小脑梗死患者执行功能的初步临床研究

发布时间：2018-01-26 22:55

本文关键词： 小脑认知功能执行功能情绪认知　出处：《昆明医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的本研究主要通过对小脑不同半球梗死患者进行神经心理测评,并结合头颅MRI探讨小脑不同半球梗死对认知功能的影响,探索小脑的非运动功能状态及调节认知功能的关系,为今后进一步深入研究小脑的非运动功能提供相关依据。方法以2014年3月至2015年3月我院神经内科收治的小脑不同半球梗死患者16例作为病例组；同期选取年龄、受教育程度相匹配,临床及影像学检查无任何神经系统异常者16例作为对照组。病例组在发病后10-30天内病情稳定,能完成所有认知功能测验。病例组和对照组均采用蒙特利尔认知评估量表(MoCA)、简明精神状态量表(MMSE)进行认知的总体评估；汉密尔顿抑郁量表(HAMD)、修订情感淡漠评定量表(MAES)进行情绪认知评估；应用顺时数字记忆广度测验(DST)、连线测试(TMT)、词语流畅性测验(VFT)、额叶功能评定量表(FAB)、威斯康星卡片分类测试(WCST)进行执行功能评估。应用3.0T核磁共振扫描系统对小脑左右侧半球病变患者行全脑磁共振成像。并利用T1加权像,使用MRIcron软件在标准层模板上对病灶进行叠加。采用SPSS20.0软件对数据进行统计分析。结果 (1)小脑梗死组与对照组比较,梗死组MAES、RA、nRPE得分均显著高于对照组,梗死组MoCA、MMSE、DST、TMT、CC得分均显著低于对照组(P0.05)(2)小脑病例组中,左侧半球梗死组、右侧半球梗死组两组进行比较,两组得分无明显差异(P0.05)。结论 (1)小脑参与了部分认知的形成与加工,小脑梗死后执行功能、情绪认知均有不同程度的下降。(2)小脑单侧梗死均使执行功能、情绪认知产生不同程度的受损。(3)但小脑不同半球梗死后认知损害无明显差异。(4)小脑损伤对执行功能的影响可能是小脑核团的损伤所致。
[Abstract]:Objective to investigate the effects of cerebral infarction on cognitive function in patients with different cerebral hemispheres by means of neuropsychological assessment and cranial MRI. To explore the relationship between the non-motor function state of cerebellum and the regulation of cognitive function. To provide the basis for further study of cerebellar non-motor function in the future. From March 2014 to March 2015, 16 cases of cerebellar cerebral infarction with different hemispheres were treated in our hospital from March 2014 to March 2015. At the same time, 16 cases were selected as the control group with matched age, education level and no neurological abnormalities in clinical and imaging examination. The patient group was stable within 10-30 days after the onset of the disease. All cognitive function tests were completed. The patients and the control group were assessed with the Montreal Cognitive Assessment scale (MMSE) and the brief Mental State scale (MMSE). Hamilton Depression scale (Hamd) and revised emotional apathy scale (MAESs) were used to evaluate emotion cognition. DSTA, TMTT, VFTT and FAB were used to test the temporal digital memory span (DST), TMTT (line test), fluency test (VFT), and frontal lobe function assessment scale (FAB). Wisconsin card sorting test (WCST) was used to evaluate the executive function. Global magnetic resonance imaging (MRI) was performed in patients with cerebellar left and right hemispheric lesions using a 3.0T magnetic resonance imaging system. T1 weighted images were used. MRIcron software was used to stack the lesions on the standard layer template. The data were statistically analyzed by SPSS20.0 software. Results 1) the cerebellar infarction group was compared with the control group. The scores of MAESU RAA n RPE in infarction group were significantly higher than those in control group, and the MMSEN DSTT TMT in infarct group was significantly higher than that in control group. CC scores were significantly lower than those in the control group (P0.05 / 2) in the cerebellar group, the left hemisphere infarction group and the right hemisphere infarction group were compared between the two groups. Conclusion the cerebellum is involved in the formation and processing of partial cognition and the executive function after cerebellar infarction. Emotional cognition decreased in varying degrees. 2) unilateral cerebellar infarction all resulted in executive function. Emotional cognition was damaged in different degrees, but there was no significant difference in cognitive impairment after cerebral infarction in different hemispheres. 4) the effect of cerebellar injury on executive function may be caused by the damage of cerebellar nucleus.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R743.3

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