Impact des AVC ischémiques sur la mémoire de travail chez l’adulte : Étude neuropsychologique en contexte de rééducation à Casablanca
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".