What neuropsychological functions best discriminate performance in adults post-stroke?

  • Jaqueline de Carvalho Rodrigues, Wagner de Lara Machado, Denise Ren da Fontoura, Andrea Garcia Almeida, Rosane Brondani, Sheila Ouriques Martins, Denise Ruschel Bandeira, Jerusa Fumagalli de Salles
  • Applied Neuropsychology Adult, April 2018, Taylor & Francis
  • DOI: 10.1080/23279095.2018.1442334

What neuropsychological functions best discriminate performance in adults post-stroke?

What is it about?

This study aimed to develop a short version of an instrument to detect cognitive impairment in stroke patients, investigate which cognitive dimensions best discriminate between stroke patients and healthy adults and to graphically analyze the relationships among the neuropsychological variables and groups. This pilot study included 94 adults (49 post-stroke and 45 neurologically healthy) who answered the Brief Neuropsychological Assessment Battery NEUPSILIN for patients with expressive aphasia (NEUPSILIN-Af) to assess orientation, perception, memory, praxis, executive functions, oral language, and academic achievement (written language and arithmetic). The IRT Rasch model for dichotomous data indicated the exclusion of items that could not be used to discriminate performances. ROC curves indicated that only the orientation, oral language, academic achievement, and executive function dimensions could be used to differentiate between the clinical and healthy groups. Graphical analysis indicated that independently of the relation among variables, orientation and executive functions tasks are essentials in the neuropsychological assessments. This study contributes to the development of specific and sensitive neuropsychological instruments to assess stroke patients and to better understand the common deficits present in this clinical population.

Why is it important?

In this study, we investigated the cognitive dimensions (tasks) and neuropsychological items with greater or lesser degrees of difficulty that are sensitive to cognitive deficits after stroke. In a short version of a neuropsychological assessment tool for stroke patients, it is important to evaluate orientation, oral language, academic achievement and executive functions. Our results help those who want to build a specific and sensitive neuropsychological test to assess stroke patients and contribute to understand common deficits in this clinical population.

Perspectives

Jaqueline Rodrigues
Universidade do Vale do Rio dos Sinos

The short version of the NEUPSILIN-Af can be applied to stroke patients. However, it is important to include additional executive function components tasks and qualitative analyses to complement the investigation of post-stroke deficits. Furthermore, neuropsychological functions are interrelated, and impairment in one can influence the overall performance. A neuropsychological assessment with a short instrument can provide indicators of deficits but can never present the diagnostic profile of patients. Therefore, the NEUPSILIN-Af short form should be utilized with caution.

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http://dx.doi.org/10.1080/23279095.2018.1442334

The following have contributed to this page: Jaqueline Rodrigues