Abstract 396: Cognitive Outcome Post Endovascular Thrombectomy for Large and Medium Vessel Occlusion: A Prospective Analysis
Bibliographic record
Abstract
Introduction Endovascular thrombectomy (EVT) is the standard of care for patients with acute large (LVO) and medium vessel occlusion (MeVO) stroke. Functional outcomes after thrombectomy are assessed using the modified Rankin Scale (mRS), which primarily measures the ability to function independently. To date, few studies have investigated the long‐term cognitive outcomes following endovascular therapy for acute ischemic stroke. Methods Prospective, single‐center cohort study of acute ischemic patients without pre‐stroke cognitive impairment, based on AD‐8 questionnaire, and baseline mRS of 0‐2, treated with EVT for LVO or MeVO, and achieving 2b‐3 reperfusion on the Thrombolysis in Cerebral Infarction (TICI) scale and discharge mRS 0‐4. Patients with life expectancy <6 months and parenchymal hematoma type 2 were excluded. Primary objective was to assess post stroke cognitive function at one, three, and six months using the Montreal Cognitive Assessment (MoCA). The primary outcomes included: incidence of cognitive impairment, defined as MoCA <26 at 6 months; trends in cognitive outcomes at 1, 3, and 6 months; and determine whether cognitive outcome is associated with functional outcome and major depression, defined as Beck Depression Inventory (BDI) score >20. Results We performed an interim analysis of our initial 12 patients. Mean age was 69 years (±19); 9 (75%) were female. The mean mRS at discharge was 1.7 (±1.8). At 1‐month follow‐up, 9 patients (75%) were evaluated. The mean mRS was 1.2 (±1), and the mean MoCA was 23.7 (±5.3). Five patients (56%) met criteria for cognitive impairment. At 3‐month follow‐up, 7 patients (58%) were evaluated. The mean mRS was 1.4 (±1.6), and the mean MoCA was 25.1 (±4.6). Four patients (57%) met criteria for cognitive impairment. At 6‐month follow‐up, 3 patients (25%) were evaluated. The mean mRS was 0 (±0), and the mean MoCA was 26.3 (±3.8). One patient (33%) met criteria for cognitive impairment. Major depression was not observed at 1‐, 3‐, or 6‐month follow‐up. Conclusion The preliminary data suggest that cognitive impairment is common in the early months following EVT, with more than half of patients meeting criteria for cognitive impairment at one‐ and three‐month follow‐up. There is a trend toward cognitive improvement over time. The mean mRS was less than 2 at one‐, three‐, and six‐month follow‐up, indicating favorable motor and functional recovery. These findings suggest that cognitive recovery may lag behind functional gains, underscoring the importance of dedicated cognitive assessments in the post‐stroke period. The study also highlights the need for closer cognitive monitoring, as functional independence may mask subtle but clinically significant cognitive deficits. Further enrollment and follow‐up are needed to confirm our preliminary findings.
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".