چکیده:
Introduction: Post-stroke cognitive impairment (PSCI) frequently complicates ischemic stroke yet remains underrecognized, particularly in middle-aged populations where early outcome data are limited.
Methods: This cross-sectional study enrolled patients aged 40–65 years with first-ever mild-to-moderate ischemic stroke (NIHSS ≤15) from 2023–2025. Diagnosis followed AHA criteria, confirmed by MRI (DWI and 3D FLAIR). Inclusion required literacy and fluency in Azari or Persian. Exclusions comprised prior stroke, major neuropsychiatric disorders, severe systemic disease, aphasia, or dominant hand motor deficits. Screening occurred in three phases: demographic collection, hyperacute assessment (≤24 hours: RASS, CAM-ICU, PHQ-2, Mini-MoCA), and acute stroke unit assessment (days 3-7) using MoCA. Mood, functional status, neurological findings, vascular risk factors, and biomarkers (routine profile, IGF-1, IL-6, quantitative CRP) were evaluated.
Results: From 1,543 screened patients, 83 comprised the final cohort. PSCI prevalence was 72.3% (n=60). Demographics were similar between groups. PSCI patients demonstrated significantly lower MoCA scores (22.7±1.88 vs. 26.61±0.96, p < 0.001), with deficits across multiple domains. Combined left-sided limb weakness was more frequent in PSCI patients (50.0% vs. 17.3%, p = 0.031). Left hemisphere lesions predominated in the PSCI group (p = 0.016). Biomarker levels did not differ between groups; however, correlation analysis showed poor glycemic control negatively associated with MoCA scores, IGF-1 positively associated with cognition/attention, and IL-6 inversely associated with language.
Conclusions: PSCI is highly prevalent within the first week post-stroke in middle-aged patients. Lesion topography, particularly left hemisphere involvement, and metabolic-inflammatory markers significantly influence cognitive profiles. Early screening integrating these factors may enhance risk stratification and targeted rehabilitation.
Methods: This cross-sectional study enrolled patients aged 40–65 years with first-ever mild-to-moderate ischemic stroke (NIHSS ≤15) from 2023–2025. Diagnosis followed AHA criteria, confirmed by MRI (DWI and 3D FLAIR). Inclusion required literacy and fluency in Azari or Persian. Exclusions comprised prior stroke, major neuropsychiatric disorders, severe systemic disease, aphasia, or dominant hand motor deficits. Screening occurred in three phases: demographic collection, hyperacute assessment (≤24 hours: RASS, CAM-ICU, PHQ-2, Mini-MoCA), and acute stroke unit assessment (days 3-7) using MoCA. Mood, functional status, neurological findings, vascular risk factors, and biomarkers (routine profile, IGF-1, IL-6, quantitative CRP) were evaluated.
Results: From 1,543 screened patients, 83 comprised the final cohort. PSCI prevalence was 72.3% (n=60). Demographics were similar between groups. PSCI patients demonstrated significantly lower MoCA scores (22.7±1.88 vs. 26.61±0.96, p < 0.001), with deficits across multiple domains. Combined left-sided limb weakness was more frequent in PSCI patients (50.0% vs. 17.3%, p = 0.031). Left hemisphere lesions predominated in the PSCI group (p = 0.016). Biomarker levels did not differ between groups; however, correlation analysis showed poor glycemic control negatively associated with MoCA scores, IGF-1 positively associated with cognition/attention, and IL-6 inversely associated with language.
Conclusions: PSCI is highly prevalent within the first week post-stroke in middle-aged patients. Lesion topography, particularly left hemisphere involvement, and metabolic-inflammatory markers significantly influence cognitive profiles. Early screening integrating these factors may enhance risk stratification and targeted rehabilitation.
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