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Cerebral hemodynamics and cognitive functions in the acute and subacute stage of mild ischemic stroke: a longitudinal pilot study

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Abstract

The association between cerebral hemodynamics and cognitive impairment has been reported in neurodegenerative and cerebrovascular disorders (CVD). However, it is still unclear whether changes occur in the acute phase of CVD. Here we investigated cognitive and hemodynamic parameters and their association in patients with CVD during the acute and subacute phases. Seventy-three patients with mild stroke, not undergoing endovascular treatment, were recruited. All subjects were devoid of intracranial or external carotid stenosis, significant chronic cerebrovascular pathology, dementia or non-compensated cardiovascular diseases. Patients were evaluated within 7 days from symptoms onset (T1) and after 3 months (T2). Clinical and demographic data were collected. NIHSS, MoCA, FAB, and Word-Color Stroop test (WCST) were used to evaluate disease severity and cognitive functions. Basal hemodynamic parameters in the middle cerebral artery were measured with transcranial Doppler. Differences between T2 and T1, correlations between cognitive and hemodynamic variables at T1 and T2, as well as correlations between the T2-T1 variation in cognitive and hemodynamic parameters were assessed. At T1, cognitive performance of MoCA, FAB, and WCST was lower compared with T2; and pulsatility index, a parameter reflecting distal vascular resistance, was higher. However, no correlations between the changes in cognitive and hemodynamic variables were found; therefore, the two seems to be independent phenomena. In the acute phase, the linear association between cerebral blood flow and cognitive performances was lost, probably due to a differential effect of microenvironment changes and vascular-specific phenomena on cognition and cerebral hemodynamics. This relationship was partially restored in the subacute phase.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Via Di Grottarossa, 1035–00189, Rome, Italy

    Michela Sforza, Edoardo Bianchini, Diletta Alivernini, Valentina Teresi, Irene Madonia, Marco Salvetti, Francesco E. Pontieri & Giuliano Sette

  2. Sant’Andrea University Hospital, Rome, Italy

    Michela Sforza, Edoardo Bianchini, Alessandra Spalloni, Valentina Teresi, Irene Madonia, Marco Salvetti, Francesco E. Pontieri & Giuliano Sette

  3. INM Neuromed IRCCS, Pozzilli, IS, Italy

    Marco Salvetti

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Contributions

Conceptualization, Michela Sforza, Edoardo Bianchini and Giuliano Sette; methodology, Michela Sforza and Giuliano Sette; formal analysis, Edoardo Bianchini.; participants recruitment, Michela Sforza, Edoardo Bianchini and Diletta Alivernini; investigation, Michela Sforza, Diletta Alivernini, Alessandra Spalloni, Valentina Teresi, Irene Madonia, and Giuliano Sette; data curation, Michela Sforza and Edoardo Bianchini; writing—original draft preparation, Michela Sforza and Edoardo Bianchini; writing—review and editing, Diletta Alivernini, Alessandra Spalloni, Valentina Teresi, Irene Madonia, Marco Salvetti, Francesco E. Pontieri, and Giuliano Sette; supervision, Francesco E. Pontieri and Giuliano Sette. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Giuliano Sette.

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Ethical approval was granted by the Local Ethical Committee of Sapienza University of Rome (Ref. CE 6584_2021). The study was conducted in accordance with the Declaration of Helsinki and its later amendments. Data collection and processing followed the current European regulation for data protection.

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Written informed consent was obtained from all individual participants included in the study.

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Michela Sforza and Edoardo Bianchini contributed equally to the work and share co-first authorship.

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Sforza, M., Bianchini, E., Alivernini, D. et al. Cerebral hemodynamics and cognitive functions in the acute and subacute stage of mild ischemic stroke: a longitudinal pilot study. Neurol Sci 45, 2097–2105 (2024). https://doi.org/10.1007/s10072-023-07260-3

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