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January 14, 2013

A quantitative systematic review of domain-specific cognitive impairment in lacunar stroke

January 15, 2013 issue
80 (3) 315-322

Abstract

Objective:

To quantitatively characterize domain-specific cognition in individuals with symptomatic lacunar stroke in a systematic review.

Methods:

Systematic searches of MEDLINE and EMBASE were conducted. Inclusion criteria were all articles published prior to December 2011 evaluating domain-specific cognitive status in individuals with a symptomatic lacunar infarct. Data extraction identified cognitive domains with reported impairment and effect size calculations and heterogeneity analyses were completed to assess the magnitude of this impairment for all studies with control group data.

Results:

Results of the search yielded 12 cross-sectional and 5 longitudinal studies that met inclusion criteria. Effect size calculations revealed small to medium effect sizes (ES) estimations for impairment after stroke in the domains of executive function (ES −0.44, 95% confidence interval [CI] −0.83, −0.50), memory (ES −0.55, 95% CI −0.96, −0.13), language (ES −0.63, 95% CI −0.92, −0.33), attention (ES −0.37, 95% CI −0.67, −0.07), and visuospatial abilities (ES −0.61, 95% CI −1.03, 0.19), and large effect sizes for global cognition (ES −0.90, 95% CI −1.48, −0.31) and information processing speed (ES −0.93, 95% CI −1.63, −0.23). Heterogeneity analyses revealed that a subset of these domains were heterogeneous and identified moderating factors accounting for this heterogeneity.

Conclusions:

Results of this systematic review are consistent with previous characterizations of cognitive impairment associated with lacunar strokes. However, impaired cognition in this stroke subtype appears less selective than previously thought, involving all major cognitive domains.

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Supplementary Material

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File (tables_e-1-4.doc)

STUDY FUNDING

Supported by funding from the NIH and National Institutes of Neurological Disorders and Stroke (NIH-NINDS) to O.R.B. (grant U01-NS38529-04A1), awards from the Canadian Institutes of Health Research to J.D.E. and A.A.S. and the Michael Smith Foundation for Health Research to J.D.E., and support from the Ralph Fisher and Alzheimer Society of BC Professorship in Alzheimer's Research Endowment Fund to C.J.

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Information & Authors

Information

Published In

Neurology®
Volume 80Number 3January 15, 2013
Pages: 315-322
PubMed: 23319476

Publication History

Received: May 11, 2012
Accepted: August 10, 2012
Published online: January 14, 2013
Published in print: January 15, 2013

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Disclosure

The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.

Authors

Affiliations & Disclosures

Jodi D. Edwards, MA
From the School of Population and Public Health (J.D.E.), Division of Neurology (C.J., B.P., O.R.B.), and College of Interdisciplinary Studies Program in Neuroscience (A.A.S., O.R.B.), University of British Columbia, Vancouver, Canada.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
Canadian Institutes of Health Research, Doctoral Research Award, 3 years
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Claudia Jacova, PhD
From the School of Population and Public Health (J.D.E.), Division of Neurology (C.J., B.P., O.R.B.), and College of Interdisciplinary Studies Program in Neuroscience (A.A.S., O.R.B.), University of British Columbia, Vancouver, Canada.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
Jacova, C., Hsiung, GYR, McGrenere, J, Lee, H. Cognitive Testing on Computer (C-TOC). Invention disclosure and Assignment - Life Sciences (UBC University-Industry Liaison Office file # 11-123). Submitted March 2011.
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
BC Ministry of Health PharmaCare Services Division, Alzheimer Drug Therapy Initiative - Clinical Meaningfulness in Alzheimer Disease Treatment (CLIMAT) Study, Principal Investigator
Research Support, Academic Entities:
1.
Canadian Institutes of Health Research, Frontotemporal Lobar Degeneration with Ubiquitinated Inclusions: Genetic, clinical, pathological and biomarker studies, Co-Investigator
Research Support, Foundations and Societies:
1.
Canadian Stroke Network / Heart & Stroke Foundation, Role of exercise on cognition and function in seniors with Vascular Cognitive Impairment, Co-InvestigatorAlzheimer Society of Canada, A Randomized Controlled Trial of Group Music Therapy in the Care of Patients with Mild to Moderate Alzheimer Disease, Co-Investigator
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Amir A. Sepehry, MSc
From the School of Population and Public Health (J.D.E.), Division of Neurology (C.J., B.P., O.R.B.), and College of Interdisciplinary Studies Program in Neuroscience (A.A.S., O.R.B.), University of British Columbia, Vancouver, Canada.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Canadian Psychological Association division of Psychopharmacology, Editor for Psynapse.
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
Canadian Institutes of Health Research: Doctoral Award
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Brandy Pratt, BKin
From the School of Population and Public Health (J.D.E.), Division of Neurology (C.J., B.P., O.R.B.), and College of Interdisciplinary Studies Program in Neuroscience (A.A.S., O.R.B.), University of British Columbia, Vancouver, Canada.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Oscar R. Benavente, MD, FRCP(C)
From the School of Population and Public Health (J.D.E.), Division of Neurology (C.J., B.P., O.R.B.), and College of Interdisciplinary Studies Program in Neuroscience (A.A.S., O.R.B.), University of British Columbia, Vancouver, Canada.
Disclosure
Scientific Advisory Boards:
1.
Honorarium for lectures from Sanofi-BMS, Otsuka, BayerConsultan for OtsukaAdvisory Board from Sanofi
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
Honorarium from Sanofi, Otsuka, Bayer
Editorial Boards:
1.
Advisory Board member for Sanofi
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
Consultant for Otsuka
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
Funded by NIH
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE

Notes

Correspondence to Dr. Benavente: [email protected]
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

Author Contributions

Ms. Edwards: study concept and design; article search, review, and selection; data analysis and interpretation; manuscript preparation and critical revision for important intellectual content. Dr. Jacova: study concept and design; data analysis and interpretation; critical revision of the manuscript for important intellectual content. Mr. Sepehry: data analysis and interpretation; manuscript revision. Ms. Pratt: article search, review, and selection; data analysis; manuscript revision. Dr. Benavente: study concept and design; article review and selection; data interpretation; critical revision of the manuscript for important intellectual content; study supervision.

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