Poststroke Cognitive Decline is Independent of Longitudinal Changes in Cerebral Hemodynamics Parameters.

نویسندگان

  • Ma Serrie Platero Suministrado
  • Esther Wan Yee Shuang
  • Jing Xu
  • Hock Luen Teoh
  • Bernard Poon-Lap Chan
  • Narayanaswamy Venketasubramanian
  • Raymond Chee Seong Seet
  • Christopher Li-Hsian Chen
  • Boon Seng Wong
  • Vijay Kumar Sharma
  • YanHong Dong
چکیده

BACKGROUND Poststroke vascular cognitive impairment is highly prevalent with significant functional consequences. However, reliable biomarkers for early prediction of cognitive decline after acute ischemic stroke (AIS) are not well established. Although parenchymal imaging in patients with AIS and transient ischemic attack (TIA) may predict the resultant cognitive impairment, it may not explain the progressive deterioration after the index event. We postulated that longitudinal changes in cerebral hemodynamic parameters may influence the cognitive performance after a cerebrovascular event. METHODS One-hundred consecutive AIS/TIA patients were recruited within 2 weeks following a cerebrovascular event. At 3-6 months, 69 patients were followed up with transcranial Doppler (TCD) and brief cognitive tests (Mini-Mental State Examination [MMSE]/Montreal Cognitive Assessment [MoCA]). Basic demographics, vascular risk factors, clinical, cognitive, and neurological status were recorded. RESULTS Considerable proportion (12%) of patients showed cognitive decline and changes in the hemodynamic parameters over 3-6 months after the index event. We showed that right middle cerebral artery (MCA) stenosis and right internal carotid artery/MCA tandem lesions at 3-6 months are associated with the change in the MMSE scores. Additionally, there was a trend toward association between increased pulsatility index of the right MCA and a decline in the MMSE score. However, we did not observe any association between cognitive decline and longitudinal changes in hemodynamic parameters. CONCLUSION Although hemodynamic parameters deteriorate in a considerable proportion of patients during first 3-6 months after a cerebrovascular event, cognitive decline appears to be an independent phenomenon.

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عنوان ژورنال:
  • Journal of neuroimaging : official journal of the American Society of Neuroimaging

دوره 27 3  شماره 

صفحات  -

تاریخ انتشار 2017