BACKGROUND: The incidence of post stroke cognitive impairment (PSCI) and predictive factors for PSCI among patients with acute lacunar infarcts is unclear. OBJECTIVE: To study the impact of acute lacunar infarcts and chronic white matter disease in the development of PSCI. METHODS: Prospective cohort study of stroke patients attending a tertiary neurology center. Patients with MRI confirmed acute lacunar infarcts without pre-existing dementia were recruited. Logistic regression was used to determine risk factors for developing PSCI. RESULTS: 145 patients with a mean age of 55.8 years were studied of which 48 patients (33.1%) were identified to have PSCI. Patients with PSCI performed worse on the MMSE, MOCA and FAB and had significantly greater white matter hyperintensity (WMH) in the frontal subcortical (FSC) region (p = 0.006) and higher frontal subcortical acute infarct load (p = 0.002). Logistic regression demonstrated that deep subcortical WMH (odds ratio, OR = 1.45) and acute FSC infarcts (OR = 1.51) were associated with PSCI. High WMH load without acute FSC infarcts was associated with increased risk of PSCI (OR = 4.1). When patients developed acute FSC infarcts on pre-existing severe WMH, the risk of PSCI increased substantially (OR = 11.0). CONCLUSIONS: Patients with acute lacunar infarcts in the FSC region have 1.5 times risk of PSCI. This risk increases substantially to 11 times when there is pre-existing severe white matter disease.
BACKGROUND: The incidence of post stroke cognitive impairment (PSCI) and predictive factors for PSCI among patients with acute lacunar infarcts is unclear. OBJECTIVE: To study the impact of acute lacunar infarcts and chronic white matter disease in the development of PSCI. METHODS: Prospective cohort study of strokepatients attending a tertiary neurology center. Patients with MRI confirmed acute lacunar infarcts without pre-existing dementia were recruited. Logistic regression was used to determine risk factors for developing PSCI. RESULTS: 145 patients with a mean age of 55.8 years were studied of which 48 patients (33.1%) were identified to have PSCI. Patients with PSCI performed worse on the MMSE, MOCA and FAB and had significantly greater white matter hyperintensity (WMH) in the frontal subcortical (FSC) region (p = 0.006) and higher frontal subcortical acute infarct load (p = 0.002). Logistic regression demonstrated that deep subcortical WMH (odds ratio, OR = 1.45) and acute FSC infarcts (OR = 1.51) were associated with PSCI. High WMH load without acute FSC infarcts was associated with increased risk of PSCI (OR = 4.1). When patients developed acute FSC infarcts on pre-existing severe WMH, the risk of PSCI increased substantially (OR = 11.0). CONCLUSIONS:Patients with acute lacunar infarcts in the FSC region have 1.5 times risk of PSCI. This risk increases substantially to 11 times when there is pre-existing severe white matter disease.
Authors: Lei Zhao; J Matthijs Biesbroek; Lin Shi; Wenyan Liu; Hugo J Kuijf; Winnie Wc Chu; Jill M Abrigo; Ryan Kl Lee; Thomas Wh Leung; Alexander Yl Lau; Geert J Biessels; Vincent Mok; Adrian Wong Journal: J Cereb Blood Flow Metab Date: 2017-09-12 Impact factor: 6.200
Authors: Perminder S Sachdev; Jessica W Lo; John D Crawford; Lisa Mellon; Anne Hickey; David Williams; Régis Bordet; Anne-Marie Mendyk; Patrick Gelé; Dominique Deplanque; Hee-Joon Bae; Jae-Sung Lim; Amy Brodtmann; Emilio Werden; Toby Cumming; Sebastian Köhler; Frans R J Verhey; Yan-Hong Dong; Hui Hui Tan; Christopher Chen; Xu Xin; Raj N Kalaria; Louise M Allan; Rufus O Akinyemi; Adesola Ogunniyi; Aleksandra Klimkowicz-Mrowiec; Martin Dichgans; Frank A Wollenweber; Vera Zietemann; Michael Hoffmann; David W Desmond; Thomas Linden; Christian Blomstrand; Björn Fagerberg; Ingmar Skoog; Olivier Godefroy; Mélanie Barbay; Martine Roussel; Byung-Chul Lee; Kyung-Ho Yu; Joanna Wardlaw; Stephen J Makin; Fergus N Doubal; Francesca M Chappell; Velandai K Srikanth; Amanda G Thrift; Geoffrey A Donnan; Nagaendran Kandiah; Russell J Chander; Xuling Lin; Charlotte Cordonnier; Solene Moulin; Costanza Rossi; Behnam Sabayan; David J Stott; J Wouter Jukema; Susanna Melkas; Hanna Jokinen; Timo Erkinjuntti; Vincent C T Mok; Adrian Wong; Bonnie Y K Lam; Didier Leys; Hilde Hénon; Stéphanie Bombois; Darren M Lipnicki; Nicole A Kochan Journal: Alzheimers Dement (Amst) Date: 2016-11-18
Authors: Noor Kamal Al-Qazzaz; Sawal Hamid Bin Mohd Ali; Siti Anom Ahmad; Mohd Shabiul Islam; Javier Escudero Journal: Sensors (Basel) Date: 2017-06-08 Impact factor: 3.576
Authors: Lei Zhao; Adrian Wong; Yishan Luo; Wenyan Liu; Winnie W C Chu; Jill M Abrigo; Ryan K L Lee; Vincent Mok; Lin Shi Journal: Front Neurosci Date: 2018-05-01 Impact factor: 4.677