POST-STROKE COGNITIVE IMPAIRMENT: A SYSTEMATIC REVIEW OF DISEASE PROGRESSION MODELS

2018 ◽  
Author(s):  
Anne Hickey
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Disease Progression ◽  
Post Stroke

scholarly journals Potential Biomarkers for Post-Stroke Cognitive Impairment: A Systematic Review and Meta-Analysis

2022 ◽  
Vol 23 (2) ◽  
pp. 602
Author(s):  
Ka Young Kim ◽  
Ki Young Shin ◽  
Keun-A Chang
Keyword(s):  
Systematic Review ◽  
Uric Acid ◽  
Cognitive Impairment ◽  
Meta Analysis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cochrane Library ◽  
Blood Proteins ◽  
Post Stroke

Stroke is a primary debilitating disease in adults, occurring in 15 million individuals each year and causing high mortality and disability rates. The latest estimate revealed that stroke is currently the second leading cause of death worldwide. Post-stroke cognitive impairment (PSCI), one of the major complications after stroke, is frequently underdiagnosed. However, stroke has been reported to increase the risk of cognitive impairment by at least five to eight times. In recent decades, peripheral blood molecular biomarkers for stroke have emerged as diagnostic, prognostic, and therapeutic targets. In this study, we aimed to evaluate some blood-derived proteins for stroke, especially related to brain damage and cognitive impairments, by conducting a systematic review and meta-analysis and discussing the possibility of these proteins as biomarkers for PSCI. Articles published before 26 July 2021 were searched in PubMed, Embase, the Web of Science, and the Cochrane Library to identify all relevant studies reporting blood biomarkers in patients with stroke. Among 1820 articles, 40 were finally identified for this study. We meta-analyzed eight peripheral biomarker candidates: homocysteine (Hcy), high-density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), uric acid, and glycated hemoglobin (HbA1c). The Hcy, CRP, TC, and LDL-C levels were significantly higher in patients with PSCI than in the non-PSCI group; however, the HDL-C, TG, uric acid, and HbA1c levels were not different between the two groups. Based on our findings, we suggest the Hcy, CRP, TC, and LDL-C as possible biomarkers in patients with post-stroke cognitive impairment. Thus, certain blood proteins could be suggested as effective biomarkers for PSCI.

scholarly journals 167Prevalence of Cognitive Impairment no Dementia (CIND) Post-Stroke: Systematic Review and Meta-analysis

2018 ◽  
Vol 47 (suppl_5) ◽  
pp. v13-v60
Author(s):  
Eithne Sexton ◽  
Niamh Merriman ◽  
Affraic McLoughlin ◽  
Nora Donnelly ◽  
Daniela Rohde ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Meta Analysis ◽  
Post Stroke ◽  
Cognitive Impairment No Dementia

scholarly journals Cognitive rehabilitation interventions after stroke: protocol for a systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Qing Zhao ◽  
Xue Wang ◽  
Tao Wang ◽  
Adam A. Dmytriw ◽  
Xiao Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Cognitive Impairment ◽  
Randomized Controlled Trials ◽  
Cognitive Rehabilitation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Post Stroke ◽  
Randomized Controlled

Abstract Background Stroke is the second leading cause of death worldwide, and 53.4% of stroke survivors suffer from post-stroke cognitive impairment. Post-stroke cognitive impairment can increase hospitalization rate and cost of care and decrease the quality of life of stroke patients. To date, multiple cognitive rehabilitation interventions have been tested in stroke populations with post-stroke cognitive impairment. However, the most efficacious intervention has not been established. This systematic review aims to compare the efficacy of cognitive rehabilitation interventions for patients with post-stroke cognitive impairment. Methods We will search MEDLINE, EMBASE, CENTRAL, PsycINFO, CINAHL, PubMed, and clinical trial registries to identify eligible randomized clinical trials with no restrictions in the date of publication and language. Studies conducted with patients aged 18 or over, with the presence of cognitive impairment after being diagnosed with stroke will be included. Studies will be restricted to randomized controlled trials comparing a cognitive rehabilitation intervention with another intervention. The primary outcome is any clinical changes in the general or specific cognitive domain (e.g., executive function, attention, memory, or perception). The secondary outcomes that will be collected include adverse effects (e.g., stroke, disability, or mortality) and quality of life. Two independent reviewers will assess articles to identify trials eligible for inclusion. Data extraction and risk of bias assessment of the included studies will also be done independently. Any discrepancies will be solved by discussion, or a third reviewer will be consulted if necessary. A meta-analysis will be carried out if appropriate. Discussion This systematic review for patients with post-stroke cognitive impairment will assess the efficacy of cognitive rehabilitation interventions. And our results will help clinical decision-making and support the development of clinical practice guidelines. Trial registration Systematic review registration: PROSPERO CRD42020173988

