INS NYC 2024 Program

Paper	Paper Session 16 Program Schedule 02/16/2024 03:30 pm - 04:55 pm Room: West Side Ballroom - Salon 4 Paper Session 16: Stroke and Cerebrovascular Disorders Final Abstract #2 Cognitive Impairment Following Cerebellar Stroke: Prevalence and Longitudinal Course Stacha Reumers, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands Mijntje Schellekens, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands Selma Lugtmeijer, School of Psychology, University of Birmingham, Birmingham, United Kingdom Roderick Maas, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands Jamie Verhoeven, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands Esther Boot, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands Merel Ekker, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands Anil Tuladhar, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands Bart van de Warrenburg, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands Dennis Schutter, Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands Frank-Erik de Leeuw, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands Roy Kessels, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands Category: Stroke/Cerebrovascular Injury and Disease (Adult) Keyword 1: cerebellum Keyword 2: stroke Keyword 3: cognitive functioning Objective: Cognitive impairment is a well-known result of a stroke, but for cerebellar stroke detailed knowledge on the nature and extent of cognitive deficits is incomplete as it relies on small-sample studies with mixed methods and outcomes. This study examined the prevalence and course of cognitive impairment in a large cohort of patients with cerebellar stroke. Furthermore, we provide an overview of MRI-derived lesion locations associated with cognitive impairment. Participants and Methods: Sixty young (18-49 years) cerebellar stroke patients completed neuropsychological assessments covering a wide range of cognitive domains in the subacute (< 9 months post-stroke) and/or chronic phase (≥ 9 months post-stroke). Performance was assessed using age- and education-adjusted z-scores and significant changes over time were evaluated using 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: Of the included patients (n=60), the majority (90%) had ischemic strokes and 10% had cerebellar haemorrhages. Cognitive impairment was observed in the subacute phase in 60.3% of the participants, and in 51.2% during the chronic phase. Cognitive performance was most frequently impaired in the domains of 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 were associated with lesions in certain cerebellar regions, however, the relative frequencies that these areas were more damaged in patients with cognitive impairment than in those without were rather low (10-20%). Subjective cognitive complaints and fatigue were present in the majority of participants and were positively correlated with each other in both phases (ρ = -.661 and ρ = -.757, p < .001, respectively). Conclusions: Results showed that cognitive impairment in cerebellar stroke patients is common, with deficits most pronounced in the domains of visuo-spatial skills and executive functioning. The course of cognitive performance was heterogenous and no predictors for either improvement or decline were identified. Although cognitive deficits seem to be associated with particular cerebellar areas, we found no distinct correlation for a specific subregion. Subjective cognitive complaints and fatigue were common and positively correlated. Vascular neurologists could use this information in the clinic, to actively screen for and better inform patients about possible cognitive sequalae following cerebellar strokes. This information could also aid diagnosis and management of the symptoms. Furthermore, our results indicate a general supportive role of the cerebellum in cognitive function.

Paper

02/16/2024
03:30 pm - 04:55 pm
Room: West Side Ballroom - Salon 4

Paper Session 16: Stroke and Cerebrovascular Disorders

Final Abstract #2

Cognitive Impairment Following Cerebellar Stroke: Prevalence and Longitudinal Course

Stacha Reumers, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands
Mijntje Schellekens, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands
Selma Lugtmeijer, School of Psychology, University of Birmingham, Birmingham, United Kingdom
Roderick Maas, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands
Jamie Verhoeven, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands
Esther Boot, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands
Merel Ekker, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands
Anil Tuladhar, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands
Bart van de Warrenburg, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands
Dennis Schutter, Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
Frank-Erik de Leeuw, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, Netherlands
Roy Kessels, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands

Category: Stroke/Cerebrovascular Injury and Disease (Adult)

Keyword 1: cerebellum
Keyword 2: stroke
Keyword 3: cognitive functioning

Objective:

Cognitive impairment is a well-known result of a stroke, but for cerebellar stroke detailed knowledge on the nature and extent of cognitive deficits is incomplete as it relies on small-sample studies with mixed methods and outcomes. This study examined the prevalence and course of cognitive impairment in a large cohort of patients with cerebellar stroke. Furthermore, we provide an overview of MRI-derived lesion locations associated with cognitive impairment.

Participants and Methods:

Sixty young (18-49 years) cerebellar stroke patients completed neuropsychological assessments covering a wide range of cognitive domains in the subacute (< 9 months post-stroke) and/or chronic phase (≥ 9 months post-stroke). Performance was assessed using age- and education-adjusted z-scores and significant changes over time were evaluated using 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:

Of the included patients (n=60), the majority (90%) had ischemic strokes and 10% had cerebellar haemorrhages. Cognitive impairment was observed in the subacute phase in 60.3% of the participants, and in 51.2% during the chronic phase. Cognitive performance was most frequently impaired in the domains of 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 were associated with lesions in certain cerebellar regions, however, the relative frequencies that these areas were more damaged in patients with cognitive impairment than in those without were rather low (10-20%). Subjective cognitive complaints and fatigue were present in the majority of participants and were positively correlated with each other in both phases (ρ = -.661 and ρ = -.757, p < .001, respectively).

Conclusions:

Results showed that cognitive impairment in cerebellar stroke patients is common, with deficits most pronounced in the domains of visuo-spatial skills and executive functioning. The course of cognitive performance was heterogenous and no predictors for either improvement or decline were identified. Although cognitive deficits seem to be associated with particular cerebellar areas, we found no distinct correlation for a specific subregion. Subjective cognitive complaints and fatigue were common and positively correlated. Vascular neurologists could use this information in the clinic, to actively screen for and better inform patients about possible cognitive sequalae following cerebellar strokes. This information could also aid diagnosis and management of the symptoms. Furthermore, our results indicate a general supportive role of the cerebellum in cognitive function.