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- Turunen, K. E. A., et al.
(författare)
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Executive Impairment Is Associated with Impaired Memory Performance in Working-Aged Stroke Patients
- 2016
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Ingår i: Journal of the International Neuropsychological Society. - : Cambridge University Press (CUP). - 1355-6177 .- 1469-7661. ; 22:5, s. 551-560
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Executive dysfunction is associated with impaired memory performance, but controversies remain about which aspects of memory are involved and how general intelligence influences these connections. We aimed to clarify these connections in stroke patients by comparing various memory measures in patients with and without executive impairment. Methods: Our consecutive cohort included patients with a first-ever ischemic stroke. Neuropsychological assessments were completed 6 months and 2 years after stroke. We classified patients as executively impaired, when at least two of five executive measures were defective at 6 months. At both 6 months and 2 years, we compared list learning of unrelated words, story recall, and recall of geometric figures in patients with and without executive impairment, while controlling for general intelligence. Results: Patients with executive impairment (n = 66; 37%) performed worse in list learning (p = .001; partial eta(2) = .058) and immediate recall of a logical passage (p = .010; partial eta(2) = .037) 6 months after stroke compared to executively intact patients (n = 113). At the end of the 2-year follow-up period, the patients who were executively impaired at 6 months (n = 53; 37%) still performed worse than executively intact patients (n = 92) in list learning (p < .001; partial eta(2) = .096), and additionally in delayed recall of the list (p = .006; partial eta(2) = .052) and immediate recall of geometric figures (p = .007; partial eta(2) = .050). Conclusions: In our working-aged stroke patients, executive impairment was common. Executive impairment was associated with memory tasks that provided less inherent structure and required the use of active memory strategies. Clinicians should remember this role of executive dysfunction when interpreting memory performance.
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| 2. |
- Turunen, Katri E A, et al.
(författare)
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Domain-Specific Cognitive Recovery after First-Ever Stroke: A 2-Year Follow-Up.
- 2018
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Ingår i: Journal of the International Neuropsychological Society : JINS. - 1469-7661. ; 24:2, s. 117-127
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this work was to study the change in different cognitive domains after stroke during a 2-year follow-up.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.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.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).
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