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Prediction of post-stroke dementia using NINDS-CSN 5-minute neuropsychology protocol in acute stroke

Published online by Cambridge University Press:  25 January 2017

Jae-Sung Lim
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Mi Sun Oh
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Ju-Hun Lee
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
San Jung
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Chulho Kim
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Min Uk Jang
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Sang-Hwa Lee
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Yeo Jin Kim
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Yerim Kim
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Jaeseol Park
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Yeonwook Kang
Affiliation:
Department of Psychology, Hallym University College of Social Sciences, Chuncheon, Republic of Korea
Kyung-Ho Yu*
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
Byung-Chul Lee*
Affiliation:
Department of Neurology, Hallym Neurological Institute, Hallym University College of Medicine, Anyang, Republic of Korea
*
Kyung-ho Yu, MD. PhD, Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22 Gwanpyeong-ro 17beon-gil, Dongan-gu, Anyang 14068, Republic of Korea. Phone: +82-31-380-3743; Fax: +82-31-380-4659. E-mail: ykh1030@hallym.or.kr
Correspondence should be addressed to: Byung-Chul Lee, MD, PhD, Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22 Gwanpyeong-ro 17beon-gil, Dongan-gu, Anyang 14068, Republic of Korea. Phone: +82-31-380-3740; Fax: +82-31-380-4659. Email: ssbrain@hallym.ac.kr.

Abstract

Background:

The National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute neuropsychology protocol consists of only verbal tasks, and is proposed as a brief screening method for vascular cognitive impairment. We evaluated its feasibility within two weeks after stroke and ability to predict the development of post-stroke dementia (PSD) at 3 months after stroke.

Method:

We prospectively enrolled subjects with ischemic stroke within seven days of symptom onset who were consecutively admitted to 12 university hospitals. Neuropsychological assessments using the NINDS-CSN 5-minute and 60-minute neuropsychology protocols were administered within two weeks and at 3 months after stroke onset, respectively. PSD was diagnosed with reference to the American Heart Association/American Stroke Association statement, requiring deficits in at least two cognitive domains.

Results:

Of 620 patients, 512 (82.6%) were feasible for the NINDS-CSN 5-minute protocol within two weeks after stroke. The incidence of PSD was 16.2% in 308 subjects who had completed follow-up at 3 months after stroke onset. The total score of the NINDS-CSN 5-minute protocol differed significantly between those with and without PSD (4.0 ± 2.7, 7.4 ± 2.7, respectively; p < 0.01). A cut-off value of 6/7 showed reasonable discriminative power (sensitivity 0.82, specificity 0.67, AUC 0.74). The NINDS-CSN 5-minute protocol score was a significant predictor for PSD (adjusted odds ratio 6.32, 95% CI 2.65–15.05).

Discussion:

