Cognitive Health After Cerebellar Stroke: Linking Socio-Educational Status and Neuropsychological Outcome

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Objective This study aimed to differentiate between chronic-phase cerebellar stroke patients with and without verbal episodic memory deficits, and to determine whether those with deficits exhibit distinct socio-demographic and clinical profiles, thereby identifying potential factors associated with these impairments. Methods Data from 15 cerebellar stroke patients in the CEREBEMO cohort were analyzed, with participants categorized into two groups based on verbal episodic memory performance: deficits (n = 8) and no deficits (n = 7). Statistical analyses, including Generalized Linear Mixed Models and Chi-Squared tests, compared socio-demographic and neuropsychological variables between the groups. Results Significant differences were observed in socio-educational levels, with a higher proportion of patients with memory deficits at intermediate education levels. Moreover, patients with memory deficits performed worse on the Montreal Cognitive Assessment and the Trail Making Test, indicating overall lower cognitive efficiency and slower processing speed. Post-hoc analysis showed that, despite the limited sample size, our sample effectively detected a significant difference between the two groups with high statistical power. Conclusion These findings highlight potential socio-educational and cognitive factors associated with memory impairments following cerebellar stroke. Cerebellum Memory Neuropsychology Phenotypes Socioeconomic Figures Figure 1 1. Introduction Over the past two decades, growing evidence has highlighted the cerebellum’s role in non-motor functions, particularly cognition[1] and emotion [2]. Cerebellar lesions in clinical populations have been shown to affect notably executive function, visual processing, linguistic skills and affect regulation. These deficits are grouped under cerebellar cognitive affective syndrome (CCAS)[3], a broad concept encompassing diverse neuropsychological impairments. While tools have been developed to assess CCAS, the factors predicting or protecting against these deficits remain unclear. Among the cognitive functions affected, episodic memory has been shown to be particularly vulnerable to cerebellar damage[4], with deficits persisting into the chronic phase [4]. However, no studies have yet systematically characterized the sociodemographic and cognitive profiles of patients with cerebellar damage in relation to their verbal episodic memory deficits. In this context, the aim of the present exploratory study was twofold. First, to differentiate, using a neuropsychological test assessing verbal episodic memory, between patients in the chronic phase following a cerebellar stroke who exhibit verbal episodic memory deficits and those who do not. Second, to determine whether patients with verbal episodic memory deficits display distinct socio-demographic and clinical profiles compared to those without such deficits, thereby identifying potential factors associated with these episodic memory impairments. 2. Methodology 2.1. Participants As part of this exploratory study, we extracted data from the CEREBEMO cohort, a project conducted at the University of Geneva that evaluated the effects of cerebellar stroke on emotion recognition [5]. In this context, participants also underwent a neuropsychological assessment. From this cohort, we selected sociodemographic (e.g., age; gender; educational level [Level 1 is equivalent to the compulsory Swiss scholarship ( 12 years of study)] and clinical data from 15 patients who had experienced a cerebellar stroke and for whom performance in verbal episodic memory was available. Moreover, the following exclusion criterions were applied: i) brainstem or occipital lesion; ii) one or more other brain lesions; iii) diffuse and extensive white-matter disease; iv) other degenerative or inflammatory brain disease; v) confusion or dementia; vi) major psychiatric disease; vii) the wearing of hearing aids or a history of tinnitus or a hearing impairment; viii) age below 18 years; ix) major language comprehension deficits precluding reliable testing. These patients were categorized based on their performance in a verbal episodic memory test, the 16-item free/cued recall (in French, épreuve de rappel libre/rappel indicé à 16 items; RL/RI-16[6]. Using standardized norms and a conservative clinical cut-off (< 5th percentile; Z-score < -1.60), we normalized their scores. Among the 15 patients, 8 exhibited deficits in at least two sub-scores, while 7 showed no deficits. This allowed us to divide the group into two subgroups: i) patients with memory deficits (n = 8) and ii) patients without memory deficits (n = 7). 2.2. Statistical analysis Given the non-parametric nature of our data, we conducted appropriate statistical analyses to evaluate the differences between the two patient subgroups. First, socio-demographic variables were analyzed using Generalized Linear Mixed Models (GLMM) of the GAMMA type for continuous variables (age, days since stroke) and Chi-Squared ( X² ) tests for categorical variables (gender, lesion lateralization, socio-educational level). Next, GAMMA and multiple-type GLMM analyses were performed to examine neuropsychological scores and psychiatric questionnaire results as the primary variables. To control for potential confounding effects, socio-demographic or clinical variables that were found to be significantly different between groups were included as covariates (random effects). This allowed us to isolate their influence and focus specifically on the neuropsychological and psychiatric outcomes of interest. Benjamini-Hochberg False Discovery Rate (FDR) type corrections were carried out. 3. Results 3.1. Sociodemographic and clinical variables The analyses showed a significant difference in socio-educational level between patients with and without memory deficits, with a higher proportion of patients at the intermediate level (Level 2) in the memory deficit group, suggesting a lower overall socio-educational level in this subgroup. No significant differences were found between patient groups in terms of age, gender, lesion hemispheric localization, or time since stroke. To further investigate the specific effect of other variables (see below), the socio-educational level was subsequently included in the analysis. This step was necessary to avoid potential confounding effects, as memory deficits were the primary discriminating variable. Table 1 Comparison of demographic and clinical characteristics between cerebellar stroke patients with and without verbal episodic memory deficits (General Linear Mixed Models GAMMA type for continuous variables (age, days since stroke) and Chi-Squared (X²) tests for categorical variables (gender, lesion lateralization, socio-educational level). Cerebellar patients without memory deficits (n = 7) Cerebellar patients with memory deficits (n = 8) Stat. and p. values Age in years (mean ± SD) 59.57 ± 14.62 61.38 ± 14.39 B = -0.232, p = .816 Gender (% women) 14.29% 37.50% X 2 = 1.03, p = .310 Socio-cultural level (% levels) Level 1 :0% Level 2: 0% Level 3: 100% Level 1 :0% Level 2: 75% Level 3: 25% X 2 = 8.75 , p = .003** Hemispheric localization of the cerebellar lesion (L/R/Bilateral) (1/4/2) (3/5/0) B = -0.70, p = .526 Time since stroke in days (mean ± SD) 370.00 ± 270.21 773.75 (± 801.56) B = -0.985, p = .336 Legend : L: left; R: right; SD: standard deviation. ** Significant after Benjamini-Hochberg FDR correction. 