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Brain Sciences
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Cognitive Impairment and Related Complications of Stroke: Prevention, Diagnosis, and...
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Cognitive Impairment and Related Complications of Stroke: Prevention, Diagnosis, and Treatment

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurorehabilitation".

Deadline for manuscript submissions: 30 July 2025 | Viewed by 4666

Special Issue Editors

Dr. Simona Spaccavento

E-Mail Website
Guest Editor
Istituti Clinici Scientifici Maugeri - IRCCS, Institute of Bari, Via Generale Bellomo 73/75, 70124 Bari, Italy
Interests: assessment and rehabilitation of cognitive deficits following acquired brain injury
Dr. Pasquale Moretta

E-Mail Website
Guest Editor
Istituti Clinici Scientifici Maugeri IRCCS, Istituto di Telese Terme, Telese Terme, Italy
Interests: clinical and rehabilitation neuropsychology with patients with acquired brain injury

Special Issue Information

Dear Colleagues,

A common consequence of stroke is cognitive impairment which occurs in up to 60% of stroke survivors. Post-stroke cognitive impairment (PSCI) refers to cognitive impairment that arises after the stroke, causing an important functional dependence and many other adverse outcomes including behavioral and emotional symptoms, such as depression, anxiety, apathy, and reduced quality of life. It is important to identify patients at risk of developing PSCI as soon as possible in order to implement adequate and timely multidisciplinary treatment.

The Special Issue entitled “Cognitive Impairment and Related Complications of Stroke: Prevention, Diagnosis, and Treatment” aims to gather together the latest studies in this field; above all those focused on protective factors, diagnostical cognitive measures, and new cognitive rehabilitation protocols. 

This Special Issue welcomes submissions of original research articles, review papers, case studies, and clinical trials concerning new assessment methods, novel rehabilitation protocols, and approaches or techniques seeking to improve the management and the quality of life of people with this condition.

Dr. Simona Spaccavento
Dr. Pasquale Moretta
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neuropsychological deficits
  • behavioral symptoms
  • functional outcomes
  • cognitive rehabilitation
  • stroke
  • post-stroke cognitive impairment

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Published Papers (4 papers)

