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Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing

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Published on: January 24, 2020

The NIHSS-plus: improving cognitive assessment with the NIHSS.

Rebecca F Gottesman¹, Jonathan T Kleinman, Cameron Davis

¹Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD, USA. rgottesm@jhmi.edu

Behavioural Neurology

|June 15, 2010

Summary

This summary is machine-generated.

The National Institutes of Health Stroke Scale (NIHSS) may underestimate stroke severity. Adding simple cognitive tests like line cancellation and visual perception to the NIHSS improves stroke volume prediction.

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Published on: December 16, 2022

Area of Science:

Neurology
Neuroimaging
Cognitive Science

Background:

The National Institutes of Health Stroke Scale (NIHSS) has limitations in assessing cognitive dysfunction and dominant hemisphere strokes.
Patients with significant strokes may receive low NIHSS scores due to these limitations.
Integrating simple cognitive assessments could enhance the clinical and research utility of the NIHSS.

Purpose of the Study:

To evaluate the predictive value of adding cognitive tests to the NIHSS for stroke volume.
To determine if cognitive assessments improve the accuracy of stroke severity estimation.

Main Methods:

Studied 200 patients with acute non-dominant hemispheric stroke.
Assessed cognitive function and performed MRI with diffusion-weighted imaging (DWI) within 5 days.
Used linear regression to analyze the predictive role of NIHSS and cognitive tests on DWI volumes.

Main Results:

NIHSS alone predicted DWI volume.
Line cancellation and visual perception tasks also predicted DWI volume.
In a multivariate model, NIHSS, line cancellation errors, and visual perception significantly improved the prediction of total infarct volume.

Conclusions:

Adding line cancellation and visual perception tasks to the NIHSS significantly enhances stroke volume prediction.
An "NIHSS-plus" incorporating these cognitive tests could offer a more accurate representation of ischemic tissue volume.
Further prospective validation of this enhanced scale is recommended.