TVA-based modeling of short-term memory capacity, speed of processing and perceptual threshold in chronic stroke patients: Case-control differences, reliability, and sensitivity to cognitive training

Attentional deficits following stroke are common and pervasive, and are important predictors for functional recovery. Attentional functions comprise a set of specific cognitive processes allowing to attend, filter and select among a continuous stream of stimuli. These mechanisms are fundamental for more complex cognitive functions such as learning, planning and cognitive control, all crucial for daily functioning, including social interactions. The distributed functional neuroanatomy of these processes is a likely explanation for the high prevalence of attentional impairments following stroke, and underscores the importance of a clinical implementation of computational approaches allowing for sensitive and specific modeling of attentional sub-processes. The Theory of Visual Attention (TVA) offers a theoretical, computational, neuronal and practical framework to assess the efficiency of visual selection performance and parallel processing of multiple objects. Here, using a whole-report experimental paradigm in a cross-sectional case-control comparison and in six repeated assessments over the course of a three-week intensive computerized cognitive training (CCT) intervention in chronic stroke patients (> 6 months since hospital admission, NIHSS < 7 at hospital discharge), we assessed the sensitivity and reliability of TVA parameters reflecting short-term memory capacity (K), processing speed (C) and perceptual threshold (t₀). Cross-sectional group comparisons documented lower short-term memory capacity, slower processing speed and higher perceptual threshold in patients compared to age-matched healthy controls. Further, longitudinal analyses revealed high reliability of the TVA parameters in stroke patients, and higher processing speed at baseline was associated with larger cognitive benefits of the CCT. The results support the feasibility, reliability and sensitivity of TVA-based assessment of attentional functions in chronic stroke patients.