Anatomical Correlates of Neuropsychological Deficits Among Patients With the Cerebellar Stroke

OBJECTIVE: To investigate the anatomical correlates of the neuropsychological deficits in patients with the cerebellar stroke. METHODS: We screened patients who were admitted to the National Rehabilitation Center with the cerebellar stroke between October 2012 and November 2016. The patients with the cerebellar stroke who underwent neuropsychological testing for which the Seoul Neuropsychological Screening Battery (SNSB) or the SNSB-II were enrolled. The neuropsychological function capacities were compared in accordance with the stroke type (hemorrhagic vs. ischemic) and the location (right/left anterior, right/left posterior intermediate, right/left posterior lateral lobe, and vermis). Mean z-scores were computed to compare the patient performances with the population averages. RESULTS: Twenty-six patients (15 with ischemic stroke and 11 with hemorrhagic stroke) with a mean age of 54.8±16.6 years were assessed 8.8±9.2 months after the stroke. Differences in the neuropsychological functioning according to the stroke type were not observed. All of the numerical subtests of the stroke patients showed significantly poorer performances compared with the population averages (mean z-score < 0), and some of the subtests revealed abnormal performances in attention-, visuospatial function-, memory-, and frontal/executive function-related tasks (mean z-score <−1). The patients with the presence of a lesion in the right posterior intermediate lobe of the cerebellum showed a poorer performance in the subtests evaluating the executive function including the Korean-version Stroop Test (p=0.04), the Digit Symbol Coding Test (p=0.01), and the Korean-version Trail Making Test (p=0.02) compared with the patients without that lesion. CONCLUSION: The present study confirms that the cerebellar stroke affects the neuropsychological functioning which is associated with the anatomical site of stroke.

Anatomical Correlates of Neuropsychological Deficits Among Patients With the Cerebellar Stroke

OBJECTIVE: To investigate the anatomical correlates of the neuropsychological deficits in patients with the cerebellar stroke. METHODS: We screened patients who were admitted to the National Rehabilitation Center with the cerebellar stroke between October 2012 and November 2016. The patients with the cerebellar stroke who underwent neuropsychological testing for which the Seoul Neuropsychological Screening Battery (SNSB) or the SNSB-II were enrolled. The neuropsychological function capacities were compared in accordance with the stroke type (hemorrhagic vs. ischemic) and the location (right/left anterior, right/left posterior intermediate, right/left posterior lateral lobe, and vermis). Mean z-scores were computed to compare the patient performances with the population averages. RESULTS: Twenty-six patients (15 with ischemic stroke and 11 with hemorrhagic stroke) with a mean age of 54.8±16.6 years were assessed 8.8±9.2 months after the stroke. Differences in the neuropsychological functioning according to the stroke type were not observed. All of the numerical subtests of the stroke patients showed significantly poorer performances compared with the population averages (mean z-score < 0), and some of the subtests revealed abnormal performances in attention-, visuospatial function-, memory-, and frontal/executive function-related tasks (mean z-score <−1). The patients with the presence of a lesion in the right posterior intermediate lobe of the cerebellum showed a poorer performance in the subtests evaluating the executive function including the Korean-version Stroop Test (p=0.04), the Digit Symbol Coding Test (p=0.01), and the Korean-version Trail Making Test (p=0.02) compared with the patients without that lesion. CONCLUSION: The present study confirms that the cerebellar stroke affects the neuropsychological functioning which is associated with the anatomical site of stroke.

Correlations between Pre-morbid Personality and Depression Scales in Stroke Patients

OBJECTIVE: To investigate the correlation between pre-morbid personality and depression scales in patients with stroke. METHOD: The subjects of this study included 45 patients with stroke and their caregivers. We conducted an interview of patients with Beck Depression Inventory (BDI) and also evaluated general characteristic (age, sex, location of lesion, cause of stroke, duration of illness, educational background, history of medication for depression) and functional level. Caregivers were evaluated with Hamilton Rating Scale for Depression (HRSD) for depressive mood, with NEO-PI (Neuroticism, Extraversion and Openness Personality Inventory) for pre-morbid personality. The results of each questionnaire were analyzed in order to investigate their correlation. The results were statistically analyzed with independent t-test, ANOVA, and Pearson correlation test. RESULTS: The HRSD score of the caregivers had a significant correlation with the BDI score (p=0.001) of the patients. The BDI score correlated with Neuroticism (p=0.021) and the HRSD score also correlated with Neuroticism (p=0.015). There were no statistical correlation of depression with sex, age, case of stroke, location of lesion, duration of illness and functional level. CONCLUSION: Among pre-morbid personalities, neuroticism of NEO-PI is the only factor which is significantly correlated with depression scales in stroke patients. Evaluating pre-morbid personality can be helpful in predicting the depressive mood in stroke patients, so we may have early intervention for it.

Application of Cognitive Perceptual Assessment for Driving (CPAD) for the Brain Injured Patients: A preliminary study

OBJECTIVE: To evaluate the utility of Cognitive Perceptual Assessment for Driving (CPAD) through the on-road test in predicting the actual road driving skills in brain injured patients. METHOD: 25 brain injured patients with actual driving experience before the occurrence of diseases participated in the handicapped driving adaptation training program of our hospital as the subjects of the study, and one round of CPAD and on-road test were performed. CPAD evaluations and on-road tests for all patients were evaluated by the same therapist. RESULTS: 11 patients passed the CPAD and all of them passed the on-road test. 3 patients failed from CPAD and they turned out to be failed at the on-road test. The mean CPAD score of the on-road test passed group was 53.6 which was significantly different from the mean 43.6 CPAD score acquired by the on-road test failed group by showing a significant difference between two groups (p<0.05). Among the 11 patients who received the borderline CPAD score, 9 patients passed the on-road test. CONCLUSION: CPAD is considered to be useful in predicting the actual road driving skills of brain injured patients who previously had driving experiences before the occurrence of the diseases.