Behavioural clusters and predictors of performance during recovery from stroke

We examined the patterns and variability of post-stroke recovery in multiple behavioural domains. A large cohort of first-time stroke patients with heterogeneous lesions was studied prospectively and longitudinally at one to two weeks, three months and one year after the stroke using structural magnetic resonance imaging to measure lesion anatomy and 44 neuropsychological tests to assess behavioural outcomes. Impairment was described at all time points by a few clusters of correlated deficits. The time course and magnitude of recovery was similar across behavioural domains, with change scores largely proportional to the initial deficit and most recovery occurring within the first three months. Damage to specific white matter tracts produced poorer recovery for several domains: Attention (superior longitudinal fasciculus II/III), language (posterior arcuate fasciculus) and motor (corticospinal tract). Finally, after accounting for the severity of the initial deficit, language and visual memory recovery was worse for those with lower levels of education, while the occurrence of multiple deficits negatively impacted attention recovery.