AUTHOR=Sagnier Sharmila , Renou Pauline , Olindo Stéphane , Debruxelles Sabrina , Poli Mathilde , Rouanet François , Munsch Fanny , Tourdias Thomas , Sibon Igor 

TITLE=Gait Change Is Associated with Cognitive Outcome after an Acute Ischemic Stroke

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=Volume 9 - 2017

YEAR=2017

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2017.00153

DOI=10.3389/fnagi.2017.00153

ISSN=1663-4365

ABSTRACT=Background. Cognition and gait have often been studied separately after stroke whereas it has been suggested that these two domains could interact through a cognitive-motor interference. 
Objective. To evaluate the influence of gait changes on cognitive outcome after an ischemic stroke (IS). 
Methods. We conducted a prospective and monocentric study including patients admitted for an acute supratentorial IS with a National Institute of Health Stroke Score ≤ 15. Cognition, gait and motor disability were evaluated at baseline, three months and one year post-stroke, using the Montreal Cognitive Assessment (MoCA), the 10-meter walking test (10-MWT) and the Fugl-Meyer motor assessment (FMMA). The effect of changes in 10-MWT over the year of follow-up on MoCA changes was estimated using a generalized linear mixed model with FMMA, age and gender as covariates. 
Results. 212 patients were included (71% male, age 64 ± 13 y.o). 10-MWT improved from baseline to one year (p < .001), as did MoCA (p < .001) and FMMA (p < .001) scores. 99 patients (47%) had a MoCA < 26 at one year. Changes in 10-MWT were independently associated with changes in MoCA (β = -0.2, 95% CI -0.24 to -0.07, Bonferroni-corrected p-value = 0.002). Analyses of MoCA sub-scores suggested that changes in gait performance was associated with changes in executive functions and recall. 
Conclusion. Gait performance is associated with cognitive outcome after a mild to moderate IS, suggesting that they should be managed together to improve post-stroke independence.