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

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Title: Network analysis of neuropsychiatric, cognitive, and functional complications of stroke: implications for novel treatment targets.
Authors: Oestreich, Lena K.L. (AUTHOR), Lo, Jessica W. (AUTHOR), Di Biase, Maria A. (AUTHOR), Sachdev, Perminder S. (AUTHOR), Mok, Alice H. (AUTHOR), Wright, Paul (AUTHOR), Crawford, John D. (AUTHOR), Lam, Ben (AUTHOR), Traykov, Latchezar (AUTHOR), Köhler, Sebastian (AUTHOR), Staals, Julie E.A. (AUTHOR), van Oostenbrugge, Robert (AUTHOR), Chen, Christopher (AUTHOR), Desmond, David W. (AUTHOR), Yu, Kyung‐Ho (AUTHOR), Lee, Minwoo (AUTHOR), Klimkowicz‐Mrowiec, Aleksandra (AUTHOR), Bordet, Régis (AUTHOR), O'Sullivan, Michael J. (AUTHOR), Zalesky, Andrew (AUTHOR)
Source: Psychiatry & Clinical Neurosciences. Apr2024, Vol. 78 Issue 4, p229-236. 8p.
Subjects: Apathy, Stroke, Activities of daily living
Geographic Terms: Casper (Wyo.)
Abstract: Aim: Recovery 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. Methods: Data 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. Results: Across 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). Conclusion: Neuropsychiatric 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. [ABSTRACT FROM AUTHOR]
Copyright of Psychiatry & Clinical Neurosciences is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Network analysis of neuropsychiatric, cognitive, and functional complications of stroke: implications for novel treatment targets.
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  Data: <searchLink fieldCode="JN" term="%22Psychiatry+%26+Clinical+Neurosciences%22">Psychiatry & Clinical Neurosciences</searchLink>. Apr2024, Vol. 78 Issue 4, p229-236. 8p.
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  Data: <searchLink fieldCode="DE" term="%22Apathy%22">Apathy</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke%22">Stroke</searchLink><br /><searchLink fieldCode="DE" term="%22Activities+of+daily+living%22">Activities of daily living</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Casper+%28Wyo%2E%29%22">Casper (Wyo.)</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Aim: Recovery 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. Methods: Data 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. Results: Across 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). Conclusion: Neuropsychiatric 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. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Psychiatry & Clinical Neurosciences is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/pcn.13633
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        Text: English
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      – SubjectFull: Activities of daily living
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              Text: Apr2024
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