Early MoCA-Assessed Cognitive Impairment After Aneurysmal Subarachnoid Hemorrhage and Relationship to 1-Year Functional Outcome
详细信息 查看全文
- 作者：George Kwok Chu Wong (1) (5)
Sandy Wai Lam (1)
Adrian Wong (4)
Vincent Mok (2)
Deyond Siu (3)
Karine Ngai (1)
Wai Sang Poon (1) - 关键词：Cerebral aneurysm ; Cognition ; Montreal cognitive assessment ; Subarachnoid hemorrhage
- 刊名：Translational Stroke Research
- 出版年：2014
- 出版时间：April 2014
- 年：2014
- 卷：5
- 期：2
- 页码：286-291
- 全文大小：136 KB
- 参考文献：1. Chau PH, Woo J, Goggins WB, et al. Trends in stroke incidence in Hong Kong differ by stroke subtype. Cerebrovasc Dis. 2011;31:138-6. CrossRef
2. Al-Khindi T, Macdonald RL, Schweizer TA. Cognitive and functional outcome after aneurysmal subarachnoid hemorrhage. Stroke. 2010;41:e519-6. CrossRef
3. Rinkel GJE, Algra A. Long-term outcomes of patients with aneurysmal subarachnoid haemorrhage. Lancet Neurol. 2011;10:349-6. CrossRef
4. Mayer SA, Kreiter KT, Copeland D, et al. Global and domain-specific cognitive impairment and outcome after subarachnoid hemorrhage. Neurology. 2002;59:1750-. CrossRef
5. Wong GK, Wong R, Mok VC, et al. Clinical study on cognitive dysfunction after spontaneous subarachnoid haemorrhage: patient profiles and relationship to cholinergic dysfunction. Acta Neurochir. 2009;151:1601-. CrossRef
6. Wong GK, Lam S, Ngai K, et al. Evaluation of cognitive impairment by the Montreal Cognitive Assessment in patients with aneurysmal subarachnoid hemorrhage: prevalence, risk factors, and correlations with 3-month outcomes. J Neurol Neurosurg Psychiatry. 2012;83:1112-. CrossRef
7. Wong GK, Lam S, Ngai K, et al. Cognitive domain deficits in patients with aneurysmal subarachnoid hemorrhage at one year. J Neurol Neurosurg Psychiatry. 2013;84:1054-. CrossRef
8. Jaja BN, Cusimano MD, Etminan N, et al. Clinical prediction models for aneurysmal subarachnoid hemorrhage: a systemic review. Neurocrit Care. 2012;18:143-3. CrossRef
9. Macdonald RL, Michael CD, Etminan N, et al. Subarachnoid Hemorrhage International Trialists Data Repository (SAHIT). World Neurosurg. 2013. doi:10.1016/j.wneu.2013.01.006 .
10. Worthington JM. Two simple tests and one complex disease. J Neurol Neurosurg Psychiatry. 2012;83:1136. CrossRef
11. Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695-. CrossRef
12. Wong GK, Wong R, Poon WS. Cognitive outcomes and activity of daily living for neurosurgical patients with intrinsic brain lesions: a 1-year prevalence study. Hong Kong J Occup Ther. 2011;21:27-2. CrossRef
13. Wong GK, Ngai K, Lam SW, et al. Validity of the Montreal Cognitive Assessment for traumatic brain injury patients with intracranial haemorrhage. Brain Inj. 2013;27:394-. CrossRef
14. Wong GK, Lam S, Ngai K, Wong A, Poon WS, Mok V. Comparison of Montreal Cognitive Assessment and Mini-Mental State Examination in evaluating cognitive domain deficit following aneurysmal subarachnoid haemorrhage. PLoS ONE. 2013;8(4):e59946. doi:10.1037/journal.pone.0059946 . CrossRef
15. Wong GK, Ngai K, Wong A, et al. Long-term cognitive dysfunction in patients with traumatic subarachnoid hemorrhage: prevalence and risk factors. Acta Neurochir. 2012;154:105-1. CrossRef
16. Banks JL, Marotta CA. Outcomes validity and reliability of the modified Rankin Scale: implications for stroke clinical trials: a literature review and synthesis. Stroke. 2007;38:1091-. CrossRef
17. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179-6. CrossRef
18. Tong A, Man DW. The validation of the Hong Kong Chinese version of the Lawton Instrumental Activities of Daily Living Scale for institutionalized elderly persons. OTJR Occup Particip Health. 2002;22:132-2.
