Aben Hugo P, Visser-Meily Johanna Ma, Biessels Geert Jan, de Kort Paul Lm, Spikman Jacoba M
Department of Neurology, Elisabeth Tweesteden Hospital, Tilburg, the Netherlands.
Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands.
Eur Stroke J. 2020 Sep;5(3):262-270. doi: 10.1177/2396987320918132. Epub 2020 Apr 14.
Deficits of emotion recognition after ischemic stroke are often overlooked by clinicians, and are mostly not spontaneously reported by patients. However, impaired emotion recognition after stroke negatively affects the ability to return to work and the quality of life. It is still unknown how often impairments of emotion recognition occur shortly after ischemic stroke. We aimed to estimate the occurrence of impaired emotion recognition after ischemic stroke and to characterise these patients with impaired emotion recognition.
Two hundred thirty patients were included, derived from a prospective study of cognitive recovery. Five weeks after ischemic stroke a neuropsychological assessment was performed, including an emotion recognition task (i.e. Ekman 60-faces test). Emotion recognition was regarded as impaired if the total score was below the fifth percentile for a large independent reference sample.
Emotion recognition was impaired in 33.5% of patients. Patients with impaired emotion recognition were more likely to have an abnormal Montreal Cognitive Assessment during hospitalisation, and 5 weeks after their stroke, a higher proportion of them had a vascular cognitive disorder (VCD). Even 20% of patients without VCD had impaired emotion recognition. Emotion recognition was often impaired after ischemic stroke. This is clinically relevant, since impaired emotion recognition negatively impacts social functioning. Even when there was no cognitive disorder in traditional cognitive domains, emotion recognition was impaired in 1 out of 5 patients. Clinicians should systematically ask patients and their caregivers about deficits in emotion recognition, and, if needed, test for these deficits.
缺血性中风后情感识别缺陷常被临床医生忽视，且大多不会被患者主动报告。然而，中风后情感识别受损会对重返工作能力和生活质量产生负面影响。目前尚不清楚缺血性中风后情感识别障碍的发生频率。我们旨在评估缺血性中风后情感识别障碍的发生率，并对这些情感识别受损的患者进行特征描述。
纳入了230名患者，这些患者来自一项关于认知恢复的前瞻性研究。缺血性中风后5周进行了神经心理学评估，包括一项情感识别任务（即艾克曼60面孔测试）。如果总分低于一个大型独立参考样本的第五百分位数，则认为情感识别受损。
33.5%的患者存在情感识别障碍。情感识别受损的患者在住院期间及中风后5周更有可能蒙特利尔认知评估结果异常，且他们中血管性认知障碍（VCD）的比例更高。甚至20%没有VCD的患者也存在情感识别障碍。缺血性中风后情感识别常常受损。这具有临床相关性，因为情感识别受损会对社会功能产生负面影响。即使在传统认知领域没有认知障碍时，五分之一的患者仍存在情感识别障碍。临床医生应系统地询问患者及其护理人员关于情感识别缺陷的情况，如有必要，对这些缺陷进行检测。
