Domain-specific cognitive recovery after first-ever stroke: a follow-up study of 111 cases.
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.
Nys
G M S
GM
Psychological Laboratory, Helmholtz Instituut, Utrecht University, The Netherlands. g.nys@fss.uu.nl
Van Zandvoort
M J E
MJ
De Kort
P L M
PL
Jansen
B P W
BP
Van der Worp
H B
HB
Kappelle
L J
LJ
De Haan
E H F
EH
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