脑卒中后与年轻中风患者的血管认知障碍有关:奥迪赛研究
Frederik J Reitsma1,2, Esmée Verburgt1, Mijntje M I Schellekens1
1Department of Neurology, Radboud Institute of Medical Innovation, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, the Netherlands.
Epilepsia
|March 14, 2026
概括
脑卒中后 (PSE) 在年轻的中风幸存者中显著增加了主要血管认知障碍 (VCD) 的风险. PSE还与注意力和工作记忆受损有关,这表明与认知缺陷有直接联系.
科学领域:
- 神经学 神经学
- 神经科学是一个神经科学.
- 认知科学 认知科学
背景情况:
- 认知障碍是年轻人中风的常见并发症,特别是那些患有中风后 (PSE) 的人.
- 将PSE与认知衰退联系在一起的确切机制,无论是直接的 (相关的网络变化) 还是间接的 (中风严重程度的影响),仍然不清楚.
研究的目的:
- 研究年轻中风患者中中风后 (PSE) 和血管认知障碍 (VCD) 之间的关联.
- 为了确定PSE和认知障碍在这个人群中的特定认知领域之间的关系.
主要方法:
- 一项多中心前性队列研究包括18-49岁的患者,他们有史以来第一次缺血性中风,过渡性缺血性发作或脑内出血.
- 在事件发生一年后,用七个领域的复合z分数评估认知功能;根据z分数值定义VCD.
- 使用多变量回归分析来评估PSE,VCD和特定领域认知障碍之间的关联.
主要成果:
- 患有PSE的患者 (n=20) 与没有PSE的患者 (n=426,20.1%) 相比,主要VCD的患病率更高 (40.0%),调整后的几率比率 (OR) 为3.96.
- 脑卒中后 (PSE) 与主要血管认知障碍 (VCD) 独立相关 (调整后OR=3.96,95%CI=1.24-12.65).
- PSE还独立地与注意力和工作记忆的认知障碍有关 (调整后OR=5.09,95%CI=1.15-22.59).
结论:
- 在中风后 (PSE) 和主要血管认知障碍 (VCD) 以及注意力和工作记忆的认知障碍之间发现了独立的关联.
- 这些发现支持了"第二次袭击假说",表明可能直接加剧中风后的认知缺陷.
- 结果强调了PSE对年轻中风幸存者的认知结果的重大影响,特别是影响注意力和工作记忆.
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