De Luca Rosaria, Manuli Alfredo, De Domenico Carmen, Lo Voi Emanuele, Buda Antonio, Maresca Giuseppa, Bramanti Alessia, Calabrò Rocco Salvatore
IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy.
Medicine (Baltimore). 2019 May;98(19):e15236. doi: 10.1097/MD.0000000000015236.
Post-stroke cognitive impairment occurs frequently in patients with stroke, with a 20% to 80% prevalence. Anxiety is common after stroke, and is associated with a poorer quality of life. The use of standard relaxation techniques in treating anxiety in patients undergoing post-stroke rehabilitation have shown some positive effects, whereas virtual reality seems to have a role in the treatment of anxiety disorders, especially when associated to neurological damage.
A 50-year-old woman, smokers, affected by hypertension and right ischemic stroke in the chronic phase (i.e., after 12 months by cerebrovascular event), came to our observation for a severe anxiety state and a mild cognitive deficit, mainly involving attention and visuo-executive processes, besides a mild left hemiparesis.
Anxiety in a patient with ischemic stroke.
Standard relaxation techniques alone in a common clinical setting or the same psychological approach in an immersive virtual environment (i.e., Computer Assisted Rehabilitation Environment - CAREN).
The patient's cognitive and psychological profile, with regard to attention processes, mood, anxiety, and coping strategies, were evaluated before and after the 2 different trainings. A significant improvement in the functional and behavioral outcomes were observed only at the end of the combined approach.
The immersive virtual reality environment CAREN might be useful to improve cognitive and psychological status, with regard to anxiety symptoms, in post-stroke individuals.
中风后认知障碍在中风患者中频繁发生，患病率为20%至80%。焦虑在中风后很常见，并且与较差的生活质量相关。在中风后康复患者中使用标准放松技术治疗焦虑已显示出一些积极效果，而虚拟现实似乎在焦虑症治疗中发挥作用，尤其是与神经损伤相关时。
一名50岁女性，吸烟者，患有高血压和慢性期（即脑血管事件发生12个月后）右缺血性中风，因严重焦虑状态、轻度认知缺陷（主要涉及注意力和视觉执行过程）以及轻度左侧偏瘫前来我们处就诊。
缺血性中风患者的焦虑症。
在普通临床环境中单独使用标准放松技术，或在沉浸式虚拟环境（即计算机辅助康复环境 - CAREN）中采用相同的心理方法。
在两种不同训练前后评估了患者在注意力过程、情绪、焦虑和应对策略方面的认知和心理状况。仅在联合治疗结束时观察到功能和行为结果有显著改善。
沉浸式虚拟现实环境CAREN可能有助于改善中风后个体焦虑症状方面的认知和心理状态。
