The Montreal Cognitive Assessment is superior to National Institute of Neurological Disease and Stroke-Canadian Stroke Network 5-minute protocol in predicting vascular cognitive impairment at 1 year.
The Montreal Cognitive Assessment is superior to National Institute of Neurological Disease and Stroke-Canadian Stroke Network 5-minute protocol in predicting vascular cognitive impairment at 1 year.
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蒙特利尔认知评估优于美国国家神经疾病研究所和中风 - 加拿大中风网络5分钟方案，可预测1年的血管认知障碍。
DOI：
10.1186/s12883-016-0570-y
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发表时间：
2016-04-12
期刊：
影响因子：
2.6
通讯作者：
Chen CL
中科院分区：
文献类型：
--
作者：
Dong Y;Xu J;Chan BP;Seet RC;Venketasubramanian N;Teoh HL;Sharma VK;Chen CL
国家神经疾病和卒中研究所-加拿大卒中网络（NINDS-CSN）5分钟方案和蒙特利尔认知评估（莫卡）在卒中后亚急性和恢复期对1年时显著血管性认知障碍（VCI）的预测能力尚不清楚。我们比较了这些测试的预后价值。缺血性卒中和短暂性脑缺血发作（TIA）患者在卒中后亚急性（2周内）和3-6个月接受莫卡，随后在1年时进行正式的神经心理学评估。NINDS-CSN 5分钟方案的总分来自莫卡。中重度VCI定义为≥ 3个领域的神经心理学损害。进行受试者工作特征曲线下面积（AUC）分析，以确定莫卡和NINDS-CSN 5分钟方案检测中重度VCI的最佳截止点和判别特性。基线时招募了四百名患者。其中，291人在中风后1年接受了正式的神经心理学评估。19%的患者有中重度VCI。莫卡在预测1年时中重度VCI方面上级NINDS-CSN 5分钟方案[亚急性AUC：0.89 vs 0.80，p < 0.01; 3-6个月AUC：0.90 vs 0.83，p < 0.01]。在相应的临界点，莫卡在基线（p = 0.01）和3-6个月（p = 0.04）时的灵敏度显著高于NINDS-CSN 5分钟方案。亚急性和卒中后3-6个月给予莫卡在预测1年时中重度VCI方面优于NINDS-CSN 5分钟方案的上级。本文的在线版本（doi：10.1186/s12883-016-0570-y）包含补充材料，可供授权用户使用。
The predictive ability of National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute protocol and Montreal Cognitive Assessment (MoCA) administered sub-acutely and at the convalescent phase after stroke for significant vascular cognitive impairment (VCI) at 1 year is unknown. We compared prognostic values of these tests. Patients with ischemic stroke and transient ischemic attack (TIA) received MoCA sub-acutely (within 2 weeks) and 3–6 months after stroke followed by a formal neuropsychological evaluation at 1 year. The total score of NINDS-CSN 5-minutes protocol was derived from MoCA. Moderate-severe VCI was defined as neuropsychological impairment in ≥ 3 domains. Area under the receiver operating characteristic curve (AUC) analyses were conducted to establish the optimal cutoff points and discriminatory properties of the MoCA and NINDS-CSN 5-minute protocol in detecting moderate-severe VCI. Four hundre patients were recruited at baseline. Of these, 291 received a formal neuropsychological assessment 1 year after stroke. 19 % patients had moderate-severe VCI. The MoCA was superior to the NINDS-CSN 5-minute protocol [sub-acute AUCs: 0.89 vs 0.80, p < 0.01; 3–6 months AUCs: 0.90 vs 0.83, p < 0.01] in predicting for moderate-severe VCI at 1 year. At respective cutoff points, MoCA had significantly higher sensitivity than the NINDS-CSN 5-minute protocol at baseline (p = 0.01) and 3–6 months (p = 0.04). MoCA administered sub-acutely and 3–6 months after stroke is superior to the NINDS-CSN 5-minute protocol in predicting moderate-severe VCI at 1 year. The online version of this article (doi:10.1186/s12883-016-0570-y) contains supplementary material, which is available to authorized users.