Kandiah et al reported the Signal2 risk score for evaluating a patient after a mild stroke. This can help to identify a patient at risk for cognitive impairment. The authors are from National Neurosciences Institute, Duke-NUS Graduate Medical School and Singapore Clinical Research Institute in Singapore.
Signal2 is an acronym for stenosis, infarct type, global cortical atrophy, number of years of education, age, leukoarisosis (white matter intensity), lacune count
Patient selection: status/post mild stroke
Parameters:
(1) age in years
(2) education in years
(3) global cortical atrophy (GCA) stages
(4) Fazekas stages for white matter hyperintensity
(5) nonlacunar cortical infarcts
(6) number of chronic lacunes
(7) intracranial stenosis
|
Parameter
|
Finding
|
Points
|
|
age in years
|
< 50 years
|
0
|
|
|
50 to 64.99 years
|
2
|
|
|
>= 65 years
|
4
|
|
education in years
|
< 6 years
|
2
|
|
|
>= 6 years
|
0
|
|
GCA stages
|
0
|
0
|
|
|
1
|
1
|
|
|
2 or 3
|
2
|
|
Fazekas stages
|
0 or 1
|
0
|
|
|
2
|
1
|
|
|
3
|
2
|
|
nonlacunar cortical infarcts stages
|
none
|
0
|
|
|
1 infarct
|
1
|
|
|
>= 2 infarcts
|
2
|
|
chronic lacunae
|
0 or 1
|
0
|
|
|
>= 2
|
2
|
|
intracranial stenosis
|
no
|
0
|
|
|
yes
|
1
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 15
• A score >= 7 has a sensitivity of 82% and specificity of 68%.
Performance:
• The area under the ROC curve is 0.83 in the derivation and 0.78 in the validation cohorts.
