Restrictions of the Mini-Mental State Examination in acute stroke
Restrictions of the Mini-Mental State Examination in acute stroke
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DOI：
10.1016/j.acn.2005.04.001
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发表时间：
2005-07-01
影响因子：
2.6
通讯作者：
de Haan, EHF
中科院分区：
文献类型：
--
作者：
Nys, GMS;van Zandvoort, MJE;de Haan, EHF
虽然简易精神状态检查（MMSE）最初是为了筛查痴呆和谵妄而开发的，但许多神经科医生使用该措施作为住院中风患者“认知障碍”的筛查工具。然而，迄今为止尚未评估过MMSE在急性中风中的有效性。我们对34名中风患者（中风和检查之间的平均间隔为6.5 ± 2.9天）和34名健康对照者进行了MMSE以及涵盖6个认知领域的神经心理学检查。除了计算MMSE上不同截止点的灵敏度和特异性外，还计算了受试者工作特征曲线下面积（AUC）。70%的患者在至少一个认知领域受损。MMSE检测认知功能障碍的准确性并不比偶然性好（AUC = 0.67; p = 0.第13段）。无法确定最佳MMSE临界值。MMSE对抽象推理、执行功能和视觉感知/构造的损伤特别不敏感。(c)2005年美国国家神经心理学学会。由爱思唯尔有限公司出版。保留所有权利。
While the Mini-Mental State Examination (MMSE) was originally developed to screen for dementia and delirium, many neurologists use this measure as a screening instrument for 'cognitive impairment' in hospitalized stroke patients. However, the validity of the MMSE as such has never been evaluated in acute stroke. We administered the MMSE in addition to a neuropsychological examination covering six cognitive domains to 34 stroke patients (mean interval between stroke and examination, 6.5 +/- 2.9 days) and 34 healthy controls. The area under the receiver operating characteristic curve (AUC) was calculated in addition to the sensitivity and specificity for various cut-off points on the MMSE. Seventy percent of the patients were impaired in at least one cognitive domain. The accuracy of the MMSE in detecting cognitive impairment was no better than chance (AUC = 0.67; p = 0. 13). No optimum MMSE cut-off value could be identified. The MMSE is particularly insensitive to impairments in abstract reasoning, executive functioning, and visual perception/construction. (c) 2005 National Academy of Neuropsychology. Published by Elsevier Ltd. All rights reserved.