02 Sep 22. Featured Paper

Associations of peak-width skeletonized mean diffusivity and post-stroke cognition

Link to paper on Life

Authors

Angela C. C. Jochems, Susana Muñoz Maniega, Una Clancy, Daniela Jaime Garcia, Carmen Arteaga, Will Hewins, Rachel Penman, Olivia K. L. Hamilton, Agnieszka Czechoń, Ellen V. Backhouse, Michael J. Thrippleton, Michael S. Stringer, Mark. E. Bastin, Maria del C. Valdés Hernández, Stewart Wiseman, Francesca M. Chappell, Fergus N. Doubal and Joanna M. Wardlaw

Abstract

Post-stroke cognitive impairment is common and can have major impact on life after stroke.

Peak-width of Skeletonized Mean Diffusivity (PSMD) is a diffusion imaging marker of white matter microstructure and is also associated with cognition.

Here, we examined associations between PSMD and post-stroke global cognition in an ongoing study of mild ischemic stroke patients.

We studied cross-sectional associations between PSMD and cognition at both 3-months (N = 229) and 1-year (N = 173) post-stroke, adjusted for premorbid IQ, sex, age, stroke severity and disability, as well as the association between baseline PSMD and 1-year cognition.

At baseline, (mean age = 65.9 years (SD = 11.1); 34% female), lower Montreal Cognitive Assessment (MoCA) scores were associated with older age, lower premorbid IQ and higher stroke severity, but not with PSMD (βstandardized = −0.116, 95% CI −0.241, 0.009; p = 0.069). At 1-year, premorbid IQ, older age, higher stroke severity and higher PSMD (βstandardized = −0.301, 95% CI −0.434, −0.168; p < 0.001) were associated with lower MoCA.

Higher baseline PSMD was associated with lower 1-year MoCA (βstandardized = −0.182, 95% CI −0.308, −0.056; p = 0.005).

PSMD becomes more associated with global cognition at 1-year post-stroke, possibly once acute effects have settled.

Additionally, PSMD in the subacute phase after a mild stroke could help predict long-term cognitive impairment.

Keywords

• Cognition
• Diffusion imaging
• Ischemic stroke
• Peak-width of skeletonized mean diffusivity
• Small vessel disease

Citation

Jochems ACC, Muñoz Maniega S, Clancy U, Jaime Garcia D, Arteaga C, Hewins W, Penman R, Hamilton OKL, Czechoń A, Backhouse EV, Thrippleton MJ, Stringer MS, Bastin ME, Valdés Hernández MdC, Wiseman S, Chappell FM, Doubal FN, Wardlaw JM. Associations of Peak-Width Skeletonized Mean Diffusivity and Post-Stroke Cognition. Life. 2022; 12(9):1362. https://doi.org/10.3390/life12091362