3.2. Neuropsychological performances and self-reported psychiatric symptoms Neuropsychological performances. Significant differences were found between the two patient subgroups for the MoCA Total score and the TMT A Time score, with poorer performance for both measures observed in cerebellar patients with memory deficits. All other comparisons were non-significant after multiple comparison correction (see Table 2 and Fig. 1 ). Self-reported psychiatric symptoms. No significant differences were found between cerebellar patients with and without memory deficits (p > .088). Table 2 Comparison of neuropsychological and psychiatric data between cerebellar stroke patients with and without verbal episodic memory deficits, based on the following statistical analysis: GAMMA for continuous and Multinomial for categorical Generalized Linear Mixed Models Cerebellar patients without memory deficits ( n = 7) Cerebellar patients with memory deficits ( n = 8) Stat. and p. values MoCA – Total score 28.00 ± 1.53 25.13 ± 1.96) B = -3.07 , p = .009** Executive and visuospatial 4.86 ± 0.38 4.00 ± 1.41 B = -0.01, p = .999 Denomination 3.00 ± 0.00 2.87 ± 0.35 B = -0.63, p = .539 Attention 6.00 ± 0.00 5.38 ± 1.06 B = -0.01, p = .999 Language 2.71 ± 0.49 2.50 ± 0.54 B = -0.78, p = .449 Abstraction 2.00 ± 0.00 1.63 ± 0.52 B = -1.26, p = .228 Recall 3.71 ± 1.25 2.38 ± 1.18 B = -0.05, p = .997 Orientation 5.86 ± 0.38 6.00 ± 0.00 B = -0.73, p = .480 FAB – Total score 17.14 ± 0.90 14.00 ± 2.73 B = -2.64, p = .020 Similarities 3.00 ± 0.00 2.75 ± 0.46 B = -1.01, p = .332 Lexical Fluency 2.71 ± 0.49 2.63 ± 0.52 B = -0.34, p = .739 Motor Sequences 2.71 ± 0.49 1.88 ± 0.99 B = -1.29, p = .240 Flexibility 2.71 ± 0.49 2.63 ± 0.52 B = -0.34, p = .739 Go/No-Go 3.00 ± 0.00 1.13 ± 1.36 B = -0.01, p = .999 Grip 3.00 ± 0.00 3.00 ± 0.00 B = 0, p = 1 Fluency 2’ (Categorical) 29.14 ± 7.80 22.75 ± 6.86 B = 1.66, p = .122 Fluency 2’ (Literal) 20.80 ± 4.32 15.33 ± 9.09 B = 1.36, p = .207 Stroop – Denomination time (sec.) 67.67 ± 14.94 73.38 ± 17.26 B = 1.36, p = .207 Stroop – Lecture time (sec.) 47.83 ± 13.96 52.00 ± 8.07 B = -0.86, p = .404 Stroop – Interference (sec.) 119.33 ± 23.89 151.00 ± 38.15 B = -1.64, p = .127 Stroop – Inhibition 51.67 ± 27.64 77.63 ± 23.22 B = 1.968, p = .073 TMT (A) – Time in seconds 34.00 ± 10.00 58.75 ± 16.71 B = 3.68 , p = .003** TMT (B) – Time in second 81.00 ± 36.72 118.50 ± 21.57 B = -2.74, p = .017 TMT B/A 47.00 ± 31.74 59.75 ± 29. 57 B = -1.10, p = .293 Apathy (AES) – Total score 0.00 ± 0.00 6.75 ± 9.63 B = -1.84, p = .088 Depression (BDI – II) – Total score 10.20 ± 4.66 14.00 ± 6.68 B = -0.95, p = .365 Cognitive subscore 7.20 ± 1.79 9.25 ± 5.97 B = -0.23, p = .822 Affective subscore 2.40 ± 2.61 4.75 ± 5.75 B = -0.69, p = .510 Alexithymia (TAS-20) – Total score 57.40 ± 12.36 55.38 ± 15.92 B = -0.31, p = .763 Description-feeling 17.60 ± 4.45 14.75 ± 4.03 B = -1.08, p = .302 Open-mindedness 21.20 ± 4.82 20.75 ± 9.05 B = -0.33, p = .750 Identification feeling 18.60 ± 5.46 19.88 ± 5.84 B = 0.42, p = .684 Legend : AES: Apathy Evaluation Scale[9] ; BDI-II: Beck Depression Inventory II [10]; FAB: Frontal Assessment Battery [11]; MoCA: Montreal Cognitive Assessment [7]; Stroop [12]; TAS-20: Toronto Alexithymia Scale[13]; TMT: Trail Making Test [8]. ** Significant after Benjamini-Hochberg FDR correction. 3. 3. Post-hoc power analyses Given the exploratory nature of our study and the small sample size, we performed post-hoc power analyses to determine the power of our results on the scores that were significantly different between the groups after correction: MoCA and TMT A. Post-hoc power analyses equations modelled on “ https://clincalc.com/stats/power.aspx ” were performed. A statistical power of 88.9% for MoCA Total-Score and 94.2% for TMT A score were found. 4. Discussion This exploratory study identified a significant difference in socio-educational levels between chronic cerebellar stroke patients with and without verbal episodic memory deficits, with a higher proportion of individuals at intermediate socio-educational levels in the memory deficit group, suggesting a potential link between lower educational status and memory impairments. Additionally, patients with verbal episodic memory deficits demonstrated poorer overall cognitive performance and reduced processing speed, even when accounting for socio-educational factors. These exploratory results are significant for several reasons. Firstly, these findings emphasize the importance of assessing chronic cerebellar stroke patients based on both their lesions and cognitive symptoms, suggesting distinct patient phenotypes with specific neuropsychological profiles. In this case, memory impairments were linked to overall cognitive decline and slower processing speed. Interestingly, the significant result for overall cognitive decline (measured with MoCA) was not driven by the memory subscore, suggesting an accumulation of different alterations at different subscores. Other clinical phenotypes may also exist, potentially encompassing psychiatric [2], affective [2] or sensori-motor [3] symptoms, highlighting the heterogeneity of the consequences of cerebellar damage. Recognizing these distinct profiles may allow for a more nuanced understanding of how cerebellar damage impacts cognitive functioning, thereby facilitating tailored rehabilitation strategies. Secondly, the findings highlight the potential influence of socio-educational level in cerebellar stroke. These results align with previous research suggesting that socio-educational level is an important factor in the resilience to cognitive disorders, particularly in the context of episodic memory, but this is also in line with an emerging literature indicating that socio-cultural factors can influence cerebellar structure, including findings that lower socio-economic status is associated with reduced cerebellar volume [14]. This suggests that the cerebellum may be particularly sensitive to environmental influences [14]. This observation is particularly noteworthy given that high socio-economic status is widely recognized as a protective factor against the development and chronicity of neuropsychological deficits [15]. Our exploratory findings thus imply that the cerebellum, being sensitive to socio-economic conditions, may be more susceptible to memory deficits in patients who have experienced a cerebellar stroke and possess low socio-economic status. The main limitations of this study include the small sample size (15 patients), which restricts the generalizability of the findings, and its exploratory nature, necessitating further research to confirm the observed associations between socio-educational status and cognitive deficits following cerebellar stroke. However, a post-hoc power analysis indicates that, despite the small sample size, the inter-group differences show sufficient statistical power, supporting potential relevance beyond this sample. Overall, these findings emphasize the impact of environmental factors on cerebellar function and cognitive health. They underscore the importance of exploring symptom assessment to enhance clinicians' ability to predict recovery trajectories and optimize treatment plans, ultimately leading to improved patient outcomes. Future studies