[Executive function deficits following stroke]

Abstract

Background: Executive function deficit is a cognitive dysfunction resulting in a reduced ability to initiate, control and monitor targeted behaviour. Our clinical experience indicates that this often remains undiagnosed following stroke.

Method: The article is based on literature searches using the search terms «Stroke» and «Executive function» via the search engine McMaster Plus, in the databases Cochrane Library and PubMed, coupled with the authors' own experience.

Results: Executive function deficit is a common form of stroke-related cognitive dysfunction which often accompanies emotional instability and depression. The condition is an important risk factor for loss of self-sufficiency and for reduced survival. Diagnosis is based on the patient's history and observation, supplemented by cognitive testing. Executive function deficits also occur in patients with no clinical signs of stroke, but who have image diagnostic signs of cerebral ischaemia, and with other cerebral diseases such as Parkinson's disease and dementia. Executive function is mainly located in the prefrontal cortex and the subcortical circuits, but executive function deficits are also seen in cases of lesions in other areas of the brain. The treatment of executive function deficits focuses on compensatory strategies and on recovery of lost function.

Interpretation: Executive function deficits are common with stroke-related cognitive impairment, and may affect the prognosis. There is a need for systematic testing and strategies for treatment and prevention.