The Impact of Acute Phase Domain-Specific Cognitive Function on Post-stroke Functional Recovery
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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.
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.
참고문헌 (38)
- Weimar C, "German Stroke Study Collaboration. Age and National Institutes of Health Stroke Scale Score within 6hours after onset are accurate predictors of outcome after cerebral ischemia: development and external validation of prognostic models", Stroke, 35, pp.158~162 (2004)
- Hankey GJ, "Long-term disability after first-ever stroke and related prognostic factors in the Perth Community Stroke Study, 1989-1990", Stroke, 33, pp.1034~1040 (2002)
- Thijs VN, "Is early ischemic lesion volume on diffusion-weighted imaging an independent predictor of stroke outcome? A multivariable analysis", Stroke, 31, pp.2597~2602 (2000)
- Schmitter-Edgecombe M, "Cognitive correlates of functional performance in older adults: comparison of self-report, direct observation, and performance-based measures", J Int Neuropsychol Soc, 17, pp.853~864 (2011)
- Atkinson HH, "Cognitive function, gait speed decline, and comorbidities: the health, aging and body composition study", J Gerontol A Biol Sci Med Sci, 62, pp.844~850 (2007)
- van Hooren SA, "Influence of cognitive functioning on functional status in an older population: 3- and 6-year follow-up of the Maastricht Aging Study", Int J Geriatr Psychiatry, 20, pp.883~888 (2005)
- Hill RD, "Determinants of functional abilities in dementia", J Am Geriatr Soc, 43, pp.1092~1097 (1995)
- Green MF, "Longitudinal studies of cognition and functional outcome in schizophrenia:implications for MATRICS", Schizophr Res, 72, pp.41~51 (2004)
- Kalmar JH, "The relationship between cognitive deficits and everyday functional activities in multiple sclerosis", Neuropsychology, 22, pp.442~449 (2008)
- Bahar-Fuchs A, "Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer’s disease and vascular dementia", Cochrane Database Syst Rev, 6, pp.CD003260~ (2013)
- Subramaniam K, "Computerized cognitive training restores neural activity within the reality monitoring network in schizophrenia", Neuron, 73, pp.842~853 (2012)
- Motl RW, "Cognitive dysfunction and multiple sclerosis: developing a rationale for considering the efficacy of exercise training", Mult Scler, 17, pp.1034~1040 (2011)
- Rasquin SM, "Cognitive functioning after stroke: a oneyear follow-up study", Dement Geriatr Cogn Disord, 18, pp.138~144 (2004)
- Sachdev PS, "Koschera A. Progression of cognitive impairment in stroke patients", Neurology, 63, pp.1618~1623 (2004)
- Desmond DW, "Recovery of cognitive function after stroke", Stroke, 27, pp.1798~1803 (1996)
- Galski T, "Predicting length of stay, functional outcome, and aftercare in the rehabilitation of stroke patients: the dominant role of higher-order cognition", Stroke, 24, pp.1794~1800 (1993)
- Larson EB, "Brief cognitive assessment and prediction of functional outcome in stroke", Top Stroke Rehabil, 9, pp.10~21 (2003)
- van Zandvoort MJ, "Early neuropsychological evaluation in patients with ischaemic stroke provides valid information", Clin Neurol Neurosurg, 107, pp.385~392 (2005)
- Nys GM, "The prognostic value of domain-specific cognitive abilities in acute first-ever stroke", Neurology, 64, pp.821~827 (2005)
- Wagle J, "Early post-stroke cognition in stroke rehabilitation patients predicts functional outcome at 13 months", Dement Geriatr Cogn Disord, 31, pp.379~387 (2011)
- Paker N, "Impact of cognitive impairment on functional outcome in stroke", Stroke Res Trea, 2010, pp.652612~ (2010)
- Marchina S, "Impairment of speech production predicted by lesion load of the left arcuate fasciculus", Stroke, 42, pp.2251~2256 (2011)
- Ozdemir F, "Cognitive evaluation and functional outcome after stroke", Am J Phys Med Rehabil, 80, pp.410~415 (2001)
- Nys GM, "Restrictions of the Mini-Mental State Examination in acute stroke", Arch Clin Neuropsychol, 20, pp.623~629 (2005)
- Lee DY, "A normative study of the CERAD neuropsychological assessment battery in the Korean elderly", J Int Neuropsychol Soc, 10, pp.72~81 (2004)
- Rankin J., "Cerebral vascular accidents in patients over the age of 60. III: Diagnosis and treatment", Scott Med J, 2, pp.254~268 (1957)
- Barnes C, "Rehabilitation outcomes in cognitively impaired patients admitted to skilled nursing facilities from the community", Arch Phys Med Rehabil, 85, pp.1602~1607 (2004)
- Patel M, "Natural history of cognitive impairment after stroke and factors associated with its recovery", Clin Rehabil, 17, pp.158~166 (2003)
- Heruti RJ, "Rehabilitation outcome of elderly patients after a first stroke: effect of cognitive status at admission on the functional outcome", Arch Phys Med Rehabil, 83, pp.742~749 (2002)
- Kong KH, "Temporal recovery of activities of daily living in the first year after ischemic stroke: a prospective study of patients admitted to a rehabilitation unit", NeuroRehabilitation, 35, pp.221~226 (2014)
- Knoflach M, "Functional recovery after ischemic stroke: a matter of age: data from the Austrian Stroke Unit Registry", Neurology, 78, pp.279~285 (2012)
- Li KY, "Ability of three motor measures to predict functional outcomes reported by stroke patients after rehabilitation", NeuroRehabilitation, 30, pp.267~275 (2012)
- Dick JP, "Mini-mental state examination in neurological patients", J Neurol Neurosurg Psychiatry, 47, pp.496~499 (1984)
- Hocker SE, "Predictors of outcome in refractory status epilepticus", JAMA Neurol, 70, pp.72~77 (2013)
- Karamchandani RR, "Incidence of delayed seizures, delayed cerebral ischemia and poor outcome with the use of levetiracetam versus phenytoin after aneurysmal subarachnoid hemorrhage", J Clin Neurosci, 21, pp.1507~1513 (2014)
- Malouin F, "Working memory and mental practice outcomes after stroke", Arch Phys Med Rehabil, 85, pp.177~183 (2004)
- Gottesman RF, "Predictors and assessment of cognitive dysfunction resulting from ischaemic stroke", Lancet Neurol, 9, pp.895~905 (2010)
- Laska AC, "Aphasia in acute stroke and relation to outcome", J Intern Med, 249, pp.413~422 (2001)