

Predictors of post-stroke cognitive impairments development and progression
https://doi.org/10.30629/2658-7947-2025-30-3-32-39
Abstract
The purpose of this study was to verify predictors of the cognitive impairment (CI) development and progression in patients in recovery period after ischemic stroke (IS) using discriminant analysis.
Material and methods. 192 patients underwent IS were examined. To assess the degree of CI on the 14th day and in 6 months after the IS development CDR scale was applied. The relationship with CDR (correlation coefficient, r) and predictive ability (ML, information gain, p.g.) was analyzed in relation to 28 parameters: demographic characteristics, comorbidity, clinical, immunological and instrumental indicators.
Results. Deterioration of cognitive function was found in 34.5% of cases (development in 15.2%, progression in 19.3%). Significant correlations (p < 0.05) with CDR and predictive ability (p < 0.001) were found for comorbidity ( r = 0.620; p.g. = 0.431), age (r = 0.320; p.g. = 0.204), CXCL10 (r = 0.322; p.g. = 0.341), CXCL1 (r = 0.333; p.g. = 0.304) and CCL2 (r = 0.440; p.g. = 0.124) concentrations.
Conclusion. Polymorbidity, age, and levels of cytokines CXCL10, CXCL1, and CCL2 were found to be most relevant to the development and progression of CI in the recovery period of IS. For better understanding of the structure and dynamics of post-stroke CI large-scale researches assessing data from extended neuropsychological testing and aspects of drug therapy consistent with current recommendations for the cognitive impairment treatment are required.
About the Authors
A. M. TynterovaRussian Federation
Kaliningrad
A. V. Gorbacheva
Russian Federation
Kaliningrad
N. N. Shusharina
Russian Federation
Kaliningrad
M. S. Khoimov
Russian Federation
Kaliningrad
D. A. Smirnova
Russian Federation
Kaliningrad
References
1. Parfenov VA. Poststroke cognitive impairment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(4):22–27. (In Russ.). https://doi.org/10.14412/2074-2711-2019-4-22-27
2. He A, Wang Z, Wu X, Sun W, Yang K, Feng W, Wang Y, Song H. Incidence of post-stroke cognitive impairment in patients with first-ever ischemic stroke: a multicenter cross-sectional study in China. Lancet Reg Health West Pac. 2023 Jan 14;33:100687. https://doi.org/10.1016/j.lanwpc.2023.100687
3. Kim KY, Shin KY, Chang KA. Potential Biomarkers for Post-Stroke Cognitive Impairment: A Systematic Review and Meta-Analysis. Int J Mol Sci. 2022 Jan 6;23(2):602. https://doi.org/10.3390/ijms23020602
4. Hasan F, Muhtar MS, Wu D, Chen PY, Hsu MH, Nguyen PA, Chen TJ, Chiu HY. Web-based artifi cial intelligence to predict cognitive impairment following stroke: A multicenter study. J Stroke Cerebrovasc Dis. 2024 Aug;33(8):107826. https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.107826
5. Ji W, Wang C, Chen H, Liang Y, Wang S. Predicting post-stroke cognitive impairment using machine learning: A prospective cohort study. J Stroke Cerebrovasc Dis. 2023 Nov;32(11):107354. https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107354
6. Rost NS, Brodtmann A, Pase MP, van Veluw SJ, Biffi A, Duering M, Hinman JD, Dichgans M. Post-Stroke Cognitive Impairment and Dementia. Circ Res. 2022 Apr 15;130(8):1252–1271. https://doi.org/10.1161/CIRCRESAHA.122.319951
7. Starchina YA. Cognitive disorder after stroke. Meditsinskiy sovet = Medical Council. 2017;(1S):27–32. (In Russ.). https://doi.org/10.21518/2079-701X-2017-0-27-32
