Impact des AVC ischémiques sur la mémoire de travail chez l’adulte : Étude neuropsychologique en contexte de rééducation à Casablanca
Notice bibliographique
Résumé
Research Project Description Title: Impact of Ischemic Stroke on Working Memory in Adults: A Neuropsychological Study in a Rehabilitation Context in Casablanca Researcher: Khadija Oufkir Institution: Université Internationale de Casablanca, Faculté des Sciences de la Santé 1. Project Overview and Context Ischemic stroke (AVC) is a major public health concern in Morocco, with incidence rates projected to rise significantly by 2030. While motor and sensory deficits are routinely diagnosed and treated, cognitive sequelae—specifically disorders of working memory (WM)—often remain under-diagnosed. Working memory is a critical component of executive functions, essential for reasoning, decision-making, and daily autonomy. This research addresses a specific gap in the Moroccan healthcare landscape: the lack of systematic evaluation of working memory in post-stroke patients and the absence of rehabilitation protocols adapted to the local socio-cultural context. 2. Research Purpose and Objectives The primary purpose of this study was to evaluate the specific impact of ischemic stroke on working memory among adult patients currently undergoing rehabilitation. Specific Objectives: Quantify Deficits: To measure the extent of working memory impairment in stroke patients compared to a healthy control group. Analyze Clinical Correlations: To determine how clinical factors—specifically lesion location (frontal, parietal, subcortical), stroke severity (NIHSS score), and functional independence (Rankin scale)—influence cognitive performance. Develop Recommendations: To formulate practical, culturally adapted recommendations for neuropsychological rehabilitation to improve patient autonomy and quality of life. 3. Methodology The study employed a mixed-method approach, combining a quantitative comparative analysis with a qualitative clinical investigation. Study Design: A comparative cross-sectional study conducted at the Noor Rehabilitation Center in Casablanca. Participants: A total of 30 participants, divided into: Experimental Group: 15 patients with confirmed ischemic stroke (post-acute phase, >1 month). Control Group: 15 healthy adults matched for age, sex, and education level. Assessment Tools: A standardized neuropsychological battery was used, including: MoCA (Montreal Cognitive Assessment): For global cognitive screening. WAIS-IV Digit Span (Forward and Backward): To assess the phonological loop and central executive. WAIS-IV Letter-Number Sequencing: To assess active manipulation of information. Clinical Scales: NIHSS (stroke severity), Modified Rankin Scale (disability), and HADS (to exclude anxiety/depression bias). 4. Key Findings and Results The study yielded statistically significant results confirming the hypothesis that ischemic stroke leads to marked working memory deficits. Quantitative Performance: The stroke group scored significantly lower than the control group across all cognitive measures (p < 0.001), specifically in the manipulation of verbal information (Backward Digit Span and Letter-Number Sequencing). Lesion-Specific Profiles: Through the analysis of specific clinical cases (e.g., Mr. Karim, Mr. Rachid, Mme Aicha), the study identified distinct cognitive profiles: Left Frontal Lesions: Resulted in moderate but significant deficits in verbal working memory. Subcortical Lesions (Basal Ganglia): Associated with severe, global deficits and marked psychomotor slowing. Bilateral Frontal Lesions: Characterized by significant cognitive rigidity and failure of inhibition mechanisms. Independence from Mood: The deficits observed were independent of anxiety or depression levels (measured by HADS), confirming they are direct neurological sequelae of the stroke. 5. Expected Outcomes and Implications This research provides a foundational evidence base for improving post-stroke care in Morocco. Outcomes: Systematic Screening: The study advocates for the mandatory inclusion of working memory assessment in the standard post-stroke care pathway. Tailored Rehabilitation: It proposes a differentiated approach to rehabilitation based on lesion location: Remediation for frontal lesions (restoring capacity). Compensation for subcortical/severe lesions (using external aids and environmental adaptation). Cultural Adaptation: The project highlights the need for rehabilitation tools that respect the linguistic and educational diversity of the Moroccan population. 6. Conclusion By highlighting the "invisible handicap" of working memory disorders, this project contributes to a holistic understanding of stroke recovery. It moves beyond simple motor rehabilitation to address the cognitive functions that are crucial for a patient's return to social and professional life.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,046 | 0,027 |
| Méta-épidémiologie (sens strict) | 0,004 | 0,005 |
| Méta-épidémiologie (sens large) | 0,003 | 0,003 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,003 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,007 | 0,004 |
| Intégrité de la recherche | 0,005 | 0,008 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,706 | 0,956 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».