Post-stroke cognitive impairment on the Mini-Mental State Examination primarily relates to left middle cerebral artery infarcts.
Post-stroke cognitive impairment on the Mini-Mental State Examination primarily relates to left middle cerebral artery infarcts.
复制标题
DOI：
10.1177/1747493020984552
复制
发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Bae HJ
中科院分区：
文献类型：
--
作者：
Weaver NA;Kancheva AK;Lim JS;Biesbroek JM;Wajer IMH;Kang Y;Kim BJ;Kuijf HJ;Lee BC;Lee KJ;Yu KH;Biessels GJ;Bae HJ
中风后认知障碍可能发生在各个大脑区域受损后，认知缺陷取决于梗塞部位。简易精神状态检查（MMSE）仍然广泛用于评估中风后认知，但它因仅捕获某些认知缺陷而受到批评。沿着这些思路，可以假设用 MMSE 测量的认知缺陷主要涉及某些梗塞部位。这项全面的病变-症状映射研究旨在确定哪些急性梗塞部位与 MMSE 上的中风后认知障碍相关。我们使用基于体素的病变症状映射，检查了 1198 名急性缺血性卒中患者（年龄 67±12 岁，43% 女性）的 MMSE 损伤（<第 5 个百分位数；规范数据）与梗塞位置之间的关联。作为参考框架，根据更详细的神经心理学评估，确定了与个体认知领域损伤相关的梗塞模式。 420 名患者 (35%) 存在 MMSE 损伤。左侧大脑中动脉区域和丘脑中的大体素簇与 MMSE 认知障碍显着相关 (p<0.01)，其中丘脑和颞上回的比值比最高 (>15)。相比之下，特定领域的损伤与两个半球的各种梗塞模式有关，包括左内侧颞叶（语言记忆）和右顶叶（视觉空间功能）。我们的研究结果表明，MMSE 的中风后认知障碍主要与左侧大脑中动脉区域的梗塞位置有关。 MMSE 显然对与其他地点相关的认知缺陷不太敏感。
Post-stroke cognitive impairment can occur after damage to various brain regions, and cognitive deficits depend on infarct location. The Mini-Mental State Examination (MMSE) is still widely used to assess post-stroke cognition, but it has been criticized for capturing only certain cognitive deficits. Along these lines, it might be hypothesized that cognitive deficits as measured with the MMSE primarily involve certain infarct locations. This comprehensive lesion-symptom mapping study aimed to determine which acute infarct locations are associated with post-stroke cognitive impairment on the MMSE. We examined associations between impairment on the MMSE (<5th percentile; normative data) and infarct location in 1198 patients (age 67 ± 12 years, 43% female) with acute ischemic stroke using voxel-based lesion-symptom mapping. As a frame of reference, infarct patterns associated with impairments in individual cognitive domains were determined, based on a more detailed neuropsychological assessment. Impairment on the MMSE was present in 420 patients (35%). Large voxel clusters in the left middle cerebral artery territory and thalamus were significantly (p < 0.01) associated with cognitive impairment on the MMSE, with highest odds ratios (>15) in the thalamus and superior temporal gyrus. In comparison, domain-specific impairments were related to various infarct patterns across both hemispheres including the left medial temporal lobe (verbal memory) and right parietal lobe (visuospatial functioning). Our findings indicate that post-stroke cognitive impairment on the MMSE primarily relates to infarct locations in the left middle cerebral artery territory. The MMSE is apparently less sensitive to cognitive deficits that specifically relate to other locations.
登录
查看更多内容
影响因子：
5.7
作者：
Karnath HO;Sperber C;Rorden C
通讯作者：
Rorden C
影响因子：
8.3
作者：
Pendlebury, Sarah T.;Cuthbertson, Fiona C.;Rothwell, Peter M.
通讯作者：
Rothwell, Peter M.
影响因子：
0.6
作者：
Ritter, Felix;Boskamp, Tobias;Peitgen, Heinz-Otto
通讯作者：
Peitgen, Heinz-Otto
影响因子：
6.9
作者：
JORM, AF
通讯作者：
JORM, AF
影响因子：
5.7
作者：
Fonov V;Evans AC;Botteron K;Almli CR;McKinstry RC;Collins DL;Brain Development Cooperative Group
通讯作者：
Brain Development Cooperative Group