TVA-based modeling of short-term memory capacity, speed of processing and perceptual threshold in chronic stroke patients undergoing cognitive training: case-control differences, reliability, and associations with cognitive performance

Geneviève Richard; Anders Petersen; Kristine Moe Ulrichsen; Knut K Kolskår; Dag Alnæs; Anne-Marthe Sanders; Erlend S Dørum; Hege Ihle-Hansen; Jan E Nordvik; Lars T Westlye

doi:10.7717/peerj.9948

TVA-based modeling of short-term memory capacity, speed of processing and perceptual threshold in chronic stroke patients undergoing cognitive training: case-control differences, reliability, and associations with cognitive performance

PeerJ. 2020 Oct 28:8:e9948. doi: 10.7717/peerj.9948. eCollection 2020.

Authors

Geneviève Richard^{1

2

3}, Anders Petersen⁴, Kristine Moe Ulrichsen^{1

2

3}, Knut K Kolskår^{1

2

3}, Dag Alnæs¹, Anne-Marthe Sanders^{1

2

3}, Erlend S Dørum^{1

2

3}, Hege Ihle-Hansen⁵, Jan E Nordvik⁶, Lars T Westlye^{1

2

7}

Affiliations

¹ NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
² Department of Psychology, University of Oslo, Oslo, Norway.
³ Sunnaas Rehabilitation Hospital HT, Nesodden, Norway.
⁴ Center for Visual Cognition, Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
⁵ Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
⁶ CatoSenteret Rehabilitation Center, Son, Norway.
⁷ KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway.

Abstract

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 (K), processing speed (C) and perceptual threshold (t ₀), 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 (n = 70) compared to age-matched healthy controls (n = 140). Further, longitudinal analyses in stroke patients during the course of CCT (n = 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.

Keywords: Attentional deficits; Cerebral stroke; Computerized cognitive training; Longitudinal assessment; Theory of visual attention; Transcranial direct current stimulation.

Grants and funding

This study was supported by the Norwegian ExtraFoundation for Health and Rehabilitation (2015/FO5146), the Research Council of Norway (249795, 248238, 298646, 300768), the South-Eastern Norway Regional Health Authority (2014097, 2015044, 2015073, 2019101), the European Research Council under the European Union’s Horizon 2020 research and innovation program (ERC Starting Grant 802998), Sunnaas Rehabilitation Hospital, and the Department of Psychology, University of Oslo. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.