Moreno-Loscertales Cristina, Canasto-Jiménez Paula, Bautista-Lacambra Mario, Serrano-Ponz Marta, Campello-Morer Isabel, Palacín-Larroy Marta, Tejada-Meza Herbert, Sierra-Martínez Esther, López Jorge Navarro, Alfaro-Almagro Fidel, Forno-Martinic Gonzalo, Marín-Cárdenas Miguel Ángel, de la Riva Patricia, Gándara Raquel Laspiur, Marta-Moreno Eugenia, Marta-Moreno Javier
Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Neuroscience Research Group, Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain.
PLoS One. 2025 Sep 9;20(9):e0330255. doi: 10.1371/journal.pone.0330255. eCollection 2025.
Stroke is a leading cause of death and disability globally, with frequent cognitive sequelae affecting up to 60% of stroke survivors. Despite the high prevalence of post-stroke cognitive impairment (PSCI), early detection remains underemphasized in clinical practice, with limited focus on broader neuropsychological and affective symptoms. Stroke elevates dementia risk and may act as a trigger for progressive neurodegenerative diseases. However, the underlying neurobiological mechanisms and the interaction between vascular and degenerative pathways are poorly understood. The ICTUSCOG study aims to address these gaps by determining the incidence, predictors and progression factors of PSCI in a prospective, multicenter cohort of nondisabling stroke patients. The work will explore distinct patient profiles, evaluate the role of biomarkers, and develop a predictive model to identify at risk individuals.
ICTUSCOG is a five-year observational project involving four Spanish centres. Recruitment began in 2022 and includes consecutive patients aged 18-75 with no prior cognitive impairment and nondisabling stroke. Participants undergo detailed neuropsychological, functional, and neuroimaging assessments at baseline, 3, 6, and 12 months, and annually thereafter. Key data include stroke characteristics, vascular risk factors, advanced neuroimaging metrics, and biological biomarkers. Neuropsychological assessments incorporate domain-specific validated tools tailored for stroke patients.
The study will quantify the incidence of early and late PSCI, identify predictors of progression, and characterise cognitive profiles. Multivariate models and clustering techniques will explore interactions among clinical, biological and imaging data. A predictive model will be developed and validated for clinical use. ICTUSCOG will provide critical insights into the mechanisms and trajectories of PSCI, informing prevention, early intervention, and rehabilitation strategies. The work aims to establish predictive tools and care pathways to mitigate the burden of cognitive impairment in stroke survivors.
中风是全球死亡和残疾的主要原因，常有认知后遗症，影响多达60%的中风幸存者。尽管中风后认知障碍（PSCI）的患病率很高，但在临床实践中早期检测仍未得到足够重视，对更广泛的神经心理和情感症状关注有限。中风会增加患痴呆症的风险，并可能引发进行性神经退行性疾病。然而，其潜在的神经生物学机制以及血管和退行性通路之间的相互作用尚不清楚。ICTUSCOG研究旨在通过确定非致残性中风患者前瞻性多中心队列中PSCI的发病率、预测因素和进展因素来填补这些空白。这项工作将探索不同的患者特征，评估生物标志物的作用，并开发一种预测模型以识别高危个体。
ICTUSCOG是一个为期五年的观察性项目，涉及四个西班牙中心。招募工作于2022年开始，纳入年龄在18 - 75岁之间、既往无认知障碍且为非致残性中风的连续患者。参与者在基线、3个月、6个月、12个月时以及此后每年接受详细的神经心理、功能和神经影像学评估。关键数据包括中风特征、血管危险因素、先进的神经影像学指标和生物标志物。神经心理评估采用为中风患者量身定制的特定领域经过验证的工具。
该研究将量化早期和晚期PSCI的发病率，确定进展的预测因素，并描述认知特征。多变量模型和聚类技术将探索临床、生物和影像数据之间的相互作用。将开发并验证一种用于临床的预测模型。ICTUSCOG将为PSCI的机制和病程提供关键见解，为预防、早期干预和康复策略提供依据。这项工作旨在建立预测工具和护理途径，以减轻中风幸存者认知障碍的负担。