scholarly journals Systematic review and meta-analysis of the effect of cognitive impairment on the risk of admission to long-term care after stroke

2020 ◽  
Vol 3 ◽  
pp. 28 ◽  
Author(s):  
Jefrey Shumba ◽  
Affraic McLoughlin ◽  
Lamorna Browne ◽  
Alenka Schmid ◽  
Maev-Ann Wren ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Functional Impairment ◽  
Odds Ratio ◽  
Long Term Care ◽  
Meta Analysis ◽  
Standard Form ◽  
Term Care ◽  
Post Stroke

Introduction: Admission to long-term care (LTC) post-stroke can be a significant source of costs. Studies evaluating the effect of cognitive impairment (CI) and dementia on risk of LTC admission post-stroke have not been systematically reviewed. The aim of this paper was to conduct a systematic review and meta-analysis of studies of the association between post-stroke CI/dementia and admission to LTC. Patients and methods: PubMed, PsycInfo and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched for peer-review articles in English published January 2000-June 2018. Included studies were population-based or hospital-based studies assessing the relationship between CI or dementia, and admission to LTC post-stroke. Abstracts were screened, followed by full-text review of potentially relevant articles. Relevant data was extracted using a standard form and the Crowe Critical Appraisal Tool was used for quality appraisal. Results were pooled using random-effects meta-analysis and heterogeneity was assessed using the I² statistic. Results: 18 articles were included in the review and 12 in a meta-analysis. 14/18 studies adjusted for covariates including functional impairment. Increased odds of admission to LTC was associated with post-stroke CI [Odds Ratio (CI 95%): 2.36 (1.18, 4.71), I²=77%] and post-stroke dementia [Odds Ratio (CI 95%): 2.58 (1.38 to 4.82), I²=60%]. Discussion and conclusion: Post-stroke CI and dementia increase odds of admission to LTC post-stroke, independent of functional impairment. This indicates the potential for interventions that reduce post-stroke CI and dementia to also reduce risk of admission to LTC post-stroke, and ultimately costs.

scholarly journals The Effect of Non-Invasive Brain Stimulation (NIBS) on Attention and Memory Function in Stroke Rehabilitation Patients: A Systematic Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 227
Author(s):  
Takatoshi Hara ◽  
Aturan Shanmugalingam ◽  
Amanda McIntyre ◽  
Amer M. Burhan
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Brain Stimulation ◽  
Meta Analysis ◽  
Attention And Memory ◽  
Post Stroke ◽  
Non Invasive ◽  
Stimulation Parameters ◽  
Global Cognition ◽  
Attention Memory

