Microstructural White Matter Abnormalities and Cognitive Impairment After Aneurysmal Subarachnoid Hemorrhage
| Autor: | Irene M.C. Huenges Wajer, Lisa A. van der Kleij, Jill B. De Vis, Rutger Heinen, J M Anne Visser-Meily, Mariska E Hendriks, Alexander Leemans, Gabriel J.E. Rinkel, Carlo Lucci, Yael D. Reijmer, Martine J. E. van Zandvoort, Geert Jan Biessels, Mervyn D.I. Vergouwen, Jeroen Hendrikse, Marc S. van den Heerik |
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| Přispěvatelé: | Experimental Vascular Medicine, Amsterdam Neuroscience - Neurovascular Disorders |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Subarachnoid hemorrhage subarachnoid hemorrhage Neuropsychological Tests 030218 nuclear medicine & medical imaging White matter 03 medical and health sciences 0302 clinical medicine Aneurysm cognitive dysfunction Internal medicine Fractional anisotropy medicine humans Aged Advanced and Specialized Nursing business.industry Cerebral infarction Brain Middle Aged diffusion tensor imaging medicine.disease Magnetic Resonance Imaging White Matter Hydrocephalus medicine.anatomical_structure Brain size aneurysm Cardiology Anisotropy Female Neurology (clinical) Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery Diffusion MRI |
| Zdroj: | Stroke, 49(9), 2040. Lippincott Williams and Wilkins Stroke; a journal of cerebral circulation, 49(9), 2040-2045. Lippincott Williams and Wilkins |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/strokeaha.118.021622 |
| Popis: | Background and Purpose— Aneurysmal subarachnoid hemorrhage (aSAH) may have detrimental effects on white matter microstructure, which may in turn explain the cognitive impairments that occur often after aSAH. We investigated (1) whether the white matter microstructure is altered in patients with aSAH compared with patients with an unruptured intracranial aneurysm and (2) whether these abnormalities are associated with cognitive impairment 3 months after ictus. Methods— Forty-nine patients with aSAH and 22 patients with an unruptured intracranial aneurysm underwent 3T brain magnetic resonance imaging, including a high-resolution diffusion tensor imaging sequence. Patients with aSAH were scanned 2 weeks and 6 months after ictus. Microstructural white matter alterations were quantified by the fractional anisotropy and mean diffusivity (MD). Cognition was evaluated 3 months after ictus. Results— Patients with aSAH had higher white matter MD 2 weeks after ictus than patients with an unruptured intracranial aneurysm (mean difference±SEM, 0.3±0.01×10 −3 mm2/s; P ≤0.01), reflecting an abnormal microstructure. After 6 months, the MD had returned to the level of the unruptured intracranial aneurysm group. No between-group differences in fractional anisotropy were found (−0.01±0.01; P =0.16). Higher MD at 2 weeks was associated with cognitive impairment after 3 months (odds ratio per SD increase in MD, 2.6; 95% CI, 1.1–6.7). The association between MD and cognitive impairment was independent of conventional imaging markers of aSAH-related brain injury (ie, cerebral infarction, hydrocephalus, total amount of subarachnoid blood, total brain volume, or white matter hyperintensity severity). Conclusions— Patients with aSAH have temporary white matter abnormalities in the subacute phase that are associated with cognitive impairment at 3 months after ictus. |
| Databáze: | OpenAIRE |
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