Neurological and psychological status in acute stage of ischemic stroke
- Authors: Dementeva OV1, Starikova NL2
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Affiliations:
- Municipal Clinical Hospital №4, Perm, Russia
- Perm State Medical University named after Academician E.A. Wagner, Perm, Russia
- Issue: Vol 96, No 6 (2015)
- Pages: 1061-1065
- Section: Assistance to the practicing physician
- URL: https://kazanmedjournal.ru/kazanmedj/article/view/1641
- DOI: https://doi.org/10.17750/KMJ2015-1061
- ID: 1641
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Abstract
Aim. Assess the changes of neurological and psychological status in patients with acute stage of the first ischemic stroke.
Methods. The study included 25 patients with ischemic stroke, the average age was 65.72±12.49 years. Neuropsychological examination was performed using a Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment scale (MoCA), Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, Lazarus Ways of Coping Questionnaire. All studies were performed twice on day 1-3 and on day 19-21 after the stroke.
Results. Mild motor dysfunction by National Institute of Health Stroke Scale (NIHHS) was registered at admission. By the end of the acute period, positive changes were registered: NIHSS score decreased by 66.4%, significant improvement in patient’s cognitive status was seen. The average depression score by Beck Depression Inventory was 15.6 points, with severe depression diagnosed in 2 patients. By the end of the acute period, depressive symptoms regressed to the average level of 11.1 points. Reactive anxiety at admission was low, personal anxiety - high. By the end of the acute period anxiety remained at the same level or slightly reduced. Direct correlations of the neurological deficit degree by NIHSS and depression score by Beck Depression Inventory, as well as the later with personal anxiety level were revealed. Inverse correlation between the MMSE cognitive status and depression levels was discovered.
Conclusion. By the end of the acute period, the severity of emotional disorders decreases and cognitive function improves together with restoring motor activity.
Keywords
About the authors
O V Dementeva
Municipal Clinical Hospital №4, Perm, Russia
Author for correspondence.
Email: ovdementeva@bk.ru
N L Starikova
Perm State Medical University named after Academician E.A. Wagner, Perm, Russia
Email: ovdementeva@bk.ru
References
- Гусев Е.И., Коновалов А.Н., Скворцова В.И., Гехт А.Б. Неврология. Национальное руководство. М.: ГЭОТАР-Медиа. 2009; 1040 с.
- Гусев Е.И., Скворцова В.И., Стаховская Л.В. Эпидемиология инсульта в России. Ж. неврол. и психиатр. 2003; (8): 4-9.
- Киспаева Т.Т. Особенности формирования и прогрессирования некоторых когнитивных нарушений при церебральном инсульте и пути их коррекции. Леч. врач. 2010; (5): 14-15.
- Сергеев Д.В. Нейропротекция при ишемическом инсульте: оправданы ли надежды? Рус. мед. ж. 2010; 18 (26): 1521-1525.
- Alajbegovic A., Djelilovic-Vranic J., Alajbegovic S., Nakicevic A. Post stroke depression. Med. Arh. 2014; 68 (1): 47-50. http://dx.doi.org/10.5455/medarh.2014.68.47-50
- Ankolekar S., Renton C., Sare G. et al. ENOS Trial Investigators. Stroke Cerebrovasc. Dis. 2014; 23 (7): 1821-1829. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2014.04.022
- Arauz A., Rodríguez-Agudelo Y., Sosa A.L. et al. Vascular cognitive disorders and depression after first-ever stroke: the fogarty-Mexico stroke cohort. Cerebrovasc. Dis. 2014; 38 (4): 284-289. http://dx.doi.org/10.1159/000366471
- Bowler J.V., Hachinski V. The concept of vascular cognitive impairment. T. Erkinjuntti, S. Gauthier eds. Vascular cognitive impairment. Martin Dunitz. 2002; 9-26.
- Broomfield N.M., Quinn T.J., Abdul-Rahim A.H. et al. Depression and anxiety symptoms post-stroke. TIA: prevalence and associations in cross-sectional data from a regional stroke registry. BMC Neurology. 2014; 14: 198. http://dx.doi.org/10.1186/s12883-014-0198-8
- Cooper C.L., Phillips L.H., Johnston M. et al. The role of emotion regulation on social participation following stroke. Br. J. Clin. Psychol. 2015; 54 (2): 181-199. http://dx.doi.org/10.1111/bjc.12068
- Guajardo V.D., Terroni L., Sobreiro M. de F. et al. The influence of depressive symptoms on quality of life after stroke: a prospective study. J. Stroke Cerebrovasc. Dis. 2015; 24 (1): 201-219. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2014.08.020
- Kauhanen M.L., Korpelainen J.T., Hiltunen P. Poststroke depression correlates with cognitive impairment and neurological deficit. Stroke. 1999; 30: 1875-1880. http://dx.doi.org/10.1161/01.STR.30.9.1875
- Leys D., Pasquier F. Post-stroke dementia. San Antonio: VASCOG. 2007; 21.
- Matsuzaki S., Hashimoto M., Yuki S. et al. The relationship between post-stroke depression and physical recovery. J. Affect Disord. 2015; 176C: 56-60. http://dx.doi.org/10.1016/j.jad.2015.01.020
- Nys G.M., van Zandvoort M.J., van der Worp H.B. et al. Early depressive symptoms after stroke: neuropsychological correlates and lesion characteristics. J. Neurol. Sci. 2005; 228 (1): 27-33. http://dx.doi.org/10.1016/j.jns.2004.09.031
- Sachdev P.S., Brodaty Н., Valenzuela M.J. et al. The neuropsychological profile of vascular cognitive impairment in stroke and TIA patients. Neurology. 2004; 62: 912-919. http://dx.doi.org/10.1212/01.WNL.0000115108.65264.4B
- Shi Y.-Z., Wu S.-L., Zhang N., Zhou J. The relationship between frontal lobe lesions, course of post-stroke depression, and 1-year prognosis in patients with first-ever ischemic stroke. PLoS ONE. 2014; 9 (7): e100456. http://dx.doi.org/10.1371/journal.pone.0100456
- Tatemichi T.K., Desmond D.W., Mayeux R. et al. Dementia after stroke: baseline frequency, risks, and clinical features in a hospitalized cohort. Neurology. 1992; 42: 1185-1193. http://dx.doi.org/10.1212/WNL.42.6.1185
- Visser M.M., Aben L., Heijenbrok-Kal M.H. et al. The relative effect of coping strategy and depression on health-related quality of life in patients in the chronic phase after stroke. J. Rehabil. Med. 2014; 45: 514-519. http://dx.doi.org/10.2340/16501977-1803
- Žikič T.R., Divjak I., Jovićević M. et al. The effect of post stroke depression on functional outcome and quality of life. Acta Clin. Croat. 2014; 53 (3): 294-301.