Surrogate Molecular Biomarkers for Poststroke Cognitive Impairment: A Narrative Review

Cognitive impairment is a clinical condition that frequently occurs after stroke, interfering with patients' functional status and increasing their risk of death. Multiple cognitive domains can be affected, including language, memory, attention, and executive functions. Current research highlights the clinical value of tools for early assessment of cognitive decline risk, enabling implementation of efficient and personalized treatment interventions. In this respect, surrogate molecular biomarkers have been identified as useful predictors of poststroke cognitive decline. After a stroke, the brain undergoes neurochemical alterations, leading to changes in the concentration of several biomarkers, which can be detected in the plasma or serum of patients and have been associated with impaired cognitive performance. However, there is still no consensus on the predictive value of those biomarkers. The present narrative review examines existing research on molecular biomarkers as a prognostic factor for poststroke cognitive deterioration, with a specific focus on the neuropsychological rigor of the methodologies used in these studies. Particularly, data concerning biomarker variations in relation to global cognitive performance and the specifically affected cognitive domains are presented. The aim is to contribute to the establishment of a scientific consensus regarding the management of stroke recovery.