脑干卒中患者的认知障碍研究  

A clinical study of cognitive impairment in patients with brainstem stroke

作　　者：付秀娟[1] 肖哲曼[1] 卢祖能[1] 

机构地区：[1]武汉大学人民医院神经内科,湖北省武汉市430060

出　　处：《国际神经病学神经外科学杂志》2017年第5期482-486,共5页Journal of International Neurology and Neurosurgery

基　　金：湖北省卫计委重点项目(WJ2015MA007);武汉市科技局2015年应用基础研究计划项目(2015060101010047)

摘　　要：目的研究急性孤立性脑干卒中患者认知功能与正常对照之间的差异,探究脑干卒中对认知功能的影响及其主要受损的认知域。方法选取符合入组标准的、性别、年龄和受教育年限匹配的首次发病的急性孤立性脑干卒中患者29例和正常对照20例,分别进行艾登布鲁克斯认知检测(ACE-Ⅲ)、蒙特利尔认知评估量表(MoCA)、数字符号转换测验(SDMT)、韦氏数字广度测验(DS)、连线测验(TMT)、Stroop词色测验等量表评测及事件相关电位P300检测。结果脑干卒中患者MoCA量表和ACE-Ⅲ量表总体评分与对照组相比显著降低(P=0.012,P=0.004),其中受损的认知域主要为语言功能(P=0.024)及视空间功能(P=0.004)。SDMT、DS、TMT和Stroop等量表完成度欠佳,与对照组相比,均未见显著差异(P>0.05)。P300检测结果显示脑干卒中患者较对照组存在显著的波幅降低(P=0.022)及潜伏期延长(P=0.033)。ACE-Ⅲ与MoCA显著正相关(P<0.001),而与P300潜伏期显著负相关(P=0.006)。结论急性孤立性脑干卒中患者存在一定的认知功能障碍,受损的认知域主要为注意力、语言及视空间能力。Objective To investigate the difference in cognitive function between patients with acute isolated brainstem stroke and normal controls,the influence of brainstem stroke on cognitive function,and injured cognitive domains.Methods A total of 29 patients with acute isolated brainstem stroke and 20 normal controls who met the inclusion criteria and were matched for sex,age,and education years were enrolled.The Addenbrooke＆#39;s Cognitive Examination Ⅲ （ACE-Ⅲ）,Montreal Cognitive Assessment （MoCA）,symbol digit modalities test （SDMT）,Wechsler digital span （DS） test,Trail Making Test （TMT）,and Stroop Color-Word Test were used for assessment and the P300 event-related potential was also measured.Results The patients with brainstem stroke had significantly lower total scores of MoCA and ACE-Ⅲ scales than the control group （P =0.012 and P =0.004）,with language function （P =0.024） and visuospatial function （P =0.004） as the major injured cognitive domains.The patients with brainstem stroke did not complete the SDMT,DS,TMT,and Stroop test well,and there were no significant differences in the results of these tests between the two groups （P ＞ 0.05）.The results of P300 measurement showed that compared with the control group,the patients with brainstem stroke had a significantly reduced amplitude （P =0.022） and a significantly prolonged latency period （P =0.033）.The ACE-Ⅲ score was positively correlated with of MoCA score （P ＜ 0.01） and negatively correlated with P300 latency （P =0.006）.Conclusions Patients with acute isolated brainstem stroke have a certain degree of cognitive impairment,and attention,language function,and visuospatial function are major cognitive domains injured.

关 键 词：脑干梗死 认知障碍 P300 认知量表 P300 

分 类 号：R749.13[医药卫生—神经病学与精神病学]