would benefit from incorporating longitudinal data to better understand the progression of cognitive deficits over time and provide deeper insights into the long-term impact of cerebellar stroke on cognitive and affective functions. Declarations Ethical Approval Written informed consent was obtained from each participant, the study met the ethical standards of the responsible committee on human experimentation, and was conducted in accordance with the Declaration of Helsinki. All participants gave their written informed consent, and the study was approved by the local ethics committee (Commission Cantonale d'Ethique de la Recherche sur l'être humain (CCER)). Funding The present research was supported by Swiss National Science Foundation (SNSF) Project grant to J.A.P. (PI) (grant no. 105314_215015). The funders had no role in data collection, discussion of content, preparation of the manuscript or decision to publish. Author Contribution P.V : wrote the main manuscript ; data curation; data analysisIM.C: data curation; data analysis, reviewingE.C: data acquisition; reviewingM.T: data acquisition; reviewingF.A: data acquisition; reviewingJA.P: funding; data acquisition; reviewing Acknowledgement The present research was supported by Swiss National Science Foundation (SNSF) Project grant to J.A.P. (PI) (grant no. 105314_215015). The funders had no role in data collection, discussion of content, preparation of the manuscript or decision to publish. Data Availability Data are available on request from JA.P References Buckner RL. The Cerebellum and Cognitive Function: 25 Years of Insight from Anatomy and Neuroimaging. Neuron 2013: 80:807 − 15. doi 10.1016/j.neuron.2013.10.044 Pierce JE, Thomasson M, Voruz P, Selosse G and Péron J. Explicit and implicit emotion processing in the cerebellum: a meta-analysis and systematic review. The Cerebellum 2023: 22:852 − 64. Schmahmann JD. The cerebellum and cognition. Neuroscience letters 2019: 688:62–75. Reumers SF, Schellekens MM, Lugtmeijer S, Maas RP, Verhoeven JI, Boot EM, Ekker MS, Tuladhar AM, van de Warrenburg BP and Schutter DJ. Cognitive impairment in young adults following cerebellar stroke: Prevalence and longitudinal course. Cortex 2024: 178:104 − 15. Thomasson M, Saj A, Benis D, Grandjean D, Assal F and Péron J. Cerebellar contribution to vocal emotion decoding: Insights from stroke and neuroimaging. Neuropsychologia 2019: 132:107141. Van der Linden M, Coyette F, Poitrenaud J, Kalafat M, Calicis F, Wyns C and Adam S. II. L’épreuve de rappel libre/rappel indicé à 16 items (RL/RI-16). 2004. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL and Chertkow H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society 2005: 53:695-9. Reitan RM. Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and motor skills 1958: 8:271-6. Marin RS, Biedrzycki RC and Firinciogullari S. Reliability and validity of the Apathy Evaluation Scale. Psychiatry research 1991: 38:143 − 62. Beck AT, Steer RA and Brown GK. Beck depression inventory. Harcourt Brace Jovanovich New York:; 1987. Dubois B, Slachevsky A, Litvan I and Pillon B. The FAB: a frontal assessment battery at bedside. Neurology 2000: 55:1621-6. Stroop JR. Studies of interference in serial verbal reactions. Journal of experimental psychology 1935: 18:643. Leising D, Grande T and Faber R. The Toronto Alexithymia Scale (TAS-20): A measure of general psychological distress. Journal of research in personality 2009: 43:707 − 10. Cavanagh J, Krishnadas R, Batty GD, Burns H, Deans KA, Ford I, McConnachie A, McGinty A, McLean JS, Millar K, Sattar N, Shiels PG, Tannahill C, Velupillai YN, Packard CJ and McLean J. Socioeconomic Status and the Cerebellar Grey Matter Volume. Data from a Well-Characterised Population Sample. The Cerebellum 2013: 12:882 − 91. doi 10.1007/s12311-013-0497-4 Skoblow HF, Proulx CM, Akpolat R and Palermo F. Early-Life Socioeconomic Position and Later-Life Cognitive Functioning: A Meta-Analysis. Social Science & Medicine 2024:117267. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 07 Jan, 2025 Read the published version in The Cerebellum → Version 1 posted Editorial decision: Revision requested 18 Nov, 2024 Reviews received at journal 16 Nov, 2024 Reviews received at journal 13 Nov, 2024 Reviewers agreed at journal 26 Oct, 2024 Reviewers agreed at journal 23 Oct, 2024 Reviewers invited by journal 23 Oct, 2024 Editor assigned by journal 22 Oct, 2024 Submission checks completed at journal 22 Oct, 2024 First submitted to journal 18 Oct, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5291473","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":371162867,"identity":"27c09c07-ff4f-4618-b26e-b35d51a26abf","order_by":0,"name":"Philippe Voruz","email":"","orcid":"","institution":"University of Geneva","correspondingAuthor":false,"prefix":"","firstName":"Philippe","middleName":"","lastName":"Voruz","suffix":""},{"id":371162868,"identity":"16503055-35b5-4588-9837-9a25cf431afe","order_by":1,"name":"Ioana Medeleine Constantin","email":"","orcid":"","institution":"University of Geneva","correspondingAuthor":false,"prefix":"","firstName":"Ioana","middleName":"Medeleine","lastName":"Constantin","suffix":""},{"id":371162869,"identity":"ea91fb1b-54e1-4b1b-92f8-a53928d3d6a0","order_by":2,"name":"Emilie Chassot","email":"","orcid":"","institution":"University of Geneva","correspondingAuthor":false,"prefix":"","firstName":"Emilie","middleName":"","lastName":"Chassot","suffix":""},{"id":371162870,"identity":"7efb4673-b87e-44be-b233-3d095e6b7267","order_by":3,"name":"Marine Thomasson","email":"","orcid":"","institution":"University of Geneva","correspondingAuthor":false,"prefix":"","firstName":"Marine","middleName":"","lastName":"Thomasson","suffix":""},{"id":371162871,"identity":"99860d90-24f8-4baf-a1e4-a2d30adc51d4","order_by":4,"name":"Frédéric Assal","email":"","orcid":"","institution":"Geneva University Hospitals","correspondingAuthor":false,"prefix":"","firstName":"Frédéric","middleName":"","lastName":"Assal","suffix":""},{"id":371162872,"identity":"99f9c084-c492-486f-bf63-0d3de42de43b","order_by":5,"name":"Julie A. Péron","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5UlEQVRIiWNgGAWjYBACxgbmhgMw9gMGBgkQg42AFka4FmYDorSANMFYbBIwBl4NzDMSGw98YLgjZ97ee6yad4eFXT8D87MHeO2YkdhwcAbDM2OZM+fSbvOekUie2cBmbkBIy2EehsOJMyRyzG7ztkkkGxzggbsQt5Y/DIfrQVqKQVrsidLCwHA4QQKohRmoxc6AgZCWnocNB3sMnhnO4DljLDm3TSJB4jCbGV4thu3Jhz/8qLgjL8HeY/jhbVudPX978zP8WhpApMEBuEBiAzM+9UAgD6EQWuwJaBgFo2AUjIIRCAA11kcns1803wAAAABJRU5ErkJggg==","orcid":"","institution":"University of Geneva","correspondingAuthor":true,"prefix":"","firstName":"Julie","middleName":"A.","lastName":"Péron","suffix":""}],"badges":[],"createdAt":"2024-10-18 19:53:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5291473/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5291473/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s12311-024-01775-x","type":"published","date":"2025-01-07T15:57:01+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":68542253,"identity":"d8514ebb-6346-4696-a6b8-4f58b4e8e261","added_by":"auto","created_at":"2024-11-08 10:55:13","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":51936,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSignificant differences between the group of cerebellar patients with episodic memory deficits and the group of cerebellar patients without episodic memory deficits (Benjamini Hochberg FDR correction applied).