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Network impact score is an independent predictor of post-stroke cognitive impairment: A multicenter cohort study in 2341 patients with acute ischemic stroke

J. Matthijs Biesbroek 1 Nick A. Weaver 1 Hugo P. Aben 2 Hugo J. Kuijf 3 Jill Abrigo 4 Hee-Joon Bae 5 Melanie Barbay 6, 7, 8 Jonathan G. Best 9 Regis Bordet 10, 11 Francesca M. Chappell 12 Christopher P. L. H. Chen 13 Thibaut Dondaine 11, 10 Ruben S. van Der Giessen 14 Olivier Godefroy 7, 8 Bibek Gyanwali 13 Olivia K. L. Hamilton 12 Saima Hilal 15 Irene M. C. Huenges Wajer 16 Yeonwook Kang 17 L. Jaap Kappelle 3 Beom Joon Kim 5 Sebastian Kohler 18 Paul L. M. De Kort 2 Peter J. Koudstaal 15 Gregory Kuchcinski 11, 19 Bonnie Y. K. Lam 4 Byung-Chul Lee 20 Keon-Joo Lee 5 Jae-Sung Lim 20 Renaud Lopes 11, 19 Stephen D. J. Makin 21 Anne-Marie Mendyk 22, 19 Vincent C. T. Mok 4 Mi Sun Oh 17 Robert J. Van Oostenbrugge 23 Martine Roussel 7, 8 Lin Shi 4 Julie Staals 23 Maria del C. Valdes-Hernandez 12 Narayanaswamy Venketasubramanian Frans R. J. Verhey 18 Joanna M. Wardlaw 12 David J. Werring 9 Xu Xin 13 Kyung-Ho Yu 17 Martine J. E. Van Zandvoort 16 Lei Zhao Geert Jan Biessels 1 
Abstract : 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 & GE; 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 in-tervals. 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 de-mographics, clinical characteristics and other advanced brain imaging biomarkers, will provide accurate indi-vidualized prediction of PSCI. A tool for calculating the network impact score is freely available at https ://
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Soumis le : vendredi 24 juin 2022 - 10:06:44
Dernière modification le : vendredi 5 août 2022 - 11:24:47

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J. Matthijs Biesbroek, Nick A. Weaver, Hugo P. Aben, Hugo J. Kuijf, Jill Abrigo, et al.. Network impact score is an independent predictor of post-stroke cognitive impairment: A multicenter cohort study in 2341 patients with acute ischemic stroke. NEUROIMAGE-CLINICAL, 2022, 34, ⟨10.1016/j.nicl.2022.103018⟩. ⟨hal-03703582⟩



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