Plasma Cluster of Differentiation 147 and Cognitive Impairment After Acute Ischemic Stroke

 Describing this problem DOES NOTHING TO PREVENT COGNITIVE IMPAIRMENT! I'd have everyone involved fired for incompetence in not knowing that the only goal of survivors IS RECOVERY!

Check how long incompetence has prevailed in NOT SOLVING THE PROBLEM!

• 24 to 70% post-stroke cognitive impairment (3 posts to November 2019)
• 50% cognitive impairment (3 posts to September 2021)
• cognitive impairment (171 posts to October 2014)

Plasma Cluster of Differentiation 147 and Cognitive Impairment After Acute Ischemic Stroke

Wenyu Zhao, MD https://orcid.org/0009-0000-8887-130X, Lulu Sun, MD, Jiaxin Zan, MD, Xuefen Zheng, MD https://orcid.org/0009-0009-1617-0892, Jinhuan Zhou, MD https://orcid.org/0009-0009-3197-1225, Xinyu Yang, MD https://orcid.org/0009-0008-4670-3605, Yonghong Zhang, MD, PhD https://orcid.org/0000-0001-6188-3490, Mengyao Shi, MD, PhD https://orcid.org/0000-0002-5883-0416 myshi@suda.edu.cn, and Tan Xu, MD, PhD 

Abstract

Background

Cluster of differentiation 147 (CD147) is a multifunctional transmembrane glycoprotein, but its effect on poststroke cognitive impairment (PSCI) is unclear.

Methods

The current study included 612 patients with ischemic stroke with plasma CD147 levels from a preplanned ancillary study of CATIS (China Antihypertensive Trial in Acute Ischemic Stroke). Mini‐Mental State Examination and Montreal Cognitive Assessment were used to evaluate cognitive function at the 3‐month follow‐up visit. PSCI was defined as a score of <27 for Mini‐Mental State Examination or <25 for Montreal Cognitive Assessment. Logistic regression models and restricted cubic spline analyses were used to assess the associations between CD147 and PSCI.

Results

As defined by Mini‐Mental State Examination, 317 participants developed PSCI. After multivariate adjustment, elevated plasma CD147 levels were significantly associated with higher odds of PSCI (odds ratio, 1.75 [95% CI, 1.21–2.51]). Multiple‐adjusted spline regression model showed a linear association between plasma CD147 level and PSCI (P for linearity=0.038). Furthermore, adding plasma CD147 to conventional risk factors improved the discriminatory power (C statistics, 0.695 versus 0.711; P=0.047). Similar findings were observed when PSCI was defined by the Montreal Cognitive Assessment.

Conclusions

Elevated plasma CD147 levels at admission were associated with higher odds of cognitive impairment at 3 months after stroke among patients with acute ischemic stroke, suggesting its potential role in the pathophysiological processes of PSCI.

Registration

URL: https://clinicaltrials.gov/study/NCT01840072; Unique Identifier: NCT01840072.

https://orcid.org/0000-0003-3798-1247

Post-stroke Vascular Cognitive Impairment in India: A National Survey of Healthcare Professionals’ Clinical Practices

 YOU will have to force your doctors to take responsibility and create EXACT PROTOCOLS FOR THIS! 

Post-stroke Vascular Cognitive Impairment in India: A National Survey of Healthcare Professionals’ Clinical Practices

Cite this article as: Dawar D, Turkstra L, Pandian J D, et al. (August 24, 2026) Post-stroke Vascular Cognitive Impairment in India: A National Survey of Healthcare Professionals’ Clinical Practices. Cureus 18(8): e115067. doi:10.7759/cureus.115067

Abstract

Background and rationale

International guidelines recommend treatment for post-stroke cognitive impairment (PSCI), yet there are few evidence-based approaches to guide intervention, leaving clinicians uncertain about how to intervene. Little is known about healthcare professionals’ approach to post-stroke cognitive rehabilitation. This survey provides the first data on how PSCI is recognized and managed in stroke units in India.

