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

Abstract

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.

Relations between executive function, language, and functional communication in severe aphasia

“…In stroke patients in general, impaired executive function is common (Rodrigues et al, 2018) and has a negative impact on quality of life, functional outcome and health-care costs (Cumming, Marshall, & Lazar, 2013). However, in many studies of cognition in stroke patients, PWA are excluded (Barnay et al, 2014;Wall et al, 2017).…”

The mini-mental state examination (MMSE) from a language perspective: an analysis of test interaction

“…Nevertheless, language problems are not always known in advance. Furthermore, the options for cognitive screening tools are limited and it is commonly used on stroke survivors, of which even individuals without aphasia may present language deficits (Rodrigues et al, 2018). Making qualitative notes alongside the MMSE-scores might be a beneficial procedure, giving an opportunity to make an informal evaluation of the test participant's answers.…”

“…To differentiate language problems from cognitive deficits such as impairments in working-memory or episodic memory is a problematic issue. There are several tools available to evaluate cognitive function in stroke patients (Rodrigues et al, 2018). However, many neuropsychological tests have a linguistic mediation and several materials are too complex for persons with severe aphasia, thus leading to floor-effects (Marinelli et al, 2017).…”

Cognitive Screening (TRIACOG) for adults with cerebrovascular diseases: Construction process and validity evidence.

“…Analysis of the performance of adults after stroke with a brief neuropsychological instrument. Using a database (Fontoura, Rodrigues, Mansur, Monção, & Salles, 2013), items and cognitive dimensions that best discriminate between groups of poststroke patients and neurologically healthy adults were identified (Rodrigues, Machado, et al, 2019). Item response theory analysis, receiver operation characteristic curves, and network analysis (Hajian-Tilaki, 2013) were performed using the Brief Neuropsychological Assessment Battery NEUPSILIN for patients with expressive aphasia (NEUPSILIN-Af; Fontoura, Rodrigues, Fonseca, Parente, & Salles, 2011).…”