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Войти в исследования Network impact score is an independent predictor of post-stroke cognitive impairment: A multicenter cohort study in 2341 patients with acute ischemic stroke.
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Biesbroek J Matthijs, Weaver Nick A, Aben Hugo P, Kuijf Hugo J, Abrigo Jill, Bae Hee-Joon, Barbay Mélanie, Best Jonathan G, Bordet Régis, Chappell Francesca M, Chen Christopher P L H, Dondaine Thibaut, van der Giessen Ruben S, Godefroy Olivier, Gyanwali Bibek, Hamilton Olivia K L, Hilal Saima, Huenges Wajer Irene M C, Kang Yeonwook, Kappelle L Jaap, Kim Beom Joon, Köhler Sebastian, de Kort Paul L M, Koudstaal Peter J, Kuchcinski Gregory, Lam Bonnie Y K, Lee Byung-Chul, Lee Keon-Joo, Lim Jae-Sung, Lopes Renaud, Makin Stephen D J, Mendyk Anne-Marie, Mok Vincent C T, Oh Mi Sun, van Oostenbrugge Robert J, Roussel Martine, Shi Lin, Staals Julie, Valdés-Hernández Maria Del C, Venketasubramanian Narayanaswamy, Verhey Frans R J, Wardlaw Joanna M, Werring David J, Xin Xu, Yu Kyung-Ho, van Zandvoort Martine J E, Zhao Lei, Biessels Geert Jan
Аннотация
AIMS: To determine if the network impact score is an independent predictor of PSCI, and of cognitive recovery or decline.
METHODS: We pooled data from patients with acute ischemic stroke from 12 cohorts through the Meta VCI Map consortium. PSCI was defined as impairment in ≥ 1 cognitive domain on neuropsychological examination, or abnormal Montreal Cognitive Assessment. Cognitive recovery was defined as conversion from PSCI < 3 months post-stroke to no PSCI at follow-up, and cognitive decline as conversion from no PSCI to PSCI. The network impact score was related to serial measures of PSCI using Generalized Estimating Equations (GEE) models, and to PSCI stratified according to post-stroke interval (<3, 3-12, 12-24, >24 months) and cognitive recovery or decline using logistic regression. Models were adjusted for age, sex, education, prior stroke, infarct volume, and study site.
RESULTS: We included 2341 patients with 4657 cognitive assessments. PSCI was present in 398/844 patients (47%) <3 months, 709/1640 (43%) at 3-12 months, 243/853 (28%) at 12-24 months, and 208/522 (40%) >24 months. Cognitive recovery occurred in 64/181 (35%) patients and cognitive decline in 26/287 (9%). The network impact score predicted PSCI in the univariable (OR 1.50, 95%CI 1.34-1.68) and multivariable (OR 1.27, 95%CI 1.10-1.46) GEE model, with similar ORs in the logistic regression models for specified post-stroke intervals. The network impact score was not associated with cognitive recovery or decline.
CONCLUSIONS: The network impact score is an independent predictor of PSCI. As such, the network impact score may contribute to a more precise and individualized cognitive prognostication in patients with ischemic stroke. Future studies should address if multimodal prediction models, combining the network impact score with demographics, clinical characteristics and other advanced brain imaging biomarkers, will provide accurate individualized prediction of PSCI. A tool for calculating the network impact score is freely available at https://metavcimap.org/features/software-tools/lsm-viewer/.