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Research

12 pages, 1180 KiB  
Article
Novel Insights into Viewer-Centered Versus Stimulus-Centered Hemispatial Neglect: A Cross-Sectional Behavioral and Imaging Study of Acute Stroke
by Ashley Raman, Andreia V. Faria, Michael Colavito and Argye E. Hillis
Brain Sci. 2025, 15(2), 208; https://doi.org/10.3390/brainsci15020208 - 17 Feb 2025
Viewed by 602
Abstract
Background/Objectives: Hemispatial neglect is common after stroke but is often evaluated only after right hemisphere (RH) stroke. We sought to determine the prevalence of two types of neglect, viewer-centered neglect (VCN) and stimulus-centered neglect (SCN), after left hemisphere (LH) and RH strokes. Additionally, [...] Read more.
Background/Objectives: Hemispatial neglect is common after stroke but is often evaluated only after right hemisphere (RH) stroke. We sought to determine the prevalence of two types of neglect, viewer-centered neglect (VCN) and stimulus-centered neglect (SCN), after left hemisphere (LH) and RH strokes. Additionally, we identified lesion load in each vascular territory and areas of hypoperfusion, estimated with FLAIR hyperintense vessels (FVHs) that contribute to neglect. Methods: A series of 233 stroke patients (73 LH and 160 RH) were administered a task to detect VCN and SCN and received brain MRI within 5 days of onset. We used multivariable logistic regression to identify vascular territories where lesion load and/or hypoperfusion contributed to each type of neglect. Results: While VCN was more prevalent after RH stroke, SCN occurred at a similar rate after LH and RH stroke. In RH stroke, lesion load in the middle cerebral artery occipital region and anterior cerebral artery territory and age predicted left VCN, whereas parietal hypoperfusion independently predicted left SCN. In LH stroke, lesion load across regions and age predicted right VCN, while lesion load in posterior cerebral artery occipital and anterior cerebral artery regions, as well as age, predicted right SCN. The addition of information about hypoperfusion improved the prediction of both VCN and SCN. Conclusions: VCN and SCN are each common after RH stroke, and SCN is common after LH stroke. Each type of neglect is accounted for by distinct areas of infarct and hypoperfusion. Results will aid in the detection of neglect after stroke and may guide reperfusion interventions to improve neglect. Full article
(This article belongs to the Special Issue Cognitive Impairment and Related Complications of Stroke: Prevention, Diagnosis, and Treatment)
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19 pages, 855 KiB  
Article
Prevalence and Clinical Correlates of Cerebrovascular Alterations in Fabry Disease: A Cross-Sectional Study
by Daniele Di Natale, Salvatore Rossi, Gianmarco Dalla Zanna, Antonio Funcis, Tommaso Filippo Nicoletti, Ludovico Luca Sicignano, Elena Verrecchia, Angela Romano, Maria Gabriella Vita, Naike Caraglia, Francesca Graziani, Federica Re, Gisella Guerrera, Luca Battistini and Gabriella Silvestri
Brain Sci. 2025, 15(2), 166; https://doi.org/10.3390/brainsci15020166 - 7 Feb 2025
Viewed by 760
Abstract
Background/Objectives: Fabry disease (FD) is an inborn error of the glycosphingolipid metabolism with variable kidney, heart, and central nervous system (CNS) involvement. CNS-related FD manifestations include early ischemic stroke and white matter lesions (WMLs) related to cerebral small-vessel disease (CSVD), possibly resulting in [...] Read more.
Background/Objectives: Fabry disease (FD) is an inborn error of the glycosphingolipid metabolism with variable kidney, heart, and central nervous system (CNS) involvement. CNS-related FD manifestations include early ischemic stroke and white matter lesions (WMLs) related to cerebral small-vessel disease (CSVD), possibly resulting in cognitive impairment. We studied 40 adult FD patients (17 male) to assess: (i) prevalence of cerebrovascular and cognitive manifestations in FD and their correlation with heart and renal involvement; and (ii) the potential value of serum neurofilament light chain (NfL) levels as an indicator of WMLs in FD. Methods: Patients underwent detailed diagnostic assessment related to FD, also including Mainz Severity Score Index (MSSI), neuropsychological tests, brain MRI to assess WMLs by the modified Fazekas score (mFS), and NfL determination by single-molecule array (SiMoA) (n = 22 FD patients vs. 15 healthy controls). Results: Overall, 4 FD patients had a history of ischemic stroke and 13/32 patients (40.6%) had an mFS ≥ 1. Almost two-thirds of FD patients (27/39, 69.2%) showed impairment on at least one cognitive test. On univariate analysis, only a reduction in estimated glomerular filtration rate was associated with an increased likelihood of having WMLs on brain MRI. Serum NfL levels were higher in FD patients vs. controls, with a trend toward significance (p = 0.08). Conclusions: Mild-to-moderate CSVD is a characteristic brain “signature” in FD patients. Both cardiac and renal involvement correlate with WML load, but only renal involvement appears to be predictive of CNS damage. Brain microvascular damage is associated with mild cognitive impairment in FD, and serum NfL might represent a potential biomarker of CSVD in FD. Full article
