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Application value of Stroop test in the evaluation of cognitive function in asymptomatic cerebral infarction
BAIQiu-ju, HUJun, ZHANGLin-jing, CHENYu, ZHANGYan-hai, WANGXian-chan, CHILi-yi
Chinese Journal of Alzheimer's Disease and Related Disorders ›› 2021, Vol. 4 ›› Issue (4) : 269-274.
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Abbreviation (ISO4): Chinese Journal of Alzheimer's Disease and Related Disorders
Editor in chief: Jun WANG
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Application value of Stroop test in the evaluation of cognitive function in asymptomatic cerebral infarction
Objective: To compare the application value of MMSE, MoCA and modified Version of Stroop in the evaluation of cognitive function in patients with silent brain infarction (SBI). Methods: A total of 126 subjects (normal group, SBI group and cerebral infarction group 42 in each group) were selected from outpatient or inpatient department of neurology, 986 Hospital of Air Force from December 2019 to January 2021. After completing MMSE, MoCA and C-StroOP, ROC curves of each group were compared. Results: MMSE, MOCA score and the correct number of C-Stroop in normal group and SBI group were significantly lower than those in cerebral infarction group (P < 0.01), and the time of C-stroop was significantly increased (P < 0.01). There were no significant differences in MMSE and MOCA scores between normal group and SBI group (P > 0.05), the correct number of C-Stroop was significantly lower than that of SBI group (P < 0.01), and c-Stroop time was significantly increased (P < 0.01). All the three tests showed good differentiation between SBI and cerebral infarction group, normal population and cerebral infarction group (area under ROC was greater than 0.8). The sensitivity, specificity and area under curve (AUC) of C-Stroop were significantly better than those of MMSE and MoCA scores,MMSE score (0.024, 1, 0.469), MoCA score (0.262, 0.905, 0.533), correct number of C-Stroop task C (0.762, 0.857, 0.809) and time consuming (0.548, 0.905, 0.723). The truncation value of correct number pairs of C-stroop task was 21.5 (AUC=0.809), 14.5 (AUC=0.946) and 16.5 (AUC=0.994) for SBI and cerebral infarction patients. The truncation value of C-stroop t ask C time between normal subjects and SBI was 38.1515 (AUC=0.723), the truncation value between SBI and cerebral infarction group was 42.692 (AUC=0.832), and the truncation value between normal subjects and cerebral infarction was 39.0075 (AUC=0.942). Conclusions: C-Stroop has higher sensitivity and specificity than MMSE and MoCA in the evaluation of cognitive function in SBI patients, and is recommended for the evaluation and rapid screening of cognitive function in SBI patients.
asymptomatic cerebral infarction / The Stroop test / MMSE / MoCA / Cognitive function
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Background and Purpose- Carotid artery stenosis is common in the elderly and contributes to cognitive impairment and dementia. Cortical cerebral microinfarcts (CMIs) play an important role in vascular cognitive impairment and dementia. We aimed to investigate the association between CMIs on 3T magnetic resonance imaging and clinical and radiological features, including plaque morphology, and cognitive function in patients with carotid stenosis. Methods- Eighty-nine patients with >30% carotid stenosis on ultrasound were prospectively enrolled, and underwent brain and carotid artery magnetic resonance imaging. CMIs were rated according to predetermined criteria based on 3D-double inversion recovery and fluid-attenuated inversion recovery images. Results- CMIs were identified in 26 patients (29%; median number 0, range 0-9). Poisson regression models adjusted for age and sex revealed that CMIs were associated with intraplaque hemorrhage (rate ratio, 1.95; 95% CI, 1.26-3.18), lacunar infarcts (rate ratio, 1.54; 95% CI, 1.00-2.44), and cortical infarcts (rate ratio, 3.22; 95% CI, 2.20-5.00). These associations were also observed in asymptomatic patients (n=64). Of 81 patients with unilateral carotid stenosis, the prevalence and number of CMIs were significantly higher in the hemisphere ipsilateral to the carotid stenosis than in the contralateral hemisphere ( P=0.005 and P<0.001, respectively). The presence of CMIs was associated with poor cognitive function. Conclusions- Our results indicate that vulnerable carotid plaque increases the risk of CMIs and subsequent cognitive impairment. Carotid atherosclerosis could be a potential therapeutic target for cognitive impairment.
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The Stroop color and word test (SCWT) is widely used to evaluate attention, information processing speed, selective attention, and cognitive flexibility. Normative values for the Italian population are available only for selected age groups, or for the short version of the test. The aim of this study was to provide updated normal values for the full version, balancing groups across gender, age decades, and education. Two kinds of indexes were derived from the performance of 192 normal subjects, divided by decade (from 20 to 90) and level of education (4 levels: 3-5; 6-8; 9-13; >13 years). They were (i) the correct answers achieved for each table in the first 30 s (word items, WI; color items, CI; color word items, CWI) and (ii) the total time required for reading the three tables (word time, WT; color time, CT; color word time, CWT). For each index, the regression model was evaluated using age, education, and gender as independent variables. The normative data were then computed following the equivalent scores method. In the regression model, age and education significantly influenced the performance in each of the 6 indexes, whereas gender had no significant effect. This study confirms the effect of age and education on the main indexes of the Stroop test and provides updated normative data for an Italian healthy population, well balanced across age, education, and gender. It will be useful to Italian researchers studying attentional functions in health and disease.
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