Key result
Anterior circulation stroke was associated with higher 3-month cognitive impairment than posterior stroke (54.9% vs 35.5%; aOR 2.18; 95% CI 1.06-4.49; p=0.035).
Why the study?
Post-stroke cognitive impairment is common, but its pattern may differ between anterior and posterior vascular territories.
Does anterior circulation infarction increase the risk of post-stroke cognitive impairment at 3 months compared to posterior circulation infarction in adults with first-ever acute ischemic stroke?
Cohort (n=167)
No
Does anterior circulation infarction increase the risk of post-stroke cognitive impairment at 3 months compared to posterior circulation infarction in adults with first-ever acute ischemic stroke?
Patients with anterior circulation acute ischemic stroke had more than twice the odds of developing post-stroke cognitive impairment at 3 months compared to those with posterior circulation strokes, despite similar global disability scores.
Post-stroke cognitive impairment (PSCI) is common, but its pattern may differ between vascular territories. This single-center cohort included adults with first-ever, magnetic resonance imaging (MRI)-confirmed acute ischemic stroke admitted between May 2022 and June 2024. Infarcts were classified as anterior or posterior circulation, and cognition was assessed in person at 3 months using the Beijing version of the Montreal Cognitive Assessment (MoCA). The primary PSCI definition was an education-adjusted MoCA score <26, with a sensitivity analysis using <22. Of 173 enrolled patients, 167 completed follow-up (91 anterior and 76 posterior circulation infarctions). PSCI occurred in 50/91 (54.9%) and 27/76 (35.5%) patients, respectively (p = 0.012). The unadjusted odds ratio was 2.21 (95% confidence interval, 1.18-4.14), and the adjusted odds ratio was 2.18 (95% confidence interval, 1.06-4.49; p = 0.035). With the <22 cutoff, the corresponding prevalences were 31.9% and 15.8%, and the adjusted odds ratio was 2.43 (95% confidence interval, 1.06-5.54; p = 0.035). After false-discovery-rate correction, differences in visuospatial/executive, naming, delayed-recall, language, abstraction, and orientation performance remained, whereas attention did not differ. Cognitive outcomes differed between vascular-territory groups despite similar global disability scores; these group-level associations do not establish a causal effect of territory or a domain-specific diagnosis.
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Zhang et al. (2026) conducted a cohort in Acute ischemic stroke (n=167). Anterior circulation acute ischemic stroke vs. Posterior circulation acute ischemic stroke was evaluated on Post-stroke cognitive impairment (education-adjusted MoCA score <26) at 3 months (Adjusted OR 2.18, 95% CI 1.06-4.49, p=0.035). Anterior circulation stroke was associated with higher 3-month cognitive impairment than posterior stroke (54.9% vs 35.5%; aOR 2.18; 95% CI 1.06-4.49; p=0.035).
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