{ "abstract": "Background: Post-stroke cognitive impairment is a common complication associated with reduced functional independence and quality of life. Although adequate daily energy intake is considered an essential component of stroke rehabilitation, its association with cognitive recovery after mechanical thrombectomy remains poorly understood. This study investigated the relationship between daily energy intake and 90-day cognitive outcomes in patients with acute ischemic stroke treated with mechanical thrombectomy. Methods: This multicenter retrospective observational cohort study included 100 consecutive patients undergoing mechanical thrombectomy between 1 April 2025 and 1 April 2026 at stroke centers in the United Kingdom and Romania. Daily energy and macronutrient intake were retrospectively extracted from routine clinical records and normalized to body weight (kcal/kg/day). Daily energy intake was evaluated primarily as a continuous exposure (kcal/kg/day), while the originally defined 31 kcal/kg/day grouping was retained for exploratory categorical analyses. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA) at baseline and, among survivors with available cognitive follow-up, at 90 days. The primary multivariable model evaluated daily energy intake (kcal/kg/day) as a continuous exposure and adjusted for baseline MoCA, atrial fibrillation, chronic coronary artery disease, admission NIHSS, C-reactive protein, and PICA/AICA/SCA occlusion. HC3 heteroscedasticity-consistent standard errors were used for robust inference. Results: Among patients with available 90-day cognitive assessment, those with higher energy intake achieved significantly higher 90-day MoCA scores than those with lower intake (24.2 ± 2.1 vs. 20.0 ± 1.5; p < 0.001) and greater cognitive improvement (ΔMoCA: 3.82 ± 1.08 vs. 0.48 ± 0.54 points; p < 0.001). In the primary continuous-exposure model, each additional 1 kcal/kg/day was associated with a 0.18-point higher 90-day MoCA score after multivariable adjustment (β = 0.179, HC3 95% CI 0.081–0.278; p < 0.001). The association remained similar in an expanded sensitivity model addressing available indicators of baseline severity (β = 0.176, HC3 95% CI 0.071–0.281; p = 0.002). Exploratory categorical analyses also showed higher 90-day MoCA scores in the higher-intake group. No significant differences were observed in NIHSS or mRS at 90 days. Conclusions: Higher daily energy intake was associated with higher 90-day cognitive performance among survivors with available cognitive follow-up after mechanical thrombectomy. Given the retrospective observational design, baseline differences between exposure groups, and potential residual confounding and reverse causality, these findings should be considered exploratory and hypothesis-generating. Prospective studies are required to determine whether nutritional optimization can influence cognitive recovery after stroke.", "abstract_shown": true, "affiliations": [ "Centre for Cognitive Research in Neuropsychiatric Pathology (Neuro-Psy-Cog), Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy from Timisoara, E. Murgu Sq., No. 2, 300041 Timisoara, Romania", "Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy from Timisoara, E. Murgu Sq., No. 2, 300041 Timisoara, Romania", "Department of Interventional Neuroradiology, Queen’s Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, London RM7 0AG, UK", "Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds LS2 9JT, UK", "Department of Stroke Medicine, Queen’s Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, London RM7 0AG, UK", "Department of Neurosciences, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK", "First Division of Neurology, Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy from Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania", "Department of Neurology I, Pius Brînzeu County Clinical Emergency Hospital, 156 L. Rebreanu Ave., 300723 Timisoara, Romania", "First Department of Surgery—Clinic of Surgical Semiotics and Thoracic Surgery, Centre for Hepato-Biliary and Pancreatic Surgery, “Victor Babes” University of Medicine and Pharmacy from Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania", "Department of Anesthesia and Intensive Care, “Victor Babes” University of Medicine and Pharmacy from Timisoara, E. Murgu Sq., No. 2, 300041 Timisoara, Romania", "Department of Radiology, “Victor Babes” University of Medicine and Pharmacy from Timisoara, E. Murgu Sq., No. 2, 300041 Timisoara, Romania", "Department of Interventional Radiology, Pius Brînzeu County Clinical Emergency Hospital, 156 L. Rebreanu Ave., 300723 Timisoara, Romania", "Doctoral School, “Victor Babes” University of Medicine and Pharmacy from Timisoara, E. Murgu Sq., No. 2, 300041 Timisoara, Romania", "Department of Neuroscience, “Victor Babes” University of Medicine and Pharmacy from Timisoara, E. Murgu Sq., No. 2, 300041 Timisoara, Romania", "Centre for Neuropsychology and Behavioural Medicine, “Victor Babes” University of Medicine and Pharmacy from Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania" ], "article_type": null, "arxiv": null, "author_total": 14, "authors": [ { "affs": [ 0, 1, 2 ], "name": "Sergiu Florin Arnăutu", "orcid": "0000-0002-4825-9658" }, { "affs": [ 1, 3 ], "name": "Diana Aurora Arnăutu", "orcid": "0000-0001-9959-5718" }, { "affs": [ 2 ], "name": "Tufail Patankar" }, { "affs": [ 2 ], "name": "Mohd Shariq", "orcid": "0000-0003-1946-2590" }, { "affs": [ 4 ], "name": "Hamood Qazi" }, { "affs": [ 2 ], "name": "Martin Lewis" }, { "affs": [ 5 ], "name": "Sara Sciacca", "orcid": "0000-0002-5263-0392" }, { "affs": [ 0, 6, 7 ], "name": "Dragoș Cătălin Jianu", "orcid": "0000-0002-7827-818X" }, { "affs": [ 8 ], "name": "Octavian M. Crețu" }, { "affs": [ 9 ], "name": "Dorel Sandesc" }, { "affs": [ 10 ], "name": "Claudiu-Daniel Malița" }, { "affs": [ 11, 12 ], "name": "Cătălin Juratu" }, { "affs": [ 12, 13, 14 ], "name": "Brenda-Cristiana Bernad" }, { "affs": [ 2, 5 ], "name": "Jeremy Lynch" } ], "bibtex": "https://research.draconitic.com/paper/ac8jz6rz67jwx.bib", "cited_by": 0, "doi": "10.3390/jcm15218333", "fulltext_url": null, "id": "ac8jz6rz67jwx", "issns": [ "2077-0383" ], "landing_url": "https://www.mdpi.com/2077-0383/15/21/8333", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2713|Acute Ischemic Stroke Management" ] ], "openalex": "W7223941013", "pdf_url": null, "pmcid": null, "pmid": null, "published": "2026-10-26", "publisher": "MDPI AG", "ris": "https://research.draconitic.com/paper/ac8jz6rz67jwx.ris", "sources": [ { "first_seen": "2026-10-30T12:20:01Z", "native_id": "10.3390/jcm15218333", "source": "crossref", "url": "https://www.mdpi.com/2077-0383/15/21/8333" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2713|Acute Ischemic Stroke Management", "subfield": "epidemiology-public-health" } ], "title": "Association Between Daily Energy Intake and Cognitive Recovery After Mechanical Thrombectomy for Acute Ischemic Stroke: A Multicenter Retrospective Study", "title_text": "Association Between Daily Energy Intake and Cognitive Recovery After Mechanical Thrombectomy for Acute Ischemic Stroke: A Multicenter Retrospective Study", "type": "peer-reviewed", "updated_at": "2026-10-30T12:20:01Z", "url": "https://research.draconitic.com/paper/ac8jz6rz67jwx", "venue": "Journal of Clinical Medicine", "versions": [] }