(This article belongs to the Special Issue Cognitive Impairment and Related Complications of Stroke: Prevention, Diagnosis, and Treatment)
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9 pages, 586 KiB  
Article
Neuropsychological Performance after Extended N-Pep-12 Dietary Supplementation in Supratentorial Ischemic Stroke
by Dafin Mureșanu, Olivia Verișezan-Roșu, Nicoleta Jemna, Irina Benedek, Julia Rednic, Irina Maria Vlad, Ana-Maria Buruiană, Ioana Mureșanu, Diana Chira, Livia Livinț Popa, Adina Dora Stan, Herbert Moessler and Ștefan Strilciuc
Brain Sci. 2024, 14(10), 986; https://doi.org/10.3390/brainsci14100986 - 28 Sep 2024
Viewed by 1453
Abstract
Background: Cognitive deficits following ischemic stroke significantly impair quality of life, highlighting the need for effective interventions. This study evaluates the efficacy and safety of extended N-Pep-12 dietary supplementation in enhancing cognitive recovery post-stroke. Methods: In this randomized, open-label, controlled study, [...] Read more.
Background: Cognitive deficits following ischemic stroke significantly impair quality of life, highlighting the need for effective interventions. This study evaluates the efficacy and safety of extended N-Pep-12 dietary supplementation in enhancing cognitive recovery post-stroke. Methods: In this randomized, open-label, controlled study, 106 patients with supratentorial ischemic stroke were enrolled to receive either 90mg N-Pep-12 or no supplementation daily for 360 days and were followed-up for 360 days. Cognitive function and emotional well-being were assessed using established neuropsychological scales at baseline, 90 days, and 360 days post-stroke. Safety was monitored through adverse events and mortality rates. Results: Significant improvements were observed in the N-Pep-12 group compared to controls, particularly in the Montreal Cognitive Assessment scores at both 90 and 360 days, and in the Digit Symbol Coding scores at 360 days, suggesting enhanced cognitive recovery with extended N-Pep-12 supplementation. A linear regression for a composite outcome analysis at day 360 further confirmed the efficacy of N-Pep-12 in contributing to cognitive improvement. Safety profiles were favorable, with no significant adverse effects attributed to N-Pep-12. Conclusions: Extended dietary supplementation with N-Pep-12 appears to offer a safe and effective approach to support cognitive recovery in ischemic stroke survivors. These findings underscore the potential of the supplement as an add-on intervention for managing post-stroke cognitive impairments. Full article
(This article belongs to the Special Issue Cognitive Impairment and Related Complications of Stroke: Prevention, Diagnosis, and Treatment)
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13 pages, 2932 KiB  
Article
A Comparative Study on Cognitive Assessment in Cerebellar and Supratentorial Stroke
by Qi Liu and Yumei Zhang
Brain Sci. 2024, 14(7), 676; https://doi.org/10.3390/brainsci14070676 - 3 Jul 2024
Viewed by 1301
Abstract
This study aims to understand the cognitive profiles of cerebellar infarction patients and compare them to those with supratentorial infarctions, particularly frontal infarctions. This current study also aims to find reliable assessment tools for detecting cognitive impairment in cerebellar infarction patients. A total [...] Read more.
This study aims to understand the cognitive profiles of cerebellar infarction patients and compare them to those with supratentorial infarctions, particularly frontal infarctions. This current study also aims to find reliable assessment tools for detecting cognitive impairment in cerebellar infarction patients. A total of fifty cerebellar infarction patients, sixty supratentorial infarction patients, and thirty-nine healthy controls were recruited. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Addenbrooke’s Cognitive Examination III (ACE-III), and Cerebellar Cognitive Affective Syndrome scale (CCAS-s) were used to assess global cognitive function. An extensive neuropsychological assessment battery was also tested to evaluate the characteristics of each cognitive domain. To assess the features of cognitive function, a comprehensive neuropsychological evaluation tool was also utilized. The cerebral infarction patients demonstrated cognitive impairment comparable to those with frontal infarcts, notably characterized by disturbance in attention and executive function. However, the degree of cognitive impairment was comparatively milder in cerebellar infarction patients. Furthermore, the patients in the cerebellar group had worse scores in the ACE-III and CCAS-s compared to healthy controls. The two assessments also demonstrated a significant area under the curve values, indicating their effectiveness in distinguishing cognitive impairment in cerebellar infarctions. In conclusion, cognitive impairment in a cerebellar infarction resembles frontal lobe dysfunction but is generally mild. It can be accurately assessed using the ACE-III and CCAS-s scales. Full article
(This article belongs to the Special Issue Cognitive Impairment and Related Complications of Stroke: Prevention, Diagnosis, and Treatment)
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