The objective of this study was to assess the discriminatory capacity of a newly developed screening test, the MCE, in patients with at most mild post-stroke cognitive impairment (PSCI) as defined by an MMSE score ≥20. The primary objective of the study was to ascertain the most accurate screening test (MMSE, MoCA, MCE) for discriminating stroke from controls. The secondary objectives were (1) to determine the most accurate test for identifying patients with PSCI, and (2) to examine the associations between MCE and the location of cerebral atrophy using VBM analysis

We included 122 patients referred in the acute stroke unit (ASU) of Amiens University Hospital (62 assessed in the ASU and 60 at post-stroke visit) (age: 64.2±13 yrs; sex: 38.5% female; infarct/hemorrhage: 92/8%; NIHSS: 3.96±5) and 436 controls; comprehensive assessment was performed in 89 patients, 44 of whom had a PSCI.

The MCE demonstrated superiority (p = 0.0001) to the MMSE and MoCA in (1)  discriminating between patients and controls (ROC AUC of 0.791 [0.731, 0.851]) and (2) discriminating patients with PSCI (ROC AUC = 0.896 [0.838-0.954]) (p=0.001). MCE score was associated with overall brain atrophy (p= 0.01) and using VBM analysis with atrophy of numerous hemispheric structures, predominantly on the left side (p ≤ 0.001, uncorrected).

This study, which exclusively included patients with at most mild PSCI, demonstrated that MCE is a highly promising diagnostic tool for identifying PSCI, even in its early stages. The potential benefit of its use as a first line test in the management of stroke patients has now to be determined.