Dementia After Ischemic Stroke, from Molecular Biomarkers to Therapeutic Options

Overview

Journal Int J Mol Sci

Publisher MDPI

Specialties Biochemistry
Chemistry
Molecular Biology

Date 2024 Jul 27

PMID 39063013

Authors

Vikalpa Dammavalam

Deborah Rupert

Marcos Lanio

Zhaosheng Jin

Neil Nadkarni

Stella E Tsirka

Sergio D Bergese

Affiliations

Soon will be listed here.

Abstract

Ischemic stroke is a leading cause of disability worldwide. While much of post-stroke recovery is focused on physical rehabilitation, post-stroke dementia (PSD) is also a significant contributor to poor functional outcomes. Predictive tools to identify stroke survivors at risk for the development of PSD are limited to brief screening cognitive tests. Emerging biochemical, genetic, and neuroimaging biomarkers are being investigated in an effort to unveil better indicators of PSD. Additionally, acetylcholinesterase inhibitors, NMDA receptor antagonists, dopamine receptor agonists, antidepressants, and cognitive rehabilitation are current therapeutic options for PSD. Focusing on the chronic sequelae of stroke that impair neuroplasticity highlights the need for continued investigative trials to better assess functional outcomes in treatments targeted for PSD.

Citing Articles

Recent developments in the design of functional derivatives of edaravone and exploration of their antioxidant activities.

Mohan R, Kulkarni N Mol Divers. 2024; 29(2):1895-1910.

PMID: 39102113 DOI: 10.1007/s11030-024-10940-7.

References

Winstein C, Stein J, Arena R, Bates B, Cherney L, Cramer S . Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2016; 47(6):e98-e169. DOI: 10.1161/STR.0000000000000098. View

Tatemichi T, Foulkes M, Mohr J, Hewitt J, Hier D, Price T . Dementia in stroke survivors in the Stroke Data Bank cohort. Prevalence, incidence, risk factors, and computed tomographic findings. Stroke. 1990; 21(6):858-66. DOI: 10.1161/01.str.21.6.858. View

Li J, Lin J, Pan Y, Wang M, Meng X, Li H . Interleukin-6 and YKL-40 predicted recurrent stroke after ischemic stroke or TIA: analysis of 6 inflammation biomarkers in a prospective cohort study. J Neuroinflammation. 2022; 19(1):131. PMC: 9235241. DOI: 10.1186/s12974-022-02467-1. View

Mijajlovic M, Pavlovic A, Brainin M, Heiss W, Quinn T, Ihle-Hansen H . Post-stroke dementia - a comprehensive review. BMC Med. 2017; 15(1):11. PMC: 5241961. DOI: 10.1186/s12916-017-0779-7. View

Leys D, Henon H, Mackowiak-Cordoliani M, Pasquier F . Poststroke dementia. Lancet Neurol. 2005; 4(11):752-9. DOI: 10.1016/S1474-4422(05)70221-0. View

Ikonomidou C, Turski L . Why did NMDA receptor antagonists fail clinical trials for stroke and traumatic brain injury?. Lancet Neurol. 2003; 1(6):383-6. DOI: 10.1016/s1474-4422(02)00164-3. View

Smith C, Emsley H, Gavin C, Georgiou R, Vail A, Barberan E . Peak plasma interleukin-6 and other peripheral markers of inflammation in the first week of ischaemic stroke correlate with brain infarct volume, stroke severity and long-term outcome. BMC Neurol. 2004; 4:2. PMC: 331413. DOI: 10.1186/1471-2377-4-2. View

Nave S, Doody R, Boada M, Grimmer T, Savola J, Delmar P . Sembragiline in Moderate Alzheimer's Disease: Results of a Randomized, Double-Blind, Placebo-Controlled Phase II Trial (MAyflOwer RoAD). J Alzheimers Dis. 2017; 58(4):1217-1228. PMC: 5523913. DOI: 10.3233/JAD-161309. View

Sagnier S, Catheline G, Dilharreguy B, Munsch F, Bigourdan A, Poli M . Admission Brain Cortical Volume: An Independent Determinant of Poststroke Cognitive Vulnerability. Stroke. 2017; 48(8):2113-2120. DOI: 10.1161/STROKEAHA.117.017646. View

10.

Wardlaw J, Smith E, Biessels G, Cordonnier C, Fazekas F, Frayne R . Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol. 2013; 12(8):822-38. PMC: 3714437. DOI: 10.1016/S1474-4422(13)70124-8. View

11.

El Husseini N, Katzan I, Rost N, Blake M, Byun E, Pendlebury S . Cognitive Impairment After Ischemic and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association/American Stroke Association. Stroke. 2023; 54(6):e272-e291. DOI: 10.1161/STR.0000000000000430. View

12.

Hill M, Goyal M, Menon B, Nogueira R, McTaggart R, Demchuk A . Efficacy and safety of nerinetide for the treatment of acute ischaemic stroke (ESCAPE-NA1): a multicentre, double-blind, randomised controlled trial. Lancet. 2020; 395(10227):878-887. DOI: 10.1016/S0140-6736(20)30258-0. View

13.

Ji Y, Gao Q, Ma Y, Wang F, Tan X, Song D . An MMP-9 exclusive neutralizing antibody attenuates blood-brain barrier breakdown in mice with stroke and reduces stroke patient-derived MMP-9 activity. Pharmacol Res. 2023; 190:106720. DOI: 10.1016/j.phrs.2023.106720. View

14.

Folstein M, Folstein S, McHugh P . "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-98. DOI: 10.1016/0022-3956(75)90026-6. View

15.

Sano M, Ernesto C, Thomas R, Klauber M, Schafer K, Grundman M . A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study. N Engl J Med. 1997; 336(17):1216-22. DOI: 10.1056/NEJM199704243361704. View

16.

Johnston S, Easton J, Farrant M, Barsan W, Battenhouse H, Conwit R . Platelet-oriented inhibition in new TIA and minor ischemic stroke (POINT) trial: rationale and design. Int J Stroke. 2013; 8(6):479-83. PMC: 4412261. DOI: 10.1111/ijs.12129. View

17.

Smith E, Schneider J, Wardlaw J, Greenberg S . Cerebral microinfarcts: the invisible lesions. Lancet Neurol. 2012; 11(3):272-82. PMC: 3359329. DOI: 10.1016/S1474-4422(11)70307-6. View

18.

Kavirajan H, Schneider L . Efficacy and adverse effects of cholinesterase inhibitors and memantine in vascular dementia: a meta-analysis of randomised controlled trials. Lancet Neurol. 2007; 6(9):782-92. DOI: 10.1016/S1474-4422(07)70195-3. View

19.

Chang W, Park Y, Ohn S, Park C, Lee P, Kim Y . Neural correlates of donepezil-induced cognitive improvement in patients with right hemisphere stroke: a pilot study. Neuropsychol Rehabil. 2011; 21(4):502-14. DOI: 10.1080/09602011.2011.582708. View

20.

Saver J, Goyal M, Bonafe A, Diener H, Levy E, Pereira V . Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med. 2015; 372(24):2285-95. DOI: 10.1056/NEJMoa1415061. View