Awareness of memory functioning in patients with stroke who have a good functional outcome

Primary objective: To determine whether patients with stroke who have a good functional outcome show awareness of memory functioning and whether over-and under-estimation of memory performance are differentially related to neuropsychological performance. Research design: Prospective cohort study. Methods and procedures: The Barrow Neurological Institute Screen for Higher Cerebral Functions and a brief neuropsychological assessment were used to evaluate language, orientation, attention, visuospatial problem-solving, perception, reasoning, executive functioning, memory, affect and awareness of memory functioning. As for the latter, the patient's estimate of memory functioning was compared with his or her actual memory performance. Patients were divided into three groups: good-estimators (estimated performance actual performance), over-estimators (estimated performance > actual performance) and under-estimators (estimated performance < actual performance). Main outcomes and results: In total, 54 patients with stroke were included, of whom 27 patients were classified as good-estimators, 19 as over-estimators and eight as under-estimators. Compared to good-estimators, over-estimators had significantly lower scores for all cognitive domains. Under-estimators had significantly poorer affect compared to good-estimators. Conclusions: These preliminary results suggest that over-and under-estimation of memory functioning can be observed in patients with stroke who have a good functional outcome and that they may reflect distinct underlying neuropsychological processes