Domain-Specific Cognitive Recovery after First-Ever Stroke: A 2-Year Follow-Up

2017 ◽  
Vol 24 (2) ◽  
pp. 117-127 ◽  
Author(s):  
Katri E.A. Turunen ◽  
Siiri P.K. Laari ◽  
Tatu V. Kauranen ◽  
Jenni Uimonen ◽  
Satu Mustanoja ◽  
...  
Keyword(s):  
Language Processing ◽  
Verbal Memory ◽  
Visual Memory ◽  
Cognitive Status ◽  
Cognitively Impaired ◽  
Cognitive Domains ◽  
Domain Specific ◽  
Cognitive Improvement ◽  
Cognitively Intact

AbstractObjectives: The aim of this work was to study the change in different cognitive domains after stroke during a 2-year follow-up. Method: We evaluated both neuropsychologically and neurologically a consecutive cohort of working-age patients with a first-ever stroke at baseline (within the first weeks), 6 months, and 2 years after stroke-onset. A total of 153 patients participated in all examinations and were compared to 50 healthy controls. Results: Forty-nine percent of the patients were cognitively impaired at baseline, 41% at 6 months, and 39% at 2-year follow-up. We analyzed seven cognitive domains (impairment rates at baseline and 2-year follow-up): psychomotor speed (34%; 23%), executive functions (27%; 17%), visual memory (21%; 4%), visuospatial function (20%; 14%), verbal memory (18%; 12%), basic language processing (baseline 11%; 6 months 5%), and reasoning (2 years 14%). The patients who were cognitively impaired at baseline improved more within 6 months, than either the controls or cognitively intact patients in all cognitive domains (all p<.05). Later on, between 6 months and 2 years, the domain-specific change scores did not differ between patients who were cognitively intact and impaired at 6 months. Also, the cognitive status (intact or impaired) remained the same in 90% of patients between 6-month and 2-year follow-ups. At 2 years, half of the patients, who were categorized cognitively impaired, were rated as well-recovered according to neurological evaluation. Conclusions: Most of the cognitive improvement took place within 6 months. Long-lasting cognitive impairment was common even after good neurological recovery. An early neuropsychological examination is essential in evaluating cognitive dysfunction and need for rehabilitation. (JINS, 2018, 24, 117–127)

Domain-Specific Cognitive Trajectories Among Patients with Minor Stroke or Transient Ischemic Attack in a 6-Year Prospective Asian Cohort: Serial Patterns and Indicators

2021 ◽  
pp. 1-12
Author(s):  
Xuhao Zhao ◽  
Eddie Jun Yi Chong ◽  
Wei Qi ◽  
Ting Pang ◽  
Xin Xu ◽  
...  
Keyword(s):  
Transient Ischemic Attack ◽  
Verbal Memory ◽  
Visual Memory ◽  
Linear Models ◽  
Minor Stroke ◽  
Cognitive Changes ◽  
Domain Specific ◽  
Cognitive Improvement ◽  
Ischemic Attack

Background: Long-term post-stroke cognitive impairment (PSCI) has often been overlooked, especially among patients with minor stroke or transient ischemic attack (TIA). Objective: To assess 6-year domain-specific cognitive trajectories among survivors of minor stroke or TIA and to identify possible indicators associated with cognitive trajectories, as well as long-term and incident PSCI. Methods: Eligible participants completed cognitive and clinical assessments at baseline (2 weeks after stroke) and up to 5 follow-up visits in 6 years. Mixed linear models and generalized estimating equations were adopted to analyze longitudinal data and survival analysis to explore incident PSCI, controlling for demographic, clinical, and vascular indicators. Results: The prevalence of PSCI and mortality rate ranged from 34.6% to 53.7%, and 0 to 7.7% respectively, among 244 patients. Incidence of PSCI was 21.9%. While visual memory demonstrated a significant improvement (p <  0.05), other cognitive domains showed a fluctuating yet stable pattern across visits (all ps >  0.05). Besides age, baseline IQCODE (attention: –0.218 SD/y, executive function: –0.238 SD/y, visual memory: –0.266 SD/y), and MoCA improvement within 1 year (visuoconstruction: 0.007 SD/y, verbal memory: 0.012 SD/y) were associated with longitudinal cognitive changes. Baseline MoCA (OR = 0.66, 95% CI = [0.59–0.74]), MoCA improvement within 3–6 months (OR = 0.79, 95% CI = [0.71–0.89], and within 1 year (OR = 0.86, 95% CI = [0.76–0.96]) were associated with long-term PSCI, while baseline MoCA (OR = 0.76, 95% CI = [0.61–0.96]) was also associated with incident PSCI. Conclusion: While most domains remained stable across-time, visual memory demonstrated an overall improvement. Short-term cognitive improvement could be an early indicator of long-term cognitive trajectory to identify individuals who may be resilient to PSCI.

