Medial temporal atrophy rather than white matter hyperintensities predict cognitive decline in stroke survivors

被引:75
作者
Firbank, Michael J. [1 ]
Burton, Emma J. [1 ]
Barber, Robert [1 ]
Stephens, Sally [1 ]
Kenny, Rose Anne [1 ]
Ballard, Clive [1 ]
Kalaria, Raj. N. [1 ]
O'Brien, John T. [1 ]
机构
[1] Newcastle Univ, Inst Ageing & Hlth, Wolfson Res Ctr, Newcastle Upon Tyne NE4 6BE, Tyne & Wear, England
基金
英国医学研究理事会;
关键词
medial temporal atrophy; post-stroke; white matter hyperintensities; vascular disease; Alzheimer's disease; dementia; MRI; cognitive decline;
D O I
10.1016/j.neurobiolaging.2006.07.009
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Stroke is an important risk factor for dementia, but the exact mechanisms involved in cognitive decline remain unclear. In this study, we related baseline MRI brain measures with later cognitive decline. Seventy-nine stroke survivors aged 75+ years without dementia were recruited 3-month post-stroke. They underwent yearly neuropsychological assessments and had an MRI at baseline and 2 years. Medial temporal lobe atrophy (MTA) was scored and volume of white matter hyperintensities (WMH) was measured at baseline. The rate of ventricular enlargement was measured by comparing the baseline and repeat images. Linear regression indicated that memory loss was related to both baseline memory and MTA (p = 0.001; standardized regression coefficient ss = -0.35) but not WMH volume. The only independent predictor of ventricular enlargement was MTA (p = 0.003; ss = 0.47). However, no baseline MRI variable differed between those who did (18%) and did not (82%) develop dementia. The association of MTA but not WMH with subsequent cognitive decline and increasing brain atrophy suggests a greater role for Alzheimer type than vascular pathology in delayed cognitive impairment after stroke. (c) 2006 Elsevier Inc. All rights reserved.
引用
收藏
页码:1664 / 1669
页数:6
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