Lee Ho Seok, Sohn Min Kyun, Lee Jongmin, Kim Deog Young, Shin Yong-Il, Oh Gyung-Jae, Lee Yang-Soo, Joo Min Cheol, Lee So Young, Song Min-Keun, Han Junhee, Ahn Jeonghoon, Lee Young-Hoon, Kim Dae Hyun, Kim Young-Taek, Kim Yun-Hee, Chang Won Hyuk
Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Rehabilitation Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea.
Front Neurol. 2025 Mar 10;16:1541245. doi: 10.3389/fneur.2025.1541245. eCollection 2025.
There are relatively few reports on the long-term sequential functional recovery and prognosis in patients with cerebellar infarction. The aim of this study was to investigate the long-term recovery of multifaceted functional outcomes up to 36 months after onset and the functional prognosis of isolated cerebellar infarction.
This study was a retrospective analysis of the Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) data up to 36 months after onset. Isolated cerebellar infarction was defined as the presence of lesions in the cerebellum without lesions in other brain parenchyma. We assessed multifaceted functional domains, including motor (Fugl-Meyer Assessment, FMA), ambulatory (Functional Ambulation Category, FAC), cognitive (Korean Mini-Mental State Examination, K-MMSE), swallowing (American Speech-Language-Hearing Association National Outcome Measurement System Swallowing Scale, ASHA-NOMS), and language functions (Short version of the Korean Frenchay Aphasia Screening Test, Short K-FAST), using serial measurements. In addition, functional outcome was assessed with the Functional Independence Measure (FIM) up to 36 months after onset.
Among 390 screened isolated cerebellar infarction patients, a total of 183 patients were included in this study. Cognitive (mean[SD] of K-MMSE 27.6 ± 3.6) and swallowing (ASHA-NOMS 6.8 ± 0.7) functions showed significant improvement up to 3 months ( < 0.05). Motor (FMA 98.8 ± 3.8) and language (ASHA-NOMS 6.9 ± 0.4) functions improved significantly up to 6 months ( < 0.05). Furthermore, ambulatory function (FAC 4.7 ± 0.9) and functional independency (FIM 122.2 ± 12.0) continued to improve up to 12 months ( < 0.05). Vascular territory involving superior cerebellar artery, older age, female sex, and greater initial severity were identified as negative independent prognostic factors predicting functional outcome measured by FIM at 12 months after stroke.
The plateau of recovery in multifaceted functional outcomes varied among patients with cerebellar infarction. Functional independence plateaued at 12 months and showed a relatively favorable prognosis up to 36 months after stroke.
关于小脑梗死患者长期序贯功能恢复及预后的报道相对较少。本研究旨在调查发病后长达36个月的多方面功能结局的长期恢复情况以及孤立性小脑梗死的功能预后。
本研究是对韩国卒中功能与康复队列（KOSCO）发病后长达36个月的数据进行的回顾性分析。孤立性小脑梗死定义为小脑存在病变而其他脑实质无病变。我们通过连续测量评估了多方面的功能领域，包括运动功能（Fugl-Meyer评估量表，FMA）、步行功能（功能性步行分类，FAC）、认知功能（韩国简易精神状态检查表，K-MMSE）、吞咽功能（美国言语语言听力协会国家结局测量系统吞咽量表，ASHA-NOMS）和语言功能（韩国版法国失语症筛查测试简版，Short K-FAST）。此外，在发病后长达36个月时使用功能独立性测量量表（FIM）评估功能结局。
在390例筛查出的孤立性小脑梗死患者中，本研究共纳入183例患者。认知功能（K-MMSE的均值[标准差]为27.6±3.6）和吞咽功能（ASHA-NOMS为6.8±0.7）在3个月时显示出显著改善（P<0.05）。运动功能（FMA为98.8±3.8）和语言功能（ASHA-NOMS为6.9±0.4）在6个月时显著改善（P<0.05）。此外，步行功能（FAC为4.7±0.9）和功能独立性（FIM为122.2±12.0）在12个月时持续改善（P<0.05）。涉及小脑上动脉的血管区域、年龄较大、女性以及初始严重程度较高被确定为预测卒中后12个月时通过FIM测量的功能结局的负面独立预后因素。
小脑梗死患者多方面功能结局的恢复平台各不相同。功能独立性在12个月时趋于平稳，且在卒中后长达36个月时显示出相对良好的预后。