scholarly journals Sex Differences in Verbal Memory Predict Functioning Through Negative Symptoms in Early Psychosis

2020 ◽  
Vol 46 (6) ◽  
pp. 1587-1595 ◽  
Author(s):  
Gabriella Buck ◽  
Katie M Lavigne ◽  
Carolina Makowski ◽  
Ridha Joober ◽  
Ashok Malla ◽  
...  
Keyword(s):  
Sex Differences ◽  
Verbal Memory ◽  
Visual Memory ◽  
Parental Education ◽  
Negative Symptoms ◽  
Early Psychosis ◽  
First Episode ◽  
Severe Illness ◽  
Cognitive Domains

Abstract Verbal memory (VM) is one of the most affected cognitive domains in first-episode psychosis (FEP) and is a robust predictor of functioning. Given that healthy females demonstrate superior VM relative to males and that female patients show less-severe illness courses than male patients, this study examined whether normative sex differences in VM extend to FEP and influence functioning. Four hundred and thirty-five patients (299 males, 136 females) with affective or nonaffective psychosis were recruited from a catchment-based specialized FEP intervention service and 138 nonclinical controls (96 males, 42 females) were recruited from the same community. One of the two neurocognitive batteries comprising six cognitive domains (VM, visual memory, working memory, attention, executive function, processing speed) were administered at baseline. In patients, positive and negative symptoms were evaluated at baseline and functioning was assessed at 1-year follow-up. Patients were more impaired than controls on all cognitive domains, but only VM showed sex differences (both patient and control males performed worse than females), and these results were consistent across batteries. In patients, better baseline VM in females was related to better functioning after 1 year, mediated through fewer baseline negative symptoms. Supplemental analyses revealed these results were not driven by affective psychosis nor by age and parental education. Thus, normative sex differences in VM are preserved in FEP and mediate functioning at 1-year follow-up via negative symptoms. This study highlights the importance of investigating sex effects for understanding VM deficits in early psychosis and suggests that sex may be a disease-modifying variable with important treatment implications.

scholarly journals White matter network damage mediates association between cerebrovascular disease and cognition

2021 ◽  
pp. 0271678X2199098
Author(s):  
Saima Hilal ◽  
Siwei Liu ◽  
Tien Yin Wong ◽  
Henri Vrooman ◽  
Ching-Yu Cheng ◽  
...  
Keyword(s):  
White Matter ◽  
Cerebrovascular Disease ◽  
Verbal Memory ◽  
Visual Memory ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Domain Specific ◽  
Epidemiology Of Dementia ◽  
Z Scores ◽  
White Matter Connectivity

