Katri E A Turunen1, Siiri P K Laari1, Tatu V Kauranen2, Jenni Uimonen3, Satu Mustanoja4, Turgut Tatlisumak4, Erja Poutiainen1. 1. 1Department of Psychology, Faculty of Medicine,University of Helsinki,Finland. 2. 3Department of Neurology and Clinical Neurophysiology,Lapland Central Hospital,Rovaniemi,Finland. 3. 4Rehabilitation services,City of Espoo,Finland. 4. 2Clinical Neurosciences,Neurology,University of Helsinki and Helsinki University Hospital,Finland.
Abstract
OBJECTIVES: The aim of this work was to study the change in different cognitive domains after stroke during a 2-year follow-up. METHOD: We evaluated both neuropsychologically and neurologically a consecutive cohort of working-age patients with a first-ever stroke at baseline (within the first weeks), 6 months, and 2 years after stroke-onset. A total of 153 patients participated in all examinations and were compared to 50 healthy controls. RESULTS: Forty-nine percent of the patients were cognitively impaired at baseline, 41% at 6 months, and 39% at 2-year follow-up. We analyzed seven cognitive domains (impairment rates at baseline and 2-year follow-up): psychomotor speed (34%; 23%), executive functions (27%; 17%), visual memory (21%; 4%), visuospatial function (20%; 14%), verbal memory (18%; 12%), basic language processing (baseline 11%; 6 months 5%), and reasoning (2 years 14%). The patients who were cognitively impaired at baseline improved more within 6 months, than either the controls or cognitively intact patients in all cognitive domains (all p<.05). Later on, between 6 months and 2 years, the domain-specific change scores did not differ between patients who were cognitively intact and impaired at 6 months. Also, the cognitive status (intact or impaired) remained the same in 90% of patients between 6-month and 2-year follow-ups. At 2 years, half of the patients, who were categorized cognitively impaired, were rated as well-recovered according to neurological evaluation. CONCLUSIONS: Most of the cognitive improvement took place within 6 months. Long-lasting cognitive impairment was common even after good neurological recovery. An early neuropsychological examination is essential in evaluating cognitive dysfunction and need for rehabilitation. (JINS, 2018, 24, 117-127).
OBJECTIVES: The aim of this work was to study the change in different cognitive domains after stroke during a 2-year follow-up. METHOD: We evaluated both neuropsychologically and neurologically a consecutive cohort of working-age patients with a first-ever stroke at baseline (within the first weeks), 6 months, and 2 years after stroke-onset. A total of 153 patients participated in all examinations and were compared to 50 healthy controls. RESULTS: Forty-nine percent of the patients were cognitively impaired at baseline, 41% at 6 months, and 39% at 2-year follow-up. We analyzed seven cognitive domains (impairment rates at baseline and 2-year follow-up): psychomotor speed (34%; 23%), executive functions (27%; 17%), visual memory (21%; 4%), visuospatial function (20%; 14%), verbal memory (18%; 12%), basic language processing (baseline 11%; 6 months 5%), and reasoning (2 years 14%). The patients who were cognitively impaired at baseline improved more within 6 months, than either the controls or cognitively intact patients in all cognitive domains (all p<.05). Later on, between 6 months and 2 years, the domain-specific change scores did not differ between patients who were cognitively intact and impaired at 6 months. Also, the cognitive status (intact or impaired) remained the same in 90% of patients between 6-month and 2-year follow-ups. At 2 years, half of the patients, who were categorized cognitively impaired, were rated as well-recovered according to neurological evaluation. CONCLUSIONS: Most of the cognitive improvement took place within 6 months. Long-lasting cognitive impairment was common even after good neurological recovery. An early neuropsychological examination is essential in evaluating cognitive dysfunction and need for rehabilitation. (JINS, 2018, 24, 117-127).
Authors: Natalia S Rost; James F Meschia; Rebecca Gottesman; Lisa Wruck; Karl Helmer; Steven M Greenberg Journal: Stroke Date: 2021-05-27 Impact factor: 10.170
Authors: Hugo P Aben; Yael D Reijmer; Johanna Ma Visser-Meily; Jacoba M Spikman; Jeroen de Bresser; Geert Jan Biessels; Paul Lm de Kort Journal: JMIR Res Protoc Date: 2018-05-28
Authors: D Pinter; C Enzinger; T Gattringer; S Eppinger; K Niederkorn; S Horner; S Fandler; M Kneihsl; K Krenn; G Bachmaier; F Fazekas Journal: Eur J Neurol Date: 2019-01-09 Impact factor: 6.089