Search Results (130)

Stroke often results in lasting cognitive impairments that severely reduce independence and quality of life. Traditional neuropsychological assessments rely on mean scores that provide an average estimate of overall cognitive function but neglect the fluctuations in performance. The variability in performance can be captured as inconsistency, i.e., fluctuations across multiple trials within a single task or as dispersion, i.e., fluctuations across multiple tasks. While inconsistency has been extensively studied, the impact of post-stroke cognitive impairment on cognitive dispersion is unknown. In this study, ninety-five stroke survivors (41 cognitively impaired and 54 cognitively normal) completed a neuropsychological battery that captured performance across five cognitive domains: executive function, attention, memory, language, and processing speed. We compared the stroke groups on across- and within-domain cognitive dispersion. Cognitively impaired stroke individuals showed elevated dispersion within executive function compared to cognitively normal individuals. The two groups did not differ on any other within-domain or across-domain cognitive dispersion. Post-stroke cognitive impairment increased variability within executive functioning. Incorporating cognitive dispersion into routine post-stroke assessment can advance clinical practice by identifying subtle cognitive instability, anticipate supportive needs, and tailor rehabilitation plans for improving stroke care. Full article

Simultaneously performing cognitive and motor tasks after a stroke interfered with each other. Considering the competing deficits of cognition and motor paresis, we aimed here to assess the overall functional impairments of patients after stroke injury. A range of dual-task (DT) assessments was made on 63 post-stroke patients (PS) and 49 healthy age-matched controls. Patients with paresis (P) and without paresis (NP) were compared with controls before and after DT training. Differences between the NP patients and controls confirmed the cognitive decline, while the comparison between the NP and P patients strengthened the motor damage in P patients. The elderly patients performed worse. According to the ArtANOVA analysis, age was more important than paresis in DT performance. Short-term training modified the test results, especially in P patients. In conclusion, paresis and older age significantly worsen the outcomes of the cognitive dual-task tests. The age-dependent results may reflect cognitive decline, especially in NP patients. Consequently, the dual-task test results may represent global cognitive deterioration after stroke. Short-term dual-task training improves dual-task performance, especially in the P groups. Full article

Background and Clinical Significance: Adults suffering from cerebellar metastases are often at high risk for rapid deterioration of their neurological status because the posterior fossa has limited compliance and the location of these metastases are close to the brain stem and important cerebrospinal fluid (CSF) pathways. In this paper, we present a longitudinal, patient-centered report on the history of an elderly individual who suffered from cognitive comorbidities and experienced a sudden loss of function in her cerebellum. Our goal in reporting this case is to provide a comparison between the patient’s pre-operative and post-operative neurological examinations; the imaging studies she had before and after surgery; the surgical techniques utilized during her operation; and the outcome of her post-operative course in a way that will be helpful to other patients who have experienced a similar situation. Case Presentation: We report the case of an 80-year-old woman who initially presented with progressive ipsilateral limb-trunk ataxia, impaired smooth pursuit eye movement, and rebound nystagmus, but preserved pyramidal and sensory functions. Her quantitative bedside assessments included some of the components of the Scale for the Assessment and Rating of Ataxia (SARA), and a National Institute of Health Stroke Scale (NIHSS) score of 3. These findings indicated dysfunction of the left neocerebellar hemisphere and possible dentate nucleus involvement. The patient’s magnetic resonance imaging (MRI) results demonstrated an expansive mass with surrounding vasogenic edema and marked compression and narrowing of the exits of the fourth ventricle which placed the patient’s CSF pathways at significant risk of occlusion, while the aqueduct and inlets were patent. She then underwent a left lateral suboccipital craniectomy with controlled arachnoidal CSF release, preservation of venous drainage routes, subpial corticotomy oriented along the lines of the folia, stepwise internal debulking, and careful protection of the cerebellar peduncles and dentate nucleus. Dural reconstruction utilized a watertight pericranial graft to restore the cisternal compartments. Her post-operative intensive care unit (ICU) management emphasized optimal venous outflow, normoventilation, and early mobilization. Histopathology confirmed the presence of metastatic carcinoma, and staging suggested that the most likely source of the primary tumor was the lungs. Immediately post-operation, computed tomography (CT) imaging revealed a smooth resection cavity with open foramina of Magendie and Luschka, intact contours of the brain stem, and no evidence of bleeding or hydrocephalus. The patient’s neurological deficits, including dysmetria, scanning dysarthria, and ataxic gait, improved gradually during the first 48 h post-operatively. Upon discharge, the patient demonstrated an improvement in her limb-kinetic subscore on the International Cooperative Ataxia Rating Scale (ICARS) and demonstrated independent ambulation. At two weeks post-operation, CT imaging revealed decreasing edema and stable cavity size, and the patient’s modified Rankin scale had improved from 3 upon admission to 1. There were no episodes of CSF leakage, wound complications, or new cranial nerve deficits. A transient post-operative psychotic episode that was likely secondary to her underlying Alzheimer’s disease was managed successfully with short-course pharmacotherapy. Conclusions: The current case study demonstrates the value of anatomy-based microsurgical planning, preservation of venous and CSF pathways, and targeted peri-operative management to facilitate rapid recovery of function in older adults who suffer from cerebellar metastasis and cognitive comorbidities. The case also demonstrates the importance of early multidisciplinary collaboration to allow for timely initiation of both adjuvant stereotactic radiosurgery and molecularly informed systemic therapy. Full article

