《中国康复理论与实践》

中国康复理论与实践 >

2020 , Vol. 26 >Issue 7: 797 - 801

DOI: https://doi.org/10.3969/j.issn.1006-9771.2020.07.012

综述

脑卒中患者执行功能的研究进展

  • 熊健 ,
  • 郑国华
展开
  • 1.上海中医药大学研究生院,上海市 201315
    2.上海健康医学院护理与健康管理学院,上海市 201318
熊健(1993-),男,汉族,江西宜春市人,硕士研究生,主要研究方向：脑功能的中西医结合康复。|郑国华(1979-),男,汉族,福建福州市人,博士,教授,主要研究方向：常见慢性病预防与康复运动与健康管理。

收稿日期: 2019-07-16

  修回日期: 2019-08-22

  网络出版日期: 2020-07-24

收起

Advance in Executive Function for Post-stroke Patients (review)

  • Jian XIONG ,
  • Guo-hua ZHENG
Expand
  • 1. Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai 201315, China
    2. College of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China

Received date: 2019-07-16

  Revised date: 2019-08-22

  Online published: 2020-07-24

Fold

摘要

执行功能障碍是脑卒中患者最为常见的认知功能障碍。除了经典范式的测量工具外,脑卒中患者执行功能的评定还有基于活动性能测试的方法。影响卒中后执行功能障碍因素有年龄、梗死区域和面积、心血管危险因素(高血压、糖尿病、房颤与吸烟)及受教育程度。除了传统的运动训练和认知康复外,非侵入性脑刺激技术(经颅直流电刺激和经颅磁刺激)、虚拟现实技术和抗抑郁药物治疗也逐渐用于改善卒中后执行功能障碍。

关键词： 脑卒中; 执行功能; 影响因素; 评定; 康复; 综述

本文引用格式

熊健 , 郑国华 . 脑卒中患者执行功能的研究进展[J]. 中国康复理论与实践, 2020 , 26(7) : 797 -801 . DOI: 10.3969/j.issn.1006-9771.2020.07.012

Abstract

Executive dysfunction is common in stroke patients. Other than the classical assessment tools, there are performance-based assessments for post-stroke executive dysfunction. The related factors include age, infarct region and area, cardiovascular risk factors (hypertension, diabetes, atrial fibrillation and smoking) and education level. In addition to traditional exercise and cognitive rehabilitation, non-invasive brain stimulation technology (transcranial direct current stimulation and transcranial magnetic stimulation), virtual reality and antidepressant have been used more and more for post-stroke executive dysfunction.

Key words： stroke; executive function; related factors; assessment; rehabilitation; review

