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Rehabilitation Practice and Science

Translated Title

應用中文簡短式智能評估（MMSE-C）與盧-尼神經心理測驗組篩檢測驗（LNNB-S）於腦中風患者之篩檢比較

Abstract

Purposes: Patients with stroke often experience neurocognitive impairment; thus, an effective screening test should be developed. The Mini-Mental Status Examination-Chinese (MMSE-C) test and the Luria-Nebraska Neuropsychological Battery-Screening (LNNB-S) test are two commonly used tests for assessing cognitive impairment. In Taiwan, few studies have been conducted on the applicability of cognitive assessment tests. In the present study, we examined the assessment effectiveness of the MMSE-C and LNNB-S and compared them regarding their assessment effectiveness for impairment in various brain regions. Methods: This study was a retrospective study. Medical records from the 2005-2014 period for patients with stroke at the rehabilitation division at a medical center in Southern Taiwan were used. A total of 158 patients diagnosed with stroke and who had completed the MMSE-C and LNNB-S tests were enrolled in this study (125 men and 33 women; average age = 52.6 years; average education duration = 10.5 years). According to their impaired brain areas, the participants were divided into four groups: left-brain impairment (n = 32), right-brain impairment (n = 37), bilateral brain impairment (n = 43), and brain impairment in multiple areas (n = 43). One-way analysis of variance (ANOVA), analysis of covariance (ANCOVA), and a chi-square test were performed. Results: (1) For 20.3% of the patients, the results of the MMSE-C and LNNB-S tests were negative; the reason might be that stroke did not highly influence their cognitive function. (2) Respectively, 44.9% and 77.9% of the patients who received the MMSE-C and LNNB-S test exhibited cognitive impairment. In addition, 95.8% of the patients whose MMSE-C test results were positive also presented positive LNNB-S test results; however, only 55.3% of the patients whose LNNB-S test results were positive presented positive MMSE-C test results. Furthermore, 64.9% of the patients with right-brain impairment presented negative MMSE-C test results; this proportion was the highest among the four groups. (3) The MMSE-C scores of the four groups were lower than those of the control group; in addition, the MMSE-C scores, orientation, recall and language of the patients with left-brain impairment, bilateral brain impairment, or brain impairment in multiple areas were significantly inferior compared with those of the patients with right-brain impairment. (4) The LNNB-S impairment scores of the four groups were higher than those of the control group; the impairment scores of the patients with left-brain impairment on number concepts and higher cognitive function were significantly higher than those of the other three groups. Conclusion: When cutoff points were used to screen patients with stroke, the detection rate of the MMSE-C test was low particularly for patients with right-brain impairment. The reason may be that the test involves verbal function. Because of the ceiling effect, the MMSE-C test was not a challenge for patients with stroke; thus, the MMSE-C test should not be used alone to diagnose patients' condition for stroke. The cutoff point for the LNNB-S test can be used to test for abnormalities in patients with stroke. Therefore, we suggest that after using the MMSE-C test, medical professionals should use the LNNB-S test to enhance accuracy in the test for impaired neurocognitive function.

Language

Traditional Chinese

First Page

19

Last Page

27

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