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Domain-Specific Cognitive Recovery after First-Ever Stroke: A 2-Year Follow-Up

Published online by Cambridge University Press:  09 August 2017

Katri E.A. Turunen ,
Siiri P.K. Laari ,
Tatu V. Kauranen ,
Jenni Uimonen ,
Satu Mustanoja ,
Turgut Tatlisumak  and
Erja Poutiainen
Katri E.A. Turunen*
Affiliation:
Department of Psychology, Faculty of Medicine, University of Helsinki, Finland Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Finland
Siiri P.K. Laari
Affiliation:
Department of Psychology, Faculty of Medicine, University of Helsinki, Finland Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Finland
Tatu V. Kauranen
Affiliation:
Department of Neurology and Clinical Neurophysiology, Lapland Central Hospital, Rovaniemi, Finland
Jenni Uimonen
Affiliation:
Rehabilitation services, City of Espoo, Finland
Satu Mustanoja
Affiliation:
Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Finland
Turgut Tatlisumak
Affiliation:
Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Finland Department of Clinical Neurosciences, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden and Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
Erja Poutiainen
Affiliation:
Department of Psychology, Faculty of Medicine, University of Helsinki, Finland Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Finland Rehabilitation Foundation, Helsinki, Finland
*
Correspondence and reprint requests to: Katri Turunen, Department of Psychology, Faculty of Medicine, P.O. Box 9, FI-00014 University of Helsinki, Helsinki, Finland. E-mail: katri.turunen@helsinki.fi
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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)

Keywords

CognitionNeuropsychologyExecutive functionMemoryPsychomotor performanceLongitudinal studies
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 24 , Issue 2 , February 2018 , pp. 117 - 127
Copyright
Copyright © The International Neuropsychological Society 2017 

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