A Retrospective Study On The Characteristics And Efficacy Of Cognitive Dysfunction In Traumatic Brain Injury And Stroke

Objective: By analyzing the clinical manifestations and rehabilitation effects of cognitive dysfunction in patients after traumatic brain injury(TBI)and stroke,and provide objective evidence for targeted rehabilitation treatment.Methods: A retrospective study of 320 cognitive dysfunction patients after TBI and stroke who were admitted to the Department of Rehabilitation,the First Hospital of Jilin University from January 2014 to December 2020,including 87 cases of TBI and 233 cases of stroke.According to the lesion site,139 patients with frontal-temporal-parietal-occipital injury(TBI 68 cases,stroke 71 cases)were enrolled.A total of 48 cases(22 cases of TBI and 26 cases of stroke)who received computer-assisted cognitive rehabilitation intervention were collected to analyze the therapeutic effects before and after treatment.Mini-Mental State Examination(MMSE)was used for screening cognitive dysfunction.Those MMSE<27 were evaluated by Mo-ntreal Cognitive Assessment(MoCA)for analyzing the characteristics of cognitive dysfunction.Computer-assisted cognitive training system was used for cognitive function training,20 minutes a day,6 days a week,3 weeks in total.Results: There were significant differences in the total MMSE scores between the two groups(p<0.05),lower total score in TBI group,and there were significant differences in the scores of orientation,registration and naming(p<0.05),lower score in TBI group,while there were no significant differences in the scores of memory,attention and calculation,recall,3-stage command,reading,writing and copying(p>0.05).There were significant differences in MOCA total scores between the two groups(p<0.05),lower total score in TBI group,and there were significant differences in naming,abstraction,registration and orientation(p<0.05),lower score in TBI group,while there were no significant differences in visuospatial and executive function,attention span,alertness,calculation,repeat and fluency(p>0.05).Comparison of transient memory and delayed recall scores between TBI group and stroke group: there were significant differences in transient memory and delayed recall scores between the two groups(p<0.05).Transient memory scores of TBI group was higher than that of stroke group,while delayed recall scores was lower than that of stroke group.Comparison of therapeutic effects before and after treatment in groups: orientation,attention and calculation,recall,3-stage command,writing,copying,visual-spatial and executive function,naming,attention span,calculation,retelling,verbal fluency and abstraction were significantly improved in TBI group(p<0.05),but memory,reading and alertness were not significantly improved(p>0.05).In the stroke group,orientation,delayed recall,3-stage command,reading,writing,copying,visuospatial and executive function,naming,attention span,alertness,calculation,repetition,and verbal fluency were significantly improved(p<0.05),while abstraction,and memory were not significantly improved(p>0.05).Comparison of therapeutic effects between groups: After treatment,there were significant differences in total MMSE score and MOCA total score between the two groups(p<0.05).There were significant differences in calculation score between the two groups after treatment(p<0.05).The total score and calculation score of the TBI group were better than that of the stroke group.Conclusions: The cognitive function of TBI and stroke patients with fronto-temporal-parietal-occipital damage have different degrees of decline.The overall cognitive function impairment of TBI patients is more serious than that of stroke,especially the naming,delayed recall,orientation,and abstraction.Transient memory of TBI patients was better than that of stroke.Computer-assisted cognitive rehabilitation significantly improved the cognitive function of TBI and stroke patients,and the recovery of caculation in TBI patients after rehabilitation intervention was better than that in stroke patients.It is suggested that the key to the treatment of TBI and stroke cognitive function is to develop targeted rehabilitation strategies according to their different clinical characteristics.