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Neuropsychological Outcome and its Predictors Across the First Year after Ischaemic Stroke

Published online by Cambridge University Press:  30 August 2016

Suzanne Barker-Collo
School of Psychology, University of Auckland, Private Bag 92019, Auckland, New Zealand
Rita Krishnamurthi
National Institute for Stroke and Applied Neurosciences, AUT University, Auckland, New Zealand
Valery Feigin
National Institute for Stroke and Applied Neurosciences, AUT University, Auckland, New Zealand
Amy Jones
National Institute for Stroke and Applied Neurosciences, AUT University, Auckland, New Zealand
Alice Theadom
National Institute for Stroke and Applied Neurosciences, AUT University, Auckland, New Zealand
P. Alan Barber
Department of Neurology, Auckland City Hospital, Centre for Brain Research, University of Auckland, Auckland, New Zealand
Nicola Starkey
Department of Psychology, Waikato University, Hamilton, New Zealand Health Research Council of New Zealand, Auckland, New Zealand
Kathryn McPherson
Health Research Council of New Zealand, Auckland, New Zealand
Elaine Rush
Centre for Physical Activity and Nutrition, Faculty of Health and Environmental Sciences, AUT University, Auckland, New Zealand
Derrick Bennett
Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK


Background: Neuropsychological deficits occur in over half of the stroke survivors and are associated with the reduced functioning and a decline in quality of life. However, the trajectory of recovery and predictors of neuropsychological outcomes over the first year post stroke are poorly understood.

Method: Neuropsychological performance, assessed using the CNS-Vital signs, was examined at 1 month, 6 months and 12 months after ischaemic stroke (IS) in a sample drawn from a population-based study (N = 198).

Results: While mean scores across neuropsychological domains at each time-point fell in the average range, one in five individuals produced very low-range scores for verbal memory, attention and psychomotor speed. Significant improvements were seen for executive functioning, psychomotor speed and cognitive flexibility within 6 months post stroke, but no gains were noted from 6 to 12 months. Stroke-related neurological deficits and depression at baseline significantly contributed to the prediction of neuropsychological function at 12 month follow-up.

Conclusions: In a significant minority of IS survivors, focal deficits are evident in psychomotor speed, verbal memory, executive functions and attention. Significant improvements in these domains were only evident in the first 6 months post stroke. Initial stroke-related neurological deficits and concurrent depression may be the best predictors of later cognitive functioning.

Themed articles on Stroke
Copyright © Australasian Society for the Study of Brain Impairment 2016 

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