Figure - available from: Frontiers in Neurology
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Neuropsychological tests' changes after NR. Functional Performance (4 scores: DEX and PCRS); Executive Functions (10 scores: WCST, Tower of Hanoi, FDT, and TMT); Attention (1 score: Brief Test of Attention); Language (2 scores: BNT and FAS); Episodic Memory (4 scores: WMS-III); Working Memory (9 scores: WAIS-III and WMS-III). The last three columns correspond to cognitive indices of WAIS-III, including all their subtests: VCI (verbal comprehension, 4 scores); PSI (speed processing, 3 scores); and POI (perceptual organization, 4 scores). Percentages were calculated intra-domain. Test scores included. DEX, DEX-family, DEX-difference; PCRS, PCRS-family, PCRS-difference; WCST, WCST-categories, WCST-conceptual, WCST-persevering; Tower of Hanoi, TH-3D-time, TH-3D-movements, TH-4D-time, TH-4D-movements; Five Digit Test, FDT-switching, FDT-flexibility; Brief Test of Attention, BTA-total score; BNT, BNT-total score; FAS, FAS-total score; WMS-III-episodic-memory, WMS-III-logical memory 1, WMS-III-logical memory 2, WMS-III-visual reproduction 1, WMS-III-visual reproduction 2; WMS-working memory, WMS-III-forward digit span, WMS-III-backward digit span, WMS-III-forward visual span, WMS-III-backward visual span; WAIS-working memory, WAIS-digit span, WAIS-arithmetic, WAIS-letter number sequencing, WAIS-working memory index; WAIS-VCI, WAIS-vocabulary, WAIS-information, WAIS-similarities, WAIS-verbal comprehension index; WAIS-PSI, WAIS-symbol search, WAIS-digit symbol, WAIS-processing speed index; WAIS-POI, WAIS-block design, WAIS-matrix reasoning, WAIS-picture completion; WAIS-perceptual organization index.
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Background
Stroke is the second leading cause of death worldwide and it causes important long-term cognitive and physical deficits that hamper patients' daily activity. Neuropsychological rehabilitation (NR) has increasingly become more important to recover from cognitive disability and to improve the functionality and quality of life of these pati...
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In 1983 the Neuropsychology Unit of the Institut Guttmann
(Barcelona, Spain) was created with the aim of providing rehabilitation
treatment to people with brain injuries. Its comprehensive
model of neuropsychological rehabilitation, based on a holistic
view of the person, comprises four areas: cognition, behavior,
emotion, and identity. Beyond the...
Citations
Cortical ischemic strokes result in cognitive deficits depending on the area of affected brain. However, we have demonstrated that difficulties with attention and processing speed can occur even with small subcortical infarcts. Symptoms appear independent of lesion location, suggesting they arise from generalized disruption of cognitive networks. Longitudinal studies evaluating directional measures of functional connectivity in this population are lacking. We evaluated six patients with minor stroke exhibiting cognitive impairment 6-8 weeks post-infarct and four age-similar controls. Resting state magnetoencephalography data were collected. Clinical and imaging evaluations of both groups were repeated six and twelve months later. Network Localized Granger Causality was used to determine differences in directional connectivity between groups and across visits, which were correlated with clinical performance. Directional connectivity patterns remained stable across visits for controls. After stroke, inter-hemispheric connectivity between frontoparietal cortex and non-frontoparietal cortex significantly increased between visits 1 and 2, corresponding to uniform improvement in reaction times and cognitive scores. Initially, the majority of functional links originated from non-frontal areas contralateral to the lesion, connecting to ipsilesional brain regions. By visit 2, inter-hemispheric connections, directed from ipsilesional to contralesional cortex significantly increased. At visit 3, patients demonstrating continued favorable cognitive recovery showed less reliance on these interhemispheric connections. These changes were not observed in those without continued improvement. Our findings provide supporting evidence that the neural basis of early post-stroke cognitive dysfunction occurs at the network-level, and continued recovery correlates with evolution of inter-hemispheric connectivity.
Cerebrovascular disease is responsible for up to 20% of cases of dementia worldwide, but also it is a major comorbid contributor to the progression of other neurodegenerative diseases, like Alzheimer’s disease. White matter hyperintensities (WMH) are the most prevalent imaging marker in cerebrovascular disease. The presence and progression of WMH in the brain have been associated with general cognitive impairment and the risk to develop all types of dementia. The aim of this piece of work is the assessment of brain functional differences in an MCI population based on the WMH volume. One-hundred and twenty-nine individuals with mild cognitive impairment (MCI) underwent a neuropsychological evaluation, MRI assessment (T1 and Flair), and MEG recordings (5 min of eyes closed resting state). Those participants were further classified into vascular MCI (vMCI; n = 61, mean age 75 ± 4 years, 35 females) or non-vascular MCI (nvMCI; n = 56, mean age 72 ± 5 years, 36 females) according to their WMH total volume, assessed with an automatic detection toolbox, LST (SPM12). We used a completely data-driven approach to evaluate the differences in the power spectra between the groups. Interestingly, three clusters emerged: One cluster with widespread larger theta power and two clusters located in both temporal regions with smaller beta power for vMCI compared to nvMCI. Those power signatures were also associated with cognitive performance and hippocampal volume. Early identification and classification of dementia pathogenesis is a crucially important goal for the search for more effective management approaches. These findings could help to understand and try to palliate the contribution of WMH to particular symptoms in mixed dementia progress.
