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“Introduction A return to work plays an important role in the occupational

health and rehabilitation of working-age post-stroke patients. Previous studies, including our own, identified determinants of early return to work in terms of functional and socioeconomic conditions of the patients (Saeki and Toyonaga 2010; Tanaka et al. 2011). These previous studies focused on the patient’s condition SYN-117 in vivo in the pre-stroke, hospitalized, and at-discharge periods, since these will predict the functional recovery which is expected within 3–6 months after onset (Bonita and Beaglehole 1988). However, the impact of higher cortical dysfunction has been poorly studied apart from a study by Tanaka et al. (2011) in which the authors identified that higher cortical dysfunction significantly reduced the chance of very early return to work within 1 month after discharge in those with mild physical impairment. Since the recovery in higher cortical function is likely to be observed several months after a stroke and into the chronic period

after 6 months (Ferro and Crespo 1988), the influence of higher cortical dysfunction on return to work in the chronic PtdIns(3,4)P2 phase could be more important than in the earlier phase. Furthermore, the earlier study did not specify what type of higher cortical function is related to return to work among those with different Tanespimycin levels of physical impairment. In this study, we specifically focused on the impact of higher cortical dysfunction on return to work in the chronic phase, in addition to the functional and social factors discussed in previous studies. Since the rehabilitation of higher cortical dysfunction often requires a distinct set of resources compared with that required for physical dysfunction, we believe that the results of this study will provide information on the need for cognitive rehabilitation in the chronic stage of stroke recovery to enable return to work. Methods Participants The study was performed on the same prospective cohort as in Tanaka et al. (2011).