Aim

This survey aimed to understand whether and how healthcare professionals, including neurologists, physiotherapists (PTs), nurses, occupational therapists (OTs), and speech-language pathologists (SLPs), assess and treat patients with PSCI in India, and to explore barriers and facilitators that influence treatment delivery.

Study method

A multicenter online survey was conducted across 50 hospitals within the Indian Stroke Clinical Trial Network (INSTRuCT). We used a purposive sampling approach to enroll healthcare professionals involved in stroke care.

Results

Of the 110 respondents, 47% were neurologists, 19% PTs, 22% nurses, 10% OTs, and 0.9% SLPs. Approximately 67% reported performing routine cognitive screening, primarily using the Montreal Cognitive Assessment (MoCA; 46%) and the Mini-Mental State Examination (MMSE; 37%). Seventy percent reported providing cognitive rehabilitation interventions, primarily aerobic exercises, strategy-based interventions, and cognitive skills training. Key barriers to providing cognitive rehabilitation included lack of time, insufficient training and expertise, and the team prioritizing other aspects of recovery before cognition.

Conclusion

This first national multicenter survey provides important insight into the current state of PSCI assessment and rehabilitation in India, identifying variation in clinical practice and persistent barriers to cognitive care. Given India’s large and growing stroke burden, these findings are clinically significant as unrecognized and undertreated PSCI may adversely affect long-term recovery and quality of life. The study highlights an urgent need for context-specific cognitive rehabilitation pathways and workforce training, with implications not only for India but also for other low-and middle-income countries facing similar resource and rehabilitation challenges.

Introduction

Post-stroke cognitive impairment (PSCI) affects over 60% of stroke survivors [1,2] and is increasingly recognized as an important component of post-stroke disability. Cognitive rehabilitation is therefore an integral component of multidisciplinary post-stroke care. Healthcare professionals play a pivotal role in identifying and addressing cognitive impairment following stroke, from initial screening to assessment and intervention. The Canadian Stroke Best Practice Recommendations (CSBPR) recommend that stroke survivors be screened for cognitive changes, with screening undertaken before discharge from acute care or inpatient rehabilitation and repeated at transition points and follow-up visits [3]. Individuals with identified cognitive impairment should undergo further standardized assessments, with referral for comprehensive assessment where appropriate [3]. Similar recommendations have been made in European stroke guidelines, which emphasize the importance of cognitive assessment following stroke while acknowledging limited evidence regarding the optimal timing and content of screening [4]. Although cognitive rehabilitation and other interventions are increasingly incorporated into post-stroke care, the evidence supporting their effectiveness remains heterogeneous, and uncertainty persists regarding the optimal type, timing, intensity, and delivery of interventions [4,5]. The need for post-stroke cognitive rehabilitation is therefore evident, but there remains limited clarity on the optimal methods to assess and intervene for PSCI in routine clinical practice. This uncertainty may contribute to variation in clinicians’ approaches to the assessment and management of PSCI.

Evidence from high-income nations has identified multiple system-level barriers to the delivery and implementation of post-stroke cognitive care, including workforce and resource constraints, unclear roles and responsibilities, limited training, unclear referral pathways, and inconsistent service organization [5,6]. Studies also note that inconsistent access to standardized tools and evidence-based interventions may further constrain the delivery of post-stroke cognitive rehabilitation [5-7]. We expect similar issues in India, at both a system level and in terms of professional educational barriers, but to a much greater magnitude. In India, PSCI affects approximately one-third of stroke survivors [8]. However, evidence regarding routine clinical practices and the implementation of PSCI care in India remains limited [9].

