Cognitive trajectory in the first year after first-ever ischaemic stroke in young adults: the ODYSSEY study

被引：5

作者：

Schellekens, Mijntje M., I ^{[1
,2
]}

Springer, Ravi C. S. ^{[1
]}

Boot, Esther M. ^{[1
,2
]}

Verhoeven, Jamie, I ^{[1
,2
]}

Ekker, Merel S. ^{[1
,2
]}

van Alebeek, Mayte E. ^{[3
]}

Brouwers, Paul J. A. M. ^{[4
]}

Arntz, Renate M. ^{[4
]}

van Dijk, Gert W. ^{[5
]}

Gons, Rob A. R. ^{[6
]}

van Uden, Inge W. M. ^{[6
]}

den Heijer, Tom ^{[7
]}

van Tuijl, Julia H. ^{[8
]}

de Laat, Karlijn F. ^{[9
]}

van Norden, Anouk G. W. ^{[10
]}

Vermeer, Sarah E. ^{[11
]}

van Zagten, Marian S. G. ^{[12
]}

Van Oostenbrugge, Robert J. ^{[13
,14
]}

Wermer, Marieke J. H. ^{[15
,16
]}

Nederkoorn, Paul J. ^{[17
]}

van Rooij, Frank G. ^{[18
]}

van den Wijngaard, Ido R. ^{[19
]}

de Kort, Paul L. M. ^{[8
]}

De Leeuw, Frank-Erik ^{[1
,2
]}

Kessels, Roy P. C. ^{[2
,20
,21
,22
]}

Tuladhar, Anil M. ^{[1
,2
]}

机构：

[1] Radboudumc, Neurol, NL-6500 HB Nijmegen, Netherlands

[2] Radboud Univ Nijmegen, Donders Inst Brain Cognit & Behav, Nijmegen, Netherlands

[3] Gelre Hosp, Neurol, Zutphen, Netherlands

[4] Med Spectrum Twente, Neurol, Enschede, Netherlands

[5] Canisius Wilhelmina Hosp, Neurol, Nijmegen, Netherlands

[6] Catharina Hosp, Neurol, Eindhoven, Netherlands

[7] Franciscus Gasthuis & Vlietland, Neurol, Rotterdam, Netherlands

[8] Elisabeth TweeSteden Hosp, Neurol, Tilburg, Netherlands

[9] Haga Hosp, Neurol, The Hague, Netherlands

[10] Amphia Hosp, Neurol, Breda, Netherlands

[11] Rijnstate Hosp, Neurol, Arnhem, Netherlands

[12] Jeroen Bosch Hosp, Neurol, Shertogenbosch, Netherlands

[13] Maastricht Univ, Neurol, Med Ctr, Maastricht, Netherlands

[14] Univ Maastricht, Sch Mental Hlth & Neurosci, Maastricht, Netherlands

[15] Leiden Univ, Med Ctr, Neurol, Leiden, Netherlands

[16] Univ Med Ctr Groningen, Neurol, Groningen, Netherlands

[17] Univ Amsterdam, Neurol, Locat AMC, Med Ctr, Amsterdam, Netherlands

[18] Med Ctr Leeuwarden, Neurol, Leeuwarden, Netherlands

[19] Med Ctr Haaglanden, Dept Neurol, The Hague, Netherlands

[20] Vincent Van Gogh Inst Psychiat, Venray, Netherlands

[21] Radboudumc, Dept Med Psychol, Nijmegen, Netherlands

[22] Radboudumc, Radboudumc Alzheimer Ctr, Nijmegen, Netherlands

来源：

JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY | 2024年 / 95卷 / 06期

关键词：

COGNITION; STROKE; NORMATIVE DATA; IMPAIRMENT; RECOVERY; VALIDITY; AGE;

D O I：

10.1136/jnnp-2023-332104

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background Limited data exists on cognitive recovery in young stroke patients. We aimed to investigate the longitudinal course of cognitive performance during the first year after stroke at young age and identify predictors for cognitive recovery. Methods We conducted a multicentre prospective cohort study between 2013 and 2021, enrolling patients aged 18-49 years with first-ever ischaemic stroke. Cognitive assessments were performed within 6 months and after 1 year following the index event, covering seven cognitive domains. Composite Z-scores using normative data determined cognitive impairment (Z-score<-1.5). A Reliable Change Index (RCI) assessed cognitive recovery (RCI>1.96) or decline (RCI<-1.96). Results 393 patients (median age 44.3 years, IQR 38.4-47.2) completed cognitive assessments with a median time interval of 403 days (IQR 364-474) between assessments. Based on RCI, a similar proportion of patients showed improvement and decline in each cognitive domain, while the majority exhibited no cognitive change. Among cognitively impaired patients at baseline, improvements were observed in processing speed (23.1%), visuoconstruction (40.1%) and executive functioning (20.0%). Younger age was associated with better cognitive recovery in visuoconstruction, and larger lesion volume was related to cognitive recovery in processing speed. No other predictors for cognitive recovery were identified. Conclusions Cognitive impairment remains prevalent in young stroke even 1 year after the event. Most patients showed no cognitive change, however, recovery may have occurred in the early weeks after stroke, which was not assessed in our study. Among initially cognitively impaired patients, cognitive recovery is observed in processing speed, visuoconstruction and executive functioning. It is still not possible to predict cognitive recovery in individual patients.

引用

页码：571 / 579

页数：9

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