Journal of the International Neuropsychological Society



Domain-specific cognitive recovery after first-ever stroke: A follow-up study of 111 cases


G.M.S.  NYS  a1 a2 c1 , M.J.E.  VAN ZANDVOORT  a1 a2 , P.L.M.  DE KORT  a3 a4 , B.P.W.  JANSEN  a4 , H.B.  VAN DER WORP  a2 , L.J.  KAPPELLE  a2 and E.H.F.  DE HAAN  a1 a2 ,
a1 Psychological Laboratory, Helmholtz Institute, Utrecht University, The Netherlands
a2 Department of Neurology, University Medical Centre Utrecht, The Netherlands
a3 Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands
a4 Department of Neurology, Tweesteden Hospital, Tilburg, The Netherlands

Article author query
nys gms   [PubMed][Google Scholar] 
van zandvoort mje   [PubMed][Google Scholar] 
de kort plm   [PubMed][Google Scholar] 
jansen bpw   [PubMed][Google Scholar] 
van der worp hb   [PubMed][Google Scholar] 
kappelle lj   [PubMed][Google Scholar] 
de haan ehf   [PubMed][Google Scholar] 

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 (all p < .05), lesion volume (p [less-than-or-equal] .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. (JINS, 2005, 11, 795–806.)

(Received March 9 2005)
(Revised August 10 2005)
(Accepted August 11 2005)


Key Words: Cerebrovascular disease; Cognition; Longitudinal; Acute; Determinants; Prognosis.

Correspondence:
c1 Reprint requests to: Dr. G.M.S. Nys, Psychological Laboratory (17.24B), Utrecht University, Heidelberglaan 2, 3584 CS Utrecht, The Netherlands. E-mail: g.nys@fss.uu.nl


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