Long-Term Functional Outcome in Patients With Isolated Thalamic Stroke: The KOSCO Study

Area of Science:

• Neurology
• Neuroscience
• Rehabilitation Medicine

Background:

• Limited data exists on the long-term prognosis for patients experiencing isolated thalamic strokes.
• The Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) study provides insights into functional outcomes.
• Understanding prognosis is crucial for effective patient management.

Purpose of the Study:

• To report the functional outcomes of patients with isolated thalamic stroke up to 24 months post-stroke.
• To analyze the recovery trajectory and long-term prognosis.
• To inform clinical management strategies for thalamic stroke patients.

Main Methods:

• Defined isolated thalamic stroke based on MRI/CT scans, excluding other brain lesions.
• Assessed physical impairments using Fugl-Meyer Assessment, Functional Ambulatory Category, Korean Mini-Mental State Examination, ASHA-NSD, and Frenchay Aphasia Screening Test.
• Evaluated functional outcomes with Functional Independence Measure and modified Rankin Scale up to 24 months.

Main Results:

• 297 patients (235 ischemic, 62 hemorrhagic) were analyzed.
• Most physical impairments improved significantly by 3 months, reaching a plateau.
• Ambulatory function and independence scores continued to improve up to 12 months.
• The proportion of patients with no significant disability (mRS < 2) increased from 47.5% at 7 days to 76.4% at 24 months.

Conclusions:

• Patients experience rapid physical recovery within 3 months post-thalamic stroke.
• Further improvements in ambulation and independence are observed up to 12 months.
• A favorable long-term functional prognosis at 24 months is demonstrated for isolated thalamic stroke.