19. Macdonald RL, Higashida RT, Keller E, et al. Clazosentan, an endothelin receptor antagonist, in patients with aneurysmal subarachnoid haemorrhage undergoing surgical clipping: a randomised, double-blind, placebo-controlled phase 3 trial. Lancet Neurol. 2011;10:618-5. CrossRef
20. Fluss R, Faraggi D, Reiser B. Estimation of the Youden Index and its associated cutoff point. Biom J. 2005;47:458-2. CrossRef
21. Youden WJ. Index for rating diagnostic tests. Cancer. 1950;3:32-. CrossRef
22. Dong YH, Venketasubramanian N, Chan BP, et al. Brief screening tests during acute admission in patients with mild stroke are predictive of vascular cognitive impairment 3- months after stroke. J Neurol Neurosurg Psychiatry. 2012;83:580-. CrossRef
23. Schweizer TA, Al-Khindi T, Macdonald RL. Mini-Mental State Examination versus Montreal Cognitive Assessment: rapid assessment tools for cognitive and functional outcome after aneurysmal subarachnoid hemorrhage. J Neurol Sci. 2012;316:137-0. CrossRef
24. Bendel P, Koivisto T, Niskanen E, et al. Brain atrophy and neuropsychological outcome after treatment of ruptured anterior cerebral artery aneurysms: a voxel-based morphometric study. Neuroradiology. 2009;51:711-2. CrossRef
25. Orbo M, Waterloo K, Egge A, et al. Predictors for cognitive impairment one year after surgery for aneurysmal subarachnoid hemorrhage. J Neurol. 2008;255:1770-. CrossRef
26. Fisher CM, Kistler JP, Davis JM. Relation to cerebral vasospasm to subarachnoid hemorrhage visualized by tomographic scanning. Neurosurgery. 1980;6:1-. CrossRef
27. Hijdra A, van Gijn J, Nagelkerke NJ, Vermeulen M, van Crevel H. Prediction of delayed cerebral ischemia, rebleeding, and outcome after aneurysmal subarachnoid hemorrhage. Stroke. 1988;19:1250-. CrossRef
28. Patel MD, Coshall C, Rudd AG, Wolfe CD. Cognitive impairment after stroke: clinical determinants and its associations with long-term stroke outcomes. J Am Geriatr Soc. 2002;50:700-. CrossRef - 作者单位：George Kwok Chu Wong (1) (5)
Sandy Wai Lam (1)
Adrian Wong (4)
Vincent Mok (2)
Deyond Siu (3)
Karine Ngai (1)
Wai Sang Poon (1)
1. Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong
5. Department of Surgery, Prince of Wales Hospital, 4/F Clinical Science Building, 30-32 Ngan Shing Street, Shatin, New Territories Hong Kong SAR, China
4. Department of Psychological Studies, The Hong Kong Institute of Education, 10 Lo Ping Road, Tai Po, New Territories, Hong Kong
2. Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong
3. Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong - ISSN：1868-601X
文摘
Recent clinical research into aneurysmal subarachnoid hemorrhage (aSAH) has confirmed the long-term effect of cognitive dysfunction on functional outcomes. We hypothesized that early cognitive impairment was a marker of permanent brain injury and hence predicted long-term functional outcome. Hong Kong Chinese patients with aneurysmal subarachnoid hemorrhage were evaluated prospectively by means of the Montreal Cognitive Assessment (MoCA) in the subacute phase (2-?weeks after aSAH) and by neuropsychological evaluation of functional outcomes in the chronic phase (1?year after aSAH). This multi-center prospective observational study is registered at ClinicalTrials.gov of the US National Institutes of Health (NCT01038193). One hundred and eight patients completed both the subacute and chronic phase assessments. Cognitive dysfunction in the subacute phase independently correlated with functional outcomes at 1?year, after adjusting for age, admission clinical condition, treatment modality, motor score, and mobility in the subacute phase, but the positive predictive values remained low. MoCA-assessed cognitive impairment in the subacute phase cannot accurately predict functional outcomes at 1?year. Future study should focus on understanding the relative importance of different components of early cognitive impairment.