Mirthe Coenen, Floor A.S. de Kort, Nick A. Weaver, Hugo J. Kuijf, Hugo Paul Aben, Hee-Joon Bae, Régis Bordet, Christopher LH Chen, Anna Dewenter, Thomas Doeven, Thibaut Dondaine, Marco Duering, Rong Fang, Ruben S van der Giessen, Jonguk Kim, Beom Joon Kim, Paul L.M. de Kort, Peter Koudstaal, Minwoo Lee, Jae-Sung Lim, Renaud Lopes, Robert J. van Oostenbrugge, Julie Staals, Kyung-Ho Yu, Geert Jan Biessels, J. Matthijs Biesbroek
{"title":"与脑卒中后认知障碍相关的战略性白质高密度位置:一项针对 1568 名脑卒中患者的多中心研究","authors":"Mirthe Coenen, Floor A.S. de Kort, Nick A. Weaver, Hugo J. Kuijf, Hugo Paul Aben, Hee-Joon Bae, Régis Bordet, Christopher LH Chen, Anna Dewenter, Thomas Doeven, Thibaut Dondaine, Marco Duering, Rong Fang, Ruben S van der Giessen, Jonguk Kim, Beom Joon Kim, Paul L.M. de Kort, Peter Koudstaal, Minwoo Lee, Jae-Sung Lim, Renaud Lopes, Robert J. van Oostenbrugge, Julie Staals, Kyung-Ho Yu, Geert Jan Biessels, J. Matthijs Biesbroek","doi":"10.1177/17474930241252530","DOIUrl":null,"url":null,"abstract":"BACKGROUNDPost-stroke cognitive impairment (PSCI) occurs in up to 50% of stroke survivors. Presence of pre-existing vascular brain injury, in particular the extent of white matter hyperintensities (WMH), is associated with worse cognitive outcome after stroke, but the role of WMH location in this association is unclear.AIMWe determined if WMH in strategic white matter tracts explain cognitive performance after stroke.METHODSIndividual patient data from 9 ischemic stroke cohorts with MRI were harmonized through the Meta VCI Map consortium. The association between WMH volumes in strategic tracts and domain-specific cognitive functioning (attention and executive functioning, information processing speed, language and verbal memory) was assessed using linear mixed models and lasso regression. We used a hypothesis-driven design, primarily addressing four white matter tracts known to be strategic in memory clinic patients: the left and right anterior thalamic radiation, forceps major and left inferior fronto-occipital fasciculus.RESULTSThe total study sample consisted of 1568 patients (39.9% female, mean age: 67.3 years). Total WMH volume was strongly related to cognitive performance on all four cognitive domains. WMH volume in the left anterior thalamic radiation was significantly associated with cognitive performance on attention and executive functioning and information processing speed, and WMH volume in the forceps major with information processing speed. The multivariable lasso regression showed that these associations were independent of age, sex, education, and total infarct volume and had larger coefficients than total WMH volume.CONCLUSIONSThese results show tract-specific relations between WMH volume and cognitive performance after ischemic stroke, independent of total WMH volume. This implies that the concept of strategic lesions in PSCI extends beyond acute infarcts and also involves pre-existing WMH.DATA AVAILABILITYThe Meta VCI Map consortium is dedicated to data sharing, following our guidelines.","PeriodicalId":14442,"journal":{"name":"International Journal of Stroke","volume":null,"pages":null},"PeriodicalIF":6.3000,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Strategic white matter hyperintensity locations associated with post-stroke cognitive impairment: a multicenter study in 1568 stroke patients\",\"authors\":\"Mirthe Coenen, Floor A.S. de Kort, Nick A. Weaver, Hugo J. Kuijf, Hugo Paul Aben, Hee-Joon Bae, Régis Bordet, Christopher LH Chen, Anna Dewenter, Thomas Doeven, Thibaut Dondaine, Marco Duering, Rong Fang, Ruben S van der Giessen, Jonguk Kim, Beom Joon Kim, Paul L.M. de Kort, Peter Koudstaal, Minwoo Lee, Jae-Sung Lim, Renaud Lopes, Robert J. van Oostenbrugge, Julie Staals, Kyung-Ho Yu, Geert Jan Biessels, J. Matthijs Biesbroek\",\"doi\":\"10.1177/17474930241252530\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUNDPost-stroke cognitive impairment (PSCI) occurs in up to 50% of stroke survivors. Presence of pre-existing vascular brain injury, in particular the extent of white matter hyperintensities (WMH), is associated with worse cognitive outcome after stroke, but the role of WMH location in this association is unclear.AIMWe determined if WMH in strategic white matter tracts explain cognitive performance after stroke.METHODSIndividual patient