The NINDS-CSN 5-minute protocol is feasible to evaluate cognitive functions in patients with acute ischemic stroke. It might be a useful screening method for early identification of high-risk groups for PSD.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Brott, T. et al. (1989). Measurements of acute cerebral infarction: a clinical examination scale. Stroke, 20, 864870.Google Scholar
Dong, Y. et al. (2016). The montreal cognitive assessment is superior to national institute of neurological disease and stroke-canadian stroke network 5-minute protocol in predicting vascular cognitive impairment at 1 year. BMC Neurology, 16, 46.CrossRefGoogle ScholarPubMed
Freitas, S., Simoes, M. R., Alves, L. and Santana, I. (2012). Montreal cognitive assessment: influence of sociodemographic and health variables. Archives of Clinical Neuropsychology, 27, 165175.Google Scholar
Gorelick, P. B. et al. (2011). Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American heart association/American stroke association. Stroke, 42, 26722713.CrossRefGoogle ScholarPubMed
Hachinski, V. et al. (2006). National institute of neurological disorders and stroke-Canadian stroke network vascular cognitive impairment harmonization standards. Stroke, 37, 22202241.Google Scholar
Kang, S. J., Choi, S. H., Lee, B. H., Kwon, J. C., Na, D. L., Han, S. H., and Korean Dementia Research Group (2002). The reliability and validity of the Korean instrumental activities of daily living (K-IADL). Journal of the Korean Neurological Association, 20, 814.Google Scholar
Kang, Y. (2006). A normative study of the Korean-mini mental state examination(K-MMSE) in the elderly. Korean Journal of Psychology, 25, 112.Google Scholar
Kang, Y., Chin, J. H., Na, D. L., Lee, J. H. and Park, J. S. (2000). A normative study of the Korean version of controlled oral word association test (COWAT) in the elderly. Korean Journal of Clinical Psychology, 19, 385392.Google Scholar
Kang, Y., Kim, H. H. and Na, D. L. (1999). A short form of the Korean-Boston Naming Test (K-BNT) for using in dementia patients. Korean Journal of Clinical Psychology, 18, 125138.Google Scholar
Kang, Y. and Na, D. L. (2003). Professional Manual; Seoul Neuropsychological Screening Battery. Seoul: Human brain research and consulting.Google Scholar
Kennedy, R. E. et al. (2014). Performance of the NINDS-CSN 5-minute protocol in a national population-based sample. Journal of the International Neuropsychological Society, 20, 856867.Google Scholar
Klimkowicz, A., Dziedzic, T., Slowik, A. and Szczudlik, A. (2002). Incidence of pre- and poststroke dementia: cracow stroke registry. Dementia and Geriatric Cognitive Disorders, 14, 137140.Google Scholar
Koski, L. (2013). Validity and applications of the Montreal cognitive assessment for the assessment of vascular cognitive impairment. Cerebrovascular Diseases, 36, 618.Google Scholar
Lee, D. W. et al. (2005). Validity of the Korean version of informant questionnaire on cognitive decline in the elderly(IQCODE). Journal of the Korean Geriatrics Society, 9, 196204.Google Scholar
Lim, J. S. et al. (2014). Cortical hubs and subcortical cholinergic pathways as neural substrates of poststroke dementia. Stroke, 45, 10691076.Google Scholar
Liu, W. et al. (2015). Influence of amyloid-beta on cognitive decline after stroke/transient ischemic attack: three-year longitudinal study. Stroke, 46, 30743080.Google Scholar
Mok, V. C. et al. (2004). Cognitive impairment and functional outcome after stroke associated with small vessel disease. The Journal of Neurology, Neurosurgery, and Psychiatry, 75, 560566.Google Scholar
Murphy, T. H. and Corbett, D. (2009). Plasticity during stroke recovery: from synapse to behaviour. Nature Reviews, Neuroscience, 10, 861872.CrossRefGoogle ScholarPubMed
Nys, G. M. et al. (2005). Domain-specific cognitive recovery after first-ever stroke: a follow-up study of 111 cases. Journal of the International Neuropsychological Society, 11, 795806.Google Scholar
Park, Y. H. et al. (2015). Executive function as a strong predictor of recovery from disability in patients with acute stroke: a preliminary study. Journal of Stroke and Cerebrovascular Diseases, 24, 554561.Google Scholar
Pendlebury, S. T. and Rothwell, P. M. (2009). Prevalence, incidence, and factors associated with pre-stroke and post-stroke dementia: a systematic review and meta-analysis. Lancet Neurology, 8, 10061018.Google Scholar
Sachdev, P. S. et al. (2014). Classifying neurocognitive disorders: the DSM-5 approach. Nature Reviews, Neurology, 10, 634642.Google Scholar
Yi, H., Chin, J. H., Lee, B. H., Kang, Y. and Na, D. L. (2007). Development and validation of Korean version of trail making test for elderly persons. Dementia Neurocognitive Disorder, 6, 5466.Google Scholar
Yu, K. H. et al. (2013). Cognitive impairment evaluated with vascular cognitive impairment harmonization standards in a multicenter prospective stroke cohort in Korea. Stroke, 44, 786788.Google Scholar
Yum, T. H., Park, Y. S., Oh, K. J., Kim, J. H. and Lee, Y. H. (1992). Manual for Korean-Wechsler Adult Intelligence Scale. Seoul: Korea Guidance.Google Scholar
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