Please use this identifier to cite or link to this item:
http://hdl.handle.net/1942/35756
Title: | European Stroke Organisation and European Academy of Neurology joint guidelines on post-stroke cognitive impairment | Authors: | Quinn, Terence J. Richard, Edo Teuschl, Yvonne Gattringer, Thomas Hafdi, Melanie O'Brien, John T. Merriman, Niamh Gillebert, Celine Huyglier, Hanne Verdelho, Ana Schmidt, Reinhold Ghaziani, Emma Forchammer, Hysse Pendlebury, Sarah T. BRUFFAERTS, Rose Mijajlovic, Milija Drozdowska, Bogna A. Ball, Emily Markus, Hugh S. |
Issue Date: | 2021 | Publisher: | SAGE PUBLICATIONS LTD | Source: | EUROPEAN STROKE JOURNAL, 6 (3) | Abstract: | Introduction: The optimal management of post stroke cognitive impairment remains controversial. These joint European Stroke Organisation (ESO) and European Academy of Neurology (EAN) guidelines provide evidence-based recommendations to assist clinicians in decision making around prevention, diagnosis, treatment, and prognosis. Methods: These guidelines were developed according to ESO standard operating procedure and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. The working group identified relevant clinical questions, performed systematic reviews and, where possible, meta-analyses of the literature, assessed the quality of the available evidence, and made specific recommendations. Expert consensus statements were provided where insufficient evidence was available to provide recommendations based on the GRADE approach. Results: There was limited randomised controlled trial evidence regarding single or multicomponent interventions to prevent post stroke cognitive decline. Interventions to improve lifestyle and treat vascular risk factors may have many health benefits but a beneficial effect on cognition is not proven. We found no evidence around routine cognitive screening following stroke but recognise the importance of targeted cognitive assessment. We described the accuracy of various cognitive screening tests but found no clearly superior approach to testing. There was insufficient evidence to make a recommendation for use of cholinesterase inhibitors, memantine or cognitive rehabilitation for post stroke dementia. We made a weak recommendation against using the nootropics actovegin and cerebrolysin, but quality of evidence was very low. There was limited evidence on the use of prediction tools for post stroke cognitive syndromes (cognitive impairment, dementia and delirium). The association between post stroke cognitive impairment and most acute structural brain imaging features was unclear. Conclusions: These guidelines have highlighted fundamental areas where robust evidence is lacking. Further randomised controlled trials are needed and we suggest priority areas for future research. | Notes: | Quinn, TJ (corresponding author), Univ Glasgow, Glasgow Royal Infirm, Inst Cardiovasc & Med Sci, New Lister Bldg Campus, Glasgow G4 0SF, Lanark, Scotland. terry.quinn@glasgow.ac.uk |
Keywords: | cognition;dementia;diagnosis;guidelines;stroke;prognosis | Document URI: | http://hdl.handle.net/1942/35756 | ISSN: | 2396-9873 | e-ISSN: | 2396-9881 | DOI: | 10.1177/23969873211042192 | ISI #: | WOS:000696341500001 | Rights: | European Stroke Organisation 2021 | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2022 |
Appears in Collections: | Research publications |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
quinn-et-al-2021-european-stroke-organisation-and-european-academy-of-neurology-joint-guidelines-on-post-stroke.pdf | Published version | 1.26 MB | Adobe PDF | View/Open |
WEB OF SCIENCETM
Citations
34
checked on Jul 11, 2024
Page view(s)
14
checked on Mar 29, 2022
Google ScholarTM
Check
Altmetric
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.