Titre :

Long-Term Post-Stroke Cognition in Patients With Minor Ischemic Stroke is Related to Tract-Based Disconnection Induced by White Matter Hyperintensities.

Auteur(s) :

Lopes, Renaud [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Kuchcinski, Gregory [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Dondaine, Thibaut [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Duron, Loïc [Auteur]
Fondation Ophtalmologique Adolphe de Rothschild [Paris]
Mendyk, Anne-marie [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Henon, Hilde [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Cordonnier, Charlotte [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Pruvo, Jean-Pierre [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Bordet, Regis [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]
Leclerc, Xavier [Auteur]
Lille Neurosciences & Cognition - U 1172 [LilNCog]

Titre de la revue :

Human Brain Mapping

Nom court de la revue :

Hum Brain Mapp

Numéro :

46

Pagination :

e70138

Éditeur :

Wiley Online Library

Date de publication :

2025-02-02

ISSN :

1097-0193

Mot(s)-clé(s) en anglais :

Bayesian model
cognitive impairment
ischemic stroke
tract-based disconnection
white matter hyperintensities

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Over a third of minor stroke patients experience post-stroke cognitive impairment (PSCI), but no validated tools exist to identify at-risk patients early. This study investigated whether disconnection features derived from ...
Lire la suite >Over a third of minor stroke patients experience post-stroke cognitive impairment (PSCI), but no validated tools exist to identify at-risk patients early. This study investigated whether disconnection features derived from infarcts and white matter hyperintensities (WMH) could serve as markers for short- and long-term cognitive decline in first-ever minor ischemic stroke patients. First-ever minor ischemic stroke patients (NIHSS ≤ 7) were prospectively followed at 72-h, 6 months, and 36 months post-stroke with cognitive tests and brain MRI. Infarct and WMH volumes were semi-automatically assessed on DWI and FLAIR sequences. Bayesian tract-based disconnection models estimated remote pathological effects of infarcts and WMH. Associations between disconnection features and cognitive outcomes were analyzed using canonical correlation analyses, adjusted for age, education, and multiple comparisons. Among 105 patients (31% female, mean age 63 ± 12 years), infarct volume averaged 10.28 ± 17.10 cm3 and predominantly involved the middle cerebral artery territory (83%). WMH burden was higher in frontal periventricular white matter. Infarct-based features did not significantly relate to PCSI. However, a WMH-derived disconnection factor, involving commissural and frontal tracts, and the right superior longitudinal fasciculus, was significantly associated with PSCI at 6 months (OR = 9.96, p value = 0.02) and 36 months (OR = 12.27, p value = 0.006), particularly in executive/attention, language, and visuospatial domains. This factor, unrelated to WMH volume, outperformed demographic and clinical predictors of PSCI. WMH-induced disconnection may be associated with short- and long-term PSCI in minor stroke. Routine MR-derived features could identify at-risk patients for rehabilitation trials.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Lille Neurosciences & Cognition (LilNCog) - U 1172

Date de dépôt :

2025-02-18T22:01:29Z
2025-02-26T09:45:51Z