Poststroke Executive Function in Relation to White Matter Damage on Clinically Acquired CT Brain Imaging.

IF 1.3 4区 医学 Q4 BEHAVIORAL SCIENCES
Georgina Hobden, Margaret Jane Moore, Grant Mair, Sarah T Pendlebury, Nele Demeyere
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Abstract

Background: Executive function (EF) impairments are prevalent post stroke and are associated with white matter (WM) damage on MRI. However, less is known about the relationship between poststroke EF and WM damage on CT imaging.

Objective: To investigate the relationship between poststroke EF and WM damage associated with stroke lesions and WM hypointensities (WMHs) on clinically acquired CT imaging.

Method: This study analyzed data from the Oxford Cognitive Screening Program, which recruited individuals aged ≥18 years with a confirmed stroke from an acute stroke unit. The individuals completed a follow-up assessment 6 months post stroke. We included individuals with a CT scan showing a visible stroke who completed follow-up EF assessment using the Oxford Cognitive Screen-Plus rule-finding task. We manually delineated stroke lesions and quantified then dichotomized WM damage caused by the stroke using the HCP-842 atlas. We visually rated then dichotomized WMHs using the Age-Related White Matter Changes Scale.

Results: Among 87 stroke survivors (M age = 73.60 ± 11.75; 41 female; 61 ischemic stroke), multivariable linear regression showed that stroke damage to the medial lemniscus ( B = -8.86, P < 0.001) and the presence of WMHs ( B = -5.42, P = 0.005) were associated with poorer EF 6 months post stroke after adjusting for covariates including age and education.

Conclusion: Poorer EF was associated with WM damage caused by stroke lesions and WMHs on CT. These results confirm the importance of WM integrity for EF post stroke and demonstrate the prognostic utility of CT-derived imaging markers for poststroke cognitive outcomes.

脑卒中后执行功能与临床CT脑成像白质损伤的关系。
背景:执行功能(EF)损伤在中风后普遍存在,并与MRI上的白质(WM)损伤有关。然而,关于脑卒中后EF和WM损伤之间的关系,在CT成像上知之甚少。目的:探讨脑卒中后EF与脑卒中病变相关的WM损害及临床CT表现的WM低强度(WMHs)的关系。方法:本研究分析了牛津认知筛查项目的数据,该项目从急性卒中单位招募了年龄≥18岁的确诊卒中患者。受试者在中风后6个月完成了随访评估。我们纳入了CT扫描显示可见中风的个体,他们使用Oxford Cognitive Screen Plus规则查找任务完成了后续EF评估。我们手动描绘了中风病变,并使用HCP-842图谱对中风引起的WM损伤进行量化,然后进行二分法。结果:87例脑卒中幸存者(Mage=73.60±11.75;41例女性;61例缺血性脑卒中)中,多变量线性回归显示,在校正了包括年龄和教育程度在内的协变量后,卒中后6个月,内侧丘系的损伤(B=-8.86,P<0.001)和WMH的存在(B=-5.42,P=0.005)与EF较差有关。结论:EF较差与脑卒中病变引起的WM损伤和CT上的WMH有关。这些结果证实了WM完整性对脑卒中后EF的重要性,并证明了CT衍生的成像标记物对脑卒中认知结果的预后效用。
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来源期刊
CiteScore
2.40
自引率
7.10%
发文量
68
审稿时长
>12 weeks
期刊介绍: Cognitive and Behavioral Neurology (CBN) is a forum for advances in the neurologic understanding and possible treatment of human disorders that affect thinking, learning, memory, communication, and behavior. As an incubator for innovations in these fields, CBN helps transform theory into practice. The journal serves clinical research, patient care, education, and professional advancement. The journal welcomes contributions from neurology, cognitive neuroscience, neuropsychology, neuropsychiatry, and other relevant fields. The editors particularly encourage review articles (including reviews of clinical practice), experimental and observational case reports, instructional articles for interested students and professionals in other fields, and innovative articles that do not fit neatly into any category. Also welcome are therapeutic trials and other experimental and observational studies, brief reports, first-person accounts of neurologic experiences, position papers, hypotheses, opinion papers, commentaries, historical perspectives, and book reviews.
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