Original Article
Long-Term Deficits in Episodic Memory after Ischemic Stroke: Evaluation and Prediction of Verbal and Visual Memory Performance Based on Lesion Characteristics

https://doi.org/10.1016/j.jstrokecerebrovasdis.2008.09.017Get rights and content

We investigated the relationship between ischemic lesion characteristics (hemispheric side, cortical and subcortical level, volume) and memory performance, 1 year after stroke. Verbal and visual memory of 86 patients with stroke were assessed with Rey Auditory-Verbal Learning Test and the Doors Test, respectively. Lesion characteristics and presence of white matter lesions were assessed on magnetic resonance imaging early after stroke. Multiple regression analyses were used to investigate prediction of verbal and visual memory performance by lesion side (left v right hemisphere), lesion level (cortical v subcortical), and lesion volume. We controlled for the influence of demographic characteristics, language disability, and visuospatial difficulties on memory. The results demonstrated that poor verbal memory (immediate and delayed recall and recognition) could be predicted by lesion characteristics: patients with left hemispheric, subcortical, and large lesions showed poor memory performance. Poor visual recognition memory could not be predicted by lesion characteristics but only by low educational level. Our results suggest that lesion characteristics play an important role in episodic verbal memory poststroke if demographic and clinical characteristics are taken into account.

Section snippets

Procedure

The study population consisted of patients with a first-ever ischemic stroke admitted to one of 6 participating stroke departments in the Netherlands. Stroke has been defined as a rapidly developing sign of focal or global disturbance of cerebral function with symptoms lasting 24 hours or longer or leading to death, with no apparent origin other than vascular.40 The research protocol was approved by our medical ethics committee. All patients gave their informed consent. Patients included had a

Results

Of 105 included patients, 19 patients could not be evaluated after 1 year poststroke (mean 377 days; SD 22): 9 patients had died; 4 patients had recurrent stroke; two patients developed comorbidity seriously affecting functional outcome; and 4 patients refused further examination. RAVLT test results of two patients were incomplete and in 8 patients the RAVLT could not be administered because of severe aphasia. Finally, 76 patients had complete data on the RAVLT. Results on the Doors Test were

Discussion

Our study investigated the relationship between lesion characteristics (lesion side, level, and volume) and episodic memory performance of patients with ischemic stroke in the chronic phase after stroke.

Our results show that 1 year poststroke, compared with norms, a large number of patients were impaired on verbal immediate and delayed recall as well as on verbal recognition. Furthermore, one quarter of the patients had impairments of recognizing learned visual information. Studies1, 9 of

Acknowledgment

We would like to thank Theo D. Witkamp, MD, neuroradiologist, for his help in analyzing the MRI scans.

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    S. K. Schiemanck was supported by a grant from the Netherlands Organization for Health Research and Development (ZON/MW) and the Scientific Foundation of Rehabilitation Center De Hoogstraat.

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