Prevalence and Clinical Correlates of Poststroke Behavioral Dysexecutive Syndrome

Wai Kwong Tang, Chieh Grace Lau, Yan Liang, Lisha Wang, Vincent Mok, Oi Yan Yannie Soo, Wai Hong Thomas Leung, Gabor S. Ungvari, Shinichiro Uchiyama, Jong S. Kim

Research output: Contribution to journalArticle

Abstract

Background Behavioral dysexecutive syndrome (BDES) is a common phenomenon following stroke. To date, research has focused mainly on individual behavioral symptoms rather than a more comprehensive characterization of goal-directed behavior in stroke survivors. This cross-sectional study evaluated the prevalence and clinical correlates of BDES in Hong Kong stroke survivors. Methods and Results A total of 369 stroke survivors were recruited from a regional hospital at 3 months after their index stroke. Patients' demographic and clinical characteristics were extracted from a comprehensive stroke database. BDES was measured with the Chinese version of the Dysexecutive Questionnaire. Four neurocognitive batteries assessed domains of cognitive executive functions. The prevalence of BDES 3 months poststroke was 18.7%. At that time point, the Hospital Anxiety Depression Scale and Mini-Mental State Examination scores and the presence of depression were significant predictors of BDES in a multivariate logistic regression analysis. These parameters remained significant predictors of the Dysexecutive Questionnaire score in a linear stepwise regression analysis and together accounted for 28.5% of the variance. Current depression was predictive of the Dysexecutive Questionnaire score in patients with BDES, with a variance of 9.7%. Furthermore, compared with the non-BDES group, patients with BDES exhibited poor performance-based executive function in the Chinese version of the Frontal Assessment Battery and color trails, arrow, and category fluency tests. Conclusions Symptoms of anxiety, current depression, and global cognitive function may be independent predictors of the presence and severity of BDES 3 months poststroke. Stroke survivors with BDES exhibit poor executive functioning, including goal maintenance and semantic memory.

Original languageEnglish
Pages (from-to)e013448
JournalJournal of the American Heart Association
Volume8
Issue number22
DOIs
Publication statusPublished - 19 Nov 2019

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Stroke
Survivors
Depression
Executive Function
Cognition
Anxiety
Regression Analysis
Behavioral Symptoms
Hong Kong
Semantics
Linear Models
Color
Cross-Sectional Studies
Logistic Models
Maintenance
Demography
Databases
Research
Surveys and Questionnaires

Cite this

Tang, W. K., Lau, C. G., Liang, Y., Wang, L., Mok, V., Soo, O. Y. Y., ... Kim, J. S. (2019). Prevalence and Clinical Correlates of Poststroke Behavioral Dysexecutive Syndrome. Journal of the American Heart Association, 8(22), e013448. https://doi.org/10.1161/JAHA.119.013448
Tang, Wai Kwong ; Lau, Chieh Grace ; Liang, Yan ; Wang, Lisha ; Mok, Vincent ; Soo, Oi Yan Yannie ; Leung, Wai Hong Thomas ; Ungvari, Gabor S. ; Uchiyama, Shinichiro ; Kim, Jong S. / Prevalence and Clinical Correlates of Poststroke Behavioral Dysexecutive Syndrome. In: Journal of the American Heart Association. 2019 ; Vol. 8, No. 22. pp. e013448.
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abstract = "Background Behavioral dysexecutive syndrome (BDES) is a common phenomenon following stroke. To date, research has focused mainly on individual behavioral symptoms rather than a more comprehensive characterization of goal-directed behavior in stroke survivors. This cross-sectional study evaluated the prevalence and clinical correlates of BDES in Hong Kong stroke survivors. Methods and Results A total of 369 stroke survivors were recruited from a regional hospital at 3 months after their index stroke. Patients' demographic and clinical characteristics were extracted from a comprehensive stroke database. BDES was measured with the Chinese version of the Dysexecutive Questionnaire. Four neurocognitive batteries assessed domains of cognitive executive functions. The prevalence of BDES 3 months poststroke was 18.7{\%}. At that time point, the Hospital Anxiety Depression Scale and Mini-Mental State Examination scores and the presence of depression were significant predictors of BDES in a multivariate logistic regression analysis. These parameters remained significant predictors of the Dysexecutive Questionnaire score in a linear stepwise regression analysis and together accounted for 28.5{\%} of the variance. Current depression was predictive of the Dysexecutive Questionnaire score in patients with BDES, with a variance of 9.7{\%}. Furthermore, compared with the non-BDES group, patients with BDES exhibited poor performance-based executive function in the Chinese version of the Frontal Assessment Battery and color trails, arrow, and category fluency tests. Conclusions Symptoms of anxiety, current depression, and global cognitive function may be independent predictors of the presence and severity of BDES 3 months poststroke. Stroke survivors with BDES exhibit poor executive functioning, including goal maintenance and semantic memory.",
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Tang, WK, Lau, CG, Liang, Y, Wang, L, Mok, V, Soo, OYY, Leung, WHT, Ungvari, GS, Uchiyama, S & Kim, JS 2019, 'Prevalence and Clinical Correlates of Poststroke Behavioral Dysexecutive Syndrome' Journal of the American Heart Association, vol. 8, no. 22, pp. e013448. https://doi.org/10.1161/JAHA.119.013448

