Influence of Gender on Verbal Memory and Metamemory After a Stroke: A Pilot Study

Abstract

Introduction
Following a stroke, concurrent or dissociated impairment of verbal memory and metamemory (the ability to monitor and regulate learning) is common. Recent studies suggest functional dissociations where one domain is preserved while the other is altered; however, evidence regarding how gender mediates these metacognitive processes remains limited. Therefore, the objective of this pilot study was to compare the verbal memory and metamemory profiles between men and women post-stroke, as well as their potential mutual relationship.

Methodology
This is a descriptive, cross-sectional pilot study. A non-probabilistic convenience sample of 24 adults with stroke (ischemic/hemorrhagic) was included from the Acquired Brain Injury Service of the INR LGII. The learning curve and delayed recall were assessed using the Neuropsi Attention and Memory subtest (NAM-3), and metamemory was evaluated using the BANFE-2 (Neuropsychological Battery of Executive Functions and Frontal Lobes). Raw scores were analyzed using descriptive statistics, the Mann-Whitney U test for between-group comparisons by sex, and Spearman's correlation coefficient using SPSS 27 software.

Results
Twelve men and twelve women were evaluated. No significant differences were found regarding age (mean: 56.05 years; p=.065), time since onset (26.74 months; p=.523), or education (12.54 years; p=.982). In the Metamemory subtest, men presented significantly more positive errors (overestimation) than women (men: 8.25 ± 1.76; women: 2.58 ± 0.83; p=.01), falling within a severe impairment range, while women remained within the normal range. In women, a significant negative correlation was observed between positive errors and verbal recognition within the memory curve (r=-0.56, p=.04).

Conclusions
Gender acts as a modulating factor in post-stroke neuropsychological processes. Men show a severe failure in cognitive monitoring by overestimating their memory performance, which suggests the need for priority interventions focused on awareness of deficit to improve their functional prognosis. In women, the close relationship between both domains suggests an integrated cognitive stimulation approach. Although the small sample size limits generalizability, these preliminary findings justify the development of rehabilitation programs with a gender perspective.