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Remission of poststroke cognitive impairment no dementia: Clinical and imaging correlates

Published online by Cambridge University Press:  16 April 2020

Y.K. Chen
Affiliation:
Neurology, Hong Kong S.A.R
E. Lee
Affiliation:
Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong S.A.R
G.S. Ungvari
Affiliation:
Psychiatry, University of Western Australia, Perth, WA, Australia
J.Y. Lu
Affiliation:
Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong S.A.R
W.C.W. Chu
Affiliation:
Radiology, Hong Kong S.A.R
V.C.T. Mok
Affiliation:
Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong S.A.R
K.S. Wong
Affiliation:
Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong S.A.R
W.K. Tang
Affiliation:
Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong S.A.R

Abstract

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Introduction

Cerebral microbleeds (CMBs) may contribute to cognitive deficits in stroke. Cognitive impairment that does not meet the criteria for dementia (cognitive impairment no dementia [CIND]) is common in stroke, and patients with such impairment can revert to normal cognition.

Objective

To investigate the association of CMBs and remission of poststroke CIND.

Aim

To understand the evolution of poststroke cognitive impairment no dementia (CIND) is bi-directional.

Methods

143 patients with CIND at three months after stroke were recruited and followed up for one year. Remission of CIND was defined as a conversion of cognitive status from CIND to cognitively intact at follow-up. MRI variables in terms of infarction, cerebral microbleeds (CMBs), and white matter hyperintensities (WMHs) and hippocampal volume were analyzed. Logistic regression was performed to find the predictors of the remission of poststroke CIND.

Results

30 (21.0%) out of the 143 patients converted to cognitive intact at follow-up. In univariate comparisons, subjects with remission of CIND had younger age (67.1 ± 9.5 vs.73.6 ± 7.6 years, p < 0.001) and higher education years (5.1 ± 4.0 vs.3.6 ± 4.0, p = 0.039). They also had lower WMHs volume (8.2 ± 8.2 vs. 18.6 ± 19.7 cm3, p < 0.001), lower frequency of CMBs (10.0% vs. 31.0%, p = 0.021) and lower volume of the lateral ventricle (33.3 ± 16.5 vs.42.6 ± 19.4 cm3, p = 0.017). In logistic regression, age (odds ratio [OR] = 0.913, 95%C.I. = 0.866–0.962, p = 0.001) and absence of CMBs (OR = 4.292, 95%C.I. = 1.174–15.625, p = 0.028) were significant predictors of remission of CIND.

Conclusions

Younger age and absence of CMBs predict the remission of poststroke CIND.

Type
P03-10
Copyright
Copyright © European Psychiatric Association 2011
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