参考文献

[1] Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2019, 394(10204): 1145-1158.
[2] Hayes S, Donnellan C, Stokes E. Executive dysfunction and balance function post-stroke: a cross-sectional study[J]. Physiotherapy, 2016, 102(1): 64-70.
[3] Diamond A. Executive functions[J]. Annu Rev Psychol, 2013, 64(1): 135-168.
[4] Povroznik J M, Ozga J E, Vonder Haar C, et al. Executive (dys)function after stroke: special considerations for behavioral pharmacology[J]. Behav Pharmacol, 2018, 29(7): 638-653.
[5] Hayes S, Donnellan C, Stokes E. Associations between executive function and physical function poststroke: a pilot study[J]. Physiotherapy, 2013, 99(2): 165-171.
[6] Snyder H R, Miyake A, Hankin B L. Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches[J]. Front Psychol, 2015, 6:328.
[7] Zinn S, Bosworth H B, Hoenig H M, et al. Executive function deficits in acute stroke[J]. Arch Phys Med Rehabil, 2007, 88(2): 173-180.
[8] Laakso H M, Hietanen M, Melkas S, et al. Executive function subdomains are associated with post-stroke functional outcome and permanent institutionalization[J]. Eur J Neurol, 2019, 26(3): 546-552.
[9] Kim H, Lee Y N, Jo E M, et al. Reliability and validity of culturally adapted executive function performance test for Koreans with stroke[J]. J Stroke Cerebrovasc Dis, 2017, 26(5): 1033-1040.
[10] 朱敏敏, 孙中武. Stroop色词测验在识别主观认知功能障碍中的作用[J]. 安徽医科大学学报, 2015, 50(9): 1316-1319.
[10] Zhu M M, Sun Z W. Appliation of Stroop Color-Word Test on Chinese elderly patients with subjective cognitive impairment[J]. Acta Univ Med Anhui, 2015, 50(9): 1316-1319.
[11] Hagenaars S P, Cox S R, Hill W D, et al. Genetic contributions to Trail Making Test performance in UK Biobank[J]. Mol Psychiatry, 2018, 23(7): 1575-1583.
[12] Chiu E C, Wu W C, Hung J W, et al. Validity of the Wisconsin Card Sorting Test in patients with stroke[J]. Disabil Rehabil, 2018, 40(16): 1967-1971.
[13] 王宗琴, 王高华, 胡晓华. 基于万方数据库的威斯康星卡片分类测验的文献计量学分析[J]. 武汉大学学报(医学版), 2018, 39(2): 340-344.
[13] Wang Z Q, Wang G H, Hu X H. Bibliometric analysis of Wisconsin Card Sorting Test based on Wanfang Database[J]. Med J Wuhan Univ, 2018, 39(02): 340-344.
[14] 邢小玲, 郭霞, 饶颖臻, 等. 执行缺陷综合征的行为评价和威斯康星卡片分类测验在脑梗死患者执行功能评估中的应用[J]. 中国康复理论与实践, 2013, 19(11): 1039-1042.
[14] Xing X L, Guo X, Rao Y Z, et al. Application of behavioral assessment of dysexecutive syndrome and Wisconsin Card Sorting Test for executive function assessment in patients with cerebral infarction[J]. Chin J Rehabil Theory Pract, 2013, 19(11): 1039-1042.
[15] 陈长香, 李建民, 王静. 应用BADS对老年人执行功能的评测[J]. 中国老年学杂志, 2010, 30(24): 3764-3765.
[15] Chen C X, Li J M, Wang J. Application of BADS test on executive function of the elderly[J]. Chin J Geront, 2010, 30(24): 3764-3765.
[16] Poulin V, Korner-Bitensky N, Dawson D R. Stroke-specific executive function assessment: a literature review of performance-based tools[J]. Aust Occup Ther J, 2013, 60(1): 3-19.
[17] 赵雅宁, 高锦云, 吴玉静, 等. 缺血性脑卒中患者执行功能障碍影响因素研究[J]. 重庆医学, 2012, 41(20): 2058-2061.
[17] Zhao Y N, Gao J Y, Wu Y J, et al. Study on executive function impairment in patients with ischemic stroke[J]. Chongqing Med, 2012, 41(20): 2058-2061.
[18] 袁大华, 张虹桥, 章成国, 等. 首发急性缺血性脑卒中患者认知功能变化及其与相关因素关系的分析[J]. 中华神经医学杂志, 2012, 11(11): 1098-1105.
[18] Yuan D H, Zhang H Q, Zhang C G, et al. Changes of cognitive function and its correlated factors in patients with first acute cerebral ischemic stroke[J]. Chin J Neuromed, 2012, 11(11): 1098-1105.
[19] Levine D A, Wadley V G, Langa K M, et al. Risk factors for poststroke cognitive decline: the REGARDS Study (Reasons for Geographic and Racial Differences in Stroke)[J]. Stroke, 2018, 49(4): 987-994.
