The Study Of The Relationship Between Post-stroke Anxiety,Depression And Attention,Executive Function

Background and ObjectiveAnxiety and depression are often present in post-stroke patients.Attention and executive dysfunction are the most common stroke-related cognitive impairments.Studies in normal populations suggest that anxiety and/or depressive states can affect the performance of attention and executive function.Previous studies suggest that emotion control,attention and executive function may be controlled by the same functional area,but the relationship between post-stroke depression,anxiety,attention and executive function has not been clarified.Attention and executive dysfunction often predict a poor prognosis for stroke survivors.However,the cognitive screening scales currently used in clinical examination are not sensitive enough to attention and executive dysfunction,while specialized attention and executive function tests are demanding and time-consuming to assess the site and are less frequently performed in clinical practice.In this study,the prevalence of post-stroke depression and/or anxiety was screened by analyzing the clinical data,functional tests and assessment results of stroke patients,and the relationship between anxiety,depression,attention and executive function in post-stroke patients was explored.To provide a basis for targeted attention,executive function tests and related treatment in the future.MethodThis study was a cross-sectional study,in which 67 patients diagnosed with cerebral apoplexy in Zhujiang hospital from August 2019 to January 2020 and April 2020 were included in the study,and general data of all enrolled patients were collected.The Hospital Anxiety and Depression Scale(HADS)was used to assess the psychological state of the patients.According to the score results,the included patients were divided into group A(post-stroke anxiety group),group B(post-stroke depression group),group C(post-stroke anxiety and depression co-existing group)and group D(non-anxiety and depression group).Montreal Cognitive Assessment(MoCA)was used to assess the overall Cognitive function.Digit Span Test(DST),Stroop color word Test(VST),Shape Trail Test(STT),and Cancelled Task(CT)were used to evaluate the attention and executive function of enrolled patients and record them.Differences in general data,overall cognitive function,attention,and executive function test results were compared between groups.Correlation analysis was conducted between HADS and HADS scores and results of MoCA,DST,VST,STT and CT.ResultsAccording to the HADS score,of all 67 stroke patients included,9 were in an anxious state(13.4%),19 were in a depressed state(28.4%),10 were in an anxious,depressed co-existing state(14.9%),and 29 had no significant symptoms of anxiety or depression(43.3%).Except for VST-C error,VST-C time,STT-A time,and STT-B time,the intergroup differences were not statistically significant(p>0.05);the intergroup differences in VST-C error were statistically significant(?2=9.920,p=0.019),and the VST-C error was significantly higher in Group C than in Group D(Z=2.900,p=0.022);the intergroup differences in VST-C time(?2=7.955,p=0.047),STT-A time(?2=8.822,p=0.032),and STT-B time(?2=9.521,p=0.023)were statistically significant,but further two-way comparisons were not statistically significant(p>0.05).Spearman correlation analysis was used to evaluate the linear correlation between HADS-A and HADS-D scores and the indicators of overall cognitive function,attention,and executive function,respectively,where HADS-A score was positively correlated with the number of VST-C errors(r=0.282,p=0.021)and VST-C time(r=-0.258,p=0.035);HADS-D score was negatively correlated with the DST-correspondence score(r=-0.330,p=0.006)and DST-backwards score(r=-0.296,p=0.015),positively correlate with the VST-B time(r=0.292,p=0.017),VST-C time spent(r=0.333,p=0.006)and STT-A time(r=0.335,p=0.006).ConclusionsIn this study,the prevalence of anxiety and depression was 13.4%within 1 year of the first stroke,28.4%after stroke and 14.9%after stroke,and the prevalence of anxiety and depression was more common among post-stroke patients.This study found that the severity of depressive symptoms in stroke patients was negatively correlated with attention and executive function.The severity of anxiety symptoms may be negatively correlated with executive function,but the relationship with attention is unclear.In patients with severe post-stroke anxiety and depressive symptoms,attention should be paid to their attention and executive function.