Department of Graduate School, Hebei Medical University, Shijiazhuang, 050000, Heibei, China.
Department of Neurology, Hebei General Hospital, Shijiazhuang, 050051, Heibei, China.
Acta Neurol Belg. 2021 Dec;121(6):1707-1714. doi: 10.1007/s13760-020-01479-z. Epub 2020 Nov 21.
Visuoexecutive impairment is common among acute ischemic stroke patients. This study aimed to examine the ability of the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) visuoexecutive subtests to detect visuoexecutive abnormality in acute ischemic stroke patients and to identify the predictors for their impairments. 336 patients who completed the MMSE and MoCA were enrolled in this study. We compared the proportion of participants with incorrect MoCA visuoexecutive tasks and MMSE pentagon copying. Multivariate logistic regression analysis was used to evaluate the associations between the visuoexecutive dysfunction and demographic and clinical characteristics in the samples. Among all the participants, the MoCA detected more visuoexecutive dysfunction than the MMSE (88.69% vs. 45.83%, respectively; p < 0.001). The predictors identified by the univariate analysis included the factors of gender, age, educational level, smoking, alcohol consumption, Oxfordshire Community Stroke Project (OCSP), previous strokes, initial NIHSS score and number of old lacunar infarctions, while from the multivariate logistic regression analysis, the factors of age, educational level, NIHSS score, previous strokes and number of old lacunar infarctions served as predictive factors for the visuoexecutive impairment in acute stroke patients. In conclusion, visuoexecutive impairment is associated with the factors of the educational level, stroke severity, stroke history and number of old lacunar infarctions. Our findings may guide the clinicians to intervene the risks for the patients at an early stage after stroke and form the basis for good rehabilitation plans.
视空间执行障碍在急性缺血性脑卒中患者中较为常见。本研究旨在探讨蒙特利尔认知评估(MoCA)和简易精神状态检查(MMSE)视空间执行分量表检测急性缺血性脑卒中患者视空间执行异常的能力,并确定其受损的预测因素。本研究纳入了 336 名完成 MMSE 和 MoCA 的患者。我们比较了 MoCA 视空间执行任务和 MMSE 五边形复制错误的参与者比例。采用多变量逻辑回归分析评估了样本中视空间执行功能障碍与人口统计学和临床特征之间的相关性。在所有参与者中,MoCA 检测到的视空间执行功能障碍比 MMSE 多(分别为 88.69%和 45.83%;p<0.001)。单因素分析确定的预测因素包括性别、年龄、教育程度、吸烟、饮酒、牛津社区卒中项目(OCSP)、既往卒中、初始 NIHSS 评分和陈旧腔隙性梗死数量,而多变量逻辑回归分析表明,年龄、教育程度、NIHSS 评分、既往卒中史和陈旧腔隙性梗死数量是急性卒中患者视空间执行障碍的预测因素。结论:视空间执行障碍与教育程度、卒中严重程度、卒中史和陈旧腔隙性梗死数量等因素有关。我们的研究结果可能指导临床医生在卒中后早期对患者进行干预,为制定良好的康复计划提供依据。