Yao Jingfan, Liu Xinxin, Liu Qi, Wang Jinfang, Ye Na, Lu Xiao, Zhao Yishuang, Chen Hongyan, Han Zaizhu, Yu Miaoxin, Wang Yu, Liu Gaifen, Zhang Yumei
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Front Neurol. 2020 Sep 30;11:1038. doi: 10.3389/fneur.2020.01038. eCollection 2020.
Non-linguistic cognitive training has been suggested to improve the communication skills of patients with post-stroke aphasia (PSA). However, the association between language and non-linguistic cognitive functions is not fully understood. In this study, we used the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) to evaluate the characteristics of non-linguistic cognitive impairments in Chinese PSA patients. A total of 86 stroke patients were recruited in this study. Language and non-linguistic cognitive impairments were evaluated by the Western Aphasia Battery (WAB) and LOTCA, respectively. The patients were divided into two groups (PSA and non-PSA), and the Chinese norm (the data came from 44 Chinese individuals without neurological disorders in a previous study) was used as the control group. The LOTCA scores were compared among the three groups. Patients in the PSA group were subdivided into the fluent aphasia group (FAG) and the non-FAG according to the Chinese aphasia fluency characteristic scale. The LOTCA scores were also compared between the PSA subdivisions. Potential confounders were adjusted in the analysis of covariance. Partial correlation analysis between the subscores of WAB and LOTCA was also performed. The total LOTCA scores in the PSA group (75.11 ± 17.08) were significantly lower compared with scores in the non-PSA (96.80 ± 7.75, < 0.001) and the control group (97.65 ± 16.24, < 0.001). The PSA group also had lower orientation, visual perception (VP), spatial perception (SP), visuomotor organization, thinking operation, and attention scores. The total LOTCA, orientation, VP, SP, and MP scores were lower in the non-FAG (69.24 ± 18.06, 8.62 ± 5.09, 12.76 ± 2.47, 7.48 ± 3.01, and 9.62 ± 2.25, respectively) compared with the FAG (80.36 ± 14.07, 12.14 ± 3.99, 14.09 ± 1.93, 9.68 ± 3.01, 10.55 ± 1.63, respectively, 's < 0.05). The aphasia quotient was positively correlated with the total score of LOTCA and scores of orientation, VP, SP, and MP ( = 0.710, 0.744, 0.565, 0.597, and 0.616; < 0.001). Compared with stroke patients without aphasia, patients with PSA often have more extensive and serious non-linguistic cognitive impairments. Patients with non-fluent aphasia often present with serious cognitive impairments than those with fluent aphasia, especially the impairments of orientation and SP. Non-linguistic cognitive impairments correlate with language impairments in aphasia.
非语言认知训练已被建议用于改善中风后失语症（PSA）患者的沟通技巧。然而，语言与非语言认知功能之间的关联尚未完全明确。在本研究中，我们使用洛文斯顿作业疗法认知评定量表（LOTCA）来评估中国PSA患者非语言认知障碍的特征。本研究共纳入86例中风患者。语言和非语言认知障碍分别通过西方失语症成套测验（WAB）和LOTCA进行评估。患者被分为两组（PSA组和非PSA组），并将中国常模（数据来自先前一项研究中44名无神经疾病的中国人）作为对照组。比较三组的LOTCA评分。根据中国失语症流利度特征量表，将PSA组患者细分为流利性失语组（FAG）和非流利性失语组（non-FAG）。还比较了PSA亚组之间的LOTCA评分。在协方差分析中对潜在混杂因素进行了校正。还进行了WAB和LOTCA子评分之间的偏相关分析。PSA组的LOTCA总分（75.11±17.08）显著低于非PSA组（96.80±7.75，<0.001）和对照组（97.65±16.24，<0.001）。PSA组在定向、视觉感知（VP）、空间感知（SP）、视运动组织、思维操作和注意力评分方面也较低。非流利性失语组的LOTCA总分、定向、VP、SP和MP评分（分别为69.24±18.06、8.62±5.09、12.76±2.47、7.48±3.01和9.62±2.25）低于流利性失语组（分别为80.36±14.07、12.14±3.99、14.09±1.93、9.68±3.01、10.55±1.63，P<0.05）。失语商与LOTCA总分以及定向、VP、SP和MP评分呈正相关（r=0.710、0.744、0.565、0.597和0.616；P<0.001）。与无失语症的中风患者相比，PSA患者通常存在更广泛、更严重的非语言认知障碍。非流利性失语患者比流利性失语患者通常表现出更严重的认知障碍，尤其是定向和SP方面的障碍。非语言认知障碍与失语症中的语言障碍相关。
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