Cramer Steven C, Richards Lorie G, Bernhardt Julie, Duncan Pamela
Department of Neurology, University of California, Los Angeles (S.C.C.).
California Rehabilitation Institute, Los Angeles (S.C.C.).
Stroke. 2023 Jan;54(1):5-9. doi: 10.1161/STROKEAHA.122.041775. Epub 2022 Dec 21.
Cognition is a central feature of human existence and brain function. Cognitive deficits are common after stroke and may strongly impact functional outcome. Recent years have seen substantial advances in our understanding of cognitive functions in the healthy state, and this new body of knowledge promises to open new avenues for understanding and treating poststroke impairments, including cognitive deficits. The 5 reviews in this Focused Update from an international cast of experts provide excellent updates on cognitive syndromes that commonly contribute to poststroke disability: neglect, aphasia, apraxia, loss of executive function, and memory disorders. Cognitive impairment remains a major source of morbidity after stroke; these reviews approach this problem by considering clinical presentations, pathophysiology, measurement tools, and treatment approaches. In doing so, they highlight a number of key questions and critical gaps. A number of issues emerge as common across cognitive domains poststroke and are summarized herein. There is a need for improved methods to measure cognitive impairments, as well as for improved insights into pathophysiology of symptom onset and mechanisms of recovery after stroke, including validated biomarkers. These 5 state of the art summaries are sure to prove useful toward these goals.
认知是人类生存和脑功能的核心特征。认知缺陷在中风后很常见,可能会对功能结局产生重大影响。近年来,我们对健康状态下认知功能的理解取得了重大进展,这一新知识体系有望为理解和治疗中风后损伤(包括认知缺陷)开辟新途径。本次重点更新中的5篇综述由国际专家撰写,出色地更新了通常导致中风后残疾的认知综合征:忽视、失语症、失用症、执行功能丧失和记忆障碍。认知障碍仍然是中风后发病的主要来源;这些综述通过考虑临床表现、病理生理学、测量工具和治疗方法来探讨这一问题。在此过程中,它们突出了一些关键问题和重大差距。中风后认知领域出现了一些共同问题,在此进行总结。需要改进测量认知障碍的方法,以及加深对中风后症状发作的病理生理学和恢复机制(包括经过验证的生物标志物)的理解。这5篇最新技术综述肯定会对实现这些目标有所帮助。