Stroke, Cognitive Deficits, and Rehabilitation: Still an Incomplete Picture
- 24 December 2012
- journal article
- review article
- Published by SAGE Publications in International Journal of Stroke
- Vol. 8 (1), 38-45
- https://doi.org/10.1111/j.1747-4949.2012.00972.x
Abstract
Cognitive impairment after stroke is common and can cause disability with major impacts on quality of life and independence. There are also indirect effects of cognitive impairment on functional recovery after stroke through reduced participation in rehabilitation and poor adherence to treatment guidelines. In this article, we attempt to establish the following: • whether there is a distinct profile of cognitive impairment after stroke; • whether the type of cognitive deficit can be associated with the features of stroke-related damage; and • whether interventions can improve poststroke cognitive performance. There is not a consistent profile of cognitive deficits in stroke, though slowed information processing and executive dysfunction tend to predominate. Our understanding of structure-function relationships has been advanced using imaging techniques such as lesion mapping and will be further enhanced through better characterization of damage to functional networks and identification of subtle white matter abnormalities. Effective cognitive rehabilitation approaches have been reported for focal cortical deficits such as neglect and aphasia, but treatments for more diffusely represented cognitive impairment remain elusive. In the future, the hope is that different techniques that have been shown to promote neural plasticity (e.g., exercise, brain stimulation, and pharmacological agents) can be applied to improve the cognitive function of stroke survivors.This publication has 97 references indexed in Scilit:
- First Decade of Research on Constrained-Induced Treatment Approaches for Aphasia RehabilitationArchives Of Physical Medicine and Rehabilitation, 2012
- Cerebral hemodynamics and cognitive impairmentNeurology, 2012
- Pumps, Aqueducts, and Drought ManagementStroke, 2011
- Predictors and assessment of cognitive dysfunction resulting from ischaemic strokeThe Lancet Neurology, 2010
- Improvement in Aphasia Scores After Stroke Is Well Predicted by Initial SeverityStroke, 2010
- Cognitive and Affective Predictors of Rehabilitation Participation After StrokeArchives Of Physical Medicine and Rehabilitation, 2010
- Aerobic Exercise Improves Cognition and Motor Function PoststrokeNeurorehabilitation and Neural Repair, 2009
- Association of Prior Stroke With Cognitive Function and Cognitive ImpairmentArchives of Neurology, 2009
- Effects of aspirin plus extended-release dipyridamole versus clopidogrel and telmisartan on disability and cognitive function after recurrent stroke in patients with ischaemic stroke in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial: a double-blind, active and placebo-controlled studyThe Lancet Neurology, 2008
- Influence of cognitive impairment on the institutionalisation rate 3 years after a strokeJournal of Neurology, Neurosurgery & Psychiatry, 2007