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

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.

Keywords

ischaemic strokeneuropsychologymoodrecoverylongitudinal
Type
Themed articles on Stroke
Information
Brain Impairment , Volume 17 , Issue 2: Themed issue on Stroke , September 2016 , pp. 111 - 122
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2016 

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