Domain-specific trends in cognitive impairment after acute ischaemic stroke
Little is known about the pattern of subacute cognitive domain impairments after ischaemic stroke, nor the temporal evolution of such impairments. Our objective was to investigate the pattern of cognitive impairment in different neuropsychological domains up to a year after ischaemic stroke. We incl...
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| Veröffentlicht in: | Journal of neurology 2013-01, Vol.260 (1), p.237-241 |
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| creator | Hurford, Robert Charidimou, Andreas Fox, Zoe Cipolotti, Lisa Werring, David J. |
| description | Little is known about the pattern of subacute cognitive domain impairments after ischaemic stroke, nor the temporal evolution of such impairments. Our objective was to investigate the pattern of cognitive impairment in different neuropsychological domains up to a year after ischaemic stroke. We included prospectively collected data from an observational database of stroke patients at the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. Patients were categorised into temporal groups according to the time between the index stroke and neuropsychological profiling. The prevalence of impairment in different cognitive domains was then compared between these categories. The final cohort consisted of 209 patients. Frontal executive function, perceptual and nominal skills all showed a strong trend, with levels of impairment of approximately 30 % at 3 months (
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| doi_str_mv | 10.1007/s00415-012-6625-0 |
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p
< 0.05). Speed and attention was the most impaired domain, but had the greatest trend for decreasing impairment, from 72.4 % acutely to 37.9 % after 3 months (
p
< 0.01). By contrast, we found that impairment in visual and verbal memory showed no statistically significant change over time. Our results suggest a domain-specific improvement in cognition after ischaemic stroke. Early assessments may overestimate longer term cognitive deficits, particularly in speed and attention and perceptual functions. The domain-specific improvement patterns may help to inform long-term rehabilitation plans, which should not be based solely on cognitive assessments undertaken within the first month after stroke.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-012-6625-0</identifier><identifier>PMID: 22865200</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cognition Disorders - epidemiology ; Cognition Disorders - etiology ; Cognitive ability ; Cohort Studies ; Executive function ; Female ; Humans ; Ischemia ; Male ; Medicine ; Medicine & Public Health ; Memory ; Middle Aged ; Neurology ; Neuropsychological Tests ; Neuropsychology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Original Communication ; Patients ; Rehabilitation ; Statistical analysis ; Statistics, Nonparametric ; Stroke ; Stroke - complications ; Time Factors ; Trends</subject><ispartof>Journal of neurology, 2013-01, Vol.260 (1), p.237-241</ispartof><rights>Springer-Verlag 2012</rights><rights>Springer-Verlag 2012.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-a7b9c1c4c4f68879cb57c54ac8047eb3b1593369249c55e3b7eca48cb52916723</citedby><cites>FETCH-LOGICAL-c438t-a7b9c1c4c4f68879cb57c54ac8047eb3b1593369249c55e3b7eca48cb52916723</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-012-6625-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-012-6625-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22865200$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hurford, Robert</creatorcontrib><creatorcontrib>Charidimou, Andreas</creatorcontrib><creatorcontrib>Fox, Zoe</creatorcontrib><creatorcontrib>Cipolotti, Lisa</creatorcontrib><creatorcontrib>Werring, David J.</creatorcontrib><title>Domain-specific trends in cognitive impairment after acute ischaemic stroke</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>Little is known about the pattern of subacute cognitive domain impairments after ischaemic stroke, nor the temporal evolution of such impairments. Our objective was to investigate the pattern of cognitive impairment in different neuropsychological domains up to a year after ischaemic stroke. We included prospectively collected data from an observational database of stroke patients at the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. Patients were categorised into temporal groups according to the time between the index stroke and neuropsychological profiling. The prevalence of impairment in different cognitive domains was then compared between these categories. The final cohort consisted of 209 patients. Frontal executive function, perceptual and nominal skills all showed a strong trend, with levels of impairment of approximately 30 % at <1 month and less than half this at >3 months (
p
< 0.05). Speed and attention was the most impaired domain, but had the greatest trend for decreasing impairment, from 72.4 % acutely to 37.9 % after 3 months (
p
