很常见,且与除记忆广度外的所有认知领域缺陷严重程度相关(执行功能仅呈趋势相关)。淡漠的影响独立于抑郁综合征的存在。

结论

心脏骤停后的短暂性全面性脑缺血通常会导致广泛的认知衰退模式,以记忆缺陷为主。淡漠是常见的后遗症,与认知缺陷相关,且独立于抑郁。研究心脏骤停后的认知特征应考虑淡漠的调节作用。

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