小脑梗死患者认知功能与运动功能的评价研究  

Evaluation of Cognitive Function and Motor Function in Patients with Cerebellar Infarction

作　　者：刘琪 张玉梅[2,3] LIU Qi;ZHANG Yumei(Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Rehabilitation,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;China National Clinical Research Center for Neurological Diseases,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院神经病学中心,北京100070 [2]首都医科大学附属北京天坛医院康复医学科,北京100070 [3]国家神经系统疾病临床医学研究中心,北京100070

出　　处：《神经损伤与功能重建》2024年第6期317-320,353,共5页Neural Injury and Functional Reconstruction

基　　金：国家自然科学基金项目(执行功能促进卒中后运动性失语症患者语言加工过程的脑网络及神经心理机制研究,No.82372555);国家自然科学基金项目(卒中后感觉性失语症患者残留语言能力的识别及其脑语义网络属性研究,No.81972144);中国留学基金委项目(联合培养博士研究生项目,No.202308110231)。

摘　　要：目的:评估小脑梗死患者运动与认知功能受损情况,分析不同梗死部位认知与运动功能的差异,并探讨该人群运动与认知功能的相关性。方法:招募于北京天坛医院神经内科住院的局灶性小脑梗死患者30例纳入病例组,招募与病例组年龄及教育程度匹配的健受试30例纳入对照组。收集所有受试者一般资料;采用Addenbrooke认知功能检查量表-第3版(ACE-Ⅲ)评估受试者的认知功能,采用共济失调评定量表(ICARS)评估受试者的小脑性共济失调的程度,采用Brunel平衡量表(BBA)评估受试者的平衡功能,采用手指敲击试验(FTT)评估受试者的精细运动功能;并进行不同组别、不同梗死叶及不同梗死侧患者间的各项评分的比较。结果:病例组的ACE-Ⅲ总分、注意力及语言流畅性得分低于对照组(P<0.01或P<0.05);后叶梗死患者的ACE-Ⅲ总分及注意力得分低于前叶梗死患者(P<0.01或P<0.05);右侧小脑半球梗死患者的ACE-Ⅲ总分、注意力及语言流畅性得分低于左侧小脑半球梗死患者(P<0.01或P<0.05)。小脑梗死患者的ICARS测评得分为(12.4±1.7)分,BBA测评得分为(10.9±1.4)分;无论侧别,病例组的FTT均低于对照组(P<0.01);前叶小脑梗死患者的ICARS得分高于后叶小脑梗死患者(P<0.01),BBA得分低于后叶小脑梗死患者(P<0.01),FTT评分差异无统计学意义;左、右侧小脑半球梗死患者的ICARS、BBA和FTT评分差异均无统计学意义。相关性分析未发现小脑梗死患者运动功能与认知功能存在相关性。结论:不同病灶位置小脑梗死患者其功能缺损症状存在差异:小脑前叶受损患者运动障碍更严重;小脑后叶及右侧小脑半球受损患者其认知障碍更严重。Objective:To evaluate the impairment of motor and cognitive functions in patients with cerebellar infarction,analyze the differences in cognitive and motor functions between different infarct locations,and explore the correlation between motor and cognitive functions in this population.Methods:Thirty patients with focal cerebellar infarction admitted to the Department of Neurology at Beijing Tiantan Hospital were recruited as the case group,and 30 healthy subjects matched for age and education level with the case group were recruited as the control group.General information was collected from all subjects;the Addenbrooke’s Cognitive Examination-Ⅲ(ACE-Ⅲ)was used to assess cognitive function,the International Cooperative Ataxia Rating Scale(ICARS)was used to assess the degree of cerebellar ataxia,the Brunel Balance Assessment(BBA)was used to assess balance function,and the Finger Tapping Test(FTT)was used to assess fine motor function;comparisons were made between different groups,different infarct lobes,and different infarct sides.Results:The total ACE-Ⅲ score,attention,and language fluency scores of the case group were lower than those of the control group(P<0.01 or P<0.05);patients with posterior lobe infarction had lower total ACE-Ⅲ scores and attention scores than those with anterior lobe infarction(P<0.01 or P<0.05);patients with right cerebellar hemisphere infarction had lower total ACE-Ⅲ scores,attention,and language fluency scores than those with left cerebellar hemisphere infarction(P<0.01 or P<0.05).The ICARS score of patients with cerebellar infarction was(12.4±1.7),the BBA score was(10.9±1.4);regardless of side,the FTT of the case group was lower than that of the control group(P<0.01);patients with anterior lobe cerebellar infarction had higher ICARS scores than those with posterior lobe cerebellar infarction(P<0.01),lower BBA scores(P<0.01),and no significant difference in FTT scores;there were no statistically significant differences in ICARS,BBA,and FTT scores between patients with lef

关 键 词：小脑梗死 运动功能 认知功能 功能分区 

分 类 号：R741[医药卫生—神经病学与精神病学] R743[医药卫生—临床医学]