Brief cognitive screening of right hemisphere stroke: relation to functional outcome.
OBJECTIVE
Traditional mental status screens have limited sensitivity in detection of focal brain damage and are particularly insensitive to right hemisphere stroke (RHS). Addition of a simple measure of constructional ability, clock drawing, should enhance the sensitivity of the Modified Mini-Mental State Exam (3MS) in RHS. The relation between the 3MS-clock drawing screen and functional outcome in RHS was also examined.


METHODS
Logistic regression analysis (Study 1) with cross validation on an independent sample (Study 2).


METHODS
Inpatient medical rehabilitation.


METHODS
Study 1: 32 acute RHS patients (mean age 75.2yrs) and 35 age- and education-matched healthy controls. Study 2 (cross-validation): 32 acute RHS patients (mean age 72.8yrs) and 36 matched healthy controls.


METHODS
3MS, clock drawing, and Functional Independence Measure scores.


RESULTS
The 3MS-clock screen accurately distinguished RHS patients from controls. The clock drawing was a valuable and unique addition to the 3MS. RHS patients who were impaired on the 3MS-clock drawing screen had significantly worse FIM scores at discharge than RHS patients who were not impaired on the cognitive screen.


CONCLUSIONS
Clinicians can enhance the sensitivity of their brief mental status examination of RHS patients, in addition to obtaining useful prognostic information, by including a clock drawing task in their screen.
Department of Psychology, Ohio University, Athens, USA.
J A
JA
Suhr
J
J
Grace
D000203:Activities of Daily Living; D000368:Aged; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation; D003071:Cognition; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome