Recognition of Cognitive Dysfunction in Cerebellar Infarction: Validation of the Chinese Cerebellar Cognitive Affective Syndrome Scale

Abstract The cerebellar cognitive affective syndrome scale (CCAS-s) has been developed to detect cognitive deficits in cerebellar disorders. This study aimed to validate the Chinese version of CCAS-s in patients with cerebellar infarction, explore the effect of age and education on it, and examine the relation between cognitive deficits and motor syndromes. Forty-five patients with acute cerebellar infarction and 30 age-, sex-, and education-matched healthy controls underwent cognitive and motor function assessment. Reliability and validity of the Chinese CCAS-s were evaluated. The Chinese CCAS-s showed acceptable reliability and validity in cerebellar infarction with moderate internal consistency and high discriminative ability. Patients showed significant impairments in semantic fluency, phonemic fluency, verbal recall, go/no-go, and affect regulation. Based on original cut-offs, the sensitivity of the Chinese CCAS-s to identify possible/probable/definite CCAS was 80.0%/53.3%/40.0% and the specificity was 40.0%/80.0/96.7%. The pass/fail diagnostic cut-off scores for each test of the Chinese CCAS-s were then adjusted. The CCAS-s total score was negatively associated with age and education and positively associated with fine motor skills. The Chinese CCAS-s is a useful tool to detect cognitive impairments in cerebellar infarction. The cut-off adaptions and age and education-dependent reference values will be important future directions to address.