Cognition and quality of life in patients with carotid artery occlusion - A follow-up study

被引:26
作者
Bakker, FC
Klijn, CJM
van der Grond, J
Kappelle, LJ
Jennekens-Schinkel, A
机构
[1] Univ Med Ctr Utrecht, Dept Neurol, Utrecht, Netherlands
[2] Univ Med Ctr Utrecht, Sector Neuropsychol, Utrecht, Netherlands
[3] Univ Med Ctr Utrecht, Dept Radiol, Utrecht, Netherlands
[4] Rudolf Magnus Inst Neurosci, NL-3508 TA Utrecht, Netherlands
关键词
D O I
10.1212/WNL.62.12.2230
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Little is known about long-term cognitive functioning and quality of life (QoL) in patients with symptomatic carotid artery occlusion who do not undergo revascularization surgery. Objective: To assess the course of cognitive impairment and changes in QoL in these patients and whether impaired cerebral metabolism predicts the course of cognitive functioning. Methods: In 73 consecutive patients with TIA or a minor stroke associated with an occlusion of the internal carotid artery (ICA), cognition and health-related QoL in a 1-year follow-up study were examined. The presence of cerebral ischemic lesions was examined by MRI; the metabolic N-acetyl aspartate/creatine ratio and the presence of lactate were measured by H-1-MR spectroscopy in the centrum semiovale ipsilateral to the symptomatic ICA occlusion. Results: Seventy percent of patients with a stroke and 40% of patients with a TIA were cognitively impaired. In patients with recurrent TIAs during follow-up, cognitive functioning remained at the same ( impaired) level ( mean impairment score: at baseline 0.7, at 1-year follow-up 0.6; p = 0.646). In patients without lactate at baseline and without recurrent symptoms during follow- up, cognitive functioning improved ( mean impairment score: at baseline 1.1, at 1-year follow- up 0.7; p < 0.001). Self-perceived QoL remained affected at 12 months' follow- up, although not to a large extent ( mean SD from norm scores < 1). Conclusions: In patients with a symptomatic ICA occlusion, cognitive functioning improved within 1.5 years after the ischemic event, if no further symptoms occurred and patients had no lactate at baseline. Self-perceived QoL remained slightly affected.
引用
收藏
页码:2230 / 2235
页数:6
相关论文
共 43 条
[1]   Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations [J].
Aaronson, NK ;
Muller, M ;
Cohen, PDA ;
Essink-Bot, ML ;
Fekkes, M ;
Sanderman, R ;
Sprangers, MAG ;
Velde, AT ;
Verrips, E .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 1998, 51 (11) :1055-1068
[2]  
[Anonymous], 1974, Wechsler memory scale manual
[3]  
[Anonymous], 1996, Neuropsychological assessment of neuropsychological disorders
[4]  
ARRINDELL WA, 1999, GEDRAGSTHERAPIE, V32, P297
[5]   Cognitive disorders in patients with occlusive disease of the carotid artery: a systematic review of the literature [J].
Bakker, FC ;
Klijn, CJM ;
Jennekens-Schinkel, A ;
Kappelle, LJ .
JOURNAL OF NEUROLOGY, 2000, 247 (09) :669-676
[6]   Cognitive impairment is related to cerebral lactate in patients with carotid artery occlusion and ipsilateral transient ischemic attacks [J].
Bakker, FC ;
Klijn, CJM ;
Jennekens-Schinkel, A ;
van der Tweel, I ;
van der Grond, J ;
van Huffelen, AC ;
Tulleken, CAF ;
Kappelle, LJ .
STROKE, 2003, 34 (06) :1419-1424
[7]   INTEROBSERVER AGREEMENT FOR THE ASSESSMENT OF HANDICAP IN STROKE PATIENTS [J].
BAMFORD, JM ;
SANDERCOCK, PAG ;
WARLOW, CP ;
SLATTERY, J .
STROKE, 1989, 20 (06) :828-828
[8]  
Bays C L, 2001, J Neurosci Nurs, V33, P310
[9]  
Bennett D. A., 2002, Neurology, V59, P198
[10]   Conceptual background to vascular cognitive impairment [J].
Bowler, JV ;
Steenhuis, R ;
Hachinski, V .
ALZHEIMER DISEASE & ASSOCIATED DISORDERS, 1999, 13 :S30-S37