Oxford Cognitive Screening Programme

Oxford Cognitive Screening Programme

The recovery of cognitive problems after stroke is still poorly understood, but preliminary data from our cognitive screening programme suggests that there are differences for contrasting cognitive domains. Differential recovery rates are observed, with grossly speaking some problems, such as language problems appearing more persistent over the medium time (6 months), some domain problems such as hemispatial neglect demonstrating relatively good recovery in a large proportion of stroke survivors.

It is likely to be important to distinguish between ‘domain-specific’ and ‘domain-general’ problems. By ‘domain-specific’ we refer to problems in a particular process that contributes only to the domain in question – for example, a problem in spatial orienting which affects spatial attention but not (say) language comprehension. By ‘domain-general’ we refer to a process that supports a variety of cognitive domains – examples being working memory and sustained attention, which support language, memory, number processing etc.  Previous research has suggested that domain-general processes may be important, but exactly how this translates into outcomes is not clear.

The aim of this research is to evaluate how cognitive measures taken at an acute stage evolve over time post stroke, how domain-specific impairments relate to each other and how cognitive impairments relate to real-life functional measures like activities of life and participation levels. In the longer term, having a better understanding of the natural time course of cognitive recovery, and its link to functional outcomes, is essential in being able to assess any added contributions when interventions are introduced to improve performance.

This study (REC reference 18/SC/0550) is actively recruiting at the John Radcliffe Acute Stroke Unit, supported by the UK Clinical Research Network.

Publications

•  Demeyere, N., & Céline R, G.. (2019). Ego- and allocentric visuospatial neglect: dissociations, prevalence, and laterality in acute stroke.. Neuropsychology, 33(3), 490–498.

• Lay report here

•  Moore, M. J., Vancleef, K., Shalev, N., Husain, M., & Demeyere, N.. (2019). When neglect is neglected: nihss observational measure lacks sensitivity in identifying post-stroke unilateral neglect. J neurol neurosurg psychiatry, jnnp–2018

• Lay report here

•  Mole, J. A., & Demeyere, N.. (2018). The relationship between early post-stroke cognition and longer term activities and participation: a systematic review. Neuropsychological rehabilitation, 1–25.