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急性单侧前庭功能丧失的认知功能。

Cognitive functions in acute unilateral vestibular loss.

机构信息

Department of Neurology, Ege University Medical School, Bornova, 35100, Izmir, Turkey.

Department of Cognitive Neurology, Ege University Institute of Health Sciences, Izmir, Turkey.

出版信息

J Neurol. 2020 Dec;267(Suppl 1):153-159. doi: 10.1007/s00415-020-09829-w. Epub 2020 May 21.

Abstract

Cognitive deficits mainly involving visuospatial functions have been defined in patients with bilateral and even unilateral vestibular loss (UVL). We compared the cognitive test results of 21 patients with acute UVL with age- and education-matched healthy controls. The diagnosis of UVL was based on the clinical findings, a normal magnetic resonance imaging with diffusion-weighted sequence and canal paresis on the affected side on caloric testing. Cognitive tests assessing visuospatial functions (Benton's Judgment of Line Orientation test, Verbal and non-verbal Cancellation tests, Rey-Osterrieth Complex Figure test) and global mental status, verbal memory, learning, retention of information, and recalling (Mini Mental State Examination, Oktem Verbal Memory Process Test, Forward and Backward Digit span) were used in addition to Beck depression and Anxiety inventories. Abnormalities in verbal and non-verbal cancellation tests (p < 0.005), Benton's Judgment of Line Orientation test (p = 0.042) and backward digit span (p = 0.029) was found. A very prominent difference regarding Beck depression (p = 0.012) and anxiety inventories (p < 0.001) was present. On multiple regression analysis, the abovementioned cognitive tests' results lost their statistical significance (p > 0.05) when depression and anxiety scores were taken into consideration. The severity of canal paresis was found to be correlated with Benton's Judgment of Line Orientation test (p = 0.008, r = - 0.5639) and Rey-Osterrieth Complex Figure test copying scores (p = 0.029, r = - 0.477). Comparison of all the results in right- and left-sided lesions did not reveal a significant difference (p > 0.05). Vestibular patients are prone to develop anxiety, and depression. Deficits in visuospatial functions, mental manipulation, psychomotor speed and short-term memory detected in our patients with acute UVL seem to be enhanced by accompanying anxiety and depression. The extent of vestibular dysfunction was correlated with the severity of deficits in visuospatial skills. Lesion side did not cause alterations in cognitive or emotional status.

摘要

认知缺陷主要涉及视空间功能,已在双侧甚至单侧前庭损失(UVL)患者中定义。我们比较了 21 例急性 UVL 患者与年龄和教育相匹配的健康对照组的认知测试结果。UVL 的诊断基于临床发现、磁共振成像扩散加权序列正常和冷热试验受累侧的管麻痹。除了贝克抑郁和焦虑量表外,还使用了评估视空间功能(本顿线定向判断测试、言语和非言语取消测试、雷奥斯特里希复杂图形测试)和整体精神状态、言语记忆、学习、信息保留和回忆(简明精神状态检查、奥克坦言语记忆过程测试、顺背和倒背数字广度)的认知测试。发现言语和非言语取消测试(p < 0.005)、本顿线定向判断测试(p = 0.042)和倒背数字广度(p = 0.029)异常。贝克抑郁(p = 0.012)和焦虑量表(p < 0.001)差异非常显著。多元回归分析显示,当考虑抑郁和焦虑评分时,上述认知测试结果失去统计学意义(p > 0.05)。管麻痹的严重程度与本顿线定向判断测试(p = 0.008,r = -0.5639)和雷奥斯特里希复杂图形测试复制分数(p = 0.029,r = -0.477)相关。左右侧病变的所有结果比较均无显著差异(p > 0.05)。前庭患者容易出现焦虑和抑郁。我们发现急性 UVL 患者存在视空间功能、心理操作、运动速度和短期记忆缺陷,这些缺陷似乎因伴随的焦虑和抑郁而加重。前庭功能障碍的严重程度与视空间技能缺陷的严重程度相关。病变侧未引起认知或情绪状态的改变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4f4/7718191/65c2e9810501/415_2020_9829_Fig1_HTML.jpg

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