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Frontal subcortical ischemia is crucial for post stroke cognitive impairment.
MedLine Citation:
PMID:  21807379     Owner:  NLM     Status:  Publisher    
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 55.8years 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.
Nagaendran Kandiah; Lynn Wiryasaputra; Kaavya Narasimhalu; Amit Karandikar; Maznah Marmin; Esther Vanessa Chua; Yih-Yian Sitoh
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-30
Journal Detail:
Title:  Journal of the neurological sciences     Volume:  -     ISSN:  1878-5883     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-8-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375403     Medline TA:  J Neurol Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier B.V. All rights reserved.
Department of Neurology, National Neuroscience Institute, Singapore; Duke-NUS Graduate Medical School, Singapore.
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