Stroke and cognition.
Stroke and cognition.
复制标题
DOI：
10.1007/s11883-001-0028-5
复制
发表时间：
2001-07-01
影响因子：
5.8
通讯作者：
Ballard, C
中科院分区：
文献类型：
--
作者：
Kalaria, R N;Ballard, C
几项研究证实，老年人中风后认知障碍和痴呆症会增加。虽然不一定与记忆缺陷有关，但认知障碍的频率可能发生在3个月后高达30%的中风幸存者身上。这种损害可能会被先前存在的认知衰退或痴呆症所混淆。相比之下，认知改变和痴呆症在中风的家族性形式中被广泛认识，如伴有皮质下梗塞的常染色体显性遗传性动脉病和白质脑病(CADASIL)。卒中类型、反复发作、病变部位和偏侧(S)、脑梗塞体积、内侧颞叶萎缩和共存的神经退行性病变等因素可预测损害程度。失语症、糖尿病、房颤和抑郁症被列为其他生物因素，这些因素进一步加剧了认知并影响了长期生存。目前还没有明确的共识是遗传因素，如载脂蛋白E e4等位基因或血管紧张素转换酶基因多态性，会改变认知变化或中风结果。尽管卒中后痴呆可能影响多个神经递质系统，但胆碱能功能的改善是一个值得研究的目标。
Several studies confirm cognitive impairment and dementia to be increased after stroke in the elderly. Although not necessarily involving memory deficits, the frequency of cognitive impairments may occur in up to 30% of stroke survivors at 3 months. This impairment may be confounded by preexisting cognitive decline or dementia. By contrast, cognitive changes and dementia are widely recognized in familial forms of stroke, such as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Several factors, including type of stroke, recurrent episodes, the site and laterality of the lesion(s), volume of cerebral infarction, medial temporal lobe atrophy, and coexistent neurodegenerative pathology predict the degree of impairment. Aphasia, diabetes mellitus, atrial fibrillation, and depression are listed among other biologic factors that further exacerbate cognition and affect long-term survival. There is no clear consensus whether genetic factors, such as the apolipoprotein E e4 allele or angiotensin converting enzyme gene polymorphisms, modify cognitive changes or stroke outcome. Although several neurotransmitter systems may be affected in post-stroke dementia, the amelioration of cholinergic function is a worthy target.