\u003c/strong\u003e A) Patients with memory deficits showed significantly lower scores in global cognitive efficiency, as measured by the MoCA, compared to those without memory deficits. B) Additionally, patients with memory deficits had significantly longer completion times on the mental flexibility task, as assessed by the Trail Making Test, compared to those without memory deficits.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLegend:\u003c/strong\u003e MoCA: Montreal Cognitive Assessment [7]; TMT: Trail Making Test [8].\u003c/p\u003e\n\u003cp\u003e** Significant after Benjamini-Hochberg FDR correction.\u003c/p\u003e","description":"","filename":"floatimage158.png","url":"https://assets-eu.researchsquare.com/files/rs-5291473/v1/e6e5ca809bfc859fdccfda78.png"},{"id":73693794,"identity":"b2a2afa6-e924-4ee4-aa76-691c4b136685","added_by":"auto","created_at":"2025-01-13 16:06:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1228884,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5291473/v1/fea4b83a-d3ee-4f9c-b2e3-474224cf0e89.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Cognitive Health After Cerebellar Stroke: Linking Socio-Educational Status and Neuropsychological Outcome","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eOver the past two decades, growing evidence has highlighted the cerebellum\u0026rsquo;s role in non-motor functions, particularly cognition[1] and emotion [2]. Cerebellar lesions in clinical populations have been shown to affect notably executive function, visual processing, linguistic skills and affect regulation. These deficits are grouped under cerebellar cognitive affective syndrome (CCAS)[3], a broad concept encompassing diverse neuropsychological impairments. While tools have been developed to assess CCAS, the factors predicting or protecting against these deficits remain unclear. Among the cognitive functions affected, episodic memory has been shown to be particularly vulnerable to cerebellar damage[4], with deficits persisting into the chronic phase [4]. However, no studies have yet systematically characterized the sociodemographic and cognitive profiles of patients with cerebellar damage in relation to their verbal episodic memory deficits.\u003c/p\u003e \u003cp\u003eIn this context, the aim of the present exploratory study was twofold. First, to differentiate, using a neuropsychological test assessing verbal episodic memory, between patients in the chronic phase following a cerebellar stroke who exhibit verbal episodic memory deficits and those who do not. Second, to determine whether patients with verbal episodic memory deficits display distinct socio-demographic and clinical profiles compared to those without such deficits, thereby identifying potential factors associated with these episodic memory impairments.\u003c/p\u003e"},{"header":"2. Methodology","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1. Participants\u003c/h2\u003e \u003cp\u003eAs part of this exploratory study, we extracted data from the CEREBEMO cohort, a project conducted at the University of Geneva that evaluated the effects of cerebellar stroke on emotion recognition [5]. In this context, participants also underwent a neuropsychological assessment. From this cohort, we selected sociodemographic (e.g., age; gender; educational level [Level 1 is equivalent to the compulsory Swiss scholarship (\u0026lt;\u0026thinsp;11 years of study); level 2 is equivalent to a vocational diploma (11\u0026ndash;12 years of study); level 3 is equivalent to Matura level and higher education (\u0026gt;\u0026thinsp;12 years of study)] and clinical data from 15 patients who had experienced a cerebellar stroke and for whom performance in verbal episodic memory was available. Moreover, the following exclusion criterions were applied: i) brainstem or occipital lesion; ii) one or more other brain lesions; iii) diffuse and extensive white-matter disease; iv) other degenerative or inflammatory brain disease; v) confusion or dementia; vi) major psychiatric disease; vii) the wearing of hearing aids or a history of tinnitus or a hearing impairment; viii) age below 18 years; ix) major language comprehension deficits precluding reliable testing. These patients were categorized based on their performance in a verbal episodic memory test, the 16-item free/cued recall (in French, \u0026eacute;preuve de rappel libre/rappel indic\u0026eacute; \u0026agrave; 16 items; RL/RI-16[6]. Using standardized norms and a conservative clinical cut-off (\u0026lt;\u0026thinsp;5th percentile; Z-score \u0026lt; -1.60), we normalized their scores. Among the 15 patients, 8 exhibited deficits in at least two sub-scores, while 7 showed no deficits. This allowed us to divide the group into two subgroups: i) patients with memory deficits (n\u0026thinsp;=\u0026thinsp;8) and ii) patients without memory deficits (n\u0026thinsp;=\u0026thinsp;7).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2. Statistical analysis\u003c/h2\u003e \u003cp\u003eGiven the non-parametric nature of our data, we conducted appropriate statistical analyses to evaluate the differences between the two patient subgroups. First, socio-demographic variables were analyzed using Generalized Linear Mixed Models (GLMM) of the GAMMA type for continuous variables (age, days since stroke) and Chi-Squared (\u003cem\u003eX\u0026sup2;\u003c/em\u003e) tests for categorical variables (gender, lesion lateralization, socio-educational level). Next, GAMMA and multiple-type GLMM analyses were performed to examine neuropsychological scores and psychiatric questionnaire results as the primary variables. To control for potential confounding effects, socio-demographic or clinical variables that were found to be significantly different between groups were included as covariates (random effects). This allowed us to isolate their influence and focus specifically on the neuropsychological and psychiatric outcomes of interest. Benjamini-Hochberg False Discovery Rate (FDR) type corrections were carried out.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e3.1. Sociodemographic and clinical variables\u003c/h2\u003e \u003cp\u003eThe analyses showed a significant difference in socio-educational level between patients with and without memory deficits, with a higher proportion of patients at the intermediate level (Level 2) in the memory deficit group, suggesting a lower overall socio-educational level in this subgroup. No significant differences were found between patient groups in terms of age, gender, lesion hemispheric localization, or time since stroke.\u003c/p\u003e \u003cp\u003eTo further investigate the specific effect of other variables (see below), the socio-educational level was subsequently included in the analysis. This step was necessary to avoid potential confounding effects, as memory deficits were the primary discriminating variable.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eComparison of demographic and clinical characteristics between cerebellar stroke patients with and without verbal episodic memory deficits\u003c/b\u003e (General Linear Mixed Models GAMMA type for continuous variables (age, days since stroke) and Chi-Squared (X\u0026sup2;) tests for categorical variables (gender, lesion lateralization, socio-educational level).