Morsund Åse Hagen, Ellekjær Hanne, Gramstad Arne, Reiestad Magnus Tallaksen, Midgard Rune, Sando Sigrid Botne, Jonsbu Egil, Næss Halvor
Department of Neurology, Møre and Romsdal Health Trust, Molde hospital, Molde and Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim and Stroke Unit, Department of Internal Medicine, St Olavs hospital, University Hospital of Trondheim, Norway.
Stroke Res Treat. 2019 Apr 1;2019:2527384. doi: 10.1155/2019/2527384. eCollection 2019.
To study the prevalence of cognitive and emotional impairment following a minor ischemic stroke compared to an age-matched group with non-ST-elevation myocardial infarction (NSTEMI).
We included patients aged 18-70 years with a minor ischemic stroke defined as modified Rankin Scale (mRS) 0-2 at day 7 or at discharge if before and age-matched NSTEMI patients with the same functional mRS. We applied a selection of cognitive tests and the patients completed a questionnaire comprising of Hospital Anxiety and Depression scale (HADS) and Fatigue Severity Scale (FSS) at follow-up 12 months after the vascular event. Results of cognitive tests were also compared to normative data.
325 ischemic stroke and 144 NSTEMI patients were included. There was no significant difference in cognitive functioning between ischemic stroke and NSTEMI patients. Minor stroke patients and to a lesser extent NSTEMI patients scored worse on more complex cognitive functions including planning and implementation of activities compared to validated normative data. For the minor stroke patients the location of the ischemic lesion had no influence on the result. The prevalence of anxiety, depression, and fatigue was significantly higher in the stroke group compared to the NSTEMI group. Depression was independently associated with reduced cognitive function.
Minor ischemic stroke patients, and to lesser degree NSTEMI patients, had reduced cognitive function compared to normative data, especially executive functioning, on 12-month follow-up. The difference in cognitive function between stroke and NSTEMI patients was not significant. Depression was associated with low scores on cognitive tests highlighting the need to adequately address emotional sequelae when considering treatment options for cognitive disabilities.
与年龄匹配的非ST段抬高型心肌梗死（NSTEMI）组相比，研究轻度缺血性卒中后认知和情感障碍的患病率。
我们纳入了年龄在18 - 70岁之间的轻度缺血性卒中患者，轻度缺血性卒中定义为第7天改良Rankin量表（mRS）评分为0 - 2分，或在出院时（前提是出院时间早于第7天）评分为0 - 2分，以及年龄匹配的具有相同功能mRS评分的NSTEMI患者。我们采用了一系列认知测试，患者在血管事件发生12个月后的随访中完成了一份包含医院焦虑抑郁量表（HADS）和疲劳严重程度量表（FSS）的问卷。认知测试结果也与标准数据进行了比较。
纳入了325例缺血性卒中和144例NSTEMI患者。缺血性卒中和NSTEMI患者在认知功能方面无显著差异。与经过验证的标准数据相比，轻度卒中患者以及在较小程度上NSTEMI患者在包括活动规划和实施在内的更复杂认知功能方面得分更低。对于轻度卒中患者，缺血性病变的位置对结果没有影响。与NSTEMI组相比，卒中组焦虑、抑郁和疲劳的患病率显著更高。抑郁与认知功能下降独立相关。
在12个月的随访中，与标准数据相比，轻度缺血性卒中患者以及在较小程度上NSTEMI患者的认知功能有所下降，尤其是执行功能。卒中和NSTEMI患者在认知功能上的差异不显著。抑郁与认知测试得分低相关，这突出表明在考虑认知障碍的治疗方案时，需要充分解决情感后遗症问题。
