Network analysis of neuropsychiatric, cognitive, and functional complications of stroke: implications for novel treatment targets-Reference-Cited by-同舟云学术

Network analysis of neuropsychiatric, cognitive, and functional complications of stroke: implications for novel treatment targets

Published:2024-01-29 Issue: Volume: Page:
ISSN:1323-1316
Container-title:Psychiatry and Clinical Neurosciences
language:en
Short-container-title:Psychiatry Clin Neurosci

Author:

Oestreich Lena K.L.¹²^ORCID,Lo Jessica W.³,Di Biase Maria A.⁴⁵,Sachdev Perminder S.³⁶^ORCID,Mok Alice H.¹,Wright Paul⁷,Crawford John D.³,Lam Ben³,Traykov Latchezar⁸,Köhler Sebastian⁹,Staals Julie E.A.¹⁰,van Oostenbrugge Robert¹⁰,Chen Christopher¹¹,Desmond David W.¹²,Yu Kyung‐Ho¹³,Lee Minwoo¹³,Klimkowicz‐Mrowiec Aleksandra¹⁴,Bordet Régis¹⁵,O'Sullivan Michael J.¹⁶¹⁷,Zalesky Andrew⁴¹⁸

Affiliation:

1. School of Psychology The University of Queensland Brisbane Queensland Australia

2. Centre for Advanced Imaging and Australian Institute for Bioengineering and Nanotechnology The University of Queensland Brisbane Queensland Australia

3. (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine University of New South Wales Sydney New South Wales Australia

4. Melbourne Neuropsychiatry Centre, Department of Psychiatry The University of Melbourne and Melbourne Health Carlton Victoria Australia

5. Department of Psychiatry Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts USA

6. Neuropsychiatric Institute The Prince of Wales Hospital Sydney New South Wales Australia

7. Biomedical Engineering Department King's College London London UK

8. Department of Neurology, UH Alexandrovska Medical University‐Sofia Sofia Bulgaria

9. School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology Maastricht University Maastricht The Netherlands

10. Department of Neurology, School for Cardiovascular diseases (CARIM) Maastricht University Medical Center (MUMC+) The Netherlands

11. Memory Ageing and Cognition Centre, Department of Pharmacology Yong Loo Lin School of Medicine, National University of Singapore Singapore Singapore

12. Independent Researcher Florida USA

13. Department of Neurology Hallym University Sacred Heart Hospital Anyang South Korea

14. Department of Internal Medicine and Gerontology Jagiellonian University Medical College Krakow Poland

15. Department of Pharmacology, Lille Neuroscience & Cognition University of Lille Lille France

16. Department of Neurology Royal Brisbane and Women's Hospital Brisbane Queensland Australia

17. Institute of Molecular Bioscience The University of Queensland Brisbane Queensland Australia

18. Melbourne School of Engineering The University of Melbourne Parkville Victoria Australia

Abstract

AimRecovery from stroke is adversely affected by neuropsychiatric complications, cognitive impairment, and functional disability. Better knowledge of their mutual relationships is required to inform effective interventions. Network theory enables the conceptualization of symptoms and impairments as dynamic and mutually interacting systems. We aimed to identify interactions of poststroke complications using network analysis in diverse stroke samples.MethodsData from 2185 patients were sourced from member studies of STROKOG (Stroke and Cognition Consortium), an international collaboration of stroke studies. Networks were generated for each cohort, whereby nodes represented neuropsychiatric symptoms, cognitive deficits, and disabilities on activities of daily living. Edges characterized associations between them. Centrality measures were used to identify hub items.ResultsAcross cohorts, a single network of interrelated poststroke complications emerged. Networks exhibited dissociable depression, apathy, fatigue, cognitive impairment, and functional disability modules. Worry was the most central symptom across cohorts, irrespective of the depression scale used. Items relating to activities of daily living were also highly central nodes. Follow‐up analysis in two studies revealed that individuals who worried had more densely connected networks than those free of worry (CASPER [Cognition and Affect after Stroke: Prospective Evaluation of Risks] study: S = 9.72, P = 0.038; SSS [Sydney Stroke Study]: S = 13.56, P = 0.069).ConclusionNeuropsychiatric symptoms are highly interconnected with cognitive deficits and functional disabilities resulting from stroke. Given their central position and high level of connectedness, worry and activities of daily living have the potential to drive multimorbidity and mutual reinforcement between domains of poststroke complications. Targeting these factors early after stroke may have benefits that extend to other complications, leading to better stroke outcomes.

Funder

Universiteit Maastricht

Medical University Sofia

Medical Research Council

National Health and Medical Research Council

Wellcome Trust

Horizon 2020 Framework Programme

Rebecca L. Cooper Medical Research Foundation

Publisher

Wiley

Subject

Psychiatry and Mental health,Neurology (clinical),Neurology,General Medicine,General Neuroscience