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCerebellar patients \u003cem\u003ewithout\u003c/em\u003e memory deficits (n\u0026thinsp;=\u0026thinsp;7)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCerebellar patients \u003cem\u003ewith\u003c/em\u003e memory deficits (n\u0026thinsp;=\u0026thinsp;8)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStat. and p. values\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge in years (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59.57\u0026thinsp;\u0026plusmn;\u0026thinsp;14.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61.38\u0026thinsp;\u0026plusmn;\u0026thinsp;14.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e= -0.232, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.816\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender (% women)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.29%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.50%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eX\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;1.03, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.310\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSocio-cultural level (% levels)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLevel 1 :0%\u003c/p\u003e \u003cp\u003eLevel 2: 0%\u003c/p\u003e \u003cp\u003eLevel 3: 100%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLevel 1 :0%\u003c/p\u003e \u003cp\u003eLevel 2: 75%\u003c/p\u003e \u003cp\u003eLevel 3: 25%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eX\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;8.75\u003c/b\u003e, \u003cb\u003ep\u003c/b\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;.003**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHemispheric localization of the cerebellar lesion (L/R/Bilateral)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(1/4/2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(3/5/0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.70, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.526\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTime since stroke in days (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e370.00\u0026thinsp;\u0026plusmn;\u0026thinsp;270.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e773.75 (\u0026plusmn;\u0026thinsp;801.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.985, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.336\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003e \u003cb\u003eLegend\u003c/b\u003e: L: left; R: right; SD: standard deviation.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003e** Significant after Benjamini-Hochberg FDR correction.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e3.2. Neuropsychological performances and self-reported psychiatric symptoms\u003c/h2\u003e \u003cp\u003e \u003cem\u003eNeuropsychological performances.\u003c/em\u003e Significant differences were found between the two patient subgroups for the MoCA Total score and the TMT A Time score, with poorer performance for both measures observed in cerebellar patients with memory deficits. All other comparisons were non-significant after multiple comparison correction (see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cem\u003eSelf-reported psychiatric symptoms.\u003c/em\u003e No significant differences were found between cerebellar patients with and without memory deficits (p\u0026thinsp;\u0026gt;\u0026thinsp;.088).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of neuropsychological and psychiatric data between cerebellar stroke patients with and without verbal episodic memory deficits, based on the following statistical analysis: GAMMA for continuous and Multinomial for categorical Generalized Linear Mixed Models\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCerebellar patients \u003cem\u003ewithout\u003c/em\u003e memory deficits\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;7)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCerebellar patients \u003cem\u003ewith\u003c/em\u003e memory deficits\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;8)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStat. and p. values\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMoCA \u0026ndash; Total score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e28.00\u0026thinsp;\u0026plusmn;\u0026thinsp;1.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e25.13\u0026thinsp;\u0026plusmn;\u0026thinsp;1.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eB\u003c/b\u003e \u003cb\u003e= -3.07\u003c/b\u003e, \u003cb\u003ep\u003c/b\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;.009**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eExecutive and visuospatial\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e4.86\u0026thinsp;\u0026plusmn;\u0026thinsp;0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e4.00\u0026thinsp;\u0026plusmn;\u0026thinsp;1.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.01, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.999\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDenomination\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.87\u0026thinsp;\u0026plusmn;\u0026thinsp;0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.63, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.539\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAttention\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e6.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e5.38\u0026thinsp;\u0026plusmn;\u0026thinsp;1.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.01, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.999\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLanguage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.50\u0026thinsp;\u0026plusmn;\u0026thinsp;0.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.78, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.449\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAbstraction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e1.63\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -1.26, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.228\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRecall\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.71\u0026thinsp;\u0026plusmn;\u0026thinsp;1.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.38\u0026thinsp;\u0026plusmn;\u0026thinsp;1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.05, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.997\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOrientation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e5.86\u0026thinsp;\u0026plusmn;\u0026thinsp;0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.73, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.480\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFAB \u0026ndash; Total score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e17.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e14.00\u0026thinsp;\u0026plusmn;\u0026thinsp;2.