Jie Yang1, Adrian Wong2, Zhaolu Wang3, Wenyan Liu3, Lisa Au3, Yunyun Xiong4, Winnie W C Chu5, Eric Y L Leung6, Sirong Chen6, Christine Lau3, Anne Y Y Chan3, Alexander Y L Lau3, Florence Fan3, Vincent Ip3, Yannie Soo3, Thomas Leung3, Chi L Ho6, Lawrence K S Wong3, Vincent C T Mok7. 1. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and Ministry of Education of China, Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. 2. Department of Psychological Studies, d Center for Psychosocial Health and Aging, The Hong Kong Institute of Education, Tai-po, Hong Kong SAR, China; Center for Psychosocial Health and Aging, The Hong Kong Institute of Education, Hong Kong SAR, China. 3. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. 4. Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China. 5. Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. 6. Department of Nuclear Medicine, Hong Kong Sanatorium and Hospital, Hong Kong SAR, China. 7. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. Electronic address: vctmok@cuhk.edu.hk.
Abstract
BACKGROUND: We hypothesized that chronic brain changes are important substrates for incident dementia after stroke and transient ischemic attack (TIA). METHODS: We compared clinical and imaging features between patients with consecutive stroke/TIA with (n = 88) and without (n = 925) incident dementia at 3 to 6 months after a stroke/TIA. Pittsburg compound B (PiB) positron emission tomography was performed in 50 patients, including those with (n = 37) and without (n = 13) incident dementia. RESULTS: Age, history of diabetes mellitus, severity of white matter changes (WMCs), and medial temporal lobe atrophy (MTLA) were associated with incident dementia. Alzheimer's disease (AD)--like PiB retention was found in 29.7% and 7.7% (P = .032) of patients with and without incident dementia, respectively. CONCLUSIONS: Chronic brain changes including WMCs, MTLA, and AD pathology are associated with incident dementia after stroke/TIA. Interventions targeting these chronic brain changes may reduce burden of vascular cognitive impairment.
BACKGROUND: We hypothesized that chronic brain changes are important substrates for incident dementia after stroke and transient ischemic attack (TIA). METHODS: We compared clinical and imaging features between patients with consecutive stroke/TIA with (n = 88) and without (n = 925) incident dementia at 3 to 6 months after a stroke/TIA. Pittsburg compound B (PiB) positron emission tomography was performed in 50 patients, including those with (n = 37) and without (n = 13) incident dementia. RESULTS: Age, history of diabetes mellitus, severity of white matter changes (WMCs), and medial temporal lobe atrophy (MTLA) were associated with incident dementia. Alzheimer's disease (AD)--like PiB retention was found in 29.7% and 7.7% (P = .032) of patients with and without incident dementia, respectively. CONCLUSIONS: Chronic brain changes including WMCs, MTLA, and AD pathology are associated with incident dementia after stroke/TIA. Interventions targeting these chronic brain changes may reduce burden of vascular cognitive impairment.
Authors: Adrian Wong; David Nyenhuis; Sandra E Black; Lorraine S N Law; Eugene S K Lo; Pauline W L Kwan; Lisa Au; Anne Y Y Chan; Lawrence K S Wong; Ziad Nasreddine; Vincent Mok Journal: Stroke Date: 2015-02-19 Impact factor: 7.914
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: Zhaolu Wang; Adrian Wong; Wenyan Liu; Jie Yang; Winnie C W Chu; Lisa Au; Alexander Lau; Yunyun Xiong; Vincent C T Mok Journal: J Clin Hypertens (Greenwich) Date: 2015-06-01 Impact factor: 3.738
Authors: Nicholas R Evans; Jason M Tarkin; John R Buscombe; Hugh S Markus; James H F Rudd; Elizabeth A Warburton Journal: Nat Rev Neurol Date: 2017-10-06 Impact factor: 42.937