Endovascular treatment improves cognition after stroke

López‐Cancio, Elena; Jovin, Tudor G; Cobo, Erik; Cerdá, Neus; Jiménez, Marta; Gomis, Meritxell; Hernández‐Pérez, María; Cáceres, Cynthia; Cardona, Pere; Lara, Blanca; Renú, Arturo; Llull, Laura; Boned, Sandra; Muchada, Marián; Dávalos, Antoni

doi:10.1212/wnl.0000000000003517

Cited by 34 publications

(23 citation statements)

References 15 publications

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“…Our study found that patients who received mechanical thrombectomy at broadened therapeutic window had better cognitive improvement after AIS in the 90 days follow-up study in the Chinese population for the first time. This result is consistent with that of the previous study, suggesting that mechanical thrombectomy treatment improves cognitive performance after stroke [14]. While, no significant improvement was found in the Hachinski Ischemic Scale, which is the favored clinical tool used for diagnosing vascular dementia.…”

Section: Discussionsupporting

confidence: 92%

Cognitive Function and Prognosis of Multimodal Neuroimage-Guided Thrombectomy on Mild to Moderate Anterior Circulation Infarction Patients with Broadened Therapeutic Window: A Prospective Study

Xu¹,

Dong²,

Niu³

et al. 2017

Eur Neurol

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Background and Objectives: Endovascular mechanical thrombectomy is an important approach for acute ischemic stroke (AIS) treatment. Multimodal neuroimaging methods ideally provide the exact localization, extent, and metabolic activity of target tissues. Post-stroke cognitive impairment has recently been realized to be another major concern except for neurological function impairment. The aim of our study was to carry out a prospective study to compare neurological and cognitive functions after thrombectomy in mild to moderate anterior circulation infarction patients selected by multimodal neuroimaging. Methods: Ninety patients were recruited from January 2016 to March 2017 consecutively. Neurological function was assessed by NIHSS before thrombectomy, and 6 h, 24 h, 7 days, 90 days after mechanical thrombectomy. Cognitive functions were evaluated by Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Hachinski Ischemic Scale. Results: Patients who received mechanical thrombectomy had significantly better neurological functions at 6 h (p < 0.001), 24 h (p < 0.001), 7 days (p < 0.001), and 90 days (p < 0.001), as well as cognitive functions evaluated by MoCA (26.23 ± 3.85 vs. 24.62 ± 2.25, p = 0.022, n = 85) and MMSE (26.65 ± 2.77 vs. 25.10 ± 2.36, p = 0.023, n = 85) compared to the standard therapy group. Conclusions: The current prospective study demonstrated that mechanical thrombectomy can significantly improve neurological and cognitive functions in patients with mild to moderate AIS at broadened therapeutic window under multimodal CT and multimodal MRI imaging.

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Section: Discussionsupporting

confidence: 92%

Cognitive Function and Prognosis of Multimodal Neuroimage-Guided Thrombectomy on Mild to Moderate Anterior Circulation Infarction Patients with Broadened Therapeutic Window: A Prospective Study

Xu¹,

Dong²,

Niu³

et al. 2017

Eur Neurol

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“…However, coping and other variables related to their adaptation to a diagnosis of stroke have not been studied [ 38 ]. In line with this, we found similar results regarding neurological outcomes and functional capacities to those obtained in the whole population studied in the REVASCAT [ 39 , 40 , 41 ], indicating that the variables analyzed in this study can be generalized to the totality of people with acute ischemic stroke currently treated with the EVT.…”

Section: Discussionsupporting

confidence: 86%

Coping Strategies, Quality of Life, and Neurological Outcome in Patients Treated with Mechanical Thrombectomy after an Acute Ischemic Stroke

