Abstract
Objective
To investigate whether crossed cerebellar diaschisis (CCD) is associated with functional
outcome in the subacute rehabilitation phase of stroke.
Design
Retrospective case-control study.
Setting
Hospital-based cohort.
Participants
The study enrolled participants who underwent brain single-photon emission computed
tomography (N=48). Patients with CCD were identified (n=24). Twenty-four controls
were selected for each case-patient by matching age, stroke type (ischemic or hemorrhagic),
lesion laterality, and lesion location.
Intervention
Not applicable.
Main Outcome Measures
The functional ambulation category (FAC), modified Barthel Index (MBI), and Mini-Mental
State Examination (MMSE) were administered at the initial (initiation of rehabilitation
therapy) and the follow-up (4wk after rehabilitation therapy) assessments.
Results
The CCD group had lower MMSE, FAC, MBI, and MMSE scores at the initial assessment
(P=.032, .016, and .001, respectively) and lower FAC and MBI scores at the follow-up
assessment, than the non-CCD group (P=.001 and .036, respectively). Although CCD was not associated with cognitive impairment,
nonambulatory status, and dependent activities of daily living (ADL) at the initial
assessment (P=.538, .083, and >.99, respectively), the CCD group had a higher risk of cognitive
impairment (adjusted odds ratio [aOR]=4.044; 95% confidence interval [CI], 1.071-15.270;
P=.039), nonambulatory status (aOR=7.000; 95% CI, 1.641-29.854; P=.009) and dependent ADL (aOR=13.500; 95% CI, 1.535-118.692; P=.019) at the follow-up assessment.
Conclusions
CCD is associated with severe functional impairment and may have an adverse effect
on functional outcomes related to cognition, ambulatory function, and ADL during the
subacute rehabilitation phase of stroke. This suggests that CCD may be a valuable
predictor of functional outcome in the subacute rehabilitation phase of stroke.
Keywords
List of abbreviations:
95% CI (95% confidence interval), 99mTc-HMPAO (99mTc-hexamethylpropyleneamineoxime), ADL (activities of daily living), aOR (adjusted odds ratio), CCD (crossed cerebellar diaschisis), FAC (functional ambulation category), MBI (modified Barthel Index), MCA (middle cerebral artery), MMSE (Mini-Mental State Examination), PET (positron emission tomography), SPECT (single-photon emission computed tomography)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 12, 2019
Footnotes
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
