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Updated: Jul 20, 2026
A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
Shorter Reperfusion Time in Stroke is Associated with Better Cognition
Joana Costa Novo1, Evelyne Rieffel2, Guillermo Coca Velarde3
1Neurology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
Insights
Longer reperfusion times after stroke negatively impact cognitive function in patients treated with endovascular therapy (EVT). Faster EVT is crucial for preserving cognitive performance post-stroke.
Area of Science:
- Neurology
- Cerebrovascular Disease
- Cognitive Science
Background:
- Cerebrovascular disease significantly impairs cognitive function and quality of life.
- Endovascular therapy (EVT) is a critical treatment for acute ischemic stroke.
- Assessing cognitive function post-EVT is essential for understanding long-term outcomes.
Purpose of the Study:
- To evaluate cognitive function in patients undergoing EVT for acute right anterior circulation strokes.
- To determine the impact of reperfusion time on cognitive performance after EVT.
Main Methods:
- Retrospective study of patients with acute right anterior circulation strokes treated with EVT (Jan 2018-Aug 2020).
- Recanalization assessed using modified treatment in cerebral infarction (mTICI).
- Cognitive function evaluated using Addenbrooke's Cognitive Examination revised (ACE-R); association with reperfusion time analyzed via multiple linear regression.
Main Results:
- Successful recanalization (mTICI ≥ 2b) was achieved in all patients.
- Longer reperfusion time was inversely associated with ACE-R scores (P=0.0203).
- Higher modified Rankin Scale (mRS) scores at 3 months and lower education levels were also linked to poorer cognitive outcomes.
Conclusions:
- Extended time to recanalization in right hemisphere ischemic stroke patients undergoing EVT correlates with diminished cognitive function (lower ACE-R scores).
- Optimizing door-to-recanalization time is vital for improving cognitive outcomes after ischemic stroke.
- Further research into factors influencing cognitive recovery post-EVT is warranted.
Background:
Cognitive changes that result from cerebrovascular disease contribute to a poor functional outcome with reduced quality of life. Among patients undergoing endovascular therapy (EVT), we aim to assess cognitive function and evaluate the impact of reperfusion time in cognitive performance.
Methods:
Patients with acute right anterior circulation strokes that underwent EVT between January 2018 and August 2020 at Centro Hospitalar de Vila Nova de Gaia/Espinho, participated in the study. Modified treatment in cerebral infarction (mTICI) assessed the level of recanalization. Cognitive evaluation was assessed with Addenbrooke's Cognitive Examination revised (ACE-R). Multiple linear regression analyses were used to determine the association between time for recanalization and ACE-R. The level of significance adopted was 0.05.
Results:
The mean age of participants was 71.5 (interquartile range [IQR] 62.0-78.2) years, and 50% (22) were women. The median time after stroke was 28.6 months (IQR 18.94-31.55). All patients in our sample had a successful level of recanalization with EVT (mTICI ≥ 2b). Time for recanalization showed an inverse association with the ACE-R (b = -0.0207, P = 0.0203). Also the mRS at 3 months had an inverse association with cognition (b = -5.2803, p = 0.0095). Level of education had a strong and direct relationship with ACE-R results (b = 3.0869, p < 0.0001).
Conclusions:
Longer time between stroke symptoms and recanalization with EVT in patients with right hemisphere ischemic stroke lead to lower ACE-R scores. Measures to improve door-to-recanalization time are also important for cognitive performance after ischemic stroke.
