| Objective: The study was aimed to explore the effect of Stroop color word test(SCWT)and shape trails test(STT)in the early detection of post-acute ischemic stroke cognitive impairment(PSCI).Methods: Totally 174 patients with acute cerebral infarction who were hospitalized in the Department of Neurology of the Third People’s Hospital of Chengdu between October 2019 and June 2020 were enrolled.The Beijing version of the Montreal Cognitive Assessment(Mo CA)and Mini-Mental State Examination(MMSE)were used to evaluate global cognition.The STT and SCWT were used to assess executive function.Patients were divided into post-stroke cognitive impairment(PSCI)group and non-post stroke cognitive impairment(NPSCI)group based on the score of Mo CA.The baseline data,global cognition,cognitive domain and executive function of these two groups were analyzed and compared.In addition,the correlation between the indictors of SCWT and STT and each cognitive domain of Mo CA was analyzed,ROC curves of SCWT and STT in predicting PSCI were plotted.Results:(1)Baseline data: 130 cases were found with PSCI,accounting for 74.7%(130/174),and 44 cases were found without PSCI.Compared with NPSCI group,the Barthel index score was lower and the ADL score and m RS score were higher in PSCI group(P<0.05).(2)Comparison of global cognition and cognitive domains: The MMSE total score,Mo CA total score,and most cognitive domain scores of PSCI group were lower than those of NPSCI group(P<0.001).(3)Comparison of executive function: Compared with the NPSCI group,patients in PSCI group spend more time finishing STT.Additionally,the PSCI group showed a longer time lag of STT-(B-A),more frequencies of prompt and smaller number of arrivals in 1 minute(P <0.001).PSCI group spent more time finishing cards A,B and C.Besides,PSCI group had greater completion time of SIE,more correct response number of SIE,higher decline rate of correct response number,higher ratio of completion time for card A,B and C to correct response number,and less correct response numbers of cards B and C on average(P<0.05).(4)Correlation between STT and Mo CA: The completion time of STT-A and STT-B,the prompt frequencies of STT-A and STT-B,the time lag of STT-(B-A)were negatively correlated with the Mo CA score and its all cognitive domains(P<0.001),while the number of arrivals in 1 minute of STT-A and STT-B were positively correlated with them(P<0.001).(5)Correlation between SCWT and Mo CA: The completion time for card A,B and C,correct response number of SIE,decline rate of correct response number,ratio of completion time for card A,B and C to correct response number were negatively correlated with Mo CA score and its all cognitive domains(P<0.05),while the correct response number of card B or C was positively correlated with them(P<0.05).(6)Analysis of ROC curve:The STT-A exhibited a sensitivity of 58.5% and a specificity of 72.7% in predicting PSCI at early stage with an AUC of 0.690,when the optimal cut-off value was determined as 110.3 seconds.The STT-B had a sensitivity of 78.5%and a specificity of 68.2% with an AUC of 0.746,when the optimal cut-off value was 236.26 seconds.The sensitivity and specificity of time lag for STT-(B-A)were 80% and 68.2% with an AUC of 0.733,when the optimal cut-off value was determined as 131.495 seconds.The sensitivity and specificity of the completion time for card C were 87.7% and 56.8% with an AUC of 0.750,when the optimal cut-off value was 95.89 seconds.The sensitivity and specificity of correct response number of SIE were 76.2% and77.3% respectively with an AUC of 0.802,when the optimal cut-off value was determined as 1.5.The sensitivity and specificity of decline rate of correct response number were 76.2% and 77.3% with an AUC of 0.796,when the optimal cut-off value was determined as 3.02%.The sensitivity and specificity of ratio of completion time to correct response number for card C were 76.9%and 72.7% with an AUC of 0.796,when the optimal cut-off value was determined as 2.36.Conclusion:(1)The prevalence of PSCI at the early stage of cerebral infarction was high.Compared with NPSCI group,PSCI patients had worse performance in global cognition,ability of daily living and prognosis at discharge.(2)In PSCI group,cognitive domains decreased significantly,especially executive function.(3)The STT and SCWT were correlated with the cognitive domains of Mo CA,they had a high sensitivity and specificity in screening PSCI.Both of them can be used as rapid screening tools for PSCI in patients with acute cerebral infarction,which may facilitate the early intervention.Objective: To investigate the effects of different locations of cerebral infarction on executive function.Methods:174 patients with acute cerebral infarction who were hospitalized in the Department of Neurology of the Third People’s Hospital of Chengdu from October 2019 to June 2020 were included.The Beijing version of the Montreal Cognitive Assessment(Mo CA)and Mini-Mental State Examination were used to evaluate global cognition.STT and SCWT were used to assess the executive function.According to the location of infarction,patients were divided into 4 groups including cortical infarction group(47cases),subcortical infarction group(71 cases),cerebellar and/or brainstem infarction group(21 cases),and multi-regional infarction group(35 cases).Then the baseline data,global cognition,cognitive domain and executive function of the four groups were analyzed and compared.Results:(1)Baseline data: The BMI of the cortical infarction group and the multi-regional infarction group(23.52±3.10,23.22±3.40)were less than that of the subcortical infarction group(24.94±3.41).In the cortical infarction group,the Barthel index(68.32±26.40)was lower than that of the cerebellar and/or brainstem infarction group(82.62±15.21)and the proportion of atrial fibrillation(31.91%)was higher than subcortical infarction group(9.86%)and cerebellar and/or brainstem infarction group(0%)(P<0.05).(2)Comparison of global cognition and cognitive domains: Compared with the multi-regional infarction group,the subcortical infarction group had higher scores in the items of Mo CA total score,visuospatial and executive functioning score,the time-orientation and location-orientation score;The cerebellar and/or brainstem infarction group showed higher scores in terms of visuospatial and executive function score and location-orientation score(P<0.05)(3)Comparison of STT: Compared with the cortical infarction group,the subcortical infarction group and the cerebellum and/or brainstem infarction group had a greater number of arrivals in 1 minute of STT-A,shorter completion time of STT-A;The subcortical infarction group had less prompt frequencies of STT-A and shorter completion time of STT-B(P<0.05).Compared with the multi-regional infarction group,the cerebellum and/or brainstem infarction group had a greater number of arrivals in 1 minute of STT-A(P<0.05).(4)Comparison of the SCWT: Compared with the cortical infarction group and the multi-regional infarction group,the completion time of card C and completion time of SIE were shorter,the correct number of SIE,decline rate of correct number and ratio of completion time to correct response number for card C were smaller in the subcortical infarction group.The correct number of card C of the subcortical infarction group was greater than that of the multi-regional infarction group(P<0.05).Conclusions:(1)Patients with cortical infarction have a higher proportion of atrial fibrillation and poorer ability of daily living.(2)Patients with multi-regional infarction had a worse performance in global cognition.(3)The executive function was significantly impaired in the cortical infarction group and the multi-regional infarction group. |
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