title: Domain-specific cognitive recovery after first-ever stroke: a follow-up study of 111 cases.
abstract: The objective of this study is to examine the prognosis of acute cognitive disorders post-stroke, and to evaluate which clinical factors predict domain-specific cognitive recovery. We followed the course of cognitive functioning in 111 stroke patients and 77 healthy controls by administering two neuropsychological examinations with a 6 to 10 month interval (mean interval, 7.5 +/- 1.3 months). The baseline examination was administered within three weeks post-stroke (mean interval, 7.9 +/- 4.2 days). To examine determinants of domain-specific cognitive recovery, we recorded vascular risk factors, clinical variables, and lesion characteristics. Recovery in visual perception/construction (83%) and visual memory (78%) was the most common. An acute cognitive disorder predicted a long-term disorder in the same domain (all p < .05), except for visual perception/construction. Factors associated with poor cognitive recovery were age (all p < .01), preexistent verbal ability (all p < .005), lesion locations involving the temporal (all p < .05), frontal (p < .05) and occipital lobe (allp < .05), lesion volume (p < or = .001), and diabetes mellitus (p < .01). An early neuropsychological examination provides valuable information on long-term cognitive performance. The prognosis of higher-level visual disorders is the most favorable. Cognitive recovery is associated with age, preexistent ability, lesion volume, lesion location, and diabetes mellitus.
authors.affiliation: Psychological Laboratory, Helmholtz Instituut, Utrecht University, The Netherlands. g.nys@fss.uu.nl
authors.forename: G M S
authors.initials: GM
authors.lastname: Nys
authors.forename: M J E
authors.initials: MJ
authors.lastname: Van Zandvoort
authors.forename: P L M
authors.initials: PL
authors.lastname: De Kort
authors.forename: B P W
authors.initials: BP
authors.lastname: Jansen
authors.forename: H B
authors.initials: HB
authors.lastname: Van der Worp
authors.forename: L J
authors.initials: LJ
authors.lastname: Kappelle
authors.forename: E H F
authors.initials: EH
authors.lastname: De Haan
mesh_terms: D000368:Aged; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011379:Prognosis; D011597:Psychomotor Performance / Q000502:physiology; D012307:Risk Factors; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation; D014652:Vascular Diseases / Q000503:physiopathology; D014796:Visual Perception / Q000502:physiology