Abstract

Language disorders are among the primary obstacles in care and rehabilitation process following acquired brain injuries (ABI). While early cognitive screening is considered critical for sketching a reliable picture of patients’ residual abilities and devising efficient therapeutic plans, it has been shown that commonly-used screening tools—which strongly rely on verbal materials—might be inappropriate when used with ABI patients. This study aimed at testing the robustness and validity of the Cognitive Assessment for Stroke Patients (CASP) battery—devised to minimize the use of verbal materials—and two gold-standards in clinical practice—i.e. Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA)—in presence of language comprehension difficulties. Forty-two ABI patients took part in the study. Half of the cohort was classified as aphasic. Participants underwent neuropsychological assessment including MMSE, MoCA and CASP, and completed the Token test to estimate language comprehension proficiency. The influence of linguistic ability on the outcomes of the screening tools was investigated. Regression analyses highlighted that, in aphasic patients, MMSE and MoCA scores proved to be significantly and remarkably determined by patients’ proficiency in linguistic comprehension, while the outcome of the CASP battery was not significantly affected by language comprehension impairments.

摘要

语言障碍是获得性脑损伤（ABI）后护理和康复过程中的主要障碍之一。虽然早期认知筛查被认为对于勾勒出患者剩余能力的可靠情况和制定有效的治疗计划至关重要，但事实证明，常用的筛查工具（强烈依赖于口头材料）在用于 ABI 患者时可能不合适。本研究旨在测试中风患者认知评估 (CASP) 的稳健性和有效性（旨在最大限度地减少语言材料的使用）以及临床实践中的两个黄金标准，即简易精神状态检查 (MMSE) 和蒙特利尔测试认知评估（MoCA）——存在语言理解困难的情况。42 名 ABI 患者参与了这项研究。该队列中有一半被归类为失语症。参与者接受了包括 MMSE、MoCA 和 CASP 在内的神经心理学评估，并完成了 Token 测试来评估语言理解能力。研究了语言能力对筛选工具结果的影响。回归分析强调，在失语症患者中，MMSE 和 MoCA 评分被证明显着且显着地取决于患者的语言理解能力，而 CASP 电池的结果不受语言理解障碍的显着影响。