Jung Hyunwoo, Jeong Jae-Gyeong, Cheong Youn-Soo, Nam Tae-Woo, Kim Ju-Hyun, Park Chan-Hee, Park Eunhee, Jung Tae-Du
Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Korea.
Department of Rehabilitation Medicine, Kyungpook National University Chilgok Hospital, Daegu 41404, Korea.
J Clin Med. 2021 Dec 7;10(24):5728. doi: 10.3390/jcm10245728.
: To determine the effectiveness of computer-assisted cognitive rehabilitation and compare the patterns of cognitive function recovery occurring in both traumatic brain injury (TBI) and stroke. A total of 62 patients were finally enrolled, consisting of 30 with TBI and 32 with stroke. The patients received 30 sessions of computer-assisted cognitive rehabilitation (Comcog) five times per week. Each session lasted for 30 min. Before and immediately after cognitive rehabilitation, all patients were evaluated by computerized neuropsychological test (CNT), Mini-Mental State Examination (MMSE), and modified Barthel index (MBI). We analyzed the differences between pre- and post-cognitive rehabilitation in each TBI and stroke group. Significant differences were observed in MMSE, MBI, and some CNT contents, including digit span forward, verbal learning, verbal learning delayed recall, visual span forward, visual span backward, visual learning, trail making test A and B, and intelligence quotient (IQ) in the TBI group ( < 0.05). In the stroke group, in addition to significant differences that appeared in the TBI group, additional significant differences in the digit span backward, visual learning delayed recall, auditory continuous performance test (CPT), visual CPT, and card sorting test. We compared the difference values at pre- and post-cognitive rehabilitation for cognitive recovery between the TBI and stroke groups. All contents, except the digital span forward, visual learning, word-color test, and MMSE, had greater mean values in the stroke group; and thus, statistically significant higher values were observed in the visual span forward and card sorting test ( < 0.05). Most evaluation results showed improvement and the evaluation between the TBI and stroke groups also showed significant differences in cognitive functions in addition to more CNT contents, which significantly change in the stroke group. The stroke group showed a high difference value in most CNT contents. Therefore, those with stroke in the focal brain region tend to have better cognitive function recovery after a computer-assisted cognitive rehabilitation than those with TBI, which could cause diffuse brain damage and post-injury inflammation.
为确定计算机辅助认知康复的有效性,并比较创伤性脑损伤(TBI)和中风患者认知功能恢复的模式。最终共纳入62例患者,其中30例为TBI患者,32例为中风患者。患者每周接受5次,共30节计算机辅助认知康复(Comcog)课程。每次课程持续30分钟。在认知康复前后,所有患者均通过计算机神经心理测试(CNT)、简易精神状态检查表(MMSE)和改良巴氏指数(MBI)进行评估。我们分析了每个TBI组和中风组认知康复前后的差异。在TBI组中,MMSE、MBI和一些CNT内容存在显著差异,包括顺背数字广度、言语学习、言语学习延迟回忆、顺向视觉广度、逆向视觉广度、视觉学习、连线测验A和B以及智商(<0.05)。在中风组中,除了TBI组出现的显著差异外,在倒背数字广度、视觉学习延迟回忆、听觉持续性操作测验(CPT)、视觉CPT和卡片分类测验中也存在额外的显著差异。我们比较了TBI组和中风组认知康复前后认知恢复的差值。除了顺背数字广度、视觉学习、颜色词测验和MMSE外,中风组所有内容的平均值均更高;因此,在顺向视觉广度和卡片分类测验中观察到具有统计学意义的更高值(<0.05)。大多数评估结果显示有改善,并且TBI组和中风组之间的评估还显示,除了更多在中风组有显著变化的CNT内容外,认知功能也存在显著差异。中风组大多数CNT内容的差值较高。因此,与可能导致弥漫性脑损伤和损伤后炎症的TBI患者相比,局灶性脑区中风患者在接受计算机辅助认知康复后往往具有更好的认知功能恢复。