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -2.64, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.020\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSimilarities\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -1.01, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.332\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLexical Fluency\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.63\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.34, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.739\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMotor Sequences\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e1.88\u0026thinsp;\u0026plusmn;\u0026thinsp;0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -1.29, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.240\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFlexibility\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.63\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.34, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.739\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGo/No-Go\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e1.13\u0026thinsp;\u0026plusmn;\u0026thinsp;1.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.01, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.999\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGrip\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e3.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFluency 2\u0026rsquo; (Categorical)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e29.14\u0026thinsp;\u0026plusmn;\u0026thinsp;7.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e22.75\u0026thinsp;\u0026plusmn;\u0026thinsp;6.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.66, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.122\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFluency 2\u0026rsquo; (Literal)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e20.80\u0026thinsp;\u0026plusmn;\u0026thinsp;4.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e15.33\u0026thinsp;\u0026plusmn;\u0026thinsp;9.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.36, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.207\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStroop \u0026ndash; Denomination time (sec.)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e67.67\u0026thinsp;\u0026plusmn;\u0026thinsp;14.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e73.38\u0026thinsp;\u0026plusmn;\u0026thinsp;17.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.36, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.207\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStroop \u0026ndash; Lecture time (sec.)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e47.83\u0026thinsp;\u0026plusmn;\u0026thinsp;13.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e52.00\u0026thinsp;\u0026plusmn;\u0026thinsp;8.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.86, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.404\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStroop \u0026ndash; Interference (sec.)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e119.33\u0026thinsp;\u0026plusmn;\u0026thinsp;23.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e151.00\u0026thinsp;\u0026plusmn;\u0026thinsp;38.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -1.64, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.127\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStroop \u0026ndash; Inhibition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e51.67\u0026thinsp;\u0026plusmn;\u0026thinsp;27.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e77.63\u0026thinsp;\u0026plusmn;\u0026thinsp;23.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.968, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.073\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTMT (A) \u0026ndash; Time in seconds\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e34.00\u0026thinsp;\u0026plusmn;\u0026thinsp;10.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e58.75\u0026thinsp;\u0026plusmn;\u0026thinsp;16.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eB\u003c/b\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;3.68\u003c/b\u003e, \u003cb\u003ep\u003c/b\u003e\u0026thinsp;\u003cb\u003e=\u0026thinsp;.003**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTMT (B) \u0026ndash; Time in second\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e81.00\u0026thinsp;\u0026plusmn;\u0026thinsp;36.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e118.50\u0026thinsp;\u0026plusmn;\u0026thinsp;21.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -2.74, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTMT B/A\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e47.00\u0026thinsp;\u0026plusmn;\u0026thinsp;31.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e59.75\u0026thinsp;\u0026plusmn;\u0026thinsp;29. 57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -1.10, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.293\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eApathy (AES) \u0026ndash; Total score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.75\u0026thinsp;\u0026plusmn;\u0026thinsp;9.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -1.84, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.088\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDepression (BDI \u0026ndash; II) \u0026ndash; Total score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e10.20\u0026thinsp;\u0026plusmn;\u0026thinsp;4.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e14.00\u0026thinsp;\u0026plusmn;\u0026thinsp;6.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.95, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.365\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCognitive subscore\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e7.20\u0026thinsp;\u0026plusmn;\u0026thinsp;1.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e9.25\u0026thinsp;\u0026plusmn;\u0026thinsp;5.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.23, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.822\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAffective subscore\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.40\u0026thinsp;\u0026plusmn;\u0026thinsp;2.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e4.75\u0026thinsp;\u0026plusmn;\u0026thinsp;5.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.69, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.510\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAlexithymia (TAS-20) \u0026ndash; Total score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e57.40\u0026thinsp;\u0026plusmn;\u0026thinsp;12.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e55.38\u0026thinsp;\u0026plusmn;\u0026thinsp;15.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.31, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.763\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDescription-feeling\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e17.60\u0026thinsp;\u0026plusmn;\u0026thinsp;4.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e14.75\u0026thinsp;\u0026plusmn;\u0026thinsp;4.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -1.08, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.302\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOpen-mindedness\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e21.20\u0026thinsp;\u0026plusmn;\u0026thinsp;4.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e20.75\u0026thinsp;\u0026plusmn;\u0026thinsp;9.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e = -0.33, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.750\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIdentification feeling\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e18.60\u0026thinsp;\u0026plusmn;\u0026thinsp;5.