Novel unsupervised comprehensive tool for monitoring vascular cognitive impairment following stroke
Novel unsupervised comprehensive tool for monitoring vascular cognitive impairment following stroke
复制标题
用于监测中风后血管认知障碍的新型无监督综合工具
DOI：
10.1002/alz.061493
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Gruia D
中科院分区：
文献类型：
--
作者：
Gruia D
背景中风是世界范围内死亡和残疾的主要原因。高达86%的急性中风病例发生认知困难（Demeyere等人，2015年，坚持三分之一。尽管迄今为止做出了许多努力，但开发用于血管性认知障碍的有效治疗干预仍然是一个很大的未满足的需求（Zotin等人，2021年）。这部分是由于疾病机制的异质性和患者表现出的认知特征。为了更好地了解影响血管损伤后长期认知结果的因素范围，越来越需要对认知功能进行可扩展且具有成本效益的深入纵向评估。为了解决这一差距，并利用最近由大流行驱动的远程医疗技术的发展，我们开发了一种自我管理的无监督，适应性强，深入的在线认知评估工具，专门针对中风患者。（注意力和执行功能）和领域特异性缺陷（记忆，语言，视觉忽视，数字技能，失用症），以及神经精神问卷。总的来说，评估持续一个小时，并与各种设备和操作系统兼容。根据这些规范，该组合被命名为IC 3（ImperialCollegeComprehensive assessment forCerebrovascular disease; https：//ic3study.co.uk/）。结果我们展示的结果概述了在年龄和教育程度匹配的对照组和中风后患者的适度样本中评估的标准范围。此外，我们还概述了我们的验证研究，这些研究检查了电池的特异性和灵敏度以及重测可靠性。我们还讨论了与已建立的临床电池（如CAT和莫卡）的比较。最后，由于该评估被设计为远程自我管理，我们还对面对面监督的电池输送进行了验证。结论IC 3是第一个对血管性脑损伤患者进行深入的无监督认知表型分析的评估，同时还允许进行可扩展且具有成本效益的纵向监测。评估票价以及对各种验证方法，使其成为一个有吸引力的工具，了解在过多的血管疾病的恢复机制。
BackgroundStroke is a leading cause of death and disability worldwide. Cognitive difficulties occur in up to 86% of acute stroke cases (Demeyere et al., 2015) and persist in a third. Despite the numerous efforts made thus far, developing effective therapeutic interventions for vascular cognitive impairment remains a large unmet need (Zotin et al., 2021). This is in part due to the heterogeneity of the disease mechanisms, and cognitive profiles exhibited by patients. To better understand the range of factors that contribute to long‐term cognitive outcomes after vascular insult, there is a growing need for in‐depth longitudinal assessments of cognitive function that are scalable and cost‐efficient. To address this gap and to capitalise on the recent growth of telemedicine technology driven by the pandemic, we developed a self‐administered unsupervised, adaptable, and in‐depth online cognitive assessment tool specifically for patients with stroke.MethodThis self‐administered web‐based tool offers an in‐depth cognitive profiling through 23 tasks spanning both domain‐general (attention and executive functioning) and domain‐specific deficits (memory, language, visual neglect, number skills, apraxia), together with neuropsychiatric questionnaires. In total, the assessment lasts one hour and is compatible with a variety of devices and operating systems. In light of these specifications, the battery has been named IC3 (ImperialCollegeComprehensive assessment forCerebrovascular disease; https://ic3study.co.uk/)ResultWe present results outlining the normative ranges for the assessment in age and education matched controls and in a modest sample of patients following stroke. Furthermore, we present an overview of our validation studies which examine the battery’s specificity and sensitivity, and test‐retest reliability. We also discuss a comparison against established clinical batteries (e.g. CAT and MoCA). Finally, as the assessment has been designed to be self‐administered remotely, we also present a validation against face‐to‐face supervised delivery of the battery.ConclusionIC3 is the first assessment to offer in‐depth unsupervised cognitive phenotyping of patients with vascular brain insult, while also allowing scalable and cost‐efficient longitudinal monitoring. The assessment fares well against various validation methods, making it an attractive tool for understanding the mechanisms of recovery in a plethora of vascular disorders.