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Objectives Post-stroke cognitive impairment ( PSCI) has considerable impact on patients and society. However, long-term studies on PSCI are scarce and may be influenced by assessment methods and selection bias. We aimed to (i) assess the prevalence of long-term PSCI; (ii) compare two common cognitive assessment instruments; and (iii) compare cognitive function of long-term stroke survivors with non-stroke persons. Methods Mini-Mental State Examination ( MMSE) and Montreal Cognitive Assessment (Mo CA) were administered to 10-year survivors from a population-based cohort of first-ever stroke patients included in the Lund Stroke Register, Sweden, in 2001-2002. PSCI was defined as MMSE<27 and/or Mo CA<25 and severe cognitive impairment as MMSE<23. Age- and sex-matched non-stroke control subjects who had performed MMSE (but not Mo CA) were recruited from the longitudinal population study 'Good Ageing in Skåne.' The odds of having cognitive impairment for stroke survivors compared to controls were examined with logistic regression analyses adjusting for education. Results Of 145 stroke survivors after 10 years, 127 participated. MMSE showed PSCI in 46%, whereas Mo CA displayed PSCI in 61%. Among the stroke survivors with Mo CA<25, 35% had MMSE≥27 ( P<.001). The odds of having severe cognitive impairment defined as MMSE<23 were higher among the stroke survivors compared to 354 controls (education-adjusted; OR=2.5; P=.004). Conclusions Post-stroke cognitive impairment was prevalent among 10-year stroke survivors, and the odds of having severe cognitive impairment were higher among the stroke survivors compared to non-stroke persons. The burden of long-term PSCI might have been underestimated previously, and Mo CA may be more suitable than MMSE to detect long-term PSCI. [ABSTRACT FROM AUTHOR]

Background and purpose Clinical stroke trials with stem cell-based approaches aiming for trophic actions, modulation of inflammation and neuroprotection are ongoing. However, experimental studies also suggest that neuronal replacement by grafted neural stem cells ( NSCs) and possibly by endogenous NSCs from the subventricular zone ( SVZ) may restore function in the stroke-damaged striatum. To evaluate the potential clinical impact of these findings, we analyzed the spatial relationship of infarcts to the SVZ and the proportion of individuals with striatal lesions in a consecutive series of ischaemic stroke patients. Methods Patients aged 20-75 years with first-ever ischaemic stroke underwent DW- MRI of the brain within 4 days after stroke onset. We analyzed location, size, number of acute focal ischaemic abnormalities and their spatial relationship to the SVZ. Stroke severity was assessed using NIH Stroke Scale ( NIHSS). Results Of 108 included patients, the distance from the nearest margin of the infarct(s) to the SVZ was ≤2 mm in 51/102 patients with visible ischaemic lesions on DW- MRI. Twenty-four patients had involvement of striatum. Eight of these had predominantly striatal lesions, that is >50% of the total ischaemic lesion volume was located in caudate nucleus and/or putamen. These 8 patients had a median NIHSS of 3. Conclusions Many stroke patients have infarcts located close to the SVZ, providing some supportive evidence that optimized endogenous neurogenesis may have therapeutic potential. However, predominantly striatal infarcts are rare and tend to give mild neurological deficits, indicating that striatum should not be the primary target for neuronal replacement efforts in humans. [ABSTRACT FROM AUTHOR]