Objective To analyze the efficacy of music therapy on the rehabilitation of post-stroke cognitive impairment (PSCI) and to provide a reference for rehabilitation intervention methods for PSCI. Methods Patients hospitalized in Beijing Bo’Ai Hospital, China Rehabilitation Research Center and diagnosed with PSCI between December 2020 and July 2022 were prospectively selected. According to the random number table method, patients were divided into a music therapy group and a control group. Both groups were given conventional neurology medication, nursing care, and conventional rehabilitation. The music therapy group received additional music therapy training, and both groups received treatment for one month. The Montreal Cognitive Assessment (MoCA), National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment Scale (FMA), and modified Barthel Index (MBI) were used before and after treatment to assess patients’ cognitive function, degree of neurological deficits, motor function and activities of daily live. Results A total of 48 patients were included, with 24 patients in both groups. There was no statistically significant difference in gender, age, education level, stroke type, lesion location, comorbidities, history of myocardial infarction or peripheral vascular disease, and smoking status between the two groups of patients (P>0.05). Before and after treatment, most patients in the two groups did not score in terms of language and delayed recall scores, and the difference were not statistically significant (P>0.05). There was no statistically significant difference in MoCA scores, visual space and executive function, naming, attention, calculation, abstract thinking, and orientation scores between the two groups of patients before treatment (P>0.05). After treatment, the MoCA score, visual space and executive function, naming, attention, calculation, abstract thinking, and orientation scores of the music therapy group improved compared to before treatment (P<0.05), while the MoCA score, visual space and executive function, naming, attention, and orientation scores of the control group improved compared to before treatment (P<0.05). After treatment, the improvement in MoCA scores [5.0 (3.0, 6.0) vs. 2.5 (1.0, 4.0)], attention [1.0 (0.0, 1.0) vs. 0.0 (0.0, 1.0)], and abstract thinking scores [0.0 (0.0, 1.0) vs. 0.0 (0.0, 0.0)] in the music therapy group were better than that in the control group (P<0.05). There was no statistically significant difference in NIHSS, FMA, and MBI scores between the two groups of patients before treatment (P>0.05), and both groups improved after treatment compared to before treatment (P<0.05). After treatment, there was no statistically significant difference in the improvement of NIHSS, FMA, and MBI scores between the two groups of patients (P>0.05). Conclusions Compared with conventional rehabilitation therapy, training combined with music therapy is more beneficial for improving cognitive function in PSCI patients, especially in the cognitive domains of attention and abstract thinking. However, significant advantages have not been found in improving the degree of neurological impairment, limb motor function, and daily living activities.
Objective To explore the 2 year cognitive trajectory of patients with acute caudate head infarction and the impact of infarct volume on cognitive impairment. Methods We consecutively enrolled patients with acute caudate head infarction admitted to Xi’an Central Hospital between January 2014 and January 2022. Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) at 1 week, 6-months, 12-months, 18-months and 24-months after admission. Infarct volume was measured via diffusion-weighted imaging. Spearman rank correlation was used to analyze the correlation between infarct volume and cognitive score changes; Friedman test with Bonferroni correction was applied for cross-time-point score comparison. Results A total of 25 patients completed the 24-months follow-up. The average was (62.08±8.90) years, the average infarct volume was (1 165.05±850.07) mm3. The average MoCA scores at the 5 time points were 20.40±4.46, 24.64±5.34, 24.48±5.65, 24.04±6.01 and 23.20±6.58. The average MMSE scores were 23.68±4.14, 26.92±4.33, 26.88±4.82, 26.76±4.85 and 26.32±5.04. The cognitive trajectory showed an initial rise followed by a decline within 24 months. MoCA score changes were strongly correlated with infarct volume (no significant correlation for MMSE). The difference in MoCA scores over the first 6 months was negatively correlated with infarct volume (P<0.001). 24-months MoCA changes were mainly attributed to visuospatial/executive function, language and delayed recall subdomains. Conclusion Caudate head infarct volume is associated with early-onset post-stroke cognitive impairment, with cognitive changes mainly driven by alterations in visuospatial/executive, language and delayed recall subdomains.
