关键词: 腔隙性脑梗死, 认知功能损害, 神经心理学测验

Abstract: Objective To investigate the characteristics and changes of the cognitive impairment in patients with the firstever lacunar cerebral infarction(LI). Methods Neuropsychological evaluation was conducted within 1 week(4.70±1.70)days, 1 month brain〔(32.71±4.54)days〕, 3 months〔(94.53±6.65)days〕, 6 months〔(177.30±9.21)days〕 and 12 months〔(364.29±7.94)days〕 after lacunar infarction for 64 patients. The scores were compared with the baseline and those of 78 healthy controls. The comprehensive neuropsychological evaluation battery included minimental state examination, Chinese version of Wechsler adult intelligence scale(digit span, picture arrangement, digit sign and block design), World Health Organization University of California-Los Angeles auditory verbal learning test, Rey complex figure test, stroop test, semantic category verbal fluency test, California card sorting test and clock drawing test, which contains tests for attention, memory, executive function, information processing speed, visuospatial and visuoconstructive function. Results Compared with healthy controls, significant difference was found on the memory, executive function, visuospatial and visuo-constructive function in acute stage of lacunar cerebral infarction. The cognitive function was improved significantly and returned to normal on the memory and most executive function since 1 to 3 months after attack. WAIS-RC digit span backwards subtest and most visuospatial and visuo-constructive function tests(figures copying and clock drawing test) was not improved during 12 months. Some of executive function (semantic category verbal fluency and California card sorting test) aggravated again at 12 months after attack. Information processing speed and attention were preserved through the course. Conclusion In acute stage of lacunar cerebral infarction, the cognitive impairment was extensive and severe. Most cognitive domains were improved in 1 to 3 months. Executive function, visuospatial and visuoconstructive function impaired irreversibly or aggravated again. The patients with cognitive impairment after lacunar cerebral infarction needed more attention and intervention early.

Key words: lacunar infarction, cognitive impairment, neuropsychological tests