The role of cognitive reserve in predicting cognitive recovery in right hemisphere damage patients undergoing neurorehabilitative treatment

In the context of cognitive impairments associated with right hemisphere damage (RHD), pragmatic abilities have garnered significant attention as a domain of interest. Pragmatics encompasses the effective use of language in context, crucial for successful communication. Numerous studies have revealed potential deficits in specific aspects of pragmatics, both in production and comprehension, among individuals with RHD. However, a comprehensive understanding of pragmatic abilities in the context of neurorehabilitation remains incomplete, as previous investigations have predominantly focused on isolated facets of pragmatic competence. Consequently, there is a need to construct a comprehensive profile of pragmatic abilities in individuals with RHD, shedding light on the broader scope of their communicative skills. Additionally, exploring the potential role of protective factors in mitigating the decline of these abilities as the disease progresses remains a largely unexplored area. The healthy control group comprised 34 individuals was matched to the RHD patient group in terms of age and education. This comparison allowed for a comprehensive examination of pragmatic abilities in RHD patients by elucidating the significant differences between patients and healthy controls. By utilizing statistical analyses, including Whitney U tests, the study demonstrated a significant difference in pragmatic abilities between the RHD patient group and the healthy control group. Additionally, exploring the potential role of protective factors in mitigating the decline of these abilities as the disease progresses remains a largely unexplored area. The study enrolled eight right hemisphere damaged (RHD) patients, who underwent cognitive reserve assessment using the Cognitive Reserve Index questionnaire. Baseline neuropsychological assessments were conducted before the initiation of neurorehabilitation, followed by a second assessment after one month of treatment. The findings revealed a significant correlation between cognitive reserve and cognitive recovery, indicating that patients with higher cognitive reserve scores exhibited greater improvements in cognitive functioning following neurorehabilitation. This result suggests that cognitive reserve plays a vital role in the cognitive recovery of RHD patients undergoing neurorehabilitation. Moreover, the integration of cognitive reserve measures in neurorehabilitation interventions has the potential to enhance treatment outcomes for RHD patients. These findings contribute to the existing literature on cognitive reserve and hold implications for clinical practice by emphasizing the advantages of incorporating cognitive reserve considerations into the design of neurorehabilitation interventions. For more detailed information regarding the assessment and role of the Cognitive Reserve Index questionnaire, readers are referred to the Supplementary Material.