Cognitive Dysfunction in Ischemic versus Hemorrhagic stroke

Main Article Content

Rasha M. Elrewainy
Fathia Mostafa Gelany
Naglaa Gadallah Mohammed
Reham Hamed Saad
Ola Mohamed Elgohary
Youssef Elbalawy

Keywords

data, stroke, results

Abstract

Background: Stroke is one of the major causes of physical and mental disability among people. Vascular cognitive impairment (VCI) represents a wide spectrum from mild cognitive impairment to dementia following cerebrovascular disorder that is resulting in either ischemic or hemorrhagic stroke.
Purpose of study: This study was conducted to investigate the difference in cognitive functions’ affection following ischemic versus hemorrhagic stroke.


Subjects: 75 subjects were enrolled in this study, 25 healthy subjects and 50 stroke patient (25 ischemic and 25 hemorrhagic stroke patients) of both sexes with age range between 45 and 55 years old, duration of illness was between 6 to 12 months and years of education of patients and subjects participated in this study was at least nine years. The patients were selected from outpatient clinic, Faculty of Physical Therapy, Cairo University, Egypt.Subjects were classified into three groups: GA (25 healthy subjects), GB (25 ischemic stroke patients) and GC (25 hemorrhagic stroke patients).


Methods: Both of healthy subjects and stroke (ischemic and hemorrhagic) patients received cognitive assessment via Montreal cognitive assessment scale (MOCA) and Rehacom system as four categories were assessed which are figural memory, attention concentration, reaction behavior and logical thinking; each category was assessed for 30min.


Results: This study results showed that there was a significant difference between the results of MOCA scale and Rehacom system among the three groups , with (P ≤ 0.05). Also, there was a significant difference between GB (ischemic stroke) and GC (hemorrhagic stroke).


Conclusion: on the basis of the present data , it can be concluded that healthy subjects have better preserved cognitive functions in comparison with stroke patients (either ischemic or hemorrhagic stroke) , based on MOCA scale results , deterioration in cognitive functions in hemorrhagic stroke was greater than in ischemic stroke , based on Rehacom System results , figural memory and logical thinking were more affected in patients with hemorrhagic stroke in comparison with ischemic stroke patients and reaction behavior and attention concentration were more affected in patients with ischemic stroke in comparison with haemorrhagic stroke patients .

