Abstract
BackgroundReliable and acceptable biomarkers are needed to anticipate the outcome and cognitive impairment following ischemic stroke. The goal of this research is to examine the association of ASPECTS with cognitive decline, biomarkers of stroke, and acute ischemic stroke outcomes. This study included 120 patients with ischemic stroke in the middle cerebral artery region. The initial NIHSS, non-contrast CT brain assessed by ASPECTS, and the biomarkers of cognitive decline such as ESR, CRP, S100B, MMP9, and glutamate were investigated. The Montreal Cognitive Assessment and modified Rankin scale (mRS) were evaluated after 3 months. Correlations between ASPECTS, MoCA, biomarkers of cognitive impairment, and mRS were done by Spearman correlation.ResultsThe incidence of cognitive impairment in our patients was 25.8%. Stroke biomarkers (ESR, CRP, S100B, MMP9, and glutamate) were significantly increased in cognitively disabled individuals with significantly lower mean MoCA scores than in cognitively intact patients. There was a strong direct correlation linking the initial ASPECTS and total MoCA test score after 3 months follow-up. Cases with unfavorable outcomes were older, more incidence of hypertension, and had higher average initial NIHSS (P < 0.05). While the average ASPECTS scores for the favorable outcome group of patients were significantly higher and there was a significant negative correlation between the initial ASPECTS and modified Rankin Scale score.ConclusionsASPECTS is a reliable scale to identify the extent of acute ischemic injury and could participate in assessing the outcome. ASPECTS and particular neurocognitive stroke biomarkers will enable the early detection of post-stroke cognitive impairment.Trial registration Registration of Clinical Trial Research: ClinicalTrials.gov ID: NCT04235920
Highlights
Reliable and acceptable biomarkers are needed to anticipate the outcome and cognitive impairment following ischemic stroke
Initial National Institutes of Health Stroke Scale (NIHSS), and Alberta Stroke Program Early Computed Tomography Score (ASPECTS) of ischemic stroke patients One hundred and twenty patients were included in our research study, 63 males (52.5%) and 57 females (47.5%) with an average age of 62.68 ± 12.4
ASPECTS, stroke severity and the outcome of acute ischemic stroke In our research, the ASPECTS score showed a negative relationship with the initial NIHSS that was close to the findings of David et al 2005 reported a strong, linear, inverse relationship linking the initial NIHSS and ASPECTS; and each increase of ten points on initial NIHSS accompanied by a decrease of around 3 points on ASPECTS [26]
Summary
Reliable and acceptable biomarkers are needed to anticipate the outcome and cognitive impairment following ischemic stroke. The goal of this research is to examine the association of ASPECTS with cognitive decline, biomarkers of stroke, and acute ischemic stroke outcomes. The initial NIHSS, non-contrast CT brain assessed by ASPECTS, and the biomark‐ ers of cognitive decline such as ESR, CRP, S100B, MMP9, and glutamate were investigated. Correlations between ASPECTS, MoCA, biomarkers of cognitive impairment, and mRS were done by Spearman correlation. Strokes are known to be the third most frequent cause of death after cardiac and neoplastic disorders [1]. With regard to adequate assessment in patients with acute ischemic stroke, brain CT is an easy, effective, appropriate and affordable tool [3]. The availability of the non-contrast CT brain to the initial evaluation makes it an effective neuroimaging marker to evaluate acute care outcomes [4, 5]
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