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
Maria del C. Valdés Hernández, Tara Grimsley-Moore, Francesca M. Chappell, Michael J. Thrippleton, Paul A. Armitage, Eleni Sakka, Stephen Makin & Joanna M. Wardlaw
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.
- Recent small subcortical infarct
- White matter hyperintensities
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Featured paper: Post-stroke cognition at 1 & 3 years is influenced by the location of white matter hyperintensities in patients with lacunar stroke.
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