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Prevalence and short‐term changes of cognitive dysfunction in young ischaemic stroke patients
Author(s) -
Pinter D.,
Enzinger C.,
Gattringer T.,
Eppinger S.,
Niederkorn K.,
Horner S.,
Fandler S.,
Kneihsl M.,
Krenn K.,
Bachmaier G.,
Fazekas F.
Publication year - 2019
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13879
Subject(s) - medicine , cognitive flexibility , cognition , neuropsychology , stroke (engine) , neuropsychological assessment , executive functions , rehabilitation , fluency , verbal fluency test , effects of sleep deprivation on cognitive performance , physical therapy , physical medicine and rehabilitation , audiology , psychiatry , psychology , mechanical engineering , mathematics education , engineering
Background and purpose Information on the prevalence and course of post‐stroke cognitive impairment in young stroke patients is limited. The aim was to assess a consecutive sample of acute young ischaemic stroke patients (18–55 years) for the presence and development of neuropsychological deficits. Methods Patients prospectively underwent a comprehensive clinical and cognitive assessment, examining general cognitive function, processing speed, attention, flexibility/executive function and word fluency within the first 3 weeks after hospital admission (median assessment at day 6) and at a 3 months’ follow‐up ( FU ). Cognitive dysfunction was defined in comparison to age‐standardized published norms. Results At baseline ( N = 114), deficits were highly prevalent in processing speed (56.0%), flexibility/executive function (49.5%), attention (46.4%) and general cognitive function (42.1%). These frequencies were comparable for those with FU assessment ( N = 87). In most domains, cognitive performance improved within 3 months, except for word fluency. However, in about one‐third of patients, cognitive deficits (as defined by 1.5 standard deviations below the standardized mean) were still present 3 months after stroke. At FU , 44.0% were impaired in the domain flexibility/executive function, 35.0% in processing speed and 30.0% in attention. Conclusions The high prevalence of cognitive deficits in acute young patients with ischaemic stroke highlights the importance of early post‐stroke cognitive assessment to capture a patient's dysfunction in a comprehensive manner and to offer adequate rehabilitation. The role of factors which promote neuropsychological deficits needs further exploration.