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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 ,
M.J.E. VAN ZANDVOORT ,
P.L.M. DE KORT ,
B.P.W. JANSEN ,
H.B. VAN DER WORP ,
L.J. KAPPELLE  and
E.H.F. DE HAAN
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
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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.)

Keywords

Cerebrovascular diseaseCognitionLongitudinalAcuteDeterminantsPrognosis
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 11 , Issue 7 , November 2005 , pp. 795 - 806
Copyright
© 2005 The International Neuropsychological Society

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