Background: In recent years, the potential of non-invasive brain stimulation (NIBS) for therapeutic effects on cognitive functions has been explored for populations with stroke. There are various NIBS methods depending on the stimulation site and stimulation parameters. However, there is no systematic NIBS review of post-stroke cognitive impairment with a focus on stimulation sites and stimulation parameters. The purpose of this study is to conduct a systematic review and meta-analysis on effectiveness and safety of NIBS for cognitive impairment after a stroke to obtain new insights. This study was prospectively registered with the PROSPERO database of systematic reviews (CRD42020183298). Methods: All English articles from MEDLINE, Scopus, CINAHL, Embase, PsycINFO, and CENTRAL were searched from inception up to 31 December 2020. Randomized and prospective controlled trials were included for the analysis. Studies with at least five individuals post-stroke, whereby at least five sessions of NIBS were provided and using standardized neuropsychological measurement of cognition, were included. We assessed the methodological quality of selected studies as described in the Physiotherapy Evidence Database (PEDro) scoring system. Results: A total of 10 studies met eligibility criteria. Six studies used repetitive transcranial magnetic stimulation (rTMS) and four studies used transcranial direct current stimulation (tDCS). The pooled sample size was 221 and 196 individuals who received rTMS and tDCS respectively. Eight studies combined general rehabilitation, cognitive training, or additional therapy with NIBS. In rTMS studies, target symptoms included global cognition (n = 4), attention (n = 3), memory (n = 4), working memory (WM) (n = 3), and executive function (n = 2). Five studies selected the left dorsolateral prefrontal cortex (DPLFC) as the stimulation target. One rTMS study selected the right DLPFC as the inhibitory stimulation target. Four of six studies showed significant improvement. In tDCS studies, target symptoms included global cognition (n = 2), attention (n = 4), memory (n = 2) and WM (n = 2). Three studies selected the frontal area as the stimulation target. All studies showed significant improvement. In the meta-analysis, rTMS showed a significant effect on attention, memory, WM and global cognition classified by neuropsychological tests. On the other hand, tDCS had no significant effect. Conclusions: In post-stroke patients with deficits in cognitive function, including attention, memory, and WM, NIBS shows promising positive effects. However, this effect is limited, suggesting that further studies are needed with more precision in stimulation sites and stimulation parameters. Future studies using advanced neurophysiological and neuroimaging tools to allow for a network-based approach to treat cognitive symptoms post-stroke with NIBS are warranted.

scholarly journals Addressing cognitive impairment following stroke: systematic review and meta-analysis of non-randomised controlled studies of psychological interventions

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e024429 ◽  
Author(s):  
Niamh A Merriman ◽  
Eithne Sexton ◽  
Grainne McCabe ◽  
Mary E Walsh ◽  
Daniela Rohde ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Psychological Interventions ◽  
Post Stroke ◽  
Randomised Controlled

ObjectiveCognitive impairment is a pervasive outcome of stroke, reported in over half of patients 6 months post-stroke and is associated with increased disability and a poorer quality of life. Despite the prevalence of post-stroke cognitive impairment, the efficacy of existing psychological interventions for the rehabilitation of cognitive impairment following stroke has yet to be established. The aim of this study is to identify psychological interventions from non-randomised studies that intended to improve post-stroke cognitive function and establish their efficacy.DesignSystematic review and meta-analysis of non-randomised studies of psychological interventions addressing post-stroke cognitive impairment.Data sourcesElectronic searches were performed in the Pubmed, EMBASE and PsycINFO databases, the search dating from inception to February 2017.Eligibility criteriaAll non-randomised controlled studies and quasi-randomised controlled trials examining psychological interventions to improve cognitive function following stroke were included, such as feasibility studies, pilot studies, experimental studies, and quasi-experimental studies. The primary outcome was cognitive function. The prespecified secondary outcomes were functional abilities in daily life and quality of life.MethodsThe current meta-analyses combined the findings of seven controlled studies, examining the efficacy of psychological interventions compared with treatment-as-usual controls or active controls, and 13 one-group pre–post studies.ResultsResults indicated an overall small effect on cognition across the controlled studies (Hedges' g=0.38, 95% CI=0.06 to 0.7) and a moderate effect on cognition across the one-group pre–post studies (Hedges' g=0.51, 95% CI=0.3 to 0.73). Specific cognitive domains, such as memory and attention also demonstrated a benefit of psychological interventions.ConclusionsThis review provides support for the potential of psychological interventions to improve overall cognitive function post-stroke. Limitations of the study, in terms of risk of bias and quality of included studies, and future research directions are explored.PROSPERO registration numberCRD42017069714.

scholarly journals Scalp acupuncture for post-stroke cognitive impairment: A systematic review and meta-analysis

IBRO Reports ◽  
2019 ◽  
Vol 6 ◽  
pp. S442
Author(s):  
Hui Zhang ◽  
Michelle Park ◽  
Yongmei Yan ◽  
Mikala C. Osani ◽  
Raveendhara R. Bannuru ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Meta Analysis ◽  
Scalp Acupuncture ◽  
Post Stroke
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