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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Early Cognitive Impairment after Minor Stroke: Associated Factors and Functional Outcome
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Early Cognitive Impairment after Minor Stroke: Associated Factors and Functional Outcome

机译：轻微中风后的早期认知障碍：相关因素和功能结果

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Objectives: Evaluation of cognitive status is not performed routinely in the acute stroke setting. This study aimed to evaluate the frequency of early cognitive impairment in patients with minor ischemic stroke, analyze the factors associated with early cognitive impairment, and assess functional outcomes. Methods: In this prospective study, 112 consecutive patients with acute minor ischemic stroke were enrolled. Neuroimages were assessed for semiquantitative evaluation of brain atrophy and small vessel disease (SVD) markers. Cognitive performance was measured within 5 days of onset using Montreal Cognitive Assessment (MoCA) scores. Functional outcome analyses were adjusted for demographic variables, premorbid cognitive status, education level, vascular risk factors, neuroimaging characteristics, stroke severity, and MoCA scores. Results: The median MoCA score was 22, and 63% of patients had cognitive impairment. Factors independently associated with cognitive impairment were education (odds ratios [OR], .79; confidence intervals [CI], .63-.99), smoking (OR, .26; 95%CI, .073-.89), and temporal horn atrophy (OR, 4.73; 95% CI, 1.66-13.49). Factors independently associated with poor functional outcome were total MoCA score (OR, .78; 95%CI, .62-.95) and the sum of 4 MoCA subscores (visuospatial/executive, attention, language, and orientation; OR, .72; 95%CI, .53-.92). The cutoff value of the sum of 4 MoCA subscores for predicting poor outcome was 13 points with 76.5% sensitivity and 81.1% specificity. Conclusions: Early cognitive impairment was common after minor ischemic stroke and was associated with preexisting temporal horn atrophy but not SVD markers. The sum of 4 MoCA subscores was useful in predicting the functional outcome.
机译：目的：急性卒中患者的认知状态评估并非常规进行。本研究旨在评估轻度缺血性卒中患者早期认知损害的频率，分析与早期认知损害相关的因素，并评估功能结果。方法：在这项前瞻性研究中，112例急性轻度缺血性卒中患者被纳入研究。对神经影像进行评估，以半定量评估脑萎缩和小血管疾病（SVD）标志物。使用蒙特利尔认知评估（MoCA）评分在发病后5天内测量认知能力。功能结果分析根据人口统计学变量、病前认知状态、教育水平、血管危险因素、神经影像学特征、中风严重程度和MoCA评分进行调整。结果：MoCA评分中位数为22，63%的患者有认知障碍。与认知障碍独立相关的因素包括教育（优势比[OR]，.79；置信区间[CI]，.63-.99）、吸烟（OR，.26；95%置信区间，.073-.89）和颞角萎缩（OR，4.73；95%置信区间，1.66-13.49）。与不良功能结果独立相关的因素包括MoCA总分（OR，.78；95%置信区间，.62-.95）和4个MoCA分项得分（视觉空间/执行、注意力、语言和方向；OR，.72；95%置信区间，.53-.92）之和。4个MoCA子评分之和预测不良预后的临界值为13分，敏感性为76.5%，特异性为81.1%。结论：轻度缺血性脑卒中后早期认知功能障碍很常见，与先前存在的颞角萎缩有关，但与SVD标志物无关。4个MoCA子评分的总和有助于预测功能结果。

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