Circadian sleep/wake rhythm abnormalities as a risk factor of a poststroke apathy
Circadian sleep/wake rhythm abnormalities as a risk factor of a poststroke apathy
复制标题
DOI：
10.1111/ijs.12433
复制
发表时间：
2015-07-01
影响因子：
6.7
通讯作者：
Mayo, Willy
中科院分区：
文献类型：
--
作者：
Cosin, Charlotte;Sibon, Igor;Mayo, Willy
卒中后冷漠影响19-55%的卒中患者，对功能恢复、总体健康和生活质量产生负面影响，同时也是护理人员的重要负担来源。脑卒中后冷漠的延迟诊断是主要的临床问题，因此我们的研究目的是评估脑卒中后早期睡眠/觉醒周期昼夜节律的改变与脑卒中后冷漠的发生之间的关系。方法选取46例近期磁共振成像确诊的脑卒中患者。主要排除标准为轻度至重度残疾妨碍出院，卒中前存在冷漠或痴呆。mri检查脑血管病变。出院时，使用活动记录仪测量患者的整体活动以及7天内的昼夜节律参数（相对振幅、日间稳定性、日内变异性）和睡眠（睡眠持续时间、睡眠效率、碎片化指数）。在出院时和三个月时使用冷漠量表和里尔冷漠评定量表评估冷漠。结果46例患者中，10例（22%）在卒中后3个月表现为冷漠（冷漠量表中位数=45）。纳入前，这10名受试者在睡眠方面与其他患者没有显著差异，纳入后，他们在冷漠、焦虑、抑郁、认知和功能能力方面也没有显著差异。然而，出院时的活动描记术发现了睡眠的显著改变(P
BackgroundPoststroke apathy affects 19-55% of patients following stroke and has a negative impact on functional recovery, general health, and quality of life, as well as being a source of significant burden for caregivers.AimsA major clinical issue is the delayed diagnosis of poststroke apathy, and so the aim of our study is to evaluate the relationship between early poststroke alterations of circadian rhythms of sleep/wake cycles and the occurrence of poststroke apathy.MethodsForty-six patients with a recent magnetic resonance imaging confirmed stroke were included. Main exclusion criteria were a mild to severe disability impeding home discharge from the hospital and the presence of apathy or dementia before stroke. Cerebrovascular lesions were evaluated by magnetic resonance imaging. At hospital discharge, an actigraph was used to measure patient's global activity as well as parameters of circadian rhythmicity (relative amplitude, interdaily stability, intradaily variability) and sleep (sleep duration, sleep efficiency, fragmentation index) over seven-days. Apathy was assessed at hospital discharge as well as at three-months using the Apathy Inventory and the Lille Apathy Rating Scale.ResultsOf the 46 patients evaluated, 10 (22%) showed apathy three-months after stroke (median Apathy Inventory=45). Before inclusion, these 10 subjects did not differ significantly from other patients concerning their sleep and, at inclusion, they did not differ concerning apathy, anxiety, depression, or cognitive and functional abilities. However, actigraphy measured at discharged identified significant alterations of sleep (P