To determine whether white matter network disruption mediates the association between MRI markers of cerebrovascular disease (CeVD) and cognitive impairment. Participants (n = 253, aged ≥60 years) from the Epidemiology of Dementia in Singapore study underwent neuropsychological assessments and MRI. CeVD markers were defined as lacunes, white matter hyperintensities (WMH), microbleeds, cortical microinfarcts, cortical infarcts and intracranial stenosis (ICS). White matter microstructure damage was measured as fractional anisotropy and mean diffusivity by tract based spatial statistics from diffusion tensor imaging. Cognitive function was summarized as domain-specific Z-scores. Lacunar counts, WMH volume and ICS were associated with worse performance in executive function, attention, language, verbal and visual memory. These three CeVD markers were also associated with white matter microstructural damage in the projection, commissural, association, and limbic fibers. Path analyses showed that lacunar counts, higher WMH volume and ICS were associated with executive and verbal memory impairment via white matter disruption in commissural fibers whereas impairment in the attention, visual memory and language were mediated through projection fibers. Our study shows that the abnormalities in white matter connectivity may underlie the relationship between CeVD and cognition. Further longitudinal studies are needed to understand the cause-effect relationship between CeVD, white matter damage and cognition.

scholarly journals The impact of cognitive impairment at admission on short-term functional outcome of elderly hip fracture patients

2010 ◽  
Vol 138 (5-6) ◽  
pp. 319-322 ◽  
Author(s):  
Emilija Dubljanin-Raspopovic ◽  
Dragana Matanovic ◽  
Marko Bumbasirevic
Keyword(s):  
Cognitive Impairment ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Functional Outcome ◽  
Cognitive Status ◽  
Cognitively Impaired ◽  
Short Term ◽  
Functional Gain ◽  
The Impact ◽  
Cognitively Intact

Introduction The number of patents with dementia increases among hip fracture patients. Cognitive dysfunction is defined as a premorbid state which is potentionally negatively related to short-term functional outcome. Objective To assess the relationship between cognitive status on admission and functional gain during an early rehabilitation period in elderly hip fracture patients. Methods Forty-five elderly patients with surgically treated hip fracture were examined. Cognitive status was assessed by the Mini Mental State Examination (MMSE) at admission; functional status was assessed by the motor subscale of Functional Independence Measure (FIM) at admission and before discharge, while absolute functional gain was determined by the motor FIM gain (FIM discharge - FIM admission). Absolute functional gain was analyzed in respect to cognitive status. Results Both cognitively impaired and cognitively intact hip fracture patients exhibited overall FIM motor improvements, as well as functional gains in specific FIM motor areas (p<0.01). Absolute functional gain, however, was higher in 1) cognitively intact compared to cognitively impaired patients (p<0.01), and 2) cognitively moderately impaired patients compared to severely cognitively impaired patients (p<0.01). No difference in functional gain was detected between the patients with moderately cognitively impaired compared to the cognitive intact patients (p>0.05). Conclusion The systematic use of MMSE identifies cognitively impaired hip fracture patients, and effectively predicts their short-term functional outcome. A higher admission cognitive status is related to a more favorable short term rehabilitation outcome. In spite of cognitive impairment, elderly patients with hip fracture can benefit from participation in rehabilitation programmes. The systematic identification of cognitively impaired hip fracture patients at admission facilitates optimal treatment and rehabilitation, and thus enables the best achievable outcome to be reached.

Characteristics of neurocognitive functions in mild cognitive impairment with depression

2016 ◽  
Vol 28 (7) ◽  
pp. 1181-1190 ◽  
Author(s):  
Hyun-Seok Dong ◽  
Changsu Han ◽  
Sang Won Jeon ◽  
Seoyoung Yoon ◽  
Hyun-Ghang Jeong ◽  
...  
Keyword(s):  
Processing Speed ◽  
Verbal Memory ◽  
Neuropsychological Tests ◽  
Visual Memory ◽  
Strong Association ◽  
Cognitive Status ◽  
Memory Recall ◽  
Major Depressive ◽  
Neurocognitive Functions ◽  
General Cognitive Status

