Change in perfusion in acute nondominant hemisphere stroke may be better estimated by tests of hemispatial neglect than by the National Institutes of Health Stroke Scale
Change in perfusion in acute nondominant hemisphere stroke may be better estimated by tests of hemispatial neglect than by the National Institutes of Health Stroke Scale
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DOI：
10.1161/01.str.0000089681.84041.69
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发表时间：
2003-10-01
期刊：
影响因子：
8.3
通讯作者：
Jacobs, MA
中科院分区：
文献类型：
--
作者：
Hillis, AE;Wityk, RJ;Jacobs, MA
背景和目的：据报道，在非优势半球卒中中，美国国立卫生研究院卒中量表（NIHSS）评分与灌注加权成像（PWI）测量的低灌注组织相关性较差。我们进行了2项研究，以确定是否测试的半侧空间忽略提供了一个更好的措施，低灌注和再灌注比NIHSS在非优势半球strok.Methods -在研究1中，74例急性缺血性，幕上中风患者进行了NIHSS，测试的忽视或失语症，弥散加权成像（DWI）和PWI的第1天（发病后24小时）的中风。计算PWI/DWI异常体积与功能测试之间的Pearson相关性。在研究2中，10例急性非优势半球卒中患者，他们是干预恢复灌注的候选人，在第1天和第3天接受了PWI、DWI、NIHSS和线取消试验。结果在研究1中，在非优势半球卒中中，PWI/DWI异常体积与忽视评分显著相关（r = 0.71; P < 0.002），但与NIHSS评分无相关性（r = 0.39; P = NS）。在优势半球卒中中，PWI异常体积与失语评分的相关性（r = 0.50; P = 0.0001）优于与NIHSS评分的相关性（r = 0.45; P = 0.001）。在研究2中，PWI上低灌注组织体积的变化与线消除性能的变化相关（r = 0.83; P = 0.003），但与NIHSS评分的变化无关（r = 0.26; P = NS.结论：对于非优势半球卒中患者，半侧空间忽略测试可能比NIHSS更好地反映功能障碍和再灌注。
Background and Purpose - It has been reported that National Institutes of Health Stroke Scale (NIHSS) scores correlate poorly with hypoperfused tissue measured by perfusion-weighted imaging (PWI) in nondominant hemisphere stroke. We conducted 2 studies to determine whether tests of hemispatial neglect provide a better measure of hypoperfusion and reperfusion than NIHSS in nondominant hemisphere stroke.Methods - In study 1, 74 patients with acute ischemic, supratentorial stroke were administered the NIHSS, tests of neglect or aphasia, and diffusion-weighted imaging (DWI) and PWI on day 1 ( < 24 hours from onset) of stroke. Pearson correlations between volumes of PWI/DWI abnormality and functional tests were calculated. In study 2, 10 patients with acute, nondominant hemisphere stroke who were candidates for intervention to restore perfusion underwent PWI, DWI, NIHSS, and a line cancellation test on days 1 and 3. Correlations between change in volumes of PWI/DWI abnormality and change in functional tests were calculated.Results - In study 1, in nondominant hemisphere stroke, volume of PWI abnormality correlated significantly with neglect scores (r = 0.71; P < 0.002) but not with NIHSS scores ( r = 0.39; P = NS). In dominant hemisphere stroke, volume of PWI abnormality correlated better with aphasia scores ( r = 0.50; P = 0.0001) than with NIHSS scores ( r = 0.45; P = 0.001). In study 2, change in volume of hypoperfused tissue on PWI correlated with change in line cancellation performance ( r = 0.83; P = 0.003) but not with change in NIHSS score ( r = 0.26; P = NS).Conclusions - Tests of hemispatial neglect may better reflect dysfunction and reperfusion than NIHSS for patients with nondominant hemisphere stroke.