Wisconsin Card Sorting Test performance after putaminal hemorrhagic stroke

Area of Science:

• Neuroscience
• Cognitive Psychology
• Neurology

Background:

• Putaminal hemorrhage (PH) is a type of stroke affecting the basal ganglia.
• Cognitive impairments, including executive function deficits, are common after stroke.
• The Wisconsin Card Sorting Test (WCST) is a neuropsychological tool used to assess executive functions, particularly set-shifting ability.

Purpose of the Study:

• To compare the performance on the WCST between patients with putaminal hemorrhage (PH) and healthy controls.
• To identify specific WCST measures affected by PH.
• To determine the diagnostic utility of WCST variables in differentiating PH patients from controls.

Main Methods:

• A cohort of 55 patients with PH (3 months post-stroke) and 69 age-matched normal controls were assessed using the WCST.
• Multivariate analysis of covariance (MANCOVA) was employed, controlling for education level.
• Univariate analyses and discriminant function analysis were used to examine group differences and identify key discriminating variables.

Main Results:

• Significant group differences were found in five WCST measures: perseverative errors (PE), perseverative responses (PR), conceptual-level responses (CLR), number of categories completed (NCC), and trials to complete the first category (TCC).
• Patients with PH showed impaired performance on TCC and PR, with 40-47% scoring in the impaired range for NCC, PR, PE, and TCC.
• WCST variables, particularly PE, CLR, and total number correct (TNC), accurately classified 91.9% of participants as either PH patients or controls.

Conclusions:

• Stroke patients with putaminal hemorrhage exhibit significant impairments in mental set shifting abilities as measured by the WCST.
• The WCST is a valuable tool for detecting executive dysfunction in PH patients.
• Findings suggest implications for rehabilitation professionals working with stroke survivors to address cognitive deficits.