Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China.
Institute of Neuroscience, Soochow University, Suzhou, 215123, China.
Sleep Breath. 2019 Jun;23(2):455-462. doi: 10.1007/s11325-018-1709-4. Epub 2018 Aug 25.
Post-stroke cognitive impairment (PSCI) is common among stroke survivors, although its risk factors are not well understood. Here, we assessed cognitive function in patients within 14 days after minor stroke and investigated the risk factors of PSCI, including sleep-related factors.
Patients with minor acute ischemic stroke (n = 86) were continuously recruited from November 2015 to October 2016. Demographic and clinical data were collected, and cognitive assessment and polysomnography were performed. Based on their cognitive performance, stroke patients were divided into PSCI and no PSCI groups. Age-, sex-, and education-matched participants (n = 36) were included as a healthy control (HC) group.
Stroke patients showed impairments in multiple cognitive domains relative to HC participants (p < 0.01). Among stroke patients, the prevalence of PSCI and obstructive sleep apnea was 81.4 and 74.4%, respectively. Impairments in attention and working memory (87.1%) and executive function (84.3%) were the most common among stroke patients. Compared with no PSCI patients, PSCI patients showed a higher prevalence of obstructive sleep apnea (50.0 vs. 80.0%, p = 0.030) and shorter total sleep time (435.1 ± 104.0 vs. 347.3 ± 98.1 min, p = 0.002). Logistic regression analysis showed that education duration, total sleep time, and lowest SaO were independent risk factors for PSCI.
The prevalence of PSCI is high after minor ischemic stroke. In particular, attention and working memory and executive function are most commonly impaired. Although the risk factors for PSCI are numerous, shorter total sleep time and degree of hypoxia at night warrant further attention.
卒中后认知障碍（PSCI）在卒中幸存者中较为常见，但其危险因素尚不清楚。在此，我们评估了发病后 14 天内的小卒中患者的认知功能，并调查了 PSCI 的危险因素，包括与睡眠相关的因素。
2015 年 11 月至 2016 年 10 月连续招募了 86 例小急性缺血性卒中患者。收集了人口统计学和临床数据，并进行了认知评估和多导睡眠图检查。根据认知表现，将卒中患者分为 PSCI 组和非 PSCI 组。选取年龄、性别和教育程度相匹配的参与者（n=36）作为健康对照组（HC）。
卒中患者在多个认知领域的表现均逊于 HC 参与者（p<0.01）。在卒中患者中，PSCI 和阻塞性睡眠呼吸暂停的患病率分别为 81.4%和 74.4%。注意力和工作记忆（87.1%）以及执行功能（84.3%）障碍在卒中患者中最为常见。与非 PSCI 患者相比，PSCI 患者的阻塞性睡眠呼吸暂停患病率更高（50.0%比 80.0%，p=0.030），总睡眠时间更短（435.1±104.0 分钟比 347.3±98.1 分钟，p=0.002）。Logistic 回归分析显示，教育年限、总睡眠时间和最低 SaO2 是 PSCI 的独立危险因素。
小缺血性卒中后 PSCI 的患病率较高。特别是注意力、工作记忆和执行功能障碍最为常见。尽管 PSCI 的危险因素众多，但总睡眠时间较短和夜间缺氧程度更值得关注。
