Serum AMPK: An Emerging Biomarker of Cognitive Outcomes in Acute Ischemic Stroke

AMP-activated protein kinase (AMPK) plays a central role in maintaining intracellular energy homeostasis and is critically involved in processes that safeguard neural function. However, its clinical significance in the context of ischemic stroke, particularly with respect to stroke severity and subsequent cognitive function has not been thoroughly investigated. A cross-sectional study was conducted involving a cohort of 58 patients experiencing acute ischemic stroke. Neurological deficits related to the stroke were assessed using the national institutes health stroke scale (NIHSS), whereas cognitive abilities were evaluated through the Montreal Cognitive Assessment–Indonesia (MoCA-InA). Circulating AMPK concentrations were measured utilizing enzyme-linked immunosorbent assay (ELISA) techniques. The analysis included correlation assessments, intergroup comparisons, and receiver operating characteristic (ROC) curve analysis. Serum AMPK concentrations demonstrated a significant positive correlation with MoCA-InA scores (r = 0.656, p<0.001), while their correlation with NIHSS scores was weakly negative and not statistically significant (r = –0.171, p = 0.200). Patients with cognitive impairment presented with markedly reduced AMPK levels (0.85 ± 0.07 ng/dL) compared to cognitively intact participants (1.02 ± 0.10 ng/dL; p<0.001). The analysis of the ROC curve yielded an area under the curve (AUC) of 0.843, indicating strong diagnostic performance. At a cutoff value of ≤ 0.94 ng/dL, sensitivity was 92.59%, and specificity was 80.65%. Serum AMPK levels are significantly associated with cognitive function, but not with stroke severity in acute ischemic stroke. AMPK shows potential as a supportive biomarker for early identification of cognitive impairment in this population.