Background/Objectives: Cognitive deficits are common after stroke and often compound motor impairments, hindering functional recovery—yet cognition remains under-addressed in stroke care. This pilot trial evaluated the feasibility and acceptability of a novel stroke telerehabilitation program—COG + OT—that delivers brief, functionally oriented cognitive rehabilitation as a primer to activity-based occupational therapy (OT). Methods: Twenty stroke survivors with arm/hand paresis participated in this single-arm pilot trial. The 8-week COG + OT program included 13 sessions across three phases: (1) cognitive rehabilitation (sessions 1–4), (2) application of cognitive strategies to task-practice OT (sessions 5–10), and (3) integration of cognitive skills into OT (sessions 11–13). Outcomes included feasibility (retention, adherence), acceptability (self-reported interest and usefulness of cognitive strategies, intervention acceptability), and engagement (digital literacy, barriers, and self-reported strategy use). Results: Retention was 95% and adherence was 99.6%. Participants reported moderate interest in cognitive strategies pre-intervention (M = 3.86/5) and found them moderately to very useful post-intervention (M = 4.42/5). Intervention acceptability and appropriateness were rated highly (M = 4.4/5). Common barriers included cognitive, environmental, and language factors; digital/technological barriers were infrequent. Self-reported use of cognitive strategies was moderate to high. Conclusions: The results of this trial strongly support the feasibility and acceptability of the COG + OT program for stroke survivors. Importantly, all participants were able to meaningfully engage in the program despite marked variability in cognitive and clinical characteristics. These findings support further investigation through randomized controlled trials to evaluate efficacy. Full article

