Speed of information processing after unilateral stroke

Speed of information processing in the subacute stage after stroke was studied in 88 first ever, unilateral, ischemic stroke patients. The patient group included 42 right and 46 left hemisphere patients. Seventy-one control subjects were also examined. Four reaction time tasks with different levels of complexity were used: two visuomotor, and two semantic categorisation tasks. The results showed that stroke causes a decrease in decision making speed, but that the effect is et for tight and left hemisphere patients. The right hemisphere group were slower than the control group on all reaction time tasks, and slower than the left hemisphere patients on the visuomotor tasks. The left hemisphere patients were slower than the healthy controls, only on the most complex tasks, the categorisation tasks

Subjective changes in emotion, cognition and behaviour after stroke: Factors affecting the perception of patients and partners

The presence and severity of changes in emotion and cognition experienced by left- and right-sided stroke patients and observed by their partners were compared at 3 months poststroke. The results showed that, regardless of the side of stroke, several changes were reported by half of the stroke patients and their partners. It appeared that while left hemisphere stroke patients agreed with their partners on the number and severity of most changes, partners of right hemisphere patients reported more frequent and more severe changes than the patients themselves. The level of observability of the altered behaviour, distress of the partner, distress of left-sided stroke patients and hemispatial neglect of right-sided stroke patients emerged a factors related to disagreement between stroke patient and partner

Frequency of anxiety after stroke: a systematic review and meta-analysis of observational studies.

BACKGROUND AND PURPOSE: Negative psychological outcomes occur frequently after stroke; however, there is uncertainty regarding the occurrence of anxiety disorders and anxiety symptoms after stroke. A systematic review of observational studies was conducted that assessed the frequency of anxiety in stroke patients using a diagnostic or screening tool. SUMMARY OF REVIEW: Databases were searched up to March 2011. A random effects model was used to summarize the pooled estimate. Statistical heterogeneity was assessed using the I(2) statistic. Forty-four published studies comprising 5760 stroke patients were included. The overall pooled estimate of anxiety disorders assessed by clinical interview was 18% (95%confidence interval 8-29%, I(2)  = 97%) and was 25% (95% confidence interval 21-28%, I(2)  = 90%) for anxiety assessed by rating scale. The Hospital Anxiety and Depression Scale-Anxiety subscale 'probable' and 'possible' cutoff scores were the most widely used assessment criteria. The combined rate of anxiety by time after stroke was: 20% (95% confidence interval 13-27%, I(2)  = 96%) within one-month of stroke; 23% (95% confidence interval 19-27%, I(2)  = 84%) one to five-months after stroke; and 24% (95% confidence interval 19-29%, I(2)  = 89%) six-months or more after stroke. CONCLUSION: Anxiety after stroke occurs frequently although methodological limitations in the primary studies may limit generalizability. Given the association between prevalence rates and the Hospital Anxiety and Depression Scale-Anxiety cutoff used in studies, reported rates could in fact underrepresent the extent of the problem. Additionally, risk factors for anxiety, its impact on patient outcomes, and effects in tangent with depression remain unclear

Checklijst voor het opsporen van cognitieve en emotionele gevolgen van een beroerte (CLCE-24)

Background and purpose. Cognitive and emotional problems are common after stroke and screening is essential. In this paper a new screening instrument is presented and its usability is investigated.methods. A group of stroke patients (n = 69) were interviewed using the new instrument, the clce-24, six months post stroke. Moreover extensive neuropsychological testing was conducted (including mmse/camcog).results. Patients, relatives and assessors (a psychologist) were positive about its use. The interview with the clce-24 took 11.1 minutes on average (5-35 minutes). Eighty percent of the patients had complaints; 73% had cognitive problems, while 51% had emotional problems. Patients with at least one complaint on the clce-24 scored lower on the mmse (t=2.5; p = 0.01) and the camcog (t= 2.5; p= 0.02) compared to patients without complaints.conclusions. The clce-24 can be applied by professionals in primary care for identification of cognitive and emotional complaints after stroke. Further research and implementation in clinical practice and the stroke service is recommended