ABSTRACTBackground:Previous studies suggest that there is a strong association between depression and cognitive decline, and that concurrent depressive symptoms in MCI patients could contribute to a difference in neurocognitive characteristics compared to MCI patients without depression. The authors tried to compare neurocognitive functions between MCI patients with and without depression by analyzing the results of neuropsychological tests.Methods:Participants included 153 MCI patients. Based on the diagnosis of major depressive disorder, the participants were divided into two groups: depressed MCI (MCI/D+) versus non-depressed MCI (MCI/D−). The general cognitive and functional statuses of participants were evaluated. And a subset of various neuropsychological tests was presented to participants. Demographic and clinical data were analyzed using Student t-test or χ2 test.Results:A total of 153 participants were divided into two groups: 94 MCI/D+ patients and 59 MCI/D− patients. Age, sex, and years of education were not significantly different between the two groups. There were no significant differences in general cognitive status between MCI/D+ and MCI/D− patients, but MCI/D+ participants showed significantly reduced performance in the six subtests (Contrasting Program, Go-no-go task, Fist-edge-palm task, Constructional Praxis, Memory Recall, TMT-A) compared with MCI/D− patients.Conclusions:There were significantly greater deficits in neurocognitive functions including verbal memory, executive function, attention/processing speed, and visual memory in MCI/D+ participants compared to MCI/D−. Once the biological mechanism is identified, distinct approaches in treatment or prevention will be determined.

scholarly journals Sex Differences in Cognitive Changes in De Novo Parkinson’s Disease

2019 ◽  
Vol 26 (2) ◽  
pp. 241-249 ◽  
Author(s):  
Ece Bayram ◽  
Sarah J. Banks ◽  
Guogen Shan ◽  
Nikki Kaplan ◽  
Jessica Z.K. Caldwell
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sex Differences ◽  
Verbal Memory ◽  
Healthy Aging ◽  
De Novo ◽  
Cognitive Changes ◽  
Progression Markers ◽  
Cognitively Intact

AbstractObjective:To evaluate the sex differences in cognitive course over 4 years in Parkinson’s disease (PD) patients with and without mild cognitive impairment (MCI) compared to controls.Methods:Four-year longitudinal cognitive scores of 257 cognitively intact PD, 167 PD-MCI, and 140 controls from the Parkinson’s Progression Markers Initiative were included. Longitudinal scores of men and women, and PD with and without MCI were compared.Results:Women had better verbal memory, men had better visuospatial function. There was no interaction between sex, diagnostic group, and/or time (4-year follow-up period).Conclusions:Sex differences in cognitive course in de novo PD are similar to healthy aging. Cognitive decline rates in PD with and without MCI are similar for the first 4 years of PD.

Impact of Androgen-Deprivation Therapy on Cognitive Function in Men With Nonmetastatic Prostate Cancer

2010 ◽  
Vol 28 (34) ◽  
pp. 5030-5037 ◽  
Author(s):  
Shabbir M.H. Alibhai ◽  
Henriette Breunis ◽  
Narhari Timilshina ◽  
Shireen Marzouk ◽  
Diane Stewart ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Working Memory ◽  
Cognitive Function ◽  
Androgen Deprivation Therapy ◽  
Verbal Memory ◽  
Visual Memory ◽  
Androgen Deprivation ◽  
Visuospatial Ability ◽  
Cognitive Domains ◽  
Immediate Memory

Purpose To evaluate the effects of androgen-deprivation therapy (ADT) on cognitive function in men with nonmetastatic prostate cancer (PC). Patients and Methods The following three groups of men age 50 years or older and matched on age and education were enrolled: patients with PC starting continuous ADT (n = 77), patients with PC not receiving ADT (PC controls, n = 82), and healthy controls (n = 82). A battery of 14 neuropsychological tests, examining eight cognitive domains, was administered at baseline, 6 months, and 12 months. Changes in cognitive scores over time were analyzed using the following three approaches: multivariable linear regression; the proportion of participants per group with 1 standard deviation (SD) or greater declines, and the proportion of participants who declined by at least 1.5 SD on two or more tests. Results The mean age and education level of participants were 68.9 years (range, 50 to 87 years) and 15.4 years of education (range, 8 to 24 years), respectively. Adjusted for age and education, all three cohorts had similar cognitive scores at baseline other than in one test of working memory. In adjusted regressions, ADT use was not associated with significant changes in the domains of attention/processing speed, verbal fluency, verbal memory, visual memory, or cognitive flexibility at either 6 months (all P > .05) or 12 months (all P > .05). One test each of immediate memory (P = .029), working memory (P = .031), and visuospatial ability (P = .034) were worse among ADT users than controls at 12 months, but these findings were not confirmed using other analytic approaches. Conclusion There is no consistent evidence that 12 months of ADT use has an adverse effect on cognitive function in elderly men with PC.

