van Rooij Frank G, Plaizier Nicole O, Vermeer Sarah E, Góraj Bozena M, Koudstaal Peter J, Richard Edo, de Leeuw Frank-Erik, Kessels Roy P C, van Dijk Ewoud J
Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, Netherlands.
Department of Medical Psychology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, Netherlands.
Behav Neurol. 2017;2017:5181024. doi: 10.1155/2017/5181024. Epub 2017 Nov 19.
Subjective cognitive impairment (SCI), depressive symptoms, and fatigue are common after stroke and are associated with reduced quality of life. We prospectively investigated their prevalence and course after a transient ischemic attack (TIA) or nonfocal transient neurological attack (TNA) and the association with diffusion-weighted imaging (DWI) lesions.
The Cognitive Failures Questionnaire, Hospital Anxiety and Depression Scale, and Subjective Fatigue subscale from the Checklist Individual Strength were used to assess subjective complaints shortly after TIA or TNA and six months later. With repeated measure analysis, the associations between DWI lesion presence or clinical diagnosis (TIA or TNA) and subjective complaints over time were determined.
We included 103 patients (28 DWI positive). At baseline, SCI and fatigue were less severe in DWI positive than in DWI negative patients, whereas at follow-up, there were no differences. SCI ( = 0.02) and fatigue ( = 0.01) increased in severity only in DWI positive patients. There were no differences between TIA and TNA.
Subjective complaints are highly prevalent in TIA and TNA patients. The short-term prognosis is not different between DWI-positive and DWI negative patients, but SCI and fatigue increase in severity within six months after the event when an initial DWI lesion is present.
主观认知障碍（SCI）、抑郁症状和疲劳在中风后很常见，并且与生活质量下降有关。我们前瞻性地调查了短暂性脑缺血发作（TIA）或非局灶性短暂性神经发作（TNA）后它们的患病率和病程，以及与弥散加权成像（DWI）病变的关联。
使用认知失误问卷、医院焦虑抑郁量表以及个体力量清单中的主观疲劳分量表，在TIA或TNA后不久以及六个月后评估主观症状。通过重复测量分析，确定DWI病变的存在或临床诊断（TIA或TNA）与随时间变化的主观症状之间的关联。
我们纳入了103例患者（28例DWI阳性）。在基线时，DWI阳性患者的SCI和疲劳程度低于DWI阴性患者，而在随访时，两者无差异。仅DWI阳性患者的SCI（=0.02）和疲劳（=0.01）严重程度增加。TIA和TNA之间无差异。
主观症状在TIA和TNA患者中非常普遍。DWI阳性和DWI阴性患者的短期预后没有差异，但在事件发生后六个月内，当初始存在DWI病变时，SCI和疲劳的严重程度会增加。
