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Cognitive performance after first ever stroke related to progression of vascular brain damage: a 2 year follow up CT scan study
  1. S M C Rasquin1,
  2. F R J Verhey1,
  3. R Lousberg1,
  4. J Lodder2
  1. 1Brain and Behaviour Research Institute, Department of Psychiatry and Neuropsychology, University of Maastricht/University Hospital Maastricht, PO Box 5800, 6200 MD Maastricht, the Netherlands
  2. 2Department of Neurology, University of Maastricht/University Hospital Maastricht, PO Box 5800, 6200 MD Maastricht, the Netherlands
  1. Correspondence to:
 Professor Dr F R J Verhey
 Department of Psychiatry and Neuropsychology, PO Box 5800, 6202 MD Maastricht, the Netherlands; F.Verheynp.unimaas.nl

Abstract

Background: Stroke is one of the most common causes of cognitive impairment in the elderly. Ischaemic brain damage (white matter lesions and silent infarcts) progresses in a substantial number of stroke patients. The aim of this study was to investigate whether the progression of ischaemic brain damage is associated with cognitive functioning after first ever stroke.

Methods: A total of 101 stroke patients were followed up for 2 years. Neuropsychological functioning was assessed at 1, 6, 12, and 24 months after stroke. Computed tomography was performed on all patients at baseline and 2 years after stroke. Progression in white matter lesions and (silent) infarcts was recorded.

Results: Patients with progressive vascular brain damage performed worse on cognitive tasks, both 1 and 24 months after stroke, yet change in cognitive functioning was not different from that of patients without progressive vascular damage. During the follow up, improvement was noticed on most cognitive domains.

Conclusions: Although patients with progressive vascular brain damage after a first stroke performed somewhat worse on cognitive tests than those without such damage, both groups showed an improved or stable performance 2 years later. Thus, there is not a simple relation between progression of ischaemic brain damage and decline in cognitive functioning after first ever stroke.

  • CT, computed tomography
  • VaD, vascular dementia
  • VCI, vascular cognitive impairment
  • WML, white matter lesion
  • cognition
  • dementia
  • stroke
  • vascular brain damage
  • vascular cognitive impairment
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Footnotes

  • This study was supported by grants from the Dutch Brain Foundation and the Adriana van Rinsum-Ponssen Foundation.

  • Competing interests: none declared

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