脑卒中后妄想与短期认知轨迹的关联
Elzbieta Klimiec-Moskal1, Joanna Pera1, Agnieszka Slowik1
1Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.
Journal of psychosomatic research
|December 14, 2024
概括
脑卒中后妄会在短期内影响特定的认知功能,但不会影响整体认知变化. 这项研究跟踪了使用蒙特利尔认知评估 (MoCA) 的中风患者和没有妄想症患者的认知变化.
科学领域:
- 神经学 神经学
- 认知科学 认知科学
- 老年学是指老年学的学科.
背景情况:
- 脑卒中后的妄想是一个重大问题,可能会增加长期认知能力下降的风险.
- 了解妄对中风后认知功能的直接影响,对于患者的管理和预后至关重要.
研究的目的:
- 调查中风后的短期认知功能变化是否在患有妄想症和没有妄想症的患者之间有所不同.
- 在中风后的急性和亚急性阶段分析认知表现的轨迹,与妄想状态相关.
主要方法:
- 一项前性观察性研究,包括402名中风后患者.
- 使用蒙特利尔认知评估 (MoCA) 评估的认知功能在中风后1天,8天和3个月.
- 混合线性回归模型用于分析经过时间调整的MoCA平均得分的变化,通过DSM-5标准诊断出妄想.
主要成果:
- 从第1天到第8天的总体MoCA得分有所改善,从第8天到第3个月的总体得分有所下降,不管 Delirium 状态如何.
- 在任何时间间隔内,患有 Delirium 和没有 Delirium 的患者之间的总 MoCA 评分变化率没有显著差异.
- 患有妄想症的患者表现出明显的短期模式:命名,定向和注意力有所改善,但从第1天到第8天的记忆恶化,随后从第8天到3个月的注意力/定向和记忆改善下降.
结论:
- 脑卒中后妄与特定的短期认知领域轨迹有关.
- 痴呆症似乎不会影响中风后短期内全球认知的整体变化.
- 这些发现突出了痴呆症对中风后认知恢复的复杂,特定领域的影响.
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