TY - JOUR
T1 - Cognitive impairment in young adults following cerebellar stroke
T2 - Prevalence and longitudinal course
AU - ODYSSEY study group
AU - Reumers, Stacha F.I.
AU - Schellekens, Mijntje M.I.
AU - Lugtmeijer, Selma
AU - Maas, Roderick P.P.W.M.
AU - Verhoeven, Jamie I.
AU - Boot, Esther M.
AU - Ekker, Merel S.
AU - Tuladhar, Anil M.
AU - van de Warrenburg, Bart P.C.
AU - Schutter, Dennis J.L.G.
AU - Kessels, Roy P.C.
AU - de Leeuw, Frank Erik
AU - van Alebeek, Mayte E.
AU - Norden, Anouk van
AU - Brouwers, Paul J.A.M.
AU - Arntz, Renate M.
AU - van Dijk, Gert W.
AU - Gons, Rob A.R.
AU - van Uden, Inge W.M.
AU - Heijer, Tom den
AU - de Kort, Paul L.M.
AU - de Laat, Karlijn F.
AU - Vermeer, Sarah E.
AU - van Zagten, Marian S.G.
AU - Wermer, Marieke J.H.
AU - Nederkoorn, Paul J.
AU - van Rooij, Frank G.
AU - van den Wijngaard, Ido R.
N1 - Publisher Copyright:
© 2024 The Author(s)
PY - 2024/9
Y1 - 2024/9
N2 - Introduction: Cognitive impairment is a well-known result of a stroke, but for cerebellar stroke in young patients detailed knowledge on the nature and extent of cognitive deficits is limited. This study examined the prevalence and course of cognitive impairment in a large cohort of patients with cerebellar stroke. Methods: Sixty young (18–49 years) cerebellar stroke patients completed extensive neuropsychological assessments in the subacute (<9 months post-stroke) and/or chronic phase (≥9 months post-stroke). Performance and course were assessed using standardized scores and Reliable Change Index analyses. Associations between cognitive deficits and lesion locations were explored using subtraction analyses, and associations with subjective cognitive complaints and fatigue were examined. Results: Sixty patients (52% male) were included with a mean age at event of 43.1 years. Cognitive impairment was observed in 60.3% of patients in the subacute phase and 51.2% during the chronic phase. Deficits were most frequent for visuo-spatial skills and executive functioning (42.5–54.6%). Both improvement and decline were observed over time, in 17.9% and 41.0% of participants, respectively. Cognitive deficits seem to be associated with lesions in certain cerebellar regions, however, no distinct correlation was found for a specific subregion. Subjective cognitive complaints were present in the majority of participants (61–80.5%) and positively correlated with fatigue in both phases (ρ = −.661 and ρ = −.757, p < .001, respectively). Discussion: Cognitive impairment in cerebellar stroke patients is common, with deficits most pronounced for visuo-spatial skills and executive functioning, as in line with the Cerebellar Cognitive Affective Syndrome. The course of cognitive performance was heterogenous, with cognitive decline despite the fact that no recurrent strokes occurred. No clear association between lesion location and cognitive deficits was observed. Subjective cognitive complaints and fatigue were prevalent and positively correlated. Clinicians could use this information to actively screen for and better inform patients about possible cognitive sequalae.
AB - Introduction: Cognitive impairment is a well-known result of a stroke, but for cerebellar stroke in young patients detailed knowledge on the nature and extent of cognitive deficits is limited. This study examined the prevalence and course of cognitive impairment in a large cohort of patients with cerebellar stroke. Methods: Sixty young (18–49 years) cerebellar stroke patients completed extensive neuropsychological assessments in the subacute (<9 months post-stroke) and/or chronic phase (≥9 months post-stroke). Performance and course were assessed using standardized scores and Reliable Change Index analyses. Associations between cognitive deficits and lesion locations were explored using subtraction analyses, and associations with subjective cognitive complaints and fatigue were examined. Results: Sixty patients (52% male) were included with a mean age at event of 43.1 years. Cognitive impairment was observed in 60.3% of patients in the subacute phase and 51.2% during the chronic phase. Deficits were most frequent for visuo-spatial skills and executive functioning (42.5–54.6%). Both improvement and decline were observed over time, in 17.9% and 41.0% of participants, respectively. Cognitive deficits seem to be associated with lesions in certain cerebellar regions, however, no distinct correlation was found for a specific subregion. Subjective cognitive complaints were present in the majority of participants (61–80.5%) and positively correlated with fatigue in both phases (ρ = −.661 and ρ = −.757, p < .001, respectively). Discussion: Cognitive impairment in cerebellar stroke patients is common, with deficits most pronounced for visuo-spatial skills and executive functioning, as in line with the Cerebellar Cognitive Affective Syndrome. The course of cognitive performance was heterogenous, with cognitive decline despite the fact that no recurrent strokes occurred. No clear association between lesion location and cognitive deficits was observed. Subjective cognitive complaints and fatigue were prevalent and positively correlated. Clinicians could use this information to actively screen for and better inform patients about possible cognitive sequalae.
KW - Cerebellum
KW - Cognitive cerebellar affective syndrome
KW - Cognitive impairment
KW - Lesion imaging
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85197777314&partnerID=8YFLogxK
U2 - 10.1016/j.cortex.2024.05.021
DO - 10.1016/j.cortex.2024.05.021
M3 - Article
C2 - 38986276
AN - SCOPUS:85197777314
SN - 0010-9452
VL - 178
SP - 104
EP - 115
JO - Cortex
JF - Cortex
ER -