Approaches to evaluation of neurocognitive profile in patients with residual schizophrenia depending on a history of cerebral stroke

Abstract

Cerebral stroke consequence assessment in patients with residual schizophrenia is a complex clinical scenario questioning both diagnostic and therapeutic strategies. Aim. To assess the structure of neurocognitive dysfunctions in patients with residual schizophrenia with pronounced negative symptoms depending on a history of cerebral stroke. Materials and methods. In the period of 2020–2023, a clinical examination of 47 patients of Zaporizhzhia Regional Clinical Psychiatric Hospital and Veselovsky Psychoneurological Boarding School with a diagnosis of residual schizophrenia (ICD-10: F20.5) was carried out. Study groups were formed: G1 – 9 patients with residual schizophrenia and the history of cerebral stroke; G2 – 36 patients with residual schizophrenia without the history of cerebral stroke. Results. The DSM-5 neurocognitive functioning assessment system was used in the study, based on which a protocol for rapid testing of neurocognitive functions adapted for patients with residual schizophrenia was developed. The group of patients with the history of cerebral stroke has demonstrated lower results in attention allocation (p ≤ 0.05). This group has also shown relatively poor results in planning (p ≤ 0.05), error correction (p ≤ 0.05), inhibition (p ≤ 0.05) and flexibility (p ≤ 0.05). As concerning verbal ability, worse results of expressive speech (p ≤ 0.05), grammar and syntax (p ≤ 0.05) have been revealed in the group of patients with the history of cerebral stroke. In terms of perceptual-motor functions, the gnosis task has been performed worse (p ≤ 0.05) by the group of patients with the history of cerebral stroke. Differences in emotion recognition and theory of mind were insignificant between groups. Conclusions. An original neurocognitive function assessment protocol adapted for the Ukrainian-speaking patient population with residual schizophrenia has been developed. The patient population with residual schizophrenia and the history of cerebral stroke or without it has been examined with the use of the developed protocol for the assessment of neurocognitive functions. According to the obtained results, patients with residual schizophrenia and the history of cerebral stroke have demonstrated worse cognitive performance compared to those without the history of stroke.

Keywords

• schizophrenia
• cerebral stroke
• cognitive functions
• neurocognitive functions
• neuropsychological testing