Girgenti Sophia G, Dallasta Isabella, Lawrence Erin, Merbach Dawn, Simon Jonathan Z, Llinas Rafael, Gould Neda F, Marsh Elisabeth Breese
Johns Hopkins School of Medicine, Departments of Neurology, Baltimore, MD, USA.
University of Maryland, Departments of Electrical Engineering, College Park, MD, USA.
medRxiv. 2024 Nov 11:2024.11.11.24317111. doi: 10.1101/2024.11.11.24317111.
Well-developed rehabilitation paradigms exist for post-stroke language and motor impairments. However, no such recovery program has been identified for commonly disabling cognitive deficits in patients following minor stroke. Mindfulness Based Stress Reduction (MBSR) is thought to engage the frontal lobes, improving concentration and attention, and therefore may be an effective option.
We prospectively enrolled a cohort of patients with subacute minor stroke and randomized them to either an 8-week online modified-MBSR course or online traditional Stroke Support Group (SSG). All patients underwent a battery of cognitive tests and measures of patient reported outcomes (PROs) pre- and post-intervention. ANOVA was used to compare changes in scores over time across both groups, as well as a third group of control patients having received neither intervention (n=128).
A total of 30 patients were randomized (n=16 for m-MBSR; n=14 for SSG). The average age of the cohort was 65.9 years. Both groups scored similarly on assessments one-month post-stroke and demonstrated increased T-scores on cognitive tasks at the 3-month visit. However, the m-MBSR group showed moderately elevated levels of improvement, specifically in processing speed, executive, and global cognitive function. Level of engagement was not associated with better clinical scores, though was unexpectedly low for both groups.
m-MBSR appears to modestly improve frontal lobe activity and demonstrates some success in increasing cognitive performance. However, further studies are needed to determine if it is more efficacious in the chronic stage of recovery when more patients are able to fully engage and actively participate.
针对中风后的语言和运动障碍,已有完善的康复模式。然而,对于轻度中风患者常见的致残性认知缺陷,尚未确定此类恢复计划。基于正念的减压疗法(MBSR)被认为可使额叶参与其中,改善注意力和专注力,因此可能是一种有效的选择。
我们前瞻性地招募了一组亚急性轻度中风患者,并将他们随机分为接受为期8周的在线改良MBSR课程或在线传统中风支持小组(SSG)。所有患者在干预前后均接受了一系列认知测试和患者报告结局(PROs)测量。方差分析用于比较两组随时间的得分变化,以及第三组未接受任何干预的对照患者(n = 128)。
共有30名患者被随机分组(m-MBSR组16名;SSG组14名)。该队列的平均年龄为65.9岁。两组在中风后1个月的评估中得分相似,并且在3个月随访时认知任务的T得分有所增加。然而,m-MBSR组显示出适度提高的改善水平,特别是在处理速度、执行和整体认知功能方面。参与程度与更好的临床评分无关,不过两组的参与程度出人意料地低。
改良MBSR似乎适度改善了额叶活动,并在提高认知表现方面取得了一些成功。然而,需要进一步研究以确定在更多患者能够充分参与并积极参与的恢复慢性阶段,它是否更有效。