Brambilla Michela, Cerasetti Martina, Pepe Fulvio, Pini Elisa, Pomati Simone, Magni Eugenio, Berlingeri Manuela, Pantoni Leonardo
Stroke and Dementia Lab, ''Luigi Sacco" Department of Biomedical and Clinical Sciences, University of Milan, Via Giovanni Battista Grassi 74, 20157 Milano, Italy.
Department of Humanities, University of Urbino Carlo Bo, Urbino, Italy.
Cereb Circ Cogn Behav. 2021 Jul 4;2:100021. doi: 10.1016/j.cccb.2021.100021. eCollection 2021.
BACKGROUND: Cognitive status evaluation is not routine in the acute stroke setting and there is no consensus on which neuropsychological tool is more feasible and informative. The aim of this pilot study was to compare the feasibility and acceptability of two brief cognitive tests, the Montreal Cognitive Assessment (MoCA) and the Oxford Cognitive Screen (OCS), in acute stroke, with a focus on patients' experience, administration time, and the cognitive data obtained. METHODS: Patients with a diagnosis of ischemic or hemorrhagic stroke or of transient ischemic attack admitted to two stroke units were included. The sample consisted of 34 participants (mean age ±SD 71.1 ± 16.1 years, 25 males). Within five days of onset, patients were evaluated by means of the MoCA and OCS by a trained neuropsychologist. RESULTS: Both tests were feasible in the stroke unit setting and had a high level of acceptability by patients. MoCA test was fully completed by 25 patients, OCS by 21 patients. The OCS administration time was longer than that of the MoCA. However, OCS was perceived less demanding than MoCA by patients. Twenty patients completed both the MoCA and the OCS entirely, and only 2 of them did not show any impairment in both tests. Seventeen patients showed at least an impaired domain on the OCS and 15 patients presented with a MoCA global score below cut-off for cognitive impairment. CONCLUSIONS: Our preliminary study did not show a superiority of the OCS over the widely used MoCA, and suggests the need for further validation in larger samples of stroke patients, exploring tests accuracy in detecting cognitive post-stroke impairment.
背景:在急性卒中环境中,认知状态评估并非常规操作,对于哪种神经心理学工具更可行且信息量更大尚无共识。这项试点研究的目的是比较两种简短认知测试,即蒙特利尔认知评估量表(MoCA)和牛津认知筛查量表(OCS)在急性卒中患者中的可行性和可接受性,重点关注患者体验、测试时间以及获得的认知数据。 方法:纳入两个卒中单元收治的诊断为缺血性或出血性卒中或短暂性脑缺血发作的患者。样本包括34名参与者(平均年龄±标准差71.1±16.1岁,25名男性)。在发病五天内,由经过培训的神经心理学家通过MoCA和OCS对患者进行评估。 结果:两种测试在卒中单元环境中均可行,且患者接受度较高。25名患者完成了MoCA测试,21名患者完成了OCS测试。OCS的测试时间比MoCA长。然而,患者认为OCS比MoCA要求更低。20名患者完整完成了MoCA和OCS测试,其中只有2名患者在两项测试中均未显示任何损伤。17名患者在OCS上至少有一个受损领域,15名患者的MoCA总体得分低于认知障碍临界值。 结论:我们的初步研究未显示OCS优于广泛使用的MoCA,并表明需要在更大样本的卒中患者中进行进一步验证,探索测试在检测卒中后认知障碍方面的准确性。
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