The Indian healthcare system faces several challenges that may further hinder the delivery of optimal cognitive rehabilitation, such as limited access to rehabilitation services and financial constraints. Understanding healthcare professionals’ perspectives could be an essential starting point; once current practices and barriers are understood, strategies to address barriers can be developed. To better understand current clinical practices related to PSCI in India, we surveyed healthcare professionals involved in post-stroke care to assess their knowledge and approaches to PSCI screening, assessment, and intervention, as well as their perceived barriers and facilitators to implementing these practices.

More at link.

Promising Tool to Predict Poststroke Cognitive Impairment

 WHAT FUCKING STUPIDITY; PREDICTION NOT RECOVERY OR PREVENTION! You're all fired for incompetence! I'd have to say you don't even have two neurons to rub together for a spark of intelligence!

Promising Tool to Predict Poststroke Cognitive Impairment

• Madeline Russell, MD, @maddyrussell16

Ferreira J, Pereira G, Alves F, Fonseca L, Moreira G, Azevedo E, Castro P. Microemboli Detection in Acute Ischemic Stroke Could Be an Early Marker of Poor Cognitive Outcome. Stroke. 2026;57:116–124.

Can transcranial Doppler imaging help predict cognitive impairment after stroke? In posing this question, this study sheds light on two growing areas of interest in the field: the use of transcranial Doppler imaging (TCD) and the burden of cognitive impairment in stroke survivors.

Over recent years, there has been increasing use for TCD in the setting of ischemic stroke. In addition to providing real-time information on vessel hemodynamics that cannot be captured on CT or MR angiography, TCDs can also be used to detect microemboli. Microembolic signals have been shown to correlate with stroke recurrence and, more recently, to correlate with cognitive impairment after carotid intervention.

In this study, the study authors theorize that patients with microemboli signals (MES) are more likely to have ischemic events and the eventual development of cognitive impairment. In short, they ask: Can we use TCD findings of microemboli to predict cognitive outcomes after stroke?

The study was conducted at Centro Hospitalar Universitario de Sao Joao in Portugal and was prospective in design. Patients were included if they had acute ischemic stroke, TCDs could be performed within 72 hours, and prestroke mRS was <4. Patients were excluded if they had conditions that would confound TCD findings or cognitive assessment, including severe aphasia, large infarct size, pre-existing cognitive impairment.

Microemboli detection portion of TCDs was performed for a total of 60 minutes per patient, with 30 minutes each for the anterior circulation (bilateral M1 segments) and posterior circulation (bilateral P2 segments). Presence of MES was defined as at least one positive signal, as analyzed by single experience and blinded reader.

Identifying key predictors of post-stroke depression and cognitive impairment in acute stroke survivors

 

You're supposed to solve problems, NOT just predict them you blithering idiots. Hoping comeuppance hits you really hard when you are the 1 in 4 per WHO that has a stroke! 

Why are you incompetently? predicting failure to recover than delivering recovery?

Laziness? Incompetence? Or just don't care? NO leadership? NO strategy? Not my job? Not my Problem!

Had you been thinking at all you would be solving the  5 causes of the neuronal cascade of death in the first week saving hundreds of million to billions of neurons! Thus, preventing cognitive impairment and depression. Or don't you have two functioning neurons to rub together for a spark of intelligence?

Identifying key predictors of post-stroke depression and cognitive impairment in acute stroke survivors

• 

  Zhiwen Yan 1†

• H

  Huan Zhao 1†

• 

  Jianjun Chen 2

• F

  Fang Liu 1

• L

  Lei Gong 1

• 

  Yingli Li 1

• J

  Jie Zhang 1

• M

  Mi Xiao 1

• 

  Jun Mu 1*

• 1. Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

• 2. Chongqing Key Laboratory of Neurobiology, Institute of Neuroscience, Chongqing Medical University, Chongqing, China

Abstract

Background: 

Post-stroke depression (PSD) and post-stroke cognitive impairment (PSCI) are prevalent complications in aging stroke survivors and are often overlooked due to the lack of early diagnostic indicators, leading to poor prognosis. Identifying reliable predictors is crucial for timely intervention.

