Ann Rehabil Med.  2016 Apr;40(2):214-222. 10.5535/arm.2016.40.2.214.

The Impact of Acute Phase Domain-Specific Cognitive Function on Post-stroke Functional Recovery

• Park J
• Lee G
• Lee SU
• Jung SH

• KMID: 2309919
• DOI: http://doi.org/10.5535/arm.2016.40.2.214

Abstract

OBJECTIVE
To assess whether the cognitive function in the acute stage evaluated by domain-specific neuropsychological assessments would be an independent predictor of functional outcome after stroke.
METHODS
Forty patients underwent 4 domain-specific neuropsychological examinations about 3 weeks after the onset of stroke. The tests included the Boston Naming Test (BNT), the construction recall test (CRT), the construction praxis test (CPT), and the verbal fluency test (VFT). The Korean version of Modified Barthel Index (K-MBI) at 3 months and the modified Rankin Scale (mRS) at 6 months were investigated as functional outcome after stroke. Functional improvement was assessed using the change in K-MBI during the first 3 months and subjects were dichotomized into 'good status' and 'poor status' according to mRS at 6 months. The domain-specific cognitive function along with other possible predictors for functional outcome was examined using regression analysis.
RESULTS
The z-score of CPT (p=0.044) and CRT (p<0.001) were independent predictors for functional improvement measured by the change in K-MBI during the first 3 months after stroke. The z-score of CPT (p=0.049) and CRT (p=0.048) were also independent predictors of functional status at post-stroke 6 months assessed by mRS.
CONCLUSION
Impairment in visuospatial construction and memory within one month after stroke can be an independent prognostic factor of functional outcome. Domain-specific neuropsychological assessments could be considered in patients with stroke in the acute phase to predict long-term functional outcome.

Keyword

Memory; Stroke; Cognition; Rehabilitation; Patient outcome assessment

MeSH Terms

Cognition
Humans
Memory
Patient Outcome Assessment
Rehabilitation
Stroke

Figure

• 

  Fig. 1 Subjects with severe cognitive deficit (z-score<–1.65) in certain domains among 4 domains, which were speech and language, visuospatial memory, visuospatial construction ability, and executive function were counted. Bar graph showed that the subjects with hemorrhagic stroke tended to have a higher number of severely impaired cognitive domains. (A) Ischemic stroke and (B) hemorrhage stroke.

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