Elisabeth-Tweesteden Hospital, Department of Neurology, Tilburg, The Netherlands.
University of Groningen, Department of Clinical and Developmental Neuropsychology, Groningen, The Netherlands.
PLoS One. 2019 Mar 15;14(3):e0213725. doi: 10.1371/journal.pone.0213725. eCollection 2019.
Behavioural changes after stroke might be explained by social cognition impairments. The aim of the present study was to investigate whether performances on social cognition tests (including emotion recognition, Theory of Mind (ToM), empathy and behaviour regulation) were associated with behavioural deficits (as measured by proxy ratings) in a group of patients with relatively mild stroke.
Prospective cohort study in which 119 patients underwent neuropsychological assessment with tests for social cognition (emotion recognition, ToM, empathy, and behaviour regulation) 3-4 years post stroke. Test scores were compared with scores of 50 healthy controls. Behavioural problems were assessed with the Dysexecutive Questionnaire (DEX) self rating and proxy rating scales. Pearson correlations were used to determine the relationship between the social cognition measures and DEX scores.
Patients performed significantly worse on emotion recognition, ToM and behaviour regulation tests than controls. Mean DEX-self score did not differ significantly from the mean DEX-proxy score. DEX-proxy ratings correlated with tests for emotion recognition, empathy, and behavioural regulation (lower scores on these items were associated with more problems on the DEX-proxy scale).
Social cognition impairments are present in the long term after stroke, even in a group of mildly affected stroke patients. Most of these impairments also turned out to be associated with a broad range of behavioural problems as rated by proxies of the patients. This strengthens the proposal that social cognition impairments are part of the underlying mechanism of behavioural change. Since tests for social cognition can be administered in an early stage, this would allow for timely identification of patients at risk for behavioural problems in the long term.
脑卒中后行为改变可能与社会认知障碍有关。本研究旨在调查一组轻度脑卒中患者的社会认知测试（包括情绪识别、心理理论（ToM）、共情和行为调节）表现是否与行为缺陷（通过代理评分测量）相关。
前瞻性队列研究，119 例患者在脑卒中后 3-4 年接受神经心理学评估，包括社会认知测试（情绪识别、ToM、共情和行为调节）。将测试得分与 50 名健康对照者的得分进行比较。行为问题采用执行功能障碍问卷（DEX）自评和代理评分量表进行评估。采用 Pearson 相关分析确定社会认知测量与 DEX 评分之间的关系。
患者在情绪识别、ToM 和行为调节测试中的表现明显差于对照组。DEX 自评得分与 DEX 代理得分无显著差异。DEX 代理评分与情绪识别、共情和行为调节测试相关（这些项目的得分越低，与 DEX 代理量表上的问题越多相关）。
即使在轻度脑卒中患者中，脑卒中后也会长期存在社会认知障碍。这些障碍中的大多数也与患者的代理人评定的广泛行为问题相关。这进一步证实了社会认知障碍是行为改变的潜在机制的一部分的观点。由于社会认知测试可以在早期进行，因此可以及时识别有长期行为问题风险的患者。
