The Evaluations Of Cognitive Functioning In Patients With Brainstem Infarct At The Acute Stage By Loewenstein Occupational Therapy Cognitive Assessment-Second Edition

Objective To investigate cognitive functioning in patients with brainstem infarct at the acute stage by Loewenstein Occupational Therapy Cognitive Assessment-Second Edition. And analyze the influencing factors of cognitive functioning in patients with brainstem infarct at the acute stage.Methods According to the inclusion and exclusion criteria, select 45 patients with brainstem infarction at the acute stage in Department of Neurology of the first Affiliated Hospital of Kunming Medical University in the period from February 2014 to February 2015 as the brainstem infarction case group, select 50 healthy people matched in age, gender and education level from patients’ families, carers and medical staffs as healthy control group. Use LOTCA-Ⅱ to evaluate the cognitive functioning after translating it into Chinese to explore if there is a difference between the brainstem infarction case group and healthy control group in cognitive functioning. The brainstem infarction case group was divided into the left side of the brain stem infarction case group and the right side of the brain stem infarction case group, or the large lesion group and the small lesion group, then to explore if there is a difference between each group. Finally, use multiple linear regression to analyze the correlation of the total score of LOTCA-Ⅱ and the age, gender, education level, smoking, excessive drinking, overweight or obesity, hypertension, diabetes, dyslipidemia, hyperuricemia, hyperhomocysteinemia,carotid artery stenosis,severity of neurological deficit, emotional incontinence, mild depression, mild anxiety.Results 1.The brainstem infarction case group scored lower than healthy control group in the total score of LOTCA-II, subprojects including visuomotor organization, thinking operations, attention and concentration, the secondary components including copying geometric forms, two-dimensional model, pegboard construction, colored block-design, plain block-design, reproduction of a puzzle, drawing a clock, Riska objection classification unstructured, Riska objection classification structured, picture sequence, geometric sequence(P≤0.05).2.There is no difference between the left side of the brain stem infarction case group and the right side of the brain stem infarction case group in the total score of LOTCA-Ⅱ and the score of each subproject; the left side of the brain stem infarction case group and the right side of the brain stem infarction case group scored lower than healthy control group in the total score of LOTCA-Ⅱ,subprojects including visuomotor organization, thinking operations(P≤ 0.05), attention and concentration(P≤0.017)3.The large lesion group scored lower than the small lesion group in the total score of LOTCA-Ⅱ,the small lesion group scored lower than healthy control group in the total score of LOTCA-Ⅱ (P≤0.017).4. Education level and the total score of LOTCA-Ⅱ were positively correlated(P≤ 0.05);men scored higher than women in the total score of LOTCA-Ⅱ(P≤ 0.05);excessive drinking, hypertension, diabetes, hyperhomocysteinemia, emotional incontinence, mild depression can make the total score of LOTCA-Ⅱ to reduce(P≤ 0.05); The total score of LOTCA-Ⅱ is irrelevant to age, smoking, overweight or obesity, dyslipidemia, hyperuricemia, carotid artery stenosis,severity of neurological deficit, mild anxiety.Conclusion l.The patients with brainstem infarct at the acute stage have cognitive impairment, especially visuomotor organization, thinking operations, attention and concentration.2.There is no difference between the patients with left brainstem infarct at the acute stage and the patients with right brainstem infarct at the acute stage in cognitive impairment.3.Cognitive impairment in the patients with a large brainstem infarct at the acute stage is more serious than the patients with a small brainstem infarct.4.Cognitive impairment in the patients with brainstem infarct at the acute stage is relevant to gender, education level, excessive drinking, hypertension, diabetes, hyperhomocysteinemia, emotional incontinence, mild depression; but it is irrelevant to age, smoking, overweight or obesity, dyslipidemia, carotid artery stenosis, hyperuricemia,severity of neurological deficit, mild anxiety.