Abstract
BackgroundStroke is the second leading cause of death worldwide, and 53.4% of stroke survivors suffer from post-stroke cognitive impairment. Post-stroke cognitive impairment can increase hospitalization rate and cost of care and decrease the quality of life of stroke patients. To date, multiple cognitive rehabilitation interventions have been tested in stroke populations with post-stroke cognitive impairment. However, the most efficacious intervention has not been established. This systematic review aims to compare the efficacy of cognitive rehabilitation interventions for patients with post-stroke cognitive impairment.MethodsWe will search MEDLINE, EMBASE, CENTRAL, PsycINFO, CINAHL, PubMed, and clinical trial registries to identify eligible randomized clinical trials with no restrictions in the date of publication and language. Studies conducted with patients aged 18 or over, with the presence of cognitive impairment after being diagnosed with stroke will be included. Studies will be restricted to randomized controlled trials comparing a cognitive rehabilitation intervention with another intervention. The primary outcome is any clinical changes in the general or specific cognitive domain (e.g., executive function, attention, memory, or perception). The secondary outcomes that will be collected include adverse effects (e.g., stroke, disability, or mortality) and quality of life. Two independent reviewers will assess articles to identify trials eligible for inclusion. Data extraction and risk of bias assessment of the included studies will also be done independently. Any discrepancies will be solved by discussion, or a third reviewer will be consulted if necessary. A meta-analysis will be carried out if appropriate.DiscussionThis systematic review for patients with post-stroke cognitive impairment will assess the efficacy of cognitive rehabilitation interventions. And our results will help clinical decision-making and support the development of clinical practice guidelines.Trial registrationSystematic review registration: PROSPERO CRD42020173988
Highlights
Stroke is the second leading cause of death worldwide, and 53.4% of stroke survivors suffer from post-stroke cognitive impairment
Patients with post-stroke cognitive impairment (PSCI) may have damage to one or more cognitive domains, and the current thinking is that stroke tends to impact more deleteriously on attention and executive function compared with its impact on memory [2]
A recent study showed that averaged performance of stroke survivors in three specific cognitive domains: action speed, executive functions, and language, might be the optimal criterion for PSCI [3]
Summary
Stroke is the second leading cause of death worldwide, and 53.4% of stroke survivors suffer from post-stroke cognitive impairment. Post-stroke cognitive impairment can increase hospitalization rate and cost of care and decrease the quality of life of stroke patients. This systematic review aims to compare the efficacy of cognitive rehabilitation interventions for patients with post-stroke cognitive impairment. Patients with PSCI may have damage to one or more cognitive domains, and the current thinking is that stroke tends to impact more deleteriously on attention and executive function compared with its impact on memory [2]. A recent study showed that averaged performance of stroke survivors in three specific cognitive domains: action speed, executive functions, and language, might be the optimal criterion for PSCI [3]. The first hypothesis highlights that stroke itself is a central factor in the development of cognitive impairment, and performing optimal acute stroke care and preventing stroke recurrence might be the most effective therapy for PSCI. Cognitive impairment is determined using multiple neurophysiological yardsticks such as the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA); there are neurophysiological tests to examine the impairment on a single cognitive domain, like executive function and memor y[11]
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