Social cognitive function in stroke survivors: a scoping review

Objective We aimed to summarize current evidence on social cognitive function in stroke survivors by: identifying social cognition domains assessed; describing assessment tools; reporting impairment prevalence; and outlining interventions targeting impaired social cognition. Methods Updated methodological scoping review guidelines were followed. Database searches were conducted by a librarian on February 26, 2024 (starting from January 1, 2000), across multidisciplinary, international databases. Two authors who independently screened title, abstract, and full texts, resolved discrepancies through discussion or senior reviewer input. Standardized data extraction forms were used, and data were analyzed using descriptive statistics. Results Of 29,069 records, 62 studies, mostly hospital-based (52%), using case-control designs (37%), met the inclusion criteria. They included 3,152 participants with stroke (62% male), mainly with ischemic stroke (61%), and right hemisphere lesions (39%). The five domains (number, most common assessment instruments, and prevalence/mean ± s.d.) of social cognitive function were: emotion perception and recognition (n=38, “Ekman 60-Faces Test,” 7–100%); theory of mind (n=23, “Reading the Mind in the Eyes,” 15–64%); empathy (n=15, 24%, “Balanced Emotional Empathy Scale,” 6–58%); emotion regulation (n=1, 2%, “Difficulties in Emotion Regulation Scale,” range: 8.8±3.87–72.07±21.54); and social problem-solving (n=2, “Social Problem-Solving Fluency Task,” range: 18.02±4.62–98.1±4.0). No study focused on interventions. Conclusion Social cognition after stroke research has mainly addressed emotion recognition, theory of mind, and empathy, with limited attention to other aspects. Although social cognition impairments were common, no studies have specifically targeted their rehabilitation, underscoring the need for focused interventions.