Background/Objectives: Despite the well-documented gender differences observed during hospitalisation, research in post-stroke recovery remains limited. This study aims to clarify this topic in subacute post-stroke patients undergoing rehabilitation, considering not only functional and cognitive outcomes but also nutritional status and food consumption. Methods: At admission (T0), patients were assessed for demographic, anamnestic, and clinical data and were diagnosed for malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. At T0 and after a six-week rehabilitation program (T1), nutritional status was assessed by anthropometric measurements, serum analysis of albumin, glucose, lipidic, metal, and oxidative stress panel, and the calculation of the Geriatric Nutritional Risk Index; food consumption was recorded daily. Functional independence in Activities of Daily Living was measured at both T0 and T1 by the modified Barthel Index (mBI), and cognitive impairment was assessed by the Montreal Cognitive Assessment (MoCA), adjusted for age and education. Results: We enrolled 87 patients (mean age 69 ± 12 years; 42 women and 45 men); of these 52.4% of women were malnourished, compared to 33.3% of men. After rehabilitation (T1), women showed higher oxidative stress (549 ± 143 vs. 491 ± 121 UCARR; p = 0.041) and poorer functional outcomes (55.3 ± 26.1 vs. 67.1 ± 21.8; p = 0.032), despite similar cognitive improvements (19.5 ± 6.4 vs. 21.9 ± 5.2; p = 0.060) compared with men. Conclusions: This study highlights the importance of personalised treatment strategies that account for gender-specific differences to optimise recovery in post-stroke patients. Full article

Background: The ability to perform simultaneous tasks, such as walking while engaging in cognitive or secondary motor activities, is crucial for autonomy post-stroke but is often impaired. Exercise-based interventions may improve dual-task gait performance. Methods: A systematic review following PRISMA 2020 guidelines (PROSPERO CRD420251082293) searched six databases for RCTs published between January 2017 and June 2025, including adults post-stroke receiving exercise-based interventions, with dual-task gait speed as the primary outcome. Data extraction and methodological quality assessment (PEDro scale) were conducted independently. A narrative synthesis was used due to heterogeneity in interventions and outcomes. Results: Seven RCTs (248 participants, 4–15 weeks) were included. Six studies reported statistically significant within-group improvements in dual-task gait speed (0.05–0.31 m/s), whereas one study showed no change. Between-group comparisons were largely inconsistent, with only one study indicating superiority of dual-task over single-task training. Methodological quality ranged from fair to good (PEDro 5–8/10). No serious adverse events were reported. Conclusions: Exercise-based interventions appear safe and can improve dual-task gait speed post-stroke. Evidence supporting the superiority of dual-task over single-task training remains inconclusive. Clinical application should consider individual goals, baseline performance, and cognitive-motor capacity. Future research should focus on larger, high-quality RCTs, standardized protocols, and clinically meaningful thresholds for dual-task gait speed. Full article

Background/Objectives: Post-stroke cognitive impairment (PSCI) affects ~40% of survivors. Diffusion Tensor Imaging Analysis Along the Perivascular Space (DTI-ALPS) is a fast, contrast-free surrogate of perivascular (glymphatic-aligned) diffusivity that may stratify PSCI risk. We systematically synthesized evidence on the diagnostic and prognostic performance of ALPS in ischemic stroke. Methods: Following PRISMA 2020, we searched PubMed/MEDLINE, Scopus, and Web of Science from inception to August 2025 for human ischemic stroke studies reporting ALPS and cognitive or functional outcomes. Eligible designs were cohort or case–control. Outcomes included group differences, associations with cognition (Montreal Cognitive Assessment [MoCA]/Mini-Mental State Examination [MMSE]), prognostic accuracy for PSCI/functional outcome, and longitudinal change. Risk of bias was appraised with QUADAS-2 (diagnostic) and QUIPS (prognostic). The protocol was registered on OSF. Heterogeneity among studies precluded a meta-analysis. Results: Five single-center cohorts (n per cohort 29–120) from Asia, Europe, and the USA used 3T DTI with ventricular-level ALPS ROIs. Across studies, ALPS was lower after stroke, with early ipsilesional depression and partial recovery over weeks to months. ALPS correlated with cognition (MoCA r ≈ 0.43–0.56) and discriminated early cognitive impairment (AUC 0.868; sensitivity 96%, specificity 66%). Follow-up ALPS predicted poor 6-month outcome (AUC 0.786). In lacunar stroke with small-vessel disease, higher baseline ALPS related to better cognitive trajectories and lower incident dementia risk (HR ≈ 0.33), though associations attenuated after adjustment for diffusion microstructural covariates (PSMD/MD). Reporting of acquisition parameters and ROI methods varied; overall risk of bias was moderate. Conclusions: DTI-ALPS shows consistent post-stroke reductions, recovery-sensitive trajectories, and promising—though context-dependent—prognostic value for PSCI and longer-term outcomes. Clinical translation will require standardized acquisition/analysis, multimodal adjustment, prespecified cut-offs, and prospective multicenter validation. Full article

