Abderrakib Anissa, Ligot Noemie, Naeije Gilles
Department of Neurology, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), Brussels, Belgium.
Front Neurol. 2022 Aug 11;13:906293. doi: 10.3389/fneur.2022.906293. eCollection 2022.
The cerebellum modulates both motor and cognitive behaviors, and a cerebellar cognitive affective syndrome (CCAS) was described after a cerebellar stroke in 1998. Yet, a CCAS is seldom sought for, due to a lack of practical screening scales. Therefore, we aimed at assessing both the prevalence of CCAS after cerebellar acute vascular lesion and the yield of the CCAS-Scale (CCAS-S) in an acute stroke setting.
All patients admitted between January 2020 and January 2022 with acute onset of a cerebellar ischemic or haemorrhagic first stroke at the CUB-Hôpital Erasme and who could be evaluated by the CCAS-S within a week of symptom onset were included.
Cerebellar acute vascular lesion occurred in 25/1,580 patients. All patients could complete the CCAS-S. A definite CCAS was evidenced in 21/25 patients. Patients failed 5.2 ± 2.12 items out of 8 and had a mean raw score of 68.2 ± 21.3 (normal values 82-120). Most failed items of the CCAS-S were related to verbal fluency, attention, and working memory.
A definite CCAS is present in almost all patients with acute cerebellar vascular lesions. CCAS is efficiently assessed by CCAS-S at bedside tests in acute stroke settings. The magnitude of CCAS likely reflects a cerebello-cortical diaschisis.
小脑调节运动和认知行为，1998年首次描述了小脑卒中后的小脑认知情感综合征（CCAS）。然而，由于缺乏实用的筛查量表，很少有人寻求诊断CCAS。因此，我们旨在评估小脑急性血管病变后CCAS的患病率以及CCAS量表（CCAS-S）在急性卒中环境中的应用效果。
纳入2020年1月至2022年1月期间在布鲁塞尔自由大学厄拉斯姆斯医院首次发生急性小脑缺血性或出血性卒中且在症状发作一周内可通过CCAS-S进行评估的所有患者。
1580例患者中有25例发生小脑急性血管病变。所有患者均能完成CCAS-S评估。25例患者中有21例确诊为CCAS。患者在8项测试中平均答错5.2±2.12项，原始平均得分为68.2±21.3（正常值为82 - 120）。CCAS-S中大多数答错的项目与语言流畅性、注意力和工作记忆有关。
几乎所有急性小脑血管病变患者都存在确诊的CCAS。在急性卒中环境中，床边测试通过CCAS-S能够有效评估CCAS。CCAS的严重程度可能反映了大脑皮质与小脑之间的失联络。
