Welcome to the WSC 2021 Interactive Program

Abstract Body

Approximately half of people with an ischemic stroke experience cognitive impairment. In my presentation I will provide an overview of known predictors of post-stroke cognitive impairment (PSCI) and I will summarize the results of a study¹ in which we evaluated infarct location as a potential determinant of PSCI and used lesion location information to develop a prediction model.

For our study we pooled and harmonized individual patient data (n=2950) from 12 cohorts through the Meta-analyses on Strategic Lesion Locations for Vascular Cognitive Impairment using Lesion-Symptom Mapping consortium (https://metavcimap.org/ ). Voxel-based lesion-symptom mapping (VLSM) was used to calculate voxel-wise odds ratios for PSCI that were mapped onto a three-dimensional brain template. In the pooled sample of 2950 patients, 1286 (43.6%) had PSCI. Brain lesion coverage was 86.9%. Infarcts in the left frontotemporal lobes, left thalamus, and right parietal lobe were strongly associated with PSCI (voxel-wise ORs >20).

For prediction of PSCI risk, a location impact score on a 5-point scale was derived from the VLSM results. The location impact score showed good correspondence on cross-validation across cohorts and by itself proved to have similar performance to a combined model with other PSCI predictors, while allowing for easy visual assessment.

Next steps are to fully integrate lesion location information with other measures of brain injury and resilience and personal factors that relate to PSCI risk, to come to an optimal personalized prediction of PSCI.

1 published in The Lancet Neurology; https://doi.org/10.1016/S1474-4422(21)00060-0