The 15-minute BCoS-ICAS demonstrated superior diagnostic accuracy compared to MoCA and NINDS-CSN for detecting ICAS-related cognitive impairment (validation cohort accuracy 0.89; 95% CI 0.84-0.93).
Observational (n=827)
Yes
Does the BCoS-ICAS accurately detect cognitive impairment in patients with intracranial atherosclerosis compared to MoCA and NINDS-CSN?
The BCoS-ICAS is a novel, efficient 15-minute scale that provides high diagnostic accuracy for detecting ICAS-related cognitive impairment and correlates with neurodegenerative biomarkers.
Background: Intracranial atherosclerosis (ICAS) related cognitive impairment has been increasingly recognized, but lacks specific diagnostic tools. We sought to develop and validate a brief cognitive scale for ICAS (BCoS-ICAS). Methods: Patients were enrolled from the Peking Union Medical College Hospital (training cohort, n=609) and 17 tertiary hospitals (validation cohort, n=218) between 2021 and 2025. All underwent comprehensive neuropsychological assessments, 3D-T1 MRI, and plasma biomarker analysis (GFAP, NfL, pTau217). The BCoS-ICAS was derived using a decision-tree machine learning algorithm and partial least squares analysis in the training cohort, then validated in the independent validation cohort. Linear regression models explored associations between the BCoS-ICAS and biomarkers. Results: The BCoS-ICAS includes the Calculation subtest, Auditory Verbal Learning Test (immediate recall and short-delay recall), and Trail Making Test Part A, administered within 15 minutes. It demonstrated superior diagnostic accuracy compared to MoCA and NINDS-CSN in the training cohort (sensitivity, 0.91 95% CI 0.87 to 0.94; specificity, 0.82 95% CI 0.78 to 0.86; and accuracy, 0.86 95% CI 0.83 to 0.89) and external validation cohort (sensitivity, 0.92 95% CI 0.86 to 0.96; specificity, 0.85 95% CI 0.76 to 0.92; and accuracy, 0.89 95% CI 0.84 to 0.93). Scales correlated with total white matter volume (natural algorithm, β 1.282, 95% CI 0.136 to 2.428), plasma GFAP (β -0.003, 95% CI -0.005 to 0.000), and NfL (β -0.004, 95% CI -0.008 to -0.001). Conclusions: The BCoS-ICAS is an efficient 15-minute scale for detecting ICAS-related cognitive impairment, with biological plausibility and potential value for monitoring disease.
Cheng et al. (Thu,) conducted a observational in Intracranial atherosclerosis (ICAS) related cognitive impairment (n=827). Brief Cognitive Scale for ICAS (BCoS-ICAS) vs. MoCA and NINDS-CSN was evaluated on Diagnostic accuracy in the external validation cohort (95% CI 0.84 to 0.93). The 15-minute BCoS-ICAS demonstrated superior diagnostic accuracy compared to MoCA and NINDS-CSN for detecting ICAS-related cognitive impairment (validation cohort accuracy 0.89; 95% CI 0.84-0.93).