Subcortical structures have been implicated in higher cortical syndromes; however, the role of subcortical structures in cognition has been understudied in patients with vascular lesions and in the rehabilitation setting. The purpose of the present study was to examine the effect of cortical and subcortical vascular lesions on intellectual and memory functions. Thirty-six patients consecutively admitted to an acute neurorehabilitation stroke unit who met screening criteria for this study were classified based on radiologically confirmed lesion locations into either a cortical (
) or a subcortical (
) group and were administered batteries of intellectual and memory tests. An analysis of variance showed that the subcortical group was significantly more impaired on global measures of higher cortical function when compared with the cortical group. Although the subcortical group showed expected attentional, mental control, and psychomotor slowing deficits, a separate analysis of the timed subtests failed to demonstrate that mental slowing was the sole factor responsible for higher level cognitive deficits. Results are discussed in terms of the rehabilitative implications of these findings. A structure/function relationship suggested that subcortical lesions, especially in the early stages of recovery, may include complex neurocognitive psychological processes and, therefore, warrant appropriate assessment and treatment in rehabilitative planning.
