| Background:Poststroke cognitive impairment (PS-CI) has been of great interest to researchers because it is clinically common, costly, and possibly preventable. The cognitive profiles after stroke in different lesions may be worth of exploration. In addition to physical function defects, there are changes in cognitive function after stroke. In the past cortex was assumed to be main functional structure, yet subcortical structures have been presumed to participate the formation of advancing cognitive function. The study of cognitive profile in thalamic or basal ganglia stroke is rare, although it is one common type of stroke. We aimed to explore the neuropsychological feature of thalamic or basal ganglia structures by comparing the characteristics of cognitive impairment of patients with thalamic or basal ganglia lesion stroke of different domain. That may provide evidents for early identification of vascular cognitive impairment(VCI) and rehabilitation after stroke.Objective:A battery neuropsychological tests were administered to assess the characteristics of cognitive impairment of patients with thalamic or basal ganglia stroke. With the recognition about cognitive changing mode of non-cortical area impairment, it may be helpful to the presumption of cerebral advancing functioning and evaluation of cognition for the VCI patients. Early identification of VCI and prevention for vascular dementia (VaD) may lessen the burden of illness.Methods:A sample of88consecutive patients (outpatients or inpatients) with single thalamic or basal ganglion lesion stroke were recruited between Dec2009to Nov2011, from neurology department of People’s Hospital of Shengzhou, Zhejiang Province. Totally, forty one patients were affected at left cerebral area while forty seven, right cerebral area. Among which, there were sixty four male and twenty four female. Four groups were classified, including20left thalamic stoke group,21left basal ganglia stroke group,21right thalamic stroke group,26right basal ganglia stroke group. Thirty four cognitively normal control (NC) were recruited, including twenty seven male and seven female. There was no statistical different for age, gender, education year and score of anxiety self-assessment. A comprehensive neuropsychological battery was used for evaluation covering global cognitive function, memory function, language function, executive function, attention and visual spatial skills. SPPS11.5was applied to analysis of cognitive function.Results:Firstly, Contrary to the NC, there was an overall decline of cognitive functions in patients with thalamic or basal ganglia stroke in memory, attention/executive function, language, and visuospatial ability. Secondly, all patients finished the Similarity test inferior to the NC, and the related function for left thalamic stoke group was affected obviously. Thalamic area was thought to be relevant to similarity test score. Thirdly, the scores of the left thalamic stroke group were worse than the other three stroke groups in language, response inhibition, the speed and accuracy of mental processing, auditory verbal learning test-immediate recall and delayed recall, attention/executive function and visuospatial ability. The scores of the left thalamic stroke group were worse than the other four groups. Fourthly, the completion of right hand related task (as trail making test, TMT and symbol digit modality test, SDMT) for left basal ganglia stroke group was superior than other three stroke group, similar to NC. Fifthly, the completion of Stroop color word test, SCWT-C for right basal ganglia stroke group was superior than other three stroke group, still inferior to NC.Conclusions:There was an overall decline of cognitive functions in patients with thalamic or basal ganglia stroke in memory, attention/executive function, language, and visuospatial ability. But, there are different characteristics of stroke for different cerebral areas. The cognition impairment may be affected thoroughly for left thalamic stroke group. |
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