Methods: 

This prospective cohort study followed 78 acute stroke survivors for 6 months. A composite neuropsychological outcome—defined as the development of PSD and/or PSCI—was determined using the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5) and NINDS-CSN criteria. To account for the limited sample size, multivariable Firth’s penalized logistic regression was employed to identify independent predictors, generating robust odds ratios (ORs) and 95% confidence intervals (CIs). An exploratory classification and regression tree (CART) analysis was also conducted for hypothesis generation.

Results: 

The final cohort comprised 78 acute ischemic stroke survivors with a median age of 62 years (IQR 51–71). Among these participants, 26.0% were women, and the median admission score on the National Institutes of Health Stroke Scale (NIHSS) was 3 (IQR 1–5). Within 6 months, 56 patients (71.8%) developed the composite outcome (13 experienced PSCI alone, 24 had PSD alone, and 19 had both conditions). A multivariable analysis revealed that right hemisphere lesions (OR = 9.019, 95% CI: 1.329–61.213, p = 0.016), greater baseline emotional distress (higher 9-item Patient Health Questionnaire (PHQ-9) scores; OR = 5.157, 95% CI: 1.835–14.494, p < 0.001), and pre-existing cognitive vulnerability (lower Mini–Mental State Examination (MMSE) scores; OR = 0.714, 95% CI: 0.517–0.984, p = 0.023) were independent predictors of poor neuropsychological outcomes. Advanced age (p = 0.094) and elevated urea levels (p = 0.095) showed only marginal trends. Exploratory CART modeling highlighted the hierarchical interaction of these baseline clinical scores for risk stratification.

Conclusion: 

Right hemisphere lesions, early emotional distress, and baseline cognitive vulnerability independently predicted a high risk of composite neuropsychological impairment at 6 months post-stroke. Rather than serving merely as novel biomarkers, high baseline PHQ-9 scores and low MMSE scores reflected the persistence of early distress and poor cognitive reserve, respectively. These highly accessible clinical parameters facilitate early risk stratification, emphasizing the absolute need for immediate psychological triage and integrated, long-term cognitive-emotional monitoring.

Mechanisms of Action and Advances in Application of Music Therapy in Improving Cognitive Impairment Based on the Theory of Neuroplasticity

 We know music therapy works in stroke; but does your incompetent? doctor even have a protocol for you?

• music therapy (105 posts back to October 2014)

Mechanisms of Action and Advances in Application of Music Therapy in Improving Cognitive Impairment Based on the Theory of Neuroplasticity

• 

  Zi-Tong Zeng

• J

  Jia-Xin Tang

• S

  Si-Rong Wang

• L

  Li-Zhu Lei

• Z

  Zi-Yi Xing

• J

  Jian-Mei Wang

• 

  Jing Wu

• Hunan University of Chinese Medicine, Changsha, China

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Abstract

As global population aging accelerates, preventing and treating cognitive impairment has become a major public health priority. Music therapy is a safe, well-tolerated non-pharmacological intervention with substantial potential to improve cognitive function. This review synthesizes the neurologic music therapy (NMT) framework, encompassing techniques targeting attention, memory, and executive function, delivered through both active and receptive approaches. Clinical investigations indicate that music therapy may improve cognition and neuropsychiatric symptoms in Alzheimer's disease (AD), vascular cognitive impairment (VCI), Parkinson's disease–related cognitive impairment, mild cognitive impairment (MCI), and traumatic brain injury (TBI); however, effects appear to vary by intervention duration and disease stage. This narrative review aims to provide a theoretical foundation and practical guidance for the non-pharmacological intervention of cognitive impairment by collating evidence on the neuroplasticity theoretical foundations, technical systems, and clinical applications of music therapy.

Summary

Copyright

© 2026 Zeng, Tang, Wang, Lei, Xing, Wang and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.