Quinn Terence J, Taylor-Rowan Martin, Elliott Emma, Drozdowska Bogna, McMahon David, Broomfield Niall M, Barber Mark, MacLeod Mary Joan, Cvoro Vera, Byrne Anthony, Ross Sarah, Crow Jennifer, Slade Peter, Dawson Jesse, Langhorne Peter
Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
Department Clinical Psychology and Psychological Therapies, University of East Anglia, United Kingdom.
Cereb Circ Cogn Behav. 2022 Jan 22;3:100042. doi: 10.1016/j.cccb.2022.100042. eCollection 2022.
Cognitive and mood problems have been highlighted as priorities in stroke research and guidelines recommend early screening. However, there is limited detail on the preferred approach.We aimed to (1) determine the optimal methods for evaluating psychological problems that pre-date stroke; (2) assess the test accuracy, feasibility and acceptability of brief cognitive and mood tests used at various time-points following stroke; (3) describe temporal changes in cognition and mood following stroke and explore predictors of change.
We established a multi-centre, prospective, observational cohort with acute stroke as the inception point - Assessing Post-stroke Psychology Longitudinal Evaluation (APPLE). We approached patients admitted with stroke or transient ischaemic attack (TIA) from 11 different hospital sites across the United Kingdom. Baseline demographics, clinical, functional, cognitive, and mood data were collected. Consenting stroke survivors were followed up with more extensive evaluations of cognition and mood at 1, 6, 12 and 18 months.
Continuous recruitment was from February 2017 to February 2019. With 357 consented to full follow-up. Eighteen-month assessments were completed in September 2020 with permissions in-place for longer term in-person or electronic follow-up. A qualitative study has been completed, and a participant sample biobank and individual participant database are both available.
The APPLE study will provide guidance on optimal tool selection for cognitive and mood assessment both before and after stroke, as well as information on prognosis and natural history of neuropsychological problems in stroke. The study data, neuroimaging and tissue biobank are all available as a resource for future research.
认知和情绪问题在中风研究中被视为重点，指南建议进行早期筛查。然而，关于首选方法的详细信息有限。我们旨在：（1）确定评估中风前心理问题的最佳方法；（2）评估中风后不同时间点使用的简短认知和情绪测试的测试准确性、可行性和可接受性；（3）描述中风后认知和情绪的时间变化，并探索变化的预测因素。
我们建立了一个以急性中风为起始点的多中心、前瞻性观察队列——中风后心理纵向评估（APPLE）。我们联系了英国11个不同医院的中风或短暂性脑缺血发作（TIA）患者。收集了基线人口统计学、临床、功能、认知和情绪数据。同意参与的中风幸存者在1、6、12和18个月时接受了更广泛的认知和情绪评估。
2017年2月至2019年2月持续招募患者。357人同意进行全面随访。2020年9月完成了18个月的评估，并获得了长期面对面或电子随访的许可。一项定性研究已经完成，并且有参与者样本生物库和个体参与者数据库。
APPLE研究将为中风前后认知和情绪评估的最佳工具选择提供指导，以及中风后神经心理问题的预后和自然史信息。研究数据、神经影像学和组织生物库均可作为未来研究的资源。
