Tang Wai Kwong, Hui Edward, Leung Thomas Wai Hong
Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Front Psychol. 2024 Nov 25;15:1451431. doi: 10.3389/fpsyg.2024.1451431. eCollection 2024.
Loss of empathy (LoE) is common among stroke survivors, yet often undiagnosed and thus untreated. LoE is related to the loss of a caring marital relationship, higher care burden and poorer quality of life in carers. The present study will evaluate the clinical and MRI correlates of LoE in a cohort of stroke survivors. The secondary objective is to describe the 12-month course of LoE.
The current study is a prospective cohort study. We will recruit 246 subjects. Subjects and carers will receive a detailed assessment at a research clinic at 3, 9, and 15 months after stroke onset (T1/T2/T3). The Chinese version of the Interpersonal Reactivity Index (IRI), a 28-item personality assessment tool, will be completed by a carer for each subject. LoE is defined as an IRI total score of 39 or less. Patients will be examined by MRI including diffusion weighted imaging (DWI) within 1 week after the onset of stroke. A stepwise logistic regression will be performed to assess the importance of lesions in the regions of interest. To examine the predictors of LoE remission, the demographic, clinical and MRI variables of remitters and non-remitters at T2/T3 will be examined by logistic regression.
This project will be the first longitudinal study on LoE in stroke survivors. The results will shed light on the association between prefrontal cortex and subcortical lesions and LoE risk, symptom severity and outcome. The findings will provide data to advance our understanding of the pathogenesis and clinical course of LoE in stroke as well as other neurological conditions. They are thus likely to be applicable to the large population of neurological patients at risk of LoE and should also stimulate further research in this field.
同理心丧失（LoE）在中风幸存者中很常见，但往往未被诊断出来，因此也未得到治疗。LoE与失去关爱性的婚姻关系、更高的护理负担以及护理人员较差的生活质量有关。本研究将评估一组中风幸存者中LoE的临床和MRI相关性。次要目标是描述LoE的12个月病程。
本研究是一项前瞻性队列研究。我们将招募246名受试者。受试者及其护理人员将在中风发作后3个月、9个月和15个月（T1/T2/T3）在研究诊所接受详细评估。护理人员将为每个受试者完成中文版的人际反应指数（IRI），这是一种包含28个项目的人格评估工具。LoE定义为IRI总分39分或更低。患者将在中风发作后1周内接受包括扩散加权成像（DWI）在内的MRI检查。将进行逐步逻辑回归以评估感兴趣区域病变的重要性。为了检查LoE缓解的预测因素，将通过逻辑回归检查T2/T3时缓解者和未缓解者的人口统计学、临床和MRI变量。
该项目将是第一项关于中风幸存者LoE的纵向研究。研究结果将揭示前额叶皮质和皮质下病变与LoE风险、症状严重程度和预后之间的关联。这些发现将为增进我们对中风以及其他神经系统疾病中LoE的发病机制和临床病程的理解提供数据。因此，它们可能适用于大量有LoE风险的神经科患者，也应该激发该领域的进一步研究。
