University of South Australia, Adelaide, South Australia, Australia.
University of Adelaide, Adelaide, South Australia, Australia.
Neurorehabil Neural Repair. 2020 Mar;34(3):187-199. doi: 10.1177/1545968320907071. Epub 2020 Feb 24.
Stroke is a leading cause of death and disability. It is a complex and largely heterogeneous condition. Prognosis for variations in impairment and recovery following stroke continues to be challenging and inaccurate, highlighting the need to examine the influence of other currently unknown variables to better predict and understand interindividual differences in stroke impairment and recovery. The concept of "cognitive reserve," a feature of brain function said to moderate the relationship between brain pathology and clinical outcomes, might provide a partial explanation. This review discusses the potential significance of cognitive reserve in the context of stroke, with reference to reduced burden of disability poststroke, health promotion, intervention and secondary prevention of cognitive impairment, ease and challenges of translation into clinical practice, prognosis and prediction of recovery, and clinical decisions and trial stratification. Discussions from the review aim to encourage stroke clinicians and researchers to better consider the role of premorbid, lifestyle-related variables, such as cognitive reserve, in facilitating successful neurological outcomes and recovery following stroke.
中风是导致死亡和残疾的主要原因。它是一种复杂且高度异质的疾病。对于中风后损伤和恢复的变化的预后仍然具有挑战性和不准确,这凸显了需要检查其他目前未知变量的影响,以更好地预测和理解中风损伤和恢复方面的个体间差异。“认知储备”的概念,即大脑功能的一个特征,被认为可以调节脑病理与临床结果之间的关系,这可能提供了部分解释。本综述讨论了认知储备在中风背景下的潜在意义,涉及中风后残疾负担减轻、健康促进、认知障碍的干预和二级预防、转化为临床实践的难易程度和挑战、预后和恢复预测以及临床决策和试验分层。本综述的讨论旨在鼓励中风临床医生和研究人员更好地考虑认知储备等发病前、与生活方式相关的变量在促进中风后成功的神经学结果和恢复方面的作用。