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 (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.
c1 Reprint requests to: Dr. G.M.S. Nys, Psychological Laboratory (17.24B), Utrecht University, Heidelberglaan 2, 3584 CS Utrecht, The Netherlands. E-mail: email@example.com