Association between Striatal Brain Iron Deposition, Microbleeds and Cognition 1 Year After a Minor Ischaemic Stroke

Maria del C. Valdés Valdes Hernandez (Corresponding Author), Tessa Case, Francesca M Chappell, Andreas Glatz, Stephen Makin, Fergus Doubal, Joanna M Wardlaw

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Abstract

Brain iron deposits (IDs) are inversely associated with cognitive function in community-dwelling older people, but their association with cognition after ischemic stroke, and whether that differs from microbleeds, is unknown. We quantified basal ganglia IDs (BGID) and microbleeds (BMBs) semi-automatically on brain magnetic resonance images from patients with minor stroke (NIHSS <7), at presentation and 12 months after stroke. We administered the National Adult Reading Test (NART, estimates premorbid or peak adult cognition) and the Revised Addenbrooke's Cognitive Examination (ACE-R; current cognition) at 1 and 12 months after stroke. We adjusted analyses for baseline cognition, age, gender, white matter hyperintensity (WMH) volume and vascular risk factors. In 200 patients, mean age 65 years, striatal IDs and BMBs volumes did not change over the 12 months. Baseline BGID volumes correlated positively with NART scores at both times (rho = 0.19, p <0.01). Baseline and follow-up BGID volumes correlated positively with age (rho = 0.248, p <0.001 and rho = 0.271, p <0.001 respectively), but only baseline (and not follow-up) BMB volume correlated with age (rho = 0.129, p <0.05). Both smoking and baseline WMH burden predicted verbal fluency and visuospatial abilities scores (B = -1.13, p <0.02 and B = -0.22, p = 0.001 respectively) at 12 months after stroke. BGIDs and BMBs are associated differently with cognition post-stroke; studies of imaging and post-stroke cognition should adjust for premorbid cognition. The positive correlation of BGID with NART may reflect the lower premorbid cognition in patients with stroke at younger vs older ages.
Original languageEnglish
Article number1293
Journal International Journal of Molecular Sciences
Volume20
Issue number6
DOIs
Publication statusPublished - 14 Mar 2019

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Keywords

  • Aged Cerebral Hemorrhage/*diagnostic imaging/etiology/metabolism/psychology Cerebral Small Vessel Diseases/complications Cohort Studies Corpus Striatum/diagnostic imaging/*metabolism Female Humans Iron/*metabolism Ischemic Attack, Transient/*psychology Magnetic Resonance Imaging Male Middle Aged Severity of Illness Index Stroke/*psychology Mri ageing brain microbleeds cognition iron deposits white matter hyperintensities
  • White matter hyperintensities
  • MRI
  • Ageing
  • Iron deposits
  • Cognition
  • Brain microbleeds
  • Corpus Striatum/diagnostic imaging
  • Severity of Illness Index
  • Humans
  • Middle Aged
  • Cerebral Hemorrhage/diagnostic imaging
  • Ischemic Attack, Transient/psychology
  • Male
  • Cerebral Small Vessel Diseases/complications
  • Magnetic Resonance Imaging
  • Female
  • Aged
  • Iron/metabolism
  • Cohort Studies
  • Stroke/psychology
  • PREDICTS
  • DEMENTIA
  • T2-ASTERISK-WEIGHTED MRI
  • CEREBRAL MICROBLEEDS
  • brain microbleeds
  • DYSFUNCTION
  • SMALL VESSEL DISEASE
  • ageing
  • RISK-FACTORS
  • cognition
  • BASAL GANGLIA
  • white matter hyperintensities
  • DAMAGE
  • DECLINE
  • iron deposits

ASJC Scopus subject areas

  • Molecular Biology
  • Spectroscopy
  • Catalysis
  • Inorganic Chemistry
  • Computer Science Applications
  • Physical and Theoretical Chemistry
  • Organic Chemistry

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