data from 9 ischemic stroke cohorts with MRI were harmonized through the Meta VCI Map consortium. The association between WMH volumes in strategic tracts and domain-specific cognitive functioning (attention and executive functioning, information processing speed, language and verbal memory) was assessed using linear mixed models and lasso regression. We used a hypothesis-driven design, primarily addressing four white matter tracts known to be strategic in memory clinic patients: the left and right anterior thalamic radiation, forceps major and left inferior fronto-occipital fasciculus.RESULTSThe total study sample consisted of 1568 patients (39.9% female, mean age: 67.3 years). Total WMH volume was strongly related to cognitive performance on all four cognitive domains. WMH volume in the left anterior thalamic radiation was significantly associated with cognitive performance on attention and executive functioning and information processing speed, and WMH volume in the forceps major with information processing speed. The multivariable lasso regression showed that these associations were independent of age, sex, education, and total infarct volume and had larger coefficients than total WMH volume.CONCLUSIONSThese results show tract-specific relations between WMH volume and cognitive performance after ischemic stroke, independent of total WMH volume. This implies that the concept of strategic lesions in PSCI extends beyond acute infarcts and also involves pre-existing WMH.DATA AVAILABILITYThe Meta VCI Map consortium is dedicated to data sharing, following our guidelines.\",\"PeriodicalId\":14442,\"journal\":{\"name\":\"International Journal of Stroke\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":6.3000,\"publicationDate\":\"2024-04-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Stroke\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17474930241252530\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Stroke","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17474930241252530","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Strategic white matter hyperintensity locations associated with post-stroke cognitive impairment: a multicenter study in 1568 stroke patients
BACKGROUNDPost-stroke cognitive impairment (PSCI) occurs in up to 50% of stroke survivors. Presence of pre-existing vascular brain injury, in particular the extent of white matter hyperintensities (WMH), is associated with worse cognitive outcome after stroke, but the role of WMH location in this association is unclear.AIMWe determined if WMH in strategic white matter tracts explain cognitive performance after stroke.METHODSIndividual patient data from 9 ischemic stroke cohorts with MRI were harmonized through the Meta VCI Map consortium. The association between WMH volumes in strategic tracts and domain-specific cognitive functioning (attention and executive functioning, information processing speed, language and verbal memory) was assessed using linear mixed models and lasso regression. We used a hypothesis-driven design, primarily addressing four white matter tracts known to be strategic in memory clinic patients: the left and right anterior thalamic radiation, forceps major and left inferior fronto-occipital fasciculus.RESULTSThe total study sample consisted of 1568 patients (39.9% female, mean age: 67.3 years). Total WMH volume was strongly related to cognitive performance on all four cognitive domains. WMH volume in the left anterior thalamic radiation was significantly associated with cognitive performance on attention and executive functioning and information processing speed, and WMH volume in the forceps major with information processing speed. The multivariable lasso regression showed that these associations were independent of age, sex, education, and total infarct volume and had larger coefficients than total WMH volume.CONCLUSIONSThese results show tract-specific relations between WMH volume and cognitive performance after ischemic stroke, independent of total WMH volume. This implies that the concept of strategic lesions in PSCI extends beyond acute infarcts and also involves pre-existing WMH.DATA AVAILABILITYThe Meta VCI Map consortium is dedicated to data sharing, following our guidelines.
期刊介绍:
The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.