Neglect and aphasia in the acute phase as predictors of functional outcome 7 years after ischemic stroke

Abstract

Background and purpose: Visuospatial inattention (VSI) and language impairment (LI) are often present early after stroke and associations with an unfavorable short-term functional outcome have been reported. The purpose of this study was to investigate whether a screening of VSI and LI as indicators of cortical symptoms early after stroke could predict long-term functional outcomes. Methods: A consecutive cohort of 375 patients with ischemic stroke was assessed for the occurrence of VSI at a median of 7 days after admission (interquartile range, 1-5 days) using the Star Cancellation Test and for LI (within the first 7 days) with the language item in the Scandinavian Stroke Scale. Seven years later, functional outcomes were assessed by the modified Rankin scale and Frenchay Activities Index in 235 survivors without recurrent stroke. Relationships between baseline predictors and functional outcome at 7 years were analyzed with bivariate correlations and multiple categorical regressions with optimal scaling. Results: The regression model significantly explained variance in the modified Rankin scale (R 2 = 0.435, P < 0.001) and identified VSI (P = 0.001) and neurological deficits (P < 0.001; Scandinavian Stroke Scale score without the language item) as the significant independent predictors. The model for Frenchay Activities Index was also significant (R 2 = 0.269, P < 0.001) with VSI (P = 0.035) and neurological deficits (P < 0.001) as significant independent predictors. Conclusions: Visuospatial inattention at acute stroke has an independent impact on long-term functional outcomes. Early recognition may enable targeted rehabilitative interventions.

Modulating functional connectivity after stroke with neurofeedback: Effect on motor deficits in a controlled cross-over study

“…There is some evidence that right lesions, in particular right parietal lesions are associated with worse outcome and less recovery ( Aszalos et al, 2002 ; Bentley et al, 2014 ; Rangaraju et al, 2015 ; Yassi et al, 2015 ). Furthermore, right lesions often lead to visuospatial neglect that is known to have a negative impact on rehabilitation ( Gerafi et al, 2017 ). None of our patients had severe neglect, but mild residual neglect might have contributed to low retention.…”

Feasibility of a minimal dataset for adults with acquired brain injury in Dutch healthcare practice

“…The MDS-ABI was developed for use with every person with ABI, but appeared unsuitable for a proportion of the target group due to communicative or cognitive limitations. Oftentimes, patients who experience these limitations are excluded from assessments in the context of scientific research or health care, when in fact, these patients are most prone to more severe long-term consequences of brain injury [43][44][45][46][47][48], leading to bias in research [49]. In order to be able to capture core data on the full spectrum of persons with ABI, we now developed a proxy-rated version of the self-reported part of the MDS-ABI (part B), which can be completed by someone who is close to the patient.…”

Mirror therapy for unilateral neglect after stroke: A systematic review

“…Unilateral neglect following stroke negatively affects motor function, activities of daily living, length of hospital stay, participation, and informal caregiver burden [10–13]. Thus, unilateral neglect after a stroke needs to be carefully diagnosed and treated.…”

“…and informal caregiver burden [10][11][12][13]. Thus, unilateral neglect after a stroke needs to be carefully diagnosed and treated.…”