Memory monitoring and memory control in chronic stroke patients Dissociated processes

Zortea, Maxciel; Jou, Graciela Inchausti de; Salles, Jerusa Fumagalli de

doi:10.1590/1980-57642018dn13-010005

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Dementia & Neuropsychologia

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Original Article • Dement. neuropsychol. 13 (1) • Jan-Mar 2019 • https://doi.org/10.1590/1980-57642018dn13-010005 copy

Memory monitoring and memory control in chronic stroke patients Dissociated processes

MONITORAMENTO DE MEMÓRIA E CONTROLE DE MEMÓRIA EM PACIENTES COM AVC CRÔNICO: PROCESSOS DISSOCIADOS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT.

Memory problems are common in stroke patients, although little is known about how accurately chronic stroke patients can monitor and control memory processes.

Objective:

The performance of memory and metamemory in stroke patients and healthy controls were investigated, as well as dissociation between performances.

Methods:

10 adults with right hemisphere lesion (mean [M] age=53.2 [SD=9.7]), 10 with left hemisphere lesion (M age=60.4 [SD=6.6]) and 20 healthy participants (M age=56.5 [SD=9.3] with no neurological disease, matched for sex, age and years of education participated in a multiple-case design study. Participants completed a metamemory experimental paradigm, as well as immediate and delayed word recall and recognition tasks.

Results:

Data indicated that 10 out of the 20 patients presented significantly lower scores compared to controls, two of which had global deficits (functional association). Functional dissociations between memory monitoring (judgments of learning, JOL), control (allocation of study time) and capacity (cued-recall task) among patients were found for eight cases, suggesting these processes are independent.

Conclusion:

These findings reveal stroke patients may have specific metamemory impairment and can contribute to the understanding of cognitive models of metamemory processing.

Key words:
metacognition; memory; stroke; cognitive processes

	Right hemisphere lesion (n=10)	Left hemisphere lesion (n=10)	Control participants (n=20)	P
Age (years) M (SD)	53.2 (9.7)	60.4 (6.6)	56.5 (9.3)	0.300^a a Kruskal-Wallis tests;
Years of education M (SD)	9.3 (3.5)	8.7 (4.4)	9.4 (3.7)	0.847^a a Kruskal-Wallis tests;
Sex (M/F)	4/6	4/6	8/12	1.000^b b Pearson Chi-square test.
Reading habits M (SD)^* * Habits during the data collection period;	5.9 (2.5)	5.8 (4.5)	7.2 (3.2)	0.438^a a Kruskal-Wallis tests;
Writing habits M (SD)^* * Habits during the data collection period;	3.2 (2.4)	2.8 (2.5)	4.1 (3.1)	0.498^a a Kruskal-Wallis tests;
BDI-II score M (SD)	18.9 (9.3)¹	19 (8.5)¹	10.7 (6.5)²	0.032^a a Kruskal-Wallis tests;

Case	Sex	Age	Years of study	RWH score	Months post-stroke	Etiology	Region		BDI-II	Measure with deviant score
Clinical cases presenting no deficits according to Crawford et al. (2009) criteria (n=10)
L1	F	58	5	1	28	H	Subc	Basal ganglia	Minimal	-
L4	F	61	9	9	56	H	Cort/Subc	Parietal	Mild	-
L8	M	52	16	24	21	I	Subc	Internal capsule, globus pallidus and thalamus	Minimal	-
L9	M	60	5	9	36	I	Subc	Corona radiata	Mild	-
L10	M	61	11	11	16	I	Cort/Subc	Insula and internal capsule	Severe	-
R1	F	57	5	4	48	I	Cort/Subc	Temporal	Moderate	-
R2	F	67	11	12	26	I	Cort	Fronto-temporal	Mild	-
R6	F	51	14	12	29	H	Subc	Corona radiata and basal ganglia	Moderate	-
R7	M	38	14	17	35	I/H	Cort/Subc	Fronto-temporo-parietal	Minimal	-
R9	M	60	8	6	24	I	Cort	Parietal	Moderate	-
Clinical cases that presented deficits according to Crawford et al. (2009)'s criteria and showed functional associations (n=2)
L3^a a Deficits in memory monitoring and control.	F	73	4	4	24	I	Subc	Parieto-occiptal	NA	-
R8^b b Deficits in memory monitoring and capacity.	M	57	11	6	11	I	Cort/Subc	Fronto-temporo-parietal	Severe	-
Clinical cases that presented deficits according to Crawford et al. (2009)'s criteria in only one of the functions evaluated (n=8)
Memory monitoring
R4	F	37	11	11	37	I/H	Cort/Subc	Frontal	Severe	ABS JOL
R5	F	49	7	13	24	I	Subc	Basal ganglia	Mild	ABS JOL
Memory control
L2	F	70	4	9	7	I	Subc	Thalamus	Severe	RST
L5	F	59	15	12	17	I	Cort	Frontal	Moderate	RST-JOL
L7	M	54	8	0	14	H	Cort/Subc	Basal ganglia and brain parenchyma	Moderate	RST
Memory capacity
L6	F	56	10	7	14	I	Subc	Internal capsule and corona radiata	Moderate	Old/new recog.
R3	F	61	4	5	22	H	Cort	Frontal	Minimal	Immed. recall
R10	M	55	8	5	23	H	Cort/Subc	Temporal	Minimal	Old/new recog.

