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Are we ready to cure post-stroke cognitive impairment? Many key prerequisites can be achieved quickly and easily

dc.rights.licenseopenen_US
dc.contributor.authorGODEFROY, Olivier
dc.contributor.authorAARABI, Ardalan
dc.contributor.authorBEJOT, Yannick
dc.contributor.authorBIESSELS, Geert Jan
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorGLIZE, Bertrand
ORCID: 0000-0001-9618-2088
IDREF: 178853267
dc.contributor.authorMOK, Vincent Ct
hal.structure.identifierInstitut des Maladies Neurodégénératives [Bordeaux] [IMN]
dc.contributor.authorSCHOTTEN, Michel Thiebaut De
dc.contributor.authorSIBON, Igor
dc.contributor.authorCHABRIAT, Hugues
dc.contributor.authorROUSSEL, Martine
dc.date.accessioned2024-10-12T09:10:20Z
dc.date.available2024-10-12T09:10:20Z
dc.date.issued2024-08-11
dc.identifier.issn2396-9881en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/202457
dc.description.abstractEnPURPOSE: Post-stroke (PS) cognitive impairment (CI) is frequent and its devastating functional and vital consequences are well known. Despite recent guidelines, they are still largely neglected. A large number of recent studies have re-examined the epidemiology, diagnosis, imaging determinants and management of PSCI. The aim of this update is to determine whether these new data answer the questions that are essential to reducing PSCI, the unmet needs, and steps still to be taken. METHODS: Literature review of stroke unit-era studies examining key steps in the management of PSCI: epidemiology and risk factors, diagnosis (cognitive profile and assessments), imaging determinants (quantitative measures, voxelwise localization, the disconnectome and associated Alzheimer's disease [AD]) and treatment (secondary prevention, symptomatic drugs, rehabilitation and noninvasive brain stimulation) of PSCI. FINDINGS: (1) the prevalence of PSCI of approximately 50% is probably underestimated; (2) the sensitivity of screening tests should be improved to detect mild PSCI; (3) comprehensive assessment is now well-defined and should include apathy; (4) easily available factors can identify patients at high risk of PSCI; (5) key imaging determinants are the location and volume of the lesion and the resulting disconnection, associated AD and brain atrophy; WMH, ePVS, microhemorrhages, hemosiderosis, and cortical microinfarcts may contribute to cognitive impairment but are more likely to be markers of brain vulnerability or associated AD that reduce PS recovery; (6) remote and online assessment is a promising approach for selected patients; (7) secondary stroke prevention has not been proven to prevent PSCI; (8) symptomatic drugs are ineffective in treating PSCI and apathy; (9) in addition to cognitive rehabilitation, the benefits of training platforms and computerized training are yet to be documented; (10) the results and the magnitude of improvement of noninvasive brain stimulation, while very promising, need to be substantiated by large, high-quality, sham-controlled RCTs. DISCUSSION AND CONCLUSION: These major advances pave the way for the reduction of PSCI. They include (1) the development of more sensitive screening tests applicable to all patients and (2) online remote assessment; crossvalidation of (3) clinical and (4) imaging factors to (5) identify patients at risk, as well as (6) factors that prompt a search for associated AD; (7) the inclusion of cognitive outcome as a secondary endpoint in acute and secondary stroke prevention trials; and (8) the validation of the benefit of noninvasive brain stimulation through high-quality, randomized, sham-controlled trials. Many of these objectives can be rapidly and easily attained.
dc.language.isoENen_US
dc.subject.enAlzheimer’s Disease
dc.subject.enStroke
dc.subject.enDementia
dc.subject.enExecutive Functions
dc.subject.enLesion Symptom Mapping
dc.subject.enMild Cognitive Impairment
dc.title.enAre we ready to cure post-stroke cognitive impairment? Many key prerequisites can be achieved quickly and easily
dc.title.alternativeEur Stroke Jen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1177/23969873241271651en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed39129252en_US
bordeaux.journalEuropean Stroke Journalen_US
bordeaux.page23969873241271651en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.institutionCNRS
bordeaux.teamACTIVE_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exportfalse
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=European%20Stroke%20Journal&rft.date=2024-08-11&rft.spage=23969873241271651&rft.epage=23969873241271651&rft.eissn=2396-9881&rft.issn=2396-9881&rft.au=GODEFROY,%20Olivier&AARABI,%20Ardalan&BEJOT,%20Yannick&BIESSELS,%20Geert%20Jan&GLIZE,%20Bertrand&rft.genre=article


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