Neuropsychologische Frühdiagnostik nach einem Schlaganfall - ein Überblick im deutschsprachigen Raum verfügbarer Instrumente und Vorstellung eines neuen Screening-Verfahrens

Kaesberg, S.; Fink, Gereon R.; Kalbe, Elke

doi:10.1055/s-0033-1350452

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…These considerations, together with the fact that clinical characteristics were not further analyzed, limit the generalizability of these preliminary validation results. Lastly, the current study does not provide sufficient validation data to allow for direct comparisons with alternative pocket-sized screening instruments [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Point-of-Care Testing Using a Neuropsychology Pocketcard Set: A Preliminary Validation Study

et al. 2022

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Neurocognitive screening instruments usually require printed sheets and additional accessories, and can be unsuitable for low-threshold use during ward rounds or emergency workup, especially in patients with motor impairments. Here, we test the utility of a newly developed neuropsychology pocketcard set for point-of-care testing. For aphasia and neglect assessment, modified versions of the Language Screening Test and the Bells Test were validated on 63 and 60 acute stroke unit patients, respectively, against expert clinical evaluation and the original pen-and-paper Bells Test. The pocketcard aphasia test achieved an excellent area under the curve (AUC) of 0.94 (95% CI: 0.88–1, p < 0.001). Using an optimal cut-off of ≥2 mistakes, sensitivity was 91% and specificity was 81%. The pocketcard Bells Task, measured against the clinical neglect diagnosis, achieved higher sensitivity (89%) and specificity (88%) than the original paper-based instrument (78% and 75%, respectively). Separately, executive function tests (modified versions of the Trail Making Test [TMT] A and B, custom Stroop color naming task, vigilance ‘A’ Montreal Cognitive Assessment item) were validated on 44 inpatients with epilepsy against the EpiTrack® test battery. Pocketcard TMT performance was significantly correlated with the original EpiTrack® versions (A: r = 0.64, p < 0.001; B: r = 0.75, p < 0.001). AUCs for the custom Stroop task, TMT A and TMT B for discriminating between normal and pathological EpiTrack® scores were acceptable, excellent and outstanding, respectively. Quick point-of-care testing using a pocketcard set is feasible and yields diagnostically valid information.

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Section: Discussionmentioning

confidence: 99%

Point-of-Care Testing Using a Neuropsychology Pocketcard Set: A Preliminary Validation Study

et al. 2022

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“… Prognostication tests EEG, median-nerve somatosensory evoked potentials (SEP), NSE Activities of daily living (ADL) Outcome Barthel index and the Barthel index for Early Rehabilitation (BI) [ 23 – 26 ]. • Level of consciousness Coma recovery scale -revised (CRS-R) [ 11 ], Glasgow Coma Scale (GCS) [ 27 ], Full outline of unresponsiveness (FOUR) [ 28 ] • Health status Neurological post-acute Core Set of the International Classification of Functioning, Disability and Health (ICF) [ 29 ] • Cognitive functioning Since the most commonly observed cognitive impairments in patients with an anoxic-ischemic brain injury are disturbances of attention/processing speed, memory, and executive function we use the subtests of the Cologne Neuropsychological Screening for Stroke Patients (German: Koelner Neuropsychologisches Screening für Schlaganfall-Patienten) for these functions [ 30 , 31 ]. • Psychosocial Outcome German version of the Hospital Anxiety and Depression Scale (HADS-D) [ 32 – 34 ].…”

Section: Methodsmentioning

confidence: 99%

Hypoxia and Outcome Prediction in Early-Stage Coma (Project HOPE): an observational prospective cohort study