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e19.88\u0026thinsp;\u0026plusmn;\u0026thinsp;5.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.42, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.684\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eLegend\u003c/b\u003e: AES: Apathy Evaluation Scale[9] ; BDI-II: Beck Depression Inventory II [10]; FAB: Frontal Assessment Battery [11]; MoCA: Montreal Cognitive Assessment [7]; Stroop [12]; TAS-20: Toronto Alexithymia Scale[13]; TMT: Trail Making Test [8].\u003c/p\u003e \u003cp\u003e** Significant after Benjamini-Hochberg FDR correction.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e3. 3. Post-hoc power analyses\u003c/h3\u003e\n\u003cp\u003eGiven the exploratory nature of our study and the small sample size, we performed post-hoc power analyses to determine the power of our results on the scores that were significantly different between the groups after correction: MoCA and TMT A. Post-hoc power analyses equations modelled on \u0026ldquo;\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://clincalc.com/stats/power.aspx\u003c/span\u003e\u003cspan address=\"https://clincalc.com/stats/power.aspx\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u0026rdquo; were performed. A statistical power of 88.9% for MoCA Total-Score and 94.2% for TMT A score were found.\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis exploratory study identified a significant difference in socio-educational levels between chronic cerebellar stroke patients with and without verbal episodic memory deficits, with a higher proportion of individuals at intermediate socio-educational levels in the memory deficit group, suggesting a potential link between lower educational status and memory impairments. Additionally, patients with verbal episodic memory deficits demonstrated poorer overall cognitive performance and reduced processing speed, even when accounting for socio-educational factors. These exploratory results are significant for several reasons.\u003c/p\u003e \u003cp\u003eFirstly, these findings emphasize the importance of assessing chronic cerebellar stroke patients based on both their lesions and cognitive symptoms, suggesting distinct patient phenotypes with specific neuropsychological profiles. In this case, memory impairments were linked to overall cognitive decline and slower processing speed. Interestingly, the significant result for overall cognitive decline (measured with MoCA) was not driven by the memory subscore, suggesting an accumulation of different alterations at different subscores. Other clinical phenotypes may also exist, potentially encompassing psychiatric [2], affective [2] or sensori-motor [3] symptoms, highlighting the heterogeneity of the consequences of cerebellar damage. Recognizing these distinct profiles may allow for a more nuanced understanding of how cerebellar damage impacts cognitive functioning, thereby facilitating tailored rehabilitation strategies.\u003c/p\u003e \u003cp\u003eSecondly, the findings highlight the potential influence of socio-educational level in cerebellar stroke. These results align with previous research suggesting that socio-educational level is an important factor in the resilience to cognitive disorders, particularly in the context of episodic memory, but this is also in line with an emerging literature indicating that socio-cultural factors can influence cerebellar structure, including findings that lower socio-economic status is associated with reduced cerebellar volume [14]. This suggests that the cerebellum may be particularly sensitive to environmental influences [14]. This observation is particularly noteworthy given that high socio-economic status is widely recognized as a protective factor against the development and chronicity of neuropsychological deficits [15]. Our exploratory findings thus imply that the cerebellum, being sensitive to socio-economic conditions, may be more susceptible to memory deficits in patients who have experienced a cerebellar stroke and possess low socio-economic status.\u003c/p\u003e \u003cp\u003eThe main limitations of this study include the small sample size (15 patients), which restricts the generalizability of the findings, and its exploratory nature, necessitating further research to confirm the observed associations between socio-educational status and cognitive deficits following cerebellar stroke. However, a post-hoc power analysis indicates that, despite the small sample size, the inter-group differences show sufficient statistical power, supporting potential relevance beyond this sample.\u003c/p\u003e \u003cp\u003eOverall, these findings emphasize the impact of environmental factors on cerebellar function and cognitive health. They underscore the importance of exploring symptom assessment to enhance clinicians' ability to predict recovery trajectories and optimize treatment plans, ultimately leading to improved patient outcomes. Future studies would benefit from incorporating longitudinal data to better understand the progression of cognitive deficits over time and provide deeper insights into the long-term impact of cerebellar stroke on cognitive and affective functions.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eEthical Approval\u003c/h2\u003e \u003cp\u003e Written informed consent was obtained from each participant, the study met the ethical standards of the responsible committee on human experimentation, and was conducted in accordance with the Declaration of Helsinki. All participants gave their written informed consent, and the study was approved by the local ethics committee (Commission Cantonale d'Ethique de la Recherche sur l'\u0026ecirc;tre humain (CCER)).\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThe present research was supported by Swiss National Science Foundation (SNSF) Project grant to J.A.P. (PI) (grant no. 105314_215015). The funders had no role in data collection, discussion of content, preparation of the manuscript or decision to publish.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eP.V : wrote the main manuscript ; data curation; data analysisIM.C: data curation; data analysis, reviewingE.C: data acquisition; reviewingM.T: data acquisition; reviewingF.A: data acquisition; reviewingJA.P: funding; data acquisition; reviewing\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe present research was supported by Swiss National Science Foundation (SNSF) Project grant to J.A.P. (PI) (grant no. 105314_215015). The funders had no role in data collection, discussion of content, preparation of the manuscript or decision to publish.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eData are available on request from JA.P\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBuckner RL. The Cerebellum and Cognitive Function: 25 Years of Insight from Anatomy and Neuroimaging. Neuron 2013: 80:807\u0026thinsp;\u0026minus;\u0026thinsp;15. doi 10.1016/j.neuron.2013.10.044\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePierce JE, Thomasson M, Voruz P, Selosse G and P\u0026eacute;ron J. Explicit and implicit emotion processing in the cerebellum: a meta-analysis and systematic review. The Cerebellum 2023: 22:852\u0026thinsp;\u0026minus;\u0026thinsp;64.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchmahmann JD. The cerebellum and cognition. Neuroscience letters 2019: 688:62\u0026ndash;75.