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Cognitive impairments in acute lacunar stroke
B Fure1, T Bruun Wyller, K Engedal
1Department of Geriatric Medicine, Ullevaal University Hospital, Oslo, Norway. bryfure@online.no
Acta Neurologica Scandinavica
|June 16, 2006
Summary
Many lacunar stroke patients experience cognitive deficits, with males at higher risk. The Mini Mental State Examination (MMSE) often misses these impairments, necessitating comprehensive cognitive screening.
Area of Science:
- Neurology
- Neuropsychology
- Stroke Medicine
Background:
- Lacunar stroke frequently leads to cognitive deficits.
- The Mini Mental State Examination (MMSE) is commonly used for cognitive assessment.
- Predictors of cognitive impairment in lacunar stroke patients require identification.
Purpose of the Study:
- To determine the prevalence of cognitive deficits in acute lacunar stroke.
- To evaluate the effectiveness of the MMSE in detecting these deficits.
- To identify factors associated with cognitive impairment post-lacunar stroke.
Main Methods:
- A cohort of 71 lacunar stroke patients underwent comprehensive cognitive screening.
- Tests included Trail Making Test A, Verbal Fluency, Object Learning Test, and Ullevål Aphasia Screening.
- Assessment covered motor apraxia, rational apraxia, and visuospatial abilities.
Main Results:
- Over half (57.7%) of patients exhibited cognitive deficits.
- MMSE sensitivity and specificity were 0.69 and 0.67, respectively, when compared to a comprehensive battery.
- Male sex was a significant predictor (OR 4.41) of cognitive deficits.
Conclusions:
- Cognitive problems are common in lacunar stroke patients.
- Male gender increases the risk of cognitive deficits.
- The MMSE is insufficient for detecting all cognitive impairments; comprehensive screening is recommended.