The RECOGNISE Study: Neuropsychological Rehabilitation for Emotional and Cognitive consequences After Neurovascular Diseases

Although acute medical care for neurovascular diseases—such as subarachnoid hemorrhage, arteriovenous malformations, and cerebral small vessel disease—has improved significantly, many patients continue to struggle with long-term consequences. Persistent cognitive complaints, emotional distress, and difficulties with daily functioning are common, yet often go unaddressed in standard post-acute care. These challenges can severely hinder patients' ability to resume work, maintain social relationships, and regain independence. Currently, there is a lack of targeted interventions that support patients during this vulnerable phase of recovery. In particular, few approaches focus on strengthening patients’ self-efficacy—their belief in their own ability to manage symptoms, cope with setbacks, and actively participate in rehabilitation. Low self-efficacy has been linked to poorer emotional well-being, reduced participation in daily life, and less favorable rehabilitation outcomes. Therefore, there is a pressing need for accessible, evidence-informed interventions that address both the psychological and practical aspects of recovery. This study aims to evaluate a novel intervention designed to enhance self-efficacy and improve rehabilitation outcomes for patients recovering from neurovascular events.

Primary objective: To assess whether a psychoeducational and peer-support-based intervention improves self-efficacy in individuals with neurovascular conditions. Secondary objectives: To examine the intervention’s effects on quality of life (QoL), participation in daily life (work, social activities, relationships), mood, and cognitive complaints.

This study employs a multiple-phase-change single-case experimental design. The study consists of four 10-week phases: (1) a double baseline control period, (2) an intervention period (five biweekly group sessions), and (3) a follow-up phase to assess the sustainability of intervention effects. Measurements will be conducted at baseline 1 (Week 0), pre-intervention (week 10), post-intervention (Week 20), and follow-up (Week 30).

The intervention is based on cognitive-behavioral principles and builds upon a previous pilot psychoeducation program at the UMCG. It consists of five structured group sessions covering the following themes: (1) introduction and brain function, (2) fatigue, (3) coping with loss of self, (4) relationships (with a significant other), and (5) summary and closure. In-person sessions are complemented by at-home assignments that encourage patients to apply the discussed strategies in their daily lives. The intervention is designed to be low-burden, providing clear and accessible information with structured summaries.

The intervention has no adverse consequences for patients or their close-others and involves no risks. The burden is low and mainly mental, as it requires patients to follow the intervention sessions and complete self-monitoring tasks. Given that the intervention is tailored to individual recovery needs, patients can proceed at their own pace. Experienced neuropsychologists will provide support throughout the process and monitor patients' well-being. Since the goal of this intervention is to enhance self-efficacy, quality of life, daily functioning, and overall well-being, it is likely that participants will experience benefits from their involvement. Our experience with similar interventions suggests that patients appreciate the structured guidance in their recovery process.