Cognitive impairment in young adults following cerebellar stroke: Prevalence and longitudinal course

IF 3.2 2区心理学 Q1 BEHAVIORAL SCIENCES

Cortex Pub Date : 2024-07-02 DOI:10.1016/j.cortex.2024.05.021

Stacha F.I. Reumers , Mijntje M.I. Schellekens , Selma Lugtmeijer , Roderick P.P.W.M. Maas , Jamie I. Verhoeven , Esther M. Boot , Merel S. Ekker , Anil M. Tuladhar , Bart P.C. van de Warrenburg , Dennis J.L.G. Schutter , Roy P.C. Kessels , Frank-Erik de Leeuw

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引用次数: 0

Abstract

Introduction

Cognitive impairment is a well-known result of a stroke, but for cerebellar stroke in young patients detailed knowledge on the nature and extent of cognitive deficits is limited. This study examined the prevalence and course of cognitive impairment in a large cohort of patients with cerebellar stroke.

Methods

Sixty young (18–49 years) cerebellar stroke patients completed extensive neuropsychological assessments in the subacute (<9 months post-stroke) and/or chronic phase (≥9 months post-stroke). Performance and course were assessed using standardized scores and Reliable Change Index analyses. Associations between cognitive deficits and lesion locations were explored using subtraction analyses, and associations with subjective cognitive complaints and fatigue were examined.

Results

Sixty patients (52% male) were included with a mean age at event of 43.1 years. Cognitive impairment was observed in 60.3% of patients in the subacute phase and 51.2% during the chronic phase. Deficits were most frequent for visuo-spatial skills and executive functioning (42.5–54.6%). Both improvement and decline were observed over time, in 17.9% and 41.0% of participants, respectively. Cognitive deficits seem to be associated with lesions in certain cerebellar regions, however, no distinct correlation was found for a specific subregion. Subjective cognitive complaints were present in the majority of participants (61–80.5%) and positively correlated with fatigue in both phases (ρ = −.661 and ρ = −.757, p < .001, respectively).

Discussion

Cognitive impairment in cerebellar stroke patients is common, with deficits most pronounced for visuo-spatial skills and executive functioning, as in line with the Cerebellar Cognitive Affective Syndrome. The course of cognitive performance was heterogenous, with cognitive decline despite the fact that no recurrent strokes occurred. No clear association between lesion location and cognitive deficits was observed. Subjective cognitive complaints and fatigue were prevalent and positively correlated. Clinicians could use this information to actively screen for and better inform patients about possible cognitive sequalae.

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小脑卒中后青壮年的认知障碍：发病率和纵向病程

认知障碍是众所周知的脑卒中后遗症，但对于小脑卒中的年轻患者，有关认知障碍性质和程度的详细知识却很有限。本研究调查了一大批小脑卒中患者认知障碍的发生率和病程。60名年轻（18-49岁）小脑卒中患者在亚急性期（卒中后＜9个月）和/或慢性期（卒中后≥9个月）完成了广泛的神经心理学评估。采用标准化评分和可靠变化指数分析法对患者的表现和病程进行评估。通过减法分析探讨了认知障碍与病变位置之间的关联，并研究了主观认知抱怨和疲劳之间的关联。共纳入了 60 名患者（52% 为男性），患者的平均年龄为 43.1 岁。60.3%的患者在亚急性期出现认知障碍，51.2%的患者在慢性期出现认知障碍。视觉空间技能和执行功能的缺陷最为常见（42.5-54.6%）。随着时间的推移，分别有 17.9% 和 41.0% 的参与者的认知能力有所改善和下降。认知障碍似乎与某些小脑区域的病变有关，但没有发现与特定亚区域有明显的相关性。大多数参与者（61-80.5%）都有主观认知抱怨，并且在两个阶段都与疲劳呈正相关（分别为 = -.661 和 = -.757, < .001）。小脑卒中患者的认知功能障碍很常见，视觉空间技能和执行功能障碍最为明显，这与小脑认知情感综合征相符。认知表现的变化过程各不相同，尽管没有发生复发性中风，但认知能力却在下降。病变位置与认知障碍之间没有明显的关联。主观认知抱怨和疲劳普遍存在，且呈正相关。临床医生可以利用这些信息积极筛查并更好地告知患者可能出现的认知后遗症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cortex 医学-行为科学

CiteScore

7.00

自引率

5.60%

发文量

250

审稿时长

74 days

期刊介绍： CORTEX is an international journal devoted to the study of cognition and of the relationship between the nervous system and mental processes, particularly as these are reflected in the behaviour of patients with acquired brain lesions, normal volunteers, children with typical and atypical development, and in the activation of brain regions and systems as recorded by functional neuroimaging techniques. It was founded in 1964 by Ennio De Renzi.