Relationship between Comorbid Cognitive Impairment and Functional Outcomes in Stroke Patients with Spatial Neglect

ABSTRACT

OBJECTIVE: The aim of this study was to investigate relationships between cognitive impairment and functional outcomes in stroke patients with spatial neglect. METHOD: Twenty seven right hemisphere ischemic stroke patients who admitted to an inpatient rehabilitation unit were included. Patients were divided into two group based on KF-NAP scores Neglect group (n=18) and non-neglect group (n=9). Neglect group (n=18) were subdivided into two groups by discharge FIM scores as poor outcome group (n=8, <70) and good outcome group (n=10, ≥70). Cognitive function assessments including attention (Attention & Calculation, Digit span test-Forward), memory (Digit span test-Backward, SVLT-Immediate recalls/Delayed recalls) and visual perception (LOTCA-Visual perception/Visuomotor organization), and stroke severity assessment including NIHSS, FMA, K-MMSE, and FIM were performed. Cognitive impairments and functional outcomes were compared between two groups. RESULTS: There were significant differences in NIHSS, FMA (affected U/E, affected L/E), discharge FIM, FIM gain and LOTCA-visuomotor organization between Neglect group and non- neglect group (p<0.05). Among the patients with spatial neglect, there were significant differences in KF-NAP, K-MMSE and assessment scores of memory and visual perception between poor outcome group and good outcome group. Attention, memory and visual perception were significantly correlated with KF-NAP scores (p<0.05). CONCLUSION: Stroke patients with spatial neglect showed more severe impairment in cognitive, motor and general functional status, which resulted in delayed functional recovery. Spatial neglect patients with combined memory and visual perception impairment may show poor functional outcome.