scholarly journals Concussion Incidence and Recovery Among Youth Athletes With ADHD Taking Stimulant-Based Therapy

2021 ◽  
Vol 9 (10) ◽  
pp. 232596712110325
Author(s):  
Muhammad Ali ◽  
Nickolas Dreher ◽  
Theodore Hannah ◽  
Adam Li ◽  
Nek Asghar ◽  
...  
Keyword(s):  
Motor Skills ◽  
Verbal Memory ◽  
Visual Memory ◽  
Adhd Group ◽  
Neurocognitive Dysfunction ◽  
Stimulant Use ◽  
Youth Athletes ◽  
Visual Motor ◽  
The Impact

Background: Attention deficit hyperactivity disorder (ADHD) may affect concussion risk and recovery in youth athletes. Purpose: To evaluate the association between incidence of concussion and postinjury recovery of symptoms and neurocognitive dysfunction among youth athletes with ADHD and differential stimulant use. Study Design: Cohort study; Level of evidence, 3. Methods: From 2009 to 2019, the authors administered the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) to youth athletes at the beginning of each season. Throughout the season, athletes with concussions were examined and readministered the ImPACT both postinjury and again 7 days after the postinjury administration. These athletes (N = 7453) were divided into those with ADHD on stimulant-based therapy (ADHD+meds; n = 167), those with ADHD not on stimulant-based therapy (ADHD-only; n = 354), and those with no ADHD (non-ADHD; n = 6932). Recovery of neurocognitive dysfunction at postinjury and follow-up was calculated using the ImPACT symptom score, verbal memory, visual memory, visual motor skills, and reaction time (calculated as standardized deviations from baseline). Univariate results were confirmed with multivariate analysis. Results: The ADHD+meds cohort had a lower incidence of concussion (37.3 concussions per 100 patient-years) compared with the ADHD-only group (57.0 concussions per 100 patient-years) (odds ratio [OR], 0.51 [95% CI, 0.37-0.71]; P < .0001) and non-ADHD group (52.8 concussions per 100 patient-years) (OR, 0.50 [95% CI, 0.37-0.67]; P < .0001). At postinjury, ImPACT scores were elevated from baseline to a similar extent in the ADHD+meds cohort compared with the other 2 groups. By follow-up, however, deviations from baseline were lower among the ADHD+meds group compared with the non-ADHD group in verbal memory (OR, 0.46 [95% CI, 0.28-0.76]; P = .002), visual memory (OR, 0.27 [95% CI, 0.10-0.66]; P = .005), and visual motor skills (OR, 0.58 [95% CI, 0.33-0.99]; P = .048). The deviation at follow-up was also lower among the ADHD+meds group compared with the ADHD-only group in visual memory (OR, 0.56 [95% CI, 0.33-0.96]; P = .04) and visual motor skills (OR, 0.42 [95% CI, 0.22-0.81]; P = .01). Conclusion: Stimulant use among youth athletes with ADHD was independently associated with reduced incidence for concussion and lower deviation from baseline in verbal memory, visual memory, and visual motor skills at 7 days postconcussion, suggesting lower neurocognitive impairment at follow-up in this group versus their peers.

scholarly journals Distinctive Patterns of Tau Accumulation and White-Matter Degeneration on Domain-Specific Neuropsychiatric Test Scores

2020 ◽  
Vol 3 ◽  
Author(s):  
Zack Hall ◽  
Billy Chien ◽  
Shannon Risacher ◽  
Andrew Saykin ◽  
Yu-Chien Wu ◽  
...  
Keyword(s):  
White Matter ◽  
Verbal Memory ◽  
Test Scores ◽  
Visual Memory ◽  
Visuospatial Ability ◽  
Domain Specific ◽  
Brain Functions ◽  
White Matter Degeneration ◽  
Tau Pet ◽  
The Brain

