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小脑中风患者神经心理缺陷的解剖学关联

Anatomical Correlates of Neuropsychological Deficits Among Patients With the Cerebellar Stroke.

作者信息

Shin Min A, Park Oak Tae, Shin Joon-Ho

机构信息

Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea.

出版信息

Ann Rehabil Med. 2017 Dec;41(6):924-934. doi: 10.5535/arm.2017.41.6.924. Epub 2017 Dec 28.

Abstract

OBJECTIVE

To investigate the anatomical correlates of the neuropsychological deficits in patients with the cerebellar stroke.

METHODS

We screened patients who were admitted to the National Rehabilitation Center with the cerebellar stroke between October 2012 and November 2016. The patients with the cerebellar stroke who underwent neuropsychological testing for which the Seoul Neuropsychological Screening Battery (SNSB) or the SNSB-II were enrolled. The neuropsychological function capacities were compared in accordance with the stroke type (hemorrhagic vs. ischemic) and the location (right/left anterior, right/left posterior intermediate, right/left posterior lateral lobe, and vermis). Mean z-scores were computed to compare the patient performances with the population averages.

RESULTS

Twenty-six patients (15 with ischemic stroke and 11 with hemorrhagic stroke) with a mean age of 54.8±16.6 years were assessed 8.8±9.2 months after the stroke. Differences in the neuropsychological functioning according to the stroke type were not observed. All of the numerical subtests of the stroke patients showed significantly poorer performances compared with the population averages (mean z-score <0), and some of the subtests revealed abnormal performances in attention-, visuospatial function-, memory-, and frontal/executive function-related tasks (mean z-score <-1). The patients with the presence of a lesion in the right posterior intermediate lobe of the cerebellum showed a poorer performance in the subtests evaluating the executive function including the Korean-version Stroop Test (p=0.04), the Digit Symbol Coding Test (p=0.01), and the Korean-version Trail Making Test (p=0.02) compared with the patients without that lesion.

CONCLUSION

The present study confirms that the cerebellar stroke affects the neuropsychological functioning which is associated with the anatomical site of stroke.

摘要

目的

探讨小脑卒中患者神经心理缺陷的解剖学关联。

方法

我们筛选了2012年10月至2016年11月期间入住国家康复中心的小脑卒中患者。纳入接受了首尔神经心理筛查量表(SNSB)或SNSB-II神经心理测试的小脑卒中患者。根据卒中类型(出血性与缺血性)和部位(右/左前叶、右/左后中间叶、右/左后外侧叶和蚓部)比较神经心理功能能力。计算平均z分数以比较患者表现与总体平均值。

结果

26例患者(15例缺血性卒中和11例出血性卒中),平均年龄54.8±16.6岁,在卒中后8.8±9.2个月接受评估。未观察到卒中类型对神经心理功能的差异。与总体平均值相比,所有卒中患者的数字子测试表现均明显较差(平均z分数<0),并且一些子测试在注意力、视觉空间功能、记忆和额叶/执行功能相关任务中显示出异常表现(平均z分数<-1)。与无小脑右后中间叶病变的患者相比,小脑右后中间叶有病变的患者在评估执行功能的子测试中表现较差,包括韩语版斯特鲁普测试(p=0.04)、数字符号编码测试(p=0.01)和韩语版连线测试(p=0.02)。

结论

本研究证实小脑卒中会影响与卒中解剖部位相关的神经心理功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6767/5773435/a2a0ed9ea366/arm-41-924-g001.jpg

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