Can subjective cognitive complaints at three months post stroke predict alteration in information processing speed during the first year?

Cognitive impairment, particularly slowing of information processing speed (IPS), is prevalent after stroke. However, the link between subjective cognitive complaints (SCC) and cognitive deficit remains unclear. This study evaluated the link between SCC at three months post stroke and deficit as well as objective alterations in IPS in the first year post stroke. Patients (N = 200) and healthy controls (N = 105) took part in the COMPlaints After Stroke study (COMPAS). SCC, IPS and depression were evaluated at 3 months, 1 and 2 years post stroke. The Reliable Change Index was used to assess change in IPS in the first year post. Approximately one out of three patients showed deficit in IPS irrespective of time post stroke, while a change in IPS (N = 117) over time was relatively uncommon. SCC at three months post stroke did not predict change in IPS between three months and one year post stroke, where depressive symptoms did show a link. Cross sectional data showed a deficit in IPS in a substantial number of stroke patients irrespective of the point in time. Longitudinal data revealed a further decline in a small subgroup in the first year post stroke, which was not predicted by SCC at three months post stroke. The findings show that, irrespective of time post stroke and even when stroke is relatively mild, impairment in IPS is prevalent, but cannot be predicted by the complaints patients express. The link with depressive symptoms needs more exploration.

Motor Impairment Three Months Post Stroke Implies A Corresponding Cognitive Deficit.

BACKGROUND: While both motor and cognitive impairment are common after stroke, the focus of (early) treatment has always been on motor deficit. AIMS: The objective of the current study was to explore the link between motor and cognitive performance in stroke patients and to examine whether motor performance is associated with cognitive functioning at three months post stroke. METHODS: In both stroke patients (n = 142) and controls (n = 135), with the groups matched on age, gender and premorbid IQ, motor functioning was evaluated using both objective (Purdue Pegboard Test) and subjective measures (specific items from the Frenchay Activities Index and Barthel Index). Cognition, specifically information processing speed, working memory and cognitive flexibility, was assessed using objective tasks. The data were analyzed using Pearson product-moment correlation coefficients and logistic regression. RESULTS: Significant correlations between motor and cognitive functioning were found in stroke patients. The objective motor task was stronger than subjective measures in statistically explaining and predicting cognitive deficit, irrespective of stroke severity. CONCLUSIONS: We conclude that motor impairment at three months post-stroke should serve as a 'red flag' for professionals: cognitive impairment is likely and should also be evaluated.

COVID-19 Neurological Manifestations and Underlying Mechanisms: A Scoping Review.

BACKGROUND: In the Corona Virus Disease 2019 (COVID-19) pandemic, the primary problem is respiratory-related, but there also is increasing evidence of central nervous system (CNS) involvement. This study aims to summarize the literature on neurological manifestations of COVID-19, underlying mechanisms of CNS involvement and cognitive consequences. METHODS: A scoping review was conducted with multiple searches in PubMed, PsycInfo, and CINAHL databases. Full text articles in English were included if they involved humans with COVID-19. The search was updated twice, the latest on 19 May 2020. RESULTS: After screening 266 records and cross referencing, 85 articles were included. The articles were case studies, opinion papers, letters to editors, and a few observational studies. No articles were found regarding cognitive consequences in COVID-19 patients. All reported on neurological manifestations and/or underlying mechanisms of CNS involvement in COVID-19. CONCLUSION: Neurological manifestations of COVID-19 vary from mild (e.g. loss of taste and smell, dizziness, headache) to severe (e.g. ischemic stroke, encephalitis). Underlying pathways are suggested to be both indirect (as a result of thrombotic complication, inflammatory consequences, hypoxia, blood pressure dysregulation), and direct (neurotropic properties of the virus). Since most articles were opinion papers and no studies have been conducted on cognitive consequences, further research is warranted.

On the use of scaling and clustering in the study of semantic deficits.

In the past decade, several studies have used scaling and clustering techniques to document semantic storage deficits in patients with Alzheimer's disease and in schizophrenia. In this article the authors argued that many of the conclusions drawn from these studies are unjustified by the data. They reviewed the methodology used in these studies and presented data from simulation studies to further investigate the validity of their conclusions. The authors elaborate on the criteria needed to exclude alternative accounts of the data and present empirical data from patients with Alzheimer's disease and normal control participants to demonstrate that analyses of the patients' proximity data do not provide unambiguous evidence for a generalized semantic storage deficit.