[20] Su C Y, Chen H M, Kwan A L, et al. Neuropsychological impairment after hemorrhagic stroke in basal ganglia[J]. Arch Clin Neuropsychol, 2007, 22(4): 465-474.
[21] Saczynski J S, Sigurdsson S, Jonsdottir M K, et al. Cerebral infarcts and cognitive performance importance of location and number of infarcts[J]. Stroke, 2009, 40(3): 677-682.
[22] Dregan A, Stewart R, Gulliford M C. Cardiovascular risk factors and cognitive decline in adults aged 50 and over: a population-based cohort study[J]. Age Ageing, 2013, 42(3): 338-345.
[23] Tsao C W, Himali J J, Beiser A S, et al. Association of arterial stiffness with progression of subclinical brain and cognitive disease[J]. Neurology, 2016, 86(7): 619-626.
[24] Zhang L, Chopp M, Jiang Q, et al. Role of the glymphatic system in ageing and diabetes mellitus impaired cognitive function[J]. Stroke Vasc Neurol, 2019, 4(2): 90-92.
[25] Cheng G, Huang C, Deng H, et al. Diabetes as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies[J]. Intern Med J, 2012, 42(5): 484-491.
[26] Nishtala A, Piers R J, Himali J J, et al. Atrial fibrillation and cognitive decline in the Framingham Heart Study[J]. Heart Rhythm, 2018, 15(2): 166-172.
[27] Kalantarian S, Stern T A, Mansour M, et al. Cognitive impairment associated with atrial fibrillation: a meta-analysis[J]. Ann Intern Med, 2013, 158(1): 338-346.
[28] Anstey K J, von Sanden C, Salim A, et al. Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies[J]. Am J Epidemiol, 2007, 166(4): 367-378.
[29] Lu D, Ren S, Zhang J, et al. Vascular risk factors aggravate cognitive impairment in first-ever young ischaemic stroke patients[J]. Eur J Neurol, 2016, 23(5): 940-947.
[30] 侯桂云, 黎光明, 谢晋艳, 等. 老年人认知功能的变化轨迹:基于潜变量增长模型的分析[J]. 心理科学, 2018, 41(4): 835-841.
[30] Hou G Y, Li G M, Xie J Y, et al. How does the cognitive function change among Chinese elderly people: a latent growth curve modeling[J]. J Psychol Sci, 2018, 41(4): 835-841.
[31] 赵雅宁, 郭霞, 窦娜, 等. 理想心血管健康行为和健康因素与首发脑梗死患者执行功能的关系[J]. 中国康复理论与实践, 2014, 20(7): 667-670.
[31] Zhao Y N, Guo X, Dou N, et al. Relationship between cardiovascular health behavior and health factor and executive function in newly acute cerebral infarction patients[J]. Chin J Rehabil Theory Pract, 2014, 20(7): 667-670.
[32] Oberlin L E, Waiwood A M, Cumming T B, et al. Effects of physical activity on poststroke cognitive function: a meta-analysis of randomized controlled trials[J]. Stroke, 2017, 48(11): 3093-3100.
[33] Kraemer W J, Ratamess N A, Nindl B C. Recovery responses of testosterone, growth hormone, and IGF-1 after resistance exercise[J]. J Appl Physiol, 2017, 122(3): 549-558.
[34] Tsai C L, Pai M C, Ukropec J, et al. Distinctive effects of aerobic and resistance exercise modes on neurocognitive and biochemical changes in individuals with mild cognitive impairment[J]. Curr Alzheimer Res, 2019, 16(4): 316-332.
[35] Tsai C L, Wang C H, Pan C Y, et al. The effects of long-term resistance exercise on the relationship between neurocognitive performance and GH, IGF-1, and homocysteine levels in the elderly[J]. Front Behav Neurosci, 2015, 9(23): 1-12.
[36] Fernandez-Gonzalo R, Fernandez-Gonzalo S, Turon M, et al. Muscle, functional and cognitive adaptations after flywheel resistance training in stroke patients: a pilot randomized controlled trial[J]. J Neuroeng Rehabil, 2016, 13(1): 37-49.
[37] Liu-Ambrose T, Eng J J. Exercise training and recreational activities to promote executive functions in chronic stroke: a proof-of-concept study[J]. J Stroke Cerebrovasc Dis, 2015, 24(1): 130-137.
[38] Sitzer D, Twamley E, Jeste D. Cognitive training in Alzheimer’s disease: a meta-analysis of the literature[J]. Acta Psychiatr Scand, 2010, 114(2): 75-90.
