Post-stroke Cognitive Impairment

Study Overview
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Brief Summary
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Present study aims to track the post-stroke cognitive trajectories and to investigate its inter-individual variability.

Detailed Description
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The study aim is to establish a model capturing patients' inter-individual variability in susceptibility to stroke damage to predict stroke-induced cognitive trajectories. This is a prospective longitudinal observational national monocentric study for 6 years (recruitment during the first 3 years). The investigators perform comprehensive neuropsychological testing in i) acute stroke phase (0-10 days post-stroke), ii) sub-acute stroke phase (3 months post-stroke), and iii) chronic stroke phase (12 months and 3 years post-stroke). At each time point, cognitive performances as well as clinical and functional status will be assessed. Furthermore, the investigators will assess the proxies of cognitive reserve and the level of post-stroke physical activity.

Official Title
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Prediction of Post-stroke Cognitive Decline and Dementia: Impact of Cognitive Reserve and Post-stroke Life Style

Conditions
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First-ever Ischemic Stroke, Cognitive Performance

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥18 years old First-ever anterior circulation ischemic stroke confirmed by routine MRI Time of enrollment: ≤ 10 days from stroke onset. Exclusion Criteria: Previous stroke anamnestic or based on clinical imaging Additional stroke in posterior circulation Conditions that preclude the cognitive testing (e.g. delirium, intubation, reduced vigilance Neurological or psychiatric conditions that preclude the data interpretation (e.g. pre-stroke dementia, schizophrenia, brain tumor, regular intake of benzodiazepine, depression) MRI contraindication Native language other than German, French or Italian

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Stroke patients<br>Adults with first-ever anterior circulation stroke | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants with delayed cognitive deterioration (DCD) | The investigators will assess number of participants with deterioration of the cognitive performance in ≥2 cognitive domains on ≥ 1 Standard Deviation (1 SD). | at 3 months, at 12 months and at 36 months post-stroke | 
| Number of participants with delayed functional deterioration | The investigators will assess number of participants with deterioration of functional disability will be defined as decrease in disability level to one point assessed via modified Rankin Scale (mRS, 0-6, whereas 0=no functional disability). | at 3 months, at 12 months and at 36 months post-stroke | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants with post-stroke cognitive impairment | The investigators will assess number of participants with post-stroke cognitive impairment that is defined as at least moderate deficit (performance below -1.5 SD) in ≥ 2 cognitive domains. The cognitive performance across all basic cognitive domains is assessed using a standardized neuropsychological test battery with available normative data. The test battery includes tests from Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Trail Making Test A + B, verbal fluency, alertness test, digit span (forward and backward), Bells test, and Montreal Cognitive Assessment. | 10 days post-stroke, 3 months, 12 months and at 36 months post-stroke | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ischemic stroke, Cognitive reserve