Neurology Department, Centre Hospitalier Wallonie picarde, 51 rue des sports, 7500 Tournai, Belgium.
Neurology Department, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
J Neurol Sci. 2022 Aug 15;439:120296. doi: 10.1016/j.jns.2022.120296. Epub 2022 May 27.
Smoking is a well-established risk factor for strokes, leading to a high incidence of cognitive deficits. Since the impact of cognitive impairment on the effectiveness of interventions for smoking cessation is not yet known, we considered important to assess it.
We compared, from April 2012 to November 2015, the success rate of quitting smoking in two groups of acutely hospitalised adult smokers. The first group consisted of stroke patients (SP, n = 54) with lesions confirmed by cerebral imaging. The second used as a control group (NSP, n = 38), included patients hospitalised for any reason other than stroke and characterised by normal global cognition. All participants were assessed twice, in acute phase (T0) and 3 months later (T1), using exhaled carbon monoxide (CO) and several questionnaires.
At T1, we observed in SP group an inverse correlation between the Montreal Cognitive Assessment (MoCA) and CO (r = -0.33, p = 0.015). Amongst patients who continued smoking, a higher increase in CO between T0 and T1 was observed in SP group (average 20 ± 15, p < 0.001) than NSP (average 9 ± 13, p = 0.002).
The inverse correlation between CO and cognitive parameters at T1 in SP group suggests an increased susceptibility to tobacco dependency in case of residual cognitive impairment. The global cognitive assessment should thus be taken into consideration when providing assistance with quitting smoking, especially in case of stroke patients.
吸烟是中风的一个既定危险因素，导致认知功能缺陷的发病率很高。由于认知障碍对戒烟干预效果的影响尚不清楚，我们认为评估这一点很重要。
我们比较了 2012 年 4 月至 2015 年 11 月期间两组急性住院成年吸烟者戒烟成功率。第一组为有脑影像学证实病变的中风患者（SP 组，n=54）。第二组为对照组（NSP 组，n=38），包括因中风以外任何原因住院且整体认知正常的患者。所有参与者均在急性期（T0）和 3 个月后（T1）两次进行呼气一氧化碳（CO）和多项问卷评估。
在 T1 时，我们观察到 SP 组蒙特利尔认知评估（MoCA）与 CO 之间呈负相关（r=-0.33，p=0.015）。在继续吸烟的患者中，SP 组 CO 在 T0 至 T1 之间的升高幅度高于 NSP 组（平均 20±15，p<0.001）。
SP 组 T1 时 CO 与认知参数之间的负相关表明，在残留认知障碍的情况下，对烟草依赖的易感性增加。因此，在提供戒烟帮助时应考虑整体认知评估，尤其是在中风患者中。
