Dataset Information

Clinically accessible neuroimaging predictors of post-stroke neurocognitive disorder: a prospective observational study.

ABSTRACT:

Background

Neurocognitive disorder (NCD) is common in stroke survivors. We aimed to identify clinically accessible imaging markers of stroke and chronic pathology that are associated with early post-stroke NCD.

Methods

We included 231 stroke survivors from the "Norwegian Cognitive Impairment after Stroke (Nor-COAST)" study who underwent a standardized cognitive assessment 3 months after the stroke. Any NCD (mild cognitive impairment and dementia) and major NCD (dementia) were diagnosed according to "Diagnostic and Statistical Manual of Mental Disorders (DSM-5)" criteria. Clinically accessible imaging findings were analyzed on study-specific brain MRIs in the early phase after stroke. Stroke lesion volumes were semi automatically quantified and strategic stroke locations were determined by an atlas based coregistration. White matter hyperintensities (WMH) and medial temporal lobe atrophy (MTA) were visually scored. Logistic regression was used to identify neuroimaging findings associated with major NCD and any NCD.

Results

Mean age was 71.8?years (SD 11.1), 101 (43.7%) were females, mean time from stroke to imaging was 8 (SD 16) days. At 3 months 63 (27.3%) had mild NCD and 65 (28.1%) had major NCD. Any NCD was significantly associated with WMH pathology (odds ratio (OR)?=?2.73 [1.56 to 4.77], p?=?0.001), MTA pathology (OR?=?1.95 [1.12 to 3.41], p?=?0.019), and left hemispheric stroke (OR?=?1.8 [1.05 to 3.09], p?=?0.032). Major NCD was significantly associated with WMH pathology (OR?=?2.54 [1.33 to 4.84], p?=?0.005) and stroke lesion volume (OR (per ml) =1.04 [1.01 to 1.06], p?=?0.001).

Conclusion

WMH pathology, MTA pathology and left hemispheric stroke were associated with the development of any NCD. Stroke lesion volume and WMH pathology were associated with the development of major NCD 3 months after stroke. These imaging findings may be used in the routine clinical setting to identify patients at risk for early post-stroke NCD.

Trial registration

ClinicalTrials.gov, NCT02650531 , Registered 8 January 2016 - Retrospectively registered.

SUBMITTER: Schellhorn T

PROVIDER: S-EPMC7905565 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Clinically accessible neuroimaging predictors of post-stroke neurocognitive disorder: a prospective observational study.

Schellhorn Till T Aamodt Eva Birgitte EB Lydersen Stian S Aam Stina S Wyller Torgeir Bruun TB Saltvedt Ingvild I Beyer Mona Kristiansen MK

BMC neurology 20210225 1

<h4>Background</h4>Neurocognitive disorder (NCD) is common in stroke survivors. We aimed to identify clinically accessible imaging markers of stroke and chronic pathology that are associated with early post-stroke NCD.<h4>Methods</h4>We included 231 stroke survivors from the "Norwegian Cognitive Impairment after Stroke (Nor-COAST)" study who underwent a standardized cognitive assessment 3 months after the stroke. Any NCD (mild cognitive impairment and dementia) and major NCD (dementia) were diag ...[more]

PMID: 33632149

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Project description:AimTo analyse the interactions of associated factors with post stroke fatigue (PSF) after discharge home and determine the predictors of PSF and their impact on stroke survivors.DesignA prospective observational study.MethodsA total of 94 patients with acute stroke were recruited between May 2019 -July 2020. The main outcomes were fatigue, depression, insomnia, sarcopenia, and health-related quality of life (HRQOL) and were assessed at admission and 1 month after discharge. Fatigue was measured using the Fatigue Assessment Scale. Depression and Insomnia were assessed using the Hospital Anxiety and Depression Scale-Depression and Insomnia Severity Index, respectively. Sarcopenia was measured using the SARC-F questionnaire, and HRQOL was assessed using the Short Form-8.ResultsAcute phase PSF was an independent predictor of PSF after discharge home. Moreover the path analysis revealed that this effect is mediated through both the direct effect of acute-phase PSF on PSF after discharge home and through the indirect effect of interaction with pre-stroke SARC-F, acute phase depression, and acute phase insomnia, which remains a separate predictor of acute-phase PSF. In total, 17% of the survivors had persistent PSF. Persistent PSF was significantly associated with depression, insomnia, sarcopenia, and a lower quality of life scores.ConclusionsPost-stroke fatigue may occur in the acute phase and persists after discharge, it will not only affect later depression, insomnia, and quality of life, but also sarcopenia.ImpactAcute phase PSF was found to be an independent predictor of PSF after discharge home. In addition, the interaction with pre-stroke SARC-F, acute phase depression and insomnia had an indirect connection with PSF after discharge home, which remains a separate predictor of acute-phase PSF. Thus, early assessment and management of mental status, sleep problems, and sarcopenia during hospitalization might be an important step in post-stroke rehabilitation and home transition.

Dataset Information

Clinically accessible neuroimaging predictors of post-stroke neurocognitive disorder: a prospective observational study.

Background

Methods

Results

Conclusion

Trial registration

Publications

Clinically accessible neuroimaging predictors of post-stroke neurocognitive disorder: a prospective observational study.

Similar Datasets

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