Cognitive Outcome in Patients with Middle Cerebral Artery and Anterior Cerebral Artery Territory Ischaemic Stroke at a Tertiary Health Care Centre
Bibliographic record
Abstract
Background: Stroke is a major cause of disability and mortality, often leading to both motor and cognitive impairments. Cognitive impairment is common among stroke survivors, with ischaemic strokes constituting the majority. While physical rehabilitation is emphasised, cognitive assessment remains underutilised in acute care. Purpose: This study aimed to assess cognitive impairment in patients with ischaemic stroke affecting the anterior circulation using the Montreal Cognitive Assessment (MoCA) scale, and to correlate clinical variables with cognitive outcomes. Methods: This observational study was conducted over 18 months at a tertiary healthcare centre in coastal Karnataka, India. Patients with first-ever ischaemic stroke involving the middle cerebral artery (MCA) and anterior cerebral artery (ACA) territories were included. Cognitive impairment was assessed using the MoCA scale within 1 week of stroke onset and again at 90 days. Clinical data such as NIHSS and mRS scores, as well as stroke subtype (via TOAST classification), were also collected. Results: A total of 96 patients were included, with a mean age of 62.5 ± 10.3 years. At baseline, 55% of patients showed cognitive impairment, which improved at the 90-day follow-up (45% impaired). The most frequently affected domains were Attention (55%), Language (45%) and Executive function (50%). Factors such as older age, lower education level and higher NIHSS scores were associated with worse cognitive outcomes. Stroke aetiology (large-artery atherosclerosis and cardioembolism) was linked to more severe cognitive deficits. Aphasia was observed in 29 patients, and follow-up MoCA testing showed minimal cognitive improvement in this group. Conclusion: Vascular cognitive impairment is a significant concern in ischaemic stroke patients. The MoCA scale is an effective tool for the early identification of cognitive impairment, even within the first week post-stroke. Age, education, NIHSS and mRS scores are critical predictors of post-stroke cognitive decline. Further studies are needed to refine cognitive assessment tools, especially for aphasic patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".