Objective

The present study first assesses calculation skills and number processing in patients suffering from cerebrovascular disease patients with Ecological Assessment Battery of Number (EABN), the only French test standardised and validated. Second, relationship between disorders-related lesions and brain lesion lateralization, and formal analytical testing and cognitive disorders were evaluated.

Material/patients and methods

Patients suffering from a stroke were included in three departments of physical and rehabilitation medicine. Inclusion criteria entailed having a stroke, over 18 years, and exempt from prior neurologic or psychiatric disease. The systematic assessment included: EABN, a formal analytical test: Évaluation clinique des aptitudes numériques (ECAN), an evaluation of speech processing (Boston Diagnostic Aphasia Examination = BDAE), a cognitive assessment (Montreal Cognitive Assessment = MOCA), and assessment of independence (Functional Independence Measure = FIM). We studied the link between variables through multivariate analyses. Non-parametric group comparisons were also conducted.

Results

Out of 48 strokes included, 36 showed left brain damage (LBD) (75%) and 10 right brain damage (RBD) (20.8%). Mean age was 59.2 years, mean duration after stroke was 8.5 months. 62.5% of subjects showed a pathological score on EABN. LBD patients were significantly more impaired ( P = 0.0089) and slower ( P = 0.0003) than RBD patients for all tests, especially for transcoding tests ( P = 0.0025). The total EABN score was correlated to the ECAN ( P < 0.0001), what accounts for its sensitivity to capture numerical skills disorders. The correlation found with the language functions ( P < 0.0001) was partly explained by the difficulties of LBD patients. Finally MOCA and MIF were correlated with the total score of the EABN ( P = 0.0009 and 0.004, respectively).

Discussion–conclusion

The EABN is a robust promising tool that enable promote more systematic screening for calculation impairment in patients with a brain damage, (in particularly those with LBL left brain lesion) and assess its major impact on everyday life activity. This tool allows us to distinguish differences in performances according to differences in locations of the brain lesion. Therefore, it seems important to assess the number processing and calculation skills in clinical practice of all LBD patients, in addition to the formal cognitive assessment.