Characteristics of Cerebellar Cognitive Affective Syndrome in patients with acute cerebellar stroke and its impact on outcome

Abstract

Abstract Objectives To evaluate the cerebellar cognitive affective syndrome scale (CCAS-S) in patients with acute cerebellar stroke (ACS) and examine its relationship with the outcomes. Methods We included patients who experienced ACS for the first time and were hospitalized in Steel Memorial Yawata Hospital within 7 days of stroke onset between April 2021 and April 2023. The CCAS-S, Mini-Mental State Examination (MMSE), and Scale for the Assessment and Rating of Ataxia (SARA) scores were evaluated 1 week after stroke onset, and Functional Independence Measure (FIM)/Barthel Index (BI) at discharge, physical function, activities of daily life, duration of hospitalization, and outcome (discharge destination) were evaluated. The Mann–Whitney U test was used to compare CCAS-S scores and variables. Results Thirteen consecutive patients with ACS (nine women) and age-and sex-matched healthy controls (seven women) were included. The MMSE score was within the normal range in all patients; however, patients with stroke had a lower total CCAS-S score (median 72, interquartile range [IQR] 66–80) and a higher number of failed tests (median 4, IQR 3–5) than healthy controls. Significant deficits were observed in semantic fluency (p = 0.008), category switching (p = 0001), and similarity (p = 009). Possible, probable, and definite CCAS were diagnosed in two, one, and 10 patients, respectively. Patients discharged home showed better SARA and FIM/BI scores but similar CCAS-S scores compared to those discharged to rehabilitation hospitals. Conclusion CCAS, along with impaired executive and language functions, is frequently observed in ACS patients; however, impaired motor function, and not CCAS, influences the outcome.