Prevalence and cognitive impact of medial temporal atrophy in a hospital stroke service: retrospective cohort study
Prevalence and cognitive impact of medial temporal atrophy in a hospital stroke service: retrospective cohort study
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DOI：
10.1111/ijs.12544
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发表时间：
2015-08-01
影响因子：
6.7
通讯作者：
Werring, David J.
中科院分区：
文献类型：
--
作者：
Kebets, Valeria;Gregoire, Simone M.;Werring, David J.
BackgroundCerebrovascular disease and neurodegeneration cause cognitive impairment and frequently coexistence.AimsOur objectives were to investigate the prevalence and cognitive impact of medial temporal lobe atrophy - a radiographic marker often associated with Alzheimer's disease - in a hospital stroke service.MethodsRetrospective cohort study of patients from a hospital stroke service.评估疑似缺血性卒中或短暂性脑缺血发作的患者，无论最终诊断如何，均接受神经心理学测试和磁共振成像。使用已建立的标准和有效的量表评定内侧颞叶萎缩、白色高信号、腔隙和脑微出血。内侧颞叶萎缩和认知之间的关联进行了测试，使用多变量逻辑回归分析，调整了年龄和脑血管疾病的影像学标志物。（43%; 95%置信区间：381-481%）有内侧颞叶萎缩; 38例患者（97%）内侧颞叶萎缩严重（平均评分2）。在整个队列的未校正logistic回归分析中，平均内侧颞叶萎缩评分与言语记忆、名义和感知技能、执行功能、速度和注意力相关。校正年龄、白色高信号、腔隙数量、脑微出血、既往缺血性卒中或短暂性脑缺血发作和病前智商后，平均内侧颞叶萎缩评分仍与言语记忆障碍相关（优势比：164; 95%置信区间104-258）和名义技能（比值比：161; 95%可信区间104-248）。结论内侧颞叶萎缩是常见的，对中风服务人群的认知功能有独立的影响，独立于混杂因素，包括年龄和脑血管疾病的磁共振成像标记物。内侧颞叶萎缩与言语记忆和名义技能独立相关，而小血管病变也有助于速度和注意力，以及执行和感知功能。
BackgroundCerebrovascular disease and neurodegeneration cause cognitive impairment and frequently coexist.AimsOur objectives were to investigate the prevalence and cognitive impact of medial temporal lobe atrophy - a radiological marker often associated with Alzheimer's disease - in a hospital stroke service.MethodsRetrospective cohort study of patients from a hospital stroke service. Patients assessed for suspected ischemic stroke or transient ischemic attack, irrespective of final diagnosis, underwent neuropsychological testing and magnetic resonance imaging. medial temporal lobe atrophy, white matter hyperintensities, lacunes, and cerebral microbleeds were rated using established criteria and validated scales. The associations between medial temporal lobe atrophy and cognition were tested using multivariable logistic regression analyses, adjusted for age and imaging markers of cerebrovascular disease.ResultsThree hundred and ninety-three patients were included, of whom 169 (43%; 95% confidence interval: 381-481%) had medial temporal lobe atrophy; in 38 patients (97%), medial temporal lobe atrophy was severe (mean score 2). In unadjusted logistic regression analyses in the whole cohort, mean medial temporal lobe atrophy score was associated with verbal memory, nominal and perceptual skills, executive function, and speed and attention. After adjustment for age, white matter hyperintensities, number of lacunes, presence of cerebral microbleeds, previous ischemic stroke or transient ischemic attack, and premorbid intelligence quotient, mean medial temporal lobe atrophy score remained associated with impairment in verbal memory (odds ratio: 164; 95% confidence interval 104-258) and nominal skills (odds ratio: 161; 95% confidence interval 104-248).ConclusionsMedial temporal lobe atrophy is common and has an independent impact on cognitive function in a stroke service population, independent of confounding factors including age and magnetic resonance imaging markers of cerebrovascular disease. Medial temporal lobe atrophy is independently related to verbal memory and nominal skills, while small vessel pathology also contributes to speed and attention, and executive and perceptual functions.