White Matter Microstructural Alterations over the Year after Acute Ischemic Stroke in Patients with Baseline Impaired Cognitive Functions.

IF 3 4区 医学 Q2 NEUROSCIENCES
Bingyuan Wu, Shida Guo, Xiuqin Jia, Zuojun Geng, Qi Yang
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引用次数: 0

Abstract

Background: The disruption of white matter (WM) integrity is related to poststroke cognitive impairment (PSCI). The exploration of WM integrity alterations in the chronic stage of acute ischemic stroke (AIS) may help to improve the long-term outcomes of PSCI.

Methods: Sixty patients showing impaired cognitive functions within 3 days after AIS (baseline) and 25 healthy controls underwent diffusion kurtosis imaging scan and cognitive assessment at baseline and 1 year. Based on the tract-based spatial statistics (TBSS), kurtosis fractional anisotropy (KFA) and mean kurtosis (MK) were compared in WM tracts between the groups.

Results: One year after AIS, 25 patients were diagnosed with PSCI and 35 patients with non-cognitive impairment (NCI). Compared with baseline, cognitive performance improved in 54 patients and remained unchanged in 6 patients at 1 year. TBSS analysis showed that there were no significant differences in WM tract integrity between the AIS and control groups at baseline (P > 0.05). Compared with the control group, the KFA and MK in multiple WM tracts in the AIS group decreased significantly at 1 year (P < 0.05). Longitudinal analysis showed that the KFA and MK of multiple WM tracts recorded at 1 year were significantly lower than those recorded at baseline in the AIS, PSCI, and NCI groups (P < 0.05), and PSCI group had a faster degeneration than NCI group (P < 0.05).

Conclusion: The finding suggests that the patients with baseline impaired cognitive functions still have WM microstructural damages at 1 year poststroke, even if their cognitive function has improved or returned to normal. Cautions should be taken against the possible negative impact of these changes on long-term cognition.

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基线认知功能受损的急性缺血性脑卒中患者脑白质微结构变化
背景:脑卒中后脑白质(WM)完整性破坏与脑卒中后认知功能障碍(PSCI)有关。探索急性缺血性脑卒中(AIS)慢性期WM完整性改变可能有助于改善PSCI的长期预后。方法:60例AIS后3天内认知功能受损的患者(基线)和25例健康对照者在基线和1年内进行弥散峰度成像扫描和认知评估。采用基于束的空间统计(TBSS)方法比较各组WM束的峰度分数各向异性(KFA)和平均峰度(MK)。结果:AIS 1年后,25例患者被诊断为PSCI, 35例患者被诊断为非认知障碍(NCI)。与基线相比,54例患者的认知能力得到改善,6例患者在1年后保持不变。TBSS分析显示,AIS组与对照组在基线时WM束完整性无显著差异(P > 0.05)。与对照组相比,AIS组患者1年时多个WM束的KFA和MK均显著降低(P < 0.05)。纵向分析显示,AIS组、PSCI组和NCI组1年时多束WM的KFA和MK均显著低于基线时(P < 0.05),且PSCI组比NCI组退变更快(P < 0.05)。结论:基线认知功能受损的患者,即使认知功能改善或恢复正常,脑卒中后1年仍存在WM微结构损伤。应注意这些变化对长期认知可能产生的负面影响。
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来源期刊
Neural Plasticity
Neural Plasticity NEUROSCIENCES-
CiteScore
6.80
自引率
0.00%
发文量
77
审稿时长
16 weeks
期刊介绍: Neural Plasticity is an international, interdisciplinary journal dedicated to the publication of articles related to all aspects of neural plasticity, with special emphasis on its functional significance as reflected in behavior and in psychopathology. Neural Plasticity publishes research and review articles from the entire range of relevant disciplines, including basic neuroscience, behavioral neuroscience, cognitive neuroscience, biological psychology, and biological psychiatry.
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