Abstract
Background and Purpose—
Cortical
cerebral microinfarcts (CMIs) have been associated with vascular
dementia and Alzheimer disease. The aim of the present study was to
evaluate the role of cortical CMI detected on 3T magnetic resonance
imaging, on the evolution of cognition during the year following an
acute ischemic stroke.
Methods—
We
conducted a prospective and monocentric study, including patients
diagnosed for a supratentorial ischemic stroke with a National
Institutes of Health Stroke Scale score ≥1, without prestroke dementia
or neurological disability. Cortical CMIs were assessed on a brain 3T
magnetic resonance imaging realized at baseline, as well as markers of
small vessel disease, stroke characteristics, and hippocampal atrophy.
Cognitive assessment was performed at 3 time points (baseline, 3 months,
and 1 year) using the Montreal Cognitive Assessment, the Isaacs set
test, and the Zazzo’s cancellation task. Generalized linear mixed models
were performed to evaluate the relationships between the number of
cortical CMI and changes in cognitive scores over 1 year.
Results—
Among
199 patients (65±13 years old, 68% men), 88 (44%) had at least one
cortical CMI. Hypertension was the main predictor of a higher cortical
CMI load (B=0.58, P=0.005). The number of cortical CMI was associated with an increase time at the Zazzo’s cancellation task over 1 year (B=3.84, P=0.01), regardless of the other magnetic resonance imaging markers, stroke severity, and demographic factors.
Conclusions—
Cortical
CMIs are additional magnetic resonance imaging markers of poorer
processing speed after ischemic stroke. These results indicate that a
high load of cortical CMI in patients with stroke can be considered as a
cerebral frailty condition which counteracts to the recovery process,
suggesting a reduced brain plasticity among these patients.
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