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In This Article

  • Summary
  • Abstract
  • Introduction
  • Protocol
  • Representative Results
  • Discussion
  • Acknowledgements
  • Materials
  • References
  • Reprints and Permissions

Summary

Clinical assessment scales are notsensitive enough to cognitive dysfunction in high-functioning stroke patients. The dual-task paradigm presents advantages and potential in the assessment and cognitive training of cognitive dysfunction. The study here proposes a dual-task Stroop paradigm to identify cognitive dysfunction in high-functioning stroke patients.

Abstract

General clinical cognitive assessment scales are not sensitive enough to cognitive impairment in high-functioning stroke patients. The dual-task assessment has advantages for identifying cognitive deficits in high-functioning stroke patients and has been gradually applied in clinical assessment and cognitive training. Moreover, the Stroop paradigm has higher sensitivity and specificity for attentional assessment than conventional clinical cognitive assessment scales. Therefore, this study presents the dual-task assessment based on the Stroop paradigm to identify cognitive deficits in high-functioning stroke patients. This study demonstrates a single- and dual-task evaluation based on the Stroop paradigm and confirms its feasibility through case experiments and synchronized functional near-infrared spectroscopy evaluation. The Stroop reaction time and correct rate are used as the main indicators to evaluate the cognitive level of the subjects. This study protocol aims to provide new ideas to figure out the ceiling effect in general clinical assessment failure for high-functioning stroke patients.

Introduction

Stroke is the leading cause of disability in humans1 and can cause varying degrees of motor, cognitive, emotional, and other functional deficits2. Some stroke patients with better prognosis and only slight functional defects show greater functional autonomy in daily activities, but the functional state of their disability may not be sufficient to support their return to work or previous activities. These patients are referred to as high-functioning stroke patients3,4. Due to their minor functional deficits, it is hard to identify their dysfunctions, especially in....

Protocol

This project was approved by the Medical Ethics Association of the Fifth Affiliated Hospital of Guangzhou Medical University (No. KY01-2020-08-06) and has been registered at the China Clinical Trial Registration Center (No. ChiCTR2000036514). Informed consent was obtained from patients for using their data in this study.

1. Recruitment

  1. Recruit stroke patients with stable conditions as confirmed by imaging examination-diagnosis conforms to the diagnostic criteria of.......

Representative Results

This study presents results from a high-functioning stroke patient, who was a 71-year-old male who suffered from ischemic stroke with left hemiplegia 2 years ago. The magnetic resonance imaging (MRI) presented bilateral chronic infarction from the basal ganglia to the radiating crown. He was able to walk and live independently in the community but was not satisfied with his cognitive recovery. However, the functional assessments were all within the normal range: FMA = 100, BBS = 56/56, TUGT = 6, MoCA = 26/30, CDR = 0.5, .......

Discussion

In our study, the results of the routine clinical cognitive assessment scales for the high-functioning stroke patient did not show any significant cognitive deficits. However, these assessment scales might show a ceiling effect and be less sensitive for identifying the mild cognitive deficits of high-functioning stroke patients. Hence, this protocol further selected ACC and RT in dual-task assessment based on the Stroop paradigm as major indicators to identify the cognitive deficits of high-functioning stroke patients. T.......

Acknowledgements

This study was supported by grants from the National Natural Science Foundation of China (No. 81804004, 81902281), China Postdoctoral Science Foundation (No. 2018M643207), Shenzhen Municipal Health Commission Project (No. SZBC2018005), Shenzhen Science and Technology Project (No. JCYJ20160428174825490), the General Guidance Program of Guangzhou Municipal Health and Family Planning (No. 20211A010079, 20211A011106), Guangzhou and University Foundation (No. 202102010100), Guangzhou Medical University Foundation (No. PX-66221494), Key Laboratory of Guangdong Higher Education Institutes  [Grant Number: 2021KSYS009] and Guangdong Province Department of Education [Grant....

Materials

NameCompanyCatalog NumberComments
Balance BallShanghai Fanglian Industrial Co, ChinaPVC-KXZ-EVA01-2015NA
E-Prime 3.0Psychology softwares Toolscommercial stimulus presentation software
fNIRSHui Chuang, ChinaNirSmart-500NA

References

  1. Dichgans, M., Pulit, S. L., Rosand, J. Stroke genetics: Discovery, biology, and clinical applications. The Lancet. Neurology. 18 (6), 587-599 (2019).
  2. Chen, G., Leak, R. K., Sun, Q., Zhang, J. H., Chen, J. Neurobiology of stroke: Re....

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