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References

1. World health organization, 2020
2. World stroke organization, Global Stroke Fact Sheet, 2022
3. Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. heart disease and Stroke Statistics—2017 Update: A Report from the
American Heart Association. Circulation. 2017; 135: e146– e603. https://doi.org/10.1161/CIR.0000000000000485 PMID: 28122885.
4. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during
1990–2010: findings from the Global Burden of Disease Study 2010. The Lancet. 2014; 383: 245–255.
5. Ntaios G. Embolic Stroke of Undetermined Source: JACC Review Topic of the Week. J Am Coll Cardiol. 2020 Jan 28;75(3):333-340. [PubMed] [Reference list]
6. Pierik R, Algra A, van Dijk E, Erasmus ME, van Gelder IC, Koudstaal PJ, Luijckx GR, Nederkoorn PJ, van Oostenbrugge RJ, Ruigrok
YM, Scheeren TWL, Uyttenboogaart M, Visser MC, Wermer MJH, van den Bergh WM., on behalf of the Parelsnoer InstituteCerebrovascular Accident Study Group. Distribution of Cardioembolic Stroke: A Cohort Study. Cerebrovasc Dis. 2020;49(1):97-104. [PubMed] [Reference list]
7. Chen S, Zeng L, Hu Z. Progressing haemorrhagic stroke: categories, causes, mechanisms and managements. J Neurol. 2014 Nov;261(11):2061-78. [PMC free article] [PubMed] [Reference list]
8. del Ser T, Barba R, Morin MM, Domingo J, Cemillan C, Pondal M, Vivancos J: Evolution of cognitive impairment after stroke and risk factors
for delayed progression. Stroke. 2005, 36:2670-75. 10.1161/01.STR.0000189626.71033.35
9. Khedr EM, Hamed SA, El-Shereef HK, Shawky OA, Mohamed KA, Awad EM, Ahmed MA, Shehata GA, Eltahtawy MA: Cognitiveimpairment after cerebrovascular stroke: Relationship to vascular risk factors. Neuropsychiatr Dis Treat. 2009, 5:103–116.
10. X. Zhang and X. Bi, “Post-stroke cognitive impairment: a review focusing on molecular biomarkers,” Journal of Molecular Neuroscience,
vol. 70, no. 8, pp. 1244–1254, 2020.
11. S. Aam and M. Einstad, “Post-stroke cognitive impairmentimpact of follow-up time and stroke subtype on severity and cognitive profile: the Nor-COAST study,” Frontiers in Neurology, vol. 11, 2020.
12. J. W. Lo, J. D. Crawford, K. Samaras et al., “Association of prediabetes and type 2 diabetes with cognitive function after stroke: a STROKOG
collaboration study,” Stroke, vol. 51, no. 6, pp. 1640–1646, 2020.
13. C. Iadecola and R. F. Gottesman, “Neurovascular and cognitive dysfunction in hypertension,” Circulation Research, vol. 124, no. 7, pp. 1025–
1044, 2019.
14. L. Pantoni, “Have stroke neurologists entered the arena of stroke-related cognitive dysfunctions? Not Yet, but they should!,” Stroke, vol. 48, no. 6, pp. 1441-1442, 2017.
15. Khedr EM, Hamed SA, El-Shereef HK, Shawky OA, Mohamed KA, Awad EM, Ahmed MA, Shehata GA, Eltahtawy MA: Cognitive
impairment after cerebrovascular stroke: Relationship to vascular risk factors. Neuropsychiatr Dis Treat. 2009, 5:103–116.
16. Ingles JL, Boulton DC, Fisk JD, Rockwood K: Preclinical vascular cognitive impairment and alzheimer disease: neuropsychological test
performance 5 years before diagnosis. Stroke. 2007, 38:1148–53. 10.1161/01.STR.0000259716.04739.60.
17. del Ser T, Barba R, Morin MM, Domingo J, Cemillan C, Pondal M, Vivancos J: Evolution of cognitive impairment after stroke and risk factors
for delayed progression. Stroke. 2005, 36:2670-75. 10.1161/01.STR.0000189626.71033.35.
18. National Stroke Association. NIH Stroke Scale. 2014; NIHSS online education. http://www.stroke.org/site/PageServer?pagename
=nihss. Accessed October 21, 2014.
19. Nasreddine Z. 2016. MoCA Montreal Cognitive Assessment. Retrieved from http:// www.mocatest.org .
20. Nasreddine ZS, Phillips NA, Bédirian V, et al. 2005. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive
impairment. J Am Geriatr Soc 53: 695–699
21. Kim H, Yu KH, Lee BC, Kim BC, Kang Y. Validity of the Montreal Cognitive Assessment (MoCA) index scores: A comparison with the
