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SYSTEMATIC REVIEW article

Front. Neurol.
Sec. Stroke
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1469152
This article is part of the Research Topic Post-Stroke Cognitive Decline and Dementia: Unraveling Mechanisms, Models, and Biomarkers View all 5 articles

Predictive value of lymphocyte-associated inflammation index in post-stroke cognitive impairment: a systematic review and meta-analysis

Provisionally accepted
Fengle Mao Fengle Mao 1*XIa He XIa He 2*Xia-lian Huang Xia-lian Huang 2*Yue-Ming Cheng Yue-Ming Cheng 1Fu-Li Qin Fu-Li Qin 1*Yan-Qiu Wang Yan-Qiu Wang 1*
  • 1 School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
  • 2 Sichuan Bayi Rehabilitation Centre (Sichuan Rehabilitation Hospital), Chengdu, China, Chengdu, China

The final, formatted version of the article will be published soon.

    Background: The predictive role of the lymphocyte-associated inflammation index in post-stroke cognitive impairment (PSCI) remains controversial. Therefore, we performed an updated meta-analysis to update the evidence. Methods: This meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases were systematically searched from their inception to May 5, 2024. Two investigators independently conducted literature screening and data extraction for the included studies. Two investigators independently assessed the quality of the included studies using the Newcastle-Ottawa Scale (NOS). Combined effect sizes were calculated using weighted mean difference (WMD) or standardized mean difference (SMD) with 95% confidence intervals (CIs). Heterogeneity was tested using the chi-square (χ2) test (Cochran's Q) and index of inconsistency (I2), Publication bias was assessed using funnel plots and Egger's regression test. Results: This systematic review included a total of 16 studies, encompassing 3406 patients. Meta-analysis revealed that neutrophil-to-lymphocyte ratio (NLR) levels were significantly higher in the PSCI group compared to the non-PSCI group (WMD: 1.12; 95% CI: 0.85, 1.40; p<0.00001). Similarly, the platelet-to-lymphocyte ratio (PLR) levels were significantly higher in the PSCI group compared to the non-PSCI group (WMD: 16.80; 95% CI: 4.30, 29.29; p=0.008). However, there was no statistically significant difference between the two groups concerning hemoglobin, albumin, lymphocyte, and platelet (HALP) scores (WMD: -12.78; 95% CI: -25.95, 0.38; p=0.06) and lymphocyte count (WMD: -0.13; 95% CI: -0.34, 0.07; p=0.20). Conclusion: Increased levels of PLR and NLR are strongly associated with the PSCI, which may serve as an effective tool for predicting PSCI. However, there is insufficient evidence to support a direct relationship between HALP scores, lymphocyte count, and PSCI.

    Keywords: post-stroke cognitive impairment1, lymphocyte2, inflammation index3, Systematic review4, Meta-analysis5

    Received: 23 Jul 2024; Accepted: 23 Dec 2024.

    Copyright: © 2024 Mao, He, Huang, Cheng, Qin and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Fengle Mao, School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
    XIa He, Sichuan Bayi Rehabilitation Centre (Sichuan Rehabilitation Hospital), Chengdu, China, Chengdu, China
    Xia-lian Huang, Sichuan Bayi Rehabilitation Centre (Sichuan Rehabilitation Hospital), Chengdu, China, Chengdu, China
    Fu-Li Qin, School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
    Yan-Qiu Wang, School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China

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