{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:04:26Z","timestamp":1789398266663,"version":"build-2803163510"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post-stroke depression (PSD) and post-stroke cognitive impairment (PSCI) are prevalent complications in aging stroke survivors and are often overlooked due to the lack of early diagnostic indicators, leading to poor prognosis. Identifying reliable predictors is crucial for timely intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study followed 78 acute stroke survivors for 6\u202fmonths. A composite neuropsychological outcome\u2014defined as the development of PSD and\/or PSCI\u2014was determined using the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5) and NINDS-CSN criteria. To account for the limited sample size, multivariable Firth\u2019s penalized logistic regression was employed to identify independent predictors, generating robust odds ratios (ORs) and 95% confidence intervals (CIs). An exploratory classification and regression tree (CART) analysis was also conducted for hypothesis generation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The final cohort comprised 78 acute ischemic stroke survivors with a median age of 62\u202fyears (IQR 51\u201371). Among these participants, 26.0% were women, and the median admission score on the National Institutes of Health Stroke Scale (NIHSS) was 3 (IQR 1\u20135). Within 6\u202fmonths, 56 patients (71.8%) developed the composite outcome (13 experienced PSCI alone, 24 had PSD alone, and 19 had both conditions). A multivariable analysis revealed that right hemisphere lesions (OR\u202f=\u202f9.019, 95% CI: 1.329\u201361.213,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.016), greater baseline emotional distress (higher 9-item Patient Health Questionnaire (PHQ-9) scores; OR\u202f=\u202f5.157, 95% CI: 1.835\u201314.494,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and pre-existing cognitive vulnerability (lower Mini\u2013Mental State Examination (MMSE) scores; OR\u202f=\u202f0.714, 95% CI: 0.517\u20130.984,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.023) were independent predictors of poor neuropsychological outcomes. Advanced age (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.094) and elevated urea levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.095) showed only marginal trends. Exploratory CART modeling highlighted the hierarchical interaction of these baseline clinical scores for risk stratification.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Right hemisphere lesions, early emotional distress, and baseline cognitive vulnerability independently predicted a high risk of composite neuropsychological impairment at 6\u202fmonths post-stroke. Rather than serving merely as novel biomarkers, high baseline PHQ-9 scores and low MMSE scores reflected the persistence of early distress and poor cognitive reserve, respectively. These highly accessible clinical parameters facilitate early risk stratification, emphasizing the absolute need for immediate psychological triage and integrated, long-term cognitive-emotional monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1636511","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:30:47Z","timestamp":1779251447000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Identifying key predictors of post-stroke depression and cognitive impairment in acute stroke survivors"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhiwen","family":"Yan","sequence":"first","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjun","family":"Chen","sequence":"additional","affiliation":[{"name":"Chongqing Key Laboratory of Neurobiology, Institute of Neuroscience, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingli","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Mu","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical 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