Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Department of Neurology, J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
J Stroke Cerebrovasc Dis. 2022 Oct;31(10):106720. doi: 10.1016/j.jstrokecerebrovasdis.2022.106720. Epub 2022 Aug 22.
Existing literature on white matter hyperintensity volume (WMHV) in stroke patients has rarely focused on post-stroke outcomes related to social functioning limitations, such as transportation, social interaction, food preparation, grocery shopping, and housekeeping. Using prospective data from the VITamin D and OmegA-3 TriaL (VITAL) study, we evaluated the association between WMHV and social functioning limitations among 151 ischemic stroke patients.
WMHV was ascertained from magnetic resonance imaging (MRI) collected at the time of the stroke event using a validated semiautomated method, and social functioning limitations were assessed using a stroke outcomes questionnaire administered a median of 1.25 years after the date of the MRI scan. Logistic regression was used to explore the association between WMHV and social functioning limitations.
After adjusting for age and sex, a statistically significant association was found between WMHV and limitations in social interaction (OR=2.82; 95% CI: 1.21-7.55). Increased risks were seen for limitations related to food preparation (OR=2.06; 95% CI: 0.99-4.54), transportation (OR=1.39; 95% CI: 0.85-2.27), and housekeeping (OR=1.37; 95% CI: 0.91-2.11); however, the associations did not reach statistical significance. We observed no association between WMHV and limitations in grocery shopping (OR=1.08; 95% CI: 0.61-1.89).
Future studies are needed to further explore the biological mechanisms underlying the relationship with limitations in social interaction and to replicate our findings using a larger and more diverse study sample.
现有关于卒中患者脑白质高信号体积（WMHV）的文献很少关注与社会功能受限相关的卒中后结局，如交通、社会交往、食物准备、杂货店购物和家务管理。本研究使用 VITAL 研究的前瞻性数据，评估了 151 例缺血性卒中患者的 WMHV 与社会功能受限之间的关系。
WMHV 是通过卒中事件时采集的磁共振成像（MRI）使用一种经过验证的半自动方法确定的，社会功能受限是通过卒中结局问卷评估的，在 MRI 扫描日期后中位数 1.25 年进行评估。使用逻辑回归来探讨 WMHV 与社会功能受限之间的关系。
在校正年龄和性别后，WMHV 与社会交往受限之间存在统计学显著关联（OR=2.82；95%CI：1.21-7.55）。与食物准备（OR=2.06；95%CI：0.99-4.54）、交通（OR=1.39；95%CI：0.85-2.27）和家务管理（OR=1.37；95%CI：0.91-2.11）受限相关的风险增加，但关联未达到统计学意义。我们未观察到 WMHV 与杂货店购物受限（OR=1.08；95%CI：0.61-1.89）之间存在关联。
需要进一步研究来探讨与社会交往受限相关的生物学机制，并使用更大和更多样化的研究样本来复制我们的研究结果。