Background: Cognitive and mood impairments are common in Stroke Survivors (SSs), leading to worse outcomes and poorer quality of life measures. Current methods of assessment of mood and cognitive performance are time consuming and rely on health care professionals. This makes assessment in hyper-acute stroke units (HASU) difficult. Here we describe the use of CognoStroke, an automated assessment of mood and cognitive impairment in the HASU. Methods: Using conversational interaction delivered through a virtual, web-based agent (CognosStroke), speech analysis was performed using three large language models (GPT2, Facebook.BART-based, and RobERTa-base) to classify thresholds levels of MoCA (threshold: 22,23,24,25,26), GAD-7 (above 5 and 10), and PHQ-9 (above 5 and 10). Results are presented as Macro F1-scores (MFSs). Patients were asked about barriers to using CogonStroke. Results: A total of 151 SSs agreed to perform CognoStroke, with 75 completing the full assessment. The best MFS of 0.723 was achieved using CognoStroke for thresholding a MoCA of 26. The MFS improved further to 0.783 when single prompts or a smaller combination of prompts from the CognoStroke bank were used. For the PHQ-9 a MFS of 0.686 was achieved thresholding above 10 and on the GAD-7 a MFS of 0.617 was achieved for thresholding above 5. Single prompts or smaller prompt combinations again achieved higher MFSs. Discussion: CognoStroke has potential to classify SSs into groups with high or low cognitive and mood thresholds, highlighting benefits for improving post-stroke cognitive assessment. Challenges of automated assessment on the HASU include patient computer access, anxiety in using technology, post-stroke fatigue, and computer literacy. Full article

Background: Stroke leads to lasting disability by disrupting the connectivity of functional brain networks. Although several rehabilitation methods are promising, our full understanding of how these strategies restore network function is still limited. Here, we map how non-invasive brain stimulation (NIBS), brain–computer interface (BCI)/neurofeedback, virtual reality (VR), and robot-assisted therapy restore connectivity within the sensorimotor network (SMN), default mode network (DMN), and salience network, and we contextualize these effects within the known temporal evolution of post-stroke motor network reorganization. Methods: This scoping review adhered to PRISMA guidelines and searched PubMed, Cochrane, and Medline from January 2015 to January 2025 for clinical trials focused on stroke rehabilitation with functional connectivity outcomes. Included studies used conventional therapy, neuromodulation, or feedback-based interventions. Results: Twenty-three studies fulfilled the inclusion criteria, covering interventions like robotic training, transcranial stimulation (tDCS/TMS), brain–computer interfaces, virtual reality, and cognitive training. Motor impairments were linked to disrupted interhemispheric sensorimotor connectivity, while cognitive issues reflected changes in frontoparietal and default mode networks. Combining neuromodulation with feedback-based methods showed better network recovery than standard therapy alone, with clinical improvements closely associated with connectivity alterations. Conclusions: Effective stroke rehabilitation depends on targeting specific disrupted networks through various modalities. Robotic interventions focus on restoring structural motor pathways, feedback-enhanced methods improve temporal synchronization, and cognitive training aims to enhance higher-order network integration. Future research should work toward standardizing connectivity assessment protocols and conducting multicenter trials. This will help develop evidence-based, network-focused rehabilitation guidelines that effectively translate mechanistic insights into personalized clinical treatments. Full article