8. Shishkova V.N, Adasheva T.V. The relevance of screening for cognitive and psychoemotional disorders in patients with metabolic syndrome and insulin resistance: A review. Consilium Medicum. 2022;24(4):252–255. (In Russ.). https://doi.org/10.26442/20751753.2022.4.201681
9. Govorushina A.A., Minakova M.S., Kalmykova A.D., Turusheva A.V., Bogdanova T.F. White Matter Hyperintensities According to Neuroimaging Analysis, Cognitive Impairment and Emotional Disorders: Is There a Link? Russian Journal of Geriatric Medicine. 2023;2(14): 121–126. (In Russ.). https://doi.org/10.37586/2686-8636-2-2023-121-126
10. Isaykina O.Yu, Vekhova K.A., Drobotov G.S., Takhirov R.A., Isaykina M.A., Gorbunov V.M. Association of cognitive impairment and arterial hypertension. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2023;15(6):4–9. (In Russ.). https://doi.org/10.14412/2074-2711-2023-6-4-9
11. Einstad MS, Saltvedt I, Lydersen S, Ursin MH, Munthe-Kaas R, Ihle-Hansen H, Knapskog AB, Askim T, Beyer MK, Næss H, Seljeseth YM, Ellekjær H, Thingstad P. Associations between post-stroke motor and cognitive function: a cross-sectional study. BMC Geriatr. 2021 Feb 5;21(1):103. https://doi.org/10.1186/s12877-021-02055-7
12. Mancuso M, Iosa M, Abbruzzese L, Matano A, Coccia M, Baudo S, Benedetti A, Gambarelli C, Spaccavento S, Ambiveri G, Megna M, Tognetti P, Maietti A, Rinaldesi ML, Gamberini G, Varalta V, Morone G, Ciancarelli I; CogniReMo Study Group. The impact of cognitive function defi cits and their recovery on functional outcome in subjects aff ected by ischemic subacute stroke: results from the Italian multicenter longitudinal study CogniReMo. Eur J Phys Rehabil Med. 2023 Jun;59(3):284–293. https://doi.org/10.23736/S1973-9087.23.07716-X
13. Springer MV, Chen B, Whitney RT, Briceño EM, Gross AL, Aparicio HJ, Beiser AS, Burke JF, Giordani B, Gottesman RF, Hayward RA, Howard VJ, Koton S, Lazar RM, Sussman JB, Ye W, Levine DA. Age diff erences in the change in cognition after stroke. J Stroke Cerebrovasc Dis. 2024 Dec; 33(12):108087. https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.108087
14. Huang Y, Wang Q, Zou P, He G, Zeng Y, Yang J. Prevalence and factors infl uencing cognitive impairment among the older adult stroke survivors: a cross-sectional study. Front Public Health. 2023 Sep 15;11 :1254126. https://doi.org/10.3389/fpubh.2023.1254126
15. Wang C, Wang J, Zhu Z, Hu J, Lin Y. Spotlight on pro-inflammatory chemokines: regulators of cellular communication in cognitive impairment. Front Immunol. 2024 Jul 1;15:1421076. https://doi.org/10.3389/fimmu.2024.1421076
16. Roberts TK, Eugenin EA, Lopez L, Romero IA, Weksler BB, Couraud PO, Berman JW. CCL2 disrupts the adherens junction: implications for neuroinfl ammation. Lab Invest. 2012 Aug;92(8):1213–33. https://doi.org/10.1038/labinvest.2012.80
17. Korbecki J, Gąssowska-Dobrowolska M, Wójcik J, Szatkowska I, Barczak K, Chlubek M, Baranowska-Bosiacka I. The Importance of CXCL1 in Physiology and Noncancerous Diseases of Bone, Bone Marrow, Muscle and the Nervous System. Int J Mol Sci. 2022 Apr 11;23(8):4205. https://doi.org/10.3390/ijms23084205
18. Jiang S, Liang J, Li W, Wang L, Song M, Xu S, Liu G, Du Q, Zhai D, Tang L, Yang Y, Zhang L, Zhang B. The role of CXCL1/CXCR2 axis in neurological diseases. Int Immunopharmacol. 2023 Jul; 120:110330. https://doi.org/10.1016/j.intimp.2023.110330
Review
For citations:
Tynterova A.M., Gorbacheva A.V., Shusharina N.N., Khoimov M.S., Smirnova D.A. Predictors of post-stroke cognitive impairments development and progression. Russian neurological journal. 2025;30(3):32-39. (In Russ.) https://doi.org/10.30629/2658-7947-2025-30-3-32-39