脑中风前认知障碍:频率和与先发性神经精神病,功能和神经成像特征的关联
Francesco Mele1, Ilaria Cova1, Alessia Nicotra1
1Neurology Unit, Luigi Sacco University Hospital, Milan, Italy (F. Mele, I.C., A.N., G.M., V.C., S.P., L.P.).
Stroke
|May 31, 2024
概括
脑中风前认知障碍 (SCI) 影响三分之一的中风患者,并与神经精神问题和功能衰退有关. 白质病变和中间叶缩是关键指标,表明SCI前的血管和退行性原因.
科学领域:
- 神经学 神经学
- 老年病的医生 老年病的医生
- 神经心理学 神经心理学
背景情况:
- 脑中风前认知障碍 (SCI前) 是一些中风患者的已知的疾病,但其潜在原因尚不清楚.
- 了解SCI前的情况对于全面的中风护理和患者管理至关重要.
研究的目的:
- 为了确定入院中风病房的患者中前SCI的患病率.
- 调查SCI前和病前神经精神病学,功能和神经成像特征之间的关联.
主要方法:
- 一项涉及474名中风患者的横截面研究,使用老年人认知衰退信息员问卷 (IQCODE) 进行评估.
- 前SCI被定义为一个IQCODE得分>3.3.3.
- 评估包括神经精神病学库存问卷 (NPI-Q),日常生活活动 (ADL) 尺度,临床痴呆评分 (CDR) 尺度和神经成像 (MRI) 对271名患者.
主要成果:
- 前SCI存在于32.5%的患者中,并且与较高的NPI-Q得分,在ADL和仪器ADL尺度上的表现较差以及较高的CDR得分显著相关.
- 多变量分析显示,年龄 (OR 1.05),白质病变 (OR 1.26) 和中间叶缩 (OR 3.97) 在整体MRI队列中独立与SCI前相关.
- 在缺血性中风患者中,白质病变 (OR 1.34) 和中叶缩 (OR 3.56) 与前SCI有关,但年龄没有.
结论:
- 大约三分之一的中风患者表现出前SCI,其特点是先前存在的神经精神症状和功能障碍.
- 前SCI与白质病变和中间叶缩的关联表明,小血管疾病和神经退行症都对其病因有所贡献.
- 这些发现强调了在中风患者中识别和解决前SCI的重要性,以潜在地改善结果.
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