Cognitive Recovery After Poststroke Delirium (RECOVER): Protocol for a Longitudinal Multimodal Study on Cognitive Assessment in Patients With Stroke
Notice bibliographique
Résumé
Background: Poststroke delirium (PSD) is a severe complication in patients with acute stroke and is characterized by rapid onset fluctuating symptoms, which affect multiple domains (cognition, motor system, and sleep-wake cycle). Similar to other types of delirium, PSD is associated with longer hospitalization, higher mortality, and a higher disability rate. Behavioral studies on cognitive functioning showed significantly poorer cognitive outcomes in both patients with and without PSD compared to healthy controls. Thus, the distinction between "stroke-related" and "PSD-related" cognitive impairments remains unclear. A frequently affected and highly disabling cognitive domain is memory function. However, imaging studies, particularly task-based functional magnetic resonance imaging (MRI) studies on PSD, are currently scarce and represent a significant gap in the existing literature. Objective: This longitudinal proof-of-concept study aims to investigate the short- and long-term effects of stroke and PSD on cognitive outcome using a multimodal approach and to outline a protocol for a repeated multimodal cognitive assessment in patients with stroke. Methods: We developed a longitudinal study protocol to investigate short- and long-term effects of stroke and PSD on cognitive impairment and recovery. Poststroke cognitive impairment (PSCI) will be assessed in a comprehensive digital multimodal approach including a multidomain neuropsychological app to facilitate a standardized, rapid testing, particularly for long-term outcomes, as well as task-based functional MRI (introducing a modified working memory task) during the acute (prior PSD development) and postacute phase post stroke and at a 3-month follow-up. In total, 40 patients with acute stroke, divided into a PSD group and non-PSD group (control), will be examined. In the context of the proof-of-concept study, the eligibility of a modified working-memory task, an app-based neuropsychological assessment, and a multimodal MRI protocol will be evaluated. The primary endpoint is a between-group comparison of the cognitive outcome, defined as global PSCI at a 3-month follow-up. Global PSCI will be classified as normal cognitive functioning, or mild, moderate, or severe cognitive impairment, according to the performance level (norm-referenced z scores) on a multidomain neuropsychological assessment. Results: This study was funded in December 2023. As of May 2025, 15 patients with stroke have been included. Recruitment and data collection were initiated in June 2024 and are ongoing until December 2025. The findings are expected to be published in summer 2026. Conclusions: This protocol outlines a proof-of-concept study aiming to fill a critical gap by systematically investigating cognitive functions in patients with acute stroke with and without delirium. Generating reliable preliminary data will provide essential groundwork for future large-scale research, ultimately enhancing understanding of the contribution of PSD to cognitive impairment.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,026 | 0,015 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,004 | 0,004 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,005 | 0,002 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,002 | 0,003 |
| Intégrité de la recherche | 0,003 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,013 | 0,005 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».