title: Cognitive deficits after subcortical infarction are comparable with deficits after cortical infarction.
abstract: OBJECTIVE
  Cerebral cortical infarctions are often considered to be associated with more severe cognitive deficits than subcortical infarctions, but the evidence is conflicting. We compared early and late cognitive deficits between cortical and subcortical lesions.
  
  
  METHODS
  Consecutive patients with first-ever cortical (n = 61) or subcortical (n = 71) cerebral infarctions were assessed neuropsychologically after a mean of 8 days and again at 6 months after infarction. Examinations included evaluation of verbal memory, executive functions, psychomotor speed and visuospatial function as well as orientation, insight and mood state. At 6 months, verbal and non-verbal reasoning were also evaluated. Neurological examinations included National Institutes of Health Stroke Scale and Barthel Index at both time-points and the modified Rankin Scale at 6 months.
  
  
  RESULTS
  In the acute phase, memory (P = 0.007), especially delayed verbal recall (P = 0.005), was more severely affected in patients with subcortical infarctions than in those with cortical infarctions, and this trend persisted at 6 months post-infarction. Psychomotor speed (P = 0.040) was lower in the subcortical group in the acute phase than in the cortical group. Neurological scores did not differ between the two groups either in the acute phase or at 6 months.
  
  
  CONCLUSIONS
  Patients with subcortical cerebral infarctions may have even worse cognitive profiles than patients with cortical infarctions.
authors.affiliation: Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland. katri.turunen@hus.fi
authors.forename: K E A
authors.initials: KE
authors.lastname: Turunen
authors.forename: T V
authors.initials: TV
authors.lastname: Kauranen
authors.forename: S P K
authors.initials: SP
authors.lastname: Laari
authors.forename: S M
authors.initials: SM
authors.lastname: Mustanoja
authors.forename: T
authors.initials: T
authors.lastname: Tatlisumak
authors.forename: E T
authors.initials: ET
authors.lastname: Poutiainen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020520:Brain Infarction / Q000150:complications* / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology; D002544:Cerebral Infarction / Q000150:complications* / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology; D003072:Cognition Disorders / Q000150:complications* / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D009460:Neurologic Examination; D009483:Neuropsychological Tests