Computer Tomography for Prediction of Cognitive Outcomes after Ischemic Cerebrovascular Events

Saini, Monica; Tan, Chuen Seng; Hilal, Saima; Dong, Yi; Ting, Eric; Ikram, M. Kamran; Sharma, Vijay K.; Chen, Christopher

doi:10.1016/j.jstrokecerebrovasdis.2014.02.007

Cited by 9 publications

(23 citation statements)

References 21 publications

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“…16 Quality scores were influenced by multiple factors, with studies performing well in some areas and poorly in others. Almost all studies had at least one problem with their definition of CIND or dementia – for example, a lack of detail on specific cut-offs used 20–24 or whether intact ADLs were required for CIND. 19,22–30 Many studies reported limited information on how patients were selected into the study, with only 10/23 studies providing a clear flow chart.…”

Section: Resultsmentioning

confidence: 99%

“…Almost all studies had at least one problem with their definition of CIND or dementia -for example, a lack of detail on specific cut-offs used [20][21][22][23][24] or whether intact ADLs were required for CIND. 19,[22][23][24][25][26][27][28][29][30] Many studies reported limited information on how patients were selected into the study, with only 10/23 studies providing a clear flow chart. [20][21][22]25,26,28,[31][32][33][34] Poor information on patient selection was a key distinguishing characteristic of studies classified as low versus high quality (see Tables S3 and S4 for more details).…”

Section: Study Qualitymentioning

confidence: 99%

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Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke

Sexton

McLoughlin

Williams

et al. 2019

European Stroke Journal

156

110

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Introduction: Increasing attention is being paid to interventions for cognitive impairment (CI) post-stroke, including for CI that does not meet dementia criteria. The aim of this paper was to conduct a systematic review and meta-analysis of the prevalence of cognitive impairment no dementia (CIND) within one year post-stroke. Patients and methods: Pubmed, EMBASE and PsychInfo were searched for papers published in English in 1995-2017. Included studies were population or hospital-based cohort studies for first-ever/recurrent stroke, assessing CIND using standardised criteria at 1-12 months post-stroke. Abstracts were screened, followed by full text review of potentially relevant articles. Data were extracted using a standard form, and study quality was appraised using the Crowe Critical Appraisal Tool. A pooled prevalence of CIND with 95% confidence intervals (CI) was estimated using random-effects meta-analysis. Heterogeneity was measured using the I 2 statistic. Results: A total of 7000 abstracts were screened, followed by 1028 full text articles. Twenty-three articles were included in the systematic review, and 21 in the meta-analysis. The pooled CIND prevalence was 38% [95% CI ¼ 32-43%] (I 2 ¼92.5%, p < 0.01). Study quality emerged as one source of heterogeneity. The five studies with the highest quality scores had no heterogeneity (I 2 ¼0%, p ¼ 0.99), with a similar pooled prevalence (39%, 95%CI ¼ 35-42%). Other sources of heterogeneity were stroke type, inclusion of pre-stroke CI, and age at assessment time. Discussion and conclusion: Meta-analysis of available studies indicates that in the first year post-stroke, 4 in 10 patients display a level of cognitive impairment that does not meet the criteria for dementia.

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Section: Resultsmentioning

confidence: 99%

Section: Study Qualitymentioning

confidence: 99%

Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke

Sexton

McLoughlin

Williams

et al. 2019

European Stroke Journal

156

110

View full text Add to dashboard Cite

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“…Fourteen (N ¼ 4368) studies measured atrophy (Figure 2). 12,13,18,[22][23][24][25][26]28,[31][32][33][34]36 Severity of atrophy was associated with PSD (unadjusted analysis) and PSCI (adjusted analysis), but there was no clear association between presence of cerebral atrophy or localized atrophy and PSD or PSCI. Two studies also reported measures of atrophy which were too heterogeneous to include in the harvest plot.…”

Section: Atrophymentioning

confidence: 99%

Predicting post-stroke cognitive impairment using acute CT neuroimaging: A systematic review and meta-analysis

Ball

Sutherland

Squires

et al. 2021

International Journal of Stroke

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Background: Identifying whether acute stroke patients are at risk of cognitive decline could improve prognostic discussions and management. Structural computed tomography (CT) neuroimaging is routine in acute stroke, and may, identify those at risk of post-stroke dementia (PSD) or post-stroke cognitive impairment (PSCI). Aim: To systematically review the literature to identify which stroke or pre-stroke features on brain CT scans, performed at the time of stroke, are associated with PSD or PSCI. Summary of review: We searched electronic databases to December 2020. We included studies reporting acute stroke brain CT, and later diagnosis of a cognitive syndrome. We created summary estimates of size of unadjusted association between CT features and cognition. Of 9536 citations, twenty-eight studies (41 papers) were eligible (N=7078, mean age 59.8-78.6 years). Cognitive outcomes were PSD (10 studies), PSCI (17 studies), and one study analysed both. Fifteen studies (N=2952) reported data suitable for meta-analyses. White matter lesions (WML) (6 studies, N=1054, OR=2.46, 95% CI=1.25-4.84), cerebral atrophy (4 studies, N=558, OR=2.80, 95% CI=1.21-6.51), and pre-existing stroke lesions (3 studies, N=352, OR=2.38, 95% CI=1.06-5.32) were associated with PSD. WML (4 studies, N=473, OR=3.46, 95% CI=2.17-5.52) were associated with PSCI. Other CT features were either not associated with cognitive outcome, or there were insufficient data. Conclusions: Cognitive impairment following stroke is of great concern to patients and carers. Features seen on visual assessment of acute stroke CT brain scans are strongly associated with cognitive outcomes. Clinicians should consider when and how this information should be discussed with stroke survivors.

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“…Patients with VCI have a higher risk for cognitive decline following AIS. Baseline computed tomography (CT) scan of the brain in patients after AIS or transient ischemic attack (TIA) may also serve as a predictor of significant cognitive impairment at 3–6 months after the index event …”

Section: Introductionmentioning

confidence: 99%

“…Baseline computed tomography (CT) scan of the brain in patients after AIS or transient ischemic attack (TIA) may also serve as a predictor of significant cognitive impairment at 3-6 months after the index event. 12 Intracranial atherosclerosis is highly prevalent among patients with Asian, Hispanic, and African ancestry. Specifically, it accounts for approximately half of all Asian AIS patients.…”

Section: Introductionmentioning

confidence: 99%

Poststroke Cognitive Decline is Independent of Longitudinal Changes in Cerebral Hemodynamics Parameters

Suministrado

Shuang

et al. 2016

Journal of Neuroimaging

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Computer Tomography for Prediction of Cognitive Outcomes after Ischemic Cerebrovascular Events

Cited by 9 publications

References 21 publications

Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke

Systematic review and meta-analysis of the prevalence of cognitive impairment no dementia in the first year post-stroke

Predicting post-stroke cognitive impairment using acute CT neuroimaging: A systematic review and meta-analysis

Poststroke Cognitive Decline is Independent of Longitudinal Changes in Cerebral Hemodynamics Parameters

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