Open AccessPrevalence and Clinical Correlates of Poststroke Behavioral Dysexecutive Syndrome
Author(s) -
Tang Wai Kwong,
Lau Chieh Grace,
Liang Yan,
Wang Lisha,
Mok Vincent,
Soo Oi Yan Yannie,
Leung Wai Hong Thomas,
Ungvari Gabor S.,
Uchiyama Shinichiro,
Kim Jong S.
Publication year - 2019
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.119.013448
Subject(s) - dysexecutive syndrome , medicine , stroke (engine) , depression (economics) , hospital anxiety and depression scale , anxiety , logistic regression , neuropsychology , cognition , physical therapy , psychiatry , clinical psychology , mechanical engineering , engineering , economics , macroeconomics
Background Behavioral dysexecutive syndrome ( BDES ) is a common phenomenon following stroke. To date, research has focused mainly on individual behavioral symptoms rather than a more comprehensive characterization of goal‐directed behavior in stroke survivors. This cross‐sectional study evaluated the prevalence and clinical correlates of BDES in Hong Kong stroke survivors. Methods and Results A total of 369 stroke survivors were recruited from a regional hospital at 3 months after their index stroke. Patients’ demographic and clinical characteristics were extracted from a comprehensive stroke database. BDES was measured with the Chinese version of the Dysexecutive Questionnaire. Four neurocognitive batteries assessed domains of cognitive executive functions. The prevalence of BDES 3 months poststroke was 18.7%. At that time point, the Hospital Anxiety Depression Scale and Mini‐Mental State Examination scores and the presence of depression were significant predictors of BDES in a multivariate logistic regression analysis. These parameters remained significant predictors of the Dysexecutive Questionnaire score in a linear stepwise regression analysis and together accounted for 28.5% of the variance. Current depression was predictive of the Dysexecutive Questionnaire score in patients with BDES , with a variance of 9.7%. Furthermore, compared with the non‐ BDES group, patients with BDES exhibited poor performance‐based executive function in the Chinese version of the Frontal Assessment Battery and color trails, arrow, and category fluency tests. Conclusions Symptoms of anxiety, current depression, and global cognitive function may be independent predictors of the presence and severity of BDES 3 months poststroke. Stroke survivors with BDES exhibit poor executive functioning, including goal maintenance and semantic memory.