Objective: To evaluate the influence of aphasia on the cognitive screening test in stroke patients with unilateral cerebral hemispheric lesions.

Method: We evaluated 51 hemiplegic patients with unilateral cerebral hemispheric lesions using CT or MRI. We divided the subjects into three groups according to the presence of aphasia and motor weakness: right hemiplegic patients with aphasia, right hemiplegic patients without aphasia, and left hemiplegic patients. Functional Independence Measure (FIM), Mini-Mental Status Examination (MMSE) and Neurobehavioral Cognitive Screening (NCSE) Tests were applied in all patients.

Results: No differences were observed in motor FIM scores between three groups. Total FIM and cognitive FIM scores

of the right hemiplegic patients with aphasia were lower than those of the other two groups. MMSE and several sub-items of NCSE (orientation, attention, comprehension, repetition, naming and calculation) showed the same results. But the mean scores of memory, similarity, and judgement items in NCSE were higher in the left hemiplegic patients than the right hemiplegic patients. No differences were observed in the construction score.

Conclusion: All three cognitive screening tests used in this study were remarkably influenced by the ability of the language function of the patients. Lack of adequate items to detect right cerebral hemispheric lesions were also noticed. (J Korean Acad Rehab Med 2002; 26: 9-13)

Objective: To investigate the correlation of main risk factors and cognitive-perceptual functions of stroke patients assessed with Mini-mental status examination (MMSE) and Motor-free visual perception test (MVPT) scores.

Method: Subjects were 41 stroke patients from 35 to 70 years of age. Data collection was done through chart review on risk factors of stroke including hypertension, diabetes mellitus, heart disease, hypercholesterolemia, and cigarette smoking. Three months after the onset of stroke, MMSE and MVPT were performed.

Results: The subjects with diabetes had significantly lower scores in MMSE (p＜0.05) and MVPT (p＜0.05) compared to those with nondiabetics. The subjects with left hemispheric lesion scored higher in MMSE than those with right hemispheric lesion (p＜0.05).

Conclusion: Among the several risk factors, diabetes mellitus has significant relationship to cognitive and visual perceptual function in the stroke patients.

Objective: The aim of this study is to develop the PC-based Mini-mental Status Examination (PC-MMSE) including its protocol to improve the reliability of MMSE, to have convenience for administration, and to evaluate the test-retest reliability.

Method: The factors of decreasing the reliability on MMSE are analyzed such as following. 1) The way of question, pronunciation, and loudness of speech can be different between the test-retest or tester-tester, 2) the learning effect can occur when the test is repeatedly administrated, and 3) the test protocol is not determined in detail. The PC-MMSE and its protocol are designed to solve this problem. PC-MMSE has been developed to have functions such as following. 1) It was made constant verbal stimulation, 2) the question contents of the same level of difficulty in changeable items were developed and some of those can be randomly selected, and 3) it was made the adminstration of test and the management on the test results, conveniently. Protocol on PC-MMSE was also developed for standardization in the administration of test. These two tests of PC-MMSE on 26 stroke patients are administrated for the evaluation of test-retest reliability.

Results: The test-retest Spearman's correlation coefficient of PC-MMSE is 0.967 (p＜0.01). The Spearman's correlation coefficient of PC-MMSE which is related with sex, education, lesion site, and hemiplegic side is more than 0.89.

Conclusion: The PC-MMSE and its protocol are thought to be useful for the repeated evaluation of cognitive function

The neurobehavioral cognitive status examination(NCSE), a screening examination tool that assesses cognitive funtion in a brief but quantitative fashion, is used as an independent test of five major areas: language, constructions, memory, calculation and reasoning. The examination also separately assesses levels of consciousness, orientation, and attention. This instrument quickly identifies the intact areas of functioning, yet provides more detailed assessment in the areas of dysfunction. To determine whether the neurobehavioral cognitive status examination is a more sensitive instrument for the detection of cognitive impairment than the minimental state examination(MMSE), we performed these test simultaneously in 26 patients with stroke. The sensitivities were 88.5% for NCSE and 53.8% for MMSE respectively. The sensitivity of NCSE was derived from two features of its design: the use of independent tests to assess skills within five major areas of cognitive functioning, and the use of graded tasks within each of these cognitive domains.