Impairments of executive function following acquired brain injury including stroke (ABI) contribute significantly to long-lasting everyday difficulties in life. Pilot work on the CO-OP Approach^TM (Cognitive Orientation to daily Occupational Performance Approach), a contextualized strategy training intervention, with ABI adults with executive dysfunction showed improved performance on untrained everyday life tasks and cognitive flexibility. Objective: Our objective was to determine the efficacy of the CO-OP Approach relative to usual occupational therapy (UOT) for community-dwelling adult survivors of ABI with executive dysfunction. Methods: Eighty-seven participants were randomized to receive CO-OP (n = 45) or UOT (n = 42) in their homes. All participants identified five personally meaningful, everyday life goals (using the Canadian Occupational Performance Measure (COPM)) and received up to 15 one-hour treatment sessions twice per week. Three goals were trained, and two were untrained. Interventions were provided by occupational therapists registered with their regulatory college. The CO-OP group was trained to apply a meta-cognitive strategy to three goals. The UOT group received therapy based on the clinicians’ (experienced in community settings) determination. Testers were masked to the participants’ group. Analysis at the primary outcome (Post-test, ~10 weeks following baseline) was on an intent-to-treat basis. Results: Participants in the CO-OP group had a mean age of 57.5 years, a mean time post-ABI of 5.3 years, and were 57.8% men. Those in the usual OT group had a mean age of 54.7 years, a mean time post-ABI of 6.2 years, and were 69.0% men. The CO-OP group reported statistically significant higher improvements on COPM performance and satisfaction scores post-test for untrained and trained goals. However, these benefits were not retained at follow-up (three months post-baseline). Conclusions: The CO-OP Approach^TM shows promise for improving performance in everyday life goals for individuals with chronic ABI relative to usual community occupational therapy. Achieving retention of these benefits remains a challenge. Full article

Background: Ischemic stroke (IS) remains a leading global cause of mortality, recurrence, and long-term disability, with survivors also at risk of post-stroke dementia (PSD) and cognitive impairment (PSCI). The precise impact of statin therapy across different IS populations, including those with cardioembolic/atrial fibrillation (CE/AF) strokes and patients with low-baseline low-density lipoprotein (LDL) cholesterol, remains unclear, as does the influence of statin timing, intensity, type, and solubility. Methods: We conducted the Impact of Statin Therapy on the Risk of Stroke Recurrence, Mortality, and Dementia After Ischemic Stroke (ISMARDD) meta-analysis, synthesizing evidence from 51 studies (n = 521,126), to evaluate the association between post-stroke statin therapy and key outcomes: all-cause mortality, stroke recurrence, cognition, and C-reactive protein (CRP). PSD was defined as new, persistent cognitive decline meeting standard diagnostic criteria, and PSCI as measurable but sub-threshold cognitive deficits. Random-effects models were used, and certainty was assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Results: Statin therapy significantly reduced all-cause mortality within 3 months (OR 0.32), at 1 year (OR 0.35), and beyond 1 year (OR 0.56). Stroke recurrence was modestly reduced both within 1 year (OR 0.77) and after 1 year (OR 0.76). Statin use was associated with a lower risk of PSD (OR 0.74) but not PSCI overall. Benefits extended to CE/AF-related strokes and patients with low-baseline LDL cholesterol, both showing significantly lower mortality with statin use. Early initiation (<24 h) was linked with reduced recurrence, though effects of statin intensity, type, and solubility were inconsistent. Statins also significantly reduced CRP levels, underscoring anti-inflammatory and pleiotropic mechanisms. Conclusions: The ISMARDD study demonstrates that statins confer survival benefit and selective cognitive protection (notably reduced PSD risk) after ischemic stroke, with modest recurrence benefit, supporting their broad use in secondary prevention. These findings highlight the need for precision-guided approaches tailored to stroke subtype, pharmacogenomics, and treatment timing to optimize therapeutic outcomes. Full article

