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Present study aims to track the post-stroke cognitive trajectories and to investigate its inter-individual variability.
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.
Analyses of the longitudinal dataset, including follow-up assessments up to 36 months post-stroke, indicated an attrition rate of up to 50%, partly attributable to post-stroke mortality. This level of attrition resulted in a substantial reduction in effective sample size and, consequently, insufficient statistical power for the planned prediction models and independent validation analyses. In particular, the reduced number of complete cases limited the robustness and generalizability of the findings. Therefore, following a recruitment pause on 02.10.2023, patient recruitment was resumed on 05.08.2025 after securing additional funding and dedicated study personnel to ensure adequate sample size for model development and validation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Stroke patients | Adults with first-ever anterior circulation stroke |
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| 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 |
| 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. |
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Inclusion Criteria:
Exclusion Criteria:
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The study recuits patients hospitalized at the Department of Neurology of the University Hospital of Bern (Inselspital)
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Roza M. Umarova, PD Dr. | Contact | +41316327000 | roza.umarova@insel.ch | |
| Laura Gallucci, MSc | Contact | +41316641506 | laura.gallucci@extern.insel.ch |
| Name | Affiliation | Role |
|---|---|---|
| Roza M. Umarova, PD Dr. | Department of Neurology, Inselspital, University Hospital Bern, University of Bern | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Neurology, Inselspital, University Hospital Bern, University of Bern | Recruiting | Bern | 3010 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28049565 | Background | Umarova RM. Adapting the concepts of brain and cognitive reserve to post-stroke cognitive deficits: Implications for understanding neglect. Cortex. 2017 Dec;97:327-338. doi: 10.1016/j.cortex.2016.12.006. Epub 2016 Dec 16. | |
| 39209968 | Derived | Gallucci L, Sperber C, Monsch AU, Kloppel S, Arnold M, Umarova RM. Improving diagnostic accuracy of the Montreal Cognitive Assessment to identify post-stroke cognitive impairment. Sci Rep. 2024 Aug 29;14(1):20125. doi: 10.1038/s41598-024-71184-x. |
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| ID | Term |
|---|---|
| D000083242 | Ischemic Stroke |
| ID | Term |
|---|---|
| D020521 | Stroke |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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Serum, plasma
| 10 days post-stroke, 3 months, 12 months and at 36 months post-stroke |
| D009422 |
| Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |