Neuropsychological rehabilitation of patients with symptoms of depression after ischemic stroke

Abstract

Introduction Depression significantly affects the effects of rehabilitation, quality of life, as well as patients’ mortality. The estimated prevalence of post-stroke depression is approximately 25%–70%. Aim To examine when neuropsychological rehabilitation after stroke affects the cognitive functions of people suffering from depression. Material and methods 42 persons after ischemic stroke suffering from depression took part in the study. The participants were in 3 weeks daily neurological rehabilitation care. Mood disorders were measured by Beck depression inventory. Cognitive functions were examined using verbal fluency test and following psychological tests: mini mental state examination, color trail test and Benton visual retention test. Results and discussion Mood disorders were diagnosed in 70% of patients. The neuropsychological diagnosis revealed existing memory disorders, low resistance to distractors (30.9% participants), impaired visuospatial function (78.7%), impaired ability to recognize visual stimuli with preserved normal vision, weakened executive functions, in particular planning, initiating and sustaining activities (85.6%), rigid thinking, slackening, difficulty with focusing on the task, problems with selective attention and increased levels of anxiety. Verbal fluency deficits was diagnosed in 92.9% of patients. Significant improvements were observed for all cognitive domains after neuropsychological rehabilitation. The biggest improvement was noted in the attentional domain (73.8%), the least – in the visuo-spatial functions (21.4%). Conclusions Depression is a frequent and important problem among patients with stroke, as a post-stroke depression is present in at least 30% of survivors from stroke. Psychological complications such as emotional, behavioral and cognitive disorders, can have a negative effects on the social functioning and the overall quality of life of stroke survivors.