Prevalence and Clinical Correlates of Poststroke Behavioral Dysexecutive Syndrome. / Tang, Wai Kwong; Lau, Chieh Grace; Liang, Yan; Wang, Lisha; Mok, Vincent; Soo, Oi Yan Yannie; Leung, Wai Hong Thomas; Ungvari, Gabor S.; Uchiyama, Shinichiro; Kim, Jong S.

In: Journal of the American Heart Association, Vol. 8, No. 22, 19.11.2019, p. e013448.

Research output: Contribution to journalArticle

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T1 - Prevalence and Clinical Correlates of Poststroke Behavioral Dysexecutive Syndrome

AU - Tang, Wai Kwong

AU - Lau, Chieh Grace

AU - Liang, Yan

AU - Wang, Lisha

AU - Mok, Vincent

AU - Soo, Oi Yan Yannie

AU - Leung, Wai Hong Thomas

AU - Ungvari, Gabor S.

AU - Uchiyama, Shinichiro

AU - Kim, Jong S.

PY - 2019/11/19

Y1 - 2019/11/19

N2 - Background Behavioral dysexecutive syndrome (BDES) is a common phenomenon following stroke. To date, research has focused mainly on individual behavioral symptoms rather than a more comprehensive characterization of goal-directed behavior in stroke survivors. This cross-sectional study evaluated the prevalence and clinical correlates of BDES in Hong Kong stroke survivors. Methods and Results A total of 369 stroke survivors were recruited from a regional hospital at 3 months after their index stroke. Patients' demographic and clinical characteristics were extracted from a comprehensive stroke database. BDES was measured with the Chinese version of the Dysexecutive Questionnaire. Four neurocognitive batteries assessed domains of cognitive executive functions. The prevalence of BDES 3 months poststroke was 18.7%. At that time point, the Hospital Anxiety Depression Scale and Mini-Mental State Examination scores and the presence of depression were significant predictors of BDES in a multivariate logistic regression analysis. These parameters remained significant predictors of the Dysexecutive Questionnaire score in a linear stepwise regression analysis and together accounted for 28.5% of the variance. Current depression was predictive of the Dysexecutive Questionnaire score in patients with BDES, with a variance of 9.7%. Furthermore, compared with the non-BDES group, patients with BDES exhibited poor performance-based executive function in the Chinese version of the Frontal Assessment Battery and color trails, arrow, and category fluency tests. Conclusions Symptoms of anxiety, current depression, and global cognitive function may be independent predictors of the presence and severity of BDES 3 months poststroke. Stroke survivors with BDES exhibit poor executive functioning, including goal maintenance and semantic memory.

AB - Background Behavioral dysexecutive syndrome (BDES) is a common phenomenon following stroke. To date, research has focused mainly on individual behavioral symptoms rather than a more comprehensive characterization of goal-directed behavior in stroke survivors. This cross-sectional study evaluated the prevalence and clinical correlates of BDES in Hong Kong stroke survivors. Methods and Results A total of 369 stroke survivors were recruited from a regional hospital at 3 months after their index stroke. Patients' demographic and clinical characteristics were extracted from a comprehensive stroke database. BDES was measured with the Chinese version of the Dysexecutive Questionnaire. Four neurocognitive batteries assessed domains of cognitive executive functions. The prevalence of BDES 3 months poststroke was 18.7%. At that time point, the Hospital Anxiety Depression Scale and Mini-Mental State Examination scores and the presence of depression were significant predictors of BDES in a multivariate logistic regression analysis. These parameters remained significant predictors of the Dysexecutive Questionnaire score in a linear stepwise regression analysis and together accounted for 28.5% of the variance. Current depression was predictive of the Dysexecutive Questionnaire score in patients with BDES, with a variance of 9.7%. Furthermore, compared with the non-BDES group, patients with BDES exhibited poor performance-based executive function in the Chinese version of the Frontal Assessment Battery and color trails, arrow, and category fluency tests. Conclusions Symptoms of anxiety, current depression, and global cognitive function may be independent predictors of the presence and severity of BDES 3 months poststroke. Stroke survivors with BDES exhibit poor executive functioning, including goal maintenance and semantic memory.

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