< 0.01). By contrast, we found that impairment in visual and verbal memory showed no statistically significant change over time. Our results suggest a domain-specific improvement in cognition after ischaemic stroke. Early assessments may overestimate longer term cognitive deficits, particularly in speed and attention and perceptual functions. The domain-specific improvement patterns may help to inform long-term rehabilitation plans, which should not be based solely on cognitive assessments undertaken within the first month after stroke.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cognition Disorders - epidemiology</subject><subject>Cognition Disorders - etiology</subject><subject>Cognitive ability</subject><subject>Cohort Studies</subject><subject>Executive function</subject><subject>Female</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Memory</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Neuropsychological Tests</subject><subject>Neuropsychology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Original Communication</subject><subject>Patients</subject><subject>Rehabilitation</subject><subject>Statistical analysis</subject><subject>Statistics, Nonparametric</subject><subject>Stroke</subject><subject>Stroke - complications</subject><subject>Time Factors</subject><subject>Trends</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kMtKAzEUhoMotl4ewI0MuHEzmutkspR6xYIbXYdMeqamdi4mGcG3N2WqguAqIef7_xw-hE4IviAYy8uAMScix4TmRUHTZQdNCWc0J1yoXTTFjONcMMEn6CCEFca4TIN9NKG0LATFeIoer7vGuDYPPVhXO5tFD-0iZK7NbLdsXXQfkLmmN8430MbM1BF8ZuwQ03OwrwaaFArRd29whPZqsw5wvD0P0cvtzfPsPp8_3T3Mrua55ayMuZGVssRyy-uiLKWylZBWcGNLzCVUrCJCMVYoypUVAlglwRpeJowqUkjKDtH52Nv77n2AEHWTVoH12rTQDUETKhkplGRFQs_-oKtu8G3aTieIlkoQyhNFRsr6LgQPte69a4z_1ATrjWk9mtbJtN6Y1jhlTrfNQ9XA4ifxrTYBdARCGrVL8L9f_9_6BZl2h6s</recordid><startdate>20130101</startdate><enddate>20130101</enddate><creator>Hurford, Robert</creator><creator>Charidimou, Andreas</creator><creator>Fox, Zoe</creator><creator>Cipolotti, Lisa</creator><creator>Werring, David J.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20130101</creationdate><title>Domain-specific trends in cognitive impairment after acute ischaemic stroke</title><author>Hurford, Robert ; Charidimou, Andreas ; Fox, Zoe ; Cipolotti, Lisa ; Werring, David J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-a7b9c1c4c4f68879cb57c54ac8047eb3b1593369249c55e3b7eca48cb52916723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cognition Disorders - epidemiology</topic><topic>Cognition Disorders - etiology</topic><topic>Cognitive ability</topic><topic>Cohort Studies</topic><topic>Executive function</topic><topic>Female</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Memory</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Neuropsychological Tests</topic><topic>Neuropsychology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Original Communication</topic><topic>Patients</topic><topic>Rehabilitation</topic><topic>Statistical analysis</topic><topic>Statistics, Nonparametric</topic><topic>Stroke</topic><topic>Stroke - complications</topic><topic>Time Factors</topic><topic>Trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hurford, Robert</creatorcontrib><creatorcontrib>Charidimou, Andreas</creatorcontrib><creatorcontrib>Fox, Zoe</creatorcontrib><creatorcontrib>Cipolotti, Lisa</creatorcontrib><creatorcontrib>Werring, David J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hurford, Robert</au><au>Charidimou, Andreas</au><au>Fox, Zoe</au><au>Cipolotti, Lisa</au><au>Werring, David J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Domain-specific trends in cognitive impairment after acute ischaemic stroke</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2013-01-01</date><risdate>2013</risdate><volume>260</volume><issue>1</issue><spage>237</spage><epage>241</epage><pages>237-241</pages><issn>0340-5354</issn><eissn>1432-1459</eissn><abstract>Little is known about the pattern of subacute cognitive domain impairments after ischaemic stroke, nor the temporal evolution of such impairments. Our objective was to investigate the pattern of cognitive impairment in different neuropsychological domains up to a year after ischaemic stroke. We included prospectively collected data from an observational database of stroke patients at the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. Patients were categorised into temporal groups according to the time between the index stroke and neuropsychological profiling. The prevalence of impairment in different cognitive domains was then compared between these categories. The final cohort consisted of 209 patients. Frontal executive function, perceptual and nominal skills all showed a strong trend, with levels of impairment of approximately 30 % at <1 month and less than half this at >3 months (
p
< 0.05). Speed and attention was the most impaired domain, but had the greatest trend for decreasing impairment, from 72.4 % acutely to 37.9 % after 3 months (
p
< 0.01). By contrast, we found that impairment in visual and verbal memory showed no statistically significant change over time. Our results suggest a domain-specific improvement in cognition after ischaemic stroke. Early assessments may overestimate longer term cognitive deficits, particularly in speed and attention and perceptual functions. The domain-specific improvement patterns may help to inform long-term rehabilitation plans, which should not be based solely on cognitive assessments undertaken within the first month after stroke.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22865200</pmid><doi>10.1007/s00415-012-6625-0</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Cognition Disorders - epidemiology Cognition Disorders - etiology Cognitive ability Cohort Studies Executive function Female Humans Ischemia Male Medicine Medicine & Public Health Memory Middle Aged Neurology Neuropsychological Tests Neuropsychology Neuroradiology Neurosciences Neurosurgery Original Communication Patients Rehabilitation Statistical analysis Statistics, Nonparametric Stroke Stroke - complications Time Factors Trends |
| title | Domain-specific trends in cognitive impairment after acute ischaemic stroke |
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