Correlation between cognitive impairment during the acute phase of first cerebral infarction and development of long-term pseudobulbar affect

Figures & data

Figure 1 Flowchart of patient inclusion.

Abbreviations: PLC, pathological laughing and crying; MoCA, Montreal cognitive assessment; ALS, amyotrophic lateral sclerosis.

Table 1 Predictors of long-term PBA: characteristics of the study subjects at baseline

	Cases (N=26)					Controls (N=26)					P-value
	N	Mean	SD	N	%	N	Mean	SD	N	%
Age (years)	26	62.27	7.54			26	61.46	7.46
Gender (male/female)	26			12/14	46.15	26			12/14	46.15
Years of education	26	7.30	2.80			26	7.40	2.80
White matter lesions	26					26
		0.96	0.59				0.88	0.70			0.658a
		1.19	0.73				1.07	0.73			0.556a
Localization of acute infarct	26					26
Frontal lobe				10	38.46				4	15.38	0.1164b
Basal ganglia region				9	34.62				5	19.23	0.3487b
Frontal lobe and basal ganglia region				7	26.92				1	3.85	0.0496b
Temporal lobe				4	15.38				6	23.08	0.3497b
Parietal lobe				3	11.54				4	15.38	1.000b
Occipital lobe				1	3.85				4	15.38	1.000b
Brainstem				5	19.23				2	7.69	0.4189b
Cerebellar				2	7.69				2	7.69	1.000b
Thalamus				3	11.54				3	11.54	1.000b
Subcortical white matter				7	26.92				6	23.08	1.000b
More than one location				11	42.31				6	23.08	0.2367b
Smoking	26			15	57.70	26			12	46.15	0.5793b
Drinking	26			3	11.54	26			4	15.38	1.000b
Hypertension	26			20	76.92	26			17	65.38	0.5414b
Diabetes	26			12	46.15	26			10	38.46	0.7793b
Hyperlipidemia	26			21	80.77	26			19	73.08	0.7432b
NIHSS	26	5.19	2.84			26	4.73	2.59			0.545a
MMSE	26	19.81	3.20			26	21.88	2.34			0.010a
MoCA	26	16.60	4.80			26	19.70	3.30			0.001a

Notes:

a Student’s t-test for continuous variables.

b Fisher’s exact test for proportions. Variables shown as mean ± SD or frequencies.

Abbreviations: PBA, pseudobulbar affect; SD, standard deviation; NIHSS, National Institute of Health Stroke Scale; MMSE, minimum-mental state examination; MoCA, Montreal cognitive assessment.

Table 2 Predictors of long-term PBA: conditional logistic regression analysis

Variable	PBA at follow-up
	OR	95% CI	P-value
MoCA	0.715	0.541–0.945	0.018
MMSE	0.461	0.241–0.882	0.019

Notes: Values are OR and 95% CI. Adjusted for smoking, drinking, diabetes, hypertension, hyperlipidemia, NIHSS scores, white matter lesion, and lesion location.

Abbreviations: PBA, pseudobulbar affect; OR, odds ratio; CI, confidence interval; MoCA, Montreal cognitive assessment; MMSE, minimum-mental state examination; NIHSS, National Institute of Health Stroke Scale.

Table 3 Predictors of long-term PBA: cognitive domain characteristics of the study subjects at baseline

Study variable	Cases (N=26)		Controls (N=26)		P-value
	Mean	SD	Mean	SD
Delayed recall (3 min)	4.07	1.87	4.46	1.42	0.4011
Delayed recall (30 min)	3.42	1.92	4.19	1.39	0.1039
Recognition	6.92	2.80	7.31	2.34	0.5889
StroopC-time	50.38	18.57	40.73	12.41	0.0322
StroopC-error	3.50	3.30	2.08	2.26	0.0763
VFT	10.54	4.17	12.35	3.76	0.1065
DST	4.07	0.97	4.73	1.15	0.0329
CDT	6.69	2.69	8.38	2.90	0.0341

Abbreviations: PBA, pseudobulbar affect; SD, standard deviation; VFT, verbal fluency test; DST, digit span test; CDT, clock-drawing task.

Table 4 Multivariate adjusted ORs of PBA for cognitive domains

Variable	PBA at follow-up
	OR	95% CI	P-value
Delayed recall (3 min)	0.641	0.401–1.024	0.0631
DST	0.386	0.163–0.911	0.030
StroopC-time	1.148	1.009–1.308	0.037
VFT	0.827	0.676–1.013	0.067
CDT	0.616	0.420–0.904	0.013

Notes: Values are OR and 95% CI. Adjusted for smoking, drinking, diabetes, hypertension, hyperlipidemia, NIHSS, white matter lesion, and lesion location.

Abbreviations: PBA, pseudobulbar affect; OR, odds ratio; CI, confidence interval; DST, digit span test; VFT, verbal fluency test; CDT, clock-drawing task.