cognitive domain scores of the Seoul Neuropsychological Screening Battery (SNSB). Dement Neurocogn Disord. 2021;20(3):28-37.
doi:10.12779/dnd.2021.20.3.28 .
22. Dautzenberg G, Lijmer J, Beekman A. Diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) for cognitive screening in old age
psychiatry: Determining cutoff scores in clinical practice. Avoiding spectrum bias caused by healthy controls. Int J Geriatr Psychiatry.
2020;35(3):261-269. doi:10.1002/gps.5227 .
23. Vásquez KA, Valverde EM, Aguilar DV, Gabarain HH. Montreal Cognitive Assessment scale in patients with Parkinson Disease with
normal scores in the Mini-Mental State Examination. Dement Neuropsychol. 2019;13(1):78-81. doi:10.1590/1980-
57642018dn13-010008.
24. Dawes P, Pye A, Reeves D, et al. Protocol for the development of versions of the Montreal Cognitive Assessment (MoCA) for people with
hearing or vision impairment. BMJ Open. 2019;9(3): e026246. doi:10.1136/bmjopen-2018-026246.
25. Dautzenberg G, Lijmer J, Beekman A. Diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) for cognitive screening in old age
psychiatry: Determining cutoff scores in clinical practice. Avoiding spectrum bias caused by healthy controls. Int J Geriatr Psychiatry.
2020;35(3):261-269. doi:10.1002/gps.5227.
26. MoCA Version November 12, 2004 © Z. Nasreddine MD www.mocatest.org
27. HASOMED GmbH (www. hasomed .de, 2012)
28. Pushpendra Nath Renjen , Charu Gauba , Dinesh Chaudhari : Cognitive Impairment After Stroke , Cureus 7(9): e335 , 5 of 9 , 2015 . DOI
10.7759/cureus.335. Open Access Original Article.
29. B. O. HUÈ TTER, J. M. GILSBACH & I. KREITSCHMANN. Quality of life and cognitive deficits after subarachnoid hemorrhage. British
Journal of Neurosurgery (1995) 9, 465 - 475.
30. Simona Spaccavento , Chiara Valeria Marinelli ,Roberto Nardulli,, Luigi Macchitella, , Umberto Bivona , Laura Piccardi , Pierluigi Zoccolotti ,
and Paola Angelelli , Attention Deficits in Stroke Patients: The Role of Lesion Characteristics, Time from Stroke, and Concomitant Neuropsychological Deficits , Volume 2019, Article ID 7835710, 12 pages .
31. S. L. Barker-Collo, V. L. Feigin, C. M. M. Lawes, V. Parag, H. Senior, and A. Rodgers, “Reducing attention deficits after stroke using
attention process training: A randomized controlled trial,” Stroke, vol. 40, no. 10, pp. 3293–3298, 2009.
32. S. L. Barker-Collo, V. L. Feigin, C. M. M. Lawes, V. Parag, and H. Senior, “Attention deficits after incident stroke in the acute period:
frequency across types of attention and relationships to patient characteristics andfunctional outcomes,” Topics in Stroke Rehabilitation, vol. 17, no. 6, pp. 463–476, 2010.
33. Ladurner, G., Iliff, L.D. and Lechner, H. (1982): Clinical factors associated with dementia in ischaemic stroke. J. Neurol. Neurosurg. Psychiat.,
45, 97-101.
34. Ladurner, G., Tschinkel, M., Klebl, H. and Lechner, H. (1985): Reaction time in vascular (Multiinfarkt) Dementia. World Congress in
Psychiatry, Vienna 1983, inprint.
35. Pirozzolo, F.J., Christensen, K.J., Ogle, K.M., Hansch, E.C. and Thomson, G. (1981): Simple and choice reaction time in Dementia. Neurobiol.
Aging, 2, 113-117.
36. Doyle KP, Quach LN, Sole M, Axtell RC, Nguyen TV, Soler-Llavina GJ, et al. (2015). Blymphocyte-mediated delayed cognitive impairment following stroke. J Neurosci 35:2133–2145.
37. Biswas, S. ., Bhagyasree, V. ., & Rathod, V. N. . (2022). A CHECKLIST OF BIRDS AND DIVERSITY OF AVIAN FAUNA IN MUDASARLOVA RESERVOIR OF VISAKHAPATNAM, INDIA . Journal Of Advanced Zoology, 42(02), 165–175. https://doi.org/10.17762/jaz.v42i02.51
38. Faisal, H. T. ., Abid, M. K. ., & Abed, A. . (2022). Study Of Some Biochemical Parameters in Dose During Pregnancy in Goats. Journal Of
Advanced Zoology, 43(1), 01–06. https://doi.org/10.17762/jaz.v43i1.109
39. Wankhade, L. N. . (2022). STUDY ON BUTTERFLY FAUNA OF KARANJA (GHADGE) TAHSIL OF DISTRICT WARDHA (MAHARASHTRA). Journal Of Advanced Zoology, 42(02), 186–193. https://doi.org/10.17762/jaz.v42i02.53