Richard Geneviève, Petersen Anders, Ulrichsen Kristine Moe, Kolskår Knut K, Alnæs Dag, Sanders Anne-Marthe, Dørum Erlend S, Ihle-Hansen Hege, Nordvik Jan E, Westlye Lars T
NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Department of Psychology, University of Oslo, Oslo, Norway.
PeerJ. 2020 Oct 28;8:e9948. doi: 10.7717/peerj.9948. eCollection 2020.
Attentional deficits following stroke are common and pervasive, and are important predictors for functional recovery. Attentional functions comprise a set of specific cognitive processes allowing to attend, filter and select among a continuous stream of stimuli. These mechanisms are fundamental for more complex cognitive functions such as learning, planning and cognitive control, all crucial for daily functioning. The distributed functional neuroanatomy of these processes is a likely explanation for the high prevalence of attentional impairments following stroke, and underscores the importance of a clinical implementation of computational approaches allowing for sensitive and specific modeling of attentional sub-processes. The Theory of Visual Attention (TVA) offers a theoretical, computational, neuronal and practical framework to assess the efficiency of visual selection performance and parallel processing of multiple objects. Here, in order to assess the sensitivity and reliability of TVA parameters reflecting short-term memory capacity (), processing speed () and perceptual threshold ( ), we used a whole-report paradigm in a cross-sectional case-control comparison and across six repeated assessments over the course of a three-week computerized cognitive training (CCT) intervention in chronic stroke patients (> 6 months since hospital admission, NIHSS ≤ 7 at hospital discharge). Cross-sectional group comparisons documented lower short-term memory capacity, lower processing speed and higher perceptual threshold in patients ( = 70) compared to age-matched healthy controls ( = 140). Further, longitudinal analyses in stroke patients during the course of CCT ( = 54) revealed high reliability of the TVA parameters, and higher processing speed at baseline was associated with larger cognitive improvement after the intervention. The results support the feasibility, reliability and sensitivity of TVA-based assessment of attentional functions in chronic stroke patients.
中风后的注意力缺陷很常见且普遍存在，是功能恢复的重要预测指标。注意力功能包括一组特定的认知过程，使人们能够在连续的刺激流中进行注意、过滤和选择。这些机制对于学习、计划和认知控制等更复杂的认知功能至关重要，而这些功能对于日常功能来说都是至关重要的。这些过程的分布式功能神经解剖学可能是中风后注意力障碍高发的原因，并强调了临床应用计算方法的重要性，这种方法能够对注意力子过程进行敏感且具体的建模。视觉注意理论（TVA）提供了一个理论、计算、神经元和实践框架，用于评估视觉选择性能和多个对象并行处理的效率。在此，为了评估反映短期记忆容量（）、处理速度（）和感知阈值（）的TVA参数的敏感性和可靠性，我们在慢性中风患者（入院超过6个月，出院时NIHSS≤7）的横断面病例对照比较中以及在为期三周的计算机化认知训练（CCT）干预过程中的六次重复评估中使用了全报告范式。横断面组间比较显示，与年龄匹配的健康对照组（=140）相比，患者组（=70）的短期记忆容量更低、处理速度更低且感知阈值更高。此外，对CCT过程中的中风患者（=54）进行的纵向分析显示，TVA参数具有高度可靠性，且基线时较高的处理速度与干预后更大的认知改善相关。结果支持了基于TVA评估慢性中风患者注意力功能的可行性、可靠性和敏感性。
