Tesis

Profil Ganggguan Kognitif Pada Pasien Dengan Gangguan Vestibular dan Faktor Faktor yang Berasosiasi di RSUPN Dr. Cipto Mangunkusumo = Cognitive Disorder Profile in Patients with Vestibular Disorders and Associated Factors at Dr. Cipto Mangunkusumo National Hospital.

Latar Belakang. Dalam dua dekade terakhir berkembang pembahasan terkait kontribusi fungsi sistem vestibular tidak hanya pada sistem vestibulookular dan vestibulospinal namun pada fungsi lebih tinggi yaitu fungsi kognitif. 9Sebanyak 60% gangguan vestibular mengalami gangguan kognitif. 10 Faktor demografi dan klinis dikatakan berpengaruh terhadap gangguan kognitif. Setiap gangguan vestibular dapat menyebabkan gangguan pada domain kognitif yang spesifik. 10 Belum ada penelitian di Indonesia, terkait evaluasi fungsi kognitif pada gangguan vestibular. Hasil penelitian ini diharapkan dapat memberikan data terkait fungsi kognitif pada pasien dengan gangguan vestibular. Metode. Studi potong lintang pada pasien poli Neurootologi dan Neurooftalmologi (NO NOT) di RSUPN Dr. CiptoMangunkusumo. Dilakukan evaluasi data demografi, data klinis dan pemeriksaan fungsi kognitif dengan MoCA INA, TMT B dan ROCFT Hasil. Dari 83 subjek didapatkan mayoritas perempuan, rerata usia 52.35±14.34 tahun, sebagian besar dengan tingkat pendidikan > 12 tahun dan sebagian besar dengan komorbid. Sebagian besar lokasi gangguan vestibular adalah difus dengan sindrom vestibular terbanyak Episodic Vestibular Syndromme (EVS). Prevalensi ganguan kognitif 81.9%. Sebagian besar gangguan kognitif adalah Mild Cognitive Impairment (MCI), 48.2% diantaranya tanpa keluhan subjektif, dengan domain kognitif terganggu terbanyak yaitu memori verbal (87%), eksekutif (65%), bahasa (56%), visuospasial dan visuokonstruksi (51%) yang terdeteksi dengan MoCA INA dan TMT B. Didapatkan asosiasi antara tingkat pendidikan dengan gangguan kognitif (p 0.022). Gangguan kognitif tidak dipengaruhi komorbid. Tidak didapatkan asosiasi antara karakteristik klinis dan gangguan kognitif. Didapatkan kecenderungan gangguan domain kognitif atensi, visuospasial dan visuokonstruksi dan bahasa lebih sering pada lokasi lesi sentral Kesimpulan. Prevalensi gangguan kognitif 81.9% dengan multidomain yang banyak terlibat memori verbal, eksekutif, bahasa, visuospasial dan visuokonstruksi. Tingkat pendidikan berasosiasi dengan gangguan kognitif. Didapatkan kecenderungan gangguan domain kognitif atensi, visuospasial dan visuokonstruksi dan bahasa lebih banyak pada lokasi lesi sentral
Kata kunci: Gangguan vestibular, gangguan kognitif; MoCA INA; TMT B; ROCFT


Background. In the last two decades, discussion has developed regarding the contribution of vestibular system function not only to the vestibuloocular and vestibulospinal systems but also to higher functions, namely cognitive function. 9 As many as 60% of vestibular disorders experience cognitive impairment. 10 Demographic and clinical factors are said to influence cognitive impairment. Each vestibular disorder can cause impairment in specific cognitive domains. 10 There is no research in Indonesia regarding the evaluation of cognitive function in vestibular disorders. The results of this study are expected to provide data related to cognitive function in patients with vestibular disorders. Methods. A cross-sectional study on patients of Neurootology and Neuroophtalmology (NO NOT) clinic at Dr. Cipto-Mangunkusumo Hospital. Demographic data, clinical data and cognitive function examination with MoCA INA, TMT B and ROCFT were evaluated. Results. Of the 83 subjects, the majority were female, the mean age was 52.35 ± 14.34 years, most of them had > 12 years of education and most of them had comorbidities. Most of the locations of vestibular disorders were diffuse with the most common vestibular syndrome being Episodic Vestibular Syndrome (EVS). The prevalence of cognitive impairment was 81.9%. Most cognitive impairments were Mild Cognitive Impairment (MCI), 48.2% of which were without subjective complaints, with the most impaired cognitive domains being verbal memory (87%), executive (65%), language (56%), visuospatial and visuoconstruction (51%) detected with MoCA INA and TMT B. There was an association between education level and cognitive impairment (p 0.022). Cognitive impairment was not influenced by comorbidities. There was no association between clinical characteristics and cognitive impairment. There was a tendency for impairment of the cognitive domains of attention, visuospatial and visuoconstruction and language to be more frequent at the central lesion site. Conclusion. The prevalence of cognitive impairment was 81.9% with multidomain involving verbal memory, executive, language, visuospatial and visuoconstruction. Education level is associated with cognitive impairment. There was a tendency for impairment of the cognitive domains of attention, visuospatial and visuoconstruction and language to be more at the central lesion site.
Keywords: Vestibular disorder, cognitive impairment; MoCA INA; TMT B; ROCFT