Associations between neurodegenerative and acute injury biomarkers and post‐stroke cognitive impairment – the Nor‐COAST study
Bibliographic record
Abstract
Abstract Background Patients with vascular risk factors have a higher incidence of Alzheimer's disease (AD), and AD patients have an increased risk of experiencing stroke. About half of all stroke survivors experience post‐stroke cognitive impairment (PSCI). Stroke triggers numerous inflammatory and neurodegenerative processes both in the acute and chronic phases. The aims of this study were to investigate longitudinal plasma biomarker data in a stroke population and whether high levels of neurodegenerative and acute injury biomarkers at baseline could predict PSCI. Method In this Nor‐COAST substudy, we included 547 stroke patients (Age [mean = 73± 12], 56 % males, 89 % ischemic strokes, 11 % haemorrhagic strokes). Brain‐derived tau (BD‐tau), phosphorylated tau 181 ( p ‐tau 181 ), total tau (t‐tau), amyloid β40 (Aβ 40 ), Aβ 42 , glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) concentrations were measured on the Simoa platform in plasma samples collected at inclusion, and after 3, 18 and 36 months. We explored the biomarkers’ associations with cognitive decline as measured by the Montreal Cognitive Assessment (MoCA) scale up to 36 months post‐stroke. Result Within the first three months BD‐tau, t‐tau, and GFAP concentrations declined by 43%, 20% and 76% respectively, whereas NfL levels continued to decrease up to 18 months (59%). p ‐tau 181 increased gradually by 24 % from acute phase to 36 months. Aβ 42 remained unchanged. Higher acute phase concentrations of BD‐tau, NfL and p ‐tau 181 predicted lover MoCA score up to 36 months post‐stroke in patients with ischemic stroke ( p value < 0.05). However, including clinical parameters attenuated the associations. These associations were not found in the patients with haemorrhagic stroke. Conclusion Concentrations of plasma BD‐tau, NfL, GFAP, and t‐tau were increased in the acute phase of stroke, but no significant change was seen for Aβ 42 . BD‐tau, t‐tau and GFAP concentrations decreased to stable levels within 3 months of event, NfL stabilized within 18 months, whereas p ‐tau181 showed an increase. Higher concentrations of BD‐tau, NfL, and p ‐tau 181 were associated with worse cognitive outcome up to 36 months post‐stroke. These results indicate that stroke trigger a continuing neurodegenerative process, as demonstrated by gradually increasing concentrations of p ‐tau 181 leading to PSCI.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".