Just like a test drive can hint at the performance of a car, a short-term Montreal Cognitive Assessment (MoCA) can predict the functional outcome after endovascular therapy for stroke patients. A study examined 647 participants and found that patients with cognitive impairment, determined by a MoCA score below 26, had higher levels of certain risk factors like age, smoking, and atrial fibrillation. Additionally, these patients had lower scores on the MoCA and NIHSS scales at both 14 days and 3 months after stroke onset. Interestingly, the study revealed a strong relationship between the 3-month MoCA score and the National Institutes of Health Stroke Scale (NIHSS), indicating that cognitive impairment is closely tied to overall stroke severity. The study also identified certain cognitive regions, such as visuospatial/executive functions, that played a significant role in predicting cognitive impairment and future functional outcomes. These findings highlight the importance of early application of the MoCA to identify high-risk patients and provide timely interventions. To explore more about this fascinating research on predicting functional outcomes after endovascular therapy for stroke patients, check out the full article!

BackgroundThe previous studies have shown that cognition in patients 4–8 weeks after stroke can predict early functional outcomes after stroke. The analyses of data from the REVASCAT trial proved that stent thrombectomy improves post-morbid wiring test outcomes in patients with AIS compared with drug therapy. However, few studies focus on the relationship between cognitive impairment and functional outcomes in patients undergoing endovascular treatment.MethodsA total of 647 participants registered from stroke centers. Stroke severity was evaluated by National Institutes of Health stroke scale (NIHSS). The functional status was estimated by modified Rankin scale (mRS). The cognitive impairment was assessed by trained neurologists at 14 (±4) and 90 (±7) days after stroke onset using the Montreal Cognitive Assessment (MoCA). A MoCA score of less than 26 was considered post-stroke cognitive impairment (PSCI).ResultsA total of 120 Patients who underwent endovascular therapy were included. The PSCI group had higher levels of age, men, educational status, atrial fibrillation, smoking, alcoholism, Alberta Stroke Program Early CT (ASPECT) score of the anterior circulation, and OTP time than the non-PSCI group (p < 0.05). In contrast, the 14-day MoCA score, 14-day NIHSS score, 3-month MoCA score, 3-month NIHSS score, 3-month mRS score, and 3-month EQ5D score were lower in those PSCI patients. The risk predictors of PSCI were age, sex, educational level, atrial fibrillation, smoking, alcoholism, ASPECT Score (anterior circulation), 14-day MoCA score, and 14-day NIHSS score. There were strong relationships between 3-month NIHSS and MoCA (r = –0.483, p < 0.001). Receiver operating characteristic (ROC) curve indicated that 14-day MoCA score, memory, abstraction, visuospatial/executive functions, attention, and language, played a significant role to predict PSCI [area under the curve (AUC) > 0.7]. It had predictive value for the 14-day visuospatial/executive functions to predict 3-month functional outcomes.ConclusionEarly application of the MoCA in different cognitive regions could predict the PSCI and future functional outcomes, which is necessary to screen high-risk patients with poor prognosis and conduct an early intervention.

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