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Medial temporal atrophy rather than white matter hyperintensities predict cognitive decline in stroke survivors

Lookup NU author(s): Dr Michael FirbankORCiD, Dr Emma Burton, Dr Robert Barber, Dr Sally Stephens, Professor Rose Anne Kenny, Dr Clive Ballard, Professor Raj KalariaORCiD, Professor John O'Brien


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Stroke is an important risk factor for dementia, but the exact mechanisms involved in cognitive decline remain unclear. In this study, we related baseline MRI brain measures with later cognitive decline. Seventy-nine stroke survivors aged 75+ years without dementia were recruited 3-month post-stroke. They underwent yearly neuropsychological assessments and had an MRI at baseline and 2 years. Medial temporal lobe atrophy (MTA) was scored and volume of white matter hyperintensities (WMH) was measured at baseline. The rate of ventricular enlargement was measured by comparing the baseline and repeat images. Linear regression indicated that memory loss was related to both baseline memory and MTA (p = 0.001; standardized regression coefficient β = -0.35) but not WMH volume. The only independent predictor of ventricular enlargement was MTA (p = 0.003; β = 0.47). However, no baseline MRI variable differed between those who did (18%) and did not (82%) develop dementia. The association of MTA but not WMH with subsequent cognitive decline and increasing brain atrophy suggests a greater role for Alzheimer type than vascular pathology in delayed cognitive impairment after stroke. © 2006 Elsevier Inc. All rights reserved.

Publication metadata

Author(s): Firbank MJ, Burton EJ, Barber R, Stephens S, Kenny RA, Ballard C, Kalaria RN, O'Brien JT

Publication type: Article

Publication status: Published

Journal: Neurobiology of Aging

Year: 2007

Volume: 28

Issue: 11

Pages: 1664-1669

Print publication date: 01/11/2007

ISSN (print): 0197-4580

ISSN (electronic): 1558-1497

Publisher: Elsevier


DOI: 10.1016/j.neurobiolaging.2006.07.009

PubMed id: 16934370


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Funder referenceFunder name
G0500247Medical Research Council