Trail Making Test Elucidates Neural Substrates of Specific Poststroke Executive Dysfunctions.
Trail Making Test Elucidates Neural Substrates of Specific Poststroke Executive Dysfunctions.
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TRAIL进行测试阐明了特定的中风后执行功能障碍的神经底物。
DOI：
10.1161/strokeaha.115.009936
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发表时间：
2015-10
期刊：
影响因子：
8.3
通讯作者：
Black SE
中科院分区：
文献类型：
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作者：
Muir RT;Lam B;Honjo K;Harry RD;McNeely AA;Gao FQ;Ramirez J;Scott CJ;Ganda A;Zhao J;Zhou XJ;Graham SJ;Rangwala N;Gibson E;Lobaugh NJ;Kiss A;Stuss DT;Nyenhuis DL;Lee BC;Kang Y;Black SE
中风后认知障碍（PSCI）的典型特征是处理速度和执行功能的显着缺陷。然而，执行缺陷的潜在神经解剖学基础尚不清楚，需要进一步阐明。分割执行功能以描绘神经基质可能有用。一种适合精细描述的测试是轨迹制作测试 (TMT)，它强调处理速度 (TMT-A) 和集合转换（TMT-B-A 差异、比例、商分数和 TMT-B 集合转换错误）。 TMT 对来自一项跨国研究的两个明显缺血性卒中队列进行：(i) 慢性卒中队列 (N=61) 和 (ii) 急性亚急性卒中队列 (N=45)。使用先前发布的胆碱能高信号预测量表 (CHIPS)，在 MRI 上对缺血性中风和白质高信号 (WMH) 进行体积量化，并对胆碱能预测的参与程度进行评级。还记录了与一些胆碱能投射共定位的上纵束（SLF）的损伤。完成多元线性回归分析。虽然较大的梗塞 (β=0.37, p<0.0001) 与较慢的处理速度相关，但 CHIPS 严重程度 (β=0.39, p<0.0001) 与集合移位的所有指标相关。然而，左侧 SLF 损伤仅与差异评分相关（β=0.17，p=0.03）。这些发现在两个队列中都得到了重复。 TMT-B 组移位错误≥2 次的患者 CHIPS 严重程度也更高。在这项多国卒中队列研究中，侧胆碱能通路和 SLF 的损伤与设定转换中的执行缺陷具有重要的神经解剖学相关性。
Post-stroke cognitive impairment (PSCI) is typified by prominent deficits in processing speed and executive function. However, the underlying neuroanatomical substrates of executive deficits are not well understood and further elucidation is needed. There may be utility in fractionating executive functions to delineate neural substrates. One test amenable to fine delineation is the Trail Making Test (TMT), which emphasizes processing speed (TMT-A) and set-shifting (TMT-B-A difference, proportion, quotient scores and TMT-B set-shifting errors). The TMT was administered to two overt ischemic stroke cohorts from a multinational study: (i) a chronic stroke cohort (N=61) and (ii) an acute-sub-acute stroke cohort (N=45). Volumetric quantification of ischemic stroke and White Matter HyperIntensities (WMH) was done on MRI, along with ratings of involvement of cholinergic projections, using the previously published Cholinergic Hyperintensities Projections Scale (CHIPS). Damage to the superior longitudinal fasciculus (SLF), which co-localizes with some cholinergic projections, was also documented. Multiple linear regression analyses were completed. While larger infarcts (β=0.37, p<0.0001) were associated with slower processing speed, CHIPS severity (β=0.39, p<0.0001) was associated with all metrics of set shifting. Left SLF damage, however, was only associated with the difference score (β=0.17, p=0.03). These findings were replicated in both cohorts. Patients with ≥2 TMT-B set shifting errors also had greater CHIPS severity. In this multinational stroke cohort study, damage to lateral cholinergic pathways and the SLF emerged as significant neuroanatomical correlates for executive deficits in set shifting.