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在脑小血管病标志物中,仅白质高信号可预测中风后的认知表现:TABASCO研究结果

Only White Matter Hyperintensities Predicts Post-Stroke Cognitive Performances Among Cerebral Small Vessel Disease Markers: Results from the TABASCO Study.

作者信息

Molad Jeremy, Kliper Efrat, Korczyn Amos D, Ben Assayag Einor, Ben Bashat Dafna, Shenhar-Tsarfaty Shani, Aizenstein Orna, Shopin Ludmila, Bornstein Natan M, Auriel Eitan

机构信息

Department of Neurology, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.

Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.

出版信息

J Alzheimers Dis. 2017;56(4):1293-1299. doi: 10.3233/JAD-160939.

Abstract

BACKGROUND

White matter hyperintensities (WMH) were shown to predict cognitive decline following stroke or transient ischemic attack (TIA). However, WMH are only one among other radiological markers of cerebral small vessel disease (SVD).

OBJECTIVE

The aim of this study was to determine whether adding other SVD markers to WMH improves prediction of post-stroke cognitive performances.

METHODS

Consecutive first-ever stroke or TIA patients (n = 266) from the Tel Aviv Acute Brain Stroke Cohort (TABASCO) study were enrolled. MRI scans were performed within seven days of stroke onset. We evaluated the relationship between cognitive performances one year following stroke, and previously suggested total SVD burden score including WMH, lacunes, cerebral microbleeds (CMB), and perivascular spaces (PVS).

RESULTS

Significant negative associations were found between WMH and cognition (p < 0.05). Adding other SVD markers (lacunes, CMB, PVS) to WMH did not improve predication of post-stroke cognitive performances. Negative correlations between SVD burden score and cognitive scores were observed for global cognitive, memory, and visual spatial scores (all p < 0.05). However, following an adjustment for confounders, no associations remained significant.

CONCLUSION

WMH score was associated with poor post-stroke cognitive performance. Adding other SVD markers or SVD burden score, however, did not improve prediction.

摘要

背景

白质高信号(WMH)已被证明可预测中风或短暂性脑缺血发作(TIA)后的认知功能下降。然而,WMH只是脑小血管疾病(SVD)的其他影像学标志物之一。

目的

本研究的目的是确定在WMH基础上增加其他SVD标志物是否能改善对中风后认知表现的预测。

方法

纳入来自特拉维夫急性脑卒中队列(TABASCO)研究的连续首次发生中风或TIA的患者(n = 266)。在中风发作后7天内进行MRI扫描。我们评估了中风后一年的认知表现与先前建议的包括WMH、腔隙、脑微出血(CMB)和血管周围间隙(PVS)的总SVD负担评分之间的关系。

结果

发现WMH与认知之间存在显著负相关(p < 0.05)。在WMH基础上增加其他SVD标志物(腔隙、CMB、PVS)并不能改善对中风后认知表现的预测。观察到SVD负担评分与整体认知、记忆和视觉空间评分之间存在负相关(所有p < 0.05)。然而,在对混杂因素进行调整后,没有关联仍然显著。

结论

WMH评分与中风后认知功能差有关。然而,增加其他SVD标志物或SVD负担评分并不能改善预测。

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