08 Mar 21. Featured Paper

Post-stroke cognition at 1 & 3 years is influenced by the location of white matter hyperintensities in patients with lacunar stroke.

Link to paper on Frontiers in Neurology

Authors

Maria del C. Valdés Hernández, Tara Grimsley-Moore, Francesca M. Chappell, Michael J. Thrippleton, Paul A. Armitage, Eleni Sakka, Stephen Makin & Joanna M. Wardlaw

Abstract

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 & their change at 1 year could predict the cognitive performance at 1 & 3 years post-stroke in lacunar stroke patients.

We used lacunar lesion location & 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) & current intelligence [Addenbrooke's Cognitive Exam-Revised (ACE-R)] were measured at 1, 12, & 36 months after the stroke.

ANCOVA analyses adjusting for baseline cognition/premorbid intelligence, vascular risk factors, age, sex & total baseline WMH volume found that the recent small subcortical infarcts (RSSI) in the internal/external capsule/lentiform nucleus & centrum semiovale did not predict cognitive scores at 12 & 36 months.

However, RSSI location moderated voxel-based associations of WMH change from baseline to 1 year with cognitive scores at 1 & 3 years.

WMH increase in the external capsule, intersection between the anterior limb of the internal & external capsules, & optical radiation, was associated with worsening of ACE-R scores 1 & 3 years post-stroke after accounting for the location of the index infarct, age & baseline cognition.

Keywords

• Cognition
• Lacunar
• Recent small subcortical infarct
• Stroke
• White matter hyperintensities