TY - JOUR
T1 - Network impact score is an independent predictor of post-stroke cognitive impairment
T2 - A multicenter cohort study in 2341 patients with acute ischemic stroke
AU - Biesbroek, J Matthijs
AU - Weaver, Nick A
AU - Aben, Hugo P
AU - Kuijf, Hugo J
AU - Abrigo, Jill
AU - Bae, Hee-Joon
AU - Barbay, Mélanie
AU - Best, Jonathan G
AU - Bordet, Régis
AU - Chappell, Francesca M
AU - Chen, Christopher P L H
AU - Dondaine, Thibaut
AU - van der Giessen, Ruben S
AU - Godefroy, Olivier
AU - Gyanwali, Bibek
AU - Hamilton, Olivia K L
AU - Hilal, Saima
AU - Huenges Wajer, Irene M C
AU - Kang, Yeonwook
AU - Kappelle, L Jaap
AU - Kim, Beom Joon
AU - Köhler, Sebastian
AU - de Kort, Paul L M
AU - Koudstaal, Peter J
AU - Kuchcinski, Gregory
AU - Lam, Bonnie Y K
AU - Lee, Byung-Chul
AU - Lee, Keon-Joo
AU - Lim, Jae-Sung
AU - Lopes, Renaud
AU - Makin, Stephen D J
AU - Mendyk, Anne-Marie
AU - Mok, Vincent C T
AU - Oh, Mi Sun
AU - van Oostenbrugge, Robert J
AU - Roussel, Martine
AU - Shi, Lin
AU - Staals, Julie
AU - Valdés-Hernández, Maria Del C
AU - Venketasubramanian, Narayanaswamy
AU - Verhey, Frans R J
AU - Wardlaw, Joanna M
AU - Werring, David J
AU - Xin, Xu
AU - Yu, Kyung-Ho
AU - van Zandvoort, Martine J E
AU - Zhao, Lei
AU - Biessels, Geert Jan
N1 - Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.
PY - 2022
Y1 - 2022
N2 - BACKGROUND: Post-stroke cognitive impairment (PSCI) is a common consequence of stroke. Accurate prediction of PSCI risk is challenging. The recently developed network impact score, which integrates information on infarct location and size with brain network topology, may improve PSCI risk prediction.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/.
AB - BACKGROUND: Post-stroke cognitive impairment (PSCI) is a common consequence of stroke. Accurate prediction of PSCI risk is challenging. The recently developed network impact score, which integrates information on infarct location and size with brain network topology, may improve PSCI risk prediction.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/.
KW - ANATOMY
KW - Brain connectomics
KW - DISEASE
KW - Dementia
KW - Diffusion-weighted imaging
KW - HUBS
KW - Ischaemic stroke
KW - LOCATIONS
KW - Post-stroke cognitive impairment
KW - RISK
U2 - 10.1016/j.nicl.2022.103018
DO - 10.1016/j.nicl.2022.103018
M3 - Article
C2 - 35504223
SN - 2213-1582
VL - 34
JO - NeuroImage: Clinical
JF - NeuroImage: Clinical
M1 - 103018
ER -