Background: Stroke represents a leading cause of disability worldwide and is frequently associated with cognitive impairment, anxiety, and post-stroke depression (PSD), all of which can hinder rehabilitation and reduce quality of life. This study aimed to evaluate the correlations between cognitive function, depression, and anxiety in stroke survivors. Methods: A total of 71 patients (41 female, 30 male; mean age 68.1 years, range 42–88) were assessed during rehabilitation using the Mini-Mental State Examination (MMSE), the Hospital Anxiety and Depression Scale (HADS), and the Patient Health Questionnaire-9 (PHQ-9). Stroke type and comorbidities, including hypertension, chronic ischemic heart disease, atrial fibrillation, and type II diabetes, were also recorded. Results: As expected, most patients experienced ischemic strokes (73.1%), while 16.9% had hemorrhagic strokes. Comorbidities were highly prevalent, particularly hypertension (63 patients) and chronic ischemic heart disease (60 patients). Cognitive impairment (MMSE < 24) was observed in 28.2% of participants. Emotional assessment showed a mean HADS score of 11.55, with 36.6% of patients classified as having moderate to severe depression (PHQ-9 ≥ 10). Hemorrhagic stroke patients reported slightly higher PHQ-9 scores (8.4 compared to 8.2), while ischemic patients had higher HADS scores (11.8 compared to 9.8). A strong correlation was found between PHQ-9 and HADS (r = 0.90), while MMSE scores showed weak associations with emotional outcomes. Conclusions: Cognitive and affective disturbances are common during stroke rehabilitation, with depression and anxiety strongly interrelated but only weakly linked to cognitive decline. These findings emphasize the need for integrated screening and mental health support in rehabilitation programs. Future studies may explore technology-assisted tools, including virtual reality, to enhance patient engagement and recovery. Full article

Background/Objectives: Guibi-tang (GBT) and its variant Kami-guibi-tang (KGBT) are traditional East Asian multi-herb formulas prescribed for memory loss, insomnia, and fatigue. Preclinical data suggest multimodal neuroprotective actions, including cholinergic signaling modulation and activation of the cAMP response element-binding protein (CREB)/extracellular signal-regulated kinase (ERK) pathway; however, clinical evidence for cognitive disorders remains scattered. This scoping review aimed to map the breadth, design characteristics, efficacy signals, and safety profile of GBT and KGBT across the full spectrum of cognitive impairment. Methods: Following the Arksey–O’Malley framework and PRISMA-ScR guidelines, seven databases were searched (MEDLINE, Embase, Cochrane Library, China National Knowledge Infrastructure, ScienceON, Scopus, Citation Information by the National Institute of Informatics) from inception to 31 January 2025, for human studies evaluating GBT or KGBT in subjective cognitive decline, mild cognitive impairment (MCI), dementia, or post-stroke cognitive impairment (PSCI). Two reviewers independently screened, extracted, and charted data on study design, participants, interventions, outcomes, and adverse events. Results: Fifteen studies met the inclusion criteria—nine randomized controlled trials, one crossover trial, and five observational reports—enrolling 555 participants (age range, 59–87 years). All were conducted in the Republic of Korea, Japan, or China. GBT or KGBT, given as monotherapy or adjunctive therapy for 4 weeks to 9 months, produced modest but consistent improvements in global cognition (Mini-Mental State Examination/Montreal Cognitive Assessment), memory domains, activities of daily living, and neuropsychiatric symptoms across MCI, Alzheimer’s disease, and PSCI cohorts. Reported adverse event rates were comparable to or lower than those of placebo, usual care, or conventional drugs, and no serious treatment-related toxicity was identified. Conclusions: Current evidence—although limited by small sample sizes, heterogeneous formulations, short follow-up durations, and regional concentration—indicates that GBT and KGBT are well tolerated and confer clinically meaningful cognitive and functional benefits. Standardized, multicenter, placebo-controlled trials with biomarker end points are warranted to confirm long-term efficacy, clarify mechanisms, and guide integrative clinical use. Full article

