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Clinical Manifestations.

YongSoo Shim1, Yun Jeong Hong2, Bon D Ku3

  • 1College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of (South).

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
PubMed
Summary
This summary is machine-generated.

Amyloid plaques accelerate cognitive decline in post-stroke cognitive impairment (PSCI) patients. While donepezil offers temporary benefits, early amyloid detection is key for personalized PSCI management.

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Area of Science:

  • Neurology
  • Neuroscience
  • Gerontology

Background:

  • Post-stroke cognitive impairment (PSCI) affects 20-80% of stroke survivors.
  • Amyloid deposition, a hallmark of Alzheimer's disease, may worsen cognitive decline in PSCI.
  • This study examines the influence of amyloid plaques on cognitive deterioration in stroke patients.

Purpose of the Study:

  • To investigate the association between amyloid plaque presence and cognitive decline in patients with PSCI.
  • To evaluate the impact of amyloid deposition on cognitive test scores over a 12-month period.
  • To assess the efficacy of donepezil treatment in amyloid-positive PSCI patients.

Main Methods:

  • A multicenter prospective observational cohort study of 192 acute ischemic stroke patients with cognitive impairment.
  • Participants were categorized into amyloid-positive (n=40) and amyloid-negative (n=152) groups via PET scans.
  • Cognitive function assessed using MMSE and MoCA over 12 months; some received donepezil.

Main Results:

  • Amyloid-positive patients exhibited lower baseline MMSE scores (19.03±6.30 vs. 21.52±5.56, p=0.016).
  • After 12 months, amyloid-positive group showed less MMSE improvement (19.48±6.70 vs. 23.28±5.47, p=0.032) and worsening CDR-SOB scores (4.31±3.46 vs. 2.63±2.82, p=0.051).
  • Donepezil provided transient cognitive benefits in amyloid-positive patients within the first 6 months.

Conclusions:

  • Amyloid plaque presence correlates with accelerated cognitive decline in PSCI, indicated by lower MMSE and worsening CDR-SOB.
  • Donepezil demonstrates short-term efficacy, but its long-term impact on cognitive function in this cohort is limited.
  • Early identification of amyloid deposition is crucial for developing tailored therapeutic strategies for effective PSCI management.