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Article type: Research Article
Authors: Heiberg, Adam Vittrupa; b; * | Simonsen, Sofie Amaliea | Schytz, Henrik Wintherb; c | Iversen, Helle Klingenberga; b
Affiliations: [a] Clinical Stroke Research Unit, Department of Neurology, Copenhagen University Hospital – Rigshospitalet, Glostrup, Denmark | [b] Faculty of Health and MedicalSciences, University of Copenhagen, Copenhagen, Denmark | [c] Danish Headache Center, Department of Neurology, Copenhagen University Hospital – Rigshospitalet, Glostrup, Denmark
Correspondence: [*] Address for correspondence: Adam Vittrup Heiberg, Clinical Stroke Research Unit, Department of Neurology, Copenhagen University Hospital –Rigshospitalet, Valdemar Hansens Vej 13, DK-2600 Glostrup, Denmark. E-mail: [email protected].
Abstract: BACKGROUND:Following acute ischemic stroke (AIS) many patients experience cognitive impairment which interferes neurorehabilitation. Understanding and monitoring pathophysiologic processes behind cognitive symptoms requires accessible methods during testing and training. Functional near-infrared spectroscopy (fNIRS) can assess activational hemodynamic responses in the prefrontal cortex (PFC) and feasibly be used as a biomarker to support stroke rehabilitation. OBJECTIVE:Exploring the feasibility of fNIRS as a biomarker during the Stroop Color and Word Test (SCWT) assessing executive function in AIS patients. METHODS:Observational study of 21 patients with mild to moderate AIS and 22 healthy age- and sex-matched controls (HC) examined with fNIRS of PFC during the SCWT. Hemodynamic responses were analyzed with general linear modeling. RESULTS:The SCWT was performed worse by AIS patients than HC. Neither patients nor HC showed PFC activation, but an inverse activational pattern primarily in superolateral and superomedial PFC significantly lower in AIS. Hemodynamic responses were incoherent to test difficulty and performance. No other group differences or lateralization were found. CONCLUSIONS:AIS patients had impaired executive function assessed by the SCWT, while both groups showed an inverse hemodynamic response significantly larger in HC. Investigations assessing the physiology behind inverse hemodynamic responses are warranted before deeming clinical implementation reasonable.
Keywords: Acute stroke, hemodynamics, near-infrared spectroscopy, stroop test, executive function, cognitive impairment
DOI: 10.3233/NRE-220171
Journal: NeuroRehabilitation, vol. 52, no. 2, pp. 199-217, 2023
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