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认知主诉及其对退行性小脑疾病患者日常生活的影响。

Cognitive Complaints and Their Impact on Daily Life in Patients with Degenerative Cerebellar Disorders.

机构信息

Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands.

Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.

出版信息

Cerebellum. 2024 Jun;23(3):1042-1052. doi: 10.1007/s12311-023-01607-4. Epub 2023 Oct 2.

Abstract

Cognitive and affective sequelae of cerebellar disease are receiving increased attention, but their actual rate of occurrence remains unclear. Complaints may have a significant impact on patients, affecting social behavior and psychological well-being. This study aims to explore the extent of subjective cognitive and affective symptoms in patients with degenerative ataxias in the Netherlands. An explorative study was set up in a heterogeneous group of degenerative ataxia patients. Self-reported cognition was evaluated in terms of executive functioning and affect (Dysexecutive Questionnaire/DEX), and memory/attention (Cognitive Failures Questionnaire/CFQ). The Daily Living Questionnaire (DLQ) was administered to quantify the impact on daily life. Furthermore, informants completed questionnaires to obtain insight into patients' self-awareness and social cognition (Observable Social Cognition Rating Scale/OSCARS). This study shows that subjective complaints in the domains of (1) executive functioning and/or (2) memory and attention were reported by 29% of all patients (n = 24/84). In addition, more difficulties in daily life in terms of language/comprehension and community/participation were reported, and this was more common for patients with cognitive complaints than those without. Discrepancies between patients and informants about executive functioning were present in both directions. Deficits in social cognition were not identified at the group level, but more social-cognitive problems were observed in patients with more executive problems rated by informants. Taken together, our findings indicate that cognitive complaints are common in patients with degenerative cerebellar disorders and have an impact on daily life functioning. These results may help to increase awareness of cognitive symptoms and their impact in patients with cerebellar ataxia, their significant others, and professional caregivers.

摘要

小脑疾病的认知和情感后遗症受到越来越多的关注,但它们的实际发生率仍不清楚。这些症状可能会对患者造成重大影响,影响其社交行为和心理健康。本研究旨在探讨荷兰退行性共济失调患者主观认知和情感症状的严重程度。在一组异质性退行性共济失调患者中进行了一项探索性研究。通过执行功能和情感(执行功能问卷/DEX)以及记忆/注意力(认知失败问卷/CFQ)来评估自我报告的认知。使用日常生活问卷(DLQ)来量化对日常生活的影响。此外,让知情人填写问卷以了解患者的自我意识和社会认知(可观察社会认知评定量表/OSCARS)。本研究表明,在(1)执行功能和/或(2)记忆和注意力方面,所有患者(n=24/84)中有 29%报告存在主观症状。此外,语言/理解和社区/参与方面的日常生活困难报告更多,并且有认知症状的患者比没有认知症状的患者更为常见。患者和知情人之间在执行功能方面的差异存在于两个方向。在群体水平上未发现社会认知缺陷,但知情人评定的执行问题较多的患者观察到更多的社会认知问题。综上所述,我们的研究结果表明,认知症状在退行性小脑疾病患者中较为常见,并对日常生活功能有影响。这些结果可能有助于提高对小脑共济失调患者认知症状及其影响的认识,包括患者及其重要他人以及专业护理人员。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e027/11102381/5e258409cda5/12311_2023_1607_Fig1_HTML.jpg

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