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.