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评估新冠后患者的视空间功能:超越传统范式。

Assessment of visuospatial functions in post-Covid 19 patients: Beyond the traditional paradigm.

机构信息

Laboratory of Clinical Neuropsychology, National Institute of Neurology and Neurosurgery, Manuel Velasco Suarez, Mexico City, Mexico.

Center for Research in Infectious Diseases-CIENI of the National Institute of Respiratory Diseases, Ismael Cosió Villegas, Mexico City, Mexico.

出版信息

Behav Brain Res. 2024 Aug 5;471:115095. doi: 10.1016/j.bbr.2024.115095. Epub 2024 Jun 8.

Abstract

Several studies indicate that some cognitive changes occur after COVID-19. Visuospatial alterations have been reported in 24-40 %. These alterations may be useful as early biomarkers of neurodegenerative disease. Thus, we can emphasize the importance of visuospatial processes in cognition through quantitative and qualitative analysis of performance on the Clock Test (CDT) and the Rey-Osterrieth Complex Figure (FCRO). Our objective was to describe the performance of post COVID 19 patients in visuospatial tests, with different degrees of respiratory impairment and to perform a qualitative analysis of the performance to check its relationship with alterations in attention and executive functions. This will allow highlighting the executive component of the performance of the CDT and ROCF and differentiate patients with possible cognitive impairment. 77 patients with SARS-CoV-2 infection were evaluated (3 months post-infection) with a complete neuropsychological battery and MRI. Overall, there is a significant difference between FCRO and CDT, with FCRO having only 9 % change and CDT having 51.9 % change. Regarding the correlations observed between groups (VM Inv, VM non I and non hospitalized) the highest correlations were observed between Boston with FCRO copy (r=0.497; p=0.001) and with FCRO memory (r=0.429; p=0.001). Comparing the performance between groups by severity, significant differences were observed only in the TMT A (13.706 p=0.001) and B (9.583 p=0.008) tests and in the phonological fluency letter A (13.445 p=0.001), we observed that the group of non-hospitalized patients had a better performance. Neuropsychological deficits often have a direct impact on daily life by affecting the ability to learn and adapt. Thus, a useful strategy for the neuropsychological characterization of post-COVID-19 patients is the qualitative analysis of visuospatial abilities in conjunction with executive functions that cannot be analyzed in isolation.

摘要

几项研究表明,COVID-19 后会发生一些认知变化。已有报道称,24-40%的患者出现视空间改变。这些改变可能作为神经退行性疾病的早期生物标志物有用。因此,我们可以通过对时钟测试(CDT)和 Rey-Osterrieth 复杂图形测试(FCRO)的表现进行定量和定性分析,强调认知过程中视空间处理的重要性。我们的目的是描述 COVID-19 后患者在视空间测试中的表现,这些患者的呼吸损伤程度不同,并对视空间测试的表现进行定性分析,以检查其与注意力和执行功能改变的关系。这将突出 CDT 和 ROCF 表现的执行成分,并区分可能存在认知障碍的患者。对 77 名 SARS-CoV-2 感染患者(感染后 3 个月)进行了全面的神经心理学测试和 MRI 评估。总的来说,FCRO 和 CDT 之间存在显著差异,FCRO 仅变化 9%,而 CDT 变化 51.9%。关于观察到的各组之间的相关性(VM Inv、VM non I 和非住院),Boston 与 FCRO 副本之间的相关性最高(r=0.497;p=0.001)和 FCRO 记忆(r=0.429;p=0.001)。通过严重程度比较各组之间的表现,仅在 TMT A(13.706;p=0.001)和 B(9.583;p=0.008)测试和语音流畅性字母 A(13.445;p=0.001)中观察到显著差异,非住院患者组的表现更好。神经心理学缺陷通常会通过影响学习和适应能力直接影响日常生活。因此,对 COVID-19 后患者进行神经心理学特征描述的一种有用策略是结合不能单独分析的执行功能对视觉空间能力进行定性分析。

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