The Study Of Loewenstein Occupational Therapy Congnitive Assessment On Cognitive Impairment In Patients Of Thalamic Stroke

Objective:To investigate the early cognitive impairment in patients with thalamic stroke, analyze the relationship among in cognitive impairment,depression, anxiety. To investigate correlation factor of the early cognitive impairment in patient with thalamic stroke.Methods:The exclusion criteria and the inclusion criteria for thalamic stroke group and control group were defined,There were 40 cases in thalamic stroke group and 40 cases of in control group included the patients without central nervous system disease or family members or the patient accompany. The Loewenstein Occupational Therapy Cognitive Assessment Battery (LOTCA) was used to evaluate the cognitive function and Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS) were used to evaluate depression, anxiety. All the patients were evaluated within half a month after the onset of the illness. Data analysis with SPSS statistic software.Results:1. Comparing the results of cognition function of thalamic stroke group and control group:①In the totle score of cognitive function, the score of each item and the score of every item, the patients of thalamic stroke have lower compared with the control, and there are significative differences between them(P＜0.05);②The time of each item in visumotor organization and the totle time of cognitive function,the patients of thalamic stroke have longer than the control, and significative differences are found between them (P＜0.05).2. The correlation analyzing among the total score of cognitive function,the level score of SDS and SAS in patients with thalamic stroke:①This association was observed dependly of the total score of cognitive function both in the level score of SDS and the level score of SAS (r= 0.336,r= 0.328,P＜0.05),②There were correlation between the orientation, visual perception, spatial perception, motor praxis,visumotor organization and thinking operation score of LOTCA and the level score of SDS and also the level score of SAS(r=0.271,0.262,0.238,0.240,0.296,0.314; 1=0.274,0.248,0.313,0.265,0.217,0.291, P＜0.05).3. The thalamic stroke patients with post-stroke depression and anxiety have lower total score of cognitive function compared with the patients without post-stroke depression and anxiety and the difference between them are achieved statistical significance(P＜0.05).4. The patients of thalamic stroke have lower socre in older,larger focal of thalamic stroke, multi-stroke, hemorrhagic thalamic stroke, hypertention, hyperglycaemia, dyslipidemia,carotid artery stenosis compared with the control,(P＜0.05); But,in gender and different side thalamic stroke, no differences were found in LOTCA total score between the patients of thalamic stroke group and the control group(P＞0.05).5. The extent of carotid artery stenosis is more serious, the total score LOTCA is lower, the correlation between them is positive(r=0.278, P＜0.05).Conclusion: 1.There is an extent degree early cognitive function impairment in patient with acute thalamic stroke,which displays general damage of orientation,visual perception,spatial perception, motor praxis,visumotor organization and thinking operation.2. Age,years of educations,size in focus of thalamic stroke,frequency of stroke, hemorrhagic thalamic stroke,blood pressure,blood glucose,blood fat and extent of carotid artery stenosis are correlative with early cognitive function in patients with acute thalamic stroke,but no correlation with gender, different side thalamic stroke.3. The depression and anxiety impact early cognitive function in patients with acute thalamic stroke.