Lopez-Rolon¹,

Bender

2015

BMC Neurol

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BackgroundThe number of resuscitated cardiac arrest patients suffering from anoxic-ischemic encephalopathy is considerable. However, outcome prediction parameters such as somatosensory evoked potentials need revision because they are based on data predating the implementation of mild therapeutical hypothermia and because data from our own laboratory suggest that they may fail to predict prognosis accurately. The present research project “Hypoxia and Outcome Prediction in Early-Stage Coma” is an ongoing observational prospective cohort study that aims to improve outcome prediction in anoxic coma by limiting the effects of falsely pessimistic predictions at the intensive care unit.MethodsOur outcome analysis is based on functional and behavioural definitions. This implies the analysis of the positive predictive value of prognostic markers yielding either positive or negative results. We also analyse the effect of covariates adjusted for age and sex such as sociodemographic variables, prognostic variables and treatment factors on functional and behavioural outcomes, with mixed effects regression models (i.e. fixed and random effects). We expect to enrol 172 patients based on the result of previous research. The null hypothesis is that there is a probability of <10 % that a positive outcome will be observed despite the presence of any of the predictors of a poor/negative outcome. We test the null hypothesis against a one-sided alternative using a Simon’s two-stage design to determine whether it is warranted to recruit the full number of patients suggested by a power analysis. The second stage has a design with a Type I error rate of 0.05 and 80 % power if the true response rate is 25 %.DiscussionWe aim to make a significant contribution to the revision and improvement of current outcome prediction methods in anoxic-ischemic encephalopathy patients. As a result, neurocritical care specialists worldwide will have considerably more accurate methods for prognosticating the outcome of anoxic-ischemic encephalopathy following cardiac arrest. This will facilitate the provision of treatment tailored to individual patients and the attainment of an optimal quality of life. It will also inform the decision to withdraw treatment with a level of accuracy never seen before in the field.Trial registrationClinicalTrials.gov NCT02231060 (registered 29 August 2014)

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“…As the patient had to be tested soon after injury and due to its preferred language for testing, we used a recently introduced German battery specifically designed for patients in the early stage of recovery after a stroke (Cologne Neuropsychological Screening for Stroke Patients; German: Kölner Neuropsychologisches Screening für Schlaganfall-Patienten (KöpSS)) [ 9 ].…”

Section: Case Presentationmentioning

confidence: 99%

Short-Term Memory Impairment and Left Dorsolateral Prefrontal Cortex Dysfunction in the Orthostatic Position: A Single Case Study of Sinking Skin Flap Syndrome

Sebastianelli

Stoll

Versace

et al. 2015

Case Reports in Neurological Medicine

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We describe the case of a patient who underwent craniectomy for hemorrhage of the left parietal lobe. Three weeks later, orthostatic memory impairment was detected as initial symptom of sinking skin flap syndrome (SSFS). This deficit was examined by neuropsychological testing and associated with a posture-dependent increase in the delta/alpha ratio at the F3 electrode, an electroencephalographic (EEG) index related to brain hypoperfusion. This EEG spectral alteration was detected in a brain region that includes the left dorsolateral prefrontal cortex, an area known to be involved in memory processing; therefore we hypothesize that SSFS induced reversible hypoperfusion of this otherwise undamaged cortical region. Neither of these findings was present after cranioplasty. This case suggests that SSFS may induce neuropsychological deficits potentially influencing outcome in the postacute phase and is further evidence supporting the clinical benefits of early cranioplasty.

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Neuropsychologische Frühdiagnostik nach einem Schlaganfall - ein Überblick im deutschsprachigen Raum verfügbarer Instrumente und Vorstellung eines neuen Screening-Verfahrens

Cited by 4 publications

References 21 publications

Point-of-Care Testing Using a Neuropsychology Pocketcard Set: A Preliminary Validation Study

Point-of-Care Testing Using a Neuropsychology Pocketcard Set: A Preliminary Validation Study

Hypoxia and Outcome Prediction in Early-Stage Coma (Project HOPE): an observational prospective cohort study

Short-Term Memory Impairment and Left Dorsolateral Prefrontal Cortex Dysfunction in the Orthostatic Position: A Single Case Study of Sinking Skin Flap Syndrome

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