The Behavioral and Cognitive Executive Disorders of Stroke: The GREFEX Study.

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Serval ID
serval:BIB_355F90AD3BEF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The Behavioral and Cognitive Executive Disorders of Stroke: The GREFEX Study.
Journal
Plos One
Author(s)
Roussel M., Martinaud O., Hénon H., Vercelletto M., Bindschadler C., Joseph P.A., Robert P., Labauge P., Godefroy O.
Working group(s)
GREFEX Study Group
Contributor(s)
Godefroy O., Le Gall D., Bertola C., Giroire JM., Joseph PA., Seron X., Coyette F., Bretault E., Bernard I., Leclercq M., Azouvi P., Vallat-Azouvi C., Pollack , Mosca C., Krier M., Meulemans T., Marquet V., Leys D., Roussel M., Renou P., Vercelletto M., Michel E., Robert P., Labauge P., Franconie C., Pillon B., Dubois B., Dieudonnée B., Verny M., Lenoir H., De Rotrou J., Hannequin D., Bioux S., Fuchs J., Bellmann A.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2016
Peer-reviewed
Oui
Volume
11
Number
1
Pages
e0147602
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
BACKGROUND: Many studies have highlighted the high prevalence of executive disorders in stroke. However, major uncertainties remain due to use of variable and non-validated methods. The objectives of this study were: 1) to characterize the executive disorder profile in stroke using a standardized battery, validated diagnosis criteria of executive disorders and validated framework for the interpretation of neuropsychological data and 2) examine the sensitivity of the harmonization standards protocol proposed by the National Institute of Neurological Disorders and Stroke and Canadian Stroke Network (NINDS-CSN) for the diagnosis of Vascular Cognitive Impairment.
METHODS: 237 patients (infarct: 57; cerebral hemorrhage: 54; ruptured aneurysm of the anterior communicating artery (ACoA): 80; cerebral venous thrombosis (CVT): 46) were examined by using the GREFEX battery. The patients' test results were interpreted with a validated framework derived from normative data from 780 controls.
RESULTS: Dysexecutive syndrome was observed in 88 (55.7%; 95%CI: 48-63.4) out of the 156 patients with full cognitive and behavioral data: 40 (45.5%) had combined behavioral and cognitive syndromes, 29 (33%) had a behavioral disorder alone and 19 (21.6%) had a cognitive syndrome alone. The dysexecutive profile was characterized by prominent impairments of initiation and generation in the cognitive domain and by hypoactivity with disinterest and anticipation loss in the behavioral domain. Cognitive impairment was more frequent (p = 0.014) in hemorrhage and behavioral disorders were more frequent (p = 0.004) in infarct and hemorrhage. The harmonization standards protocol underestimated (p = 0.007) executive disorders in CVT or ACoA.
CONCLUSIONS: This profile of executive disorders implies that the assessment should include both cognitive tests and a validated inventory for behavioral dysexecutive syndrome. Initial assessment may be performed with a short cognitive battery, such as the harmonization standards protocol. However, administration of a full cognitive battery is required in selected patients.
Keywords
Adult, Aged, Aneurysm, Ruptured/complications, Aneurysm, Ruptured/diagnosis, Anterior Cerebral Artery, Apathy, Case-Control Studies, Cerebral Hemorrhage/complications, Cerebral Hemorrhage/diagnosis, Cognition/physiology, Cognition Disorders/diagnosis, Cognition Disorders/etiology, Executive Function/physiology, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Severity of Illness Index, Stroke/complications, Stroke/diagnosis, Venous Thrombosis/complications, Venous Thrombosis/diagnosis
Pubmed
Web of science
Open Access
Yes
Create date
01/03/2016 19:20
Last modification date
20/08/2019 14:22
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