Artificial Intelligence and Emerging Digital Technologies Across the Stroke Continuum: From Risk Prediction to Real-Time Monitoring and Rapid Response
Matteo Gregorini, Lorenzo Lorusso, Larissa Airoldi, Maria Di Stefano, Anna Formenti, Gabriele Lucchi, Paola Melzi, Elisabetta Perego, Elena Tagliabue, Antonio Tetto, Manuela VaccaroStroke remains a leading cause of death and long-term disability worldwide, making prevention strategies a global health priority. Emerging technologies—including artificial intelligence (AI), wearable devices, digital health applications, and drone-assisted emergency systems—are increasingly being explored to improve stroke prevention and early management. In primary prevention, machine learning models can identify individuals at high risk of stroke using clinical and behavioral data with high reported predictive accuracy, although most models are derived from retrospective, single-center datasets and still require prospective external validation. Digital devices and wearable technologies enable continuous monitoring of cardiovascular risk factors and support behavioral interventions aimed at reducing vascular risk. In secondary prevention, AI-based tools are being developed to predict stroke recurrence, identify modifiable risk factors, and detect patients at risk of poor medication adherence. In the acute setting, AI-assisted neuroimaging platforms are already integrated into clinical and telestroke workflows, supporting rapid triage and treatment decisions. In parallel, drone-based emergency systems may contribute to improved outcomes by reducing prehospital delays and facilitating telemedicine-based triage in remote or resource-limited settings, although current evidence is derived largely from out-of-hospital cardiac arrest pathways rather than stroke-specific trials. Although advanced neurotechnological systems capable of real-time neurophysiological monitoring and closed-loop neuromodulation exist in other neurological disorders, their role in stroke prevention remains largely theoretical. Overall, these technologies offer promising opportunities to reshape the continuum of stroke prevention and care, but further validation, integration into clinical workflows, and evidence of real-world effectiveness are required before widespread implementation.