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Published on: February 22, 2020
Non-motor Outcomes After Stroke: Updated Systematic Review and Meta-Analysis
Hatice Ozkan1,2, Taniya Esmail2, Gareth Ambler3
1Stroke Research Centre, Department of Translational Neuroscience and Stroke, UCL Queen Square Institute of Neurology, London, UK.
Summary
Adverse non-motor outcomes are common after stroke, with methodological limitations in studies. More long-term, rigorous research is needed to improve stroke patient care and life after stroke.
Area of Science:
- Neurology
- Public Health
- Clinical Research
Background:
- Adverse non-motor outcomes are prevalent post-stroke, but their exact prevalence and prognosis are unclear due to methodological inconsistencies.
- This study synthesizes evidence on non-motor outcomes to address heterogeneity in research settings, definitions, measurement tools, stroke types, and follow-up durations.
Purpose of the Study:
- To comprehensively synthesize evidence on the prevalence of adverse non-motor outcomes after stroke.
- To examine the influence of study settings, outcome definitions, measurement instruments, stroke type, and follow-up duration on prevalence.
- To identify study-level characteristics associated with adverse non-motor outcomes.
Main Methods:
- A systematic review and meta-analysis of 357 prospective cohort studies (247,541 participants) published between January 1999 and November 2025.
- Searched multiple databases (PubMed, MEDLINE, EMBASE, Scopus, Web of Science, PsycINFO).
- Pooled prevalence was estimated using random-effects models; meta-regression identified associated factors. Study quality was assessed using the Newcastle-Ottawa Scale.
Main Results:
- Prevalence of adverse non-motor outcomes was high across hospital and population settings, with no significant differences except for bowel dysfunction in population studies.
- Studies using non-validated measures reported higher prevalence for anxiety, apathy, sleep disturbance, and bowel dysfunction.
- Older age, intracerebral hemorrhage (ICH), and non-validated measures were associated with higher prevalence. Most studies focused on early outcomes (≤6 months) with limited long-term follow-up (>2 years).
Conclusions:
- Non-motor outcomes are highly prevalent post-stroke, underscoring significant methodological limitations in current research.
- Urgent need for long-term, methodologically rigorous studies to improve consistent assessment and clinical care for life after stroke.
- Limited data exists for intracerebral hemorrhage (ICH) and long-term outcomes, highlighting critical research gaps.