Prevalence of Poststroke Neurocognitive Disorders Using National Institute of Neurological Disorders and Stroke-Canadian Stroke Network, VASCOG Criteria (Vascular Behavioral and Cognitive Disorders), and Optimized Criteria of Cognitive Deficit

Barbay, Mélanie; Taillia, H.; Nédélec-Ciceri, Claudine; Bompaire, Flavie; Bonnin, Camille; Varvat, Jérôme; Grangette, Françoise; Diouf, Momar; Wiener, Emmanuel; Mas, Jean‐Louis; Roussel, Martine; Godefroy, Olivier

doi:10.1161/strokeaha.117.018889

Cited by 68 publications

(52 citation statements)

References 51 publications

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“…On a group level, we found severe impairment in almost every cognitive domain. This corresponds with findings of other recent studies; however, contrary to those studies, we found memory to be the most severely impaired of the cognitive domains (12,17). This finding continued to be significant when patients with pre-stroke dementia were excluded.…”

Section: Discussionsupporting

confidence: 89%

“…Previous studies have reported conflicting results regarding the prognosis for patients suffering PSCI; these have indicated deterioration, no progression, and even improvement in cognition over time for subgroups ( 4 – 11 ). Several cognitive domains are affected in PSCI; of these, impairment in attention and executive function seem to be the most prevalent and severe shortly after and a long time after suffering a stroke ( 12 – 16 ). A recent study on PSCI a short time after a stroke showed a high prevalence of impairment in global cognition and in the five most commonly assessed domains: attention, memory, language, perceptual-motor function, and executive function ( 17 ).…”

Section: Introductionmentioning

confidence: 99%

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Post-stroke Cognitive Impairment—Impact of Follow-Up Time and Stroke Subtype on Severity and Cognitive Profile: The Nor-COAST Study

et al. 2020

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Background: Post-stroke cognitive impairment (PSCI) is common, but evidence of cognitive symptom profiles, course over time, and pathogenesis is scarce. We investigated the significance of time and etiologic stroke subtype for the probability of PSCI, severity, and cognitive profile. Methods: Stroke survivors (n = 617) underwent cognitive assessments of attention, executive function, memory, language, perceptual-motor function, and the Montreal Cognitive Assessment (MoCA) after 3 and/or 18 months. PSCI was classified according to DSM-5 criteria. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). Stroke subtype was categorized as intracerebral hemorrhage (ICH), large artery disease (LAD), cardioembolic stroke (CE), small vessel disease (SVD), or un-/other determined strokes (UD). Mixed-effects logistic or linear regression was applied with PSCI, MoCA, and z-scores of the cognitive domains as dependent variables. Independent variables were time as well as stroke subtype, time, and interaction between these. The analyses were adjusted for age, education, and sex. The effects of time and stroke subtype were analyzed by likelihood ratio tests (LR). Results: Mean age was 72 years (SD 12), 42% were females, and mean NIHSS score at admittance was 3.8 (SD 4.8). Probability (95% CI) for PSCI after 3 and 18 months was 0.59 (0.51-0.66) and 0.51 (0.52-0.60), respectively and remained constant over time. Global measures and most cognitive domains were assessed as impaired for the entire stroke population and for most stroke subtypes. Executive function and language improved for the entire stroke population (LR) = 9.05, p = 0.003, and LR = 10.38, p = 0.001, respectively). After dividing the sample according to stroke subtypes, language Aam et al. Post-stroke Cognitive Impairment improved for ICH patients (LR = 18.02, p = 0.003). No significant differences were found in the severity of impairment between stroke subtypes except for attention, which was impaired for LAD and CE in contrast to no impairment for SVD (LR = 56.58, p < 0.001). Conclusions: In this study including mainly minor strokes, PSCI is common for all subtypes, both early and long-term after stroke, while executive function and language improve over time. The findings might contribute to personalizing follow-up and offer new insights into underlying mechanisms. Further research is needed on underlying mechanisms, PSCI prevention and treatment, and relevance for rehabilitation.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Post-stroke Cognitive Impairment—Impact of Follow-Up Time and Stroke Subtype on Severity and Cognitive Profile: The Nor-COAST Study

et al. 2020

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“…Within the VASCOG criteria, harmonization of the threshold used to determine cognitive impairment will be an important point considering its major influence on the diagnosis of cognitive deficit. The recent finding that the 5th percentile threshold applied to a global cognitive score provides the highest sensitivity and specificity among various deficit criteria [51] may contribute to this objective.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Prevalence in Post-Stroke Neurocognitive Disorders in Hospital-Based Studies

Barbay¹,

Diouf²,

Roussel³

et al. 2018

Dement Geriatr Cogn Disord

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Background/Aims: Post-stroke neurocognitive disorders (post-stroke NCD) have been reported with a very variable prevalence. Methods: Based on a systematic literature search, hospital-based studies published between January 1990 and September 2015 were selected when they reported the prevalence of total, mild, and major post-stroke NCD diagnosed by using specified criteria. Factors affecting prevalence were assessed using meta-regression analysis. Results: Among the 7,440 references evaluated, 16 hospital-based studies were selected, corresponding to a total of 3,087 patients. The overall prevalence of total post-stroke NCD was 53.4% (95% CI: 46.9–59.8): 36.4% for mild post-stroke NCD (95% CI: 29–43.8) and 16.5% (95% CI: 12.1–20.8) for major post-stroke NCD. The overall prevalence was mainly influenced by the threshold score used for categorization (p = 0.0001) and, in the subgroup of studies using a conservative threshold (i.e., ≤7th percentile), by the recurrent stroke rate (p = 0.0005). The prevalence of major post-stroke NCD was mainly influenced by age (p = 0.003). Conclusion: More than half of stroke survivors experience post-stroke NCD, corresponding to mild post-stroke NCD in two-thirds of cases and major post-stroke NCD in one-third of cases. Harmonization of stroke assessment and cognitive score thresholds is urgently needed to allow more accurate estimation of post-stroke NCD prevalence, especially mild post-stroke NCD.

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“…Somatosensory and cognitive impairment, cardiorespiratory disability following stroke, are associated with reduced activity partic-ipation. [18][19][20] Winovich et al observed that markers of physical function-walking speed and grip strength-were consistently associated with survival and recovery after ischemic stroke. 21 Leijon et al showed that the symptoms and signs indicate that the crucial factor for the development of CPSP is a lesion affecting the spino-thalamo-cortical pathway important for temperature and pain sensibility.…”

Section: Discussionmentioning

confidence: 99%

Does Kinesiophobia Associated with Poststroke Neuropathic Pain and Stroke Severity?

Koca¹,

Gulkesen²,

Nacitarhan³

et al. 2019

J PMR Sci

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Prevalence of Poststroke Neurocognitive Disorders Using National Institute of Neurological Disorders and Stroke-Canadian Stroke Network, VASCOG Criteria (Vascular Behavioral and Cognitive Disorders), and Optimized Criteria of Cognitive Deficit

Abstract: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01339195.

Cited by 68 publications

References 51 publications

Post-stroke Cognitive Impairment—Impact of Follow-Up Time and Stroke Subtype on Severity and Cognitive Profile: The Nor-COAST Study

Post-stroke Cognitive Impairment—Impact of Follow-Up Time and Stroke Subtype on Severity and Cognitive Profile: The Nor-COAST Study

Systematic Review and Meta-Analysis of Prevalence in Post-Stroke Neurocognitive Disorders in Hospital-Based Studies

Does Kinesiophobia Associated with Poststroke Neuropathic Pain and Stroke Severity?

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