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Attentional bias modification may offer a low-burden, nonpharmacological option during the acute phase, but its presence and determinants in patients with acute stroke and depressive symptoms remain unclear. This multicenter cross-sectional study will recruit patients 7–30 days post-onset, assess depressive symptoms with the HADS depression subscale, and measure attentional bias using dot-probe and cue–target tasks with face and word stimuli.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/depressive-symptoms-and-attentional-bias-in-acute-stroke-study-protocol/148466/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/depressive-symptoms-and-attentional-bias-in-acute-stroke-study-protocol/148466.png","ImageObject",300,407,{"name":92,"@type":93},"Valentina","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-04","2026-08-26",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is post-stroke depression important in acute stroke patients?","Question",{"text":113,"@type":114},"Post-stroke depression affects about 30% of patients and is linked to delayed recovery in daily living, reduced rehabilitation effectiveness, and poorer quality of life.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What is the main purpose of this multicenter cross-sectional study?",{"text":118,"@type":114},"To examine the association between depressive symptoms and attentional bias in patients with acute stroke, compare bias across task and stimulus types, and evaluate the influence of cognitive function on this association.",{"name":120,"@type":111,"acceptedAnswer":121},"How will depressive symptoms and attentional bias be assessed?",{"text":122,"@type":114},"Depressive symptoms will be measured using the depression subscale of the Hospital Anxiety and Depression Scale, while attentional bias will be measured using dot-probe and cue–target tasks with face and word stimuli.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},148466,1787780062,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":130,"read_time":145},13056703020460,"https://ap-avatar.wpscdn.com/avatar/be000253dac470eee5d?_k=1778207105932848923","medRxiv preprint doi: [https://doi.org/10.64898/2026.06.13.26355568](https://doi.org/10.64898/2026.06.13.26355568); this version posted June 16, 2026. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.  \nIt is made available under a CC-BY 4.0 International license .  \n1 Cross-sectional study of the association between depressive symptoms and attentional bias  \n2 to emotional stimuli in patients with acute stroke: Study protocol  \n3  \n4 Short title: Depressive symptoms and attentional bias in acute stroke  \n5  \n6 Miyu Yamashita 1, 2, Hirokazu Takizawa 1, Kohei Koizumi 1, Toyohiro Hamaguchi 1*  \n7  \n8 1 Department of Rehabilitation, Graduate School of Health Science, Saitama Prefectural  \n9 University, Saitama, Japan  \n10 2 Department of Rehabilitation, NiizaShiki Central General Hospital, Saitama, Japan  \n11  \n12 * Corresponding author  \n13 [E-mail: hamaguchi-toyohiro@spu.ac.jp](E-mail: hamaguchi-toyohiro@spu.ac.jp) (TH)  \nNOTE: This preprint reports new research that has not been certifid by peer review and should not be used to guide clinical practice.  \nmedRxiv preprint doi: [https://doi.org/10.64898/2026.06.13.26355568](https://doi.org/10.64898/2026.06.13.26355568); this version posted June 16, 2026. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.  \nIt is made available under a CC-BY 4.0 International license .  \n14 Abstract  \n15 Post-stroke depression affects approximately 30% of patients after stroke and is  \n16 associated with delayed recovery in activities of daily living, reduced rehabilitation  \n17 effectiveness, and poorer quality of life. Attentional bias modification may provide a low-  \n18 burden, nonpharmacological approach for patients in the acute phase of stroke. However, before  \n19 such an intervention can be implemented in clinical practice, it is necessary to clarify whether  \n20 attentional bias is present in patients with acute stroke and depressive symptoms, whether  \n21 cognitive function influences the manifestation of this bias, and which task and stimulus formats  \n22 are most appropriate for assessment. This multicenter, cross-sectional observational study will  \n23 enroll patients with acute stroke between 7–30 days after stroke onset. Depressive symptoms will  \n24 be assessed using the depression subscale of the Hospital Anxiety and Depression Scale.  \n25 Attentional bias will be measured under four task conditions based on the dot-probe task and the  \n26 cue–target task, using face and word stimuli. Secondary assessments will include cognitive  \n27 function, anxiety symptoms, activities of daily living, health-related quality of life, and clinical  \n28 background variables. The aims ofthis study are to investigate the association between  \n29 depressive symptoms and attentional bias in patients with acute stroke, compare attentional bias  \n30 characteristics across task and stimulus types, and examine the potential influence of cognitive  \n31 function on this association. The findings are expected to provide an empirical basis for  \n32 designing future attentional bias modification protocols targeting post-stroke depression in the  \n33 acute phase. This study has been registered with the UMIN Clinical Trials Registry  \n34 (UMIN000059166) .  \nmedRxiv preprint doi: [https://doi.org/10.64898/2026.06.13.26355568](https://doi.org/10.64898/2026.06.13.26355568); this version posted June 16, 2026. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.  \nIt is made available under a CC-BY 4.0 International license .  \n35 Introduction  \n36 Stroke remains a major global health challenge and is one of the leading causes of  \n37 disability worl","cbCaikWf5GkS3UtX","https://ap.wps.com/l/cbCaikWf5GkS3UtX","pdf",932031,48,"English","# Abstract\n## Study design and objectives\n# Introduction\n## Burden of post-stroke depression\n## Need for early nonpharmacological interventions\n## Rationale for attentional bias modification","[{\"question\":\"Why is post-stroke depression important in acute stroke patients?\",\"answer\":\"Post-stroke depression affects about 30% of patients and is linked to delayed recovery in daily living, reduced rehabilitation effectiveness, and poorer quality of life.\"},{\"question\":\"What is the main purpose of this multicenter cross-sectional study?\",\"answer\":\"To examine the association between depressive symptoms and attentional bias in patients with acute stroke, compare bias across task and stimulus types, and evaluate the influence of cognitive function on this association.\"},{\"question\":\"How will depressive symptoms and attentional bias be assessed?\",\"answer\":\"Depressive symptoms will be measured using the depression subscale of the Hospital Anxiety and Depression Scale, while attentional bias will be measured using dot-probe and cue–target tasks with face and word stimuli.\"}]","Depressive symptoms and attentional bias in acute stroke - Study protocol | PDF",121]