Yan Zhijie, Xu Shuo, Wei Dongshuai, He Xinyuan, Li Chong, Zhang Yongli, Chen Mengye, Zhang Jingna, Li Xiaofang, Yang Qing, Jia Jie
Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Department of Rehabilitation Medicine, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
Front Psychol. 2022 Oct 20;13:896095. doi: 10.3389/fpsyg.2022.896095. eCollection 2022.
The cognitive level of post-stroke aphasia (PSA) patients is generally lower than non-aphasia patients, and cognitive impairment (CI) affects the outcome of stroke. However, for different types of PSA, what kind of cognitive assessment methods to choose is not completely clear. We investigated the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), and the Non-language-based Cognitive Assessment (NLCA) to observe the evaluation effect of CI in patients with fluent aphasia (FA) and non-fluent aphasia (NFA).
92 stroke patients were included in this study. Demographic and clinical data of the stroke group were documented. The language and cognition were evaluated by Western Aphasia Battery (WAB), MoCA, MMSE, and NLCA. PSA were divided into FA and NFA according to the Chinese aphasia fluency characteristic scale. Pearson's product-moment correlation coefficient test and multiple linear regression analysis were performed to explore the relationship between the sub-items of WAB and cognitive scores. The classification rate of CI was tested by Pearson's Chi-square test or Fisher's exact test.
The scores of aphasia quotient (AQ), MoCA, MMSE, and NLCA in NFA were lower than FA. AQ was positively correlated with MoCA, MMSE, and NLCA scores. Stepwise multiple linear regression analysis suggested that naming explained 70.7% of variance of MoCA and 79.9% of variance of MMSE; comprehension explained 46.7% of variance of NLCA. In the same type of PSA, there was no significant difference in the classification rate. The classification rate of CI in NFA by MoCA and MMSE was higher than that in FA. There was no significant difference in the classification rate of CI between FA and NFA by NLCA.
MoCA, MMSE, and NLCA can be applied in FA. NLCA is recommended for NFA.
脑卒中后失语（PSA）患者的认知水平通常低于非失语患者，且认知障碍（CI）会影响脑卒中的预后。然而，对于不同类型的PSA，选择何种认知评估方法尚不完全明确。我们研究了蒙特利尔认知评估量表（MoCA）、简易精神状态检查表（MMSE）和非语言认知评估（NLCA），以观察其对流利性失语（FA）和非流利性失语（NFA）患者CI的评估效果。
本研究纳入92例脑卒中患者。记录脑卒中组的人口统计学和临床数据。采用西方失语成套测验（WAB）、MoCA、MMSE和NLCA对语言和认知进行评估。根据汉语失语流利性特征量表将PSA分为FA和NFA。采用Pearson积矩相关系数检验和多元线性回归分析，探讨WAB各子项与认知得分之间的关系。采用Pearson卡方检验或Fisher精确检验对CI的分类率进行检验。
NFA患者的失语商（AQ）、MoCA、MMSE和NLCA得分均低于FA患者。AQ与MoCA、MMSE和NLCA得分呈正相关。逐步多元线性回归分析表明，命名解释了MoCA方差的70.7%和MMSE方差的79.9%；理解解释了NLCA方差的46.7%。在同一类型的PSA中，分类率无显著差异。MoCA和MMSE对NFA患者CI的分类率高于FA患者。NLCA对FA和NFA患者CI的分类率无显著差异。
MoCA、MMSE和NLCA均可应用于FA患者。对于NFA患者，推荐使用NLCA。
