Influence of seizures on stroke outcomes A large multicenter study

被引:107
作者
Huang, Chin-Wei [1 ,2 ]
Saposnik, Gustavo [3 ,4 ]
Fang, Jimming [4 ]
Steven, David A. [1 ]
Burneo, Jorge G. [1 ]
机构
[1] Univ Western Ontario, Dept Clin Neurol Sci, Epilepsy Program, London, ON, Canada
[2] Natl Cheng Kung Univ, Dept Neurol, Natl Cheng Kung Univ Hosp, Sch Med, Tainan 70101, Taiwan
[3] Univ Toronto, St Michaels Hosp, Toronto, ON M5S 1A1, Canada
[4] Inst Clin Evaluat Sci, Toronto, ON, Canada
关键词
TISSUE-PLASMINOGEN ACTIVATOR; CANADIAN NEUROLOGICAL SCALE; ACUTE ISCHEMIC-STROKE; PERIINFARCT DEPOLARIZATIONS; CEREBRAL-ISCHEMIA; SEX-DIFFERENCES; RELIABILITY; VALIDATION; MORTALITY; EPILEPSY;
D O I
10.1212/WNL.0000000000000166
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To investigate the associations among beta-amyloid (A beta), cortical thickness, and episodic memory in a cohort of cognitively normal to mildly impaired individuals at increased risk of vascular disease. Methods: In 67 subjects specifically recruited to span a continuum of cognitive function and vascular risk, we measured brain A beta deposition using [C-11] Pittsburgh compound B-PET imaging and cortical thickness using MRI. Episodic memory was tested using a standardized composite score of verbal memory, and vascular risk was quantified using the Framingham Coronary Risk Profile index. Results: Increased A beta was associated with cortical thinning, notably in frontoparietal regions. This relationship was strongest in persons with high A beta deposition. Increased A beta was also associated with lower episodic memory performance. Cortical thickness was found to mediate the relationship between A beta and memory performance. While age had a marginal effect on these associations, the relationship between A beta and cortical thickness was eliminated after controlling for vascular risk except when examined in only Pittsburgh compound B-positive subjects, in whom A beta remained associated with thinner cortex in precuneus and occipital lobe. In addition, only the precuneus was found to mediate the relationship between A beta and memory after controlling for vascular risk. Conclusion: These results suggest strong links among A beta, cortical thickness, and memory. They highlight that, in individuals without dementia, vascular risk also contributes to cortical thickness and influences the relationships among A beta, cortical thickness, and memory.
引用
收藏
页码:768 / 776
页数:9
相关论文
共 35 条
[1]  
Alberti A, 2008, VASC HEALTH RISK MAN, V4, P715
[2]   Acute seizures in acute ischemic stroke: does thrombolysis have a role to play? [J].
Alvarez, Vincent ;
Rossetti, Andrea O. ;
Papavasileiou, Vasileios ;
Michel, Patrik .
JOURNAL OF NEUROLOGY, 2013, 260 (01) :55-61
[3]  
Andrews Peter J D, 2004, Curr Opin Crit Care, V10, P110, DOI 10.1097/00075198-200404000-00006
[4]   CLASSIFICATION AND NATURAL-HISTORY OF CLINICALLY IDENTIFIABLE SUBTYPES OF CEREBRAL INFARCTION [J].
BAMFORD, J ;
SANDERCOCK, P ;
DENNIS, M ;
BURN, J ;
WARLOW, C .
LANCET, 1991, 337 (8756) :1521-1526
[5]  
BURN JPS, 1992, STROKE, V23, P438, DOI 10.1161/str.23.3.438b
[6]   Impact of seizures on morbidity and mortality after stroke: a Canadian multi-centre cohort study [J].
Burneo, J. G. ;
Fang, J. ;
Saposnik, G. .
EUROPEAN JOURNAL OF NEUROLOGY, 2010, 17 (01) :52-58
[7]   Retrospective assessment of initial stroke severity - Comparison of the NIH Stroke Scale and the Canadian Neurological Scale [J].
Bushnell, CD ;
Johnston, DCC ;
Goldstein, LB .
STROKE, 2001, 32 (03) :656-660
[8]   Seizures and epilepsy after ischemic stroke [J].
Camilo, O ;
Goldstein, LB .
STROKE, 2004, 35 (07) :1769-1775
[9]   THE CANADIAN NEUROLOGICAL SCALE - VALIDATION AND RELIABILITY ASSESSMENT [J].
COTE, R ;
BATTISTA, RN ;
WOLFSON, C ;
BOUCHER, J ;
ADAM, J ;
HACHINSKI, V .
NEUROLOGY, 1989, 39 (05) :638-643
[10]   Antidepressant use and risk of adverse outcomes in older people: population based cohort study [J].
Coupland, Carol ;
Dhiman, Paula ;
Morriss, Richard ;
Arthur, Antony ;
Barton, Garry ;
Hippisley-Cox, Julia .
BMJ-BRITISH MEDICAL JOURNAL, 2011, 343