Abstract T P415: Assessment Of Cognitive Symptoms In Sub-acute Stroke With An iPad Test-battery

Abstract

Introduction and hypothesis: Research into the time-course of cognitive symptoms in stroke as well as planning of rehabilitation is dependent on reliable and sensitive cognitive testing. Usually, it is not possible to have all patients seen by a neuropsychologist. Moreover, a battery for stroke patients poses special challenges as symptoms like aphasia, hemineglect and hemiplegia may exclude many patients from performing a number of traditionally employed test methods. Finally, the battery has to be performed in a short timespan because many patients are easily fatigued. Method: We developed a battery comprising tests for anosognosia, aphasia, neglect, depression, episodic memory, attention span, working memory, mental speed, manual motor speed, and executive function (response inhibition). We present data from sub-acute stroke patients and age-matched controls. Both groups were tested twice with a 3 month interval in order to: 1) assess the proportion of patients able to perform the different tests; 2) determine the typical time needed to do the testing; 3) demonstrate the sensitivity to cognitive symptoms in sub-acute stroke Results: 51 stroke patients 43 healthy controls were included. 49 patients (96%) were able to do at least one test and 41 (80%) were able to do all tests. Mean duration for the testing of sub-acute stroke patients was 39 minutes (range 30-60 minutes). Mean Age 67 years (patients 65 and controls 69, range 33-90). Mean verbal fluency correct in 1st session: patients 29.2 and Controls 45.3; Mean difference 16.03, 95%CI (10.1-22.0) p 〈0.001. Mean change in patients from 1st to 2nd Session: 6.2, 95%CI(1.2-11.2) p=0.017. Mental speed by coding: patients 29.3 and controls 45.7; mean difference 16.4, 95% CI(10.3-22.4) p〈0.001. Similar analysis of memory, attention span, and executive function showed significant differences between control and patient groups as well as in patients from 1st to 2nd session. Conclusion: Our cognitive test-battery for iPad can be used with most stroke patients in the sub-acute phase. It can be performed in a relatively short time span. It is sensitive to cognitive reduction after stroke and remission of symptoms.