本文關(guān)鍵詞： 小腦認知功能 執(zhí)行功能 情緒認知　出處：《昆明醫(yī)科大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的本研究主要通過對小腦不同半球梗死患者進行神經(jīng)心理測評,并結(jié)合頭顱MRI探討小腦不同半球梗死對認知功能的影響,探索小腦的非運動功能狀態(tài)及調(diào)節(jié)認知功能的關(guān)系,為今后進一步深入研究小腦的非運動功能提供相關(guān)依據(jù)。方法 以2014年3月至2015年3月我院神經(jīng)內(nèi)科收治的小腦不同半球梗死患者16例作為病例組；同期選取年齡、受教育程度相匹配,臨床及影像學檢查無任何神經(jīng)系統(tǒng)異常者16例作為對照組。病例組在發(fā)病后10-30天內(nèi)病情穩(wěn)定,能完成所有認知功能測驗。病例組和對照組均采用蒙特利爾認知評估量表(MoCA)、簡明精神狀態(tài)量表(MMSE)進行認知的總體評估；漢密爾頓抑郁量表(HAMD)、修訂情感淡漠評定量表(MAES)進行情緒認知評估；應用順時數(shù)字記憶廣度測驗(DST)、連線測試(TMT)、詞語流暢性測驗(VFT)、額葉功能評定量表(FAB)、威斯康星卡片分類測試(WCST)進行執(zhí)行功能評估。應用3.0T核磁共振掃描系統(tǒng)對小腦左右側(cè)半球病變患者行全腦磁共振成像。并利用T1加權(quán)像,使用MRIcron軟件在標準層模板上對病灶進行疊加。采用SPSS20.0軟件對數(shù)據(jù)進行統(tǒng)計分析。結(jié)果 (1)小腦梗死組與對照組比較,梗死組MAES、RA、nRPE得分均顯著高于對照組,梗死組MoCA、MMSE、DST、TMT、CC得分均顯著低于對照組(P0.05)(2)小腦病例組中,左側(cè)半球梗死組、右側(cè)半球梗死組兩組進行比較,兩組得分無明顯差異(P0.05)。結(jié)論 (1)小腦參與了部分認知的形成與加工,小腦梗死后執(zhí)行功能、情緒認知均有不同程度的下降。(2)小腦單側(cè)梗死均使執(zhí)行功能、情緒認知產(chǎn)生不同程度的受損。(3)但小腦不同半球梗死后認知損害無明顯差異。(4)小腦損傷對執(zhí)行功能的影響可能是小腦核團的損傷所致。
[Abstract]:Objective to investigate the effects of cerebral infarction on cognitive function in patients with different cerebral hemispheres by means of neuropsychological assessment and cranial MRI. To explore the relationship between the non-motor function state of cerebellum and the regulation of cognitive function. To provide the basis for further study of cerebellar non-motor function in the future. From March 2014 to March 2015, 16 cases of cerebellar cerebral infarction with different hemispheres were treated in our hospital from March 2014 to March 2015. At the same time, 16 cases were selected as the control group with matched age, education level and no neurological abnormalities in clinical and imaging examination. The patient group was stable within 10-30 days after the onset of the disease. All cognitive function tests were completed. The patients and the control group were assessed with the Montreal Cognitive Assessment scale (MMSE) and the brief Mental State scale (MMSE). Hamilton Depression scale (Hamd) and revised emotional apathy scale (MAESs) were used to evaluate emotion cognition. DSTA, TMTT, VFTT and FAB were used to test the temporal digital memory span (DST), TMTT (line test), fluency test (VFT), and frontal lobe function assessment scale (FAB). Wisconsin card sorting test (WCST) was used to evaluate the executive function. Global magnetic resonance imaging (MRI) was performed in patients with cerebellar left and right hemispheric lesions using a 3.0T magnetic resonance imaging system. T1 weighted images were used. MRIcron software was used to stack the lesions on the standard layer template. The data were statistically analyzed by SPSS20.0 software. Results 1) the cerebellar infarction group was compared with the control group. The scores of MAESU RAA n RPE in infarction group were significantly higher than those in control group, and the MMSEN DSTT TMT in infarct group was significantly higher than that in control group. CC scores were significantly lower than those in the control group (P0.05 / 2) in the cerebellar group, the left hemisphere infarction group and the right hemisphere infarction group were compared between the two groups. Conclusion the cerebellum is involved in the formation and processing of partial cognition and the executive function after cerebellar infarction. Emotional cognition decreased in varying degrees. 2) unilateral cerebellar infarction all resulted in executive function. Emotional cognition was damaged in different degrees, but there was no significant difference in cognitive impairment after cerebral infarction in different hemispheres. 4) the effect of cerebellar injury on executive function may be caused by the damage of cerebellar nucleus.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R743.3

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