White matter hyperintensities are an independent predictor of cognitive decline 3 years following first-ever stroke-results from the PROSCIS-B study
| Autor: | Huma Fatima Ali, Lea Fast, Ahmed Khalil, Eberhard Siebert, Thomas Liman, Matthias Endres, Kersten Villringer, Anna Kufner |
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| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
Cerebrovascular risk factors
Depression Magnetic Resonance Imaging diagnostic imaging [White Matter] etiology [Cognitive Dysfunction] Cognition Cognitive impairment Recurrent cerebrovascular events Neurology First-ever ischemic stroke pathology [White Matter] diagnostic imaging [Stroke] White matter hyperintensities Humans complications [Stroke] ddc:610 Prospective Studies Neurology (clinical) complications [Cognitive Dysfunction] epidemiology [Stroke] |
| Zdroj: | Journal of Neurology Journal of neurology 270(3), 1637-1646 (2022). doi:10.1007/s00415-022-11481-5 |
| Popis: | Background White matter hyperintensities (WMH) are the result of cerebral small vessel disease and may increase the risk of cognitive impairment (CI), recurrent stroke, and depression. We aimed to explore the association between selected cerebrovascular risk factors (CVRF) and WMH load as well as the effect of increased WMH burden on recurrent vascular events, CI, and depression in first-ever ischemic stroke patients. Methods 431 from the PROSpective Cohort with Incident Stroke (PROSCIS) were included; Age-Related White Matter Changes (ARWMC) score was used to assess WMH burden on FLAIR. The presence of CVRF (defined via blood pressure, body-mass-index, and serological markers of kidney dysfunction, diabetes mellitus, and hyperlipoproteinemia) was categorized into normal, borderline, and pathological profiles based on commonly used clinical definitions. The primary outcomes included recurrent vascular events (combined endpoint of recurrent stroke, myocardial infarction and/or death), CI 3 years post-stroke, and depression 1-year post-stroke. Results There was no clear association between CVRF profiles and WMH burden. High WMH lesion load (ARWMC score ≥ 10) was found to be associated with CI (adjusted OR 1.05 [95% CI 1.00–1.11]; p p = 0.18). WMH burden was not associated with depression 1-year post stroke (adjusted OR 0.72 [95% CI 0.31–1.64]; p = 0.44). Conclusion Higher WMH burden was associated with a significant decline in cognition 3 years post-stroke in this cohort of first-ever stroke patients. |
| Databáze: | OpenAIRE |
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