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

Published online by Cambridge University Press:  16 December 2005

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

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 ≤ .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.)

Type
Research Article
Copyright
© 2005 The International Neuropsychological Society

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