Reverté-Villarroya

Dávalos

Font‐Mayolas

et al. 2020

IJERPH

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New reperfusion therapies have improved the clinical recovery rates of acute ischemic stroke patients (AISP), but it is not known whether other factors, such as the ability to cope, might also have an effect. The aim of this study was to evaluate the effect of endovascular treatment (EVT) on coping strategies, quality of life, and neurological and functional outcomes in AISP at 3 months and 1 year post-stroke. A multicenter, prospective, longitudinal, and comparative study of a sub-study of the participants in the Endovascular Revascularization with Solitaire Device versus Best Medical Therapy in Anterior Circulation Stroke within 8 Hours (REVASCAT) clinical trial was conducted after recruiting from two stroke centers in Catalonia, Spain. The cohort consisted of 82 ischemic stroke patients (n = 42 undergoing EVT and n = 40 undergoing standard best medical treatment (BMT) as a control group), enrolled between 2013–2015. We assessed the coping strategies using the Brief Coping Questionnaire (Brief-COPE-28), the health-related quality of life (HRQoL) with the EQ-5D questionnaire, and the neurological and functional status using the National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), modified Rankin Scale (mRS), and Stroke Impact Scale-16 (SIS-16). Bivariate analyses and multivariate linear regression models were used. EVT patients were the ones that showed better neurological and functional outcomes, and more patients presented reporting no pain/discomfort at 3 months; paradoxically, problem-focused coping strategies were found to be significantly higher in patients treated with BMT at 1 year.

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“…This observation adds to the notion that reducing the overall stroke burden such as through systemic thrombolysis or mechanical thrombectomy may reduce the risk for poststroke cognitive impairment. 38,39 In addition to infarct volume, location is another important predictor of outcome as suggested by earlier studies. Infarct in cortical location tend to predict poor outcomes.…”

Section: Discussionmentioning

confidence: 90%

Leukoaraiosis Predicts Short-term Cognitive But not Motor Recovery in Ischemic Stroke Patients During Rehabilitation

Khan

Heiser

Bernicchi

et al. 2019

Journal of Stroke and Cerebrovascular Diseases

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Background: Leukoaraiosis has been shown to impact functional outcomes after acute ischemic stroke. However, its association with domain specific recovery after ischemic stroke is uncertain. We sought to determine whether preexisting leukoaraiosis is associated with short term motor and cognitive recovery after stroke. Methods: We retrospectively studied ischemic stroke patients admitted to acute inpatient rehabilitation (AIR) between January 2013 and September 2015. Patient baseline characteristics, infarct volume, prestroke modified Rankin Scale, stroke cause, rehabilitation length of stay, and Functional Independence Measure (FIM) scores were recorded. Leukoaraiosis severity was graded on brain MRI using the Fazekas scale. Multiple linear regression was used to determine factors independently associated with the total, cognitive, and motor FIM scores at AIR discharge, respectively. Results: Of 1,600 ischemic stroke patients screened, 109 patients were included in the final analysis. After adjustment, the initial NIHSS (β −0.541, CI −0.993-−0.888; p=0.020) and preexisting leukoaraiosis severity (β −1.448, CI −2.861-−0.034; p=0.045) independently predicted the total FIM score. Domain specific analysis showed that infarct volume (β −0.012, CI −0.019-−0.005; p=0.002) and leukoaraiosis severity (β −0.822, CI −1.223-−0.410; p=0.0001) independently predicted FIM cognitive scores at discharge from AIR. Leukoaraiosis did not predict FIM motor score (p=0.17).

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Endovascular treatment improves cognition after stroke

Cited by 34 publications

References 15 publications

Cognitive Function and Prognosis of Multimodal Neuroimage-Guided Thrombectomy on Mild to Moderate Anterior Circulation Infarction Patients with Broadened Therapeutic Window: A Prospective Study

Cognitive Function and Prognosis of Multimodal Neuroimage-Guided Thrombectomy on Mild to Moderate Anterior Circulation Infarction Patients with Broadened Therapeutic Window: A Prospective Study

Coping Strategies, Quality of Life, and Neurological Outcome in Patients Treated with Mechanical Thrombectomy after an Acute Ischemic Stroke

Leukoaraiosis Predicts Short-term Cognitive But not Motor Recovery in Ischemic Stroke Patients During Rehabilitation

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