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eReumers SF, Schellekens MM, Lugtmeijer S, Maas RP, Verhoeven JI, Boot EM, Ekker MS, Tuladhar AM, van de Warrenburg BP and Schutter DJ. Cognitive impairment in young adults following cerebellar stroke: Prevalence and longitudinal course. Cortex 2024: 178:104\u0026thinsp;\u0026minus;\u0026thinsp;15.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThomasson M, Saj A, Benis D, Grandjean D, Assal F and P\u0026eacute;ron J. Cerebellar contribution to vocal emotion decoding: Insights from stroke and neuroimaging. Neuropsychologia 2019: 132:107141.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVan der Linden M, Coyette F, Poitrenaud J, Kalafat M, Calicis F, Wyns C and Adam S. II. L\u0026rsquo;\u0026eacute;preuve de rappel libre/rappel indic\u0026eacute; \u0026agrave; 16 items (RL/RI-16). 2004.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNasreddine ZS, Phillips NA, B\u0026eacute;dirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL and Chertkow H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society 2005: 53:695-9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eReitan RM. Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and motor skills 1958: 8:271-6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMarin RS, Biedrzycki RC and Firinciogullari S. Reliability and validity of the Apathy Evaluation Scale. Psychiatry research 1991: 38:143\u0026thinsp;\u0026minus;\u0026thinsp;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBeck AT, Steer RA and Brown GK. Beck depression inventory. Harcourt Brace Jovanovich New York:; 1987.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDubois B, Slachevsky A, Litvan I and Pillon B. The FAB: a frontal assessment battery at bedside. Neurology 2000: 55:1621-6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStroop JR. Studies of interference in serial verbal reactions. Journal of experimental psychology 1935: 18:643.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLeising D, Grande T and Faber R. The Toronto Alexithymia Scale (TAS-20): A measure of general psychological distress. Journal of research in personality 2009: 43:707\u0026thinsp;\u0026minus;\u0026thinsp;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCavanagh J, Krishnadas R, Batty GD, Burns H, Deans KA, Ford I, McConnachie A, McGinty A, McLean JS, Millar K, Sattar N, Shiels PG, Tannahill C, Velupillai YN, Packard CJ and McLean J. Socioeconomic Status and the Cerebellar Grey Matter Volume. Data from a Well-Characterised Population Sample. The Cerebellum 2013: 12:882\u0026thinsp;\u0026minus;\u0026thinsp;91. doi 10.1007/s12311-013-0497-4\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSkoblow HF, Proulx CM, Akpolat R and Palermo F. Early-Life Socioeconomic Position and Later-Life Cognitive Functioning: A Meta-Analysis. Social Science \u0026amp; Medicine 2024:117267.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"the-cerebellum","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"cere","sideBox":"Learn more about [The Cerebellum](http://link.springer.com/journal/12311)","snPcode":"12311","submissionUrl":"https://submission.nature.com/new-submission/12311/3","title":"The Cerebellum","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Cerebellum, Memory, Neuropsychology, Phenotypes, Socioeconomic","lastPublishedDoi":"10.21203/rs.3.rs-5291473/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5291473/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eWhile deficits in episodic memory have been noted following cerebellar damage, there is a lack of research systematically exploring the socio-demographic and cognitive profiles of patients with such impairments.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eThis study aimed to differentiate between chronic-phase cerebellar stroke patients with and without verbal episodic memory deficits, and to determine whether those with deficits exhibit distinct socio-demographic and clinical profiles, thereby identifying potential factors associated with these impairments.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eData from 15 cerebellar stroke patients in the CEREBEMO cohort were analyzed, with participants categorized into two groups based on verbal episodic memory performance: deficits (n\u0026thinsp;=\u0026thinsp;8) and no deficits (n\u0026thinsp;=\u0026thinsp;7). Statistical analyses, including Generalized Linear Mixed Models and Chi-Squared tests, compared socio-demographic and neuropsychological variables between the groups.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eSignificant differences were observed in socio-educational levels, with a higher proportion of patients with memory deficits at intermediate education levels. Moreover, patients with memory deficits performed worse on the Montreal Cognitive Assessment and the Trail Making Test, indicating overall lower cognitive efficiency and slower processing speed. Post-hoc analysis showed that, despite the limited sample size, our sample effectively detected a significant difference between the two groups with high statistical power.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThese findings highlight potential socio-educational and cognitive factors associated with memory impairments following cerebellar stroke.\u003c/p\u003e","manuscriptTitle":"Cognitive Health After Cerebellar Stroke: Linking Socio-Educational Status and Neuropsychological Outcome","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-08 10:55:09","doi":"10.21203/rs.3.rs-5291473/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-11-18T16:04:48+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-11-17T02:59:02+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-11-13T09:21:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"323701225292540962132728494786979594990","date":"2024-10-27T01:32:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"12234920842088115080155966465422357590","date":"2024-10-23T10:40:54+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-10-23T09:35:05+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-10-22T07:51:19+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-10-22T07:50:18+00:00","index":"","fulltext":""},{"type":"submitted","content":"The Cerebellum","date":"2024-10-18T19:50:55+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"the-cerebellum","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"cere","sideBox":"Learn more about [The Cerebellum](http://link.springer.com/journal/12311)","snPcode":"12311","submissionUrl":"https://submission.nature.com/new-submission/12311/3","title":"The Cerebellum","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"14e1400c-19e0-4b41-bcb2-5bda97bb4368","owner":[],"postedDate":"November 8th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-01-13T15:59:06+00:00","versionOfRecord":{"articleIdentity":"rs-5291473","link":"https://doi.org/10.1007/s12311-024-01775-x","journal":{"identity":"the-cerebellum","isVorOnly":false,"title":"The Cerebellum"},"publishedOn":"2025-01-07 15:57:01","publishedOnDateReadable":"January 7th, 2025"},"versionCreatedAt":"2024-11-08 10:55:09","video":"","vorDoi":"10.1007/s12311-024-01775-x","vorDoiUrl":"https://doi.org/10.1007/s12311-024-01775-x","workflowStages":[]},"version":"v1","identity":"rs-5291473","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5291473","identity":"rs-5291473","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}