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      Cognitive and Functional Impairment in Stroke Survivors with Basilar Artery Occlusive Disease

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          Abstract

          Background. Despite growing literature on posterior vascular disease, specific information about the cognitive and functional profiles of patients with basilar artery occlusion disease (BAOD) is scarce. The aims of this study were (1) to compare the cognitive statuses of BAOD survivors versus healthy controls and (2) to correlate the functional capacity outcomes with the cognitive profiles of BAOD patients. Methods. Comprehensive cognitive and functional assessments were carried out in 28 patients with BAOD and 27 age- and education level-matched healthy controls. Results. Compared to matched controls, patients presented impairments in selective, sustained, and set-shifting attention, processing speed, visuospatial skills, mental flexibility, and monitoring rules. There were significant deficits in verbal episodic memory (immediate and delayed recall) and visuospatial episodic memory (immediate and delayed recall and recognition). Functional capacity outcomes were significantly related to the cognitive test results. Seventy-five percent of patients had a Modified Rankin Scale score of 0 or 1. Conclusions. Our results indicate good functional outcomes in a selected group of BAOD survivors, despite the presence of subnormal performance on some cognitive tests, including tests of attention, executive function, and long-term memory.

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          A modified card sorting test sensitive to frontal lobe defects.

          H Nelson (1976)
          Milner's (1963) report of impaired performance on the Wisconsin Card Sorting Test (WCST) in a group of patients with frontal lobe lesions suggested that this test might be a useful one in the investigation of individual patients with suspected brain lesions. However, for many of our older hospital population the WCST was found to be too difficult and distressing, and also the inherent ambiguities associated with certain responses limited the test's usefulness for research purposes. Therefore, a simpler and less ambiguous modification was devised (MCS) and a new method of measuring perseverative errors proposed. In a group of 53 patients with unilateral cerebral lesions, those with frontal lobe lesions performed less well with the MCST and made a higher proportion of perseverative errors than those with lesions elsewhere: there were no laterality effects in either frontal or non-frontal groups. The usefulness of the MCST for detecting frontal lobe lesions in individual patients was established, and the use of cut-off scores briefly discussed.
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            [Suggestions for utilization of the mini-mental state examination in Brazil].

            Mini-metal state examination (MMSE) is a screening test to detect cognitive impairment. The objectives of the present study are to describe some adaptations for use of MMSE in Brazil and to propose rules for its uniform application. We evaluated 433 healthy subjects using the MMSE and verified the possible influence of demographic variables on total scores. Educational level was the main factor that influenced performance, demonstrated by ANOVA: F(4,425) = 100.45, p<0.0001. The median values for educational groups were: 20 for illiterates; 25 for 1 to 4 yrs; 26.5 for 5 to 8 yrs; 28 for 9 to 11 yrs and 29 for higher levels. The MMSE is an excellent screening instrument and definitive rules are necessary for comparison purposes.
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              Sugestões para o uso do mini-exame do estado mental no Brasil

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                Author and article information

                Journal
                Behav Neurol
                Behav Neurol
                BN
                Behavioural Neurology
                Hindawi Publishing Corporation
                0953-4180
                1875-8584
                2015
                3 June 2015
                : 2015
                : 971514
                Affiliations
                1Department of Neurology, University of São Paulo, 05403-000 São Paulo, SP, Brazil
                2Stroke Clinic, Department of Neurology, University of São Paulo, 05403-000 São Paulo, SP, Brazil
                3Department of Radiology, University of São Paulo, 05403-000 São Paulo, SP, Brazil
                Author notes
                *Eliane Correa Miotto: ecmiotto@ 123456usp.br

                Academic Editor: Olivier Piguet

                Article
                10.1155/2015/971514
                4469759
                26146461
                ab8ad756-a86a-4c86-a24b-09ecc0617e76
                Copyright © 2015 Kenia Repiso Campanholo et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 February 2015
                : 14 May 2015
                : 26 May 2015
                Categories
                Research Article

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