[39] 邹淑怡, 温红梅, 窦祖林, 等. 多层次执行功能综合训练对脑卒中恢复期患者执行功能障碍的影响[J]. 中华物理医学与康复杂志, 2017, 39(9): 659-663.
[39] Zou S Y, Wen H M, Dou Z L, et al. The effect of hierarchical executive function training on stroke survivors' executive dysfunction during recovery[J]. Chin J Phys Med Rehabil, 2017, 39(9): 659-663.
[40] 田亮, 叶祥明, 李厥宝, 等. 认知功能训练对基底核区脑卒中患者运动及执行功能的影响[J]. 中华物理医学与康复杂志, 2013, 35(9): 708-711.
[40] Tian L, Ye X M, Li J B, et al. The effects of cognitive function training on motor and executive functions after basal ganglia stroke[J]. Chin J Phys Med Rehabil, 2013, 35(9): 708-711.
[41] Woods A J, Antal A, Bikson M, et al. A technical guide to tDCS, and related non-invasive brain stimulation tools[J]. Clin Neurophysiol, 2015, 127(2): 1031-1048.
[42] Jo J M, Kim Y H, Ko M H, et al. Enhancing the working memory of stroke patients using tDCS[J]. Am J Phys Med Rehabil, 2009, 88(5): 404-409.
[43] Narushima K, Paradiso S, Moser D J, et al. Effect of antidepressant therapy on executive function after stroke[J]. Br J Psychiatry, 2007, 190(3): 260-265.
[44] 陈长香, 张敏, 张卫红, 等. 体感游戏训练改善脑卒中患者执行功能的效果分析[J]. 中华物理医学与康复杂志, 2014, 36(3): 211-213.
[44] Chen C X, Zhang M, Zhang W H, et al. Effect of somatic sense interactive game on executive function for patients with stroke[J]. Chin J Phys Med Rehabil, 2014, 36(3): 211-213.
[45] 王静, 马景全, 陈长香, 等. 体感游戏Kinect改善脑卒中患者执行功能的效果研究[J]. 中国康复医学杂志, 2014, 29(8): 748-751.
[45] Wang J, Ma J Q, Chen C X, et al. Effect of somatosensory game Kinecton executive function for patients with stroke[J]. Chin J Rehabil Med, 2014, 29(8): 748-751.
[46] 李丹, 陈长香, 徐金献, 等. 体感交互技术对脑卒中患者执行功能的疗效[J]. 中国康复理论与实践, 2014, 20(1): 63-65.
[46] Li D, Chen C X, Xu J X, et al. Effect of somatic sense interactive game on executive function for patients with stroke[J]. Chin J Rehabil Theory Pract, 2014, 20(1): 63-65.
[47] 丁晨, 王君泽, 瞿畅, 等. Kinect体感交互技术及其在医疗康复领域的应用[J]. 中国康复理论与实践, 2013, 19(2): 136-138.
[47] Ding C, Wang J Z, Qu C, et al. Kinect somatosensory interaction technology and its application in medical rehabilitation[J]. Chin J Rehabil Theory Pract, 2013, 19(2): 136-138.
[48] Faria A L, Andrade A, Soares L, et al. Benefits of virtual reality based cognitive rehabilitation through simulated activities of daily living: a randomized controlled trial with stroke patients[J]. J Neuroeng Rehabil, 2016, 13(1): 96-108.
[49] Klomjai W, Katz R, Lackmy-Vallee A. Basic principles of transcranial magnetic stimulation (TMS) and repetitive TMS (rTMS)[J]. Ann Phys Rehabil Med, 2015, 58(4): 208-213.
[50] Smith M C, Stinear C M. Transcranial magnetic stimulation (TMS) in stroke: Ready for clinical practice[J]. J Clin Neurosci, 2016, 31:10-14.
[51] Luo J, Zheng H, Zhang L, et al. High-frequency repetitive transcranial magnetic stimulation (rTMS) improves functional recovery by enhancing neurogenesis and activating BDNF/TrkB signaling in ischemic rats[J]. Int J Mol Sci, 2017, 18(2): 455-468.
[52] 刘远文, 方杰, 姜荣荣, 等. 高频重复经颅磁刺激对脑卒中患者执行功能的影响[J]. 中华神经科杂志, 2017, 50(10): 745-750.
[52] Liu Y W, Fang J, Jiang R R, et al. Effects of high frequency repetitive transcranial magnetic stimulation on executive function in patients after stroke[J]. Chin J Neurol, 2017, 50(10): 745-750.
[53] 尹明宇, 罗婧, 胡昔权, 等. 高频重复经颅磁刺激对脑卒中后认知功能障碍的影响[J]. 中国康复医学杂志, 2018, 33(7): 763-769.
[53] Yin M Y, Luo J, Hu X Q, et al. Effects of high frequency repetitive transcranial magnetic stimulation on post-stroke cognitive impairment[J]. Chin J Rehabil Med, 2018, 33(7): 763-769.
[54] Park I S, Yoon J G. The effect of computer-assisted cognitive rehabilitation and repetitive transcranial magnetic stimulation on cognitive function for stroke patients[J]. J Phys Ther Sci, 2015, 27(3): 773-776.
Options
文章导航

/

〈 〉