Yuriko Nakaoku1, Naoya Oishi2, Yoshiki Hase3, Mai Hase3, Satoshi Saito4, Takahiro Mitsueda5, Masaru Matsui5, Kazunori Toyoda6, Kazuyuki Nagatsuka4, Raj N Kalaria3, Hidenao Fukuyama2, Masafumi Ihara7, Ryosuke Takahashi8. 1. Department of Neurology, National Cerebral and Cardiovascular Center, 565-8565 Suita, Japan; Department of Neurology, Japanese Red Cross Otsu Hospital, 520-8511 Otsu, Japan; Department of Neurology, Kyoto University Graduate School of Medicine, 606-8507 Kyoto, Japan. Electronic address: yurikon@kuhp.kyoto-u.ac.jp. 2. Research and Educational Unit of Leaders for Integrated Medical System, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, 606-8303 Kyoto, Japan. 3. Institute of Neuroscience, Newcastle University, NE4 5PL Newcastle upon Tyne, UK. 4. Department of Neurology, National Cerebral and Cardiovascular Center, 565-8565 Suita, Japan. 5. Department of Neurology, Japanese Red Cross Otsu Hospital, 520-8511 Otsu, Japan. 6. Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, 565-8565 Suita, Japan. 7. Department of Neurology, National Cerebral and Cardiovascular Center, 565-8565 Suita, Japan. Electronic address: ihara@ncvc.go.jp. 8. Department of Neurology, Kyoto University Graduate School of Medicine, 606-8507 Kyoto, Japan.
Abstract
OBJECTIVE: Valid and reliable measures are needed to assess post-stroke cognitive impairment. The Montreal Cognitive Assessment (MoCA) has been considered a superior screening test to the Mini-Mental State Examination (MMSE) for patients with post-stroke cognitive impairment, particularly in executive function, which may be related to reduction in regional cerebral blood flow (rCBF). In this study, we determined whether MoCA and MMSE scores correlate with rCBF assessed with SPECT in the subacute phase after ischemic stroke. PATIENTS AND METHODS: We retrospectively enrolled 28 patients who were admitted to the Red Cross Otsu Hospital with acute cerebral infarction, which was confirmed by magnetic resonance imaging (MRI), if they underwent cognitive assessment (MoCA/MMSE) and 123I-IMP SPECT imaging within 3 weeks post-stroke during a study period of 5 months. Correlation analyses between rCBF and MoCA or MMSE scores were performed by statistical parametric mapping (SPM) and volume-of-interest (VOI) analyses. RESULTS: Total MoCA score correlated with the rCBF in the prefrontal cortex, cingulate cortex, caudate nucleus and thalamus by SPM analysis (uncorrected p < 0.001; cluster-level corrected p < 0.05). Among the subtest scores of MoCA, visuoexecutive function, attention, language and delayed recall scores were positively correlated with rCBF in the prefrontal cortex by VOI analysis (p < 0.05). However, total MMSE score did not correlate significantly with any of the rCBF measures. CONCLUSIONS: Post-stroke cognitive performance assessed with MoCA positively correlated with rCBF in brain regions mainly comprising the prefrontal-subcortical circuits. The findings of this hypothesis-generating study support the notion that MoCA is useful for assessing post-stroke cognitive status.
OBJECTIVE: Valid and reliable measures are needed to assess post-stroke cognitive impairment. The Montreal Cognitive Assessment (MoCA) has been considered a superior screening test to the Mini-Mental State Examination (MMSE) for patients with post-stroke cognitive impairment, particularly in executive function, which may be related to reduction in regional cerebral blood flow (rCBF). In this study, we determined whether MoCA and MMSE scores correlate with rCBF assessed with SPECT in the subacute phase after ischemic stroke. PATIENTS AND METHODS: We retrospectively enrolled 28 patients who were admitted to the Red Cross Otsu Hospital with acute cerebral infarction, which was confirmed by magnetic resonance imaging (MRI), if they underwent cognitive assessment (MoCA/MMSE) and 123I-IMP SPECT imaging within 3 weeks post-stroke during a study period of 5 months. Correlation analyses between rCBF and MoCA or MMSE scores were performed by statistical parametric mapping (SPM) and volume-of-interest (VOI) analyses. RESULTS: Total MoCA score correlated with the rCBF in the prefrontal cortex, cingulate cortex, caudate nucleus and thalamus by SPM analysis (uncorrected p < 0.001; cluster-level corrected p < 0.05). Among the subtest scores of MoCA, visuoexecutive function, attention, language and delayed recall scores were positively correlated with rCBF in the prefrontal cortex by VOI analysis (p < 0.05). However, total MMSE score did not correlate significantly with any of the rCBF measures. CONCLUSIONS: Post-stroke cognitive performance assessed with MoCA positively correlated with rCBF in brain regions mainly comprising the prefrontal-subcortical circuits. The findings of this hypothesis-generating study support the notion that MoCA is useful for assessing post-stroke cognitive status.
Authors: Knut K Kolskår; Kristine M Ulrichsen; Genevieve Richard; Erlend S Dørum; Michel Thiebaut de Schotten; Jaroslav Rokicki; Jennifer Monereo-Sánchez; Andreas Engvig; Hege Ihle Hansen; Jan Egil Nordvik; Lars T Westlye; Dag Alnaes Journal: Brain Behav Date: 2022-07-21 Impact factor: 3.405