Glutamate receptors represent a potential target for neuroprotection in neurodegenerative neurological conditions. Perampanel, a non-competitive α-amino-3-hydroxy-5-methyl-4-isoxazole propionate receptor (AMPAR) antagonist, is clinically approved for the management of epilepsy. Perampanel’s neuroprotective effects have been reported in global and focal cerebral ischemia models, but the cellular mechanisms remain incompletely understood. Therefore, we studied the potential neuroprotective effects of perampanel in rats using the pial vessel disruption (PVD) stroke model, an established focal cortical non-reperfusion ischemic stroke model. Perampanel was given once intraperitoneally (3 mg/kg body weight) 1 h after PVD surgery and repeated on days 2–3 post-surgery. On the fourth day post PVD, animal behavioral assays and imaging, biochemical, and electrophysiological analyses were performed. Compared to vehicle control, perampanel in PVD-treated rats significantly inhibited hippocampal neurodegeneration and long-term potentiation deficits. Perampanel also attenuated PVD-induced motor deficits, depressive/anxiety-like behaviors, and hippocampal-dependent cognitive impairment. In addition, perampanel prevented the PVD-induced downregulation of surface-expressed GluA1 and GluA2 AMPARs and increased phosphorylation of GluA1 at S831 and S845. Molecular docking analysis revealed perampanel binding to transmembrane regions M1, M3 and M4 of GluA1 and GluA2 subunits. Together, our results show that perampanel attenuated PVD-induced neurodegeneration and behavioral deficits by blocking AMPARs and decreasing GluA1 and GluA2 internalization. In addition, this study shows the neuroprotective potential of perampanel through the inhibition of neuroinflammation mediated by activated microglia and astrocytes following cerebral ischemia. This study is the first to evaluate perampanel in the pial vessel disruption model of ischemia without reperfusion, a clinically relevant stroke paradigm that differs fundamentally from middle cerebral carotid artery occlusion and photothrombosis stroke models. Full article

Background and Objectives: Stroke is widely recognised for its physical consequences. However, cognitive and emotional impairments, such as depression, anxiety, and vascular cognitive impairment (VCI), are often under-recognised and under-treated. Our study aimed to identify and characterise cognitive and emotional sequelae in patients hospitalised for acute ischemic stroke. Materials and Methods: We conducted a cross-sectional study involving 73 patients within seven days of an acute ischemic stroke. Patients were assessed using the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Montreal Cognitive Assessment (MoCA), Hachinski Ischemic Score (HIS), and the Clinical Assessment of Depression (CAD) questionnaire, which includes four subscales (Depressed Mood (DM), Anxiety/Worry, Disinterest, and Physical Fatigue). K-means clustering was applied to ten standardised clinical and psychometric variables. In addition, multiple linear regression was performed to determine independent predictors of cognitive and affective outcomes, with MoCA and CAD-DM as dependent variables. Results: Three distinct patient profiles emerged: (1) Mild Impairment Profile, characterised by minimal cognitive or emotional symptoms; (2) Depressive Profile, marked by elevated emotional symptom scores despite mild physical impairment; and (3) Vascular Cognitive Impairment Profile, comprising older patients with the most severe cognitive and functional deficits. ANOVA confirmed significant differences between groups in NIHSS, mRS, MoCA, HIS, and CAD scores, but not for age or education. Linear regression revealed that older age (β = –0.10, p = 0.012) and higher NIHSS at discharge (β = –0.72, p = 0.020) predicted lower MoCA scores, whereas years of education (β = 0.58, p = 0.013) predicted better cognition (R² = 0.29). No demographic or clinical factors predicted depressive symptoms (all p > 0.29). Conclusions: Our study highlights the heterogeneity of post-stroke outcomes. Neuropsychiatric impairments may be present even in patients with minimal physical deficits and require targeted evaluation and management. Full article