	JOL	FOK	REL JOL	REL FOK	ABS JOL	ABS FOK	RST	RST JOL	RST Cued recall	4-altern. recog	Cued recall
Age	-0.157	0.107	-0.441	0.207	-0.306	0.018	0.231	0.540^* * p<0.05;	0.283	0.146	-0.406
Years of formal education	0.140	0.106	0.483^* * p<0.05;	-0.469^* * p<0.05;	0.022	0.020	-0.467^* * p<0.05;	-0.066	-0.011	0.285	0.096
Reading habits (before)	0.054	-0.279	0.312	-0.503^* * p<0.05;	0.006	-0.309	-0.314	0.028	0.249	0.226	0.054
Writing habits (before)	-0.066	-0.206	0.325	-0.092	-0.021	-0.197	-0.030	0.028	0.028	0.076	-0.136
Reading and writing habits (before)	0.017	-0.280	0.331	-0.415	0.022	-0.285	-0.207	-0.013	0.172	0.165	-0.006
Reading habits (after)	0.413	-0.069	0.309	-0.605^ p<0.01.	0.276	-0.197	-0.654^ p<0.01.	-0.268	-0.092	0.298	0.460^* * p<0.05;
Writing habits (after)	0.176	0.000	0.456	-0.491^* * p<0.05;	0.139	-0.058	-0.519^* * p<0.05;	-0.110	0.045	0.361	0.209
Reading and writing habits (after)	0.255	-0.022	0.486^* * p<0.05;	-0.599^ p<0.01.	0.180	-0.110	-0.598^ p<0.01.	-0.184	-0.021	0.351	0.296
Months post-stroke time	0.365	0.000	-0.069	-0.269	0.529^* * p<0.05;	0.101	-0.276	-0.293	-0.221	0.087	0.333

		RHL (n=10) M (SD)	LHL (n=10) M (SD)	Control (n=20) M (SD)	p
Memory monitoring	JOL	2.14 (0.5)	2.16 (0.8)	2.35 (0.7)	0.530
	REL JOL	0.85 (0.2)	0.86 (0.2)	0.8 (0.2)	0.216
	ABS JOL	-0.01 (0.1)	0.05 (0.1)	0.08 (0.2)	0.155
Memory control	RST	7.91 (2.8)	9.26 (7.3)	6.93 (3.9)	0.143
	RST JOL	-0.61 (0.3)	-0.22 (0.4)	-0.36 (0.3)	0.062
	RST cued recall	-0.56 (0.3)	-0.36 (0.5)	-0.44 (0.3)	0.340
Memory capacity	Cued recall	0.46 (0.3)	0.32 (0.2)	0.38 (0.2)	0.588
	Immed. free recall	4.30 (1.4)	4.80 (1.7)	4.10 (1.1)	0.746
	Delayed free recall	2.20 (1.9)	1.70 (2.0)	1.55 (1.8)	0.286
	Old/new recogn.	14.70 (4.1)	14.40 (2.6)	14.50 (2.4)	0.448

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E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Maxciel Zortea. Rua Ramiro Barcelos 2350 / Centro de Pesquisa Clínica / sala 21608 / Hospital de Clínicas de Porto Alegre - 90035-903 Porto Alegre RS - Brazil. E-mail: max.zortea@gmail.com.