Cerebral Small Vessel Disease Burden Is Associated With Accelerated Poststroke Cognitive Decline: A 1-Year Follow-Up Study
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其它資訊
摘要Objective:
This study investigated the association between small vessel disease (SVD) burden, a combination of multiple SVD markers and cognitive dysfunction after stroke.

Methods:
The study sample comprised 451 patients with first-ever acute ischemic stroke. Cognitive functions were assessed with the Mini-Mental State Examination (MMSE) at 3, 9, and 15 months after the index stroke. Cognitive impairment was defined as an MMSE score of ≤26. A total SVD score, indicating SVD burden, was constructed by summing the scores of the 4 SVD markers (white matter hyperintensities [WMHs], lacunes, cerebral microbleeds, and perivascular spaces) ascertained by magnetic resonance imaging (range: 0-4). The association between SVD burden and cognitive dysfunction was assessed with linear mixed models or generalized estimating equation models, as appropriate.

Results:
The majority of patients had mild-to-moderate stroke and at least one identifiable SVD marker. Cognitive impairment was found in about one-third of patients. After adjusting for confounding factors, the SVD burden was associated with MMSE scores (β = −0.37, P = .003) and cognitive impairment (odds ratio [OR] = 1.20, 95% confidence interval [CI] = 1.02-1.42). SVD burden was specifically associated with the performance of MMSE subscores including orientation to place and time, calculation, and word recall. Of the SVD markers, WMHs was the most robust predictor of decrease in MMSE scores (β = −0.25, P = .01) and cognitive impairment (OR = 1.14, 95% CI = 1.01-1.29).

Conclusion:
Cerebral SVD burden is associated with decreased MMSE scores, suggesting cognitive dysfunction during the first year after mild-to-moderate acute ischemic stroke.
出版社接受日期22.05.2019
著者Liang Y, Chen YK, Liu YL, Mok VCT, Ungvari GS, Chu WCW, Seo SW, Tang WK
期刊名稱Journal of Geriatric Psychiatry and Neurology
出版年份2019
月份11
卷號32
期次6
頁次336 - 343
國際標準期刊號0891-9887
電子國際標準期刊號1552-5708
語言美式英語
關鍵詞cognition, mild cognitive impairment, acute stroke, cerebral small vessel diseases

上次更新時間 2020-09-07 於 01:02