Impact of cognitive impairment on the upper limb function recovery after lacunar stroke

Abstract

The purpose of this study was to evaluate impact of cognitive impairments on the upper limb function recovery after acute lacunar stroke (LS). Material and methods. 139 patients (aged from 35 to 80 y. o.) with acute LS were examined. Along with the clinical and neurological examination, an upper limb function was evaluated by Action Research Arm Test and 9-Hole Peg Test, a study of cognitive status was made using the Montreal Cognitive Assessment (МоСа) and Frontal Assessment Battery (FAB). Results. Impaired upper limb function was revealed in 79% of patients with LS. After 2 weeks of acute period of LS, a significant improvement or the complete recovery of the upper limb function was observed in 81%. Moderate/severe executive dysfunction (FAB < 15 points) was defined in 65% of patients with LS and upper limb dysfunction. Moderate/severe cognitive impairments (МоСа < 26 points) were revealed in almost 55% of patients. In acute period of LS, the negative prognostic factor for complete recovery or significant improvement of the arm function was the presence of moderate/severe executive dysfunction (OR 3.89; 95% CI 1.07-14.19; p = 0.04) and general cognitive deficit (OR 3.27; 95% CI 1.10-9.70; p = 0.03). Conclusions. Cognitive impairments including executive disorders may affect the upper limb function recovery in acute period of LS. The data obtained can be used for the development of personalized rehabilitation programs for these patients.