TY - JOUR
T1 - Post-stroke cognition at 1 and 3 years is influenced by the location of white matter hyperintensities in patients with lacunar stroke
AU - Valdés Hernández, Maria Del Carmen
AU - Grimsley-Moore, Tara
AU - Chappell, Francesca M
AU - Thrippleton, Michael J.
AU - Armitage, Paul A
AU - Sakka, Eleni
AU - Makin, Stephen
AU - Wardlaw, Joanna M
N1 - MV was funded by Row Fogo Charitable Trust (Grant No. BROD.FID3668413). Patient recruitment, data acquisition, and processing were funded by the Wellcome Trust (Ref No. WT088134/Z/09/A). Fondation Leducq (Perivascular Spaces Transatlantic Network of Excellence), EU Horizon 2020 (SVDs@Target) and the MRC UK Dementia Research Institute at the University of Edinburgh (Wardlaw programme) partially fund our research.
The original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding author/s.
PY - 2021/3/1
Y1 - 2021/3/1
N2 - Lacunar strokes are a common type of ischemic stroke. They are known to have long-term cognitive deficits, but the influencing factors are still largely unknown. We investigated if the location of the index lacunar stroke or regional WMH and their change at 1 year could predict the cognitive performance at 1 and 3 years post-stroke in lacunar stroke patients. We used lacunar lesion location and WMH-segmented data from 118 patients, mean age 64.9 who had a brain MRI scan soon after presenting with symptoms, of which 88 had a repeated scan 12 months later. Premorbid intelligence (National Adult Reading Test) and current intelligence [Addenbrooke's Cognitive Exam-Revised (ACE-R)] were measured at 1, 12, and 36 months after the stroke. ANCOVA analyses adjusting for baseline cognition/premorbid intelligence, vascular risk factors, age, sex and total baseline WMH volume found that the recent small subcortical infarcts (RSSI) in the internal/external capsule/lentiform nucleus and centrum semiovale did not predict cognitive scores at 12 and 36 months. However, RSSI location moderated voxel-based associations of WMH change from baseline to 1 year with cognitive scores at 1 and 3 years. WMH increase in the external capsule, intersection between the anterior limb of the internal and external capsules, and optical radiation, was associated with worsening of ACE-R scores 1 and 3 years post-stroke after accounting for the location of the index infarct, age and baseline cognition.
AB - Lacunar strokes are a common type of ischemic stroke. They are known to have long-term cognitive deficits, but the influencing factors are still largely unknown. We investigated if the location of the index lacunar stroke or regional WMH and their change at 1 year could predict the cognitive performance at 1 and 3 years post-stroke in lacunar stroke patients. We used lacunar lesion location and WMH-segmented data from 118 patients, mean age 64.9 who had a brain MRI scan soon after presenting with symptoms, of which 88 had a repeated scan 12 months later. Premorbid intelligence (National Adult Reading Test) and current intelligence [Addenbrooke's Cognitive Exam-Revised (ACE-R)] were measured at 1, 12, and 36 months after the stroke. ANCOVA analyses adjusting for baseline cognition/premorbid intelligence, vascular risk factors, age, sex and total baseline WMH volume found that the recent small subcortical infarcts (RSSI) in the internal/external capsule/lentiform nucleus and centrum semiovale did not predict cognitive scores at 12 and 36 months. However, RSSI location moderated voxel-based associations of WMH change from baseline to 1 year with cognitive scores at 1 and 3 years. WMH increase in the external capsule, intersection between the anterior limb of the internal and external capsules, and optical radiation, was associated with worsening of ACE-R scores 1 and 3 years post-stroke after accounting for the location of the index infarct, age and baseline cognition.
KW - recent small subcortical infarct
KW - lacunar
KW - stroke
KW - white matter hyperintensities
KW - cognition
U2 - 10.3389/fneur.2021.634460
DO - 10.3389/fneur.2021.634460
M3 - Article
VL - 12
JO - Frontiers in Neurology
JF - Frontiers in Neurology
SN - 1664-2295
M1 - 634460
ER -