Background:  Diagnosis of AD is often started via cognitive tests such as the Mini Mental Status Exam (MMSE) or Montreal Cognitive Assessment (MOCA) with the diagnosis being finalized with autopsy. Currently, positron emission tomography (PET) tracers are used to visualize tau and beta amyloid accumulation in the brain. These imaging techniques demonstrate significant correlations with cognitive decline and have been used to aid in the diagnosis of AD. Particularly, tau accumulation has been shown to progress in a distinct pattern and has been linked to white matter degeneration. We hypothesized that tau accumulation and white matter degeneration in different brain regions have unique correlation patterns with domain-specific neuropsychiatric test scores.   Methods:  This study included 87 older adults (57 cognitively normal subjects and 27 mild cognitive impairment) from the Indiana Alzheimer’s Disease Center. All participants underwent tau-PET ([18F] Flortaucipir PET) and diffusion MRI (dMRI) exams. Tau accumulation was quantified with tau-PET SUVR. White-matter structural connectivity (SC), which probes the integrity of white-matter connections of the brain, was quantified by metrices extracted from dMRI using network analysis. Both tau accumulation and SC measurements were quantified in 84 cortical region of interests (ROIs) and were compared to their domain specific neuropsychiatric test scores with linear regression analysis.  Results:  The verbal memory, visual memory, and visuospatial ability all had unique region-specific correlations with white-matter degeneration and tau accumulation. Verbal memory was solely correlated with tau accumulation. Visual memory was related to both tau accumulation and white-matter SC. Finally, visuospatial ability was only correlated with white-matter SC.   Potential Impact:  This data reveals that although there is a tight interplay between tau accumulation and white-matter degeneration, they affect brain functions in different ways. Specifically, grey-matter tau accumulation is associated with overall memory loss and decrease in the white-matter connectivity affects the visual-related information processing.  

scholarly journals MO966COGNITIVE FUNCTIONING AMONG VARIOUS MODALITIES OF RENAL REPLACEMENT THERAPY- ROLE OF RENAL TRANSPLANT

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Anupma Kaul ◽  
Manas Behera
Keyword(s):  
Cognitive Function ◽  
Renal Transplant ◽  
Verbal Memory ◽  
Visual Memory ◽  
Spatial Reasoning ◽  
Graft Function ◽  
Cognitive Status ◽  
Motor Speed ◽  
Post Transplant ◽  
Esrd Patients

Abstract Background and Aims Evidences have shown diverse responses on thedescription of cognitive function in patients who have undergone renaltransplantation. The present study examined the changes in cognitive functionamong ESRD patients on maintenance haemodialysis or on CAPD and followingthey post renal transplant. We also looked into the ccognitive status among frailand non frail ESRD patients and their performance in the post transplant period Method 67 patients who were stable ESRD on thrice a week haemodialysis or onCAPD were investigated 6 months pre and post transplant using a battery ofneurophysiologic testing. Transplant function was assessed on regular interval andfollowing a stable graft function and on stable doses of immunosuppressive medication 6 months post transplant. Results CAPD compared to HD had better preservation of cognitive functionsassessed 6 months after initiation of dialysis. There was statistically significantimprovement in general cognitive status performance (P &lt; 0.001), motor speed,spatial reasoning, verbal memory and visual memory post transplant compared tothe pre transplant state. However, non-significant improvements were observed indomains of attention, executive functioning, language and verbal fluency. Theanxiety and depression scores did not show significant improvement despitetransplant. On the basis of fraility, frail individuals experienced less improvement in cognitive function as compared to non frail recipients in our study. Conclusion The data demonstrate improvements in cognition following kidneytransplant and emphasize the reversibility of the memory problems evidencedamong patients on dialysis.Focus should be made for interventions in terms ofprevention of cognitive decline among frail patients very early in pre-end stage thus helping in overall outcomes post transplant.

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