Clinical correlates of social cognition after an ischemic stroke: preliminary findings.

Maria De Fátima Dias De Souza,Érica Leandro Marciano Vieira,Vinicius Sousa Pietra Pedroso,Talita Hélen Ferreira E Vieira,Milene Alvarenga Rachid,Leonardo Cruz De Souza,Aline Mansueto Mourão,Maíra Glória De Freitas Cardoso,Aline Silva De Miranda,Alberlúcio Esquirio Pessoa,Natália Pessoa Rocha,Antônio Lúcio Teixeira

doi:10.1590/1980-57642021dn15-020010

Abstract

ABSTRACT.The co-occurrence of post-stroke behavioral disorders and cognitive impairment has been extensively investigated. However, studies usually do not include social cognition among the assessed cognitive domains.Objective: To investigate the potential association between facial emotion recognition, a measure of social cognition, and behavioral and cognitive symptoms in the subacute phase of ischemic stroke.Methods: Patients admitted to a Stroke Unit with ischemic stroke were followed up to 60 days. At this time point, they were evaluated with the following tools: Mini-Mental State Examination (MMSE); Frontal Assessment Battery (FAB); Visual Memory Test of the Brief Cognitive Battery (VMT); Phonemic Verbal Fluency (F-A-S Test); Digit Span; Facial Emotion Recognition Test (FERT) and Hospital Anxiety and Depression Scale (HADS). A control group composed of 21 healthy individuals also underwent the same evaluation.Results: Eighteen patients with ischemic stroke were enrolled in this study. They had similar age, sex and schooling years compared to controls. Depression symptoms and episodic memory deficits were significantly more frequent in patients compared to controls. The recognition of sadness expression positively correlated with the levels of anxiety and depression, while and the recognition of fear expression negatively correlated with depression in the stroke group.Conclusions: After an ischemic stroke, patients exhibit impairment in social cognition skills, specifically facial emotion recognition, in association with behavioral symptoms.

Highlights

Stroke is a common, serious, and disabling global health problem
The current study focused on the evaluation of facial emotion recognition, a marker of social cognition, investigating whether it would be associated with a series of cognitive domains, as well as depression and anxiety symptoms in the subacute phase of ischemic stroke
There was no significant difference between patients and controls in Facial Emotion Recognition Test (FERT) scores, we observed that among patients the recognition of sadness expression positively correlated with the levels of anxiety (Spearman’s rank correlation coefficient [rho]=0.587, p

Summary

Introduction

The development of post-stroke behavioral disorders and cognitive impairment leads to worse clinical prognosis.[1] these disorders have been extensively described following cerebral ischemic events, these studies usually do not include social cognition among the assessed cognitive domains.[1,2,3,4,5,6,7,8,9,10]. Only a few studies evaluated facial emotion recognition after stroke, reporting decreased ability to recognize emotions in patients when compared with healthy controls.[14,15,16,17] these studies did not investigate potential interactions among behavior, general cognition and social cognition measures

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